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. Please let us know if you find something that is outdated or proven inaccurate. Information is falling upon us like an avalanche during the pandemic and it is quite challenging to stay abreast of all the emerging data.

Additionally, our Blog Page has dozens of posts that relate to Covid-19 and other topics related to health 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. Children are most frequently asymptomatic (as are many adults), but there are some cases of Childhood Multi-system Inflammatory Syndrome that have emerged due to Covid-19. Symptoms of Covid-19 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.

Stanford medical epidemiology Professor John Ioannidis’ article published March 19th, pertaining to asymptomatic spread and the urgent need for more testing can be found at: The 2nd link is the follow-up publication by Dr. Ioannidis 2 months later.

Professor Ioannidis 1

Professor Ioannidis 2

*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).

Update: Evidence is surfacing of possible airborne spread of the virus, which would make the virus more contagious than previously thought. This concern has not been fully accepted and adopted into the CDC guidelines yet, so stay tuned.

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.

Update: There is a bunch of more recent research data that indicates some people can test positive for up to 3 months after recovery. This begs the question: So when is it safe to hang around people who have “recovered?” It looks like 10-20 days from symptom onset is generally safe, but our August 18th Blog-post discusses this subject in depth.

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

Click on Childhood Multi-system Inflammatory Syndrome to learn about this rare but serious complication that affects only pediatric covid patients.

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.

Update: More recent data suggests that there is an X-Chromosome Gene That May Be Associated With Severe Covid Infection, In Men only. There is also some European evidence that Blood Type “A” may be more susceptible to severe respiratory covid disease, however this was not reproducible in further research.

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.

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.

Update: Extensive research has consistently demonstrated that wearing a mask is an effective means of curbing spread of the Coronavirus. However, the type of mask and how it is worn are both critical, as is wearing a face shield in the certain environments.

Click here to read one of our Blog posts about the ongoing mask controversy and discussed the evidence as of a couple of months ago, which supported that masks do work.

Click here to watch a short video explaining how to make a mask more efficacious. After all, it is not just wearing a mask that matters, it is the type of mask and how it is worn that makes it either effective or ineffective.

Click here to read why face shields are more effective than masks.

Click here to read why face masks are NOT dangerous, as some people have alleged over social media.

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

Update: This was proven to be inaccurate. NSAIDs are safe to use for Covid symptoms.

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/

Update: It appears that this is inaccurate and that ACEIs and ARBs are probably safe, and may even provide some protection from respiratory failure from Covid, in some individuals.

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

Update: Further research found Hydroxychloroquine to be unsafe, when used in a high dose to treat severe Covid. This drug has been in FDA approved for use for 6 decades, and the safety profile is quite good, except when used in high dose, or with individuals with certain types of underlying heart disease. However, there is some data to suggest that a very low “prophylactic” dose may be protective. As soon as there is anything definitive that emerges about this we will post in our Blog about it.

There are many other drugs in trials and some progress has been made in this regard. For daily updates about drug trials and more, check out FDA Daily Roundup for Covid-19.

For Immunization progress you can read our 1st summary of vaccine development posted several months ago by Clicking Here. We will be posting a 2nd part about vaccination soon, which you can follow on our Blog-Page, where you can also sign-up for to receive notification whenever a new article is posted.

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.