Coronavirus - COVID-19 CMA Briefing

We have received several questions regarding whether or not practitioners in the UK can return to work.
The most immediate way for us to keep you updated is via The Complementary Medical Association Facebook page here.  Please ensure that you check here - or The CMA Facebook page regularly to keep up to date.  Remember that we cannot provide any advice that is contrary to government guidelines.  The UK government's page to follow is here - for further guidance.

This page features our latest guidance for practitioners and training school owners/teachers on returning to work, helpful information sources and resouces and helpful information about staying safe and finally a look at the devlopment of COVID-19 since the start.  

We appreciate this this a long page housing a great deal of information, so do please feel free to print it out for easier reading.

 


 

 

 

COVID-19 coronavirus

CMA Covid-19 Guidance

Published: 19th June 2020

This document accompanies the live tutorial delivered by Jayney Goddard MSc, FCMA, FRSPH on 19th June 2020 on the topic of ‘Emerging From Lockdown and Safely Returning to Work’. 

IMPORTANT: At this extremely challenging time, where information from the government seems to change from day to day, The CMA is providing our guidance based upon our experience and high-level understanding of what constituted best practice, in this field – across a wide variety of disciplines.  At no time do suggest going against UK Government guidelines – or if you are not UK based, that you should contravene the guidelines set out by the government in your own country. The CMA cannot be held liable for any errors or omissions. CMA members must satisfy themselves that they are following and adhering to the latest official guidance in your jurisdiction.

The Complementary Medical Association has members across the world and in many countries the official lockdown is starting to ease somewhat. Governmental guidance is changing from day to day, and what we provide you with in this document is up to date at time of writing. We know that you are very keen to get back to work, if you practice any of the disciplines that have been subject to remaining closed.  This document provides you with guidance and best practice discussion points and we also provide support and discussion points for our Members who are not yet in a position to return to work – or who simply don’t feel it is right for them to do so in the near future (e.g. vulnerable or in designated ‘Shielding’ categories).

We have been inundated by CMA members asking us when they are allowed to go back to work. As you will appreciate, throughout the entire COVID-19 pandemic the Complementary Medical Association has been keeping you abreast of all the latest news – as it pertains to whether or not we can work with our clients.

Although lockdown is easing we will continue to keep you updated on this website – so do check back for updates - and of course will continue to support you in any way we can, through The CMA’s weekly newsletters, via our social media platforms, and of course by direct email messages as necessary. 

Action Points:

CMA Support for YOU!

It is important to stay connected to The CMA and we will continue to help you with growing your practice or training school with our exceptionally helpful weekly tutorials that we have provided free of charge to all our Members – and we are always here for you should you need to make contact at all.

Part of the absolute uniqueness of The CMA is that this incredible non-profit organisation is run by people who all have a complementary medical, natural therapy, science, caring and nursing background.  Therefore, when you make contact, you can be sure that we genuinely understand your issues – and we are in a position to help.

 

Steps to protect yourself – and your clients;

What follows below are CMA recommendations that are designed to help you in returning to work. Please remember though that we are not COVID-19 experts, neither are we lawyers, therefore please do not assume that what we are telling you is prescriptive, or in fact is legal advice. We are giving you the best advice that we feel is helpful at this time. As the situation develops, we may change this advice – in light of new findings.

Gather knowledge:

The first steps that you might like to take is to consider instigating a risk assessment. You can find out how to carry out a thorough risk assessment at the Health and Safety Executive website here https://www.hse.gov.uk  Risk assessments are helpful as they can assist you in understanding elements of potential risk to yourself and others – furthermore, if you keep a written risk assessment (and we suggest you do), this is a document that could be very useful if a claim was brought against you – and you needed to call upon your insurers for support.

You might also like to familiarise yourself with the most up-to-date ‘Best Practice’ information over at the British Medical Journal’s website https://bestpractice.bmj.com/patient-leaflets/en-gb/pdf/3000166/Coronavirus.pdf

Rethink your working practices:

Do you need to put any extra steps in place to protect yourself, colleagues and clients?

Consider the following:

  • Do you need to adapt your business premises and treatment areas?
  • Do you need to make any practical changes to the actual way that you deliver your therapy, treatment or consultations?
  • Are there any changes needed to your overall hygiene protocols?
  • Do you need to spend more time between clients to decontaminate areas?
  • Does your aftercare information need to be updated?
  • Do you need to make any special purchases in order to further maintain cleanliness?
  • How will your new way of practicing affect the more practical elements of the way that you run your business? (Fees, cash taking, card processing, payment up front?)
  • Do you need to update your website or leaflets to reflect any changes?
  • Have your insurance needs changed in any way?

We strongly suggest making an inventory of everything within your practice and workspace that could possibly be a source of cross-contamination or infection.  Think about where people place their hands – it is really quite surprising!  We suggest that a ‘walk-through’ of your practice would be helpful – so check everything right from the front doorbell, to the back door and all points between.

We have created this checklist for you, but we are sure that you will be able to add to this once you undertake a full assessment of your practice environment and identify potentially hazardous contamination points:

  • Main entry – doorbell, knocker, letterbox, intercom
  • Hallway, bannisters, rails, hall tables, literature boxes
  • Light switches, lift buttons
  • Chairs, tables, sofas your practice room / waiting area
  • Toilet, taps, sink, soap dispensers, towel / towel dispenser
  • Your treatment table / couch / seating
  • Payment methods: pen and pad or touch screen devices screens
  • Your computer / mouse / mouse mat. Your desktop, your seat, and more

Do add to this list as you see fit.  We have seen some really creative uses of this list – with CMA practitioners even making YouTube videos where they explain to their clients exactly how the premises will be sanitised between each client appointment.

Think about whether you will ask your clients to bring anything with them to their appointment – do you want them to bring a mask?  Bring their own refreshments? Will you expect them to provide any PPE of their own?

A note regarding PPE

It is crucial that you dispose of any PPE properly - guidance on how to do this can be found here https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/879105/PHE_COVID-19_Doffing_gown_version.pdf

Before your appointment

Conduct sensible pre-treatment assessments – is your client in good health – or are they (or anyone they have been in close contact with) displaying COVID-19 symptoms? Have they tested positive for COVID-19 or do they have a positive antibody test? Do they have a high temperature, sore throat, loss of smell or taste? Do check the current list for potential COVID-19 symptoms to make sure that you are fully up to date with these.

The consultation process and aftercare advice

We have complete faith in you as a professional and it is not up to The CMA to proscribe how you practice.  We know that you are aware of safety in practice – but if in doubt at all, please refer to the best source of information about managing potential contamination and reducing the risk of this happening at the NHS websites.

We know that for many of you, you are a vital support to your clients – they will be concerned about the risks of coming back to see you – so do demonstrate that you are taking steps for their (and your) safety – perhaps with videos as suggested above, and also point them in the direction of NHS and government websites that demonstrate how to reduce the spread of COVID-19 – to reassure your clients that you are absolutely up to date with all of this and are taking all the necessary measures to keep them safe.

What if I don’t want to return to work at this time?

If you do not yet feel that you want to return to face to face consultations, consider how you can begin – or continue to offer online support to your clients.  As an important lifeline at this time – it is crucial that you are there for them – so think about creative ways that you can branch out to offer your support.

What if you are in the shielding category yourself and don’t’ feel that you should return to work just yet?

You will need to make some decisions about when you will feel safe returning to work and set plans for that – bearing in mind of course that this is a very fluid situation which is changing day to day.  Nevertheless, at times of great uncertainty, it is helpful to set yourself targets and create plans, while building some flexibility into these.  Also consider whether you’ll still be eligible for any support that you might have been receiving from the government during lockdown and whether this is likely to continue after we emerge from lockdown.

Can you thrive, personally and professionally, in the face of adversity?

Th key to thriving at very challenging times is resilience and we have every faith in you! Consider ways of pivoting your business – so that you are able to not just survive but thrive in the face of adversity.  What else can you do, can you provide counsel, can you begin to teach? What other dormant talents do you have that you haven’t capitalised upon?

What else could you do?  For example, xould you set up an online course? (If you are curious about this option, see CMA President, Jayney Goddard’s brilliant free tutorial on ‘How to set up and teach an online course’).  There are lots of incredibly helpful professional resources over at the Private Facebook Group; Jayney Goddard MasterClasses – videos, worksheets, Facebook Lives and more. Do take advantage of these – they were created by Jayney and are supported by The CMA specially to help you in your work at this challenging time.

Further overall support for your clients

It is important that your clients know that they can trust you to be a source of accurate and helpful information about COVID-19 and other aspects of general wellness.  Point them to The Complementary Medical Association’s website, Facebook page and YouTube channel for information about staying well at this time and overall selfcare.  Remember, any advice you give your clients constitutes a ‘consultation’ so this should be documented on your client notes as they could be required for insurance purposes in the event of a claim at some point in the future.

 Maintaining protection and coverage

Finally, ensure that your CMA Membership is up to date and that your insurance policy is current. These are confusing, fluid times so be sure that you, your practice or, if you teach, that your school is fully protected. 

IMPORTANT: At this extremely challenging time, where information from the government seems to change from day to day, The CMA is providing our guidance based upon our experience and high-level understanding of what constituted best practice, in this field – across a wide variety of disciplines.  At no time do suggest going against UK Government guidelines – or if you are not UK based, that you should contravene the guidelines set out by the government in your own country. The CMA cannot be held liable for any errors or omissions. CMA members must satisfy themselves that they are following and adhering to the latest official guidance in your jurisdiction.

Helpful contact details and information sources:

The Complementary Medical Association pages on COVID-19 and Coronavirus – Https://www.The-CMA.org.uk

We have incredibly helpful resources for you on The CMA site – everything including practice support, business development, mental healthcare, staying physically fit and well during this time, The development of COVID-19, symptomatology, natural antiviral suggestions and so much more.

Citizen’s Advice https://www.citizensadvice.org.uk

Health and Safety Executive website here https://www.hse.gov.uk

British Medical Journal Best Practice Overall Guidance https://bestpractice.bmj.com/topics/en-gb/3000168/patient-leaflets

British Medical Journal printable Best Practice leaflet https://bestpractice.bmj.com/patient-leaflets/en-gb/pdf/3000166/Coronavirus.pdf

United Kingdom Government site: “Closing Certain Businesses and Venues in England” page  https://www.gov.uk/government/publications/further-businesses-and-premises-to-close/further-businesses-and-premises-to-close-guidance

Wales: https://gov.wales/sites/default/files/publications/2020-03/coranivirus-closure-of-businesses-and-premises.pdf

Scotland: https://www.gov.scot/publications/coronavirus-covid-19-phase-2-business-and-physical-distancing-guidance/pages/businesses-and-premises-which-must-close/

Northern Ireland: https://www.nidirect.gov.uk/information-and-services/coronavirus-covid-19/advice-businesses-and-workers

World Health Organisation – Coronavirus Information Updates: https://www.who.int/health-topics/coronavirus#tab=tab_1

Royal Society of Medicine: RSM Live: free webinars which keep up to date with the latest developments on a range of topics and specialties. Https://www.rsm.ac.uk/resources/rsm-live/

 

 


 

  

Coronavirus 2019-nCoV / COVID-19

The CMA's Update - Part 5

Jayney Goddard, President, The CMA

This is a long article and I appreciate that it can be difficult to read at length onscreen - so, if it is easier, please feel free to print this article out.  Also, do share it with your friends - and anyone who might find it of interest.

NOTE: This article is in two parts.  Part 1 is helpful If you are more interested in finding out how to protect yourself and your loved ones, and Part 2 covers the latest information and is very useful if you'd like to keep up to date with current findings and statistics. 

 

Video Resources

We have now prepared several videos on various aspects of this topic to help you to remain safe.  You can find these videos here. Please sign up for The CMA's newsletter so that we can keep you in the loop as things develop - and we discover more about this virus and steps we can take to protect ourselves.  You can find a link for this in the purple box at the top of this page.

How do you treat Coronavirus conventionally?

At the moment there aren’t any vaccines or other drugs that have shown any promise in treating Coronavirus at the moment the conventional advice is to rest and hydrate, much as one would if one had a mild cold and some centres are advising the use of ibuprofen, although, other centres disagree and state that ibuprofen is potentially harmful and may exacerbate symptoms. For those hospitalised and exhibiting respiratory distress, the use of ventilators and IV hydration drips are the most likely treatment pathways. Tests are under way in China to ascertain whether two antiviral drugs used to treat HIV - lopinavir and ritonavir - might offer effective treatment. These drugs were shown to help combat the SARS virus in 2003, after data emerged that HIV patients who were using the drugs and who also had SARS had better outcomes. Other drugs under consideration include Tocilizumab - the biological therapy that is used to suppress the immune systems of people with autoimmune illnesses including Rheumatoid Arthritis.  It is an IL-6 inhibitor - it supresses the activity of the pro-inflammatory IL-6 cytokine.

Coronavirus header

PART 1 - What are our options in Complementary Medicine?

As you will appreciate, this is my ‘best guess’ too as I have not treated anyone with Coronavirus, nor have I seen it first hand, but I am working from my knowledge of the well-described presenting symptoms in patients that have been provided by the doctors treating them, and using my own expertise based upon over three decades of working with patients presenting with a vast variety of conditions.  As we know, in Complementary Medicine, we do not ‘treat conditions’ as such – we aim to understand why a patient is expressing certain symptoms and we use these to ascertain how we can best support that person’s return to optimal wellness.

CAVEAT:

Under no circumstances deviate from the Governmental safety guidlines.  Handwashing is as important now as ever! Remember that 'personal distancing' is extremely important and observe any guidance (or laws that may come into place) that the government in your country have implemented.  We are keeping this information general as The CMA is a global organisation and each country has it's own set of guidelines that must be adhered to.

Lifestyle and Nutrition

Given that adults with compromised immune systems seem to be most at risk – particularly if they have respiratory or heart/circulatory conditions – it is essential for these people to take steps to develop healthy lifestyle habits and to stop smoking immediately – if that is an issue.

We will all need to eat healthily and the most robust data point to a whole food, plant-based diet as the optimal nutrition approach for general wellness and resilience.  Ideally, we should aim to eat a rainbow of different coloured fruits and veggies – with as much variety at every meal.  This nutritional advice applies to the generally well population – and those of us who struggle with other conditions.

Avoid sugar and all refined carbohydrates such as white bread, pastries, pasta, biscuits/cookies, sweets/candies etc.  Sugar compromises immune activity. It is best avoided in general – but more so if there is a potentially harmful virus in circulation.

Avoid alcohol.  The most up to date research really shows that there is no safe level for alcohol consumption.

Cut out processed, refined fats and all animal fats – these compromise circulatory function and promote inflammation – which weakens immune response.

Cut out caffeine as this too can compromise immune response in some people.

Hydration

Adequate hydration is crucial – hydration attenuates the viral load – should we succumb to any virus – which is why we are often told to rest and drink plenty of water when we are ill.  Remember to avoid tea, coffee and other caffeinated drinks – especially so if they contain sugar. You’ll know when you are adequately hydrated if your urine is a pale straw colour.

Exercise

Exercise is vital for us all – and it does a great deal to support a robust, healthy immune system.  We humans are designed to move, and it is impossible to be optimally healthy if we lead a sedentary life.  As we know, 'sitting is the new smoking' – and active gym sessions (even if the gyms were open!) and bouts of exercise don’t offset the damage done by long periods of sitting, e.g. watching TV, working on a computer etc. It’s vital to take at least 30 minutes exercise every day but aim for more than that – and spread your activity throughout the day too.  If you do watch TV, ensure that you get up and move about periodically.

Resistance training is hugely important for us all – this includes weight training, heavy manual work etc. see my video with one of the world's leading vegan bodybuilders and lastly, try more mindful forms of exercise, such as yoga, pilates, tai chi, qi gong etc. are helpful both physically and as a form of moving meditation.  

Try to get out into nature if at all possible - and remember to maintain a safe (2-3 meter) distance from others.  If you can't get out, remember that it is important to breathe fresh air - so throw those windows open for at least part of the day.

Stress Response Management

You’ll notice that I don’t talk about ‘stress management’ as it is impossible to manage sources of stress – life happens – and it’s how we deal with things that distress us that actually matters.  Building resilience to stressors is vital to maintaining optimal physical health – as well as giving us psychological poise – and one of the best ways to do this is to learn a technique called “The Relaxation Response”.  This 20-minute meditation technique was pioneered by Dr Herbert Benson of Harvard Medical School and it is incredibly simple to do.  I have recorded an instructional download for you that you can access completely free at my personal website JayneyGoddard.org

Sleep

Adequate sleep is vital to health as we all know – and so much has been written about this already so I won’t go into it in depth here. However, it is a fact that poor, disrupted sleep and insomnia really do dramatically compromise immune function. So, with this in mind, I wanted to point you towards a Yoga Nidra Meditation for Deep, Restorative Sleep recording download that is also available free of charge at my website JayneyGoddard.org

Hygiene

Hand-washing

It is always a sensible precaution to observe general hand sanitation procedures all year round - and even more so when there is a potentially serious virus doing the rounds, whether it is seasonal flu (which kills many thousands of people every year) or Coronavirus. I always carry hand sanitiser with me when out - especially if I'm travelling on public transport.  There are plenty of videos on YouTube that demonstrate how to wash one's hands the correct way - It's surprising how many people don't know how to do this!

 

Essential Oils

Essential oils can be dispersed with an atomizer (one to five drops essential oil for every 3 tablespoons of distilled water). For a very basic anti-microbial spray, mix a few drops of the essential oils of Lavender and Tea-tree with distilled water in a plant sprayer and spray liberally around your rooms.

Spritz the air regularly. Do feel free to add other oils as desired, as various oils do have differing anti-microbial effects – so there is a good rationale for using a mixture of any of the following essential oils: Clove, Cinnamon, Thyme, Oregano, Lavender, Sweet Marjoram, Peppermint, Tea-tree. Get Jayney Goddard's e-book on the use of anti-viral essential oils during this pandemic here (totally free of charge)

 

Of particular relevance to Coronavirus is that research study has found that the essential oils mentioned above have specific properties which protect our respiratory tract from pathogens, although it is important to realise that none of the oils above have been tested against this novel form of coronavirus - yet. If such research is undertaken, we will be sure to let you know.  We can only provide data about the performance of oils against previously-seen coronaviruses and other pandmic flu viruses.

Treating symptoms of Coronavirus using Complementary Medical Approaches

I have analysed the symptom picture of those presenting with symptoms and so well described by the doctors in China, that I believe that the best homeopathic remedy that is the closest match, over all, to the symptoms described is Gelsemium.  You can read about this remedy here on The CMA site.  Personally speaking, if I were to feel unwell following exposure to Coronavirus, this would be my go-to remedy.  I would then prescribe according to how my symptoms developed and possibly consider other remedies.  Obviously that’s easy enough for a trained homeopath, but if you aren’t then I suggest looking for trained, qualified homeopaths here on The CMA site as they will be in a position to guide you – according to any symptoms you might display, should you start to feel unwell. Homeopathy has a history of performing well in other pandemics and major epidemics - and has been especially useful when there were no other viable conventional treatment options around. In the 1918 Spanish Flu (H1N1) pandemic we have reliable data which show that: 

•Spanish flu deaths in infected and symptomatic people using homeopathy were <1%
 
•Deaths in those using allopathic medicine were in excess of 30%
 
•Cohort sizes were 26000 in one record and 24500 in another.  These data are reliable and were collated by the army doctors who were responsible for the welfare of the soldiers at two major bases. Similar cohorts showed the same statistics.
 
You can view my presentation on just how well homeopathic medicine performed in the 1918 "Spanish Flu" pandemic here.  At the moment, it is simply a set of Powerpoint slides, but now that we have a pandemic upon us I shall, in the next couple of days, record a voiceover that will better explain the data for you.
 

Other Complementary Medical Options

All of the 'holistic lifestyle' disciplines or complete 'systems' of medicine such as Traditional Chinese Medicine (TCM), Ayurveda and more have much to offer and many of the herbs used in both Eastern and Western medicine show strong anti-viral activity. Of particular interest is elderberry as it does seem to perform well as an antiviral, however, I am not advising people to take commercial elderberry syrup preparations which contain a lot of sugar as this is, as we know, counter-productive and weakens the immune response. Essentially, any approach that we offer in the field of Complementary Medicine that takes into account the patient's individual totality of symptoms and prescribes upon this, is useful.
 

The following herbs are proven to have strong anti-pathogen activity - and are oustanding additions to a healthy diet:

Turmeric

  • Anti-Pathogenic (including anti-viral)
  • Anti-Hypertensive
  • Anti-Inflammatory
  • < Tumour Formation
  • Anti-Cancer(Anti-Proliferative)
  • Cholesterol Lowering
  • Mucin Increasing
  • Antibiotic

Ginger

  • Anti-viral
  • Anti-Inflammatory
  • Analgesic
  • Suppresses Inappropriate production of PG and LT
  • Prevents Platelet Aggregation
  • Anti-Oxidant
  • Cardio-tonic
 

Garlic

  • Anti-viral
  • Anti-Inflammatory
  • Analgesic
  • Suppresses Inappropriate Production of PG and LT
  • Prevents Platelet Aggregation
  • Anti-Oxidant
  • Cardio-tonic
 

Resveratrol (usually found as a supplement but derived from plant sources including red grapes)

  • Anti-viral
  • Anti-Inflammatory
  • Anti-Oxidant
  • Anti-Cancer and Anti-Proliferative
  • Anti-Angiogenic
  • Anti-Cardio-Fibrotic
  • Anti-Ageing
 

Rosemary

  • Anti-viral
  • Supports Anti-inflammatory Action of D3
  • Potent Cox2 Inhibitor
  • Anti-Oxidant
  • Anti-Cancer
  • Fights Against Lipid Peroxidation (LDL)

Can pets at home spread the new coronavirus (2019-nCoV)?

This information comes from the World Health Organisation:

At present, there is no evidence that companion animals/pets such as dogs or cats can be infected with the new coronavirus. However, it is always a good idea to wash your hands with soap and water after contact with pets. This protects you against various common bacteria such as E.coli and Salmonella that can pass between pets and humans.

In Closing

We hope that you will find this article useful and we'd love to hear from you with your thoughts, observations and suggestions for ways that we in Complementary Medicine can support people, should the virus mutate and become more transmissible between humans. Email us here with your comments

  


 

 

 

Part 2

Fighting the new Coronavirus (2019-nCoV) has been a battle against the unknown for doctors and virology/immunology researchers and of course they are looking for ways to fight the virus in those already infected – and to find vaccines that will be able to prevent infection.  The trouble with this approach is that it takes AT LEAST 6 months to grow a vaccine in sufficient quantities that will enable global coverage.

This DOES NOT include the lead time that it takes to ascertain which version of the virus will be the one that is in circulation in over six months’ time.  Remember, viruses constantly mutate – so we really don’t know exactly how the virus will be behaving in six months+ time - it really is a ‘best guess’ situation and one where a crystal ball really would come in handy.  BBC reports state that the experts they have interviewed do not believe that a vaccine will be available for at least a year - and they point to the fact that there's still no vaccine available against the 2009 Swine flu virus - over ten years later.

It is hugely challenging for Big Pharma to realistically come up with anything viable and of course, you’ll realise that I haven’t even touched on the potential harms from added vaccine ingredients – preservatives and adjuvants – that have the potential to seriously compromise health.  There are plenty on online resources that provide reliable, up to date, evidenced-based data about these issues, should you wish to read further.

 

Coronavirus is a pandemic

A pandemic like the current corona virus outbreak is a bonanza for the drug companies – and as I wrote in my books on pandemic flu1, governments globally are sitting ducks for the pharmaceutical companies, who would love nothing better than for mass coronavirus panic to break out so that their coffers can be lined. 

Governments have their arms twisted behind their backs as they are under huge public pressure to “DO SOMETHING” to protect the populace – so they really have to be seen to be spending billions purchasing drugs and vaccines that have little, to no proof, of efficacy.

Back in 2005 and again in 2009, during the Bird flu (H5N1) and Swine flu (H1N1) pandemics, respectively, governments spent literally billions stockpiling supplies of Tamiflu (oseltamivir) – a neuraminidase inhibitor drug that was supposed to prevent flu from developing, and it was eventually discovered that not only did it not adequately prevent, or even reasonably shorten, the duration of these influenzas, it came with an array of horrendous side-effects (which particularly affected children, with some appalling neuropsychiatric outcomes)2. In fact, Tamiflu was deemed so dangerous that some governments actually banned the drug. 

Let us not also forget that the manufacturers of Tamiflu, Gilead Sciences and F Hoffmann-La Roche, falsified or (if we are being charitable), made grave errors when reporting their trial results, and it is believed by many that they perpetrated a huge crime against governments and thus, taxpayers, worldwide - scamming them out of all those billions. Oddly enough, no one was ever prosecuted!

Back to Coronavirus:

Due to the difficulties in producing any viable treatment via the usual conventional pharmaceutical routes as described above, we need to look at what we can contribute from our health and wellness perspective in complementary medicine.  And, of course this article is not the place to explore the dastardly doings of Big Pharma and their lies about Tamiflu, you can read all about these issues in my books – where I cover all this in great depth. Instead, in this article, I wanted to provide you with information about how the current version of the virus operates, and the types of symptoms that it produces – and which population cohorts are most likely to be affected – so that we, complementary medicine and lifestyle medicine practitioners have a heads up on what is actually going on.  I have collated this information from various sources including The Lancet, the World Health Organisation, BMJ and more.  Sources and references are at the end of this article.

Hopefully the information here will help clarify what is happening at the moment, and the types of symptoms infected patients will display – and we will look at what we might be able to do to help people, should the virus mutate to become more highly transmissible between humans – and demonstrate a higher mortality rate.

 

 

What are the main symptoms displayed by patients?

Primary complaint - Lung involvement

Patients have been admitted to the hospital with pneumonia - their lungs were inflamed and the alveoli, which transfer oxygen from air to the blood, were filling with fluid. There is evidence of a cytokine storm in some patients - an overwhelming immune response that is highly dangerous.

Other symptoms exhibited by patients included:

  •  fever
  • cough
  • shortness of breath
  • muscle ache
  • confusion
  • headache
  • sore throat
  • Gastrointestinal symptoms

Where it all began - China

This next section will give you some helpful background that will illustrate what happened right at the point that COVID-19 became serious:

First deaths

The first two patients to die were generally healthy, aside from the fact that they were long-term smokers and that would have weakened their lungs. 

The first man was 61 years old, and already exhibited symptoms of severe pneumonia upon arrival at hospital. He was in acute respiratory distress thus his lungs couldn’t provide enough oxygen to his organs to keep his body alive. 

He was put on a ventilator, but his lungs failed, and his heart stopped beating, and he died 11 days after he was admitted.

The second patient was a 69-year-old man who also exhibited symptoms of acute respiratory distress syndrome.

He was put onto an ECMO (extra-corporeal membrane oxygenation) machine – sometimes called an ‘artificial lung’ but this wasn't sufficient to save his life. He succumbed to severe pneumonia and septic shock after his blood pressure plummeted.

 

Initial Mortality Rate

At least 10% of those known to be infected and showing symptoms died – but view these figures with extreme caution

As of 25 January, of the 99 patients:

  • 57 were still in hospital
  • 31 had been discharged
  • 11 had died

Current Mortality rate for comparison:

 

Infection Fatality Rate (23k / 1.7M = 1.4% IFR)

Actual Cases with an outcome as of May 1 = estimated actual recovered (1,671,351) + estimated actual deaths (23,430) = 1,694,781.

Infection Fatality Rate (IFR) = Deaths / Cases = 23,430 / 1,694,781 = 1.4% (1.4% of people infected with SARS-CoV-2 have a fatal outcome, while 98.6% recover).

Mortality Rate (23k / 8.4M = 0.28% CMR to date) and Probability of Dying

As of May 1, 23,430 people are estimated to have died out of a total population of 8,398,748 in New York City. This corresponds to a 0.28% crude mortality rate to date, or 279 deaths per 100,000 population, or 1 death every 358 people. Note that the Crude Mortality Rate will continue to increase as more infections and deaths occur

 

Incubation Period (how long it takes for symptoms to appear)

See full details: COVID-19 Coronavirus Incubation Period

Symptoms of COVID-19 may appear in as few as 2 days or as long as 14 (estimated ranges vary from 2-10 days, 2-14 days, and 10-14 days, see details), during which the virus is contagious but the patient does not display any symptom (asymptomatic transmission).

Age and conditions of Coronavirus cases

See latest findings: Age, Sex, Demographics of COVID-19 Cases and Deaths

According to early estimates by China's National Health Commission (NHC), about 80% of those who died were over the age of 60 and 75% of them had pre-existing health conditions such as cardiovascular diseases and diabetes.[24]

According to the WHO Situation Report no. 7 issued on Jan. 27:

  • The median age of cases detected outside of China is 45 years, ranging from 2 to 74 years.
  • 71% of cases were male.

A study of 138 hospitalized patients with NCIP found that the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men.[25]

The WHO, in its Myth busters FAQs, addresses the question: "Does the new coronavirus affect older people, or are younger people also susceptible?" by answering that:

  • People of all ages can be infected by the novel coronavirus COVID-19.
  • Older people, and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus.

Patient who died in the Philippines was a 44-year old male

The patient who died in the Philippines on February 2, in what was the first death occurring outside of China, was a 44-year-old Chinese man from Wuhan who was admitted on Jan. 25 after experiencing fever, cough, and sore throat, before developing severe pneumonia. In the last few days, “the patient was stable and showed signs of improvement, however, the condition of the patient deteriorated within his last 24 hours resulting in his demise." according to the Philippine Department of Health.

 

Serious Cases of 30 year old patients in France

As of Jan. 29, according to French authorities, the conditions of the two earliest Paris cases had worsened and the patients were being treated in intensive care, according to French authorities. The patients have been described as a young couple aged 30 and 31 years old, both Chinese citizens from Wuhan who were asymptomatic when they arrived in Paris on January 18 [19].

Age and Sex of the first deaths as reported by the China National Health Commission (NHC)

The NHC reported the details of the first 17 deaths up to 24 pm on January 22, 2020. The deaths included 13 males and 4 females. The median age of the deaths was 75 (range 48-89) years.[21]

WHO Risk Assessment: Global Emergency

See full details: WHO coronavirus updates

On January 30, the World Health Organization declared the coronavirus outbreak a Global Public Health Emergency.

For more information from the WHO regarding novel coronavirus: WHO page on Novel Coronavirus (2019-nCoV)

 

NOTE: it is extremely difficult to analyse actual mortality rates.  The current estimates do not accurately indicate that the mortality rate of the Coronavirus is circa 11%, though, as some of those still in hospital may yet die and many others have very mild symptoms, so they do not end up in hospital. Furthermore, some leaked data from China indicate that greater numbers of people are succumbing to the disease and dying – but as these reports are not officially substantiated, it is impossible to tell. At time of writing – we don’t yet know how dangerous coronavirus really is.  For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally4. SARS had a death rate of more than 10%. And the 2005 pandemic of Bird Flu (H5N1) had a mortality rate of circa 85% according to the WHO.

Now, let's look at the Coronavirus Incubation Period:

2 - 14 days
Possible outliers: 0 - 27 days
 
  • 2-14 days represents the current official estimated range for the novel coronavirus COVID-19.
  • However, a case with an incubation period of 27 days has been reported by Hubei Province local government on Feb. 22 [12]
  • In addition, a case with an incubation period of 19 days was observed in a JAMA study of 5 cases published on Feb. 21. [13]
  • An outlier of a 24 days incubation period had been for the first time observed in a Feb. 9 study.[11]WHO said at the time that this could actually reflect a second exposure rather than a long incubation period, and that it wasn't going to change its recommendations.
  • Period can vary greatly among patients.
  • Mean incubation period observed:
    3.0 days
    (0 - 24 days range, study based on 1,324 cases)
    5.2 days (4.1 - 7.0 days range, based on 425 cases).
  • Mean incubation period observed in travelers from Wuhan:
    6.4 days
    (range from 2.1 to 11.1 days).

Demographics:

Who was affected initially?

Market workers were originally infected

It is believed that, similarly to the 2005 Bird Flu (H5N1) and the 2009 Swine Flu (H1N1) live animals sold at the Huanan seafood market are the source of the infection, called 2019-nCoV or COVID-19 – which has become transmissible to humans. 

It is believed that market workers have been affected primarily, as 49 out of the 99 patients had a direct link to the market:

  • 47 worked there, as managers or working on the market stalls
  • 2 were customers who had briefly visited the market

Middle-aged men worst affected

The majority of the 99 patients were middle-aged men, (average age 56 - and 67).   

However, more recent figures suggest a more even gender split. The China Centres for Disease Control and Prevention has stated a gender ratio of 1.2 infected men to 1.0 infected women. 

Why might men be more vulnerable?

It isn’t known why men might be more susceptible to Coronavirus – there are so many confounding factors that could be responsible for the difference – lifestyle, socio-cultural reasons, immune system variance and more.

Dr Li Zhang, who works at the hospital, suggested: "The reduced susceptibility of females to viral infections could be attributed to the protection from X chromosome and sex hormones, which play an important role in immunity."

Which health conditions/illnesses did those people who were already infected have?

It should be noted that the 99 patients had other diseases that may have made them more susceptible to the virus as a "result of the weaker immune functions of these patients":

  • 40 had a weak heart or damaged blood vessels due to disorders including heart disease, heart failure and stroke
  • A further 12 patients had diabetes

Age, Sex, Existing Conditions of COVID-19 Cases and Deaths

Most recent data available. Last updated: February 29, 4:40 GMT

There are two sources that provide age, sex, and comorbidity statistics:


  • The Report of the WHO-China Joint Mission published on Feb. 28 by WHO, [2] which is based on 55,924 laboratory confirmed cases. The report notes that "The Joint Mission acknowledges the known challenges and biases of reporting crude CFR early in an epidemic" (see also our discussion on: How to calculate the mortality rate during an outbreak)
  • A paper by the Chinese CCDC released on Feb. 17, which is based on 72,314 confirmed, suspected, and asymptomatic cases of COVID-19 in China as of Feb. 11, and was published in the Chinese Journal of Epidemiology [1]

We will list data from both, labeling them as "confirmed cases" and "all cases" respectively in the tables.

 

 

COVID-19 Fatality Rate by AGE:

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on the age group. The percentages shown below do not have to add up to 100%, as they do NOT represent share of deaths by age group. Rather, it represents, for a person in a given age group, the risk of dying if infected with COVID-19.

 

AGE

 

DEATH RATE
confirmed cases 

DEATH RATE
all cases

80+ years old 

21.9%

14.8%

70-79 years old 

 

8.0%

60-69 years old 

 

3.6%

50-59 years old 

 

1.3%

40-49 years old 

 

0.4%

30-39 years old 

 

0.2%

20-29 years old 

 

0.2%

10-19 years old 

 

0.2%

0-9 years old 

 

no fatalities 

 

Pre-existing medical conditions (comorbidities)

As we now know - patients who reported no pre-existing ("comorbid") medical conditions had a case fatality rate of 0.9%. So, pre-existing illnesses that put patients at higher risk of dying from a COVID-19 infection are:

COVID-19 Fatality Rate by COMORBIDITY:

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on pre-existing condition. The percentage shown below does NOT represent in any way the share of deaths by pre-existing condition. Rather, it represents, for a patient with a given pre-existing condition, the risk of dying if infected by COVID-19.

PRE-EXISTING CONDITION

DEATH RATE
confirmed cases 

DEATH RATE
all cases

Cardiovascular disease

13.2%

10.5%

Diabetes

9.2%

7.3%

Chronic respiratory disease

8.0%

6.3%

Hypertension

8.4%

6.0%

Cancer

7.6%

5.6%

no pre-existing conditions 

 

0.9%

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). The percentages do not have to add up to 100%, as they do NOT represent share of deaths by condition.

 

 

 

 

References:

1 See The Survivor’s Guide to Swine Flu: The Complementary Medical Approach Over 577 pages in the Kindle edition with in excess of 600 references to robust research supporting all the recommendations and data in this book.

2 Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis BMJ 2009;339:b5106 https://doi.org/10.1136/bmj.b5106 (Published 08 December 2009) Last accessed 06 February 2020

3 Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study The Lancet (Online First) https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2820%2930211-7/fulltext Last accessed 06 February 2020

4 Global mortality associated with seasonal influenza epidemics: New burden estimates and predictors from the GLaMOR Project J Glob Health. 2019 Dec; 9(2): 020421. Published online 2019 Oct 22. doi: 10.7189/jogh.09.020421 Last accessed 06 February 2020

 

 

 

 

 

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