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Wednesday, January 27, 2021

WHO recommends follow-up care, low-dose anticoagulants for COVID-19 patients (26 January 2021)

WHO recommends that patients who have COVID-19 - both confirmed and suspected - should have access to follow-up care if they have persistent, new or changing symptoms.

This is one of the recommendations made by WHO in revised clinical management guidelines.

Evidence was gathered on the post COVID condition, so-called ‘long COVID’, where people who have recovered from COVID-19 continue to have longer-term issues like extreme fatigue, persistent cough and exercise intolerance.

Understanding this condition is one of WHO’s priority areas of work. In February 2021, WHO will organize a series of consultations to reach consensus on a description of this condition and its subtypes, and case definitions. This scientific understanding will inform the name of the condition. The consultations will include a broad range of stakeholders, including patient groups.

For COVID-19 patients at home, WHO suggests the use of pulse oximetry to measure oxygen levels in the blood. This needs to be coordinated with other aspects of home care, such as education for the patient and care provider and regular follow-up of the patient.

For hospitalized patients, WHO suggests the use of low dose anticoagulants for preventing the blood clots forming in blood vessels (thrombosis).

For hospitalized patients who are taking supplemental oxygen (including high-flow nasal oxygen) or non-invasive ventilation, WHO suggests positioning patients on their stomachs to increase oxygen flow (awake prone positioning).

The guidelines also include recommendations on the use of care bundles to systematize care provision for COVID-19 patients, as well as a recommendation to favour clinical judgement over models in making decisions for the patient’s care.

The recommendations were made by an independent panel of experts, the Guideline Development Group, on the basis of detailed rapid reviews of all available evidence.

The guidelines are a living document, updated regularly as more data becomes available.

Source: https://www.who.int/news-room/feature-stories/detail/who-recommends-follow-up-care-low-dose-anticoagulants-for-covid-19-patients

Wednesday, January 13, 2021

Considerations for Wearing Masks


Know How to Wear Your Face Mask Correctly

Your mask helps protect those around you:

COVID-19 spreads mainly from person to person through respiratory droplets. Respiratory droplets travel into the air when you cough, sneeze, talk, shout, or sing. These droplets can then land in the mouths or noses of people who are near you or they may breathe these droplets in.

Masks are a simple barrier to help prevent your respiratory droplets from reaching others. Studies show that masks reduce the spray of droplets when worn over the nose and mouth.

You should wear a mask, even if you do not feel sick. This is because several studies have found that people with COVID-19 who never develop symptoms (asymptomatic) and those who are not yet showing symptoms (pre-symptomatic) can still spread the virus to other people. Wearing a mask helps protect those around you, in case you are infected but not showing symptoms.

It is especially important to wear a mask when you are indoors with people you do not live with and when you are unable to stay at least 6 feet apart since COVID-19 spreads mainly among people who are in close contact with one another.

Your mask offers some protection to you:

A cloth mask also offers some protection to you too. How well it protects you from breathing in the virus likely depends on the fabrics used and how your mask is made (e.g. the type of fabric, the number of layers of fabric, how well the mask fits).

Certain groups of people who may find it difficult to wear a mask:


Some children 2 years and older, and people of any age with certain disabilities

Masks should not be worn by:

  • Children younger than 2 years old
  • Anyone who has trouble breathing
  • Anyone who is unconscious, incapacitated, or otherwise unable to remove the mask without assistance

Appropriate and consistent use of masks may be challenging for some children and for people of any age with certain disabilities, including cognitive, intellectual, developmental, sensory, and behavioral disorders.

When deciding if children and people with certain disabilities should wear a mask, determine if they can:

  • Use a mask correctly
  • Avoid frequent touching of the mask and their face
  • Limit sucking, drooling, or having excess saliva on the mask
  • Remove the mask without assistance

If children and people with certain disabilities are unable to wear a mask properly or cannot tolerate a mask, they should not wear one.

People with certain underlying medical conditions

Most people with underlying medical conditions can and should wear masks.

  • If you have respiratory conditions and are concerned about wearing a mask safely, discuss with your healthcare provider the benefits and potential risks of wearing a mask.
  • If you have asthma, you can wear a mask. Discuss with your healthcare provider if you have any concerns about wearing a mask.

High intensity activities

  • Masks should be used in public settings, but if you are unable to wear a mask because of difficulty breathing during high intensity activities, choose a location with greater ventilation and air exchange (for instance, outdoors versus indoors) and where you can keep at least 6 feet from others during the activity.
  • If you are able to wear a mask, remove your mask if it gets moist from sweat and replace it with a clean mask.
  • Opt for an activity that does not require using mouth guards or helmets. Wearing a mask with these types of protective equipment is not safe if it makes it hard to breathe.
  • Supervise children who are wearing a mask while playing sports.

Types of masks

Some masks work better than others to help stop the spread of COVID-19 outside of healthcare settings. Medical masks and N-95 respirators should not be used because they should be conserved for healthcare personnel.

RECOMMENDED
Non-medical disposable masks






Masks that fit properly (snugly around the nose and chin with no large gaps around the sides of the face)








Masks       made with breathable fabric (such as cotton)








Masks made with tightly woven fabric (i.e., fabrics that do not let light pass through when held up to a light source)
























Masks with two or three layers











Masks with inner filter pockets
NOT RECOMMENDED

Masks that do not fit properly (large gaps, too loose or too tight)









Masks made from         materials that are hard to breathe through (such as plastic or leather)





Masks made from loosely woven fabric or that are knitted, i.e., fabrics that let light pass through


    
    Masks with one layer







Masks with exhalation valves or vents




Wearing a scarf/ski mask as a mask

Cloth masks


The most effective fabrics for cloth masks are

  • Tightly woven fabrics, such as cotton and cotton blends
  • Breathable
  • Two or three fabric layers

Less effective fabrics for cloth masks are

  • Loosely woven fabrics, such as loose knit fabrics
  • Difficult to breathe through (like plastic or leather)
  • Single layer

Non-medical disposable masks

Disposable face masks are single-use masks. They are sold online and through large retail stores. These are not the same as surgical or other medical masks.

You may prefer using disposable masks in situations where your mask is likely to get wet or dirty. As with cloth masks, make sure your disposable mask fits close to your face without large side-gaps and completely covers your nose and mouth. Bring extra disposable masks with you in case you need to change out a dirty or wet mask.


Masks with exhalation valves or vents

CDC does not recommend using masks with exhalation valves or vents because this type of mask may not prevent you from spreading COVID-19 to others. The hole in the material may allow your respiratory droplets to escape and reach others. Research on the effectiveness of these types of masks is ongoing.


Face shields and goggles

For example, people who interact with those who are deaf or hearing impaired may find that a face shield is better than a mask when communicating. If you must wear a face shield instead of a mask:

  • Choose a face shield that wraps around the sides of your face and extends below your chin or a hooded face shield. This is based on the limited available data that suggest these types of face shields are better at preventing spray of respiratory droplets.
  • Wash your hands after removing the face shield. Avoid touching your eyes, nose, and mouth when removing it.
  • Clean and disinfect reusable face shields according to the manufacturer’s instructions or by following CDC face shield cleaning instructions. If you use a disposable face shield, wear it once and throw it away according to the manufacturer’s instructions.

Recent studies

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  • Furukawa NW, Brooks JT, Sobel J. Evidence Supporting Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 While Presymptomatic or Asymptomatic [published online ahead of print, 2020 May 4]. Emerg Infect Dis. 2020;26(7):10.3201/eid2607.201595. Link
  • Aydin O, Emon B, Saif MTA. Performance of fabrics for home-made masks against spread of respiratory infection through droplets: a quantitative mechanistic study. medRxiv preprint doi: https://doi.org/10.1101/2020.04.19.20071779, posted April 24, 2020.
  • Ma QX, Shan H, Zhang HL, Li GM, Yang RM, Chen JM. Potential utilities of mask-wearing and instant hand hygiene for fighting SARS-CoV-2. J Med Virol. 2020.

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Wednesday, January 6, 2021

Recognizing Day to Day Signs and Symptoms of Coronavirus

COVID-19 affects different people in different ways. Infected people have had a wide range of symptoms reported – from mild symptoms to severe illness.

Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:
  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea
Look for emergency warning signs for COVID-19. If someone is showing any of these signs, seek emergency medical care immediately:
  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
Call your medical provider for any other symptoms that are severe or concerning to you.

COVID-19 HOTLINE: 536-4500

For more information on the coronavirus kindly review the website of the Barbados Government Information Service (BGIS) at:https://gisbarbados.gov.bb/covid-19/

How does contact tracing work?

COVID-19 continues to spread around the globe. You can help stop COVID-19 by participating in contact tracing.

Check out this video and learn how contact tracing works.

For more information on COVID-19, visit http://www.who.int


Tuesday, January 5, 2021

How much more contagious is the new strain B.1.1.7?


In Dec. 2020, a new strain of the coronavirus that causes COVID-19 was reported in the news media. The new strain’s existence raises questions: Is the coronavirus more contagious now? Will the vaccines still work? Are there new or different things you should do now to keep your family safe?

Stuart Ray, M.D., Vice Chair of Medicine for Data Integrity and Analytics, and Robert Bollinger, M.D., M.P.H., Raj and Kamla Gupta Professor of Infectious Diseases, are both experts in SARS-CoV-2, the virus that causes COVID-19. They talk about what is known about this new strain, and answer potential questions and concerns you may have.

Why did the coronavirus change?

New strains of viruses occur when there is a change (mutation) to the virus’ genes. Ray says it is the nature of RNA viruses such as the coronavirus to evolve and change gradually. “Geographic separation tends to result in genetically distinct strains,” he says.

Mutations in viruses — including the coronavirus causing the COVID-19 pandemic — are neither new nor unexpected. Bollinger explains: “All viruses mutate over time, some more than others. For example, flu viruses change often, which is why doctors recommend that you get a flu shot every year.

“We have already seen multiple variants of the SARS-CoV-2 coronavirus that are different from the version we first saw in China,” he says.

He notes that this particular strain was detected in southeastern England in September 2020. In December, it became the most common version of the coronavirus, accounting for about 60 percent of new COVID-19 cases. The new strain also appeared in Denmark, the Netherlands, and other European countries, and a similar variant emerged in South Africa.

Extract taken from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/a-new-strain-of-coronavirus-what-you-should-know 

HEALTH INFOGRAPHIC: What we are doing to keep you safe

 
Following COVID-19 protocols

Wearing masks and protective equipment

Screening everyone who enters our school

Rigorously cleaning

Physical distancing

Practising frequent hand hygiene

Avoid touching face

If feeling sick, unless it's an emergency, staying at home and calling doctor about symptoms

Practising wellness and stress relief

Encouraging families to follow the same guidelines

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