"There isn't yet any widely accepted additional reason to avoid it for COVID-19."
Tom Wingfield, PhD, a senior clinical lecturer and honorary
consultant physician with the Liverpool School of Tropical Medicine, UK, agreed. "In the UK, paracetamol would generally be preferred over
NSAIDs such as ibuprofen to relieve symptoms caused by infec- tion such as fever," he told the UK Science Media Center. "This is because, when taken according to the manufacturer's
and/or a health professional's instructions in terms of timing and maximum dosage, it is less likely to cause side effects." He underscored that more clarity is needed to determine the
significance of the message from the French Health Ministry regarding the effect of NSAIDs on COVID-19. "It is not clear from the French Minister's comments wheth-
er the advice given is generic 'good practice' guidance or spe- cifically related to data emerging from cases of COVID-19, but this might become clear in due course," Wingfield said.
Corticosteroids and COVID-19 Poland noted that the French Health Ministry also recom-
mends against the use of cortisone in COVID-19, which is con- sistent with recommendations by the World Health Organization and the CDC.
Corticosteroids, though having a different mechanism of
action than NSAIDs, are still noninflammatory and therefore seem [ideal] to use in an inflammatory disease," Poland said. "But the reasons for the recommendation against them is the observation that with SARS I, they not only did not improve the clinical course, but in fact appeared to have short-term and mid- term adverse effects in delaying viral clearance.” But experts recommend that people taking cortisone or
other steroids for chronic diseases shouldn’t stop them, except on advice from their doctor. Berenbaum, the French rheuma- tologist, reiterated this in his interview with Medscape Medical News. Separately, the UK Society for Endocrinology has issued
advice on coronavirus for people with adrenal or pituitary insuf- ficiency who take hydrocortisone or other steroids.
Reprinted with permission from
webmd.com
UNDERSTaNDINGWHaTWORKS: HOWSOmE COUNTRIES aRE
BEaTING BaCK THE CORONaVIRUS With Europe and the United States locked in deadly battle
with the coronavirus that causes Covid-19, a number of countries that were hit early by the virus are doing a far better job of beat- ing it back. China, which is now diagnosing more cases in returning
travelers than in people infected at home, reported no new do- mestically acquired cases on Wednesday, for the first time in more than two months. South Korea, which had an explosive outbreak that began in February, is aggressively battering down its epidemic curve. Singapore, Hong Kong, and Taiwan have together reported only about 600 cases. Those successes have been bought by a layering of what are known as non-pharmaceutical initiatives — including social
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distancing and travel restrictions — aimed at severing chains of transmission to keep the virus from going into an exponential growth cycle. None of the other countries has been as aggressive as China,
which put tens of millions of people into forced quarantine for weeks. And these other locales have not all adopted an across- the-board checklist of measures. While kids in Hong Kong haven’t been in school since late January, class continues in Singapore. Here’s a look at some of the techniques these governments
employed, and how they stack up to steps being taken in the United States as well as the United Kingdom, which has come under heavy scrutiny for its approach, fairly or not.
Let’s start with Singapore. The island city-state was one of the first places to ban incom-
ing flights from the Chinese city of Wuhan, where the virus originated. And it placed people coming into the country from countries affected by Covid-19 into mandatory quarantine. Singapore has seen its numbers gradually tick up. But it hasn’t
had an explosion of cases, likely because it has aggressively tracked where the virus was circulating. Of the 345 cases it has recorded, 124 have recovered and 221 are considered active cases. It has not yet recorded a death. “Singapore has done everything right,” said David Heymann,
who led the World Health Organization’s response to the 2003 SARS outbreak and now teaches infectious diseases epidemiol- ogy at the London School of Hygiene and Tropical Medicine. “They’ve been openly communicating every day on what’s going on. And they’ve made it clear to the population and the popula- tion understands that they are not only to protect themselves but protect others.”
APRIL 2020
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