When sweat starts to pour from your pores, it’s usually trying to cool you down. But have you ever experienced a time when you sweat and it wasn’t hot out or you weren’t working out? For instance, you might just be waiting to go to a meeting and feeling a little nervous. Nervous sweat, it turns out, is a little different from the other kinds. Here’s why it can come without warning, why it smells bad and what you can do about it.
Sweat to cool the body
That salty fluid called sweat is your body’s response to rising temperatures. You can get hot when the temperature rises or from burning calories during exercise.
When the “thermostat” in your brain thinks your body’s getting too hot, it sends a message to one set of sweat glands called the eccrine glands. These glands are spread all over your body and release sweat that is about 90% water. Sweating usually starts slowly and builds.
Sweat connected to emotions
Located in your armpits and crotch, the apocrine glands react instantly. Before long, you may feel drenched. This is because the sweat in these glands is only 80% water and 20% fat and protein.
Stress sweat comes from nervous excitement. It usually hits you all at once. When something excites or scares you, your body releases stress hormones (adrenaline and cortisol). They set your heart to pounding. And when they tell those eccrine glands to get busy, they also alert other glands: the apocrine glands.
The bad smell comes from bacteria that feed on and reproduce in the fat, moisture and protein. Scientists are trying to determine why the body wants to send that strong smell signal when people are scared, stressed or sexually aroused.
They don’t really know the answer. Researchers found that people who get a whiff of sweaty excitement also become more alert. Maybe it tells them to stay away. In the case of sex, maybe it delivers the pheromones that say you’re ready.
Nervous sweat might have meant something in the evolutionary jungle. But in the meeting, smelling bad and having wet armpits is no advantage.
What can you do about it?
Nervous sweating now and then is just a fact of life for everyone. So if possible, don’t sweat it. Accept sweat with humor. When you know you’re going into battle—er, that meeting—here are some tips for preparing:
Wear layers and absorbent natural fiber clothing.
Try stronger antiperspirants.
Use disposable underarm clothing shields to absorb sweat.
Go ahead and cancel your membership, you already have the tools you need
If you want to be as healthy as possible, there are no treadmills or weight machines required.
Don’t just take my word for it — look to the longest-lived people in the world for proof.
Instead, they live in environments that constantly nudge them into moving without even thinking about it. This means that they grow gardens, walk throughout the day, and minimize mechanical conveniences for house and yard work.
In fact, researchers determined that routine natural movement is one of the most impactful ways to increase your life span, and a common habit among the world’s longest-lived populations.
Of course this might not seem realistic in our current knowledge economy, where we’re often tied to a desk and in front of a computer screen all day.
Moving naturally throughout the day might sound pleasant and romantic, but the reality is that 100 years ago only 10% of us had sedentary jobs, whereas today it’s 90%.
However, there are still easy ways to add more movement into your busy lifestyle.
One of the best ways to do this is to use an active mode of transportation. This could mean walking your kids to school, walking or biking to the grocery store, to a friend’s house, or out to dinner.
Ideally you could walk or bike to work as well (or walk/bike to the bus or train station, if that’s more feasible).
Research shows that the best work commute you can have is a 15-minute walk each way, but any physical activity built in along your commute is a plus. On the flip side, the daily car commute is the number two thing Americans hate the most on a daily basis, behind only housework (but maybe housework would be more enjoyable if you reminded yourself of the life-extending natural movement involved!).
If active transportation isn’t possible in your community, you can still find time to go out for a walk.
A recent study from the American Cancer Society revealed that walking for six hours per week resulted in a lower risk of dying from cardiovascular disease, respiratory disease, and cancer than not being active at all. But the research also showed that walking even as little as two hours per week could reduce the risk of disease and help you live longer.
Walking is also great medicine for your mind. A daily walk could reduce the risk of dementia by 40%, according to Anders Hansen, a physician, and psychiatry specialist from the Karolinska Institute in Sweden.
If long walks aren’t your thing, break it up by taking several smaller walks per day instead (five minutes per hour).
Make it a point to stand at your desk, or at least get-up and move around regularly throughout the day. Get outside at lunch for some fresh air.
The bottom line is that our bodies were designed to move.
And that doesn’t necessarily mean going to the gym.
You don’t need to lift heavy weights or grind through high-intensity interval workouts to live a long and healthy life.
Simple, natural movement can be even more impactful.
Do as the world’s centenarians do — move naturally.
The virus can be spread when an infected person coughs or sneezes. Hand-washing is a first line of defence
How is the coronavirus spread?
The Wuhan coronavirus outbreak is a new illness and scientists are still assessing how it spreads from person to person, but similar viruses tend to spread via cough and sneeze droplets.
When an infected person coughs or sneezes, they release droplets of saliva or mucus. These droplets can fall on people in the vicinity and can be either directly inhaled or picked up on the hands then transferred when someone touches their face, causing infection. For flu, some hospital guidelines define exposure as being within six feet of an infected person who sneezes or coughs for 10 minutes or longer.
How to protect yourself and others
Wash your hands: wet your hands with clean, running water and apply soap. Lather your hands, including the backs, between your fingers, and under your nails and scrub for at least 20 seconds. Rinse.
Cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the bin and wash your hands. If you do not have a tissue to hand, cough or sneeze into your elbow rather than your hands.
Face masks offer some protection as they block liquid droplets. However, they do not block smaller aerosol particles that can pass through the material of the mask. The masks also leave the eyes exposed and there is evidence that some viruses can infect a person through the eyes.
Seek early medical help if you have a fever, cough and difficulty breathing, and share your travel history with healthcare providers.
If visiting live markets in affected areas avoid direct, unprotected contact with live animals and surfaces that have been in contact with animals.
If you are in an affected area avoid eating raw or undercooked animal products and exercise care when handling raw meat, milk or animal organs to avoid cross-contamination with uncooked foods.
If you have returned from an affected area in China in the last two weeks, stay indoors and avoid contact with other people for 14 days. This means not going to work, school or public areas.
If you have returned from an infected area and develop a high temperature, cough, runny nose, sore throat or difficulty breathing do not leave your home until you have been given advice by a doctor.
Congratulations on taking a forward step to get in shape and feel great. Many people are guilty of wishing they could get a sculpted body from eating junk food and watching TV all day. But that is just not going to happen. Even though getting in shape sounds like a long, time-wasting process, the effort put towards being in shape has many positive effects. If you want to start your journey to having a better body to feel great, here are some tips:
1. Exercise Daily
Exercise daily for at least an hour. You do not have to kill yourself from running, jogging, etc., but you should have some sort of moderate physical activity in your everyday life. If you’re looking to shed a few pounds fast, do a higher-level intensity workout. For example, go on a walk at a brisk pace for an hour. Or, you can jog and set certain intervals to sprint during that hour. Make sure you’re not in severe pain during your workout. Just a warning, your muscles will ache after a high intensity workout. It may be irritating, but that means your body is changing for the better. Be sure to stay hydrated, stretch, and eat foods with a decent amount of protein after each workout. The protein will help keep your muscles, not fat, rebuilding.
No matter how bad your stomach is telling you to go for candy over healthy food, try to stay away from sweets. Sugar from candy will not help you get in shape. Even if it’s just a single candy bar, one will eventually lead to another. Fruits and vegetables are the best thing to eat when getting into shape. Apples, for example, do a good job at making the stomach feel full for up to 3 to 4 hours. Green vegetables such as green beans and broccoli keep the digestive system clean and running.
Also, stick to lean meats like turkey and chicken. Seafood, such as, shrimp, and tilapia are also great alternatives. These foods are full of protein and healthy nutrients to help keep muscles fit and ready for workouts. In addition, be sure to portion what you eat. Having a good metabolism comes from portioning meals. Try to plan out eating six times a day and setting smaller portions, rather than having three large meals throughout the day. This will also help you find yourself breathing smoother when working out rather than huffing and puffing for air. This is because you will have less food in your digestive system, which means more energy is used toward your exercise.
3. Keep Track of Calories and Food Intake Per Day
Keeping track of how many calories you eat in a day will be helpful in planning out your physical exercising. Ever wonder why body builders’ body masses are so big? That’s because they plan out their meals and take in more (healthy) calories than the average person. On the other hand, losing weight and striving for a skinnier physique will involve more physical exercise than calories you ingest.
4. Be Sure to Get Sleep
Even though most of us have eight-hour jobs during the day or night, it is crucial to get enough sleep to recharge the body’s batteries. Six to eight hours of sleep will keep the body going throughout the day, but if you happen to feel tired at any point after coming home from work, by all means take a small nap before exercising. You should only nap for about a half hour. This will prevent you from staying up later in the night.
All of us are aware of the fact that some diseases are more prominent in certain seasons than others. For instance, cold, flu and cough are common diseases of winters, dengue and malaria of monsoon, and diarrhea of summers. Of these, the diseases of summers bring along a host of other health problems as well that range from simple ones like a headache, skin rashes, sunburns, etc. to severe ones like measles, jaundice, and more.
The months of May and June are usually the hottest in India. While, in some areas, the temperature rises as high as 51 degrees Celsius, there are many regions that experience moderate summers. No matter where one lives, some summer diseases are inevitable. However, as wisely quoted by a learned man, “prevention is better than cure.” You must take necessary preventive measures against summer diseases even if you think you are fit and healthy. Here, we enlist some common summer diseases that you must safeguard yourself against.
The leading food poisoning causes is the consumption of contaminated food or water. It spreads by bacteria, viruses, toxins, and chemicals which, post entering the human body, cause the onset of stomach pain, nausea, diarrhea or vomiting. Raw meat, food sold in the open by roadside vendors, and contaminated water are common carriers of disease-causing microbes.
If on a hot summer day, you experience headache, drying of skin, cramps, weakness, vomit, increased heart rate, or shallow breathing, it’s quite possible you’re suffering from a heat stroke. The very first sign of heatstroke is dizziness which is usually followed by a bunch of other conditions such as nausea, seizures, etc. But when it turns severe, it usually leads to a condition of coma. To prevent heatstroke, doctors advise that one must overdo with clothes, which typically traps the body heat inside and causes problems. Additionally, staying in cooler areas helps avoid heatstroke conditions.
Exposure to the sun for longer durations is not healthy for humans or animals due to the penetration of UV rays in the body. People who encounter lower levels of melanin formation are even prone to skin cancer as it causes melanoma. During hot summer days when people are exposed to the sun for an extended period, their skin might turn red, dry, itchy and cracks may develop. Afterward, the victim usually feels cold, experiencing chills, nausea, vomit, feverish and at times witness flu-like symptoms. If the skin cells burn too much, then blisters might appear on the skin and peeling of dried/dead skin at a later stage may occur. The best way to prevent sunburns is by using sunscreen with SPF 30 or higher and taking preventive measures to keep the moisture of skin intact.
During summers, skin rash is a common skin problem among children and adults. This typically happens when an individual sweats too much. The sweat accumulates in the clothes and constant rubbing or wearing the sweat laden clothes for a prolonged period causes itchiness and further leads to a rash. Skin reddening, dryness, irritation are the visible signs of skin rash.
Chickenpox makes one of the most common summer diseases. It starts in the form of fluid-filled, red and small rashes accompanied by fever as high as 102 Fahrenheit and ultimately turns into fluid-filled blisters which crust or chip over leaving marks on the skin. People who have diabetes, cancer, blood pressure problem, HIV, tuberculosis, on specific steroids or those with a weak immune system are prone to chickenpox. Usually, the virus (Varicella-zoster) travels through droplets present in the environment exhibited by an infected person either during his/her sneezing or coughing spells. In many individuals, the virus causing chickenpox also remains dormant in the body until it gets exponentially favorable weather conditions to propel again. Common symptoms of chickenpox include scabs, blisters, itchy skin, redness, high-grade fever, loss of appetite, and headache which usually lasts for more than a week or two.
Measles is yet another common summer disease. Also known as rubeola or morbilli, it’s more or less the same as chickenpox in the way it is transmitted. It usually infects the lining at the back of the throat. The paramyxovirus which causes measles breeds faster during the summers. Its initial symptoms are cough, high fever, sore throat, and reddening in eyes. At a later stage, the tiny white spots and measles rash appear all over the body. In most of the cases, it starts around the hairline and the face. As a preventive measure, it is usually recommended to get the MMR vaccination (Measles, Mumps, and Rubella).
Jaundice is a common water-borne disease. It can be a result of Hepatitis A and is mainly caused due to the consumption of contaminated food and water. Jaundice THAT spreads due to Hepatitis A is transmitted by the feces-oral route. It is when an uninfected person ingests food or water contaminated with the feces of an infected person. It can either be foodborne or waterborne. If not treated on time, this disease can affect the functionality of the liver leading to the overproduction of bile. The visible symptoms include a yellow discoloration of the skin, mucous membranes and the whites of the eyes, light-colored stools, dark-colored urine, and itchy skin.
One of the common diseases in summer is typhoid. Through the oral-fecal route, it is passed on to the healthy individuals. It is also known as typhoid fever it is a waterborne disease. It spreads when the Salmonella typhi bacteria pass through the oral-fecal route. The contaminated food and water sources become the breeding ground for the bacteria leads to the outbreak when consumed. Visible symptoms of typhoid are weakness, loss of appetite, fatigue, pain in the abdomen, high fever. As a preventive measure vaccination is done to protect typhoid. During vaccination, the weakened bacterium is injected in the form of medicine or a pill so as to build the immunity against it.
Of all summer diseases, mumps is another extremely contagious viral disease. As a summer disease in India it occurs mainly in children during peak summertime. It is contagious in nature and gets transmitted when an infected person coughs or sneezes. Some of the visible symptoms are swelled salivary gland, muscle ache, fever, headache, loss of appetite and weakness. To prevent the doctor recommends the MMR (Measles, Mumps, and Rubella) vaccine during treatment.
Summer Diseases and Prevention
The primary reason behind the outbreak of diseases in summer is the presence of favorable weather conditions for bacteria, virus and other parasites to breed. Here is the list highlighting the best summer health tips to immune oneself from diseases in summer.
Try to avoid activities outside the home during peak sun hours.
Avoid exposure to direct sunlight and crowded areas.
Increase water or liquid intake so as to prevent dehydration.
Use sunscreen with a higher SPF to prevent skin damage.
Avoid roadside food or contaminated water.
Increase the consumption of fruits and vegetables.
Wear wide-brimmed hats to avoid direct exposure to the sun.
Prefer light-colored, loose clothing as dark colors absorb heat.
Keep your premises healthy and clean.
Summer is a beautiful time to enjoy vacations and spend time with family, friends, making memories only if you are healthy. All that you need to do to stay fit is the little awareness and few precautions to enjoy the good times.
Uric acid is a natural waste product from the digestion of foods that contain purines. Purines are found in high levels in some foods such as:
Purines are also formed and broken down in your body.
Purines are also formed and broken down in your body.
Normally, your body filters out uric acid through your kidneys and in the urine. If you consume too much purine in your diet, or if your body can’t get rid of this by-product fast enough, uric acid can build up in your blood.
While uric acid is usually linked to protein-rich foods, recent studies show that sugar may also be a potential cause. Added sugars to food include table sugar, corn syrup, and high fructose corn syrup, among others.
The sugar fructose is the main type of simple sugar in processed and refined foods. Researchers have found that this type of sugar, in particular, could lead to high levels of uric acid.
Check food labels for added sugars. Eating more whole foods and fewer refined packaged foods can also help you cut out sugars while allowing you to intake a more wholesome diet.
Sugary drinks, soda, and even fresh fruit juices are concentrated with fructose and glucose-containing sugar.
You’ll also want to keep in mind that high-fructose corn syrup contains a mix of fructose and glucose, usually with 55 percent fructose and 42 percent glucose. This is similar to the ratio of 50 percent fructose and 50 percent glucose in table sugar.
Fructose from refined sugar in juice or other foods is absorbed faster than sugar from foods that have natural makeup that need to be broken down in your body. The faster absorption of refined sugars spikes your blood sugar levels and also leads to higher amounts of uric acid.
Replace sugary drinks with filtered water and fiber-rich smoothies.
Drink more water
Drinking plenty of fluids helps your kidneys flush out uric acid faster. Keep a water bottle with you at all times. Set an alarm every hour to remind you to take a few sips.
Drinking alcohol can make you more dehydrated. It can also trigger high uric acid levels. This happens because your kidneys must first filter out products that occur in the blood due to alcohol instead of uric acid and other wastes.
Some types of alcoholic drinks such as beer are also high in purines.
Along with your diet, extra pounds can raise uric acid levels. Fat cells make more uric acid than muscle cells. Additionally, carrying extra pounds makes it harder for your kidneys to filter out uric acid. Losing weight too quickly can also affect levels.
If you’re overweight, it’s best to avoid fad diets and crash dieting. Talk to a nutritionist about a healthy diet and weight loss plan that you can follow. Your doctor can recommend a healthy weight goal for your body type.
Have your blood sugar level checked when you visit your doctor. This is important even if you don’t have diabetes mellitus.
Adults with type 2 diabetes may have too much insulin in their bloodstream. This hormone is necessary to move sugar from your blood into your cells where it can power every bodily function. However, too much insulin leads to excess uric acid in the body, as well as weight gain.
Individuals with a condition called prediabetes may also have high insulin levels and a higher risk for type 2 diabetes.
Your doctor may want to check your serum insulin level in addition to your blood glucose level if insulin resistance is suspected.
Diet, exercise, and other healthy lifestyle changes can improve gout and other illnesses caused by high uric acid levels. However, they can’t always replace necessary medical treatment.
Take all prescribed medications as directed by your doctor. The right combination of diet, exercise, and medications can help keep symptoms at bay.
It may seem as if there is a lot of foods you need to avoid to help lower uric acid levels. The best way to limit these foods is by making a weekly meal plan. Talk to your nutritionist for help in making the best diet plan for you.
Keep a list of foods on your shopping list that you should eat, rather than what you can’t eat. Stick to the list as you grocery shop. You can also join an online support group for people with uric acid-related illnesses for more ideas on how to prepare the best meals for you.
Sure, you can lose weight quickly. There are plenty of fad diets that work to shed pounds rapidly — while leaving you feeling hungry and deprived. But what good is losing weight only to regain it? To keep pounds off permanently, it’s best to lose weight slowly. And many experts say you can do that without going on a “diet.” Instead, the key is making simple tweaks to your lifestyle.
Eat Breakfast Every Day. One habit that’s common to many people who have lost weight and kept it off is eating breakfast every day. “Many people think skipping breakfast is a great way to cut calories, but they usually end up eating more throughout the day, says Elizabeth Ward, MS, RD, author of The Pocket Idiot’s Guide to the New Food Pyramids. “Studies show people who eat breakfast have lower BMIs than breakfast-skippers and perform better, whether at school or in the boardroom.” Try a bowl of whole-grain cereal topped with fruit and low-fat dairy for a quick and nutritious start to your day.
Close the Kitchen at Night. Establish a time when you will stop eating so you won’t give in to the late-night munchies or mindless snacking while watching television. “Have a cup of tea, suck on a piece of hard candy or enjoy a small bowl of light ice cream or frozen yogurt if you want something sweet after dinner, but then brush your teeth so you will be less likely to eat or drink anything else,” suggests Elaine Magee, MPH, RD, WebMD’s “Recipe Doctor” and the author of Comfort Food Makeovers.
Choose Liquid Calories Wisely. Sweetened drinks pile on the calories, but don’t reduce hunger like solid foods do. Satisfy your thirst with water, sparkling water with citrus, skim or low-fat milk, or small portions of 100% fruit juice. Try a glass of nutritious and low-calorie vegetable juice to hold you over if you get hungry between meals. Be careful of alcohol calories, which add up quickly. If you tend to drink a glass or two of wine or a cocktail on most days, limiting alcohol to the weekends can be a huge calorie saver.
Eat More Produce. Eating lots of low-calorie, high-volume fruits and vegetables crowd out other foods that are higher in fat and calories. Move the meat off the center of your plate and pile on the vegetables. Or try starting lunch or dinner with a vegetable salad or bowl of broth-based soup, suggests Barbara Rolls, Ph.D., author of The Volumetrics Eating Plan. The U.S. government’s 2005 Dietary Guidelines suggest that adults get 7-13 cups of produce daily. Ward says that’s not really so difficult: “Stock your kitchen with plenty of fruits and vegetables and at every meal and snack, include a few servings,” she says. “Your diet will be enriched with vitamins, minerals, phytonutrients, fiber, and if you fill up on super-nutritious produce, you won’t be reaching for the cookie jar.”
Go for the Grain. By substituting whole grains for refined grains like white bread, cakes, cookies, and pretzels, you add much-needed fiber and will fill up faster so you’re more likely to eat a reasonable portion. Choose whole-wheat breads and pastas, brown rice, bran flakes, popcorn, and whole-rye crackers.
Control Your Environments. Another simple strategy to help cut calories is to control your environment — everything from stocking your kitchen with lots of healthy options to choosing the right restaurants. That means avoiding the temptation by staying away from all-you-can-eat restaurants. And when it comes to parties, “eat a healthy snack before so you won’t be starving, and be selective when you fill your plate at the buffet,” suggests Ward. Before going back for more food, wait at least 15 minutes and have a big glass of water.
Trim Portions. If you did nothing else but reduce your portions by 10%-20%, you would lose weight. Most of the portions served both in restaurants and at home are bigger than you need. Pull out the measuring cups to get a handle on your usual portion sizes, and work on paring them down. Get instant portion control by using small bowls, plates, and cups, says Brian Wansink, PhD, author of Mindless Eating. You won’t feel deprived because the food will look plentiful on dainty dishware.
Add More Steps. Get yourself a pedometer and gradually add more steps until you reach 10,000 per day. Throughout the day, do whatever you can to be more active — pace while you talk on the phone, take the dog out for an extra walk, and march in place during television commercials. Having a pedometer serves as a constant motivator and reminder.
Have Protein at Every Meal and Snack. Adding a source of lean or low-fat protein to each meal and snack will help keep you feeling full longer so you’re less likely to overeat. Try low-fat yogurt, small portion of nuts, peanut butter, eggs, beans, or lean meats. Experts also recommend eating small, frequent meals and snacks (every 3-4 hours), to keep your blood sugar levels steady and to avoid overindulging.
We also face a new threat. The next epidemic has a good chance of originating on a computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus or a contagious and highly deadly strain of flu. So, the point is that we ignore the strong link between health security and international security at our peril. Whether it occurs by the hand of nature or at the hand of a terrorist, epidemiologists show through their models that a respiratory-spread pathogen would kill 30 million people in less than a year. And there is a reasonable probability of that taking place in the years ahead.
—Bill Gates talking at Munich Security Conference in 2017.
As the novel coronavirus—termed 2019-nCov, and later SARS-Co V-2—continued its spread beyond the borders of China, the World Health Organization (WHO) was forced to call it a public health emergency of international concern (PHEIC) on the Jan. 30.
Understandably, the outbreak has also spawned many conspiracy theories, which rely heavily on parts of Gates’ premise, mostly with zero evidence. WHO has named the new disease Covid-19, short for “coronavirus disease 2019.” Many countries have limited the travel of their citizens to China, Chinese cities are locked down, trade to and from China has taken a hit, and the economic costs to China have been termed enormous already. Some forecast that global economic growth in 2020 will be curbed by up to 0.3%, while the first-quarter growth of the US economy itself could be reduced by up to 0.4%.
International Health Regulations (IHR) were agreed upon by the global community to improve the detection and reporting of potential public health emergencies worldwide. IHR (2005) requires that all countries have the ability to detect, assess, report and respond to public health events with potential spillover effects across borders. Under IHR, once a WHO member identifies a potential event, it must assess the public health risks and notify WHO. Since IHR came into being, WHO has declared four PHEICs namely, H1N1 influenza (2009), Polio (2014), Ebola (2014) and Zika virus (2016). Covid-19 is the fifth time a PHEIC is declared by the WHO.
There have been some complaints that China dragged its feet before it reported the outbreak to the international community, but China’s efforts to minimise spread have largely drawn praise from global players since. Indeed, an epidemic that demands very strict containment measures is perhaps one rare instance when the Western world applauds an authoritarian regime. China’s general disdain for human rights has certainly contributed to its “setting a new standard for outbreak response.” Of just above 43,000 global Covid-19 cases, around 42,700 are still within Chinese borders. All the deaths (1017), barring one, have been on Chinese soil.
The heavy-handed Chinese response has certainly limited the global spread of the disease. Tedros Adhanom Ghebreyesus, director-general of WHO repeated many times during the press conference that declared Covid-19 a PHEIC that WHO is declaring it a global health emergency not because of what is happening in China, but because the virus is spreading to countries with ill-prepared, “weak” health systems.
The disease spreading to countries like India which are quite unprepared to contain a potential spread has certainly contributed to the WHO’s decision to declare it a PHEIC.
The ministry of health and family welfare in India has termed the situation within the country “under control” presently, and states were asked to remain alert and vigilant with efforts generating community-level awareness taking centre stage. Screening of passengers for Covid-19 symptoms is going on in 21 airports, 12 major seaports, and border crossings across the country. According to ministry communication, 2148 flights and 232613 passengers from China have been screened so far. Despite China’s initial reluctance, India managed to evacuate on Feb. 1 hundreds of Indians who were stranded in Wuhan due to the outbreak.
Almost two weeks after the evacuation, the government reported that all Indian evacuees from Wuhan—645 of them—have tested negative for 2019-nCoV. Over 11,500 individuals are presently under community surveillance in 34 states/union territtories and contact tracing is going on. As of now, 1,632 samples from suspected patients have been tested from across the country of which three samples have tested positive; all from the state of Kerala. Interestingly, reports indicate that all three patients are medical students undergoing training in Wuhan.
Latest data indicate that about 82% of cases are mild, 18% cases are severe, of which 3% require intensive care; and that the fatalities are mostly old patients and those with pre-existing conditions. Many medical personnel are getting affected as well. Since the rapidly spreading Covid-19 is also a relatively mild infection with generic symptoms, many cases have not been counted and there is a high likelihood that the severity is overestimated, and it triggers panic. On the other end, in weak health systems like India, an ineffective surveillance system may not allow for aggressive case detection, thus underestimating the true burden.
Even for Nipah with a case fatality rate of around 80% , India has a history of calling it a “mystery fever,” and moving on, and finding the real cause only later, retrospectively. With a much milder Covid-19, missing a few cases or even a cluster of cases will be normal in many Indian states. In fact, it has to be expected. Given the Indian climate and air pollution levels, a few cases with mild respiratory disease getting drowned in the usual flood of mild respiratory diseases across the country is a distinct possibility. There are indications that higher temperatures may slow transmission of the new virus, which may be delaying its spread in India. However, instead of strengthening systems, Indian public health establishment has often chosen a knee-jerk response to the media frenzy around outbreaks, as seen in Nipah’s case, where it unfortunately clamped down on foreign collaborations of Indian research institutions.
Given this context, Kerala’s response to Covid-19 has been remarkable. Kerala has been publishing daily updates about quarantine, tests and hospitalisations. Reportedly, two out of the three patients infected with Covid-19 have now tested negative. However, given the close linkages between Kerala and Wuhan, both hospital-based and community-based quarantine efforts are actively on. Of the 11,500 individuals presently under community surveillance in 34 states/union territories across India, around one-third are in Kerala alone. A day-wise graph of hospital-based and home-based surveillance is given below.
Of the suspected patients kept under isolation in hospitals, many are being discharged and shifted back to community surveillance as test results are negative and symptoms subside. At its peak, on Feb. 4, around 100 suspected patients were kept in various hospitals across the states; however, now the number is only 27. A total number of 380 samples were tested for Covid-19 until today, and 344 have already proven negative, as the next graph shows.
On Feb. 7, the Kerala government withdrew the “state calamity” warning it issued earlier in the wake of three cases of Covid-19, as no new positive cases of infection were detected despite active surveillance. Although the Centre suggested a quarantine period of 14 days, Kerala government is taking no chances and quarantining people for 28 days as a precautionary measure. If current trends continue, the state expects to be free of 2019-nCoV by early March, which seems overly optimistic, unless the global situation improves drastically.
Measures like contact tracing will have only limited impact once the spread beyond China becomes large enough. Judging from the sustained transmission within China and even in countries like Japan, Singapore, Korea and Germany, it is just a matter of time before the disease becomes truly “global”. Given China’s sphere of influence, it is likely that we will soon have cases reported in Africa, as the limiting factor currently seems to be diagnostic capacity. Sustained transmission makes travel bans less effective, and at best can buy more time for health systems to be ready for impact. Singapore, with a well-functioning public health system, is already reporting community-level transmission.
The unfolding story of the cruise ship The Diamond Princess, off Japanese coast is instructive. In terms of positive cases of Covid-19, The Diamond Princess has been termed as “the second-largest country in the world right now behind only to China.” The following graph shows clearly what 2019-nCoV can do in a relatively crowded space with space constraints. Experts have termed passenger population density as a reason for the rapid spread of the virus. Sounds very familiar, if one knows Indian urban spaces and hospitals. Therefore, the cruise ship is a particularly interesting part of this outbreak for countries like India. As of Feb. 12, of a total of 441 confirmed cases outside China, a staggering 175 are on The Diamond Princess alone. Recent reports indicate that on Feb. 13 alone, 44 more travellers have tested positive, including Indians.
Countries like India will have to start thinking hard about a shift in strategy from containment to mitigation at some point. Given the fact that Covid-19 as of now is a relatively mild infection, many positive cases across India may be missed through misdiagnosis or missed diagnosis.
However, if there is sustained spread and panic sets in, irrespective of the relatively low case fatality rates, Covid-19 can kill many in India through two pathways. First, older and chronically ill can get potentially fatal Covid-19 infection at hospitals where they visit for routine treatment, and second, panic-stricken common flu patients can crowd hospitals and overwhelm the health care delivery capacity of private and public sector. The latter scenario can see many people in real need of advanced care getting left out. If there is community-level transmission in India, the resulting societal disruption will be immense, unless the government takes sufficient measures, and be ready for any eventuality in the coming months.
As the above graph shows, with strict travel restrictions and other measures in place, daily hospitalisations of suspected cases have shrunk considerably in Kerala, and the number of patients daily discharged after a negative report and subsided symptoms outnumber the former consistently. Timely dissemination of surveillance data was an effective way in which the government of Kerala managed to keep panic under check and gain the confidence of the community. The state looks ready for any possible spread even at the community level.
As the country braces for Covid-19’s impact, the government of India should ensure the regular release of state-wise data on quarantine and tests, which it compiles on a daily basis, so that media speculation is avoided. With Nipah, and now Covid-19, Kerala provides a template for the central government, of calm and alert public health problem-solving. Perhaps over and above what Kerala is doing on social media, the central government can effectively leverage WhatsApp, too, to allay fears, as Covid-19 spreads across the world.null
COVID-19 coronavirus is seen in yellow, emerging from cells (in blue and pink) cultured in the lab. This image is from a scanning electron microscope.NIAID-RML
The images of the current outbreak of the new coronavirus have so far been very human: air travelers wearing masks, tourists stranded on cruise ships, medical workers wearing protective suits.
But new images of the virus show us what it looks like up close.
These images were made using scanning and transmission electron microscopes at the National Institute of Allergy and Infectious Diseases’ Rocky Mountain Laboratories in Hamilton, Mont. NIAID is part of the National Institutes of Health.
This image from a scanning electron microscope shows, in orange, the coronavirus that causes the disease COVID-19. The virus was isolated from a patient in the U.S. and is seen here emerging from the surface of cells — in gray — cultured in the lab.NIAID-RML
Emmie de Wit, chief of NIAID’s Molecular Pathogenesis Unit, provided the virus samples. Microscopist Elizabeth Fischer produced the images, and the lab’s visual medical arts office digitally colorized the images.
In this image from a scanning electron microscope, the new coronavirus is in orange.NIAID-RML
NIAID notes that the images look rather similar to previous coronavirus MERS-CoV (Middle East respiratory syndrome coronavirus, which emerged in 2012) and the original SARS-CoV (severe acute respiratory syndrome coronavirus, which emerged in 2002).
“That is not surprising: The spikes on the surface of coronaviruses give this virus family its name – corona, which is Latin for ‘crown,’ and most any coronavirus will have a crown-like appearance,” the institute explains in a blog post.
On Tuesday, the World Health Organization formally named the disease caused by the new coronavirus: COVID-19.
There have been more than 47,000 laboratory-confirmed cases so far and more than 1,300 deaths. Cases have been documented in 25 countries, but the vast majority are in China.
This image of the virus is from a transmission electron microscope.NIAID-RML
China’s Hubei province expanded its criteria for identifying new coronavirus cases on Thursday, which led to a major spike in reported cases there. The province added a new category to its reporting: “clinical cases.” That means patients will be counted if they exhibit all the symptoms — which include fever, cough and shortness of breath — but have either not been tested or tested negative for the virus itself.
That sudden spike, caused by the change in reporting, may complicate efforts to track the disease’s progression in China.
Are hand dryers effective in killing the new coronavirus?
No. Hand dryers are not effective in killing the 2019-nCoV. To protect yourself against the new coronavirus, you should frequently clean your hands with an alcohol-based hand rub or wash them with soap and water. Once your hands are cleaned, you should dry them thoroughly by using paper towels or a warm air dryer.
Can spraying alcohol or chlorine all over your body kill the new coronavirus?
No. Spraying alcohol or chlorine all over your body will not kill viruses that have already entered your body. Spraying such substances can be harmful to clothes or mucous membranes (i.e. eyes, mouth). Be aware that both alcohol and chlorine can be useful to disinfect surfaces, but they need to be used under appropriate recommendations.
Is it safe to receive a letter or a package from China?
Yes, it is safe. People receiving packages from China are not at risk of contracting the new coronavirus. From previous analysis, we know coronaviruses do not survive long on objects, such as letters or packages.
Can pets at home spread the new coronavirus (2019-nCoV)?
At present, there is no evidence that companion animals/pets such as dogs or cats can be infected with the new coronavirus. However, it is always a good idea to wash your hands with soap and water after contact with pets. This protects you against various common bacteria such as E.coli and Salmonella that can pass between pets and humans.
Can regularly rinsing your nose with saline help prevent infection with the new coronavirus?
No. There is no evidence that regularly rinsing the nose with saline has protected people from infection with the new coronavirus.
There is some limited evidence that regularly rinsing nose with saline can help people recover more quickly from the common cold. However, regularly rinsing the nose has not been shown to prevent respiratory infections.
Does putting on sesame oil block the new coronavirus from entering the body?
No. Sesame oil does not kill the new coronavirus. There are some chemical disinfectants that can kill the 2019-nCoV on surfaces. These include bleach/chlorine-based disinfectants, either solvents, 75% ethanol, peracetic acid and chloroform.
However, they have little or no impact on the virus if you put them on the skin or under your nose. It can even be dangerous to put these chemicals on your skin.
Does the new coronavirus affect older people, or are younger people also susceptible?
People of all ages can be infected by the new coronavirus (2019-nCoV). Older people, and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus.
WHO advises people of all ages to take steps to protect themselves from the virus, for example by following good hand hygiene and good respiratory hygiene.
Are there any specific medicines to prevent or treat the new coronavirus?
To date, there is no specific medicine recommended to prevent or treat the new coronavirus (2019-nCoV).
However, those infected with the virus should receive appropriate care to relieve and treat symptoms, and those with severe illness should receive optimized supportive care. Some specific treatments are under investigation, and will be tested through clinical trials. WHO is helping to accelerate research and development efforts with a range or partners.