CORONAVIRUS UPDATE

This is an update to the post https://l-dove.blogspot.com/2020/01/what-you-need-to-know-about-coronavirus.html about coronavirus. In this post, let’s take a look at the following:

WHO’S AT RISK?

HOW DO YOU KEEP YOUR LOVED ONES AND YOU SAFE?

HOW DO YOU MAKE YOUR HAND SANITIZER AT HOME BASED ON RECOMMENDATIONS FROM WORLD HEALTH ORGANIZATION?

OVERCOMING FEAR IN A PERIOD LIKE THIS

WHO’S AT RISK

Risk factors are conditions, characteristics, or features that increase the likelihood of someone contracting a disease or developing a condition. They are usually underlying. According to the World Health Organization, the elderly and those with other underlying medical conditions are at risk of suffering more severe forms of the COVID-19. For this book, there are three broad categories of people who are risk of contracting the COVID-19 or for the development of severe forms of the disease. They are the following:

• People with poor immune systems
• People with comorbidities
• The elderly.

INDIVIDUALS WITH POOR IMMUNE SYSTEMS

The immune system refers to the defence mechanism of the body. Our bodies come in contact with germs and dangerous microorganisms every day that can cause diseases of varying degrees and severity. These include viruses (such as the coronavirus), bacteria, parasites, and other microscopic pathogenic groups. Without a means of preventing them from getting into our bodies or pushing them out peradventure they enter, we will be down with one sickness or another all the time. The immune system serves as the security officers guarding the various gateways into our bodies. These gateways include all openings (such as our eyes, ears, mouth, nose et cetera) and broken skin (a cut on the skin).

The human system is divided into two main classes namely: acquired and innate immune system. The innate immune system is nonspecific, attacking all foreign entrants into the body with the same vigour at every encounter because it does not keep their information stored. An example of the innate, nonspecific immune system is an uncut skin. A skin without cut ensures that no pathogen regardless of the type comes into the body.

Without going too deep into the vast field of immunology, the acquired immunity has links with the innate immunity. In this case, the immunity is learned over time as the body comes in contact with foreign particles, hence, the name was given to it. It is specific because a particular foreign body will elucidate a different acquired response from another one. For instance, the pathway of immunity triggered by bacteria is different from those triggered by viruses. The specific immunity acts faster on the second contact with the same invading particle because it immediately recognizes it. B-cells and T-cells are the mediators of the specific immune system. While B-cells produce antibodies, T-cells secrete chemicals that can get rid of specific pathogens.

Individuals with a poor immune system may be immunosuppressed, immunodeficient, or immunocompromised and are unable to adequately protect themselves against invading particles. These are immunologic terms but the bottom line is that an individual in any of the categories will not enjoy robust immunity. Therefore, they easily fall prey to infections with greater severity. A lot of things can render the immune system of a person poor.

LIFESTYLE: Alcohol and tobacco consumption are lifestyle habits that have been linked to a poor immune system.

POOR NUTRITION: Using the computer language, ‘GIGO,’ it is garbage-in, garbage-out. A body system well-fed with a balanced diet can fend off invading foreigners faster and better than a malnourished system.

DISEASES: Some infections such as the Acquired Immune Deficiency Syndrome (AIDS) particularly attack the immune system, rendering it vulnerable to infections caused by some other types of microorganisms. As a result, COVID-19 will be of a more severe consequence in an individual with AIDS than someone without. Individuals in this category are classified as being immunodeficient, referring to the inability of the body to mount up sufficient immune response.

Pregnant women usually become immunosuppressed when in the state. However, there has been no certified link between pregnancy and the severity of COVID-19. On the other hand, approximately the same rate and outcome of COVID-19 has been observed among pregnant women and those without. Also, it is not clear if pregnant women can pass the virus to their unborn children or if it has any adverse effect on them.

THE ELDERLY

According to the World Health Organization, COVID-19 is more fatal in persons older than 65 years with a rate of fatality as high as 50% compared to people below 50 years of age. As we grow older, our bodies also age. As a result, with an increase in age comes a reduction in the immune system response. The body becomes easily overwhelmed by invading foreign bodies (new or old) because of its decreased ability to fight back. B-cell and T-cell production against antigens (invaders) decreases. Naïve T-cells and B-cells are those cells not yet exposed to any foreign particle. In aged adults, the synthesis of these types of naïve cells becomes significantly impacted. So, the immune response in the advent of infection is not always robust. Likewise, the activity of matured lymphocytes in secondary lymphoid tissues reduces. Therefore, older people are more susceptible to COVID-19 and are likely to suffer more severity upon infection. Why this process occurs with ageing is not understood, but it is ascribed to multiple intrinsic factors. Nevertheless, this does not infer that aged individuals are immunodeficient. They are rather referred to as being immunosenescence.

PEOPLE WITH COMORBIDITIES 

People with pre-existing conditions are other groups susceptible to the contraction of COVID-19. They are most likely to suffer more severe forms of the disease as well. The underlying factor is the reduced immune system or immunosuppression caused by the pre-existing disease or condition. Individuals with chronic respiratory disease, hypertension, diabetes, cancer and cardiovascular diseases have been shown to suffer from a more severe form of the COVID-19, often with resulting complications after viral resolution.

Although I said earlier that the people at risk for coronavirus will only be grouped into three categories for this book, it is expedient that we consider a fourth class of ‘at risk’ individuals- the health practitioners.

In a period of lockdown, health practitioners still need to go to work, coming in contact and working on what everybody is running away from. Although there is protective equipment available, it is no longer news that even the most sophisticated and developed nations are running out of stock. Aside from having contact with infected sources, other predisposing factors make health practitioners vulnerable to the 2019 n-CoV. Many of the facilities taking care of the corona-infected patients are full, placing the health workers under enormous stress. Poor feeding habits, lack of adequate sleep, emotional and psychological stress, not to mention the long working hours without break can induce reduced immune abilities. Hence, the coronavirus will do well in such a host once it gets the opportunity to establish an infection.

PREVENTION AND TREATMENT

Currently, no treatment exists for the COVID-19. In the same vein, there are no vaccination or immunization programs available to curb the menace of the virus. Therefore, the keyword is PREVENTION. 

Unlike the treatment, the routes of transmission of the 2019 n-CoV are known. They include coming in contact with an infected person, object or aerosols through coughing, sneezing, hugging et cetera. As a result, the following are suggested ways on how to prevent the virus from spreading and causing more havoc.

• Social distancing: Practice safety by keeping the recommended 1 m distance between you and the next person. While social distancing advocates limited contact between two persons during this period, it does not support discrimination in any way. Therefore, politely ask the person near you to keep a distance if you are not comfortable with the proximity between you.  
• Stay at home: Many countries are on lockdown, not because they like to go on vacations or holidays but as a result of their understanding of the threat further spread of the virus poses. The virus spreads very quickly, almost as fast as the influenza virus but with a longer incubation period. Because of this stage of hibernation, identifying infected individuals will be difficult. However, with the sit-at-home order, less contact occurs among people which in turns leads to the lesser spread of the infectious agent.
• Maintain excellent personal hygiene: Topping the list on hygiene maintenance is the well-advocated hand-washing practice. Most of us use our hands for many things, clean or unclean. Research has shown that our hands are the number one culprits when it comes to fast transmission of infections. An uninfected person can contract the virus by touching an infected source, then, going around with that hand unwashed. Good handwashing techniques are, therefore, necessary to keep the virus at bay.

• HAND WASHING STEPS
• Using little quantity of clean water, wet your hands a little
• Apply the desired soap and rub hands until it lathers
• Thoroughly wash the hands for the next twenty seconds. Ensure that all crevices are touched
• Rinse under clean running water
• Dry your hands using disposable or clean hand towels
• WHEN DO I WASH MY HANDS?
• Before, during, and after preparing food
• Before and after eating
• Before and after handling a sick person.
• After paying a visit to the toilet
• After handling garbage
• After touching an animal, pet or otherwise
• After coughing, sneezing, or touching the nose

These are some of the instances where we are required to wash out hands. It is impossible to exhaust when and where we are to wash our hands.

• Cultivate the use of hand sanitizers: Handwashing remains the best solution for curbing the spread of infections. However, it may sometimes be impossible to get a hand-washing unit. Thus, each person must own a hand sanitizer containing a minimum of 60% alcohol.

Here are quick facts to know about hand sanitizers:

• They are not replacements for good handwashing practices.
• They do not kill every type of existing germs
• They are not remedies for the removal of heavy metals
• Ensure that your hands are grease-free and clean to optimize the function of the hand sanitizer
• Learn to sneeze into your elbows and teach those around you the same too.
• If you must, cough into a tissue and dispose immediately
• Avoid touching your face and picking your nose. The mouth and nose are direct gateways into the body and must be kept guarded at all times.
• Eat a balanced diet with lots of vegetables and fruits to boost the body’s immune system
• Lastly, ensure that you get only adequate pieces of information and stay calm wherever you are.

HOW CAN YOU PROTECT YOURSELF AND YOUR LOVED ONES?

The preventive measures discussed earlier are also part of the ways to make sure that our loved ones and we stay safe as much as possible. However, in a situation where the virus has been contracted, you can keep your loved ones safe with the following method along with what have been itemized in the previous chapter.

QUARANTINE/SELF-ISOLATION: Self-isolation is not intended for those that are yet to become infected with the virus. Uninfected persons are advised to practice social distancing and staying at home to minimize contact. However, an infected person or someone who has contact with an infected individual is expected to go on self-isolation for 14 days for the virus to run its incubation period. In the same vein, self-isolation is advised if a person is not sure of his/her status. At the end of 14 days incubation, isolated persons are further tested to confirm suspicions. There are agitations for the elongation of the quarantine period as some people develop signs and symptoms after 14 days.

Studies show that active shedding of the virus occurs even when people are not showing symptoms. Therefore, you will be protecting your loved ones and other people from possibly contracting the disease from you by going on self-isolation.

USE YOUR NOSE MASKS: While there are no pieces of evidence to show that the use of nose masks by uninfected persons protect them from contracting the virus, it is advised that those already with the COVID-19 use nose masks to reduce the rate of spread of the virus. In this case, an infected individual can cough, sneeze, or carry out other aerosol-generating activities into the nose mask without putting other people at risk of contracting the infection.

HOME REMEDY FOR HAND SANITIZER

Hand sanitizers are the new gold in the market. The prices of hand sanitizers and nose masks have skyrocketed and are still rising. However, you don’t need to go into the panic mode because making your sanitizer at home is possible. The following are step-wise instructions on how to make your hand sanitizers by yourself and in the comfort of your house.

DIY HAND SANITIZERS PREPARATION STEP - WHO GUIDELINES                                                                                                                       

The hand sanitizer must contain at least 60 % alcohol for effective action against germs.

The glycerol in the mixture acts a moisturizer such that the mixture doesn’t get dry on time. It has no antibacterial function and shouldn’t cause an allergic reaction during use. While the hydrogen peroxide is not an active ingredient for the sanitation of an object, its antibacterial properties ensure that the solution remains free from contaminating fungal spores. Choice of colour can be independently decided, however, it must not disrupt the antibacterial function and pH of the mixture. The same goes for the fragrance selected. However, the use of fragrance is discouraged to prevent allergic reactions.

The hand sanitizer has been duly measured such that it is replicable.

Ingredients needed: Isopropyl alcohol (99.8 %), 3 % hydrogen peroxide, 98 % glycerol boil OR 

         Ethanol (96 %), 3 % hydrogen peroxide, 98 % glycerol boil

Other materials: Mixing through, or a 10 ml plastic bucket, Mixing ladle, measuring cups, funnels, dispensing funnels of about 100mls, alcoholmeter.

Weighed products per 10 l: 7517 ml Isopropyl alcohol (99.8 %), 417 ml of 3 % hydrogen peroxide, 145 ml of 98 % glycerol boil

     8333 ml Alcohol (99.8 %), 417 ml of 3 % hydrogen peroxide, i45 ml of 98 % glycerol boil

Stepwise Procedure:

· Measure the required amount of alcohol (isopropyl alcohol or ethanol) into a large 10 l mixing container using a graduated container

· With the aid of a measuring cylinder, add your hydrogen peroxide

· Measure the required amount of glycerol and add to the mixture. Glycerol is a sticky transparent liquid. With the aid of cold boiled water, wash every viscous portion of glycerol into the mixing container

· Make up the rest of the solution with the required amount of water until the 10 l mark is reached

· The solution is highly volatile and prone to evaporation. So, ensure that the screw is tightly locked to prevent evaporation

· Use the mixing paddle to gently mix the solution or gently rock the container to achieve the same result

· Dispense the final product into procured 50 ml or 100 ml containers. It is advised that product should be quarantined for another 72 hours to allow the growth of any spore in utilized containers to germinate if present.

After making the hand sanitizer, the final concentration of ingredients per bottle dispensed is: alcohol (75% v/v), 0.125 % v/v hydrogen peroxide, 1.45 % v/v glycerol boil OR alcohol (80 % v/v), 0.125 % v/v hydrogen peroxide, 1.45 % v/v glycerol boil.

To ensure that your final product is of quality standard, you must carry out your analysis before and after every production cycle. Also, the alcohol concentration must be monitored to ensure compliance with acceptable standards.

Why Hand Sanitizers?

The use of hand sanitizers is not to replace standard hygienic protocols. As of now, hand washing remains the best method to prevent the easy spread of germs and diseases. However, the use of hand sanitizers is encouraged in places where it is difficult to get materials for hand washing. Nonetheless, the efficacy of hand sanitizers is compromised when the hands are visibly dirty or greasy. The World Health Organization advocates the use of hand sanitizers because of the following reasons:

• Evidence shows that hand sanitizers have a broad-range spectrum of microbicidal functions without the fear of the development of antimicrobial resistance
• Hand sanitisers are perfect for areas where it is difficult or impossible to practice proper handwashing, especially in resource-limited or remote areas
• It helps to make compliance to hand hygienic practices faster and easier
• Of economic importance by reducing the generated costs for hand hygiene
• Minimizes associated risks with outbreaks (such as COVID-19) as a result of heightened safety back up by product acceptance and tolerance among users

There are other procedures on how to prepare hand sanitizers using isopropyl alcohol, aloe vera gel, and essential oils on the internet. However, they may not be ideal as they are not present in the WHO guidelines for the preparation of hand rubs. You must adhere to instructions about volumes and concentrations to avoid making harsh or ineffective hand sanitizers.

 CONCLUSION/ HOW TO OVERCOME FEAR

In conclusion, we need to accept that the pandemic of COVID-19 is a reality. At this stage, denial will do nothing to salvage the situation but worsen it. However, prevention is not the same as panicking. Summarily, we must stay in touch with relevant bodies that can give us current and accurate information about what is going on. How do we do that? The World Health Organization, Centre for Disease Control and other recognized designated health parastatals have websites that can be easily accessed via the internet from the safety of your room.

Practising self-isolation or social-distancing is not an excuse not to be abreast the recent happenings. We all must remain individually updated about the happenings in our respective neighbourhoods, environments, and countries. In times like this, information is power. Nonetheless, I will like to emphasize that only the right pieces of information should be entertained and that without fear. Adhere to instructions and keep yourself safe. By doing this, you ensure that you do not contract the virus or present a risk to others.

Fear is a crippling factor. It robs anyone of the ability to optimally perform by projecting untrue images as the ideal and real ones. With fear, it becomes difficult for us to make objective decisions and act accordingly. It is impossible not to have casualties in an outbreak of this magnitude. Nonetheless, don’t focus on the daily saddening news but feed on the positive energy associated with the good news. In recent times, countries with high burdens of the disease such as China and Italy announced the failure to record new incidences and reduced daily death as a result of the virus. These are fear-attacking news. It projects the thought that there is indeed a source of light, no matter how dim it is, at the end of every tunnel. The world at large is going through one of the most difficult times in history, but feeding on fear is not the way forward. Avoid individuals that will only dampen your hopes while you maintain objectives outlooks on the available platforms.

Fear is not an ally but a destroyer with nothing to offer in return. While it is inevitable, it can be channelled into more productive use. Let your fear spur you to engage in appropriate hand hygiene (handwashing and use of sanitizers), practice social distance, and self-isolation as the need arises. Eat a balanced diet, drink plenty of water, and exercise as much as possible from the confines of your home.