Corona Virus Pandemic: Part V
SEASONAL FLU VERSUS COVID-19 INFECTION
Now that the fall has arrived, we need to worry about the seasonal influenza in addition to the pandemic. We are about to face a twindemic, which may be hard to deal with; so, it’s time to be extra-vigilant.
Influenza and Covid-19 are both contagious illnesses but caused by different viruses as you already know. SARS-CoV-2, the virus that causes Covid-19, is much more virulent than flu and can produce severe respiratory and widespread coagulation disorders that could be lethal. Differentiating the two infections, Covid-19 vs. flu, is critical because of the prognostic implications. As of now, a total of 6.8 million people have been infected with the virus in the U.S. with death rate approaching 200,000 and the count is going up every day!
Symptoms of Corona Virus Disease
Xiaoyan Song, Ph.D, director of the Office of Infection Control and Epidemiology at Children's National Hospital in Washington, D.C., and colleagues investigated the commonalities and differences between the clinical symptoms of Covid-19 and influenza in children. Here is their conclusion:
“Distinguishing Covid-19 from flu and other respiratory viral infections remains a challenge to clinicians. Although our study showed that patients with Covid-19 were more likely than patients with flu to report fever, gastrointestinal and other clinical symptoms at the time of diagnosis, the two groups do have many overlapping clinical symptoms. Until future data show us otherwise, clinicians need to prepare for managing co-infections of Covid-19 with flu and/or other respiratory viral infections in the upcoming flu season."
Generally, flu symptoms tend to be milder. It may start with a little fever, headache, cough and sore throat, runny nose and fatigue. Other symptoms include muscle and body aches, headaches and runny nose. People with Covid-19 have had a wide range of symptoms reported and these symptoms may appear 2-14 days after exposure to the virus. Incubation period for flu is much shorter, usually 2-4 days. Influenza and Covid-19 can coexist occasionally and that will make the outlook much worse.
There are some key differences in clinical symptoms between the two conditions. Significant shortness of breath with fever is a cause for alarm. In New Delhi, with proliferation of Covid-19 cases, the patients are encouraged to buy a pulse oximeter – a handy little electronic gadget when clipped to your finger measures oxygen saturation in your red blood cells (normal range: 95 – 100%). The O2 Sat is an indication of how well your lungs are working. The device costs about $13 (under $25 in the U.S.) and patients are asked to report to their physician when the blood O2 Sat drops to 94%. Although the majority of patients who contract the virus have only mild disease, the vulnerable population that tests positive needs close surveillance and proper therapy.
Persistent pain or pressure in the chest, new onset of confusion, inability to wake up or stay awake, bluish lips or face, new loss of taste or smell, gastrointestinal symptoms like nausea, vomiting or diarrhea are more likely to be from Covid-19. Even mild breathing difficulty has to be taken seriously because this may herald the onset of a serious pneumonia.
The virus can also trigger many types of cardiovascular diseases, including inflammation of the heart muscle, actual heart attacks and sudden cardiac death as well as strokes. The virus does its damage through two main pathways – by triggering an immune response that sets up “hyper inflammation,” and by triggering blood clots. And strokes have been observed in otherwise relatively young, healthy people, which appear to be caused by spontaneous blood clotting.
Diagnostic testing can help determine if the patient is sick with flu or Covid-19. Rapid molecular diagnostic test to detect influenza virus types A and B can be done in a doctor’s office and results can be had in 15-20 minutes. Although a viral test for Covid-19 from a sample collected from the nose is available through most labs, there is a delay in getting the results. It’s always better to get the symptomatic patient tested immediately.
The latest news is that U.S. coronavirus rates are rising fast among children and hence the necessity for testing and definite diagnosis. And vulnerable patients like the elderly and those with heart disease, diabetes, obesity, hypertension and immune deficiency, need to be evaluated quickly and, if necessary, hospitalized. Since flu vaccine is freely available and it protects you from most strains, I would hope all of you would go ahead and get vaccinated without delay.
M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. For further reading, “Second Chance - A Sister’s Act of Love” by Dr. Nathan from Outskirts Press, can be found at www.amazon.com
Eye Care
CATARACT Surgery in a SPA; No pain, No Injections, No drugs; Just Music AND Vision!
Yes, you read that right. Imagine cataract surgery but not in a rushed surgery-mill on a cattle call with an impersonal experience to come out on a stretcher. Rather, how about in a spa-like ambience with no injections, no IV drugs, no pain, warm and individually focused environment with music and walking out of surgery (not on a stretcher) with immediate vision recovery?
This future is already here and you can take advantage of it.
During Healthy Aging Month (American Academy of Ophthalmology) in September, we must understand that one in six Americans ages 65 and older have a vision impairment that cannot be corrected with glasses or contact lenses. The risk of eye disease increases with age, yet many older adults neglect to see an ophthalmologist for care.
Of different age-related changes in the eye, the most correctable and life impacting, which certainly will include 100 percent of the ageing population at some time in their life, is cataracts.
Many of you may have received this diagnosis from your eye doctor and are left puzzled and depressed (who wants to be reminded of our continued aging process). You are further confused when they tell you it is “just starting” or “small.” Questions whizzing in your mind, what is “small,” how big should it become? Should we let it become ripe first?
A cataract is not a disease; most commonly, it is the clouding of our clear natural lens with age. In other words, everyone who lives long enough will need cataract surgery eventually. Radiation exposure, steroids, diabetes and eye trauma can accelerate their development. Cataracts are the most common age-related eye condition and the leading cause of preventable blindness. Twenty million people in the U.S. age 40 and older have cataracts. Cataracts are treated by removing the eye’s cloudy natural lens and surgically replacing it with an intraocular lens or IOL.
Raising cataract surgery to an experience: LenzOplastique™ (the “O” stands for “optimized vision”)
When you raise surgery to artistry from delicate surgical steps with no pain while correcting not only the cataract but associated glasses prescription for all distance of vision “optimized for your best brain potential” in a comfortable environment, you are experiencing LenzOplastique – art of cataract surgery!
With technological advances of lens implants from over 30 choices (not just three) along with laser precision and tailored vision goals, see your eye doctor and ask about your options. There is no need to wait till you are “blind enough” or your cataract “ripe enough.” Take charge of your vision.
Please do visit your eye doctor to check on the health of your eyes and if you are over 60, for cataracts too and then do your research and enjoy the activity of researching for the best technology, surgical ambience and surgeon to see for the rest of your life.
Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at [email protected] or visit www.gulanivision.com