12Coronavirus outbreak US map for March 19, 2020.
The State Department on Thursday issued a a severe warning to American travelers abroad amid the coronavirus pandemic: return home or seek shelter elsewhere.
President Trump, meanwhile, said the Federal Drug Administration has made “very encouraging” progress in testing potential treatments, though FDA officials couldn’t say when a remedy would be available.
“We slashed red tape to develop vaccines and therapies as fast as it can possibly be done, long before anybody else was even thinking about doing this,” Trump said.
Here’s what else we learned today:
- One New Jersey family has now lost four members to the coronavirus.
Elected officials fall ill
- Two members of Congress have tested positive for coronavirus, Florida Rep. Mario Diaz-Balart and Utah Rep. Ben McAdams.
- The cases have sparked fears that the illness will spread among lawmakers and that vital virus legislation will be delayed.
- But GOP Senators appeared confident they were close to a deal on sending $1,200 to most Americans to counteract the economic woes caused by the coronavirus.
Coronavirus and the young
- A Centers for Disease Control and Prevention report says one in five coronavirus patients hospitalized in the US is under the age of 44 — although more older people actually die from it.
- The Red Cross warned of a critical blood shortage caused by the virus and is urging healthy, young Americans to help their country and donate blood.
- It’s no time for spring break. Florida Gov. Ron DeSantis declared the “party’s over” as he announced the state will enforce CDC guidelines to prevent large crowds on any beach in the state.
- Young people in New York City have already begun pitching in, delivering groceries and other supplies directly to the doors of elderly residents.
Put a lid on it
- Starbucks baristas have begun urging the coffee giant to close down stores to keep thousands of workers out of risk from the virus.
- The Bank of America warned that the US economy has fallen into a recession because of the coronavirus pandemic that will make for a “brutal” three months ahead, with lost jobs, destroyed wealth and battered confidence.
- But US stocks stabilized slightly Thursday, closing slightly higher as central banks took additional measures to ease Wall Street’s fears about the epidemic.
Italy’s death toll
- Italy’s fatalities from the coronavirus have surpassed China, with so many dead that soldiers were brought in to haul away coffins and health care workers said they stopped counting bodies.
In New York
- The city’s first drive-thru coronavirus testing facility opened on Staten Island Thursday, with several hundred appointments booked on the first day.
- The head doctor at Rikers Island warned that a “storm is coming,” predicting that the coronavirus will inevitably spread through the city’s vast jail complex unless precautions are taken.
- An Amazon warehouse worker in Queens tested positive for the coronavirus, the first known case among the company’s warehouse employees in the US.
- A 76-year-old Queens man infected with COVID-19 died after being sent home from a hospital to self-quarantine.
And some good news
- Dolphins have been spotted in Italy’s now much clearer waterways, a rare sight as the country grapples with a total shutdown amid a coronavirus crisis.
- Tom Hanks, who has tested positive for COVID-19 along with his wife, keeps fighting the disease: “He’s not great, but still OK,”
COVID-19 vaccinations in patients with inflammatory bowel disease
Advances in the treatment of patients with inflammatory bowel disease (IBD) have substantially improved disease activity and quality of life, and reduced hospitalization rates and the need for surgery. However, prolonged immunosuppression in these patients can result in increased susceptibility to opportunistic infections. Many of these infections are preventable through vaccination and immunization strategies that should be undertaken as early as possible after diagnosis because the risk of opportunistic infections increases following the first year of immunosuppressive therapy.
The COVID-19 pandemic has led to substantial concerns for patients with IBD who are on immunosuppressive medications, many of whom are using additional protective measures. Although early COVID-19 studies have suggested that immunosuppressive medications are safe, robust and reproducible data are not available to adequately risk stratify patients with IBD, and current measures are mostly based on observational studies and theoretical risk.
Large scale, prospective, population-based registry studies, and meta-analyses have identified key risk factors associated with a higher probability of mortality from COVID-19, including age, socioeconomic deprivation, diabetes, respiratory disease, obesity, and being from a Black, Asian, or other minority ethnic group.
One of the best ways to mitigate the risk of COVID-19 is the rapid development of safe and effective vaccines. Although initial phase 1/2 studies are promising,
patients on immunosuppressant medications have largely been excluded from these studies, creating potential future concerns regarding the safety and generalisability of outcomes for individuals with IBD.
To achieve a sufficient degree of herd immunity, vaccination programs are primarily successful only when there are high rates of coverage and acceptance. The importance of patients with IBD being included in vaccine trials is compounded by the concern that these patients have a lower response to vaccinations and that vaccinations are generally underused in this population. Melmed and colleagues
showed that in patients with IBD there was an uptake of only 22–46% for the influenza vaccination, and a mere 9% were vaccinated for pneumococcal pneumonia, despite both vaccines being recommended in the British and European IBD guidelines for vaccinating patients.
A patient survey showed a perceived lack of benefit from a vaccination as the most frequent reason for low vaccine uptake, as well as concerns regarding side-effects, risk of disease flares, needle aversion, and inconvenience.
However, in the present pandemic, both perception of risk and health awareness might be very different, with implications for vaccine acceptance.
In patients with IBD who were vaccinated against influenza, an immune response was induced, but the use of concomitant infliximab and immunomodulatory therapy were associated with inadequate rates of seroconversion.
In adult populations vaccinated with the pneumococcal vaccine PSV-23, an impaired immune response was shown in patients with Crohn’s disease taking combination immunosuppressive therapy.
Other vaccines such as those against hepatitis A and B virus, tetanus, and herpes zoster have also been shown to be potentially less effective in patients with IBD than in control groups.
The extent to which medications might affect vaccine response, independent of underlying disease activity, is unclear. Of note, concurrent anemia, which is a common finding in patients with active IBD, might impair response to vaccinations.
There is therefore an urgent need for a better understanding of both the effectiveness of potential vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with underlying health conditions, as well as the potential impact of effective disease control on rates of vaccine response.
Currently, the candidate vaccines in phase 3 trials include inactivated, mRNA, or vector-based approaches. The classic inactivated or live-attenuated vaccines raise safety concerns due to possible induction of the disease. However, the ChAdOx1 nCoV-19 trial vaccine uses a replication-deficient chimpanzee adenovirus to deliver a SARS-CoV-2 protein to induce a protective immune response. This vaccine seems to be promising for patients with IBD because adenovirus vectors do not integrate the viral genomic DNA into the host’s genome, are highly immunogenic, and can induce robust innate and adaptive immune responses. The same adenovirus vaccine platform is also being assessed for use against malaria, HIV, influenza, and the Ebola virus.
Nevertheless, the phase 1/2 trials of the ChAdOx1 nCoV-19 vaccine were done on young, healthy volunteers and as such do not address the potential immunity concerns in patients with chronic diseases or those on immunosuppressants.
Moreover, we cannot assume that data on one vaccine type in a specific group of people can be extrapolated to other vaccine types.
There needs to be a stronger emphasis on vaccinating patients with IBD within the broader health-care preventative scheme. These factors must be considered when policymakers and national health services start to design and develop future COVID-19 vaccination programs. Equitable access to COVID-19 vaccination programs should be endorsed. If this is not feasible, then we propose that future community vaccination programs support and promote vaccines that can be used by the high-risk cohort of patients with IBD.
Having been under virtual house arrest for some time, it’s easy to get carried away with the excitement of a short break, post Covid-19. You’re taking in new sights, sounds, smells and tastes. It’s an adventure for the soul. But rich foods and drinks, lack of exercise and the stress of travel, particularly with young children, can take a toll on your health. To avoid paying for it later on, take a few steps to remain healthy.
REMEMBER TO GET ENOUGH SLEEP
A holiday after such a stressful period for everyone might be much welcomed, but don’t neglect your sleep patterns. Aim for six to nine hours a night and take a short nap in the afternoon if you need it.
WASH YOUR HANDS OFTEN
Stop germs in their tracks. Remember: wet, lather, scrub, rinse, and dry. This isn’t just good advice in a pandemic, it’s important every single day of your life. Practice it frequently throughout the day to prevent spread of diarrhea and respiratory disease, too. PACK SMART While it’s great to finally be free to enjoy a break, beware of the holiday cheer. Many hotels offer complimentary drinks, snacks or cakes. The result can be hard on your system. Pack Udo’s Choice Ultimate Digestive Enzyme Blend, to aid your digestion. A unique blend of seven plant-based digestive enzymes assist in the breakdown of proteins, fats, carbohydrates and fibre. Udo’s Choice Super 8 Microbiotic is a hi-count microbiotic blend that contains eight strains of lacto and bifido bacteria. Each daily capsule contains 42 billion ‘friendly’ bacteria. Both products can be found in your local health food store or pharmacy.
ALWAYS KEEP HYDRATED
Drink lots of water. Spending hours travelling can dehydrate you. Carry a large bottle of water to have throughout your journey, and pack Manuka Lozenges with vitamin C for an added immune boost and try to choose caffeine free drinks throughout the day.
If you’re staying by the sea, eat lots of fresh grilled fish. Oily fish –including sardines, fresh tuna, salmon and mackerel – is particularly good as it’s rich in Omega 3, which keeps your skin hydrated and encourages healthy digestion as well as weight loss. Try to eat a variety of different coloured fruits and vegetables – oranges, red peppers, green courgettes, yellow sweet corn – to get a wide range of antioxidants.
PROTECT FROM THE SUN
Lying in the sunshine feels great but you only need 10 minutes of unprotected sun to get your daily dose of vitamin D. After that you should use sunblock. As we get older, the collagen in our skin breaks down more rapidly, leading to lines, wrinkles and discolouring. To prevent the breaking down of collagen, eat lots of purple fruits, such as fresh blackberries, blueberries and black grapes.
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