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Do You Need to Wear Gloves at the Grocery Store?

Our experience with food has changed dramatically in a matter of a few weeks (along with everything else in life) because of COVID-19. We’re cooking at home more than ever before, and grocery shopping has become one of the few essential errands we leave the house for. Armed with our long shopping list and a face mask, we head out wondering if there’s anything else we can do to protect ourselves.

One question that keeps coming up is – Should you wear gloves at the grocery store?

The short answer is no. You do not need any kind of gloves at the grocery store.

Gloves will not protect you. If you touch a contaminated surface, the virus can transfer to your glove just like it could transfer to your fingers, so there’s no added protection from the gloves. If you touch your mouth or nose with the glove, you can pass the virus to yourself. And taking the gloves off after shopping is an especially vulnerable moment, as you can easily transfer any germs on the gloves to your hands and face if you’re not careful.

The reality is you’re much more likely to catch the coronavirus from the respiratory droplets of a person talking or sneezing near you rather than from an item you touch at the store – that’s why physical distancing is so important. To protect yourself at the grocery store, wear a cloth face mask and keep a minimum 6-foot distance from others. Plan your grocery trip so you can get in an out quickly during quiet times to minimize contact with others.

Gloves do not replace hand hygiene. Given that gloves don’t protect you from the virus, wearing gloves doesn’t save you time from hand washing. You still have to keep up with hand hygiene. That’s the most important way to remove the virus from your hands.

To protect yourself, you’ll want to use hand sanitizer as you enter and exit the grocery store and wipe down your shopping cart handle with a disinfectant. When you get home, wash your hands well with soap and water for 20 seconds. And clean any other items that might be dirty, like your phone and reusable grocery bags.

Gloves do not protect others. As you move about the grocery store, the gloves can get dirty from whatever you touch and transfer it along to others – just as your fingers would.

To protect others, touch as little as possible while you’re out. Don’t pick up produce and then put it back down.

Save the medical gloves. Medical gloves are meant for protection when you’re in high risk situations, like if you’re exposed to bodily fluids like blood, mucous, vomit and urine. The gloves protect patients, caregivers, and health care workers all day long from tasks at home like washing the laundry of a person sick with COVID-19, to tests and procedures at the hospital. For grocery shopping, the gloves don’t add benefit and aren’t necessary. Given medical gloves are in short supply, just as medical face masks are, please use gloves wisely.

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6 Essentials for an Effective Face Mask

At some point, all of us will have to leave our homes and venture into public places. For now, it may be the grocery store or the doctor’s office, but later as social distancing measures slowly ease, we may actually be able to get a haircut or return to the office for work. The new normal will be different – seating will be spaced far apart, there will be plenty of clear barriers to protect workers, and you will likely be wearing a face mask.

In many places, you are already required to wear a cloth face covering, and it makes good sense. According to Dr. Anthony Fauci between 25% to 50% of people can be infectious and spread the virus without symptoms. It is easily transmitted by respiratory droplets simply by speaking or laughing, along with coughing or sneezing.

Of course, a cloth face mask is not foolproof protection from COVID-19, but it is much better than no mask. It is another important layer to physical distancing when used in combination with 6 foot spacing from others and hand hygiene. Unfortunately, there aren’t enough N95 or other medical masks in the U.S. for everyone. We need to save those masks for people on the frontline caring for those sick with COVID-19.

Not surprisingly, the cloth face mask market is increasing exponentially to meet demand, and the science behind what makes a good cloth face mask is inching along slowly. It is difficult to know what qualities to prioritize when searching for a face mask.

Here is what we know about what makes a good cloth face mask:

Sew or no-sew: Either sew or no-sew options are fine when used correctly. Do what’s reasonable for you. If you’re in a rush, go with a no-sew option. If you’re crafty, make your own mask at home. Or, order your masks locally or online. Choose mask designs recommended by reliable sources like the CDC. Another option is to check your local hospital’s website. Many are posting patterns with precise instructions to make masks they’ll accept as donations.

Fabric: The best cloth masks will use at least 2 layers of a tightly woven cotton fabric. Look for a high thread count. This acts as a filter blocking respiratory droplets while still allowing you to breathe comfortable.

Filter: Some will have a space to slip in a filter for an added layer of protection. The CDC recommends adding coffee filters to homemade masks. Online I’ve seen many filter options pop-up as people experiment with products in their home. These include cutouts from reusable fabric grocery bags made of polypropylene non-woven fibers, nylon fabric from pantyhose, paper towels, kitchen towels, bra pads, denim, and canvas to name a few.

We do not have much science to go on, so common sense is critical here. Is the filter worth adding when you consider safety and usability? The filter needs to be dense enough to block tiny, moist particles while also being breathable and comfortable. Are you inadvertently breathing something toxic? For example, some HEPA (high-efficiency particulate air) filters can have fiberglass, which would be very dangerous to inhale. Definitely do your own research to keep up with new information.

Fit: You need to be able to breathe comfortably with the mask on so that you do not have to slip it off while you’re in public to take a breath. The face mask must have a snug fit from nose to under the chin and back towards the ears. It’s useless if there are gaps that allow the air in. There are face masks available that come in different sizes. Also, you don’t want to have to fiddle with the mask, for example if it’s stiff, and potentially contaminate your fingers touching the outside layer of the mask. If you feel like you can’t breathe comfortably with your mask, don’t use it, and talk to your doctor about other face covering options.

Ease of use: Once you find a face mask you like, it’s only as good as how you use it. Make sure you can easily untie or remove the loops from your face and pull the mask away from your face without being contaminated by touching the front of the mask. Infinity scarves are not a good option for masks because they’re difficult to cleanly take on and off.

Plan your outings knowing you should not slip the mask on and off to eat or talk on the phone. If you’re exercising outdoors, you may not be able to tolerate a mask when you breathe hard. In that case, choose your exercise location carefully to make sure you can keep a physical distance from others and be safe.

Durability: You will need to wash the cloth mask after each use, so look for reviews online that comment on the masks wear and tear. If the mask loses shape, you will not be able to use it. If you are adding a filter, cleaning it will depend on what kind of filter you use. A coffee filter should be thrown away after each use. Also, the fabric should be pre-washed so that you don’t need to worry about shrinkage.

When you wear a cloth face mask, it shows you care about your own health and the health of others. It signals to others to be respectful of physical distancing measures and keep a 6-foot distance from you. A cloth face covering is also a subtle reminder that the professional masks are for those on the front line. With all the cool colors and patterns out now, you can even make it a style statement.

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Alzheimer’s gene risk triggers blood-brain barrier damage

Scientists have known for some time that the APOE4 gene is a risk factor for Alzheimer’s disease. A new study helps to explain why, by showing that the variant has an association with damage to the blood-brain barrier.

APOE4 is the leading genetic risk factor for Alzheimer’s disease. Almost one-quarter of people have one copy of the gene, which increases the risk of developing Alzheimer’s disease by up to four times.

In rarer cases, approximately 2–3% of the population, people carry two copies of the gene, which increases the risk of developing the disease by up to 15 times.

People who carry the variant, whether they have one copy or both, also develop the disease earlier than those who do not.

Although APOE4 is clearly important in the onset of many cases of Alzheimer’s disease, precisely how the genetic variant increases risk has been unclear.

Scientists from the University of Southern California (USC) have now shown a link between APOE4 and damage to the blood-brain barrier, the key structure that protects the brain from toxic substances.

The findings, which could aid the development of personalized treatment strategies for Alzheimer’s disease, appear in Nature.

APOE4 and the blood-brain barrier
This latest study focused on the blood-brain barrier, the protective border of cells separating the blood from the brain. Previous research from the group had shown that people who develop problems with their memory early on also had damage to this structure.

Their research has also shown that people with the APOE4 variant who go on to develop Alzheimer’s disease have a leaky blood-brain barrier, even before doctors can see any changes to cognition.

To investigate the connection between APOE4 and the blood-brain barrier in more detail, the team behind this study used a specialized form of MRI. They looked at the blood-brain barrier of people with mild cognitive impairment — which can be a precursor to Alzheimer’s disease — and those with normal cognitive function, both with and without APOE4.

They found that people who carried the APOE4 variant had a leaky blood-brain barrier in parts of the brain that are critical for memory function, including the hippocampus, even if they were cognitively healthy at the time of the scan.

Those who were experiencing cognitive decline had even worse damage to their blood-brain barrier.

Changes link with cognitive decline
To understand what was causing the leakage in the blood-brain barrier, the researchers looked for damage to a particular cell type — the pericytes — which wrap around blood vessels in the brain to form the critical barrier.

Using a biomarker of pericyte injury, they found higher levels of damage in APOE4 carriers. What is more, the researchers associated levels of the biomarker with both blood-brain barrier damage and cognitive decline.

“Severe damage to vascular cells called pericytes was linked to more severe cognitive problems in APOE4 carriers,” explains senior author Prof. Berislav Zlokovic, director of the Zilkha Neurogenetic Institute at USC.

Further experiments showed that the damage also correlated with levels of a protein that causes inflammation called cyclophilin A, which is known to be an early sign of Alzheimer’s disease.

Thus, the team was able to put together a hypothesis for how APOE4 causes damage to the blood-brain barrier, potentially leading to the onset of Alzheimer’s disease.

“APOE4 seems to speed up the breakdown of the blood-brain barrier by activating an inflammatory pathway in blood vessels, which is associated with pericyte injury,” says Prof. Zlokovic.

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Treating the damage
Some parts of the theory need fleshing out, for example, how damage to the blood-brain barrier causes the symptoms of Alzheimer’s disease. Nevertheless, these findings are a step forward in our understanding of how APOE4 shapes Alzheimer’s disease risk.

Future work will be necessary to better understand the genetic risk factors for the disease and, potentially, developing personalized treatments.

Experiments in mice have already shown that blocking the inflammatory process that APOE4 triggers can restore the blood-brain barrier and improve neuronal function, raising hope that doctors could use similar treatments for Alzheimer’s.

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Using convalescent blood to treat COVID-19: The whys and hows

Some researchers and doctors have started using plasma from people recovering from COVID-19 to treat others who have developed the disease. Medical News Today spoke to Dr. Arturo Casadevall, from Johns Hopkins University, to learn more about this approach.

In the search for an effective treatment for COVID-19, an old method of fighting infectious diseases has recently resurfaced: transfusions with convalescent plasma. Plasma is a component of blood.

This method has a simple premise. The blood of people who have recovered from an infection contains antibodies. Antibodies are molecules that have learned to recognize and fight the pathogens, such as viruses, that have caused disease.

Doctors can separate plasma, one of the blood components that contain such antibodies, and administer it to people whose bodies are currently fighting an infectious disease. This can help their immune systems reject the pathogen more efficiently.

Recently, researchers and healthcare professionals have been looking into the possibility of using this method to treat people with COVID-19, the respiratory disease caused by the SARS-CoV-2 virus.

In the United States, a group of researchers and doctors from 57 institutions, including Johns Hopkins University, the Albert Einstein College of Medicine, and the Icahn School of Medicine at Mount Sinai, are investigating and applying convalescent plasma therapy for COVID-19.

This is a concerted initiative — called the “National COVID-19 Convalescent Plasma Project” — born after the publication of a viewpoint paper in The Journal of Clinical Investigation in March, 2020.

The paper argued for the potential merits of passive antibody therapy in the treatment of COVID-19. It was authored by immunologists Dr. Arturo Casadevall, chair of the Molecular Microbiology & Immunology Department at Johns Hopkins Bloomberg School of Public Health, and Dr. Liise-anne Pirofski, professor of Infectious Diseases in the Department of Medicine at the Albert Einstein College of Medicine.

To understand more about convalescent plasma therapy, its merits, its risks, and its current use in COVID-19 treatments, Medical News Today recently spoke to Dr. Casadevall.

Here is what he told us, alongside more information on the current state of convalescent plasma therapy.

A therapy ‘used for over 100 years’
So, where did the idea of using convalescent plasma, or passive antibody therapy, come from?

This notion was first introduced in the late 19th century when physiologist Emil von Behring and bacteriologist Kitasato Shibasaburou discovered that they could use antibodies present in serum — another blood component — to fight the bacterial infection diptheria.

Since then, doctors have used passive antibody therapy, on and off, at least since the 1930s to treat or prevent both bacterial and viral infections, including forms of pneumonia, meningitis, and measles.

When we asked him how the idea of using convalescent plasma therapy to treat COVID-19 came about, Dr. Casadevall told us: “I have worked on antibodies my entire life professional life […], and I knew that convalescent plasma — or sera […] — was being used for over 100 years.”

“In fact, the first Nobel Prize was given [to Behring] for the use of serum to treat diphtheria, so I knew the history.” This long history of successfully using this method against different infectious diseases suggested that it might also be effective against the disease caused by SARS-CoV-2.

“I knew that in epidemics when you don’t have a lot of things, […] the blood of those who recover can have antibodies that can be used [as treatment],” Dr. Casadevall explained.

“So it’s an old idea, it’s been around for a long time, and I think that my contribution was, in fact, to alert my friends, authorities, that this [therapy] could be used in this epidemic.”

Recent research has already shown that people who have contracted SARS-CoV-2 have developed antibodies that can react to the coronavirus.

“There [are] now multiple studies that have shown that when people recover from the virus, they have in their blood neutralizing antibodies that are able to kill the virus,” Dr. Casadevall also told MNT.

Although “[p]eople differ greatly in the amount of antibodies that they make — some make large amounts, some make small amounts — […] the good news is that most have [them],” he added.

Given the willingness of people who have recovered from COVID-19 to donate blood, the method seems feasible right now. In fact, some doctors are already using convalescent plasma therapy in some cases.

Settling the matter of safety
In the U.S., the National COVID-19 Convalescent Plasma Project have already been trialing this method as widely as possible.

Dr. Casadevall told MNT that “in the United States, we have close to 12,000” people who have received the convalescent plasma treatment for COVID-19.

Based on the data obtained from a little less than half of this cohort, Dr. Casadevall and his colleagues have concluded that this approach is safe for the patients receiving treatment — the first step necessary before ascertaining the method’s effectiveness.

The team has reported these findings in a preprint that they have made available online.

“[On May 14], we put out a paper on the first 5,000 [patients] showing that [this therapy] was relatively safe. That’s the first step,” Dr. Casadevall explained.

“You want to show safety. And then the question of efficacy will be coming in the next few weeks. Right now, the data [is] being analyzed. We are hopeful,” he also told MNT.

“And,” he added, “especially since [the] Italians are reporting already that the use of convalescent plasma was associated with a drop in mortality [due to COVID-19]. We are hopeful that similar insights [will] come from the analysis of the data in the United States.”

In Europe, the European Blood Alliance — a non-profit association — report that 20 countries have initiated the use of convalescent plasma in the treatment of COVID-19 or are considering it for the near future. These include Italy, Spain, and the United Kingdom, some of the European countries most aggressively hit by SARS-CoV-2.

Demonstrating this procedure’s safety is essential because of the risks inherent to the transfusion of blood or blood components.

There is also the issue that adding more liquid volume into a person’s vascular system could lead to a risky overload, Dr. Casadevall explained.

“The concerns when you give plasma [include the fact that] rarely, you can get a transfusion reaction, [and] rarely, you could have a volume overload. What do I mean by that? I mean that […] you’re putting volume into blood, and if it goes in too rapidly, it could [lead to an] overload [of the] cardiac system,” he said.

“So when we looked at the experience of the first 5,000 [patients], we were very reassured that we did not see any major problems.”

Worries and hopes going forward
While different centers in the U.S. are already using convalescent plasma in the treatment of COVID-19, Dr. Casadevall expressed a worry that the therapy is not as effective as it might be because most patients receive it too late in the course of the disease.

Aside from its use in clinical trials, the Food And Drug Administration (FDA) have approved the administration of this form of therapy only in emergency situations to patients in a severe stage of the disease, which may not be soon enough.

“Often, physicians are using the plasma on patients that are very ill, and we don’t really know whether that’s going to be as effective as if you gave it early in the course of the disease,” Dr. Casadevall pointed out.

“Here in the United States, patients have been treated when they’re intubated, but we think that is relatively late. Many physicians are trying to move it earlier, that is, when people begin to decompensate,” he added.

But even where there is a will, getting this treatment to the patients who need it sooner rather than later is not always straightforward. “Some of the problem […] is that it takes time,” Dr. Casadevall explained.

“Because let’s say the doctor orders plasma and people are getting worse. It sometimes takes a while for the plasma to arrive. Some hospitals have it on site, others have to get it from blood banking centers.”

Despite these obstacles, the use of convalescent plasma therapy is so attractive to healthcare practitioners because they can access it and use it now.

Unlike with vaccines, whose development takes time, or experimental medication, which needs to go through several different stages of testing before it can obtain formal approval, this approach allows doctors to use what is already there — the blood of those who have recovered from the illness — to treat hospitalized patients.

“People often get confused [about the difference between convalescent plasma therapy and some vaccines] because they both involve antibodies,” Dr. Casadevall told MNT.

But while vaccines also operate on the premise of stimulating a person’s immune system to block or kill the virus, they do not use “ready made” antibodies, and testing them for safety and efficacy could take a year or more.

“When you get plasma, someone else is giving you the antibodies, and you get them immediately,” Dr. Casadevall explains.

Going forward, he thinks that doctors could use this therapy alongside other options as they gradually become available.

“[C]onvalescent plasma provides something that can be used today with standard knowledge and standard procedures […] But we do hope that better options will be available in the future,” he reiterated.

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8 weeks on fruit- and vegetable-rich diets tied to better heart health

A new study has looked at the links between markers of heart health and three types of diet: the DASH diet, a different fruit- and vegetable-rich diet, and a typical Western diet. Its conclusion? Diets that include lots of fruit and vegetables are associated with better heart health.
A new observational analysis recently published in the Annals of Internal Medicine adds to evidence that diets rich in fruits and vegetables may help protect cardiovascular health.

The analysis draws on data from the Dietary Approaches to Stop Hypertension (DASH) trial, which assessed the effects of a specially designed diet on blood pressure, in comparison with other types of diets.

This DASH diet was developed by specialists in nutrition who were affiliated with the National Institutes of Health (NIH).

On the whole, the DASH diet favors the intake of fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, nuts, and beans over that of red meats and fatty, sugary, or salty foods.

Studying the effects of diet on heart health
For the current analysis, the researchers — including the study’s lead author, Dr. Stephen Juraschek, of the Beth Israel Deaconess Medical Center, in Boston, MA — compared the effects of three types of diet on markers of heart health. The diets trialed were the DASH diet, a different diet rich in fruits and vegetables, and “a typical American diet.”

The latter reflected levels of nutrient consumption reported by the average U.S. adult, while the diet rich in fruits and vegetables was, in many ways, similar, but it contained more natural fiber and included fewer snacks and sweets.

Researchers looked at data from three randomly assigned groups of participants from the DASH trials. The total number of participants in the present analysis was 326, and each had followed one of the three diets mentioned above for a period of 8 weeks.

The investigators assessed the levels of three biomarkers related to heart health in samples of serum, a component of blood, collected from the participants.

The participants’ mean age was 45.2 years, and none had preexisting cardiovascular conditions.

The serum samples had been collected, first, after a 12-hour fast before the participants had started on their respective diets and, later, at the end of the 8-week study period.

Fruit and vegetable intake may be key
The serum biomarkers that the team assessed were: high-sensitivity cardiac troponin I, N-terminal pro–B-type natriuretic peptide, and high-sensitivity C-reactive protein.

Troponin helps regulate the contractions of the heart muscle, and overly high levels of this protein can indicate heart damage.

High levels of C-reactive protein in the bloodstream can indicate inflammation, while very high levels of pro–B-type natriuretic peptide are a marker of heart failure.

After assessing the serum samples taken before and after the 8-week dietary interventions, the team found that people who had followed either the DASH diet or the other fruit- and vegetable-rich diet consistently had significantly lower concentrations of two biomarkers — troponin and pro–B-type natriuretic peptide — than their peers who had followed the typical American diet.

This, the investigators suggest, indicates better heart health in those groups. Levels of the two biomarkers did not differ among the people who had followed either of the plant-rich diets.

C-reactive protein levels — which can indicate the presence of inflammation — were not affected by any of the three diets.

While it is unclear which aspects of the DASH and the other plant-rich diets may have benefited heart health, the study authors do have a hypothesis. They write: Nevertheless, they caution, “Further research is needed to confirm whether similar diets can improve cardiac function in adults with established heart failure.”

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Yoga : How It Works

Workout fads come and go, but virtually no other exercise program is as enduring as yoga. It’s been around for more than 5,000 years.

Yoga does more than burn calories and tone muscles. It’s a total mind-body workout that combines strengthening and stretching poses with deep breathing and meditation or relaxation.

There are more than 100 different forms of yoga. Some are fast-paced and intense. Others are gentle and relaxing.

Examples of different yoga forms include:

Hatha. The form most often associated with yoga, it combines a series of basic movements with breathing.
Vinyasa. A series of poses that flow smoothly into one another.
Power. A faster, higher-intensity practice that builds muscle.
Ashtanga. A series of poses, combined with a special breathing technique.
Bikram. Also known as “hot yoga,” it’s a series of 26 challenging poses performed in a room heated to a high temperature.
Iyengar. A type of yoga that uses props like blocks, straps, and chairs to help you move your body into the proper alignment.

Intensity Level: Varies with Type
The intensity of your yoga workout depends on which form of yoga you choose. Techniques like hatha and iyengar yoga are gentle and slow. Bikram and power yoga are faster and more challenging.

Areas It Targets
Core: Yes. There are yoga poses to target just about every core muscle. Want to tighten those love handles? Then prop yourself up on one arm and do a side plank. To really burn out the middle of your abs, you can do boat pose, in which you balance on your “sit bones” (the bony prominences at the base of your pelvic bones) and hold your legs up in the air.

Arms: Yes. With yoga, you don’t build arm strength with free weights or machines, but with the weight of your own body. Some poses, like the plank, spread your weight equally between your arms and legs. Others, like the crane and crow poses, challenge your arms even more by making them support your full body weight.

Legs: Yes. Yoga poses work all sides of the legs, including your quadriceps, hips, and thighs.

Glutes: Yes. Yoga squats, bridges, and warrior poses involve deep knee bends, which give you a more sculpted rear.

Back: Yes. Moves like downward-facing dog, child’s pose, and cat/cow give your back muscles a good stretch. It’s no wonder that research finds yoga may be good for relieving a sore back.

Type
Flexibility: Yes. Yoga poses stretch your muscles and increase your range of motion. With regular practice, they’ll improve your flexibility.

Aerobic: No. Yoga isn’t considered aerobic exercise, but the more athletic varieties, like power yoga, will make you sweat. And even though yoga is not aerobic, some research finds it can be just as good as aerobic exercise for improving health.

Strength: Yes. It takes a lot of strength to hold your body in a balanced pose. Regular practice will strengthen the muscles of your arms, back, legs, and core.

Sport: No. Yoga is not competitive. Focus on your own practice and don’t compare yourself to other people in your class.

Low-Impact: Yes. Although yoga will give you a full-body workout, it won’t put any impact on your joints.

What Else Should I Know?
Cost. Varies. If you already know your way around a yoga mat, you can practice for free at home. Videos and classes will cost you various amounts of money.

Good for beginners? Yes. People of all ages and fitness levels can do the most basic yoga poses and stretches.

Outdoors. Yes. You can do yoga anywhere, indoors or out.

At home. Yes. All you need is enough space for your yoga mat.

Equipment required? No. You don’t need any equipment because you’ll rely on your own body weight for resistance. But you’ll probably want to use a yoga mat to keep you from sliding around in standing poses, and to cushion you while in seated and lying positions. Other, optional equipment includes a yoga ball for balance, a yoga block or two, and straps to help you reach for your feet or link your hands behind your back.

What Family Doctor Melinda Ratini MD Says:
There are many types of yoga, from the peaceful hatha to the high-intensity power yoga. All types take your workout to a level of mind-body connection. It can help you relax and focus while gaining flexibility and strength. Yoga can also boost your mood.

Even though there are many instructional books and DVDs on yoga, it is well worth it to invest in some classes with a good instructor who can show you how to do the postures.

Chances are, there’s a type of yoga that suits your needs and fitness level. It’s a great choice if you want a holistic approach to mind and body strength.

Yoga is not for you if you like a fast-moving, competitive workout. Be open-minded, since there are physical and mental benefits you can gain by adding some yoga into your fitness plan, even if it isn’t your main workout.

Is It Good for Me If I Have a Health Condition?

Yoga is a great activity for you if you have diabetes, high blood pressure, high cholesterol, or heart disease. It gives you strength, flexibility, and mind-body awareness. You’ll also need to do something aerobic (like walking, biking, or swimming) if you’re not doing a fast-moving type of yoga.

If you have high blood pressure, diabetes, or heart problems, ask your doctor what you can do. You may need to avoid certain postures, like those in which you’re upside down or that demand more balance than you have right now. A very gentle program of yoga, coupled with a light aerobic activity like walking or swimming, may be the best way to start.

Do you have arthritis? Yoga can help you stay flexible and strong without putting added stress on your joints. You get the added benefit of a mind-body approach that can help you relax and energize.

If you’re pregnant, yoga can help keep you relaxed, strong, and in shape. If you’re new to yoga or have any health or pregnancy related problems, talk to your doctor before you give it a try. Look for an instructor who’s experienced in teaching prenatal yoga.

You’ll need to make some adjustments as your baby and belly grow and your center of gravity shifts. After your first trimester, don’t do any poses that have you lying on your back. And don’t try to stretch any further than you did before pregnancy. Your pregnancy hormones will loosen up your joints and make you more likely to get injured.

While you’re pregnant, avoid postures that put pressure on your belly or low back. Don’t do “hot” yoga, where the room temperature is very high.

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Coronavirus 2020 Outbreak: Latest Updates

April 15, 7:26 p.m.

Industry leaders meeting with President Donald Trump before Wednesday’s White House Coronavirus Task Force briefing told him that more testing is needed before reopening the country. Public health officials, state and local leaders have been asking for more testing as a way to know who is infected and then to find out who has immunity. Trump is seeking guidance from the leaders on plans to loosen restrictions due to the virus.

At the briefing, Trump said he plans to speak to governors on Thursday “and we will have some information on some openings. I would say we have 20 states, but probably 29, that are in really good shape. We miss sports, we miss everything. We want to get our country open again. ”

Deborah Birx, MD, the coronavirus task force response coordinator, said social distancing has to continue despite some progress in reducing the spread of the coronavirus. Birx said they will look at states and metropolitan areas individually as they come up with the new guidelines, which are expected to be announced Thursday.

25 FEMA Workers Have Contracted COVID-19

April 15, 3:51 p.m.

More than two dozen employees for the Federal Emergency Management Agency have tested positive for coronavirus, according to NBC News. Sources told the network Tuesday that employees were “dropping like flies” and unable to work.
Expanded Coverage

At least one of the 25 workers was in the agency’s main response center for the COVID-19 outbreak, NBC said, and several workers were placed into quarantine. FEMA is the lead agency coordinating the coronavirus response, and the National Response Coordination Center in Washington, D.C., is the main facility where the federal government is managing the pandemic.

The employee tested positive on Monday, according to Politico, and FEMA employees at the center left at the end of the day. The agency started deep cleaning the facility based on CDC guidelines, the news publication reported.

FEMA conducted contact tracing to determine if the employee had contact with members of the White House Coronavirus Task Force in recent days, and reported that the employee and others who were in contact with the employee didn’t come within 6 feet of the task force, according to The Associated Press.

On Tuesday, a FEMA spokesperson confirmed that 25 employees tested positive but didn’t indicate how many response center workers were included in the group, NBC News reported. The spokesperson also didn’t respond to questions about the response center’s protective gear policies such as wearing masks and gloves but said the agency is taking “every precaution recommended by the CDC.”

“The health and safety of the workforce, including our interagency partners and members of the White House Coronavirus Task force, is a top priority for the Federal Emergency Management Agency as we continue to lead the federal operations in response to the pandemic,” the FEMA spokesperson wrote in an email to NBC. “Like many large employers, FEMA has employees who have tested positive.”

More Than 9,000 Health Care Workers Have Contracted COVID-19

April 15, 11:01 a.m.

More than 9,200 U.S. doctors, nurses, and other health care professionals had contracted the coronavirus, and 27 had died by the end of last week, the CDC reported Tuesday.

The numbers are likely an underestimation, the CDC said. The data comes from the 315,000 total cases reported to the CDC between Feb. 12 and April 9. Of those, only 16% listed an occupation. For instance, the 9,200 cases make up 3% of the 315,000 reported cases where job information was reported, but in states with more complete reporting of occupation, health care workers accounted for 11% of cases.

Health care workers with mild or no symptoms may not have been tested as well.

“It is critical to make every effort to ensure the health and safety of this essential national workforce of approximately 18 million [health care professionals], both at work and in the community,” according to a statement from the CDC’s COVID-19 Response Team, published in the CDC Morbidity and Mortality Weekly Report.

According to the data, the average age of the health care workers who tested positive for the new coronavirus was 42, and about 73% were women. More than a third reported at least one other health condition.

In addition, 723 health care workers were hospitalized, and 184 were placed in intensive care. Although most of the health care workers weren’t hospitalized, severe outcomes were reported for all ages.

Among the 27 who died, 10 were age 65 or older. This should be considered when retired health care workers are encouraged to help with a COVID-19 surge, the report stated, which could mean using retired workers for telemedicine, administrative assignments, or non-coronavirus cases.

As more COVID-19 hospitalizations and deaths occur, the number of health care professionals who test positive and die will likely increase as well, according to the report. “Additional measures” could reduce the risk of transmitting the virus, such as screening health care workers for fever and symptoms at the beginning of their shifts, prioritizing them for testing, and discouraging them from working while ill. Reporting more details about COVID-19 cases would help the CDC to draw better conclusions and create better guidelines, too.

“Improving surveillance through routine reporting of occupation and industry not only benefits [health care professionals], but all workers during the COVID-19 pandemic,” the CDC response team wrote.

First Case of Coronavirus Spreading From a Corpse Reported in Thailand

April 14, 4:05 p.m.

A medical professional in Thailand was infected with the new coronavirus while working with a corpse, apparently the first known case of the virus spreading from a dead body, according to letter in a medical journal.

The medical professional, only identified as a “forensic practitioner” in Bangkok, died from the coronavirus, said a letter published in the Journal of Forensic and Legal Medicine.

“According to our best knowledge, this is the first report on COVID-19 infection and death among medical personnel in a Forensic Medicine unit,” said the letter written by Won Sriwijitalai of the RVT Medical Center in Bangkok, and Viroj Wiwanitkit of Hainan Medical University in Haikou, China.

They wrote that pathology/forensic units might want to adopt the disinfection procedures used in operating rooms. Workers in forensic departments are already wearing protective devices such as gloves, goggles, and masks, they wrote.

Angelique Corthals, a professor of pathology at City University of New York, told BuzzFeed that medical examiners, morgue technicians, and people working in funeral homes need to take special care. “It’s a real concern,” she said.

The letter in the medical journal said forensic medical professionals have a low chance of coming in contact with patients who have the new coronavirus, but “they can have contact with biological samples and corpses.”

The letter writers said nobody knows how many corpses contaminated with coronavirus exist because dead bodies are not routinely examined for the virus in Thailand.

Thailand has not been hit hard by coronavirus — Johns Hopkins University reports about 2,600 cases and 40 deaths — but was one of the first countries outside of China to report a case.

People Pay Attention to Social Distancing Orders, CDC Says

April 14, 1:20 p.m.

A CDC report says it appears the public listens when the government orders social distancing to reduce the spread of the coronavirus.

Using location tracking data on mobile devices, the CDC said people in San Francisco, Seattle, New York, and New Orleans started moving around less after different levels of government ordered sheltering in place, banned gatherings of a certain size, and shut down schools.

“Community mobility in all four locations declined from Feb. 26, 2020 to April 1, 2020, decreasing with each policy issued and as case counts increased,” the CDC said. “This report suggests that public policy measures are an important tool to support social distancing and provides some very early indications that these measures might help slow the spread of COVID-19.”

The CDC said it measured “community mobility” using publicly available information from SafeGraph, a company that aggregates location data from mobile devices like smartphones and tablets. The data shows whether a device “leaves home” by traveling more than 150 meters (492 feet) from the place it normally spends the night.

In all four cities, about 80% of the people tracked were leaving home on Feb. 26, the CDC said. By April 1, the percentage of people leaving home had dropped to 42% in New York City, 47% in San Francisco, 52% in Seattle, and 61% in New Orleans.

It looks like a confluence of government actions, not just one thing, persuaded the public to pay attention.

“Overall, across the four areas, emergency declarations (the first policies issued) did not result in a sustained change in mobility; however, declines in mobility occurred after implementation of combinations of policies (such as limits on gatherings or school closures) and after the White House 15 Days to Slow the Spread guidelines were implemented,” the CDC said.

San Francisco, Seattle, New York, and New Orleans all had heavy outbreaks of the coronavirus. The CDC said it studied 3.6% to 6.4% of the mobile devices in the cities.

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Baby Talk: Communicating With Your Baby

Your baby’s first year will be a flurry of changes — and not just diapers. From the first smiles, gurgles, and coos to learning to say “mama” or “dada,” babies love to communicate with their own form of baby talk. And they hope you’ll “baby talk” right back.

All through this first year, you can do a lot to encourage your baby’s communication skills. And it’s easy. All you need do is smile, talk, sing, and read to your baby.

Why focus on communicating with your baby? Because early speech and language skills are associated with success in developing reading, writing, and interpersonal skills, both later in childhood and later in life.

Baby Talk: Smile and Pay Attention

Long before they can speak clearly, babies understand the general meaning of what you’re saying. They also absorb emotional tone. Encourage baby’s early attempts to communicate with you with loving attention:

  • Smile often at your baby, especially when he is cooing, gurgling, or otherwise vocalizing with baby talk.
  • Look at your baby as he or she babbles and laughs, rather than looking away, interrupting, or talking with someone else.
  • Be patient as you try to decode your infant’s baby talk and nonverbal communication, like facial expressions, gurgling, or babbling sounds that could signal either frustration or joy.
  • Make time to give your baby lots of loving attention, so he can “speak” to you with his or her baby talk, even when you’re busy with other tasks.

Baby Talk: Imitate Your Baby

Right from the start, baby talk should be a two-way street. By imitating your baby, you’ll send an important message: what he is feeling and trying to communicate matters to you.

  • Have back-and-forth conversations in baby talk to teach your baby the give-and-take of adult conversation.
  • Imitate baby’s vocalizations — “ba-ba” or “goo-goo” — then wait for him to make another sound, and repeat that back.
  • Do your best to respond, even when you don’t understand what your baby is trying to say.
  • Reinforce communication by smiling and mirroring facial expressions.
  • Because gestures are a way babies try to communicate, imitate your baby’s gestures, as well.

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First 72 Hours After Acute Kidney Injury Matter

Acute kidney injury (AKI) — even when it resolved quickly — was tied to poorer long-term renal outcomes in a prospective cohort study.
People who experienced non-resolving AKI saw more than a two-fold higher risk for a major adverse kidney event (MAKE) compared with those who didn’t have AKI (adjusted hazard ratio 2.30, 95% CI 1.52-3.48, P<0.001), reported Pavan Bhatraju, MD, MSc, of the University of Washington in Seattle, and colleagues. Even those whose kidney function resolved within 72 hours after a diagnosis of AKI also had a 52% higher risk for a long-term MAKE compared with those with AKI (aHR 1.52, 95% CI 1.01-2.29, P=0.04), according to the study online in JAMA Network Open. However, when the researchers compared cases of AKI, those whose AKI did not resolve saw a significantly higher rate of a MAKE -- a composite of progressive kidney disease, need for long-term dialysis, or all-cause mortality (aHR 1.51, 95% CI 1.22-1.88, P<0.001) compared with those whose AKI resolved. These associations were adjusted for demographic factors like age, sex, and race, as well as for clinical factors including diabetes status, chronic kidney disease status, cardiovascular disease, and sepsis. The associations were also still significant after the group controlled for the magnitude of increased serum creatinine concentrations -- or the AKI stage -- in those who recovered from their AKI. Nearly three-quarters of those with AKI had injury classified as stage 1. "The use of AKI recovery subgroups to risk stratify patients with AKI we believe is clinically intuitive," Bhatraju's group wrote. The observational study included 1,538 hospital patients: half of whom did not experience AKI, 31% of whom had resolving AKI, and 19% who had non-resolving AKI within 3 months of admission. AKI was defined according to standard diagnostic criteria: an increase in serum creatinine concentration of 50% or more or 0.3 mg/dL or more above an outpatient, non-emergency department baseline value within 7 to 365 days prior to the initial hospital admission. AKI that resolved was considered to be a decrease in serum creatinine concentration of 0.3 mg/dL or more or at least 25% from maximum within the initial 72 hours following an AKI diagnosis. During median follow-up of 4.7 years, 36% of the entire cohort had a MAKE. "[These findings] provide evidence for considering the timing of functional recovery from AKI as a factor associated with future adverse events," Ravindra Mehta, MBBS, MD, DM, of the University of California San Diego, said in an accompanying commentary. He also noted that while these findings highlight the value of using AKI recovery pattern to predict long-term kidney outcomes, the study simultaneously underscores how current AKI staging criteria was not helpful in predicting these outcomes "as the severity stage by itself did not differentiate among which patients would develop MAKE." "It is ... clear that clinicians managing patients with AKI should consider the severity of the disease and the ensuing course and tailor their diagnostic and therapeutic interventions to facilitate rapid and complete recovery of kidney function," he concluded.

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Prostate cancer : Noninvasive urine test moves a step closer

Researchers have identified a unique molecular signature of prostate cancer in urine. This may pave the way for an accurate, noninvasive test for the condition.
The scientists — from Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore, MD — used RNA and other molecules in urine to differentiate between males with prostate cancer and those with nonmalignant prostate conditions or healthy prostates.

Prostate cancer is the second most common cancer among males in the United States, after skin cancer. Around 1 in 9 males will receive a diagnosis of this condition in their lifetime.

In the U.S. alone, almost 192,000 males will receive a diagnosis in 2020, and over 33,000 will die from the condition.

Flawed tests
Prostate cancer is highly treatable, especially if a doctor diagnoses it early. However, there are often no symptoms in the early stages, and existing screening tests are problematic.

For example, the widely used prostate-specific antigen (PSA) blood test is unreliable, giving a lot of false-positive results and not discriminating benign from aggressive forms of cancer.

As part of a regular health check, or if a male’s PSA levels are elevated, a doctor may perform a digital rectal examination (DRE). However, these tend to be quite invasive, which discourages many males from undergoing them.

Doctors recommend a biopsy if they find anything suspicious during a DRE. However, even a biopsy cannot provide a definitive test, and the procedure can be painful.

“A simple and noninvasive urine test for prostate cancer would be a significant step forward in diagnosis,” says senior study author Ranjan Perera. The study now appears in the journal Scientific Reports.

“Tissue biopsies are invasive and notoriously difficult because they often miss cancer cells, and existing tests, such as PSA […] elevation, are not very helpful in identifying cancer.”

According to the National Cancer Institute, only about 25% of males who undergo a biopsy following a positive PSA test actually have prostate cancer.

Dislodged cells
Male urine contains a small amount of cells shed from different parts of the urinary tract, including the prostate. Scientists can isolate, process, and analyze these cells using various molecular techniques.

Existing prostate urine tests involve a health professional first massaging the prostate to dislodge more of these cells. However, recent research suggests that this may be unnecessary. Indeed, males may actually be able to collect urine samples at home and mail them to a laboratory for testing.

For the new study, the researchers recruited 126 males. Of these, 64 had prostate cancer, 31 had nonmalignant prostate conditions (benign prostatic hyperplasia or prostatitis), and 31 had no cancer. They collected urine samples without first massaging the prostate.

Cells become cancerous partly as a result of genetic and metabolic changes that provide the energy boost they need to proliferate rapidly.

To identify a unique molecular signature of these changes in prostate cancer, the researchers sequenced RNA molecules and used mass spectrometry to measure metabolites in the samples.

“We discovered cancer-specific changes in urinary RNAs and metabolites that — if confirmed in a larger, separate group of patients — will allow us to develop a urinary test for prostate cancer in the future.”

– First study author Bongyong Lee, of Johns Hopkins All Children’s Hospital in St. Petersburg, FL

Unlike the PSA test, the RNA and metabolite profile that the researchers identified could distinguish between males with prostate cancer and those with nonmalignant prostate conditions.

The scientists write in their paper that a test based on their findings could also determine how advanced a cancer is.

However, they emphasize that this was a proof-of-principle study. Larger studies are necessary to validate the test before it is ready for clinical use.

They say that in the future, their findings might inspire new treatments for the condition based on the metabolic changes they identified.