88planoAg said:

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Tylenol is recommended over those pain relievers/fever reducers that are processed through the kidneys. My family uses Aleve to treat normal aches/pains/headache. Is there a reason to switch to Tylenol prior to getting sick with CV?

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Ok... So this one is a little medically complicated but I will try to explain it so it makes some sense. The short answer to your question is maybe and it is a theoretical and anecdotal benefit more than a study-proven benefit to take Tylenol over NSAIDs (ibuprofen (aka Advil/Motrin) and naproxen (Aleve)).

There is some evidence that this virus may bind the ACE receptors (Angiotensin Converting Enzyme receptors) in the body as a way to get into cells. By a complicated pathway, NSAIDS increase the number of ACE receptors in the body and so there has been a recommendation that we give acetaminophen (Tylenol) instead as it does not up regulate ACE receptors in the body. The thought is that you could potentially make a person worse with NSAIDs by unintentionally increasing their ACE receptors binding sites for the virus.

Since body aches and congestion are much less intense in Covid-19 and the presenting symptoms are usually cough and fever anyway, I think it is reasonable to avoid NSAIDs for now and treat fever with Tylenol if you are worried about Covid-19.

claydeezy said:

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Reveille, thanks for what you're doing. Really appreciate you putting in the overtime on this...

Came across this on my timeline:

What are your thoughts on chloroquine being used to treat coronavirus patients?

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This one is really complicated and probably better answered by a biochemist or virologist. However, the coronavirus is a positive-strand RNA virus with lots of similarities to bat coronavirus. Early testing shows that certain surface glycoproteins (ORF8) that could bind to porphyrin while others (ORF10, ORF3a) attack porphyrin. Porphyrin binds to hem in the hemoglobin molecule. The surface glycoproteins in the virus that attack porphyrin interfere with normal heme pathway causing significant human disease.

Chloroquine helps prevent the ORF8 from binding the ORD10, ORF3a from binding to some extent and may help treat this disease.

claydeezy said:

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Thanks for the reply. Struggling to understand exactly what all of that means, but overall it seems like there's a decent chance it could work. Is this drug currently being used in the U.S. for treating COVID-19 patients? If not, what are the roadblocks keeping you from prescribing it as a treatment option?

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From what I understand, they have been using it off label on some of the critically ill patients. It is already FDA approved so they can use it. You wouldn't want to use this drug except in very ill patients as it has pretty bad side effects.

TAMUallen said:

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Reveille said:

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Most recent update

https://www.facebook.com/1998386763777604/posts/2641575666125374/?sfnsn=mo

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Date at top of write up says 2014 FYI

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Thanks, I fixed it! Wrote it late last night and not sure how that happened. Woke up to about a hundred messages about the date. Guess a lot of people are early risers or night owls. LOL

maroonbeansnrice said:

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Reveille said:

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eidetic78 said:

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Law361 said:

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Reveille,

With the prospect of having my 3 young kids at home for the next several weeks, my wife and i are trying to put a schedule together to help them get out of the house. We know that walks are a good idea, but what about public parks? Not talking about playing with other kids, just playing on the equipment. How long can the virus survive on an outdoor surface that doesn't get regularly disinfected? Thanks

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With respect to the duration a virus remains infectious on playground surfaces, it really depends on the local weather conditions. It also varies widely from virus to virus, but obviously we're talking about coronavirus here.

Based on previous SARS and MERS strains, this virus is stable for a relatively short period of time outside of the body. Weather conditions that lead to quick desiccation (warm / dry / sunny) and surfaces exposed to UV will render any virus present non-infections quickly. Within just a few minutes. Some of these reports about coronavirus being stable for many days on inanimate objects are under ideal conditions without any exposure to UV/water/heat/etc... They also are reporting ANY remaining detectable infectious virus. My point being once the virus is out of its host, the particles begin to degrade quickly. So even though there may be a few infectious particles after an extended time, the vast majority of the initial number are inert.

For public playground equipment, as you said those surfaces don't get "disinfected" regularly (or ever), but, depending on where you live, the normal weather can keep them fairly sterile. Specifically in the case of coronavirus, the more exposed surfaces will be safer. Overall, unless the equipment is currently or recently occupied with many kids, in my opinion it's a very low risk activity.

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I agree didn't see answer prior to responding but I agree outside I can't imagine the virus living long which is why I said previously in a labratory.

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I think I also read, in the most-often cited study, they used a nebulizer to see how long the virus could float around in the air. I thinks this (I blame the press) has led to a misconception of what the virus can do. Correct me if I'm wrong doc, but your body doesn't create these kinds of "floating" micro-particles through normal exhalation.

Obviously this is different than a cough or sneeze (that can project droplets up to like six feet?). Stay away from sick people for sure.

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I have addressed this previously somewhere but it is important so will discuss it again.

This disease is respiratory transmitted not airborne. What does that mean? Respiratory means it is shed by coughing, sneezing or directly breathing on someone within 6 ft possible up to 10 feet. Airborne is much more dangerous as it stable and floating in the air for long periods of time. Thus circulating through the air and into air conditioners etc potentially infecting everyone in the building. This was the type of virus in the movie outbreak. However, even airborne bacteria and viruses can slowed or stopped now as many hospitals and clinics like mine have installed UV sterilization killing everything in the air. I have seen NO STUDIES proving or even suggesting that this disease is air borne.

I have seen the media use the terms improperly probably leading to confusion.

Big Al 1992 said:

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So hearing no ibuprofen or steroids with this virus, have y'all read the same? Same concerns of aspirin that there are with other NSAIDS? And guessing prednisone which works well with stubborn coughs and things like pleurisy are not good for this virus?

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Absolutely no steroids if you can avoid them. The studies in China did show a correlation between death and steroid use. Now take in to consideration over there most of the population smokes so the steroid use could mean they had severe COPD but regardless it weakens your immune system so if you can be off them I would recommend it. Unfortunately some people need steroids.

As for aspirin/NSAID's they also should be avoided. We don't want any drugs that could affect the kidney's as the two most common causes of death are respiratory and renal failure.

Capitol Ag said:

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TAMUallen said:

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Reveille said:

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Most recent update

https://www.facebook.com/1998386763777604/posts/2641575666125374/?sfnsn=mo

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Date at top of write up says 2014 FYI

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The good doctor went back in time and sent this from 2014 in an attempt to stop the virus before it happens. He's attempting a time heist. Worked in Endgame!

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Yes I tried to jump in my Delorean hit 88mph and fix this so we could have Aggie spring sports again!

Badace52 said:

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Badace52 said:

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88planoAg said:

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Tylenol is recommended over those pain relievers/fever reducers that are processed through the kidneys. My family uses Aleve to treat normal aches/pains/headache. Is there a reason to switch to Tylenol prior to getting sick with CV?

---

Ok... So this one is a little medically complicated but I will try to explain it so it makes some sense. The short answer to your question is maybe and it is a theoretical and anecdotal benefit more than a study-proven benefit to take Tylenol over NSAIDs (ibuprofen (aka Advil/Motrin) and naproxen (Aleve)).

There is some evidence that this virus may bind the ACE receptors (Angiotensin Converting Enzyme receptors) in the body as a way to get into cells. By a complicated pathway, NSAIDS increase the number of ACE receptors in the body and so there has been a recommendation that we give acetaminophen (Tylenol) instead as it does not up regulate ACE receptors in the body. The thought is that you could potentially make a person worse with NSAIDs by unintentionally increasing their ACE receptors binding sites for the virus.

Since body aches and congestion are much less intense in Covid-19 and the presenting symptoms are usually cough and fever anyway, I think it is reasonable to avoid NSAIDs for now and treat fever with Tylenol if you are worried about Covid-19.

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Here is my post from above in this thread answering the Aspirin and NSAID question. It is why physicians have been suggesting Tylenol.

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Excellent explanation!! Thanks for your contributions and help!!!

3rd Generation Ag said:

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So I read the advice not to take aspirin or alieve or motrin and it is going to be tough. I have major pain in a hip that probably needs to be replaced and have arthritis pain in some other locations. It takes those to let me walk normally. Tylenol does not help my pain level at all.

But I don't want to die from this thing. However my family for generations has a stroke history. Does this mean to stop taking that baby aspirnin daily also.

I will hope lydocaine (please dont' tell me it leads to death from carona also) on the areas of greatest pain will see me through this.

I can not tolerate any narco type pain meds--constant vomit after the second pill, and cannot tolerate Tramedall (sp) either for the same reasons. We learned that with my two hip surgeries in 2011 (pinning then replacing). I had to do the second surgery with just motrin and that is why I am determined NOT to have the other hip replaced till it hurts worse than my memory of my surgical pain.

So do you recommend not taking even the low dosage aspirin for stroke awareness?

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I think in situations like yours taking baby aspirin, motrin or other NSAID's is probably ok unless you contract the virus. We are certainly not saying that you absolutely can not take NSAID's. It possibly could increase your risks of kidney disease with the virus. I don't want you to suffer unnecessary pain. My suggestion is take what you need to allow you remain functional but certainly if you get ill or feel sick at all to stop the NSAID's at that time. For people who do not need to take NSAID's than avoid them if you can use Tylenol instead.

tandrus said:

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Supposed to fly to Mexico next week. Wife and I are younger. Thinking we're going to cancel... is airplane travel heavily recommended against at this point?

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I would recommend postponing any unnecessary travel at this time.

Ag210 said:

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Curious if you have any thoughts on taking anti-leukotriene drugs. I currently taking Montelukast for mild asthma and allergies?

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That should be no problem at all. In fact controlling asthma and allergies is important at this time, as coughing has become a serious social stigma. Coughing is about to pick up with all of the pollen levels beginning to rise in Spring. Every person that coughs will be looked at in an evil way unnecessarily.

Ravis Ewman said:

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Any concern with nasal steroid sprays like Flonase? Thanks!

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I wouldn't consider any nasal steroids to likely be dangerous as the amount systemically absorbed is very low. In addition as I stated previously controlling allergies is going to be important to help decrease the amount of coughing.

Generally droplet spread diseases do not require negative pressure rooms. I imagine each hospital is developing their own policy, but I would be surprised if they were isolating these patients in negative pressure rooms at most hospitals.

They may put them on separate floors or in separate areas depending on the size of the hospital, but it is not really necessary for this type of spread to do so as long as those entering and leaving infected patient rooms practice proper droplet and contact precautions.