Posted in coronavirus, Covid-19, Health, medications, news

Is Xanax The Next Coronavirus “Cure”?

Researchers from Barcelona plan to study a slew of medications that they believe could stop the SARS-CoV-2 virus from replicating in human cells.

These medications include:

  • Perampanel (antiseizure)
  • Carprofen (antiiflammatory)
  • Celecoxib (antiinflammatory)
  • Alprazolam (antianxiety)
  • Trovafloxacin (antibiotic)
  • Sarafloxacin (antibiotic)
  • Ethyl biscoumacetate (anticoagulant)

They are evaluating the M-pro enzyme inhibition activity that some medications such as alprazolam (brand name Xanax) may possess to inhibit COVID infection.

They state, “Here, we implement an original virtual screening (VS) protocol for repositioning approved drugs in order to predict which of them could inhibit the main protease of the virus (M-pro), a key target for antiviral drugs given its essential role in the virus’ replication. Two different libraries of approved drugs were docked against the structure of M-pro using Glide, FRED and AutoDock Vina, and only the equivalent high affinity binding modes predicted simultaneously by the three docking programs were considered to correspond to bioactive poses.”

As researchers study these drugs, we need be patient to see if there is conclusive evidence that these medications could work in fighting the deadly virus.

Alprazolam belongs to the benzodiazepine family and is used by millions for anxiety and sleep disorders. Unfortunately it’s one of the more highly addictive types of medications and its dependence has been rising for decades.

Benzodiazepine Abuse Being Overlooked

Initial reports of hydroxychloroquine efficacy in treating COVID led some, including President Trump, to take the medication prophylactically. However, medications such as those to be studied by the Barcelona scientists have multiple side effects and possible addictive potential and should not be taken unless prescribed by one’s medical provider once research points to their use and safety in treating COVID-19.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in coronavirus, Covid-19, economy, Employment, Health, news

Did Your Period Change During the Lockdown? Here’s Why…..

Many women have reported their periods have been irregular since the start of the pandemic, not surprisingly though as 2020 has been one of the most unpredictable years yet.

However, some feel it’s because they lack the “syncing” that occurs when women are around other women, such as in the workplace.

The theory of women who live or work together subsequently menstruate the same time during the month has been suggested for centuries. In 1971, Dr. Martha McClintock from the Department of Psychology in Harvard tested this theory on 135 females from a college dorm and found a “significant increase in synchronization” in college roommates and/or their best friends as it pertained to their monthly cycle. This was called the “McClintock” effect.

However multiple studies since then have debunked this theory finding no major evidence of menses syncing among women who are in close proximity to each other.

So if being separated from one’s coworkers is not the cause, why would periods change?

Menstrual cycles can vary in regularity due to multiple factors. These include:

  • Stress
  • Change in exercise
  • Change in diet
  • Change in weight
  • Thyroid disorders – or issues with taking one’s medication regularly
  • Sexual activity
  • Pregnancy
  • Hormonal disorders such as polycystic ovarian syndrome

For those who had strict work, eating and exercise schedules, lockdowns prevented gym attendance and allowed for more stay-at-home-and-eat-activity.

Moreover fear of COVID, being layed off and trying to teach and entertain the kids who would have been in school all these weeks added copious amounts of stress in a short period of time.

Cycles may come every 21-35 days with a 2-7 day menstrual flow. Some women are able to consistently predict the day and time of their next period, whereas others venture a guess that could range up to a week. So menstrual cycle changes are not that uncommon throughout a woman’s reproductive years. However, if one becomes irregular after months of regularity, skips a cycle or finds their bleeding to change significantly, this should prompt an evaluation by their medical provider.

Will returning to work get you back on your schedule? It could, but then again, it could be your “new normal”…..Either way, don’t expect your female work comrades to sync your cycle anytime soon.

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in coronavirus, Covid-19, economy, Education, Employment, Health, news, Politics, school

Trump Vows Another Shutdown Will Not Occur In the Fall – But Does He Have Control?

Image above from AP/Getty Images

Speaking at a Ford plant in Ypsilanti, Michigan, President Donald Trump vowed he would not allow the country to shut down again if a second wave of COVID plagues us this Fall.

He stated, We are going to put out the fires. We’re not going to close the country. We can put out the fires.”

Although his optimism was applauded by many who have found the economic downturn from months of business closures to be irreparable, many wonder if he actually has control of stopping a second country shutdown.

In early March the Trump administration tried to contain the panic, and keep businesses open, however other powers were at play.

Schools closed down first. With school closures, many employees could not leave their children unattended and needed to stay home.

Then traffic to many businesses slowed, as many chose to “shelter in place” for fear of being exposed to COVID-19. Employees of businesses chose to stay home as well in fear of exposing vulnerable family members to the virus.

Then as death tolls were reported, Governors began to institute stay at home orders and business closures.

As businesses reopen and schools ready for the new school year, many teachers and parents are preparing for a bumpy road ahead.

Even if a COVID second wave spares us, influenza is notorious for causing death, and each year takes its toll on the pediatric population.

Concerned parents may easily call for school closure and online learning because of flu, COVID, school shootings, or any other issues that could tragically affect children.

If schools close this Fall for any reason, employees will be forced to stay home and the cycle can occur all over.

Many businesses are transitioning to work from home models, however many businesses still require traffic and in person customer service such as restaurants, salons, movie theaters, shops, etc.

I believe our healthcare system will, as Pres. Trump suggests, be able to address new COVID cases, however, whether the administration will have the ability to mitigate the panic or calls for business shutdown is entirely another issue.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in coronavirus, Covid-19, fires, Health, news, travel

If Hand Sanitizer is “Flammable” Should TSA Be Allowing Larger Bottles on Airplanes?

A recent debate has surfaced whether hand sanitizers can explode in one’s car due to the summer heat.

Then this week, the TSA has announced new rules regarding air travel that allows each traveler to carry a 12 oz bottle onto a plane.

One box of matches or a lighter is allowed per person onboard an aircraft according to the FAA.

One book/packet of matches in carry-on or on the person. When a carry-on bag is checked at the gate or at planeside, any matches in the carry-on must be removed from the bag and kept with the passenger in the aircraft cabin. Strike-anywhere matches are forbidden.

Disposable and Zippo lighters are allowed on one’s person per the TSA as well.

So questions remain, will there be a risk of an accident or terrorist attack while in flight?

Some FAA experts believe alcohol-based sanitizers can ignite if exposed to high temperatures.

In 2010, however, a flammability test performed by the FAA found the following:

As expected, the hand sanitizer, which is approximately 60% alcohol by volume, is flammable and can easily be ignited with a common grill lighter when poured into a pan. It tends to burn relatively coolly, with peak flame temperatures between 500° and 1000°F, compared to fuel, plastic, or cellulose fires. The observed temperatures above the flame were higher for the liquid hand sanitizer compared to the gel hand sanitizer. The vapor, which is generated by heating the liquid from the bottom, is flammable. The hot liquid does not have to be present to ignite the vapor; however, the vapor could not be ignited at room or elevated ambient temperatures (up to 100°F) without bottom-heating the hand sanitizer.

So whereas a car may only reach 170 degrees, an explosion would be more likely if a bottle of sanitizer was exposed to higher temperatures such as from a flame.

Multiple sites demonstrate how kids can perform sanitizer fire tricks in their home.

Although the sites say the flame is “cool enough to touch” its still flammable and fire plus hand sanitizer means more fire.

The FAA and TSA may, therefore, need more rigorous safety protocols as it pertains to matches and lighters on planes.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in coronavirus, Covid-19, disease, dogs, Health, news, travel

Dogs To Be Trained To Sniff Out COVID At Airports

The UK is planning a trial in which dogs will be trained to determine if someone has COVID, even if they are asymptomatic.

When a person is infected with a pathogen, be it bacteria, virus or fungus, they may elicit an odor. Researchers from London School of Hygiene and Tropical Medicine (LSHTM) in collaboration with Medical Detection Dogs and Durham University will train the canines to learn the smell taken from samples of hospitalized patients.

If all goes well, the UK may have a team of dogs ready to screen travelers coming into their country within 6 months. Euronews reports that the dogs could potentially screen up to 250 passengers an hour.

We assume authorities would then test the potential COVID patient by conventional antigen testing, but the screening process may allow countries to open their borders sooner than anticipated.

Can pets detect cancer?

PBS reports that dogs can smell 40 times better than humans, with over 300 million olfactory receptors in their nose.  They can smell parts per trillion, a keen sense that is potentially sharp enough to pick up cancer cells and the smells they produce.

Healthline reports that cancer cells raise polyamine levels which come with an odor.  Moreover if cancer cells incite an immune response, this can expel a scent as well.

In 1989 a case report revealed a woman’s dog tried to bite a mole off her leg which ended up being malignant melanoma.

According to a 2011 study in the journal Gut, Labrador retrievers were able to sniff out colon cancer in 97% of stool samples.

The Italian Ministry of Defense’s Military Veterinary Center was successful in training German Shepherds to recognize prostate cancer proteins in urine to 98% accuracy.

For those of you with a pet pigeon, don’t feel left out. A University of Iowa study found pigeons to be trained to detect breast cancer cells to 85% accuracy.

So despite our animals possessing the power to sense microscopic anomalies, we shouldn’t panic every time they sniff or lick us.  But if they persist on one area of your body, it might be worth getting checked out.

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in coronavirus, Covid-19, economy, Employment, Health, masks, news

Business “Mask and Social Distancing Requirement” Puts Employees at Risk of Customer Violence

In early May, a security guard was shot when he asked a customer at a Michigan Family Dollar store to wear a mask per company policy.

One week later a shooting occurred at a McDonald’s in Oklahoma City because a customer was asked to leave when she wasn’t following social distancing guidelines.  Three employees needed to be taken to the hospital but all recovered.

Then last week, an Aurora, Colorado Waffle House customer allegedly shot a cook when asked to wear a face mask or risk not being served.

Employees who work for small businesses who are struggling to follow the new reopening restrictions are putting their lives at risk when a person with mental illness does not want to follow the new laws.

Government officials may not be aware that “laws” being implemented need assistance when it comes to enforcement and the average restaurant or store does not have a security detail to protect their employees and other customers if someone doesn’t want to follow the new laws.

“Refusing service” can trigger one with mental illness to turn violent.  Rejection, accosting, and negative interactions can be perceived as “attacks”, putting an employee who is not trained in tactical movements or negotiation at risk.

A video has gone viral of a Costco employee asking a customer to put on his mask. The customer was not violent but refused to wear one, so his shopping cart was confiscated. Fortunately the altercation ended there, but do altercations need to happen in the first place?

costco-tison-1589985758

If an employee feels a customer is beginning to get angry they should:

  • Not engage the customer
  • Get a manager or someone designated to deal with customer complaints
  • Contact local authorities or call 911 if they feel they are at risk of being harmed

Most government officials will not close a business down if the incident (in which an altercation was diffused by providing service) was documented and reported.

When laws and ways of life change quickly and rules are forced on already stressed employees and customers, chaos can ensue.  State and government officials need to be aware of the consequences that can result without proper guidance in how to execute these rapidly changing rules.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

Posted in coronavirus, Covid-19, economy, environment, Health, news

Most COVID Reopening Guidelines May NOT Be Environmentally Friendly…..Then What?

After decades of recycling and limiting pollutants in our air, the US population has been forced to make a 180 degree turn to prevent COVID spread in their workspace.

Disinfectant sprays, disposable paper products and plastic barriers are now at the forefront of most businesses’ reopening strategies.

Lysol disinfectant spray, touted by the CDC as effective against fighting COVID, has received an “F” rating by the Environmental Working Group for its effects on the environment and human body as it contains “MIPA-Borate, Ammonium hydroxide and petroleum gases.”

lysol 2

Plexiglass, being used by salons and casinos as a barrier between customers, contains methyl methacrylate (MMA), which can accumulate short term in a local environment but are not theorized to cause long term damage.

Some restaurants are turning to paper menus rather than cleaning reusable ones, so as to discard each after use.

trees

And don’t get me started on the toilet paper apocalypse…..

Brick and mortar stores who have turned to online sales while forced to shut down are utilizing exponential amounts of boxes for packaging.

Customers waiting to be seated at a restaurant or salon need to wait outside or sit in their car.  During the summer months, cars will need to be turned on and idle to as to allow air conditioning during the wait. This produces more emissions.

So our paper, plastic and aerosol use has exploded in such a short period of time, causing business owners to wonder, will these methods need to be reversed once environmental experts sound the alarm?

I suggest before businesses invest in thousands of dollars of products they may be forced to abandon in the near future to try to aim for “environmentally friendly” solutions if they can.  Not easy, but it could be a mess if both the COVID and Environmental “crises” collide…

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

 

Posted in coronavirus, Covid-19, Employment, Health, news

Do N95 Respirators and Facial Masks Cause Respiratory Difficulty?

With the CDC’s (Center for Disease Control’s) recommendation to cover one’s face to prevent the spread of coronavirus, and state official’s guidelines on returning to work, many Americans are searching for ways to cover their nose and mouth throughout their eight to twelve hour shift.  Some are able to access top of the line masks such as the N95 respirators while some have made and used decorative cloth face coverings.

However, mask fatigue and reports of “difficulty breathing” while wearing a facial covering begs the question, “are some of us losing oxygen or building up carbon dioxide while wearing a mask?”

Mask Fatigue: Do Workers Need “Mask Breaks?”

Last month a car accident in New Jersey was reported when a driver, wearing an N95 mask, became syncopal and passed out, “crashing” the vehicle.  The report was later revised as authorities believed it could have been a “contributing factor” to the accident. The driver was treated for non life-threatening injuries.

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 varies depending on the materials used.

Mask-Materials-Effectiveness-1-Micron-EN-1024x744

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 is easily managed while wearing a properly fitted N95 mask.

In breathing, we inhale air, extracting the oxygen in our lungs, while exhaling carbon dioxide, a byproduct from the body’s metabolism.

However, some people may require less of a barrier in order to get the oxygen requirement they need.  These individuals include those who may suffer from heart conditions or respiratory illnesses, such as emphysema and COPD. They may breathe too shallowly, not releasing the carbon dioxide that has accumulated.

If one has difficulty releasing the carbon dioxide they build up, they can become hyercapneic.  Hypercapnea is a condition where one may present with headaches, dizziness, fatigue, shortness of breath, difficulty focusing and if severe can cause muscle twitching, confusion, abnormal heart beats, seizures and fainting.

In 2006, a study of 212 healthcare workers found 37.3% to suffer from N95 mask related headaches, most of whom reported an average of 6 a month. Authors concluded that continuous use of mask wearing (approximately 4 hours) could induce headaches and shorter durations of use may mitigate the frequency and severity of the risk.

Infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security in Maryland, told Health, “Someone wearing an N95 mask for a prolonged period of time may have alterations in their blood chemistry that could lead to changes in level of consciousness if severe.”

Studies could be designed to give more conclusive data on blood oxygen and carbon dioxide level changes as one wears a mask for certain periods of time, but for now, we don’t have definitive guidance on how long a mask should be worn to prevent hyercapneic symptoms. We are, however, urged to wear masks to prevent our spread of germs.

Therefore, for those who may be susceptible to breathing issues and are working long shifts that require facial coverings to be worn, I suggest speaking with one’s medical provider as management may be needed for their respiratory and/or cardiac condition.  Mask breaks can also be an option. Mask breaks can occur outside or in “safe rooms” that are not open to the public to allow one to get some uninhibited air before replacing the mask and returning to one’s work.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in coronavirus, Covid-19, economy, food, Health, news, Politics

Casino Restaurants Allowed to Reopen, But Many Won’t Be Able to…Here’s Why

Although gaming and casinos are still closed in Nevada, their restaurants have been given the green light to reopen with restrictions.

According to the Nevada Control Board and Gaming Commission, restaurants can reopen in the current Phase 1 if they follow the following requirements:

 The restaurant complies with the requirements set forth on page 8 (below) of the industry-specific guidance for food establishments, published by the Governor’s Office, found here (below).
 The gaming licensee must confirm with the Gaming Control Board whether there is a separate entrance for the restaurant, apart from any entrance to the restaurant off the gaming floor. If there is not a separate entrance for the restaurant, the licensee must articulate to the Board how it will ensure that patrons are only able to enter the restaurant from inside the property without
traversing the gaming floor.
 If there is no restroom inside the restaurant, the licensee must articulate to the Board how it will ensure that patrons may enter restrooms outside of the restaurant without traversing the gaming floor.
 The licensee must confirm that it will comply with any directives or orders issued by its county commission or health district that enact more restrictive measures on reopening.
 If a licensee wishes to open a restaurant pursuant to these restrictions in a county with a population of 100,000 or more, the licensee must provide the Board with a plan by which it will prevent customers from congregating outside of the restaurant prior to entry

Page 8 of Guidelines

roadmap restaurants

Although many restaurants are now working to schedule staff, set menus and adhere to guidelines, others feel they need to wait until restrictions ease up.  Why?

Many restaurants were designed to be focal points in their respective casinos, helping choreographic traffic around the gaming floor and advertisements.  If they cannot direct traffic to a restroom or their entrance without traversing the casino by which they’re built and deeply rooted, they cannot open.

Many casino restaurants are patroned by visitors, or those staying in the hotels.  Tourism has been severely affected by the pandemic and surrounding shutdowns.  Hotels are still closed to the public.  Many of these restaurants will then need to rely on local traffic.  Although locals do frequent casino restaurants, they have been slow to do so thus far with their neighborhood establishments.  There is no guarantee they will drive to the Resort Corridor for dining alone.

Those with outside access must keep lines from forming.  If their front door is street front, Las Vegas Boulevard traffic could be dangerous for some trying to social distance from others on the sidewalk.

With such short notice, food and supplies need to be ordered for an unpredictable  clientele number that can vary depending on coronavirus concern or reservation availability.

Moreover, work stations must ensure 6 feet of social distancing. However the average kitchen may not have the square footage to accommodate large areas between staff, unless less staff are on site. Less staff means less orders are able to be filled.

Alsco-AU-greenroom-articles-busy-kitchen

Maximum occupancy for onsite dining must be 50% of the maximum seating capacity, which means the restaurant’s profit margin gets cut considerably.

So restaurants need to weigh whether a restricted opening will put them at a loss or in trouble with the Nevada Gaming Board if they try to make their opening highly profitable.  Some will try to serve the public in an attempt to reopen Nevada but many will unfortunately have to sit this one out.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

Posted in coronavirus, Covid-19, Health, news, Politics

Who Takes Over if President Trump and Vice President Pence Get COVID?

Two members of the White House staff tested positive for coronavirus, including an aide to the Vice President, and the West Wing is now donning facial masks.  Some White House officials, including Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), have gone into quarantine after potential exposure.  Which leaves the question, if both the President and Vice President of the United States become incapacitated with Coronavirus, who takes over?

When UK Prime Minister Boris Johnson came down with COVID, he, for a short period of time, was in the intensive care unit, and with no deputy leader in place to assume the role, Foreign Secretary Dominic Raab took over responsibilities.

In the US, if the President in unable to serve as Commander in Chief, per Article II, Section 1, Clause 6 of the Constitution, the Vice President assumes the role.

Article II, Section 1, Clause 6:

In Case of the Removal of the President from Office, or of his Death, Resignation, or Inability to discharge the Powers and Duties of the said Office, the Same shall devolve on the Vice President, and the Congress may by law provide for the Case of Removal, Death, Resignation or Inability, both of the President and Vice President, declaring what Officer shall then act as President, and such Officer shall act accordingly, until the Disability be removed, or a President shall be elected.

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The 25th Amendment, Section 3, however, takes this deeper:

Whenever the President transmits to the President pro tempore of the Senate and the Speaker of the House of Representatives his written declaration that he is unable to discharge the powers and duties of his office, and until he transmits to them a written declaration to the contrary, such powers and duties shall be discharged by the Vice President as Acting President.

and specifies how the President can return to duty once well in Section 4:

….when the President transmits to the President pro tempore of the Senate and the Speaker of the House of Representatives his written declaration that no inability exists, he shall resume the powers and duties of his office unless the Vice President and a majority of either the principal officers of the executive department or of such other body as Congress may by law provide, transmit within four days to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office. Thereupon Congress shall decide the issue, assembling within forty-eight hours for that purpose if not in session. 

Deciding who succeeds the Vice President, however, has not been so clear cut throughout the centuries.

In 1792, the Presidential Succession Act was passed, putting the president pro tempore, followed by the House Speaker in charge if the office of Vice President was vacant.

Then in 1886, Congress substituted their members from the line of succession with the Secretary of State and Cabinet members.

Then in 1947, Congress revised the order of succession by adding the Speaker of the House and Senate president pro tempore ahead of the Cabinet members.

So the succession list currently looks like this:

  • Vice President Mike Pence
  • Speaker of the House Nancy Pelosi
  • Senate president pro tempore Chuck Grassley
  • Secretary of State Mike Pompeo
  • Secretary of the Treasury Steve Mnuchin
  • Secretary of Defense Mark Esper
  • Attorney General William Barr

and continues with the various Cabinet members/Executive department heads.

Debate, however will ensue over the definition of “Inability” and if the President or Vice President can still hold office while fighting COVID.

Additionally, legal experts have wrestled with the term “Officer” and if that excludes Congressional leaders from holding another office per the verbiage from Article I:

No Senator or Representative shall, during the Time for which he was elected, be appointed to any civil Office under the Authority of the United States, which shall have been created, or the Emoluments whereof shall have been increased during such time; and no Person holding any Office under the United States, shall be a Member of either House during his Continuance in Office.

Would this mean that Nancy Pelosi, as Speaker of the House, would have to resign her position to be able to take over as Commander in Chief?

So in conclusion, if President Trump and Vice President Pence become exposed and ill with COVID-19 and there are no clear cut parameters as to what constitutes their “inability” (assuming they aren’t intubated) and if a member of Congress cannot officially take an executive branch role, the fight for control of the White House could be messier than any election we’ve seen thus far…..

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.