SIMPLE ANSWERS TO COMPLEX QUESTIONS ABOUT COVID-19 

Overwhelmed by the abundance of information about Covid-19? Not sure who to trust or how to find answers to questions truly important to you?  Check out the Covid-19 Navigator, a simple to use dashboard that draws from trusted sources to deliver straight talk about what you need to manage the impact of Covid-19 on your daily life.  It’s available for mobile and desktop at covid19navigator.com.
 
The Dashboard features five buttons that lead to a deeper dive on facts about Covid-19, getting what you need, staying inside, staying safe and what happens next.  Relieve anxiety caused by too much information with the touch of a button.
For example, the “Getting What I Need” button covers advice on grocery shopping, ordering from restaurants, home deliveries, prescriptions and seeing the doctor for non-urgent needs.  Answers are short and to the point.  No need to wade through lots of information to find what you’re looking for.Hit the grocery shopping button and it will let you know that while there is no evidence that Covid-19 can be transmitted by food, if someone else has touched the item before you, that could be an issue.  So wherever you buy your groceries, be sure to wash food containers and produce.
 
The ordering from restaurants button says that ordering cooked meals from local restaurants is relatively safe and provides practical advice like checking to see if the restaurant is open and whether the delivery service has waived fees.The Navigator will be regularly updated to keep up with new questions presented by Covid-19 in the weeks ahead.  So stay tuned and check the navigator regularly.
 
The Covid-19 Navigator is from the folks at Wondros, a creative solutions company founded by Jesse Dylan to solve complex problems. As Jesse puts it, “We did it because Wondros is about serving people.  Creating a simple user interface to ease access to information people can truly use and trust is a natural for us.”
Among the sources curated to answer Navigator questions are the CDC, WHO, NIH, CNN, Consumer Reports, Los Angeles Times and USA Today among others.

Meditation App Offers Special Session for Those Under Quarantine

With most of the world under quarantine, people are looking for ways to relax and accept their situation.  Meditation app Namatata offers a special session that will remain free throughout the entire confinement period.

Created in partnership with psychiatrist François Bourgognon, the French leader of mobile meditation applications, Namatata, offers a fun and simple way to meditate, with pre-recorded sessions, to all its users. As most people are currently confined at home, the application is ideal for starting up new practices, relaxing, and better accepting the situation. As part of the launch of its English version, Namatata offers seven days free, including a “special confinement” meditation of ten minutes to help everyone best undertake their confinement. This special meditation will remain available for free throughout the entire confinement period.

Better undertake the confinement through meditation 

Scientists and doctors have shown that meditation is effective in dealing with stress, anxiety and improving sleep.  In confinement, alone or with others, these problems can arise more easily. Anxiety during a health crisis is very important, as it brings up legitimate questions of one’s own health, as well as the health of their loved ones.

When all these thoughts and emotions come to attack us in a way, meditation can often be the best way to deal with them. By focusing on yourself for a few minutes a day, meditation greatly reduces stress and boosts the immune system.

Namatata offers seven days of free access and a special confinement meditation

The application, which is available on iOS and Android, promises to make the current period easier by offering seven days of free access to its 400 sessions to all new users through the confinement period. A special confinement meditation launched today on the application and will remain free for the duration of the crisis. All people in a situation of confinement can find help through it.

For people alone, a 10-minute meditation has been specially developed to deal with the feeling of loneliness.

For children, meditation audios are also available. These meditations in the form of stories imagined by psychologist Cécile Neuville, can serve to initiate them into this beneficial learning experience. For parents, this is also an opportunity to help their children find time to refocus and to keep them busy intelligently in these difficult days.

For everyone, each mindful meditation makes it easier to accept confinement. Meditation allows you to let go and deal with a situation that you cannot change. Breathing and concentration exercises where you focus on the present moment help you let go of difficult emotions and stray thoughts. A daily practice of ten minutes will, undoubtedly, improve everyone's physical and mental balance.

To find this special confinement meditation, please click here:

A word by founder Antoine Gerlier:

"In this current period, the concept of acceptance seems very important to me. It is by accepting that things are the way they are that we learn to live with them and to let go. When a big wave comes crashing down on us, it is better to deal with it by surfing on it. Meditation is a real "art of living" that I teach on a daily basis and that I wanted to share with the world by launching Namatata. Today, the confinement is ideal to refocus your thoughts and discover your virtues. "

Namatata in numbers:

1,000,000 users in the world

30,000 new users every month

400 meditations created by psychology professionals 

25 programs of 7 days spread out into 5 themes

About Namatata: Namatata is a meditation application available on iOS and Android for everyone. It aims to democratize the daily practice of mental gymnastics in everyone's life. Founded by Antoine Gerlier, who got the help of psychiatrist François Bourgognon, the application allows you to meditate 10 or 20 minutes a day. Based on scientific research, particularly in neuroscience, the application gathers one million users who can access more than 400 meditation sessions.

Single Dose Hydroxychloroquine Monthly May Reduce the Necessity for Mechanical Ventilation in COVID-19 Patients

By Eddie Fatakhov, M.D.

With an appropriate primary focus being on the treatment options for currently infected COVID-19 patients, the question still lingers as to if there are any additional potential preventative treatments, outside of social distancing and quarantine, that may be used by healthcare professionals on the frontlines and people considered in the high-risk category that have yet to contract the virus.  

 The public has been made aware of the anti-malaria drug, hydroxychloroquine, being used in hospitalized patients as a potential treatment.  While those trials are unfolding and a vaccine actively in the works, prevention is still a major concern for those who are healthy but in contact with confirmed cases and for the population that is high-risk but has remained virus-free for now.   

As this pandemic rapidly evolves throughout the world, researchers and physicians are aggressively looking into the reasons why certain COVID-19 infected patients are rapidly declining and how this could possibly be prevented.  Recent research has suggested that COVID-19 is starting as a viral infection in the upper respiratory system.  As it progresses, it is migrating to the lower respiratory system - resulting in mechanical ventilation of a vast number of patients.  Hospitals are flooded and being forced to allocate ventilators to the sickest of the sick.  The mechanisms of action by hydroxychloroquine could possibly hinder the virus from moving from the upper to lower respiratory tract - in turn making mechanical ventilation less likely to be a necessity. 

Hydroxychloroquine has shown to accumulate in highest concentrations in the liver, adrenal and lung tissue in rodent trials.  Determination of a drug’s potency needed to induce the desired response, also known as the EC50 value, is key to the potential effectiveness of a drug.  Physiological-based pharmacokinetic models (PBPK) have been implemented to simulate the concentrations of hydroxychloroquine in the body.  The results suggest that a single dose of 800mg of hydroxychloroquine may provide a lung tissue concentration that is greater than twenty times the required EC50 values necessary to inhibit COVID-19 in the lungs.  A single dose of 200mg of hydroxychloroquine has a half-life of 22 days, meaning that half of the administered dose remains in the system at day 22.  This evidence would lead to the potential of greatly reducing COVID-19 induced lung damage.  This lung damage leads to increased necessity of mechanical ventilation.   

If proven to be effective, this would not stop one from contracting the virus itself.  It would potentially stop the virus from progressing to such deadly states with possibly as little as one dose taken every three weeks.  Further research is needed to continue to validate these findings but provides hope for those who are battling this virus on the frontline that there may be a protective option available in coming days.   

References:  

Concordia Pharmaceuticals Inc. (2015). Plaquenil® hydroxychloroquine sulfate tablets, USP. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/009768s037s045s 047lbl.pdf 

Tansan, S. (n.d.). A possible role for single dose hydroxychloroquine for prevention of lethal coronavirus infection. Retrieved March 29, 2020, from https://tansan.com.tr/a-possible-role-for-single-dose-hydroxychloroquine-for-prevention-of-lethal-coronavirus-infection/

 Yao, X., Ye, F., Zhang, M., Cui, C., Huang, B., Niu, P., Liu, X., Zhao, L., Dong, E., Song, C., Zhan, S., Lu, R., Li, H., Tan, W., & Liu, D. (2020). In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, ciaa237. Advance online publication. https://doi.org/10.1093/cid/ciaa237 

Yimin, W., Nygard, G. A., Ellertson, S. L., & Khalil, S. K. W. (1995). Stereoselective disposition of hydroxychloroquine and its metabolites in rats. Retrieved March 29, 2020, from https://doi.org/10.1002/chir.530070807

Eddie Fatakhov, M.D, is a Board-Certified Physician, Nutritionist and Best-Selling Author who has been a featured expert interview guest on national television programs including CNN, with commentaries featured regularly in U.S. News & World Report and other publications. 

SpiderTech Develops Product to Protect Healthcare Workers from their Protective Masks

TORONTO, March 31, 2020 /CNW/ - Face masks have become the first line of defense for health care professionals around the globe battling COVID-19. Yet through prolonged use, that same protective equipment may be putting them at further risk. In response, an unlikely company has come to the rescue. Its name is SpiderTech. Their medical team has developed a new kinesiology tape to prevent the skin abrasions that can become gateways to any number of health problems.

SpiderTech is the pioneer behind precut kinesiology tape, which is used by athletes worldwide to take pressure off overused muscles and reduce pain. This new version, a 100% cotton breathable tape, was developed specifically to protect the faces of medical professionals and first responders forced to wear masks for long periods. Users apply one to three strips of the pre-cut tape, called Gentle Mini iSTRIPs, over the bridge of their nose or in a triangle pattern around the nose and mouth to relieve the pressure of surgical masks' elastic bands. The gel-like acrylic adhesive on the strip maintains a seal on the skin without irritation and can be removed painlessly. https://youtu.be/PdjDqxuzG8c

"We saw images of nurses and doctors on news and social media bearing cuts, bruises and friction marks from their masks and knew we had to do something for these brave caregivers," said Dr. Nick Martichenko, SpiderTech. "Our kinesiology tape acts as a barrier between the user's face and their mask or eye wear. Besides discomfort, broken skin caused by masks can open the door to very serious health complications." 

In fact, according to wound-care experts, open wounds under a medical face mask can become a portal for coronavirus to penetrate the body and allow other hospital-acquired infections access to the circulatory system. 

Gentle Mini iSTRIPs are applied directly to the face under the worker's PPE. It can be left on for multiple days and the user's PPE can be worn or removed without affecting the protective base. 

SpiderTech has also devised wide-roll kinesiology tape that can be applied on top of face strips to create a do-it-yourself mask. The user can place any piece of filter material behind the tape for added protection. 

Founded in 2009, SpiderTech is a division of NUCAP Industries with a 25 year successful track record in development of safety-related products. Visit www.SpiderTech.com

SOURCE SpiderTech

EQ Care to power Hub International's Health and Wellness Platform

MONTREAL, March 31, 2020 /CNW Telbec/ - EQ Care, Canada's pioneer in telemedicine, is pleased to announce that its virtual health platform will be integrated into a care management and navigation service provided by Hub International (Hub), one of the world's largest insurance brokerages, to workforces across Canada. 'Hub Care' members will join the EQ Care Community and soon have 24/7 access to physicians, mental health specialists and other medical professionals in English or French.

With more than 475 offices across North America, Hub's extensive business network will help further the advancement of telemedicine and wellness programs to plan sponsors and their employees, especially in the midst of a pandemic. Patients can connect live to EQ Care Managers and medical professionals who have been trained to detect symptoms of COVID-19 (Coronavirus) and will follow each patient through their care and treatment journey.

"Hub International's commitment to workplace wellness will pay dividends for both its vast network of clients and the Canadian public healthcare system," said EQ Care CEO Daniel Martz. "Workplace virtual care deployed by experienced healthcare managers, providing access to a network of hundreds of doctors, specialists, mental health and paramedical professionals, can immediately relieve pressure on an overburdened public system, especially at this critical time."

Virtual Healthcare Is Here to Stay 

In choosing a virtual care provider for its client network, Hub prioritized a proactive, preventative benefit solution to further workplace wellness. Their "One Front Door In" policy is aimed to create a gateway to provide clients and their employees the fastest possible access to experienced medical professionals via a secure, web-based video-conferencing, text and voice-based platform.

"We are in the midst of a technology revolution that is disrupting and transforming healthcare around us every day. We see the EQ Care virtual healthcare platform as a significant value-add for our clients, and the service aligns with our innovation roadmap to improve the health and wellbeing of our plan members and their dependents," said Mary Lou MacDonald, HUB International's National Practice Lead, Canada, Health and Performance. "EQ Care's commitment to continuous improvement and service excellence, coupled with its forward-looking mindset in bringing market-changing innovations to the health and wellness space, are the elements that drove our decision to partner with EQ Care to power HUB International's health and wellness platform strategy."

EQ Care Is Transforming Virtual Health Care

As some of Canada's largest employers are beginning to offer EQ Care to their employees, virtual care is becoming an essential component to modern medicine. With over three decades of experience in homecare and as the first to introduce wide-scale telemedicine in Canada, EQ Care is well-placed to continue setting benchmarks in Canadian health care.

"With our storied history in Canadian healthcare, and as the first to offer virtual healthcare solutions to Canadians, our success has been built on the foundation of our ability to stay at the forefront of change, while offering a compassionate and individualized healthcare experience for each patient," added Daniel Martz. "We see great synergy between HUB International's health and wellness strategy and EQ Care's virtual healthcare platform, and are deeply committed to helping HUB International's clients and their employees get faster and better access to care."

About EQ Care

EQ Care offers patients 24/7 national and bilingual online access to a specialized medical and mental health team providing personalized, comprehensive treatment options from any mobile or internet connected device. On the cutting edge of patient care, our mission is to ensure that our patients receive the highest quality service through our leading proprietary virtual health technology platform.

As the market leader in Canadian virtual care with over 30 years of health care experience, an ISO 9001:2015 certification, and over 400,000 virtual medical consultations managed, we are continually innovating to bring cutting edge mobile tools and approaches to our Plan Sponsors and Members.

About Hub International

Headquartered in Chicago, Illinois, Hub International Limited is a leading full-service global insurance broker providing property and casualty, life and health, employee benefits, investment and risk management products and services. With more than 12,000 employees in offices located throughout North America, Hub's vast network of specialists provides peace of mind on what matters most by protecting clients through unrelenting advocacy and tailored insurance solutions. 

SOURCE EQ Care

Opinion: Young Jamaican's invention could help tackle spread of viruses like COVID-19
 By Patricia Scotland, Commonwealth Secretary-General 30 March 2020 Five years ago more than 40 babies born in Jamaican hospitals became infected with lethal bacteria - half of them died.The bacteria Klebsiella, like the coronavirus, is spread from person-to-person or via contaminated surfaces. It can be killed by hand-washing with warm soapy water.The situation caught the attention of technology student Rayvon Stewart based in Jamaica who set about finding a way to curb the spread of harmful germs."I made a determined decision that I was going to find a solution to limit the transfer of pathogens to multiple surfaces, thereby saving lives," says Rayvon.Young innovators in healthI met Rayvon at the Commonwealth Health Ministers Meeting (CHMM) in Geneva last year. He was among the finalists shortlisted for last year’s Commonwealth Health Innovation Awards. He took part in an exhibition on the theme ‘Universal Health Coverage: Reaching the unreached, ensuring that no-one is left behind’ which highlighted how young people are tackling age-old challenges with modern technology and disruptive thinking. The event underlined Commonwealth commitment to empowering young people as outlined in our charter and also our contribution to achieving the Sustainable Development Goals. I spoke to five extraordinary innovators who made it as finalists of the Commonwealth Health Innovation Awards which recognise outstanding young people whose groundbreaking projects have made a real impact in helping their countries achieve Sustainable Development Goal 3, which is to ‘ensure healthy lives and promote well-being for all at all ages’. William Wasswa was working on a digital pathology platform for automated diagnosis and classification of cervical cancer from pap-smear images. Then there was Midia Hassan using 3D printing technology to provide prosthetics to amputees living in refugee camps and poverty zones. Another timely invention is that of Nitash Jangir who was one of 15 finalists at our SDG innovation awards. Nitash invented a neonatal breathing support device for low resource settings, with multiple powering options. It maintains respiration and oxygenation in premature neonates with Respiratory Distress Syndrome by providing constant airflow and pressure to keep the lungs open during transport to a tertiary care setting.I was struck by the ability of young minds to find solutions to real problems in their communities, and their persistence in finding support to scale-up their projects.In Rayvon’s case, he focused on the most common places where bacteria and viruses could easily be left by one person and picked up directly by another. He came up with what he calls ‘Xermosol’- a simple-to-install device that automatically disinfects door knobs and handles after each use.The innovation uses ultraviolet light to target and specifically kill harmful microorganisms, while being harmless to human beings.The potential to save livesThe potential impact of Rayvon’s invention could now be even more important than when he first conceived it, as the world battles the frightening COVID-19 pandemic.The coronavirus lives up to two or three days on stainless steel and metal, and several hours on fabric depending on factors such as temperature and humidity.Field and laboratory testing has validated Xermosol’s efficiency in killing more than 99.9% of deadly pathogens. In addition to health facilities, Rayvon hopes it could help reduce transmission of germs in other public spaces such as schools and businesses. Tests carried out in conjunction with University of Technology, Jamaica and University of the West Indies show Xermosol destroys organisms such as MRSA and E-coli and destroys viral cells such as influenza virus H1N1. This is a huge step in the fight against microorganisms and offers new ways of thinking around combatting viral cells such as Coronavirus.Supporting young people to innovateRayvon says the recognition he received from the Commonwealth Health Innovation Awards was a key moment in Xermosol’s progress, generating immense interest in the project.But now the production of Xermosol faces a number of considerable challenges - from development funding to finding a manufacturer to mass produce. Financing options are mostly focused on large-scale innovation, but the Commonwealth is exploring and proposing that all 54 member-countries go into partnership with the Global Innovation Fund to help young innovators like Rayvon.Over the past two years, the Commonwealth Youth Health Network has worked closely with the Commonwealth Secretariat and member states to leverage the unique capabilities of young people and drive forward progress toward SDG3 (which includes a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases) and health-related development goals. Citizens aged under 30 comprise 60 per cent of the Commonwealth’s population - a proportion that is 10 per cent higher than the global average. In the course of my interaction in and with our member countries I am continually impressed by the drive of these 1.4 billion young people. They have the ideas, energy and talent to make a huge difference in their communities – and they are doing so.
AG HAIR SUPPORTS HEALTH AUTHORITIES BY PRODUCING HAND SANITIZER IN TIME OF CRISIS

Professional hair care company shifts production to hand sanitizers, sources badly needed 
medical supplies from contacts in China 

Vancouver, B.C. (March 30, 2020) – As COVID-19 escalates in Canada, AG Hair is shifting full focus to hand sanitizer production with the goal of supporting health organizations like Vancouver Coastal Health and the Government of Canada during a time of mass sanitizer shortages. The company will also leverage its extensive global manufacturing contacts to source badly needed medical supplies like N95 surgical masks, disposable gloves and other personal protective equipment that meet Health Canada and other recognized health standards.

Production of AG’s Hands Free hand sanitizer gel and Hands Free hand sanitizer spray will take place in the state-of-the-art, 70,000-square-foot manufacturing headquarters in Coquitlam, B.C. starting immediately with an expected first delivery mid-April. Certified by Health Canada and the FDA as an OTC (Over the Counter) drug production facility and a Health Canada NHP (Natural Health Product) facility, AG has converted its entire manufacturing capacity and has re-directed staff to fulfil these urgently needed sanitizing products. AG Hair follows strict GMP guidelines with a highly qualified team of R&D and QC/QA technicians overseeing all aspects of production. 

Killing 99.9% of germs, both the sanitizer gel and spray are formulated with 73% corn-derived alcohol, exceeding the Centre for Disease Control (CDC) and World Health Organization (WHO) sanitizer guidelines, as well as Vitamin E, glycerin and aloe vera to ensure hands stay smooth and hydrated. The sanitizers are licensed for sale in both Canada and the USA and will be available to the public for purchase through the company website and Amazon.com. In addition to the supply of health authorities, 10% of sanitizer production will go toward supporting front line health personnel and those most vulnerable.

Co-Founder, John Davis, is committed to help. “We have been developing high quality formulas and manufacturing products for the professional hair care industry since 1989. But today we face our biggest challenge as we strive to support the health needs of our overworked medical teams and provide products that will help reduce the spread of this disease.”

“Our current social and economic climate calls for ingenuity, adaptability and a willingness to support our community and country – all attributes our team lives and breathes each and every day,” said Graham Fraser, CEO of AG Hair. “We are committed to doing our part to help flatten the curve by sourcing medical supplies that are in scarcity and supporting ongoing needs for hygiene and disinfectants.”

For more than 30 years, AG Hair has held distinction as Canada’s only manufacturer of professional haircare products, successfully positioning itself as an industry authority on award-winning innovation. Founded in Vancouver, Canada by John and Lotte Davis, the company has built a longstanding reputation among industry and consumers for an unwavering commitment to formulate products that are gentle on hair while delivering powerful results. A portion of every bottle sold supports One Girl Can, a registered charity that provides educational opportunities to impoverished girls living in marginalized areas of Africa. For more information, visit aghair.com.

Global health expert available to discuss COVID-19 threat to hospitals in sub-Saharan Africa
Rice University bioengineer and US Science Envoy Rebecca Richards-Kortum can outline coronavirus preparations

HOUSTON – (March 30, 2020) – Rice University bioengineer and global health pioneer Rebecca Richards-Kortum is available to discuss how hospitals in sub-Saharan Africa are preparing to deal with the COVID-19 pandemic.

"Most hospitals in sub-Saharan Africa lack the resources to treat critically ill COVID-19 patients," said Richards-Kortum, director of the Rice 360º Institute for Global Health. "Ventilators are especially rare. In many countries, there are fewer ventilators than hospitals. Personal protective equipment is also scarce, and sources of oxygen such as oxygen concentrators or oxygen cylinders are often in short supply due to lack of spare parts and trained maintenance personnel."

Richards-Kortum, Rice's Malcolm Gillis University Professor, creates and implements medical technologies for communities that can least afford them. She has worked with African doctors, hospitals and health care officials for more than a decade and was selected by the State Department in 2018 as a U.S. Science Envoy for Health Security with a focus on expanding opportunities for U.S. collaboration in Africa.

Richards-Kortum is also a co-founder of NEST360°, an international collaboration that's working to slash newborn deaths in sub-Saharan hospitals by 50%. Launched in London last fall with $68 million in philanthropic support, NEST360°'s first phase is focused on Malawi, Tanzania, Kenya and Nigeria. Phase two will target Ethiopia, Ghana, Ivory Coast and Uganda, with the goal of catalyzing continentwide change in newborn hospital care.

To schedule an interview with Richards-Kortum, contact Jeff Falk, director of national media relations at Rice, at jfalk@rice.edu or 713-348-6775.

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Image for download:

http://news.rice.edu/files/2018/04/0423_ENVOY-rrk-lg-qoufy6.jpg
CAPTION: Rebecca Richards-Kortum (Photo courtesy of the John D. & Catherine T. MacArthur Foundation)

This news release can be found online at news.rice.edu.

Follow Rice News and Media Relations on Twitter @RiceUNews.

Located on a 300-acre forested campus in Houston, Rice University is consistently ranked among the nation’s top 20 universities by U.S. News & World Report. Rice has highly respected schools of Architecture, Business, Continuing Studies, Engineering, Humanities, Music, Natural Sciences and Social Sciences and is home to the Baker Institute for Public Policy. With 3,962 undergraduates and 3,027 graduate students, Rice’s undergraduate student-to-faculty ratio is just under 6-to-1. Its residential college system builds close-knit communities and lifelong friendships, just one reason why Rice is ranked No. 1 for lots of race/class interaction and No. 4 for quality of life by the Princeton Review. Rice is also rated as a best value among private universities by Kiplinger’s Personal Finance.

Digestive Symptoms Present in Mild COVID-19 Disease, Sometimes Without Fever

Study from The American Journal of Gastroenterology suggests patients with new-onset digestive symptoms after a possible COVID-19 contact should be suspected for the illness, even in the absence of cough, shortness of breath, sore throat, or fever

Bethesda, MD, March 30, 2020 -- A new study published in pre-print today by The American Journal of Gastroenterology is the first analysis of gastrointestinal symptoms reported by COVID-19 patients with mild disease rather than those with moderate or critical illness and finds a unique sub-group with low severity disease marked by presence of digestive symptoms, most notably diarrhea. The authors from Union Hospital and Tongji Medical College in Wuhan, China report that among some of the patients included in the study, these digestive symptoms, particularly diarrhea, were the presentation of COVID-19, and were only later, or never, present with respiratory symptoms or fever.

According to Brennan M.R. Spiegel, MD, MSHS, FACG, Co-Editor-in-Chief of The American Journal of Gastroenterology, “This study is vital because it represents the 80% or more of patients who do not have severe or critical disease. This is about the more common scenario of people in the community struggling to figure out if they might have COVID-19 because of new-onset diarrhea, nausea, or vomiting.” 

Digestive Symptoms Present in Mild COVID-19 Disease, Sometimes Without Fever

The analysis included 206 patients with low severity COVID-19, including 48 presenting with a digestive symptom alone, 69 with both digestive and respiratory symptoms, and 89 with respiratory symptoms alone. Between the two groups with digestive symptoms, 67 presented with diarrhea, of whom about one in five experienced diarrhea as the first symptom in their illness course. The diarrhea lasted from 1 to 14 days, with an average duration of over five days and a frequency around four bowel movements per day. Concurrent fever was found in 62% of patients with a digestive symptom, meaning that nearly one-third did not have a fever. 

Delayed Diagnosis for COVID-19 Patients with Digestive vs. Respiratory Symptoms

Patients with digestive symptoms presented for care later than those with respiratory symptoms (16 day vs. 11 day delay, p<0.001) and this delay in care is consistent with a recent paper by Pan, et al. that analyzed 204 sicker patients from three hospitals in Wuhan, China that was published as a pre-print article in The American Journal of Gastroenterology on March 18, 2020.

In this analysis of patients with milder COVID-19 disease by Han, et al., those with digestive symptoms had a longer total course between symptom onset and viral clearancePatients with digestive symptoms were more likely to be fecal virus positive (73% versus 14%) and have a longer overall course of the illness versus those with respiratory symptoms. 

The authors conclude the following: “Importantly, digestive symptoms are common in the community, and most instances of new-onset diarrhea, nausea, vomiting, or low appetite are not from COVID-19. Nonetheless, clinicians should recognize that new-onset, acute digestive symptoms in a patient with a possible COVID-19 contact should at least prompt consideration of the illness, particularly during times of high COVID-19 incidence and prevalence. Failure to recognize these patients early and often may lead to unwitting spread of the disease among outpatients with mild illness who remain undiagnosed and unaware of their potential to infect others. The data in this study highlight the presence and features of this important subgroup of COVID-19 patients and should be confirmed in larger international studies.”

 Key Findings: Han, et al.

  • There is a unique sub-group of COVID-19 patients with low severity disease marked by presence of digestive symptoms. 
  • These patients are more likely to test positive in stool for COVID-19 RNA, to have a longer delay before viral clearance, and to experience delayed diagnosis compared to patients with respiratory symptoms but no digestive symptoms.
  • In some cases, the digestive symptoms, particularly diarrhea, can be the initial presentation of COVID-19, and may only later or never present with respiratory symptoms or fever. 
  • Importantly, only two-thirds of people in this study had a fever, meaning it is not even necessary to have a fever to suspect the diagnosis. 
  • These data emphasize that patients with new-onset digestive symptoms after a possible COVID-19 contact must be suspected for the illness, even in the absence of cough, shortness of breath, sore throat, or fever. 

Read the Study 

Han, et al., Prevalence and Clinical Characteristics of Mild Severity COVID-19 Patients with Digestive Symptoms, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, Am J Gastroenterol Pre-Print March 30,3030 

https://journals.lww.com/ajg/Documents/COVID19_Han_et_al_AJG_Preproof.pdf

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About The American Journal of Gastroenterology
Published monthly since 1934, The American Journal of Gastroenterology (AJG) is the official peer-reviewed journal of the American College of Gastroenterology. The goal of the Journal is to publish scientific papers relevant to the practice of clinical gastroenterology. It features original research, review articles and consensus papers related to new drugs and therapeutic modalities. The AJG Editorial Board encourages submission of original manuscripts, review articles and letters to the editor from members and non-members. AJG is published by Wolters Kluwer. www.amjgastro.com

About the American College of Gastroenterology

Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 14,000 individuals from 86 countries. The College's vision is to be the pre‐eminent professional organization that champions the evolving needs of clinicians in the delivery of high‐quality, evidence‐based and compassionate health care to gastroenterology patients. The mission of the College is to advance world‐class care for patients with gastrointestinal disorders through excellence, innovation and advocacy in the areas of scientific investigation, education, prevention and treatment. www.gi.org. Follow ACG on Twitter @AmCollegeGastro.     

Approval of Settlement of Canadian AMS Women's Pelvic Mesh Litigation

TORONTO, March 28, 2020 /CNW/ - Siskinds LLP, Siskinds, Desmeules s.e.n.c.r.l., Rochon Genova LLP, and Merchant Law Group announced today court approval of a Canada-wide settlement reached in two class actions related to certain women's pelvic mesh devices for treatment of Pelvic Organ Prolapse ("POP") and Stress Urinary Incontinence ("SUI") manufactured and distributed by American Medical Systems Canada Inc. and American Medical Systems, Inc. ("AMS"). The class actions, which were commenced in 2012 against AMS and Endo Pharmaceuticals, allege various injuries associated with AMS' women's pelvic mesh devices.

The settlement applies to all Canadian women who have been implanted with one or more of these device(s) at any time on or before June 25, 2019 and provides for the payment by the defendants of $20,858,488.48 (Canadian dollars) for eligible claims, administration costs, health care expenses incurred by Provincial Health Insurers and legal fees. 

"We are very pleased with this significant settlement and look forward to implementation of the compensation program" said Jill McCartney of Siskinds. "We would like to commend American Medical Systems for putting this compensation program in place for Canadian women and finally resolving the claims of participating Class Members."

The Settlement is not an admission of liability on the part of the defendants, nor has there been any finding of liability by the Court against them. The defendants deny the allegations made in the lawsuits. 

The settlement was approved by the Ontario Superior Court of Justice on October 4, 2019 and was recognized and enforced by the Superior Court of Québec on December 20, 2019. The Ontario Court also approved the Compensation Protocol, which governs which Class Members are eligible for compensation and in what amount. For information about the eligibility criteria and compensation levels, you should review the long-form Notice, the Compensation Protocol and the Settlement Agreement and related documents at www.amsmeshclassactions.ca, or contact the Claims Administrator or Class Counsel at the addresses below. 

Class Members Can Claim Compensation

Class Members can now submit claims for compensation which will be adjudicated by the Claims Administrator pursuant to the eligibility terms of the Compensation Protocol. Further information relating to the settlement, including copies of the Settlement Agreement, Compensation Protocol, and related documents, and how to make a claim, including a copy of the claim form, is available at www.amsmeshclassactions.ca or by calling the Claims Administrator at 1-866-571-7804. 

Pursuant to the Compensation Protocol, there will be an Initial Claim Period, which will end on July 27, 2020, and a Supplemental Claim Period, ending on July 27, 2022. The Supplemental Claim Period is designed to compensate Class Members for injuries sustained after July 27, 2020, or for worsening injuries during that time period, and to compensate women who miss the Initial Claim Period deadline.

To qualify in the Initial Claim Period, claims must be submitted (postmarked) by July 27, 2020

Filing a claim is complex and requires medical records which will take time to retrieve. As a result, you may wish to retain a lawyer to assist you. You can retain Class Counsel or a lawyer of your choice. 

The law firms of Siskinds LLP, Siskinds, Desmeules s.e.n.c.r.l., Rochon Genova LLP and Merchant Law Group represent the Class Members and may be contacted as follows: 

Siskinds LLP
680 Waterloo St.
London, ON N6A 3V8
Elizabeth deBoer
Tel: 1-800-461-6166
Siskinds, Desmeules sencrl
Les Promenades du Vieux-Québec
43, rue Buade, bur 320
Québec, QC G1R 4A2
Erika Provencher
Tel: 418-694-2009
Rochon Genova LLP
900-121 Richmond St. W.
Toronto, ON M5H 2K1
Joel P. Rochon
Tel: 416-363-1867
Merchant Law Group
100-2401 Saskatchewan Dr.
Regina, SK S4P 4H8
Evatt Merchant
Tel: 306-359-7777