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By Peter Greaney, M.D.
Since I wrote my previous blog post about an unknown reservoir in connection with the spread of coronavirus (COVID-19), new developments in the intervening period have helped shed light on the situation.
Fecal transmission, as with SARS through hand-mouth contamination, apparently played a significant role in the recent cruise ship epidemic that required passenger quarantines. Apart from this, there is evidence that person-to-person transmission requires close or intimate contact with an infected person’s body fluids such as droplets from coughing or sneezing, or by touching surfaces that an infected person has coughed or sneezed on.
Close contact is defined as either face-to-face contact or spending more than 15 minutes within about six feet of an infected person.
Good hygiene (e.g., frequent hand washing, covering coughs and sneezes and throwing tissues away) is our BEST line of defense. The risk of transmission through casual contact is low. SOCIAL DISTANCING works.
There are still a lot of unknowns as to why COVID-19 spread so easily in Wuhan, China, and why the death rate there is apparently higher than it is in the rest of world. The answer may depend on environmental or genetic factors. For example, air pollution in Wuhan might play a role in allowing viral particles to remain suspended for longer periods, or there could be genetic factors that increase susceptibility and death rates in Asian populations.
Some scientists have suggested that cells lining the surface of the respiratory tract and lungs of Asians contain higher concentrations of prostaglandins and two distinct isoenzymes (COX 1 and COX 2). These mediators are involved in various physiological pathways. Higher concentrations in some people may allow greater opportunity for corona viruses, in general, and COVID-19 specifically to bind and penetrate the cell, in turn increasing infection and death rates.
Is there a role for COX inhibitors like Ibuprofen in prevention? Only time will tell.
Dr. Greaney is Executive Chairman and Chief Medical Officer at WorkCare.
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