April 3, 2020: Roundup & Myth Busting
Intro and Disclaimer
QM would like to help you make sense of information being circulated by: 1. Translating data into digestible language, 2. Dispelling misconceptions and linking to evidence, and 3. Curating relevant data, and articles on a weekly basis. Our RoundUp/Myth Busting projects are intended to help our QM family make sense of information being circulated. Taking control of our health as a queer community includes making institutional knowledge accessible to the public.
Disclaimer: Although this information has been evaluated and determined to be accurate by Queering Medicine (QM), we at QM do not want to give the impression that we are the sole gatekeepers of medical knowledge. As a collective, QM members bring professional and personal qualifications that allow us to research and share credible knowledge. Our goals for this weekly round up and myth busting is to translate data into digestible information, dispel misinformation, and curate relevant data for the Lansing queer community. We encourage the community to question knowledge found outside of reputable sources, however, Queering Medicine will gladly help facilitate this process. If evidence or recommendations change, or any inaccuracies are found, we will correct them and explain the changes. If you have any questions about our methodology and sources, or you would like to point out any inaccuracies, please let us know!
"Spiro” (spironolactone)
Claim: Spironolactone (Spiro) increases COVID-19 severity by increasing ACE2 activity, the receptor which COVID-19 binds to in order to enter cells.
Verdict: Increased ACE2 activity is not the same as an increase in the number of receptors available for COVID-19 to bind to. There is no evidence that Spiro will increase transmission of the virus between cells.
Further info: ACE 2 is Angiotensin converting enzyme 2 and is an enzyme attached to the outer surface of cells in the lungs, arteries, heart, kidney, and intestines. The paper referenced by the dermatologist is about cells coming from patients with congestive heart failure. Their cells already have altered levels of ACE2, which have been increased to offset high angiotensin (Angiotensin is a hormone that causes vasoconstriction and an increase in blood pressure) levels so the results may not be applicable to everyone who is taking spironolactone. It is important to note that the cells used in the study are also not the ones being infected by the virus, which are the epithelial cells lining our upper respiratory system and then cells in the lungs (mucosal cells). Other cells may respond differently, for example, one study found “[cells] pretreated with [spironolactone] exhibited a non-significant reduction in ACE2 protein levels”. This study directly measured the protein while the first study looked at mRNA, which can alter without changing the actual number of ACE2 proteins available to bind to the virus.
Ibuprofen
Claim: Ibuprofen increases COVID-19 Severity.
Verdict: Ibuprofen, like many other medications, has risks. There is no current evidence that Ibuprofen will increase COVID-19 severity in all individuals, but there are potential risks of Ibuprofen exacerbating acute respiratory dysfunction, with or without COVID-19 infection. Those experiencing COVID-19 symptoms, which may include acute respiratory dysfunction, should discuss all medication usage (including Ibuprofen) with their doctor. It is important that a person taking over the counter or prescribed medication understand why it is being used, how discontinuation can affect your underlying condition, and discuss safer alternatives. Ibuprofen helps to alleviate pain and fever primarily; tylenol is not the same drug and is most often prescribed to break fever.
Face masks
Claim: Homemade masks may reduce transmission of COVID-19 from people who have no symptoms but have the virus.
Verdict:
As of April 3, 2020, the CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission. We will try to keep folks updated if there are any changes nationally and locally.
Homemade masks will not serve the same purpose or be as effective as an N95 respirator/mask or a surgical mask (sometimes referred to as face masks) as these masks are made to certain specifications. With the severe shortage of these supplies for frontline/essential workers, there is a concern that recommending widespread usage of these will make the shortage worse and further endanger people who have to work in environments in constant contact with the virus. If you, however, have extra N95 respirator masks or surgical masks and would like to donate them, please feel free to contact us at queeringmedicinelansing@gmail.com .
Maintaining social distancing practices and hygiene practices are still of utmost importance.
A barrier is a barrier and may aid in reducing transmission of COVID-19, for example, by reducing people from directly touching their faces or by possibly preventing those without any signs or symptoms of being sick from giving it to other people
We want to provide resources for making your own masks:
From The University of Hong Kong Shenzhen Hospital: https://www.youtube.com/watch?v=JY-29VBkGmw&feature=emb_title
From UnityPoint Health Cedar Rapids:https://www.youtube.com/watch?v=ZnVk12sFRkY&feature=youtu.be&app=desktop
PDF of Olsen Mask Pattern: https://www.unitypoint.org/cedarrapids/filesimages/Coronavirus/003902oo-1%20Olson%20Mask%20V07.pdf
PDF Mask Design from Johns Hopkins Medicine https://www.hopkinsmedicine.org/coronavirus/_documents/INF2003076_VW_Hand-Sewn%20Mask%20instructions-1.pdf
Kaiser Permanente Instructional Video https://www.youtube.com/watch?reload=9&v=4aMCFnK5bHk
6. There are many different ways to make masks, or different patterns, and there is no official consensus as to which is most effective. If you want to make your own barriers:
Contain and dispose of used masks when possible. For example, put used masks into a separate ziploc bag for disposal.
If supply is low, you can wash them in hot water with detergent and dry them completely on a hot setting, depending on the material that you have used.
Make sure your used masks are kept separate from new, clean masks
Minimize handling of masks after usage, and when handling use disposable gloves and wash your hands thoroughly.
7. There have been reports, particularly from the Asian American Pacific Islander communities nationally, that masks have been related to racist/xenophobic behavior. Individuals have reported mask usage as making them targets for such behavior. As a disclaimer, please be wary of your surroundings for physical, mental, and social health and safety.
Reminder: Homemade face mask are meant to prevent your possible transmission of Covid-19 to others. They have not been proven to reduce the risk of acquiring Covid-19.
References:
Guidelines from Minnesota Department of Health https://www.health.state.mn.us/diseases/coronavirus/hcp/masksalt.pdf
WHO Mask Usage https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks
CDC Guidelines Under Crisis Capacities https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html
CDC Cloth Mask Recommendation as of April 3, 2020 https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html
FDA N95 vs Surgical Masks https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/n95-respirators-and-surgical-masks-face-masks
How can you protect yourself and others https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fprevention.html
Gargling warm water, salt, or vinegar
Claim: Gargling warm water and salt or vinegar (acetic acid) will eliminate the virus that causes COVID-19.
Verdict: False. Gargling warm water and salt or vinegar has not been shown to eliminate the virus.Helpful links:
Johns Hopkins: “COVID-19 Myths vs. Realities” (https://www.jhsph.edu/covid-19/articles/coronavirus-facts-vs-myths.html)
WHOL Advice For the Public - Myth Busters (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters)
Blood donation
Claim: FDA loosens restrictions on LGBTQ+ blood donors amid COVID-19 pandemic
Verdict: Mostly true. In response to a significant shortage in the supply of blood in the United States, the FDA has reduced the deferral period from 12 months to 3 months for men who have had sex with men and females who have had sex with men who have had sex with a man. For example, the individual will have to wait 3 months from their most recent sexual contact in order to become eligible to donate blood. This policy change is a movement towards a more equitable donation process that treats all potential donors with dignity and respect, but it also reflects how much more work our community has to do as a collective. Any deferral period on a specific group of people despite safe sexual practices, and meeting other reasonable blood donation eligibility criteria, is discriminatory and contrary to our innate human nature to rise to the occasion in a time of crisis.
Read below for a quick glance at the criteria. Follow this link to the FDA Revised Recommendations For Reducing the Risk of HIV Transmission by Blood and Blood Products April 2020. (https://www.fda.gov/regulatory-information/search-fda-guidance-documents/revised-recommendations-reducing-risk-human-immunodeficiency-virus-transmission-blood-and-blood)
Eligibility as it pertains to trans* folks,
I am a trans man: it has to be at least 3 months after your most recent sexual contact if you identify as male and have sex with another man.
I am a trans woman: if you identify as female and have sex with men, you may be eligible to donate blood with all other blood donation elibility criteria being met.
Among other eligibility changes:
Wait 3 months after the most recent event that involves exchanging sex for money or drugs.
Wait 3 months after the most recent non-prescription injection drug use.
Wait 3 months after the most recent sexual contact with a person who: has ever had a positive test for HIV, ever exchanged sex for money or drugs, or ever engaged in non-prescription injection drug use.
Wait 3 months after completion of treatment for syphilis or gonorrhea.
Wait 3 months after the most recent tattoo, ear or body piercing. However, individuals who have undergone tattooing within 3 months of donation are eligible to donate without waiting if the tattoo was applied by a state regulated entity with sterile needles and non-reused ink. This also applies to piercings that were done using single-use equipment.
Sexual Contact during Covid-19 Crisis
Claim: “Coronavirus can be spread through sexual contact even if there is no exchange of air or touching of faces.”
Verdict: Best practice would be to apply public health recommendations of social distancing and limiting human contact – including sexual contact – to those who live with you. What we know is that Corona Virus is spread through droplets and aerosols. It is unclear if other bodily fluids transmit Covid-19 (semen, vaginal secretions, sweat), and whether it is airborne and for how long. It is becoming more clear that a person can transmit Covid-19 without having symptoms.
Sexual intimacy is important for many of us! We believe in being sex positive and safe sex practices- HIV/STI testing, condoms, PrEP, U=U. It is critical we stay sex positive during these chaotic and stressful times. No sex shaming!
Keeping it real about sex during Covid-19: Consent IS SEXY! Risk is always a conversation you and your partners should have. It applies to these times – if you and your partner are still sexually active, we advise you discuss risk. Self-monitor at home for symptoms and take your temperature daily (if you have a thermometer available). Social distancing means no new hook-ups, no new partners, if they don't live with you we encourage you not to have physical/ sexual contact. Now is not the time to test out a glory hole. Now is the time to practice self-pleasure, video and phone sex, and maybe finally read that erotic novel you’ve been meaning to finish. Get creative with sexual pleasure while keeping a safe distance. Channel your inner kinky self, get to know your body, intimacy starts with you. #sexinthetimeofcovid
“Your risk for infection with the new coronavirus starts as soon as someone gets within six feet of you. (And of course, if you do have sex, your risk for pregnancy and S.T.I.s remains the same, and the previous definition of “safe sex” still applies.)”
References: