COVID-19: Meat Processing Personnel, School Opening Problem and Nosocomial Infections

It is widely recognized that the meat processing industry has been hit hard; here’s the data: more than 16,000 cases in April-May from 23 reporting states:


School opening decisions are now being worked out.  While reports have indicated that school opening is going fine in many places in Europe, their caseload is much much lower.

From Mike Lukovich’s Twitter Feed:

Related blog post: What Our Office is Recommending: Schools and IBD Patients

Also: this link, RIVM Children and COVID-19, describes experience with opening schools in Europe and Australia



Also, an interesting Wall Street Journal Article (Behind Paywall): Hospitals Struggle to Contain Covid-19 Spread Inside Their Walls

What Our Office Is Recommending: School and Pediatric IBD Patients

We are getting a lot of calls from families trying to figure out what they should be doing for their children with inflammatory bowel disease in regards to school attendance.  Here is what our ICN team has developed:

School guidance during Covid pandemic:

With the flood of information in the lay and scientific media, GI Care for Kids wanted to assure that our patients and families who had children with inflammatory bowel disease (IBD), Crohn’s or ulcerative colitis, had some guidance in making important decisions about beginning the 2020-2021 school year.  Currently, research shows that just having IBD, DOES NOT put a person more at risk for acquiring (i.e. catching) coronavirus (COVID-19) infection.  In addition, research suggests that biologics (e.g. Remicade, Humira) DO NOT seem to increase the risk for more severe Covid related illnesses.

However, steroids, thiopurines (e.g. 6-MP; azathioprine, immuran) and prograf DO appear to have a larger effect on increasing risk for more severe coronavirus infection and COVID-19 disease.  Additional research is being carried out with oldest patients (e.g. > 65 years of age) who appear to be at increased risk for infection and COVID-related disease, and, other co-morbid conditions (e.g. obesity, diabetes, cardiovascular disease) being at highest risk for COVID-19 disease as well.

All patients should practice good hand hygiene, wear masks at all times outside of the house, and observe social distancing.  If your family does not feel that return to a traditional school building is in your child’s best interest, please let us know, and we will help make sure we support you from a medical standpoint. 

For further information on the status of coronavirus in people with IBD world-wide, young or old, please go to: www.covidibd.org.

Additional information about the status of COVID-19 can be found at the following websites:


Also, this:

Facebook link (1:22 min): This is what happens when a Special Effects guy stays at home with his son during lockdown


Disclaimer: This blog, gutsandgrowth, assumes no responsibility for any use or operation of any method, product, instruction, concept or idea contained in the material herein or for any injury or damage to persons or property (whether products liability, negligence or otherwise) resulting from such use or operation. These blog posts are for educational purposes only. Specific dosing of medications (along with potential adverse effects) should be confirmed by prescribing physician.  Because of rapid advances in the medical sciences, the gutsandgrowth blog cautions that independent verification should be made of diagnosis and drug dosages. The reader is solely responsible for the conduct of any suggested test or procedure.  This content is not a substitute for medical advice, diagnosis or treatment provided by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a condition

Curcumin Was NOT Effective For Post-operative Crohn’s Disease, Goldman Sachs Take on Masks

NBC/NY Link: Goldman Sachs Says National Mask Mandate Could Slash Infections, Save Economy From 5% Hit


Briefly noted: G Bommelear et al. Clin Gastroenterol Hepatol; 2020; 18: 1553-60. Oral Curcumin No More Effective Than Placebo in Preventing Recurrence of Crohn’s Disease After Surgery in a Randomized Controlled Trial

Methods:

  • Double-blind randomized controlled trial at 8 referral centers in France, from October 2014 through January 2018, with 62 consecutive patients with CD undergoing bowel resection.
  • Patients received azathioprine (2.5 mg/kg) and were randomly assigned to groups given oral curcumin (3 g/day; n = 31) or an identical placebo (n = 31) for 6 months, and were then evaluated by colonoscopy.
  • The primary endpoint: postoperative recurrence of CD in each group (Rutgeerts’ index score ≥i2) at month 6

Key findings:

  • Postoperative recurrence at 6 months: (Rutgeerts’ index score ≥i2): 58% receiving curcumin vs 68% receiving placebo (P = .60).
  • Severe recurrence: 55% receiving Curcumin 55%vs 26% receiving placebo –had a severe recurrence of CD (Rutgeerts’ index score ≥i3) (P = .034).
  • Clinical recurrence of CD (CD activity index score >150) at 6 months: 30% with curcumin compared with 45%  receiving placebo (P = .80)

My take: Curcumin was ineffective in preventing recurrent post-operative Crohn’s disease

Related blog posts:

 

Weekend News: Elevators, Maskne, Fraudulent Mask Exemptions, Vaccine Optimism, and Taking Healthcare from Millions

Weekend News:

:NY Times: Maskne Is the New Acne, and Here’s What Is Causing It

Maskne — the most common kind of which is acne mechanica, a.k.a. the type of acne a football player may get where the helmet rubs — is also enough of a thing that the Covid-19 task force of the American Academy of Dermatology (A.A.D.) felt compelled to release advice on the subject.

The article describes how mask can trigger acne and ways to prevent/treat this.

Related: American Academy of Dermatology: 9 WAYS TO PREVENT FACE-MASK SKIN PROBLEMS

NY Times: Don’t Whistle on the Elevator. Don’t Even Talk. (print version article title)

“The good news is: If you don’t like small talk in the elevator, those days are over,”…“Imagine if you have a 30-story office building in New York City and you’re trying to get 5,000 people in between 7 and 9 in the morning,”

From NPR:

This administration should present its ‘plan’ and pass it before taking healthcare insurance from millions.

 

Data on Mask Efficacy and COVID-19 Safety –How U.S. Compares

According to this ranking, U.S. is 58th in the world:

From Health Affairs, Full Text: Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US

Related blog posts:

Pandemic Is NOT Taking a Summer Holiday

More data indicate that the coronavirus pandemic is NOT taking a summer holiday.  Projections from IHME indicate that Georgia is likely to have 4 times as many deaths by October (~2500 to  >10,000) and Florida 6 times as many (~3000 to >18,000) due to COVID-19. If projections do not worsen, the U.S. will still have more than 200,000 deaths by October.

In Europe which had at one point accounted for ~80% of new infections, the daily toll is ~10%. From Financial Times website:

From Financial Times website

From Financial Times website

From CNN/Johns Hopkins

NPR: Younger Adults Are Increasingly Testing Positive for Coronavirus

The fact that younger adults account for a large fraction of the new cases is likely a significant reason why the number of daily deaths has not spiked (& improved).

Data from Broward County, FL

Related blog posts:

Need/Benefit of Widespread Use of Masks

NPR interview (5 minutes) with Atul Gawande: How The Widespread Mask Use Could Slow The Coronavirus Pandemic

“NPR’s Mary Louise Kelly talks with Dr. Atul Gawande, a staff writer for the New Yorker, about the efficacy of different face masks and why masks remain essential in dealing with the coronavirus”


Proceedings of the Royal Society A. Published: https://doi.org/10.1098/rspa.2020.0376 Full Text Link: A modelling framework to assess the likely effectiveness of facemasks in combination with ‘lock-down’ in managing the COVID-19 pandemic

Related blog posts:

 

Eight States with Increasing COVID-19 Problems

States with unfavorable trends: Arizona, Arkansas, Florida, North Carolina, South Carolina, Tennessee, Texas, and Utah.  From Eric Topol Twitter feed:

Also recent modeling indicates that face masks lower transmission rate –from Reuters: Widespread mask-wearing could prevent COVID-19 second waves: study

Related blog posts:

Wired: When Health Care Moves Online, Many Patients Are Left Behind

Wired: When Health Care Moves Online, Many Patients Are Left Behind

An excerpt:
Amid the coronavirus pandemic, more of the nation’s medical care is being delivered by telephone or videoconference, as in-person care becomes a last resort for both doctors and patients. That’s a problem for tens of millions of Americans without smartphones or speedy home internet connections. For them, the digital divide is exacerbating preexisting disparities in access to health care…

Overall, as many as 157.3 million people in the US only have access to substandard download speeds. During the pandemic, roughly half of low-income American say they’re concerned about affording to pay their broadband and smartphone bills, according to April Pew Research data. In rural areas (where Pew figures suggest only 63 percent of residents have home broadband subscriptions), phone calls might be patients’ best option.

Related blog post: #NASPGHAN19 Impact of New Technology