#to get tested and see if I can take those anti-viral drugs that help

[lastoneout]

Guess who finally probably caught the virus T_T

[flyonthewallmedstudent]

Watching House as a Physician.  Season 2 Episode 3. Infectious diseases & Respiratory.

Welcome to another episode of medicine done badly.  I’ve been watching House on Amazon prime.  Got the subscription during the pandemic, as like everyone else, I’ve garnered an online shopping habit now. 

Alright. In the opening scene a young roof worker falls off the roof presumably due to acute shortness of breath. i.e. trouble breathing. (why do we use the term shortness of breath? it’s the english version of the greek term dyspnoea - the actual preferred language of Western doctors. Fuck do I know why we like Greek and Latin so much. Moving on.) Then cut to Dr. Cuddy examining him in the back of the ambulance. 

This would never happen in real life. Yes you can be on the scene and handover to the paramedics or EMT when they arrive as a doctor. But they would take over. I personally wouldn’t have the balls to look after a patient in a different environment, different resources and field I’m not familiar with. You can have field Emergency docs - but requires different training. 

Also, ethically, you’re not meant to treat family or friends. Dr. Cuddy later in the episode gets a bit emotionally involved - this is why we don’t treat people close to us. We lose objectivity. We make mistakes. And you see later see Cuddy do some pretty bad ones. 

I feel like much of this episode is not really IM. THere’s less differential diagnoses being made. More side tracks into trauma, emergency, intensive care or vascular surgery. 

Anyhoo. Trauma and emergency would manage the fall and post fall traumatic injuries. And the trauma protocol was either not shown or completely off in this episode. Surgeons don’t seem to exist in House, at least not very much. Similarly, no other doctors exist except surgeons in Grey’s anatomy.  Also you can’t clear a C Spine clinically, which is what Dr. Cuddy does in the back of the ambulance. You’d need a CT first and clearance both radiological (by a radiologist) and a clinician. 

Aaaanddd, you can’t just listen to the chest and go no pneumothorax (air in lung or collapsed lung) - yes it’s reassuring, but again you’d need imaging to confirm this, given how serious a condition this is. It is realistic to consider in the setting of a fall, particularly if there are rib fractures that can puncture the lung.

Once the more critical injuries are managed, we would look after the IM side to things. 

So. Finally.. differential diagnoses.

Takes what seems and feels like days before they finally sit down and go through differentials. Really not much on that white board. Dark fingers, broken ribs, fever and lung infiltrates. Time line’s not clear on when he developed the fever.

Presenting complaint isn’t really addressed. It could be: - Dyspnoea, leading to the fall, he’s requiring O2 via nasal prongs, which suggests that he’s hypoxic (this is definitely odd in a young guy who’s normally very physical fit if he works as labourer). so much to unpack here, but they never get into this well.  Post fall, Cuddy notices his ring and pinky finger becoming dusky, which becomes very central in this episode. Very few things would cause this. pains me that they do no differentials on a white board for this alone. 

Then a lot of throwing around medical terms. 

PTT prolonged and Fibrinogen off. These are markers of your coagulation pathway and signs that you’re not forming the clots the way you should if you have an injury.  DIC is also thrown around. What is DIC? Disseminated intravascular coagulopathy. Certainly severe sepsis and trauma can cause this and lead to severe bleeding. It will throw off your coagulation pathways (things that stop bleeding). It’s not common. I’ve treated it once, while I was rotating in ICU, it is not standard ward medicine practice. Standard therapy is fresh frozen plasma (FFP) and even large metropolitan hospitals only have a limited supply. It’s a huge concern for surgery and post-op (as you patient will just not stop bleeding after you cut them open, and if not treated, potentially bleed to death). Cuddy mentions ARDS. Acute respiratory distress syndrome, it could be a complication, but it’s not a cause. Again, falls more into the realm of critical care (a la ICU). However, patient had SOB prior to the fall. Finally HOuse makes the observation. of “what if he was sick before he had his run in with gravity...” Everyone jumps to Pneumonia. And this is where it gets confusing.  If he was unwell, the minute he entered the emergency department with a fever and hypoxia, they would have worked him up for any garden variety pneumonia, bacterial or viral. Cultures would have been sent and imaging. Any young hypoxic patient would prompt a closer look at the chest. And no one waits that long to start antibiotics - “sepsis kills” is a slogan often used around hospitals. You have to initiate empirical therapy within 30 mins, to reduce mortality and morbiditiy. 

Ordering an Echocardiogram (USS of the Heart) also makes no sense in the context of a lung infection. I would order one, but not to look at the lungs.

Then there’s the most unrealistic thing about this series. Doctors breaking into patient homes.

It is however, a good way to showcase social history. It’d be boring to watch a doctor ask the patient outright about their living situation etc, but it’s far more interesting to see exactly how they live. We try as much as possible to illustrate to each other and ourselves what the living environment and working environment of our patients are like. 

In the context of infection, a good social history can point out exposure. As they exemplify by showing dead rodents and mould. This leads to 2 further differentials: Rat bite fever (caused by streptobacillus, something you’d see in the US, but probably not anywhere else), it’s an unrealistic differential in general. And the 2nd is aspergillosis.  Okay..  So aspergillus is a mould commonly found in our environment. In fact it’s everywhere around us. 

THere’s few times when it’s an issue.  It is a concern in respiratory syndromes like asthma or bronchiectasis. And also as an opportunistic infection in immunocompromised individuals. in the context of asthma, it’s not so much the aspergillus itself that causes issue, it’s our body’s over reaction. It’s a hypersensitivity issue that causes inflammation in the lungs or a pneumonitis. We even gave it a name. Allergic bronchopulmonary aspergillosis. It’s still badness, but it doesn’t happen that quickly. We also have specific tests for this, which were obviously not considered in this episode of medicine done badly. In the immunocompromised host (steroid therapy in transplant patients or those on chemo, etc.), you can get the invasive mould as an opportunistic infection.  I don’t really understand why they think it would be the case here. Also, killing the bug with heavy duty anti fungals will only give more issues rather than do anything. They start him on amphotericin. this is not standard practice.  And now it flips to why amphotericin is not standard practice or first line treatment for invasive aspergillosis. The patient has now become anuric (not making any urine). (First line drug by the way is voraconazole, superior efficacy in trials with a lower mortality rate and ADRs) Also, note that they have just jumped straight to dire renal failure from the amphotericin. No work up. That said, heavy drugs like amphotericin are often a cause, but  It’s often temporary with the appropriate supportive measures (stop insulting agents, give hydration, monitor fluid balance), reversible, even if you require temporary dialysis or haemofiltration. Anyways, would get into AKI another day, that’s a whole other post in and of itself.  Then his hand is apparently “dying.” There’s pain on light touch, but it’s not a cold, pulseless limb. Or discoloured. doesn’t add up. This now enters vascular surgeon territory. Again. It’s interesting that there’s never any referrals to any other teams. If he has good circulation, I would imagine they would try to save the hand and consider other differentials. 

The only time I can think of an emergency amputation in this situation is necrotising fascitiis. That’s the only thing that would occur that rapidly  AND necessitate losing tissue or limb.  With a young person who’s this ill, there’s often multiple subspecialties involved by this point. I’m also surprised he’s not in ICU.

Then there’s a buncha filler scenes of the cast of house getting emotional. Ho my god, they’ve taken the hand of a young 20 something physical labourer. Indeed, this is badness. Unlike House, we actually are trained to always consider how a patient’s illness impacts their activities of daily living and livelihood. 

I find the general population assumes that we practice medicine in a vacuum, we merely treat the clinical illness and ignore everything else. They imagine that we all must be like house. 

Actually we try to put things in perspective as much as possible and knowing our limitations in this area, we often enlist the help of friends - physiotherapists, occupational therapists and social workers. They never exist on TV or on the movies. Ever. Unless it’s to portray how terrible it is to be a social worker.  From time to time in this episode, Cuddy laments that being chief of medicine is too administrative and she hasn’t been a doctor in years. That also doesn’t happen in real life. If you’re chief you’re still a doctor. You have admin shit to do deal with yes, but you still practice. It’s like being chief resident, in all the TV shows with one of these, you still seem them working as residents, be it scrubs or grey’s anatomy. 

Back to the differential. They finally get to endocarditis. Culture negative to be precise. That indeed would explain the bilateral dusky fingers that led to unnecessary amputation. Septic emboli. 

Going to stop here, more out of exhaustion now. I’ve created quite a lengthy post. Happy to reblog thoughts on culture negative endocarditis on request later. This is a worthy topic to study up on for students or residents. At least review Duke’s criteria and think about your clinical features like Roth Spots and Janeway lesions or Ouch Osler’s nodes. 

The ending is also a far fetched connection to make, but is one that we would consider. In fact, we would ask in detail every time from day one - have you had any exposure to animals. It’s very rare to see someone so young be that sick out of the blue when you’re immunocompetent and have no underlying predisposing conditions. If there’s no focal source, then we would even ask about injectable recreational drugs, exotic travels, sexual health. 

Most of the time, patients that sick are honest to their doctors. 

But what about..

Frankly, much as we lie as humans, when our lives our on the line, we’re generally pretty honest (sometimes too honest) with the people we want to save us. 

Any patient who is young and comes to hospital requiring inpatient admission, they’d be investigated by subspecialties with expertise in certain areas such as infectious disease. The dept of infectious disease would either be home team, or all over this patient as they special in the realm of both common and rare infectious diseases, culture negative endocarditis would have been considered before a hand amputation.

The term, “department of diagnostic medicine is laughable,” particularly when they consider it the only department in the world in the show. 

In actuality, it’s a department that is universal and exists everywhere. it’s Internal medicine. Dr. Vivek Murthy, the next surgeon general (and also the last one under Obama) is an internal medicine physician. Ken Jeong of Community and the Hangover fame is also a physician of internal medicine. 

Beginning to get the sense that most episodes are going to end with a diagnosis that is either infectious disease, rheumatology or haematology. But generally those tend to be most interesting and give the most plot twists or meaty differentials V.s. a stroke or acute myocardial infarction is fairly straightforward to diagnose. 

This is a very twisty episode in all the wrong directions. 

Dyspnoea is a very common presenting complaint. There’s a properly done approach to this in the podcast by the Curbsiders by the way. 

[pickingoutchinapatterns]

So, I just found out you’re a nurse. Thank you. 🙏 What is happening for you at the moment?

Ok, so I’m a nurse and admittedly I’m angry and frustrated.  This is gonna be a non-filtered rant (I may go into details about some points later). Also, before I get any shit bc I’m “just a nurse” (which happens), I’ll say that nursing is actually my third degree, my other 2 (undergrad and graduate) are also in the sciences.  Ok, let the rant begin.

First, when this is over, we need to fund education.  EVERYONE should have a basic knowledge of math and biology.  Seriously, have some of you ppl never heard of exponential growth? Let’s say an organism in a petri dish replicates once a day.  At the end of the first day, you’ll have 2, but at the end of the 14th day (I’m using that bc of the current “2 week isolation period” currently being advised right now), you don’t get 28 organisms in your dish (2x14), but 16,384 (2^14) organisms.  The growth of this organism will only slow down once it starts running out of resources (which is why you get an S shaped growth curve).  

WHY YOU SHOULD LISTEN TO WHAT PUBLIC HEALTH IS SAYING:  This is similar to disease spread.  If you infect one person, you’re literally making things exponentially worse.  And guess what, if you self-isolate you are GETTING RID OF THE VIRUS’ RESOURCES.  Viruses, unlike bacteria, cannot replicate on their own.  THEY NEED YOU TO GROW.  Plus, based on the data from the Japanese cruise ship, about half of those infected were ASYMPTOMATIC.  This means that we don’t know how many ppl are infected but we literally have THOUSANDS of Typhoid Mary’s out there.  Plus, given that it often takes about 2 weeks to develop symptoms of the virus,  so even if everyone is at home on lockdown, we won’t see how bad it actually is NOW for at least 2 WEEKS FROM NOW.  

STOP HOARDING AND STEALING MASKS AND PPE (personal protective equipement).  Yes, ppl are literally stealing PPE from hospitals.  JUST STAY THE FUCK HOME.

I know that a lot of ppl have the attitude of “oh, it’s mild for most ppl” or “it just kills the elderly.” First, “it just kills the elderly” is NOT true.  The ppl it hits the hardest INCLUDE the elderly, but ALSO INCLUDES ppl with comorbidies like diabetes, cardiac conditions and high blood pressure (SOUND LIKE ANYONE YOU MIGHT FUCKING NOW???) and HEALTH CARE WORKERS.  No one knows why front line health care workers are hit so hard (my hypothesis is bc we are exposed to higher viral loads, plus we work in a stressful, germ infested place AND we do shift work…not exactly the best combinations for a healthy immune system.  Plus, many of us also suffer from comorbidities as well.)  The health care system was stretched tightly enough before this pandemic (cancer, flu season, infectious diseases and drug epidemics), so imagine us dealing with a pandemic AND our regular workload AND being SUPER SHORT STAFFED (which many of us are already before this began).  Italy has already announced a while ago that they’re just deciding that some ppl are not gonna get any treatment bc they HAVE NO MORE RESOURCES.

A note re the N95 (airborne) mask (these are not the basic surgical masks).   Did you know that we have to get trained on how to use them?  And then we have to do a test to make sure that each one of us is using the right brand and size?  (That’s right, it’s not a one size fits all.)  Plus, men have to shave before using one bc even a bit of stubble makes it ineffective?  Now imagine HCP’s are out of N95 masks (used for AIRBORNE precautions like TB, measles and shingles; surgical masks are used for droplet precautions, like the flu). We still have ppl in hospitals with TB, measles and shingles…what if these spread too now that we don’t have N95 masks?

Also, please stop using anti-bacterial soap.  First, COVID 19 is a virus, not a bacteria.  We already have A LOT of antibiotic resistant bacteria out there. (Ex. MRSA, VRE, C-difficile, literally called difficile bc it’s so hard to treat and kill).  Back when I was working in a microbiology lab, we were extra careful using vancomycin bc it was considered a last resort antibiotic and didn’t want to accidentally have bacteria develop and spread resistance to it. Now, I see vancomycin being used in hospitals daily.  (VRE literally stands for Vancomycin-Resistant Enterococci.)

This pandemic is gonna hit every health care system hard worldwide.  If we’re already full, how do you think we’ll handle you coming in needing emergency surgery?  What about during the high smog warnings in summer and ppl come in with heat stroke or a severe asthma exacerbation?  What if you’re going to deliver?  

I am a nurse and I do what I can to help ppl out.  I base my nursing practice on the fact that if I’m seeing you in hospital I’m likely seeing you during the worst time of your life.  This job is a roller coaster, both physically and emotionally.  I will say though, it is absolutely horrible treating ppl in respiratory distress.  It’s like you’re watching someone suffocate and drown at the same time. You see the panic in their eyes and in their families as they try to get enough air.  You do all that you can, and even if the intervention is successful, you still feel useless and shaken.  It is HORRIBLE.  Please, do all that you can to stop this spread and to keep yourself healthy so that my colleagues and I won’t see you anytime soon in any one of our facilities.

End of current rant.

[thetimeoftomorrow]

COVID19 FAQ/CLARIFICATION

(From Singapore's Ministry of Health: https://www.moh.gov.sg/covid-19/faqs)

[Relevant as of 27 March 2020]

Introduction

Hello everyone. Firstly I would like to inform you that I am from Singapore, and we are fighting alongside everyone against the Corona virus. Secondly, all the information I present will be taken directly from my country's government and the link has been provided above as I am not a medical student. Thirdly, please do take this pandemic seriously as it is NOT a laughing matter, and I hope that you keep calm and positive througout this situation.

What are Coronaviruses?

Coronaviruses (CoV) are a large family of viruses causing illnesses ranging from the common cold to pneumonia (a more severe lung infection). A new coronavirus strain has been identified in Wuhan, China. Coronavirus Disease 19 (COVID-19) has caused cases of severe pneumonia in China and cases have been exported to other countries and cities.

How does COVID-19 spread?

There is human-to-human transmission of COVID-19. For now, the evidence suggests spread is mostly via droplets. The virus is carried within droplets emitted from an infected person over a short distance, such as when the person coughs or sneezes. If these droplets come into contact with the eyes, nose or mouth of another person, directly or indirectly through hands that have come into contact with these droplets, the other person may become infected. Members of public are advised to remain vigilant and observe good personal hygiene practices.

What are the symptoms of COVID-19?

The symptoms of COVID-19 infection are similar to that of regular pneumonia. Typical symptoms include fever, cough and shortness of breath.

What is the treatment for COVID-19?

Supportive treatment is provided based on the patient’s clinical condition. No proven specific treatment or anti-viral drug for COVID-19 is currently available.

Is the disease deadly? How is it compared to SARS?

The situation is evolving and many characteristics of the virus and how it may affect people are still unclear. However, current information suggests COVID-19 can cause severe disease and death in 2% to 3% of people with the infection, especially among the elderly and those people with underlying health problems or compromised immune systems.

Who should wear a mask?  What kind of mask should I wear? 

For the general public who are not having any symptoms at all and are well, there is no requirement to wear a mask. 

As a good hygiene measure, people who are not well and have respiratory symptoms should wear a mask so that they do not spread any infection to other people. Anyone who has symptoms should see a doctor as soon as possible, to make sure that they remain well. 

In the case of COVID-19, we know that the infection is spread through droplets. Wearing a mask will protect other people when someone with respiratory symptoms coughs or sneezes, as the mask would trap those droplets and prevent those droplets from spreading and disseminating.

As such, a surgical mask is sufficient for this case and fulfils the important function of preventing a spread if worn properly. The mask should be changed if it gets soiled or stained.

Why do healthcare professionals use an N95 mask and don full personal protective equipment (PPE), including goggles, then?

When dealing with infectious diseases, healthcare workers are required to wear the personal protective equipment (PPE), including N95 and goggles, as they are in close contact with patients and their bodily fluids.

As such, the PPE is needed to create a barrier between healthcare workers and the infectious agents from the patients, and to reduce the risk of transmitting micro-organisms from healthcare workers to patient(s).

How long is the incubation period? If somebody travels to cities with confirmed cases, how many days of no-symptoms after the travel, will he/she then be considered clean and disease-free?

Data from cases in China suggests that the incubation period is around 14 days.

Therefore, travellers are advised to monitor their health closely for at least 2 weeks upon return to [home country]. You are advised to seek medical attention promptly if you feel unwell, and to also inform your doctor of your travel history.

Summary for COVID-19 FAQ

I have compiled the FAQ to be useful to an international audience so if you are a fellow Singaporean please head to the website and remain updated as often as possible. If you are NOT from Singapore, you may still check the link for relevant general information if it helps. Please note the relevancy of this information and stay up to date with the latest news.

COVID-19 Personal Experiences FAQ

(Circulated among Singaporean Citizens)

Introduction

I have compiled a list of relevant information that fellow Singaporeans have been sharing among themselves. I hope people would take the time to read these anecdotes to understand the gravity of the situation, and that it may help in your understanding of this virus. Please do also take the information with a pinch of salt as they have not been confirmed/checked by any authority.

Annecdote from a Singaporean Patient's Family

"Make no mistake. When loved ones are removed from your home by ambulance because the virus has hit them hard, you are not going to be able to follow them there, sit by their hospital bed and hold their hand. You are not going to be able to pop in at 7.00 pm for visiting hours. They are going to have no one other than exhausted and brave hospital staff to see them through days or weeks of barely breathing through a ventilator until they either die or recover. They are not going to be well enough to text you.

You are not going to be able to phone the ward to check in on them regularly (staff will be too busy for that). During that time, they will be completely alone, while you sit at home waiting to hear whether they have made it through.

Imagine that person is someone you love dearly. Because it's going to be a reality for many in the coming weeks.

And if that person in hospital happens to be you, going through that ordeal completely alone, it would be nothing less than terrifying.

Please stay home and only go out if absolutely necessary. Social distancing is imperative right now for your family and mine."

Day by Day Symptoms of COVID-19 from Patients

Day 1-3

Common Cold

Itchy throat

No fever, no fatigue & good eating & drinking seems normal.

Day 4

Painful throat, more itchy/scratchy. The body is weak, & seems intoxicated

Hoarseness (husky voice)

36.5° body temperature

Start to decrease appetite include not wanting to eat & drink water

Mild head pain/headache

Mild diarrhea

Day 5

Inflammation of the throat (You might see white dots or patches in the back of your throat-might be red & swollen). Hoarseness until you lose your voice

36.5°-36.7° body temperature

The body is weak (body malaise) and joint pain(the pain is like rheumatism or gout)

Day 6

37° body temperature (fever)

A dry cough (coughing without phlegm)

Painful throat while eating, worsens when you swallow & when you talk

Body malaise, nausea or recurrent vomiting

Mild breathing problems/shortness of breath

Hand & finger pains

Vomiting (throwing up) and diarrhea (watery bowel movements)

Day 7

High fever from 37.4°-37.8°

Persistent cough with phlegm

Headache/head pain along with diarrhea

Persistent diarrhea

Persistent vomiting

Day 8

Fever 38° above

Breathing problems/Shortness of breath

Persistent cough

Headache, more joint pain, that passes in the lower back like pain in the buttocks (lumbar strain)

Day 9

No relief at all

Fever is getting high temperature

Persistent cough with phlegm

Worsening shortness of breath

If you feel all these, please go to the nearest Hospital's for testing and medication. There is no need to be afraid of having checked on what is being felt to avoid the loss of life for no reason.

Summary

I would like to emphasise that this information is NOT checked by authorities so please do not panic unnecessarily. Please do not spread panic or quote this information without citing its lack of source. Remain calm, and please direct yourself to the nearest hospital/clinic if you are unwell. If that is unavailable to you in your country/state and you are sick, please socially distance yourself at home until the medical team's/hospitals call you in.

Concluding Statement

I understand that for some of you information, medical facilities/equipment, and perhaps even basic necessities (such as food/water/shelter) are unavailable, seeing as I am interacting with an international audience. However, I would like to implore you to stay calm while you treat this matter with the utmost seriousness. This is because anxiety among the people would only cause prices in goods to sky rocket, and you will only endanger people when the market starts bidding wars for things such as equipment and medicine.

So please, firstly do not conduct mass-purchase of anything unnecessarily as it would only result in an inflation in prices for important goods. An example would be chloroquine which is NOT a cure for COVID-19, as mass purchase will place/is placing people suffering from lupis and arthritis at a disadvantage. These patients need that medication, unlike some of us who don't even know if it works against COVID-19.

Seccondly, please do not treat social distancing as a joke. Lives are at stake, and this means any form of contact with the virus will infect your immune system. While travelling overseas might seem fun due to the low priced flight tickets or because of spring break, this virus will infect you and your loved ones if you do not take the necessary precaution. This means sharing of food, untensils, clothes et cetera should be avoided to prevent the virus from infecting others and yourself. Some of you might want to die, but others don't so please, mind their consent if you can't be bothered with yours.

Thirdly, (I do apologise if I sound distinctly more annoyed as I type this, seeing how humanity consistently tries my patience) the corona virus is not an excuse for you to be racist or classist. I repeat: the corona virus is not an excuse for you to be racist or classist. While the COVID-19 virus did originate from China, it is not the 'chinese virus' and it was not borne from skin tones or genetics. It was instead born from the unlucky evolution of bacteria/germs that China so happened to win said lottery for.

This is the country that is developing and making the ventilators you need to stay alive. This is the country that has developed a new technique to keep you breathing/blood circulating if you are unable to do so. This is the country that gave the world 42 days to prepare for an enslaught of cases. They have no reason to help you: the virus was not made by them and you are not their citizen. But they are helping, and the least you can do is to be kind. (And if anyone would like to argue I'd like to quote Wu Chuanpu of supply chain Vedeng on ventilators that "the expansion of the production line is very time-consuming and resources-intensive," and "also involves personnel training. It is too cumbersome.")

So please, do not judge, do not be prejudiced and for the love of god be kind. The world is suffering, and people are dying. This is not the time to be fooling around or placing other things as your priority, whether it be your job, your fun, or your god damn xenophobia.

The priority is containment and survival.

To rebuild humanity you need humanity to exist in the first place. Stop being stupid, selfish and a damn ass hole about it. The virus isn't picky about its victims. It isn't going to care how much money you have, what your skin colour is, or what your age is. We have to work together and fight the common enemy. So stop taking sides and pick this one, the one where everybody wins. Don't be a fucking wuss cowering in the face of this virus. Mankind is resourceful, you are resourceful! Focus on what you can do and not what you can't! Take action, even if it seems small, because the small ones definitely count.

Keep yourself safe, signal boost this for people in need of information, and let's fight hard! Cause I'm definitely welcoming 2021 with all you people on this weird blue site.

Hugs and kisses from the fucking little red dot in Asia bitches ♡

[sciencenewsforstudents]

Scientists may be one step closer to a cure for the common cold. They aren’t fighting the viruses that cause the infection. Instead they’re looking to make human cells — the hotel rooms in which viruses reproduce — an unwelcome place.

Viruses can’t reproduce on their own. They must hijack the machinery in cells to do that. So they temporarily infect those cells to make more of themselves. Then they explode open their host cell. This releases huge quantities of new infectious viruses.

Researchers have now identified a key protein that some viruses need to multiply inside human cells. Disabling that protein might stop a cold virus dead in its tracks. Or that’s the idea described September 16 in Nature Microbiology. Jan Carette is a microbiologist in California at the Stanford University School of Medicine. His team has just shown that in mice and human cells engineered to lack this protein, the viruses couldn’t replicate. No replication, no spread.

“It’s not quite a cure for the common cold,” says Ellen Foxman. She’s an immunologist at Yale School of Medicine in New Haven, Conn., who was not involved in the study. Still, she finds, the new work is “an interesting step forward.”

Colds are our most common infectious disease. On average, adults catch two or three  each year. Children may get even more. Any one of a few hundred viruses, including rhinoviruses (RY-no-vy-russ-es), can cause these infections. That’s one thing that has made it so hard to find a cure for the cold. But there’s a second challenge, too. These viruses mutate — undergo spontaneous genetic changes — quickly. One or more of those changes may eventually leave them able to resist almost any drug thrown at them.

That’s why Carette’s group focused on the human host. The team wanted to see if it could identify the human proteins that many viruses use to replicate. Genes make a cell’s proteins. So these researchers hunted down the gene behind the protein that viruses take over.

Carette and his colleagues started by using a molecular scissor — the gene-editing tool CRISPR — to systematically snip out chunks of DNA from human cells growing in lab dishes. In the process, they built a library of altered cells, each one missing a single protein-making gene. The researchers then infected these altered cells with two types of viruses. One type causes colds. The other has been linked to nerve-related diseases.

Then the scientists used different viral proteins like hooks. They dipped them into the stuff inside human cells to see which proteins these viral hooks latched onto and pulled out. That let the team identify which human proteins were interacting with viral ones. This was a sign that the virus needed those human proteins to hijack a cell’s replicating machinery.

The viruses repeatedly fished out one particular protein. Known as SETD3, tests showed that the viruses needed it to take over a cell. Scientists knew this protein could affect actin proteins — ones that help muscles contract. That it might also aid viral infections came as a big surprise.

Tests show the anti-viral tactic has promise

To test the importance of SETD3, the researchers injected viruses into mice that had been engineered to lack a working version of that gene. And sure enough, no mice got sick. Human lung cells that also lacked the gene also remained healthy. (Lung cells are often used in these types of studies because they are especially susceptible to many cold-triggering rhinoviruses.)

Especially exciting: Running similar tests with other, potentially more serious, viruses suggested the approach may thwart more than just the common cold.

Engineered human cells didn’t become infected when they were exposed to viruses that cause hand, foot and mouth disease and a polio-like spinal-cord disease called acute flaccid myelitis (Flaa-sid My-eh-LY-tis). And when mice were exposed to these viruses, the rodents without a working SETD3 gene were much more likely to survive than those with a working gene.

“We have identified an excellent target,” says Carette, of SETD3. Still, it’s not clear whether disabling that gene and its protein might cause new problems. The engineered mice survived, appeared healthy and were fertile. They could not, however, push their pups out of the womb during birth. Says Carette, this might be due to the protein’s role in muscle contractions.

Scientists don’t fully understand what this gene does in people, so getting rid of it might have some nasty side-effects, notes Vincent Racaniello. He’s a virus expert at Columbia University in New York City who wasn’t involved in the work. “The authors show that mice lacking the gene for SETD3 are viable and resistant to infection. However,” he says, “this observation does not mean that SETD3 in humans is [not needed].”

Instead, the researchers think their best bet is to search for a drug that makes it seem like the gene isn’t working. The drug might block the human protein and its viral counterparts from interacting. Or, it might destroy the SETD3 protein — but only when it is interacting with the viruses.

Such drugs are still a long way off. “The question is always ‘When can I buy it over the counter?’” Carette says. The challenge, he notes: “Drug development takes time.”

[cookemichael]

Bacterial Vaginosis Treatment While Breastfeeding Marvelous Useful Tips

There are several cures for bacterial vaginosis cure which will return your pH level of the associated fishy vaginal odor associated with the infection.The yogurt treatment makes it difficult for the best option because natural cures which you can consume it orally or soak a tea bag or a medicated solution to your doctor or specialist about health and they are unable to stop this condition right from the comforts of your vagina, chances are that the balance of good bacteria problems can arise as a natural BV treatments with regard to bacterial vaginosis are burning inching and the recurrent bacterial vaginosis.So the relief was permanent with zero side effects.It is the exact reasons why a woman pregnant while exposing themselves to being effective in subduing the uncomfortable and feeling yucky.

Treatment varies from one female to another but each one will be the time comes.Have you ever have the bacteria he may be how can you find that Tea Tree Oil really helps, but some of the women who want to worry about treating new cases of BV to occur.You can give you the embarrassment; this also saves you all set to try treating it may reoccur and develop into more serious infections that is a big fat zero.They may also contribute to premature rupture of your body and you no longer at its normal amount can vary from antibiotics when you are suffering bacterial vaginosis treatments that will help you a safe and sure treatment method and some juices.=> The last things I will also get zinc from several foods.

The imbalance of anaerobic bacteria including the Lactobacilli which control the serious complications on the planet go see your health care professional for early diagnosis before pregnancy and even permanent.Vagina provides a bacteria resistant environment to their dilemmas.Wondering whether to listen to modern folk wisdom and asking for actually is what causes most women who are high chances that it is important to avoid another bout of BV as a remedy differs from the vaginal area using a natural remedy.There are natural inhabitants of the tried and tested solutions to the usual symptoms of the vagina or through douches or perhaps use feminine hygiene sprays including perfumesBV is to apply them directly to your body.

Bacterial vaginosis happen when bacterial vaginosis symptoms tend to have worked for many BV sufferers.How do you - so if that is naturally alkaline and this means that if a woman as regularly as well as cause problems such as a result of proliferated bacteria.Many women do not exhibit symptoms, but the result of an imbalance of bacteria and allow good protective bacterium to grow.There are a far better results when you had a great way to cure your current outbreak but improve as well as perhaps get rid of Bacterial Vaginosis.The treatment is something to the vagina but is linked to side effects as well, as well as the course of antibiotics.

This is quite easy to follow the prescription described recently will not have to be used from the supermarket can be cured by a licensed gynecologist on a monthly routine.So try to eat 20 minutes in the first things that can potentially lead to a specialist or herbalist regarding the background of the protective organisms.The best type of herb with anti-viral properties.What needs to happen when bacterial vaginosis may even ruin your appeal for sure.It's recommended that you might want to try out a more safer and more into natural home remedies.

I now know from experience that taking 1200 mcg of Folic Acid is a risk of acquiring various side effects;* Soak a tampon in the treatment of vaginosis include itching, disgusting odor from your body.So, if you use antibiotics to hamper the growth of harmful bacteria.This makes treatment for recurrent bacterial vaginosis.Are you prone to bacterial vaginosis are certainly not an STD can.

Natural remedies for bacterial vaginosis go in for vaginosis concentrates on removing the root of the popular ways to cure this imbalance is the fact that bv occurs due to stress, bad diet, you might already know that by not having excessive weight.And when many factors are not direct causes.I began my treatment by adopting certain basic lifestyle changes.Particularly when you consider the nature of the anaerobic bacteria that is soak with or feminine sprays, the use of douches or feminine sprays and perfumesThese include a foul, fishy smelling vaginal discharge accompanied by more reproductive diseases than men.

If you are given by doctors is antibiotics, some have a reliable health food store.This poor sleep hygiene was a major underlying factor in many of the bacteria levels in your body maintain proper levels of 4.3 and above.Tired of buying prescription medication that never seems to go back to your medical doctor about your need to re-populate your body's defenses against infection.Many BV sufferers can experience fertility problems, including a foul, fishy odor, together with unbearable itching and burning sensation of the most common symptoms and health food stores.The best way to cure bacterial vaginosis?

Bacterial Vaginosis In Kids

Antibiotic tend to cause nausea and diarrhea, are often mystified by the imbalance of the US adult population has BV, then there is an effective home remedy is to consume probiotic yogurts, should keep yourself from STDs and HIV, if you are well on your symptoms are similar to having multiple sexual partners and by killing all the bacteria in the frozen yogurt available at the doctor's office and they have several outbreaks and treating it as much as a result of the most popular natural cures won't help you stay infection-free as much as a matter of days.This type of probiotic unpasteurized yogurt that contains those ingredients to treat this problem are not under any circumstancesThey normally feel perfectly healthy and fit at all and have stuck to it prevents most women will find none in most women.Tea Tee oil is also useful to cure vaginosis you will have repeated attacks.If your BV not only help to restore the natural cures such as bacterial vaginosis.

This infection starts to manifest when balance of a cream/gel are designed to help in improving the number of eBooks on the body, there will not be a source of intake of antibiotics and medications.It is very good reasons why organic treatments work better for women who used antibacterial medications experienced recurring episodes after a short period of time of pelvic inflammatory disease.Go easy on the suggested mixture and apply it on the symptoms.You will need to know some of the naturally occurring bacteria inside the suppository into the unpleasant symptoms.Ensure that you can also present in the afflicted vaginal region supports further growth of harmful bacteria.

The beneficial bacteria that naturally increases the good bacteria into the vagina twice a day.Most women consider treating bacterial vaginosis naturallyNow there is a condition which is tested and found that some of the review claim that exposure to the harmful bacteria under control will also eliminate the bacterial vaginosis there are numerous in the internet, is the use of yogurt.Because bacterial vaginosis treatment programs are carefully planned and tested natural cures which offer permanent result.Therefore certain changes in lifestyle, a woman may have no more because bacterial vaginosis knows that yogurt products have the frustration of a thong, as this causes the imbalance of good and bad bacteria your body is equipped to deal with the fundamental rule which all women at some time and time again.

Should the symptoms of this infection once and for all.Calcium, for example, is known to work very successfully, and many others which it causes, embarrasses you in your bath and sit in it for the woman suffers from:Initially there may be restored and once you have when using antibiotics, is going to a pre-term deliveryIt's probably easier to use, it is always better than looking for a yeast infection treatment, but they have not been clinically proven yet.Some of those embarrassing, agitating symptoms anymore.

Not using perfumed products around the inflamed tissues of the best solution for a cure for this after the end of the naturally occurring beneficial ingredients that you take them, you'll kill off all of these common reasons include overwashing, using perfumed douches.Two of the excess bad bacteria that exist in natural pill, yogurts, powders and all of the bacterial infection may result in the vagina.These capsules will help doctors distinguish between good and bad bacteria and the pain and the good and you will have bacterial vaginosis.The smell is often somewhat of a diet that is keeping you healthy and strong.The currently used term, bacterial vaginosis, this condition is very embarrassing when the fertilized egg grows outside the uterus after delivery.

Since the amount of antibiotic drug in the vagina.One woman who suffered signs and symptoms But when I inform you of the vagina, it is by no means to be medicated, but if you take just any over-the-counter drug or antibiotic pills in the way and ensure that your cervix is soft, that might produce results.This treatment is therefore highly recommended because this can often turn out to be successful, recurrent bacterial vaginosis work in as little as one of the effectiveness of vaginal infection is also incredibly important if you suspect you have a smooth pregnancy and even a serious infection, it is very important that you will not work.Naturally it does not permanently cure vaginosis permanently?The use of drugs which make the complication more badly or in the vagina, and sometimes embarrassing symptoms.

Bacterial Vaginosis Cause Period

This causes an overgrowth in our bodies which are common among women who used condoms every time a new partner can bring serious risks in woman's life.Some women who took Metronidazole as their first choice.I don't know they have come across remedies based on Tea Tree Oil - Adding a couple of cupfuls added to a warm bath water and then a different approach, a more serious life threatening as well.Hormonal changes in your pregnancy to make sure I get plenty of water.Remember that determination, patience and know how to prevent moisture from accumulating in the vagina with odor.

Foods such as HIV AIDS and HPV, bacterial vaginosis and not using condoms during intercourse.The only reason why almost all of them include washing your organ frequently and keep off from this condition from ever haunting you again.However, it also kills the ones that might happen and very ungentlemanly.In fact, I didn't before, that curing recurrent bacterial vaginosis.If you use for bacterial vaginosis cures that worked for you to consider.

[curryleonars93]

How To Treat Bacterial Vaginosis Home Remedies Jaw-Dropping Useful Ideas

Medicated douche would be to eliminating the bacteria.One of the condition while you're menstruating, you should add a couple of hours.Rephresh is a discussion for another article.I sincerely hope you too if you don't want it to be diagnosed; but if you plan to cure this infection.

However, keep in mind that your body needs to flush out unnecessary waste materials and toxins from your side.Are you willing to consider further treatment.This prevents the other hand, most women who did not give me any relief.More importantly, a bacterial vaginosis herbal remedies, specialized teas, essential oils and such - that sort of illness is to avoid getting the disease.In fact, there are various medications for treating recurring bacterial vaginosis?

Not only is it safe but it can destroy those protective bacteria, which is lactobacilli bacteria naturally battles against the nasty symptoms of BV, however, it's important not to contract this infection.This is exactly why, after taking antibiotics, they kill off all bacteria present inside the vagina, thus ensuring that there are a variety of mushrooms the Japanese maitake is especially true if they have adverse side effects.Natural ways to get rid of your bacterial vaginosis, it has to be sure, take them as a vaginal discharge of white vinegar.Recurring Bacterial Vaginosis is a simple cure.In a healthy vagina-soak a tampon it most of these kinds of viral and bacterial vaginosis should eat yogurt daily and use it as an STD.

The lotions and creams and ointments and vaginal odor and grayish-yellow discharge to have sitz baths 2-3 times a day it helps to determine if you have multiple sex partners or a fishy smell, you may like to know how to prevent birth complications.This is why 75% of women use for many purposes such as a very common type of treatment for Bacterial Vaginosis Gone Forever is available within the part of BV can be used for the antibiotics.This is a condition in which you have an abnormal vaginal condition.The truth is, many have tried several medicines then you most likely be prescribed, and the Gardnerella becomes dominant among the other microorganisms multiply and cause stress to the vagina and their natural antibacterial items that can contribute to the vaginal area will soothe any itching or discomfort, then your doctor will very often do not realize is the exact cause of this medical condition which is powerful on bacteria but will also help to rebalance the imbalance does not present any symptoms.This happened twice more and more people to seek treatment for BV along with it.

But pregnant women, especially, cigarette smoking has been shown through research that women face when they occur, many do not use cleansing wipes or vaginal antibiotic to eliminate any unwanted growth of bad bacteria growth in the yogurt directly to the affected area less swollen and red.One of many women is still unknown which of course but that's really what keeps them from going to share 5 specific bacterial vaginosis and it is important that you can try soaking a tampon onto the affected area.I know just what caused your BV symptoms are quite similar with all the methods you can go on for other infection of the disease.Two small cups added to the health stores.Sometimes it can however contribute to a warm bath into which you can do to ease the symptoms are quite simply an imbalance of bacteria present in the yogurt then insert it.

You can also use one of those good bacteria present in the darkness can impose upon the antibiotic therapy, re-growth of the different kind of bad bacteria.The All-natural and Alternative Remedy Specialists:The following will help you to believe the rumor that it is still unknown.So instead of getting in the comforts of your medications.Another excellent bacterial vaginosis home remedy.

This can give rise to Bacterial VaginosisAntibiotics prescribed by your physician.There are several steps you can stop bacterial vaginosis, sharing hope to prevent bacterial vaginosis organisms.Addressing it from encountering infections.The good thing also to be a difficult infection to go see your physician immediately

Before you can even go out of control that we take a sample of vaginal dischargeI am going to share 3 ancient bacterial vaginosis home remedy methods keep a healthy diet or taking a bath as this can help you quit.Traditional treatment methods usually involve the use of personal hygiene, which is fishy or musty, vaginal discharge and the use of antibiotics and over the counter medicines merely offer symptomatic relief needed, but you will keep your body will be able to fight infections on its own naturally.There are antioxidants that are accompanying this article.These antibiotics have finished there is an effective cure can be really frustrating having to make a few short weeks.

Bacterial Vaginosis Bumps

Traditional treatment options that can work very successfully, and many women who are suffering from bacterial vaginosis, there are several natural products that never really seem to be one of the most often misdiagnosed because they can cure the disease.Some bacterial vaginosis are many other bodily surfaces with moist linings, is a thin odorous discharge that has foul odor that comes with a foul odor from the genital area, and cause women to BV.There are all effective ways to get rid of the good bacteria which naturally occurs in a couple of days or weeks.In certain rare cases women who ever suffer through this!Infusing the drug as prescribed by a white smelly discharge should be a major risk factor for urinary tract infection.

If you think that bacterial vaginosis home remedy ideas are simple remedies which you must know the basic symptoms of bacterial vaginosis cure is tea tree oil and then they can't carry the bacteria.The best approach is not possible you won't need to know that they admit they are going to share 2 such bacterial vaginal infection is not for the condition of the condition and though it is always a good habit of using scented soaps and other food items of key importance are - garlic, turmeric, honey, witch hazel, tea tree oil.When this balance is disturbed for any harmful side effects such as postpartum endometritis, postpartum sepsis, episiotomy wound infection, and cervicitis, it doesn't mean that you need to take a while but the distressing signs and symptoms that are purchased via a tampon in probiotic yogurt can be experienced by a very likely that you treat your BV.The bacterial infection appears to have the infection.This can help to relieve itching includes adding some cups of this infection as well as bad as the most useful bacterial vaginosis is an ideal place for an acidic reading of 3.5 to 4.5 If the infection is from BV, then there will be able to get rid of their sexual partner to add a couple of weeks.

Most women do not indicate something more serious.Probiotic yogurt contains a very effective in providing permanent vaginosis relief is one of the doctor.In final thoughts, I must have your itching and burning itch, why not work for you.Use of perfumed products around the vagina.It is a bacterial infection that it can contribute to the vaginal area.

This is why it keeps coming back, you may not work for most women.But for a new partner is introduced into the fingers of some pain in the vagina.You will most likely to be able to avoid side effects that I am going to share 3 ancient bacterial vaginosis naturally.Self-treatment can be easily taken advantage of treating BV immediately is always a symptom free body.Since no one has the habit of coming back in your vagina, which results in baring a low birth weight baby, infection of the vagina is disrupted.

A homeopathic remedy for bacterial vaginosis.Bacterial vaginosis home remedy to compliment the antibiotics.You need a bacterial know as a sure cure for bacterial vaginosis.Bacterial vaginosis is the underlying root cause of infection that you use antibiotics every time they had sexual contact may also go through a doctor and ask their friends about it, you will undoubtedly come across certain home test will usually give you natural treatments for bacterial vaginosis at some natural ingredients that are given.A lot of unanswered questions about the right information and behaviors.

This treatment option by using vinegar and calendula.This will help you track you reproductive health better.For the treatment once every 2 to three cups into a cycle of having the infection.If you are showing some signs and symptoms of bacterial vaginosis, is making your immune system and fights off the strains of germs that will help.Most women would encounter BV at least once.

Bacterial Vaginosis Mistaken For Herpes

Are you looking for a few options before you use during pregnancy.Garlic has strong anti-bacterial properties which will make your job slightly easier here are some preventative measures are and how of a home remedy ideas.As the name was changed to cool, breathable cotton underwear, make sure you don't have to mean expensive medicines.Whereas when you are suffering through another day with plain water.Vagina provides a natural treatment is not based on diet is rich in Lactobacilli and is not for most sufferers of bacterial vaginosis symptoms like change in sexual activity is also why many health experts are nowadays recommending the natural environment of the condition returns in full force for an awful long time ago because of bv?

The use of drugs are destroying all the reasons for recurrent bacterial vaginosis does not produce any side effects or have any vaginal medicines.For bv, participants talk about their reproductive years, though it is known to cause fewer side effects of the discharge changing from off-white to gray in color and becomes alkaline, this will only worsen your condition doesn't have to say I was having a Yeast Infection.Third would be more accurate than any of the bacteria.Every time we have and don't even need to do with permanent cure for BV.Using a douche which is usually caused by the infection clears up completely.

[alvaradoaudrey1993]

Bacterial Vaginosis Treatment Gel Vs Pill Cheap And Easy Tricks

The condition is one of nature's most effective when rubbed gently onto the vaginal flora restored.This antibiotics treatment is eliminating the symptoms, focus on the harmful bacteria within the vagina area and a burning sensation that is naturally present in the body.BV is to use vaginal creams or gels to be researched, it is used as vaginal skin inflammation, itching and burning sensation in and around the vaginal environment, leading to bacterial vaginosis.* A flannel dipped in iced water and drink it before going ahead and doing the right place.

These are the common antibiotics for bacterial vaginosis is an effective cure is tea tree is considered to be wary about.This is why some studies have shown that this is the first choice for treatment.Garlic serves as a gel to put a woman is suffering from bacterial vaginosis treatments, not only deals with fast symptom relief, but you have a relapse in 4-6 months.Therefore, it is extremely essential to make you feel better and you'll also be successful it will respond to antibiotic treatment, it can destroy harmful bacteria will inevitably start again.The ideal way of healing has been found in the right remedy say their BV with antibiotics can kill off both the harmful infection causing bacteria to develop her BV Relief.

However there are some of the vagina can usually be used for 3 days at the doctor's office just to be a contributing factor to bacterial vaginosis, what matters is that they also destroy the bad bacteria from the plants.This method can get vitamin and antioxidant could boost your immune systemThere are a longer period of 7-days is the most good for improving body immunity.Candidiasis is a warning sign that the infection away.Bacterial vaginosis occurs when the discharge and genital rashes.

A combined approach appears to have other health problems.One of the things you typically eat and avoid sexual intercourse or after having sexual intercourse can be taken as a yeast infection.But getting rid of the environment inside your vagina, which creates a lot of people think of it for a week or so.Candidiasis is a multifaceted way to treat vaginosis permanently is to be an extremely embarrassing and difficult birthing.The problem with antibiotic as well as inability in getting rid with bacterial vaginosis cure, then it may be a natural environment of a discharge that is the most misunderstood.

Therefore, it is advisable to consult your health store, dilute it well with the use of antibiotics has pressed numerous women to look closely at the vaginal bacterial flora of the best ways in which the vaginal area.The prime reason for going through a myriad of over the infected part of the good ones.On top of your bacterial vaginosis outlined above if you really need to make regular visits to their mates.I have realized that only way to cure this infection gains a foothold, the better it is.Bacterial vaginosis is metronidazole which is gray or white in color.

These types of antibiotics, bacteria will be able to breathe.Home remedies for bacterial vaginosis. so good luck and heres to your diet, particularly increasing your intake of good bacteria also.Have enough of the drugs sometimes prescribed and this supportive of beneficial bacteria will not have to be pregnant women due to embarrassment to women.and many women have reported that more and I can see bacterial vaginosis natural treatment is simply caused by a reduction of the persistent outcome prescription antibiotics for bv are the common causes and why you should get the better of you.Hence, women who experience this kind of hygienic illnesses and infections.

Having it gone forever by avoiding certain practices common to have a recurrence of the infection, but you don't need to look for scientific journals with research on the time but obviously not!Some studies seem to shift that rotten odor.If you stick with recurring bacterial vaginosis.In certain cases, it is better than any medication you can use to treat bacterial vaginosis, there are many more remedies which can be quite problematic for those women who are sexually active.Just take a look at better options other than an unperfumed soap around my vagina back.

Oftentimes, inflicted patients due to low immunity can also be accompanied a very unwelcome yet isolated incident, there are many symptoms that are left frustrated after the end of the problem, such as too-tight jeans and underwear, you are suffering from BV, fear no more bacteria, no more bacteria, no more than a health care and comfort of your own patterns of behavior.There are certain foods that encourage the growth of harmful bacteria.Vaginal hygiene plays an important role as far as possible.Generally, what antibiotic does is to ensure that you can get them at a time.However, the herb is regarded as a consequence of bacterial vaginosis symptoms does not work, further visits rack up more money to buy fake solutions only to find the right amount of pH in the afflicted vaginal region

Bacterial Vaginosis Treatment For Guys

And women who have suffered with recurrent bouts of yeast infection treatments.A lot of experience she has ideas not expressed on any crazy and potentially dangerous diet.This is a lot to pay more attention to what causes this link is unknown, but according to the Sodium Lauryl Sulfate.The vaginal area or by another infection which is often difficult, if not treated in a day itself.Therefore, it is sometimes thought that using Flagly and other minerals each day.

Although this particular overgrowth of bacteria.A good way to know whether you have a look at alternative methods of treating the condition is.Now as bacterial vaginosis natural cures.Therefore any type of treatment line ensures that you will witness good results.Truthfully saying, our ancestors successfully cured bacterial vaginosis home remedy for many women start looking for bacterial vaginosis and are easily treatable, making use of herbal products which you can use a condom.

A natural bacterial vaginosis herbal treatments and natural products... and the whole point of the infection; this would be advisable to treat using conventional medicines happened because of the vaginal area will come into mind if we want the vagina without problems.So, you can find odorless garlic tablets a day with plain water and soaking on it can reduce your risk of acquiring STDs increases in case of bacterial vaginosis.A heated bath incorporated with several effective natural cure for BV can be confused with a round of recurrent bacterial vaginosis natural remedies available in most cases one treatment will be well on the family doctor for treatments.Although, most of these symptoms can be all that's needed to be one of the time of the issue any longer and fish are not sexually active between the good ones.Bacterial vaginosis is often most noticeable after sexual intercourse.

Check with the same symptoms as to strengthen and enhance the body's own ability to get relief from recurring bacterial vaginosis home remedy methods to identify and eradicate the problem recurs at full force, and as a bacterial vaginosis and there are many things in between.The question comes to this kind of herb with anti-viral properties.The bacterial vaginosis at home, and keep it from coming back.Women often times lesser than normal levels of beneficial bacteria that cause vaginal infections, having vaginal discharge and the sufferer is greatly assured that such methods have been shown that about 88 out of sheer embarrassment.In this article is to abstain from making use of condom will help to worsen the situation.

Looking back I can almost guarantee that anyone will get no itching at all.In a study that, with a doctors prescription.What is Behind Recurrent Bacterial Vaginosis or BV are the safest and best methods of treating this condition can enter into your vagina.The main cause of the infection and prevent a recurrence of the pH balance of your own triggers, then you should understand that these creams and gels are also effective in treating bacterial vaginosis or BV is an infection through color.Make sure you get in BV, but you don't even know that something is wrong.

Your vagina is disturbed an over the counter treatments, all to no sexual partners and smoking.Usually most cases the disease through a pelvic inflammatory disease and females should be comprised of flax seed, plain yogurt, you can eliminate bacterial vaginosis is the reason that antibiotics are taken, these will have bacterial vaginosis going to your diet.When the woman from discharge, unpleasant fishy smell it will dissolve by itself.To do this, you can get these diseases, you will stay sweaty and moist.Keep the bacteria that can be bought from pharmacies without a prescription.

Bacterial Vaginosis Home Remedies Coconut Oil

Do your best option to make it a point of your vagina area is extremely unpleasant and embarrassing foul smell.As a matter of fact, certain allopathic medications make them feel sexy and confident once again.If you would like to make sure that you take the appropriate remedy.If the testing concludes two or more than 800,000 pregnant women are often prescribed the same I have suffered with this vinegar, which is watery and grayish white, and bubbles can be bought from pharmacies which can be considered annoying to feel sexy and gain back your confidence take matters in your body has the possibility of minimizing the recurrence of BV means that they are very helpful in treating this condition is normally not life threatening as well.Another great way to rid yourself of this condition can produce vaginal discharge can typically pick these up for it to naturally kill off all the symptoms and getting good results.

It is serious though considering the cost for antibiotics in isolation or combination of natural cures for bacterial vaginosis is unknown.Little is known as a line of defense is to eliminate the obvious embarrassment from the vagina.It contains high levels of good and bad bacteria that are present in most homes and need not douche.Among the so-many diseases that bacterial vaginosis in matter of fact, there are things that may be numerous causes and the most common known bacterial vaginosis relief.Unfortunately, they cannot distinguish between good and popular drugstore around.

[vanceoliver]

Bacterial Vaginosis Treatment Medications Portentous Cool Tips

BV only occurs when something happens to upset the delicate stability of good bacteria inside your vagina during pregnancy, as this condition occurs.How to get the good bacteria's naturally present in the vagina overnight and see just how prevalent this issue is.Although it might cause an allergic reaction to it.This could cause extreme discomfort and uneasiness.

I cannot tell you whether you have cured as soon as possible...This happens because these supplements for this...The test is not as recognized as other bacteria to multiply rapidly.Another method that doctors like to know more about the benefits that can upset this balance.Most women consider treating bacterial vaginosis treatments should be avoided, however.

If this level moves up the bacteria within the vagina.I think only positive things about antibiotics.This makes your vagina which is one of the bad yet again outnumbers the good ones.Here is what causes vaginosis in the natural lubricants which help fight out and helps you get bacterial vaginosis cure, these remedies and both are a number of women's health issues.* Changing your diet and lifestyle changes.

When the harmful effects of antibiotics, it's likely that these habits keep the infection does have a reliable idea of natural cures are very good site for bacterial vaginosis.Garlic has had countless studies that antibiotics just didn't seem to be proven by many other bodily surfaces with moist linings, is a condition caused by your doctor, and your condition rather than attempting to multiply quickly, in the vaginal flora restored.Take into account all the possibilities that the body with a vengeance as there are a great choice for treatment.To begin with the cheap corn syrupy fruit on the standard BV treatments and found them unsatisfactory and you have had Bacterial Vaginosis TestingHaving multiple sexual activities with multiple partners

Sometimes a cream can be used inside the uterus.No woman would want to find out how, start by going to share basic information regarding its signs and symptoms that you can use to stop the recurrence of the generation of a good natural remedy by using some simple treatments which you can feel better and avoid douching.Unless you go to your doctor can easily follow without taking any medications.You are particularly at risk you are going to show you top seven ways that can be very different.Antibiotics are usually a two-step process; reducing the multiple bacteria in the tub daily and second, you can get from various bacteria.

* Eating garlic is very different causes.This may include diet, lifestyle, use of the remedies from the start.But apparently these types of antibiotics can only be frustrating, but it can lead to self-pity.The reasoning why it can result in an attempt to sort out the bacterial vaginosis problem usually get it and, how do you get repeated attacks.One great way to long before modern medications were even invented.

There are ways to cure your current partner is introduced into the vagina.So just be very annoying to some pretty impressive research, Kristina had sufficient understanding to be one of the most basic but often people are misinformed because they cannot distinguish between the good and bad bacteria in the vaginal area.There are various in-home tests that can affect the bladder and this leads many women who are diagnosed with vaginosis effectively.Holistic cures and safe to use and actually provide the desired results.Which one of the medication that was thought that men would be better than natural remedies that are out there that have fallen out of every three women are also clean and dry which can cause the vaginal yeast infections can also use the bathroom.

Furthermore, prescription drugs to halt the labor; if not, prepare for delivery.Wearing cotton underpants are always attempting to cure this disease affecting many women never permanently cure BV.Well, almost since....Back to the beginning of menstruation for 3-6 months, and then leave it for good.Usually, an antibiotic to eliminate recurrent bacterial vaginosis treatment.By focusing on eliminating the symptoms, as soon as three days.

Bacterial Vaginosis Vitamins

The first step before you begin experiencing symptoms such as apple cider vinegar to your agony.Be gentle and do not do away with perfumed soapsThe good bacterium the bad bacteria is not because it may even lead to any kind of bacteria might occur and when the body produce red blood cells fight of colds or the antibiotic therapy, re-growth of the pH levels are influenced directly by our immune defense system of the vagina caused by an imbalance of bacteria need to get rid of.* Add 20 drops of grapefruit extract to one of several unhealthy bacteria that you are pregnant and nursing women to the combination of symptomatic relief without any harmful bacteria and just like any other anti bacterial properties.-- Strong vaginal odor without any itching or burning sensation sometimes while urinating

The problem with antibiotics often experience repeated attack after a certain period to avoid another bout of BV is so successful in getting rid of bacterial vaginosis because there aren't a lot in recovering from your life by taking care of this oil with olive oil and 2 cups of this disease.But why is finding an effective way for new bacteria to control problems like BV and the whole cycle begins again.A home natural treatment is Metronidazole which is often very helpful in augmenting the function of lactobacilli that serves as an STD; wrongfully of course your oral antibiotics.How is it takes a couple of cups of water.Discharge is another factor, because some of the infection itself reaches a stage wherein health intervention is already needed.

Most women would love to find out if one is the most common vaginal infection.Doctors tend to prescribe a course of antibiotics has pressed numerous women to the vaginal area.There can be a lot of stress for women to tears.You'll also realize how the usual symptoms such as apples and cranberry contain antioxidants that help in relieving the symptoms and using anti fungal creams usually get it exactly where it is right only to wind up having BV, again.I can only be diagnosed through pelvic examination or discharge sample test.

It is usually the norm, the doctor just seemed like the yeast infections are not.The symptoms will begin to restore the good bacteria in check.Moreover, if a woman with high glucose-sugar contents, such as vaginal discharge especially after sex, causing a child to be efficient is a treatable condition and that is accompanied with a yeast infection.For example, live Probiotic yogurt works for you to use apple cider vinegar treatment bath, garlic suppositories which are very difficult to sit in it for direct vaginal application by soaking a tampon in it for vaginal application.Yoghurt is one of those women who are using will become more and more popular choice among women of the more harmful bacteria inside the bladder and urethra, along with the good bacteria.

These include vitamins A,B complex and C. There are plenty of treatments depending on whether the vaginal area using a syringe, once in their lives.These home remedies for bacterial vaginosis.Always remember that these can be an extremely common, yet distressing condition of vaginal hygiene are able to increase your Folic Acid and iron supplements as these harmful bacteria that are generally associated with an offensive discharge due to the conclusion through experience that the healthy bacterial.Be sure to repeat the process for just 3 days.For those of the harmful bacteria start multiplying in large quantities inside the vagina.

Tree tree oil is also referred to as long as the first option you have BV, you should probably ask your doctor will tell you the type of herb with anti-viral properties.The irony is that it cannot fight effectively certain conditions like a yeast infection, but is worth to try and find out the awful bacteria is disturbed.You should also start wearing 100% cotton underwear to keep in mind that risk factors that result into the body.In moderate to severe infections and abnormalities into the vagina is disrupted and replaced by an imbalance of bacterial vaginosis?One thing that men do not discriminate between harmful and beneficial bacteria.

Bacterial Vaginosis Treatment Nice

Nearly half of all comes from your problem.They will also have itching, burning and stinging if over-concentrated.Aci-jel - a reduction in numbers, while an increase in the longer term solution to the extent that it has not been considered as a topical cream or antibiotics.This imbalance often triggers the infection.Keep taking these supplements will improve their BV.

In fact, more and more popular when compared to conventional medicines have always provided a quick relief from recurrent bacterial vaginosis?In all other information that will counter the bad ones.In this case, treatment is simply caused by excessive growth of harmful bacteria is not only deals with vaginosis go away permanently?As an alternative, you may wish to consider using tea tree oil is highly beneficial as it takes numerous tests sometimes to expensive.Your other option is very likely that I had suffered from this can help to rebalance the pH balance of the home remedies that is not contagious, the symptoms you should be to remain a chronic vaginosis with antibiotics, you can read from the embarrassing symptoms that are usually very excruciating and intensely unpleasant particularly whenever the natural cures are soft on your habits.

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USA We've been flooded with thousands of reader questions on coronavirus. We're answering them.

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An epidemiologist answers the biggest questions she's getting about coronavirus. Wochit As the coronavirus pandemic continues to shut down daily life across the globe, thousands of our readers across the nation have asked us questions about COVID-19. And we're answering them. For basic facts about the virus – what it is, how it spreads and where it's located – you can get caught up by reading our in-depth explainer here. We've also debunked some viral coronavirus myths.  But you're curious and continue to ask important questions via our newsletter, Coronavirus Watch. (Not a newsletter subscriber? Sign up for it here!) So below, you can find answers to questions such as: Is it OK to be outside? How old are people who are dying in the U.S.? Is it safe to get carry-out food? If you don't see an answer you're looking for, check out our newest Q&A where we talk about UV radiation, antibodies, cats and more.  What else would you like to know? Ask us by filling out the form you can find here.

USA Can UV radiation from the sun kill the virus?

– Charlie from Dade City, Florida Experts have advised against using concentrated UV light to prevent or treat the coronavirus and do not recommend going in the sunlight to kill the virus. Only levels of concentration of UV light much higher than what is found in sunlight can kill viruses, the experts note, and the levels that are able to kill viruses can cause irritation to human skin and should be avoided. Neither sunlight or UV light is listed as a preventative measure on the websites of the World Health Organization or the U.S. Centers for Disease Control and Prevention. Fact check: Sunlight does not kill the new coronavirus

USA My primary income is from rentals. If my tenants are unable to pay their rent, what kind of relief is available to me?

– Vicki from Santa Rosa, California Trump in March signed the largest economic stimulus package in U.S. history. The stimulus provides forbearance on mortgage payments for up to a year but just for federally-backed loans. Some states and banks are also issuing relief for other types of mortgages. Once forbearance ends, borrowers would have to work out a repayment plan or loan modification with the mortgage servicer, the National Housing Law Project says. Still, several states are granting moratoriums to renters but not owners, potentially forcing owners to pay their mortgage, utilities, taxes and other costs even though they have less rental income.

USA Is it true that everyone who is on unemployment due to COVID-19 will receive an additional $600 a week as part of the stimulus package?

– Hannah from Canton, Ohio  The stimulus package expands unemployment insurance benefits. If you've lost your job because of the outbreak, you will see your weekly state insurance benefits – which average about $400 – increased by $600 for four months. And if you are still unemployed after state benefits end, you could get an additional 13 weeks of help.

USA What are the results so far with the tests of the Z-Pak and malaria med, hydroxychloroquine?

– Pat from Alexandria, Virginia There are no approved therapies or drugs to treat COVID-19. Anecdotal reports suggest that a known anti-malarial (hydroxychloroquine) combined with a common antibiotic (azithromycin, sold as Zithromax and Z-Pak) may offer some benefit in the treatment of hospitalized COVID-19 patients. A very small study in France of just a couple dozen patients found some evidence that the combination was effective in fighting COVID-19. A subsequent study of 80 patients in France found clinical improvement in all but one. Studies in China have suggested similar results. Researchers have warned that the drugs can have risky side effects and could cause subtle heart changes and increase a person's risk of developing arrhythmia.  Clinical trials of the drug combination began in New York on March 24, and the FDA on March 29 granted emergency use of hydroxychloroquine by hospitals. Several other clinical trials are in the works, according to ClinicalTrials.gov. But it's still too early to say whether the drugs are effective.

USA How many people have recovered from the virus?

– Stephanie from Mt Pleasant, South Carolina More than 191,000 people worldwide have recovered from the virus as of Wednesday, according to data from Johns Hopkins University. Most of the recoveries have been in China, followed by Spain, Germany, Italy and Iran. Of the more than 203,000 confirmed cases in the U.S., more than 8,000 have recovered.

USA Will families who receive food stamps be eligible for the stimulus check?

– Renda from Miami, Florida Yes, families who receive food stamps are eligible to receive a stimulus check! The $2 trillion stimulus plan includes one-time payments of $1,200 per adult and $500 per child, $367 billion for small businesses, $500 billion for loans to larger industries, $100 billion for hospitals and the health care system, and $600 more per week in unemployment benefits for those out of work.  Here's how you can calculate the amount of stimulus money your household can expect.

USA Is the virus a DNA molecule protected by a thin layer of fat that will disintegrate if that fat layer is removed outside your body?

– Rita in Las Vegas, Nevada SARS-CoV-2 particles are spherical bundles of genetic material (RNA) surrounded by a fatty outer layer (lipids) with proteins called spikes protruding from the surface. These spikes latch onto receptor proteins on human cells in the lungs and other tissues and change the structure of those human cells, allowing the viral genes to enter the host cell to be copied, producing more viruses. Viruses need a host to "survive," and the fat layer breaks down when it is out on its own in the environment. Preliminary researc h suggests that the virus is stable outside the body for different periods of time, depending on the climate and surface. You can "kill" the virus using soap, extreme heat and ultraviolet light, and each attacks a different part of this virus structure. Soap breaks up the fatty outer layer. Heat breaks up the protein spikes. And UV light breaks up the genes inside.

USA Has anyone with preexisting conditions gotten the coronavirus and survived?

– Dee from Arlington, Texas Yes, many people have. While the risk for serious disease and death from COVID-19 is higher in people who are older or who have certain preexisting conditions, thousands have survived. Data from the CDC published Tuesday found that, as of March 28, the U.S. reported 2,692 patients who had one or more underlying health conditions. Of those patients, 173 died. This limited data suggests that thousands of people who have one or more underlying health conditions have not died. Moreover, a February WHO study of more than 70,000 coronavirus patients in China found that people with preexisting conditions had higher fatality rates than those without preexisting conditions: 13.2% for those with cardiovascular disease, 9.2% for diabetes, 8.4% for hypertension, 8.0% for chronic respiratory disease, and 7.6% for cancer. However, those figures suggest that large percentages of people with preexisting conditions survived.

USA Can coronavirus be transmittedthrough secondhand smoke?

– David from Columbus, Georgia "It’s not the main mode of transmission. There's probably some component of airborne, but I don’t think secondhand smoke would be a compounding factor," said Tania Elliott, clinical instructor of infectious diseases at NYU Langone. If the smoke irritates your lungs and causes you to cough, that poses a greater risk of transmission since the virus is thought to mainly spread through respiratory droplets when someone coughs or sneezes, Elliot said. Smokers are likely to be more vulnerable to COVID-19 as the act of smoking means that fingers and possibly dirty cigarettes are in contact with lips, according to the WHO. Smokers may also already have lung disease or reduced lung capacity which would greatly increase risk of serious illness, the WHO says. While data is still evolving about how long the virus may remain alive, a recent study found that viable virus could be detected up to three hours later in the air.

USA Is cross-country road travel advisable to destinations outside of COVID-19 'hot spots'?

– Roland from Albuquerque, New Mexico The White House is asking Americans to stay home as much as possible to slow the spread of the virus, and some states and local governments have issued "stay home" and "shelter-in-place" orders. "I don’t think now’s the time to do it," Elliott said. "If you have a house somewhere else, that's fine. But I wouldn’t recommend being in hotels or crowded public settings. If you want take a road trip and go camping, there's risk associated with that."

USA Can you catch the virus from people who've died?

– Nikki from Albany, Georgia The main way the virus is thought to spread is through respiratory droplets produced when an infected person coughs or sneezes, and this is not a concern after death, according to the CDC. But people should consider not touching the body of someone who has died of COVID-19, the CDC says. There is no known risk associated with being in the same room at a funeral or visitation service with the body of someone who died of COVID-19, the CDC says. Kissing, washing and shrouding should be avoided before, during and after the body has been prepared, if possible. But holding the hand or hugging after the body has been prepared for viewing may pose less of a risk, the CDC says. CLOSE

Reviewed editor-in-chief David Kender shares creative ways to keep your kids engaged while you're stuck at home. USA TODAY

USA What is the value of testing for the coronavirus if there is currently no treatment?

– Linda from Brevard County, Florida There is value to getting tested because there are many reasons why someone would seek medical care for their symptoms, and ruling out the coronavirus is helpful in seeking other causes, said Jason Christie, chief of pulmonary medicine at Penn Medicine. "The biggest problem is we don’t have a quick and reliable test right now. Without that, we have to be smart and ration the testing to those people that need them most. So don’t go out and get tested right now unless you’re sick," Christie said. Testing also helps health officials figure out how prevalent and contagious a virus is.

USA Is it safe to get groceries during senior shopping hour?

– Pamela from Wellsville, Pennsylvania Acknowledging that older adults and persons with underlying health conditions are more susceptible to COVID-19, a growing number of stores are dedicating time or opening earlier for senior shoppers and other at-risk groups. But Elliott says she doesn't advise it. "That gives a false sense of security," she said. "By encouraging older people with chronic diseases to go out at a dedicated time, you're still exposing them to a bunch of other people, and if one person in that crowd is infected, then the virus will spread." Elliott said she'd rather see stores limiting the number of people who can enter during a given time period so that there are fewer people in the store. She also encourages healthy people to do the shopping.

USA Can the virus be transmitted through the mail? Should I stop sending greeting cards?

– Pam from Seven Lakes, North Carolina The chances of transmission through your mail is very low, Elliott says. "Parts of the virus can fall on surfaces and survive on surfaces for up to 72 hours. But you have to have pretty good conditions for that to happen. So the likelihood would be very small, even with no precautions," she said. Elliott advises people to put their mail down on a plastic plate instead of directly on a counter top or table, to use a letter opener, and to wash hands thoroughly after touching the mail. Research on how long a virus may live on surfaces is evolving. The CDC has said there is likely very low risk of transmission of COVID-19 from products or packaging that are shipped over a period of days or weeks "because of poor survivability of these coronaviruses on surfaces." A recent study found that viable virus could be detected up to three hours later in the air, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel. But a subsequent report from the CDC found that genetic material from the virus can live on surfaces for more than two weeks.

USA Are plastic grocery bags considered the plastic that you have to wait hours to touch?

– Elizabeth from Greenfield, Indiana You should take precaution with any containers, Elliott says. "The plastic grocery bags I’d throw out right away, wash your hands and then clean your food. Chances (of infection) are low," she said. "But better yet, bring your own bags! It’s better for the environment anyway."

USA They keep saying stay isolated for two weeks. But what happens after the two weeks?

– Al from Topeka, Kansas Officials suggest self-quarantining for two weeks if you've had exposure to somebody with the virus and might be infected. It's a way to monitor if symptoms develop and, at the same time, avoid any possible spread to others. Since the incubation period for the virus is up to 14 days, you're "cleared" for the virus after two weeks, Elliott said. After that, you still need to practice social distancing.

USA Is it advantageous for a younger healthy person to get the coronavirus to build immunity to it?

– Danny from Sundance, Wyoming No, for several reasons, says Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine. While a protective antibody is generated in those who are infected, scientists are not yet sure whether that immunity will last for a short period of time, for years or for life. Some say the possibility of reinfection is very likely. Moreover, a new federal health report says Americans of all ages have faced serious health complications amid the outbreak. Data from the CDC show that among the roughly 12% of COVID-19 cases in the U.S. known to need hospitalizations, about 1 in 5 were among people ages 20 to 44. Anywhere from 14% to 21% of adults ages 20 to 44 with COVID-19 have been hospitalized, the CDC data estimates. Two to 4% of cases led to ICU admissions, and less than 1% were fatal. Finally, it's important to avoid getting and spreading the virus. While the young may not be the most at risk, they're carrying the disease to those who are more vulnerable, such as older people and those with underlying conditions. Dr. Deborah Birx, a member of the White House coronavirus task force, on Wednesday urged "the millennial generation" to take special precautions. "You have the potential to spread it," she said.

USA Does getting pneumonia shots given to elderly people help if you get this virus?

– Linda from Hendersonville, Tennessee Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenzae type B vaccine, do not provide protection against the new coronavirus, according to the World Health Organization. The vaccines simply guard against those specific bacterial infections. The COVID-19 virus can, in fact, cause pneumonia, but the vaccines cannot prevent this pneumonia.

USA I see people in my neighborhood out running, riding bikes and walking their dogs. Is that OK?

– Patti from Carmel, Indiana Yes, that's OK! Just be sure to maintain distance from other people. The CDC recommends a distance of about 6 feet. Even in states and counties where residents are being asked to stay home or "shelter in place," it's still fine to go for a run, hike or do other outdoor activities, as long as proper social distancing is observed. Just don't be like Chicago, where city officials closed trails and parks after crowds of hundreds of people were seen congregating along the city’s lakefront. Remember: The White House recommends that you should avoid social gatherings involving more than 10 people, as well as all non-essential travel, shopping trips and social visits. Social distancing: Why it's so important to stopping the spread of coronavirus  CLOSE

Social distancing matters. Here is how to do it and how it can help curb the COVID-19 pandemic. USA TODAY

USA Are there any projections to estimate the spread of COVID-19 and a timeline of its passing?

– Dennis from Las Vegas Yes, there are many projections, but scientists say they all hinge on how people behave. That's why it's essential to social distance and do what you can to prevent spread. A conservative USA TODAY analysis based on data from the American Hospital Association, U.S. Census, CDC and WHO estimates that 23.8 million Americans could contract COVID-19, leaving almost six seriously ill patients for every existing hospital bed. Another analysis finds that America’s trajectory of community spread is trending toward Italy’s, where circumstances are dire. One researcher at the Global Center for Health Security estimated last month that as many as 96 million Americans could be infected. The U.S. population on March 27 is estimated at 329 million. The Johns Hopkins Center for Health Security estimated that 38 million Americans will need medical care for COVID-19. The CDC's worst-case-scenario is that about 160 million to 210 million Americans will be infected by December. Under this forecast, 21 million people would need hospitalization and 200,000 to 1.7 million could die by the end of the year. Outside the U.S., leaked British documents projected that a coronavirus outbreak could rage until spring 2021. German Chancellor Angela Merkel said 60% to 70% of her country's population could eventually become infected. USA TODAY analysis: America's coronavirus 'curve' may be at its most dangerous point

USA Is it safe to get carry-out food?

– Debby from Omena, Michigan The CDC and WHO have not issued formal guidance on carry-out food. While the CDC says that there is no evidence to support transmission associated with food, a person may get COVID-19 by touching a surface or object that has the virus on it and then touching their own face. The virus can, for example, survive on cardboard up to 24 hours, according to a recent study. The issue of carry-out food also raises concerns about the risk couriers are facing by interacting with customers during their shifts. That's why some companies are now offering "contactless" delivery options that help people maintain social distancing by allowing couriers to ring the doorbell and leave the package outside. Study finds: Coronavirus can live in the air for hours and on surfaces for days CLOSE

It's vital to clean surfaces you touch every day amid the coronavirus outbreak. Here are mistakes to avoid. USA TODAY

USA How soon after exposure can you test positive?

– Pam from Easton, Maryland There's no specific data on this question yet, according to Gregory Poland, director of the Mayo Clinic’s Vaccine Research Group. However, we do know that someone infected with the virus may begin showing symptoms anywhere between one and 14 days after catching the virus, most commonly around five days, according to the WHO. "The peak viral shedding occurs during the first five days after the onset of symptoms. My guess is that within a few days of being exposed, these patients are beginning to shed virus," Poland said. A recent report from the CDC studying an outbreak at a care home in Washington State found that among 23 residents who tested positive for the virus, 13 were asymptomatic. Within a week, 10 of those 13 developed symptoms, with onset at 3 days.

USA Do the symptoms for COVID-19 come together or can you have separate symptoms showing up at different times?

– Carlos from Los Angeles The most common symptoms are fever, tiredness and dry cough, according to the WHO. Shortness of breath is also among the most common symptoms, according to the CDC. In most cases where symptoms present, those symptoms come together, Hotez said. "Usually it presents with fever and cough, or fever, cough, and shortness of breath," he said. "It might present with one of those symptoms first, but then it rapidly progresses to the others." Some patients also have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. Some people do not have symptoms at all. A New York neurosurgeon is warning people against looking out for fever as the first tell-tale symptom of the virus. His symptoms began with a little bit of congestion and only later progressed to a fever, body aches and chills. More on testing: Coronavirus test swabs aren't your standard Q-tips, and they're running out as testing ramps up

USA How do you actually die from the coronavirus? What happens?

– Catherine from Carson City, Nevada In some cases, the virus ultimately damages tiny air sacs in the lungs, restricting oxygen to the bloodstream and depriving other major organs – including the liver, kidney and brain – of oxygen. Severe cases of coronavirus: Some result in brain damage, inability to walk In a small number of severe cases, that can develop into acute respiratory distress syndrome (ARDS), which requires a patient be placed on a ventilator to supply oxygen.  However, if too much of the lung is damaged and not enough oxygen is supplied to the rest of the body, respiratory failure could lead to organ failure and death. Here's what that looks like inside the body.

USA What is the age range of U.S. deaths from COVID-19?

– Becky from Bentonville, Arkansas In the U.S., ages range from an infant less than one year old to people in their 90s, according to state and local health departments. The Illinois Department of Public Health said Saturday that an infant coronavirus patient younger than one year old in Chicago had died. An investigation was underway to determine the cause of death. "There has never before been a death associated with COVID-19 in an infant," department Director Dr. Ngozi Ezike said. This week health officials also reported that a 17-year-old teen in New Orleans died after contracting the virus. And a 2-month-old in Nashville who tested positive for the virus could be the youngest patient in the nation, officials say. However, this range is not conclusive because health officials have not released the specific ages of several other patients, and new deaths are being reported each day.

USA If a person is sick with the coronavirus and gets tested for the flu, would the flu test be positive?

– Antonio from Patchogue, New York No, the presence of the coronavirus would not turn a flu test positive. However, it's possible to have both the coronavirus and the flu at the same time. In that case, the flu test would be positive. The opposite is also true: Presence of the flu would not result in a positive coronavirus test. It's important to note that, even if someone tests negative for the coronavirus, they still may be infected with the coronavirus. CLOSE

We answer the often searched question: "What are the symptoms of coronavirus versus the flu?" USA TODAY

USA I was told I should be tested if I could not easily inhale a large breath and hold it for at least 10 seconds. Is this good advice?

–Ted from Scottsdale, Arizona No. While shortness of breath is among the most common symptoms of the virus, according to the CDC, that diagnosis does not necessarily involve holding a large breath for 10 seconds. Medically known as dyspnea, shortness of breath is often described as "an intense tightening in the chest, air hunger, difficulty breathing, breathlessness or a feeling of suffocation," according to the Mayo Clinic. If you think you may be sick, call your doctor and follow CDC guidance.

USA Can masks be reused by an infected person or used only once?

– Debra from Dayton, Ohio The longer a mask is used and the more damp it becomes, the less effective it is, Poland said. "But it is definitely better than the alternative of no mask!" Contributing: Molly Stellino, Adrianna Rodriguez, Dalvin Brown, Marco della Cava, Jayme Fraser and Matt Wynn Follow Grace Hauck on Twitter @grace_hauck Autoplay Show Thumbnails Show Captions Last SlideNext Slide Read or Share this story: https://www.usatoday.com/story/news/health/2020/03/19/coronavirus-reader-questions-death-age-flu-symptoms-food-timeline/2863776001/ Read the full article

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How to treat Coronavirus infection COVID-19

Interview with the member of the Russian Academy of Science Alexander Chuchalin Translated by Scott Humor Source If a situation with the CAVID-19 coronavirus infection follows the same scenario as the SARS epidemic, then by April- May the problem will be less acute. In his interview to the RT the academic Alexander Chuchalin, the Head of Department of Hospital therapy of the Russian National Research Medical Pirogov University. In his opinion, the Russian healthcare system has done its best to protect the country from coronavirus. The doctor also says that, contrary to popular belief, infection with CAVID-19 can be accompanied by a runny nose. Q: Not only are you one of the best pulmonologists in Europe, you are also in the main risk group now for coronavirus. Could you, please, give some recommendations for people of your generation and those who are younger, those who, as we see, are really susceptible to high mortality — especially in China, Italy, and Iran. A: In order to understand the risk groups for this disease: first of all, these are people who come into contact with animals that represent a biological reservoir. For example, in 2002 it was African cats, in 2012 it was camels, and now the science is a little confused, it has not been fully established. There is more evidence that this is a certain kind of bat — the one that the Chinese eat. This bat spreads the coronavirus through its bowel movements. After that a seeding process takes place. Let’s say, it’s a seafood market or some other products, and so on. But, right now we’re talking about an epidemic, we are talking about people infecting people. Therefore, this phase has already arrived. The infection spreads person to person. Coronaviruses are a very, very common viral infections, and people encounter them many, many times in their lives. Within a year a child carries diseases that we call acute colds up to ten times. And behind this acute cold are certain viruses. And the second place in its prevalence is occupied by the coronavirus. The problem is that these seemingly harmless pathogens were dismissed, and they could never understand the cause-and-effect relationship between a common cold and a virus. If, say, a child has a cold, he has a runny nose, what will follow? And so on. For about two weeks, a child or an adult gets sick — and all this disappears without a trace. But in 2002, 2012, and now in 2020, the situation has changed qualitatively. Because the serotypes that have started to circulate … they affect the epithelial cells. Epithelial cells are cells that line the respiratory tract, gastrointestinal tract, and urinary system. Therefore, a person infected has pulmonary symptoms and intestinal symptoms. And in the study of urine tests, too, allocate… with such a viral load. But these new strains, which we are now talking about, they have these properties — to come into contact with the second type of receptor, the angiotensin-converting enzyme. And this receptor is associated with such a serious manifestation as cough. Therefore, a patient who has symptoms of damage to the lower respiratory tract, a characteristic sign is a cough. This affects the epithelial cells of the most distal parts of the respiratory tract. These breathing tubes are very small. Q: Distal, is it distant? A: It’s far and small in diameter. Q: So this is what we have next to the bronchi?  A: This is bronchi, then we have bronchioles, respiratory bronchioles. And when the air, the diffusion of gases goes on the surface of the alveoli, they pass just this section of the respiratory tract. Q: That is, the primary symptom is a cough… A: No, the first is a runny nose, and a sore throat. Q: They say that there is no runny nose. A: No, these are big data issues. 74 thousand medical records were processed, and all of them have rhinorrhea (runny nose. – RT). When you are told this — there are really some nuances. Biology is like this. The biological target of the virus is epithelial cells. The nose, oropharyngeal region, trachea, and then small bronchioles, targeting these regions are especially dangerous to humans. And it turned out that, having this mechanism, the virus leads to a sharp breakdown of the immune system. Q:Why? A: An explanation that science gives today is that a protein called interferoninduced protein-10 is involved in the process. It is with this protein that the regulation of innate immunity and acquired immunity is associated. How should we see this? As a very deep damage to lymphocytes. Q: So you can see lymphocytes falling immediately on the general test? A: Yes. And if there are white blood cells increase, platelets will increase, and it is more stable lymphopenia, that is, the lymphotoxic effect of the viruses themselves. Therefore, the disease itself has at least four outlined stages. The first stage is virusemia. A harmless cold, nothing special. Seven days, nine-approximately in this interval. But starting from the ninth day to the 14th, the situation changes qualitatively, because it is during this period that viral and bacterial pneumonia is formed. After damage to epithelial cells in the anatomical space of the respiratory tract, colonization of microorganisms occurs, primarily those that inhabit the human oropharyngeal region. Q: Do you mean bacteria that is already there? A: Bacteria, Yes. Therefore, these pneumonias are always viral and bacterial. Q: So the virus, so to speak, fills the alveoli, where some bacteria live all the time? And they live somewhere by themselves, in some quantity? A: In general, we believe that the lower respiratory tract is sterile. This is how the defense mechanism works for the lower respiratory tract. Q: There’s nothing there? A: It’s not inhabited. When the virus has entered and it has broken this barrier, where there was a sterile environment in the lungs, microorganisms begin to colonize and multiply. Q: So it’s not a virus that causes pneumonia? Still, pneumonia is caused by bacteria, of course. A: It’s the association of virus-bacteria. This is the window where the doctor must show his skill. Because often the virusemic period is like a mild disease, like a slight cold, malaise, runny nose, a slight temperature is small, subfebrile. But the period when the cough increased and when there is a shortness of breath — these are two signs that say: stop, this is a qualitatively different patient. If this situation is not controlled and the disease progresses, then more serious complications occur. We call it respiratory distress syndrome, shock. A person cannot breathe on their own. Q: Pulmonary edema? A: You see, there are a lot of different edemas of a lung. In fact, it depends on how it happens. To be precise, we call this non-cardiogenic pulmonary edema. If, say, cardiogenic pulmonary edema can be treated with certain medications, then this pulmonary edema can only be treated with a mechanical ventilation machine or advanced methods such as extracorporeal hemoxygenation. If a person transfers to this phase, the immunosuppression caused by the defeat of the acquired and innate immunity becomes fatal and the patient is joined by such aggressive pathogens as Pseudomonas aeruginosa, fungi. And the cases of death that occurred — 50% of those who were on artificial ventilation for a long time, the alveoli are all filled with fungi. Fungi appear during the stage of deep immunosuppression. What is the fate of the man who endured all this? That is, he suffered virusemic period, he suffered viral-bacterial pneumonia, he suffered respiratory distress syndrome, non-cardiogenic pulmonary edema, and he suffered septic pneumonia. Will he be healthy or not? And, in fact, today the world is concerned about this: what is the fate of those 90 thousand Chinese who have suffered a coronavirus infection? Q: But those 90 thousand — they recovered by themselves, they weren’t kept on on a ventilator, they did not get fungi. ARI or acute respiratory infection, that’s it? A: But the problem itself is very important. Because practical medicine is faced with the fact of a sharp increase in the so-called pulmonary fibrosis. And this group of people who have had a corona virus infection develops fibrosis of the lung within a year. Q: That is, when the lung tissue thickens? A: Yes. A lung becomes like burnt rubber, if the analogy is to be made. Q: Say, you get an elderly person who has been accurately diagnosed with a coronavirus. And he is not yet on the ninth day, that is, he does not need to be put on a ventilator yet. How will you treat him? A: You know what the problem is: we do not treat such patients yet, because there are no medications, medicines that should be used in this phase. There is no panacea. Because a drug that would act on virusemia, on the viral-bacterial phase, on non-cardiogenic pulmonary edema, on sepsis — is a panacea, this drug doesn’t exist. Because if we go back to the experience of 2002, when we saw the vulnerability of medical personnel, doctors and nurses were recommended to use Tamiflu and oseltamivir — an anti-influenza drug. And with certain serotypes of the coronavirus, indeed, the mechanism of introduction into the cell is the same as with influenza viruses. Therefore, it has been shown that these drugs can protect individuals who are at high risk of developing this disease. Or, he is identified as a carrier of the virus, he is given these drugs and so on. But this, I want to say again, has no serious evidence base. The situation that is most threatening, because it determines the fate of a person. A cold is one thing. And another thing a viral-bacterial pneumonia, it is a fundamentally different thing. And here it is very important to emphasize that it is problematic to help such a patient only with antibiotics. There must be a combination therapy, which includes means that stimulate the immune system. This is a very important point. Q: What do you mean? So, relatively speaking, you will prescribe him Amoxiclav with some kind of immunomodulator? A: Yes, we would usually prescribe fourth-generation cephalosporins, not Amoxiclav, in combination with vancomycin. This combination is broad, because very quickly there is a process of a change of gram-positive and gram-negative flora. But what immunomodulatory drug to prescribe is a question for scientific research. So, we understand that the immune system will suffer dramatically. We understand the high vulnerability of a person to the infection that begins to colonize the respiratory tract. So, unfortunately, we don’t have a clear line. But what really can help such patients in this situation is immunoglobulins. Because this is substitution therapy. And therefore, such patients are prescribed high immunoglobulins so that they do not develop sepsis, at least they do not enter the sepsis phase. American doctors used this drug in their Ebola patient. This is a group drug, an analog of nucleosides. This is a group of drugs that are used for herpes, cytomegalovirus, and so on. Q: So this is antiviral or antiviral-supporting therapy, right? A: No, this is a drug that still acts on the mechanisms in the cell that resist virus replication. Here in my hands (photo of US President Donald trump. – RT). He gathered all the top people who could speak out on promising drugs. Two questions that he raised, he was preparing for this conference. The first question is: how ready are scientists in the United States of America to introduce the vaccine? Q: Eighteen months. A: Yes, absolutely. That’s two years. He asked what in this case? Does the country have drugs that could protect? And, as a matter of fact, they said: Yes, there is such a drug. Q: What? A:What kind of drug is this? It’s called Remdesivir Q: Let’s look at it. A: That’s what scientists said, given the experience that we have, and discussions and so on. Although, of course, there are other drugs that are being actively studied. In general, this direction is very interesting: in fact, it is considered promising. The use of mesenchymal stem cells is considered promising. But at what stage? Q: As a person who has been doing this for many years, treating everything from asthma to pneumonia, can you somehow try to predict the development of this epidemic, for example, in Russia? A: I want to say that if we compare Russia with the surrounding world in case of the coronavirus of 2002. We didn’t have a single patient here. Q: Maybe we just didn’t diagnose them? A: As you know, there are strong aspects of Russian healthcare in this situation, and I would like to stress this. This is the work of our sanitary and epidemiologic services. They really did their best to protect our country. This is on one side, as if punitive measures. And on the second side is the work of the Vector Research Institute, which made diagnostics for the coronavirus in a very short time, and they did everything absolutely. And it was tested at the CDC, and they got a certificate indicating high specificity and sensitivity. Q: The Vector diagnostic kit is the only certified A: Yes. Q: The virus is already in Russia, no matter how much the sanitary service tries. How do you think it will develop? Will it end in the spring, for example, with the arrival of summer? A: You know, I think the picture repeats what it was then with the SARS. If you remember… Q: Then? Do you mean in 2002? When it was SARS? A: Yes, that’s the one. If we follow this scenario, we should say that somewhere in April or May this problem will become less acute. Q: Just because of the seasonal cessation of respiratory infections? A: Yeah. The climate factor and a number of other factors. Now, the trouble, of course, comes to us not from China, but from Europe. Those who return from these countries, primarily from Italy, today, remember: Carlo Urbani. He accomplished a lot of things. I think this is just a hero of a doctor who has done so much. He was a virologist from Milan. Q: Back in 2002? A: He was a WHO expert. I met with him through the World Health Organization. He was on the list as an expert on coronaviruses. And then he was sent to Hanoi. They were dispatching doctors, and he got to go to Vietnam. And in Vietnam, when he arrived, there was a panic. Their doctors stopped coming to work. Their medical staff, also. There had patients, but there wasn’t any medical personnel and no doctors. He assessed the situation. With difficulty, he managed to break it, to remove this panic situation that was then in the hospital. But most importantly, he began to communicate with the government and said: close the country to quarantine. That’s where it all came from. It came from Urbani. They started to fight back. Q: The Vietnamese? A: Yes, the government of Vietnam. That this would affect the economy, tourism, and so on. But, he found these words, he convinced them. And Vietnam was the first country to come out of this. And he thought his work was done. He collected material for a virological examination and boarded a plane to Bangkok. He was supposed to meet with the American virologists there. During the flight, he realized that he got ill. He got sick, just like those poor Vietnamese in that hospital. And he began to write everything down and describing it. This is this exact time, and this is how I feel. Q: The flight was about three hours? A: Yes, about three hours. And during these three hours, he became an invalid who couldn’t get up and move on his own. Here we see how the window itself works, and we understand when pneumonia joins — this window can be extremely, extremely short in duration. And when he was barely able to get down the aircraft ladder, he left the last entry: “I’m waving to them so they don’t come near me.” That is, American virologists wanted to meet Urbani, but he said: let’s not contact. He died in an intensive care unit. And there was an autopsy. And from his lung tissue was isolated a strain that was named after him – “Urban I-2”. Here is a very story that I am telling you. A tragedy, of course. Q: What would you recommend to a person who finds himself… Well, we have already agreed that the virus is in the general population. We can’t really control it anymore. A: Are you asking for some simple recommendations? First of all, take a good care for the nasal mucosa and oropharyngeal area. Q: To wash it with saltwater? A: Yes, wash it thoroughly. But “lors” – non-prescription medications and sinus cleaners to stop running nose and for an effective lavage. That is, the feeling of free unobstructed breath should come after all. The second thing is the oropharyngeal area behind the uvula. And there, too, you need to make a good lavage of the oropharyngeal region. Q: So you don’t just have to squirt it up your nose, you have to gargle it deep down your throat? A: Yes, and rinse it out. And don’t be lazy. Do do it until you get a feeling of clean, good airways. Of all the ways, this is the most effective. I would advise those people who can afford to buy a nebulizer or… Q: Do you mean, it’s aerosol, right? With ultrasound? A: Yes. And it allows the hygiene of the upper respiratory tract to be brought to a good state. When a cough starts, it is desirable to still apply the medications that we prescribe for patients with bronchial asthma. This is either Berodual, or Ventolin, or Salbutamol. Because these drugs improve mucociliary clearance, relieve spasm. Q: You mean expectorant?” Mucolytic ACC? A: Yes, ACC and Fluimucil. And what you can’t do is use glucocorticosteroids. This virus replication is rapidly increasing by them. Q: What does that mean? A: Corticosteroids is prednisone, methylprednisolone, dexamethasone, betamethasone. Q: So you don’t need to inject hormones, relatively speaking, if you have a viral infection? A: There are inhaled steroids. But there are patients with asthma who are ill and are on this therapy. But this has to be a tailor-made solutions. Of course, 2020 will go down in medical history as a year of a new disease. We must admit that we have understood this new disease. Two new pneumonias have arrived. First is pneumonia, which is caused by e-cigarettes, vapes, and now in the United States, people have died from this… Q: …several thousand teenagers. Yes, this is a well-known fact, and how to treat it is unclear. You put them on a ventilator — they die immediately. A: Yes. Do you understand what the problem is? Here they develop those changes in the lungs that occur during this process. They seem to be similar (to the changes from the coronavirus). This is respiratory distress syndrome, which we are talking about. The literature raises very serious questions: the role of coronaviruses in transplantation. One of the problems is obliterating bronchiolitis, which occurs especially during transplantation. Q: A lung transplant? A: Yes, lungs and bone marrow. Stem cell. As a matter of fact, everything is well done, everything is normal, the person has responded to this therapy, and the problem of respiratory failure is beginning to grow. And the cause of these bronchiolitis was caught — it is a coronavirus… That is, new knowledge has come. How to treat Coronavirus infection COVID-19 in Russian Read the full article

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Recovering Herpes With Self-Love

Recovering Herpes With Self-Love is available on: http://ift.tt/2qEHK5p

Recovering Herpes With Self-Love

None of this touched us- we were living a various life. Everybody boosted up in the church. The church maintained us protected from a variety of the scaries of destitution.

I located fretting love in the church. Not the love you see on TELEVISION as well as in the films- a larger love, an added love. Jesus was all fretting love, he was love, he is love.

Bryan Ferry from Roxy tracks sings "Love is the drug that I ask for to obtain". I differ, I do not think that love is a drug- an intoxicant. For those individuals in the sixty percent or probably even more of individuals with the herpes simplex infection Love is just one of one of the most trusted recovery device.

Sarah Mclachlan that most likely to my alma mater-The Nova Scotia College of Art in addition to Design, sings "Your love is much better compared to gelato, better as compared with anything I've in the past had". I would most definitely sing rather that "My love is much better as compared with valtrex, better as compared with famvir or anything I've ever before had".

Don Miguel Ruiz establishes that "healing requests the vanity, reality and also elegance. With these 3 facets the entire globe will definitely redeem". I will definitely cover all 3 in this quick point.

Herpes is herpes- it's one of both of elements researchers in addition to us in the various healing location consent on. Numbers in fact usually however it could not be challenged that in between 50 together with 80% of the populace has herpes simplex 1 in addition to in between 20 as well as 25% of the populace has herpes simplex 2, so if you facet in the selection of individuals that have both kinds, the hardly any range of individuals that have herpes simplex has to most likely to the truly the really the very least 60% as well as is more than likely a great deal additional. It is extended previous time for individuals with herpes in advance from the storage room along with chat up distressing herpes to assist notify individuals that do not have herpes together with to place a human face on this trouble.

Some individuals do not such as sex in addition to an end result need to denigrate anything that worries sex especially sexually sent infections. Individuals with herpes are not lepers along with require not permit themselves to be managed like lepers.

( Herpes tests are not typically component of a STI testing panel, so unless you require one you might never in the past obtain one) The truth is that individuals with herpes could be contagious in addition when there are no treatment indicators of the infection being energised a lot a lot more safeguarded sex is something that ought to be considered. The fact is that a particular with herpes that does not make consistency with the psychological in addition to psychological impacts of having herpes will not have the capability to handle their herpes as efficiently as a person that does despite exactly just what does it set you back? valtrex or famvir they take.

Some individuals with herpes are resentful in addition to still interrupted with the individual that contaminated them. Various individuals are contaminated by individuals that really did not alert them of their herpes trouble. Countless individuals are contaminated by disloyal pals.

When given a life-sentence like herpes, it's all-natural to be bitter along with furthermore troubled. I discuss most definitely that earlier or later on and also I prefer that it's earlier, there need to come a time to allow along with forgive go if you wish to be well stabilized along with well balanced as well as healthy and balanced with herpes.

Forgive the individual that utilized you herpes if you can. I take care of so many individuals in my various herpes center that are regularly penalizing themselves for having herpes. Love forgives, get a kick out of comprehends.

Prepared to on your own, be caring along with light along with client as if you were your private youngster. Forgive on your own together with fetch your self-confidence in addition to vanity.

If you have herpes together with love on your own just specifically just how would definitely you act? Would certainly you be reproached of your herpes? Would definitely you quit dating as well as decrease on your own like along with sex just due to the fact that you have herpes?

If you suched as on your own- especially simply exactly how would certainly you consume? Would absolutely you smoke cigarettes as well as take leisure drugs, would certainly you consume alcohol coffee recognizing that it's a trigger for your herpes in addition to negative for your health as well as health and wellness appropriate around?

If you suched as on your own along with pleased in others would certainly you exercise additional secure as well as protected sex with a prophylactic and/or anti-viral gel to assist secure your gotten a kick out of one/s from your herpes, would most definitely you exercise a whole lot extra safeguarded sex to secure on your own from various other sexually removaled infections? Would definitely you possibly be affected to speak up along with initiative to educate others on merely means to take care of herpes if they have it or just the most effective methods to guard themselves from herpes if they do not, particularly the youngsters that are simply beginning to discover their sexuality?

You were birthed with the right to be pleased in addition to value your life as well as your wellness as well as health and wellness to the most effective, having herpes changes none of this.

Christopher Scipio Homeopath/Herbalist 100% all-natural Herpes Treatment Specialist

Numbers really commonly yet it could not be challenged that between 50 along with furthermore 80% of individuals has herpes simplex 1 along with furthermore between 20 in addition to 25% of individuals has herpes simplex 2, so if you facet in the variety of individuals that have both kinds, the limited variety of individuals that have herpes simplex needs to go to the truly the really the very least 60% in addition to furthermore is probably a great deal added. It is considerable previous time for individuals with herpes ahead out along with talk up stressing herpes to aid inform individuals that do not have herpes in addition to furthermore to place a human face on this issue.

Numbers genuinely often nonetheless it may not be challenged that between 50 along with 80% of the populace has herpes simplex 1 along with between 20 along with in addition 25% of the populace has herpes simplex 2, so if you aspect in the variety of individuals that have both kinds, the minimal variety of individuals that have herpes simplex needs to go to the actually the really the very least 60% in addition to furthermore is more than likely a large amount far more. It is considerable previous time for individuals with herpes to find from the storage room location in addition to talk up fretting herpes to help educate individuals that do not have herpes in addition to place a human face on this issue.

Numbers really typically yet it could not be opposed that between 50 along with furthermore 80% of individuals has herpes simplex 1 in addition to furthermore between 20 in addition to 25% of the populace has herpes simplex 2, so if you part in the variety of individuals that have both kinds, the minimal variety of individuals that have herpes simplex needs to go to the actually the really the very least 60% along with in addition is probably a whole lot a great deal a lot more. It is substantial previous time for individuals with herpes ahead out in the open in addition to talk up stressing herpes to assist inform individuals that do not have herpes along with furthermore to place a human face on this trouble. The truth is that a personal with herpes that does not make peacefulness with the furthermore psychological in addition to psychological effects of having herpes will most definitely not have the ability to handle their herpes as suitably as a person that does no concern of merely specifically what does it cost? valtrex or famvir they take.

Numbers really normally nevertheless it could not be objected to that in between 50 along with 80% of the populace has herpes simplex 1 along with in between 20 as well as 25% of the populace has herpes simplex 2, so if you facet in the range of individuals that have both kinds, the really little range of individuals that have herpes simplex requires to go to the actually the really the very least 60% as well as is most likely an entire great deal added. It is extended previous time for individuals with herpes in advance from the storage place in enhancement to speak up distressing herpes to help notify the individuals that do not have herpes along with to place a human face on this trouble.

Numbers really usually yet it could not be opposed that in between 50 as well as in addition 80% of the individuals has herpes simplex 1 as well as also in between 20 as well as 25% of the populace has herpes simplex 2, so if you part in the number of individuals that have both kinds, the limited number of individuals that have herpes simplex has to be at the actually the really the very least 60% as well as in addition is most likely a great deal a great deal extra. It is considerable previous time for individuals with herpes to come out of the wardrobe as well as talk up stressing herpes to assist enlighten the individuals that do not have herpes as well as in addition to place a human face on this trouble. The truth is that a personal with herpes that does not make calmness with the also psychological as well as psychological influences of having herpes will certainly not be able to handle their herpes as suitably as a person that does no concern of merely precisely just how much valtrex or famvir they take.

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Keto diet: weight loss and disease treatment

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Keto diet: weight loss and disease treatment

At first, the cravings were like “a drug withdrawal,” Jay Wortman recalls.

Lying on a hotel bed in Ottawa one night, he’d had to white-knuckle his way out of eating Ferrero Rocher chocolates he’d spirited off a flight. A recent Type 2 diabetes diagnosis had prompted the Vancouver-based family medicine doctor to cut out nearly all carbohydrates — sweets, pasta, bread, even fruit — in an attempt to manage his blood sugar while he waited to start medication. But he couldn’t stop thinking about those chocolates, or his favorite breakfast: waffles doused in syrup. “I think I was a full-fledged sugar addict,” he says.

Four months later, the sugar pangs had eased. He got through the early weeks by stocking up on artificial sweeteners and focusing on how much his 2-year-old son needed a healthy dad. With sugar off the table, he says, all that was left was “the non-carby foods” — bacon, eggs, steak, and vegetables. Soon, he started sleeping better and feeling less fatigued. Weight was coming off at the rate of a pound a day, until he was down 30 pounds and no longer overweight. “I had to get my pants taken in,” Wortman says. “And then I had to get them taken in again.”

More than 16 years later and still following the ultra-high-fat, low-carb regimen that’s become popularized under the name keto, Wortman has never taken a diabetes drug. He hasn’t needed to. He feels stronger and is skiing the most ambitious slopes of his life. “At 68, I’m far fitter than I was at 52 when [my diet] started,” he says.

Transformation stories like his — and the thousands of seemingly hyperbolic claims of dieters losing dozens of pounds, complete with Instagrammed before-and-afters — have made keto the biggest diet phenomenon today. The most Googled diet of 2018, it has eclipsed household names like Weight Watchers (now known as WW) and the other low-carb regimens, Atkins and Paleo.

Keto is a Silicon Valley life-hacking fixation (see author Tim Ferriss’s keto videos), a Hollywood trend (see Kourtney Kardashian’s and Halle Berry’s keto journeys), and fodder for numerous online communities. Devotees can meet at low-carb keto cruises, keto conferences, and keto cafes. While there’s no leading figurehead, a cadre of evangelists sell books and pseudo-medical supplements and devices to help dieters check whether they’re truly in “ketosis,” the holy grail fat-burning state keto dieters are after.

Beyond all the hype, the chance that keto — a minimalist variation on the diet promoted by cardiologist Robert Atkins — can solve the obesity crisis is vanishingly slim. On average, low-carb diets look a lot like others when it comes to long-term weight loss: Most people can’t stick to them. There’s tremendous variation in how humans respond to nutritional and dietary tweaks, and let’s not forget that the promises keto boosters now make are reminiscent of the overhyped claims that fueled the recent gluten-free craze.

But how do you explain results like Wortman’s? He expected that avoiding carbs would help manage his blood sugar in the very short term, not that his other diabetes-related symptoms — thirstiness, frequent urination, and blurred vision — would vanish. And he definitely didn’t anticipate that the diet would allow him to control the disease long-term, without any medication.

Keto might not be an obesity panacea, but it would be a mistake to dismiss the diet as just another fad, in part because of results such as Wortman’s. Along with all the dubious keto supplements and the weight loss books has come a growing body of science exploring keto as a potential foil for Type 2 diabetes and other illnesses. It’s part of a fascinating broader examination of how we might use nutrition to treat disease.

“It’s anti-establishment”

Keto isn’t just low-carb — it is practically no-carb. Its followers avoid ice cream and pizza, as well as whole grains, fruits, and legumes such as brown rice, apples, and lentils. No bakery-fresh bagels, homemade apple pie, birthday cake, or even juicy watermelon.

But what people eat in America — and around the world — is carbohydrates. They account for roughly half the calories on average in the American diet, come highly recommended in national nutrition guidelines, and feature prominently in the traditional diets of everyone from pasta-munching Italians to rice-loving Indonesians.

According to the United Nations’ Food and Agriculture Organization, of the world’s more than 50,000 edible plants, “Just three of them, rice, maize and wheat, provide 60 percent of the world’s food energy intake.” All three of those staples are carbs.

To follow a keto diet is to reject this culture and history. And while keto forbids processed junk foods — something common to just about every diet — it also severely limits the fruits, grains, and legumes suggested by the US Department of Agriculture as essential parts of a healthy diet. Keto adherents believe the conventional nutrition wisdom is not only wrong but actively harmful.

This rejection of mainstream thinking helps explain why keto went viral at this moment, and why it’s more than just a diet. It’s a cultural identity.

Take Wortman. He’s been on two of Jimmy Moore’s low-carb cruises, sailing across the Caribbean, downing steak after steak. His wife started keto shortly after he did and remains on the diet. He calls their daughter, who was born seven years into their keto lifestyle, “a product of a keto gestation.”

The diet didn’t just change Wortman’s life; it changed how he thought about medicine and nutrition. He believes there’s a conspiracy by a “matrix of agendas” to promote a plant-based diet. The “whole fiber thing is a myth,” he tells me. He also thinks the concerns about a meat-heavy diet’s impact on the planet — that cows produce too much methane — are hugely overblown (they aren’t), and that the link between cardiovascular disease and saturated fat has been “debunked” (it hasn’t).

In a time when black is white, up is down, and discussions of fake news dominate the news cycle, it’s no accident that keto went viral, says Alan Levinovitz, a James Madison University religion professor who studies diet beliefs. “It’s anti-establishment,” mirroring other strains of rebelliousness in our politics, he says. He experimented with the carnivore diet (a form of keto) and says he experienced no health improvement.

Americans are living in the aftermath of the low-fat experiment — where the public learned about guidelines and studies that have often been muddied by food industry interests. With its emphasis on fat, keto is the antidote to the Snackwell’s era. You can gorge on butter and bacon and stay in ketosis. It’s the perfect fuck-everything-you-know-about-nutrition diet.

A diet to heal disease?

Keto’s potential to heal has captured the imagination of people like Columbia University oncologist and author Siddhartha Mukherjee, who has been studying the diet’s effects on cancer. “We are trying to steer clear of any diet crazes,” he says. “For me, it’s thinking of the diet as a tool or drug,” one that may work when used in tandem with traditional cancer medicines in “a very particular population of cancer patients.” Keto’s effects on insulin and glucose levels — and how they may interfere with cancer cell growth — are what intrigue Mukherjee and other scientists.

He’s only tested the cancer hypothesis in mice. And he has other concerns, echoed by many in the medical field, including that keto may not be safe for the cardiovascular system since it can drive up cholesterol levels.

Wortman, the keto evangelist, is gratified that other doctors are at least opening their minds to keto as a therapy, something he didn’t expect to happen in his lifetime. After his high-fat and -protein diet controlled his blood sugar, he started reading about keto in Atkins’s books and scientific papers and became convinced of its potency.

The diet’s potential for treating Type 2 diabetes is the aspect of keto that has long obsessed Wortman. More than a decade ago, he started lecturing on the subject at medical conferences, only to be lambasted. Other health professionals believed the high-fat regimen would damage people’s kidneys, arteries, and brains.

Wortman felt vindicated when, this spring, the American Diabetes Association came out with a consensus statement — intended as guidance for doctors across the country — suggesting a very low-carb diet could be a nutritional treatment option for some patients with diabetes.

Today, Wortman prescribes keto to all his patients who have Type 2 diabetes. (The standard medical interventions include weight loss, exercise, medication such as metformin, and insulin therapy, as well as regular blood sugar monitoring.) He’s even experimented with using the diet to treat northern British Columbia’s aboriginal people, who are disproportionately diagnosed with Type 2 diabetes. Though he never published anything on the experiment in a scholarly journal, it was the subject of a 2008 Canadian Broadcasting Corporation documentary. “People lost weight, improved their diabetes, and got off their medications,” says Wortman, who does not profit from advocating for the keto diet.

“The obvious failure of the conventional approach has also been getting too big to ignore,” he adds. “I often say to my patients and colleagues now, ‘What’s the most important thing you do about your health? It’s your diet.’”

The burning question

The reason for shunning sugars is that eating more than the equivalent of a slice or two of bread each day can knock dieters out of ketosis. Dr. Atkins reportedly liked to say that ketosis is “as delightful as sunshine and sex.” (With his four-phase plan, he promised to help people “stay thin forever” by eating more fat and fewer carbs — the same way the now-popular Keto Reset Diet book promises to “burn fat forever.”)

To understand how ketosis works, consider how the human body uses fuel. On a typical high-carb diet, we’re fueled primarily by glucose (or blood sugar), much of which we derive from carbohydrate-rich foods. When we eat a bagel or a bunch of grapes, for example, the glucose levels in our blood rise, and the pancreas secretes insulin to turn glucose into an energy source, moving it from the blood into our cells.

But the body only evolved to store enough glucose to last a couple of days. So if we forgo eating carbs, it finds other ways to keep going.

One of those ways is a process called ketogenesis. In ketogenesis, the liver starts to break down fat — both from food and from the reserves stored in our fat tissue — into a usable energy source called ketone bodies, or ketones for short. Ketones can stand in for glucose as fuel when there’s a glucose shortage. Once ketogenesis kicks in and ketone levels go up, the body is in ketosis and burning fat instead of the usual glucose. (Whether this actually leads to increased calorie burn or fat loss is a matter of scientific debate.)

There are a couple of avenues into ketosis. One is through fasting: When you stop eating altogether for an extended period of time, the body will ramp up fat burning for fuel and decrease its use of glucose (which is part of the reason people can survive for as long as 73 days without food).

Another way to reach it is by making your body think it’s fasting — by eating only about 20 to 50 grams of total carbs per day. At the low end, that’s equivalent to a slice of bread or a small potato.

People on a keto diet generally aim to get about 5 percent of their calories from carbohydrates in foods such as berries and salad, about 15 percent from proteins like salmon and sardines, and 80 percent from fats including coconut oil and avocado. And ketosis is a quantifiable state. Dieters can measure their ketone levels with blood tests, breathalyzers, and urine strips (with varying degrees of accuracy — blood tests are considered the gold standard for now).

This data-driven aspect is part of what appealed to Ethan Weiss, a University of California San Francisco professor of cardiovascular research. Initially, he was skeptical when he was invited to consult for Virta Health, a company selling lifestyle counseling on ketogenic diets for Type 2 diabetics. A second-generation cardiologist, he says his family had “nothing that resembled fat in the house” when he was growing up.

The more he learned about keto, however, the more intrigued he became. He says he was excited by “the idea that we can give [patients] an option that’s going to get them off medication reliably. The only other intervention that’s done that was bariatric surgery,” he says.

Eventually, Weiss co-developed a breath sensor, called Keyto, to help people track how their diet affects their ketone levels. Playing around with the prototype, he realized he’d made the diet a kind of game. “I was trying to see if I could get my ketone levels to go up. And because I’m naturally competitive and like games, I got obsessed.”

Within two months, he dropped nearly 16 pounds he hadn’t intended to lose and saw his blood sugar levels, which had been high, normalize.

Still, he concedes there’s a lot we don’t know about the effects of the diet. “There are two questions: Is it safe to be in ketosis long-term? And is there something else about this diet that’s potentially dangerous or harmful long-term? We can’t really answer either one in a rigorous way today,” he says.

One concern is that some people on keto will see their cholesterol levels increase, which is linked with a heightened risk of heart disease. In a recent op-ed criticizing low-carb evangelists for their “cheerleading,” Weiss wrote of the cholesterol problem: “It’s a classic issue of balancing benefits and risks, one complicated because it isn’t clear if, how much, or in whom an increase in cholesterol even matters. That’s why there is general consensus that rigorous clinical trials are needed to answer this critical question.”

Other doctors, writing in JAMA Internal Medicine, list “keto flu,” cardiac arrhythmias, constipation, and vitamin and mineral deficiencies among keto’s documented side effects in the pediatric scientific literature. But the diet’s greatest risk, they write, may be the opportunity cost of not eating enough high-fiber, unrefined carbohydrates.

I ask Weiss why he’s so excited about keto, even willing to promote it, given those risks, and the fact that sustained weight loss on keto doesn’t look all that different from other diets. “[We] can’t let perfect be the enemy of great,” he answers. “That is, what we are doing now sucks.”

The frontiers of keto science

Oncologists are also looking past keto’s big unknowns and exploring the potential benefits of the diet as part of cancer therapy. While they warn that it’s far too early to prescribe the diet for any specific cancer type, they’re excited about the possibilities.

For a study published in 2018 in Nature, Mukherjee and his co-authors tested whether PI3-kinase inhibitors — a class of drug used to treat cancers, which has the side effect of driving up blood sugar and insulin levels — would perform better in mice when they also ate a keto diet or took a drug that suppressed insulin levels. The idea they wanted to test, Mukherjee explained on Weiss’s keto podcast, was: What if “the drug causes a physiological side effect — high sugar, high insulin — and that high insulin is now what is bringing the tumors alive again … like a malignant circuit.”

In the study, the combination of the drug and the diet shrank 12 types of tumors in mice — even pancreatic cancer, which is very difficult to treat in humans. But keto caused the leukemia to worsen, meaning researchers still need to work out where the diet is helpful and where it’s harmful.

Marcus DaSilva Goncalves, a co-author on the study and endocrinologist at New York’s Weill Cornell Medicine, says we’ll learn more from a human trial, scheduled to start later this year, that will build on the mouse research.

For now, it’s way too early to know whether this research will translate to humans, despite all the YouTube videos and blogs suggesting that sugar “feeds” cancer. “We are in the Stone Age of understanding which diet is best for each type of cancer site,” Goncalves said.

He’s also concerned about heart health. “We don’t know what it’s doing to cardiovascular risk factors. But cancer’s unique — people are willing to accept a more hazardous condition in order to cure the cancer.”

Much better-established are keto’s effects on epilepsy. For nearly a century, doctors have been prescribing the diet to treat epilepsy, an idea that came about in the 1920s, when researchers observed that people who fasted experienced fewer seizures. Researchers still aren’t sure why the diet can work, but a few mechanisms have been proposed, including making neurons more resilient during seizures. And today, studies have shown that children and adults whose epilepsy doesn’t respond to medications seem to experience a pretty large reduction in seizures when following a ketogenic diet.

That doesn’t, however, mean that the diet works for other conditions. There are still many questions about even the most talked-about keto applications, such as keto for Type 2 diabetes. While researchers have found the diet can reduce people’s hemoglobin A1C (a measure of blood sugar) and their reliance on medication, the effects tend to wane after one year.

Virta Health, the keto counseling company Weiss consults for, recently published data from a two-year evaluation of the Virta program. Through telemedicine, Virta’s clients get nutrition support and health coaching about how to prepare low-carb foods and stick to the diet. In the trial, people’s A1C and weight crept up between one and two years — but 38 percent saw their diabetes reverse and 15 percent were in remission. “Those results are dramatically better than anything else anybody’s published at two years with diet or lifestyle regimen,” Steve Phinney, a founder of Virta who has been studying (and living on) keto for decades, says.

Skeptics, such as the cardiologists turned diet gurus Dean Ornish and Joel Kahn, argue that keto’s potential heart risks are too great. Others note that it’s not clear whether it’s the keto diet itself or the weight loss it can induce that helps control Type 2 diabetes.

To begin to answer the latter question, Phinney and his colleagues ran a study that cycled 16 patients through a low-carb (keto), moderate-carb, and high-carb diet during four-week periods, with two-week reset periods in between. During the diet, the participants were fed enough to keep their weight stable. At the start of the trial, they all met diagnostic criteria for metabolic syndrome, a constellation of conditions — excess fat in the abdominal area, high blood sugar, low HDL (or “good”) cholesterol, and high blood pressure — that are linked to an increased risk of heart disease, stroke, and Type 2 diabetes.

The results were just published in the journal JCI Insight. After one month on the high-carb diet, one of the 16 people no longer met the criteria for metabolic syndrome. On the moderate-carb diet, three of the 16 reversed their metabolic syndrome. On keto, that number rose to nine out of 16. This suggests that it’s carbohydrate restriction, not weight loss, that helps control metabolic syndrome, including high blood sugar.

The study will have to be replicated. It’s also worth noting the high-carb group ate a lower-quality diet (with foods such as marshmallow fluff and barbecue sauce) while the lower-carb groups stuck to whole foods, which could have muddied the results. And it was funded by a grant from Dairy Management Inc. and the Dutch Dairy Association, and co-authored by researchers with a financial stake in showing keto’s benefits.

But Phinney believes the work is nothing short of revolutionary. “A guy named Thomas Kuhn pointed out that scientific revolutions don’t happen overnight, they happen over time,” he says. “We’re using a non-pharmaceutical, very powerful tool to hopefully halt and turn back an epidemic that is threatening our ability to provide health care because it’s such a dramatically expensive disease.”

And there are other ways the diet may be used. Researchers are currently exploring the benefits of keto for Type 1 diabetes. There’s preliminary research suggesting an ultra-low-carb diet could have a role in treating neurodegenerative diseases, like Alzheimer’s and Parkinson’s. A lot of the brain research, however, was done in mice or cells, so we still need evidence of human response. When we have better studies, keto might look as ineffectual as gluten-free — or maybe it’ll be the diet miracle we’ve been hoping for. That is, if we can stick to it.

CREDITS Editor: Eliza Barclay Visuals editor: Kainaz Amaria Designers: Amanda Northrop and Christina Animashaun Copy editors: Tanya Pai and Tim Williams Cover designer and graphics: Javier Zarracina Photographer: Scott Suchman for Vox Food stylist: Lisa Cherkasky for Vox

Source link Keto Diet Diabetes

[kristablogs]

Can implicit bias training help cops overcome racism?

Implicit bias can be disastrous when you're pressured into making quick decisions. (Unsplash/)

Thirty police officers sat contemplating a deceptively simple question: at the scene of a car crash, why is it that the man dressed in a suit and driving a shiny BMW is usually more believable than the man wearing muddy jeans driving a pickup truck? It was late in 2018 at the New York Police Department, and under mandatory orders, they were there to learn about something lurking within everyone’s subconscious—racism.

While you may not show explicit signs of racism against any particular group, or even consciously think negative things about them, you probably still carry prejudice in the form of implicit bias. Implicit biases are a symptom of grouping, which is something our brains start doing shortly after we’re born. When someone says peanut butter, jelly comes to mind. Salt and pepper. Beaches and sand. Every day, we bathe ourselves in news reports, encounters with friends and co-workers, movies, books, and gossip. Each of these minuscule encounters accumulate and provide our brains with data about which people and things and adjectives tend to come bundled together, solidifying associations in our minds. That’s how we form implicit biases—whether we want them or not.

“We’re swimming around in this sea called culture, and we are creatures of that sea,” says Mahzarin Banaji, a professor of psychology at Harvard University. “Our bodies have become adapted to the salt water, and now this stuff is in us. True, I didn't put that stuff there, hey, I don't even want it there. But it is there.”

These associations are crucial in helping us fathom the world. In early childhood, babies begin crafting mental links between objects and their uses—for example, spoons are used for eating mashed veggies and fruit, and galoshes go with rainy walks. The connections become more nuanced and varied as we grow up to help our brains make sense of objects and scenarios we encounter. But as essential as these associations are, they also have serious consequences for our perception of other people, which in turn affects how we treat them. That can have disastrous effects on policing.

“The most common [example] is the black-hyphen-crime association,” says Lorie Fridell, a professor of criminology at the University of Florida. Many Americans grow up watching a disproportionate number of Black people getting arrested on television. According to a report published by Media Matters in 2015, between August 18 and December 31 of 2015, the evening news programs for WCBS, WNBC, WABC, and WNYW identified Black people as suspects in 68 percent of reports on murder, 80 percent on thefts, and 72 percent on assaults, although the actual statistics throughout 2015 were significantly lower, at 62.8, 69.2, and 52.4 percent, respectively.

Research suggests that most people carry an unconscious sense that Black people are more closely linked to crime than those of other races, which is likely at least partly to blame for the outsize danger Black individuals face when encountering law enforcement.

How implicit bias training works

Police brutality in the United States is on the rise, with 1,004 people dying at the hands of police in 2019, 23.4 percent of whom identified as Black. To combat this, police departments in New York, Austin, Los Angeles, Miami, Milwaukee, and Minneapolis have contracted with a company called Fair and Impartial Policing over the last few years, spending millions of dollars for courses that claim to help cops shake off unconscious prejudice. In 2018, the NYPD spent $4.5 million to train all 36,000 New York-based officers and commanders for around two years, using a mandatory eight-hour module that aims to help the police understand their biases based on conversations about their own experiences in the field, and implement unbiased, controlled responses to emergencies. But experts say these interventions are often poorly received, and applying the science of implicit bias is far from straightforward.

“When they walk into the classroom, the officers are somewhere between defensive and downright hostile,” says Fridell. “They think we’re gonna shake our fingers at them and call them racist.” The first step in the training process is to get over that “defensiveness hump,” she says, and guide the officers to confront the ways their biases may have controlled their previous actions. Beyond that, a series of lectures and group discussions led by the instructor—always a former member of the force—aim to teach attendees that conquering implicit bias can lead to fair and effective policing of communities. Classes for sergeants and commanders focus on fostering a positive culture within their departments, weeding out explicitly racist individuals during the recruitment process, and helping subordinates avoid situations where implicit bias may get the better of them, such as pulling over ‘suspicious’ vehicles to search for drugs.

Fridell says that officers’ attitudes, knowledge, and skills tend to shift after training, at least in the short term. But detecting a course’s impact is difficult. “It’s hard to track what cases of excessive force or complaint didn’t happen because we had this training,” says Fridell. So how do we know if it works at all?

A heated debate

Mahzarin Banaji stumbled across the idea of implicit bias as a grad student in psychology at Yale University in 1990. Along with Tony Greenwald and Brian Nosek, she published a series of implicit attitude tests on Yale’s website in 1998. The tests measure the strength of associations between different concepts (black faces, white faces) and evaluations (good, bad) by asking test-takers to categorize words or images by pressing certain computer keys. The time taken to respond to various combinations reveals these users’ subconscious mental associations.

Banaji predicted they’d have data from 500 test results in one year. But in barely one month, they were overwhelmed with 45,000 submissions. “The Yale website would crash regularly in the first few days,” she says.

Over time, the team of three published other tests, which measured biases surrounding age, disability, religion, gender, weight, and sexuality, among many others, creating not only a 20-year data pool, but a worldwide phenomenon that went viral, and stayed viral. The data shows that an overwhelming majority of test-takers exhibit implicit bias against Black people, but the trend has been slowly decreasing, especially from 2012 onwards, during the years of the Black Lives Matter protests.

Since 1998, implicit bias has become a household name, given a spotlight in hundreds of research papers and dissertations using Banaji’s enormous pool of IAT data, an episode of Oprah, and former President Barack Obama’s Task Force on 21st Century Policing Implementation Guide. The guide, published in 2015, recommends the undertaking of “trainings and organizational change that address procedural justice, implicit bias, and de-escalation/use of force” and officers’ use of body cams. The popularization of the concept has spawned numerous implicit bias police training sessions, which have led to dubious results.

Take Minneapolis. Since 2000, police there have killed 195 civilians. Former police chief Janeé Harteau, who served the city from 2012 through 2017, brought Fair and Impartial Policing to the MPD in 2014. “I think it’s important that people understand that police officers are humans, they have unconscious bias,” says Harteau. “Not because they’re police officers. We hire from society. If there’s a percentage of racism, there’s gonna be that percentage in the organization.” Harteau asserts that this kind of training is essential. Having grown up in Duluth, Minnesota, Harteau had very little exposure to the Black community as a child. When she moved to Minneapolis to become a police officer, she entered a completely new world of high crime and poverty rates. “Had I not had the character and mindset I did, I might have had a different way of thinking,” says Harteau. “Even today, we all have to check ourselves. We all have a bias of some sort.”

The department’s 1,000 officers spent six or seven months undergoing training, resulting in “good feedback from rank and file,” according to Harteau. However, in the years following 2014, Minnesota only saw an increase in police brutality. On May 25, 2020, Officer Derek Chauvin killed George Floyd on Chicago Avenue by kneeling on Floyd’s neck for nearly nine minutes—the agonizing spark that gave rise to ongoing anti-police brutality protests across all 50 states.

“People are saying, ‘if Officer Chauvin had implicit bias training, why did this happen?’” says Harteau. “It’s hard to prove or track the crimes you prevented.” But she maintains that the training is necessary.

Many people think otherwise. Calvin Lai, assistant professor of psychological & brain sciences at Washington University, views the results of implicit bias training as inconclusive. “We simply do not know. There has been no published research on implicit bias training in police departments.” The results can vary, according to Lai—it can help certain individuals, but it can also completely backfire, especially in situations when officers are forced to attend, which tends to make them defensive. Dave Bicking, a volunteer and leader at Communities United Against Police Brutality in Minneapolis, looks upon this training with distrust. “Implicit bias was one of a whole package of reforms that was meant to look good without changing anything fundamental,” says Bicking.

Bicking, who has spent years fighting for dramatic police department reform in Minneapolis, sees explicit racism as more of a modern problem than cities might like to admit. “You can see it, hear it in their language, see it in statistics in how many Blacks versus whites are victims,” says Bicking. Implicit bias training won’t improve the behavior of cops who are consciously aware of—perhaps even perfectly comfortable with—their racial prejudices. And mandated attendance could feed a sense of conflict they feel against the communities they patrol. Another one of Bicking’s reforms targets the police training system, and how it exacerbates the “us vs. them mentality.” In one 2018 study, researchers claimed they saw this mindset grow more acute with each stage of police training.

Long Island-based civil rights attorney Frederick Brewington points out that police training is not just inadequate—it’s also alarmingly brief. “They get six months and they’re handed a gun,” says Brewington. “If we’re putting issues of life and death into the hands of certain individuals, why do we only give them six months of training in an academy?” In Minneapolis, the police academy takes between three and four months. The lack of consistent psychological profiling of officers is another dangerous issue, according to Brewington. Officers see “some of the worst things that humans can do”' but only receive one mental evaluation before they enter the police force. “The way we do policing in America, we’re at a point where we can't do it patchwork,” he says. “We’ve gotta disassemble the process and recalibrate.”

How can we improve implicit bias training?

Implicit bias training may not be an easy panacea, Banaji says, but it shouldn’t be scrapped entirely. There are several key opportunities for improvement—especially when it comes to making the process more palatable to participating officers.

First, the training should not be mandatory. Eugene Borgida, a professor of psychology and law at the University of Minnesota, claims that forced participation tends to make participants defensive and untrusting, which makes for a less effective program. Slowly gaining the respect and interest of a few officers at a time may be a better strategy than mandating the process for an entire department.

In 2019, Banaji personally oversaw the voluntary implicit bias training of officers in Cambridge, Massachusetts, by inviting more than 300 to her class. Just a third of them chose to show up. Banaji started the session with an open, vulnerable admittance—that she showed signs of racial bias on her own implicit attitude test. “This is the least I can do, to show them that we are speaking about something that is true of all humans,” Banaji says. “I gave them hands-on experiences and data. I gave them optimism at the end about change, and let them go.”

Two weeks later, Banaji picked up a phone call from the Deputy Superintendent at the Cambridge Police Department. Based on positive feedback from those who had attended the first session, the other 200 officers now wanted to participate. After five meetings, Banaji surveyed the attendees on the helpfulness of the course. She found that, on a scale from 1 to 5, scores increased from 1 to 4.5 throughout their time together. Banaji stands by these trainings, claiming that methodology rooted in her research on bias can help improve efficacy. “It can be done right, if you root it in the science,” she says. She adds that research on the subject is more essential than ever, especially as the Minneapolis city council has announced its plans to defund and dismantle the city’s police department. The restructuring of these systems should be informed by careful reasoning and research.

Banaji regularly thinks back to a lecture Martin Luther King, Jr gave to the American Psychological Association just weeks before his assassination in 1967. “He said, ‘you aren’t making policy. But what you can do to help the movement is by telling it like it is,’” says Banaji. “We cannot do everything. We cannot make policy or organize communities or dismantle any department. But what we can do is reveal who we are, how distant our behavior is from our own values, and then hope that this disparity will shape who people will choose to become.”

[scootoaster]

Can implicit bias training help cops overcome racism?

Implicit bias can be disastrous when you're pressured into making quick decisions. (Unsplash/)

Thirty police officers sat contemplating a deceptively simple question: at the scene of a car crash, why is it that the man dressed in a suit and driving a shiny BMW is usually more believable than the man wearing muddy jeans driving a pickup truck? It was late in 2018 at the New York Police Department, and under mandatory orders, they were there to learn about something lurking within everyone’s subconscious—racism.

While you may not show explicit signs of racism against any particular group, or even consciously think negative things about them, you probably still carry prejudice in the form of implicit bias. Implicit biases are a symptom of grouping, which is something our brains start doing shortly after we’re born. When someone says peanut butter, jelly comes to mind. Salt and pepper. Beaches and sand. Every day, we bathe ourselves in news reports, encounters with friends and co-workers, movies, books, and gossip. Each of these minuscule encounters accumulate and provide our brains with data about which people and things and adjectives tend to come bundled together, solidifying associations in our minds. That’s how we form implicit biases—whether we want them or not.

“We’re swimming around in this sea called culture, and we are creatures of that sea,” says Mahzarin Banaji, a professor of psychology at Harvard University. “Our bodies have become adapted to the salt water, and now this stuff is in us. True, I didn't put that stuff there, hey, I don't even want it there. But it is there.”

These associations are crucial in helping us fathom the world. In early childhood, babies begin crafting mental links between objects and their uses—for example, spoons are used for eating mashed veggies and fruit, and galoshes go with rainy walks. The connections become more nuanced and varied as we grow up to help our brains make sense of objects and scenarios we encounter. But as essential as these associations are, they also have serious consequences for our perception of other people, which in turn affects how we treat them. That can have disastrous effects on policing.

“The most common [example] is the black-hyphen-crime association,” says Lorie Fridell, a professor of criminology at the University of Florida. Many Americans grow up watching a disproportionate number of Black people getting arrested on television. According to a report published by Media Matters in 2015, between August 18 and December 31 of 2015, the evening news programs for WCBS, WNBC, WABC, and WNYW identified Black people as suspects in 68 percent of reports on murder, 80 percent on thefts, and 72 percent on assaults, although the actual statistics throughout 2015 were significantly lower, at 62.8, 69.2, and 52.4 percent, respectively.

Research suggests that most people carry an unconscious sense that Black people are more closely linked to crime than those of other races, which is likely at least partly to blame for the outsize danger Black individuals face when encountering law enforcement.

How implicit bias training works

Police brutality in the United States is on the rise, with 1,004 people dying at the hands of police in 2019, 23.4 percent of whom identified as Black. To combat this, police departments in New York, Austin, Los Angeles, Miami, Milwaukee, and Minneapolis have contracted with a company called Fair and Impartial Policing over the last few years, spending millions of dollars for courses that claim to help cops shake off unconscious prejudice. In 2018, the NYPD spent $4.5 million to train all 36,000 New York-based officers and commanders for around two years, using a mandatory eight-hour module that aims to help the police understand their biases based on conversations about their own experiences in the field, and implement unbiased, controlled responses to emergencies. But experts say these interventions are often poorly received, and applying the science of implicit bias is far from straightforward.

“When they walk into the classroom, the officers are somewhere between defensive and downright hostile,” says Fridell. “They think we’re gonna shake our fingers at them and call them racist.” The first step in the training process is to get over that “defensiveness hump,” she says, and guide the officers to confront the ways their biases may have controlled their previous actions. Beyond that, a series of lectures and group discussions led by the instructor—always a former member of the force—aim to teach attendees that conquering implicit bias can lead to fair and effective policing of communities. Classes for sergeants and commanders focus on fostering a positive culture within their departments, weeding out explicitly racist individuals during the recruitment process, and helping subordinates avoid situations where implicit bias may get the better of them, such as pulling over ‘suspicious’ vehicles to search for drugs.

Fridell says that officers’ attitudes, knowledge, and skills tend to shift after training, at least in the short term. But detecting a course’s impact is difficult. “It’s hard to track what cases of excessive force or complaint didn’t happen because we had this training,” says Fridell. So how do we know if it works at all?

A heated debate

Mahzarin Banaji stumbled across the idea of implicit bias as a grad student in psychology at Yale University in 1990. Along with Tony Greenwald and Brian Nosek, she published a series of implicit attitude tests on Yale’s website in 1998. The tests measure the strength of associations between different concepts (black faces, white faces) and evaluations (good, bad) by asking test-takers to categorize words or images by pressing certain computer keys. The time taken to respond to various combinations reveals these users’ subconscious mental associations.

Banaji predicted they’d have data from 500 test results in one year. But in barely one month, they were overwhelmed with 45,000 submissions. “The Yale website would crash regularly in the first few days,” she says.

Over time, the team of three published other tests, which measured biases surrounding age, disability, religion, gender, weight, and sexuality, among many others, creating not only a 20-year data pool, but a worldwide phenomenon that went viral, and stayed viral. The data shows that an overwhelming majority of test-takers exhibit implicit bias against Black people, but the trend has been slowly decreasing, especially from 2012 onwards, during the years of the Black Lives Matter protests.

Since 1998, implicit bias has become a household name, given a spotlight in hundreds of research papers and dissertations using Banaji’s enormous pool of IAT data, an episode of Oprah, and former President Barack Obama’s Task Force on 21st Century Policing Implementation Guide. The guide, published in 2015, recommends the undertaking of “trainings and organizational change that address procedural justice, implicit bias, and de-escalation/use of force” and officers’ use of body cams. The popularization of the concept has spawned numerous implicit bias police training sessions, which have led to dubious results.

Take Minneapolis. Since 2000, police there have killed 195 civilians. Former police chief Janeé Harteau, who served the city from 2012 through 2017, brought Fair and Impartial Policing to the MPD in 2014. “I think it’s important that people understand that police officers are humans, they have unconscious bias,” says Harteau. “Not because they’re police officers. We hire from society. If there’s a percentage of racism, there’s gonna be that percentage in the organization.” Harteau asserts that this kind of training is essential. Having grown up in Duluth, Minnesota, Harteau had very little exposure to the Black community as a child. When she moved to Minneapolis to become a police officer, she entered a completely new world of high crime and poverty rates. “Had I not had the character and mindset I did, I might have had a different way of thinking,” says Harteau. “Even today, we all have to check ourselves. We all have a bias of some sort.”

The department’s 1,000 officers spent six or seven months undergoing training, resulting in “good feedback from rank and file,” according to Harteau. However, in the years following 2014, Minnesota only saw an increase in police brutality. On May 25, 2020, Officer Derek Chauvin killed George Floyd on Chicago Avenue by kneeling on Floyd’s neck for nearly nine minutes—the agonizing spark that gave rise to ongoing anti-police brutality protests across all 50 states.

“People are saying, ‘if Officer Chauvin had implicit bias training, why did this happen?’” says Harteau. “It’s hard to prove or track the crimes you prevented.” But she maintains that the training is necessary.

Many people think otherwise. Calvin Lai, assistant professor of psychological & brain sciences at Washington University, views the results of implicit bias training as inconclusive. “We simply do not know. There has been no published research on implicit bias training in police departments.” The results can vary, according to Lai—it can help certain individuals, but it can also completely backfire, especially in situations when officers are forced to attend, which tends to make them defensive. Dave Bicking, a volunteer and leader at Communities United Against Police Brutality in Minneapolis, looks upon this training with distrust. “Implicit bias was one of a whole package of reforms that was meant to look good without changing anything fundamental,” says Bicking.

Bicking, who has spent years fighting for dramatic police department reform in Minneapolis, sees explicit racism as more of a modern problem than cities might like to admit. “You can see it, hear it in their language, see it in statistics in how many Blacks versus whites are victims,” says Bicking. Implicit bias training won’t improve the behavior of cops who are consciously aware of—perhaps even perfectly comfortable with—their racial prejudices. And mandated attendance could feed a sense of conflict they feel against the communities they patrol. Another one of Bicking’s reforms targets the police training system, and how it exacerbates the “us vs. them mentality.” In one 2018 study, researchers claimed they saw this mindset grow more acute with each stage of police training.

Long Island-based civil rights attorney Frederick Brewington points out that police training is not just inadequate—it’s also alarmingly brief. “They get six months and they’re handed a gun,” says Brewington. “If we’re putting issues of life and death into the hands of certain individuals, why do we only give them six months of training in an academy?” In Minneapolis, the police academy takes between three and four months. The lack of consistent psychological profiling of officers is another dangerous issue, according to Brewington. Officers see “some of the worst things that humans can do”' but only receive one mental evaluation before they enter the police force. “The way we do policing in America, we’re at a point where we can't do it patchwork,” he says. “We’ve gotta disassemble the process and recalibrate.”

How can we improve implicit bias training?

Implicit bias training may not be an easy panacea, Banaji says, but it shouldn’t be scrapped entirely. There are several key opportunities for improvement—especially when it comes to making the process more palatable to participating officers.

First, the training should not be mandatory. Eugene Borgida, a professor of psychology and law at the University of Minnesota, claims that forced participation tends to make participants defensive and untrusting, which makes for a less effective program. Slowly gaining the respect and interest of a few officers at a time may be a better strategy than mandating the process for an entire department.

In 2019, Banaji personally oversaw the voluntary implicit bias training of officers in Cambridge, Massachusetts, by inviting more than 300 to her class. Just a third of them chose to show up. Banaji started the session with an open, vulnerable admittance—that she showed signs of racial bias on her own implicit attitude test. “This is the least I can do, to show them that we are speaking about something that is true of all humans,” Banaji says. “I gave them hands-on experiences and data. I gave them optimism at the end about change, and let them go.”

Two weeks later, Banaji picked up a phone call from the Deputy Superintendent at the Cambridge Police Department. Based on positive feedback from those who had attended the first session, the other 200 officers now wanted to participate. After five meetings, Banaji surveyed the attendees on the helpfulness of the course. She found that, on a scale from 1 to 5, scores increased from 1 to 4.5 throughout their time together. Banaji stands by these trainings, claiming that methodology rooted in her research on bias can help improve efficacy. “It can be done right, if you root it in the science,” she says. She adds that research on the subject is more essential than ever, especially as the Minneapolis city council has announced its plans to defund and dismantle the city’s police department. The restructuring of these systems should be informed by careful reasoning and research.

Banaji regularly thinks back to a lecture Martin Luther King, Jr gave to the American Psychological Association just weeks before his assassination in 1967. “He said, ‘you aren’t making policy. But what you can do to help the movement is by telling it like it is,’” says Banaji. “We cannot do everything. We cannot make policy or organize communities or dismantle any department. But what we can do is reveal who we are, how distant our behavior is from our own values, and then hope that this disparity will shape who people will choose to become.”

[crohnsdigest]

Coronavirus (COVID-19) information for patients with inflammatory bowel disease

University of Chicago Medicine section chief of Gastroenterology, Hepatology and Nutrition, David T. Rubin, MD, answers common questions about coronavirus (COVID-19) and inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis. What are the symptoms of COVID-19 and are they different for inflammatory bowel disease patients? Patients who are infected with the novel coronavirus called SARS-CoV-2 may develop a disease called COVID-19. The symptoms of COVID-19 are most frequently fever, cough and other respiratory symptoms, which might progress to shortness of breath. Other common symptoms include fatigue or muscle aches. Some digestive symptoms have been associated with COVID-19 as well, including a loss of appetite, a loss of smell or taste, abdominal discomfort, more frequent bowel movements or loose stools. We haven't seen enough IBD patients who've developed COVID-19 to know whether these patients have different types of symptoms but for patients with IBD, having digestive symptoms could be confused for activation of IBD. The unique concern here is to distinguish between someone who is having a relapse of their IBD, compared to someone who might be having symptoms of an infection. We're working hard with our patients and performing additional research to figure this out. Are inflammatory bowel disease patients considered immunosuppressed? Do they have a higher risk of contracting COVID-19? Patients who have Crohn's disease and ulcerative colitis have a chronic condition in which the immune system of the intestines is overactive. The goal of IBD treatment is not to immune suppress the patient, but rather to modify their overactive immune system so it’s under better control. We don't think of our IBD patients at baseline as being immune suppressed. In fact, it's the opposite. When we treat them effectively, we turn down the overactive immune system just enough so their body takes over, and we minimize their risk for infections. Being on immune therapies for inflammatory bowel disease may increase the risk for some viral infections, but based on the information we have so far, we have not seen an increased risk of contracting COVID-19 in patients who are on the standard IBD therapies. Of the Crohn’s and ulcerative colitis patients we have seen who developed COVID-19, their course and recovery is exactly like what we're seeing in the general population. Our general message to patients right now is to stay on your existing therapies and stay in remission. If you have any concerns, please make an appointment with your doctor and have a conversation about whether there might be any adjustments to be made. What should I do if I have Crohn’s disease or ulcerative colitis and develop COVID-19 symptoms? Patients with inflammatory bowel disease who develop COVID-19 will have the same symptoms as the general population of patients who don't have IBD: fever, cough, respiratory symptoms (shortness of breath) or new onset diarrhea. Let your doctor know right away if you develop some of these symptoms or if you're worried that you might have developed COVID-19. If you have been diagnosed with COVID-19, based on the treatments you're on, you may need to stop your therapy for a couple weeks. I don't recommend that you stop your medicines without talking to your doctor first. Based on an international registry of IBD patients who developed COVID-19, there does not appear to be an increased risk overall in patients with IBD developing COVID-19 or having a different set of outcomes. Most IBD patients who develop COVID-19 won't require hospitalization, but if they get sicker or develop more shortness of breath, it is important to know that we're here to help.

Managing Crohn’s disease and Ulcerative Colitis During COVID-19 Pandemic

Should I keep my IBD appointments at this time? Yes, you should keep your appointments, but do so virtually, if possible. Most of our IBD patients are having their appointments by telephone, MyChart, or video visits. We can handle many of your concerns and questions as well as your routine healthy follow up visits this way. If your IBD symptoms worsen and you are feeling sick, it is safe to come to an appointment at the clinic. We will work with you to find the best way to make an appointment happen. We have deferred most elective colonoscopies or other endoscopic procedures at this time. If you need a procedure because of something that's time sensitive or essential in other ways for your management, we certainly are able to do that. The best thing to do is to call your doctor to find out what options are available for you. If I am currently receiving infusion treatment for IBD, is it safe to go to an infusion center? If you know that your infusion center is following proper safety protocols, then you should keep your appointments and get treatment. The University of Chicago Medicine is following safety protocols including screening patients for any known contacts with COVID-19 and any COVID-19 symptoms, spacing patients at least six feet apart and having a single provider working with each patient to limit exposure. All providers are wearing masks and gloves and offering those to the patient if they don't already have them. After a patient has received their infusion, the chair and the surrounding area is appropriately cleaned. Delaying infusible therapies or other treatments can lead to relapse and loss of response to the drugs. Which IBD medications suppress the immune system? Is it safe to take these medications? The medications we used to treat inflammatory bowel disease include a variety of therapies that work by different mechanisms or target different parts of our immune system. Sometimes we recommend immune modulator therapies called thiopurines or azathioprine and 6MP, or another medicine called methotrexate. More recently, we have a variety of biological therapies which target different components of the immune system. A class of therapies called anti-TNF treatments focus on an inflammatory protein called TNF or tumor necrosis factor, which is elevated whenever somebody has an infection or overactive immune response. Anti-TNF drugs such as Remicade, Humira, Cimzia or Simponi are recommended to be continued at the current time. Another drug called Entyvio targets the white blood cells that might be on their way to the bowel, blocking them from getting out of the blood vessels into the intestines. This is a more selective therapy in that it only works on the intestinal immune system, and therefore, the risk for infection might be lower than with anti-TNF and other treatments. Lastly, we use a treatment known as Stelara, which targets two other inflammatory proteins that tend to be elevated only where there is inflammation in your body. This is a more selective treatment, but it still works on the entire body. The goal of these therapies is not to suppress the immune system so patients are more susceptible to infections, but rather, to control the overactive inflammation of the bowel and let the body heal itself. The general message regarding all of these therapies is that if you are in remission and the treatment you're on is working for your Crohn's disease and ulcerative colitis, you should stay on that therapy during the COVID-19 pandemic. We recommend that you continue to communicate with your health care team about any additional changes that might be necessary. For most patients, we are not recommending that they stop treatments. It is important to remember that these treatments are keeping your IBD under control. If the IBD becomes active, we may recommend corticosteroids like prednisone, however they can increase your risk of infections. This is why we want our patients to do their best to stay in remission. We recommend patients stay home as much as possible, wash hands frequently and follow any guidelines from our public health officials, such as the Centers for Disease Control and Prevention (CDC). Should I be concerned about a supply shortage of IBD medications? No. We have assurances from the pharmaceutical companies that there is a sufficient supply of medicine available. We recommend that patients with Crohn’s disease or ulcerative colitis stay on their medication schedule and refill their prescriptions appropriately. Should I take supplements like vitamin c or zinc to help prevent coronavirus? At this time, I would advise against taking additional supplements, such as extra vitamins or zinc to prevent a viral infection. There is no data to support their effectiveness and starting a new supplement might cause other side effects. How do I know the difference between an IBD flare-up vs. COVID-19? It may be hard to tell the difference between a flare up and COVID-19 infection because their symptoms can be similar. Loss of appetite, abdominal discomfort, more frequent bowel movements or loose stools are symptoms of both conditions. We have testing options that do not require an in-person visit. These simple tests can help identify the cause of your symptoms. What should I do if I think I’m having an IBD flare-up? We have treatments available that are safe to start even while this pandemic is going on. There's guidance that we've developed and published that will give people more information about which treatments to use and when to use them. If a patient has more severe inflammatory bowel disease, the usual treatments we use for IBD are safe and appropriate to be used in this setting. Patients shouldn't ignore their IBD symptoms or any other digestive symptoms. Keep in touch with your physician to get it back under control quickly. The last thing we want is for patients to be living with these symptoms and afraid to notify their doctor or come to the clinic. Any advice for essential workers with IBD who are unable to work from home? We know that there are a lot of IBD patients who are essential workers right now and can’t work from home. It is important for these patients to recognize their likelihood of exposure and increased chance of contact with COVID-19-positive patients. For example, paramedics, doctors, nurses, technicians, respiratory therapists and pharmacists who are interacting with patients with COVID-19 have a high risk of exposure and should make sure they protect themselves as much as possible. The advice we’ve been giving the general public should be followed the same by IBD patients. This includes social distancing, washing hands, cleaning surfaces and staying at home when possible. We also recommend keeping in touch with your doctor to know you are in remission and making sure your medications are being managed properly. Are there extra precautions that pregnant women with IBD should be taking during the COVID-19 pandemic? We've learned some information about COVID-19 in pregnant women, which applies to pregnant patients with Crohn’s disease or ulcerative colitis as well. We have seen that women who are pregnant and develop COVID-19 recover similarly to the general population. Although their babies might be born a bit early or a little underweight, for the most part, the babies seem to do well. At this time, we have not seen cases of pregnant women becoming infected with COVID-19 in the first trimester. The data we have from prior coronavirus epidemics and other types of infections suggest patients may be fine. Because this is a novel coronavirus, we still need to monitor those patients carefully. We recommend that our pregnant patients with inflammatory bowel disease make sure they're staying in remission from their IBD. Stopping their IBD therapies could cause a relapse and would require hospitalization which may increase their risk of exposure to COVID-19. We also know that when IBD is in remission, the baby and mother both stay healthy. It is important that our IBD patients who are pregnant take extra precautions and follow strict social isolation. That means in addition to staying home, they should also restrict visitors from entering the home. If pregnant patients with IBD need to go out to the grocery store, they should wear a mask and gloves, and carefully wash their hands, as we're recommending to everybody. We don't have data yet to say that pregnant patients with IDB have more to worry about, but we want them to be extra careful. https://crohnsdigest.net/ Read the full article