CMAAO
CORONA FACTS and MYTH BUSTER 34
Dr K K Aggarwal
President Confederation of Medical
Associations of Asia and Oceania
312: CDC recommends people wear cloth masks to block the spread of
COVID-19
Fact. Yes. Surgical masks and N95 respirators should be reserved for
health care workers.
The Centers for Disease Control and Prevention (CDC) released new guidelines
today recommending that people in the US wear homemade face coverings to
prevent the spread of the novel coronavirus.
The CDC is additionally advising simple cloth coverings to help people
who may have the virus and do not know it keep from transmitting to others.
The White House task force and the CDC have been re-evaluating their
mask recommendations over the past few days. Research shows that people without
symptoms can infect others, and that the virus may spread when people speak or
breathe — not just when they cough or sneeze. “In light of this new evidence,
the CDC recommends and the task force recommends people wear cloth face
coverings in public settings where other distancing measures are difficult to
maintain.
If people cover their faces with a cloth mask or another barrier, it may
blunt the amount of virus-laden particles they release.
There is limited evidence that these types of makeshift masks prevent
the spread of disease, though some research shows that they do reduce the
amount of particles a person wearing them spreads. Some experts say that
they’re better than nothing. The CDC says people should continue to stay six
feet apart when in public as much as possible, even if they’re wearing masks.
Some cities and states, like Colorado and New York City, had already
asked people to cover their faces when out in public.
313:
Groups at Higher Risk for Severe Illness
Fact: Based on what we know now, those at high-risk
for severe illness from COVID-19 are:
People 65 years and older
People who live in a nursing home or long-term care
facility
What You Can do if You are at Higher Risk of Severe
Illness from COVID-19
Learn how you can help protect yourself if you are at
higher risk of severe illness from COVID-19.
People of all ages with underlying medical conditions
are at higher risk for severe illness, particularly if the underlying medical
conditions are not well controlled. This includes people with:
Chronic lung disease or moderate to severe asthma
Serious heart conditions
Conditions that can cause a person to be
immunocompromised, including cancer treatment, smoking, bone marrow or organ
transplantation, immune deficiencies, poorly controlled HIV or AIDS, and
prolonged use of corticosteroids and other immune weakening medications.
Severe obesity (body mass index [BMI] of 40 or higher)
Diabetes
Chronic kidney disease and who are undergoing dialysis
Liver disease
314:
Younger people can be serious
Yes,
Fact: In Italy, one of the largest outbreaks
in the world, 10% to 15% of all people in intensive care are under 50.
In Korea, one in six deaths have been
people below the age of 60
Last month, world health officials referenced a study in China that
looked at 2,143 cases of children with confirmed or suspected COVID-19
that were reported to the Chinese Centers for Disease Control and Prevention
between Jan. 16 and Feb. 8.
That study showed that more than 90% of the cases were
asymptomatic, mild or moderate cases. However, nearly 6% of the children’s
cases were severe or critical, compared with 18.5% for adults.
315: Stability
of SARS-CoV-2 in different environmental conditions, SARS-CoV-2 in wastewater,
and guidance on repurposing anaesthesia machines as ventilators
Fact: According to a study published in The Lancet
Microbe, SARS-CoV-2 can be highly stable in a favourable environment, but
it is also susceptible to standard disinfection methods.
Alex W. H. Chin, MD, University of Hong Kong, Hong Kong, China, and
colleagues conducted various experiments to test the stability of SARS-CoV-2 at
different temperatures, on various surfaces, and its susceptibility to
disinfection methods.
First, the researcher measured the stability of SARS-CoV-2 at different
temperatures. SARS-CoV-2 in virus transport medium (final concentration ∼6.8 log unit of 50% tissue culture infectious dose [TCID50] per mL) was
incubated for up to 14 days and then tested for its infectivity.
Results showed that SARS-CoV-2 is highly stable at 4 degrees Celsius,
but sensitive to heat. At 4 degrees Celsius, there was only around a 0.7
log-unit reduction of infectious titre on day 14. When the incubation
temperature increased to 70 degrees Celsius, the time for virus inactivation
was reduced to 5 mins.
The researchers then investigated the stability of this virus on
different surfaces, including paper, tissue paper, wood, cloth, glass,
banknotes, stainless steel, plastic, and surgical masks. Briefly, a 5 μL
droplet of virus culture (∼7.8 log unit of
TCID50 per mL) was pipetted on a surface and left at room temperature (22
degrees Celsius) with a relative humidity of around 65%. The inoculated objects
retrieved at desired time-points were immediately soaked with 200 μL of virus
transport medium for 30 mins to elute the virus.
No infectious virus could be recovered from printing and tissue papers
after a 3-hour incubation, whereas no infectious virus could be detected from
treated wood and cloth on day 2. By contrast, SARS-CoV-2 was more
stable on smooth surfaces. No infectious virus could be detected from treated
smooth surfaces on day 4 (glass and banknote) or day 7 (stainless steel and
plastic).
Strikingly, a detectable level of infectious virus was still present on
the outer layer of a surgical mask on day 7 (∼0.1% of the original inoculum).
316: can povidone iodine kill the
virus
Yes; The researchers also tested the virucidal effects of disinfectants
by adding 15 μL of SARS-CoV-2 culture (∼7.8 log unit of
TCID50 per mL) to 135 μL of various disinfectants at working concentration.
Disinfectants included household bleach, hand soap, ethanol,
povidone-iodine, chlorhexidine, and benzalkonium chloride. With the exception
of a 5-minute incubation with hand soap, no infectious virus could be detected
after a 5-minute incubation at room temperature.
316: Can the virus survive in waste
water
In an article, published in The Lancet
Gastroenterology & Hepatology, researchers report the detection of
SARS-CoV-2 in wastewater.
From February 17, 2020, onwards, Willemijn Lodder, and Ana Maria de Roda
Husman, Centre for Infectious Disease Control, Bilthoven, the Netherlands, took
samples once a week from human wastewater collected at Amsterdam Airport
Schiphol, Haarlemmermeer, the Netherlands, for virus analyses. Samples tested
positive for virus RNA by quantitative reverse transcriptase-polymerase chain
reaction (RT-PCR) methodology 4 days after the first cases of coronavirus
disease 2019 (COVID-19) were identified in the Netherlands on February 27,
2020.
This could be explained by virus excretion from potentially symptomatic,
asymptomatic, or pre-symptomatic individuals passing through the airport.
Furthermore, human wastewater sampled near the first Dutch cases in
Tilburg, Netherlands, also tested positive for the presence of viral RNA within
a week of the first day of disease onset. These findings indicate that
wastewater could be a sensitive surveillance system and early warning tool, as
was previously shown for poliovirus.
317: Faeco oral transmission
Fact: Whether SARS-CoV-2 is viable under environmental conditions that
could facilitate faecal-oral transmission is not yet clear…[however], the
possibility of faecal-oral transmission of COVID-19 has implications,
especially in areas with poor sanitation where diagnostic capacity might be
limited, such as Africa. Wastewater surveillance, especially in areas with a
scarcity of data, might be informative, as we have previously shown in
monitoring antibiotic resistance on a global scale.
318: Can you convert anaesthesia
machines into ventilators
American Society of Anesthesiologists (ASA) have published guidance on how to safely and effectively
convert anaesthesia into life-sustaining mechanical ventilation for patients
during the COVID-19 pandemic, when there are not sufficient ICU ventilators to
meet patient care needs.
Although guidance is available from the manufacturers, the guidance may
not convey all of the clinical considerations. Anaesthesia professionals will
be needed to put these machines into service and to manage them while in use.
Safe and effective use requires an understanding of the capabilities of the
machines available, the differences between anaesthesia machines and ICU
ventilators, and how to set anaesthesia machine controls to mimic ICU-type
ventilation strategies.
SOURCE: The Lancet Microbe, The Lancet Gastroenterology & Hepatology,
and American Society of Anesthesiologists
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