Category: coronavirus

What is the COVID-19 antigen test? Learn what the rapid antigen test is used for, how it works, and what the pros and cons are

COVID-19 antigen testing is a new diagnostic method for detecting coronavirus that received emergency use authorization by the U.S. Food and Drug Administration (FDA). 

The rapid COVID-19 antigen test detects the presence of SARS-CoV-2 virus proteins in the sample, allowing early detection of the infection.

How does the COVID-19 antigen test work?

An antigen is a substance (protein) that causes the immune system to produce antibodies and trigger an immune response. In the case of COVID-19, spike proteins are found on the surface of SARS-CoV-2 virus. Therefore, the antigen test detects these proteins or genetic material of the SARS-CoV-2 virus. 

The rapid antigen test should be performed during the initial days after the onset of symptoms and for asymptomatic people who have had recent direct contact with a COVID-19-positive person.

How to use an at-home COVID-19 antigen test

The COVID-19 antigen test is affordable and may allow people to test themselves for COVID-19 rather than relying on getting tested at a screening center. The test includes all the necessary material for its use in nasopharyngeal samples:

• Collect the mucosa sample through the nasal cavity with the help of a sterile swab. Then carefully remove the swab.
• Insert the swab into the extraction tube and press in the area indicated by arrows.
• Rotate the swab according to the instructions for use and remove it from the extraction tube.
• Place the cap on the tube nozzle and apply the extracted sample to the well of the cassette according to the instructions in the manual.
• Read the test result in the time indicated in the manual (usually 15 to 30 minutes).

The antigen test is read as either positive (with test and control lines visible), negative (only control line is visible) or invalid (only test line appears or no line appears). Newer devices have digital immunoassays that display the result as positive, negative, or invalid rather than relying on the operator to read the results off the strip.

The World Health Organization currently states that rapid antigen detection tests (RADTs) should only be used if reverse transcription polymerase chain reaction (RT-PCR) is not available, and it must be proven to have ≥90% sensitivity and 99% specificity.

What are the pros and cons of the COVID-19 antigen test?

Pros

• Speed: 
  • One of the benefits of antigen testing is the high speed of testing compared with the standard reverse transcription polymerase chain reaction (RT-PCR).
  • Once the sample is added to the testing strip, it takes about 10 to 15 minutes for the results to appear. These procedures may differ from test kit to test kit.
• Cost:
  • Antigen testing is less expensive compared with other tests.
• Convenience:
  • People can test themselves comfortably in their homes and do not require personal protective equipment.
  • In fact, antigen testing kits do not require extensive laboratory training because most critical steps are automated in a single device.

Cons

• Accuracy:
  • Results are unfortunately not as sensitive, although antigen testing technology continues to improve..
  • If the test result is negative and clinical symptoms persist, additional testing using other clinical methods is recommended. A negative result does not at any time preclude the possibility of SARS-COV-2 infection.
• False positive results:
  • Positive antigen tests are considered much more accurate, but they still can produce false positives. 
  • The concern is that false positives could be caused by the presence of other viruses, improper collection techniques, or other substances produced by the body during infection that interfere with the results. 

Latest Coronavirus News

• Moderna Vaccine Against Breakthrough Infections
• All HHS Health Care Workers Must Get COVID Vaccine
• Delta Breakthrough Infections: Should You Worry?
• FDA OKs Third COVID Shot for Vulnerable Americans
• Coronavirus Outbreak on Carnival Cruise Ship
• Want More News? Sign Up for MedicineNet Newsletters!

Daily Health News

• When Does Metabolism Slow?
• Delta Breakthrough Infections
• Diabetes Meds Reduce Alzheimer’s
• Moderna Vaccine vs. Delta Breakthrough
• Bimonthly PrEP Prevents HIV
• More Health News »

Trending on MedicineNet

• COVID Symptoms in Kids
• Symptoms of Melioidosis
• Good Heart Rate by Age
• Can I Get COVID-19 Again?
• What Are the 4 Genders?

What other tests are used to detect COVID-19?

Molecular/polymerase chain reaction (PCR) tests

• Reverse transcription polymerase chain reaction (RT-PCR) is the gold standard of diagnostic testing for COVID-19.
• A molecular test is usually performed using a technique known as PCR that works by rapidly making millions to billions of copies of viral-related deoxyribonucleic acid (DNA).
• If there are even small amounts of this genetic material in the sample, it will be detected. Thus, molecular/PCR tests are very sensitive, and they are very specific.
• A positive test is almost never wrong in determining that SARS-CoV-2 is present.
• Tests can be done on samples taken by nasal or throat swabs and even by saliva.

Antibody tests

• An antibody test looks for the body's response to SARS-CoV-2 virus that causes COVID-19.
• The antibody test should not be used to diagnose the virus. It is a blood test that is good at determining if you had the disease but not good for determining if you have the disease.
• Positive antibody tests are currently used for epidemiological surveys.

U.S. life expectancy declined in 2020

The average life expectancy in the United States dropped from 78.8 years in 2019 to 77.8 years in 2020, a decrease of a full year. For males, life expectancy at birth declined to 75.1 years, and for women, life expectancy declined to 80.5 years.

Life expectancy declined considerably for certain ethnic groups:

• African American males: 68.3 years
• African American females: 75.8 years
• Hispanic females: 83.3 years
• Hispanic males: 76.6 years

Chart: Life expectancy based on age, ethnicity and sex in the U.S., 2020 All origins Hispanic Non-Hispanic

Age (years)
Total
Male
Female
Total
Male
Female
Total
Male
Female

0 (at birth)
77.8
75.1
80.5
79.9
76.6
83.3
72.0
68.3
75.8

1
77.2
74.5
80.0
79.3
76.0
82.7
71.8
68.1
75.5

5
73.3
70.6
76.0
75.4
72.1
78.8
67.9
64.2
71.6

10
68.3
65.6
71.0
70.4
67.1
73.8
63.0
59.3
66.7

15
63.4
60.7
66.1
65.4
62.1
68.8
58.1
54.4
61.7

20
58.5
55.9
61.2
60.6
57.3
63.9
53.4
49.8
56.9

30
49.2
46.8
51.5
51.1
52.7
54.2
44.4
41.1
47.4

40
40.0
37.8
42.1
41.8
39.0
44.6
35.5
32.6
38.3

50
31.1
29.2
33.0
32.8
30.2
35.2
27.2
24.6
29.6

60
22.9
21.3
24.4
24.4
22.2
26.4
19.7
17.5
21.7

70
15.5
14.4
16.5
17.0
15.4
18.3
13.6
11.9
14.8

80
9.3
8.6
9.7
10.7
9.8
11.4
8.5
7.5
9.1

What is life expectancy?

Life expectancy estimates the average number of years that a person of a given age can expect to live. It is a hypothetical measure and differs considerably by sex, age, ethnicity and geographical location. The most commonly used measure is life expectancy at birth, which is the average number of years an infant is expected to live if death rates at the time of its birth don’t change.

Life expectancy is generally calculated for specific groups of people rather than for the population in general. It is calculated based on a life table, which shows the probability of death, death rate and number of survivors for each age or age group.

What factors impacted U.S. life expectancy in 2020?

Deaths from COVID-19 were the main factor in the overall decrease in life expectancy in 2020. At the end of 2020, more than 3.2 million COVID-19 deaths were reported in the U.S., with the increase in deaths being impacted by disrupted medical and social services during the pandemic.

Other factors that impacted the decrease in U.S. life expectancy during the pandemic include:

• Forgoing health screenings
• Access to medical care
• Stress caused by job loss
• Eating poorly
• Drinking alcohol
• Drug overuse
• Long-term health problems caused by COVID-19

The effects of COVID-19 will likely linger for quite some time, which means that it could negatively impact U.S. life expectancy in future years as well.

What other factors affected U.S. life expectancy?

Despite the fact that the U.S. has some of the best health care facilities in the world, factors other than COVID-19 contributed to declining life expectancy in 2020. These include a rise in drug overdoses and alcoholism, as well as disparities among different ethnic groups, geographical locations and socioeconomic situations.

Endotracheal intubation is a procedure to administer mechanical ventilation through a tube inserted in the airway.

• Endotracheal intubation is a procedure by which a tube is inserted through the mouth down into the trachea (the large airway from the mouth to the lungs).
• Before surgery, this is often done under deep sedation.
• In emergency situations, the patient is often unconscious at the time of this procedure.

What kind of intubation tube is used?

The tube that is used today is usually a flexible plastic tube. It is called an endotracheal tube because it is slipped within the trachea.

How is the tube inserted into the trachea in endotracheal intubation?

• The doctor often inserts the tube with the help of a laryngoscope, an instrument that permits the doctor to see the upper portion of the trachea, just below the vocal cords.
• During the procedure the laryngoscope is used to hold the tongue aside while inserting the tube into the trachea.
• It is important that the head be positioned in the appropriate manner to allow for proper visualization.
• Pressure is often applied to the thyroid cartilage (Adam's apple) to help with visualization and prevent possible aspiration of stomach contents.

What is the purpose of endotracheal intubation?

• 
  Readers Comments 7
• 
  Share Your Story

• The endotracheal tube serves as an open passage through the upper airway.
• The purpose of endotracheal intubation is to permit air to pass freely to and from the lungs in order to ventilate the lungs.
• Endotracheal tubes can be connected to ventilator machines to provide artificial respiration.
• This can help when a patient is unconscious and by maintaining a patent airway, especially during surgery.
• It is often used when patients are critically ill and cannot maintain adequate respiratory function to meet their needs.
• The endotracheal tube facilitates the use of a mechanical ventilator in these critical situations.

Is endotracheal intubation used for COVID-19 coronavirus patients?

• Endotracheal intubation is the approved way of providing breathing support to COVID-19 coronavirus disease patients as of this article's update in early April, 2020. 
• Non-invasive mechanical ventilation like CPAP (continuous positive airway pressure) machines used for sleep apnea are not good for COVID-19 patients, according to clinical guidelines from the American Society of Anesthesiologists. In some cases, CPAP masks or nasal pillows may provide adequate oxygen, but current devices aerosolize virus particles in the patient's breath and spread them around wherever the patient is housed, potentially infecting more people in the area.
• Endotracheal intubation and ventilation supports a COVID-19 patient's breathing so the body can survive as the immune system fights the virus. This means a better chance of fighting off the virus, but ventilators can't cure COVID-19.

What are the complications of endotracheal intubation?

• 
  Readers Comments 9
• 
  Share Your Story

• If the tube is inadvertently placed in the esophagus (right behind the trachea), adequate respirations will not occur.
• Brain damage, cardiac arrest, and death can occur. Aspiration of stomach contents can result in pneumonia and ARDS.
• Placement of the tube too deep can result in only one lung being ventilated and can result in a pneumothorax as well as inadequate ventilation.
• During endotracheal tube placement, damage can also occur to the teeth, the soft tissues in the back of the throat, as well as the vocal cords.
• This procedure should be performed by a physician with experience in intubation. In the vast majority of cases of intubation, no significant complications occur.

What can cause loss of smell and taste are numerous factors, such as COVID-19, nasal blockage, deviated septum and more.

Loss of the sense of smell is termed anosmia, and loss of the sense of taste is termed ageusia. The olfactory area in the nose controls both smell and taste, so any inflammation or infection to the nose and sinus areas causes anosmia and ageusia.

Whenever there is a loss of smell, loss of taste also follows. Your taste buds detect a food's sweetness, sourness, bitterness or saltiness. The specifics, such as whether that sweet taste is from a grape or an apple, are determined by your nose.

Loss of smell and taste can be caused by various factors including:

• Illness or infections, such as viral sinus infections, COVID-19, cold or flu and allergies
• Nasal blockage (the passage of air decreases affecting smell and taste)
• Polyps in the nose
• Deviated septum
• Injury to the head (the nerves that carry impulses may be damaged)
• Injury to the nerves of the nose such as the olfactory nerve
• Dental or oral problems
• Dry mouth
• Damage to the salivary gland (taste cannot be appreciated in the absence of saliva)
• Changes in hormones (pregnancy)
• Vitamin D deficiency or malnutrition
• Intake of certain medicines (antidepressants, antibiotics and heart medications)
• Exposure to chemicals such as solvents and insecticides
• Radiation therapy for head and neck cancer
• Snorting of drugs through the nose
• Smoking cigarettes
• Alcohol intake
• Aging (especially in people older than 60 years)
• Genetics (few people may be born with these disorders)

Other rare conditions that cause a loss of smell and taste include:

• Hormonal disorders
  • Cushing’s syndrome
  • Adrenocortical insufficiency syndrome
  • Kallmann syndrome
  • Hypothyroidism
  • Diabetes
• Central nervous system disorders
  • Epilepsy
  • Tumors of the brain
  • Psychiatric conditions
  • Alzheimer’s disease
• Tumors of sinus cavities or nose
• Autoimmune disorders
  • Sjogren’s syndrome
  • Systemic lupus erythematosus
• Turner syndrome

Some illnesses or risk factors can cause loss of scent that is reversible, partially reversible or permanent. Examples are as follows:

• When a person quits smoking or uses drugs, their sense of smell normally improves although the amount of improvement varies.
• Loss of smell caused as a side effect of medicines may be temporary or permanent.
• Breathing chemicals may cause permanent loss of smell.

What health issues are associated with loss of smell and taste?

Anosmia and ageusia may be signs of an underlying disease, which can affect your quality of life. Problems with taste and smell might indicate various health issues, such as:

• Diabetes
• Kidney disease
• Obesity
• Poor nutrition
• High blood pressure
• Nervous system disease
  • Multiple sclerosis
  • Parkinson’s disease
  • Alzheimer’s disease

What is the importance of smell and taste?

Sense of smell and taste greatly improve one’s quality of life. Here are some factors that explain the importance of smell and taste:

• The fragrance of food stimulates appetite, and a loss of smell can result in a loss of appetite and interest in food.
• Saliva production can be reduced if you lose your sense of smell, making dry foods, such as biscuits and crackers, more difficult to eat as a result of this.
• Changes in taste may cause you to avoid certain items, such as meat, resulting in a nutrition deficiency and potentially misleading you into adding more spice and salt to food that may later cause medical issues, such as gastric irritation and high blood pressure.
• Consumption of rotten/spoiled food is harmful to the body, and your sense of smell and taste helps you identify and avoid spoiled food and contaminated water.
• In the absence of smell and taste, your satiety reduces, which makes you eat more leading to health issues and weight gain.
• Sense of smell and taste help form new memories and recall old ones, causing a powerful emotional response.
• Smell and taste also act as warning signs and alert us about harmful events such as a gas leak, toxic chemical fumes or fire.
• When you lose your sense of smell, you may not realize when you need to take a bath, apply deodorant or wash your clothes, which may result in a lack of hygiene.
• With damage to the areas that deal with smell and taste, other nearby sections of the brain may also be affected, leading to several problems, including:
  • Emotional problems such as depression and irritability
  • Behavioral problems such as aggressiveness and impulsiveness
  • Inability to understand and respond well to other’s feelings and needs

If you observe any changes in your sense of smell and taste, you must consult an otolaryngologist who specializes in the diagnosis and treatment of conditions related to the ear, nose and throat, along with the mouth and parts of the neck and face. They examine and perform special tests to identify the cause of the condition and provide treatment accordingly.

People with compromised immune systems who have already received two doses of either the Pfizer or Moderna COVID-19 vaccine are eligible for a third shot if they meet these immunocompromised conditions.

On August 12, 2021, the U.S. Food and Drug Administration (FDA) rolled out the emergency use authorizations (EUAs) for both the Pfizer-BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine in people with immunocompromised conditions. According to the Centers for Disease Control and Prevention (CDC), a booster dose of the COVID-19 vaccine is recommended for people who are moderate to severely immunocompromised, which includes people that:

• Have been receiving active cancer treatment for tumors or cancers of the blood.
• Are organ transplant recipients and are taking immunosuppressants (medications to suppress the immune system).
• Have received a stem cell transplant within the last two years or are taking immunosuppressants.
• Have moderate or severe primary immunodeficiency (a condition in which the immune system does not work correctly leading to frequent infections. Examples include DiGeorge syndrome, Wiskott-Aldrich syndrome, severe combined immunodeficiency or SCID).
• Have advanced or untreated HIV infection.
• Are receiving active treatment with high-dose corticosteroids or other drugs that may suppress the immune response.

If you are not sure whether you are eligible for an additional dose (booster shot) of the COVID-19 vaccine, you can discuss it with your doctor. For receiving a booster dose of the Moderna vaccine, the individual must be at least 18 years of age, whereas individuals who are 12 years and older are eligible to get the Pfizer-BioNTech COVID-19 vaccine.

Why is a COVID vaccine booster important for immunocompromised people?

Your immune system helps you fight infections and other diseases. Being immunocompromised means that you do not have an immune system strong enough to protect you from diseases. When an individual with a healthy immune system receives a vaccine, their immune system mounts a significant response against the antigen that helps them produce the antibodies to fight the infection against which the vaccine was given. In immunocompromised individuals, however, the immune system is unable to build an immune response to the vaccine as strong as individuals with a healthy immune system. Thus, they may need additional vaccine dosages (boosters) to boost their immune response.

About three percent of the adult population in the US is moderate to severely immunocompromised. These individuals are particularly vulnerable to the COVID-19 infection. When infected, they are also more likely to have severe complications. Studies have so far revealed that the efficacy of the COVID-19 vaccine may not be as good in immunocompromised individuals as in those with a healthy immune system.

Studies have also suggested that fully vaccinated immunocompromised individuals contribute to a large share of hospitalized vaccine breakthrough cases (cases in which people were infected by COVID-19 despite being fully vaccinated). Generally, vaccine breakthrough cases do not result in severe complications or hospitalization. However, in the case of immunocompromised individuals, there may be a higher chance of getting hospitalized.

Furthermore, a booster dose in immunocompromised individuals also reduces the risk of the spread of COVID-19 because these people tend to spread the virus more effectively (prolonged viral shedding) than those with a healthy immune system. Hence, a booster dose of the COVID-19 vaccine is beneficial for both the immunocompromised person and the community.

When should an immunocompromised individual get the COVID-19 vaccine booster dose?

According to the present guidelines, a booster dose of COVID-19 mRNA vaccine (Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine) can be administered at least 28 days (four weeks) after the second dose of the same vaccine. This means if the person took two doses of the Pfizer-BioNTech COVID-19 vaccine, the booster must also be of that vaccine. Similarly, if the person took two doses of Moderna COVID-19 vaccine, the booster must also be that vaccine. If, however, the same mRNA vaccine product is not available or is unknown, the individual can be administered either of the mRNA COVID-19 vaccine (Pfizer-BioNTech COVID-19 or Moderna COVID-19).

How many booster shots of the COVID-19 vaccine can an immunocompromised person take?

The CDC presently recommends only one booster dose of the mRNA COVID-19 vaccine. This means that an individual should not take more than three doses of the mRNA COVID-19 vaccine in total.

Should immunocompromised individuals who received the J&J/Janssen COVID-19 vaccine also receive a booster dose?

No, the present guidelines do not recommend a booster dose for immunocompromised individuals who received the J&J/Janssen COVID-19 vaccine. This is because currently there is not enough data to support whether immunocompromised people who receive the J&J/Janssen COVID-19 vaccine will have a substantially improved immune response by receiving a booster dose of the same vaccine. Thus, the present emergency use authorizations (EUAs) by the FDA are only for the mRNA vaccines (Pfizer-BioNTech COVID-19 or Moderna COVID-19).

Here’s everything you need to know about the Delta variant, why it’s so contagious, and whether COVID-19 vaccines can protect against infection

The Delta variant is a highly contagious strain of the coronavirus (SARS-CoV-2) that caused COVID-19. Also known as B.1.617.2, documented samples of this variant were first isolated in India in October 2020, although the first case wasn’t diagnosed until December 2020. 

Since the diagnosis of the first Delta variant case in the United States in March 2021, it has emerged as the dominant strain in the country. Data from the CDC reveal that by the end of July, the Delta variant will account for over 80% of the COVID-19 cases.

Why is the Delta variant so contagious?

All viruses, including SARS-CoV-2, tend to mutate over time, meaning their genetic makeup undergoes changes. Although most of these genetic changes don’t affect the characteristics of the virus, some cause concern when they alter viral properties, such as:

• Infectivity or ease of spread
• Disease severity, including mortality
• Diagnostic tests
• Vaccine efficacy
• Response to treatment

The Delta strain has high rates of transmission due to a change in the spike protein. Mutations on the protein make it easier to infect human cells, meaning that the strain is highly contagious and easily spread.

Due to its high infectivity, the Delta variant has raised concerns about the possibility of accelerating the pandemic. Studies so far suggest that the Delta variant is spreading 50% faster than the Alpha variant. Also, it has a 50% higher rate of transmission than the original strain of SARS-CoV-2.

What are symptoms of the Delta variant?

Symptoms of the Delta variant infection are similar to those caused by other variants, although some studies suggest that the Delta variant may cause slightly different dominant symptoms than the original COVID-19 strain. 

According to reports in the U.K., predominant COVID-19 symptoms, such as loss of smell and persistent cough, are less common with the Delta variant. More common symptoms seem to be:

• Headache
• Sore throat
• Fever
• Runny nose

There are, however, no symptoms specific to the Delta strain.

Do vaccines protect against the Delta variant?

Vaccines are still the best protection against the different COVID-19 variants, including the Delta variant. The vaccines available in the US are safe and highly effective in protecting you from infection.

You are considered fully vaccinated if at least 2 weeks have passed since you received either of the following:

• Second dose of the Pfizer or Moderna vaccine
• First (and only) dose of Johnson & Johnson's (J&J) vaccine

Do I need to wear a mask even if I am fully vaccinated?

Even if you are fully vaccinated, it is best to wear a mask and follow other safety precautions, including social distancing and hand washing, especially in crowded areas.

Infections in vaccinated people are rare but not impossible. Studies are still underway to determine how long the vaccines offer protection against infection after the person is fully vaccinated. The World Health Organization (WHO) has therefore recommended that vaccinated individuals mask up again because of the new Delta variant. No such recommendations, however, have been made by the CDC. 

According to the CDC, people with weakened immune systems, including people who take immunosuppressive medications, may not be protected even if fully vaccinated. However, so far vaccines still offer the best protection against COVID-19, so anyone who is eligible for the vaccine should get vaccinated.

Is the Delta variant more deadly?

Studies so far do not suggest with certainty that the Delta variant causes more severe infection or increases hospitalization rates compared to the previous variants. 

More studies are underway to confirm whether there are any changes in the disease severity caused by this strain. However, some studies have suggested that the disease is more severe among unvaccinated individuals.

Is the Delta variant the same as the Delta Plus variant?

The Delta Plus variant (also called B.1.617.2.1 or AY.1) is considered a subvariant of the Delta variant. This variant has an additional mutation in the spike protein the virus uses to enter human cells, called K417N, allowing the virus to better attack lung cells. Most properties of this virus are similar to the Delta variant.

Although the Delta Plus variant has now been found in multiple countries including the U.S. both the WHO and CDC have not yet labeled the variant a concern.

The Delta variant is a highly contagious strain of the COVID-19 virus. Learn about symptoms of the Delta variant and how to protect yourself from infection

Studies identifying specific symptoms caused by the Delta variant are still underway. According to a study conducted in the United Kingdom (where the Delta strain is dominant) symptoms of the Delta variant infection such as cough and loss of smell are less common.

Most common symptoms include:

• Fever (100 degrees F or higher)
• Headache
• Sore throat
• Runny nose
• Dry cough
• Fatigue

Other symptoms include:

• Body aches
• Muscle or joint pain
• Shortness of breath
• Mucus/phlegm
• Conjunctivitis
• Nasal congestion
• Nausea or vomiting
• Diarrhea
• Chills
• Dizziness
• Skin rash or discoloration of the fingers or toes

Serious symptoms include:

• Shortness of breath or difficulty breathing
• Persistent chest pain or pressure in the chest
• Loss of speech or movement
• Loss of appetite
• Confusion
• High temperature
• Bluish lips or face

Symptoms that may require hospitalization include:

• Severe neurological complications such as delirium, brain inflammation, stroke, or nerve damage
• Difficulty breathing
• Chest pain or pressure
• Extreme disorientation and altered mental status with or without seizures

On average, it may take 5-6 days for symptoms to appear after infection, although this period ranges from 1-14 days.

What is the Delta variant?

The Delta variant, also called B.1.617.2, is a mutant strain of COVID-19. The World Health Organization (WHO) declared COVID-19 outbreak a pandemic on March 11, 2020. The virus subsequently mutated as it spread throughout the world. Each mutation is assigned a letter (Alpha, Beta, Delta, etc.).

The first case of Delta variant infection in the United States was reported in March 2021. The Delta variant now accounts for 83.2% of all new infections in the U.S. according to the most recent data from the Center for Disease Control and Prevention (CDC).

Studies have reported that the Delta variant:

• Is 50% more contagious than the original alpha COVID-19 virus strain
• Is associated with a higher risk of complications and hospitalization
• Spreads and infects quickly
• Affects the younger population more often
• Creates hospitalization risk for unvaccinated individuals

Are vaccines effective against the Delta variant?

All vaccines offer some level of protection against the Delta variant. Vaccination and mask use are therefore crucial in protecting yourself against infection.

• Pfizer-BioNTech vaccine: 
  • Found to be 36% and 88% effective against symptomatic disease caused by the Delta variant after first and second doses, respectively. 
  • Found to be 94% and 96% effective in preventing hospitalization after first and second doses, respectively.
• Moderna vaccine: 
  • Uses the same technology as that of Pfizer; therefore, researchers believe it should provide similar protection as that provided by the Pfizer vaccine. 
  • Studies are underway to determine exactly the extent of protection the vaccine offers.
• AstraZeneca vaccine:
  • Found to be 60% effective against symptomatic disease caused by the Delta variant and 93% effective against complications and hospitalization after both doses.
• Johnson & Johnson vaccine: 
  • Single-shot vaccine that has been shown to be effective against the Delta variant, although not as protective as the Pfizer or Moderna vaccines. 
  • Some researchers believe this vaccine has similar results to those of the AstraZeneca vaccine, although more studies are underway.

How does the coronavirus spread?

COVID-19 spreads in the following ways:

• When an infected person coughs or sneezes, releasing viral particles into the air, and another person breathes in those particles, they can become infected with the virus. It spreads between people in close contact, within 6 feet.
• Sometimes, it can spread to a person exposed to small droplets or aerosols containing the virus that stay in the air for several minutes or hours.
• Moreover, it can spread if a person touches a surface or object with viral particles on it and then touches their mouth, nose, or eyes.

How is the Delta variant infection treated?

Currently, there are no specific treatments for COVID-19, including an infection caused by the Delta variant. Scientists are working on developing treatment methods, and many clinical trials are underway. Doctors therefore advise taking precautions such as getting vaccinated, wearing a mask, and maintaining social distance and good hygiene.

• People with mild COVID-19 can ease their symptoms with sufficient rest and medications as prescribed by their doctor. 
• Antibiotics do not help because they help treat bacterial infection, not viral infection. 
• Doctors do not advise self-medicating or using herbs to attempt preventing or curing COVID-19.
• Supportive care includes oxygen for people who are severely ill and respiratory support such as ventilation for people who are critically ill.  
• Research has shown that the use of hydroxychloroquine, remdesivir, lopinavir, ritonavir, and interferon have little or no effect in treating COVID-19.
• Various steroid medications including dexamethasone are being used to treat COVID-19, which has been found to reduce the risk of death. However, studies on their effectiveness are still being conducted. The indiscriminate use of dexamethasone may also result in superinfection with other bacteria or fungi.

How are COVID-19, allergies, cold, and flu caused?

Symptoms of Coronavirus disease or COVID-19 can easily be confused with symptoms of the common cold or flu, or even allergies.

Coronavirus disease or COVID-19 is an infectious disease caused by a newly discovered coronavirus called SARS-CoV-2. This disease can affect people of any age and gender. Most people with COVID-19 will experience a mild to moderate respiratory illness and recover without the need for intensive or special treatment. 

Serious illness is more likely in elderly people and those with underlying medical conditions such as

• heart disease, 
• diabetes, 
• chronic respiratory disease and 
• cancer.

Common cold is also a viral infection that may be caused by many types of viruses. The virus typically infects the nose and throat. Common cold usually manifests as a mild to moderate harmless illness. It can affect anyone, although children under age six are more susceptible.

Allergies occur when the immune system reacts to foreign substances such as dust, pollen, mold, and certain medications that may be harmless for most people. During an allergic reaction, the immune system releases antibodies (proteins delivering a message to cells to release chemicals) that cause allergic symptoms.

Flu or influenza is also an infectious viral disease. It is caused by an influenza virus. It can cause a mild to severe disease with the severe form occurring more frequently in infants and small children. 

Anyone can get influenza, but some people are at a high risk of serious complications. These include infants, small children, people aged 65 years and above, people with certain long-term medical conditions (such as diabetes, asthma, or heart disease) and pregnant women.

How to differentiate between the signs and symptoms of COVID-19, allergies, cold and flu?

Diseases affecting the respiratory system (starting from the nose to the lungs) often manifest with overlapping signs and symptoms. Symptoms of COVID-19 usually occur from 2-14 days after exposure. The symptoms may vary from person to person and may range from mild to severe disease.

COVID-19 symptoms include the following:

Most common symptoms

• Fever
• Dry cough
• Tiredness or fatigue

Less common symptoms

• Aches and pains
• Sore throat
• Diarrhea
• Conjunctivitis
• Headache
• Loss of taste or smell
• Skin rash or discoloration of the fingers or toes

Serious symptoms

• Breathing difficulty or shortness of breath
• Chest pain or pressure
• Loss of speech or movement

Comparison of the symptoms of COVID-19, allergies, cold, and flu

Fever

• COVID-19: common
• Allergies: absent
• Flu: common
• Cold: sometimes

Cough

• COVID-19: common
• Allergies: rare
• Flu: common
• Cold: common

Shortness of breath

• COVID-19: common
• Allergies: rare
• Cold: rare
• Flu: rare

Muscle aches

• COVID-19: common
• Allergies: absent
• Flu: common
• Cold: sometimes

Sore throat

• COVID-19: sometimes
• Allergies: rare
• Flu: sometimes
• Cold: common

Diarrhea

• COVID-19: sometimes
• Allergies: absent
• Flu: sometimes
• Cold: absent

Congestion

• COVID-19: sometimes
• Allergies: common
• Flu: sometimes
• Cold: common

Loss of smell

• COVID-19: sometimes
• Allergies: sometimes
• Flu: sometimes
• Cold: sometimes

Runny nose

• COVID-19: sometimes
• Allergies: common
• Flu: sometimes
• Cold: sometimes

Itchy eyes

• COVID-19: absent
• Allergies: common
• Flu: absent
• Cold: absent

Sneezing

• COVID-19: sometimes
• Allergies: common
• Flu: sometimes
• Cold: sometimes

Chills

• COVID-19: sometimes
• Allergies: rare
• Flu: sometimes
• Cold: rare

Repeated shaking with chills

• COVID-19: sometimes
• Allergies: absent
• Flu: absent
• Cold: absent

Headache

• COVID-19: sometimes
• Allergies: rare
• Flu: sometimes
• Cold: rare

Should I visit my doctor if I am not sure whether my symptoms are due to COVID-19, allergies, cold or flu?

If you are not sure of the cause of your symptoms, call your physician to seek advice over the phone. You must seek immediate medical help if you have any of the serious symptoms such as breathing difficulty or shortness of breath, chest pain, high fever or pressure and loss of speech or movement. 

Always contact your doctor on phone before visiting them or any health facility. If you have mild symptoms and are otherwise healthy, you should manage your symptoms at home with the necessary medical guidance from a healthcare provider on the phone.

What is hydroxychloroquine (Plaquenil), and what is it used for?

• Hydroxychloroquine (Plaquenil) and its sister drug chloroquine (Aralen) are under investigation for treatment of the COVID-19 coronavirus disease
• Korean doctors used these anti-malaria drugs to treat COVID-19 with some success, according to a paper filed with Elsevier in March 2020, but effectiveness is unproven.

Hydroxychloroquine is classified as an anti-malarial drug. It is similar to chloroquine (Aralen) and is useful in treating several forms of malaria as well as lupus erythematosus and rheumatoid arthritis. Its mechanism of action is unknown. Malarial parasites invade human red blood cells. Hydroxychloroquine may prevent malarial parasites from breaking down (metabolizing) hemoglobin in human red blood cells. Hydroxychloroquine is effective against the malarial parasites Plasmodium vivax, P. malariae, P. ovale, and susceptible strains of P. falciparum. Hydroxychloroquine prevents inflammation caused by lupus erythematosus and rheumatoid arthritis. The FDA approved hydroxychloroquine in April, 1955.

What brand names are available for hydroxychloroquine (Plaquenil)?

Plaquenil

Is hydroxychloroquine (Plaquenil) available as a generic drug?

Yes

Do I need a prescription for hydroxychloroquine (Plaquenil)?

Yes

What are the side effects of hydroxychloroquine (Plaquenil)?

Side effects include

• irritability,
• headache,
• weakness,
• hair lightening or loss,
• stomach upset,
• nausea,
• dizziness,
• muscle pain,
• rash and
• itching.

Rarely, hydroxychloroquine can affect the bone marrow leading to reduced white blood cells (leukopenia) or platelets (thrombocytopenia) and abnormal red blood cells (anemia).

Rare but potentially serious eye toxicity can occur. This toxicity affects a part of the eye called the retina and can lead to color blindness and even loss of vision. An ophthalmologist (eye specialist) often can detect changes in the retina that suggest toxicity before serious damage occurs. Therefore, regular eye examinations, even when there are no symptoms, are mandatory.

Patients who are genetically deficient in a certain enzyme, called G6PD, can develop a severe anemia resulting from the rupture of red blood cells. This enzyme deficiency is more common in persons of African descent and can be evaluated by blood testing. Hydroxychloroquine may worsen psoriasis.

What is the dosage for hydroxychloroquine (Plaquenil)?

The usual adult dose for treating malaria is 800 mg initially, followed by 400 mg 6-8 hours later and then 400 mg at 24 hours and 48 hours. The dose for malaria prevention is 400 mg every week starting 1 or 2 weeks before exposure and for 4 weeks after leaving the high risk area.

The recommended adult dose for rheumatoid arthritis is 400-600 mg daily for 4-12 weeks followed by 200-400 mg daily.

Systemic lupus erythematosus is treated with 400 mg once or twice daily for several weeks then 200-400 mg daily. Hydroxychloroquine should be taken with food or milk in order to reduce stomach upset.

Which drugs or supplements interact with hydroxychloroquine (Plaquenil)?

• Administration of hydroxychloroquine with penicillamine (Cuprimine, Depen) may increase penicillamine levels, increasing the risk of penicillamine side effects. The mechanism is unknown.
• Combining telbivudine (Tyzeka) and hydroxychloroquine may increase the risk of unexplained muscle pain, tenderness, or weakness because both drugs cause such side effects.
• Hydroxychloroquine suppresses the immune system and should not be combined with drugs that also suppress the immune system or live vaccines.

Is hydroxychloroquine (Plaquenil) safe to take if I’m pregnant or breastfeeding?

Hydroxychloroquine should only be used in pregnant women for malaria prophylaxis or treatment.

Hydroxychloroquine may be secreted in breast milk and may cause side effects in the infant.

What else should I know about hydroxychloroquine (Plaquenil)?

What preparations of hydroxychloroquine are available?

Tablet: 200 mg.

How should I keep hydroxychloroquine stored?

Hydroxychloroquine should be stored at room temperature up to 30 C (86 F) in a sealed, light resistant container.