Safety and Effectiveness of "Disinfection Card"

With increasing COVID-19 pandemic situation, different disinfection and sterilization products are being introduced into the market. One of them is a disinfection card, claimed to protect from coronavirus infection.  It generally contains chlorine dioxide producing chemical called sodium chlorite. "Wearing a disinfection card on your neck only creates a little of low-concentration chlorine dioxide that blows in the wind, which has a very limited effect," said Dong Chuan, director of Shanxi University's Institute of Environmental Science. 

Moreover, sodium chlorite used in the card is a hazardous chemical. If the card is damaged, it can cause serious health problems from skin burns to even respiratory poisoning. Ministry of Health has declared that such products have not been given permission to be marketed. However, such products are widely available in the market. Are such products being monitored and controlled by the relevant regulatory body?

Let's check the material safety data sheet of sodium chlorite and related chemicals from Sigma Aldrich.

FDA takes action against fraudulent COVID-19 products

A number of fraudulent products claiming to prevent, treat, mitigate, diagnose or cure COVID-19 are emerging in the world. The U.S. Food and Drug Administration is issuing warning letters to firms for selling such fraudulent products. They are actively monitoring to control the marketing of unapproved products and those making false or misleading claims. The detailed list of 76 warning letters related to COVID-19 is given in the table below. 

We can see a wide range of products ranging from hypochlorous spray, cannabidiol products, rapid test kits, iodine products, dietary supplements, hand sanitizers, herbal products, traditional medicines, homeopathic medicines, ayurvedic products, chlorine solution, nasal spray, misleading food products etc. Please have a look on the table for details. 

The Latest Monograph of Turmeric vs COVID-19

Turmeric is one of the most common household spices in Asian kitchen. It contains a yellow colored antioxidant called curcumin. It is known to have some therapeutic properties. It is considered possibly effective for hay fever, depression, high cholesterol, fatty liver, osteoarthritis and itching. However, it is considered possibly ineffective for Alzheimer disease, stomach ulcers and radiation dermatitis. 

Some people also believe its effectiveness against heartburn, memory skills, inflammatory bowel disease, stress etc, but we don't have sufficient scientific evidence to support this assumption. 

Turmeric is considered likely safe for use as food and when applied to the skin. Because of its antioxidant and therapeutic properties, it is considered one of the healthy food ingredient. 

Recently, the health benefits of turmeric has got a lot of attention from politician, relevant experts, medical practitioners and general public. There are different views from the different personnel. In general, they can be categorized as follows:

1. Turmeric is a medicine that can be used to cure or treat the COVID-19 disease.

2. Turmeric is a healthy food ingredient with some known therapeutic properties. Since healthy people are more likely to get recovered from COVID-19, the use of turmeric might benefit us during this pandemic situation.

3. Turmeric is a healthy ingredient. But, it does not help in the recovery from COVID-19.

4. Turmeric is just a food ingredient, as it gives yellow color. It does not have any health benefit or therapeutic properties.

Let's try to read the updated monograph of turmeric to evaluate different views.

COVID-19 perception and fact check

Last week, we had carried out poll to collect the public opinion on the risk of coronavirus infection from different sources. The poll question was : "In your opinion, how much is the risk of coronavirus infection from the different sources?" The poll is still open for you to give your opinion here.

Let's check the results and do the fact check. The fact check information is obtained from  "German Federal Institute for Risk Assessment".

Frequently Asked Questions (FAQ) on Coronavirus infection

 

We are currently facing COVID-19 pandemic due to the infection with the new type of coronavirus (SARS-CoV-2). Knowledge about the exact transmission methods of this coronavirus is still limited.

Last week, we had carried out poll about the risk of infection from different sources. We can check the results of the poll here. We can clearly see that we have a wide range of variation in our understanding. So, let's try to do a fact check.

Here, we will try to discuss frequently asked questions and answers.

(Please note that these are not my opinion. All the following information below has been obtained from German Federal Institute for Risk Assessment. To read the original article, please go to their website.)

Frequently Asked Questions (FAQ)

1. What are the known transmission pathways of coronavirus?

The known transmission pathways are

·         a. Droplet infection (for example, when sneezing or coughing) is the most common pathways

·         b. Aerosol transmission when speaking - also seems possible

·         c. Contact or smear infections: viruses located on the hands enter the mucus membranes of the nose or eyes, where they may lead to an infection.

2. Can we become infected with coronaviruses via food or objects?

Public risk perception on the coronavirus infection: Poll results till now

Here are the preliminary results of risk perception of the coronavirus infection till now from the following poll.
The poll is still open for you to give your opinion here.

The poll question was : 
"In your opinion, how much is the risk of coronavirus infection from the different sources?"

And the preliminary results are:

Risk of coronavirus infection: Poll

On the occasion of World Food Safety Day, I would like to request you to give your opinion on the following poll.CHECK THE POLL RESULTS HERE

Simulating an Epidemic with SIR Model

Check out this video to understand epidemic.

Source: https://www.3blue1brown.com/videos-blog/simulating-an-epidemic

COVID-19 control strategies: Part 3

This is continuation of the previous post related to the COVID-19 control strategies around the world.
Please read the Part 1 and Part 2 of the series.
For the comparison of COVID-19 cases and testing coverage, please follow this link.

In this post, we will compare the COVID-19 testing and contact tracing policy  around the world and will try to see where Nepal stands.

A. Comparison of testing policy around the world

This chart shows the government policies on testing for COVID-19. It includes PCR testing only and does not include non-PCR, antibody testing methods.
Countries have been grouped into four categories: 

• No testing policy
• Testing only for those who both (a) have symptoms AND (b) meet specific criteria (e.g. key workers, admitted to hospital, came into contact with a known case, returned from overseas)
• Testing of anyone showing COVID-19 symptoms
• Open public testing (e.g “drive through” testing available to asymptomatic people)

Nepal is mainly testing symptomatic and key groups only.

B. Comparison of contact tracing policy around the world

COVID-19 control strategies: Part 2

This is continuation of the previous post related to the control strategies around the world. Please read the Part 1 of the series. 

The second most applied strategy around the world is restriction on public events and gatherings. Let's compare the application of this strategy around the world.

A) CANCELLATION OF PUBLIC EVENTS

B) RESTRICTIONS ON PUBLIC GATHERINGS

COVID-19 control strategies: Part 1

Currently, Nepal government is adopting lockdown approach to control COVID-19 pandemic. Many people are supporting this approach. However, there are increasing number of people against this approach and are demanding for alternative options. Some people even believe the conspiracy theory about COVID-19.

Everyone has the right to make their own opinion.
Let's try to compile the different control strategies adopted around the world.

We can then evaluate where Nepal stands compared to other countries around the world. 

A) SCHOOL CLOSURE STRATEGY AROUND THE WORLD

B) WORKPLACES CLOSURE STRATEGY AROUND THE WORLD

COVID-19 Cases vs Testing Coverage

 Let's check out where Nepal stands in COVID-19 cases and the testing coverage.

  

SIRD Model: COVID-19 In Pakistan

The SIRD model (as per wikipedia)

The Susceptible-Infectious-Recovered-Deceased-Model differentiates between Recovered (meaning specifically individuals having survived the disease and now immune) and Deceased. This model uses the following system of differential equations:

${\displaystyle {\begin{aligned}&{\frac {dS}{dt}}=-{\frac {\beta IS}{N}},\\[6pt]&{\frac {dI}{dt}}={\frac {\beta IS}{N}}-\gamma I-\mu I,\\[6pt]&{\frac {dR}{dt}}=\gamma I,\\[6pt]&{\frac {dD}{dt}}=\mu I,\end{aligned}}}$

where ${\displaystyle \beta ,\gamma ,\mu }$ are the rates of infection, recovery, and mortality, respectively.

COVID-19 Modelling Indian data (Part 2)

COVID-19 infection in India: SIR simulation and Prediction (Part 2)

I hope that you liked the first part. If you have not read the first part, you should read that before reading this post. 
So, we have already completed modelling and prediction for stage 2. It was interesting to note that we could not see much difference in the model at stage 2 compared to stage 1. If lock-down worked, we would expect to see some of its impact in stage 3.

let's start with stage 3

3) Stage3: third and fourth weeks after lock-down

# April 08 to April 22

start_date <- "2020-04-08"

end_date <- "2020-04-22"

After modelling, there was a clear impact of lock-down at this stage. The R0 value dropped down to around 1. (details not shown). Let's only look at the graph first.

The prediction plot below now clearly shows the flattening of the infection curve. This is the effect of lock-down. To make clearly visible, the graph is also given in logarithmic scale. The model still predicts that 10,000,000 people will be infected during the peak time, if further improvements does not occur.

Now, the current stage 4,

4) Stage4: fifth and sixth weeks after lockdown

# April 21 to May 01

start_date <- "2020-04-21"

end_date <- "2020-05-01"

The effect of lock-down remains and the value of R0 drops to around 1.

The prediction plot below now clearly shows the flattening of the infection curve. Lock-down continues to keep the impact. To make it clearly visible, the graph is also given in logarithmic scale. The model still predicts that around 1,000,000 people will be infected during the peak time, if a further improvement does not occur. This prediction is 10 times lower than the prediction based on data from previous weeks (stage 3). Since lock-down continues further for two weeks, the peak number is likely to be flattened more. Hence, less than 100,000 people are likely to be infected at the peak, if lock-down continues.

The continuation of Lock-down will help to flatten the curve further. Please note that, even though the number of infection looks high, only small portion of population is likely to be serious. So government should plan lock-down in such a way that the fraction of population likely to be serious during the peak period is within the countries healthcare capacity to handle such condition.

Please note that this is mathematical simulation and prediction based on model. It is aimed to give guidance for the policy makers for planning purpose only. General public should not be afraid of these hypothetical scenarios, as government would hopefully take better measures to keep the condition under control (like they are doing at the current situation).

Let’s all support the Lock-down. I can also make prediction on how worse it can be if lock-down will be removed. But, I don’t want to make that public already. 

Please provide feedback, suggestions and relevant comments. If anybody wants to get code to do such modeling and simulation, contact me.

COVID-19 Modelling Indian data (Part 1)

SIR Modelling and Prediction of COVID-19 infection in India (Part 1)

Kshitij Shrestha

The objective of this post is to share with you the modeling of COVID-19 infection using real data of India till today. I am using R-software to do all the modeling. The source code has not been displayed here, as most of you will have difficulty understanding that code. If you are really interested, contact me, I can share with you that one.

The modeling is done using SIR (susceptible , infected , recovered ) model.  For more information about such model please read the following links: Link to Wikipedia,  Link to MAA information page. There are much more information in the website.

I am going to use real data of COVID-19 infection from India. I will do the modelling and would like to evaluate the impact of lock-down on the flattening of the curve. The first confirmed case in India started in January 30, 2020. The confirmed case remained less than 5 in number, till march 03, 2020.  On a single day 23 confirmed cases were found on march 04, 2020. Afterwards, the number of infection increased exponentially. The government announced lock-down on march 25 and is still continuing it till date.

I have decided to do modeling in 4 stages.

Stage 1: exponential growth stage before starting lock-down (from march 04 to march 25)

Stage 2: first two weeks after lock down

Stage 3: third and fourth weeks after lock down

Stage 4: fifth and sixth weeks after lock-down

For each stage, the data has been used to do SIR modeling to estimate beta, gamma and R0 parameter.  The beta parameter is indication of rate of infection and gamma parameter is indication of rate of recovery and R0 is reproduction number. Please read relevant literature for more details about them.

After modeling in each stage, I have used model parameter to estimate around 200 days future prediction. That shows the scenarios likely to be if the situation would have been constant ( model parameters remaining constant). 

Lets start with first stage:

1. Stage1: Before Lock-down started

# March 04 to March 25 (before starting the lock-down) 

# before that date, situation was stable with less than 5 confirmed cases

# on march 04, 23 confirmed cases were found and the growth afterwards was exponential

Prediction with such situation without lock-down is shown below. It shows that more than 70 % population could have been infected at the peak point, which is likely to reach in August/September. The second graph is presented in logarithmic scale for better viewing. The predicted scenarios without lock-down is really scary.

2) Stage2: first two weeks after lock-down

# March 26 to April 08

start_date <- "2020-03-26"

end_date <- "2020-04-08"

The lock-down was started on march 25, 2020. 

The growth of confirmed cases continues to be exponential. The observation below is very similar to the one we observed during stage 1. Majority of this infection probably occurred before lock-down. It was confirmed only in this week due to the incubation period of the virus infection. 

The data does not indicate any impact of  lock-down yet. The prediction still looks scary.

The modelling and prediction for stage 3 and stage 4 will be provided in the next post. We have not seen any impact of lock-down till stage 2. 

Do you expect to see impact in stage 3 and 4. Give your comments. Please provide feedback for improvements. Follow me to read stage 3 and 4. 

Coming soon...........

COVID-19 & Food Safety Guidance

There is now an urgent requirement for the industry to ensure compliance with measures to protect food workers from contracting COVID-19, to prevent exposure to or transmission of the virus, and to strengthen food hygiene and sanitation practices.

The following WHO guideline is to highlight these additional measures so that the integrity of the food chain is maintained, and that adequate and safe food supplies are available for consumers.

Download Food Safety Guideline for Food Business

Food Industry Guideline for Reducing Workforce Impacts related to COVID-19

Food businesses are encouraged to consider what contingencies can be put in place to reduce workforce impacts caused by COVID-19. The following resource can assist food businesses:

Guideline for Reducing Workforce Impacts related to COVID-19

Covid-19: European officials warn that exiting lockdown will be “very long” and will require cooperation

European Union officials have unveiled their “roadmap” to phase out the ongoing coronavirus containment measures. But they warned of a “very long” exit from a crisis that has been a devastating double whammy to the continent’s health and economic wellbeing.

The European Commission president, Ursula von der Leyen, warned that a failure by countries to work together on their exit strategies could lead to a dangerous second wave of covid-19. “If shops are open on one side of the border, we don’t want people moving from one member state to the next to use the shopping opportunity,” she said, urging authorities in EU member states not to erase the progress made from the painful lockdowns imposed over the past month.

Over 80 000 people have died in Europe from covid-19, about two thirds of the global death toll, but some EU countries have already started easing their lockdowns by allowing some school classes and businesses to reopen. Von der Leyen said that EU countries should use a “gradual, tailormade approach” to lifting lockdown restrictions.

“The way back to normality will be very long,” the commission’s roadmap says, warning that masks, gloves, tests, and applications to track people’s movements will become routine—and that a full economic recovery will probably have to wait until a vaccine is found.

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1549

Food safety issues related to wildlife have not been taken seriously from SARS to COVID-19

Guangyue Weim, Xidian University, 266 Xinglong Section of Xifeng Road, Xi’an, Shaanxi, 710126, China

Abstract

17 years after the outbreak of SARS, the 2019-nCoV broke out in December 2019. It’s an unprecedented huge challenge and disaster for people all over the world. According to Web of Science database, The author found that 95,724 virology papers have been published in the past 17 years, 68,632 of which are supported by fund (71.7%). Meanwhile, 50,567 papers related to food safety have been published in the past 17 years, 28,165 of which are supported by fund (55.7%%). It seems that people’s safety and global stability are greatly guaranteed. However, whether SARS or 2019-nCoV, scientists were targeting wildlife, the author found that only 515 studies on food safety related to wildlife have been published worldwide in the past 17 years. After SARS, the whole world did not pay enough attention to food safety related to wildlife. 
https://doi.org/10.1016/j.envres.2020.109605

Food Safety and COVID-19

Coronaviruses are generally thought to be spread from person-to-person through respiratory droplets. Currently there is no evidence to support transmission of COVID-19 associated with food. Before preparing or eating food, it is important to always wash your hands with soap and water for 20 seconds for general food safety. Throughout the day, wash your hands after blowing your nose, coughing or sneezing, or going to the bathroom.

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.

You should always handle and prepare food safely, including keeping raw meat separate from other foods, refrigerating perishable foods, and cooking meat to the right temperature to kill harmful germs. See CDC’s Food Safety site for more information. 

https://www.cdc.gov/foodsafety/newsletter/food-safety-and-Coronavirus.html