Syphilis rates up in 2019, but public health shifts to virus - Bay Area Reporter, America's highest circulation LGBT newspaper
Syphilis rates up in 2019, but public health shifts to virus - Bay Area Reporter, America's highest circulation LGBT newspaper |
- Syphilis rates up in 2019, but public health shifts to virus - Bay Area Reporter, America's highest circulation LGBT newspaper
- Sexually Transmitted Diseases - Your Guide to STDs - WebMD
- I Can’t Tell if It’s a Bad Idea to Have Sex in My COVID-19 Hospital Unit - Slate
- Experts answer your COVID-19 questions: 'Should we assume the opening up to the green phase will be months away from now?' - TribDem.com
- 15 Common STD Symptoms - Common Signs of STDs in Men and Women - WomansDay.com
| Posted: 01 Apr 2020 12:00 AM PDT Dr. Christopher Hall of the National Coalition of STD Directors. Photo: Courtesy Nurx The public health infrastructure traditionally dedicated to fighting sexually transmitted diseases has shifted its focus to fighting the novel coronavirus as a recent report showed an increase in syphilis cases in San Francisco. "This is the big story that's just starting to be told — the remarkable way that STD programs are being affected by the redeployment of workers," Dr. Christopher Hall, the chair of the clinical advisory committee of the National Coalition of STD Directors, told the Bay Area Reporter in a March 26 phone call. "In some cases there's an absence of a functioning STD clinic. In others, such as in San Francisco, they're able to prevent it from getting gutted, but everywhere clients access services are being affected." Hall was a medical director of the Magnet men's health clinic in the Castro from 2004 until 2020. He also served as the vice president of medical affairs at the San Francisco AIDS Foundation, which now operates Magnet at its Strut men's health center in the Castro. At Magnet, sexual health services have been limited to essentials, according to a receptionist interviewed in-person March 20. Those essentials include sexually transmitted infection testing if acute symptoms are present, testing of people who have had sexual contact with those who have tested positive for syphilis, people who are worried about HIV exposure, and those who need to access antiretrovirals or their PrEP medications. Hall said that disruptions in STD services happening nationwide include people not being able to get injected antibiotic treatments, clinics being less able to test for STDs using oral swabs because of fears of coronavirus transmission in close proximity, adapting to drive-through testing similar to the drive-through COVID-19 (the disease caused by the novel coronavirus) test sites, and not wanting to let people who are symptomatic of COVID-19 inside. "It's intense," Hall said. "It's intense for folks who work in STD care and now have to do the next best thing (to treat STDs)." San Francisco Department of Public Health officials, and other medical professionals contacted by the B.A.R. for this story, said that they could not comment on the year-end STD report for the city in 2019 (released in early March) because they are devoting their resources to fighting the coronavirus. When asked about the intersection of COVID-19 and STDs, DPH said that having an STD does not necessarily increase one's risk. "SFDPH does not have any evidence that STDs have any impact on a person's risk of acquiring any respiratory virus, including the coronavirus (COVID-19)," Jenna Lane of DPH wrote in an email to the B.A.R. March 11. Meanwhile, as the B.A.R. previously reported, the coronavirus outbreak has caused a hearing on allowing gay bathhouses in San Francisco to be delayed. Restrictions on bathhouses in the city were first enacted in 1984 as a response to the AIDS epidemic. That hearing was pushed back to July. Gay District 8 Supervisor Rafael Mandelman announced in early February that he's preparing an ordinance aimed at updating the city's policies regarding private rooms in adult sex venues. It was to be taken up by the supervisors' public safety and neighborhood services committee, which he chairs. The two gay bathhouses in the Bay Area — Steamworks in Berkeley and The Watergarden in San Jose — shuttered after government orders limiting non-essential businesses' ability to operate as a result of the coronavirus outbreak. The pandemic is hampering public health officials' ability to fight STDs, according to the National Coalition of STD Directors. "More than half of the nation's public health outbreak response workforce, STD disease investigation specialists, have been redeployed for COVID-19, and up to half of the nation's STD clinics are closed or repurposed for the virus," the group announced in a March 20 news release. "This is across the board," Matthew Prior, the director of communications for the coalition, said in a phone interview with the B.A.R. March 20. "STD prevention in the United States has slowed to a halt with up to half of staff being relocated for coronavirus response." Prior said that what STD first responders — "the people that go into communities, find disease and arrest the spread of infection" — need the most, is more of them. "We have needed more first responders for a long time," Prior said. "There's not enough people to go around to respond to coronavirus and maintain effective STD services." Prior said that coronavirus is limiting even STD clinics that remain open, with rules about what those clinics can provide and how many people are allowed in at one time. Syphilis cases rise in the city as other STDs stay flat Hall said that the reason more syphilis cases are being found among women is because more tests are being given to pregnant women so that their babies won't be born with syphilis. "There has been increased case-finding of congenital syphilis," Hall said. "If you don't treat women appropriately during pregnancy, that's when the newborn becomes infected." There were 1,665 cases of syphilis in San Francisco in 2018 and 1,860 in 2019, according to DPH statistics. Of these, 114 of the 2018 cases were among women, compared with 159 of the 2019 cases — a rise of 29%. There was one case of congenital syphilis in San Francisco in 2019, according to DPH statistics, compared with zero cases the year before. Dr. Jeffrey Klausner, who was director of STD prevention and control services at the San Francisco Department of Public Health from 1998 to 2010, said the rising syphilis rates are the result of budget cuts. "We've been seeing rates go up for the past 10 years now," Klausner, who is now an adjunct professor of medicine at UCLA, said in a phone interview with the Bay Area Reporter March 6. "They leveled off in the mid-2000s in San Francisco, partly because of our Healthy Penis campaign, but when that was defunded the rates went upward again." The popular campaign featured a Healthy Penis and Phil, the syphilis sore, urging men who have sex with men to regularly get tested for STDs. Syphilis cases were at a near all-time low nationally at the turn of the millennium, and have spiked since then. According to Klausner, intravenous drug use is a major cause for the increase in cases among women (cases of the bacterial infection are still predominantly spread between men who have sex with men). "A cause is the relationship to the opiate epidemic and the exchange of needles, drugs for sex, and the intersection of that with poverty," Klausner said. "With proper resources, syphilis can be brought under control. "The spillover of the male population to female is concerning because syphilis in that population can become congenital syphilis," he added. Gonorrhea rates were down from 5,915 in 2018 to 5,565 in 2019. Male rectal gonorrhea cases were down from 1,629 in 2018 to 1,561 in 2019. Chlamydia, too, was down, from 9,465 in 2018 to 9,438 in 2019. Male rectal chlamydia cases declined from 2,446 in 2018 to 2,427 cases in 2019. Hall said that there had been concern that increased PrEP use as a prophylaxis for HIV infection had made some people think numbers of bacterial STDs would explode. But Hall said that hasn't happened because a PrEP prescription is often accompanied by increased testing for those infections. "The offsetting phenomenon is that people on PrEP are getting screened every three months or so with regular screening so you are catching STIs earlier," Hall said. "On average, sexually active gay men were getting screened every nine-12 months but in the era of PrEP what is happening is we are catching STIs earlier and the forward transmission is blunted or decreased. The increased screening is keeping the numbers of STDs relatively in check."  |
| Sexually Transmitted Diseases - Your Guide to STDs - WebMD Posted: 12 Nov 2019 05:05 PM PST 
Sexually transmitted diseases, commonly called STDs, are diseases that are spread by having sex with someone who has an STD. You can get a sexually transmitted disease from sexual activity that involves the mouth, anus, vagina, or penis. According to the American Social Health Organization, one out of four teens in the United States becomes infected with an STD each year. By the age of 25, half of all sexually active young adults will get an STD. STDs are serious illnesses that require treatment. Some STDs, like HIV, cannot be cured and are deadly. By learning more, you can find out ways to protect yourself from the following STDs. What Are the Symptoms of STDs?Sometimes, there are no symptoms of STDs. If symptoms are present, they may include one or more of the following:
How Do I Know If I Have an STD?Talk to your doctor. He or she can examine you and perform tests to determine if you have an STD. Treatment can:
How Are STDs Treated?Many STDs are treated with antibiotics. If you are given an antibiotic to treat an STD, it's important that you take all of the drug, even if the symptoms go away. Also, never take someone else's medicine to treat your illness. By doing so, you may make it more difficult to diagnose and treat the infection. Likewise, you should not share your medicine with others. Some doctors, however, may provide additional antibiotics to be given to your partner so that you can be treated at the same time. ContinuedHow Can I Protect Myself From STDs?Here are some basic steps that you can take to protect yourself from STDs:
How Can I Avoid Spreading an STD?
 |
| I Can’t Tell if It’s a Bad Idea to Have Sex in My COVID-19 Hospital Unit - Slate Posted: 27 Apr 2020 08:58 AM PDT  Photo illustration by Slate. Photos by Getty Images Plus. How to Do It is Slate's sex advice column. Have a question? Send it to Stoya and Rich here. It's anonymous! Dear How to Do It, I'm a medical student who has a little bit of a crush on one of my interns at the hospital where I'm working. I didn't think he was into me until a few days ago when he saw me changing into my scrubs and proceeded to flirt with me that afternoon. I'm horny as hell, as we probably all are in this era of sheltering in place. This hookup, if it were to happen, would be mostly ethical regarding the virus if it happened at work in an on-call room. (We're both working in the same COVID-19 unit with improper PPE, have both had symptoms and recovered without testing, and both live alone.) He hasn't mentioned a partner, whereas everyone who has one has mentioned it (again, newly formed COVID-19 unit with a whole lot of people from other units coming to help, so we're all still getting to know each other). I think with the way workplaces have changed, for the better in my opinion, in light of the #MeToo movement, he wouldn't hit on me overtly. But I'm really not used to making the first move with men, unless I'm at a bar on my third drink. How do I show him I'm attracted and open to whatever he wants to do? Do I slip him a note with my number? Just wait and hope we work on the same days a few more times and this progresses naturally? (Did I mention I'm very horny and sex deprived already?) —Play Doctor Dear Play Doctor, I'm not entirely convinced that this is as ethical as you make it out to be, but then I never watched Grey's Anatomy so I'm not entirely conversant in the flow of power here or what qualifies as acceptable on-call-room behavior. I also wish I had slightly more background here: "One of [your] interns" implies this guy could be your superior, if you're still a medical student. Regardless, pandemic or not, I think the principle of not shitting where you eat is an important one to keep in mind, especially for someone who is less than secure about making the first move, and especially if there's a potential power dynamic that could go sour. With all due respect, you don't seem particularly seasoned. And remember, you have to see this person regularly. Could get awkward, or worse. But I know: These are desperate times. Without endorsing this, I'll say I find the easiest way to transition a pleasant association into a sexual one is by talking about sex. You know, casually mentioning it in conversation. You could do this while discussing how the pandemic has been affecting you: You miss your family, you now have to work out in your living room, and oh, you're also so horny. Tee hee. When a conversation between attracted parties starts out platonic and then turns to sex, it tends to stay there. And then sex happens. Just something I've noticed. I don't think you have to tread lightly if this guy's already been flirting with you. You could probably say, "Wanna bang?," and that would be that. I'm sure you're dealing with a lot right now, so I'll leave it there. Dear How to Do It, Is anxiety making us come faster? I've been dating a wonderful woman for eight months. We've had a really enjoyable sex life. With the pandemic, we've basically been together nonstop since early March. What's changed in the bedroom? The sex is even hotter, but strangely, we are climaxing within five to 10 minutes. Normally we spend about 45 minutes making love. We both are dealing with added anxiety due to COVID-19. Is that why we're coming so fast? We've laughed together about how fast we're coming, but it seems kinda weird to me. Is it my fragile male ego? Should we just keep having fast orgasms? Thanks for your input! —Quick Shot Dear Quick Shot, Why stop having fast orgasms? Nobody's looming over your bed with a stopwatch in hand. I love it when I can come fast with a guy; I've got sandwiches to eat and movies to watch. Don't get me wrong, a long session is great, but there's something about the efficiency of a five-minute bang that results in mutually satisfied parties that makes me marvel at the capabilities of the human body. If both of you are laughing about this and having fun, there's no problem to fix. As to whether anxiety is contributing to your speed-coming, the answer isn't a definitive no. Anxiety, especially of the sexual variety, is often cited for its nullifying effects on arousal and orgasm, but in some cases, anxiety has been thought to induce orgasm. In the '50s, a doctor by the name of S.S. Feldman wrote about spontaneous and masturbatory orgasms caused by a variety of seemingly boner-killing sources like fear of failure in public performance, fear of missing trains, threats of being arrested, or fantasies of being brought to trial or sentenced to death. Nothing about pandemics in there, but hey, it's a horny time. I haven't found anything about the orgasm-inducing effects of general anxiety or specific anxiety that is not the result of an immediately present stimulus, but the bigger picture here is that different people have different responses to anxiety. If the coronavirus is making sex more efficient for you two, consider yourselves lucky—it means at least one positive thing has come out of this society-upending disaster. Dear How to Do It, Before the pandemic, I had a one night stand and had an unprotected sexual encounter with a woman while under the influence of alcohol. I am a little bit of the anxious and paranoid type, so I immediately went to the doctor to get myself tested for STIs. Thankfully everything came back negative, but I was still worried about HIV, and based on my research, HIV takes about a month to be fully conclusive. So after a few weeks, I went back to the doctor and asked to be checked again for STIs. A week later, I got notified I had a nonurgent appointment with the doctor. I went to his office, but this time I got the biggest shock of my life: The doctor said I tested positive for HSV2, or genital herpes. Based on my research, I have no physical symptoms of herpes, and I never have cold sores either, so I am little perplexed as to why he tested me in the first place. Given blood tests for herpes are not recommended for people with no physical symptoms and can be inconclusive (i.e., false positive), do I now have to tell every single partner I might meet in the future? I already struggle to speak to women, and I am the shy type when it comes to relationships. The thought of carrying this burden of disclosure is making me extremely anxious and sick. I also don't think the doctor was behaving ethically here either, given no doctor has ever tested me for herpes via blood tests before because I never have had any physical symptoms. In the first test, he didn't include herpes in the blood test, and in the second, I assumed he would do the same, but he didn't. I was in a rush to get to work that day and I didn't do a proper check before my blood was taken out, so partly it's my fault as well, but I trusted him because he was a doctor. Do you think this is right? Should I lodge a complaint against this doctor? He is someone I have recently started visiting since I moved to this city. —Standardized Test Dear Standardized Test, False positives in HSV2 tests are so common—nearly 1 in 2, estimates the U.S. Preventive Services Task Force—that you cannot for sure say that you have herpes right now.* The results are inconclusive. I think the best thing to do would be to monitor for potential symptoms and perhaps get another test (or five) to give you a better picture of whether you're a carrier. If in fact you do have an active virus, yes, you're obligated to tell your potential partners, but as you suggest, a source no less authoritative than the Centers for Disease Control and Prevention concedes that "diagnosing genital herpes in someone without symptoms has not shown any change in their sexual behavior (e.g., wearing a condom or not having sex) nor has it stopped the virus from spreading," which is why the agency specifically does not recommend testing asymptomatic people for HSV2. Regarding how to handle the doctor, that's also inconclusive. It is indeed somewhat unusual to test for herpes without symptoms, but that test came about after you requested a second battery of tests than the first standard round of STD checks. It's too tough for me to determine negligence or wrongdoing here because I do not know how the conversation went. You might have a good argument that you did not give properly informed consent to the herpes test, but some things to consider are whether you gave informed consent to each and every test that was taken (I'm assuming you did not), and the fact that these informed consent disputes regarding testing are almost always about HIV. I agree, it's annoying that your doctor even put in your head that you might have herpes given the unreliability of the tests, but if he understood that you wanted to be tested for everything, perhaps his version of everything does not match yours, and a lack of specific communication is the cause of the disparity. Unless you specifically said you did not want to be treated for HSV2, I don't think you have a case here. And what would you even do with the case, anyway? The effect of your report could be to get someone in trouble for doing what you asked a little too thoroughly for your taste, which you could have stopped anyway but for your haste the day you were tested. As much as you may hate to hear it, I think you should talk to him about this and the faultiness of herpes tests. It's easier to run and tell a disinterested party about perceived misdeeds, but what you've presented does not indicate decisive misconduct on his part, and if the test came back negative, I highly doubt you'd have the impulse to report him anyway. Dear How to Do It, When my husband and I started dating 10-plus years ago, I was attracted to his bouncer-like physique—broad shoulders, strong arms—and his wider waist was not an issue. Over the years, he's put on 50-plus pounds and, now that he's approaching his 50s, is beginning to have health issues that are significantly attributable to his eating and exercise habits. Frankly, I'm no supermodel and, being in my late 40s, struggle balancing my glacial metabolism against my sweet tooth and emotional eating habits. Since I have a family health history that can be greatly exacerbated by weight, I try to stay on track balancing discipline and indulgences. About four years ago, we were planning an international vacation and I expressed my concerns for his health and about our trip. His size was about to require him to purchase a second seat and impinge on our planned activities that had weight limits. We both worked hard for this trip, and I didn't want him to spend our time being held back and feeling bad. He agreed and took some temporary steps, but quickly slid back into old habits. Well, the trip rolled around and, while we were able to upgrade his seat to give him enough room, there were multiple activities we couldn't participate in because of weight limitations. He was apologetic and depressed, and I tried my best to stay positive and supportive as we found other things to do. Since then, we've had multiple conversations about being healthier as we age so we can be active when we finally retire. He repeatedly tells me that he doesn't want to be a burden and makes self-depreciating comments about his body daily. He can maintain balanced habits for a few weeks and then slides back into old habits—often bringing me into it with meals out, insisting on appetizers and dessert, etc. I take responsibility for what goes into my body. When I point out that I've been overdoing, he feels like I'm judging him. The past six months have become a spiral. The overhang of his abdomen has become an impediment in our lovemaking. We've tried multiple approaches and positions, but he's unable to achieve satisfaction. His doctor prescribed ED medication, which has been unhelpful. While he is able to get an erection, we're not able to get into a workable position without him losing it. He is frustrated and depressed about it, but seeks every solution other than reducing his weight. I've always told him that I don't care about his size. I care about his health. I feel like I've tried every way I can to be supportive and encouraging. I want him to be happy with who he is—inside and out, as that's what is attractive to me. But I feel like we're stuck at an impasse and it's becoming harder and harder to remain patient as he simultaneously complains of discomfort from his health issues while overindulging. Is there anything I can do? —Worried and Frustrated Dear W&F, As far as his behavior is concerned, you should make like the Beatles at their least creatively engaged and let it be. This is your husband's battle to fight—you can't will him to lose weight any more than you can decide what goes into his body by chewing up his food for him and force-feeding him. It sounds like you've tried to voice your concerns about his health many times and in many different ways, but if you haven't found a neutral time to fully lay this out for your husband the way you have for me here, soberly and with compassion, that may be worth a try. But if that's happened already, the best you can do is to focus on your own eating and fitness habits and hope that your example will prompt him to follow suit. I feel for you both—food issues are particularly difficult as they can't be conquered with simple abstinence. Every dinner table is a slippery slope. Do the best you can in a tight spot and continue to be supportive, affectionate, and nonjudgmental. Don't avoid the topic of his health, but don't harp on it either. As for sex, depending on your tastes, oral could provide a satisfying outlet that intercourse cannot at the moment. Try that, and good luck. —Rich
More How to Do ItThe other day my male roommate left a pair of his underwear on the bathroom floor. I'm also a guy. I have no idea why I did it, but I picked them up and smelled them. Then I masturbated to the smell. Then I felt horrified with myself and wondered what the hell I was thinking. How bad of a violation was this? I feel like such a creep—but also keep getting turned on by the thought of it. Correction, April 27, 2020: This article originally misidentified the U.S. Preventive Services Task Force as the U.S. Preventative Service Task Force.  |
| Posted: 29 Apr 2020 08:00 AM PDT  Have a question about coronavirus, also known as COVID-19? We will ask the experts. Send questions to tribdem@tribdem.com. • • • • • "Should we assume the opening up to the green phase will be months away from now? When do you expect large gatherings such as wedding receptions, concerts, etc., to be allowed again?" The answer: The reopening of Pennsylvania, and our region specifically, to the green phase is going to be decided by case data. As it stands now, a region must have 50 new cases or fewer in a 14-day period to move to the yellow phase. The green phase will follow that – when we see a sharp decline in cases. The decision to move through the phases is going to depend on data. That data is dependent on accurate testing and contact tracing of individuals who are infected. The Pennsylvania Department of Health is working to collect the most accurate data with Carnegie Mellon University. An important thing to point out here is a number we call the R0. This indicates the contagiousness of an infectious disease. For COVID-19, this number is between 2.5 and 3.0. That means that one infected person will transmit the disease to as many as three people. To move to the green phase from the yellow phase is going to require people to follow the rules. If the public observes the rules – wearing a mask when out in public, aggressively washing their hands, and avoiding gatherings of 25 or greater – then we can move through the yellow phase more quickly. In short, we are in this for the long haul. Viruses such as SARS CoV 2 don't go away. We must either have a vaccine to prevent the disease or have two-thirds of the nation recovered from the illness. I implore everyone to urge officials to make more testing available, to aid public health officials when asked for information, and to limit your exposure to others (until one of the above occurs). Together is the only way we can decrease our time apart. – Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. • • • • • "I had severe symptoms in March, was hospitalized and tested. The test came back positive on March 16. My husband had mild symptoms, but he wasn't hospitalized nor tested. As an essential worker, I had to be re-tested in order to go back to work, so on April 23 my husband and I got tested. I was negative and he was positive. Now what do we do?" The answer: The CDC recommends two strategies for returning to work. One is a test-based strategy that states you should have two consecutive negative molecular (genome) tests in which the swabbing has been done greater than 24 hours apart. The other is a non-testing based strategy where you must be fever free for 3 days and be at least 7 days removed from when symptoms started. The CDC also recommends that an individual with a laboratory confirmed case who is asymptomatic should wait 10 days before returning to work. This situation is in the in-between. You are negative, but your husband is positive. If we take the guidelines and adapt them to your situation, it may be prudent for you to wait the 10 days before returning to work. At the very least, it is prudent to be sure your husband is fever free for 3 days and that it has been 7 days since his symptoms started before you return to work. – Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. • • • • • "Can coronavirus testing be done anonymously, similar to STD testing?" The answer: At this time, all COVID-19 testing requires an order from a health care provider, and the specimen must be collected by someone trained to do it, such as a nurse. The ordering physician shares the test results with the patient. So it is not a fully anonymous process, currently. But health care providers work diligently to protect your personal health information, so you can feel confident getting a test if it is recommended. – Emily Korns, director of marketing communications, Conemaugh Health System • • • • • "I am a 67-year-old woman, active and in good health. I rent my basement to a traveling nurse who is working at a local ER. She has already had one COVID-19 scare and was quarantined until her results came in – thankfully negative. "However, she could of course become positive at any time. Should I be concerned?" The answer: If this nurse is compliant with Department of Health and CDC recommendations including personal protective equipment, proper hand washing hygiene, and if she is following hospital ER infection protocols, the risks to others including yourself should be minimal. You have already established separate living areas if the nurse is in your basement. Practice social distancing and good hand washing, and frequently clean surfaces you may both touch. I also recommend you both wear face masks when in the same area of the house. Finally, we should all be thankful for nurses and all health care personnel for their care. – Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "I am hearing more and more that this virus causes clotting in the body – causing strokes and organ failure due to bodies being riddled with clots. But we can't take NSAIDs (nonsteroidal anti-inflammatory drugs) such as Ibuprofen, which have been known to thin the blood and prevent clotting. What can we do to prevent the clotting aspect of this virus?" The answer: In our cases locally, we have not yet seen the severe clotting described by the reader, or deaths attributed to clots or pulmonary embolism, but we recognize this is a complication. Most likely, this level of clotting is due to sepsis brought on by a very severe form of the infection. In the hospital, patients may be prescribed a medication, such as heparin to avoid clotting. For the average patient at home with a mild or moderate case of COVID, anti-clotting therapy doesn't seem to be indicated. If you have a personal history or family history of blood clots, this is important information to share with your primary care physician or your emergency care provider. With COVID-19 or any condition where you may be inactive due to illness, it's a good idea to try to move around a bit to keep blood flowing, even if it's just getting up to walk around the couch." – Dr. Uchenna Okereke, infectious disease specialist, Conemaugh Physician Group. • • • • • "I'm a 50-year-old male with severe asthma and hypertension. Both diseases are well controlled with medications. I realize that I have two high risk factors for COVID-19 complications if I became infected. However, I never get sick. Given that I have a strong immune system, does that make me any less likely of becoming infected with COVID-19?" The answer: It is important that your asthma and hypertension are both well controlled, and that you have a good immune system. Patients that are immunosuppressed or immunocompromised are at a higher risk of infection and complications. However, there are other important contributing factors including behavior (contact length and frequency), virulence of the virus and environment (crowding, poor air quality and pollution). Therefore, immune status is not the only determining factor whether or not you become infected with COVID-19. – Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "I'm 67 and was diagnosed with the virus about two weeks ago. I'm quarantined and have shortness of breath, but have been to emergency room twice and all tests are good. How long does it take for symptoms to subside?" The answer: There are no specific answers for duration of illness or exact recovery time, and each patient is different. Those with milder symptoms may recover in 7-10 days. Others with more moderate or severe symptoms may take 3 to 4 weeks. I also read medical reports of patients who were hospitalized with significant complications and were subsequently discharged, but were still not completely recovered at 10 weeks or longer. I certainly hope that your symptoms resolve soon, and it is very important that you follow up with your treating physician. – Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "Does spraying the soles of my shoes with bleach without wiping kill the coronavirus instantly, or does It take some time? Is there a better way to clean them to prevent the virus from spreading into the house?" The answer: COVID-19 is spread via respiratory droplets and anything that those droplets get on. The term for this is fomite transmission. Research has shown that the virus can survive on surfaces for a few hours to a few days, depending on the surface. A disinfectant such as bleach will destroy the virus. You may spray with a bleach solution (1/3 cup of bleach per gallon of water) or use a household disinfectant spray (such as Lysol) and allow the shoes to dry. This can take a few minutes. Another option that can be done is to wipe the shoes down with a hydrogen peroxide wipe (it only takes 30 seconds for these wipes to kill). Lastly, you may use a 70% alcohol-based solution to wipe the shoes down and allow them to dry (this can take up to a minute). If you are worried about bringing the virus into the house, you may want to spray the shoes outside your home and bring them in after the 30-180 seconds has passed. That's what I do! – Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. • • • • • "If someone is asymptomatic yet positive for COVID-19, how long would they be considered contagious?" The answer: Great question. If you test positive: • Notify your close contacts and let them know they should quarantine at home for 14 days. This includes your family members. • Self-isolate in your home until each of the following conditions are met: 1. It has been at least 7 days since your symptoms first appeared, AND 2. It has been at least 3 days since you have not had a fever (without using fever-reducing medications) and your respiratory symptoms (cough, shortness of breath) are improving. – Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "We have all these stories of how many caught the coronavirus and how many deaths have been recorded, but not one single number on people who have recovered from it. Is there an accurate estimate of COVID-19 recoveries in Pennsylvania?" The answer: An accurate figure does not exist. They may start collecting hospital discharges, but since only 10% of all confirmed COVID-19 cases end up in the hospital, it doesn't mean that much. They aren't really "recovered" when they are sent home anyway. If someone gets a positive test, stays home while the illness runs its course and returns to the self-distancing world, that person is not being checked or reported as recovered. Not to mention hundreds, probably, who get mild symptom but are just being told to stay home, and then recover without even testing. They aren't even showing up on the daily positive report. – Randy Griffith, health care reporter, The Tribune-Democrat • • • • • "Should we be concerned, as we soon turn on our air conditioning, about airborne spread of coronavirus?" Answer: COVID-19, SARS-CoV-2, is droplet transmission. The airborne droplets travel through the air and can make it about six feet. When you add an air conditioner, you are adding strong airflow into the equation. This would allow the airborne droplets to travel farther. If you are using the air conditioner in your home and no one in your household is sick, then you don't need to worry about transmission. What can be of concern is, if social distancing is lessened and you are in a public building with air conditioning with a symptomatic (or asymptomatic) COVID-19 patient, the six-foot rule may not help. The air flow from the air conditioner would allow the droplets to transfer farther than the average of six feet. Reference: Lu J, Gu J, Li K, Xu C, Su W, Lai Z, et al. COVID-19 outbreak associated with air conditioning in restaurant, Guangzhou, China, 2020. Emerg Infect Dis. 2020 Jul [4/15/20]. https://doi.org/10.3201/eid2607.200764 – Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. • • • • • "What if my car inspection is due? Is there a grace period? I really don't want to take my car to a shop right now." The answer: For driver licenses, photo ID cards and learner's permits scheduled to expire from March 16, 2020 through April 30, 2020, the expiration date is now extended until May 31, 2020. – Pennsylvania Department of Transportation website (https://www.penndot.gov/pages/coronavirus.aspx). • • • • • "When in a risky area (such as a store), you might encounter someone within the 6-foot recommendation who is sneezing, coughing or simply asking for your help, and you could feel compromised and at risk. "Would more personal immediate actions reduce the COVID-19 risk, aside from the obvious of keeping your mouth closed or wearing a mask or goggles? "Although unorthodox to some, would blowing your nose (carrying tissues) and/or blinking your eyes, despite no real need to, mitigate being infected if the virus is airborne – followed by a thorough washing of your hands, mouth, nose and eyes (area or drops) when possible?" The answer: An excellent and practical question. The Centers for Disease Control and Prevention recommends "wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain" – grocery stores and pharmacies, and especially in areas of significant community-based transmission. The right way to wear a face covering or mask is to cover your entire nose and mouth, which means that the face mask should be tight-fitting underneath your chin. It will be less effective if you remove it from your face when you're in a crowded store, such as to speak to someone. An important takeaway from the CDC's message is that covering your face when you leave the house must not replace thoroughly washing your hands. It's also worth emphasizing that sewing your own face mask may not prevent you from acquiring the coronavirus in a high-risk situation, such as lingering in crowded places. – Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "Can I catch COVID-19 from my cat or my dog?" The answer: There have been some studies that are looking into whether domesticated cats and dogs can get SARS-CoV2. These results indicated SARS-CoV2 could replicate in cats and that SARS-CoV2 could be transmitted via respiratory droplets between cats, though it appears that it is not highly contagious between cats. They also show that dogs are not really susceptible to the infection. These studies show that cats can catch it from you, but none have shown that cats can transmit the virus to humans. That work has not been done, so the answers is we don't know yet. The best approach right now for cat owners is to keep their indoor cats inside and their outdoor cats outside. For more information check out this article in Nature: www.nature.com/articles/d41586-020-00984-8. It is a good summary of the work that has been done so far. – Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown • • • • • "I would like to know if it's normal for a person to experience symptoms (day 1) and feel better over the next few days, only to experience those same symptoms on day 10-11 that were far worse." The answer: Another excellent question. Patients may have a mild common cold-like illness and/or an uncomplicated upper respiratory viral infection with symptoms such as fever, fatigue, cough, muscle pain, sore throat, shortness of breath, nasal congestion or headache. Rarely, patients may initially have diarrhea, nausea and vomiting. The above symptoms may improve, or progress in 7-10 days to a severe viral pneumonia leading to acute respiratory distress depending upon the immune status of the patient, age, and other chronic underlying medical conditions. – David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "I would like to know if it's normal for a person to experience symptoms (day 1) and feel better over the next few days, only to experience those same symptoms on day 10-11 that were far worse." The answer: Another excellent question. Patients may have a mild common cold-like illness and/or an uncomplicated upper respiratory viral infection with symptoms such as fever, fatigue, cough, muscle pain, sore throat, shortness of breath, nasal congestion or headache. Rarely, patients may initially have diarrhea, nausea and vomiting. The above symptoms may improve, or progress in 7-10 days to a severe viral pneumonia leading to acute respiratory distress depending upon the immune status of the patient, age, and other chronic underlying medical conditions. – David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "With summer and warmer weather coming soon, can the coronavirus be spread by mosquitos?" The answer: I can understand your concern – my goodness, what would we do it this were true! Infectious disease transmission types are two basic categories: Direct (person to person) and indirect (which involves an intermediate carrier). Indirect transmission can come from fomites (inanimate objects that transmit disease), vehicles (food and water) or vectors (living things that transmit disease). COVID-19 (SARS-CoV 2) is spread by airborne droplets, a form of direct transmission. That means it is spread by coughing, sneezing and talking. There are all kinds of modes of transmission – ways that infectious diseases spread – but this one is only airborne droplets. – Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown • • • • • "We have scheduled a Bahamas trip in September with Carnival Cruise Lines. They have not canceled yet. Is it OK to keep this vacation or should we cancel?" The answer: "Cruise lines all have different policies. Generally, people are waiting (to cancel)." – Epic Journeys For more information, contact your travel agent. For information specific to Carnival Cruise Lines, visit: www.carnival.com • • • • • "I work in a nursing home as a certified nursing assistant. If one of the residents goes to the hospital and tests positive, does our upper management have the right to not disclose this information to employees." The answer: There is no requirement from either CMS (Centers for Medicare & Medicaid Services) or the Pennsylvania Department of Health that nursing homes or hospitals are required to inform employees of confirmed cases. But we do expect facilities to take steps to protect the health and safety of residents and share information with those who may be affected. – Pennsylvania Department of Health • • • • • "I am a registered nurse and I want to know how long is a surgical mask, fabric mask or N95 mask effective? "I do home care and can work one-on-one with one patient for up to eight hours a day in their home, or visit up to four patients in one day and am provided with surgical masks. "In searching for an answer, I came across an article in the International Journal of Infection Control, 2013, that suggested that face masks are no longer effective beyond two hours of use! "What renders them ineffective? Is it the moisture that accumulates? If so, could I recycle the surgical mask I wear with the same patient after it dries? My employer is unable to provide enough masks for me to change the mask every hour (changing every two hours doesn't make sense if it's rendered ineffective by two hours!). "I share custody of my children (ages 11 and 14) with my ex, and my husband shares custody of his children (ages 13, 16 and 18) with his ex, so we have five children coming and going between homes and being exposed to their other parents and step-parents (but no other children) in their other homes. My step-kids' mom is a social worker and continues to work in-person with people in the public. "As an RN doing in-home visits and infusion therapy for medically-vulnerable patients, I fear that I have too much external exposure outside of my control to maintain a low-risk of being exposed, becoming a carrier, and therefore infecting the vulnerable population I care for. "My fear is that I will need to choose between my husband and me being able to see our children and my continued work as a nurse in the community. What advice can you offer?" The answers: Excellent and interesting questions. I'm not aware of any evidence-based data that states face masks are ineffective after two hours. In my opinion, if the patient contacts are not high risk for COVID-19, and/or not confirmed COVID-19 positive, a surgical face mask may be used the entire day, unless the mask becomes soiled. If the face mask becomes soiled, then it should be changed immediately. A healthcare worker administering an aerosol treatment must wear a N95 mask – and a surgical mask on top of the N95. The surgical mask must be properly disposed of after the treatment. The N95 mask may be reused by the same healthcare worker that day if not soiled. Regarding your living and working situation, your concerns are understandable. You can mitigate risks by limiting in-home visits to only those patients that are absolutely necessary, and not routine visits. You also need to follow strict Pa. Department of Health and CDC guidelines by frequent hand washing before and after each patient encounter, wearing gloves and a face mask as described above, and washing your hands when you return home. Social distancing is very difficult with children; however, you can limit other outside family contact exposures. It's impossible for healthcare workers (myself included) who are treating patients in the home, in doctors' offices or at the hospital to eliminate all patient contact or exposure. This is the profession we chose. – David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "Why do the experts say that this week and next week will be the worst for COVID-19? I understand the virus is out of control, but how do they know what is to come in the next two weeks? What makes these weeks different?" The answer: The next two weeks are going to see more cases of SARS CoV2, COVID-19. This is because more testing is being done nationally. Another thing to consider is the disease course. The incubation period, where an infected individual is asymptomatic, can be up to 14 days with an average time of 4.5 days. The symptomatic phase is about 14 days. Mild symptoms last for about five days with severe disease to follow on days 5 through 8. Some patients, about 20%, have some type of respiratory distress that may require hospitalization and this can last from days 8 to 12. If we take all of these things together (more testing and the number of sick people from two weeks ago), it is quite possible that we will see a great number of new cases and a higher death toll in the coming weeks. It is so very important to keep social distancing in place; it is our best defense at flattening this curve of new infections and slowing the spread of SARS-CoV2. – Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. • • • • • "A vaccine for COVID-19 might be available in 12 months. How helpful will it be if this coronavirus mutates by then, as the flu does yearly?" The answer: This is a great question. SARS-CoV2 or COVID-19 is definitely mutating. The question is whether that mutation will happen in a part of the virus that effects transmissibility or disease course (symptom severity). Coronaviruses have an ability that Influenza doesn't, they proofread their genomes before they package it into a new virus. This means that SARS-CoV2 mutates at 1/3 to 1/2 the rate of Influenza. Variants may happen with this virus, but with the slow rate of change individuals will be protected for years after acquiring the infection or getting vaccinated. This is different from the months of protection seen with influenza. – Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. • • • • • A New Jersey-based reader of The Tribune-Democrat asked: "My daughter and her entire family of five have been extremely ill with all of the symptoms of this virus including temperatures as high as 104. My daughter, an X-ray tech, and her husband, a first responder, were tested at separate times and separate sites and to our surprise, the results were negative. My daughter was also tested for influenza which was negative. Is there another virus going around that mimics COVID? Should their results be trusted? Have there been false negative results?" The answer: All excellent questions. With rapid influenza tests, there can be 20-30% "false negative" results. Therefore, if you believe an individual has acute influenza, and a negative rapid flu test, you should still treat for flu. There are other viruses going around including adenovirus, parainfluenza, and RSV (respiratory Syncytial virus). There is a viral panel test that a physician may order which tests for these other viruses. Regarding COVID-19 testing, the PCR (Polymerase Chain Reaction) which detects RNA from the COVID-19 virus is very accurate, but a negative result does not rule out the possibility of COVID-19 based on the timing of the exposure and the incubation period of the virus. So a negative result should not be used as the solo basis for patient management decisions. – Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "My family (husband, myself, 3-year-old and 18-month-old) has quarantined for the past week and a half. We have a livestock feed business at our house that we continue to operate, but we have one or two customers at any given time and have been following the 6-foot rule, along with disinfecting twice a day. We have only done grocery pick up and drive-thru for a couple lunches just to get out of the house. My mom and sister have been quarantining at a different location for the same amount of time, following basically the same guidelines. If all of us quarantine for two weeks with absolutely no symptoms, would we be safe to then only have contact with my mom and sister? I realize you can't predict with 100% certainty, but your thoughts would be greatly appreciated." The answer: Although risk may be minimal if the relatives are local, there's still risk and kids are not good at understanding social distancing. Children especially don't practice good hygiene, and exposing them to older adults could be risky for both. – Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. • • • • • "When you report about the cases of the coronavirus, why don't you name the town or city for the confirmed cases?" The answer: At Conemaugh Health System we understand how concerned the community is about the spread of COVID-19. And, as healthcare providers, we are obligated by law to protect the privacy of all of our patients. We will not, and cannot, share identifying information about our patients without consent. We do share our patient data in real time with the Pennsylvania Department of Health (and in turn, the CDC). This includes test results, symptoms, diagnosis, and demographic information related to COVID19 or any other infectious disease. These public health experts are responsible for mapping the spread of disease and interpreting the data, and they do a great job of it. It may seem important in today's environment to know details about those infected in the community – their age, where they work, their address – so you can determine your risk of exposure. However, this can have the unintended consequences of causing panic and singling people out as targets for unwelcome attention. The public health message will be the same whether someone lives in your neighborhood or not – stay physically distant, wash your hands, don't touch your face, disinfect surfaces and watch for symptoms. The best advice right now might be to behave as if everyone has COVID-19, rather than trying to determine who does or doesn't. – Emily Korns, director of marketing and communications, Conemaugh Health System Health institutions must adhere to federal privacy guidelines as stipulated in the Health Insurance Portability and Accountability Act (HIPAA): "The HIPAA Privacy Rule establishes national standards to protect individuals' medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections." – U.S. Department of Health & Human Services (HHS.gov) • • • • • "I have rheumatoid arthritis. Am I considered high risk for contracting COVID-19?" The answer: The short answer is yes. Autoimmune disorders that are a result of inflammatory conditions put the individual at a greater risk for all types of infectious diseases. With RA specifically, individuals can be on immunosuppressive drugs. This can subdue the non-specific immune response to viruses. Science doesn't know if you are at a greater risk of contracting the virus, but you are at a greater risk of severe symptoms if you do. For more information on inflammatory autoimmune disorders and COVID-19, I suggest you check out this website: www.creakyjoints.org. – Jill D. Henning, Ph.D., associate professor of biology at the University of Pittsburgh at Johnstown. • • • • • "Can you contract the influenza virus unknowingly, and then contract COVID-19 virus with diagnosed known symptoms detection at or around the same time? And if so, would your risk of life be greater having both and to what extent? Also, would the flu show up when tested for COVID virus, or would it go undetected?" The answer: Influenza symptoms are fever, chills, muscle aches, cough and tiredness. These symptoms come on quickly; you can wake up feeling fine and six hours later be sick. Symptoms of COVID-19 are fever, dry cough and shortness of breath, which is consistent with the viral pneumonia it causes. COVID-19 is a slower onset, the illness ramps up over a period of days. In fact, you can divide the slow onset into three stages: 1. asymptotic incubation period, where the virus may or may not be detectable; 2. non-severe symptomatic period, where you can detect the virus and; 3. severe respiratory symptomatic stage, with high virus levels in the body. It would be unlikely that you would unknowingly have influenza. It is possible to have both infections, it is just unlikely. Since both viruses infect the lungs, in different cell types, that presents a greater risk to your health and life. Some tests for COVID-19 use a nasal swab or oral swab and compare the genetic material captured on the swab with the genetic code of COVID-19. There is a new test that was just approved by the FDA that will be using a clumping reaction, like what is done for strep throat. This test is quicker and produces results in 15 minutes or less. Since these test are specific for COVID-19, they would not be able to show infection with influenza. A test specific for influenza would be needed to determine infection. – Jill D. Henning, Ph.D., associate professor of biology at the University of Pittsburgh at Johnstown. • • • • • "For other, and possibly this, coronavirus, does the route of transmission affect symptoms? Is it possible that the lungs could be spared if a person contracted the virus via the eye or digestive tract instead of through the air?" The answer: Viruses are specific to a certain cell type. Think of it like the key for your front door only one key will open that door, that key is specific to your door. Viruses are like the key. If the right lock isn't present on the cell, the virus can't get in. So when we think about route of transmission, the virus is transmitted in the way that will best get it to the cell that it wishes to infect. For COVID-19, its specific cells are found in the part of the lungs called the alveoli; these cells help with gas exchange. So if you come in contact with the virus, it will seek out the specific lung cells to infect. If it gets in your eye, the ears, nose and throat are connected and the virus could get to the lungs. If it comes in via the digestive tract, it is harder for the virus to get to your lungs. – Jill D. Henning, Ph.D., associate professor of biology at the University of Pittsburgh at Johnstown. • • • • • "Is anyone identifying persons who had contact with the COVID-19 infected? These contacts should be self-quarantined." The answer: "We identify those who were exposed, use the Pa. Department of Health Risk Assessment, and follow Pa Department of Health guidelines and recommendations. "Regarding self quarantine: Yes, and again based upon the Pa. Department of Health risk assessment and following Pa. Department of Health guidelines and recommendations." – Dr. David Csikos, Chief Medical Officer, Chan Soon-Shiong Medical Center at Windber. The Pennsylvania Department of Health website can be found at health.pa.gov. On this topic, the DOH says: • Isolation separates sick people with a contagious disease from people who are not sick. Isolation is usually voluntary, but in an emergency, officials have the authority to isolate people who are sick. • Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick. Quarantined people may or may not become sick; but separating them from those who were never exposed helps prevent the spread of the disease. Quarantine can be voluntary, but in an emergency, officials have the authority to quarantine people who have been exposed to an infectious disease. • • • • • "If someone gets the virus and recovers, is that person immune from the virus and probably won't get it again?" The answer: The Los Angeles Times reports that China has seen more than 100 cases of individuals being released from hospitals and later testing positive for the coronavirus a second time. A man, 36, died five days after being declared virus-free and discharged. Keiji Fukuda, director of Hong Kong University's School of Public Health, said the likely reasons are testing errors and patients leaving hospitals too soon. "If you get an infection, your immune system is revved up against that virus," Fukuda said. "To get reinfected again when you're in that situation would be quite unusual unless your immune system was not functioning right." – Los Angeles Times reports • • • • • "If someone has traveled to a known hot spot for COVID-19 in a state such as California or Washington or out of the country, how are other employees and clients protected if an employee refuses to do a self-quarantine after travel and/or contact with potential COVID-19 risk factors and continues to come in contact with people at the workplace?" The answer: The Occupational Safety and Health Administration (OSHA) recently published Guidance on Preparing Workplaces for COVID-19, outlining steps employers can take to help protect their workforce. OSHA has divided workplaces and work operations into four risk zones, according to the likelihood of employees' occupational exposure during a pandemic. These different classifications can inform employers on how to treat their workplace during this pandemic. Employers have a duty to provide a safe workplace to all employees, this includes exposure to COVID-19 in the workplace. Employers should be understandably concerned about providing a safe environment for their employees and, as such, may ask employees about the areas they have recently traveled to and if they may have had any exposure to COVID-19. If an employer concludes that an employee may pose a health threat to other employees, the employer can require that the employee stay home for the duration of the COVID-19 incubation period, which has generally been assigned as 14 days. They can also ask employees to seek medical attention and/or get tested for COVID-19, but cannot require them to do so. The employer also has no obligation to report a suspected or confirmed case of COVID-19 to the local, state, or federal health departments. Only healthcare providers that receive confirmation of a positive test are mandatory reporters. In short, the employer cannot require the employee to self-isolate, but must take steps to protect other employees from any potential exposure, including sending the potentially infected employee home. Here is a link to some more helpful information that was recently published by my law firm: https://www.muslaw.com/covid-19-update-mitigation-of-employment-law-risks/ – Katelin Montgomery, associate attorney with the law firm Meyer, Unkovic and Scott LLP, in Pittsburgh. • • • • • "Can a person have coronavirus and flu virus simultaneously?" The answer: "It is possible to get two infections at the same time. For example, you can have a common cold, from a virus, and that can lead to a bacterial infection in the sinuses. Yes, you can get the flu and COVID-19 at the same time. It is recommended that if you haven't gotten your flu shot yet that you do so now. It won't protect you from COVID-19, but it will keep you from getting the flu. "Symptoms are similar for both illnesses with the major difference being that COVID-19 causes shortness of breath due to the viral pneumonia." – Jill D. Henning, Ph.D., associate professor of biology at the University of Pittsburgh at Johnstown.  |
| 15 Common STD Symptoms - Common Signs of STDs in Men and Women - WomansDay.com Posted: 03 Apr 2019 12:00 AM PDT  Swollen Testicles  |
| You are subscribed to email updates from "std symptoms male" - Google News. To stop receiving these emails, you may unsubscribe now. | Email delivery powered by Google |
| Google, 1600 Amphitheatre Parkway, Mountain View, CA 94043, United States | |
Comments
Post a Comment