Many have postulated that secondary bacterial infections may be one culprit. Indeed, as much as we try to avoid it, many patients suffering from COVID-19 do in fact get bacterial infections in the lungs and other organs. Are these infections – and the sepsis they may cause – the reason why some COVID-19 patients die? New research just published in Nature Microbiology challenges this assertion.

Researchers from New York studied samples from the lungs of 142 patients who underwent clinically indicated bronchoscopies (cameras tests in the lungs) during their course of treatment of COVID-19. They found that – in those patients who ultimately died – the amount of virus in the lungs, known as the viral load, was significantly higher than those that survived. Moreover, the immune response in the lungs themselves was also weaker in those patients who died as well.

They did not find bacterial infection to be associated with mortality, interestingly. And the researchers did extensive analysis on the bronchoscopic samples. These findings make sense.

The more virus you have in the lung, the more viral replication occurs, and the more virus-induced destruction of lung tissue occurs. This helps explain why many patients with severe COVID-19 develop collapse of the lung requiring chest tube placement. What surprised me was the fact that it was not an exaggerated immune response that did the destroying, but the immune response was actually not strong enough in those patients that ended up dying from COVID-19.

What are the implications of these findings?

First, does this mean that suppressing the immune response may be counterproductive? Yet, steroids are recommended as first-line therapy for COVID-19 pneumonia causing hypoxia, or low oxygen levels. And the anti-inflammatory drug tociluzimab has also been shown to provide beneficial outcomes as well. Why the disconnect?

Second, if there are fewer antibodies in the lungs of those who died from COVID-19, should be we giving them antibodies – either with monoclonal antibodies or convalescent plasma – to help the immune system along? Yet, when this very thing was studied, patients who were critically ill actually did worse, and these therapies are not recommended. Again, why the disconnect?

It remains unclear. Still, these findings are very important, and they help explain why some patients succumb to this horrible illness: there is so much virus in the lungs, and all that virus overwhelms the immune response and causes extensive, and ultimately irreversible, destruction in the lungs. Several other studies have also shown that mortality corresponds to viral load, and the current investigation is further confirmation of this.

The other major takeaways of this stud for me are that, first, we need to get vaccinated against COVID-19. The patients in this study were infected early on in the pandemic, before the vaccines were available. Now, we have no excuse. Vaccines are free and widely available, and they are extremely effective at preventing the very thing from which these study patients suffered: death and/or severe illness.

Second, wear a mask. A mask helps reduce viral particles that get into your upper airway (which is why leaving the nose uncovered is counterproductive). This is especially true if everyone is masked. With less viral particles, the chance of severe infection – or perhaps even any infection – goes down.

The science on SARS CoV-2 and COVID-19 is forever changing. We are constantly learning new things about this virus and the scourge it is causing. This is ultimately a good thing. Knowledge is power, and the more we know, the more we can learn about what this virus does and how we can effectively fight against it.

The post Amount of Virus in Lungs Tied to Death from COVID-19 appeared first on Medika Life.

“If you’re going to the grocery store or you are an essential worker coming in contact with a lot of people, I recommend wearing a cotton mask over a surgical mask which can catch more than 90% of respiratory aerosols.” — Joseph Allen, Harvard University

Ever want to be a superhero? Today, it’s as simple as wearing two masks, not one, during the COVID-19 pandemic. The move from calls for simply covering your face with a bandana or a folded t-shirt has now caught up with the science. One mask isn’t sufficient to protect you and us.

The idea that a single, homemade facemask would be adequate protection was thought of as a good idea by Dr. Jerome Adams, the Surgeon General of the United States. He encouraged people to follow his demonstration of a DIY mask that was uploaded to Youtube. “With items, you can find around the house.”

Making your own masks may be the only option for some people, but here it’s a matter of quality of the material.

“If you’re making a cloth mask from 600-thread-count Egyptian cotton sheets, that’s different than making it from a cheap T-shirt that’s not very finely woven,” according to Dr. Ramzi Asfour, an infectious-disease physician.

Sorry, doc, that that ain’t good enough and it never was good enough. You tried, but it was a failed effort.

The N95 mask and other masks, used in healthcare settings and difficult to find in stores, were seen as the protection needed. But was it sufficient? Studies are now revealing that even this mask may not be adequately protective.

“…an N95 mask reduces the droplet leakage around the mask edges during the cough. However, the pressure inside the mask increases during coughs and the turbulent jet is directed through the front. Although both surgical and N95 masks decelerate the turbulent jet, none of them will prevent the droplets entirely from penetrating or escaping the mask, i.e., droplet transmission.”

Both mask leakage due to material construction and the saturation of the mask are prime factors requiring consideration in preventing droplet dispersion. Here, in the delicate interplay of weave and fiber characteristics, i.e., the smoothness or fuzziness of fiber, the true dynamics of a cough or virus spread must be calculated. While the CDC recommends cloth masks for the public, are they sufficient? Seemingly not.

What other factors besides the material of the mask must be considered? Numerous elements are brought into play, such as cough volume, droplet size, distance from an infected person, and the mask’s fit.

The mask-to -face fitting is important. Even in the case of a tight-fitting scenario, if there exist some small openings, this can lead to additional leakage of droplets around the mask, which cannot be ignored.

The Case for Doubling Masking

The case has been made for the need to wear a mask and the seriousness of transmission of a virus. Even wearing a mask, depending on the type, nothing appears to provide 100% protection, and many masks offer more than slightly 50% to the wearer.

Concern is now being expressed regarding the new variants of the COVID-19 virus, its virility, and its high transmission rate. Both of these together may indicate that a smaller quantity of material may be just as deadly or result in more infections. The secret to this increased infection by variants lies in its molecular shape, which affords a more efficient bonding and access to cells.

The N501Y mutation seems to refine the shape of the puzzle piece, allowing a tighter fit and increasing the chance of a successful infection.

Whether or not this is the case, it makes sense to increase our protection as an additional measure to maintain health. Present vaccines may prove to have decreased effectiveness in treating these new variants. Masks need to be more efficient, and therein lies the rationale for double masking.

Based on these (research) findings, we recommend a three-layer mask consisting of outer layers of a flexible, tightly woven fabric and an inner layer consisting of a material designed to filter out particles. This combination should produce an overall efficiency of >70% at the most penetrating particle size and >90% for particles 1 μm and larger if the mask fits well.

The research may not have caught up with the variants yet. Is a three-layer, single mask the solution, or should a more aggressive approach be taken? The new attack of the virus variants has been a game-changer. Seemingly, the thinking is that two masks, not one, may be the answer even if it has three layers.

The reasoning is that wearing more than one mask may inhibit the viral blobs’ pathway that reaches you. If the masks can trap those particles, you may be safe, but they remain in the mask, don’t they? This, then, makes a case for changing your mask and not continuing to carry around a mask full of viruses.

Isn’t it worth your health to change your mask and not hang on to it?

The post Not Simply Masking, But Double Masking Is Needed appeared first on Medika Life.