Post#131 » by mcmurphy » Sun Mar 29, 2020 9:07 am
A great and simple resume done by a Italian Specialist in Anesthesia and Resuscitation about Covid-19 (quickly translated with Google translator):
- Viruses are microparticles, about a hundred times smaller than a bacterium. For this reason they are not visible under the optical microscope (the normal one to indent us), but only the electronic one.
- viruses have an extremely simple structure: they contain filaments of genes (in the form of DNA or RNA), which are enclosed by a protein shell (càpside), around which a layer of fat is (often but not always) (phospholipids). Coronavirus this fat envelope has it.
- viruses don't have a metabolism. They don't move. They are there, capable of infecting only if transported / conveyed. They do not reproduce / multiply if they do not have a cell to infect.
- Who are Coronaviruses transported by? From humans (the virus is contained in water vapor droplets emitted during normal exhalation, sneezing, coughing and stool) and some materials
- if the virus stops being transported (this is the very important meaning of the quarantine) it ceases to infect.
- viruses (in general) can infect cells (that is, they penetrate them) of an animal, vegetable and, sometimes, they also infect bacteria. They are real cellular parasites.
- SARS-CoV-2 is the seventh Coronavirus to have been identified.
- Coronavirus is an RNA virus. Do you know those beautiful (not kidding!) Images of the viral particle on whose surface you see all those "tacks"? Here, those nails are very important proteins, the so-called glycoproteins, necessary for the virus to interact with the cell to be infected (if the cell in turn does not have certain glycoproteins on its surface, the virus cannot infect it => see innate immunity against HIV in subjects who do not express CCR5 glycoprotein on lymphocytes)
- what do viruses do once they enter the cell? They reproduce: some by exploiting the metabolism and cell organelles of the infected cell, others by inserting their own genes among the genes of the host (ie infected) cell. Multiplication of the virus equates to an increase in its pathogenicity (aggressiveness) for the organism.
- Coronavirus favors respiratory cells (that's why CoViD19 gives a clinical picture that varies from dry cough in mild cases to very severe pneumonia in cases requiring intubation, mechanical ventilation and intensive care unit).
- Coronavirus also has an affinity for some nerve cells, which is why anosmia and ageusia occur in some individuals (loss of sense of smell and taste respectively)
- Viral particles that have not reached (i.e. have not been transported to) the target cell (the one to be infected) decay / denature / disintegrate. The spontaneous denaturation time depends on / is influenced by various factors: temperature, humidity, material from which the surface on which the virus is found is made. On porous surfaces it disintegrates within 3 hours, on copper after about 4 hours, on cardboard after about 24 hours, on metal after about 42 hours, on plastic after about 72 hours.
- Coronavirus subjected to temperatures of 70 celsius grasps disintegrates. A disintegrated virus is no longer infectious.
- what are you interested in then?
- know that Coronavirus penetrates the body through some main ports, namely mouth, nose, eyes. That's why the need not to touch your face with potentially contaminated hands.
And that's why the importance of the mask.
- The FFP2 and FFP3 masks protect you from viruses in case you are negative; these masks have a "life" of about 6-8 hours after which the filter "runs out" and the mask itself, if badly handled, can carry the virus. They must also be worn perfectly on the face, the beard reduces its protective effect.
- Normal surgical masks do not protect you from the virus, but if we all wear it, we reduce the emission of water vapor droplets, protecting each other. In addition, the surgical mask protects us from bacterial infections affecting the respiratory system. If we avoid bacterial infections we make sure that our immune system remains strong, how to say, we keep it healthy to cope with Coronavirus, in case we become infected.
- Alcoholic disinfectants containing between 90% and 100% ethanol or those containing at least 30 grams of propanol are virucidal.
- Why is it said that it is enough to wash your hands with soap? Because the old and dear chemical rule "grease washes grease" applies. Soap is a fat that dissolves the fatty tissue of the viruses mentioned above.
- how should you behave in everyday life? Simple: go out wearing a mask and gloves, avoiding watches. You have to stay focused: when you have a mask and gloves your hands should not touch your face. Much less you have to use your cell phone with gloves. Well yes, we have to get used to leaving the phone at home, that is to live as pre-smartphones at the time. Hurry up your errands you will go home, take off your gloves, wash your hands with soap, take off your mask taking care not to touch the external surface (which is the one that possibly comes into contact with the virus). At that point you will relax your hands and enjoy the relaxation of your home. The objects in your apartment are not contaminated (if you have followed the rules above), the virus does not enter through the window! So please ventilate the premises is a must.
- the mask should be thrown away !!! If you don't have hundreds of them, spray the outside with alcoholic disinfectant (without moistening it too much!) Always taking care not to touch the outside with your hands.
- reuse of gloves needless to talk about it!
- how should you behave if you receive parcels or food at home? Open with mask and gloves, keep away from the courier, ask that the goods be placed on the ground. Collect it, bring it inside and, again with a mask and how many, disinfect it.
- personally I find the use of steam (vaporetto et similia) very suitable for the purpose. You can disinfect parcels and groceries (water vapor has a temperature of 100 or more degrees Celsius).
- always observe the safety distance of at least 1.5 meters, even with friends! for couples and families the speech is worth very little.
- washing your hands often and using disinfectants often damages the skin and its lipid layer. So if on the one hand the disinfectant kills bacteria and viruses on your skin, on the other it damages the hands making them more exposed to infections. Here is the importance of moisturizers (we also use them who work in the operating room;))
- keep your nails short
- the general rules of the grandmother are always valid: zinc at high concentrations (for example 25 mg per day) and vitamin c (of which they are rich for example raw peppers) support the immune system (no, I am not talking about hoax of the high buffalo doses of Vitamin C to counteract the acute phase of disease)
- if you become infected and develop a mild form that does not require hospitalization, you can also use paracetamol and also IBUPROFENE as antipyretics, remembering that ibuprofen also acts as an anti-inflammatory.
- quitting smoking would be an advantage however (I omit the discussion on the likely lower incidence of CoViD19 in smokers because there are insufficient data. For now it seems to be a mere clinical observation)
- if you want to rinse and gargle you can use 3% hydrogen peroxide diluted with water (attention: very unpleasant taste). It is implied that the mixture should not be swallowed / drunk (is it?).
- I believe there are explanatory videos on youtube showing how to effectively disinfect / wash your hands. The sequence of movements is not so obvious, which is why I recommend that you take a look at them.
- smile and breathe
Dr. Spiga
(Specialist in Anesthesia and Resuscitation)