Anika H Ahmed MD, Author at Stanwork

Disturbing long-term complications of Covid-19-Remote Work & Neurological Symptoms!

Anika H Ahmed MD — Thu, 19 Jan 2023 17:49:39 +0000

As we almost complete four years of Covid-19 restricted life, with many either following the remote work or hybrid model, one cannot help wondering what the long-term effects of the Coronavirus may be and how we shall continue to pay our dues to it. Research indicates that although the commute time has sharply declined in the majority but the screen time has greatly increased. This is showing new symptoms in many enrolled in observational studies. It is worrisome to see that many of the observed symptoms are similar to people recovering from Post Traumatic Stress Disorder (PTSD). Major symptoms being sleeplessness, headache, fatigue, dizziness, light headedness, blurring of vision, depression, anxiety and weakness.

Research continues on patients who did get positive with the Coronavirus, and they are being closely studied after they were marked as fully recovered on paper, meaning that they longer tested positive. A lot of people still continue to suffer even after their so-called recovery and observational studies of them show many people struggling with memory problems, mental fog, and mood changes. Scientists agree that one reason for these symptoms are long-term damage to the brain, both from the virus and the increased screen time with no defined working hours. People tend to spend more time on gadgets now that they either do not have a commute or less time on the road every week!

Currently studies are being carried out in various medical universities with a team of scientists taking a lead at the University of Virginia, California National Primate Research Center at UC Davis, and the NYU Grossman School of Medicine. A study led on hospitalized patients found that more than 13% of hospitalized COVID-19 patients have developed a new neurological disorder usually seen soon after being infected with the Coronavirus. When these patients were followed up six months later, it was observed that the group who survived were still showing cognitive problems and preferred remote work rather than in-person.

The main health risks to the brain are internal bleeding, blood clots, inflammation, oxygen deprivation and disruption of the blood-brain barrier. The changes seen in the brain are subtle but even minor affects on the brain could be a significant change in cognition. SARS-CoV-2 virus when observed in animals clearly shows infecting not just the animal’s lungs and body tissues but also infecting the brain, an organ that has yet not received much attention. The monkeys studied showed that neurons, the brain cells that make thinking possible are infected although not confirmed in human beings yet under observation, but many researchers have found evidence that the virus can infect human brain cells.

As seen in monkeys, it is believed that the virus appears to enter the brain through the nose. A potential route for the Coronavirus to makes its way to the brain is through a nerve located on top of the nose called the Olfactory bulb. The Olfactory Bulb provides a possible route for the Coronavirus to travel from the respiratory system to the brain. The Coronavirus appears to infect and destroy nerve cells in the Olfactory Bulb, which surely explains why many COVID-19 patients complain of loss of sense of smell!

In addition to this, the Coronavirus has also been observed to infect cells that line blood vessels, including those that go through the brain and hence lead to damage that can trigger blood clots or bleeding that can lead to life threatening strokes. It can also damage cells that protect the blood-brain barrier leading to disruption and allowing harmful substances including the Coronavirus to enter the brain. Furthermore, the Coronavirus can also damage a person’s lungs to the extent that their brain is no longer able to get sufficient oxygen. Sone scientists also believe COVID-19 may be causing brain injuries that may increase the risk of developing Alzheimer’s later in life.

This impact of the Coronavirus on the brain certainly makes its extremely important to treat every COVID-19 patient in the initial stages with the newly approved Pfizer anti-Covid-19, PAXLOVID and stop the disease evolving towards more advanced stages, that can cause neuronal damage that cannot be reversed. The bottom line of all ongoing and past research is that the best way to prevent COVID-related brain damage is to get promptly vaccinated, cut down on screen time and spend at least some time outdoors!

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Ready for a Coronavirus breath test?

Anika H Ahmed MD — Fri, 15 Apr 2022 22:43:58 +0000

The words ‘Breath test’ immediately bring to mind the image of being pulled over by the police and asked for a driver’s license followed by the breath test, where you have to blow as hard as you can. Well, that association is going to change with the recent emergency approval of ‘InspectIR Covid-19 Breathalyzer’ by the US Food and Drug Administration that is able to spot chemical compounds associated with the Coronavirus in the breath.

This emergency approval on Thursday, April 14, 2022, shall prove to be a turning point in the early diagnosis and management of Covid-19.

The approved breathalyzer should soon be available in doctor’s offices, pharmacies, clinic, hospitals, mobile health clinics, testing sites, and later, even at airports for a quick confirmation of a possible positive case. It is able to separate and identify chemical mixtures to quickly detect 5 compounds related to SARS-COV-2 infection and is able to give results in less than 3 minutes.

It shall prove to be practical as it can be wheeled around like carry-on luggage and can be moved from place to place very easily. So far, the clinical trial carried on with it indicates that it is able to detect 90% of positive cases and 100% of all negative cases. Furthermore the ‘InspectIR Covid 19 was also tried on the Omicron variant and found to be highly effective in detecting positive cases. The Food and Drug Administration still recommends, however, that a positive test should be confirmed with a PCR test too.

The successful operation of the InspectIR in detecting positive cases is another positive innovative step towards a safer tomorrow. This shall equip medical workers with an innovative tool that can help in early diagnosis of all possible positive cases, with immediate management with isolation and quarantine to prevent the spread of the Coronavirus and keep all contacts at the minimum.

Advanced technology with modern effective quick testing tools is making it possible to achieve the target of keeping our communities safe from Covid-19 and all Covid-19-related hospitalization down to zero in future!

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Covid at all Time Low: – Kudos, Everyone!

Anika H Ahmed MD — Thu, 07 Apr 2022 17:23:31 +0000

The first week of April 2022 has become historical as we hear the much-awaited news that hospitalization due to Covid-19 in the United States is at its all-time low now. Numbers collected by the US Department of Health & Human Services, which started tracking the information in July 2020, indicate that as of Tuesday, March 5^th, 2022, there were 15,250 positive Covid-19 people hospitalized in US hospitals. Data also indicates that presently only 2% of the hospital beds are being used for Covid-19 patients.

The previous lowest point was reached at the end of June 2021 with 160,000 people hospitalized with Covid-19, and then everything changed as we were hit by the Delta variant, followed closely by the Omicron variant.

Heaving a deep sigh of relief, it is time to congratulate everyone who made this happen. Special plaudits go to all the health workers, working tirelessly round the clock taking care of the sick in hospitals, clinics, pharmacies, parking lots and makeshift hospitals in churches, temples, mosques, hotels, pavilions, theatres, and stadiums. It is time to acknowledge our clinicians, researchers, statisticians, scientists, pharmacists, pharmaceutical staff members, program managers and data analysts who worked behind the doors to get effective vaccines out to the masses, in record breaking time.

Special kudos to the people of America who followed the SOPs laid out by the Centers for Disease Control and Prevention, U.S. Department of Health & Human Services. The extreme loneliness coming from self-isolation over the last two years, at times quarantine & depression also, has paid off. Those following the SOPs wore masks sometimes for over 24 hours not only at work but also during travel in tight compartments, is now showing positive results.

Kudos also to the US Food and Drug Administration for the fast approval of the much-needed vaccines for different age groups.

A recent poll conducted by CNN indicates that the majority in significant parts of the United States still feel that Covid-19 continues to affect their lifestyles. Mask wearing and social distance has become a way of life for them, and they wish to continue with it. The poll indicates that 59% of those polled state that people should continue to wear masks in public places to prevent another surge of Covid-19 cases.

Can the remaining 41% join this practice to bring the present low 2% Covid-19 US hospitalization to a zero?

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Are you Ready for a fourth shot of Coronavirus Vaccine?

Anika H Ahmed MD — Tue, 29 Mar 2022 19:51:01 +0000

As the last booster shot for the majority of Americans appears to be either more than six months or nearing six months’ time frame, many wonder if they still retain immunity against the Coronavirus. One question that I have been asked multiple times at social gatherings is ‘Am I done with vaccination for Covid-19?’. The answer to this question is NO.

We will not likely ever be done with vaccinations for Covid-19 and we will need to keep our immunization status updated, as new variants sprout and our immune systems indicate weakness with low immunity status.

The Food and Drug Administration recently approved a fourth booster shot of both Pfizer and Moderna, for people over 50 years of age. This will soon be available and all individuals in this age bracket are encouraged to get this shot if their last booster shot has been more than four months ago.

Many debate whether only 65 and above should go for it but the recent Food and Drug Administration approval for 50 years and above approval even without consultation of their independent panel of experts, indicates that there is an immediate and urgent need to boost the immune system of a larger age bracket.

This step has been taken to give extra protection to a vulnerable population just in case there is a new wave of Coronavirus with new variants like BA.2 or Omicron. Previously the Food and Drug Administration had approved the fourth booster shot for only 12 years and older with a very weak, vulnerable immune system, and now it has stated that this group may need an additional fifth dose to keep immunity strong.

The data of Centers for Disease Control and Prevention shows that the number of Covid-19 cases are at its all-time low after the winter surge with Omicron, and about two thirds of Americans have gotten their two initial doses and a booster dose of Covid-19 vaccination. The recommendation by Food and Drug Administration for a fourth shot is a precaution to prevent a new surge in Covid-19 cases.

Data shared by other countries like Israel indicates that populations receiving a fourth booster shot definitely showed fewer positive cases compared to populations without a fourth shot.

The data recently released by the Centers for Disease Control and Prevention indicates that during the highly infectious US Omicron wave, two doses of Covid-19 vaccination were 80% effective against hospitalization requiring the use of a ventilator, and a third booster shot raised the effectiveness to 94%. Those in the immunocompromised group without a third booster shot demonstrated vaccine efficacy of only 74%.

These are encouraging numbers further emphasizing the need to keep the immune system strong with multiple layers of defense and prevent deaths from Coronavirus. Research so far indicates that immunity from vaccination starts wearing off after six months or so, and the vulnerable elderly population should plan on getting a fourth booster shot.

Time will eventually tell as to how many more booster shots may be needed and for how long each booster shot will impart immunity. Presently it remains our responsibility to follow guidance of the regulatory authorities and get our booster shots when recommended to do so. This will be our civil duty to keep each other protected from this deadly, severely-infectious virus which has established a record of causing one of the worst pandemics in history.

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And here comes a new variant of Coronavirus! Highly-Transmissible Omicron BA.2

Anika H Ahmed MD — Tue, 22 Mar 2022 08:18:13 +0000

Researchers and scientists have been keeping a close watch on any further Coronavirus mutation giving rise to a new variant without taking a break. All possible tools are being used, varying from rapid antigen testing and polymerase chain reaction (PCR) diagnostic tests to even testing of sewage water for early diagnosis of positive possible variant cases.

As warily expected, a new highly-transmissible variant of the circulating Omicron variant, now named BA.2, has been detected not only in the United States but also overseas. It is presently seen mostly in Hong Kong and the United Kingdom.

The people at risk are mostly the still unimmunized population. In the United States at present there are 28 million seniors who are largely at risk of getting seriously ill from Covid-19, because they are either still unimmunized or partially immunized, or their last immunization shot was more than 5 months ago.

Ongoing clinical trials indicate that the immunity generated with vaccines wanes over time. Protection from vaccines against the Omicron variant is only 10% effective after six months of a second dose of immunization. Although booster shots of vaccine do boost the immune system, scientists are now researching and investigating the long term benefits of vaccine protection against the Omicron variant of Coronavirus.

The conclusion drawn so far is that booster shots are 40-50% effective in preventing an Omicron infection among adults.

The new Omicron variant BA.2 can easily cause a severe Covid-19 infection in the vulnerable, unimmunized population, especially the elderly, children under 5 years of age, and the very young toddlers and infants that are still waiting for their vaccination shots.

Everyone needs to still exercise caution to prevent yet another wave of Covid-19, and not allow it to spring back again into a pandemic stage from a much-awaited endemic stage.

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Covid-19 Pandemic Second Anniversary marking once-incredible milestone

Anika H Ahmed MD — Fri, 11 Mar 2022 05:29:46 +0000

Today, Friday March 11, 2022, marks the second anniversary of the Covid-19 pandemic and for everyone it is a solemn moment of reflection of where we are today. March 11, 2020, was when Americans received news of the World Health Organization declaring Covid-19 outbreak a global pandemic. Majority of the working class went home with instructions for remote work, given responsibility of figuring out various collaboration packages on their own to stay connected.

Stores ran out of toilet paper, paper towels and all cleaning supplies, as people hoarded essential items in fear of the unknown. Grocery stores showed empty shelves of dry rations, parking lots remained full as people anxiously shopped as if preparing for a famine or a war. It was indeed on a war footing that the fight against the microscopic enemy named Coronavirus was launched.

Tribute must be paid to the essential health workers who have been working long shifts, not only at the hospitals taking care of the seriously sick, but also at laboratories and research centers running tests and gathering more information about the Coronavirus, its life cycle, spread, variants, symptoms, and management.

Two years later, we sadly note a heavy toll of deaths despite rushed clinical trials and vaccinations approvals.

The latest statistics shared by John Hopkins University show that more than 964,000 Americans have fallen victim to this deadly, merciless, microscopic enemy with a death toll of 50,000 in just the past 28 days. At this current rate, it looks like by the end of March we shall get to the somber milestone of 1 million Covid-19 deaths in the United States of America alone.

How wrong was the prediction of 100,000 deaths in total made in April 2020 by the then administration? In February 2021, soon after the new administration came into office, the death toll hit 500,000. One year later we are now approaching one million, a grim, sad milestone that was totally unimaginable at the beginning of Covid-19 pandemic.

Our present statistics clearly indicate that we are not out of the woods yet.

An announcement coming out today also extended the mask wearing requirement on airlines and all kinds of public transport to April 18. This is a smart decision, as after the announcement by the Centers of Disease Control and Prevention of lifting essential mask wearing indoors in public places like restaurants etc. and allowing it to be an individual’s personal decision, led to the majority dumping their masks and starting a mask free, carefree life.

Although most of the states have moved to an ‘Endemic’ state with pledges of quick management of community outbreaks, with efficient quick testing, daily single pill management, isolation and shut down of positive areas, we all still need to stay responsible.

Every individual needs to remain cautious and avoid any behavior that may give rise to spread of new variants, further prolonging the misery of the pandemic. We may need to live with the Coronavirus but let us be in control of the virus and not let it continue to control our lives!

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Is it really time to let your guard down?

Anika H Ahmed MD — Thu, 10 Mar 2022 14:43:35 +0000

After the Centers of Disease Control announced a mask less policy, based on the number of hospitalizations, vaccination status and prevalence of positive cases, people were overjoyed. Public places opened doors to welcome eager visitors who are out to have fun and put the pandemic behind them. The message read on everyone face is ‘Covid -19 is a thing of the past and it can no longer control our lives’. But how true is it?

I had a chance of being at the Union Station last night in Washington and was horrified to see the majority stepping out of trains with no masks. My main worry is that we are being over enthusiastic and somewhat negligent in letting go of the mask too soon. Yes, according to NBC news data, in every state of the United States the rate of hospitalization has decreased by at least 47% and in many states even as much as 70%. In the past one month, the daily death rates have gone down by more than 43%, coming down from a one-week average of 2,600 per day.

But can we ignore the fact that we are still having 1,500 deaths/day?

We Americans as a nation have seen our death graphs go so sky high over the past two years, with a total death count from Coronavirus being above 950,000, that having 1,500 deaths per day appears minimal. If we step back and look at our numbers from March 2020 to March 2022, the reduction in numbers is encouraging, but still of concern.

The fact that there are still gaps in our health system and primarily in healthcare services in some states, with laboratories not well equipped for testing Coronavirus, especially its new variants, does point towards a need for maintaining caution. Letting go of the masks outdoors is acceptable as long as you are fully vaccinated, can maintain social distance, are not immunocompromised or taking care of an immunocompromised individual, old or young.

Don’t throw away all your masks, have them handy in case you come across people coughing and sneezing. One good thing that the Coronavirus has taught us is taking care of basic hygiene. Everyone is in the habit of washing hands frequently, especially when returning from public spaces, and it has become a habit for the majority. Kids growing up in this pandemic will have good hygiene habits for life.

Word of caution for everyone is: do not let your guard down yet. Carry your hand sanitizer still, with frequent use – remember it kills most of the germs, including Coronavirus, that you pick up from anywhere and get sick because of. Wait, don’t let go of your masks yet!

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Ready to be unmasked? Follow the 3C’s

Anika H Ahmed MD — Tue, 08 Mar 2022 05:30:37 +0000

Spring may come early this year as the announcement of the Centers for Disease Control last week felt like a fresh breath of air. The much-awaited announcement stated that mask wearing could be relaxed indoors for people that are fully immunized. Most of the United States government buildings have withdrawn the requirement of wearing masks indoors and all federal buildings can now be accessed without a mask.

As the temperatures continue to warm up, everyone cannot wait to be outdoors. The chirping birds are a pleasant reminder that spring is around the corner. However, as everyone eases back into pre-Covid normal life, many are still nervous about letting go of their masks, especially parents of young toddlers and children who are still waiting for their Covid-19 vaccination.

The announcement of the Centers for Disease Control regarding the end of indoor mask wearing, did however advise people who are immunocompromised, suffering from a chronic medical condition, or have children that are not fully vaccinated, to still exercise caution. They should continue to wear masks when in closed spaces or in big crowds. For now, those opting to not wear masks must avoid the following 3Cs, which have been tested out in Japan and demonstrate low Coronavirus infection rates:

Crowds: – Avoid being unmasked when hanging out with huge crowds, as seen in concerts, games, or live shows. The bigger the crowd the greater the chance that there may be a large number of people that are still not fully vaccinated and could easily transmit the Coronavirus through droplet infection. Be smart and wear a mask that completely covers your nose and mouth while out having fun with friends in such settings, even if fully vaccinated.

Close contact:- Any time you know you will be having close contact with people that may not be full vaccinated or have young children waiting for their shots, it is best to wear a mask around them.

Closed space:- In closed spaces such as an elevator or an airplane, masks come in handy, keeping one protected while breathing air shared with others in tight, closed spaces.

As the mask requirement has been eased off in many states, in government as well as private sectors, the decision now lies with the people to wear or not to wear a mask. It is true that everyone wants to put the Covid-19 life behind them and move ahead to a normal, restriction-free life, at the earliest possible.

This could be a turning point for Covid-19 as we ease into a less restrictive but still cautious lifestyle and avoid yet another wave of an old or new variant of Coronavirus. We need to be aware of the 950,000 precious lives that have been lost in the United States alone in the last two years.

Keeping in mind the 3C’s above could be the key to avoiding yet another wave of Covid-19!

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Is the Covid-19 Pandemic an Endemic Now? Are we there yet?

Anika H Ahmed MD — Wed, 23 Feb 2022 21:47:26 +0000

Covid-19 has taught us many new things over the past two years, and it has raised public understanding of the difference between an epidemic, pandemic and endemic. When there was a sudden surge of new cases of Covid-19 starting from Wuhan, China in 2020 as a typical Infectious Communicable Disease, we started hearing the word ‘Epidemic’, which is defined by the Centers for Disease Control and Prevention (CDC) as a sudden, unexpected increase in number of cases of a disease in a certain geographical area. An epidemic can be contagious or non-contagious, for example smallpox, polio or obesity, West Nile fever, smoking, etcetera.

The difference in the state of an epidemic and pandemic is not in the severity of the disease but the extent to which it has spread. In a matter of weeks in the spring of 2020, we moved from the stage of ‘Epidemic’ to ‘Pandemic’ as positive cases of Covid-19 went sky high, with increased hospitalizations and the worrisome need for isolation and quarantine of sick people. The Centers for Disease Control and Prevention (CDC) declares a pandemic when the disease’s growth and spread are markedly exponential. Meaning that the number of cases grow at increasing rates each successive day, at times doubling or tripling, following an exponential pattern. A pandemic moves across international boundaries and sweeps across states, countries, and continents, making the health issue global.

Two years later presently, some scientists are optimistic and enthused as the number of hospitalizations and positive cases are going down and they are now using the term ’Endemic’ for Covid-19, encouraging local health bodies and state governments to ease off the non-medical interventions of prevention like wearing masks, maintaining social distance, frequent washing up, and increased medical intervention of vaccination and testing.

By definition ‘Endemic’ is a state when a disease may be consistently present but remains limited to a certain geographical region or season and the pattern of spread is predictable, allowing timely interventions to keep the disease under control. An example is Malaria in certain regions, especially during the monsoon season and summer in hot and humid tropical areas. Endemic does not mean less infectious or less severe cases, but instead, a more predictable and stable spread over time.

As far as Covid-19 is concerned, it has not reached an ‘Endemic’ stage yet but is moving towards it day by day as more and more people are getting vaccinated. The positive cases are going down, which shows that an ‘endemic’ stage may be round the corner now. However, all health professionals and researchers along with many scientists are being conservative still, as they see the transformation of Covid-19 from a pandemic into an endemic, cautioning everyone to maintain safe practices.

Many states across the United States including California, New Jersey, New York, Delaware and Connecticut are easing mask requirements for indoor dining, schools, colleges, and universities. This policy was adopted by Denmark a short while back and it resulted in making Denmark the top country in terms of the largest number of positive cases today. Let us not make the same mistake that Denmark made; let’s learn from it as a cautionary tale, and slowly ease into a pre-Covid way of life.

It is hoped that Omicron was the last big wave of Covid-19 and although there may be more variants, their spread will be well controlled and predictable, qualifying and maintaining the disease at an Endemic’ stage before long!

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Another tool being used to detect Covid-positive cases: Sewage Wastewater

Anika H Ahmed MD — Wed, 16 Feb 2022 01:47:10 +0000

Scientists have not stopped at taking nasal swabs to detect Corona virus. As the pandemic evolves, research continues on the transmission of the Coronavirus from positive Covid-19 cases. It is interesting to see that the Coronavirus positive individuals are not transmitting the virus only while sneezing, coughing, talking, or laughing, as the droplets stay suspended in air or land on hard surfaces.

In addition to this, all Covid-19 positive cases are also excreting the virus in their feces, giving rise to a positive poop. Once it infects a person, Coronavirus can reside in different cells of the body, primarily in the respiratory tract and in the gastrointestinal tract. The Coronavirus genetic framework comprising of the viral RNA gets excreted in feces and can be detected in stool, days before any symptoms appear.

This unique feature of the Coronavirus has provided scientists with a public health tool that can have a wide range of usage. Presently it is mainly being used on university campuses to detect positive cases long before the students are sick and show symptoms. This is the practice seen across some of the campuses in California where samples from individual buildings are drawn from wastewater that comes out of sewage pipes. This is done by a human manually using a dipper at the end of a rod. This way after the positive cases are traced, they can be isolated immediately and hence prevented from causing cross infections.

The effective early detection and isolation of positive cases has been supported by the Center for Disease Control and Prevention, which has set up a federal database of wastewater samples that will allow the local health departments to transform the data into valuable information. This will help in detecting the pattern of spread in certain neighborhoods and also monitor the positive cases sprouting across campuses, where students reside in large numbers in dorms.

The encouraging results of early detection of positive cases through sewage wastewater has set the grounds for early detection of other infectious communicable diseases too like polio, E. coli, salmonella, norovirus and a deadly drug-resistant fungus, Candida Auris. All these infectious diseases outbreaks can cause a deadly global threat, especially in hospitals and nursing homes. Close monitoring of vulnerable communities will help keep potential threats under control.

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