Khalid Simply Says

  5 Things We Should Know About Infection Control, Viruses and Respiratory Droplets. Courtesy of: CDC Project First Line   The CDC created the Inside Infection Control vlog series to share some basic ideas behind infection control, how they apply to COVID-19 and how these ideas can help yourself and others.   The difference between SARS-CoV-2 and COVID-19. SARS-CoV-2 is the scientific name of the virus that causes coronavirus disease 2019 (COVID-19). COVID-19 Symptoms   A person with the disease COVID-19 may experience these symptoms: fever, chills, cough, difficulty breathing, etc. When discussing the pandemic, we often talk about the number of people with COVID-19. All viruses have a couple of parts, including genes and proteins. These parts help the virus get around inside the infected person's body and transmit to others. The genes contain the information a virus needs to multiply. Most of the proteins in a virus come together to create a shell or...

    One of the frequent comments from the hesitant unvaccinated Americans is that they need more data to be sure that the Covid vaccines are safe.  No vaccine is absolutely safe and various side effects in healthy volunteers have been reported in the vaccine related clinical trials. However, there is pre-ponderance of evidence that the adverse events associated with Covid-19 are far greater (including death), than the adverse effects of the Covid vaccine.  A recent paper from Israel caught my attention and is the subject of this blog.  The study was published in the “New England Journal of Medicine”, one of the most prestigious peer reviewed medical journals. As I scanned the table of content of my September 16 issue, I quickly jumped to the paper titled “Safety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting” by Dr. Barda and his colleagues and the accompanying editorial. .  This large observational study was carried out in Israe...

 Congratulations. You have taken a step towards being protected and towards the threshold of living without the fear of Covid-19 affliction. But you are not there yet.   An elder of my family recently wrote to me stating that he had himself tested for antibodies to the coronavirus a month after having been fully vaccinated. The result came back as disappointingly low level of antibodies.   So he asked: What am I supposed to do now?   Nothing different that you have been doing all along, I said.  The same standard operating principals: Maintain social distance, cover face and nose and hand hygiene. Since you don’t have a strong level of antibodies, you are not fully protected. Antibody testing after vaccination is not recommended by the CDC at this time.   He was not happy to hear this but recognized that Covid-19 being a new infection and a pandemic, there was no one straight answer.   No single action offers 100% protection, whereas the outc...

South Korea is often cited as an international example in controlling the spread of coronavirus. In the recent issue of the Journal of American Medical Association (Vol: 323, No: 21, page 2129, June 2, 2020),  the authors explained how South Korea managed to trace, track, contain the coronavirus epidemic. The methodology and outcome were so much different than how it was handled in the United States, that I thought of sharing this medical journal article   with you. The authors state that the first case of COVID-19 was detected in South Korea on January 20, 2020. As of April 20th, there were 10,683 confirmed cases, 2,233 people were quarantined or hospitalized, and 237 deaths.   According to the press accounts, the first USA confirmed case in the USA was on January 20th.The confirmed cases, and deaths as of April 20th were 749,203 and 35,793, respectively. On the per capita basis, South Korea had 2 deaths per 10 million population, vs. U.S. A’s 50 deaths per ...

As the acute phase of the novel coronavirus pandemics starts to ebb, the discussion is moving towards vaccines and how can we protect the populace from another wave in the fall or the next spring It seems clear that to fight off the virus, and prevent another public health crisis, most if not all of us must have immunity (herd immunity).We will develop the immunity either by having been infected and recovered, or by having received a vaccine.   This reality is the force behind the rush to develop a vaccine sooner than later. Whereas you, I and our elected officials would like to have an effective vaccine available for everyone who wants it, tomorrow, it just cannot happen that fast. For an effective, safe, commercially available vaccine in hundreds of millions of doses (or billions of doses for the whole world), there are many known and un-foreseen challenges. I have discussed the basics about vaccines in a previous blog and will skip them here. One of the challe...

As COVID-19 illness spreads, the authorities are pressing all buttons to stop the spread, treat those who are infected, save lives and develop strategies to prevent future spread of the virus. All of these steps are essential in fighting the pandemic. On the treatment front, we at least have one anti-viral drug that has been given the green light by the FDA. Over the next coming weeks and months, the drug remdesivir will be supplied to many hospitals treating severe cases of COVID-19. Another treatment is being tested is the convalescent plasma. Since thousands of people have recovered from the coronavirus infection, they can be the source of this plasma. What is convalescent plasma? Our blood has cells that float in a liquid medium called plasma. It has everything in it like water, proteins, sugar, nutrients, enzymes, and hormones to name a few. These materials are transported from one place in the body to the destination organs by the powerful pump, the heart. Ou...

Checking our temperature has become an essential ritual in this era of COVID-19 pandemic. No one used to care if I had fever, but now fever rules the world. Now everyone wants to know if I have fever. If I do, not only will I be denied entry to a school, office, restaurant, airplane, or a train, but I will most likely be quarantined. So, when the Wall Street Journal published an article on the subject, it gave me the idea to write about fever and thermometers. Heat in the body is produced by metabolic activity, mostly in the muscles and the liver. It is the responsibility of the temperature regulatory center, which is in the brain (the hypothalamus) to maintain a steady temperature. Excessive heat is removed through the skin and our breath. The normal core body temperature is generally defined as 98.6 ºF (37ºC). The body temperature does fluctuate between men and women, time of the day, environmental exposure, clothing, and many other factors. Fever, an elevation in core body...

Most of us watched the news of Dr. Anthony Fauci on April 29, 2020 announcing positive results of the clinical trial of the antiviral drug remdesivir. This positive news was like a ray of bright sunshine suddenly peeking through the dark clouds that had hung over the nation for last two months. It looks like that we have a winner. As good a news as this is, it is still preliminary and not the magic bullet that we are hoping for. So, I spent hours this morning digging through the sources and here is the story behind the story. The Story: The National Institute of Allergy and Infectious Diseases (NIAID, a division of the NIH, USA) sponsored clinical trial shows remdesivir accelerates recovery from advanced COVID-19. The NIH News Release April 29. 2020.   Story behind the story: The NIAID had launched a multicenter clinical trial of the drug remdesivir in February 2020 in 100 testing sites globally. The drug, given intravenously, was to be tested in hospitalized...

Let us admit: Masks are going to be the new normal. Whether we like it or not, it will become part of our dress for the foreseeable future as we start to return to schools, offices and factories. There are as many questions about masks as the variety of masks out there. There are DIY masks made at home, the one sewn by grandmas, made with 3-D printers, bandannas, surgical masks, the N95, the ones worn by the construction workers, and many more that I cannot even enumerate.   Which one’s work and for what? Do they protect or not? Protect us or the others around us? One thing is clear, any type of mouth and nose covering when in public, is essential. “Normally, you think about wearing a mask to protect yourself,” said Mike Bell, deputy director of the Division of Healthcare Quality Promotion at the U.S. Centers for Disease Control and Prevention. “That’s not what this is about. It’s about not spraying respiratory secretions and spit into the air around you” he said, as he s...

Students, employees, and workers are getting cabin fever during the prolonged lock down and are eager to return to normalcy or the new normal. The authorities are torn between safeguarding the public health vs. allowing resumption of routine social and business activities. So when will it be safe to return to work or school? There is no one answer because each situation and circumstance will be different. One general answer is: When we will have herd immunity. To achieve that goal, we will need to test a lot of people, millions of people. That is easy said, but difficult to do. A key component of herd immunity is to know how many have developed antibodies to the virus and therefore have some level of protection against being re-infected. If we think of the virus as a “body” or a foreign entity that attacks us, then the “antibody” is the substance that is produced to repel and prevent the infection from taking hold. The “antibodies” produced by our immune system ar...

What are Vaccines and How Will they Work against the Coronavirus. Vaccines are most often used to prevent infectious diseases, although they have also been used to treat certain illnesses including cancer.  Most vaccines are given as “shots” while some such as the polio vaccine are given as drops, to be taken by mouth. The classic example is the Polio vaccine that is used to prevent Poliomyelitis, a paralyzing disease of the nervous system. To understand how vaccines work, one needs a basic understanding of the immune system. Almost all living organisms are endowed with an immune system that protects them from foreign invaders such as bacteria and viruses. Even tiny bacteria can become infected with viruses.  When a germ enters our body, it is recognized as “foreign” by the immune system and efforts are mounted to get rid of this invader. Drug manufacturers use this property to develop vaccines. There are many ways by which the tell-tale information of ...

Most living organisms have immune systems that help them stay alive and healthy. But there are times when the immune response overshoots the boundary and becomes dangerous and even lethal to “self “. We know this because during this pandemic, many people are dying not only because of weak immune system but due to overactive immune response. A physiological phenomenon called “cytokine storm” that was unknown 50-60 years ago, is now commonly talked about during the coronavirus pandemic. Before we talk about the abnormal, lets learn a little bit about the normal immune system. Immune system is both “innate” (that we are born with) and acquired (we develop it over our lifetime). It is also classified as cellular (where the main players are cells) and humoral (where the main actors are proteins called antibodies). Innate immune system recognizes tissues that are “self” and rejects or destroys those that are “foreign”. A good example is blood group. An individual who inheri...

Summary of COVID-19 Treatment Guidelines Infectious Diseases Society of America (ISDA) Guidelines on the Treatment and Management of Patients with COVID-19 in my words Published by IDSA , 4/11/2020 The following is my take on the treatment recommendations put out by the experts at the Infectious Diseases Society of America. The original article can be accessed here. Most people who become infected, suffer a mild illness consisting of sore throat, cough and fever. In some cases, the virus infects the lungs causing shortness of breath and pneumonia. For those who are advised hospitalization, the treatments may include intravenous fluids and control of the fever. In more severe cases, breathing support may be needed in the form of a ventilator. Since there is no established treatment for this novel virus, many treatments are being tested. The treatments (clinical trials) are available at most of the major hospitals and institutions.   The experts at the ISDA have th...

ABC: Animals, Bats and Corona Virus Lord Matt Ridley’s report in my words This much we know that an animal was the source of the SARS-CoV-2 virus (the current novel coronavirus). However, was it a bat or a pangolin (a scaly anteater) or perhaps both? It’s not clear. As I sat down to read the paper this past weekend, an article in the Wall Street Journal caught my eye. I thought to share it with my friends. So here it is a report by Lord Matt Ridl ey —in my words. But before I do that, let me share what I have learnt so far about bats. There are about 1,300 species of bats in the world. Some are tiny, as tiny as a bumble bee, while others such as fruit bats can weigh up to 4 pounds and flying foxes have a wingspan of 5 feet. Bats are mammals and can live up to 30 years. Some live solitary lives while others live in colonies of more than a million. Bats have been the source of most of the dangerous new diseases of the past two decades. The natural reservoir of rab...

Possible Treatments for COVID-19 There are no proven methods to treat COVID-19, the illness caused by the novel (new) coronavirus. When the infection is mild, it causes sore throat, cough and low-grade fever.   It is often self-limited and does not require prescription medication. However various treatment options are being discussed in the media. Here is a summary of what was presented by the New York City Health and Hospitals Corporation, Office of Population Health on 4/5/2020. Some of the following drugs are FDA approved, others are not. Some of these drugs are very costly and like all drugs, have potential serious side effects. Although some side effects are universally known, they may vary in intensity based on the individual’s physiology, underlying diseases and health status. It is highly advised that none of these should be taken without being prescribed and without the supervision of a knowledgeable physician. Remdesivir This anti-viral drug has yet not be...

My Dear Family. Greetings First, I want you to know that as of today, we are well. No cough, no fever and no shortness of breath.   Tomorrow is another day, but so far so good. Thank you for your good wishes and prayers. Your telephone and video calls are greatly appreciated. They cheer us up. Today, I write to you about a subject that is not pleasant, so please forgive me if you do not like what I have to say. Today I am writing to you about death and dying. You do know that I am an optimist. So you must be wondering why I am I talking about death and dying. And you have guessed right. It is the coronavirus. No. I am not infected, or at least I don’t think that I am. Thank God, I have no symptoms.   But coronavirus has made me realize how fragile my life is and this little bug can turn it upside down so easily.   The virus has made me think if I am "ready"and "prepared". I don’t fear death, but I do worry if I am ready. Do I have financial, me...