Coronavirus – An Update

Posted Posted in Elder Care, Homestudy, Nutrition, Seminars, Webinars

By Mary O’Brien, M.D.

It’s progressing. We knew it would.

The novel coronavirus, just renamed CoVID 19, has surpassed SARS in the number of deaths caused.

The number of confirmed cases worldwide is 60,081 with 1363 deaths. Nearly 99% of cases are still in China and the mortality rate remains around 2‒3%. There are undoubtedly far more unconfirmed cases in China since large numbers of people are at home with mild to moderate symptoms, or even asymptomatic infection. Inadequate testing to confirm the virus or rapidly triage and admit patients to intensive care in Chinese hospitals appears to be a serious problem.

The Chinese physician who first recognized an outbreak of SARS-like illness was targeted and arrested for “rumor-mongering.” He was even forced to recant his story. Dr. Li Wenliang contracted the coronavirus and died last week. Even his death was denied by authorities for a day. Dr. Li joins a brave, dedicated, compassionate group of heroic physicians throughout history who succumbed to the very illness they were treating. His memory will be honored.

The only way to solve a serious problem is to address it in an open, straightforward manner. Secrecy rarely solves serious problems. We’ve all heard the old dictum, “Sunlight is the best disinfectant.” Fortunately, the President’s task force on the coronavirus has done an excellent job of educating the public, securing and screening ports of entry, coordinating distribution of viral test kits to U.S. labs, evacuating Americans from China, and quarantining appropriate people with possible exposure.

The CDC, NIH, and Department of Health and Human Services personnel are working nonstop to contain the virus and develop a vaccine and potential treatment. In the meantime, supply chain disruption is affecting car companies, tech firms, and even medical supply businesses. Many of our OTC and prescription medications, including antibiotics, are made in China. The FDA has evacuated our personnel who inspect these production plants. There may well be consequences in the coming weeks and months here in the U.S.

Meanwhile, we’re in peak cold and flu season. Fastidious hygiene remains key:

  • Wash your hands – frequently and with soap and hot water for at least 20 seconds.
  • Do not touch your mouth, nose, and eyes. Viral particles suspended in respiratory droplets can penetrate mucous membranes and conjunctiva very easily.
  • Maintain at least 6 feet between yourself and others (social distancing)
  • Avoid crowds and unessential travel
  • Get more sleep than you think you need
  • Stay home if you have cold or flu symptoms (and don’t lay a guilt trip on colleagues who are sick)
  • Disinfect hard surfaces frequently. This coronavirus can apparently survive on hard surfaces as long as 9 days. Phones, keyboards, bathroom fixtures, door handles, and steering wheels are just a few examples.

Seasonal epidemics triggered by a mutated virus can be devastating, but eventually they are contained. Until then, our job is to stay calm, stay informed, and practice the time-tested principles of good patient care and common sense.

The Zika Virus: A New Warm Weather Worry

Posted Posted in Pain, Seminars, Webinars

mosquito-542156_640It’s odd to think about mosquitoes in the middle of winter. However, in Brazil, it’s not the middle of winter.  The Zika virus, a potentially devastating illness, has captured medical headlines around the world.  Carried by mosquitoes, the Zika virus has been documented in Central and South America, the Caribbean and several southern states.  Apart from causing miserable flu- like symptoms, this unusual and worrisome virus can cause catastrophic birth defects.  In fact, as of January 31, 2016, the Brazilian government has traced over 3,000 birth defects to Zika virus exposure in utero.

Patients with Zika infection may experience high fevers, severe musculo-skeletal pain and profound malaise.  Symptoms are often similar to those caused by another warm weather mosquito-borne culprit, Chikungunya virus.  The word, “Chikungunya,” is a tribal word describing the acute, contorted, bent-over posture of people doubled-over with pain, as the illness strikes.  An intense, maculo-papular rash on the trunk and extremities is often present early on. Encephalitis, myocarditis, and hepatitis can develop.  The most recent outbreak of Chikungunya virus flared up in October, 2013 on the island of St. Martin.

Researchers believe the current outbreak of Zika virus can be traced to large crowds and warm weather at the most recent World Cup events.  The illness has now been confirmed in 24 countries. Nearly 40 cases are being evaluated in the United States, however, all of these cases are apparently related to exposure while traveling.

Zika virus in the expectant mother can result in severe birth defects, neurologic deficits, and even anencephaly in newborns.  The Brazilian government has taken the unprecedented measure of warning women not to get pregnant until the situation is controlled.  This is an extreme policy designed to prevent extreme tragedy.  The best advice for everyone combines current science and common sense:

  • Women who are pregnant or may become pregnant should avoid travel to endemic areas of infection.
  • Be careful around upcoming Mardi Gras and Carnivale celebrations.
  • If travel is essential to these areas, avoid camping, “jungle expeditions,” dense tropical vegetation, standing water, or other obvious exposures to mosquitoes.
  • Minimize outdoor exposures at dawn and dusk.
  • Keep arms and legs covered and use insect repellants properly.
  • If symptoms develop, seek medical attention promptly and give a precise travel history.

For now, staying informed and exercising common sense and good judgment is everyone’s best bet.

zikavirus