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One of London's top doctors on why we should be wearing protective face masks – Tatler

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Only a few months ago, wearing a mask in public would have raised eyebrows. It is now a sobering reminder of the extraordinary times we are living in.

There has been a lot of debate, back and forth, as to whether masks should or should not be compulsory, or indeed, is it ineffective and just providing a false sense of security?

The most effective way to avoid transmission is from hand washing and social distancing. The added advantage of a mask is to mitigate the spread of the virus from an infected individual. In terms of preventing you from catching it, the evidence is sketchy at best, and depends on a number of variables. There is also a chance that the airborne virus can transmit though eyes, so should we be wearing goggles as well as masks? I think most people would draw the line there.

Fine droplets invisible to the eye are produced when sneezing, coughing and even speaking. Simply saying ‘stay safe’” could project airborne droplets containing the virus. Some of the finer particles (known as aerosol, for example, from an infective cough) can be suspended in the air for up to 3 hours. However, this is unlikely to be the common mode of transmission and is most likely a risk to health professionals who have a higher proportion of exposure. Hence the need for them to wear N95 masks which can protect up to 95% of aerosol fine particles.

The WHO have still remained consistent in their view. They feel masks are helpful in preventing spread if you have Covid, but is not sufficiently protective.

The key issue, is that up to 20% of people (possibly more) who have Covid-19 will not exhibit symptoms, and for those who contract the illness, there is an asymptomatic incubation period of up to 14 days (on average this is closer to 5 days). So ideally, everybody should be wearing masks, which is what the likes of Germany, Czech Republic and Turkey have agreed upon.

However, it is never straight forward. There are different types of masks, with different levels of protection. The most effective, N95 masks, should quite rightly be reserved for the frontline health workers and those caring for the vulnerable. There is undoubtedly a stock issue, which may be in part why the government has not made wearing masks compulsory. Surgical masks and cloth masks will have some benefit, and would be a good option for the public.

The other major issue is that people do not know how to put on, adjust or dispose of the masks. This could lead to increased transmission, due to inadvertently touching your face and spreading the virus, which would be counterproductive. This is a big issue, even NHS staff are given lessons on how to fit an N95 mask correctly, as it is surprisingly easy to get wrong.

The mask should be put on and taken off only after hand-washing (with soap and water – the soap actually breaks down the virus’ protective shell). There should be an effective seal at the bridge of the nose and under the chin. The mask should be removed from behind, taking care not to touch the front of the mask. If it is reusable, you can wash it with detergent at 60 degrees Celsius.

‘We are all in this together’ and should work to help prevent spread in the community, especially to those who are vulnerable and at risk. For this reason, I feel that correctly worn masks, which are not touched or adjusted during the time they are worn, could confer benefits to the community as a whole.

Written by Dr Tim Lebens, a private GP in Central London, with a subspecialty in health optimisation and latest advances in medicine. www.drlebens.com

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COVID-19 study linking hydroxychloroquine, death risk retracted from medical journal – Global News

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Three of the authors of an influential article that found hydroxychloroquine increased the risk of death in COVID-19 patients retracted the study on Thursday, citing concerns about the quality of the data behind it.

The anti-malarial drug has been controversial in part due to support from U.S. President Donald Trump, as well as implications of the study published in British medical journal the Lancet last month.

READ MORE: Medical journal questioning findings of hydroxychloroquine coronavirus study

The three authors said Surgisphere, the company that provided the data, would not transfer the full dataset for an independent review and that they “can no longer vouch for the veracity of the primary data sources.”

The fourth author of the study, Dr. Sapan Desai, the CEO of Surgisphere, declined to comment on the retraction.

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The observational study published in the Lancet on May 22 looked at 96,000 hospitalized COVID-19 patients, some treated with the decades-old malaria drug. It claimed that those treated with hydroxychloroquine or the related chloroquine had higher risk of death and heart rhythm problems than patients who were not given the medicines.






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WHO halts hydroxychloroquine clinical trials


WHO halts hydroxychloroquine clinical trials

Several clinical trials were put on hold after the study was published. The World Health Organization, which paused hydroxychloroquine trials after The Lancet study was released, said on Wednesday it was ready to resume trials.

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Many scientists voiced concern about the study. Nearly 150 doctors signed an open letter to the Lancet last week calling the article’s conclusions into question and asking to make public the peer review comments that preceded publication.


READ MORE:
Hydroxychloroquine doesn’t prevent COVID-19 in people exposed to the virus, study finds

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“I did not do enough to ensure that the data source was appropriate for this use,” the study’s lead author, Harvard Medical School Professor Mandeep Mehra, said in a statement. “For that, and for all the disruptions – both directly and indirectly – I am truly sorry.”

Surgisphere was not immediately available for comment.

The Lancet in a statement said, “there are many outstanding questions about Surgisphere and the data that were allegedly included in this study.”

© 2020 Reuters

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N.B. to welcome Canadians with immediate family, property in province – CBC.ca

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New Brunswick plans to open its borders to Canadians who have immediate family in the province or who own property, starting June 19, provided they self-isolate for 14 days, Premier Blaine Higgs announced Thursday.

Cabinet and the all-party COVD-19 committee have also deemed attending funerals in New Brunswick essential travel, he told reporters during a news conference in Fredericton.

The decision to loosen restrictions comes the same day New Brunswick had its first COVID-19-related death and a new confirmed case —  both linked to a long-term care facility in the Campbellton region, where there is an outbreak.

Daniel Ouellette, 84, who tested positive for COVID-19 at the Manoir de la Vallée in Atholville last week, died Thursday morning at the Campbellton Regional Hospital.

Four other elderly residents and four employees have also tested positive for the respiratory disease, including the latest case, a health-care worker in their 20s.

They are among a cluster of 15 active cases now in the Campbellton region, also known as Zone 5.

Daniel Ouellette, 84, was one of 15 people who tested positive for COVID-19 in the Campbellton region. He died Thursday morning. (Submitted by Michel Ouellette)

Higgs said he, like all New Brunswickers, received the news “with a heavy heart” and offered his condolences.

But the rest of the province will move forward with the next phase of the yellow level of the COVID-19 recovery plan tomorrow, as scheduled, he said. The Campbellton region will remain under the stricter orange phase.

“We are grieving today, but we are also moving forward today,” said Higgs, describing it as a “combination of sadness and hope.”

On Tuesday, Tide Head Mayor Randy Hunter said there were more vehicles with Quebec licence plates in the area than there should be considering COVID-19 restrictions. (Google Maps)

Officials have linked the outbreak that started May 21 to a medical professional who travelled to Quebec for personal reasons and returned to work without self-isolating for the required 14 days.

Dr. Jean Robert Ngola told Radio-Canada’s program La Matinale on Tuesday he’s not sure whether he picked up the coronavirus during the trip to Quebec or from a patient he saw in his office on May 19 who later tested positive.

Ngola, who has been suspended and is under investigation by the RCMP, said he made an overnight return trip to Quebec to pick up his four-year-old daughter because her mother had to travel to Africa for her own father’s funeral.

He drove straight there and back with no stops and had no contact with anyone, he said, and none of his family members had any COVID-19 symptoms at the time.

He did not self-isolate upon returning, he said. He went to work at the Campbellton Regional Hospital the next day.

“Maybe it was an error in judgment,” said Ngola, pointing out that workers, including nurses who live in Quebec, cross the border each day with no isolation required.

Minister defends northern border crossing

The province’s public safety minister is defending a border crossing that residents of a small village near Campbellton fear is letting in too many people from out of the province.

On Tuesday, Tide Head Mayor Randy Hunter said there were more vehicles with Quebec licence plates in the area than there should be considering COVID-19 restrictions and that the province is giving the wrong impression about how much traffic there is at the crossing.

“The premier’s reporting and the news is reporting perhaps 60 to 70 cars a day, well that is not factual,” said Hunter.

Public Safety Minister Carl Urquhart said he’s convinced there isn’t a security issue at the border. (CBC)

“I know people that work for public safety there and the average [number of cars] on that bridge is about 200 a day.”

The checkpoint is located on the New Brunswick side of the border, a short distance from the bridge to Matapédia, Que.

But Public Safety Minister Carl Urquhart said there was a bit missing in that interpretation.

There are about 200 vehicles making that crossing every day, but only 65 of them would be private vehicles.

“Approximately 65 [private vehicles] the other day and then 130 commercial. So you’re looking at approximately 200 all together,” said Urquhart.

Urquhart said public safety officers are the ones that determine whether someone can come into the province or not, but that commercial vehicles are checked to make sure they’re actually making deliveries.

Urquhart said he’s convinced there isn’t a security issue at the border, and while he would love to send more public safety officers up there, they’re needed elsewhere.

“If I had a lot more people I could put them all over the province,” said Urquhart.

“You have to work with all you have.”

What to do if you have symptoms

People concerned they might have COVID-19 can take a self-assessment on the government website at gnb.ca. 

Public Health says symptoms shown by people with COVID-19 have included: a fever above 38 C, a new cough or worsening chronic cough, sore throat, runny nose, headache, new onset of fatigue, new onset of muscle pain, diarrhea, loss of sense of taste or smell, and difficulty breathing. In children, symptoms have also included purple markings on the fingers and toes.

People with two of those symptoms are asked to:

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Study authors retract influential Lancet hydroxychloroquine article – National Post

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NEW YORK — Three of the authors of an influential article that found hydroxychloroquine increased the risk of death in COVID-19 patients retracted the study on concerns about the quality of the data in the study.

They said that Surgisphere, the company that provided the data, would not transfer the full dataset for an independent review and they “can no longer vouch for the veracity of the primary data sources.”

The study was published in British medical journal the Lancet last month. (Reporting by Michael Erman Editing by Chris Reese)

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