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Covid-19

New Promising COVID-19 Vaccine Selects Hoag Hospital for Trial

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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 clincialresearch@hoag.org. 

Sources:

  1. https://www.ocregister.com/2020/10/21/hoag-memorial-selected-as-trial-site-for-promising-covid-19-vaccine/
  2. https://www.who.int/docs/default-source/coronaviruse/novel-coronavirus-landscape-covid-19cc0232c16129498983a6a0e30ca94000.pdf?sfvrsn=87aa8dc9_1&download=true
  3. https://nantkwest.com/immunitybio-study-shows-positive-t-cell-and-antibody-immune-responses-to-its-covid-19-vaccine-candidate-that-targets-both-spike-and-nucleocapsid-virus-proteins/
  4. https://www.hoag.org/news/clinical-trial-for-pancreatic-cancer-patients2/

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Covid-19

Getting Back Into Shape During Covid

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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!

Sources:

  1. https://wordofhealth.com/2020/05/05/gov-newsom-announces-california-to-begin-reopening-at-end-of-this-week/
  2. https://wordofhealth.com/2019/05/09/a-brief-guide-to-injury-prevention/
  3. https://www.shape.com/fitness/how-get-back-working-out
  4. https://www.self.com/story/heres-exactly-how-to-ease-back-into-working-out
  5. https://www.shape.com/fitness/tips/what-is-posterior-chain-exercises

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

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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

Sources: 

  1. https://www.ocregister.com/2020/09/17/orange-county-health-officials-warn-of-coronavirus-and-flu-twindemic/
  2. https://www.ocregister.com/2020/09/08/orange-county-gains-ground-against-coronavirus-advances-from-purple-tier-to-less-restrictive-red-tier/
  3. https://healthy.kaiserpermanente.org/health-wellness/videos/covid-19/symptoms-cold-flu
  4. https://wordofhealth.com/2020/09/18/coronavirus-sanitize-or-disinfect/
  5. https://wordofhealth.com/2020/07/13/disinfecting-medical-masks-and-n95-respirator-masks/

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Coronavirus: Sanitize or Disinfect?

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During the COVID-19 pandemic, it is imperative that you wash your hands frequently or sanitizing them when soap and water are not available and cleaning commonly-touched-surfaces to keep yourself protected.

While sanitizers and disinfectants are commonly referred to as interchangeably, both products are different and should be used in separate circumstances.  

According to the CDC, cleaning, sanitizing, and disinfecting all have different definitions:

  • Cleaning eliminates germs, dirt, and other impurities from surfaces, but does not necessarily kill them.
  • Sanitizing decreases the number of germs on surfaces or objects by killing them or removing them—to a safe level, according to public health standards or requirements.
  • Disinfecting kills germs on objects or surfaces.

Diane Calello, MD, executive and medical director of New Jersey Poison Center and associate professor of emergency medicine at Rutgers New Jersey Medical School, states sanitizing does not kill everything. 

The Environmental Protection Agency (EPA) defines sanitizers as chemical products that can kill 99.9% of germs on hard surfaces. Again, disinfectants are more potent, killing 99.999% of germs on hard, non-porous surfaces or objects.

The difference comes down to that sanitizing solutions aren’t as potent as disinfecting solutions. Some products can be both sanitizers and disinfectants. Dr. Calello says concentrated bleach can be a disinfectant, but if it’s very diluted, it might be a sanitizer meaning it kills fewer bacteria and viruses.

Sanitize or Disinfect?

There are specific procedures for cleaning groceries, surfaces in your home like doorknobs, and your hands, and it’s crucial to get them right. When it comes to groceries, you don’t need to wipe them down with disinfectant wipes (or any other disinfectants) or a sanitizer. You can clean them using water, but no soap when you bring them to your home.

For highly-touched areas of your home like doorknobs, toilet handles, and even sinks, you want to save disinfectants for these areas. However, for countertops where surfaces are exposed to food preparation, its best to sanitize those so any chemical residue isn’t as powerful and potentially harmful.

As for your own hands, you should not use disinfecting wipes as it can be hazardous for your skin, according to Dr. Calello. She further adds that at the poison center, she works for has seen people’s adverse effects using disinfectants on their own bodies. She said there was a man who acquired powerful, industrial-use disinfectant wipes and developed a blistering rash.

Donald Ford, MD, family medicine doctor at Cleveland Clinic, states that you can wipe off surfaces but wash your hands. Due to the “good” bacteria that live on your skin, when you apply something that kills all the bacteria on your hands, you’re killing off some helpful and natural bacteria. 

Dr. Calello says there is a reason why we do not apply something that does not kill every organism like a hand sanitizer, which should contain 60% alcohol. However, it’s essential to remember that hand sanitizer is adequate if you’re out in public, but washing hands with soap and water for at least 20 seconds is preferred.

Since the COVID-19 pandemic, there has been an increase in people purchasing disinfectants and sanitizing products and knowing when to sanitize and disinfect surfaces or objects can help in practicing proper sanitation. 

Sources: 

  1. https://www.health.com/condition/infectious-diseases/coronavirus/sanitize-vs-disinfect
  2. https://www.cdc.gov/flu/school/cleaning.htm
  3. https://www.epa.gov/sites/production/files/documents/ece_curriculumfinal.pdf
  4. https://www.njpies.org/administrative-staff/
  5. https://rutgershealth.org/provider/diane-calello
  6. https://www.health.com/condition/infectious-diseases/coronavirus/how-to-use-cleaning-chemicals-safely

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