Posted by on May 5, 2020 in Blog, Coronavirus / COVID-19 | 0 comments

We’ll try to keep this page updated with your frequently asked questions (FAQ). Some of the answers will be right here, inline. Some will direct you to other resources on Medivizor.com, or other trusted sources that we have found that already include the response.

Oh – and please ask questions in comments and we’ll either respond to your comments, add the question if it’s frequently asked, or both!

Every day we learn more and more. So this is a rapidly changing field of knowledge.

Here's a recent blog post about what is known about the virus.

Oh, and did you know that the first Nobel prize in medicine is also related?

There is increasing evidence that persons with mild or no symptoms at the pre-symptomatic and early stages of infection can contribute to the spread of COVID-19. A face mask may help reduce the spread of infection in the community by minimizing the excretion of respiratory droplets from infected individuals who may not even know they are infected and before they develop any symptoms. In this respect, mask use by asymptomatic persons can be regarded as an extension of the current practice of face mask use by symptomatic individuals.

The data on the protective effect for the person who wears the mask against viruses is conflicting. However, the World Health Organization (WHO) conditionally recommends face mask use in the community for asymptomatic individuals in severe epidemics or pandemics in order to reduce transmission in the community. 

The correct use of face masks is important. The face mask should completely cover the face from the bridge of the nose down to the chin. Hands should be cleaned with soap and water or alcohol-based hand sanitizer before putting on and taking off the face mask. When taking off the face mask, it should be removed from behind, avoiding to touch the front side. The face mask should be disposed of safely if it is disposable. The hands should then be cleaned again after disposing of the mask. Washable, reusable face masks should be washed as soon as possible after each use, using common detergent at 60 °C.

But not all masks are created equal, as you can see in this video:

https://www.youtube.com/watch?v=6KMIUkOnEBs

(Based on information from ECDC)

This virus spreads very effectively between people, in the air, in droplets, and on surfaces. That's good for the virus that wants to spread, but not for humans. In fact, without any measures, it spreads exponentially and can make many vulnerable people sick and overwhelm the healthcare resources of any healthcare system.

Here's an explanation of how social, or more correctly, physical distancing, helps "flatten the curve" and lengthen the duration of the pandemic, but reduce, dramatically, its health implications - and, in fact, also the economic implications.

Studies to date show that COVID-19 spreads primarily from person to person, through small droplets from the nose or mouth. These can be expelled through coughs, sneezes or even when a person speaks. These droplets are relatively heavy, do not travel far and quickly sink to the ground. People can catch COVID-19 if they breathe in these droplets from a person infected with the virus. 

There is not enough research so far that demonstrates that the virus remains in the air long enough to infect people. However, social distancing and etiquette (sneezing or coughing in the flexed elbow or a disposable tissue), wearing a mask, and regularly washing and disinfecting your hands are very important measures in limiting the spread.

(based on information from WHO/UN)

COVID-19 spreads primarily from person to person, through small droplets from the nose or mouth. These can be expelled through coughs, sneezes, or even when a person speaks. Depending on the circulation of air, its temperature, and humidity, these small droplets may remain in the air for some time (ranging from minutes to hours).

(Based on information from WHO)

There are some reports among social media and publications that certain heart disease medication such as angiotensin-converting enzyme (ACE) inhibitors (such as enalapril, captopril, perindopril, etc) and angiotensin receptor blockers (ARBs, or sartan medicines such as candesartan, irbesartan, etc), could worsen coronavirus disease (COVID-19). 

ACE inhibitors and ARBs are most commonly used for treating patients with high blood pressure, heart failure or kidney disease.

The fact that ACE-inhibitor or ARB treatment can make COVID-19 infection worse is not supported by clinical evidence. These medicines work by affecting the renin-angiotensin-aldosterone system (RAAS). This is a hormone system involved in the regulation of blood pressure and fluid and electrolyte balance. Because the virus uses a target called angiotensin-converting enzyme 2 (ACE2), which is part of this system, to enter human cells, and the medicines ACE inhibitors and ARBs and can increase ACE2, one of the suggestions was that they could also increase virus activity. However, the interactions of the virus with the RAAS in the body are complex and not completely understood.

Professional societies such as the American College of Cardiology and American Heart Association (ACC/AHA) and the Council on Hypertension of the European Society of Cardiology (ESC) state that there aren't any experimental or clinical data to support the beneficial or harmful effect of ACE inhibitors and ARBs in the context of the COVID-19 pandemic. Therefore, they recommend that doctors and patients should continue treatment with their usual medications for valid heart disease indications.

Yes. The likelihood of an infected person contaminating commercial goods is low and the risk of catching the virus that causes COVID-19 from a package that has been moved, traveled, and exposed to different conditions and temperatures is also low. There is currently no confirmed case of COVID-19 transmitted through food or food packaging.

(Based on information from WHO/UN)

When making an online delivery or takeout order, it is recommended to pay online or on the phone (if possible).

Accept deliveries without in-person contact whenever possible. Ask for deliveries to be left in a safe spot outside your house (such as your front porch or lobby), with no person-to-person interaction. Otherwise, stay at least 2 meters (6 feet) away from the delivery person.

After receiving your delivery or bringing home your takeout food, wash your hands with soap and water for 20 seconds. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.

After collecting mail from a post office or home mailbox, wash your hands with soap and water for at least 20 seconds or use a hand sanitizer with at least 60% alcohol.

(Based on information from CDC)

When grocery shopping, keep at least 1-meter distance from others and avoid touching your eyes, mouth, and nose. If possible, sanitize the handles of shopping trolleys or baskets before shopping. Once home, wash your hands thoroughly and also after handling and storing your purchased products.

Oh - and we wrote a blog post about taking how to do grocery shopping for the vulnerable, more at-risk, and immunosuppressed people you care for.

(Based on information from WHO)

Hygiene refers to frequently washing your hands, face and body with clean water and soap, but also to practice good hygiene etiquette when sneezing, coughing.

Hands should be washed with soap and clean water for at least 20 seconds. If soap and water are not available, use an alcohol-based sanitizer that contains at least 60% alcohol to clean hands.

In order to limit the spread of disease, it is important to cover your mouths and nose with a tissue, which should be thrown away immediately after using it. In the absence of a tissue, you can sneeze in your flexed elbow and not your hands. Also, remember to immediately wash your hands after blowing your nose, sneezing or coughing.

(Based on information from CDC)

We actually have a separate blog post about this. Essentially, microwaves kill viruses due to heat and not radiation. Therefore, it's vital to heat things up enough to kill the virus. Read the post for more details.

Since COVID-19 is a new disease, there is still limited information regarding risk factors for severe illness. However, based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19 and should take additional precautions.

(Based on information from CDC)

People with a weakened immune system, including cancer treatment, bone marrow or organ transplantation, immune deficiencies, HIV with a low CD4 cell count or not on HIV treatment, and prolonged use of corticosteroids and other immune weakening medications, have a reduced ability to fight infectious diseases, including viruses like COVID-19. Although knowledge is limited about the virus that causes COVID-19, based on similar viruses, there is concern that immunocompromised patients may remain infectious for longer than other COVID-19 patients.

If you are immunocompromised, it is recommended to continue any prescribed medications or treatments and follow the advice of your healthcare provider.

Call your healthcare provider if you have concerns about your condition or feel sick.

Oh - and we wrote a blog post about taking how to do grocery shopping for the vulnerable, more at-risk, and immunosuppressed people you care for.

(Based on information from CDC)

Blood donation centers can facilitate the safe donation of blood because they are skilled in infection control practices and already have procedures in place to prevent the spread of infections. Blood donation centers always take steps to prevent staff and donors who are not feeling well or who have a fever from reaching the donor area, and they are now taking additional social distancing precautions wherever possible.

Do not donate blood if you have a fever or other symptoms of COVID-19 (cough, shortness of breath, or difficulty breathing) or if you had close contact with someone diagnosed with or suspected of having COVID-19 in the last 14 days. If you have been diagnosed with or suspected of having COVID-19 you cannot donate blood until 14 days after your illness has resolved.

If you have recovered from COVID-19, your blood that includes antibodies for the virus may be most useful, as it may be used as part of an experimental therapy for patients. Look for opportunities to donate blood. If you are in the USA, review this.

(Based on information from FDA)

Due to the COVID-19 pandemic, travel has been suspended in most affected countries for non-essential reasons. As countries across the globe report further declines in COVID-19 cases, governments have started to lift some of the restrictions. However, in order for individuals to be able to resume planning vacations, it is necessary that governments, the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to give thumbs-up to travel. We expect this will take place gradually, initially, with fairly significant restrictions on people that travel. 

There are hundreds of simultaneous efforts worldwide to research and make available effective treatments and vaccines for coronavirus / COVID-19.

We will update the response to this question with more information over time. For now, here are the most promising treatments in a blog post we put together to cover them.

First, Medivizor is certainly such a place. We encourage anybody that has a serious/chronic illness diagnosis to sign up to Medivizor, in general (it's free and private).

We are updating in our Coronavirus / COVID-19 resource center about all the new and trusted information.

And, if you'd like more - here are more great resources.

At this point, this seems fairly unlikely. It's not impossible, but there is really no good evidence that it is going to do less harm than good - the pre-requisite for any therapy.

Here's an excellent summary of the state of the art by Milton Packer, MD.

First, if you are concerned, you may want to check our Self Assessment tool.

The symptoms of COVID-19 infection can be very different among people. It can feel like a common cold with runny or congested nose, sore throat, or more like a flu with high fever, muscle aches, shortness of breath and dry cough. Many people have a loss of smell and taste, skin rashes and even digestive symptoms such as nausea, vomiting or diarrhea. However, a large proportion of people don't exhibit any symptoms, but can transmit the disease (are contagious).

The only way to know for sure you have/had COVID-19 is to get tested.

There are two ways of getting tested. The first type is viral testing. This type of test is the most reliable and involves giving a sample from your respiratory tract. This means a medical professional will use a cotton swab to take samples from your nose and back of the throat. These samples will then be tested into a lab for the presence of the virus. If you've had the COVID-19 infection and you already recovered, this test should not be positive.

The second way to get tested is by blood (antibody test). In this way, your blood is checked for evidence that your immune system has reacted to the presence of the virus, by checking for specific antibodies. However, antibodies don't form immediately that this virus enters the body. It can take between 1 and 3 weeks for antibodies to form. Therefore, the test may not be positive early on during the infection. However, this test can indicate if you have ever had COVID-19 or another type of coronavirus infection. It is unclear at this point if these antibodies protect against being infected again.

(Based on information from CDC)

It is very difficult to interpret fatality information regarding the COVID-19 infection. First, the rate of fatal cases of COVID-19 infection depends on the number of confirmed cases. However, many people go through the infection without exhibiting any symptoms, therefore they usually do not get tested, so they do not enter the reported statistics. Also, there are people that can have symptoms that do not fit the general criteria for COVID-19, so they also might not get tested. 

The second problem in determining the fatality rate from COVID-19 stems from people that have additional severe medical conditions. There has been a debate regarding people with severe conditions who have lost their lives since the pandemic started if their death is really due to the COVID-19 infection or because of their previous medical condition(s). Also, each country reports differently the deaths during the pandemic. However, experts have started to compare fatality rates from the beginning of the pandemic and from the same period of time from the past years and it seems that in many parts of the world the fatality rates have indeed risen during this period, unlike the same time in past years.

Since the start of the pandemic there have been many comparisons between the COVID-19 and influenza (flu) infections. Although both are viral infections that cause respiratory disease, there are very important differences between the two infections that have implications for the public measures that need to be put in place.

A similar aspect between the two viral infections is their presentation (how they appear). Both infections can be asymptomatic (no symptoms present) or can cause similar symptoms such as tiredness, muscle aches, headaches, cough, shortness of breath, fever, chills or even pneumonia. Also, both viruses are transmitted from person to person by contact, or from droplets from the cough, sneeze or from an infected person talking. Both infections need similar hygiene measures such as frequent washing/disinfecting hands and good respiratory etiquette such as sneezing/coughing in the elbow or in a disposable tissue and staying home when sick in order to prevent spreading of the disease. 

However, the speed with which viruses are transmitted from a person to another is significantly different, so is the time from infection until symptoms appear. The influenza virus has a shorter time from infection to appearance of symptoms (incubation period), ranging from 1 to 4 days. In the COVID-19 infection, the incubation period is estimated to be longer, between 2 and 14 days. 

The period during which a person is contagious (can transmit the infection to other individuals) is also different. Influenza is most contagious in the first 3-4 days of the infection and can spread up to 5-7 days after a person becomes sick. With COVID-19, the infectious period can range from 2 to 12 days.

Another difference between the 2 infections is how rapidly it can spread in the community, i.e how many people can be infected from one infected individual. This is called the reproductive number (R0). The R0 is estimated to be higher for the COVID-19 virus, between 2 and 2.5, compared to influenza viruses. The 2009 influenza flu (H1N1), for example, has an R0 or 1.2-1.6.

Also, risk factors may be different between the two viral infections. For influenza, children, pregnant women, elderly individuals and those with other chronic medical conditions seem to be more at risk. For COVID-19, current data suggests that older age and underlying medical conditions increase the risk for severe infections. The fatality rate also appears to be higher for COVID-19 compared to influenza. 

In terms of medical interventions, for influenza there are available antiviral medications and vaccines. However, vaccines and treatments for COVID-19 are still under investigations.

Put together, this all means that COVID-19 is much worse than the flu and has already killed many more people in the countries that were hit hard (Italy, Spain, France, UK, US, and more), and is bound do dwarf even the worse flu season in recorded history in terms of its health mortality, health, and financial impact.

(Based on information from WHO)

Well, it probably might not be possible to totally prevent a second wave as this virus is highly contagious. However, Wired explains it fairly nicely what might be necessary. It should be noted that different governments are employing different approaches - which may or may not lend themselves to the approached described here:

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