Topic: Medicine/Pulmonology

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2019–20 Coronavirus Pandemic

United States Disaster management Medicine Viruses Korea COVID-19 Europe China/Chinese history Iran North America Medicine/Pulmonology Italy China East Asia

The 2019–20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The outbreak was first identified in Wuhan, Hubei, China, in December 2019, and was recognized as a pandemic by the World Health Organization (WHO) on 11 March. As of 28 March 2020, more than 663,000 cases of COVID-19 have been reported in over 190 countries and territories, resulting in approximately 30,800 deaths. More than 141,000 people have since recovered.

The virus is mainly spread during close contact and via respiratory droplets produced when people cough or sneeze. Respiratory droplets may be produced during breathing but the virus is not considered airborne. People may also catch COVID-19 by touching a contaminated surface and then their face. It is most contagious when people are symptomatic, although spread may be possible before symptoms appear. The time between exposure and symptom onset is typically around five days, but may range from 2 to 14 days. Common symptoms include fever, cough, and shortness of breath. Complications may include pneumonia and acute respiratory distress syndrome. There is no known vaccine or specific antiviral treatment. Primary treatment is symptomatic and supportive therapy. Recommended preventive measures include hand washing, covering one's mouth when coughing, maintaining distance from other people, and monitoring and self-isolation for people who suspect they are infected.

Efforts to prevent the virus spreading include travel restrictions, quarantines, curfews, workplace hazard controls, event postponements and cancellations, and facility closures. These include the quarantine of Hubei, national or regional quarantines elsewhere in the world, curfew measures in China and South Korea, various border closures or incoming passenger restrictions, screening at airports and train stations, and outgoing passenger travel bans. Schools and universities have closed either on a nationwide or local basis in more than 160 countries, affecting more than 1.5 billion students.

The pandemic has led to severe global socioeconomic disruption, the postponement or cancellation of sporting, religious, and cultural events, and widespread fears of supply shortages which have spurred panic buying. Misinformation and conspiracy theories about the virus have spread online, and there have been incidents of xenophobia and racism against Chinese and other East and Southeast Asian people.

Liquid Breathing

Medicine Medicine/Pulmonology Physiology Scuba diving Physiology/respiratory

Liquid breathing is a form of respiration in which a normally air-breathing organism breathes an oxygen-rich liquid (such as a perfluorocarbon), rather than breathing air.

This requires certain physical properties such as respiratory gas solubility, density, viscosity, vapor pressure, and lipid solubility which some, but not all, perfluorochemicals (perfluorocarbon) have. Thus, it is critical to choose the appropriate PFC for a specific biomedical application, such as liquid ventilation, drug delivery or blood substitutes. The physical properties of PFC liquids vary substantially; however, the one common property is their high solubility for respiratory gases. In fact, these liquids carry more oxygen and carbon dioxide than blood.

In theory, liquid breathing could assist in the treatment of patients with severe pulmonary or cardiac trauma, especially in pediatric cases. Liquid breathing has also been proposed for use in deep diving and space travel. Despite some recent advances in liquid ventilation, a standard mode of application has not yet been established.

Discussed on

Covid-19 Vaccine Candidates

Disaster management Medicine Viruses COVID-19 Medicine/Pulmonology Medicine/Emergency medicine and EMS

A COVID-19 vaccine is a hypothetical vaccine against coronavirus disease 2019 (COVID‑19). Although no vaccine has completed clinical trials, there are multiple attempts in progress to develop such a vaccine. In February 2020, the World Health Organization (WHO) said it did not expect a vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus, to become available in less than 18 months. The Coalition for Epidemic Preparedness Innovations (CEPI) – which is organizing a US$2 billion worldwide fund for rapid investment and development of vaccine candidates – indicated in April that a vaccine may be available under emergency use protocols in less than 12 months or by early 2021. On 4 May 2020, the WHO organized a telethon to raise US$8 billion from forty countries to support rapid development of vaccines to prevent COVID-19 infections, also announcing deployment of an international "Solidarity trial" for simultaneous evaluation of several vaccine candidates reaching Phase II-III clinical trials.

By May, 159 vaccine candidates were in development, with five having been initiated in Phase I–II safety and efficacy studies in human subjects, and seven in Phase I trials.

Discussed on

Extracorporeal Membrane Oxygenation

Medicine COVID-19 Medicine/Pulmonology Medicine/Cardiology

Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. The technology for ECMO is largely derived from cardiopulmonary bypass, which provides shorter-term support with arrested native circulation. The device used is a membrane oxygenator, also known as an artificial lung.

ECMO works by temporarily drawing blood from the body to allow artificial oxygenation of the red blood cells and removal of carbon dioxide. Generally, it is used either post-cardiopulmonary bypass or in late-stage treatment of a person with profound heart and/or lung failure, although it is now seeing use as a treatment for cardiac arrest in certain centers, allowing treatment of the underlying cause of arrest while circulation and oxygenation are supported. ECMO is also used to support patients with the acute viral pneumonia associated with COVID-19 in cases where artificial ventilation alone is not sufficient to sustain blood oxygenation levels.