Abled ALERT: Outbreak | Emergency. COVID-19 Coronavirus Pandemic. Ongoing Coverage. Text is placed before an illustration of microscopic COVID-19 cells.

An Abled® Response To A Crisis

As we evolve the updates and upgrades to our Abled®com Networks, our awareness of the often conflicting, confusing and sometimes false information spiraling out of control from the coronavirus pandemic prompted us to create a consolidated and curated COVID-19 information hub.

Our mission is to inspire everyone to live a more Abled® life by producing content, products, services and technology that enable better, self-informed life choices along the way.

At no time has it been more important to be self-informed than now, for ourselves, our family, friends and colleagues, as we are all being faced with potentially life-changing decisions to make during this crisis.

Our Abled®ALERT Network is evolving in real time as an organic, constantly updating resource, and we hope you find the impartial information and videos we’re curating, via our non-profit independent journalism,  helpful.

Note: Because of the frequency of use throughout all our content, in some places we have truncated COVID-19 to C19 for brevity.

We also appreciate your patience if you encounter any of our “Content in Production” placeholders as we work under reduced circumstances through these challenging times.

 

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THE LATEST

Abled.ALERT: Computer graphic shows a map of the United States filled with dots of varying sizes signifying the level of COVID-19 cases across the country.

+10M Cases | +500K Deaths

The world has reached a new milestone in COVID-19 infection with global cases surpassing the 10 million mark, and leaving over 500 thousand fatalities along its path.

Worst hit, the United States has recorded over 2.5 million cases and over 125 thousand deaths, with Brazil at over 1.3 million cases, Russia at over 633 thousand, and India at 528 thousand. Those numbers from Brazil and India have tripled in only a month.

Reuters has calculated that over 4,700 people are dying of COVID-19 disease every 24 hours, or 196 people every hour based of averages from June 1 to 27.

Health officials in the U.S. and U.K. have said the reported overall numbers are likely vastly underestimated because of inconsistencies in reporting and testing.

Read more about the latest global numbers and case surges being reported across the United States in our COVID-19 News Logs >>>

 

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COVID-19: AZ Record Spike

Abled.ALERT:Arizona Governor Doug Ducey gives a press conference as words on digital screens behind him read "You are safer at home. The Virus is widespread."

Arizona records its 8th record-breaking increase in COVID-19 infections this month with 3,857 new cases on Sunday. Doctors are urging state leaders to declare “crisis care standards” and to reinstate a stay-at-home order. More in our COVID-19 News Logs >>>

COVID-19: CA Beaches To Close

Abled.ALERT: Photo of people on Santa Monica Beach in Los Angeles looking north towards the mountains.

California Governor Gavin Newsom orders bars to close again as COVID-19 infection rates spike in the state. Public health officials across the country have identified bars as the riskiest non-essential businesses.  More in our COVID-19 News Logs >>>

COVID-19: FL Beaches To Close

Abled.ALERT: Photo of many people on South Beach in Miami, Florida with beachfront hotels and condos in the background.

People in Florida flock to beaches before they are closed for the 4th of July holiday weekend. Broward and Miami-Dade Counties will close beaches, and the Florida Keys will close beaches on Thursday. More in our COVID-19 News Logs >>>

COVID-19: TX Bars To Shut Again

Abled.ALERT: Photo of skyline of downtown Houston from across a park.

COVID-19 infections surge to record highs as cases & hospitalizations spike across the U.S. ‘sunbelt’ states. Texas presses “pause” on reopening and orders bars to shutter again in the wake of record COVID-19 cases. More in our COVID-19 News Logs >>>

COVID-19: “”Worst Yet To Come”

Abled.ALERT: Global map from the World Health Organization shows the number of COVID 19 cases represented by blue circles of various sizes tied to rate of infection.

WHO Director-General warns that the COVID-19 pandemic is “speeding up” and criticizes governments that have failed to set up reliable testing and contact tracing protocols as global cases surpass 10 million. More in our COVID-19 News Logs >>>

COVID-19: Brazil’s Tragedy

Abled.ALERT: Workers in orange protective gear wheel a trailer loaded with six coffins through a graveyard in Brazil marked by a hillside of blue crosses.

President Jair Bolsonaro is leading Brazilians “to the slaughterhouse”. That prediction in April from the country’s former President Lula da Silva. His fears about “Bolsonaro’s recklessness” have come true. Watch Special Reports in our COVID-19 News Logs >>>

Rx: FDA Pulls Approval

Abled.ALERT: Photo of a person wearing a protective glove while holding a tablet of Hydroxychloroquine Sulfate next to its labeled container as their face is out of focus in the background.

The U.S. Food and Drug Administration (FDA) has rescinded Emergency Use Authorization for Chloroquine & Hydroxychloroquine for COVID-19 treatment. Learn why the drugs touted by President Trump are pulled on our COVID-19 News Logs Page >>>

UI: $600 Supplement Doomed

Abled.Money: Split frame video still of White House Economic Advisor Larry Kudlow and Jake Tapper, host of "State of the Union" on CNN.

White House Economic Advisor Larry Kudlow calls the weekly $600 unemployment supplement a “disincentive to work” and says the spike in COVID-19 cases in 24 states is “no second wave”. Hear more about his comments on our Abled®Money Network >>>

COVID-19: What is MIS-C?

Abled.ALERT: Composite images show the symptoms of Kawasaki Syndrome in children including a child's back covered in a rash, bloodshot eyes, strawberry-colored tongue and red, cracked lips, red palms/soles and swollen hands/feet.

Medical professionals around the world are rushing to compile data about Multisystem Inflammatory Syndrome in Children (MIS-C). We detail what parents need to know, and have compiled an information hub on our Abled®Health Network >>>

DATA

Total Cases Confirmed

10,982,238

Active: 4,357,346

Total Deaths

523,947

+4,979

Total Critical

58,134

+175

Total Recovered

5,933,762

+200,594

Global map updated June 5th, 2020 of COVID-19 pandemic with infection clusters shown as red dots sized to the proportion of cases. Map prepared by the CSSE department at Johns Hopkins University.

Flag of the United States.

United States

2,837,189

+57,236

131,485 Dead

+3,380

15,907 Critical

1,191,091 Recovered

 

Flag of Brazil

Brazil

1,501,353

+47,984

61,990 Dead

+1,358

8,318 Critical

916,147 Recovered

 

Flag of the Russian Federation.

Russia

661,165

+7,686

9,683 Dead

+162

2,300 Critical

428,978 Recovered

 

Flag of India

India

627,168

+22,527

18,225 Dead

+391

8,944 Critical

379,902 Recovered

 

Flag of Peru

Peru

292,004

+3,527

10,045 Dead

+185

1,220 Critical

182,097 Recovered

 

Flag of Chile

Chile

284,541

+2,498

5,920 Dead

+167

2,099 Critical

249,247 Recovered

 

The Union Jack flag of the United Kingdom.

United Kingdom

283,757

-29,726

43,997 Dead

+89

279 Critical

N/A Recovered

 

Flag of Spain.

Spain

250,103

+444

28,363 Dead

+4

617 Critical

150,376 Recovered

 

Flag of Italy

Italy

240,961

+201

34,818 Dead

+30

676 Critical

191,083 Recovered

 

Flag of Iran

Iran

232,863

+2,652

11,106 Dead

+148

3,097 Critical

194,098 Recovered

 

Flag of Mexico

Mexico

238,511

+6,741

29,189 Dead

+679

378 Critical

142,593 Recovered

 

Flag of Pakistan

Pakistan

217,809

+4,339

4,473 Dead

+78

2,723 Critical

104,694 Recovered

 

UPDATED: 07/02/2020, 10:00:00 PM EDT

Sources: COV19.cc | ncoV2019.live | Johns Hopkins University CSSE 

 

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Abled.ALERT: Photo of medical personnel wheeling a COVID-19 patient in a parking lot.
Abled/ALERT: 3D computer model of the COVID-19-Coronavirus.
Abled.ALERT: Split screen photos of Queen Elizabeth and UK Prime Minister Boris Johnson speaking by telephone

Source:  cov19.cc  Best viewed in landscape orientation on smartphones.

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Abled.ALERT-Photo of U.S. President Donald Trump with members of the Coronavirus Task Force at a press briefing in the White House.
Abled.Alert: Photo shows people wearing masks and goggles pass by a COVID-19 screening tent outside the Brooklyn Hospital Center on March 20, 2020 in the Brooklyn borough of New York.
Abled.ALERT: Actors Tom Hanks and his wife Rita Wilson wearing curved caps post a selfie to Instagram.

Source: cov19.cc Best viewed in landscape orientation on smartphones.

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COVID-19 DIRECTORY

Directory

Abled/ALERT: 3D computer model of the COVID-19-Coronavirus.

Your first stop for the latest Alerts from the global pandemic, and data on the latest global, national and regional cases. We’ve compiled C19 FAQs and curated videos to answer all your coronavirus questions at our COVID-19 Directory >>>

Global & Accessible Briefings

Abled.ALERT: C19 Briefings link banner. Image: Photo of U.S. President Donald Trump leading a Coronavirus Task Force briefing at the White House.

Here you can find COVID-19 audio/video briefings we’ve produced for the benefit of blind and low-vision users as a companion to downloadable PDF summaries of the latest pandemic developments, along with global video briefings at COVID-19 Briefings >>>

News

Abled.ALERT: C19 News Logs link banner. Image: 3D model of coronavirus blends into a montage of news images in the background.

This is your destination for a consolidated & curated collection of the most important news & issues evolving during the global COVID-19 pandemic. We focus on topics with relevance to potential personal decision-making at our COVID-19 News Logs >>>

Cases | Deaths | Recoveries

Abled.ALERT: C19 Case Logs link banner. Image: 3D model of coronavirus blends into a global map in the background.

This channel of our Abled®ALERT Network curates and compiles notable cases of COVID-19 infection, tracking data, and paying tribute to notable passings and recoveries as the pandemic rages across social classes at our COVID-19 Case Logs >>>

Tests | Treatments | Vaccines

Abled.ALERT: C19 Rx Logs link banner. Image: 3D model of coronavirus blends into a photo of medical personnel in full protective gear transporting a patient on a gurney.

This is our consolidated hub where you can monitor the latest developments as scientists around the world develop Tests, Treatments and Vaccines for deployments in responding to the COVID-19 global pandemic. Go to COVID-19 Rx Logs >>>

Videos

Abled.ALERT: C19 Video Logs link banner. Image: 3D Model of a coronavirus blends into a curved video wall background.

This is where we’ve curated a collection of videos that provide additional background and context on the COVID-19 pandemic. This includes reports from the frontlines, the search for treatments, and global impacts. Go to our COVID-19 Video Logs >>>

THE FAQs

Abled.ALERT: What is C19? I3D computer model of the SARS-CoV-2 virus is layered with a photo of lab workers in protective gear and a global map.
Abled.ALERT: Outbreak | Emergency: COVID-19 Coronavirus Pandemic. Abled.FAQS. Image: Lab workers in hazmat suits work at a desk.

What Is COVID-19?

Illustration of microscopic view of COVID-19 Coronavirus.

COVID-19 is the short-form name given to a new Coronavirus disease discovered in 2019.

Coronaviruses are transmitted between animals and people and cause illnesses like the common cold, flu and more serious diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).

It is an infectious disease newly identified in Wuhan, China in November, 2019.

It has since been declared a pandemic by the World Health Organization (WHO), meaning that it has spread  across international boundaries and continents and is infecting large numbers of people.

Sources: CDC | WHO | Wikipedia 

More resources:

Here are some COVID-19 Factsheets in multiple languages from the New York City Department of Health:

 

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How Does It Spread?

Image of people traveling through an airport.

Coughing and Sneezing

The virus spreads by respiratory droplets. These spread by coughing, sneezing, or through respiratory secretions.

A person who is infected with COVID-19 but not experiencing any symptoms can still spread the infection to others. 

The virus that causes COVID-19 is spreading from person-to-person. Someone who is actively sick with COVID-19 can spread the illness to others.

That is why CDC recommends that these patients be isolated either in the hospital or at home (depending on how sick they are) until they are better and no longer pose a risk of infecting others.

How long someone is actively sick can vary so the decision on when to release someone from isolation is made on a case-by-case basis in consultation with doctors, infection prevention and control experts, and public health officials and involves considering specifics of each situation including disease severity, illness signs and symptoms, and results of laboratory testing for that patient.

Current CDC guidance for when it is OK to release someone from isolation is made on a case by case basis and includes meeting all of the following requirements:

  • The patient is free from fever without the use of fever-reducing medications.
  •  
  • The patient is no longer showing symptoms, including cough.
  •  
  • The patient has tested negative on at least two consecutive respiratory specimens collected at least 24 hours apart.

Someone who has been released from isolation is not considered to pose a risk of infection to others.

 

Sources: CDC | mass.gov

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What Are The Symptoms?

Symptoms illustration: Severe Symptoms: High Fever; Pneumonia. Primary Symptoms: Fever, runny nose, dry cough, shortness of breath, fatigue, body ache. Illustration by The University of Alabama at Birmingham.

UPDATED APRIL 27, 2020

Data coming in from the frontlines of the global COVID-19 pandemic has promoted the U.S. Centers for Disease Control and Prevention to add six new symptoms to their previous advisories.

They have updated their list to say that they may appear 2-14 days after exposure to the virus. The previous symptoms only associated fever, cough and shortness of breath or difficulty breathing with the disease.

New possible COVID-19 symptoms:

  • Loss of taste or smell
  • Headache
  • Chills
  • Muscle pain
  • Repeated shaking
  • Sore throat

Other less common symptoms can include:

  • Stuffy or runny nose
  • Aches and pains
  • Sore throat
  • Headaches
  • Diarrhea or nausea

Still not officially included in this list are growing cases of COVID-19 causing blood clots and major strokes in younger patients, and the appearance of what’s being called “COVID-Toes”, in which micro blood vessels are also being blocked in the feet. We’ve included a video report on these last two sets of symptoms in your Headlines Tab in the C19 News Logs section.

 

If you develop emergency warning signs for COVID-19 get medical attention immediately!

 

Emergency warning signs include*:

 

1. Trouble breathing

2. Persistent pain or pressure in the chest

3. New confusion or inability to arouse

4. Bluish lips or face

 

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

Sources: CDC | 

 

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Are There Any Treatments?

Bottles of Remdesivir are grouped together on a shelf in a hospital for COVID-19 patients in Wuhan, China.

*UPDATE: FDA Approves Plasma Treatment For COVID-19

The U.S. Food and Drug Administration has approved the use of what it calls “COVID-19 convalescent plasma” for patients with life-threatening forms of the illness.

The serum is derived from the donated blood of COVID-19 survivors who have built up antibodies to the new coronavirus. More details in our Headlines section.

Other than this, there are currently no other approved treatments or preventive vaccines for COVID-19 infection. 

As researchers in a number of countries race to develop a vaccine, drugs approved for other conditions are making news as potential treatments for patients with the newest coronavirus.

At an earlier stage in the outbreak, Remdesivir, a drug approved to treat Ebola, was showing promising treatment results, but because of potential side-effects such as liver toxicity, it requires further clinical study before being used on the frontlines of treating COVID-19.

Since then another drug – Chloroquine – approved for treating malaria, lupus and severe rheumatoid arthritis, was being hailed as a “miracle drug” after a number of patients in critical condition said it made the difference between life and death.

However, this drug is also not without serious side-effects, including liver toxicity. Officials in Nigeria report three cases of chloroquine poisoning after people overdosed on the drug.

Some doctors and individuals have been reporting successful treatment outcomes when using a combination of the less-toxic hydroxychloroquine with the antibiotic Azithromycin, and a Zinc supplement.

We’ve placed more information on this in our C19 Rx Logs tab, and videos about it in our C19 Video Logs tab section.

The Trump administration has taken measures to allow critically-ill COVID-19 patients to have access to these as-yet unproven therapies.

 

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How Can I Protect Myself?

Illustration showing phases of hand washing. 1. water and soap. 2. Palm to palm. 3. Between fingers. 4. Focus on thumbs. 5. Back of hands. 6. Focus on wrists. Illustration from initial.com.sg

Take Steps To Protect Yourself

protect-wash-hands.png

Clean your hands often

  • Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
  • If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  •  

protect-quarantine.png

Avoid close contact

Take steps to protect others

COVIDweb_02_bed.png

Stay home if you’re sick

COVIDweb_06_coverCough.png

Cover coughs and sneezes

  • Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
  • Throw used tissues in the trash.
  • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
  •  

COVIDweb_05_mask.png

Wear a facemask if you are sick

  • If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room. Learn what to do if you are sick.
  •  
  • If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.
  •  

COVIDweb_09_clean.png

Clean and disinfect

  • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
  • If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.

Sources: CDC

More Resources:

Here are links to multiple language versions of a flyer prepared by the New York City Department of Health:

 

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What Should Caregivers Do?

Stock photo of a young woman with an elderly woman.

 

Caring For Someone At Home

Most people who get sick with COVID-19 will have only mild illness and should recover at home.* Care at home can help stop the spread of COVID-19 and help protect people who are at risk for getting seriously ill from COVID-19.

COVID-19 spreads between people who are in close contact (within about 6 feet) through respiratory droplets produced when an infected person coughs or sneezes.

If you are caring for someone at home, monitor for emergency signs, prevent the spread of germs, treat symptoms, and carefully consider when to end home isolation.

*Note: Older adults and people of any age with certain serious underlying medical conditions like lung disease, heart disease, or diabetes are at higher risk for developing more serious complications from COVID-19 illness and should seek care as soon as symptoms start.

Monitor the person for worsening symptoms. Know the emergency warning signs.

  • Have their healthcare provider’s contact information on hand.
  • If they are getting sicker, call their healthcare provider. For medical emergencies, call 911 and notify the dispatch personnel that they have or are suspected to have COVID-19.

If you develop emergency warning signs for COVID-19 get medical attention immediately.

Emergency warning signs include*:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

Prevent the spread of germs when caring for someone who is sick

  • Have the person stay in one room, away from other people, including yourself, as much as possible. 
    •  
    • If possible, have them use a separate bathroom.
    •  
    • Avoid sharing personal household items, like dishes, towels, and bedding
    •  
    • If facemasks are available, have them wear a facemask when they are around people, including you.
    •  
    • It the sick person can’t wear a facemask, you should wear one while in the same room with them, if facemasks are available.
    •  
    • If the sick person needs to be around others (within the home, in a vehicle, or doctor’s office), they should wear a facemask.
    •  
  • Wash your hands often with soap and water for at least 20 seconds, especially after interacting with the sick person. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
  •  
  • Avoid touching your eyes, nose, and mouth.
  •  
  • Every day, clean all surfaces that are touched often, like counters, tabletops, and doorknobs
    • Use household cleaning sprays or wipes according to the label instructions.
    •  
  • Wash laundry thoroughly.
    • If laundry is soiled, wear disposable gloves and keep the soiled items away from your body while laundering. Wash your hands immediately after removing gloves.
    •  
  • Avoid having any unnecessary visitors.
  •  
  • For any additional questions about their care, contact their healthcare provider or state or local health department.

Provide symptom treatment

  • Make sure the sick person drinks a lot of fluids to stay hydrated and rests at home.
  •  
  • Over-the-counter medicines may help with symptoms.
  •  
  • For most people, symptoms last a few days and get better after a week.

When to end home isolation (staying home)

  • People with COVID-19 who have stayed home (are home isolated) can stop home isolation under the following conditions:
  •  
    • If they will not have a test to determine if they are still contagious, they can leave home after these three things have happened:
    •  
      • They have had no fever for at least 72 hours (that is three full days of no fever without the use medicine that reduces fevers)
        AND
      • other symptoms have improved (for example, when their cough or shortness of breath have improved)
        AND
      • at least 7 days have passed since their symptoms first appeared
      •  
    • If they will be tested to determine if they are still contagious, they can leave home after these three things have happened:
    •  
      • They no longer have a fever (without the use medicine that reduces fevers)
        AND
      • other symptoms have improved (for example, when their cough or shortness of breath have improved)
        AND
      • They received two negative tests in a row, 24 hours apart. Their doctor will follow CDC guidelines.

Sources: CDC 

 

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Abled FAQS: Cover coughs and sneezes. Socially isolate and wear a face mask if you are sick. Wash hands with soap often. Clean and disinfect surfaces. Seek immediate help if you have difficulty breathing.

COVID-19 Symptoms Map

Allergies, Cold, Flu or COVID-19?

The Symptoms Map shared below from the Asthma and Allergy Foundation of America (AAFA) consolidates data from the World Health Organization (WHO) and U.S. Centers for Disease Control (CDC) and does not include more recent anecdotal reports of gastrointestinal pains and loss of appetite and loss of sense of smell, although researchers are reporting the last two are affecting up to 60% of those who test positive for the coronavirus.

It also doesn’t include symptoms that may mimic a heart attack which have evolved out of two studies, one in China and one in Nebraska. You can read more about that in our “Heart Attack or C19?” report above.

UPDATE: Data scientist Seth Stephens-Davidowitz has written in the New York Times Opinion section that Google searches for “loss of smell” and “eye pain” or “burning eyes” have correlated with the rise of COVID-19 diagnoses in geographic hotspots.

He said the data showed that searches in Italy for “bruciore occhi” (“burning eyes”) were five times their usual levels in March, and above fourfold in Spain, and up 50% in Iran and that the condition could be considered symptoms of the coronavirus. However none of this has been confirmed by health officials.

Other data points out that sneezing and a runny or stuffy nose is one symptom that largely differentiates cold and allergies from COVID-19. Another differentiating symptom, according to the AAFA graphic, is shortness of breath. People suffering from shortness of breath could be a sign they have COVID-19.

Allergies, cold and flu can trigger shortness of breath for those with asthma, according to AAFA. Regardless, anyone developing chest pain and/or shortness of breath should  seek immediate medical attention.

Symptoms Map best viewed in landscape orientation on smartphones and tablets.

 

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Abled.ALERT: Symptoms comparison map for Allergies, Cold, Flu and COVID-19. Text list in previous FAQS section.

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COVID-19 Extended Damage

Understanding the extent of the damage

As the number of coronavirus cases continues to surge worldwide, health experts are learning more about the extent of the damage COVID-19 can do.

The lungs have been considered ground zero, but now doctors are finding its reach extends to other organs.

Dr. Qanta Ahmed, a New York pulmonologist and intensive care specialist, joined CBSN to break it all down in the video below.

 

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20 Questions About C19

The international outbreak of COVID-19 poses a serious public health threat.

The federal government is working closely with state, local, tribal, and territorial partners, as well as public health partners, to respond to this public health threat.

The public health response is multi-layered, with the goal of containing the spread and mitigating the impact of this virus.

During this special webinar from CDC EPIC in March, Dr. Jay Butler shared the state of the outbreak at the time, what the U.S. Centers For Disease Control (CDC) is doing to respond to it, and how partners, organizations, and the public can help.

 

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When To Call 911?

CDC’s Dr. Nancy Messonnier recommends everyday preventive actions to help prevent the spread of respiratory viruses, including novel coronavirus that causes COVID-19 disease.

 

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How Does It Spread?

CDC’s Dr. Nancy Messonnier recommends everyday preventive actions to help prevent the spread of respiratory viruses, including novel coronavirus that causes COVID-19 disease.

 

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C19 Coping At Home

If you are sick with COVID-19 or suspect you are infected with the virus that causes COVID-19, follow the steps above to help prevent the disease from spreading to people in your home and community.

 

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Are You At Higher Risk?

Older adults and people of any age who have serious underlying medical conditions may be at higher risk for severe complications from COVID-19

 

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Can I Take Ibuprofen?

Dr. John Brooks, CDC’s Chief Medical Officer for the COVID-19 response, answers a key question about the novel coronavirus outbreak.

 

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Can C19 Re-infect?

Abled.ALERT: Stock photo of an African-American couple. The man holds a tissue, while the woman checks a thermometer.

Studies out of China, and reports from Japan and South Korea are producing frightening headlines about recovered COVID-19 patients testing positive for the new coronavirus after being discharged. Should we be worried?

Sick After Getting Better

Is it a re-infection? Is it a relapse? Is it a virus mutation? Is it the result of a mistake in testing? Many questions have popped-up in the wake of those worrisome headlines out of Asia.

Anecdotal reports from separate friends in California report symptoms similar to coronavirus infection that occurred in late November/early December that went away and then re-appeared a few weeks later in January. This, without the benefit of testing to confirm or rule-out if it was the SARS-CoV2 coronavirus.

That’s because they simply didn’t know about it yet. The government in Wuhan, China didn’t confirm that health officials there were contending with dozens of cases of pneumonia from an unknown cause until December 31, and researchers in China didn’t identify the virus until January 8.

The first case in the U.S. wasn’t identified until January 21 in a man from Washington State who developed symptoms after returning from a trip to the Wuhan region.

It’s also a virus that impacts different people in different ways – some have mild symptoms for a day or two, while others are flat on their backs, out of commission for a week or two. And some who don’t show any symptoms or ill effects have tested positive, meaning that, until that test, they can be invisible “super-spreaders”.

In either scenario, the prevailing wisdom is that the body would be building antibodies to the infection within a week to 10 days after infection. A number of infectious disease experts say testing positive after what seemed like a recovery could be the result of a false negative and that the patient is still infected.

Residual RNA from the virus could be another source of a positive test result, post-recovery, and it’s also possible the virus becomes latent elsewhere in the body after a high immune response, only to rise again “when the coast seems clear.”

We’re still relatively early into this pandemic, and as more time goes by, researchers will hopefully be able to compile more definitive data. 

Hillary Leung has examined this in more detail at Time.com, including the data results from Shenzhen, China where almost 15% of coronavirus patients tested positive after they were discharged.

 

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Heart Attack Or C19?

Abled.ALERT: Illustration of the heart and surrounding blood vessels in a transparent male torso.

More evidence is emerging from around the world that the COVID-19 coronavirus may be damaging the heart as well as the lungs in many patients because it triggers a cytokine storm. We explain what that is below.

The C19 Cytokine Storm

With every new diagnosis of COVID-19 disease caused by the new SARS-CoV-2 coronavirus, doctors are accumulating more knowledge that raises more troubling questions.

One of them is: “Should every coronavirus patient be tested for high blood levels of troponin to see if the virus has attacked the heart?” 

That’s a question New York Times science and medicine reporter Gina Kolata raises in documenting the case of a 64 year-old patient rushed to a Brooklyn hospital with all the signs of a serious heart attack, including high levels of a protein called troponin, and an “ominous heart rhythm”.

Yet in surgery, doctors didn’t find any blocked arteries. They concluded it wasn’t a heart attack. It was coronavirus.

That conclusion appears to concur with similar cases in China and Italy documented in the  Journal of American Medicine Cardiology (JAMA Cardiology), with a study lead at Wuhan University saying they found 20% of COVID-19 patients had some evidence of heart damage.

The resulting question is whether that damage is caused by the virus itself, or the body’s immune response to it? When bacteria or viruses invade the body, our immune system cells “spray the battlefield” with cytokines, a family of molecular messengers that have various functions. If the response gets out of control and turns into a flood – the aforementioned “cytokine storm” – the resulting inflammation and potential for blood clots damages the lungs and the heart.

Damaged lungs can increase the risk for arrhythmias. Some COVID-19 patients have reported a rapid heartbeat that felt like it was going to “beat out of their chest”.

The Wuhan study found that the risk of death was over four times higher among COVID-19 patients with heart complications than those without. That becomes an ominous clarion for medical professionals around the world to assess the heart, as well as the lungs in treating COVID-19 infection.

 

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Airborne C19 Danger?

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Fears that the C19 virus can be spread through the air have risen after a new study found high levels of it in the air of hospital rooms and traces in corridors hours after patients had left. More details below.

New Contagion Concerns

As the world learned about the outbreak of the COVID-19 coronavirus, people were told by health authorities everywhere that it is spread by droplets through coughing and sneezing.

Then we progressively learned the virus could survive on surfaces for hours and days.

Now, a new, but small, study out of the University of Nebraska says the virus can spread through the air and remain contagious for hours – just the frightening scenario health officials have been dreading.

During the initial isolation of 13 people confirmed positive with COVID-19 infection, air and surface samples were collected in 11 isolation rooms to examine environmental contamination.

Air collectors found high levels of C19 in the air in hospital rooms hours after patients had left. Just as troubling, they found traces of it in the corridors outside those rooms where medical staff had been coming and going, suggesting that COVID-19 patients, even those who are only mildly ill, may create aerosols of virus and contaminate surfaces that may pose a risk for transmission.

This means it’s possible people may become infected even if they are not in the presence of someone who is.

The UNMC Newsroom is quick to emphasize, “IMPORTANT context about this information: Our findings DO NOT confirm that this virus spreads in an airborne fashion.

The identification of genetic material from the virus that causes COVID-19 in air samples found in this study provides limited evidence that some potential for airborne transmission exists.

More study is underway to determine if live culturable virus was captured in this study and additional evidence is needed to determine the risk of SARS-CoV-2 transmission via the airborne route.”

That said, there is a very important takeaway from the study: “Our findings show how important it is for health care workers providing direct care to these patients to take enhanced transmission precautions,” said John Lowe, PhD, vice chancellor for Inter-professional Health Security Training and Education.

“That means wearing the proper personal protective equipment, using negative air pressure rooms for these patients whenever possible and being mindful about the method of entering and exiting these rooms.”

You can read more about the study at the University of Nebraska Medical Center.

 

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How To Make A Mask?

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As more states move toward loosening lockdown orders, many are mandating the wearing of face coverings in public settings. In the following video, the U.S. Surgeon-General shows how to make a face covering at home from your own clothing.

Ventilator Drugs Crisis?

Abled.ALERT: Video still showing an anesthesiologist and an assistant dressed in protective gear intubating a mannequin as a demonstration of what would be done with a COVID-19 patient in respiratory distress.

Coronavirus briefings and the resulting media headlines focus on having enough ventilators. Yet, the growing shortage of drugs needed to sedate patients intubated on those ventilators may become a catastrophe.

Like An Ambulance Low On Gas

There is an invisible 800-pound gorilla in the room every time the topic of ventilators comes up in White House or state coronavirus briefings.

If you’re a health professional, you can have all the ventilators in the world, but they’re not going to do you, or COVID-19 patients, any good if you run out of the essential medications required to use them.

At the stage a C19 patient develops breathing difficulties because fluid is filling the lungs, they need to be rush to the  ICU (Intensive Care Unit) and intubated.

This means giving them oxygen and a mix of medications to induce sedation before a breathing tube is inserted in their throat and down their trachea and then connected to a mechanical ventilator that helps them breathe better than they can on their own.

Then you need medications to maintain that sedation, which in some C19 cases can last for weeks. Without adequate supplies of fentanyl, propofol (yes, the drug that killed Michael Jackson) and versed, the prospect of intubation without them would be excruciatingly torturous and not even feasible.

Ventilators would sit idle just like a fleet of ambulances that have run out of gas.

And there’s no quick fix. With healthcare systems being overwhelmed around the world by this pandemic, those on the frontlines are raising the alarms about the dwindling medication supply, as much as 80% of it filled by generics produced outside the United States in China and India.

So invoking the wartime Defense Production Act isn’t even an option for those companies. And DEA hospital restrictions on volume-buying many of these controlled substances, coupled with a mandatory three-week sterility quarantine, mean time is not only of the essence – we’re already behind.

Dan Kistner negotiates cheaper medicine contracts for over half of hospitals and healthcare facilities in the United States, including purchases of sedatives, pain meds and paralytics essential for patients who are on ventilators.

The Group Senior VP at group purchasing organization Vizient says even “if you started making more of these drugs today, it would take a minimum of five weeks to get it into the hands of an ER doctor beside a ventilator . . . you have to act now.”

In addition to the drug shortage, hospitals and care facilities could face a shortage of healthcare workers trained to operate them.

Dr. Doug White, an intensive care physician at the University of Pittsburgh School of Medicine told ABC News, “If you have a thousand more ventilators magically appear, do you have the 20 ICU [Intensive Care Unit] doctors, 300 ICU nurses, 150 respiratory therapists and all of the PPE (Personal Protective Equipment) needed to support those 1,000 new ventilators? Simply put, ventilators don’t run themselves.” 

So, what to do?

Freelance investigative journalist, and the 2019-2020 Snedden Chair of Journalism at the University of Alaska Fairbanks, Lois Parshley posed that question to Kistner and health professionals on the COVID-19 front.

You can read the answers she got at Vox.com.  You can also listen to a report from Melissa Block on NPR’s “All Things Considered” where Dan Kistner explains that the FDA has been “receptive” to recommendations from Vizient to respond to this challenge.

 

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Ventilator Alternatives?

Abled.ALERT: Video still of a hospital mannequin wearing a CPAP breathing mask for non-invasive ventilation.

As U.S. President Trump enacts wartime powers to force the auto industry to build ventilators, researchers are testing non-invasive methods for ventilation not dependent on scarce sedation drugs. 

Testing "Viagra Gas"

It’s been used to treat newborns with heart defects, and it led to the development of the erectile dysfunction medication Viagra.

Now, nitric oxide, a colorless gas that causes blood vessels to dilate, or expand, by relaxing the smooth muscle in them, is being tested to see if it can help COVID-19 patients avoid the need for being hooked up to a ventilator and the invasive intubation process that involves.

In a new international clinical trial overseen by Boston’s Massachusetts General Hospital, and involving partner facilities in Alabama, Louisiana, Austria, Italy and Sweden.

Using a non-invasive CPAP (Continuous Positive Airway Pressure) machine, often used by people with sleep apnea, coronavirus patients with mild to moderate symptoms will inhale the nitric oxide gas for 20 to 30 minutes twice a day for two weeks.

If the study results show promise, this treatment approach could be put into widespread use immediately because the gas is already FDA approved.

Professor of Pediatrics, Surgery and Medicine Dr. Keith Scott, principal investigator of the trial taking place at Louisiana State University Health in Shreveport, says, “Nitric oxide is one of possibly many therapeutic agents that may show it will help mitigate COVID-19 severe lung injury. It is not a silver bullet but it’s our hope it would have a positive affect on reducing the progression of a disease that devastates the lungs.”

He added, “Most of these patients will be on the ventilator and have severe lung injuries so it would be a loved one who would decide if they wanted us to try this. It’s just really a raging phenomenon that occurs in the lung and if we can just calm that down a little bit and allow the body’s natural systems to come in and heal it, that’s the real goal.”

A second trial is also being considered that would have healthcare workers who are routinely exposed to COVID-19 patients inhaling a high dose of the gas for 10 to 15 minutes at the start and end of every shift.

 

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Allergies, Flu Or C19?

Abled.ALERT: Photo shows a woman sneezing into a handkerchief near flowers and bushes in her garden.

The global COVID-19 pandemic has collided head-on with cold and flu season, and is now spreading well into allergy season. The dilemma for many people is how to tell the symptoms apart? We compare them below.

Comparing Symptoms

In this mashup of cold, flu and now allergy season, the biggest symptom a cough or sneeze may trigger is fear – fear that it’s COVID-19.

Because so much is unknown about the new coronavirus, possible symptoms are evolving as the pandemic spreads and more cases are treated by doctors.

Dr. Bruce Aylward of the World Health Organization told npr that 90% of COVID-19 patients have a high fever as an early symptom and 70% have a dry cough. “It’s not the sniffles,” he says. “It’s not a runny nose. That can be a symptom, but that’s rare.”

Spring has come early for the estimated 19 million allergy sufferers in the U.S., and with it a paranoia that their usual seasonal symptoms of red eyes, a runny nose, scratchy throat, coughs, sneeze and body aches may be the signs of the more sinister coronavirus.

Time/AP reports that Jessica Tanniehill, 39 of Adamsville, Alabama ran that gamut of symptoms and figured her seasonal allergies had started. But then they were followed by shortness of breath. She had tested positive for COVID-19, but the report points out that this “doesn’t preclude the possibility she’d had allergies as well.”

In the following TAB section, we’ve placed a “Symptoms Map” compiled by the Asthma and Allergy Foundation of America (AAFA) based on shared data from the CDC and WHO that differentiates symptoms between conditions.

 

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COVID-19 Symptoms Map

Allergies, Cold, Flu or COVID-19?

The Symptoms Map shared below from the Asthma and Allergy Foundation of America (AAFA) consolidates data from the World Health Organization (WHO) and U.S. Centers for Disease Control (CDC) and does not include more recent anecdotal reports of gastrointestinal pains and loss of appetite and loss of sense of smell, although researchers are reporting the last two are affecting up to 60% of those who test positive for the coronavirus.

It also doesn’t include symptoms that may mimic a heart attack which have evolved out of two studies, one in China and one in Nebraska. You can read more about that in our “Heart Attack or C19?” report above.

UPDATE: Data scientist Seth Stephens-Davidowitz has written in the New York Times Opinion section that Google searches for “loss of smell” and “eye pain” or “burning eyes” have correlated with the rise of COVID-19 diagnoses in geographic hotspots.

He said the data showed that searches in Italy for “bruciore occhi” (“burning eyes”) were five times their usual levels in March, and above fourfold in Spain, and up 50% in Iran and that the condition could be considered symptoms of the coronavirus. However none of this has been confirmed by health officials.

Other data points out that sneezing and a runny or stuffy nose is one symptom that largely differentiates cold and allergies from COVID-19. Another differentiating symptom, according to the AAFA graphic, is shortness of breath. People suffering from shortness of breath could be a sign they have COVID-19.

Allergies, cold and flu can trigger shortness of breath for those with asthma, according to AAFA. Regardless, anyone developing chest pain and/or shortness of breath should  seek immediate medical attention.

Symptoms Map best viewed in landscape orientation on smartphones and tablets.

 

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Abled.ALERT: Symptoms comparison map for Allergies, Cold, Flu and COVID-19. Text list in previous FAQS section.

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#GetUsPPE

URGENT NEED FOR PPE

The growing scale of the COVID-19 pandemic is overwhelming medical facilities and medical professionals world-wide, and causing a critical shortage in PPE (Personal Protection Equipment).

#GetUsPPE is a coalition of people in medicine that is trying to coordinate donation and distribution of masks, gloves, goggles and other essential items through an online data base that connects donors with healthcare workers and facilities.

They are also trying to unite with the maker community to validate designs that can be widely shared among the medical community and easily printed in local manufacturing facilities.

You can request or give as follows:

I NEED PPE | I HAVE PPE

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