Therapist D. Clay Akerly from Washington in a column for Vox spoke about a 50-year-old patient who got COVID-19 twice with a difference of three months, and if for the first time he was bothered only by a mild cough and sore throat, then he had fever, shortness of breath, oxygen starvation. Formerly a doctor from New Jersey talked about similar cases.
Akerli admits that his patient simply did not recover completely: sometimes the symptoms of COVID-19 remain for months (we wrote about this in one of the press reviews) But the therapist believes this is unlikely, because between diseases the tests for coronavirus twice yielded a negative result and for six weeks the man felt good.
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After the first time, the presence of antibodies was not checked, but they are not found in all people who have had an infection, and in the rest their concentration drops rapidly. It is hoped that those who are ill without antibodies are protected thanks to cellular immunity, but the described case makes one doubt this. In addition, it is known that immunity to other coronaviruses does not last long.
If a few people really get infected again, then perhaps we will not be able to develop collective immunity in a natural way. It is possible that vaccines will provide only short-term protection, if they can be done at all. Finally, those who are ill think that they are no longer afraid of the virus, and that they themselves do not pose a danger to others, therefore they behave less carefully.
It is too early to judge whether these cases or the exception are an exception, but one should not just wait until drugs and vaccines appear. You need to wear masks, wash your hands, keep a distance from each other, and the authorities should massively test people, isolate the infected and monitor their contacts.
What if SARS-CoV-2 is really airborne
Made a noise last week open letter More than 200 scientists who contacted the World Health Organization (WHO) to acknowledge that the new coronavirus is transmitted by air. Questions disassembled The Guardian.
- According to the WHO definition, airborne transmission means that you can get infected through droplets of mucus with a diameter of less than five microns that contain the virus, hang in the air for a long time and spread over a distance of more than a meter (at first it was believed that only larger drops were dangerous, rapidly settling on surfaces – approx. TASS).
- How widespread this infection is is still unclear. Laboratory experiments show that this is possible in principle. The experts interviewed by The Guardian do not have a common opinion, but one of those who signed the open letter believes that there is no other way to explain large outbreaks, such as during a rehearsal of a choir.
- Cloth masks could serve as protection for others if the one who wears it is infected. To protect yourself, you need a N95 respirator (in MIT Technology Review article on the same topic, one expert said that masks are extremely important, and another that masks hold tiny drops worse. Experts all more often urge wear masks wherever there are other people – approx. TASS).
- The authors of an open letter to WHO wrote that, in addition to masks, hand washing and distance, it is necessary to improve ventilation, install air filters and carry out UV treatment. The Guardian expert thinks that if the virus is really transmitted through the air, then you should close the bars, gyms, the distance between people should be more than two meters, and N95 respirators should be worn in hospitals. Another expert says that they will have to keep the windows open, even in winter.
- As for air conditioners, the article provides the conclusion of the European Center for Disease Control and Prevention. On the one hand, air conditioners can filter out relatively large drops, but small ones can fly further than under normal conditions. So far, no cases of infection due to air conditioning are known.
Radiation Against Pneumonia
In the first half of the 20th century, doctors tried to treat pneumonia with X-rays, and they supposedly did it. Radiation therapy is now being tested on patients with COVID-19, but not all experts approve of this approach. writes STAT.
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Severe cases of COVID-19 are often accompanied by pneumonia, and it is caused, presumably, by an excessive reaction of the immune system. Doctors expect that a small dose of radiation can suppress inflammation and save a person.
More than a dozen clinical trials have been registered in Italy, Spain, Iran, India and the USA, during which prospective therapy will be tested. In the 1920s and 1940s, pneumonia was treated in patients with influenza. Articles published in those days speak of 75–90 percent efficiency. One small study has already been done with patients with COVID-19, it has yielded promising results.
But opponents warn of flaws and dangers.
- In order to properly check radiation therapy, large studies are needed. While they are being conducted, something better will appear, such as steroid treatment. Steroids are safer, and their mechanism of action is better justified theoretically.
- Radiation can kill cells of the immune system, then the patient will be worse.
- Earlier experiments showed that radiation plays into the hands of some viruses.
- Radiation helped patients with arthritis, but with COVID-19, the inflammation is much stronger, so X-rays may not be effective enough.
- It is not clear why in general coronavirus causes such a powerful inflammation, and not in all people.
- First, it would be worth checking out radiation therapy in primates, not in humans.
- Many hospitals lack patients for clinical trials of drugs, which may be the best alternative.
- Irradiation increases the risk of cancer, even if it remains small.
- It is unclear at what point it is better to prescribe radiation therapy.
But clinical trials are needed to answer some of these questions. Proponents of radiation therapy say that such treatment is not designed for everyone, but for critically ill patients who have nothing to help or who have nothing to treat, it leaves hope.
Prepared Marat Kuzaev
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