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Today while waiting in a line at the store, everyone wearing the required masks, the woman in front of me told me that the masks are useless and that there isn't good evidence that the coronavirus is spread through the air. Huh? Where did she get that idea? Of course there is airborne transmission of the virus!

It's true that some government agencies are hedging about airborne transmission of SARS-CoV-2 (the virus which leads to COVID-19 infection) , but the scientific evidence for aerosol and droplet transmission of the virus is growing and very clear. [Aerosols are smaller than droplets, and both carry the virus.] Fortunately, the evidence just isn't there for getting this particular virus from touching surfaces (such as doorknobs or faucets) - which originally was a big worry.

The following are some articles that discuss how airborne transmission occurs, why wearing a mask protects us from others exhaling the virus, and also protects us from inhaling the virus and lowers how much virus we are exposed to (cloth and surgical masks protect us from most virus particles, but not all). In fact, some scientists are wondering whether wearing masks so lowers the amount of virus a person is exposed to (viral load), that if a person gets the infection, the body can deal with it much better and the infections may be asymptomatic or minor.

In case you're wondering: being outdoors dilutes and disperses the virus. If you are concerned about the virus spreading indoors - then open a window (to dilute and disperse the virus).

This is a really big deal - the possibility that up to 95% of infections could be asymptomatic! Excerpts from an interesting article by Dr. Monica Gandhi (Prof. of Medicine at Univ. of California) at The Conversation: Cloth masks do protect the wearer – breathing in less coronavirus means you get less sick

It seems people get less sick if they wear a mask.   ...continue reading "Masks Protect Us Several Ways From the Coronavirus"

Several studies are now suggesting that low vitamin D levels are linked to increased risk of getting COVID-19. And if you get COVID-19, low vitamin D levels are linked to a higher risk of developing serious symptoms requiring admission to intensive care,  and also not surviving. These studies are observational and don't prove that vitamin D levels are the cause, but a number of studies from countries worldwide and several lines of research are suggesting the same thing.

The best source of vitamin D is sunlight, but if taking supplements - then take vitamin D3. Researchers, doctors, and medical organizations vary in their recommended dosages, but many (such as Mayo Clinic) suggest 1000 to 2000 IU per day. The minimum daily requirement is 600 IU.

Some studies also suggest that having adequate magnesium is needed for vitamin D to be metabolized well. Good food sources of magnesium are nuts, seeds (especially pumpkin seeds), peanut butter, whole grains, beans, leafy vegetables, some fatty fish (halibut, salmon, mackerel), milk, yogurt, dark chocolate, legumes (beans), quinoa, tofu, and bananas. Daily magnesium requirements are 420 mg for men, 320 mg for women. Food is generally considered a better source than supplements.

However, some researchers point out that having a disease (e.g. diabetes) or chronic inflammation results in lowering of vitamin D levels (and not that low vitamin D levels causes disease). We need good double-blind studies (people randomly assigned to groups, and no one knows who is getting what) to understand if it really is vitamin D that's causing beneficial health effects.

Excerpts from Medscape: Low Vitamin D in COVID-19 Predicts ICU Admission, Poor Survival

Having low serum vitamin D levels was an independent risk factor for having symptomatic COVID-19 with respiratory distress requiring admission to intensive care — as opposed to having mild COVID-19 — and for not surviving, in a new study from Italy. ...continue reading "Vitamin D and COVID-19"

Covid-19 is a weird and scary virus. It turns out that while most people report none or minimal symptoms from a Covid-19 infection, there are also thousands of people reporting prolonged symptoms. Instead of being sick with Covid-19 for 2 weeks or so (the average for mild cases), they get sick with the viral infection and then it never seems to go away. There may be big ups and downs with a wide variety of serious symptoms (including neurological and gastrointestinal symptoms, fatigue, fevers, heart palpitations), but they are still sick weeks or months after the initial infection.

What is going on? People experiencing long-term Covid-19 symptoms refer to themselves as "long-haulers" or "long-termers". Covid-19 is a new and complex disease that seems to attack many organs of the body. It is such a new disease that much is still unknown, including why some people seem to experience Covid-19 symptoms for weeks or months after the initial infection. But some possibilities are emerging, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) . ME/CFS clusters have occurred in the past after many infectious outbreaks, including after the SARS epidemic (a similar coronavirus) of 2003.

Paul Garner, professor of infectious diseases at Liverpool School of Tropical Medicine, has documented his battle with long-term Covid-19 symptoms in the British Medical Journal blog (also June 23 follow-up), and the need for "pacing" during recovery to prevent relapses. [twitter.com/paulgarnerwoof?lang=en ]

There are support groups on Facebook such as Survivor Corps, Covid-19 Support Group (have it/had it), Long Covid Support Group, and Long Haul Covid Fighters. Fiona Lowenstein started a Covid-19 support group (Body Politic Covid-19 support group) for people living with the virus

Bottom line: Don't let others, including doctors, dismiss your symptoms. They are real. Read about the experiences of others and join support groups. The good news is that slowly, over time, most people are reporting improvement. Unfortunately, it will take time for public health officials, including the CDC, to catch up and acknowledge what people are already experiencing.

The following are some good articles to read. Start with Ed Yong's article in The Atlantic: Covid-19 Can Last for Several Months

A first person account of prolonged Covid-19 symptoms. Professor Paul Garner's original British Medical Journal (BMJ) piece for the BMJ blog: Paul Garner: For 7 weeks I have been through a roller coaster of ill health, extreme emotions, and utter exhaustion

From VOX, the site for explanatory journalism: The emerging long-term complications of Covid-19, explained

From VOX: My coronavirus survivor group is my most important medical support right now

The CDC view of ME/CFS (but with no mention of Covid-19). From the Centers For Disease Control and Prevention (CDC): Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

Worrisome news: having a COVID-19 infection during pregnancy may be injuring the placenta, even if the pregnant woman has no symptoms (asymptomatic) and the baby appears healthy at birth. The human placenta is the temporary organ that nourishes and maintains the developing fetus during pregnancy. It provides oxygen and nutrients to the baby, and removes waste products.

A small study by doctors at the Feinberg School of Medicine (Chicago, Illinois) examined 16 placentas after babies were born - 15 in the third trimester (all live, healthy babies), 1 in the second trimester (after the fetus died). The placentas of women who were currently infected with COVID-19 or had it earlier in the pregnancy showed abnormal or injured blood vessels, which can result in insufficient blood flow between the mother and developing baby. Two common types of injuries were abnormal blood vessels (maternal vascular malperfusion) and blood clots in the placenta (intervillous thrombi).

The study authors said that pregnant women should therefore be monitored more carefully, perhaps with non-stress tests (to see how well the placenta is delivering oxygen) or ultrasounds to measure growth. The good news is that currently the evidence does not suggest that pregnant women have more severe COVID-19 infections than non-pregnant women.

Also good news is that the 15 babies born in the third trimester appeared healthy and normal weight (only one was pre-term, but healthy), and that at birth all the babies were negative for COVID-19. Thus, they did not get the infection from their mothers during pregnancy.

Excerpts from Science Daily: Placentas from COVID-19-positive pregnant women show injury

The placentas from 16 women who tested positive for COVID-19 while pregnant showed evidence of injury, according to pathological exams completed directly following birth, reports a new Northwestern Medicine study.   ...continue reading "COVID-19 During Pregnancy"

Two big risk factors are emerging over who will develop severe COVID-19 infections that lead to hospitalizations and needing intensive care. A number of studies throughout the world are reporting that the main risk factor in persons under 60 years is being significantly overweight, especially obesity, and the other risk factor is being over 65 years of age.

What is significantly overweight? A body mass index (BMI) of 30 or more is considered obese - probably 40 pounds or more overweight. For example, a 5 ft 5 inch person weighing 181 pounds or more, or a 5 ft 10 inch person 210 pounds or more. [see BMI chart]

Two studies of New York City hospital patients had similar findings. Doctors at NYU Langone Health (Lighter et al) found that overweight patients who were under age 60 were twice as likely to be hospitalized as their thinner peers, while those who were obese were three times as likely to need intensive care, the study found. And this is in patients who didn't have any other diseases or conditions - they were healthy, but overweight. The medical thinking is that this may because obesity is a state of chronic inflammation.

The scary part is that the US has a very high obesity rate - with the NYU researcher Jennifer Lighter pointing out that nearly 40% of adults in the US are obese with a body mass index (BMI) of 30 or more!

A French study found that a key finding was that those with a BMI of greater than 35 had more than sevenfold increased risk of requiring mechanical ventilation (compared to those with a BMI of less than 25). Studies are also finding that disease severity increased with increasing BMI.

Interestingly, obesity wasn't a predictor of severe disease leading to hospital admission or the ICU (intensive care unit) in those over the age of 60 years. But in those younger than 60 years, it was.

Excerpts from Medscape: Obesity Link to Severe COVID-19, Especially in the Under 60s

It is becoming increasingly clear that obesity is one of the biggest risk factors for severe COVID-19 disease, particularly among younger patients ...continue reading "Being Overweight Is Higher Risk For Severe Coronavirus Infections"

Is male hair loss a risk factor for having a severe infection with COVID-19? An international group of researchers (in a joint letter in Dermatologic Therapy) hypothesize that the reason some people have severe infections of COVID-19 and others only mild symptoms, may be related to the male hormones (androgens) linked to hair loss.

"Male pattern baldness" is considered androgen-dependent hair loss and is known as androgenetic alopecia. Androgens increase in boys at puberty.

As support for their hypothesis of androgen involvement, the researchers point out that a greater proportion of men get severe COVID-19 and also die from it. They propose this possibility as an additional risk factor to consider besides the known ones of older age (over 60) and underlying conditions.

And of course they say that research is now needed to look into this possibility. In a nutshell, their hypothesis is "...the scientific evidence gives us reason to believe that beardy, bald men may be more vulnerable to COVID-19 than other individuals." At this point, who knows?

From Futurity: Hypothesis: Is COVID-19 Severity Tied to Hair Loss?

Researchers hypothesize that the same male hormones that cause hair loss may be linked to the vulnerability of patients to SARS-CoV-2, the virus that causes COVID-19.  ...continue reading "Is There A Link Between Severe COVID-19 and Male Hair Loss?"

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Have you recently lost your sense of taste or smell? Then you may be infected with the coronavirus COVID-19, even if you don't display any other symptoms.

The American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) posted on its web-site that loss of a sense of smell (anosmia) and loss of a sense of taste (dysgeusia) are both symptoms of  COVID-19. Even if there are no other symptoms of COVID-19 - meaning it's a mild case, but it is still infectious and can be spread to others. Reports from South Korea are that about 30% of patients and from Germany that more than half of patients experience this.

It doesn't seem to matter how sick you are, or whether you are congested or not. Nothing seems to help - not nose drops or sprays.  Persons regain their sense of smell and/or taste after a few days or weeks.

It is suggested that loss of sense of smell could be used as a COVID-19 screening tool. Excerpt from the UK ENT group statement posted on the AAO-HNS web-site...continue reading "Loss Of Sense of Smell Or Taste May Indicate You Have Covid-19"

News stories about the coronavirus called COVID-19 now sweeping the globe have stressed that people over the age of 60, or people immunocompromised in some way, or with underlying health conditions are especially vulnerable to the virus. Which led many people to think that in persons younger than 60 getting a COVID-19 infection wasn't a big deal.

However, a report from the CDC (Centers for Disease Control and Prevention) looking at COVID-19 cases in the United States that occurred during February 12–March 16, 2020, found that surprisingly large numbers of younger adults also require hospitalization. They reported that nearly 40% of younger adults with COVID-19 between the ages of 20 and 54 wind up being hospitalized, and that nearly half of people admitted to intensive care units were under the age of 65. And there were some deaths.

On the other hand, no ICU admissions or deaths were reported among persons aged less than 19 years. Whew...

Still, the authors wrote, “these preliminary data also demonstrate that severe illness leading to hospitalization, including I.C.U. admission and death, can occur in adults of any age with Covid-19".

Excerpt from NY Times: Younger Adults Make Up Big Portion of Coronavirus Hospitalizations in U.S ...continue reading "Severe Illness From COVID-19 Can Occur In Adults Of All Ages"

Is blood type important in coronavirus COVID-19? A study of 2173 patients from 3 hospitals in China found that not only is blood type important in the risk of contracting COVID-19, but also in whether one dies from it.

The study found that people with type A blood are more prone to being infected with COVID-19, and also dying from it - as compared to people with other types of blood. People with type O blood had the lowest risk of catching COVID-19 and also dying from it.

The researchers pointed out that these same blood type differences occurred in the earlier SARS outbreak (lower risk in those with type O blood, and higher risk in those with type A blood). The researchers felt that "blood type is a biomarker for differential susceptibility of COVID-19" - meaning how susceptible you are to the virus. And that perhaps it is linked to "natural anti-blood group antibodies, particularly anti-A antibody, in the blood".

The study still has to be peer-reviewed, but what an interesting finding! General article describing the research from Newsweek: RISK OF GETTING COVID-19 COULD BE LINKED TO CERTAIN BLOOD TYPES, CORONAVIRUS STUDY SUGGESTS

Original study (in preprint): Relationship between the ABO Blood Group and the COVID-19 Susceptibility

Novel coronavirus COVID-19. Credit: NIAID-RML

Worried about the new coronavirus? And trying to find accurate information about its spread? As you probably know, the novel coronavirus is called COVID-19 and is now spreading throughout the world, with numbers increasing daily.

There is one great site with a coronavirus global map that is updated numerous times every day. It has been developed by Johns Hopkins University researchers, and actually posts information down to the county and city level, including number of cases, deaths, and recovered. But please note that it really should be viewed on a computer, and not cell phone. Lots of detailed global information. Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE

Interestingly, one can see how some countries are dealing much better with the coronavirus than others. For example, Singapore (about 5.7 million people, and among the best healthcare systems in the world) has 117 documented cases at this time, with 78 recovered, but ZERO deaths. Which means a 0% death rate there. [Note: Unfortunately, the U.S. health care system is not ranked that well - not even in the top 20 globally]

The NY Times has a much simpler tracking map for the United States, with fewer details, along with an explanatory article.

We now know that most people (at least 80%) with the coronavirus don't have symptoms at all or only minor symptoms (whew!), but this allows the virus to spread "stealthily" through communities. So keep in mind that any map with "reported cases" is only recording those who have sought both medical care and been tested.

The goal is to try to slow down the spread of the virus until effective antivirals are available and good treatment protocols are in place. Studies are now ongoing (with results hopefully in a few weeks), with many thinking that the best antiviral may turn out to be remdesivir. Of course other drugs and vaccines are in development. Even older drugs such as chloroquine (an anti-malarial) are being looked at.

Best protection advice: 1) wash hands thoroughly with soap and water for 20 seconds, 2) keep your fingers away from your face - especially the eyes, nose, and mouth, 3) try to keep a social distance of at least 3 feet (better 6 feet) from other people, and 4) cough and sneeze into your elbow, or into a tissue which you then dispose of into garbage or a plastic bag. Stay home if feeling sick. And stay calm!

And for a little humor regarding the mass stampede for supplies and resulting bare shelves. (Make sure to look at photos): Costco completely out of divination supplies, thanks to artist  And: Coronavirus panic-buying in Australia is weirdly, obsessively focused on toilet paper.

Novel coronavirus COVID-19. Credit: NIAID-RML