COVID-19 LOCKDOWN !

As the cases continue to increase worldwide more and more countries have begun to take drastic measures to prevent the spread of COVID-19. In some places it is clear containment is no longer achievable, as too many people have become infected and the natural exponential increase in number of cases is inevitable. Now the focus switches to damage mitigation.

We first saw this in Wuhan, with city wide quarantine measures. Then Italy enacted similar measures, now extending across the country with all non-essential services and businesses closed for the foreseeable future. The Italian health service has become strained with the rising patient load, with reports of drastic measures taken in hospitals including conversion of operating theatres into intensive care bays. We have previously discussed the effect this has had on the Italian economy.

A NEW EPICENTRE

With Europe now seen as the “epicentre” of the pandemic, other countries have begun following suit. Spain is the second hardest hit country in Europe, with 6,000 infections and nearly 200 deaths. After a lengthy meeting of the government cabinet, the Spanish PM has enacted a partial lockdown of the country, with the use of armed forces on standby to assist. This includes closure of all shops except those selling food and basic necessities, reduction in medium-distance rail traffic to stem the spread of people around the country, and economic measures to support business workers.

France has also shut down all non-essential businesses, with food shops, chemists, banks and petrol stations remaining unaffected. The PM urged a reduction in travel amongst the population, and to enact “social distancing”. Germany has 3,800 cases but remarkably has only had 8 deaths so far. Berlin has banned all public and private events with more than 50 participants, with similar bans occurring in other cities across the countries.

So what do they hope to achieve with such measures? At first people were advised to take measures to wash hands, practice basic hygiene, self-quarantine if developing symptoms. But it became apparent this was not enough. Social distancing and lockdowns further reduce the spread of the virus by drastically reducing the number of people out in public, the number of interactions they can have. Schools and universities act as breeding grounds for infections, large congregations amongst which respiratory infections can spread like wildfire.

SHUT DOWN EVERYTHING

Lockdown also carries great political power. People respond well to drastic action, rather than soft recommendations to slightly change their daily habit with washing hands and increased hygiene. This is why masks have been so popular amongst the populous. It is decisive, it is visible. It is however NOT recommended by the WHO and most governments to wear as it is unnecessary unless around infected patients, and increased demands is straining supply for medical professionals and those who truly need it.

Similarly, Lockdown is a decisive action. It reassures the population that something is being done, that the government is taking the IT seriously. But it is not a cure to COVID. It is a plaster, a temporary stopping measure, one that cannot continue indefinitely. Shutting businesses can seriously affect the economy, affect people’s income and subsequently prevent them from paying off mortgages or loans. Forcing children to stay at home can affect their education, parents have to choose whether to work or look after their unsupervised kids.

It’s true that lockdown is now a necessity in some countries, and the lockdown of the Hubei province and parts of China was credited with significantly slowing down the spread of COVID. But it will not stop the viral spread completely. For this reason the UK has adopted an alternate strategy, one that we will discuss in our next blog.

Dr Rajan Choudhary, London UK

Head Of Products, Second Medic Inc

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Guillain-Barre syndrome - Symptoms and causes

Guillain-Barré syndrome (GBS) is a rare but serious neurological condition in which the body’s immune system mistakenly attacks the peripheral nervous system. This condition can lead to muscle weakness, numbness, and even paralysis in severe cases. Understanding Guillain-Barré syndrome symptoms, causes, and treatment options is crucial for early detection and effective management.

Guillain-Barré Syndrome Symptoms

The symptoms of Guillain-Barré syndrome typically begin with mild sensations of tingling or numbness in the hands and feet. These early signs of Guillain-Barré syndrome may quickly progress to more severe issues, including:

Muscle Weakness: Starting in the legs and spreading to the upper body, this weakness can become so severe that mobility is significantly impaired.
Reflex Loss: Deep tendon reflexes, such as the knee-jerk response, are often diminished or absent.
Pain: Many individuals experience sharp or cramping pain, particularly in the lower back.
Difficulty with Eye or Facial Movements: Symptoms may include difficulty speaking, chewing, or swallowing.
Respiratory Problems: In some cases, Guillain-Barré syndrome and respiratory failure become significant concerns, necessitating immediate medical intervention.
Autonomic Dysfunction: Irregular heart rhythms, blood pressure fluctuations, and other involuntary functions can be affected.

Guillain-Barré Syndrome Causes

The exact causes of Guillain-Barré syndrome are not fully understood. However, it is widely believed that the syndrome is triggered by an overactive immune response to an infection or other environmental factors. Common Guillain-Barré syndrome causes and risk factors include:

Viral Infections: Conditions such as influenza, Zika virus, and Epstein-Barr virus have been associated with GBS.
Bacterial Infections: Campylobacter jejuni, a bacterium often linked to food poisoning, is a common trigger.
Vaccinations: Although extremely rare, certain vaccines have been linked to GBS.
Surgical Procedures: Some individuals may develop Guillain-Barré syndrome following surgery.
Other Risk Factors: A history of autoimmune disorders or genetic predispositions may increase the risk.

Guillain-Barré Syndrome Progression Stages

Guillain-Barré syndrome progression stages typically unfold in three distinct phases:

Initial Stage: Lasting 1-4 weeks, this stage includes the rapid onset of Guillain-Barré syndrome symptoms such as weakness and numbness.
Plateau Stage: Symptoms stabilize but remain severe. This stage can last several weeks.
Recovery Stage: Gradual improvement begins, although Guillain-Barré syndrome recovery time can vary significantly between individuals, often taking weeks to months.

Guillain-Barré Syndrome Diagnosis

Diagnosing Guillain-Barré syndrome requires a thorough clinical evaluation. Physicians rely on specific Guillain-Barré syndrome diagnosis criteria, which include:

Patient History: Recent infections or medical procedures may provide crucial clues.
Neurological Examination: Reflexes, muscle strength, and sensory responses are assessed.
Electrodiagnostic Tests: Nerve conduction studies (NCS) and electromyography (EMG) help identify nerve damage.
Lumbar Puncture: Testing cerebrospinal fluid (CSF) can reveal elevated protein levels, a hallmark of GBS.

Early diagnosis is essential for effective treatment and to prevent complications like Guillain-Barré syndrome and respiratory failure.

Guillain-Barré Syndrome Treatment

Treatment for Guillain-Barré syndrome focuses on managing symptoms and speeding up recovery. The primary Guillain-Barré syndrome treatment options include:

Plasma Exchange (Plasmapheresis): This procedure removes harmful antibodies from the blood.
Intravenous Immunoglobulin (IVIG): High-dose immunoglobulin therapy helps neutralize the antibodies attacking the nervous system.
Supportive Care: Ventilatory support may be needed in severe cases, along with physical therapy to aid rehabilitation.

Guillain-Barré Syndrome Prognosis

The prognosis for Guillain-Barré syndrome varies depending on the severity of the condition and the timeliness of treatment. While most individuals recover fully, Guillain-Barré syndrome prognosis can include long-term complications such as:

Persistent Weakness: Some patients may experience lingering muscle weakness.
Nerve Damage: Chronic nerve pain or numbness can occur in rare cases.
Recurrence: Although uncommon, some individuals may develop Guillain-Barré syndrome again.

Guillain-Barré Syndrome Recovery Time

Guillain-Barré syndrome recovery time can range from a few weeks to several months. Factors that influence recovery include:

Age: Younger individuals generally recover faster.
Severity: Severe cases with extensive nerve damage may take longer to heal.
Timely Treatment: Early intervention is key to minimizing long-term effects and shortening recovery time.

Conclusion

Guillain-Barré syndrome is a challenging condition that requires early recognition and prompt treatment. By understanding the symptoms, causes, and treatment options, individuals can better manage this syndrome and improve their outcomes. If you or a loved one suspect Guillain-Barré syndrome, consult a healthcare professional immediately. Early diagnosis and treatment are critical for a full recovery.