(WXYZ) — It’s not just COVID-19 cases that are on the rise. Many Michiganders are surprised to learn they’re sick with the flu and not COVID-19.

I know many patients who were convinced that they had COVID-19 when they were actually sick with the flu. I get that there are similarities when it comes to COVID-19 and the flu because they are both upper respiratory infections.

For instance, both can cause symptoms like runny nose, sore throat, fever, cough, difficulty breathing and body aches.

So how can you tell them apart?

Well, a loss of taste or smell was once a telltale sign you had COVID-19 as this rarely happened with the flu. But those symptoms are not as prominent anymore.

Another indicator was to look at how fast symptoms appeared. Symptoms tend to come on faster with the flu, whereas it can take longer for a person who has COVID-19.

But here’s the bottom line. The only real way to really know if you have the flu or COVID19 is to get tested. Otherwise, it’s very difficult to tell the difference between the two viruses just by looking at symptoms alone as they are nearly identical.

Both the flu and COVID-19 can be asymptomatic, mild or severe. Both can lead to complications like pneumonia, respiratory failure, sepsis, fluid in the lungs, cardiac injury, multiple organ failure and inflammation of the heart, brain, or muscle tissues. Also, both the flu and COVID-19 can be fatal.

Is one virus deadlier than the other? The answer is: yes. COVID-19 appears to cause more serious illnesses, which can lead to hospitalization and death. While the people most at risk are older adults, pregnant women and people with certain underlying medical conditions, we know that severe illness and death can happen even to healthy people.

Also, some people can develop post-COVID-19 symptoms that last weeks or months. And long COVID can happen to anyone, even if their symptoms were mild or asymptomatic.

The good news is that we have vaccines for both COVID-19 and the flu that can help prevent serious illness and death. It is never too late to get either vaccine, especially as we’re seeing the flu season drag on a bit longer than usual and rising cases for both viruses.

Additional Coronavirus information and resources:

View a global coronavirus tracker with data from Johns Hopkins University.

See complete coverage on our Coronavirus Continuing Coverage page.

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SOUTHAMPTON, England--(BUSINESS WIRE)-- Synairgen plc (LSE: SNG), the respiratory company developing SNG001, an investigational formulation for inhalation containing the broad-spectrum antiviral protein interferon beta, today announces the first presentation of the full data analysis from its Phase 3 SPRINTER trial evaluating the efficacy and safety of SNG001 in patients hospitalised with COVID-19.

SPRINTER (SG018; NCT04732949) was a global, randomised, placebo-controlled, double-blind clinical trial assessing the efficacy and safety of inhaled SNG001 for the treatment of adults hospitalised due to COVID-19 who required treatment with supplemental oxygen. The trial recruited a total of 623 patients who were randomised to receive SNG001 (n=309) or placebo (n=314) on top of standard of care (SOC).

The data from this pivotal trial will be presented today at the Clinical Trials Symposium of the American Thoracic Society 2022 (ATS 2022) International Conference, being held in San Francisco, California from 13-18 May 2022. A separate poster presentation is scheduled for 17 May 2022.

Synairgen announced in February 2022 that the Phase 3 SPRINTER trial did not meet the primary endpoints of discharge from hospital and recovery. There was, however, an encouraging signal in reduction in the relative risk (RRR) of progression to severe disease or death within 35 days (25.7%1 reduction in the Intention-to-Treat population and 36.3% reduction in the Per Protocol population).2

To assess the strength of this signal and identify specific patient populations that might benefit most from treatment, post hoc analyses were performed on groups of patients recognised to be at greater risk of developing severe disease in hospital. These analyses included patients ≥65 years old, those with co-morbidities associated with worse COVID-19 outcomes, and those who, at baseline, despite receiving low flow oxygen, had clinical signs of compromised respiratory function (defined as oxygen saturation of ≤ 92% or respiratory rate ≥ 21 breaths/min).

These analyses showed stronger treatment effects with SNG001 in these high-risk patient sub-groups, with the strongest effect observed in those who had clinical signs of compromised respiratory function. In these patients, who represented approximately one-third of the SPRINTER trial population, SNG001 significantly reduced the risk of progression to severe disease and death compared to placebo by 70% in the Per Protocol population (Odds Ratio (95% Confidence Interval) 0.23 (0.06, 0.98); p=0.046).

SNG001 was well tolerated in the SPRINTER trial with a favourable safety profile consistent with previous studies:

  • The proportion of patients with any treatment-emergent adverse events (TEAE) related to study treatment was 22.6% for SNG001 vs. 25.4% for placebo.
  • The proportion of patients with any serious TEAE was 12.6% for SNG001 vs. 18.2% for placebo.
  • The proportion of patients with a serious respiratory3 TEAE was 4.7% for SNG001 vs. 9.9% for placebo.

Phillip Monk, Ph.D., Chief Scientific Officer of Synairgen, said: “The post hoc analyses presented at the ATS conference today suggest that SNG001 may be having a beneficial effect with respect to prevention of severe disease or death. These results provide a strong clinical rationale to continue to investigate SNG001 in a trial evaluating progression and/or mortality in hospitalised patients with COVID-19 and more widely in patients with severe viral lung infections.”

Tom Wilkinson, Chief Investigator of the SPRINTER trial and Professor of Respiratory Medicine, University of Southampton, said: “The improvement in standard of care for COVID-19 means that most patients are currently discharged fairly rapidly from hospital; however, this further analysis shows that some patients struggle in their battle with the virus and show signs of respiratory compromise, with faster breathing rates and lower oxygen saturations, despite being on oxygen. For these higher-risk patients, there remains an urgent need for new treatment options, and this analysis suggests that SNG001 could be a potentially efficacious treatment option for them.”

The full analysis of the Phase 3 SPRINTER trial data will be submitted for publication in a peer-reviewed journal. A company recording of the ATS presentation will be available on the Synairgen website by 12:00 Pacific Daylight Time/20:00 British Summer Time today, and for ATS members, the symposium recording will be available on the ATS website.

SNG001 is not approved for use anywhere in the world.

For further information on the ATS International Conference visit: conference.thoracic.org/

This announcement contains inside information for the purposes of Article 7 of Regulation (EU) No. 596/2014 ('MAR').

Notes for Editors

About SPRINTER (SG018) trial

The SPRINTER trial (SG018; NCT04732949) was a global Phase 3, randomised, placebo-controlled, double-blind, clinical trial assessing the efficacy and safety of inhaled SNG001 on top of standard of care (SOC) for the treatment of adults hospitalised due to COVID-19 requiring treatment with supplemental oxygen by mask or nasal prongs. Patients requiring high-flow nasal oxygen therapy, non-invasive ventilation, or endotracheal intubation (invasive ventilation) at randomisation were excluded. COVID-19 was confirmed using a validated molecular test for the presence of the SARS-CoV-2 virus.

About SNG001

SNG001 is a pH-neutral formulation of interferon-beta (IFN-beta) for inhalation that is delivered directly into the lungs using a mesh nebuliser, currently being investigated as a potential host-directed antiviral treatment for patients hospitalised with COVID-19. SNG001 has broad potential applicability for patients hospitalised with respiratory symptoms due to viral infections such as influenza, Respiratory Syncytial Virus (RSV) and para-influenza.

The SARS-CoV-2 virus has been shown to suppress the production of IFN-beta, a naturally-occurring protein that orchestrates the body's antiviral defences, with the aim of evading host immune responses. By administering IFN-beta into the lungs, the aim is to correct this deficiency, potentially switching back on the lungs' antiviral pathways to clear the virus. SNG001 has been shown to demonstrate potent in vitro antiviral activity against a broad range of viruses including SARS-CoV-2 and Alpha, Beta, Gamma, Delta and Omicron variants.

About Synairgen

Synairgen is a UK-based respiratory company focused on drug discovery, development and commercialisation. The Company’s primary focus is developing SNG001 (inhaled interferon beta) for the treatment of severe viral lung infections, including COVID-19, as potentially the first host-targeted, broad-spectrum antiviral treatment delivered directly into the lungs. SNG001 has been granted Fast Track status from the US Food and Drug Administration (FDA). Founded by University of Southampton Professors Sir Stephen Holgate, Donna Davies and Ratko Djukanovic in 2003, Synairgen is quoted on AIM (LSE: SNG). For more information about Synairgen, please see www.synairgen.com.



This was reported as 27.1% in the topline analysis in February 2022 but changed between 35- and 90-day database lock.



The main reason patients were excluded from the Per Protocol population was failure to receive two full doses in the first three days of treatment.



Respiratory, thoracic and mediastinal system organ class


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The Asthma and Respiratory Foundation NZ is advising the 700,000 New Zealanders with respiratory conditions to be well prepared for a potentially tough winter ahead.

"With ongoing Covid-19 infections, new strains of winter flu entering the country and low community immunity to these strains, it’s more important than ever that people with a respiratory illness are taking steps to keep themselves well," says ARFNZ Chief Executive Letitia Harding.

Influenza is a serious illness that affects the nose, throat and lungs, and can worsen existing respiratory conditions like asthma. A further risk this winter is the possibility of having flu and Covid-19 within a short space of time.

"Our message to all of those with respiratory illnesses like asthma or Chronic Obstructive Pulmonary Disease (COPD) is to firstly ensure that your condition is well-managed. If it is not well-managed, or you are unsure about what to do if your symptoms get worse, then please see a healthcare practitioner and get advice," says ARFNZ Research and Education Manager Joanna Turner.

ARFNZ is also reminding people to protect themselves by getting a flu vaccine. People with asthma who are prescribed regular preventative medicine and those with other chronic breathing conditions are eligible for free flu vaccines. These vaccines are available to adults and children aged three years and over, between April and December each year from authorised pharmacist vaccinators and GP/health care practices.

Children between the ages of six months and five years, who have a history of significant respiratory illness can also access free flu vaccines from their GP/health care practice. In 2022, the flu vaccine is free for Māori and Pasifika, aged 55 years and over.

If you have not yet had your Covid-19 vaccine or booster, you can receive this at the same time as your flu vaccine. If you have recently had Covid-19, the Ministry of Health recommends getting your flu vaccine as soon as you are recovered, but if you are unsure talk to a health professional.

The Ministry has also highlighted that there is a low risk of getting a second case of Covid-19, within 90 days of a first infection. In this situation, anyone with underlying respiratory conditions should seek advice from their GP or Healthline.

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The Asthma and Respiratory Foundation NZ is advising the
700,000 New Zealanders with respiratory conditions to be
well prepared for a potentially tough winter

"With ongoing Covid-19 infections, new strains
of winter flu entering the country and low community
immunity to these strains, it’s more important than ever
that people with a respiratory illness are taking steps to
keep themselves well," says ARFNZ Chief Executive Letitia

Influenza is a serious illness that affects
the nose, throat and lungs, and can worsen existing
respiratory conditions like asthma. A further risk this
winter is the possibility of having flu and Covid-19 within
a short space of time.

"Our message to all of those
with respiratory illnesses like asthma or Chronic
Obstructive Pulmonary Disease (COPD) is to firstly ensure
that your condition is well-managed. If it is not
well-managed, or you are unsure about what to do if your
symptoms get worse, then please see a healthcare
practitioner and get advice," says ARFNZ Research and
Education Manager Joanna Turner.

ARFNZ is also
reminding people to protect themselves by getting a flu
vaccine. People with asthma who are prescribed regular
preventative medicine and those with other chronic breathing
conditions are eligible for free flu vaccines. These
vaccines are available to adults and children aged three
years and over, between April and December each year from
authorised pharmacist vaccinators and GP/health care

Children between the ages of six months and
five years, who have a history of significant respiratory
illness can also access free flu vaccines from their
GP/health care practice. In 2022, the flu vaccine is free
for Māori and Pasifika, aged 55 years and over.

you have not yet had your Covid-19 vaccine or booster, you
can receive this at the same time as your flu vaccine. If
you have recently had Covid-19, the Ministry of Health
recommends getting your flu vaccine as soon as you are
recovered, but if you are unsure talk to a health

The Ministry has also highlighted that
there is a low risk of getting a second case of Covid-19,
within 90 days of a first infection. In this situation,
anyone with underlying respiratory conditions should seek
advice from their GP or

© Scoop Media


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This article was originally published here

Am J Case Rep. 2022 May 14;23:e936734. doi: 10.12659/AJCR.936734.


BACKGROUND Despite unprecedented speed in the execution of the COVID-19 vaccine and therapeutic clinical trials, pregnant patients have been largely excluded from initial studies. In addition, pregnant patients who are unvaccinated against SARS-CoV-2 have greater morbidity risk with severe COVID-19 disease as compared to patients of similar age and comorbidity status. Intravenous immunoglobulin (IVIG) has been deemed safe in pregnancy in other diseases. Prior data demonstrate the possible benefit of utilizing IVIG for the treatment in hospitalized patients with severe respiratory symptoms associated with COVID-19 active infections when administered within 14 days of COVID symptom onset. CASE REPORT We administered IVIG (Privigen®, CSL Behring) 0.5 g/kg daily for 3 consecutive days to 4 pregnant patients (ages 24-34 years of age) who were hospitalized with moderate-to-severe COVID-19 and not vaccinated against SARS-CoV-2. All patients received concomitant glucocorticoid therapy. Gestational ages were 26, 17, 35, and 35 weeks. All patients were discharged home breathing room air after a mean hospital stay of 15 days. Two patients had uncomplicated cesarean section at 35 weeks during the hospitalization. The pre-term pregnancies at 17 and 26 weeks were intact at hospital discharge and resulted in normal vaginal deliveries at term. All 4 patients consented to participate in this case series report. CONCLUSIONS IVIG may be a safe treatment consideration in pregnant women with severe COVID-19 to avoid pregnancy complications. Its use warrants further study in pregnancy acute respiratory distress syndrome (ARDS) due to SARS-CoV-2, influenza, and other respiratory viruses to which pregnant patients are vulnerable.

PMID:35567293 | DOI:10.12659/AJCR.936734

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Best Covid 19 Self Test Kit For Travelers

“A Convenient Covid 19 Self Test Kit for Travel”

Covid-19 has had a lasting impact on society regarding travel. As travel resumes there are options for best self test kits to take with you as you travel. Easy to use and convenient travel kits are key for travellers and makes re-entry into a country much easier. These are the best options for Covid 19 self test kits and how to best use them.

The COVID-19 outbreak remains an unprecedented disaster in most countries. It has become the biggest global health emergency since the influenza pandemic of 1918. The pandemic has been catastrophic for every single industry. Travel, in particular, has been one of the most affected, and the economy built around it has seen a decline since the very beginning of the crisis. Those infected by the COVID-19 virus may suffer both short and long-term health problems, financial distress, and even long-term mental health issues. The uncertainty of what is happening to the world today has caused a chain-reaction that makes travel seem like an unusually dangerous and problematic endeavor.

What is Covid-19? How does it affect travelers?

Coronavirus disease, known as COVID-19, is a highly transmittable disease caused by intense acute respiratory syndrome SARS-CoV-2. It had a devastating impact on the world demographics resulting in more than 5.3 million deaths worldwide. The first case of this predominant respiratory viral infection was reported first in Wuhan, Hubei Province, China; in late December 2019. SARS-CoV-2 rapidly spread across the globe in a short time, forcing the World Health Organization (WHO) to proclaim it a global pandemic on March 11, 2020.

Covid 19 has numerous signs and symptoms that go beyond respiratory issues. In the beginning, it was thought that many of those infected had no symptoms at all. Individuals with Covid 19 developed mild to moderate symptoms, though the illness would become severe if not effectively treated. Now it’s understood that some of those with no visible symptoms of the disease, may have had other complications that were simply thought as not related to COVID-19. The most known symptoms of coronavirus are:

  • Respiratory distress
  • Fever
  • Breathing difficulties
  • Tiredness
  • Irritated throat
  • Coughing

Some individuals present other more severe symptoms that require hospitalization. Some severe signs of covid 19 are pneumonia, Acute respiratory distress syndrome (ARDS), sepsis, and septic shock. Some Covid 19 emergency warning signs that require immediate medical attention include:

  • Problem breathing or shortness of breath
  • Persistent chest pain or pressure
  • Confusion
  • Bluish face or lips

Travel Restrictions and their effect on travelers

There are numerous ways in which the pandemic has affected travel. Due to the pandemic, different countries had travel restrictions in place to contain the spread of the deadly virus. These restrictions became bans and bans caused certain areas of tourism to be forced to shut down entirely. Though the world is recovering from the damage caused by the pandemic, travelers can still feel its effects. Here are some of the ways the COVID-19 is still affecting individual travelers and the tourism industry in general:


We all like to have a certain amount of safety when traveling, be it for business or leisure travel. As humans, we mentally assign a threshold as to how much we’re willing to risk in achieving our goals. That is often referred to as risk management. Whether it’s touring famous destinations or traveling to a meeting in Florida, we assess our risk before we jump into a plane, cruise, or other method of transportation. Because of the Covid 19 pandemic, there’s an inherent risk of catching a disease that may directly or indirectly impact us, our work, and worst of all—our loved ones. This has changed our behavior as a social species. Before the pandemic, crowded destinations where acceptable and posed no major risk in our collective psyche. Nowadays, to prevent the spread of the virus, we’ve seen how individuals and families have opted to spend their time in less crowded places. This is due largely in part to the combined efforts of various institutions, such as the CDC, to reduce the spread of this deadly virus.


Travelers now experience an abnormal amount of stress and anxiety over what seems to be a never-ending stream of ever-changing travel restrictions. Everyone has a different threshold when it comes to their travel risk management. To some, facing flight cancellations due to the travel restrictions and other requirements for visitors, could possibly be the biggest deterrent of all. To others, it could be the lack of access to public transportation, or the temporary or permanent closure of businesses and attractions we they wanted to visit. This all leads to negative emotions, such as anxiety, and dismay – which we naturally never want associated with our travels.


The consequences of the Covid-19 pandemic have antagonistic effects on the tourism sector and the world economy. A few countries imposed strict travel bans to contain the pandemic spread. Countries such as Barcelona, Rome, and Bali are tourist attractions that have suffered an economic breakdown. The United Nations World Tourism Organization announced that the global predicament caused by COVID-19 in the tourism industry led to the loss of US$300–450 billion.

How to safely go back to traveling?

As a traveler, you also have a role to play in reducing the spread of Covid 19, so the world will not face another lockdown. You do not have to be a health practitioner to know the effects of the disease and its impact on our lives and our quality of life. By testing for COVID-19 you can detect the virus early and report yourself to health workers for adequate treatment. This action can help prevent the spread of the virus and ensure that we can keep the pandemic under control for long enough to see the restrictions lifted and our ability to travel (and enjoy traveling!) restored.

The good news is that every traveler can now perform their own Covid 19 Rapid Test at their convenience and the comfort of their own home. Remember when we all had to travel to COVID testing locations? some near you, some way too far away—(and, oh the lines!); well, those days are gone. The introduction and FDA approval of At-Home Self-Test Kits has changed everything. They became the go-to for those wanting to travel and the method of choice accepted by airlines, cruises, restaurants, and tourist destinations.

Which COVID 19 self test kit is the best for Travelers?

Two of the most popular kits highly recommended for their accuracy are the BinaxNOW COVID 19 At-Home Antigen Self Test Kit and IHealth® Covid-19 Self Test Kit. Both kits have been approved by the FDA and guarantee same-day results. These kits efficiently detect covid virus infection with the accuracy expected from a lab, without the uncomfortable feeling of getting your nostrils swabbed by a 3rd party. You can test all covid 19 variants with the kits in under 15 minutes.

Convenience and Comfort: 

Both of these Covid 19 self-tests require no prescription, and they come with an instruction card you can easily follow, with the option to download an app to watch their instructional videos. They promise zero discomfort, and you can do the test any time of the day.


Each Covid 19 self-test box comes with 2 test kits for repeat testing. You only must test yourself twice within three days or at least after 36 hours. Frequent testing is one of the best ways to stop the virus from spreading and increase the accuracy of your results. Human error still plays a big part in the accuracy of these tests, which means that you should always exercise caution when performing and reading the test results to avoid false negatives or false positives. Taking your time and thoroughly reading the instructions included will improve the chances of an accurate test result significantly.

Covid 19 Variant Detection: 

BinaxNow and iHealth covid self-test kits can detect numerous COVID-19 strains, including the latest Delta and Omicron variants.

Where to buy BINAXNOW and IHealth® COVID 19 AT-HOME Antigen Self-Test Kits?

Since these test kits do not require a prescription, you can get them over the counter or you can purchase them from the comfort of your home by ordering it online from a trusted and authorized online supplier.

Early detection of the virus prevents the spread and keeps you from developing more severe symptoms. It means you will receive early effective intervention to keep you and your loved ones safe and healthy. It’s a small action that can have such a big impact in recovering from the pandemic so we can embark on travel adventures once again.

Media Contact
Company Name: Peach Medical Labs
Contact Person: Andriy Tkach
Email: Send Email
Country: Canada
Website: peachmedicallabs.com/

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If you’re constantly sneezing, coughing, or experiencing a sore throat, the first thing you might think about is colds or flu. It is actually difficult to distinguish because they have similar symptoms. However, those can also be signs of allergies. Colds, flu, and allergy affect your respiratory system, mainly the nose and throat, which commonly causes sneezing.

Doctor Allergies Do you know why you're sneezing? Labcorp

Since the COVID-19 virus is still out there, you might also be concerned about whether the symptoms you’re experiencing—like sneezing—are COVID-related or just an allergy. It is important to understand their differences to help you choose the right treatment or method of relief. 

Differences Between Colds, Flu, and Allergy

Colds and flu are contagious respiratory illnesses caused by viruses. Flu is caused by influenza viruses specifically, while common colds can be caused by different viruses, such as rhinoviruses and parainfluenza, and several coronaviruses (from the same family of viruses as SARS-CoV-2, which causes COVID-19). Both can cause a runny or stuffy nose, congestion, coughing, sneezing, and sore throat. 

Flu can cause a high fever that lasts for three to four days, as well as headache, fatigue, and general aches and pains. It can lead to serious complications like pneumonia. On the other hand, colds are usually milder than flu and do not typically result in severe health problems. People with colds are more likely to have a runny or stuffy nose.

Breathe Breathe easy. Pexels

While flu and colds are contagious, an allergy can not be passed from one person to the other. Once you inhale a substance (also called an allergen) you are allergic to, such as pollen, dust mites, mold, animal dander, and other substances that are not infectious, your immune system will react to it, causing your nose to become stuffy or runny. Allergies typically last for as long as you’re exposed to the allergen. It can be up to six weeks during the spring, summer, and fall pollen seasons.

Allergy: Symptoms and Treatments 

Your body produces IgE (immunoglobulin E) antibodies when encountering allergens that can inflame your skin, sinuses, and airways. They cause the release of chemicals like histamine, which results in swelling and inflammation. As your body tries to get rid of the allergens, you may experience symptoms such as a runny nose, itchy or watery eyes, rashes, and sneezing. 

Allergy symptoms depend on the substance involved. Allergic reactions can range from mild to severe. In some severe cases, it can cause a potentially fatal reaction known as anaphylaxis. There are also different types of allergies: 

  • Seasonal allergy (Pollen allergy, dust allergy, hay fever) 
  • Mold allergy
  • Pet allergy
  • Food allergy
  • Drug allergy
  • Skin allergy
  • Eye allergy
  • Insect sting allergy
  • Latex allergy

One of the most effective and natural ways to prevent or manage allergy symptoms is to avoid triggers or allergens. Since allergens are everywhere, making it difficult to avoid, you can take medications to relieve your symptoms. Antihistamines, corticosteroids, and decongestants can be used to treat minor allergy symptoms.

Allergy Symptoms Keep your allergy symptoms at bay. Labcorp

If your symptoms are no longer manageable with over-the-counter medications, you should see a healthcare provider to determine if you might benefit from other treatments. If you are experiencing a severe allergic reaction like anaphylaxis, you must seek medical care immediately. 

Why Do You Sneeze When You Have an Allergy?

Many of you might be wondering why people are sneezing when experiencing allergies. Allergens commonly target the nose and sinuses, so your immune system will create a protective response like sneezing or coughing. It triggers the release of the harmful substance, alerting the brain to sneeze to force the allergen out of your system. 

When you’re cleaning the house or simply walking outside, you may notice that you’re suddenly sneezing a lot. It is probably because you inhale dust or pollen, causing irritation. When these substances enter your body, it responds by releasing histamine to attack the invading allergens through sneezing.

Accessible Allergy Blood Test

More than 50 million Americans suffer from allergies each year. However, most people are unaware of the allergen or allergens causing their symptoms. Allergies generally cannot be prevented, but allergic reactions can be. Once you know you’re allergic to a substance, you can identify strategies that help you avoid the allergen.  Strategies include being in an air-conditioned environment during peak hay fever season or eliminating dust mites and animal dander from your home.

Allergy Blood Test Get tested. Labcorp

According to AllergyInsider.com, up to 80 percent of people with allergies are sensitized to multiple things, making it complicated to track symptoms back to the specific sources. This underlies the reason to take an allergy blood test. Labcorp OnDemand has an Indoor and Outdoor Allergy Test that can easily assess potential allergens so you can seek the necessary treatment and lifestyle modifications. 

The Labcorp OnDemand Indoor and Outdoor Allergy Package includes the following:

  • Dust Mite (D pteronyssinus)
  • Dust Mite (D farinae)
  • Cat Dander
  • Dog Dander
  • Mouse Urine
  • German Cockroach
  • Bermuda Grass
  • Kentucky Bluegrass
  • Leaf Mold
  • White Oak
  • American Elm
  • Short Ragweed
  • English Plaintain (Lamb's Tongue)
  • Sheep Sorrel

Simply shop for the test at Labcorp OnDemand and pay via a credit card or HSA/FSA.   You can then schedule an appointment or walk in to nearly 2,000 convenient Labcorp locations for a quick blood collection.

In a few days, you will be notified to access and view your easy-to-read results online in your Labcorp OnDemand account. You can also download your results if you need a copy or bring them to the doctor.

Labcorp OnDemand’s Indoor and Outdoor Allergy Package is one of the most helpful ways to manage and understand your allergies. It will also guide you to make informed decisions about your health and the surrounding environment during allergy season or year-round. 

Although allergies are typically not severe, please keep in mind that you need to consult a doctor if your allergy causes trouble breathing, persists for many months or returns frequently.

To learn more about Labcorp OnDemand and the portfolio of tests that can be purchased, please visit OnDemand.Labcorp.com

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As fatigued as we all are of COVID-19, it would be disrespectful today not to recognize and mourn the horrible milestone we'll likely cross by Monday — the deaths of 1 million Americans to a virus that could and should have been snuffed out last year had it not become another ridiculous political culture war talking point.

One million of us dead is not just a number.

It is one million people who, had we never heard of this virus in early 2020, would still be breathing and laughing and loving among us.

And one million of us dead is something none of us would ever have imagined possible in the modern and technical world in which we live. Even now, it's hard sometimes to wrap our heads around the impact of one million dead.

Thanks to a wonderful recent Washington Post opinion video about this unprecedented American tragedy, here are some eye openers:

Within weeks of the first reported U.S. COVID death, that of a middle-aged man in Washington state, the virus had killed more people than all of the plane crashes in the U.S. in the previous 20 years.

By late March 2020, it had killed more people than were lost in Hurricane Katrina's 2005 hit on New Orleans.

By early April that year, COVID had killed more Americans than all the service members killed in the wars in Iraq and Afghanistan combined.

About two weeks later, the virus was killing so regularly that it was like being hit by a 9/11 terrorist attack every other day, and by late May it had claimed its first 100,000 lives.

By December, 300,000 of us were gone, and by March: 542,000.

During the winter of 2021, about 2,500 people died daily — roughly the equivalent of having a Pearl Harbor attack every day for three consecutive months.

Vaccinations slowed the disease, and July 2021 saw the lowest monthly toll in more than a year — 8,600.

But then came vaccine resistance. And the delta variant. In September and October another 100,000 of us succumbed and COVID's cumulative toll of 744,000 deaths that fall surpassed the losses of the 1918 influenza pandemic in the U.S.

On delta's heels came omicron and more than 2,000 a day died in January and February this year — more than 125,000 deaths in two months.

The Washington Post notes:

"Historians estimate the death toll for the American Civil War to be about 750,000 military and 50,000 civilian deaths. COVID killed tens of thousands more people, in about half the time."

Today, coronavirus cases and hospitalizations are rising in a majority of American states in what appears to be the first widespread increase since the peak of omicron early this year, according to The New York Times.

Virus cases are up here, too: As of Friday, 14-day changes in cases per 100,000 residents were up 88% in Tennessee, up 55% in Georgia and up 67% in Alabama, the Times reports.

Nationally, 78% of people are vaccinated, 66% are fully vaccinated and 31% are boosted.

In our states? Nowhere close.

Our fully vaxed numbers hover between 51% and 55% and in the last two weeks, cases of the highly contagious BA.2 subvariant of omicron have more than doubled in states across the country from West Virginia to Utah.

There is some good news in the Times report. Though it's clearly too soon to count COVID as over, new data from the Centers for Disease Control and Prevention shows more than 60% of Americans have been infected with the virus at least once, "lending credence to the belief that the modest effects [milder cases] of this surge could reflect growing immunity from previous infections and vaccinations.

That is encouraging. Still, it doesn't bring back the 1 million lives we've lost — 1,151 here in Hamilton County.

Hug your family and friends. And stay safe out there.

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Published on 05/11/2022 06:57.

With the proliferation of viruses that cause respiratory diseases and the great demand for care in pediatric emergencies, some medicines are starting to be out of stock in pharmacies.

Increases number of patients with respiratory syndromes at HEC in Feira de Santana

Photo: Ed Santos/Acorda Cidade | State Children’s Hospital (HEC)

Laiane Cruz

With the arrival of autumn, the number of children who received care at the State Children’s Hospital (HEC), in Feira de Santana, affected by flu syndromes grew. According to data provided by the unit, in February this year 1,185 children were admitted to the emergency room, in March 2,096 and in April 2,138. In the first eight days of May, 648 children with respiratory problems were treated.

Photo: Ed Santos/Acorda Cidade

According to pediatric infectious disease specialist Igo Araújo, who works at the HEC, the numbers are frightening and reveal an accelerated increase in cases of respiratory syndromes in children.

“Even if we compare it with other years, we will see that there is really an important difference in the increase in cases. We usually say that from March to August are the months that pediatricians work the most in the emergency room. There was a 100% increase in cases, but we can see that there was an increase if we compare it to 2019, maybe there is no way for us to confirm or be sure, these children who were isolated for a long time, now they started to circulate and started to increase the circulation of these viruses”, he justified, in an interview with Acorda Cidade.

According to the specialist, most of the symptoms present in children are cough, runny nose, fever, abdominal pain, headaches, and sometimes, wheezing and bronchospasm.

“The great difficulty for us is to determine if it is an asthma condition for those children who already have a history of diseases before or if it is just a flu condition. The cold we say is caused by rhinovirus and often there is no fever, the flu usually already has a fever within the frame, but there are other viruses that can cause it, and then, it is the famous common flu. Most children have arrived at the hospital with the pattern of coughing, tiredness, difficulty breathing, sometimes just a runny nose, a hoarseness. Small children, under 2 years of age to under 1 year of age, are the ones who most require care, they get tired very quickly, they do not have the ease of mobilizing the secretion, as an older child and they will not say what they are sense,” warned the doctor.

Igo Araújo clarified that the beginning of the autumn/winter period has a drier, less humid climate and that actually causes pollution and these viruses to circulate more. Children with the return of classes, daycare centers, schools end up being clustered, closer together, facilitating the transmission of these viruses, such as covid-19, which is transmitted by droplets of saliva.

“Influenza, influenza, acute respiratory syndrome tend to be more aggressive than a cold, but depending on the public or the patient they affect, either one can be aggressive. Then the mothers get crazy, they get tired of us saying that the treatment is nasal wash and nebulization and they can trust that this is really it, some patients need some specific therapy, like we have Oseltamivir, which is an inhibitor of a replication of the virus of Influenza, but for some specific populations, under 2 years of age, some use specific medications, with some medications in nebulization such as steroids, but in fact that old grandmother’s syrup with honey is what will help many of them, remembering that the honey should be given over one year of age”, oriented the infectious disease specialist during an interview with Acorda Cidade.

With the proliferation of viruses that cause respiratory diseases and the great demand for care in pediatric emergencies, some medicines are starting to be out of stock in pharmacies. According to the infectious disease specialist, there is a lack of antiallergic and children’s antibiotics.

“When I think of antibiotics, when I think of a viral infection, which causes a bacterial infection, the first treatment ends up being amoxicillin, amoxicillin with clavulanate, and for the flu, some patients who have an allergic condition or a condition associated with asthma are now in need of treatment. Salbutamol or butazolidine, which are inhaled corticosteroids. Every viral condition, especially in children, can cause an accumulation of secretion, the infectious process, low immunity, and the child is not prepared for the bacteria, which lives in that environment and takes advantage of the opportunity and makes the infection. So we have it from otitis, which is ear infection, sinusitis of the face, pneumonia with some cases and unfortunately from children with cerebral empyema, which is pus in the head, especially after a sinus disease”, he informed.

With information from reporter Ed Santos from Acorda Cidade

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GP Associate Professor Vicki Kotsirilos lists some of the silver linings that have emerged alongside the dark clouds of the COVID-19 pandemic.

Sun rays shining behind clouds
Positives have emerged from the gloom of the COVID-19 pandemic.

Despite the well documented devastation wrought by the COVID-19 pandemic, it has also impacted my life and our clinic in a very positive way.


I work three days a week as a GP in an urban practice with my husband who is a dentist. We run the group clinic with two other part-time GPs and two part-time dentists. 


Early in the pandemic we embraced the huge changes that were necessary to adapt to the pandemic. Recommendations by government were at first difficult, and rapidly changing.


Our primary focus was to continue to serve our patients and community while also ensuring the protection of our staff from COVID-19 infection. We had to maintain a positive attitude to adopt the changes.


Improved infection control capabilities

We installed clear patient screens at the front reception desk to reduce transmission of aerosol spread of SARS-CoV-2, and with support from our local Primary Health Network, we had access to personal protective equipment (PPE) and were able to familiarise all staff on how to use it appropriately.


The transition from not wearing masks to wearing P2/n95 masks all the time with patients in a consulting room was extremely difficult.


It felt suffocating when we were not able to have a breather without them. Now we continue to wear level 3 surgical face masks in low-risk situations as they are more comfortable, despite not being as effective as the P2 masks in reducing transmission of the virus.


We believe that masks continue to play an important role in protecting our staff and our patients.

Most of our patients are continuing to wear their masks, except for a handful who find them difficult. All patients are welcomed to the practice whether they are wearing a mask or not.


Ventilation is important, so each consulting room has a window we leave open for clean air. We also installed a new front security door to keep the front and back doors open for circulation of air, and the reception area and the main medical consulting room have air purifiers with inbuilt ionisers.


Most staff now wear scrubs which make us look a lot more professional, and we have continued other protocols such as surface cleaning. We also purchased a large batch of COVID rapid antigen tests and offered these for free to staff to test before work, when and if required.


Healthier staff

The most noticeable difference we have experienced since the start of the pandemic, is that not a single staff member has taken time off for any respiratory infections – not one.


Prior to COVID, staff consistently needed to take time off for flus or colds, despite immunisation with the flu vaccine.


This experience correlates with influenza infection rate reductions in Australia and has been a positive outcome of the protective measures we have implemented at work. The challenge will be maintaining this record now that influenza is making a comeback in Australia.


We have valued these positive changes, which together with telehealth have had a positive effect on our practice. While several staff have been infected with COVID-19, this occurred over their holiday breaks – not from work exposure.


Occasionally staff needed to take time off following exposure to a household contact, but since the recent changes to guidelines, this is no longer required if they are negative on testing and asymptomatic.


Enhanced technology

The introduction of electronic prescribing, ordering of pathology and radiology testing by emailing patients, and the use of either telephone or telehealth for consultations was enormously welcomed by our patients and staff.


Some patients preferred to continue seeing the doctors face-to-face and that was all ok – we had an equal mix of face-to-face and telehealth consultations.


Positive outcomes included less paperwork and the ability to consult with patients if they had respiratory symptoms or COVID-19 infection when safe to be cared for at home. The support of COVID-related government services is incredibly useful and we are grateful to the Department of Health for their mostly swift advice, support and action in these areas.  


Cleaner air

Lockdowns caused enormous challenges for many of our patients.


GPs and healthcare professionals were lucky – we were able to continue working. But the repeated and extended lockdowns escalated COVID anxiety and stress due to isolation, loss of employment for many, business disruption and/or collapse, uncertainty, and staying home more than usual.


These devastating impacts were felt across the community and should not be discounted; however, a wonderful biproduct was the significant drop in traffic when restrictions came in and more people were working from home. The fewer vehicles on the road made our streets quieter and safer, and resulted in less air pollution and cleaner air.

COVID-positive-article.jpgCOVID lockdowns provided an opportunity to focus on improving health and wellbeing, writes Dr Vicki Kotsirilos.


Stress management and coping mechanisms

Doctors and healthcare workers have been greatly impacted by COVID stress and mental health-related issues.


In our efforts to continue serving our patients and the community, we became very busy at work, and acutely aware that we were now working harder. So, preventing burnout was a big challenge with the extra demands and workload.


It was important staff talked about their feelings and emotions, supported each other, and discussed strategies to minimise stress at home and in the work environment.


What helped us cope?


All staff now aim to have a one-hour lunch break, and use the time to rest, exercise and stretch. It was important we continued to practise self-care to stay mentally and physically healthy. This helped us to develop resilience.


Personally, practising mindfulness-based stress reduction in my garden every morning helps me cope. I also directed patients to useful internet sites to learn mindfulness when required, eg Headspace and Beyond Blue.


These techniques have also proved invaluable when helping patients with their own mental health challenges.


Working from home and self-care

For some people, working from home during the pandemic was satisfying and continues to be so due to less travel time to work and creating more time for self-care, such as exercise.


I found it to be a good opportunity to speak to patients about the importance of positive behavioural and lifestyle approaches, daily exercise, adequate sun exposure, healthy eating habits, and nutrition to support a healthy immune system.


Smoking avoidance; breathing clean air; addressing obesity and chronic diseases, such as diabetes also play an important role in supporting the immune system.


Apart from general health benefits such as CVD and diabetes control, daily moderate outdoor exercise helps to manage stress, moods, and restore good sleeping patterns.


With more exercise, people were appreciating and spending more time in nature. This was the way I coped during the pandemic.


Connecting with nature

Every morning I spent 30 minutes to one hour a day before work, and longer on my days off, using mindfulness walking on the beach, at a local park or a forest.


A study found nature contact ‘buffers’ the negative effect of lockdown on mental health, helped people cope better with lockdown measures, and was associated with more positive emotions.


So, our connection with nature helps us cope and gives us even more reasons why we need to take better care of our planet.


The COVID lockdowns were a great opportunity for myself, our practice staff and the wider community to focus on improving our health and wellbeing through lifestyle, connection with nature and positive behavioural changes.


Crisis breeds opportunity, and destruction often provides the platform for regeneration.


So it has been with COVID-19, and while the past two or so years have been among the most challenging in recent memory, they have also given us the chance to create a better and more positive world for ourselves and future generations.


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COVID-19 mental health pandemic self-care

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· COPD is a common, preventable and treatable lung disease and the third leading cause of death worldwide, with over 80 per cent of deaths occurring in low and middle-income countries.

· Cochrane systematic review suggests current models of educational intervention are not working, and new approaches are needed.

· A new Monash randomised controlled trial called ‘TERRACOTTA’ will set out to address deficiencies in Australia’s primary care relating to COPD management.

Researchers from Monash University have conducted a Cochrane Review of existing international evidence to determine the effectiveness of educational interventions for health professionals managing chronic obstructive pulmonary disease (COPD) in the primary care setting. The researchers reviewed all available studies up until May 2021 and found that current models of educational interventions for health professionals to improve COPD management in primary care are not working, and new approaches are needed. COPD is the third leading cause of death worldwide, yet it is a preventable and treatable health condition. There is an urgent need to identify the best type of interventions to improve guideline recommended management of COPD and improve patient-related outcomes. In this review, the Monash researchers included randomised controlled trials or studies of similar design that studied educational interventions aimed at any health professionals involved in the management of COPD in primary care. A range of simple-to-complex interventions were used across the studies, including education provided to health professionals via sessions, workshops or online modules, provision of practice support tools or tool kits, provision of COPD clinical practice guidelines and training on lung function tests. First author, Dr Amanda Cross, who sits within Monash’s Centre for Medicine Use and Safety (CMUS), said it was unclear whether any published educational interventions for health professionals actually improved the management of COPD in primary care, with the exception of influenza vaccination rates. “There was little-to-no evidence that educational interventions for health professionals improved COPD management, including proportion of cases diagnosed with spirometry, proportion of patients who participate in pulmonary rehabilitation or the proportion of patients prescribed guideline-recommended COPD respiratory medications,” she said. “Interventions and outcomes varied greatly among the studies and there were a number of limitations in the design and reporting of the studies included which affected the overall quality of the evidence.” Professor Michael Abramson, an expert in COPD from the Monash School of Public Health and Preventive Medicine, said: “Based on this review, we have concluded that further high-quality studies are necessary to determine the effectiveness of educational interventions for health professionals managing COPD in primary care, to help improve outcomes for those impacted by COPD.” Senior author of the review and member of the Lung Foundation Australia’s COPD guidelines committee, Dr Johnson George of CMUS, is leading a new cluster randomised controlled trial to address some of the deficiencies in primary care relating to COPD management. “COPD is not only a complex condition, but also a heterogeneous condition and needs a personalised medicine approach,” he said. The ‘Targeting Treatable Traits in COPD to Prevent Hospitalisations’ (TERRACOTTA) trial will be the first of its kind offering tailored interventions targeting treatable traits in COPD for individuals at risk of exacerbations, to improve quality of life and avoid hospitalisations. Treatable traits refers to individually assessing patients for a specified set of treatable problems, followed by the development and implementation of an individualised treatment programme. Primary care is ideally placed to deliver individualised preventive interventions and initiate early management targeting treatable traits. Dr George said that the findings from the trial will inform clinical practice and facilitate continuous quality improvement in COPD: “COPD was the top cause of preventable hospitalisations for chronic diseases in Australia in 2016-19. Our trial aims to demonstrate the efficacy of a coordinated intervention targeting treatable traits in moderate-severe COPD patients in general practice for improving health-related quality of life and reducing hospitalisations/emergency department visits.” “TERRACOTTA will focus on a national roll-out of the interdisciplinary model of care, to inform its scale-up as a routine service,” said Dr George. The TERRACOTTA randomised controlled trial has been funded by the GSK investigator-initiated scheme. The trial has received ethics approval and is soon to commence patient recruitment.

/Public Release. This material from the originating organization/author(s) may be of a point-in-time nature, edited for clarity, style and length. The views and opinions expressed are those of the author(s).

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COVID-19 can cause gastrointestinal symptoms, which can be difficult to distinguish from other ailments like food poisoning or the stomach bug.

Gastrointestinal symptoms like nausea, vomiting, diarrhea, or even gas can develop with a wide range of conditions, infections, or even chronic disorders.

This article will focus on gastrointestinal symptoms, such as diarrhea and sulfur-smelling burps, and when to suspect COVID-19 or something else as the cause.

Every year, about 48 million people in the United States experience some level of food poisoning. Some cases may go almost unnoticed, but about 128,000 U.S. people are hospitalized for food poisoning every year, and about 3,000 die.

The symptoms and severity of food poisoning can depend on what type of food poisoning you have and how much of the affected food you consumed. Common symptoms of food poisoning include:

  • an upset stomach
  • nausea
  • vomiting
  • stomach cramping
  • diarrhea
  • fever

These symptoms can develop within hours or days after you consume an affected food or drink. In most cases, you can ride out a case of food poisoning at home. It’s best to focus on drinking plenty of fluids to prevent dehydration.

The stomach flu is a collection of symptoms rather than an actual diagnosis in most cases. The stomach flu is not actually a type of influenza at all. It’s a generic name given to gastroenteritis, which is inflammation that occurs in the stomach or intestines for a variety of reasons.

Bacteria, parasites, and even some chemicals can cause gastroenteritis, but viruses are one of the most common culprits. The onset of gastroenteritis symptoms can depend on the cause and even the type of virus.

  • Norovirus is the most common cause of viral gastroenteritis. Symptoms usually begin 12 to 48 hours after exposure and can last up to 3 days.
  • Rotavirus infections begin about 2 days after exposure and symptoms usually last between 3 and 8 days. There is a vaccine to prevent rotavirus infection.
  • Adenovirus symptoms start between 3 and 10 days after exposure to the virus and can last for up to 2 weeks.
  • Astrovirus symptoms begin 4 or 5 days after exposure to the virus and can last for up to 4 days.

Other viruses can also cause gastroenteritis, including coronaviruses, but these are less common.

Symptoms of gastroenteritis usually include things like:

  • watery diarrhea
  • stomach cramping
  • nausea
  • vomiting
  • possible fever

There are many causes of stomach infections. The coronavirus is just one type of virus that can cause viral gastroenteritis.

Coronaviruses are a family of viruses, and there are several forms, including the one that causes COVID-19 infections. There are also several variations and mutations of the virus that causes COVID-19, and some types affect your gastrointestinal system in different ways.

Some of the more common gastrointestinal symptoms associated with COVID-19 infection may be overlooked before other symptoms like fever and respiratory symptoms because they’re so common to a number of stomach issues.

However, about 5 to 10 percent of people who get COVID-19 end up with some form of digestive symptom.

Stomach and digestive symptoms that have been linked to COVID-19 infections include:

Diarrhea is the most common gastrointestinal symptom associated with COVID-19 infections. There’s debate as to whether or not the appearance of digestive problems signals more or less severe cases of infection.

What causes sulfur burps and what’s the best way to get rid of them?

Sulfur burps is the name given to burps that have a very particular smell, like that of rotten eggs. Burps can happen any time but may occur more when you are having other gastrointestinal problems.

In most cases, the types of food you’re eating and how you’re eating them can cause sulfur burps. Avoiding foods that create a lot of gas and taking time to eat more slowly can help reduce sulfur burps.

What’s the fastest way to cure diarrhea?

There’s really no cure for diarrhea, and managing this symptom usually depends on the cause. If you have a chronic condition that causes diarrhea, treatment is more complex.

In most cases of diarrhea caused by certain types of foods or simple stomach bugs, there are over-the-counter medications that can help you manage your bowels.

However, the biggest concern is to avoid dehydration caused by diarrhea by drinking fluids. Most cases of diarrhea resolve in about 2 days.

Are sulfur burps and diarrhea a sign of pancreatic cancer?

Sulfur burps and diarrhea can appear with many types of stomach problems, including pancreatic cancer. Your pancreas makes chemicals called enzymes that help you digest food. When you have cancer, the production of these enzymes can be affected.

Any changes in digestion can lead to problems like diarrhea and increased gas production. Talk with a doctor if you are experiencing these symptoms repeatedly or for long periods of time.

Can long-haul COVID-19 affect the gastrointestinal system?

Long-haul COVID-19 and the symptoms associated with this chronic, post-infection condition are still being researched. But there are a number of symptoms that have been linked to the severe inflammation COVID-19 causes throughout the body.

If you experience gastrointestinal symptoms after a COVID-19 infection, talk with a doctor about treatment strategies and ways to reduce inflammation in your digestive tract.

Stomach problems like smelly burps, nausea, and diarrhea are linked to all kinds of conditions, infections, and diseases.

The key to knowing the cause of your symptoms and how to treat them is to pay attention to other symptoms or changes that occur alongside your gastrointestinal problems.

For most acute infections, the key to treating gastrointestinal symptoms is to drink plenty of water and to rest. If your symptoms get worse after a few days, talk with a doctor about other possible causes and treatments.

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A ‘pragmatic guide’ for GPs on use of point-of-care C-reactive protein (CRP) has been published by the Primary Care Respiratory Society in a bid to cut antibiotic prescribing.

An expert panel of PCRS members have developed algorithms for use of CRP testing in both COPD exacerbations and respiratory tract infections in general to support uptake of the technology in general practice.

It follows the experience of other countries such as the Netherlands in adopting point of care CRP tests as part of strict antibiotic stewardship leading them to use fewer antibiotics than any other European country.

Several trials, including a large English study published in 2019 in COPD patients have shown dramatic reductions in use of antibiotics when CRP testing is introduced but without any added harms, the PCRS said.

NICE 2014 guidelines on pneumonia included the use of point of care testing for CRP but were withdrawn during Covid, the PCRS guidance notes.

There have been several barriers to the use of CRP testing in primary care including determining the best model for implementing its use in general practice and funding its use.

Professor Jonathan Cooke, visiting professor in infectious diseases and immunity at Imperial College London and co-author of the guidelines said the issue seemed to have fallen between the gaps of various committees and organisations and so had not been taken up.

‘Unless there is prescriptive guidance from the centre to make these barriers come down it won’t happen,’ he said. ‘There have been a number of pilots but no-one has put a firm recommendation together to implement it. At the moment it’s not joined up.’

He added: ‘The technology exists, it’s a case of driving it through and once you do the advantages are enormous. We did a study in general practice in Manchester and there was a 50% reduction in antibiotic prescribing.’

The PCRS guidance said the clear algorithms they had developed should help improve the use of these diagnostic tests in primary care.

Triage steps include ruling out Covid-19 and influenza, taking account of other symptoms and using the point of care CRP test if the prescriber feels antibiotics are probably needed.

In someone with a respiratory tract infection, this can help determine when if they are not needed, if a delayed prescription may be warranted or if they should be prescribed.

Or in patients with COPD the algorithm and CRP test can help indicate when antibiotics may be needed, but also taking into account if purulent sputum is present.

In the guidance, the PCRS also called on NICE to re-open the review of the current COPD management guidelines and come to a position on the use of point of care CRP testing.

‘Without national guidance, the PCRS panel expressed concern that the NHS could face “postcode diagnostics” and, possibly, differences in antimicrobial resistance patterns’, it concluded.

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Spontaneous pneumomediastinum (SPM) is a rare and self-limiting condition characterized by the presence of air in the mediastinum not related to trauma or surgical procedures [1]. Described by Laennec in 1819 as a complication of trauma, Hamman 120 years later published his case series of SPM. This condition typically affects young adults aged 20-30 years, with a male preponderance of 8:1. SPM is associated with other medical conditions, including asthma, connective tissue disease, interstitial lung disease, diabetic ketoacidosis, chronic obstructive airway disease, and influenza-like syndrome. [1] SPM is reported to develop in 10% of cases of intubated COVID-19 with acute respiratory distress syndrome (ARDS) even with low tidal volume strategies [2,3]. One unmatched case control study of 271 patients showed the incidence of SPM among non-intubated acute COVID-19 patients at 3.3%, similar to our patient [4]. The case we described would fit into this group. 

The cause of COVID-19, SARS-CoV 2, is a novel coronavirus associated with wide heterogeneity in clinical presentation ranging from asymptomatic to critical illness. The first infection was detected in late 2019 in Wuhan, China, after which it rapidly spread worldwide. Mortality was high among those with advanced age and significant comorbidities. The acute phase of COVID-19 infection lasts approximately three to four weeks. After four weeks of infection, SARS-CoV 2 no longer has the capability to replicate, and residual illness in this stage is called the post-acute COVID-19 syndrome [5]. Symptoms associated with the infection may persist, such as lethargy, easy fatigability, and shortness of breath, with some requiring prolonged supplemental oxygenation. To our knowledge, the incidence and risk factors of SPM among patients who have recovered from COVID-19 infection, i.e., patients in the post-acute phase, is yet to be studied.

We present a case of SPM in a patient with post-acute COVID-19 syndrome who received high flow nasal oxygen therapy in the acute stages of the disease.

The patient was a 58-year-old Chinese gentleman who never smoked. He had a BMI of 29.4kg/m2 and was fully vaccinated for COVID-19 (last dose was given three months prior to admission). He was admitted to the emergency room complaining of a productive cough accompanied by shortness of breath. A nasal pharyngeal swab for polymerase chain reaction (PCR) detecting SARS‐CoV‐2 ribonucleic acid (RNA) resulted in a positive. His significant medical history included hypertension and hyperlipidemia. He had no prior trauma, asthma history, diabetes, pulmonary tuberculosis, or connective tissue disease.

On admission, physical examination showed decreased breath sounds on both lungs and diffuse systolic murmur. He was febrile at 38 degrees Celsius, with a blood pressure of 114/77mmHg, heart rate of 143 per minute, and respiratory rate of 35 per minute. Oxygen saturation was at 89% on 100% non-rebreather mask. Arterial blood gas showed type 1 respiratory failure with a P/F ratio of 46. Therefore, we decided to start oxygen therapy with a high-flow nasal cannula (HFNC) (FiO2: 100%, flow: 60 L/min with SpO2: 96%). Initial chest X-ray (CXR) revealed right middle and lower zone patchy airspace opacities without pleural effusion or pneumothorax (Figure 1).

The full blood count showed a white blood cell count (WBC) of 6.95x10^9/L, hemoglobin 15.2g/dL, platelets 191x10^9/L, C-Reactive protein (CRP) 151.1mg/L (N=1.0-5.0mg/L), procalcitonin 1.2ng/mL (N=0.5 to 2.0ng/mL), serum lactate 1.9mmol/L (N=0.6-1.4mmol/L), serum urea 6.8mmol/L (N=2.4 to 6.6mmol/L) and beta-hydroxybutyrate 0.35mmol/L (N=0.02-0.27). His International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) 4C score was nine, signifying high risk and an in-hospital mortality of 31.4 to 34.9%. The patient was prescribed intravenous dexamethasone before transferring to medical intensive care unit (MICU).

In the medical intensive care unit, he received empiric intravenous amoxicillin-clavulanic acid and oral doxycycline. Blood cultures and sputum cultures, which were taken from endotracheal tube (ETT), were all reported as no bacterial growths. Fever persisted, and a repeat chest X-ray showed worsening bilateral airspace opacities. Antibiotics were escalated to intravenous piperacillin-tazobactam while on intravenous dexamethasone therapy. Blood cultures and sputum cultures were repeated and were negative. On day six of illness, he received the first dose of a five-day course of intravenous remdesivir. Due to persistent hypoxia, he received two doses of intravenous tocilizumab on day six and day 26 of illness.

He also developed starvation ketosis and revealed newly diagnosed diabetes mellitus with HbA1c of 8.1%. Subcutaneous (SC) intermediate-acting insulin (Insulatard) was prescribed. Thromboprophylaxis with subcutaneous enoxaparin was given during the pulmonary phase of the illness. The HFNC setting for the first 15 days was on maximum flow of 60L/min, with a taper to 40L/min on the remaining seven days. Initial FiO2 on HFNC was at 100%, with subsequent gradual weaning to 40% on day 28 of illness. On day 10 of illness, he received a trial of continuous positive airway pressure ventilation (CPAP), but HFNC was resumed as no significant improvement was seen on oxygenation. CRP levels improved from 151mg/L to 72.8mg/L, and by day 28 of illness, the CRP was at 4.4mg/L. The patient performed awake prone positioning to improve oxygenation.

On day 30 of illness, he was weaned off to a non-rebreather mask and managed to sustain adequate oxygen saturation on nasal cannula oxygenation at 5-liter oxygen. He was transferred to the general ward for rehabilitation. He remained afebrile and normotensive with a resting tachycardia at 100-110/min. Despite mild dyspnea and easy fatigability, oxygen saturations were at 98% on 4-liter oxygen nasal cannula. Intravenous dexamethasone was gradually tapered down.

On day 34 of illness, COVID-19 PCR with cycle threshold (CT) ratio was 33.34/33.37. Despite this, his saturations dropped to 77% while on 4-liter oxygen nasal cannula. He was put on 100% non-rebreather mask, and oxygen saturations increased to 96-99%. Repeat CXR showed stable bilateral diffuse airspace opacities with no evidence of pneumothorax. Repeat arterial blood gas revealed type 1 respiratory failure with a P/F ratio of 119 and CRP of 0.7mg/L. An electrocardiogram showed normal sinus rhythm at 73/min. A computed tomography pulmonary angiogram (CTPA) was arranged to rule out acute pulmonary embolism. SC enoxaparin was restarted at a therapeutic dose. The scan was negative for pulmonary embolism but detected a pneumomediastinum (PM), pneumopericardium (PP), and subcutaneous emphysema (Figure 2, 3). Respiratory medicine service recommended keeping him on non-rebreather mask oxygenation, and he was deemed a poor candidate for positive pressure ventilation in the event of current deterioration. On examination, he was alert tachypneic with bilateral scattered crackles in the middle and lower zones on auscultation. He developed subcutaneous emphysema at the neck but no change in the quality of his voice. After discussion with the patient and his family, he opted for maximum ward management in the event of further deterioration. The family was hopeful for his full recovery. On day 36 of illness, he developed atrial flutter with a pulse rate of 160bpm on 12-lead electrocardiography (ECG) with a blood pressure of 109/79mmHg. He received rate control measures, including intravenous amiodarone, oral bisoprolol, and digoxin, and his heart rate improved to sinus rhythm at 76bpm on 12-lead ECG.

On day 40 of illness, the patient was found unresponsive with pulseless electrical activity on the cardiac monitor. Cardiopulmonary resuscitation (CPR) was initiated and he was intubated by the on-call airway team. Despite the resuscitation team’s best efforts, no return of spontaneous circulation was achieved, and the patient was pronounced demised.

There are a number of mechanisms that lead to the development of spontaneous pneumomediastinum. First is the alveolar rupture secondary to inflammation and diffuse alveolar pressures due to coughing. The escaping air from the ruptured alveoli tracks along the bronchovascular sheaths, dissecting into the pulmonary hila and escaping into the mediastinal space. This is seen on thoracic computed tomography scans demonstrating the Macklin effect, described as linear collections of air continuous to the bronchovascular sheaths dissecting into the pulmonary hilum [6]. Second is the direct viral invasion of the lung parenchyma, visceral and parietal pleura causing disruption of the parenchymal and pleural integrity or ruptured alveoli leading to subsequent air leak [7]. Third is the prothrombotic effect of COVID-19 infection-causing pulmonary vascular thrombosis and subsequent necrosis in the alveolar membranes. Fourth is cytokine storm-induced diffuse alveolar injury or direct viral infection of type 1 and type 2 pneumocytes increasing the risk of alveolar rupture [3].

COVID-19 related SPM affects an older population aged 38-72 years of age versus 5-34 years for non-COVID SPM [8]. COVID-19 related SPM has been associated with a more severe course of the disease and a mortality rate of 28.5% versus non-COVID SPM, which has an estimated mortality rate of 5.6% [1].

We highlight the risk of SPM, PP, and subcutaneous emphysema developing in COVID-19 patients without the usually associated conditions who did not receive invasive positive pressure ventilation at the post-acute phase of the disease. We also hope this launches further investigations comparing the non-invasive and invasive modalities of oxygen supplementation and the respective settings for severe COVID-19 to achieve the optimal oxygenation profile while minimizing the risk of barotrauma and PP and PM. We also anticipate more studies that look into developing multidisciplinary treatment protocols for patients who develop COVID-19 related PP and PM. The question is: which modality achieves optimal oxygenation while minimizing the risk of barotrauma and SPM? 

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Face masks became the new fashion accessory and the most effective tool in the battle against coronavirus as it became important that you opt for a covering which offers sufficient protection. Public mask-wearing resulted in notable drops in Covid-19 cases as a face mask comes handy not only because it blocks the large respiratory droplets from coughs or sneezes and prevents passing of the virus to others but also because it blocks the smaller airborne particles or aerosols, which are produced when people talk or exhale.

In an interview with HT Lifestyle, Dr Vasant Nagvekar, Co-Director, Infectious Diseases at Sir HN Reliance Foundation Hospital, “With the increase in cases in some parts of the country, it will be a healthy habit to have your masks on at least in indoor spaces and may have some relaxation outdoor where there is free air circulation. It not only will help a person from Covid but other viral infections and from airborne diseases like Tuberculosis and other airborne illnesses. My take is to continue to wear masks as a healthy habit in crowded and indoor spaces.”

Echoing the same, Dr Harish Chafle, Senior Consultant - Pulmonology and Critical Care at Parel Mumbai's Global Hospital, said, “Masks are required in enclosed locations all throughout the world in this Covid-19 pandemic since March 2020. Although sometimes difficult, the habit is becoming part of our lifestyle. Wearing a mask appears to have more drawbacks than benefits for many people. There are advantages and disadvantages in any circumstance. Wearing a mask, which is recommended by public health authorities, has an advantage that cannot be overlooked: it protects ourselves, and we protect others by properly using it.”

He added, “You've most likely heard about the drawbacks of wearing a mask. Breathing becomes more difficult, hearing becomes more difficult, and your glasses fog up, among other things. We agree with this, but we would argue that the benefits are significantly more essential in a pandemic situation like the current one. Simple solutions exist to keep your glasses from fogging up, but you must be aware of them to avoid impeding your vision. A condensation effect causes fogging, such as when you take a shower and the mirrors fog up. To fix this, place a tissue or paper towel between the top edge of your mask and your skin to absorb any excess moisture.”

It is no secret that now, the use of masks is a part of a comprehensive package of prevention and control measures that can limit the spread of certain respiratory viral diseases, including Covid-19. Masks can be used for protection of healthy persons i.e. worn to protect oneself when in contact with an infected individual or for source control i.e. worn by an infected individual to prevent onward transmission or both. 

Dr Sushil Jain, Pulmonary consultant at Masina Hospital, said, "The use of a mask alone is insufficient to provide an adequate level of protection. Potential advantages of mask use by healthy people in the general public include: reduced spread of respiratory droplets containing infectious viral particles (including from infected persons before they develop symptoms), reduced potential for stigmatisation and greater of acceptance of mask wearing (whether to prevent infecting others or by people caring for Covid-19 patients in non-clinical settings), making people feel they can play a role in contributing to stopping spread of the virus, encouraging concurrent transmission prevention behaviours such as hand hygiene and not touching the eyes, nose and mouth, preventing transmission of other respiratory illnesses like tuberculosis and influenza and reducing the burden of those diseases during the pandemic).

Pointing out the potential disadvantages of mask use by healthy people in the general public, Dr Sushil Jain said that it causes, “Headache and/or breathing difficulties depending on type of mask used, development of facial skin lesions, irritant dermatitis or worsening acne when used frequently for long hours, difficulty with communicating clearly especially for persons who are deaf or have poor hearing or use lip reading, discomfort, a false sense of security leading to potentially lower adherence to other critical preventive measures such as physical distancing and hand hygiene, poor compliance with mask wearing, waste management issues like improper mask disposal leading to increased litter in public places and environmental hazards, difficulty wearing masks especially for children, developmentally challenged persons, those with mental illness or breathing problems, those who have had facial trauma or recent oral surgery and those living in hot and humid environments>”

He added, “Many people with asthma have questioned if it is safe for them to wear a mask. According to the American Academy of Allergy, Asthma & Immunology (AAAAI), there is no evidence that wearing a face mask can worsen your asthma. Data from a recent study found that wearing a face mask does not affect oxygen saturation levels, whether the wearer has asthma or not. The US Centers for Disease Control and Prevention (CDC) says that wearing a mask does not raise the carbon dioxide (CO2) level in the air you breathe.”

He revealed that on the rumours about CO2, the CDC says, "Cloth masks and surgical masks do not provide an airtight fit across the face. The CO2 escapes into the air through the mask when you breathe out or talk. CO2 molecules are small enough to easily pass through mask material. In contrast, the respiratory droplets that carry the virus that causes Covid-19 are much larger than CO2, so they cannot pass as easily through a properly designed and properly worn mask." 

Suggesting an alternative, he said, “At present, face shields are considered to provide a level of eye protection only and should not be considered as an equivalent to masks with respect to respiratory droplet protection and/or source control. In the context of non-availability or difficulties wearing a non-medical mask (in persons with cognitive, respiratory or hearing impairments, for example), face shields may be considered as an alternative, noting that they are inferior to masks with respect to droplet transmission and prevention. If face shields are to be used, ensure proper design to cover the sides of the face and below the chin.”

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By Tahnee Jash of the ABC

After two years of dodging Covid-19, Ashley Brown found herself struggling recently with some of the worst cold-like symptoms she'd ever experienced.

Husband housekeeping and cleaning concept, Happy young man in blue rubber gloves wiping dust using a spray and a duster while cleaning on floor at home.

Research shows Covid-19 doesn't survive long on surfaces.
Photo: 123rf

Then, she tested positive to Covid.

"The first few days were awful. I had every symptom you could imagine. I couldn't eat or sleep, was severely fatigued and had shortness of breath," she says.

By day five she felt a slight shift in her energy levels. She missed her family and friends while she was isolating in her apartment alone and it made her determined to get better and back to normal.

"I opened all the windows and disinfected everything: My towels, pillows, blankets as well as the cushions in my lounge room. It was like a mini spring clean," she says.

"I mopped the floor and wiped down all the benches, door handles and light switches in my house.

"Because my symptoms were still there by the second week, I cleaned my house again."

Ashley hopes her mum can come over to visit soon, and so she's taken extra precautions to clean her house given that her mum is immunocompromised.

People with compromised immunity have an increased risk of severe symptoms and treatments may be delayed if they are forced to quarantine.

"My mum has chronic diabetes and while we've had some medical scares in the past, she's now at a good point where she's learned how to manage it," she says.

"I only have one mum and I wouldn't forgive myself if she got really sick."

Cleaning your house after having Covid

Research shows Covid-19 doesn't survive long on surfaces.

Depending on where it's found, the virus only lasts a couple of hours and in some instances a few days. To survive, it needs a "host" and the longer it's been on that surface, the less infectious it is.

Despite this, there's still some social anxiety around catching Covid from surfaces.

When Covid first broke out, there was plenty of advice about how to keep yourself safe. At the time, it included washing your hands, high-touch surfaces and wiping any items brought into your home.

It's partly why cleaning product purchases rose by 50 per cent in 2020. Yet the Doherty Institute reported that 80 per cent of survey respondents did not feel they knew how to thoroughly clean their home after having Covid.

Dr Paul Griffin, an infectious diseases specialist and microbiologist with the University of Queensland, says "deep cleans" (to remove dirt and bacteria from surfaces not cleaned regularly) aren't as necessary anymore.

"We learned more about this virus every day from when it was first discovered," Dr Griffin says.

"While there's talk about deep cleans, and we saw pictures of people with fogging machines we [now know] that surface transmission has been shown to be a lot less important."

Dr Griffin says simply wiping down surfaces with your household disinfectants will do a great job.

"What we typically recommend is just a simple wipe over of high touch surfaces like countertops and door handles [with disinfectant products]."

"If we're trying to decontaminate our home environment, in-wash disinfectants [for clothes etc.] are useful as is simply hanging things on the line to let the sun get on them. But [it's] not a common way of [Covid] transmission."

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Photo: RNZ / Samuel Rillstone

Ventilation is key

The most common way to catch the coronavirus is through tiny droplets in the air passed through close contact.

Dr Griffin recommends sitting outside if you have people visit soon after your isolation period, maintaining social distancing and avoiding "high risk environments, like prolonged indoor close contact".

"Opening windows helps dilute the amount of virus that's around or even purchasing an air purifier with HEPA filtration will basically clean the air inside your home," Dr Griffin says.

If you're using your air conditioner or ducted system while infectious, opening the windows while it's on can be helpful too.

"It can potentially [transmit through that system], although that's not the most common method of transmission. Have the air moving [around your home] and look at opening the window, and have fans on or consider getting an air purifier so it can improve ventilation," he says.

With flu season just around the corner, Dr Griffin recommends having an air purifier not only to help with Covid but with influenza too.

How long should you wait to visit someone after having Covid?

Current New Zealand health advice is you need to isolate at least seven days after you have received a positive Covid-19 result.

"[The] bulk of the symptoms should resolve within that time but there are a lot of symptoms that can persist, that we don't tend to associate with being infectious [like] fatigue and a dry cough," Dr Griffin says.

Ashley hasn't seen her mum for over three weeks and while she's no longer infectious, it's the lingering symptoms she's worried about.

"I've tested negative now but wouldn't feel comfortable inviting mum over until my symptoms are gone. Knowing I've thoroughly cleaned the house and my car after having Covid makes me feel a lot better," she says.

If you're visiting someone in an apartment block or shared housing, there's a higher risk of spaces like lifts and hallways could be be contaminated, so it's good to take extra precautions.

"Doing your hand hygiene really well will protect those people from potentially being infected, if there are contaminated surfaces," Dr Griffin says.

"They could also consider wearing a mask so if the air is contaminated, they're going to reduce their chance of breathing it in."


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Chronic obstructive pulmonary disease (COPD) is a common, preventable and treatable lung disease. COPD makes it harder for a person to get air in and out of the lungs. Symptoms include shortness of breath, cough, excess phlegm and wheezing. COPD can cause a huge impact on a person's life and lead to poor health. 


What evidence exists for educational interventions delivered to health professionals managing COPD in primary care?

Search strategy:

To find relevant studies, we searched six online databases, trial registries and the reference list of included studies, retrieving studies published up until May 2021. 

Selection criteria:

We included randomised controlled trials (RCTs) or studies of similar design comparing a group of health professionals or patients (or both) receiving an intervention with a group receiving usual care (no intervention) or receiving a different intervention. We included trials that studied educational interventions aimed at any health professionals involved in the management of COPD in primary care. 

Main results:

We identified 38 studies, 36 of which tested interventions versus usual care, and seven of which compared two or more different types of interventions. A range of simple to complex interventions were used across the studies, including education provided to health professionals via sessions, workshops or online modules (31 studies), provision of practice support tools or tool kits (10 studies), provision of COPD clinical practice guidelines (nine studies) and training on lung function tests (five studies). 

The studies we identified were very different in terms of who received the interventions, what interventions people received, where the interventions were delivered, and how and when the outcomes were measured. Due to these differences and problems with how the trials were conducted, we mostly considered the overall quality of the evidence to be low or very low.

Based on the current evidence, we were unable to determine the effects of educational interventions for health professionals on the proportion of COPD diagnoses confirmed with lung function tests, the proportion of patients with COPD who participated in pulmonary rehabilitation (specialised education and exercises to improve breathing) and the proportion of patients with COPD who were prescribed medications for their lungs/breathing that were consistent with recommended guidelines. However, the available evidence does suggest that educational interventions for health professionals probably improve influenza (flu) vaccination rates among patients with COPD and patient satisfaction with care.   

Author's conclusions:

It was unclear whether educational interventions improved COPD management in primary care, including COPD diagnosis confirmed with lung function tests, participation in pulmonary rehabilitation and prescribing of guideline-recommended respiratory medication. However, educational interventions for health professionals may improve influenza vaccination rates and patient satisfaction with care. Interventions and outcomes varied greatly among studies, and there were problems regarding how the trials were conducted, which may have affected their results. Further high-quality studies are necessary to determine the effectiveness of educational interventions for health professionals managing COPD in primary care. 

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An elderly woman has become the first fatality of a COVID-19 and influenza combination in Australia.

The unvaccinated 90-year-old from Victoria died in January after catching the coronavirus and the flu at the same time, a condition that has been dubbed "flurona," News.com.au reported.

She was among the six people in the state who contracted both respiratory diseases, noted the outlet.

The five other cases, all of whom aged between 16 and 64 years old, were vaccinated for COVID-19, a report by Yahoo News said.

Overall, more than a dozen Australians have been infected with the coronavirus and flu at the same time, as per 7News.com.au.

A recent study in the United Kingdom found that the combination doubles the risk of death compared to a COVID-19 infection.

In addition, flurona also "greatly increases the change of all the serious outcomes" from either COVID-19 or the flu, according to Dr. Paul Griffin, an infectious diseases expert at the University of Queensland.

"[Y]ou’re much more likely to end up in hospital, and much more likely to have those serious consequences," said Griffin.

"And even if you don’t get both together, because our population is very susceptible, the consequences of the flu this year are going to be very significant," he added.

Nadav Davidovitch, the director of the School of Public Health at Ben-Gurion University in Israel, warned in January that people were at risk of catching the combo infection due to the "high activity" of both COVID-19 and influenza.

"I don't think this is going to be a common situation, but that's something to consider," Davidovitch said.

It is reportedly not possible for someone to determine if they have COVID-19, the flu or flurona based on symptoms alone since fever, cough, chills, sore throat, body aches, congestion, runny nose, vomiting and diarrhea are common in all three conditions.

Victoria’s Department of Health has urged people to make sure all of their jabs were up to date ahead of the flu season.

"By getting vaccinated against both highly contagious infections, you’re not only protecting yourself and those around you, but you’re also helping to ease pressure on our health system," a spokesman for the department said.

Australia has reported a total of 6,122,957 COVID-19 cases and 7,424 virus-related deaths, based on data provided by the government.

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Pure Essence Diffuser

Breathe deeply

Deep breathing clears the lungs and creates a full oxygen exchange. In a smallscale study published in the Indian Journal of Physiology and Pharmacology, researchers concluded that deep breathing, even for only a few minutes, was beneficial for lung function-increasing the vital capacity (max lung capacity) of the volunteers after just 2 and 5 minutes of deep breathing exercises.

The American Lung Association (ALA) agrees too. A breathing exercise you can try now is by first slowly breathing in through your nose alone, then breathing out at least twice as long through your mouth. Try counting your breaths. Inhale for 4 seconds, then exhale for 8. Shallow breaths come from the chest, and deeper breaths come from the belly, where your diaphragm sits. 

Train Your Lungs

Exercise can keep your lungs in shape just as it does your body. During exercise, the heart beats faster and your lungs work harder. Your lungs will step up their activity to deliver the extra oxygen while expelling additional carbon dioxide. 

According to one article, your breathing increases during exercise from about 15 times a minute to about 40 to 60 times a minute. The more consistent we exercise, the more efficient our lungs become. Strong and healthy lungs through exercise also helps to better resist aging and disease.

Avoid Pollutant Exposure

Air pollutants can damage the lungs and accelerate aging. You can reduce exposure by avoiding secondhand smoke, staying indoors during times of peak air pollution, exercising away from heavy traffic, and practicing safety precautions in work conditions that expose you to pollutants.

When it comes to decreasing indoor pollutants, you can: make your home a smoke-free zone, dust the furniture and vacuum at least once a week while wearing a mask, increase indoor air ventilation, and avoid synthetic air fresheners and candles that can expose you to harmful chemicals like formaldehyde and benzene. Aromatherapy diffuser and essential oils are better options to naturally scent the air.

Don't smoke

It's a well-known fact that smoking increases the risk of lung cancer. But that's not the only disease it can cause. Smoking is linked to most lung diseases, including COPD, idiopathic pulmonary fibrosis, and asthma. It also makes those diseases more severe. 

Smoking also increases the severity of diseases. For example, smokers are 12 to 13 times more likely to die from COPD than nonsmokers. Smoking also causes the lungs to age more rapidly, with the chemicals changing lung cells from normal to cancerous.

Quitting can help at any age. The ALA states that within just 12 hours of quitting, the carbon monoxide level in the blood drops to normal. Within a few months, the lung function begins to improve. Within a year, your risk of coronary heart disease is half that of a smoker's. And it only gets better the longer you stay smoke-free.

By sharing just a bit of time and energy on these tasks, you can help keep your lungs working optimally at any stage in life. Several supplements also help in improving cardiovascular functions. KPTown's Honeyed Sliced Red Ginseng can be taken as a sport or travel snack, especially after an exhausting exercise or a long journey. 

To complement that, Manitou Nutrition's Ultra Lung Care helps fight against the oxidative damage caused by free radicals and prevents new influenza and respiratory diseases. Both products are available in KPTown at discounted prices.

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A recent report by the Niti Aayog has said that the incidents of obesity are rising rapidly in Indian children, adolescents and women. According to the National Family Health Survey, the rate of obesity in women has increased to 24% in 2019-20 from 20.6% in 2015-16. People with obesity are at risk of developing multiple medical conditions like type-2 diabetes, high blood pressure, heart disease, obstructive sleep apnoea, joint pains, PCOD, infertility, certain cancers and so on. Additionally, obesity has a detrimental effect on lung health and is a major risk factor for “bronchial asthma”.

What the doctor says

Laparoscopic and bariatric surgeon Dr Aparna Govil Bhasker says: “People with a body mass index (BMI) greater than 27.5 Kg/m2 fall in the obese category. Women with obesity are twice more likely to develop asthma as compared to their lean counterparts whereas men with obesity are almost 1.5 times more likely to develop asthma.

“People with obesity not only have increased risk of developing asthma, but they also tend to have more symptoms, more frequent and more severe episodes. They also have reduced response to medications and generally have a poorer quality of life,” she adds.

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The connection between obesity and asthma

  • Obesity leads to a reduction in lung volume and tidal volume which in turn promotes narrowing of the airway.
  • Obesity is a state of low-grade systemic inflammation that may lead to the exacerbation of asthma.
  • Changes in adipose-derived hormones, like leptin and adiponectin, may enhance the inflammatory state of obesity.
  • Diseases associated with obesity, such as dyslipidemia, gastroesophageal reflux (GERD), sleep-disordered breathing, type-2 diabetes, or hypertension may exacerbate asthma.
  • Obesity and asthma may share common genetics, common in utero conditions, or common predisposing dietary factors (foods high in sugar, diet poor in vegetables etc).
  • Breastfeeding has been associated with a lower risk of both obesity and asthma.

The takeaway

Weight loss is an essential part of the treatment in patients with obesity and asthma. A minimum of 5% total body weight loss is needed for significant improvement in the control of asthma. The more the weight loss, the better asthma control is.

Diet and lifestyle intervention: It is advisable to follow a well-balanced diet and a moderate exercise routine to maintain an optimum weight. At the same time, one must work on reducing stress levels and maintaining good sleep hygiene. Increased stress levels and poor sleep hygiene have also been implicated in weight gain and can lead to asthma. Exercise helps to release endorphins which in turn help to beat stress to a large extent.

Medical treatment for weight loss: At times, diet and lifestyle modification alone may not be enough for achieving weight loss and more support may be needed. Soon, potentially good weight loss medication is expected which may be of help in shedding some weight.

Bariatric surgery: In patients with clinically severe obesity and asthma, bariatric surgery has shown good results. Presently bariatric surgery is the only effective method for sustained weight loss in patients with severe obesity. Most studies have reported very significant improvements in asthma control, airway reactivity and lung function after bariatric surgery. Bariatric surgery has been shown to decrease the episodes of asthma by 60%. Surgery induced weight loss also decreases the risk of infections like influenza and bacterial pneumonia, which also play a role in reducing asthma exacerbations.

Dr Bhasker adds: “Obesity is an important risk factor for asthma in both children and adults. As we work on improving our understanding of the mechanisms that lead to asthma in obesity, we must focus on healthy living. Prevention of obesity is a must. However, we must also work on the stigma against obesity so that people with obesity can seek medical help without any delay. Weight reduction is an integral part of the medical management for obese asthmatics.”

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