• Published on: May 15, 2020
  • 4 minute read
  • By: Dr Rajan Choudhary

Living With COVID And Returning To BAU!

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Hurdles to Business As Usual – Hurdles to Life as Usual –   Living with COVID!

Obstacles to re-open the country

As we come to the 2-month mark of lockdown, its effect on the populous is becoming apparent. The extreme restrictions have had a significant impact on people’s physical health, mental health, and general livelihood, and many people are itching for life to get back to normal. Many countries including New Zealand, Germany, Italy, and Spain have seen the first peak of COVID infections pass, and some have already begun reopening parts of their economy. This has led to concerns from public health officials that relaxing the lockdown too early and too liberally will lead to a rapid increase in infection rates. Indeed, Germany has already seen an increase in R0 above 1 (one infected person will infect more than one person, causing the disease to propagate).

Trying to work out how to reopen a country without causing another spike in COVID deaths is probably the biggest issue faced by public health officials across the world. And trying to convey clear instructions to the public is an issue some countries are currently struggling with. In the next few blogs we will look at the issues faced, what has worked and what needs improvement, and what we as the public can do to keep ourselves safe.

THE MASKS WE WEAR

We have discussed masks at the start of the pandemic, and we have discussed masks as the pandemic has progressed. Why are we bringing it up again?

Masks have been a heated point of contention, but their role in public health has matured over the past few weeks. At the beginning of the pandemic, masks were a rare commodity, with DIY stores running dry of masks, stories of people stealing masks from clinical environments, and very confusing advice on whether the public should wear masks in public.

At that time the WHO had recommended only infected patients and those working with infected people wear masks, to save on the precious PPE for medical professionals. N95 respirators are seen as the gold standard in protective equipment, and hospitals are still struggling to provide staff with enough respirators, let alone the public. Concerns have also been raised on whether using masks will provide a false sense of security, especially if they stop washing hands or touch the infected parts of the masks.

But now we are past the first COVID peak, and advice on masks has changed. People should wear a mask if they are in public. Germany has implemented this advice, as has Austria for its public markets. In the US many stores are requesting public wear masks before entry. Rather than surgical masks or respirators, the use of homemade or purchased cotton masks has been encouraged.

LET’S LOOK AT WHY

Surgical masks and respirators aim to protect the user from inhaling microscopic aerosolized COVID particles. Cotton masks do not function this way. Instead, they prevent the wearer from spreading COVID by catching much larger droplets that is coughed/sneezed or generally breathed out.

The majority of people with COVID-19 are able to spread the infection to others up to 3 days before they show symptoms. Indeed as many as 50% of infections seem to occur from pre-symptomatic individuals. During this time they produce the greatest amount of viral particles, and these particles can stay in the air for several hours.  Someone with asymptomatic COVID walking around in public or in a shop could infect lots of people.

So wearing a mask, even if you are not symptomatic or around infected patients helps prevent the spread of the infection. We know already just how infective COVID-19 is, so any measures that reduces infection even a little will end up reducing spread drastically on a population level. It has been compared to seatbelts – one person might not feel the benefits, but they save thousands of lives across the country on a yearly basis.

IS THERE ANY EVIDENCE?

In our blogs, we often talk about the importance of evidence. We look at the quality of evidence, how different types of research gives good and bad evidence, and why we should always give evidence-based advice.

So is there any evidence supporting masks? We have evidence that cloth masks can stop 99% of droplets that are coughed up, and whilst it doesn’t block aerosols or actual viral particles it still has a significant impact on transmission. We also have strong evidence from high infectivity in choir groups and at call centers that the majority of transmission is via the air, rather than from surfaces.

But what about the highest level of evidence? Comparing people who do or don’t wear masks is not a study that can be easily performed or one that has been performed adequately. But why should you wait? There is minimal to no risk associated with wearing a cloth mask, it offers some protection to you and a lot of protection to the public. In these cases, we should take a precautionary approach.

We don’t have any high-quality evidence looking at hand washing or physical distancing. But precautionary measures enforced have helped reduce infectivity. The same applies to masks. The best we can offer is an Australian study looking at mask use during influenza. They found observational data suggest that transmission of viral respiratory infection was significantly reduced during the SARS epidemic with the use of face masks as well as other infection control measures” and “in an adjusted analysis of compliant subjects, masks as a group had protective efficacy in excess of 80% against clinical influenza-like illness.”. In compliant users, masks were highly efficacious.

So that’s our advice. If you're going to go out in public, wear a mask.

If you don’t have a mask, you can order one online. Or be adventurous. Make one out of an old T-shirt or sock. Here are some ways to make one without needing to sew.

https://www.theguardian.com/us-news/2020/may/11/make-non-medical-coronavirus-face-mask-no-sewing-required masks

https://www.youtube.com/watch?v=r51YroAFPds DIY Face Mask

MORE INFORMATION

https://www.fast.ai/2020/04/20/skeptics-masks/#mightnt-people-handle-their-masks-wrong-and-make-things-worse Masks - FAQ

https://www.bmj.com/content/369/bmj.m1435 face masks for the public

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30918-1/fulltext wearing face masks in the community during the COVID-19 pandemic: altruism and solidarity

https://twitter.com/trishgreenhalgh/status/1253244613927874560 twitter trisha

Dr Rajan Choudhary, UK, Chief Product Officer, Second Medic Inc

www.secondmedic.com

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diabetes 2 symptoms

Understanding Diabetes Type 2 Symptoms: A Simple Guide

Diabetes is a common health condition that affects millions of people around the world. Among its different types, Type 2 diabetes is the most widespread. It often develops slowly and can go unnoticed for years. That's why it’s important to understand the symptoms of diabetes type 2, so you can take timely action and protect your health.

In this blog, we will explain what Type 2 diabetes is, the signs to watch out for, and when to see a doctor.

 

What is Type 2 Diabetes?

Type 2 diabetes is a chronic condition where your body either doesn't produce enough insulin or can’t use it properly. Insulin is a hormone that helps your body control blood sugar (glucose) levels. Without enough insulin, sugar builds up in your bloodstream instead of being used for energy.

This buildup of sugar can damage your organs over time, including your heart, kidneys, eyes, and nerves. That’s why early detection and treatment are very important.

 

Who is at Risk?

Type 2 diabetes can affect anyone, but some people are more likely to get it. You may have a higher risk if you:

  • Are overweight or obese
     

  • Have a family history of diabetes
     

  • Are over the age of 45
     

  • Live a sedentary (inactive) lifestyle
     

  • Have high blood pressure or cholesterol
     

  • Had gestational diabetes during pregnancy
     

  • Belong to certain ethnic groups (such as South Asian, African-Caribbean, or Hispanic)
     

Knowing your risk factors can help you stay alert and get tested early.

 

Common Diabetes Type 2 Symptoms

The symptoms of Type 2 diabetes often develop slowly, and many people may not notice them right away. Some people don’t experience any symptoms at all until complications arise. That’s why it’s sometimes called a "silent" disease.

Here are the most common diabetes 2 symptoms to look out for:

1. Frequent Urination

If you find yourself needing to urinate more often than usual, especially at night, it could be a sign of high blood sugar. Your body tries to get rid of the excess glucose through urine.

2. Excessive Thirst

Frequent urination can make you lose a lot of water, leading to dehydration. This makes you feel unusually thirsty all the time.

3. Increased Hunger

Despite eating enough, people with Type 2 diabetes may feel hungry more often. This is because the body isn’t using the glucose in the blood properly for energy.

4. Fatigue and Tiredness

When your body can’t use sugar for fuel, it leads to low energy levels. This can make you feel tired, weak, or sluggish even after a good night's sleep.

5. Blurred Vision

High blood sugar levels can affect the tiny blood vessels in your eyes, leading to blurry vision. If untreated, it can even cause permanent eye damage.

6. Slow Healing Wounds

Cuts, bruises, or infections may take longer to heal if your blood sugar is high. This happens because diabetes affects blood circulation and the immune system.

7. Tingling or Numbness

Many people with diabetes experience tingling, pain, or numbness in their hands or feet. This is known as diabetic neuropathy and is caused by nerve damage due to high blood sugar.

8. Unexplained Weight Loss

If you're losing weight without trying, it could be a warning sign. When your body can’t use sugar properly, it starts burning fat and muscle for energy.

9. Skin Problems

Dark patches on the skin, especially around the neck or armpits (a condition called acanthosis nigricans), can be an early sign of insulin resistance.

 

When Should You See a Doctor?

If you notice any of the above symptoms, it’s important to see a healthcare provider for a simple blood sugar test. Early diagnosis can help you manage the condition better and prevent serious complications.

Even if you feel fine, it's a good idea to get regular health check-ups, especially if you’re at higher risk.

 

How is Type 2 Diabetes Diagnosed?

Doctors use the following tests to diagnose Type 2 diabetes:

  • Fasting blood sugar test: Measures blood sugar after not eating for 8 hours
     

  • HbA1c test: Shows your average blood sugar levels over the last 2-3 months
     

  • Oral glucose tolerance test: Measures how your body handles sugar after drinking a sweet drink
     

  • Random blood sugar test: Can be done at any time of the day
     

Your doctor may repeat tests or use more than one type to confirm the diagnosis.

 

Can Type 2 Diabetes be Managed?

Yes! Type 2 diabetes can be managed with lifestyle changes, medications, and regular monitoring. Some people are even able to reverse it through weight loss and healthy habits.

Here’s how you can manage it:

  • Eat a balanced diet: Include whole grains, vegetables, lean proteins, and fruits
     

  • Exercise regularly: Aim for at least 30 minutes of activity most days of the week
     

  • Lose excess weight: Even a small amount of weight loss can improve your blood sugar
     

  • Take medications if needed: Your doctor may prescribe tablets or insulin
     

  • Monitor blood sugar: Keep track of your glucose levels as advised by your doctor
     

  • Avoid smoking and alcohol: These can worsen diabetes and its complications
     

 

Final Thoughts

Type 2 diabetes is a serious condition, but it can be controlled and even reversed with the right steps. Understanding the early warning signs and diabetes 2 symptoms can make a big difference in your health journey.

If you or someone you love is experiencing these symptoms, don’t wait—talk to a doctor today and get tested. Early action can help you lead a healthier, longer life.

 

Take control of your health today—recognize the diabetes 2 symptoms early and consult your doctor for a proper diagnosis and care plan.

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