Convalescent plasma therapy for COVID-19: Why is it promising?

Some researchers and doctors have started using plasma from people recovering from COVID-19 to treat others who have developed the disease. Medical News Today spoke to Dr. Arturo Casadevall, from Johns Hopkins University, to learn more about this approach.

In the search for an effective treatment for COVID-19, an old method of fighting infectious diseases has recently resurfaced: transfusions with convalescent plasma. Plasma is a component of blood.

This method has a simple premise. The blood of people who have recovered from an infection contains antibodies. Antibodies are molecules that have learned to recognize and fight the pathogens, such as viruses, that have caused disease.

Doctors can separate plasma, one of the blood components that contain such antibodies, and administer it to people whose bodies are currently fighting an infectious disease. This can help their immune systems reject the pathogen more efficiently.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

Recently, researchers and healthcare professionals have been looking into the possibility of using this method to treat people with COVID-19, the respiratory disease caused by the SARS-CoV-2 virus.

In the United States, a group of researchers and doctors from 57 institutions, including Johns Hopkins University, the Albert Einstein College of Medicine, and the Icahn School of Medicine at Mount Sinai, are investigating and applying convalescent plasma therapy for COVID-19.

This is a concerted initiative — called the “National COVID-19 Convalescent Plasma Project” — born after the publication of a viewpoint paper in The Journal of Clinical Investigation in March, 2020.

The paper argued for the potential merits of passive antibody therapy in the treatment of COVID-19. It was authored by immunologists Dr. Arturo Casadevall, chair of the Molecular Microbiology & Immunology Department at Johns Hopkins Bloomberg School of Public Health, and Dr. Liise-anne Pirofski, professor of Infectious Diseases in the Department of Medicine at the Albert Einstein College of Medicine.

To understand more about convalescent plasma therapy, its merits, its risks, and its current use in COVID-19 treatments, Medical News Today recently spoke to Dr. Casadevall.

Here is what he told us, alongside more information on the current state of convalescent plasma therapy.

A therapy ‘used for over 100 years’

So, where did the idea of using convalescent plasma, or passive antibody therapy, come from?

This notion was first introduced in the late 19th century when physiologist Emil von Behring and bacteriologist Kitasato Shibasaburou discovered that they could use antibodies present in serum — another blood component — to fight the bacterial infection diptheria.

Since then, doctors have used passive antibody therapy, on and off, at least since the 1930s to treat or prevent both bacterial and viral infections, including forms of pneumonia, meningitis, and measles.

When we asked him how the idea of using convalescent plasma therapy to treat COVID-19 came about, Dr. Casadevall told us: “I have worked on antibodies my entire life professional life […], and I knew that convalescent plasma — or sera […] — was being used for over 100 years.”

“In fact, the first Nobel Prize was given [to Behring] for the use of serum to treat diphtheria, so I knew the history.” This long history of successfully using this method against different infectious diseases suggested that it might also be effective against the disease caused by SARS-CoV-2.

“I knew that in epidemics when you don’t have a lot of things, […] the blood of those who recover can have antibodies that can be used [as treatment],” Dr. Casadevall explained.

“So it’s an old idea, it’s been around for a long time, and I think that my contribution was, in fact, to alert my friends, authorities, that this [therapy] could be used in this epidemic.”

Recent research has already shown that people who have contracted SARS-CoV-2 have developed antibodies that can react to the coronavirus.

“There [are] now multiple studies that have shown that when people recover from the virus, they have in their blood neutralizing antibodies that are able to kill the virus,” Dr. Casadevall also told MNT.

Although “[p]eople differ greatly in the amount of antibodies that they make — some make large amounts, some make small amounts — […] the good news is that most have [them],” he added.

Given the willingness of people who have recovered from COVID-19 to donate blood, the method seems feasible right now. In fact, some doctors are already using convalescent plasma therapy in some cases.

Settling the matter of safety

In the U.S., the National COVID-19 Convalescent Plasma Project have already been trailing this method as widely as possible.

Dr. Casadevall told MNT that “in the United States, we have close to 12,000” people who have received the convalescent plasma treatment for COVID-19.

Based on the data obtained from a little less than half of this cohort, Dr. Casadevall and his colleagues have concluded that this approach is safe for the patients receiving treatment — the first step necessary before ascertaining the method’s effectiveness.

The team has reported these findings in a preprint that they have made available online.

“[On May 14], we put out a paper on the first 5,000 [patients] showing that [this therapy] was relatively safe. That’s the first step,” Dr. Casadevall explained.

“You want to show safety. And then the question of efficacy will be coming in the next few weeks. Right now, the data [is] being analyzed. We are hopeful,” he also told MNT.

“And,” he added, “especially since [the] Italians are reporting already that the use of convalescent plasma was associated with a drop in mortality [due to COVID-19]. We are hopeful that similar insights [will] come from the analysis of the data in the United States.”

In Europe, the European Blood Alliance — a non-profit association — report that 20 countries have initiated the use of convalescent plasma in the treatment of COVID-19 or are considering it for the near future. These include Italy, Spain, and the United Kingdom, some of the European countries most aggressively hit by SARS-CoV-2.

Demonstrating this procedure’s safety is essential because of the risks inherent to the transfusion of blood or blood components.

“[One] of the issues that we were worried about 2 months ago [when the initiative started] was whether the administration of antibodies would make things worse. Even though there’s very little precedent about that, you have to always worry that your intervention can do harm. Fortunately, we did not see any of that, so we are now focusing on efficacy.”

– Dr. Arturo Casadevall

There is also the issue that adding more liquid volume into a person’s vascular system could lead to a risky overload, Dr. Casadevall explained.

“The concerns when you give plasma [include the fact that] rarely, you can get a transfusion reaction, [and] rarely, you could have a volume overload. What do I mean by that? I mean that […] you’re putting volume into blood, and if it goes in too rapidly, it could [lead to an] overload [of the] cardiac system,” he said.

“So when we looked at the experience of the first 5,000 [patients], we were very reassured that we did not see any major problems.”

Worries and hopes going forward

While different centers in the U.S. are already using convalescent plasma in the treatment of COVID-19, Dr. Casadevall expressed a worry that the therapy is not as effective as it might be because most patients receive it too late in the course of the disease.

Aside from its use in clinical trials, the Food And Drug Administration (FDA) have approved the administration of this form of therapy only in emergency situations to patients in a severe stage of the disease, which may not be soon enough.

“Often, physicians are using the plasma on patients that are very ill, and we don’t really know whether that’s going to be as effective as if you gave it early in the course of the disease,” Dr. Casadevall pointed out.

“Here in the United States, patients have been treated when they’re intubated, but we think that is relatively late. Many physicians are trying to move it earlier, that is, when people begin to decompensate,” he added.

But even where there is a will, getting this treatment to the patients who need it sooner rather than later is not always straightforward. “Some of the problem […] is that it takes time,” Dr. Casadevall explained.

“Because let’s say the doctor orders plasma and people are getting worse. It sometimes takes a while for the plasma to arrive. Some hospitals have it on site, others have to get it from blood banking centers.”

Despite these obstacles, the use of convalescent plasma therapy is so attractive to healthcare practitioners because they can access it and use it now.

Unlike with vaccines, whose development takes time, or experimental medication, which needs to go through several different stages of testing before it can obtain formal approval, this approach allows doctors to use what is already there — the blood of those who have recovered from the illness — to treat hospitalized patients.

“People often get confused [about the difference between convalescent plasma therapy and some vaccines] because they both involve antibodies,” Dr. Casadevall told MNT.

But while vaccines also operate on the premise of stimulating a person’s immune system to block or kill the virus, they do not use “ready made” antibodies, and testing them for safety and efficacy could take a year or more.

“When you get plasma, someone else is giving you the antibodies, and you get them immediately,” Dr. Casadevall explains.

Going forward, he thinks that doctors could use this therapy alongside other options as they gradually become available.

“This [therapy] will provide something that is immediately available. I think what you [will] see in the United States [will be its] continuous use. I hope that there will be better options down the line. For example, [I and my colleagues] are trying to make antibodies from convalescent plasma that may become available in a few months. There is also a hope for monoclonal antibodies in the future and various antivirals.”

– Dr. Arturo Casadevall

“[C]onvalescent plasma provides something that can be used today with standard knowledge and standard procedures […] But we do hope that better options will be available in the future,” he reiterated.

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

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Should you fly yet? An epidemiologist and an exposure scientist walk you through the decision process

We don’t know about you, but we’re ready to travel. And that typically means flying.

We have been thinking through this issue as moms and as an exposure scientist and infectious disease epidemiologist. While we’ve decided personally that we’re not going to fly right now, we will walk you through our thought process on what to consider and how to minimize your risks.

Why the fear of flying?

The primary concern with flying—or traveling by bus or train—is sitting within six feet of an infected person. Remember: Even asymptomatic people can transmit. Your risk of infection directly corresponds to your dose of exposure, which is determined by your duration of time exposed and the amount of virus-contaminated droplets in the air.

A secondary concern is contact with contaminated surfaces. When an infected person contaminates a shared armrest, airport restroom handle, seat tray or other item, the virus can survive for hours though it degrades over time. If you touch that surface and then touch your mouth or nose, you put yourself at risk of infection.

Before you book, think

While there is no way to make air travel 100% safe, there are ways to make it safer. It’s important to think through the particulars for each trip.

One approach to your decision-making is to use what occupational health experts call the hierarchy of controls. This approach does two things. It focuses on strategies to control exposures close to the source. Second, it minimizes how much you have to rely on individual human behavior to control exposure. It’s important to remember you may be infectious and everyone around you may also be infectious.

The best way to control exposure is to eliminate the hazard. Since we cannot eliminate the new coronavirus, ask yourself if you can eliminate the trip. Think extra hard if you are older or have preexisting conditions, or if you are going to visit someone in that position.

If you are healthy and those you visit are healthy, think about ways to substitute the hazard. Is it possible to drive? This would allow you to have more control over minimizing your exposures, particularly if the distance is less than a day of travel.

You’re going, now what?

If you choose to fly, check out airlines’ policies on seating and boarding. Some are minimizing capacity and spacing passengers by not using middle seats and having empty rows. Others are boarding from the back of the plane. Some that were criticized for filling their planes to capacity have announced plans to allow customers to cancel their flights if the flight goes over 70% passenger seating capacity.

Federal and state guidance are changing constantly, so make sure you look up the most recent guidance from government agencies and the airlines and airport you are using for additional advice, and current policies or restrictions.

While this may sound counterintuitive, consider booking multiple, shorter flights. This will decrease the likelihood of having to use the lavatory and the duration of exposure to an infectious person on the plane.

After you book, select a window seat if possible. If you consider the six-foot radius circle around you, having a wall on one side would directly reduce the number of people you are exposed to during the flight in half, not to mention all the people going up and down the aisle.

Also, check out your airline to see their engineering controls that are designed or put into practice to isolate hazards. These include ventilation systems, on-board barriers and electrostatic disinfectant sprays on flights.

When the ventilation system on planes is operating, planes have a very high ratio of outside fresh air to recirculated air – about 10 times higher than most commercial buildings. Plus, most planes’ ventilation systems have HEPA filters. These are at least 99.9% effective at removing particles that are 0.3 microns in diameter and more efficient at removing both smaller and larger particles.

How to be safe from shuttle to seat

From checking in, to going through security to boarding, you will be touching many surfaces. To minimize risk:

Bring hand wipes to disinfect surfaces such as your seat belt and your personal belongings, like your passport. If you cannot find hand wipes, bring a small washcloth soaked in a bleach solution in a zip bag. This would probably freak TSA out less than your personal spray bottle, and viruses are not likely to grow on a cloth with a bleach solution. But remember: More bleach is not better and can be unsafe. You only need one tablespoon in four cups of water to be effective.

Bring plastic zip bags for personal items that others may handle, such as your ID. Bring extra bags so you can put these things in a new bag after you get the chance to disinfect them.

Wash your hands or use hand sanitizer as often as you can. While soap and water is most effective, hand sanitizer is helpful after you wash to get any parts you may have missed.

Once you get to your window seat, stay put.

Wear a mask. If you already have an N95 respirator, consider using it but others can also provide protection. We do not recommend purchasing N95 until health care workers have an adequate supply. Technically, it should also be tested to make sure you have a good fit. We do not recommend the use of gloves, as that can lead to a false sense of security and has been associated with reduced hand hygiene practices.

If you are thinking about flying with kids, there are special considerations. Getting a young child to adhere to wearing a mask and maintaining good hygiene behaviors at home is hard enough; it may be impossible to do so when flying. Children under 2 should not wear a mask.

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China's COVID-19 vaccine 'safe' in world's first completed human trial

China’s coronavirus vaccine is deemed ‘safe’ and triggers an immune response in world’s first completed human trial of 108 volunteers – but it may not ‘neutralize’ infection, expert says

  • Chinese CDCs and universities tested a candidate vaccine in 108 people
  • With results published Friday, it’s the first human trial to be completed in the world
  • It was found safe after no serious side effects were seen in any of the volunteers, though some had mild reactions, such as fever, pain and muscle aches 
  • Immune responses were seen in most patients, though more research is needed to determine if its enough to prevent infection 
  • A US vaccine expert told DailyMail.com he’s concerned, however, that the Chinese shot didn’t trigger enough ‘neutralizing’ antibodies to block the virus
  • Here’s how to help people impacted by Covid-19

A coronavirus vaccine trialled in 108 healthy volunteers in China safely triggered an immune response in the participants, a new study reveals. 

Antibody production seen in the patients is a good sign that the vaccine may protect them from infection, but it’s too soon to say for sure. 

The Chinese vaccine was the very first shot to enter clinical trials earlier this year – months ahead of human testing for the UK’s lead candidate jab – made by Oxford University – or the American lead-contender, made by biotech Moderna. 

Most of the people dosed with the vaccine had immune responses, although their levels of antibodies thought to neutralize the virus were relatively low. Researchers saw a stronger ramp-up of other immune compounds, called T-cells, that might also help fight the infection off. 

There were side effects – primarily pain, muscle aches and fever – but they subsided within 28 days, and no serious or dangerous side effects were reported. 

Promising results from the completed first human trial China’s Ad5 coronavirus vaccine place it at the front of the global race for a shot, though only by a slim margin, an expert told DailyMail.com. 

Chinese researchers have become the first to complete a human trial for a coronavirus vaccine, which was safe and triggered an immune response in participants, but a US expert worries the shot didn’t produce enough ‘neutralizing’ antibodies to block infection (file) 

The study, conducted by the collaborating universities and local CDC’s in China, recruited 108 patients ranging in age from 18 to 60, and split them into three groups the received, respectively, low, middle and high doses of the vaccine 

At the study’s start, none of the patients – who had never been infected with coronavirus – had neutralizing antibodies against SARS-CoV-2, the virus that causes COVID-19. 

Within two weeks, researchers started to see signs that their levels of antibodies were ramping up ‘moderately,’ and peaked 28 days after the volunteers got their shots, according to the study published Friday in The Lancet.

Levels of neutralizing antibodies – a type of immune cell that binds to a virus and may be able to completely block infection – were more than twice as high among the participants who got the high dose shot, compared to those given the low dose.  

While any increase in neutralizing antibodies was a significant gain over the subjects’ starting levels (zero), Dr Peter Hotez, a vaccine expert at Baylor College of Medicine in Texas, was unimpressed with the levels produced in the trial participants. 

‘The one thing not we’re not seeing is a really high neutralizing antibody titer,’ he told DailyMail.com. 

‘The question is whether we’re going to need that and whether these vaccines will be adequate to stimulate an immune response.’ 

Patients in the trial did have more robust increases in their levels of T cells, immune cells that perform a search and destroy function, rather than the blocking work done by neutralizing antibodies. 

More studies will be needed to determine whether the vaccine can protect against infection in practice. 

Encouragingly, none of the 108 patients had serious side effects. 

More than 80 percent did have some side effects, but these were mostly mild or moderate, like muscle aches, fever and pain. Most subsided within a couple of weeks, and almost all resolved by the end of the study. 

Moderna is working closely with the NIH to develop its vaccine, and is leading the US race 

The US government has placed an order for 300 million doses of AstraZeneca’s shot, developed with Oxford University 

‘That’s pretty good,’ Dr Hotez says. 

Side effect profiles may be particularly important to getting people to get vaccinated against coronavirus once one is available. 

A Reuters poll published Thursday found that a quarter of Americans were not very or not at all interested in getting a vaccine for the virus that has infected more than 1.6 million people in the US. 

Many of them said they were concerned the vaccine would be riskier than the disease itself because development is moving so fast. 

So far, the US government is supporting the development of 14 candidate vaccinations through its Operation Speed initiative. 

It’s unclear if the US is coordinating with the Chinese vaccine developers. 

In the US and UK, vaccines from Moderna and Oxford University (collaborating with AstaZeneca) are in human trials, and have shown promising early results. 

China’s completed trial puts it ahead – but not by much, says Dr Hotez. He says that all of the vaccines will need to go through large, Phase III trials before they become available, bringing their timelines close together.  

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Coronavirus bombshell: Hidden factors that play role in contracting deadly virus exposed

UCL Intensive Care Medicine Professor Hugh Montgomery claimed multiple factors explain why coronavirus cases differ from country to country. Professor Montgomery, who currently represents the Intensive Care Society Charity, insisted genes, pollution, culture and how data is recorded all played a role in the overall number of official coronavirus cases. During an interview with Express.co.uk, Professor Montgomery highlighted many of the risk factors that explained why coronavirus may differ between areas.

Professor Montgomery said: “There are other differences you have got to consider that account for different levels of mortality.

“It is a little unfair, in some cases, to compare Vietnam, that maybe only had four or five intensive cases, to Britain or somewhere else.

“There are demographic factors as well.

“We know obesity is a risk factor for severe disease and if you look at a place like Vietnam, the bulk of the population is very thin.

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“They eat healthy vegetable-based diets and take more physical exercise so are very lean.

“It could be simple factors such as that.”

Professor Montgomery also noted that air pollution may play a role in the spread of coronavirus and the severity if contracted.

He said: “Factors like obesity combined with air pollution which may well be playing a part in the transmission of the virus.

“It may also be making the severity worse as well as other risk factors like diabetes, high blood pressure and so forth.”

Mr Montgomery concluded that it was difficult to pinpoint one true cause of the spread of the virus as there are many factors to consider.

He closed by saying: “It is very hard to judge how much it is genes, how much it is the nature of the people, how much of it is cultural and how much of it is down to reporting.”

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Professor Montgomery has also warned if Britons do not take responsibility for their actions, a second coronavirus wave could overwhelm the NHS.

While the Government is confident the NHS can now deal with the number of people with COVID-19, Professor Montgomery claimed the NHS is still recovering from the first wave and dealing with a tsunami of new cases could prove to be difficult.

The charity Professor Montgomery represents, The Intensive Care Society, is currently working to provide essential wellbeing and support to the intensive care community through the coronavirus pandemic. Any donations to this cause are appreciated during this difficult time period. 

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Mouthwash Can’t Replace a Mask for Stopping the Spread of COVID-19

  • Experts are looking at mouthwash to see if it can help stop the spread of COVID-19.
  • In labs, mouthwash may help kill the new coronavirus.
  • Other experts disagree and point out that the coronavirus can quickly multiply in the throat even after using mouthwash.
  • Masks and physical distancing are still the best ways to prevent spreading or developing COVID-19.

Frequent handwashing, following social or physical distancing rules, and using face coverings in mass transportation and shops are still some of the best ways to protect against the new coronavirus.

However, a new study finds that ingredients in commercially available mouthwash may damage the virus that causes COVID-19 in a way that makes it harmless. The report, recently published in the journal Function, suggests that there’s an “urgent need” to test the effectiveness of this approach in clinical trials.

Previous research has shown that interfering with the lipid envelope represents an effective strategy to target similar viruses. Although experts are not recommending people trade in masks for mouthwash.

“Information has emerged highlighting how important the throat and salivary glands are as a site of virus replication in early disease and also in people who don’t have symptoms and how they seem to be involved in transmission of infection,” lead author Valerie O’Donnell, PhD, director, division of infection and immunity and co-director of the Systems Immunity Research Institute at Cardiff University, told Healthline. “It seemed worthwhile to check if there was any potential for direct antiviral targeting of virus in the throat via damaging the membrane.”

SARS-CoV-2 has a vulnerable spot

According to researchers, the virus strain that causes COVID-19, called SARS-CoV-2, is an enveloped virus with a fatty (lipid) membrane.

This envelope comes from the infected cell, or host, in a process called “budding off,” according to the National Cancer Institute. During this process, newly formed virus particles become “enveloped” or “wrapped” in an outer coat made from a small piece of the cell’s membrane. The envelope may help a virus survive and infect other cells.

“We found that there is evidence from other people’s research that enveloped viruses like influenza, herpes simplex, and other coronaviruses are sensitive to common ingredients in mouthwash, but this evidence is from test-tube experiments — not from studies on viruses in the mouth, where their response may be different, and where little work has been done,” explained O’Donnell.

However, she cautioned, “It’s important to note that studies haven’t been done on this coronavirus because it’s new.”

Infection begins in the nose and throat

SARS-CoV-2 infection is believed to happen through respiratory droplets, and the virus particle is viable in aerosols for up to 3 hours.

“Dampening transmission by any means could be a preventative measure, and we don’t have any ways to do this currently,” said O’Donnell.

“CDC have recommendations for dentists where patients use mouthwash before procedures for preventing transmission of respiratory disease already,” she continued. But she added that this is based on theoretical benefit, not benefit proven through clinical trials, which haven’t been conducted yet.

O’Donnell concluded, “This is where research needs to be done, first to find out if these ingredients can inactivate this virus in the throat, and then if they can, whether this could reduce transmission.”

Mouthwash could have an unexpected effect on health

Post-exercise hypotension (PEH) is a common physiological process that lowers blood pressure after “acute exercise.”

But how this happens is still not fully understood.

Recent research finds that interfering with the bacteria in your mouth may affect your cardiovascular health. The study examined whether the “nitrate-reducing activity” of bacteria in our mouths is a key trigger for PEH.

Scientists used a randomized, double-blind, and crossover study design, which means neither the testers nor the participants knew who received mouthwash or a placebo.

Findings suggest that the participants who used mouthwash experienced significantly higher blood pressure after exercising than the placebo group, reducing an important benefit of cardiovascular exercise.

Of course, this doesn’t mean that mouthwash is bad for you or doesn’t provide important benefits.

COVID-19 researcher weighs in

“There is potential for mouthwash with alcohol to reduce, maybe slightly, short-term spread of virus to close household contacts. The alcohol might kill virus in the mouth surfaces temporarily — so might a shot of whiskey, rum, or tequila,” said Eric Bortz, PhD, assistant professor of biology, University of Alaska Anchorage.

But Bortz, who is currently researching the genome sequencing of COVID-19, pointed out, “If someone is actively infected, the infected cells in the throat will soon produce more virus.”

He added that the upper and lower respiratory tissues are very often infected and can produce transmissible virus. “So for most people with coronavirus, mouthwash will be of limited value in preventing spread of COVID19.”

“Face coverings [masks], social distancing, and limiting contact are the best public health measures. But good oral hygiene is good for health, so it’s good to maintain it [mouthwash use] anyway!” Bortz advised.

It kills the virus, but it’s not the best defense

Bortz agreed that anything that kills the virus in a test tube might kill the virus in the mouth, “But that doesn’t mean you should use it as a first line of defense. For example, bleach kills virus — but don’t drink it or wash your mouth with it because it might kill you too!”

“The coronavirus survives inside of cells mainly in the respiratory tract, not just the mouth,” he emphasized.

Mouthwash won’t cure anyone of COVID-19, concluded Bortz, “or prevent infection by coronavirus.” But he remarked that good oral hygiene is a part of good health: “So for adults non-alcohol or alcohol-based mouthwashes are great, but for children, no alcohol.”

Mouthwash company Listerine has urged consumers not to use mouthwash to fight COVID-19 during the pandemic. “LISTERINE mouth rinse has not been tested against the coronavirus and is not intended to prevent or treat COVID-19,” the company said in a statement.

The bottom line

Research finds that mouthwash ingredients have a potential role in the fight against COVID-19. They say that commercially available mouthwash could damage the new coronavirus in such a way to render it harmless.

Some scientists emphasize that since the throat is a major area of infection for COVID-19, then strategies, like mouthwash, that reduce the concentration of virus in mucous membranes could contribute to reduced transmission risk.

Other experts disagree and point out that the coronavirus can quickly multiply in the throat even after using mouthwash, and that masks and social or physical distancing are still the best ways to prevent spreading or developing the infection.


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Cooking more at home? Diverse food cultures can expand heart-healthy menu

For many in the United States, dinner means a large portion of meat and two sides, usually a starch and a vegetable. Think steak, potatoes and peas, or chicken, carrots and rice.

“That’s a very American and northern European idea—a meal which stems from a large amount of meat being available, and also wealth,” said Amy Bentley, a professor of food studies at New York University.

But trying different dishes from diverse cultures can open up a new menu of heart-healthy food options and go-to meal ideas. And now, with more people making their own meals as they stay home to limit the spread of the coronavirus, what better time than World Day of Cultural Diversity to try something different for dinner?

Meat is just an accent on the dish in many other parts of the world, said Bentley, author of “Inventing Baby Food: Taste, Health and the Industrialization of the American Diet.” Vegetables, including legumes like black beans or chickpeas, make up a medium portion of the plate. A starch like rice or polenta usually makes up the largest portion. Spices add flavor.

Think an Indian curry or Chinese stir-fried chicken and vegetables.

If you’re cooking the dish for the first time, Bentley recommends making a smaller amount or going light on spicier ingredients to get used to the flavors.

Keep moderation in mind when sizing up portions, too, said Ronaldo Linares, a New Jersey-based chef and restaurant consultant who teaches cooking classes. Linares, who comes from a Cuban-Colombian background, wrote the cookbook, “Sabores de Cuba,” a recipe collection of classic Cuban dishes with a healthy, diabetes-friendly twist.

Eating one big meal has the potential to cause fluctuations in blood sugar, Linares said. Research shows fluctuations in blood pressure, blood sugar and cholesterol could put people at higher risk for heart attack or stroke.

Using fresh ingredients and avoiding processed foods can add interesting flavors, he added. “If you are sticking to the guidelines of traditional cooking, it’s going to be naturally healthy.”

Instead of store-bought salsa, Bentley suggested making homemade salsa with chopped-up tomatoes, onion, cilantro, jalapenos and a pinch of salt. If a recipe calls for butter, Linares suggested substituting avocado oil or olive oil, which are high in heart-healthy monounsaturated fats.

Both Linares and Bentley noted that for some families, a lack of access to affordable, fresh ingredients can hamper the ability to eat diverse or healthier foods. Food choices also can be influenced by the exposure to ads for sugary drinks and fast food, regardless of one’s racial or ethnic background.

Just 1 in 10 adults meet the daily recommendation of having at least 1 1/2 to 2 cups of fruit and 2 to 3 cups of vegetables as part of a healthy eating pattern, according to a 2017 report from the Centers for Disease Control and Prevention.

“Ultimately, we need a better food environment,” Bentley said. “It’s too much to expect the individual to be solely responsible because so much of this is about the food that’s available in the culture as well as socioeconomic issues.”

Some general nutritional guidelines can fit into meals within any cultural preference, according to the Academy of Nutrition and Dietetics. They include making half your plate fruits and vegetables, and adding calcium-rich foods to each meal.

“It’s better to talk about healthy approaches to eating through actual food rather than nutrients,” Bentley said, “and not get hung up on portions and the minute mechanics that only adds to people’s stress.”

The American Heart Association suggests a healthy dietary pattern to reduce heart disease risk factors, such as obesity, diabetes and high blood pressure. Plant-based and Mediterranean diets are singled out in AHA dietary guidelines.

Linares picked Peruvian cuisine when asked to highlight another food culture for people looking to try heart-healthy but flavorful alternatives. His sample meal starts with ceviche, a seafood dish.

“So, let’s say a ceviche of cooked octopus. It’s super tender, they char it, serve it cold, toss it in some lime juice and some herbs,” he said. “Then you have a sweet potato puree and add some aromatics and seasoning. Add some corn, some pickled onions and you put it together in this beautiful bowl.

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Calvin Harris Says His Heart Stopped in 2014: 'Interesting Year for Me'


Calvin Harris needed lifesaving help in 2014 after his heart stopped.

The DJ and singer revealed on Twitter that he had to have his heart “restarted” in the emergency room.

Harris retweeted a video on Tuesday night from his June 2014 performance at the Electric Daisy Festival, and added that it was an “interesting year.”

“Started with me knocking myself off number 1 in the UK and ended with my heart getting restarted in the ER…this sort of stuff happened in between,” he said.

Harris had hinted at his condition that year, but hadn’t previously said that his heart had stopped. Rather, the “Slide” singer said that he had “some heart problems” that needed to “be fixed” and were the reason why he canceled several shows.

He later clarified that he had an arrythmia, a heart condition that causes an irregular heartbeat and can lead to chest pain, fainting and dizziness.

That pushed him to give up drinking, he said on Twitter in 2018.

“Haven't drank in 4 years big man,” Harris told a fan who asked why he was abstaining from alcohol. "Aye things are a bit less fun but haven't had an arrhythmia since 2014.”

But Harris said he’s happy with the decision.

“The last thing I want to do is down 2 bottles of jack daniels a night, live on greggs pasties and sleep on an absolutely stinking bus all year, scream down a mic for 55 minutes and pretend to play a keyboard 5x a week those days are behind me son,” he added to the fan.

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The cholera outbreak in a Victorian asylum that anticipated the coronavirus crisis in care homes

In 1849, a cholera epidemic that was sweeping through Britain reached West Riding Asylum in Wakefield, West Yorkshire. The deadly disease soon spread through the wards. Searching for the source of the outbreak, the consulting physician eventually settled on an individual who had been admitted while ill. The doctor described this unfortunate patient as the “unconscious messenger of death”.

Over a century and a half later, a care-home owner in Devon—alarmed by the fact that local care homes could admit residents with COVID-19—expressed his fears in a strikingly similar way. In early April 2020, the government issued guidelines that permitted taking in new residents even if sick. This, the care-home owner argued, would be “tantamount to importing death”.

Care homes are the epicentre of the COVID-19 pandemic in the UK. Compared to all other settings, they have seen the biggest relative increase in deaths since the start of the outbreak. Most of the vast asylums of the Victorian era closed in the 20th century, as attitudes to treating mental health changed. Yet there are haunting parallels to be seen. Responses to, and experiences of, an outbreak of disease at one of these asylums back in the 19th century are disturbingly resonant today.

Cholera, an acute diarrhoeal disease, claimed the lives of more than 100 patients at West Riding Asylum in 1849. Such was the scale of the tragedy that the consulting physician, Thomas Giordani Wright, was commissioned by the asylum’s regulators to investigate and account for this disaster. The result, a report published in 1850, allows us to reconstruct the story of the cholera outbreak in minute detail. It is a story which foreshadows our own.

Cholera grips the asylum

The 19th century witnessed a huge expansion in the number of asylums in England.

In 1808, the British government passed legislation that allowed counties to collect and spend taxes on building asylums for those unable to pay for private treatment for mental illness. While most counties didn’t begin construction until they were forced to by further legislation in 1845. Yorkshire was quick off the mark. West Riding Asylum opened its doors in November 1818, initially with a view to accommodating 150 patients. By the middle of the century, extensions and a second building meant that more than 500 patients filled its wards.

Global cholera pandemics were a repeated problem throughout the 19th century. When the disease hit Britain in the autumn of 1848, Yorkshire was initially spared. But by September 1849, it had reached Wakefield. In his report, Wright conjures an image of the institution besieged, with “the spread of the pestilence all around the asylum”.

Some of those who had been attached to the asylum for a long time, like Wright himself, might have taken confidence from the fact it had escaped disaster during the previous cholera pandemic to hit England, in 1832. In 1849, sadly, it would not be so lucky.

In his report, Wright sought to understand how the disease had infiltrated the institution. He was doing so a few years before John Snow’s discovery that cholera was waterborne. Yet an inspection of both the drainage and ventilation did take place at West Riding Asylum; both were given a clean bill of health. Indeed, the inspectors—Messrs West and Dawson—were left to conclude that “the visitation, fatal as it has been to many, must be considered either as the immediate infliction of Divine Providence, or as dependent on causes of which nothing as yet is known”.

Wright looked elsewhere for causes. And in spite of his admission that “the laws of contamination are, in fact, little known”, he set his sights on one Elizabeth Fenton—his “unconscious messenger of death”.

The hunt for ‘patient zero’ begins

Elizabeth Fenton, a person with epilepsy, had been admitted to West Riding Asylum on 17 September 1849. She came from the nearby Gomersal Workhouse, where she had been for the past six years after her husband, a stonemason, abandoned her and their two children. Although her transfer had been recommended some weeks earlier, when the local official called at the workhouse to take her to the asylum, it took people at the workhouse by surprise.

Strokes of ill luck might, in part, explain the disastrous chain of events which followed. Two residents at the Gomersal Workhouse had died of cholera the night before Fenton was transferred; one of them normally slept in the same room as her. Yet authorities may have been lulled into a false sense of security by the fact that Fenton had not had direct contact with these residents before her transfer. She had suffered an unusually violent seizure that week, and so had spent most of her last nights in the workhouse restrained in a chair in another room. And the day before her transfer, she had been given a laxative to help relieve constipation. An early warning sign of cholera infection, diarrhoea, was thus concealed.

By the evening of her first day in the asylum, Fenton had developed symptoms. She was isolated immediately, as it had become clear that an outbreak was underway in Gomersal Workhouse. Her room was locked, and access restricted to a select few. But within a week, four more women had fallen ill. From that point on, the disease spread like wildfire through the female as well as male patient populations of the asylum.

Since the male cases were known not to have had any direct contact with any of the female cases, and the original four women were not even thought to have seen Fenton, Wright was stumped to explain whether the mode of transmission was “gaseous or solid, material or immaterial, vegetable or animal, magnetic or electrical”.

But he was firm in his conclusion that “infection was in some way brought into the asylum by that patient”. He cinched his argument by referring back to the 1832 pandemic, which the asylum had escaped unscathed. The only difference, he argued, between the two contexts was that no new patients from infected districts had been admitted in 1832, whereas in 1849, they had: Fenton. Case closed.

Yet Wright pursued this line of investigation further, with prosecutorial zeal, by turning his attention to Gomersal Workhouse. Fenton had brought the disease from Gomersal to West Riding Asylum—but how, in the first place, had it arrived at Gomersal?

From the medical officer at the workhouse, Wright learned that on 6 September “a dirty Irish woman, and her four children, were brought into the workhouse”. Showing signs of cholera, they had been taken to the workhouse hospital, where the mother had died just hours after arrival. One of her children died “a day or two after”; the exact timing was not thought worth recording. And just a day before Fenton was transferred to the asylum, two other women at the workhouse died.

As we know all too well from COVID-19, Aids and other recent pandemics, the hunt for the first person to fall ill—known as “patient zero”—collides with other vectors of stigmatisation. In the case of COVID-19, this has been clear above all in the horrifying rise in anti-Asian racism and xenophobia worldwide.

By 1849, the arrival in England of hundreds of thousands of Irish displaced by the Great Famine had contributed to wider anti-Irish sentiment, cementing a prejudicial association with poverty, dirt and disease. Forced into desperate living conditions, including dog kennels and cellars, this was an association which drew vicious strength from the staggeringly high death rates among the Irish during times of epidemic disease. As well as being epidemiologically unhelpful, Wright’s explicit identification of a local Irish patient zero fed into growing anti-Irish racism and a representation of the Irish as carriers, rather than fellow sufferers, of the disease.

The human cost rises

With cholera loose in the institution, the medical officers and attendants at West Riding Asylum tried to fight it using the full arsenal at their disposal: removal of patients to a separate cholera ward; improvements in diet—including “extra allowances of tea and brandy for supper”; fumigation of wards; and laundering of all bed sheets and clothes.

But as in the current pandemic, there was no cure, no vaccine. By the end of the year, more than 100 residents had died of cholera. Nineteen had died in just a single day towards the end of October.

In what Wright evidently considered to be a small mercy, the patients “generally did not appear to be much affected by fear, nor were they aware of the extent of the mortality”. But just as in today’s care homes, for the staff of the institution, it was traumatic. “It was a period of awful emergency, and the consternation of all was increased by the fearful mystery of the pestilence, the rapidity of its attack, without previous symptom or warning, and the little more than failure of every effort, to mitigate its course, or avert its progress.”

Amid this horror, it is unsurprising—particularly, unhappily, to us now—that residents were not the only fatalities. On November 4 1849, Mrs Reynolds, the chief nurse of the ward set up to tend to cholera cases, died of the disease.

In a separate report in November 1849, the director of the asylum quoted Reynolds as saying: “If I should die, I shall have the satisfaction on my death bed of knowing that I have done my duty.” Wright later wrote movingly of “her heroic and unremitting devotion to her duties” and “her kindness and humanity”.

Reynolds was not alone in being held up for praise. In 1851, the director of the asylum looked back on the service of all staff in these harrowing months “with gratitude and admiration”. And while noting that “no pecuniary recompense can adequately remunerate such services”, he drew attention to the princely sum of £264 which had been distributed among staff by the visiting justices, and a further—unspecified but “very large”—sum disbursed by a visiting magistrate (there to oversee Wright’s investigation) in a private capacity.

There is a poignant coda to this story, however. In contrast to the “substantial tokens of public approbation” the surviving officers and attendants had received, Wright used his report to draw attention to the sad inadequacy of Reynolds’s final resting place: a grave “without a mark to record her fate”. He pleaded with the magistrates and medical officers to make contributions so that her life and service could also be properly remembered.

Were lessons learnt?

Wright rounded off his report with a “lessons learnt” section—a genre with which we are likely to become all too familiar in the coming months and years.

While noting that changes to diet and fumigation appeared to bear some fruit, the lesson Wright was desperate to hammer home was the importance of “the precaution of not admitting into the asylum fresh patients from infected districts”. In that respect, his advice was much stricter than that issued by the Board of Health, the body charged with the control of epidemic disease, whose confident assurances—he suggested—had influenced people “to disregard all risk of communication”.

Wright concluded: “We have been fatally taught, that it is most important to use every possible vigilance to avert the approach of cholera; for, if it once find an entrance, no human resources are of much avail, to mitigate its intensity or abate its ravages.”

The colossal asylums of the 19th century may no longer be with us, but the parallels haunt us still. The risk to care homes was clear early in the contemporary crisis, according to chief scientific adviser Sir Patrick Vallance. And the vulnerability of institutionalised populations was not only foreseeable; doctors during the 1849 cholera outbreak tried to pass down lessons to future generations.

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Restart at the Corona-Hotspot West meat in Coesfeld

The Coronavirus pandemic in Germany medicine, politics, tourism and society firmly in its grip: More than four million people globally have become infected with the pathogen of Sars-CoV-2, 175.173 of them in Germany.

Restart at the Corona-Hotspot West meat in Coesfeld

After a forced break due to the many Corona-infections-Western meat starts on Tuesday with a test operation in the Coesfeld plant. In the first step, but still no pigs are to be slaughtered. The gradual start-up of the operation is accompanied by surveillance authorities. Used only for employees, you can have negative test results with the Coronavirus to be.

The district of Coesfeld had closed the plant in front of one and a half weeks temporarily, after numerous plant had infected the workers with the Coronavirus.

Also in lower Saxony is in operation in the district of Osnabrück, are employees of a Meat many Coronavirus infections have become known to the company West crown in Dissen, which is also operated by the battle company West meat together with Danish Crown. There, the district tested a total of 92 employees in a positive way.

On Monday, the operation rested thereupon. According to the district of approximately 2000 tonnes of meat may process. Thereafter, the operation for 14 days, it must close completely. A total of around 300 employees work in Dissen.

All further news about Corona-pandemic from Germany, Europe and the world, you will find in the News Ticker of FOCUS Online.  

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After Edeka and Netto Lidl now sells Designer masks by Van Laack

chip.de After Edeka and Netto Lidl now sells Designer masks by Van Laack

Most physicians have seen false-negative COVID-19 test results

(HealthDay)—Most physicians believe they have seen false-negative results for a COVID-19 diagnostic test, according to the results of a recent survey.

Sermo, a social platform for physicians, has been conducting a weekly international poll. In week 7, conducted from May 3 to 5, 2020, 4,476 physicians offered their perspectives regarding false negatives and reinfection rates.

According to the results of the recent poll, more than eight in 10 physicians report they have seen some degree of false-negative test results, including 96 percent of “supertreaters” in an intensive care unit setting (physicians who have treated more than 20 COVID-19 patients) who believe they have seen COVID-19 tests produce a false negative. Just over one-third of hospital-based respondents believe that more than 20 percent of the tests have produced false negatives. Relatedly, four in 10 physicians report seeing at least one false positive. Nearly one in 10 physicians believe they have seen a patient with a reinfection, with higher rates among physicians working internationally (5 percent saw reinfections in the United States versus 15 percent in Italy and Spain and 14 percent in China).

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