Corona Content

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Introduction

In light of the immense volume of ever-changing information about the Covid-19 Pandemic bombarding us each day, we at PAA have compiled some facts about the pandemic for educational and informational purposes.  This information is intended to support our clients, our customers, and our global community in obtaining accurate and reliable information.  What you’ll find below is by no means an exhaustive compilation, though we believe it is the most relevant information available.  Some of us at PAA are medical professionals who closely follow daily developments and are delighted to share this information with you.  During these perilous times, we need to constantly be reminded to put aside our differences so that we can maintain perspective about the larger challenges we are all facing around the globe.  As Plato so beautifully said thousands of years ago, “Be Kind, For Everyone Is Fighting A Hard Battle.” 

This page does not contain our individual opinions or politics, and is all derived from official sources and peer-reviewed journals.  We encourage input and questions, and we are available via email or telephone.  Whatever we cannot answer we will attempt find out from the appropriate authorities and will respond with a vetted answer as quickly as possible.

Additionally, our Blog Page has dozens of posts that relate to Covid-19 and others that may be of interest to you.  If there are topics that you would like to read about please submit your input to info@patientadvocatealliance.com or via our Contact Page.

What is COVID-19

COVID-19 is a respiratory infection caused by the virus SARS-CoV-2, which was recently discovered after an outbreak began in Wuhan, China, in December 2019. SARS-CoV-2 is a type of coronavirus, which is a large family of viruses that cause illnesses ranging from the common cold to more severe infections in humans.

COVID-19 causes a variety of symptoms in people who are infected, and not all people infected with COVID-19 will have the same symptoms. Fever, dry cough, shortness of breath, fatigue, or body aches (myalgias) are some of the most common symptoms; however, some people have experienced headache, abdominal pain, diarrhea, and sore throat as well. As of the creation of this page, there have been some retrospective studies showing upwards of 50% of cases involving gastrointestinal symptoms, and more recently, there have been reports of a reduced or even absent sense of smell and taste. Symptoms typically appear 2 to 14 days after exposure, although some patients may not develop symptoms until later, or at all. Absence of symptoms is an important issue, as it likely indicates that this virus can be transmitted by asymptomatic individuals. It also indicates that there are likely many more individuals already infected with SARS-CoV2 than we know of, given the fact that they would not be tested or identified as being sick. For this reason, medical epidemiologist, Professor John Ioannidis of Stanford University believes that the numbers we are seeing, in terms of mortality rate in particular, are significantly exaggerated and are very likely similar to seasonal Influenza. However, he argues that more testing data is urgently required, of the general population, in order to make decisions about our next moves as a society.  As further data emerges about asymptomatic spread, we will know how significant of a factor this is and to what extent social distancing is required.

Professor Ioannidis’ article published March 19th can be found at:

Click here

The follow up to the above, published two months later, can be found at:

Click here

*Please refer to our Blog-Page for covid-19 updates and relevant new data that emerges throughout the pandemic.

How is Corona-virus Spread

Current evidence suggests that the virus can be spread through respiratory droplets after an infected person coughs or sneezes, between people who are within about 6 feet of each other, and possibly through touching surfaces that have the virus on them, such as handrails, telephones, or doorknobs. Very recent data indicates that the virus can travel in the air significantly further than previously believed, and can remain suspended in the air for up to 4 hours in certain conditions, and up to 3 days on plastic and stainless steel, and up to 1 day on cardboard (see below for details).

Corona Viruses are Enveloped Viruses

This means that they are easily killed by most disinfectants and are not able to live outside the body very long, unless indoors in mild conditions (see below).  The virus is easily destroyed by the ultraviolet (UV) radiation in sunlight, and is easily killed by heat above 133°F (56°C). If outdoors, in the elements of sun and wind, the virus will not typically be able to survive long enough to be infectious.

How Long Does the (SARS-CoV-2) Virus Live in the Air & On Various Surfaces (Outside of the Body)?

The virus can remain in the air for several hours, depending on the environmental conditions.  If indoors without good air flow the virus will remain in the air longer, up to 3-4 hours. The medial time the virus remained aerosolized in this study was 1 hour.  The droplets that infectious viral material can travel significantly further than 6 feet depending on the projectile force of an individual’s cough or sneeze.

The virus can remain on plastics and stainless steel for up to 3 days (72 hours), on cardboard for up to 24 hours, and on copper for up to 4 hours. 

https://www.nejm.org/doi/full/10.1056/NEJMc2004973

https://www.who.int/csr/sars/survival_2003_05_04/en/

To learn more about why the virus can stay in the air for so long and travel in the air please click the link below.

https://jamanetwork.com/journals/jama/fullarticle/2763852

It is extremely important to note that this virus can live impressively long on plastic, up to 3 days, so disinfecting plastic is crucial, as is stainless steel and cardboard.  When returning home from the grocery store it is important to disinfect these materials or wash them with soap and water right away, and leave cardboard outside, preferably in the sunlight.

More recent data published in June indicates that surface-spread is not as big of a factor as initial thought, while person-to-person spread is the predominant means of transmission.  Read our Blog for a review of this literature.

https://patientadvocatealliance.com/surfaces-no-longer-concern-for-corona-spread

Contagious

We can still be contagious even after we have full symptomatic recovery, according to this research. This corroborates other reports from abroad and is a scenario likely more common than we realize with viral infections in general. However, this is something important for us all to be aware of. Just because we feel better does not mean we can’t make other people sick. It should be noted that this study only consisted of 16 subjects, so further investigation is warranted. Regardless, it is advisable to discuss being tested for clearance of the virus with your doctor before returning to life as normal.

https://neurosciencenews.com/covid-19-infectious-symptoms-16010/amp/

How Long Do We Stay Contagious

According to this research paper, we can still be contagious even after full recovery of symptoms. This corroborates other reports from abroad and is a scenario likely more common than we realize with viral infections in general. This is something important to be aware of. Just because we feel better does not mean we won’t make other people sick.

It should be noted that this study only consisted of 16 subjects, so further investigation is clearly needed. It is nevertheless advisable to discuss being tested for clearance of the virus with your doctor before discontinuing social distancing protocols.

Scientists also believe that we can be contagious even before we develop symptoms. This is not unique to Covid-19 infection, but is particularly concerning and is a good reason to quarantine yourself if you have reason to believe you were exposed. The time it takes to fall ill with Covid-19 ranges from 2 days to 11 days after exposure, so if you think you may have been exposed then it is advisable to take precautions as soon as possible, and continue for 2 weeks.

How are Kids Affected by the 2019 Novel Coronavirus (SARS-CoV-2)

As of mid March the Chinese CDC (center for disease control) published study data of over 72,000 cases of the 2019 novel coronavirus (SARS-CoV-2).  Less than 1% of these cases were in children under 10 years of age.  This is fairly reliable data.  Kids may or may not become ill with Covid-19, but they are still highly likely to able to transmit the virus to other people, even in the absence of symptoms.

https://www.nejm.org/doi/full/10.1056/NEJMc2005073

Who's at Risk for Serious Illness from COVID-19

Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:

  • Older adults
  • People who have serious chronic medical conditions like:
    • Heart disease
    • Diabetes
    • Lung disease and Asthma
    • Immune conditions
    • Those on immunosuppressant therapies
    • Smokers

If you are at higher risk for serious illness from COVID-19 because of your age or because you have an underlying long-term health problem, it is extra important for you to be proactive about reducing your risk of getting sick with the disease.  Please stay home and call your doctor to discuss this and make an action plan to help you stay healthy.

Watch for Covid Symptoms and Emergency Warning

  • Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call your doctor.
  • If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs*:
    • Difficulty breathing or shortness of breath
    • Persistent pain or pressure in the chest
    • New confusion or inability to arouse
    • Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

Covid-Page 2

How to Prevent Infection

1. Wash your hands for at least 20 seconds with soap and water or hand sanitizer that contains at least 60% alcohol often (especially after touching common surface areas, using the bathroom, shaking hands, and other social interactions).

2. Social Distancing. Avoid large crowds, crowded public places, and maintain at least 6 feet of distance between yourself and others, especially if they are coughing or sneezing.

3. If you are older or have underlying medical problems, take extra care to avoid these situations, including non-essential travel and appointments.

4. Avoid touching your eyes, nose, and mouth with unwashed hands, because contaminated hands can transfer virus to these areas and make you sick.

5. If you are sneezing or coughing, cover your mouth and dispose of tissues after used once. Unless you have respiratory symptoms, are a health care worker, or are in close contact with or caring for someone with COVID-19, wearing a medical mask is not indicated.

6. Avoid shaking hands when greeting others. Disinfect surfaces that are used regularly, using household sprays or wipes. Wearing gloves in public is not effective protection from COVID-19, because gloves can be contaminated. Frequently washing your hands is the best way to protect yourself and your loved ones.

7. Get some exercise. Here is an article that studied 5,000 participants and found that exercise was associated with lower all-cause-mortality, specifically counting the number of steps, rather than the intensity of the regimen in this case. It is good to get some exercise while sitting at home during this shut-down, because it might just tip the scale in their favor should they develop a Covid-19 infection.

https://jamanetwork.com/journals/jama/fullarticle/2763292

Emerging Treatment for Covid-19

While there are no known treatments for the novel corona virus SARS-CoV-2, we do have some emerging data on pharmaceutical interventions that may be helpful and some that may be harmful. 

1. This JAMA (Journal of the Americal Medical Association) article is an excellent review about the significant considerations with regard to the compassionate use of a variety of off-label drugs and treatments going on right now around the globe.  It is succinct and well written.

https://jamanetwork.com/journals/jama/fullarticle/2763802

2. The NSAID (Non Steroidal Anti-Inflammatory Drug) Ibuprofen (Advil, Motrin) should be avoided during a Covid-19 infection, according the BMJ (British Medical Journal).  There are reports of otherwise young healthy individuals developing more serious disease in association with using NSAIDs. The Italians have reported some success in reducing the ‘cytokine storm’ syndrome associated with ARDS (acute respiratory distress syndrome), which has been causing fatalities.  However, it is advisable to avoid NSAIDs unless instructed otherwise by a treating physician. It remains unclear whether Naproxen (Aleve, Naprosyn) also fall into this advisory, but given that Naproxen’s mechanism of action is identical to Ibuprofen’s, it should probably also be avoided by most.

https://www.bmj.com/content/368/bmj.m1086

3. Researchers confirm ACE (Angiotensin Converting Enzyme) inhibitors and ARB(Angiotensin Reuptake Blocker) medications may increase the risk of patients with COVID-19 developing more severe symptoms.  These medications are used for high blood pressure and should not be stopped unless instructed to do so by your treating physician. However, we encourage our viewers to please discuss this publication with your doctor as soon as possible to prevent unnecessary complications, should Covid-19 infection occur.

https://neurosciencenews.com/covid-19-ace-inhibitors-15972/amp/

4. In this WHO article the Chinese government announces that a Japanese drug (Favipiravir) for Influenza (Flu) is effective at treating the novel Corona Virus. There is no clear literature about the efficacy of this drug, and there is some recent literature that it is not helpful for Covid-19 infection thus far. 

https://www.who.int/csr/sars/survival_2003_05_04/en/

5. This article is relating to the hot topic of the combination of the antimalarial drug Chloroquine (or Hydroxychloroquine) and the antibiotic Azithromycin, in the treatment of severe Covid-19 infection.

https://edhub.ama-assn.org/jn-learning/audio-player/18337225

As of June, much has changed with regard to treatments that have promise and those which have been proven ineffective.  Hydroxychloroquine was disproven, though there are still some researchers who are pressing on regardless. There are many other drugs in trials and some progress has been made in this regard, but nothing noteworthy enough to report yet.  For daily updates about drug trials and more, check out FDA Daily Roundup for Covid-19.

Corona Fraud

There are scams and rackets occurring as a result of widespread fear about the Corona Virus epidemic. This website is provided by the National Health Care Anti-Fraud Association.  It provides official up-to-date alerts and notifications about schemes going on in real-time.  One example is the defective face masks being sold online, and even a fake vaccine being sold.

http://www.nhcaa.org

There will always be opportunists who feed off of our fears and anxieties, trying to take advantage or even steal from us in our most vulnerable moment. Please be aware that scammers have begun their assaults on the vulnerable, which is most of us, especially our seniors.

https://www.usatoday.com/story/news/nation/2020/04/02/coronavirus-test-sites-operate-without-louisvilles-knowledge/5112310002

Click here for our Blog about Corona Scams.

Corona Scams Surge

Helpful Links

This Atlas Comprehensively Covers Nearly All of the Most Important Covid-19 Items, in a Chronologic & Sequential Fashion. 

General Information About Quarantining & Social Distancing in the Age of Covid19

https://www.nejm.org/doi/full/10.1056/NEJMp2004211 

For An Immense Volume of Relevant Resources Pertaining to Covid-19 Please Visit The Following Site
 
 

Real-Time Tab of Covid-19 Cases & Fatalities In the US & Around The Globe

https://ncov2019.live/data

https://coronavirus.jhu.edu/map.html (Johns Hopkins)

  • COVIDView (A Weekly Surveillance Summary of U.S. COVID-19 Activity)
  • COVID-NET (U.S. COVID-19 Hospitalization Data)
  • NCHS (U.S. COVID-19 Mortality Data)

The WHO (World Health organization) & Johns Hopkins University Are Also Good Resources For Covid19

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

https://coronavirus.jhu.edu

These Links Are Excellent Resources For Scientific Studies & Other Articles Pertaining To The Novel Coronavirus Pandemic

  1. FDA Daily Roundup for Covid-19

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-daily-roundup-march-24-2020

  1. CDC Corona Virus Updates & Information

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html

https://www.cdc.gov/coronavirus/2019-ncov/index.html

  1. CDC Cases Reported in the US and Abroad

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

  1. WHO (World Health Organization) General Resources

https://www.who.int/health-topics/coronavirus#tab=tab_1

  1. WHO Covid-19 Information Based on Region in the World

https://www.who.int/health-topics/coronavirus#

  1. New England Journal of Medicine Corona Virus Literature

https://www.nejm.org/coronavirus

This Post Has 4 Comments

    1. Justin Groode

      Thank you! Which article in particular did you appreciate, or was it the general Covid page? I appreciate your input! Justin Groode

  1. Thanks to the author for sharing such a great post. The article was very well written and providing information about covid-19. It can be really great for people like me who are looking for grabbing more knowledge about it.

    1. Justin Groode

      Thank you for taking the time to share your feedback about the post, it is very appreciated! Don’t hesitate to reach out with any questions or concerns related to this or other topics covered in my Blogs or on the Patient Advocate Alliance site. Dr. Groode

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