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First U.S. Omicron Case Detected

Anika H Ahmed MD — Wed, 01 Dec 2021 23:25:25 +0000

First Omicron Positive Case Detected in the United States

Anika H. Ahmed, MD

On Wednesday, December 1^st, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases announced at a press briefing at the White House that the first positive case of Omicron variant of the Coronavirus has been detected in California. The positive individual did travel back from South Africa to the United States on Monday, November 22^nd, 2021, and was identified as positive on Monday, November 29^th, 2021, by the University of California in San Francisco, through genomic sequencing. The California and San Francisco Departments of Public Health and the US Centers for Disease Control and Prevention confirmed that the positive Covid-19 was caused by the Omicron variant.

So far, the information on the Omicron positive individual is that the person was fully vaccinated but had not had his booster shot yet. Presently he is suffering ‘mild symptoms’ not requiring hospitalization and is under self-quarantine and isolation. So far, all contacts of the individual have tested negative for Coronavirus and are under observation. The main symptoms of the Omicron variant are extreme fatigue, headache and generalized body aches.

The World Health Organization has identified Omicron variant as a ‘variant of concern’ as it poses a very high global risk. Omicron first identified in South Africa has since been detected in several countries, including now in the United States too. It is being emphasized by researchers and scientists across the globe that the Omicron variant is highly contagious and tends to spread rapidly. The only way to keep oneself protected is firstly to avoid travelling to South Africa, where thousands of people are already positive, practice social distancing in public places, continue to wear a mask and wash hands frequently. In addition to these, both the World Health Organization and the Center for Disease Control are encouraging everyone to get booster shots to acquire immunity to the new Omicron variant of the Coronavirus.

Health professionals continue to work hard round the clock to collect data, and determine how transmissible is the Omicron variant, which populations are more vulnerable, how severe are the symptoms in most positive cases, and how well do the current available vaccines work. Till the right answers are found, everyone needs to be very cautious and practice preventive measures against the virus. In regard to this, one precautionary step announced by the president of the United States has been restricted travel from South Africa and seven other countries and urging eligible people to get vaccinated against Covid-19 or get a booster shot as soon as possible.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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Booster Vaccines

Anika H Ahmed MD — Sun, 28 Nov 2021 22:45:08 +0000

To get or not to get booster vaccine for Covid-19

Anika H. Ahmed, MD

As pharmaceutical staff continues to work round the clock, conducting clinical trails, collecting data, circulating questionnaires and surveys, they have been successful in bringing out the booster shots for protective vaccination against the highly infectious, often deadly Coronavirus causing the global pandemic of Covid-19. Public now has multiple choices in relevant vaccination against Covid-19, with pharmaceutical companies like Pfizer, Moderna, Johnson & Johnson, and Sinopharm taking the lead.

The most amazing feature of the human immune system is that it has an immunological memory of past infections or vaccines. Any time the immune system is exposed to an infection or a vaccine, which is basically an attenuated form of the virus or bacteria, it can trigger an antibody response of the immune system, hence keeping the body protected. However, it is normal for the virus fighting antibodies, such as those that are stimulated by a Covid-19 vaccine to wear out over time. Research indicates that these protective antibodies remain high for six months after the second dose of the vaccine and then wane over time. One way of measuring vaccine efficacy is to measure the antibody levels in the blood, and this has led scientists to repeatedly find a decline in the antibody levels, among vaccinated individuals, six months after the second dose of mainly Pfizer or Moderna Covid-19 vaccine.

Booster Covid-19 vaccine shots cash on the unique feature of the immune system to have a remarkable immunological memory of past vaccines. In people getting booster shots of Covid-19 vaccine, the memory response of the immune system is even more vigorous than the original response to earlier vaccination. This is why some people may experience more severe side effects, lasting for a longer time period, but with full recovery in 24-48 hours. This memory response of the immune system not only includes antibody response, but also includes an additional arm of the immune system controlled by a different group of white blood cells called T cells or T lymphocytes. T cells immune response are especially important for viral infections like Coronavirus, as they have proven to be just as important as antibody response, in protecting against infection and preventing serious complications requiring hospitalization.

If there are limited supplies, both FDA and CDC do support a mix and match approach of booster shots, with one booster dose of Pfizer given after a Moderna first and second dose or vice versa. However, if the supplies last, the current public health recommendations are that people should stick to one type of mRNA vaccine for all doses of vaccination, maintain an immunization record card and be ready for more booster shots as new variants make an appearance that may not be covered by the previous shots of vaccines.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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The Omicron Variant

Anika H Ahmed MD — Sun, 28 Nov 2021 22:37:14 +0000

Another variant of Covid 19 Coronavirus- Omicron

Anika H. Ahmed, MD

The unique feature of a virus, any virus is that it is constantly mutating and generating new forms, labelled as variants of the original virus. Coronavirus has deeply impacted the lives of everyone across the globe and still continues to do so, today posing a new risk with a new variant -Omicron, detected and announced by South Africa’s National Institute of Communicable Diseases (NICD) on Nov. 25,2021 from samples taken from a laboratory between Nov. 14 to Nov. 16,2021. There has been an explosion of new cases in South Africa, which previously had a low level of infection, only after scientists discovered the Omicron variant. First detected in South Africa, it has quickly spread too, as people, whether symptomatic or asymptomatic, continue to travel back and forth. So far, the Omicron variant has already been detected in Britain, the Netherlands, Germany, Italy, Denmark, Belgium, Botswana, Israel, Australia, and Hong Kong. The United States is closely monitoring and according to the Center of Diseases Control and Prevention (CDC) so far there have been no new cases of Covid-19 due to the Omicron variant. CDC and the Department of Health & Human Services are closely, continuously monitoring variants and the US variant surveillance system previously reliably detected new variants in the United States. If Omicron emerges in the United States, it shall be identified quickly.

The Coronavirus continues to dig deeper and deeper roots across the world and the virus that initially started as a microscopic red mark in Asia, has grown into a massive tree, branching out as variants in different countries. Presently this huge Coronavirus tree growing across the globe, has established four huge branches namely the Alpha Variant (formerly called the UK Variant), the Beta Variant (formerly called the South Africa Variant), the Gamma Variant (formerly called the Brazil Variant) and the Delta Variant (formerly called the India Variant). The tree continues to sprout new branches and has recently grown a fifth variant namely the Omicron that has seen to sprout in South Africa. Scientists are closely studying this new Omicron variant of Coronavirus and so far, know that this could be more infectious than other variants, could be transmitted easily through droplet infection and may show resistance to a person’s immune system that has vaccine-induced antibodies or convalescent serum after a person’s been infected and has monoclonal antibodies.

Current research indicates that in the Omicron variant there are about 32 or more mutations in the very important spike protein of the virus, which makes it more transmissible and more resistant to antibodies that were effective against the first main four Coronavirus variants mainly Alpha, Beta, Gamma and Delta.

To prevent the spread of this new Omicron variant of Coronavirus the Center of Diseases Control & Prevention (CDC) highly recommends everyone to follow prevention strategies such as wearing a mask (even if fully vaccinated) in public indoor settings, especially in substantial high risk, community transmission areas, washing hands with soap and water frequently, and physical distancing from others. Besides this, everyone 5 years and older must protect themselves by getting fully vaccinated, including getting a vaccine booster dose. This will prepare the immune system to better fight the Omicron variant and result in milder symptoms, hence avoiding hospitalization and all possible complications.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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Safety of US Food Supply During Pandemic

Anika H Ahmed MD — Sun, 28 Nov 2021 16:48:57 +0000

Is the US food supply safe?

Anika H. Ahmed, MD

The COVID-19 pandemic spreads by person to person transmission through droplet infection. Close contact with any infective COVID-19 person can transmit the infectious Coronavirus leading to symptoms of COVID-19. Humans handle food and it goes through various hands of food industry workers before it makes it to the consumer. The outbreak of COVID-19 in a meat plant with 130 positive workers has given risen to a question whether the meat is safe. Is the food supply safe in the United States? Research indicates that COVID-19 does not directly spread through food. Consuming food that may have been handled by a positive COVID-19 does not directly lead to the disease. However, handling packages that may have been sprayed with Coronavirus through coughing or sneezing of a positive COVID-19 can lead to transmission of the Coronavirus to the hands of the consumers. In addition to different hard surfaces like doorknobs, elevator buttons, escalator railings, door handles, counter tops, and trolleys, Coronavirus can survive on plastic and paper for about 12 hours.

Maintaining the highest standards of hygiene on the consumer end is the key to controlling the pandemic. Anything brought into the house from outside, including food packages in the form of salad boxes, vegetable and fruit bags, milk cartons, cheese boxes, canned goods and cereal boxes must be wiped down. The best way to wipe down food packages is either with a wipe of rubbing alcohol or by spraying down with a disinfectant. This must be followed by frequent washing of hands for 20 seconds, wiping down of all counter tops used for placement of the food packages and wiping down of refrigerator shelves before putting the groceries away. This precaution may be time consuming but will be worth the effort to keep oneself protected from the Coronavirus.

On the other hand, outbreak of COVID-19 at a food processing and packaging plant does raise concerns. One positive case could lead to outbreak in the entire staff of the plant as it is rapidly transmitted from person to person. The deadly consequence of this spread could be contamination of packaging of the food. This contaminated package, if handled by consumers without precautions of sanitization of packages, frequent washing of hands and maintaining hygiene, will surely lead to greater spread of COVID-19. Due to the highly infectious nature of Coronavirus, it is better to assume that the package may have been contaminated with the virus at any point in the food chain supply going through multiple hands and follow the precautionary guidelines set by health authorities as explained above, in order to stay protected from COVID-19.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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Keeping Essential Workers Protected from Coronavirus

Anika H Ahmed MD — Sun, 28 Nov 2021 01:01:16 +0000

Keeping Essential Workers Protected from Coronavirus

Anika H. Ahmed, MD

I am a physician with more than 25 years’ experience in preventive medicine and have throughout my career focused on the primary prevention of infectious communicable diseases, primarily Influenza, HIV/Aids, Tuberculosis, and Hepatitis C. I have conducted multiple clinical trials to study the behavior pattern of patients on long term multi drug regimes and the various risk factors leading to infectious communicable diseases. With the current Covid-19 pandemic in full swing across the globe, I want to share some useful tips that can keep everyone protected, especially the essential workers who admirably report to duty and provide for the people who can stay safe at home in a much more controlled, healthy environment.

All essential workers need to understand the most important fact about Covid-19: one cannot get infected if one does not breathe the air containing the virus. The question is, how does the virus get in the air? It is a very infectious virus that suspends in the air each time an infectious person or a carrier coughs, sneezes, talks, or laughs. Saliva and mucous sprays out and any other person within six feet of the infectious person can get the virus through droplet infection by just breathing in the air. This is why it is crucial nowadays to have six feet of social distancing from EVERYONE, assuming that every person is either a carrier or susceptible to the virus. Think of every person’s mouth and nose as a virus spraying agent and stepping outside of the radius will help keep you safe.

The second foremost fact that all essential workers need to understand is that one cannot get infected through physical contact if one’s hands are CLEAN. Anytime the face, especially eyes, nose, or mouth is touched with hands that have come into contact with dirty surfaces – particularly doorknobs, elevator buttons, escalator railings, shared keypads, computers, desks, and telephones – you can fall victim to Coronavirus. But here is the good news. You can shoo away the virus if you wash your hands regularly for at least 20-30 seconds, especially before touching your face. Make a habit of washing your hands immediately after you reach home after exiting public transport, stores, or offices. Having disinfectant wipes these days is a luxury. Save them to wipe down surfaces, especially shared ones like telephones, desks, computers, keypads, mousses, trollies, doorknobs, light switches, and ID/security badges after you swipe or punch them in and out at work.

At work, the two major NESTS of Coronavirus are two places: restrooms and breakrooms/shared pantries. In both these places, the golden rule to follow is MINIMAL TOUCH. Put visual reminders in shared office spaces that say, “minimal touch!” It will be hard initially but knowing that humans are creatures of habit, things will get easier as they will become habits and conditioned behavior. Avoid touching doors by using elbows or feet to open and close. Grab a tissue and use it to close water faucets (after thoroughly washing hands for 20-30 seconds) and doors. Avoid touching shared gadgets like fridges, freezers, microwaves, toasters, and phones as much as you can and wipe down surfaces before using, especially before eating and drinking. Refuse to share your eating table with a colleague and avoid sitting in groups. Most of the elevators at work are small (less than 6 by 6) so try to take either the stairs or ride the elevator alone. Try to maintain a six-foot distance from EVERYONE!

Those who work long shifts end up having at least one or two meals at work, sometimes more. Eat balanced meals and do not skip your fresh fruits, vegetables, and salads thinking that they may have Coronavirus. Unlike E.Coli and Salmonella, Covid-19 is not a food-borne illness. Everyone should thoroughly wash all open, fresh produce in running water. Bagged fresh produce, such as bagged salad kits, are already up to food hygiene standards and do not have to be washed again before consumption. Fresh produce should be had regularly as it contains phytonutrients that promote health, boost the immune system, and keep one healthy. The only note of caution regarding food is to avoid restaurants, cafeterias, and buffets with open food trays. If anyone has coughed on, sneezed on, or touched the food with dirty hands, they can contaminate the food as well as the serving containers. Try to buy food that is sealed to avoid the risk of contamination. Best scenario: pack your office meals at home, keep them sealed, and eat fresh and balanced!

Protective personal equipment (PPE) including masks, gloves, scrubs, and protective suits, is essential for all healthcare workers. For other essential workers, cloth masks that can cover the mouth and nose may be worn in public, especially if six feet of social distancing cannot be maintained. A word of caution for smokers and those fond of vaping: now would be a good time to quit, as smoking can weaken your lungs and make them prone to pneumonia- the worst complication of Covid-19 – pushing the patient into intensive care and dependency on a ventilator for life support. All essential workers with underlying chronic diseases like Diabetes and Chronic Obstructive Pulmonary Diseases (such as asthma, bronchitis, emphysema) must wash their hands thoroughly, regularly, and frequently, and maintain minimal touching of surfaces with hands. That is their key to avoid becoming victims of Covid-19.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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Necessary Travel During Pandemic

Anika H Ahmed MD — Tue, 28 Sep 2021 04:51:16 +0000

What should I do if I need to travel for work or in an emergency?

Anika H. Ahmed, MD

A major risk factor of cross infection is always there while travelling, especially in air travel when one is confined to a small space in an airplane. This risk factor is markedly increased during the COVID-19 pandemic and poses a serious threat to the health of all travelers, especially the elderly and those with underlying chronic medical conditions. When travel is unavoidable for work or during an emergency, the following precautions must be exercised strictly in order to avoid catching the Coronavirus that can lead to COVID-19:

1) Practice the highest level of hygiene, especially of hands. Make a conscious effort of washing hands frequently for at least 20 seconds, especially before eating or touching your face. Hand washing with soap and water frequently is ideal but may not be possible during long travel. Washing with water and soap can be replaced with wiping of hands with a rubbing alcohol swab or an alcohol-based hand sanitizer. Alcohol is able to kill most germs, including those of the Coronavirus whose spikes stick to most surfaces and hands. The outer layer of Coronavirus gets destroyed with alcohol and hence most disinfectants are effective in getting rid of the Coronavirus.

2) Cleaning and disinfecting surfaces. This can be the key to remaining germ-free during travel. While travelling, wipe all surfaces close to your seat, especially the arms of your seat, food tray, touch screens and remotes, plastic covers of pillows, blankets, and complimentary travel kits, buttons for lights and calls, airways and vents.

3) Practice hygiene with food also. Try to only have sealed meals and make sure hands are either washed or wiped with disinfectants before each meal.

4) Avoid touching the face, especially nose and mouth and if possible, wear a mask. A mask will keep you protected from droplet infection of fellow passengers if it is used correctly. The most important factor along with the use of masks is proper hygiene of hands. Hands must be washed immediately after touching a mask. Every mask must be worn in a manner where there is no gap between the mask and the face. The nose and mouth must be completely covered with the mask and it is important to hold the mask from its ties while taking it off and avoid touching the part covering the face.

5) Travelers are discouraged from eating food from open markets, which could heighten the risk of transmitting Coronavirus from animals to humans.

6) Travelers coughing or sneezing must practice covering the cough and the sneeze with a tissue or their elbow. The tissue should be disposed of immediately.

All travelers should expect to receive a thermal scan upon arrival, to complete health related documents and travel documents pertaining to points of travel and duration of stay enabling the tracing of potential contacts and carriers, to quarantine for 14 days and to potentially test for COVID-19 if testing is available.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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Food Supply During Pandemic

Anika H Ahmed MD — Tue, 22 Dec 2020 11:48:45 +0000

How does the US manage its food supply during COVID-19?

Anika H. Ahmed, MD August 2020

The massive pandemic of COVID-19 started from China and spread like a wave across the globe, infecting humans, shaking economies, crippling businesses, and shutting down operations in all commercial locations, forcing people to stay in quarantine and isolation. With the start of the pandemic the first instinct of the people across the globe was to stock up on food with the worry that the food supply chain will be disrupted leading to scarcity of essential items. It immediately led to scenes of hoarding and empty shelves in supermarkets, grocery stores and wholesale warehouses. While we are still in the midst of the pandemic and remain unclear on the COVID-19 vaccine availability, the main question on everyone’s mind is how will the US manage its food supply during COVID-19?

It is comforting to know that in the United States, the food industry is supplied from the following three sources:

Domestic production with a key role played by farmers, agricultural workers and agriculture plants workers processing meat, wheat, and dairy products. This involves a network of manufacturers and distributors to process all the agricultural products, prepare them for human consumption, move products from farms to processing plants and finally get them to consumers.
Imports- The United States imports meat, fresh fruits and vegetables, dairy products, and dry rations from across the globe.
Storage- The US Department of Agriculture has strict guidelines on workers handling food products at processing plants and storage. Test kits have been supplied with close monitoring of all workers, shutting down of plants and warehouses with positive cases, imposition of quarantine for 14 days, and permission for getting back to work only when negative and asymptomatic, while still maintaining basic operation at food storage facilities.

So far there has not been a break in the chain of food supply and consumers have been able to get basic food supply of fresh groceries and dry rations. The question then arises as to why we saw empty shelves in grocery stores, especially in March and April? This was basically triggered by immediate reaction of panic and anxiety of COVID-19 among people, leading to hoarding and purchase of more goods than usual. It toppled off the balance between supply and demand and retailers could not keep up with the sudden increased demand of customers. Restocking with increased supplies of basic food as well as cleaning supplies with disinfectants and bleach products on top of the list calmed down the anxiety among the public and led to more control over the market. Human behavior generally decides the course of action for the future. The more anxious the people are, the lesser the supplies appear. Quarantine, lock downs and isolation have shut down restaurants which were big buyers in the food industry. No restaurant supplies meant more food supplies to retailers of grocery stores and wholesale markets, and hence more food for the people. At this point it can be concluded that there will be no food shortage as far as domestic production is concerned. However, imports may be affected with delay of supplies due to restrictions on flights and shipments.

So far, the US Department of Agriculture has assured us that we are fine on food supply on the domestic production front, imports, and storage. Even countries massively affected by the COVID-19 pandemic continue to ship supplies, although there may be a few days’ delay due to limited essential workers on the job.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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U.S. Food Supply During COVID-19

Anika H Ahmed MD — Fri, 04 Dec 2020 12:03:34 +0000

How does the US manage its food supply during COVID-19?

Anika H. Ahmed, MD

It is comforting to know that in the United States, the food industry is supplied from the following three sources:

Domestic production with a key role played by farmers, agricultural workers and agriculture plants workers processing meat, wheat, and dairy products. This involves a network of manufacturers and distributors to process all the agricultural products, prepare them for human consumption, move products from farms to processing plants and finally get them to consumers.
Imports- The United States imports meat, fresh fruits and vegetables, dairy products, and dry rations from across the globe.
Storage- The US Department of Agriculture has strict guidelines on workers handling food products at processing plants and storage. Test kits have been supplied with close monitoring of all workers, shutting down of plants and warehouses with positive cases, imposition of quarantine for 14 days, and permission for getting back to work only when negative and asymptomatic, while still maintaining basic operation at food storage facilities.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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Coronavirus Longevity on Cardboard Box

Anika H Ahmed MD — Sat, 03 Oct 2020 08:17:05 +0000

How long can COVID-19 live on cardboard boxes?

Anika H. Ahmed, MD

Cardboard boxes commonly used for packing and shipping goods are prepared by pressing together two moist sheets of paper, usually cellulose pulp obtained from wood or grasses and dried into various sizes of flexible sheets. It is much thicker than paper and can withstand the weight of light goods, hence used widely for shipping but it can provide a temporary home to viruses and bacteria. During the COVID-19 pandemic across the globe, people have survived mainly by ordering basic goods online. This leads to almost weekly, if not daily, pick up of cardboard boxes from mailboxes and front doors. A concern many share is whether the cardboard boxes being brought into a home otherwise sanitized and safe could be a source of Coronavirus infection. Scientists have conducted various studies to see how long the Coronavirus can survive on various surfaces. In one study there was a simulation done by spraying Coronavirus through coughing and sneezing on different surfaces including cardboards, clothes, plastic, and various hard surfaces. This study led to the conclusion that COVID-19, besides spreading through close contact between humans, can also be spread by touching contaminated surfaces and then touching the face, especially the nose and the mouth with contaminated hands.

As I write this, a UPS truck pulls over at my neighbor’s house and drops a package. My neighbor, an extra cautious woman, does not even allow the UPS person to come to her front door. She signals him to drop the package in her front yard under the tree. She next sprays down the package and moves back. Observing her behavior over the last two months, I know she is going to let the package sit for another 24 hours before being willing to touch it. Why is she that cautious?

After many scientific studies it has been observed that Coronavirus can survive and is detectable for up to four hours on copper, two to three days on plastic and stainless steel, and 24 hours on cardboard specifically. This scientifically proven fact should warn everyone (including my neighbor) that handling cardboard boxes is not entirely safe. Anytime a positive COVID-19 case whether symptomatic or asymptomatic has sprayed on it through coughing or sneezing, it can be a source of infection. If proper guidelines laid out by Centers For Disease Control of frequent hand washing properly for at least 20 seconds is not followed, then many can become victims of COVID-19 by just touching a cardboard package within 24 hours after it gets contaminated. Realistically there is no way of ensuring that the box sitting in your mailbox or at your front door will not give you COVID-19. To cut down on the risk, it is strongly recommended to wipe down the package with a rubbing alcohol swab or to spray it with a disinfectant and let it sit for a few hours before opening it. Recycling to dispose of the cardboard box is greatly encouraged, followed by the thorough washing of hands.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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