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Is Ibuprofen Really Risky for Coronavirus Patients? Is Ibuprofen Really Risky for Coronavirus Patients?
(3 days later)
The health minister of France, Olivier Véran, has issued a blunt warning about painkillers taken by people ill with the coronavirus: Stay away from drugs like ibuprofen and aspirin.The health minister of France, Olivier Véran, has issued a blunt warning about painkillers taken by people ill with the coronavirus: Stay away from drugs like ibuprofen and aspirin.
Take acetaminophen instead, he advised in a tweet on Saturday. So-called nonsteroidal anti-inflammatories like ibuprofen worsened symptoms of the illness caused by the coronavirus, he said.Take acetaminophen instead, he advised in a tweet on Saturday. So-called nonsteroidal anti-inflammatories like ibuprofen worsened symptoms of the illness caused by the coronavirus, he said.
Some patients had experienced serious adverse effects while taking Nsaids, the health ministry said in a bulletin to doctors, and Nsaids should never be used in these patients.Some patients had experienced serious adverse effects while taking Nsaids, the health ministry said in a bulletin to doctors, and Nsaids should never be used in these patients.
The advice left many medical experts scratching their heads. The coronavirus is a new pathogen, and little is known about the disease it causes, called Covid-19, or how patients respond to common medications.The advice left many medical experts scratching their heads. The coronavirus is a new pathogen, and little is known about the disease it causes, called Covid-19, or how patients respond to common medications.
On Wednesday, the World Health Organization said it was aware of no research showing that ibuprofen should not be taken by patients with Covid-19.On Wednesday, the World Health Organization said it was aware of no research showing that ibuprofen should not be taken by patients with Covid-19.
Dr. Véran’s warning followed a letter published in The Lancet this month. The letter’s authors proposed that certain drugs increase the number of so-called ACE2 receptors on the surfaces of cells.Dr. Véran’s warning followed a letter published in The Lancet this month. The letter’s authors proposed that certain drugs increase the number of so-called ACE2 receptors on the surfaces of cells.
The coronavirus uses these receptors to infect cells, the authors noted, and so in theory patients taking the drugs might be more vulnerable to the virus. One of the drugs was ibuprofen.The coronavirus uses these receptors to infect cells, the authors noted, and so in theory patients taking the drugs might be more vulnerable to the virus. One of the drugs was ibuprofen.
But there was no research to back up the contention. “No data,” said Dr. Michele Barry, director of the Center for Innovation in Global Health at Stanford University. There is no reason to think that infected patients should avoid temporary use of ibuprofen, she added.But there was no research to back up the contention. “No data,” said Dr. Michele Barry, director of the Center for Innovation in Global Health at Stanford University. There is no reason to think that infected patients should avoid temporary use of ibuprofen, she added.
“It’s all anecdote, and fake news off the anecdotes,” said Dr. Garret FitzGerald, chair of the department of pharmacology at the Perelman School of Medicine at the University of Pennsylvania. “That’s the world we are living in.”“It’s all anecdote, and fake news off the anecdotes,” said Dr. Garret FitzGerald, chair of the department of pharmacology at the Perelman School of Medicine at the University of Pennsylvania. “That’s the world we are living in.”
“Until there is evidence, there is no reason at all to be issuing public health guidance” about Nsaids and the coronavirus, he added.“Until there is evidence, there is no reason at all to be issuing public health guidance” about Nsaids and the coronavirus, he added.
There are reasons to worry about long-term, heavy use of Nsaids, which have been linked an increased risk of kidney damage in some patients. People taking blood thinners also should avoid Nsaids.There are reasons to worry about long-term, heavy use of Nsaids, which have been linked an increased risk of kidney damage in some patients. People taking blood thinners also should avoid Nsaids.
But for infectious disease specialists, the greater concern is that when Nsaids and acetaminophen reduce fever, patients may be more comfortable but their lower temperatures can short-circuit the body’s main defense against infection.But for infectious disease specialists, the greater concern is that when Nsaids and acetaminophen reduce fever, patients may be more comfortable but their lower temperatures can short-circuit the body’s main defense against infection.
Studies have found that if people infected with a variety of viruses and other microorganisms bring their fevers down, with Nsaids or with acetaminophen, their symptoms may last longer and they continue to shed virus for a longer time — meaning they may be contagious for longer periods.Studies have found that if people infected with a variety of viruses and other microorganisms bring their fevers down, with Nsaids or with acetaminophen, their symptoms may last longer and they continue to shed virus for a longer time — meaning they may be contagious for longer periods.
“Everything that walks, flies, crawls or swims on the face of this earth makes fever,” said Dr. Paul Offit, an infectious disease expert at the University of Pennsylvania and Children’s Hospital of Philadelphia. Even lizards, he added, which crawl to the top of rocks and sun themselves when they are ill to bring their temperatures up.“Everything that walks, flies, crawls or swims on the face of this earth makes fever,” said Dr. Paul Offit, an infectious disease expert at the University of Pennsylvania and Children’s Hospital of Philadelphia. Even lizards, he added, which crawl to the top of rocks and sun themselves when they are ill to bring their temperatures up.
The immune system works better when the body’s temperature is higher, enabling it to more efficiently kill viruses and bacteria. Dozens of studies — in animals, reptiles and humans — have found that fever is beneficial in fighting infections.The immune system works better when the body’s temperature is higher, enabling it to more efficiently kill viruses and bacteria. Dozens of studies — in animals, reptiles and humans — have found that fever is beneficial in fighting infections.
But there is a trade-off. For every 1 degree centigrade that the body’s temperature rises, the metabolic rate increases by 12 percent. “We don’t want to pay that metabolic price when we don’t have to, so we only make a higher temperature when we need it,” Dr. Offit said.But there is a trade-off. For every 1 degree centigrade that the body’s temperature rises, the metabolic rate increases by 12 percent. “We don’t want to pay that metabolic price when we don’t have to, so we only make a higher temperature when we need it,” Dr. Offit said.
Updated June 2, 2020 Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
A very high temperature, edging toward 104 degrees Fahrenheit, is not good for babies, pregnant women or people with cardiovascular disease. And everyone with a fever that high feels miserable.A very high temperature, edging toward 104 degrees Fahrenheit, is not good for babies, pregnant women or people with cardiovascular disease. And everyone with a fever that high feels miserable.
But taking a drug to reduce fever can lead to longer periods when people are infectious with viral infections, like the flu and or infections with other microorganisms, said Dr. Myron M. Levine, associate dean for global health, vaccinology and infectious diseases at the University of Maryland School of Medicine.But taking a drug to reduce fever can lead to longer periods when people are infectious with viral infections, like the flu and or infections with other microorganisms, said Dr. Myron M. Levine, associate dean for global health, vaccinology and infectious diseases at the University of Maryland School of Medicine.
There is at least a theoretical danger the fever-reducers — including acetaminophen — may have a similar effect in patients ill with the coronavirus. Although there is no research yet, “my personal gut feeling,” Dr. Levin said, is that it might be reasonable for a person infected with the coronavirus to avoid both kinds of painkillers.There is at least a theoretical danger the fever-reducers — including acetaminophen — may have a similar effect in patients ill with the coronavirus. Although there is no research yet, “my personal gut feeling,” Dr. Levin said, is that it might be reasonable for a person infected with the coronavirus to avoid both kinds of painkillers.
A drug like acetaminophen or ibuprofen can bring a fever down, but you don’t want to keep taking it constantly, said Dr. Marguerite Neill, an infectious disease expert at Brown University. Let the fever do its job.A drug like acetaminophen or ibuprofen can bring a fever down, but you don’t want to keep taking it constantly, said Dr. Marguerite Neill, an infectious disease expert at Brown University. Let the fever do its job.
“A single dose of an Nsaid when the temperature is 103 or 104 in an adult who has the flu — I’m not saying that’s wrong,” Dr. Neill said. “But don’t keep pumping it in if the fever is lower.”“A single dose of an Nsaid when the temperature is 103 or 104 in an adult who has the flu — I’m not saying that’s wrong,” Dr. Neill said. “But don’t keep pumping it in if the fever is lower.”
She quoted an 18th-century English physician, Dr. Thomas Sydenham: “Fever is nature’s engine which she brings to the battlefield to vanquish her enemies.”She quoted an 18th-century English physician, Dr. Thomas Sydenham: “Fever is nature’s engine which she brings to the battlefield to vanquish her enemies.”