The SARS-CoV-2 virus has not gone away as hoped and is now ravaging young adult communities.
What once was considered a “65 and older” disease, more and more young adults are reporting symptoms of severe COVID.
These include shortness of breath, fever, chest pain, body aches, cough, headache and fatigue.
Additional symptoms include nasal congestion, sore throat, loss of taste and smell, nausea, vomiting, diarrhea and rash.
As businesses struggle to remain open during the pandemic due to social distancing guidelines, employee call-outs due to illness add to the strain of staffing these businesses, thus heightening risk of closure.
In Arizona, Governor Doug Ducey ordered the closure of bars and nightclubs for 30 days as their state has seen the highest uptick in cases in the 20-44 year old age group.
In Nevada, the Department of Health and Human Services show younger individual age groups to be more affected than those over 60 years old.
In the last 7 days, those in the 20-44 year age group saw the most prominent spikes.
Why are younger adults more affected?
Firstly, many older individuals might have been exposed and infected during the first wave such that the proportions have changed now that more younger people are testing.
2. More testing is being required by employers, hence non-retired workers, who may comprise the younger population, are coming forward to get tested.
3. The virus might have mutated. Some believe it weakened, but in a sense it might have strengthened to overcome a younger, more healthy immune system.
4. Younger individuals who engaged in vaping, tobacco or marijuana use might have become a more susceptible population for a new strain of COVID.
5. Younger adults might have been more social during reopenings or taken part in mass gatherings, protests and demonstrations thereby exposing themselves more than the older, stay at home, population.
The moral: This virus is unpredictable, may mutate, and will infect various population groups leaving younger individuals just as vulnerable as older ones. Don’t let your guard down, wash your hands, keep safe distances away from others, keep up good nutrition and sleep, and seek medical care and/or testing if you feel ill.
In an effort to preserve the progress made in fighting the COVID pandemic, Governor Cuomo has signed an executive order to cut COVID health benefits for those residents who leave the state and travel to high hit areas.
States grappling with surges in COVID cases (higher than 10% positive test rate) include:
Any New York residents travelling back from these states need to self quarantine for 14 days, according to another executive order given this last week. Fines up to $10,000 could be levied according to the order.
According to the the Governor’s website, he states:
“New Yorkers have controlled the spread of this unprecedented virus by being smart and disciplined, and our progress to date is illustrated by the current low numbers of new cases and hospitalizations,” Governor Cuomo said. “But as we are seeing in other states who reopened quickly, the pandemic is far from over and we need stay vigilant. We’re prepared to do the aggressive testing and contact tracing required to slow and ultimately control any potential clusters of new cases like the one in Westchester County. If we are going to maintain the progress we’ve seen, we need everyone to take personal responsibility — that’s why I’m issuing an executive order that says any New York employee who voluntarily travels to a high-risk state will not be eligible for the COVID protections we created under paid sick leave.”
Benefits were extended for COVID related illness in March allowing paid sick leave and protection from losing one’s job. Companies with more than 100 employees are to grant 14 days sick leave and those with 11-99 employees and some (netting over $1 Million) with less than 10 employees are given 5 days sick leave.
As the multiple fires burns in Southern Nevada and Utah many residents worry what consequences could result in inhaling the smoke. Here are your questions answered.
What is in wildfire smoke?
According to the EPA, smoke emanating from forest and community fires may include any of the following:
Carbon monoxide, which competes with oxygen in the blood
Carbon dioxide, a respiratory byproduct
Acrolein – used as a pesticide
Plastics, and those byproducts after incineration
and thousands of different respiratory irritants.
According to the EPA,
Smoke is composed primarily of carbon dioxide, water vapor, carbon monoxide, particulate matter, hydrocarbons and other organic chemicals, nitrogen oxides, trace minerals and several thousand other compounds. The actual composition of smoke depends on the fuel type, the temperature of the fire, and the wind conditions. Different types of wood and vegetation are composed of varying amounts of cellulose, lignin, tannins and other polyphenolics, oils, fats, resins, waxes and starches, which produce different compounds when burned.
What symptoms may individuals experience?
Some may have no idea they are breathing in harmful compounds that could affect their lungs and heart. However, many may experience:
Racing Heart (palpitations)
Exacerbation of their lung disease including COPD, asthma, chronic bronchitis
Exacerbation of heart conditions such as angina, heart attack, and cardiac arrhythmias.
Increased susceptibility to new lung infections as well as flu
What are PM2.5s?
PM2.5 are particles less than 2.5 micrometers in diameter that are present in pollution and wildfire smoke that can penetrate deeply into the lung linings. Larger, coarse particles 10 micrometers in diameter are called PM10. Both impair lung function as they inflame the lungs and interfere with the work of alveoli that need to oxygenate the blood. Moreover the small particles can use this pathway to enter the blood stream. Although the direct health impacts of the fine particulate matter are not clearly defined it is believed that increased PM2.5 levels increase the risk of lung and heart disease as discussed above.
Symptoms may begin at levels greater than 55 µg/m3 .
Which individuals are the most at risk?
Infants and Children
Those with chronic lung disease, including asthma and emphysema
Those at risk for heart disease and stroke
Those with diabetes
Those with chronic allergies
How can residents protect themselves?
Avoiding the area of wildfires is paramount. Additionally, the following may be considered:
Avoid outdoors until air quality reports improve. Do not rely on how “clear” the air looks.
Take heed of wind and air quality advisories.
Recirculate the air in your home and car.
Keep windows closed.
Consult with your medical provider to monitor blood pressure, heart rhythm, lung function and refill any medications you may need BEFORE you feel symptoms.
Be wary of facemasks sold as PM2.5 safe as many do not protect against the very small particles. Respirator masks labelled N95 or N100 may provide SOME protection against particulates but not against the toxic fumes such as formaldehyde and acrolein.
The AAP (American Academy of Pediatrics) released a statement urging kids to be allowed this Fall to be “physically present” in school.
On their website they state that schools are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activity, among other benefits.
Schools were closed this Spring when data reflected children being able to carry the virus and expose adults, even if they were not symptomatic.
Most parents initially supported the idea of school closures and having online teaching to avoid spread of the virus to parents and grandparents.
But online learning did not appear to be as productive, and many parents feel their children learn better in a classroom environment.
The AAP agrees but only if the following benchmarks are met:
School policies must be flexible and nimble in responding to new information, and administrators must be willing to refine approaches when specific policies are not working.
It is critically important to develop strategies that can be revised and adapted depending on the level of viral transmission in the school and throughout the community and done with close communication with state and/or local public health authorities and recognizing the differences between school districts, including urban, suburban, and rural districts.
Policies should be practical, feasible, and appropriate for child and adolescent’s developmental stage.
Special considerations and accommodations to account for the diversity of youth should be made, especially for our vulnerable populations, including those who are medically fragile, live in poverty, have developmental challenges, or have special health care needs or disabilities, with the goal of safe return to school.
No child or adolescent should be excluded from school unless required in order to adhere to local public health mandates or because of unique medical needs. Pediatricians, families, and schools should partner together to collaboratively identify and develop accommodations, when needed.
School policies should be guided by supporting the overall health and well-being of all children, adolescents, their families, and their communities. These policies should be consistently communicated in languages other than English, if needed, based on the languages spoken in the community, to avoid marginalization of parents/guardians who are of limited English proficiency or do not speak English at all.
Children were one of the smallest groups affected by COVID, but some did suffer from Multisystem Inflammatory Syndrome (MIS-C), with fever, rash, and multiple organ involvement.
The AAP cites evidence that school closures are harmful to children. They state:
Lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation. This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality.
School’s however grapple with the notion that if COVID or flu cases surge this next Fall they may be forced to re-close down, again subjecting the students to abrupt, changes in learning. Some have suggested “hybrid” learning formats that include both in classroom and online learning for student safety by limiting group sizes, thus additionally easing the transition if a lockdown happens again.
As states mandate face coverings when out in public, businesses find themselves between a rock and a hard place when it comes to executing their Governor’s orders.
Although legally a business can “refuse service” to those not wearing a mask during the COVID pandemic, negative publicity will pervade social media long before an employee/business owner is able to defend their legal right.
Employees on the other hand grapple with enforcing their employers’ mandate to ensure all customers are wearing masks while being unclear as to what is allowed under the law.
Guidance therefore is needed from our state officials on how to address these delicate issues.
For example, Zahur Abdiaziz, was refused service at Marissa’s Bakery in Minneapolis when she came in wearing a hijab instead of a mask. The employee behind the counter could be heard saying “no mask no service”, appearing to not acknowledge that the hijab was covering her nose and mouth, allowed within state guidelines. The bakery has apologized and the fate of the employee has not been disclosed.
At a Trader Joe’s in Los Angeles, an unmasked woman is seen in a video posted by D. Giles, being accosted by multiple people in a store. She subsequently throws down her basked and says, “I have a breathing problem, my doctor will not let me wear a mask. So anyone harassing me to wear a mask, you guys are violating federal law.” Allegedly she was wearing a mask according to a nearby witness, prior to her entering the store, and it is unclear why she removed it.
If issues such of refusal of service to one who has an alleged medical condition become legal battles, it is currently believed that this courts will allow the face mask rule to supersede ADA mandates to not discriminate against one who suffers from a medical condition, as the mask mandate comes during a public health emergency.
Last week, however, the Department of Justice warned employers of fake exemption cards, threatening ADA violations and fines. They state, “The Department urges the public not to rely on the information contained in these postings and to visit ADA.gov for ADA information issued by the Department.”
However, employers and employees are unclear as to which decision they make could get them into more trouble, hence caught between a rock and a hard place.
Avoiding “Corona Discrimination”
Know the laws. If a mask mandate in your state allows age and medical exemptions, inform your staff and coworkers of these before an issue arises.
Offer a mask if they don’t appear or have proof of a medical condition. Your offering a facial covering, and documenting as such, provides you some protection if the state were to inspect or audit a case for non compliance.
Explain to the customer your need to show compliance to state officials if ever in question and if they could sign a small form documenting your request that they cover their nose and mouth
Have signage before one enters the store and document photographic proof of such signs (in case one takes it down).
If you do have a medical condition that precludes face mask coverings, consider having your medical provider write a note (without specifying any specific medical conditions) that you can show if asked upon requesting service.
Consider carrying a scarf. Although not the most ideal for protection, scarves are allowed under most state mandates to be used to cover nose and mouth. They can be worn easily around the neck and so if a break needs to be made to breathe or cool down, depending on what issue you may have with a facial covering, it can be easily moved up and down.
Consider having someone, who can wear a face covering, do your shopping or essential purchases for you.
The New Mexico Department of Health has reported 3 deaths, 3 in critical condition and one permanently blind after allegedly ingesting hand sanitizer that was made with methanol.
All of these cases occurred in May.
According the NMDOH website they state:
The New Mexico Department of Health (NMDOH) reports three recent deaths from methanol poisoning. In addition to the three people who died, one person is permanently blind, and three others are still in critical condition. All seven people are believed to have drunk hand sanitizer containing methanol.
The FDA last week released a warning to consumers to avoid the following brands of hand sanitizer manufactured by Eskbiochem SA de CV in Mexico, as they may contain methanol instead of ethanol and can therefore cause methanol poisoning. These include:
All-Clean Hand Sanitizer (NDC: 74589-002-01)
Esk Biochem Hand Sanitizer (NDC: 74589-007-01)
CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-008-04)
Lavar 70 Gel Hand Sanitizer (NDC: 74589-006-01)
The Good Gel Antibacterial Gel Hand Sanitizer (NDC: 74589-010-10)
CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-005-03)
CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-009-01)
CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-003-01)
Saniderm Advanced Hand Sanitizer (NDC: 74589-001-01)
Signs of methanol poisoning may include:
If anyone believes they were exposed to methanol in their hand sanitizer or are experiencing any reaction are urged to call their local Poison Control Center or 911 if having any symptoms.
Should We Be Rethinking Our Hand Sanitizer Use?
Last decade, we were warned by health experts that our obsession with hand sanitizer could threaten our existence as our use of antimicrobial gels could spur the growth of “superbugs”. Now our use appears to have jumped exponentially as a result of COVID and reopening guidelines urging “hand sanitizing” stations to be readily available.
Although proper hand washing has been urged by most health officials to help fight the spread of disease, hand sanitizers provide a convenient and quick way to “wash up” and appear to be more popular than the tedious trip to the bathroom. Hand sanitizer may have anywhere from 60-95% alcohol base, which is toxic to many pathogens. Ethanol can be an effective toxin to viruses and isopropyl alcohol is also very effective at killing bacteria. But are they the safest, wisest choice in hand hygiene?
Although hand sanitizers may be considered heroes to some, others have criticized them for the following:
They can give rise to “superbugs”
A superbug is a pathogen, most commonly bacteria, that can survive antibiotics that most species would buckle under. Its resistance could be caused by a variety of factors. Maybe it has a mutation that makes it stronger. Maybe its genetic material shields it from the toxic medicine. Maybe it’s luck. So shortly after it celebrates surviving the antibiotic assault, it divides to reproduce, making more bacteria. If this progeny bacteria maintain the same genetic material as its parent, or if included, mutation, they can be now be resistant to the antibiotics as well.
DRUG RESISTANT E. COLI – IMAGE FROM BBC
A study published in Science Tranlsational Medicine in 2018 found a multi-drug resistant strain of the bacteria, Enterococcus faecium, to be resistant to hospital grade hand sanitizers as as well.
The same can hold true with viral pathogens and fungi.
According to the CDC: Each year in the United States, at least 2.8 million people become infected with bacteria that are resistant to antibiotics and at least 35,000 people die each year as a direct result of these infections.
The bottles of “sanitizer” one comes across may have contaminants or undisclosed products
When the COVID pandemic began, consumers flocked to stores to purchase hand sanitizer and supplies ran out almost immediately. The WHO offered instructions on DIY hand sanitizer. Slowly supply is coming back but at a steep price for businesses trying to reopen.
So for those businesses eager to open up and needing ample supply of sanitizer, they may be utilizing DIY recipes.
Many business establishments have generic containers offering “hand sanitizer” that reportedly leave a smell of vodka or tequila once applied.
Reports on social media are fueling speculation that some large businesses are using alcohol to create enough supply to meet the sanitizing demands of their customers.
Name brand bottles could also be reused as many companies create their own. Hence if there is no regulation of the product and its efficacy, concerns rise as to how protective the product is.
Frequent hand sanitizer use may cause severe skin conditions
Alcohol is a desiccant, which means it dehydrates, or dries. For those of us with delicate skin or conditions such as eczema, judicious hand sanitizer use can cause painful flare ups.
Dry, cracked skin can cause a breakdown in the barrier that the skin provides, hence infection can ensue. Yep hand sanitizer designed to prevent infection can put dry skin at risk for infection.
Chemicals within some hand sanitizers could pose health risks
Fragrances or products within hand sanitizers could cause allergies or disruption in one’s metabolism. Triclosan, for example, although not used in most products today, has been known to affect thyroid hormone levels.
Many apply hand sanitizer incorrectly
For those who choose to swap hand swashing with soap and water for a couple quick pumps of hand sanitizer, they may be missing out on some good cleansing.
The process takes about 30 seconds. However, in a study released last year, researchers from the University Hospital Basel found that if all steps were taken but performed in 15 seconds, the same results will be obtained. However, if fewer steps were taken, more bacteria/viruses/pathogens would remain on the hands.
Hence if someone avoided an effective means to clean one’s hands such as hand-washing with soap and water for slip shot sanitizing they could be doing themselves and others a disservice.
There’s no doubt it’s going to take some heavy weapons to fight COVID-19….we just need to make sure the treatment is not worse than the disease itself.
New social media platform, “Parler”, is turning heads and users from Facebook and Twitter who are looking for a site that promises to be “unbiased.”
Founders John Matze and Jared Thomson from Henderson, Nevada created Parler in 2018 in response to Twitter and Facebook users being censored if their posts were considered “extreme”. Both founders have computer science degrees from the University of Denver.
They began the #Twexit campaign calling for followers to “reject censorship and exit Twitter.”
On Friday, the United States House of Representatives plans to pass a bill to make Washington D.C. the 51st state in the nation.
Additionally, the name would be changed from “District of Columbia” to “Washington, Douglass Commonwealth,” named after Frederick Douglass, Maryland-born author, social reformer, public speaker and a leader in the abolitionist movement.
America’s capital is currently home to 706,000 residents. Washington D.C. was originally established in 1800, named after both George Washington and Christopher Columbus.
The currently Republican held Senate is not expected to pass the bill, however, Democrats are hoping to gain control this next election and Joe Biden has tweeted support of the measure.
As employees return to work battling allergies, many are being sent home if they exhibit any signs or symptoms of COVID.
Initially these included cough, fever and/or shortness of breath. But as COVID positive cases were investigated and reviewed, officials found a myriad of symptoms reported by patients including nausea, diarrhea, loss of taste and sense of smell.
Last month the CDC updated their list of symptoms that could be associated with a COVID-19 infection, including runny nose and congestion.
People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness.Symptoms may appear 2-14 days after exposureto the virus. People with these symptoms may have COVID-19:
Fever or chills
Shortness of breath or difficulty breathing
Muscle or body aches
New loss of taste or smell
Congestion or runny nose
Nausea or vomiting
Severe symptoms can include chest pain, worsening breathing, change in skin color, dizziness, confusion, severe headache and more, prompting immediate medical attention.
Runny nose and congestion were incorrectly used by many patients and medical providers as “disqualifiers” that they had a COVID infection, when we needed to remind patients that COVID could manifest in a variety of symptoms. Moreover someone could suffer from allergies and COVID at the same time, so as to not exclude the viral disease based on having additional symptoms not yet listed on the CDC website.
The CDC further explains: This list does not include all possible symptoms. CDC will continue to update this list as we learn more about COVID-19.
As allergy season plagues most the nation and resurges in the Fall for many, common symptoms such as sneezing and nasal congestion can prevent many from returning to work or school, requiring isolation.
There is no clear cut way to diagnose or exclude a diagnosis of COVID without testing. Hence many employees cannot return to work until their testing proves negative or they have completed their period of isolation, despite swearing that “all I have is allergies!!”
If you suffer from allergies for months on end…..you’re not have an easy time no matter how you look at it…..
Allergies are the result of the immune response to a foreign particulate that our body senses. One could be allergic to pollen, dust, dander, food, insects, mold, metals, transfused blood, grafts, medicine and anything the body senses as a foreign intruder. Even though these may be individually harmless, a hypersensitivity reaction occurs as a result of their intrusion into the body. IgE antibodies find the allergen (intruder) and activate mast cells in the tissue and basophils in the blood. When these cells get activated, they release substances to help protect the body, including histamines, leukotrienes, and cytokines. These help the body attempt to sneeze and cough the allergen out, wall off the antigen, signal more antibodies, or produce tears and nasal secretions to flush it out.
What are symptoms of seasonal allergies?
Symptoms of allergies could include any or a combination of the following:
Congestion….. to name a few.
How do they differ from a cold?
Colds may have very similar symptoms to allergies. However they are different.
The common cold is caused by a virus. When one gets infected by the virus they may feel malaise, fever, and achy. This does not occur with allergies.
Moreover, nasal secretions from allergies are usually clear. In a cold, the mucous could be thicker and with color.
The same holds true with sputum. During an allergy the cough may have little to no mucous and if so, be light-colored. Thick mucus could be a sign of an infection.
An allergic sore throat will seem more dry and scratchy. A sore throat from a cold is more uncomfortable and less easy to soothe.
Allergies may persist or be cyclical. Cold symptoms will usually subside after a few days and rarely persist longer than 10 days.
Can allergies lead to a cold?
Yes and no. Allergies should not in and of themselves cause an infection. However they may make one more vulnerable for a virus or bacteria to take over. Hence a bronchitis, sinus infection, or pneumonia could uncommonly follow an asthma attack.
Are seasonal allergies dangerous?
As stated previously, if one is susceptible to colds, an allergic attack could make them vulnerable. Moreover if one suffers from asthma, an allergy attack could incite an asthma attack. Very rarely would we see a life threatening anaphylaxis to an allergen such as pollen.
Avoiding, or decreasing exposure to the allergen is key. We suggest the following:
Be aware of your local weather and pollen counts. If the weather begins to warm and regional vegetation is blooming, allergy season may be upon you sooner than you know.
Avoid outside pollen from coming into your house. Avoid the urge to open all the windows during Springtime as wind will bring the pollen in.
Clean your air filters. Replace air filters frequently and consider using HEPA Filters
Wash off pollen from your hair and clothes before you sit on the couch or jump into bed.
Close your car windows when you park.
“Recirculate” the air in your car
Discuss with your medical provider if you are a candidate for medications such as antihistamines, nasal corticosteroids or leukotriene antagonists.
If you suffer from respiratory illnesses or a chronic medical condition, discuss with your medical provider if you need to start your allergy medication before allergy season hits. Some of these medications may take a couple of weeks to reach therapeutic levels.
How can I find my local pollen counts?
Local tree, ragweed and grass pollen counts can be obtained here.
Requests for exemptions from face mask use have skyrocketed over the last few weeks.
Issues such as breathing difficulties, anxiety, skin irritation and panic attacks are prompting many to ask for accommodations at work.
Nevada this week joined states such as California, Oregon, Washington, Maine, Rhode Island, Kentucky, New Jersey, New Mexico, and New York in mandating use of a mask when being in public.
But many employees find the employer mandates of mask wearing too restrictive.
Employers, however, run the risk of business sanctions or closures if they don’t comply with employee mask directives. Moreover, any failure to comply with medical-related requests could put them in violation of the ADA (Americans with Disabilities Act).
What should employers/business owners do if employees do not want to wear the mask?
Both employers and employees have options.
Most state mandates exclude mask use for those who suffer medical ailments that can be exacerbated by a facial covering.
An employee can provide medical documentation from their medical provider requesting the accomodation.
An employer can also allow flexibility in face mask coverings, hence allow employees to design their own, if the ones offered through the company will not work.
An employee also can also ask to not be scheduled for shifts until the mask mandates are over. This might fall under unpaid leave, but it is still an option for those who do not want to lose their job for failure to wear a mask.
Employers can offer frequent breaks for those who get “mask fatigue”.
This week, however, the Department of Justice warned employers of fake exemption cards, threatening ADA violations and fines. They state, “The Department urges the public not to rely on the information contained in these postings and to visit ADA.gov for ADA information issued by the Department.”
Why are masks being mandated?
A mask that covers the nose and mouth provides a barrier to and from the outside environment, or from one’s mouth to others. The effectiveness of the barrier in preventing pathogen spread varies depending on the materials used and how often it is cleaned or replaced.
N95 respirators appear to be the most protective. They are designed to keep pathogens out during oxygen and carbon dioxide exchange. They are made from non-woven polypropylene fibers and they are >95% efficient at filtering 0.3-μm particles (smaller than the average 5μm particles given off during coughing and talking). Breathing can be easily managed while wearing a properly fitted N95 mask. However most state mandates allow flexibility in material choice for one’s mask.
Because studies have shown a properly fitted and worn mask to prevent the spread of some pathogens, it’s considered an extra tool in the fight against COVID as the country sees a spike in cases.