Use of Cloth Face Coverings to Help Slow the Spread of COVID-19

Cloth face coverings should fit snugly but comfortably against the side of the face be secured with ties or ear loops include multiple layers of fabric allow for breathing without restriction be able to be laundered and machine dried without damage or change to shape.

CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.

CDC also advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.

Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.

Should cloth face coverings be washed or otherwise cleaned regularly? How regularly?

Yes. They should be routinely washed depending on the frequency of use.

How does one safely sterilize/clean a cloth face covering?

A washing machine should suffice in properly washing a face covering.

How does one safely remove a used cloth face covering?

Individuals should be careful not to touch their eyes, nose, and mouth when removing their face covering and wash hands immediately after removing.


Sew and No Sew Instructions

Sewn Cloth Face Covering

Materials

  • Two 10”x6” rectangles of cotton fabric
  • Two 6” pieces of elastic (or rubber bands, string, cloth strips, or hair ties)
  • Needle and thread (or bobby pin)
  • Scissors
  • Sewing machine


Quick Cut T-shirt Face Covering (no sew method)

Materials

  • T-shirt
  • Scissors


Bandana Face Covering (no sew method)

Materials

  • (or square cotton cloth approximately 20”x20”)
  • Coffee filter
  • Rubber bands (or hair ties)
  • Scissors (if you are cutting your own cloth)

Source: CDC

Black Forest Roulade

Ingredients

1 tsp sunflower oil, for oiling
6 oz semisweet chocolate
2-3 tbsp kirsch or cognac
5 eggs
1 cup superfine sugar
2 tbsp confectioners’ sugar, sifted

Filling

1-1/2 cups heavy cream
1 tbsp kirsch or cognac
12 oz fresh black cherries, pitted, or 14 oz canned sour cherries, drained and pitted

Method

  1. Preheat the oven to 375°F/190°C. Lightly oil and line a jelly roll pan with nonstick parchment paper.
  2. Break the chocolate into small pieces and place in a heatproof bowl set over a saucepan of gently simmering water. Add the kirsch and heat gently, stirring until the mixture is smooth. Remove from the pan and set aside.
  3. Place the eggs and superfine sugar in a large heatproof bowl and set over the saucepan of gently simmering water. (Alternatively, place in the bowl of a free-standing mixer and use a balloon whip.) Whisk the eggs and sugar until very thick and creamy and the whisk leaves a trail when dragged across the surface. Remove from the heat and whisk in the cooled chocolate.
  4. Spoon into the prepared jelly roll pan, then tap the pan lightly on a counter to smooth the top.
  5. Bake in the preheated oven for 20 minutes, or until the top feels firm to the touch. Remove from the oven and immediately invert onto a whole sheet of parchment paper that has been sprinkled with the confectioners’ sugar. Lift off the pan and its lining paper, then roll up, encasing the new parchment paper in the roulade. Let stand until cooled.
  6. For the filling, whip the cream until soft peaks form, then stir in the kirsch, reserving 1-2 tablespoons. Unroll the roulade and spread over the cream to within 1/4 inch of the edges. Scatter the cherries over the cream.
  7. Carefully roll up the roulade again and place on a serving platter

Makes 8 to 10 servings.

Source: 100 Best Delicious Chocolate

Keep Your Immune System in Top Shape with These Tips

For years, Dr. Ahmad Garrett-Price has been counseling patients about the need to keep their immune systems strong, emphasizing exercise, nutrition and sleep.

As the COVID-19 pandemic toll continues to grow, the advice is even more relevant.

“We don’t have a proven vaccine, and we don’t have proven treatments,” said Garrett-Price, a family practice physician with Baylor Scott & White Health System in Dallas. “So, our immune system is our first line of defense.”

Although a strong immune system is helpful, he and other health experts stress the guidelines in place to battle the coronavirus’s spread remain crucial: social distancing, frequent hand-washing, avoiding touching your face with unwashed hands, and staying at home as much as possible to avoid getting COVID-19 in the first place.

“But this is a viral infection, a much stronger viral infection than many other viruses,” said Marie-Pierre St-Onge, associate professor of nutritional medicine and director of the Sleep Center of Excellence at Columbia University Irving Medical Center in New York City. “If your immune system is strong, you’re better equipped to fight those infections, and the likelihood of having a milder case and recovering is better.”

Garrett-Price calls his approach “lifestyle-centered medicine that really keeps you in the preventive mode.” It starts with exercise, which in addition to cardiovascular benefits can contribute to good mental health and reduce stress – all important during this time of COVID-19.

“Exercise has anti-inflammatory benefits and promotes cellular repair, cell production and producing immune cells that help you fight off disease,” he said.

In a study of 1,002 adults published in the British Journal of Sports Medicine in 2011, people who exercised at least five times a week cut their risk of colds by nearly half compared to people who were largely sedentary. Many of those who did get sick had less severe symptoms.

“You may need to exercise in a more socially responsible manner, in your home or garage or backyard,” Garrett-Price said. “But it’s great to get that heart rate up.”

Eating right is no less important given that about 70% of the immune system is housed in the gut. “We want to drive home the concept of food as medicine,” Garrett-Price said.

The healthy foods on his list may sound familiar but are worth repeating: green leafy vegetables, citrus fruits, nuts, berries, fish, whole grains, foods rich in vitamins A, C and E – and don’t forget the garlic.

“Putting good food in your body benefits your overall immune system,” he said.

So does giving your body enough rest.

St-Onge, who has conducted extensive research into the links between sleep and health, said studies show “people who have adequate sleep have a much stronger immune system than those who have poorer sleep.”

She pointed to a 2015 study in the journal Sleep in which 164 healthy volunteers were given nasal drops containing rhinovirus, or the common cold, and sequestered in a hotel. Those who slept less than five hours per night had 4.5 times the odds of developing a cold than those who slept more than seven hours.

St-Onge said the current swirl of stressful news about the pandemic might make it harder to get a good night’s sleep. She suggests relaxing activities before bed to ease the stress, with one particular recommendation.

“Shut the TV off a couple hours early and don’t listen to the latest statistics,” she said. “Enjoy your loved ones … and go to bed with a sound mind.”

One silver lining in the current crisis might be that people staying at home don’t have to commute to work. “So maybe take that time to wake up a little later,” she said.

Garrett-Price sees another possible health benefit down the road.

“We’ve always known we were supposed to wash our hands to prevent the spread of germs,” he said. “But now we really know it can prevent a potentially fatal disease. I think that whenever we get on the other side of this, we’ll have a more health-conscious society.”

Source: American Heart Association

The Evidence for Using Hydroxychloroquine to Treat COVID-19 is Flimsy

Umair Irfan wrote . . . . . . . . .

In the rush to treat the hundreds of thousands of people sick with the Covid-19 coronavirus, many — including President Trump — have touted the anti-malaria drug hydroxychloroquine. This has led to shortages of the drug across the country.

But researchers know little about its effectiveness against the disease because rigorous scientific studies have not yet been conducted.

“The data are really just, at best, suggestive,” Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, told CBS’s Face the Nation on April 5. “There have been cases that show there may be an effect, and there are others to show there’s no effect. So I think, in terms of science, I don’t think we could definitively say it works.”

However, as Covid-19 spreads throughout the country, the need for an effective treatment is mounting. And as hospitals struggle with a lack of equipment and personnel, health workers are running out of options for how to help the infected.

That’s adding to the pressure to deploy a drug like hydroxychloroquine during the pandemic. Yet without robust clinical trials to verify its potential, the treatment could do more harm than the disease itself.

How we could find out if hydroxychloroquine is a good treatment for Covid-19

Clinical trials are the main way researchers figure out whether a drug works — and whether taking it is worth potentially harmful side effects. Doctors in individual cases can repurpose a drug like hydroxychloroquine that’s been cleared to treat other illnesses, prescribing it for off-label use.

But even drugs previously approved to treat one illness need clinical trials before they can be used as a widespread standard treatment for another condition. Repurposing drugs cleared for one purpose to use for another also has a tragic history of severe harm to patients.

Researchers also don’t know whether hydroxychloroquine is actually good at fighting against Covid-19. Most patients infected with the disease recover with no treatment. So scientists need to distinguish whether the drug is actually helping patients recover faster or if they are getting better on their own, making sure that what they’re seeing isn’t due to chance.

The small sample studies and anecdotes around hydroxychloroquine that have emerged so far don’t cut it.

The gold standard for figuring out cause and effect is a double-blind randomized controlled trial. Here, patients are sorted randomly between those receiving the treatment and those in the control group, or those receiving a placebo. To make a study “double-blind,” not only do the patients not know if they are receiving the active treatment, the people administering it also don’t know (thus controlling for unintentional bias). These trials, when large enough, can yield robust results and overcome biases that emerge in smaller samples, like having a certain age demographic overrepresented in the study group.

There are now larger studies underway to resolve questions about the effectiveness of hydroxychloroquine, some recruiting thousands of patients.

Such trials are especially important because of the scale of the Covid-19 pandemic. Millions of people are likely to contract the virus, and without widespread treatment, many of them will suffer and die. On the other hand, a treatment like hydroxychloroquine could do more damage than good if prescribed to patients without proper testing to see which circumstances make the most sense to use the drug.

But randomized controlled trials are expensive and frustratingly time-consuming in the context of a mounting pandemic. It’s not surprising that people are scrounging for whatever information is already available.

What we currently know about using hydroxychloroquine for Covid-19

The anti-malaria drug hydroxychloroquine, sold under the brand name Plaquenil, is also prescribed as an anti-inflammatory drug for conditions like arthritis and lupus. It’s a derivative of another anti-malaria drug, chloroquine.

Hydroxychloroquine is an appealing prospect because it’s already been tested in humans and is available in a low-cost generic form. Doctors in several countries, including the United States, France, China, and South Korea, have reported success in treating Covid-19 patients with hydroxychloroquine, sometimes paired with the antibiotic azithromycin.

But these are anecdotes that don’t offer much insight into how effective the drug could be in a wider population.

A laboratory study of hydroxychloroquine showed that it could prevent SARS-CoV-2, the virus behind Covid-19, from entering cells in a petri dish. While it shows a plausible mechanism for the drug, the effects on cells in a dish can be different from those in living people.

Human trials of hydroxychloroquine, by contrast, have so far yielded mixed results. A tiny study by researchers in France found that the drug could clear the infection in a few days. But the study sample included only 36 patients, and the trial wasn’t randomized, meaning the administrators were deliberately picking which patients received the treatment, potentially skewing the results.

Other studies have been even less promising. A study in China found that hydroxychloroquine was no better than standard medical treatments without the drug. This study was also small, 30 patients, but the treatment was randomized. Another study in France among 11 patients found that hydroxychloroquine was ineffective at best, with one patient dying, two transferred to an intensive care unit, and one patient who experienced a dangerous heart problem and had the hydroxychloroquine treatment stopped early.

In Sweden, some hospitals have stopped offering the drug after some patients reported seizures and blurred vision.

The listed side effects of hydroxychloroquine are long and well-known. The Food and Drug Administration (FDA) has reported problems like irreversible retinal damage, cardiac arrhythmias, muscle weakness, and a severe drop in blood sugar. There are psychiatric effects as well, including insomnia, nightmares, hallucinations, and suicidal ideation. The drug can also have harmful interactions with medicines used to treat diabetes, epilepsy, and heart problems.

These side effects are a big reason why the World Health Organization no longer recommends hydroxychloroquine as the routine treatment for malaria.

Some health workers have been hoarding hydroxychloroquine as a means to ward off the illness. Several patients who need the drug for approved uses have reported trouble getting their prescriptions filled. But there’s no evidence that the drug works as a prophylactic for Covid-19.

Some of the rules for drugs like hydroxychloroquine have now been relaxed to allow doctors to experiment with treatments for patients in dire need during the pandemic.

The FDA has granted emergency use authorization of hydroxychloroquine and chloroquine to fight Covid-19. But expanding the use of these drugs to sick but not critical patients still warrants further testing due to the potential side effects.

High blood pressure and diabetes, for example, already make the infected more likely to suffer severely from Covid-19. So a treatment like hydroxychloroquine could worsen those underlying conditions, or could result in a dangerous interaction with the medicines used to treat those conditions.

More than 50 clinical trials for the drug are now planned or underway around the world. But while randomized controlled trials do help health workers figure out how to safely deploy drugs, they don’t guarantee the drug will work for everyone, nor will they eliminate risks completely.

Source : Vox


Read also:

Caution recommended on COVID-19 treatment with hydroxychloroquine and azithromycin for patients with cardiovascular disease . . . . .

Potential harms of chloroquine, hydroxychloroquine and azithromycin for treating COVID-19 . . . . .

Lobster Digestion of Microplastics Could Further Foul the Food Chain

Tiny fragments of plastic waste are dispersed throughout the environment, including the oceans, where marine organisms can ingest them. However, the subsequent fate of these microplastics in animals that live near the bottom of the ocean isn’t clear. Now, researchers report in ACS’ Environmental Science & Technology that lobsters can eat and break down some of this microplastic material, releasing even smaller fragments into the water that other deep-sea organisms could ingest.

Microplastic pollution that makes its way into the ocean eventually sinks to the seabed. Nephrops norvegicus, which is also known as the Norway lobster, langoustine or scampi, lives in this region of the ocean, so it is a good indicator species for microplastic contamination of the deep sea. Prior research on the contents of stomachs or entire digestive tracts from lobsters had shown that they can ingest microplastics. And previous lab experiments had shown that a different type of crustacean that lives in the water column, rather than the seabed, can break plastic into smaller particles through digestion. Alessandro Cau and colleagues wanted to know whether this fragmentation happens in nature, and with species dwelling on the seabed.

In lobsters collected near Sardinia in the Mediterranean Sea, the researchers found that larger plastic particles became trapped in the crustaceans’ stomachs. However, some particles passed into the “gastric mill,” a complex of small calcified plates that grind against each other to break down food in a lobster’s stomach. This process fragmented some of the plastic into smaller particles, which then moved on to the lobsters’ intestines. In live animals, these smaller fragments would presumably be expelled into the ocean. These findings highlight the existence of a new kind of “secondary” microplastic, introduced into the environment by living organisms, that could represent a significant pathway of plastic degradation in the deep sea, the authors say. They also note that these tinier particles could then be more bioavailable to smaller creatures in the deep-sea food chain.

Source: American Chemical Society


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