Sickle cell and COVID-19, By Tola Dehinde

Health

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There are many ongoing rumours that people with sickle cell cannot have coronavirus.  Coronavirus can affect anyone, but people with pre-existing health conditions and older people are thought to be at greater risk of developing severe symptoms.

It appears that the elderly, those with weak immune systems and people who have underlying chronic conditions, including heart disease, diabetes, or sickle cell are more at risk of severe effects if they contract it.

The guidance strongly advises people with serious underlying health conditions like  homozygous sickle cell to rigorously follow shielding measures to keep themselves safe.

What is Shielding?

Shielding is a measure to protect extremely vulnerable people by minimising interaction between those who are extremely vulnerable and others.

If you fall into the extremely vulnerable group (e.g. homozygous sickle cell SS), you are strongly advised to stay at home at all times and avoid any face-to-face contact for a period of at least 12 weeks.

Below is further guidance on shielding:

  • Strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19)–high temperature and/or new and continuous cough
  • Do not leave your house
  • Do not attend any gatherings (including gatherings of friends and families in private spaces for example family homes, weddings and religious services)
  • Do not go out for shopping, leisure or travel
  • Food or medication deliveries should be left at the door to minimise contact
  • Keep in touch using remote technology such as phone, Internet, and social media

People at higher risk include people above 70 or under 70 with any of the following underlying health conditions: chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease, emphysema or bronchitis; chronic heart disease, chronic kidney disease; chronic liver disease, such as hepatitis; chronic neurological conditions, such as Parkinson’s disease, motor neuron disease, multiple sclerosis, a learning disability or cerebral palsy; diabetes.

Others include problems with your spleen–for example sickle cell disease or if you have had a spleen removed; a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy; being seriously overweight or those pregnant.

Everyone is being told to practise social-distancing to help reduce the chance of contracting and spreading coronavirus.  People in higher risk groups are strongly advised to follow the advice.

People with sickle cell disease have an increased risk of developing certain infections. They include pneumonia, blood stream infections, meningitis, and bone infections. In people with sickle cell disease, the spleen does not work correctly. The spleen is an organ in the abdomen that helps protect against infection. It filters bacteria from the bloodstream and by producing antibodies. Early in life, sickle cells clog the blood vessels in the spleen. This leads to damage and poor protection against infection.

Common symptoms of an infection are: fever—temperature of 100.4 degrees F (38.3o C) or higher; cough, chest pain, trouble breathing; swelling, tenderness, and redness in the skin or in the area over a bone or joint.

Preventing infection: One of the best ways to prevent infection is keeping your hands clean. Wash your hands with soap and water for at least 20 seconds. Wash your hands when preparing food and before eating.  Wash your hands after using the restroom, sneezing, coughing, shaking hands, or touching things that might have germs.

How do I protect myself?  The best thing is regular and thorough hand washing, especially with soap and water.

Coronavirus spreads when an infected person coughs small droplets–packed with the virus, into the air.  These can be breathed in, or cause an infection if you touch a surface they have landed on, then your eyes, nose or mouth.  So coughing and sneezing into tissues, not touching your face with unwashed hands, and avoiding close contact with infected people are important for limiting the spread.

What can you do to prevent contracting and spreading the virus?  Wash your hand frequently with soap and water or use a hand sanitiser. Catch coughs or sneezes with disposable tissues.  Throw away used tissues, (then wash hands).  If you don’t have a tissue, then use your sleeve.  Avoid touching your eyes, nose and mouth with unwashed hands.  Avoid close contact with people who are unwell.

What are coronavirus symptoms?  Coronavirus infects the lungs.  The symptoms start with a fever, followed by a dry cough, which can lead to breathing problems.  This is a new continuous cough and means coughing a lot for more than an hour, or having three or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual).  It takes five days on average to start showing the symptoms, scientists have said, but some people will get symptoms much later than this.  In fact, the World Health Organisation says the incubation period lasts up to 14 days.

Fake health advice you should ignore:

Garlic: Lots of posts recommending eating garlic to prevent infection are being shared on facebook. The WHO says that while it is ‘a healthy food that may have some antimicrobial properties’, there’s no evidence that eating garlic can protect people from coronavirus.  In many cases, these kinds of remedies aren’t harmful in themselves, as long as they aren’t preventing you from following evidence-based medical advice.  But they have the potential to be.  The South China Morning Post reported a story of a woman who had to receive hospital treatment for a severely inflamed throat after consuming 1.5kg of raw garlic.

Drink water every 15 minutes: One post, copied and pasted by multiple FB accounts, quotes a ‘Japanese doctor’ who recommends drinking water every 15 minutes to flush out any virus that might have entered the mouth.  A version in Arabic has been shared more than 250,000 times.  Prof Trudie Lang at the University of Oxford says there is ‘no biological mechanism’ that would support the idea that you can just wash a respiratory virus down into your stomach and kill it.  Infections like coronavirus enter the body via the respiratory tract when you breathe in.  Some of them might go into your mouth. But even constantly drinking water isn’t going to prevent you from contracting the virus.  Nonetheless, drinking water and staying hydrated is generally good medical advice.

Heat and avoiding ice cream: There are lots of variations of the advice suggesting heat kills the virus, from recommending drinking hot water to taking hot baths, or using hairdryers.  One post, copied and pasted by dozens of social media users in different countries and falsely attributed to UNICEF, claims that drinking hot water and exposure to the sun will kill the virus and that ice cream should be avoided.

Charlotte Gornitzka, who works for UNICEF on coronavirus misinformation, says “A recent erroneous online message purporting to be a UNICEF communication appears to indicate that avoiding ice cream and other cold foods can help prevent the onset of the disease.  This is, of course, wholly untrue.”

We know the flu virus doesn’t survive well outside the body during the summer, but we don’t yet know how heat impacts on the new coronavirus.

Trying to heat your body or expose yourself to the sun, presumably to make it inhospitable to the virus is completely ineffective, according to Prof Bloomfield.  Once the virus is in your body, there’s no way of killing it, your body just has to fight it off.  Outside the body, “to actively kill the virus, you need temperatures of around 60 degrees (Celsius)”, says Bloomfield, far hotter than any bath.  And having a hot bath or drinking hot liquids won’t change your actual body temperature, which remains stable unless you are already ill.

We know, in general, that eating fruits and vegetables and drinking plenty of water is good for you, especially in staying healthy.

References: http://www.bbc.com/    https://www.stjude.org/    http://www.nhs.org

If you would like to get in touch with me about this column or SC, please email me on: t.dehinde@yahoo.com  and do check out my blog: www.howtolivewithsicklecell.co.uk

Credit: Tola Dehinde, Punch

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