A spectrum of ultraviolet light that can kill the novel coronavirus
without harming humans may be key to reducing viral exposure in widely
occupied spaces such as hospitals, according to Columbia University
researchers, the Pittsburgh Post-Gazette reports.
The shorter wavelength UV light, dubbed far-UVC light, cannot reach
or damage living human cells unlike conventional, longer wavelength UV
light that can cause cancer and cataracts in humans exposed to it,
according to the report. However, the far-UVC light can kill very small
viruses and bacteria that float in the air and reside on surfaces,
according to the report.
The use of far-UVC lamp technology, which provides little to no
actual light, may eventually be used to treat air and surfaces in indoor
and public locations such as hospitals, schools, airports, buses and
trains, David Brenner, PhD, director of Columbia University’s
radiological research center, told the publication. In hospitals, the
lamps could significantly reduce the spread of the virus for patients
and clinicians as well as speed sterilization of medical equipment and
hospital rooms, according to Dr. Brenner.
Dr. Brenner’s radiology team has been working to develop the far-UVC
lighting for five years. High-capacity production and FDA approval have
been two of the project’s biggest barriers; Dr. Brenner said that before
the pandemic, his best estimate for when the issues would be solved was
about nine months and that his team is now trying to finish sooner. In
late March, the FDA issued an advisory that allows the use of sterilizer
and disinfection devices, including the far-UVC lamps, in hospitals and
other public health facilities during the coronavirus pandemic.
Eden Park Illumination, a Champaign, Ill.-based lighting tech
company, has been working with Dr. Brenner on a National Institutes of
Health contract and since 2018 has been producing “a small number” of
the far-UVC lamps for industrial use, according to the report. Eden Park
Illumination is currently looking to hire more workers due to an
increase in demand from the healthcare industry.
As for pricing, a thin, two-inch square far-UVC light costs about
$500, according to Eden Park Illumination CEO Cy Herring.
Pittsburgh-based Allegheny Health Network is currently evaluating
implementing the lamp technology across its hospital network in
conjunction with its existing ultraviolet decontamination systems in its
air-handling units. https://www.beckershospitalreview.com/healthcare-information-technology/ultraviolet-technology-shines-new-light-on-covid-19-infection-prevention.html
The coronavirus can travel through the air at least 13 feet — more
than twice as far as social distancing guidelines, according to a report
from the Centers for Disease Control and Prevention (CDC).
Research published in the federal agency’s Emerging Infectious Diseases journal shows the contagion spreading far further than previous official suggestions — and also getting spread on people’s shoes.
“The aerosol distribution characteristics … indicate that the
transmission distance of [COVID-19] might be 4 m,” the report says,
translating as more than 13 feet.
“Furthermore, half of the samples from the soles of the ICU medical
staff shoes tested positive,” the researchers wrote of samples taken at
Huoshenshan Hospital in Wuhan.
“Therefore, the soles of medical staff shoes might function as carriers.”
The report, based on research by a team at the Academy of Military Medical Sciences in Beijing, appears to reaffirm fears that the current social distancing guidelines of 6 feet may not be enough.
It also suggests people — especially medical staff on the frontlines —
could inadvertently be spreading the bug away from its source,
recommending stringent disinfecting measures.
High levels were also found on frequently touched surfaces like computer mice, trashcans and bed rails.
The CDC recommends 6 feet for social distancing, while the World Health Organization claims just 3 feet should be enough, less than a quarter of the distance the current study suggests it spreads. https://nypost.com/2020/04/12/the-coronavirus-can-travel-at-least-13-feet-new-study-shows/
On Monday morning, at a private nursing home in Queens, a registered
nurse arrived for what she thought would be a job interview. She found
more than a dozen prospective applicants, all of them responding to the
same urgent, unsolicited text message from the Fairview Rehab &
Nursing Home. They were whisked through a brief training session and
hired on the spot.
The nurse leading the orientation, who’d started at the facility only
three days earlier, explained that much of Fairview’s regular staff and
management are out sick with COVID-19. There are more than forty
residents for every nurse, she said, before asking who in the group
could begin a double shift immediately.
The situation inside disturbed even battle-hardened medical
professionals. According to multiple healthcare workers who spoke to
Gothamist this week, a majority of the 200 residents at Fairview are
suffering from acute pressure ulcers — gaping sores on their shoulders
or elbows or pelvic bones, indicating they haven’t been turned over in
days.
One nurse was so horrified by what she saw she began taking detailed
notes of her shifts, which she shared with Gothamist. Her accounts,
relayed here, were confirmed by multiple staff members at Fairview.
(We’ve agreed to withhold the names of some of the healthcare workers,
because they were not authorized to speak to the press.)
“They’re slumped over in bed, just laying there rotting,” said one
nurse. Another staff member, reached by phone mid-shift, said she wasn’t
sure who was in charge at Fairview anymore. “It’s crazy in here right
now,” she said. “Everything you’re hearing is true.”
Left unsupervised, some of the new personnel roamed the five-story
building, finding shortages of gloves, hand sanitizer, stethoscopes and,
most concerningly, medication. When they can’t locate a certain pill,
they’re told to note that a resident refused it, rather than record it
as out of stock, according to two of the employees.
Tests for COVID-19 are hard to come by at nursing homes across New
York, and while nurses say they were told of at least one positive
patient at Fairview, it’s not clear who else may be infected. Many of
Fairview’s residents are in need of medical care typically offered at
hospitals, employees said.
Some nursing assistants, newly out of school and certified through an
emergency federal waiver, are given high-level tasks. One of them is
observed inserting a nasal oxygen cannula upside down. The potentially
deadly error is caught in time, but not before sending the elderly
resident into a gasping fit of hypoxia.
By the end of their first shift, multiple newly-hired workers had
quit, citing fear of being named in an inevitable malpractice suit.
“I don’t think anyone is going in there and getting better,” said one nurse. “They’re in there getting worse.”
Repeated inquires to Fairview were not returned.
“Like Fire Through Dry Grass”
The arrival of COVID-19 in a nursing facility, Governor Andrew Cuomo
observed late last month, “can be like fire through dry grass.” In the
days since, the number of confirmed cases in nursing homes has
skyrocketed to more than 4,000. At least 1,231 residents have died from
COVID-19, up from 86 recorded deaths from the virus just two weeks ago,
according to state data. Nursing homes now account for more than 17
percent of all fatalities statewide.
Given the speed with which the virus can kill the elderly and immunocompromised,
some of that growth may have been inevitable. But according to
healthcare workers and watchdog groups, the combination of critical
staffing shortages and bureaucratic neglect have greatly exacerbated the
anguish and death inside New York’s nursing homes.
Even before the pandemic, chronic staffing shortages in New York’s 620 nursing homes were widely seen as a point of concern.
The state-licensed facilities are almost entirely funded by Medicaid,
meaning they typically pay nurses significantly less than hospitals.
A proposal unveiled by Cuomo last year to slash Medicaid spending by $2.5 billion
forced many nursing homes to cut back on already depleted resources;
despite the staggering economic toll of the pandemic, the governor says he still plans to go through with the cuts.
As nursing home operators have struggled to provide existing staff
with necessary personal protective equipment, the workforce has withered
in recent weeks, according to Stephen Hanse, president and CEO of the
New York State Health Facilities Association and the New York State
Center for Assisted Living.
A survey conducted by his organization found more than 100 downstate
nursing homes in New York are having an “extremely difficult” or
“impossible” time filling shifts with registered nurses and licensed
practical nurses.
At the urging of Governor Cuomo and Mayor Bill de Blasio, tens of
thousands of medical workers have volunteered to help ease the strain
that COVID-19 has put on hospitals. The vast majority have not yet been put to work; it’s unclear whether any have been sent to nursing homes.
The dire staffing shortages come as many nursing homes are busier than ever. A directive from the state health department,
issued over fierce objections from nursing home operators, now requires
the facilities to accept patients discharged from hospitals, regardless
of whether they have a suspected or confirmed COVID-19 diagnosis.
Mixing infected patients with those hyper-susceptible to the disease,
while not ensuring the facilities are equipped with the necessary staff
or protective equipment, is akin to a mass death sentence, according to
advocates.
“As a result of not being prepared, we’re experiencing a whirlwind,”
said Susan Dooha, the executive director at the Center for Independence
of the Disabled in New York. “We’re going to have so many more people
die than needed to.”
In an effort to increase bed capacity, the city has reopened a public
hospital at the Roosevelt Island Medical Center, which shares a
building with an acute nursing facility known as Coler. Though residents
were initially told the new hospital would not include coronavirus
patients, that assurance was later rescinded. A spokesperson for NYC
Health + Hospitals, Chris Miller, said the patients are kept in separate
areas with “no overlap.”
A resident at Coler, meanwhile, told Gothamist he believed cross
contamination was responsible for the recent spread of cases inside the
nursing home. He noted that his own nurses share an elevator and other
parts of the facility with personnel treating COVID-19 patients. Members
of the staff published a video last week pleading for N95 masks and
other equipment.
“I feel like I’m trapped here,” said the patient, a parapalegic with
breathing issues, who asked for anonymity because he feared retribution
for speaking out. “This is a nursing home with real, vulnerable people
where they’re spreading an outbreak.”
“You Should Take Them Out Right Now”
Major outbreaks have been reported inside nursing homes in
Washington, California, Louisiana, Connecticut, and elsewhere. But
unlike some of those other states, New York is not releasing the names
or locations of the nursing homes where coronavirus cases and fatalities
have been identified. Cuomo has cited privacy concerns, a justification
that fellow lawmakers dispute.
“Each facility is a black box,” said Dooha. “We cannot get our arms
around this right now if there’s no transparency and people can’t make
appropriate decisions.”
The New York Department of Health is supposed to conduct unannounced
inspections at nursing homes every 9 to 15 months. But those visits
appear to have slowed or stopped entirely during the pandemic, according
to Dooha.
An agency spokesperson told Gothamist that the health department is
still investigating complaints, but would not say whether inspections
were proceeding on schedule.
Absent official information about where the worst nursing home
outbreaks are located, information has trickled out haphazardly. On
Friday, City Councilmember Justin Brannan expressed shock at a report
suggesting eight bodies were left unattended for days at a Crown Heights nursing home.
At one large Westchester nursing home, 25 patients have died in the
span of a week, compared to an average or one or two before the
pandemic, according to a nursing supervisor at the facility.
“They never stood a chance,” the healthcare worker told Gothamist.
“If you have loved ones in a nursing home and have the capability to
take care of them, you should take them out right now.”
That option is not available for many of New York’s more than 100,000
nursing home patients. With little time to make high-stakes decisions,
even those who may be able to evacuate a loved one from an infected
facility say they’ve been stymied by bureaucratic indifference and a
series of maddening dead ends.
On Thursday morning, Jiayang Fan received a text message from a
healthcare worker informing her that multiple cases of COVID-19 were
detected at the Henry J. Carter Specialty Hospital and Nursing Facility,
a long-term care ward run by the city’s public hospital system, where
her 68-year-old mother has lived for six years.
Fan was already exploring options for removing her mother, who has
ALS and diabetes, from the facility. When she called patient services on
Thursday, Fan was told it would take weeks to arrange the necessary
sign-offs and equipment, and that her mother was better off in the
nursing home anyway.
“The hospital basically sabotaged my attempt to get my mother out,”
she said. “They were very dismissive of my concerns.” Fan, a staff
writer for The New Yorker, who has written previously about her mother’s nursing home, emphasized that blame rested with the administrators and city officials, not healthcare workers.
Adding to her anxiety, she soon learned that her mother’s live-in
aide, who plays a critical role in her care, would have to evacuate the
facility, due to a new policy banning private health aides. The worker
was escorted from the facility by security guards on Thursday evening,
as Fan’s mother sobbed uncontrollably into a video conference with her
daughter.
A spokesperson for New York City’s public hospital system did not respond to a request for comment by press time.
“I don’t know if my mom will be alive tomorrow or if she’s choking on
her own saliva,” Fan told Gothamist on Thursday evening. “It feels
helpless.” https://gothamist.com/news/neglect-death-in-nys-nursing-homes-theyre-laying-there-rotting
Retail giant Amazon says it will build its own coronavirus testing lab to monitor the health of its staff.
Cases of Covid-19 have been reported at more than 50 Amazon
facilities across the US. Some have involved multiple infected workers.
The company said it had assembled a team to build its own “incremental testing capacity”.
Amazon staff have previously criticised the firm over its response to the coronavirus pandemic.
In March, Amazon fired a New York warehouse worker who organised a
protest over a lack of safety precautions taken by the company.
In a statement, Amazon said “We did not terminate Mr Smalls’
employment for organizing a 15-person protest. We terminated his
employment for putting the health and safety of others at risk and
violations of his terms of his employment. Mr Smalls received multiple
warnings for violating social distancing guidelines.”
Later, a memo from a meeting of Amazon executives was leaked. It
said: “We should spend the first part of our response strongly laying
out the case for why the organiser’s conduct was immoral, unacceptable,
arguably illegal, in detail, and only then follow with our usual talking
points about worker safety.”
‘Regular testing’
Amazon blogged it had made more than 150 “significant process changes” in response to coronavirus.
“Our operations sites and grocery stores are distributing masks to
employees and conducting employee temperature checks,” the company said.
“A next step might be regular testing of all employees, including
those showing no symptoms. Regular testing on a global scale across all
industries would both help keep people safe and help get the economy
back up and running.”
The company acknowledged that testing resources were limited, so it
had assembled a team of employees to develop its own facility.
“We have begun assembling the equipment we need to build our first
lab and hope to start testing small numbers of our front line employees
soon. We are not sure how far we will get in the relevant timeframe, but
we think it’s worth trying, and we stand ready to share anything we
learn with others.”
According to news site Bloomberg, at least one Amazon facility is being investigated by the US Occupational Safety and Health Administration over concerns it has not done enough to safeguard employees.
The Pennsylvania warehouse receives products from manufacturer before sending them to smaller Amazon warehouses around the US. https://www.bbc.com/news/business-35547368
While officials in California and New York have increased efforts to
slow the spread of COVID-19, states like Florida and Texas are starting
to ease back.
On Friday, Los Angeles County extended its stay-at-home order through May 15th.
According to Department of Public Health Director Barbara Ferrer,
non-essential businesses, beaches, parks and trails will all remain
closed possibly into the summer.
Referring to recent data, Ferrer stated if the order was lifted any
sooner, about 96 percent of residents would become infected by August
1st, as opposed to roughly 30 percent if the order remained.
Meanwhile, New York Governor Andrew Cuomo has said officials are “cautiously optimistic”
that the infection rate is slowing in his state. For the first time
since the outbreak began, hospitals reported a decrease in the number of
patients in the ICU this week.
“If the hospitalization rate stays the same, we have up to a 90,000
bed capacity in our system, fully taxed up to the brim,” he stated. “But
that’s an overflow capacity that I hope we don’t use if we keep this
curve down.”
On the other hand, Florida Governor Ron DeSantis announced his intent to reopen schools,
starting as early as next month. The governor pointed out that school
age kids do not appear to be at higher risk for COVID-19 than adults and
said he’ll make a decision based on whether or not there are active
virus concerns in each district.
“There’s probably not been one aspect of society that’s had a more
broad-based effect on than our education system, because we have
millions of people involved in it,” stated DeSantis. “We want kids to be
in school, I think most parents want that, so we’re going to continue
to look, see how this develops and then make a decision there.”
In Texas, Governor Greg Abott is trying to get residents back to
work. According to recent reports, Abbott plans to sign an executive
order next week outlining how businesses will reopen in the Lone Star
state.
Small business owner Megan Hollek, whose entire staff has filed for
unemployment benefits, told local reporters she is scared to know how
long social distancing measures will last.
“As soon as it’s safe, let people work,” she said. “Even if it is on a
smaller scale, we will abide by any guidelines we need to.” https://www.oann.com/government-officials-across-u-s-reevaluate-covid-19-guidelines/
The U.S. Food and Drug Administration recently granted an “emergency use authorization”
of a blood test for antibodies against SARS-CoV-2, the novel
coronavirus that causes COVID-19. It is the first such test to receive
approval for the U.S. market. And it comes at a time when health experts and leaders are embracing immunity as a potential end point to the pandemic. In Colorado, a company that makes a coronavirus antibody test has donated kits to the state’s San Miguel County
so that everyone there can be tested if they want to. And in Italy,
politicians want to use antibody status to determine which people will
get “back to work” passes.
Several ambitious surveys to test for these antibodies have now been launched around the globe. The World Health Organization’s Solidarity II study will pool antibody data from more than half a dozen countries. In the U.S., a collaborative multiyear project aims
to provide a picture of nationwide antibody prevalence. Its first
phase is already collecting samples from blood donors in six major urban
areas, including New York City, Seattle and Minneapolis. And the effort
will evolve into three national surveys of donors, supported by the
Centers for Disease Control and Prevention and conducted this fall and
in the fall of 2021.
Unlike diagnostic tests,
which are used to confirm the presence and sometimes load, or amount,
of the virus, antibody tests help determine whether or not someone was
previously infected—even if that person never showed symptoms.
Widespread use of such assays could give scientists greater insight into
how deadly the virus is and how widely it has spread throughout the
population.
It is less clear what those antibody tests mean for real life,
however, because immunity functions on a continuum. With some pathogens,
such as the varicella-zoster virus (which causes chicken pox), infection confers near-universal, long-lasting resistance. Natural infection with Clostridium tetani, the bacterium
that causes tetanus, on the other hand, offers no protection—and even
people getting vaccinated for it require regular booster shots. On the
extreme end of this spectrum, individuals infected with HIV often have large amounts of antibodies that do nothing to prevent or clear the disease.
At this early stage of understanding the new coronavirus, it is
unclear where COVID-19 falls on the immunity spectrum. Although most
people with SARS-CoV-2 seem to produce antibodies, “we simply don’t know
yet what it takes to be effectively protected from this infection,”
says Dawn Bowdish, a professor of pathology and molecular medicine and
Canada Research Chair in Aging and Immunity at McMaster University in
Ontario. Researchers are scrambling to answer two questions: How long do
SARS-CoV-2 antibodies stick around? And do they protect against
reinfection?
Early on, some people—most notably U.K. Prime Minister Boris Johnson (who has the virus and is currently in intensive care)
and his government’s scientific adviser Patrick Vallance—touted hopes
that herd immunity could be an eventual means for ending the pandemic.
And although it appears that recovered COVID-19 patients have antibodies
for at least two weeks, long-term data are still lacking. So many scientists are looking to other coronaviruses for answers.
Immunity to seasonal coronaviruses (such as those that cause common
colds), for example, starts declining a couple of weeks after infection.
And within a year, some people are vulnerable to reinfection. That observation is disconcerting when experts say it is unlikely we will have a vaccine for COVID-19 within 18 months.
But studies of SARS-CoV—the virus that causes severe acute respiratory
syndrome, or SARS, which shares a considerable amount of its genetic
material with SARS-CoV-2—are more promising. Antibody testing shows
SARS-CoV immunity peaks at around four months and offers protection for
roughly two to three years. As Preeti Malani, chief health officer and a professor of medicine at the University of Michigan, said in a video interview with JAMA
Editor in Chief Howard Bauchner,this period presents “a pretty good
time line for thinking about vaccines and therapeutics” for COVID-19.
Even if the antibodies stick around in the body, however, it is not
yet certain that they will prevent future infection. What we want,
Bowdish says, are neutralizing antibodies.
These are the proteins that reduce and prevent infection by binding to
the part of a virus that connects to and “unlocks” host cells. They are
relatively easy to detect, and they are far easier for vaccine
developers to generate than the alternative: the immune system’s T
cells. In contrast, nonneutralizing antibodies still recognize parts of
the pathogen, but they do not bind effectively and so do not prevent it
from invading cells.
“If humans naturally make neutralizing antibodies [against
SARS-CoV-2], then all we have to do is figure out what [sites they are]
binding on the virus and really target that one little piece of protein,
and that’s our magic bullet,” Bowdish says. For SARS-CoV-2, that target
site is most likely on the so-called receptor-binding domain of its spike glycoprotein—a
protein attached to a sugar that the virus uses to enter cells. But,
Bowdish says, this spot may present a challenge because human immune
systems are not very good at making antibodies against sugar-coated
substances.
Nevertheless, a few small studies of cells in laboratory dishes suggest that SARS-CoV-2 infection triggers the production of neutralizing antibodies. And animal
studies indicate such antibodies do prevent reinfection, at least for a
couple of weeks. Furthermore, because some antibodies seem to recognize
and react to the spike proteins on multiple coronaviruses,
including SARS-CoV and MERS-CoV (the virus that causes Middle East
respiratory syndrome, or MERS), researchers can build on knowledge
learned from previous outbreaks.
Research on real-life immunity to SARS-CoV-2 is in its preliminary stages, and uncertainties remain. One study
found no correlation between viral load and antibody presence, leading
the authors to question the antibodies’ actual role in clearing the
virus in humans. In addition, peer-reviewed research on SARS-CoV and preprint studies on SARS-CoV-2
report that some nonneutralizing coronavirus antibodies might trigger a
harmful immune response upon reinfection with those pathogens or cross
infection with other coronaviruses. Thus, while much of the emerging
research is promising, Bowdish cautions against using antibody testing
to drive policy until researchers know the proportion of COVID-19
survivors who are producing neutralizing antibodies.
In an ideal world, SARS-CoV-2 immunity would resemble that acquired
by children who get chicken pox. Early research suggests we are in for a
much more complex scenario but one that time and unprecedented global
cooperation might be able to untangle. Eventually antibody tests could
be the key to getting our lives and economies back on track. For now,
they promise to give experts, officials and citizens a clearer picture
of the pandemic. https://www.scientificamerican.com/article/what-immunity-to-covid-19-really-means/
The new coronavirus’s ability to wreak havoc in the lungs is raising a
lot of concerns and questions from my asthma patients. They already
know how it feels to have trouble breathing. Now, they are wondering
what risks they face amid this new pandemic.
Some worry that their asthma inhalers
could increase their risk of COVID-19 infection. Others are asking if
nebulizers are safe, and if they can use expired inhalers.
Here are answers to some of the common questions I’m hearing as an allergist. Do people with asthma face a higher risk of severe illness if they get COVID-19?
There’s a lot we still don’t know about COVID-19 and how it affects asthma patients.
Based on the data we have so far, asthmadoes not
appear to increase the risk of acquiring COVID-19. However, the Centers
for Disease Control and Prevention does list “chronic lung disease or
moderate to severe asthma” under groups at higher risk for severe illness if they get COVID-19.
It’s important to understand what “severe illness” means.
One complication from COVID-19 is acute respiratory distress syndrome,
a severe lung disease that results from damage to the alveoli, the air
sacs of the lungs. When COVID-19 patients require ventilators, it’s
often for acute respiratory distress syndrome. We don’t know very much
about the risk factors for developing acute respiratory distress
syndrome or how to treat the specific type of inflammation that drives
this condition, but there is no evidence that asthma is a risk factor
for developing acute respiratory distress syndrome if infected with
COVID-19.
In contrast to acute respiratory distress syndrome, asthma is a chronic condition that we know a lot about. It is characterized by airway inflammation, mucous production and airway spasm. Respiratory viruses, including strains of coronavirus that cause the common cold, can trigger asthma symptoms,
and it’s likely that COVID-19 could do the same. Even though asthma is
also an inflammatory condition, in contrast to acute respiratory
distress syndrome, we have very effective treatments for asthma. What should I do to protect myself?
Get your asthma under control and maintain that control. I cannot stress that enough. That means staying on your usual medications.
At the first onset of respiratory symptoms, asthma patients should follow their individualized asthma action plan and contact their health care provider to see if additional treatments are necessary to prevent symptoms from worsening. Can I keep using steroid medications?
A few patients have told me they stopped their inhaled corticosteroid
medication because they were concerned that the steroids would suppress
their immune systems. That’s exactly what asthma doctors don’t want to hear.
Asthma controller therapies reduce the frequency and severity of
everyday asthma symptoms as well as asthma attacks. Stopping asthma
controllers can increase the likelihood of a severe asthma attack when
exposed to a trigger, such as a virus or allergen. An asthma attack,
even if unrelated to COVID-19, may result in an emergency room visit,
which can then increase risk of exposure to COVID-19.
For patients with COVID-19, the messages about corticosteroids can be confusing. In SARS and MERS, as well as emerging studies on COVID-19, corticosteroids have not been shown to have a survival benefit. The World Health Organization and the CDC recommend that corticosteroids not be used routinely to treat viral pneumonia or ARDS due to COVID-19.
However, if a patient has an asthma attack, regardless of whether the trigger is COVID-19, corticosteroids are usually effective and should be used. Are nebulizers OK to use at home?
Sometimes patients have difficulty using handheld inhalers and
instead use nebulizers, which turn liquid medicine into a mist.
Particularly when the patient is experiencing severe asthma symptoms, nebulizers can be more effective at delivering medication slowly into the airways.
The current concern about nebulizers is that if they are used by a
patient with a respiratory infection, the nebulizer could aerosolize
droplets containing virus, allowing the virus to stay in the air longer.
Hospitals and other facilities are being advised to reduce their use of nebulizers to reduce spread of the new coronavirus.
If an asthma patient finds that nebulized therapy is more effective
than inhalers, the nebulizer should be used in a room that is isolated from other household members. What can I do if my pharmacy runs out of albuterol rescue inhalers?
Some parts of the country are experiencing shortages of albuterol inhalers,
in part because hospitals are using them more for COVID-19 patients. If
the pharmacy is out of stock, patients have some options:
Albuterol handheld inhalers are marketed under various names, and
not all are in short supply. It’s worth asking the pharmacist if another
formulation is available.
Nebulized albuterol is widely available and may be an alternative if the user takes the recommended precautions.
Check with mail order or other local pharmacies.
Ask your physician whether other rescue inhalers, such as
levalbuterol or ipratropium, would be appropriate. Your physician may
also suggest other alternatives.
If necessary, patients can use albuterol that has expired.
In general, medications are thought to be safe one year after their
expiration date, but they are not guaranteed to have the same potency.
What else should I do to stay healthy?
Asthma care is individualized, and I recommend that asthma patients
check in with their health care providers to make sure they are using
daily controller medications correctly have a plan in place in case
asthma symptoms worsen. Keep a 30-day supply of your usual medications,
but don’t stockpile medications, which can lead to shortages.
At this point, most people are aware of the CDC’s recommendations on
how to protect yourself, including social isolation, hand hygiene and
disinfecting surfaces. I would add one more—pay attention to your mental health, too.
When I asked one patient whether she had experienced asthma symptoms
recently, her response was that she was hyperventilating at times just
sitting and watching the news. She knew it was time to turn off the TV.
It’s a stressful time. Getting good sleep and being kind to yourself and others is more important than ever. https://medicalxpress.com/news/2020-04-asthma-patients-coronavirus-scary.html
