Is it really time to let your guard down? Read More »
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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 Read More »
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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? Read More »
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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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]]>One Vaccine may Protect Against all Coronavirus Variants Read More »
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]]>Good News- New COVID-19 Vaccine may protect against all variants of Coronavirus!
Anika H. Ahmed, MD
The Coronavirus continues to create havoc in everyone’s life across the globe and researchers are today back at the drawing board, trying to figure out one vaccine that may be able to help the immune system defend against all existing and future variants of the Coronavirus. Some good news came out of the University of Virginia where health professionals are working diligently to develop a vaccine that will offer complete coverage. This new vaccine has so far shown promising results in early animal testing in existing variants and may provide protection against all future variants of Coronavirus.
Developments are as follows:
The scientists at University of Virginia and Virginia Tech Health department are working on a new platform, recently invented, to rapidly develop new vaccines. This new platform will offer developing vaccines at very low cost estimated to about a $1 per vaccine, would be easy to store and transport, even in remote areas of the world and could be produced in existing vaccine manufacturing factories around the world. This could be the key to putting an end to the pandemic!
This new vaccine involves making a DNA that can direct the production of a piece of the virus that can instruct the immune system as to how to start a protective antibody response. This DNA is inserted in another small circle of DNA called a plasmid that can multiply within a bacteria. The plasmid is next introduced to E. Coli bacteria, guiding the bacteria to place pieces of proteins on their surfaces. One major break through is the innovation that E. Coli have had a large number of its genes deleted. Deleting these genes that also includes parts of its outer membrane, cause a substantial increase in the response of the immune system to recognize and respond to the vaccine antigen placed on the surface of the bacteria. This entire process from identifying a potential vaccine target to producing the gene-deleted bacteria that do have the vaccine antigens on their surfaces, need a time frame of only two to three weeks, a speed that will make it ideal to controlling the pandemic, with its fast-upcoming various variants now and in the future.
This vaccine is being tried out in pigs and so far, two such vaccines, one designed to protect against Covid-19 and another developed to protect against porcine epidemic diarrhea virus (PEDV) are being tried out in animals. Both PEDV and the virus that causes Covid-19 are Coronaviruses, but they are not closely related. Like all the Coronaviruses they do share several of the amino acids that form the fusion peptide. PEDV is seen to infect pigs, causing diarrhea, high fever and vomiting, a pig pandemic that has killed about 10% of the US pigs.
Interestingly killed whole-cell vaccines are presently being used widely around the world to cure fatal diseases like Cholera and whopping cough. Factories in many developing and underdeveloped countries are manufacturing million of doses of these vaccines per year, for a low a cost as $1per dose and at times even at much lesser cost. It is a promising possibility to use the technology and innovation to make this new, one vaccine that shall be effective against all the existing and future variants of Coronavirus causing Covid-19.Fingers crossed as more convincing data is collected and human clinical trials begin!
Copyright Anika H. Ahmed, MD, The Stanwork Group
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]]>Laboratories’ Ability to Detect Omicron Read More »
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]]>Are our laboratories ready to detect the Omicron variant?
Anika H. Ahmed, MD
Scientists are not stopping when it comes to the fight against COVID-19. The first case of the Omicron variant was detected and announced on November 25, out in South Africa and it was detected upon evidence of new sequencing in the COVID-19 samples. Clinicians became suspicious when a large number of patients showed up at clinics with extreme fatigue, exhaustion, headache and generalized body aches. Careful analysis of the samples at the laboratories indicated new mutations and sequencing in the Coronavirus, that was labelled as the Omicron variant.
This is where technology plays a key role in figuring out new variants of the Coronavirus. Correct detection all depends on the way the computer code looks for the differences in the virus compared to the original Wuhan strain. The sequencing is actually exactly the same. A positive specimen for SARS-COV-2 is actually sequenced the exact same way whether it is an Alpha, Delta or an Omicron or any unknown variant, that we may not know. Then a computer algorithm is put in to check and make sure that all the critical mutations for the different variants of Coronavirus are looked into. The outcoming result is reported and identified as a particular variant namely Alpha or Delta or Omicron.
All the identified variants of SARS-COV-2 have unique mutations. It has been observed so far that actually the Alpha variant and the Omicron variant, do have some things in common. They are both more transmissible and hence spread faster. They both have some of the same mutations that may predict more transmissibility, which in plain words means that there are mutations in both Alpha and Omicron variants, that makes the virus attach more tightly and multiply efficiently, thus helping it spread faster and wider. .
To correctly detect the new Omicron variant, all laboratories need to make sure that their computer methods are in place and ready. With all these mutations, it needs to be ensure dthat the current sequencing laboratory techniques work to amplify all of the different regions of the Coronavirus. Most of the laboratories have been working on this aspect and have confirmed that their current sequencing methods would be able to detect and successfully sequence Omicron.
Copyright Anika H. Ahmed, MD, The Stanwork Group
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]]>First U.S. Omicron Case Detected Read More »
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]]>First Omicron Positive Case Detected in the United States
Anika H. Ahmed, MD
On Wednesday, December 1st, 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 22nd, 2021, and was identified as positive on Monday, November 29th, 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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]]>How Omicron Variant of Covid-19 differs from Alpha & Delta Variants Read More »
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]]>How is the Omicron Variant different from Alpha & Delta Variants of COVID-19?
Anika H. Ahmed, MD
As family and friends depart for their respective destinations after celebrating Thanksgiving together, and folks hosting Thanksgiving dinners are still finishing their leftovers, they receive news of yet another variant of Coronavirus, namely Omicron, first detected in South Africa. This new variant is fast making waves across the globe leading to new travel restrictions on flights going back and forth from South Africa, in particular. Many countries including the United States, United Kingdom, Canada, European Union Countries, Germany, Italy, Israel, Belgium, Hong Kong, Australia, and Pakistan have announced travel restrictions. The United States is presently allowing only fully vaccinated, essential workers and US citizens to board flights coming from South Africa, a strict precautionary measure to prevent Omicron from entering the Unites States. So far, no Omicron has been detected in the United States.
Research continues on the new Omicron variant and scientists are conducting observational studies and collecting data for comparison between the original, Alpha Variant of Covid-19 detected first in the United Kingdom, the deadly Delta variant first detected in India and the now new Omicron variant detected initially in South Africa. Interestingly all three variants present clinically with somewhat different symptoms as following:
- Alpha Variant: Patients testing positive for Alpha variant of Coronavirus usually present clinically with symptoms 2-14 days after exposure to the virus and have fever, chills, dyspnea with difficulty in breathing, generalized body aches, fatigue, headache, loss of taste or smell, chest congestion and runny nose, nausea, vomiting and diarrhea.
- Delta Variant: The most common symptoms of patients testing positive for Delta variant are cold like symptoms namely sore throat, headache, fever, fatigue and loss of taste and smell.
- Omicron Variant recently detected in patients presents clinically with extreme fatigue and joint pains. It is also observed that these patients have mild symptoms that subside in a couple of days, with majority complaining of extreme fatigue and exhaustion. It is more dangerous because early evidence on omicron shows that the variant has a large number of mutations, some of which have concerning characteristics — including an increased risk of reinfection compared to other highly transmissible variants. This surely means that people who contracted Covid-19 and recovered could be again subject to catching the Coronavirus again and developing symptoms. This variant also appears to be more infectious leading to a much rapid spread globally.
The good news is that all variants can be detected with available Covid-19 detection tests. Both the rapid antigen and polymerase chain reaction tests will detect the omicron variant. However, the World Health Organization says it poses a “very high” risk due to concerns about transmissibility, immune system evasion and vaccine resistance. Studies have shown that the available Covid-19 vaccines are effective against both the Alpha and Delta variants, but scientists are still conducting studies to see how effective vaccines are against the Omicron variant. The vaccine manufacturers mobilized hundreds of health workers early morning on Thanksgiving holiday, to study Omicron and to keep it under control before it starts a new wave of Covid-19, leading to restricted travelling and socializing, for celebrating the holidays together with friends and family!
Copyright Anika H. Ahmed, MD, The Stanwork Group
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]]>More Variants of Coronavirus Read More »
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]]>How many more variants of Coronavirus?
Anika H. Ahmed, MD
Medical practitioners started seeing patients sick with flu like symptoms in early March of 2020 and the cause was identified as a deadly, highly contagious, droplet transmissible virus from the Coronavirus family. The disease with symptoms of fever, cough, sore throat, runny nose, body aches, loss of sense of smell and taste, difficulty in breathing, extreme fatigue etc was named Covid-19. Scientists worked day in and out to find a vaccine to fight this infectious Coronavirus and it took them close to a year to get approval for a vaccine for adults. As people across the globe heaved a sigh of relief and opted to get vaccinated despite concerns of its safety, efficacy and long-term side effects, there came a variant of the Wuhan Coronavirus. This was followed by first an Alpha variant, then a delta variant and now an Omicron variant.
As vaccination becomes available to more and more people in every country, the question arises that with variants popping up in different parts of the world-Alpha in the United Kingdom, Delta in India, and Omicron in South Africa, is there any benefit of getting vaccinated in the first place? This is a legitimate question on the minds of many people vaccinated or non-vaccinated. Research based on clinical trials, observational studies and questionnaire surveys indicate that all the variants of the Coronavirus namely, Alpha, Delta and Omicron spread readily, speedily, and dangerously in non-vaccinated populations, as compared to vaccinated population. The fact that just in a weeks’ time Omicron positive cases of 400/day went up to 10,000 per day in a week’s time was mainly due to the low vaccination status of the general population of South Africa.
It is worth noting that these dangerous variants of Coronavirus will continue to emerge and cause alarm and illness across the globe. This virus continues to evolve and as long as the virus has millions of people with weak immune systems, low antibodies profiles, non-vaccinated status, it will continue to potentially infect the vulnerable population and continue to become more and more infectious, mutating and giving rise to new variants. The new Omicron wave of the Covid-19 pandemic starting in South Africa could lead to a new ‘Omicron Plus’ variant. There is certainly an immediate worldwide threat with this new variant and all the countries with low vaccination rates are going to see more infections all because the Coronavirus can spread, so much more easily. Scientists expect and are preparing for more variants to come in future, due to continued evolution of the Coronavirus.
However, there is light at the end of the tunnel, and one is greatly encouraged by the fact that fortunately the Coronavirus has still not evolved to evade the available vaccines against it. So far, the mutated variants cannot avoid the vaccine induced antibodies and that is presently the key in controlling the new Omicron driven Covid-19 wave. Scientists are repeatedly emphasizing the importance of getting vaccinated, in order to break the perfect environment for the Coronavirus to flourish in non-vaccinated population and provide another recipe for disaster across the globe. If vaccination is taken lightly, the variant could evolve into a vaccine resistant phenotype. Everyone including children 5years and above need to get vaccinated, as soon as possible and also get the booster shot too, which remains in circulation to give immunity to the various variants of the Coronavirus!
Copyright Anika H. Ahmed, MD, The Stanwork Group
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]]>COVID-19 Vaccination for Children Read More »
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]]>COVID-19 vaccination for children
Anika H. Ahmed, MD
As the Covid-19 pandemic continues worldwide, with so far five new variants sprouting more in certain countries like the United States, United Kingdom, Germany, Italy, Brazil, India and South Africa, scientists continue to work round the clock on clinical trials, to get approval for a vaccine that can be given to children. It is certainly a big achievement in a very short time, when after successfully conducting clinical trials on 3000 children, the Food and Drug Administration (FDA) has confirmed that the Pfizer-BioNTech COVID-19 vaccine has met the safety and efficacy standards for administration in children ages 5 through 11 years old.
The approved Pfizer-BioNTech vaccine is easily available in the United States and is now being administered to children between 5-11 years of age. Many parents are still hesitant in giving their children the vaccine as they are afraid of short- and long-term side effects. The facts remain that like any other vaccine, the Covid-19 vaccine also will have side effects, more in certain children, while less or no side effects in other children, depending on how each individual’s immune system reacts. The common side effects seen so far in clinical trials are soreness or pain at the site of the injection, fatigue, muscle pain, chills, generalized body aches, fever and joint pain. These side effects are typically seen within 24-48 hours of vaccination and usually disappear about 1-2 days later.
Approved vaccination for children is a big break through that can help keep children healthy and safe in schools and they can once again attend in person classes. Vaccination certainly gives protection against Covid-19 with some children still developing symptoms if exposed to the Coronavirus, but definitely milder with a speedier recovery. Although the Covid-19 vaccine does work well, some children will still get sick, because no vaccines are 100% effective. The few children getting Covid-19 despite vaccination will be the vaccine breakthrough cases, and as seen in adults, they will not have serious complications requiring hospitalization and will recover well with supportive symptomatic treatment at home, under care of a primary physician.
The main benefit of giving children a Covid-19 vaccination is preventing him or her from becoming severely ill or experiencing short term or long-term complications. This is especially true for children with underlying serious health conditions like juvenile diabetes, asthma, obesity, and congenital heart diseases. For children the main incentive of getting vaccinated, in addition to getting a sticker and a lollypop from the health worker, shall be staying in school with friends, participating in sports, group school activities and having frequent playdates!
Copyright Anika H. Ahmed, MD, The Stanwork Group
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]]>Weather Effects on Coronavirus Transmission Read More »
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]]>Does warmer weather stop the outbreak of COVID-19?
Anika H. Ahmed, MD
From the evidence so far, the COVID-19 virus can be transmitted in all climates, including areas with hot and humid weather. Research indicates that in order to kill the Covid-19 Coronavirus, heat virus containing objects for 3 minutes at temperatures above 75°C (160°F), 5 minutes for temperatures above 65°C (149°F) and 20 minutes for temperatures above 60°C (140°F). This indicates that hot weather with temperatures above 75°C (160°F can shorten the life span of the virus but it can still be transmitted. Scientists remain busy studying the correlation of COVID-19 and temperatures. These studies have indicated that as the air gets hotter and more humid, the Coronavirus remains suspended in droplets for much lesser time and drops to the ground. The warmer summer temperatures carry more moisture, and the Coronavirus does not travel far in humidity. This reduces the virus range and also concentration available for cross infection from person to person, in cases when people come into close contact with each other. Rising temperatures also bring more people outdoors and into open spaces, which is by far a less conducive environment for Coronavirus to thrive and spread.
COVID-19 started in winter of 2019 in China and as the weather got warmer many hoped that it will slowly taper off, with the temperatures soaring upward. However, the last summer season indicated that the Coronavirus continued to spread, especially in communities not following the prevention protocols. The fact that influenza and colds occur mostly in winter is mainly because the air is drier, and the virus lasts longer in droplets suspended in air. The Coronavirus has spared no part of the globe and cases have sprouted up on hot and humid islands like Singapore, Indonesia, and Malaysia.
The ongoing research and case studies conducted so far indicate that the spread of COVID-19 is dependent mainly on the population density, lifestyle of the people with or without social distancing measures, and availability of public health tools like testing and contact tracing. These factors have a deeper impact by far than does the weather.
Increasingly, research indicates that warmer temperatures may not be able to stop the pandemic, but they may be able to slow down the sprout of new cases. The effects of low or high temperatures may explain why certain areas of the tropics have not been hit quite as hard as compared to the temperate regions of the globe. Some scientists have started incorporating temperatures in their study models for COVID-19, and have concluded so far that yes, there is a correlation, roughly about 2%-3% reduction in transmission for every degree Celsius increase in temperature. Relative atmospheric pressure and humidity certainly added to this effect It is not a big difference but certainly a relevant factor.
However, there is not enough clinical data available to establish high temperatures as a key to controlling the pandemic of COVID-19. Even as the temperatures continue to fluctuate between high and low (a frequent pattern seen now due to climate change) everyone must be cautious and continue to practice social distancing of at least 6 feet and wearing masks, especially in closed spaces and around infective COVID-19 positive individuals. Warmer weather by itself cannot end the pandemic, even though it can help in reducing the transmission of the Coronavirus and thus control the fatal pandemic somewhat. Regardless of climate, adopt protective measures if you live in, or travel to an area reporting COVID-19, especially in areas with new variants.
Copyright Anika H. Ahmed, MD, The Stanwork Group
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