• Try to get a few extra months’ worth of prescription meds, if possible.
• Think through now how we will take care of sick family members while trying not to get infected.
• Cross-train key staff at work so one person’s absence won’t derail our organization’s ability to function.
• Practice touching our faces less. So how about a face-counter app like the step-counters so many of us use?
• Replace handshakes with elbow-bumps (the “Ebola handshake”).
• Start building harm-reduction habits like pushing elevator buttons with a knuckle instead of a fingertip.

B. Be Prepared Spiritually: **


Christians have been taught for years to always be prepared as “the end” can come at any time and that this world is not our final destination: eternity is our final destination. Be sure to remind your kids of this as they can sense any fear you have about viruses, death, pain. This is very true and should always give one hope and joy knowing that no matter what today and tomorrow bring, eternity with a loving God is our goal.




Thus, my recommendation is:
1. Go about your daily business but make sure you are in a state of grace. Continue to go to daily mass. Shake hands but do not touch your hands, face or eat before and alcohol pump or good hand washing.
2. Go to confession weekly: a great way to be always ready.
3. Fast and pray: some demons like such a deadly virus can only be removed by fasting and prayer.
Tomorrow is Ash Wednesday so just in time for a good fast & prayers!
4. Call your family and make sure everyone is prepared and doing well.
5. Make amends to friends, neighbors who have hurt you or you have hurt.
6. Prepare a bit, but don’t panic or stress: let go and let God and your guardian angel guide and help you.




SLC






More information below.
  
I would recommend every office have N95 Masks available for all there MDs and staff members, especially if you are in a big metropolitan area.


Many of the best kind are still sold out, so would do this as soon as possible as 1 case of Coronavirus in your hospital or practice, could shut it down for at least 1 month. And being known as the hospital or office or family that spread the virus to others, would be a concern.


https://www.3m.com/3M/en_US/company-us/all-3m-products/~/3M-Health-Care-Particulate-Respirator-and-Surgical-Mask-1860-N95-120-EA-Case/?N=5002385+3294795990&preselect=3293786499&rt=rud

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All these by 3M on Amazon are out of stock but are good when available again.


https://amzn.to/2SYEUoj


https://amzn.to/3cbBJ4a


https://amzn.to/37ZGgUf

A Comparison of Surgical Masks, Surgical N95 Respirators, and Industrial N95 Respirators

• May 01, 2014

• May include masks labeled as surgical, laser, isolation, dental, or medical procedure masks
• Are primarily intended to protect the patient, not the wearer, from the wearer’s saliva and respiratory secretions
• May also help protect the wearer against exposure to microorganisms, body fluids, and large particles in the air but are not tight fitting and likely have substantial inward leakage for particles and organisms
• Are designed to cover the mouth and nose loosely but are not sized for individual fit
• Are not NIOSH (National Institute for Occupational Safety and Health) approved

• Form a tight seal over the mouth and nose.
• Require fit-testing and must be adjusted to your face to provide the intended effectiveness of filtering 95 percent of particles with a mass median diameter of 0.3 micrometers.
• Employers and users are required to follow the OSHA Respiratory Protection Standard, 29CFR 1910.134, as well as other state or local regulations, as appropriate.
• Have specific use instructions, warnings, and limitations for use in health care environments.
• Are NIOSH certified.
• Are fluid resistant to a certified level measured against a stream of artificial blood directed at the respirator.

Approval and Certification
Surgical masks

The U.S. Food and Drug Administration (FDA) clears surgical masks for sale in the United States. FDA does not test and certify the respirator. Instead, they clear the respirator for sale after reviewing the manufacturer’s test data and proposed claims. The manufacturer performs and submits the results from several tests, including particle filtration efficiency, bacterial filter efficiency, fluid resistance, etc.

The particulate filter efficiency gives an indication of the quality of the health care surgical mask. However, this rating is completely different and far less rigorous than the NIOSH N95 filter efficiency rating and should not be used as a comparison between the two.

Surgical N95 respirators
Surgical N95 respirators are approved by NIOSH as to their respiratory protection efficiency and resistance and other NIOSH requirements. They are also separately cleared by FDA as medical devices. FDA clears surgical masks for sale in the United States but does not test and certify the respirator. Instead, the agency clears the respirator for sale after reviewing the manufacturer’s test data and proposed claims. The manufacturer performs and submits the results from several tests, including particle filtration efficiency, bacterial filter efficiency, fluid resistance, etc.

The biological filter efficiency gives an indication of the quality of the health care surgical mask. However, this rating is completely different and far less rigorous than the NIOSH filter efficiency rating and should not be used as a comparison between the two. Surgical N95 respirators and N95 industrial respirators share the same NIOSH requirements. NIOSH also has other efficiency certification levels for industrial respirators (see below).

Industrial respirators (including industrial N95 respirators) and Surgical N95 respirators
In the United States, NIOSH is responsible for testing and certifying respirators to be used in the workplace. NIOSH not only reviews the manufacturer’s test data, but also performs its own independent tests on the respirators in NIOSH’s governmental laboratories to verify the manufacturer’s results. The tests include filter efficiency, degradation, and flow rate, to name a few. In addition to testing the respirators during the submittal process, NIOSH also will periodically purchase respirators in the field and test them to make sure the respirators are performing to their original certification.

Once the respirator is initially approved, NIOSH will certify its classification as N, R, or P and its filter efficiency as 95 percent, 99 percent, or 99.97 percent. It is also important to note that even though a respirator just by its use often helps to prevent the wearer from contaminating the environment; it cannot be considered a surgical mask unless it has been cleared by the FDA.

Surgical masks
The most important thing to remember about surgical masks is that they are not designed to pass a fit test. As explained above, their purpose is to help protect the environment and other nearby persons from the wearer’s contaminants. When many surgical masks are worn, they will have gaps around the edges that allow many small particles to enter the respiratory system of the wearer. Even tighter-fitting surgical masks will have some gaps that allow small particles to enter the wearer’s respiratory system.

Surgical N95 and industrial N95 respirators

Respirators are designed to seal the respirator to the face and pass a fit test. Under Respiratory Protection Standard 29 CFR 1910.134, the Occupational Safety and Health Administration requires the wearer of a respirator to be fit tested before he or she can use the respirator in a contaminated environment. OSHA also requires the wearer to perform user seal checks on the respirator before each use, as well as comply with the other elements of a comprehensive respiratory protection program in accordance with 29 CFR 1910.134.

Experts have been wrong before. Experts are in a tough spot as they do NOT want to miss a pandemic which could kill many people but they also do not want to create needless fear.

https://www.cnbc.com/2020/02/25/coronavirus-latest-updates.html

https://fightthenewdrug.org/15-things-experts-got-proved-wrong/

Why it could spread:

1. It is a virulent virus with a high deadly rate. 

2. People are people and do not wash their hands before they touch their face.

3. Countries, cities, towns, hospitals, offices, homes are not ready to contain such a virus quickly. 

Why it could be contained:

1. A vaccine should be out hopefully in April: God willing

2. Spring & Summer should see a huge decline in infection rates as Vitamin D levels increase again: so get in the sun safely & often .

3. People are outside more in the Spring which prevents person to person spread.

https://www.facs.org/about-acs/covid-19

The American College of Surgeons (ACS) has developed an informational web page for surgeons about the Coronavirus Disease 2019 (COVID-19). Although risk of exposure to COVID-19 in the U.S. is currently very low, recent forecasts by the Centers for Disease Control and Prevention (CDC) about its imminent rise in the U.S. are not optimistic. In the event that surgeons encounter someone with symptoms in their practice setting, ACS suggests that surgeons prepare now and familiarize themselves with CDC infection control practices and equipment recommendations (ie: N95 respirators, and personal protective equipment).

About the Coronavirus Disease 2019 (COVID-19)

Information for Surgeons

As the number of cases of Coronavirus Disease 2019 (COVID-19) continues to rise internationally, the American College of Surgeons (ACS) recommends that all surgeons continue to monitor the website of the Centers for Disease Control and Prevention (CDC) for the latest updates and information about it.

Here you’ll find an information section on the CDC COVID-19 website solely dedicated to health care professionals:

 Go to CDC Information for Health Care Professionals

Although the number of confirmed cases in the U.S. remains low, a CDC official publicly commented on February 25 that:

“We expect we will see community spread in this country,” said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases. “It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness.” [Source: CNN]

Although you may not currently be experiencing COVID-19 exposure issues in your practice setting, now is the time to prepare for it. Start by familiarizing yourself with these infection control practices in the event you encounter someone with symptoms:

• Don N95 respirator masks
• Don full personal protective equipment (PPE), including protective eyewear
• Doff PPE responsibly as you would for exposure to any infectious disease
• After doffing equipment, decontaminate hands with an ETOH-based gel

To review protective gear steps, download and view this three-page CDC instructional document.

We’ll continue to monitor the situation and post updates to this page as needed.

If you have any information that you think the ACS should be aware of, please email: dhoyt@facs.org

——

Treatments for Coronavirus:

What are the treatments for coronavirus infections?

There are no specific treatments for coronavirus infections. Most people will get better on their own. However, you can relieve your symptoms by

• Taking over-the-counter medicines for pain, fever, and cough. However, do not give aspirin to children. And do not give cough medicine to children under four.
• Using a room humidifier or taking a hot shower to help ease a sore throat and cough
• Getting plenty of rest
• Drinking fluids

Experimental Treatment Options: Trial Starting in China

1. remdesivir

2. chloroquine

3.  HIV drugs lopinavir and ritonavir

4. shuanghuanglian, a Chinese herbal medicine that contains extracts from the dried fruit lianqiao (Forsythiae fructus), which is purported to have been used for treating infections for more than 2,000 years. The trial has 400 participants, including a control group given standard care but not a placebo therapy.

https://www.nature.com/articles/d41586-020-00444-3

NEWS 

 15 FEBRUARY 2020

More than 80 clinical trials launch to test coronavirus treatments

As HIV drugs, stem cells and traditional Chinese medicines vie for a chance to prove their worth, the World Health Organization attempts to bring order to the search.

Amy Maxmen

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 PDF version

China has more than 80 running or pending clinical trials on potential treatments for COVID-19, the illness caused by a coronavirus that has thus far killed nearly 1,400 people and infected more than 48,000 across China.

New pharmaceutical drugs are listed beside thousand-year-old traditional therapies in a public registry of China’s clinical trials, which is growing every day. There is no known cure, and doctors are eager to help those with the disease — but scientists caution that only carefully conducted trials will determine which measures work.

Soumya Swaminathan, chief scientist at the World Health Organization (WHO), says that its teams have been taking stock of China’s many trials, as well as drawing up a plan for a clinical-trial protocol that could simultaneously be run by clinicians around the world. If China’s trials, which include as many as 600 people each, are not designed with strict standards for study parameters, such as control groups, randomization and the measures of clinical outcomes, the efforts will be in vain. So the WHO is working with Chinese scientists to set standards from the start. For example, a person’s stages of recovery or decline should be measured in the same way, regardless of the treatment being tested. “We can hopefully bring some sort of structure into the whole thing,” Swaminathan explains.

The WHO’s clinical-trial protocol is designed to be flexible and allow researchers around the world to pool their results over time. It will compare two or three therapies backed by scientific evidence, including an HIV-drug combination (lopinavir and ritonavir) and an experimental antiviral called remdesivir.

“Getting the clinical trials straight is a priority, since if we get information on what is working and not working, we can benefit patients now,” Swaminathan says.

Best guesses

China has already begun trials on the drugs to be included in the WHO’s master plan. The Chinese Clinical Trial Registry, a database of biomedical studies in China, lists these investigations among dozens of other controlled trials on existing therapies, experimental procedures and traditional medicines. These treatments have varying amounts of evidence backing their efficacy.

The two HIV drugs block enzymes that viruses need to replicate. In animal studies, they have reduced levels of the coronaviruses that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS)1. Remdesivir, a nucleotide analogue made by the biotechnology company Gilead in Foster City, California, has had some success against coronaviruses in animals, too2. In January, researchers reported that one person in the United States had survived a COVID-19 infection after being treated with remdesivir3. During the first week of February, China launched two placebo-controlled trials of remdesivir, slated to include 760 people with COVID-19. The studies should be completed by the end of April, and remdesivir could be approved by Chinese authorities as early as May, says Shibo Jiang, a virologist at Fudan University in Shanghai. “But the epidemic might be gone by then,” he says.

China has launched a few trials that test chloroquine, a malaria drug that killed off the new coronavirus (recently named SARS-CoV-2) in cell culture4. And researchers are studying whether steroids diminish inflammation in people with severe COVID-19, or cause harm. “It will be interesting to see these results,” says Yazdan Yazdanpanah, an epidemiologist with France’s national health agency, INSERM, in Paris. Research clinicians around the world will need this information if the outbreak continues to spread, he adds.

Another study — a 300-person controlled trial — will test serum from COVID-19 survivors. The bare-bones strategy, based on the idea that the antibodies one person steadily builds up to fight a virus can rapidly help someone freshly infected to fight it off, has had modest success when used to treat other viruses in decades past5.

Two stem-cell trials are also listed in China’s registry. In one, a team at the First Affiliated Hospital of Zhejiang University will infuse 28 people with stem cells derived from menstrual blood, and compare results with those from people who did not receive the infusions. So far, there is minimal evidence indicating that stem cells clear coronavirus infections. Swaminathan says that the WHO cannot control what researchers do, but she says the agency published guidance on the ethics of running trials amid outbreaks in 2016. And it will be posting a more accessible, brief report on the issue soon.

About 15 trials listed in China’s registry expect to enroll a total of more than 2,000 people in studies on a variety of traditional Chinese medicines. One of the largest among them assesses shuanghuanglian, a Chinese herbal medicine that contains extracts from the dried fruit lianqiao (Forsythiae fructus), which is purported to have been used for treating infections for more than 2,000 years. The trial has 400 participants, including a control group given standard care but not a placebo therapy.

The WHO is working with Chinese scientists to standardize the design of all the studies, including those on traditional medicines. The efforts stem from a controversial move last year, in which the organization recognized traditional Chinese medicine in its compendium of diseases. Critics argued that the WHO’s recognition amounted to endorsement, but Swaminathan disagrees. She says that the WHO’s move helps the organization to codify medical terminology so that herbal remedies can be evaluated with the same rigour expected of pharmaceutical testing. “We want a scientific approach to testing traditional medicine,” she says.

Moving forward

While these trials take off, researchers are searching for new drugs that would combat multiple coronaviruses, including those that haven’t surfaced yet. A spike-shaped protein on the surface of the viruses underlying SARS, MERS and COVID-19 provides a tantalizing target. Already, Jiang and other research groups have found compounds and antibodies that glom onto that spike6, which could prevent coronaviruses from invading human cells. But Emily Erbelding, a microbiologist at the US National Institutes of Health in Bethesda, Maryland, cautions that studies like these are at an early stage — and the compounds still need to be developed into drugs and tested in animals. To drive COVID-19 research, the NIH announced ‘urgent award’ grants in early February.

With many therapeutic possibilities and limited time, Jiang says the WHO should provide advice about which treatments to move forward, and which to ditch, as trials progress. And he hopes that research on better, broader therapies will be continued after the outbreak ends. “I worry this will be the same situation as during SARS,” he says, “where the work starts, then stops.”

Nature 578, 347-348 (2020)

Coronaviruses are a large family of viruses found in many different species of animals, including camels, cattle, and bats. A new strain of coronavirus has been identified as the cause of the outbreak of respiratory illness in people first detected in Wuhan, China. On February 11, 2020 the World Health Organization named the disease COVID-19. (Formerly, it was referred to as 2019-nCoV.) Rarely, animal coronaviruses jump species and infect people, and then possibly spread between people, such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).

The media has reported that some people are seeking “alternative” remedies to prevent infection with SARS-CoV-2 or to treat the 2019 coronavirus disease now called COVID-19. Some of these purported remedies include herbal therapies and teas. There is no scientific evidence that any of these alternative remedies can prevent or cure the illness caused by this virus. In fact, some of them may not be safe to consume.1  

While scientists at NIH and elsewhere are evaluating candidate therapies and vaccines to treat and prevent the novel coronavirus, currently there are no treatments or vaccines for COVID-19 approved by the U.S. Food and Drug Administration. The best way to prevent infection is to avoid exposure to this virus. The Centers for Disease Control and Prevention (CDC) also recommends everyday preventive actions to help prevent the spread of this and other respiratory viruses, including the following:

• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
• If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home when you are sick, and keep children home from school when they are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

If you feel sick with fever, cough, or difficulty breathing, and have traveled to China or were in close contact with someone with COVID-19 in the 14 days before you began to feel sick, seek medical care. Before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel or exposure and your symptoms.

References:

1. https://www.npr.org/sections/goatsandsoda/2020/02/11/804862868/theres-no-specific-drug-that-kill-coronavirus-but-doctors-have-ways-to-treat-it

There’s No Specific Drug That Kills Coronavirus. But Doctors Have Ways To Treat It

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February 11, 20204:09 PM ET

Heard on All Things Considered

RICHARD HARRIS

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Medical workers in protective suits tend to coronavirus patients at the intensive care unit of a hospital in Wuhan, China.

China Daily via Reuters

Even though the coronavirus disease that has sickened tens of thousands of people in China is new to science, doctors have a pretty good idea about how to treat it. COVID-19, as it is now named, attacks the lungs. Doctors see similar symptoms from other diseases all the time, especially from serious cases of the flu.

There’s no specific drug that can kill this virus. So doctors provide what’s known as supportive care, says Dr. Laura Evans, a critical care specialist at the University of Washington and a member of the Society of Critical Care Medicine’s Leadership Council.

“Supportive care is something we’re quite used to,” Evans says, “particularly in the intensive care unit environment, because we lack specific therapies for a lot of the things that we deal with in the intensive care unit.”

The strategy of supportive care is to do whatever’s possible to keep vital organ systems functioning. That means monitoring vitals such as temperature, blood pressure and oxygen levels “and trying to keep those as normal as we can,” she says.

Providing oxygen can be critical, particularly for a lung ailment. The method can range from a simple tube in the nostrils (a nasal cannula) to much more aggressive approaches, such as a mechanical ventilator, which involves a breathing tube threaded into a person’s airways.

“We’re just trying to support their bodies through it while they deal with the infection themselves,” she says.

At the end of the day, it’s the person’s immune system, rather than the doctors, that does the hard work of fighting off an infection. Drugs can help as well, whether it’s for blood pressure, heart performance or infection control.

“Sometimes these patients could have bacterial infections along with the viral infections,” says Dr. Charles Dela Cruz, a critical care specialist at Yale University’s School of Medicine. “They may or may not need antibiotics in certain situations.”

He has helped analyze case reports of coronavirus from China. About 80% of COVID-19 cases are comparatively mild and don’t require major medical interventions, but the remaining 20% can be quite serious.

Dela Cruz notes that patients who survive a crisis still may have a long road ahead of them.

“They have a lot of consequences of what they’ve gone through, especially if they’re mechanically ventilated for a long time,” Dela Cruz says. “And so a lot of them have a harder time to get back to their baseline. It sometimes takes weeks or even months. And there’s also a lot of mental health distress.”

People who have had a disorienting experience in the ICU may end up with delirium, which can have long-term consequences.

Researchers in China are already testing drugs that target the coronavirus. One is an experimental medication from the United States called remdesivir, which was originally developed by Gilead Sciences to treat Ebola (but has not been approved for any purpose). These drugs stop the virus from replicating but can’t undo damage that the virus has caused to a person’s body.

Dr. Fred Aoki at the University of Manitoba has studied antiviral drugs in the context of the flu, which has strong parallels to COVID-19. Those drugs are mostly effective within just a day or two of a person developing symptoms — that is, before the virus has had a chance to make someone really sick. They can prevent the virus from doing a lot of damage at that point.

The drugs can also reduce the risk of death in hospitalized patients, Aoki says. “In those cases, anti-influenza drugs will have an effect out to five and six days after onset of illness and will produce a salutary change in the course of the illness.”

He says these flu medicines are actually most effective in people who are well but who have been exposed to the virus, say from a member of their household. The drug can actually prevent disease at that point.

Researchers studied this effect during the pandemic flu a decade ago. “These pills would reduce the illness in the other family members by about 70 to 80 percent,” he says.

Logistics are the biggest challenge, Aoki says, because if people have to wait for doctors’ appointments to get a prescription, they’ve lost precious time.

But even in the best of circumstances, we should not expect too much from antiviral medications.

“In the case of influenza, where we have approved antiviral therapy, we still see people become very ill and requiring hospitalization or requiring intensive care,” says Evans of the University of Washington. “And we know thousands in the U.S. die every year from influenza. So I don’t think we should think of an antiviral drug as a magic bullet here.”

People will still need supportive care, she says, to buy them time to heal.

And then there is other news on Coronavirus: my mom sent me this. Not sure what to make of it. 

An Italian doctor graduated with a master’s degree and works in the Shenzhen hospital. He was transferred to study the Wuhan Pneumonia virus, or Corona-Virus. Notify your Italian colleagues: If when you have a cold, you have a runny nose and sputum, it cannot be the new type of Corona-virus pneumonia, because Corona-virus pneumonia gives a dry cough without a runny nose. This is the easiest way to identify it. Tell your friends that if you have more medical knowledge, you will be more aware of how to identify and prevent it. Dean’s Reference

It is good to know by this time that the Wuhan virus or Corona-virus is not heat resistant and dies at a temperature of 26 to 27 degrees. Therefore, drink more hot water. You can tell your friends and family to drink more hot water to avoid it (Infusions). Expose yourself to the sun. It is cold at the time of the year, so drinking hot water (such as tea and infusions) is very convenient. It is not a cure but it is good for the body. Drinking hot water is effective in killing all viruses. Remember! Try not to drink ice,

Doctor’s advice about the Corona-virus:

1. The virus is of a fairly large size (the cell has a diameter of approximately 400-500 nm), so any normal mask (not just the mask of 3M N95) should be able to filter it. However, when someone infected sneezes in front of you, it will take about 3 meters (about 10 feet) before it falls to the ground and no longer flies, that is, it is suspended in the air.

2. When the virus falls on the surface of a metal, it will live for at least 12 hours. So remember that if you come into contact with any metal surface, wash your hands thoroughly with soap.

3. The virus can remain active in the tissue for 6-12 hours. Normal laundry detergent should kill the virus. For winter clothes that do not require daily washing, you can put it in the sun to kill the virus.

Information on the symptoms of pneumonia caused by the Corona-virus:

1. It will first infect the throat, then in the throat it will feel like a dry sore throat that will last 3 to 4 days.

2. Then, the virus will fuse with the nasal fluid and drip into the trachea and enter the lungs, causing Wuhan’s pneumonia. This process will take 5 to 6 days.

3. There will be a stage with pneumonia, high fever and breathing difficulties. Nasal congestion is not like normal nasal congestion. You will feel like drowning in the water. It is important to seek medical attention immediately if you have this feeling.

On prevention:

1. The most common way to get infected is to touch things in public such as handrails, door handles, handles on the bus, etc., so you should wash your hands frequently. The virus can only live in your hands for 5-10 minutes, but many things can happen in those 5-10 minutes (You can rub your eyes or not wanting to rub your nose without knowing that you have it in your hands).

2. In addition to washing your hands frequently, you can gargle with Betadine throat to eliminate or minimize germs while they are still in the throat (before dripping to the lungs).

Friends, be very careful and drink a lot of water.