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WOH Series Part 2: Current treatments for COVID-19



Patients diagnosed with the coronavirus are receiving different care depending on the severity of their symptoms. Current healthcare facilities are in clinical trials with possible antiviral drugs that could be used as a treatment, such as remdesivir. Even plasma from recovered patients is being considered for a potential treatment for COVID-19 patients. If respiratory problems caused by the virus persist, healthcare professionals are turning to ventilators to help patients breathe and fight for their lives. Researchers are currently evaluating the effectiveness of these treatments to determine which care is suited for various patients with mild to severe symptoms. 

One drug that is the furthest along in clinical trials for treating COVID-19 is remdesivir. Researchers are also testing older medications that are typically used to treat other conditions to see if they are also useful in treating COVID-19. 


This antiviral drug is administered by intravenous (IV) infusion in the hospital. Remdesivir is a new drug that has been given an “emergency use authorization.” Previously, the drug showed to have some effect against SARS, MERS, and Ebola in cell and animal models

Based on the positive reports from studies, the FDA issued an emergency use authorization (EUA) for remdesivir on May 1, 2020. The EUA does not mean that the FDA has approved remdesivir for the treatment of COVID-19. Instead, the EUA intends to make it easier for doctors to get remdesivir for hospitalized patients with severe COVID-19 symptoms. These are patients who require mechanical ventilation or extra oxygen

Hydroxychloroquine and chloroquine

Hydroxychloroquine and chloroquine are two medications that have been used to treat malaria and autoimmune conditions like rheumatoid arthritis and lupus. Some studies suggest that both medicines may also help treat hospitalized patients with mild cases of COVID-19. In contrast, other studies showed that hydroxychloroquine did not make a difference. Based on what we now know, the risks of heart problems and other issues appear to outweigh the benefits relative to treating COVID-19. More comprehensive studies are needed to confirm whether these medications work in treating COVID-19.

Convalescent plasma

On March 24, 2020, the FDA issued an Emergency Investigational New Drug (eIND) for convalescent plasma to treat people with COVID-19. Plasma is the liquid part of blood that carries blood cells. Currently, antibodies containing plasma from a recovered patient are given by transfusion to a patient suffering from COVID-19. The donor antibodies help the patient fight the illness, possibly reducing the length or lessening the severity of the disease.

In China, ten adults with severe COVID-19 symptoms were given convalescent plasma. The researchers reported that all symptoms (such as fever, cough, shortness of breath, and chest pain) had significantly improved within three days. Still, it is not widely available since healthcare centers have just recently begun collecting it.


Patients with increased respiratory complications, healthcare professionals are turning to ventilators to help patients breathe. Ventilators are used for patients that can no longer breathe and need the machine to help provide oxygenation. In short, a ventilator takes over the body’s breathing process when the disease has caused the lungs to fail. This gives the patient time to fight off the infection and time to recover. There are two types of medical ventilators that can be used to treat patients. 

Graphic showing two common types of medical ventilation

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How is the ventilator used? 

In severe cases, the virus can cause damage to the lungs, prompting the body’s oxygen levels to drop, making it harder to breathe. A ventilator pushes air with increased levels of oxygen into the lungs to alleviate these problems. The ventilator has a humidifier, adding heat and moisture to the air supply matching the patient’s body temperature.

Patients are given medication to stay sedated and help relax the respiratory muscles to tolerate the discomfort from the ventilators. 

Timeline of Ventilators

The average timeline of ventilators is two to three weeks, possibly even longer, when a COVID-19 patient requires mechanical ventilation support. Some individuals could require a tracheostomy, where a tube is inserted in the opening of one’s neck rather than down the windpipe. Doctors must consider whether a ventilator’s complications are worth it in giving the patient enough time to recover from COVID-19, which can take weeks on the machine.

Possible Complications 

The pressure from a ventilator can make a patient’s lungs collapse or increase the risk of pneumonia. Gradually, doctors use reduced volumes of oxygen with lower pressure to limit injury to patients. However, ventilators are still “not completely safe and harm-free,” says Dr. David Hill, a pulmonary and critical care physician and board member of the American Lung Association.


Rehabilitation usually involves physical and occupational therapy to help patients get up and to move again. Eventually, a patient will begin transitioning to either home or a rehabilitation facility to start the recovery process after being taken off the ventilator. The recovery process varies for each patient, and older individuals with existing medical conditions could have a longer recovery period

Though COVID-19 is still relatively new, researchers are still conducting studies such as clinical trials, to determine which treatment is effective for patients with mild to severe symptoms. 



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Getting Back Into Shape During Covid



The motivation to stay active during quarantine can be quite difficult, especially with many opting to use garages or bedrooms as a personal gym without any equipment or legroom available. Even as gyms reopen, understanding what your body needs to become stronger, leaner, & fitter can be a difficult challenge to tackle.

Keep in mind that your level of progression is widely based on your total time off, and your level of fitness before it. If you start by placing a high demand on your body, you risk the possibility of injury and a quick regression backward. Being extremely sore the next day does not indicate a quality workout. Here is an outline to guide and help you ease back into your workout without losing motivation or risking injury.

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1. Start with Flexibility Workouts

Your first progressive step should be to incorporate a couple of days of flexibility workouts to increase blood flow and circulation while supporting range of motion and joint mobility. Developing flexibility is one of the most overlooked protocols of fitness routines, and building these protocols early on will allow your body to properly readjust to the new demands that will be placed on it. Signing up or participating in a beginner yoga class or videos you can do at home to increase flexibility and build strength. Choose 10 to 15 stretches, performing each flexibility movement for up to one minute. 

2. Add Easy Cardio

The next step is integrating light cardiorespiratory workouts after a couple of stretching or yoga sessions. An excellent way to start is a brisk 20-minute outdoor walk that will revitalize your mind and get your body moving again. Other options you can include in your workout, such as low impact HIIT workout (high-intensity interval training) for beginners. Machines you can use at your gyms include treadmills, ellipticals, and stationary bikes are great indoor options. If you had a well-established fitness base before a month-long break, your first week might consist of light jogging instead of walking.

3. Start Strength Training

After your first week of flexibility and light cardio, start to incorporate strength workouts into your routine by trying gentle strength training workout for getting back into the gym. The time apart from the gym most likely involved a fair amount of sitting that causes weakness in your posterior chain, which refers to all the muscles on the backside of the body from your head down to your heels. These particular muscles are essential for basic everyday movement and keep your spine upright when at the desk. That is why incorporating exercises that improve your posture, develop core strength, and activate muscles throughout your glutes and hamstrings are essential. 

Exercises like squats, lunges, bridges, TRX hamstring curls, stability ball mobility, and core work will help activate these muscles. Bodyweight workouts are ideal for working these muscles and establish a safe transition back into your fitness regimen, and you can work within your fitness level. 

4. Begin your workout with a proper warm-up and end with a good cool-down

It is important to begin your workout with a proper warm-up that prepares your body for the increase in activity, and a cool-down helps your heart rate return to normal resting rate. Don’t jump into any physical activity without easing into it. Muscles that have not been accustomed to strenuous activity for a while, and will experience some form of DOMS (delayed onset muscle soreness), which means you will be tight and achy for 24-72 hours after your workout. You may also experience this when you work out regularly but up to your intensity. With a proper cool-down session, you can help some of the soreness you could experience the day following your workout. 

5. And spend a few minutes stretching.

Stretching is an important dynamic when getting back into your fitness routine to help loosen those tight muscles before starting your workouts. After your workout, its good to release that muscle tension

6. Focus on your form

When you’re getting back into your regular routine, quality will always trump quantity. Maintaining proper form will help target and work your muscles without straining or overexerting yourself. Take your time to focus on your form, breathing, and control. This is extremely important because proper technique and form are crucial to help prevent injury

7. Don’t skip rest days!

Don’t jump into working out a six-days-a-week workout routine too soon. Recovery is a big part of being active. When you don’t take a day off, your body doesn’t get to take the necessary time to replenish your muscles. Rest days are vital to long-term wellness, and the lifestyle you are recreating for yourself now should consist of frequency. Promoting recovery is a good way to build habits of your workouts without leading to a sprain or strain delaying your workout and fitness routines. 

8. Listen to your body

Your body will let you know when it is working hard, but learning the difference between hurts-so-good and hurts-not-so-good will save you a trip to the doctor’s office. If something feels uncomfortable or causes you pain, stop doing whatever is causing your body to feel that way. There is a not-so-fine line between muscle discomfort from a good workout, and pain lets you know something’s not right. Be attentive to your body to help you progress through your workouts safely. 

Slowly easing your way to recreating your fitness regimen will help you stay consistent and achieve your fitness goals. It’s important to remember we are all on our fitness journey, so take your time and stay motivated!



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New Promising COVID-19 Vaccine Selects Hoag Hospital for Trial



UCI graduate Chen Cao became the first of 35 individuals to be vaccinated in NantKwest Inc. and ImmunityBio’s phase 1 clinical trial for COVID-19. This trial is only happening at Hoag Memorial Hospital Presbyterian in Newport Beach, CA.

According to the WHO, there are 44 vaccine candidates in clinical evaluation worldwide and another 154 in preclinical evaluation. Most are targetting the coronavirus’ signature spike protein, which leads to its name “corona,” meaning “crown” in Latin

NantKwest/ImmunityBio’s vaccine also does the same, but it also targets structures within the virus’ cytoplasm called nucleocapsids that have been shown to stimulate T-cell responses.

Philip Robinson, Hoag’s medical director of infection prevention and principal investigator for the vaccine trial, states, “This vaccine is novel because it stimulates the second arm of the immune system, the cell-mediated immunity, the T-cell response.” 

Based on SARS-CoV 1, he added that patients who developed that T-cell and cellular immune response have long-lasting immunity that can be measured 17 years after they got infected. T-cell responses are more durable than antibody responses activated by the spike protein alone and develop a much longer-term immunity, the company states. 

This vaccine’s dual-edged approach is a “key advantage” that could also prevail in mutations in the spike proteins, which might reduce the efficacy of “S-only” vaccines moving forward. There are several other features that the NantKwest/ImmunityBio vaccine has that is generating enthusiasm.

While several vaccine candidates are using adenoviruses — which cause the common cold — to transfer the coronavirus’ genetic material into the human body to hopefully induce an immune response, however, there’s a potential risk that the body’s immune systems could recognize the cold virus and attack before it can complete its task. This vaccine overcomes this challenge by making deletions to the adenovirus that render it invisible, Robinson said.

Similar to other vaccine candidates, this one will consist of two shots, three weeks apart. But apart from many others, it won’t need to be stored in frigid temperatures, which can pose significant logistical challenges. 

Instead, it just requires standard refrigeration and can remain viable at room temperature “for quite a long time,” Robinson said. Down the line might also be delivered by mouth or by nasal spray, rather than just by injection, making administration even easier.

Last Wednesday, five volunteers received their first injections at Hoag, and five more will get their first injections this week, according to Deborah Fridman, Hoag’s director of clinical research. There will be a pause after each set of 10 to review the safety, side effects, and immune system reactions. 

This phase 1 trial’s primary goal is to confirm the vaccine’s safety and induces immunity, Fridman said. If proven successful, it will expand into phases 2 and 3 next year, recruiting hundreds, and then thousands, of participants.

Hoag Hospital has participated in more than 20 COVID-19 clinical trials since caring for the state’s first known COVID-19 patient in January. Hoag has given patients access to advanced therapies and innovative treatments, officials said. Though, this vaccine is its first COVID-related vaccine trial.

The hospital has expanded its research department in recent years. Hoag has a relationship with Los Angeles County-based NantKwest, Inc., and ImmunityBio is the only Orange County hospital. It is the only nonacademic institution to offer the companies’ phase 2 immunotherapy clinical trial for solid tumors.

Patient No. 1 Chen Cao must report any side effects to Hoag immediately. She has a diary to record how she’s feeling and will return regularly for evaluation and blood draws. 

Anyone interested in participating should email 



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Health Officials in Orange County Warn Residents of Flu and Coronavirus ‘twindemic’



Fall has officially begun with another flu season in store, but this year, public health officials and politicians are warning the flu could increase the demand on Orange County’s health care grid, which has been stressed due to the coronavirus pandemic.

A second outbreak is a primary concern with cooling temperatures approaching, and relaxing pandemic rules could lead to more people gathering in tighter quarters.

County leaders are urging residents to maintain their pandemic habits, to help prevent a so-called “twindemic” of influenza and the coronavirus, and advise residents to get a flu shot.

Andrew Noymer, an epidemiologist and professor of public health at UCI, states that the driving factor is COVID, a new virus, and the flu shot is not. 

Both are respiratory diseases with similar transmission modes such as coughs and sneezes spouting infectious droplets around – the flu has been around for centuries, and health systems know how to manage it, Noymer stated.

The COVID-19 countermeasures like wearing face masks, social distancing, and frequent hand washing will also work against the flu. 

One concern is that both diseases share symptoms that could cause the lesser-studied COVID-19 to spread undetected if a sick person believes they have the flu, Noymer said. That will be a challenge for an already stressed healthcare system, he said. 

Annual flu hospitalizations could cause hospitals to maintain pandemic surge plans that added beds and staff. Healthcare providers are spreading the message to their patients ahead of the expected strain. 

This week, Kaiser Permanente emailed Orange County members with a video explaining the differences between a seasonal cold, the flu, and COVID-19.

The differences between all three can be hard to distinguish, which is why mild coronavirus cases might go undetected, the video explains. The main symptoms of COVID-19 include fever, cough, shortness of breath, with onset up to two weeks after exposure. As with influenza or the flu, it starts suddenly with fever, cough, sore throat, nasal congestion, and body aches. 

Meanwhile, common colds slowly take hold with symptoms, including a runny nose, sore throat, sneezing, headaches, and high fevers are rare.

The flu kills 60,000 people per year nationwide, Noymer said, but “COVID-19 has killed 200,000, and the year is not even over yet,” 

According to public health data, since 2017, influenza and pneumonia have killed an average of 576 people per year in Orange County. Since March, the COVID-19 death toll among residents has climbed to more than 1,100 people.

For health experts, the coronavirus still is the wildcard as winter approaches. Noymer further added that the county’s population is more susceptible to COVID than the flu because they have flu shots and currently don’t have a COVID shot. 

The ongoing coronavirus spread could create a second wave of cases caused by business and school reopenings as well as changes in temperature and humidity.

Recently, Dr. Robert Redfield, the director of the US Centers for Disease Control and Prevention, told a Senate subcommittee he suspects a COVID-19 vaccine will be available in the U.S. by December in limited supply.

For more information on disinfecting and sanitization measures click here



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