Some good news amid the doom and gloom: People have Longer immunity to Coronavirus infection after recovering from it.

After someone has recovered from a Coronavirus infection, the body remembers how to fight the virus in future. This is called immunity and it is not known how long this immunity will last.

If the immunity is not long lasting, people can get coronavirus infection again during the second and even third wave.

The body’s immunity is made up of two types of cells: B cells and T cells. T cells and B cells are central to the human immune system.

B cells produce antibodies and previously in various studies , they were found to decline rapidly give rise to fear that people would get Coronavirus infection again and again.

Now a study has reported that T cell immunity can last more than 6 months in patients who have recovered from an infection.

This news is also good from a vaccine point of view. It gives us hope that sooner or later an effective vaccine would become available.

BMJ News.
Covid-19: T cell response lasts for at least six months after infection, study shows
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4257 (Published 02 November 2020)
Cite this as: BMJ 2020;371:m4257

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Cancer and COVID-19

Cancer patients, as expected, did badly during the 1st wave of the COVID-19 pandemic

Data presented at ESMO ( European Society of Medical Oncology) shows that Cancers had – higher rates of Hospitalisation, higher risk of Complications and increased risk of Death.

Elderly cancer patients on the whole did very badly but surprisingly cancer patients under age of 50 did far worse than their peers without cancer.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

COVID-19 risk assessment of NHS members : is it an opportunity missed?

The National Health Service had recently embarked on a Risk assessment exercise of its staff to assess the Vulnerability of individual members to Coronavirus infection ( COVID-19).

The exercise is being done with good intentions. Given the unprecedented situation of the pandemic and lack of concrete data , the exercise seemed to have steered away from firm “one size fits all” type of recommendations.

Given the uncertainties with the currently available data on various forms of protection ( from simple surgical masks to shielding) , the exercise could have been a starting point for an nationwide intervention study .

An opportunity seems to have been missed and if there is a second wave, NHS might regret not learning from the first wave.

Please do add your opinion at the rapid response section of the BMJ.

References

1. Covid-19 risk assessment in BAME staff

Covid-19 risk assessment: a futile metaphorical strip search

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3251 (Published 26 August 2020)

Cite this as: BMJ 2020;370:m3251

2. Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2743 (Published 15 July 2020)

Cite this as: BMJ 2020;370:m2743

3. Complete protection from covid-19 is possible for health workers

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2641 (Published 07 July 2020)

Cite this as: BMJ 2020;370:m2641

4. Two metres or one: what is the evidence for physical distancing in covid-19?

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3223 (Published 25 August 2020)

Cite this as: BMJ 2020;370:m3223

If you survive the Coronavirus, Can you get Coronavirus infection again ?

Yes, you can get infection again.

Last month, we had studies reporting that the immunity to Coronavirus fades quickly after recovering from an infection. The scientists have warned that re-infection is a risk.

Now, we have a case in Hong Kong where a patient seem to have been unlucky to get the infection again. It is a worrying report and suggests that coronavirus is going to be with us for a long time.

The only reassuring fact is that patient was free of symptoms during second infection. One has to hope that all re-infections are mild !

References

1. Sundar.blog. CAN YOU GET CORONAVIRUS INFECTION MORE THAN ONCE?

2. BBC. Hong Kong reports ‘first case’ of virus reinfection.

3. Clinical Infectious Diseases : report on twitter.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Can you get Coronavirus infection more than once?

If you are one of the unlucky ones to have already been infected with Coronavirus infection but recovered from it, can you become unlucky again and get another Coronavirus infection later this year ?

Unfortunately, the answer is a YES.

Some Viral infections can sometimes lead to life long immunity. For example, most people who had chicken pox as a child tend to have lifelong immunity and it would be uncommon to get chicken pox again. (except in some circumstances).

But infection with ‘Coronavirus causing COVID-19’ doesn’t seem led to long lasting immunity or resistance to a second Coronavirus infection.

A Newspaper report on a study by a team from King’s College London suggests that susceptibility to a second infection may occur as short as 3 months in some patients. This because the level of antibodies produced by the immune system after first infection start to fade away within a few months in some patients.

If confirmed, this is probably one of the most worrying news during this pandemic.

This study result could also affect Vaccine development and how frequently it may need to be administered.

References

Guardian Newspaper: Coronavirus outbreak. Immunity to Covid-19 could be lost in months, UK study suggests. Ian Sample. Science editor. @iansample. Sun 12 Jul 2020 17.31 BST

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Can Coronavirus linger in air, and cause COVID-19 by spreading through air ?

Normally many flu-like viruses spread by direct or close contact.

Because Virus containing droplets are heavier than air, scientifically it is thought that when someone coughs or sneezes, virus particles quickly fall to ground or surrounding objects.(“like a brick or stone falling to ground“).

But a group of scientists and WHO have raised the possibility that coronavirus can stay in air for longer periods, float around and cause more infections. (“float like a balloon“). This is called air-borne transmission.

What does it mean?

If confirmed– this means “closed spaces” are high risk even if you maintain 2 metre distance from an infected person. AVOID CLOSED SPACES.

As many people in UK do not wear masks in public places, there is a high chance of second wave of infections in the coming weeks as lock down is eased. WEAR A MASK.

It also means avoiding non-essential visitors to hospitals so that visitors cannot catch the infection or pass the infection to vulnerable patients. AVOID NON-ESSENTIAL VISITORS AT HOSPITALS.

If air borne transmission is confirmed, it is also bad news for the coming winter.

If Coronavirus is still in community and not eliminated by winter, air-borne transmission is likely to result in further wave of infections.

This is because Winter means more closed spaces and more chance of infection !!!!!!

STAY SAFE

References

1. Daily Mail Newspaper. Group of 239 scientists demand that WHO admit coronavirus is AIRBORNE -meaning the public should wear masks indoors and AC units should be fitted with filters .By Ariel Zilber For Dailymail.com and Reuters and Associated Press. 17:44, 05 Jul 2020 , updated 08:14, 06 Jul 2020

2. Guardian Newspaper. WHO underplaying risk of airborne spread of Covid-19, say scientists. Open letter says there is emerging evidence of potential for aerosol transmission. Hannah Devlin. Science correspondent. @hannahdev

3. Guardian Newspaper. Coronavirus outbreak Global report: WHO says ‘evidence emerging’ of airborne coronavirus spread. Martin Farrer and agencies.

4. BBC News. Coronavirus: WHO rethinking how Covid-19 spreads in air.

5. It is Time to Address Airborne Transmission of COVID-19. Lidia Morawska, Donald K Milton. Clinical Infectious Diseases, ciaa939, https://doi.org/10.1093/cid/ciaa939. Published: 06 July 2020

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Chloroquine not useful for treating or preventing Coronavirus infections

Randomised Study is the considered as the gold standard for trials.

Placebos are dummy pills . Placebos are inactive drugs that look like the real drug but are essentially sugar coated dummy pills.

Trials which involve a placebo vs active drug comparison are considered one of the best trials for some clinical situations.

A “randomised trial” involving “Chloroquine ” and “placebo ” has been published in NEJM .

A randomised trial suggests Chloroquine is not better than a placebo in treatment of COVID.

Another randomised trial suggests, Hydroxycloroquine is not useful for prevention of COVID-19.

In summary, Hydroxycloroquine is not useful either as COVID-19 treatment or as a COVID-19 preventative drug as advocates in certain countries.

Please Note : Chloroquine and HydroxyChloroquine are different drugs but have broadly similar effects.

References

1. Guardian newspaper: Coronavirus outbreak. Hydroxychloroquine no better than placebo, Covid-19 study finds.

2. NEJM. https://www.nejm.org/

3. BMJ India Correspondent. Covid-19: Doctors criticise Indian research agency for recommending hydroxychloroquine prophylaxis. BMJ2020;369:m2170. doi:10.1136/bmj.m2170 pmid:32471832.

4. BMJ news: Covid-19: Hydroxychloroquine does not benefit hospitalised patients, UK trial finds. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2263 (Published 08 June 2020)

5. BMJ news. Covid-19: Hydroxychloroquine was ineffective as postexposure prophylaxis, study finds. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2242 (Published 05 June 2020)

———————————————————————–

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Is Chloroquine useful in treatment of Corona Virus?

Chloroquine and the related drug Hydroxy-Chloroquine are drugs commonly used to prevent and treat Malaria infections; and treat some Joint conditions.

During the initial stages of COVID-19 pandemic, there were some reports of Chloroquine being useful in treating Corona Virus.

A Chinese trial published in British Medical Journal BMJ now reports that ” Administration of hydroxychloroquine did not result in …. any meaningful antiviral benefits… compared to standard of care alone in patients admitted to hospital with mainly persistent mild to moderate covid-19

Chloroquine was not only useless but it had significant side effects in a minority. So Chloroquine or Hydroxy-Chloroquine should not be used routinely outside a clinical trial setting.

References

1. Hydroxychloroquine (HCQ). Wiki. https://en.m.wikipedia.org/wiki/Hydroxychloroquine

2. BMJ. Chloroquine and hydroxychloroquine in covid-19. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1432 (Published 08 April 2020)

3. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1849 (Published 14 May 2020)

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Face Masks: Should Public wear face masks because of Corona Virus pandemic ?

Should Public wear face masks because of Corona Virus pandemic ?

Yes.

In some of the Asian Countries there has been universal acceptance of face masks even before Corona Virus pandemic. Hence, it is not surprising that there is wide spread use of face masks during this pandemic .

In USA, after initial hesitation, CDC now recommends use of cloth face masks by public.

In Germany, many states have made face masks compulsory.

In UK, there has been no official recommendation about widespread use of face masks.

With so many unknowns, it is prudent to follow the advice published in British Medical Journal : WEAR A MASK !!

References

1. USA CDC. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

2 Germany: BBC news. Coronavirus: Germany’s states make face masks compulsory. 22 April 2020. https://www.bbc.co.uk/news/world-europe-52382196

3. TIME Magazine. https://time.com/5815251/should-you-wear-a-mask-coronavirus/

4. BMJ paper. Analysis. Face masks for the public during the covid-19 crisis. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1435 (Published 09 April 2020). Cite this as: BMJ 2020;369:m1435

5. BMJ editorial. Editorial. Covid-19: should the public wear face masks?. Editorials. Covid-19: should the public wear face masks? BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1442 (Published 09 April 2020). Cite this as: BMJ 2020;369:m1442

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views expressed are not substitute for professional advice.