According to the data obtained from a study in 2018, about 128 people in the United States lose their lives daily after overdosing on pain killers, with numbers reaching an alarming average of 43,000 to 50,000 deaths per year- almost comparable to flus and other highly infectious diseases. Pain killers such as opioids are originally prescribed to treat chronic pain but with prolonged use, the pain relieving effects may lessen with the pain worsening and the body can develop dependence. Worse still, in addition to prescription-dependence cycle, some of the illegal/street drugs that are available to the public are made with unknown amounts of fentanyl. Fentanyl is a very potent opioid that cannot be seen, smelled or tasted and is lethal in a dose as small as a pinch).This dependence towards opioids causes withdrawal symptoms making it difficult to stop taking them. A major fact is that some patients can be condemned to a life of addiction within a week of exposure to the drugs as proven by several studies. Currently, there is no other known drug or medication that kills people such as opioid overdose. Drugs classified as opioids include oxycontin, fentanyl, buprenorphine, oxymorphone, codeine and morphine. These are usually prescribed by healthcare providers to manage severe and chronic pain in addition to heroin and are illegal drugs of abuse. These drugs are regrettably almost indispensable in the practice of medicine and even till this day some of the drugs remain essential in managing some covid-19 patients on ventilators.

Negative effects of opioid use vary broadly and may differ from person to person. These include:

• Powerful and compulsive urge to use these drugs even when they are no longer required medically
• Withdrawal symptoms such as muscle cramping, diarrhea and anxiety
• Shortness of breath, unconsciousness and deaths
• Neonatal opioid withdrawal syndrome
• Spread of infectious diseases such as HIV and viral hepatitis B and C due to injection drug use
• Social, economic and health crisis such as lost productivity , addiction treatment and criminal justice burdens

Opioid crisis dates as far back as late 1990’s when pharmaceutical companies started. The Sackler brothers reassured the medical community that patients cannot become addicted to the prescription opioid pain relievers and then the health care providers began to prescribe them at very high rates as they were very effective. This led to the widespread lie and abuse of the medications before it was proven that these medications were highly addictive.

With current statistics and data, including the percentage of patients that are prescribed opioids who misuse them and those that develop an opioid use disorder, it is obvious that opioids crisis is on the rise.

The US Department of Health and Human Services spreads it efforts across five major aims which are:

• Improving access to treatment facilities and recovery services
• Promoting use of overdose-reversing drugs and medications such as naloxone and Suboxone
• Strengthening the understanding of the epidemic through improved public health surveillance
• Supporting up to date research on pain and addiction
• Advancing better practices for pain management

The above measures help in tackling the opioid crisis but a lot more can be done to end the epidemic. Pharmaceutical companies are currently allowed to sell these drugs without regulation which is unsafe. Unfortunately, corruption, lobbying and a profit motive have led individuals and lawmakers to take actions like stripping the DEA of its ability to suspend suspicious narcotic sales thus hindering their ability to regulate and enforce laws that prevent the over use and over distribution of opioids. This does not serve the interest of the people affected by this crisis but favors the big pharmaceuticals that clearly want to make profits at risk of human lives. Additionally, more organizations like HEAL (helping to end addiction long term) and NIH should be endorsed. The Saskatchewan Health Authority since its launch in 2015, has also aided in fighting of the opioid crisis by the use of its naloxone kit program and the training of personnel for people at risk of an opioid overdose. Finally, people should be more informed and educated on these, more studies on medications and technologies to handle opioid abuse should also be conducted.

CORONAVIRUS: IMPORTANT FACTS AND UPDATES

Although, the early symptoms of COVID-19 and influenza (flu) infections are similar in that they both cause fever and similar respiratory symptoms, the speed of transmission is an important difference between the two viruses. Influenza typically has a shorter incubation period (the time from infection to appearance of symptoms) than COVID-19, which means that influenza spreads faster than COVID-19. On the other hand, the proportion with severe disease appears to be higher for COVID-19 given that approximately 15% of infected people have severe symptoms and 5% require intensive care in a hospital. Generally, the proportions of severe and critical COVID-19 infections are higher compared to influenza infections.

Currently, the World Health Organization suggests that the risk for contracting coronavirus from someone who isn’t showing any symptoms is quite low. However, experts believe that people infected with coronavirus can possibly transmit it to others even before showing any serious symptoms. According to the CDC, people who have contracted the virus are most contagious when they’re showing symptoms- and that’s when they’re most likely to transmit the virus. CDC maintains that COVID-19 is not limited by race as infection can make anyone sick regardless of their ethnicity. However, the immediate risk of becoming seriously ill from the virus is thought to increase by age- higher in older adults compared to younger adults. Older adults and people of any age with underlying health conditions, such as diabetes, lung disease, or heart disease, have weaker immunity, are more vulnerable and are at greater risk of severe illness from COVID-19.

The overall period of COVID-19 infection varies from person to person and depends on the immune system of the host. Mild symptoms in an otherwise healthy individual may resolve in about a few days. However, recovery in older or unhealthy individuals with underlying health problems, such as respiratory conditions, may take weeks and in severe cases lead to mortality. People who have completed quarantine or have been released from isolation pose no risk of infection to others and should not be stigmatized. Experts emphasize there isn’t a specific course of treatment for corona virus infection, considering that a new strain of virus causes it. Therefore, one must heed the general advice and take the standard precautionary measures as these can help to strengthen the immune system.

It is uncertain how long COVID-19 specifically survives on surfaces but it seems to behave like other coronaviruses- persisting on varying surfaces from some hours up to several days, depending on the material. This duration may be influenced by different conditions and factors such as the type of surface, as well as the temperature and humidity of the environment.  Maintaining proper hygiene and cleanliness remain the best ways to protect one-self. Surfaces thought to be exposed should be wiped thoroughly with household disinfectant to kill the virus and keep the surface clean. Hands must be regularly and constantly cleaned with alcohol-based sanitizers or washed for at least 20 seconds with soap and water. Additionally, it is important to avoid touching the face, eyes, mouth, or nose with unclean hands.

Today, most of the world is on lockdown with borders, airports, companies, schools, churches mosques and stores shut down in order to contain the spread of the virus. Countries such as China, Italy, the United States- representing three continents, have had the highest cases so far. It is advised that people, especially those experiencing symptoms, should wear masks and hand gloves, call their hospital or public health hotlines, stay at home and not go out to public areas, not use public transport, taxis, or ride-sharing services and not attend public events such as religious gatherings, social events, music festivals or sporting matches.

As Always, Stay Safe!

CORONAVIRUS:  SYMPTOMS AND PREVENTION- HOW TO PROTECT MYSELF AND OTHERS

Following exposure to coronavirus, it takes about 14 days for symptoms to develop. This is called the incubation period of the virus, which is the number of days between coming in contact with the infectious agent (exposure to droplets of infected people) and the establishment of an infection. An infection is established when the virus replicates in sufficient amount to overwhelm the host’s immunity and cause symptoms. Symptoms associated with corona virus are somewhat similar to that of other viruses that cause upper respiratory tract infections. They include:

• Runny nose
• Sneezing and Wheezing
• Coughing and Sore throat
• Headache and Fever
• Lethargy
• Shortness of breath and breathing difficulties

Most of the above listed symptoms are identical to some other viral infections making it challenging to reach a diagnosis. Corona virus usually affects the upper respiratory tract and can be mild. However, the infection may become severe and result in more serious conditions such as pneumonia, bronchitis, severe acute respiratory syndrome, kidney failure or death if it affects lower respiratory tract, including lungs and windpipe. The severity of the symptoms is much more in older adults and vulnerable populations with compromised immunity. It is important to seek medical advice if one comes in close contact with anyone diagnosed with COVID-19. More so, people who live in or have recently traveled from areas with ongoing spread of COVID-19 should be isolated for 14days. Since the major reliable and medically protective measure- vaccination, is not yet available for corona virus, it is important to follow a few simple guidelines and measures to prevent infection:

• Proper and frequent hand washing with soap or any other alcohol-based hand sanitizer- for at least 20 seconds, especially after blowing the nose, coughing,  sneezing, going to the bathroom and before eating or preparing food
• Covering nose and mouth with tissues when sneezing or coughing, tissues should be immediately disposed properly in a trash can
• Social distancing and avoiding any form of close contact with infected individuals, typically anybody feeling feverish or exhibiting associated symptoms
• Cooking foods thoroughly, particularly meat and eggs, before consumption
• Avoid touching face- eyes, nose, and mouth with unwashed hands
• Staying and remaining home when sick
• Keeping oneself protected when in contact with wild or domestic animals, dead or alive
• Drinking sufficient amounts of fluids daily
• Getting adequate rest and taking prescribed over-the-counter medicines in case of sore throat or fever

CORONA VIRUS: WHAT IT IS AND HOW IT IS TRANSMITTED

In general, viruses are inactive, microscopic and parasitic infectious agents that cannot reproduce by themselves outside a host cell. However, once they infect a susceptible cell, viruses have the capacity to direct the machinery of the infected cell to reproduce and multiply itself, thereby causing diseases. The whole infectious virus particle is called a virion and it consists of the nucleic acid and an outer shell of protein. Viruses contain either RNA or DNA as their genetic material and their nucleic acid may be single or double-stranded. The simplest virus particles contain only enough RNA or DNA to encode four proteins while the most complex viruses encode about 200 proteins.

Now that we understand what viruses are in general, let us then focus on and discuss the virus of significance at the moment- corona virus. The most recent outbreak is reported to have begun in Wuhan (China) in late 2019, infecting more than 90,000 people and claiming over 4,000 lives. Corona viruses are crown-like shaped infectious agents or a group of agents which can cause diseases in birds and mammals. The virus, which was first identified in the 1960’s, is a common virus that predominantly infects the nose, upper throat and sinuses. While most strains aren’t dangerous, some strains and less common forms such as SARS, MERS, and COVID-19 cause severe symptoms and can be lethal. In humans more specifically, corona viruses cause respiratory tract infections that are characteristically mild, as in some cases of the common cold. Symptoms vary in other species, for example; in chickens, they cause an upper respiratory tract disease, while in cows and pigs they cause diarrhea. Treatment measures for viruses such as vaccines and antiviral drugs to prevent or treat human corona virus infections are yet to be developed.

Coronavirus infection, like all viral infections, begins when the virus gains access into the body of the host organism and attaches itself to the complementary host cell receptor using its spike protein. Following the viral attachment, a protease of the host cell cleaves and activates the attached spike protein. Depending on which protease is available in the host cell, cleavage and activation permits the entry of the virus into the cell through endocytosis or direct fusion of the viral envelop with the host membrane. Once in the host cell, the virus particle is uncoated, and its genome enters the host cell cytoplasm. Then, the viral RNA attaches to the host cell’s ribosome for translation and transcription while the host ribosome begins to replicate and reproduce the viral genome. Establishing an infection, determining tissue tropism, infectivity and species range of the virus all depend on the interaction of the corona virus spike protein with its complementary host cell receptor.

Similar to most flu-like viruses, human to human transmission of corona virus occurs predominantly through respiratory droplets generated by sneezing and coughing. Infection occurs when the virus gains access into the host cell following direct or close contact with these droplets released by already infected people. Infection can also occur through touching everyday objects such as doorknobs that may be harboring these droplets, and then using the infected hands to touch ones face.