Prepare for a pandemic
BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m864 (Published 05 March 2020) Cite this as: BMJ 2020;368:m864
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Dear Editor
Need of The Hour is Personal Hygiene to Prevent COVID- 2019 Spread
The Novel Coronavirus COVID- 2019 outbreak is spread as of today to 96 countries in all continents and in one International conveyance "Diamond Princess"; it is now heading towards Pandemic Spread with over one lakh (100 713) confirmed cases. Among them 55 995 were recovered and about 3412 deaths were reported as of today .
The need of the hour is personal hygiene. COVID 2019 is now become a tourism related Infectious disease.
So mass screening before and after air, train and other transport travel is important.
Voluntary testing and screening can also help to prevent the spread.
At home, indoor isolation for family members with respiratory infections can also help.
Precautions of using hand disinfectant and hygiene should be encouraged while choosing the items during shopping.
Providing isolated space in Pharmacies can also help to some extent. Unnecessary travel to crowded places and in public transport can be avoided.
In public toilets on flights, in airports and railway stations and in other public places, hygienic handling of rest room facilities is important to prevent acquiring and spreading of infection
Competing interests: No competing interests
Dear Editor,
Factually stated. Enough experience has been obtained at the country of origin. Containment is an important measure; a fully fledged health DMP (Disaster Management Plan) is called for in countries where new coronavirus entry / positive tests have been detected. The virulence of mutations is less known; persons above 60 with underlying cardiac conditions are considered most vulnerable. Countries with developed health services but planned preparedness will certainly do better in combating the coronavirus threat both real and looming after the transcontinental spread
Dr Murar E Yeolekar, Mumbai
Competing interests: No competing interests
Zinc supplementation and containment of covid-19 virus pandemic
Dear Editor
Zinc supplementation and containment of covid-19 virus pandemic
Modulation of zinc homeostasis is an important factor in the host-antiviral responses. A review of the antiviral activity of zinc, in a range of viruses, includes coronaviruses [1]. There are three population subgroups that would benefit from zinc supplementation. Zinc deficiency is a feature of lifestyle factor such as vegetarianism and conditions such as inflammatory bowel disease, hepatic cirrhosis and alcoholism. Alcohol promotes zinc excretion.
Zinc absorption is diminished in the elderly. The recommended daily intake for zinc is 9.5 mg for the male and 7.5 mg for the female. The elderly require up to 20 mg per day.
Patients immune-compromised for whatever reason, should receive zinc supplements. Since zinc boosts the overall immune response, all patients infected with the covid-19 virus would derive some benefit from zinc supplementation, especially those with latent zinc deficiency. Antiviral activity for zinc has been shown in coronaviruses such as SARS-CoV, MERS and EAV viruses. Zinc ionophores block the replication of these viruses in cell culture [2]. As yet, no such effect has been shown for covid-19 virus.
Blood and serum levels of zinc do not necessarily reflect the cellular zinc status. Zinc is transported albumin-bound in the blood. Low blood albumin level, in the susceptible subjects described, would require correction. Zinc supplementation may play an important role in limiting the incidence rate for the disease, especially in the elderly.
References
01. Read SA, Obeid S, Ahlenstiel C, Ahleinstiel G. The role of zinc in antiviral immunity. Adv Nutr. 2019; 10, 4:696-710.
02. te Velthuis AJ, van den Worm SH, Sims AC, Bovic RS, Snijder van Hemert MJ. Zinc(+2) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. Plos Pathog. 2010; 6 (11):e1001176.
Authors
Vinay K Dave
retired consultant dermatologist
Chloe A Hylton
senior biomedical scientist microbiology
Whiston Hospital
Competing interests: No competing interests