Ventilation, masks stop Covid spread better than social distancing

A modeling study has suggested that masks and a good ventilation system are more important than social distancing for reducing the airborne spread of COVID-19 inside a room.

In the research, published in the journal Physics of Fluids, the researchers created a computer model of a classroom with students and a teacher, Press Trust of India reported.

They then modelled airflow and disease transmission, and calculated airborne-driven transmission risk.

The classroom model was 709 square feet with 9-foot-tall ceilings, similar to a smaller-size classroom.

The model had masked students — any one of whom could be infected — and a masked teacher at the front of the classroom.

“The research is important as it provides guidance on how we are understanding safety in indoor environments,” said Michael Kinzel, an assistant professor at the University of Central Florida in the US.

“The study finds that aerosol transmission routes do not display a need for six feet social distancing when masks are mandated,” Kinzel said.

The study highlights that with masks, transmission probability does not decrease with increased physical distancing, which emphasises how mask mandates may be important to increasing capacity in schools and other places, according to the researchers.

The team examined the classroom using two scenarios — a ventilated classroom and an unventilated one — and using two models, Wells-Riley and Computational Fluid Dynamics.

Wells-Riley is commonly used to assess indoor transmission probability and Computational Fluid Dynamics is often used to understand the aerodynamics of cars, aircraft and the underwater movement of submarines.

Masks were shown to be beneficial by preventing direct exposure of aerosols, as they provide a weak puff of warm air that causes aerosols to move vertically, thus preventing them from reaching adjacent students, Kinzel said.

The researchers noted that a ventilation system in combination with a good air filter reduced the infection risk by 40 to 50 per cent compared to a classroom with no ventilation.

This is because the ventilation system creates a steady current of air flow that circulates many of the aerosols into a filter that removes a portion of the aerosols compared to the no-ventilation scenario where the aerosols congregate above the people in the room.

These results corroborate recent guidelines from the US Centers for Disease Control and Prevention (CDC) that recommend reducing social distancing in elementary schools from six to three feet when mask use is universal, Kinzel said.

“If we compare infection probabilities when wearing masks, three feet of social distancing did not indicate an increase in infection probability with respect to six feet, which may provide evidence for schools and other businesses to safely operate through the rest of the pandemic,” Kinzel said.

The results suggest exactly what the CDC is doing, that ventilation systems and mask usage are most important for preventing transmission and that social distancing would be the first thing to relax, the researcher added.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Beware of Signs That Confirm COVID-19 is Spreading in Your Lungs

COVID-19 is associated with various complications and the most severe ones begin appearing when the SARS-CoV-2 starts spreading in your lungs. This is the time when your condition may start worsening and you can start experiencing other pulmonary and lung complications. COVID-19 reaches this stage when you are not able to diagnose the condition in its preliminary phase. Here, we tell you about a few warning signs to look for in order to avoid the development of the complication.

SARS-CoV-2 divides and increases in number in your chest linings. This is how it further causes inflammation and also creates a blockage in your chest. This causes constant coughing. If you are experiencing a dry cough and that persists for at least 2 weeks, you need to consult a doctor as it is a sign of lung infection. 

Shortness of Breath

When the COVID-19 causing virus enters your lungs and blocks the entry point of oxygen to the lungs, you feel shortness of breath. A dip in your oxygen level can turn fatal and you may require ventilation support.

Chest Pain

COVID-19 can cause lung damage and that can lead to chest pain. If you suddenly start feeling this symptom, you need to consult a doctor as it can be a sign of severe COVID-19 infection.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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ARDS is a Common Cause of Death in Critically Ill Coronavirus Patients—Here's Why

The majority of people—about 80% according to research—only suffer mild symptoms with COVID-19. Others may require hospitalization—but for some patients, the new coronavirus can be deadly.

One life-threatening complication that can arise is acute respiratory distress syndrome, commonly referred to as ARDS. And new research from the JAMA Internal Medicine suggests that more than 40% of individuals in the study hospitalized for severe and critical COVID-19 developed ARDS—and over 50% of those diagnosed died from the disease.

What exactly is ARDS?

The American Lung Association (ALA) says ARDS is a rapidly progressive disease that can occur in critically ill patients—most notably now, in those diagnosed with severe illness resulting from coronavirus.

ARDS is sometimes initially diagnosed as pneumonia or pulmonary edema (fluid in the lungs from heart disease), and, per the ALA, those with ARDS often have severe shortness of breath, cough, and fever. Fast heart rate and rapid breathing also shows up in ARDS patients, along with chest pain, particularly during inhaling. "ARDS is manifested as rapid and progressive shortness of breath," Shervin Takyar, MD, PhD, a Yale Medicine pulmonologist, tells Health.

The disease can be caused by direct injuries to the lungs (pneumonia, aspiration, near drowning, or smoke inhalation), or indirect injuries to the lungs (sepsis, blood transfusions, or medication reactions). While many still won't develop ARDS even with those injuries, some risk factors—like a smoking history, oxygen use, obesity, and recent chemotherapy—can increase a person's risk of developing the disease.

How is ARDS treated and what are the complications?

In most cases of ARDS, patients will have to be supported by supplemental oxygen and mechanical ventilation soon after the start of their symptoms, says Dr. Takyar. When their blood oxygen levels remain low, patients may be flipped on their stomachs—into a prone position—to get more oxygen into their blood, says the ALA.

Proning is literally turning people over on their bellies, instead of having them on their back on a ventilator, Jeanne Marrazzo, MD, professor of medicine in the infectious diseases division at the University of Alabama at Birmingham, explained during a recent media briefing sponsored by the Infectious Diseases Society of America. "And when you do that in a cycle, you get better oxygenation, and the outcomes are incredible," per Dr. Marrazzo.


In some cases, if inflammation and fluid in the lungs persists, some ARDS patients will develop scarring of the lungs (the fibrotic stage of ARDS). In others, the lung or lungs can eventually pop and deflate, leading to a pneumothorax or a collapsed lung.

According to the American Thoracic Society, the death rate for ARDS shows that it has a mortality rate of 30-40% of those diagnosed with the disease. In those who recover, lung function gradually improves over six months to a year, and even then they're left with significant scarring and lower than normal lung volumes. Those who survive ARDS can also go on to suffer from anxiety, depression, and PTSD from the impaired quality of life and lung function, Gregory P. Cosgrove, MD, Chief Medical Officer of the Pulmonary Fibrosis Foundation, tells Health.

How does COVID-19 lead to ARDS?

Similar to many other viruses, coronaviruses—including the novel coronavirus, or SARS-CoV-2—can infect and damage the lung cells, setting the stage for the occurrence of ARDS, explains Dr. Takyar. “It is thought that the infection-induced damage and inflammation cause a malfunction of the lung vasculature [the pulmonary vessels within the lungs]," he says. When that happens, the exchange of oxygen within the body is impaired. Among viruses, the ones that cause pneumonia (like COVID-19) are more likely to cause ARDS.

When patients are in the late stages of novel coronavirus infection—after severe damage has already been done to their lungs—their body will try to fight off the virus by sending immune cells to the lungs, which is what ultimately causes the inflammatory reaction, explains Dr. Takyar. In fact, ARDS in coronavirus “seems to be less directly due to the virus itself and more related to inflammation, or the body’s response to the virus,” adds Jaimie Meyer, MD, a Yale Medicine infectious disease specialist. 

While experts are still in the early stages of learning about COVID-19, research surrounding ARDS and coronavirus has found that the two often go hand-in-hand. According to the earlier JAMA study, researchers also concluded that an older age translated to a higher risk factor of developing ARDS and dying, "likely owing to less rigorous immune response," per the study authors. Additionally, the authors noted that if an ARDS patient was running a higher fever, they were more likely to recover, due to the body fighting off the infection.

An alternate study published in January in The Lancet also found that ARDS can develop incredibly quickly in critically ill coronavirus patients. Those researchers found that ARDS developed in 17% of those diagnosed COVID-19, among whom, 11 worsened in a short period of time and died of either ARDS or other serious complications like multiple organ failure.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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What Is a Cytokine Storm? Doctors Explain How Some COVID-19 Patients' Immune Systems Turn Deadly

 The immune system is there to help us fight infection, but sometimes it wreaks more havoc than the disease itself.

The news cycle is heavily saturated with stress-inducing information about COVID-19, but one of the most worrying aspects so far has been the huge disparity in the way the novel coronavirus presents itself: Why do some people have no symptoms (or only mild ones), while others are so sick they require ventilation?

There isn’t a definitive answer, but many experts suspect our own immune system is to blame for the intense illnesses some people are experiencing. The immune system is there to help us fight infection—and usually it does—but sometimes it goes rogue, wreaking more havoc than the disease itself.

It’s called cytokine storm syndrome (known more broadly as a cytokine storm), and although no one knows for sure how many COVID-19 patients are becoming very ill as a result of this escalated immune response, it’s reasonable to assume that the condition's responsible for at least some of the coronavirus-related fatalities we’ve seen. Here’s everything you need to know.
What is a cytokine storm?

Whenever a healthy body is fighting an infection, there’s a natural immune system response that occurs. According to Carl Fichtenbaum, MD, professor in the division of infectious diseases at the University of Cincinnati College of Medicine, part of this response involves releasing cytokines, biological chemicals that stimulate cell pathways and allow for communication between cells. These cytokines, according to the American Cancer Society, essentially signal the immune system to start doing its job.

Again, that’s normal—unless this outpouring of cytokines suddenly becomes accelerated. "Normally, cytokines are meant to be helpful to us in moderation," explains Dr. Fichtenbaum, "but when a certain pathway is engaged [too much] the immune system starts causing damage to the patient."

Dr. Fichtenbaum says that when most people hear the term "storm," they think of a raining downpour, but that’s not the most accurate way to explain a cytokine storm.

Clinically speaking, a cytokine storm means a cell pathway has been turned on, leading to the production of a number of biological mediators (which are kind of like signal transmitters) that cause changes to the body and interfere with normal cell function. Commonly, this means an excessive number of cytokines are released, which create high levels of inflammation in the area of the body being flooded—so much inflammation, even, that it can be fatal.

"Imagine that you put your foot on the accelerator and it gets glued to it," Dr. Fichtenbaum says. "You can't get your foot off the gas to slow down your car." Essentially, these storms can be more deadly than the original virus the body is fighting.

Are these storms occurring in patients with COVID-19?

Yes, and clinicians aren’t surprised: Cytokine storms can be instigated by a number of infections, including influenza, pneumonia, and sepsis. This heightened immune response doesn’t happen in all patients with severe infections, obviously, but experts don’t know what makes some people more susceptible than others.

That’s especially true with COVID-19, since we know so little about how it works. What doctors do know, at this point, is that some patients are simply becoming very sick, very quickly.

"We’re seeing people across the course of this illness respond in a hyper-inflammatory way," says Deepa Gotur, MD, a critical care physician at Houston Methodist Hospital. "It’s a cascade of cytokines affecting the patient’s lungs, heart, kidneys. The extent [to which their bodies are overreacting] is similar to the way cancer patients respond to infection."

Most of the COVID-19 patients experiencing cytokine storms are presenting with fevers and shortness of breath, then having so much difficulty breathing they eventually require ventilation, says Dr. Gotur. This typically occurs about six or seven days after the onset of illness.
How are cytokine storms detected and treated?

There’s no way to test whether or not someone is experiencing a cytokine storm, though bloodwork may give clinicians clues that a hyper-inflammatory response is happening. "Some clinicians and investigators have been suggesting we do certain blood tests upon hospital admission for warning signs that this might be an impending problem, but that’s a theoretical idea that hasn’t been proven at this time," explains Dr. Fichtenbaum.

Otherwise, doctors are looking at how individual patients are presenting, such as if they are continuing to have breathing difficulty despite receiving oxygen. That might mean their bodies are being flooded with cytokines.

As far as treatment, there are several interventions, like ventilator intubation and extracorporeal membrane oxygenation (ECMO). Doctors are also paying close attention to how patients are responding to some of the treatments being used, like antibody plasma infusions, protein binding medications, and stem cell therapies.

Dr. Fichtenbaum says some clinicians are also using a medication that blocks interleukin-6 (IL-6), one of the key biological mediators responsible for cytokine storms. Anecdotally, these doctors are reporting improvement when treating COVID-19 patients with anti-interleukin-6 medications (or IL-6 inhibitors), which is encouraging, but it’s not a well-studied treatment.

What are the outcomes for patients who experience a cytokine storm?

There isn’t much data available on how many patients recover from cytokine storms, especially ones caused by the novel coronavirus, though Dr. Fichtenbaum says the fatality rate is higher for patients who experience this heightened inflammatory response.

What’s more, Dr. Gotur says that since many people are already experiencing a storm by the time they finally get themselves to the hospital, it’s often difficult to avoid serious interventions like life support and ECMO.

Still, her team is working hard to prevent patients from ever reaching the storm phase. At Houston Methodist, clinicians have mobilized to determine how to treat every patient in every stage of the disease, using all their resources—from experimental medications to oxygen treatments—in hopes avoiding the kind of hyper-inflammatory response that requires more serious interventions or, ultimately, can lead to fatalities.

"We quickly realized we needed to start utilizing our resources earlier to prevent patients from being intubated or going on life support," Dr. Gotur says. "Our mortality is low because we have a set algorithm and approach for every stage of this disease process. We have instances where we feel we have prevented the patient from needing a ventilator or ECMO support."

Moving forward, Dr. Fichtenbaum says it will be important for experts to perform controlled studies to answer a few key questions if we want to have better outcomes for patients regarding cytokine storms:

    Who is at most risk, and is there a way we can predict a storm before it happens?
    Can preemptive strategies and therapies be successful?
    Once a storm happens, can we treat it effectively with mediator blockers or other medications that interfere with the cytokine storm pathway?

We don’t currently have that research, but clinical trials are ongoing in the midst of the pandemic, with clinicians tracking and reporting on all of the medications, therapies, and strategies they’re using to treat COVID-19 patients. With more answers, we could hopefully see more patient recoveries and success stories, too.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement