Plaquenil, PPE and Covid 19…oh my!

There has been a lot of media coverage surrounding the use of Plaquenil also known as hydroxychloroquine, for treatment of the novel coronavirus. So much coverage that people are drinking fish tank cleaner to try to prevent getting coronavirus; therefore, we here at Keystone feel some information regarding this topic is needed. This medication is traditionally used to treat severe malarial infections, lupus and rheumatoid arthritis. These work by increasing intracellular pH changing the way proteins within the cell work. By doing this it changes “antigen processing” in our white blood cells ultimately decreasing your immune system response in the above conditions. The way it works in covid-19 is still not entirely known, however it is thought to be due to decreasing the immune response known as a “cytokine storm” which seems to be why this condition is so deadly. Studies also use this medication in conjunction with azithromycin, a commonly used antibiotic that many know as a z-pack to treat the underlying pneumonia that occurs. 

Additionally, hydroxychloroquine has been found to be a zinc ionophore which means that it increases zinc uptake by the cell making it useful in many conditions including viruses and even certain cancers. So why is this important in regards to covid-19? Dr. Wright will discuss the uses of zinc in treatment of this condition and how it works so well, which will also explain why it is important to consider Plaquenil as an ionophore for severe cases. This medication should only be used and prescribed under direct supervision of a physician since it can be dangerous. Please do not try to find other ways to obtain this medication. 

            PPE stands for personal protective equipment and up until a few months ago wasn’t a widely used term throughout society, however most people now know what this is. So what does PPE consist of? On the basic level it is gloves and a face mask but it can go up form there depending on how much protection you may. Current full PPE protocol when dealing with covid-19 includes gloves that should be changed between each patient contact, an N95 mask with goggles and/or face shield, full gown and booties. All of these things should be changed regularly throughout a work day when dealing with the affected population, however there is currently a supply and demand issue that has arisen. The general population is now wearing PPE when going out of the house, even minimally so, making it difficult to obtain any of these supplies. Let’s discuss appropriate ways to protect yourself using PPE outside the home during this outbreak. 

            

Face masks are designed to protect you from viral particles that have been aerosolized in respiratory secretions including saliva, nasal secretions, and those from coughing. It can protect you from others as well as protecting others from you, however only masks that are graded to “block” viral particles are sufficient and that is mainly the N95 masks. However even paper masks and cloth masks can help, not necessarily from the particles themselves but can help remind you not to touch your face. Touching your face, nose, mouth, and/or eyes is some of the fastest ways that any virus can enter your body. 

Gloves are designed to help prevent spreading of germs by acting as a physical barrier between your hands and someone else’s infected secretions. However these are designed to be changed after every patient. In the office we would use one set of gloves for each IV we begin, each blood draw, every minor surgery or any other procedure it was indicated for. We would then remove those gloves before even leaving the room and wash our hands. This prevents the spread of germs that may be on those gloves, if you wear your gloves consistently what makes them different than bear hands? Many individuals continue to wear the same pair of gloves while doing all their shopping or anytime they are out of their house which will cross-contaminate anything that they touch, furthermore many also still touch their face, phone, car keys etc… defeating the purpose of wearing gloves. So please, save the gloves for when relay needed and change them regularly. 

If you desire to wear PPE when outside of the home feel free to do so, but understand the risk of cross contamination and how to use these devices as intended to protect yourself as much as possible. 

Resources: 

https://www.ncbi.nlm.nih.gov/pubmed/8278823
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/

Dr. Randahl