Khalid Simply Says

  Millions of doses of different Covid vaccines are now available. Which one should one get, is the question? My answer: Whichever is available in your community. All of them are effective, although none is 100% effective. It is however certain that vaccines will reduce the severity of the infection even if they cannot fully protect us against the virus. Does everyone develop immunity after vaccination? We hope so. It depends on many factors. Individuals with less robust immune system due to factors such as age, underlying health conditions and current medications, may not develop enough protection. Some vaccines may have degraded during storage and transportation. We must be kept in mind of reports of fake vaccines that are being sold in some countries. The race to develop and produce large quantities of vaccines against the coronavirus is on. Whereas many countries have developed vaccines and are on their way to vaccinate their respective citizens, billions of the people in the...

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 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...

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...

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...

Let’s Flatten the Curve The Covid-19 illness caused by the novel coronavirus has introduced many words and phrases in the routine conversations. Flatten the Curve is one of them. The medical experts on TV networks are telling us that one of the essential components of the war against coronavirus is to "Flatten the Curve". The concept has been described many times in the media but for some who may have missed it, let me explain: If the case numbers of the Covid-19 illness are plotted on the graph paper, it will have a bell-shaped curve. There will be a beginning, a peak, and then it will bottom out.   If the virus affects a lot of people at the same time, the peak of the curve will be very slim and tall, and the base will be narrow. So, if one thousand people get sick over one week, it will yield a curve with small base and a tall peak. (see the diagram) If one were to look at a flat curve, it’s top will be rounded and will look like a rainbow arc. In ...

Of Ventilators, Inhalers and Nebulizers Anyone who suffers from asthma has heard of inhalers and nebulizers. The term ventilator is rather new for some of us. In the times of coronavirus, it is good to know the what these terms mean and how are they used in our health care system. Breathing, like the beating of the heart, are autonomous functions of the body. They go on, on their own and are vital to our survival. Unless we pay attention, we don’t even know that we are breathing. That however is not the case for people who have some form of lung or respiratory disease.  The air passages start at the nose and mouth. The air that we breath, passes through the air pipe called the trachea , then through the two branches called  bronch i, one going to the left and the other to the right lung. There are certain conditions such as allergies and infections that can cause the airways to narrow. The allergies cause them to constrict and the infection/inflammation cause...

How to Navigate the Corona Virus Sharing useful information from the Wall Street Journal Edited and summarized by Khalid Rehman. MD How to Navigate Corona Virus was published in the Wall Street Journal on Friday March 13, 2020. I found the information accurate, clear and timely and have summarized it here. What is Corona Virus and where did it come from?: The scientific name of this new (novel) virus is SARS-CoV-2 and the illness it causes is called COVID-19. It belongs to the Corona Virus family. SARS and MERS viruses are the other notable members of this family. It generally infects bats and small mammals. It is believed to have been transmitted to humans from a small mammal in the city of Wuhan in China. It is highly infectious and is transmitted through particles spread during coughing and sneezing. How do you know if you have it? The virus can cause mild flu like symptoms as well as lower respiratory infection like pneumonia. The early symptoms are sore thr...

Do I have common cold or Corona Virus? All of us have had viral infections sometimes in our lives. Common cold, the stomach virus and Influenza virus are some of the more common ones. The current worldwide epidemic named COVID-19 is a respiratory tract illness that is caused by a virus that belongs to the corona virus family. The official name of the virus is SARS-CoV-2. The other well-known viruses in the corona virus family are SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) viruses. The common way to diagnose infections is to culture the germs, e.g. for suspected strep throat, the doctor takes a swab from the throat and sends it to the lab for culture. The lab grows the bugs in the petri dish and report back to the doctor’s office in day or two. Unfortunately, viruses cannot be grown in the petri dish. So how do we diagnose viral infections?   There are essentially two methods: One is to determine if the patient has the in...