Two new studies each suggest that dozens of drugs already approved for use in the United States may prove effective against the new coronavirus.
“Repurposing these FDA-approved drugs could be a fast way to get treatment to patients who otherwise have no option,” explained the co-author of one of the studies, Dr Hesham Sadek. He’s professor in the departments of internal medicine, molecular biology and biophysics at UT Southwestern Medical Center, in Houston.
However, experts stressed that this research is still in its early stages, so people shouldn’t try any of the drugs now to prevent or treat Covid-19.
Right now, “there is no specific medicine recommended to prevent or treat the new coronavirus,” according to the World Health Organization (WHO). “Some specific treatments are under investigation, and will be tested through clinical trials,” the WHO said, according to the Washington Post.
It could take months
As Covid-19, the illness caused by the new coronavirus, sickens hundreds of thousands worldwide, the race is on to find a drug that might help save severely ill patients.
But even with rapid government approval, it could take months to develop new drugs from scratch that might be effective against the virus, Sadek explained in a UT Southwestern news release.
That led his team to conduct computer modelling studies on certain drugs already approved by the US Food and Drug Administration, to assess their potential in combating the coronavirus.
The results showed that the most promising drugs include several antiviral drugs – including Darunavir, Nelfinavir, and Saquinavir – and several other types of drugs, including the ACE inhibitor Moexipril; the chemotherapy drugs Daunorubicin and Mitoxantrone; the painkiller Metamizole; the antihistamine Bepotastine; and the antimalarial drug Atovaquone.
Another promising candidate is the cholesterol-lowering statin rosuvastatin, which is sold under the brand name Crestor. It’s already taken by millions of patients around the world to lower their cholesterol, is safe, inexpensive and readily available, Sadek noted.
The results were published on a pre-print server called ChemRxiv; they have not yet been subject to peer review.
Findings submitted to journal
Also, because this study was completely computer-based, their effectiveness against the new coronavirus remains theoretical. Only further research could confirm their effectiveness prior to use in actual patients, the Houston researchers stressed.
A second study was led by biologist Nevan Krogan of the University of California, San Francisco. It found that nearly 70 drugs – some already approved, some still experimental – might prove effective against the novel coronavirus.
Krogan’s group has so far only published their findings on the website bioRxiv, and the findings have been submitted to a medical journal, The New York Times reported.
In this effort, the researchers took a deep dive into the genetic makeup of the novel coronavirus, focusing on key proteins the virus uses to hijack the genetic machinery of a host human cell. The coronavirus uses the cell’s protein to then manufacture millions of copies of itself.
Krogan’s team searched for drugs that target the same human cellular proteins that the virus also targets during its invasion of the host cell. They uncovered 24 drugs already approved by the FDA for use against a wide range of diseases, such as cancer, Parkinson’s disease and high blood pressure.
Also on the list were certain antibiotics; metformin, the go-to drug for type 2 diabetes; the schizophrenia drug haloperidol; and the malaria drug chloroquine.
Well-run trials essential
The latter drug gained prominence after President Donald Trump suggested at a recent news briefing that it might work against Covid-19. But Dr Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases, quickly qualified that statement, saying there was only “anecdotal evidence” that chloroquine might work against the new coronavirus.
He stressed that only well-run trials could prove effectiveness; such trials are being planned by the WHO and the state of New York, the Times noted.
And there’s a potentially lethal downside to trying any of the aforementioned drugs on your own, experts warned.
That danger was illustrated in a tragedy occurring just this week. According to the Washington Post, one Arizona couple in their 60s took matters into their own hands after watching Trump’s news briefing. Buoyed by his words on chloroquine, the couple self-treated with the drug – which they had previously used to clean their koi pond.
After mixing the chemical with soda and drinking it, they each felt dizzy and started vomiting. The husband died at the hospital, and the wife is still under critical care in the hospital, the Post reported.
A number of ongoing efforts
So, don’t “self-medicate” with any of these drugs until better research is done. Krogan’s collaborators at the Icahn School of Medicine at Mount Sinai in New York City and the Pasteur Institute in Paris have already begun testing the mettle of 22 compounds on their list against the coronavirus, under laboratory conditions, the Times said.
The new coronavirus first appeared in China in late 2019. As of 23 March, there had been nearly 335 000 cases of Covid-19 and nearly 14 700 deaths worldwide, according to the WHO.
There are a number of ongoing efforts to develop effective treatments and vaccines, but no clear treatment or prevention strategies currently exist.
According to a new alert released this week by the American Academy of Ophthalmology (AAO), conjunctivitis, also known as pink eye, may be a symptom of the new coronavirus, with experts estimating it could be present in 1–3% of Covid-19 cases.
The Covid-19 virus, officially named SARS-CoV-2, primarily causes respiratory infection. Common symptoms include a dry cough, fever, and shortness of breath.
Recent research has revealed that some patients may also experience digestive symptoms such as diarrhoea, nausea, vomiting and abdominal discomfort. Sudden loss of smell also seems be an indicator of the virus – especially in people who may not be exhibiting other symptoms or meeting the vital criteria for testing, a previous article by Health24 reported. And now, most recently, pink eye has been included as a rare symptom of the virus.
Eye doctors to take precautions
According to Health24, conjunctivitis, or pink eye, is defined as “an inflammation of the delicate membrane that covers the white of the eyes and lines the inside surfaces of the eyelids.” It can cause swelling, a burning sensation or watery discharge.
After several preliminary studies and anecdotal reports found this eye condition in Covid-19 patients, the American Academy of Ophthalmology issued an alert, explaining: “Two published reports and a more recent news article suggest the virus can cause conjunctivitis. Thus, it is possible that SARS-CoV-2 is transmitted by aerosol contact with the conjunctiva.
“Affected patients frequently present to eye clinics or emergency departments. That increases the likelihood ophthalmologists may be the first providers to evaluate patients possibly infected with Covid-19.”
Pink eye is highly contagious and can be spread via skin-to-skin contact, or by touching a contaminated surface, such as a doorknob.
Other causes
The Academy therefore cautions ophthalmology practices to provide only urgent care to patients and to ensure their practices are sterilised regularly, as well as to minimise the number of patients in their waiting areas.
One out of 30 patients was found to have pink eye in a small February study in China. The researchers discovered traces of the Covid-19 virus in the patient’s eye secretions. However, in another study, the AAO clarified that infection of the virus through tears is rather low.
The New England Journal of Medicine also published a study that found that, of 1 099 patients across 30 different Chinese hospitals, nine (almost 1%) had presented with “conjunctival congestion”.
Although pink eye may have been found to be a rare symptom of the virus, the AAO also said to bear in mind that pink eye can have other causes too, including other viruses, bacteria, and allergies.
*As of 31 March 2020, there are more than 1 300 confirmed cases of the new coronavirus in South Africa. Find all the updateshere.
The new coronavirus may be a respiratory bug, but it’s becoming clear that some severely ill patients sustain heart damage. And it may substantially raise their risk of death, doctors in China are reporting.
They found that among 416 patients hospitalised for severe Covid-19 infections, almost 20% developed damage to the heart muscle. More than half of those patients died.
Doctors in China have already warned that heart injuries appear common in Covid-19 patients, particularly those with existing heart disease or high blood pressure. A recent study found that 12% of hospitalised patients had the complication.
These latest findings, from a team led by Dr Bo Yang of Renmin Hospital of Wuhan University, and recently published in JAMA Cardiology, add a concerning layer: Patients who develop heart damage may face an “unexpectedly” high risk of death.
Cardiologists ready to jump in
Much remains to be learned. For one, the findings come from a single hospital in Wuhan, where the outbreak began. US experts said it’s not known whether the grim outlook will hold true at other hospitals worldwide.
“We certainly hope not,” said Dr Thomas Maddox, head of the Science and Quality Committee of the American College of Cardiology (ACC).
The ACC has already issued clinical guidance to cardiologists. Among other things, it highlights the extra risks to patients with heart disease, and tells cardiologists to be ready to jump in to assist other doctors caring for severely ill patients.
“We’re anticipating that patients with underlying cardiovascular disease will struggle,” Maddox said.
The novelty of the coronavirus means that it’s not fully clear how to best manage those hospitalised patients. Standard heart medications and devices to provide cardiac support are being used, according to Maddox.
“We are continuing to figure this out,” he said.
An important question
But the importance of prevention is more obvious than ever. Maddox said people with existing heart disease – such as a past heart attack – or a history of stroke should consider themselves at “high risk” and be vigilant about protecting themselves.
For those living in a community with a Covid-19 outbreak, that means staying home as much as possible, according to the US Centers for Disease Control and Prevention. Meanwhile, all high-risk people should wash their hands often, disinfect surfaces they routinely touch, and be serious about “social distance” if they do go out.
Among the unknowns, though, is whether people with high blood pressure might also fall into the high-risk category.
“This is an important question, and one on many people’s minds,” said Dr Elliott Antman, former president of the American Heart Association and a senior physician at Brigham and Women’s Hospital in Boston.
Of the 82 patients in this study who developed a heart injury, 60% had high blood pressure. About 30% had a previous diagnosis of coronary heart disease, while almost 15% had chronic heart failure.
Leading theories
Antman said it’s hard to tell whether high blood pressure alone – without other health issues – was a risk factor for heart injury. Plus, he said, there’s no information on whether patients’ high blood pressure was under control with medication or not.
Of patients who sustained heart damage, just over 51% died in the hospital, according to the study. That compared with 4.5% of those without heart injury.
It’s not certain, though, that the heart complication is actually what caused those deaths, Antman said. “This could all be a reflection of a very bad infection,” he explained.
Why does the coronavirus wreak havoc on some patients’ hearts?
Again, no one is sure, Maddox said. But he explained the leading theories.
Don’t stop taking prescriptions
One suspect is the immune system’s reaction to the coronavirus. If it veers out of control, in what’s called a “cytokine storm”, it can damage the body’s organs. A second possibility is that in people who already have heart disease, the overall stress of the infection harms the heart muscle.
Finally, it’s possible that the new coronavirus directly invades the heart, Maddox said. Researchers say the virus very effectively latches onto receptors on our body cells called ACE2. Those receptors are found not only in the lungs, but elsewhere in the body – including the heart and digestive tract, he explained.
There has been some speculation that common blood pressure drugs – ACE inhibitors and angiotensin receptor blockers – might make people more vulnerable to falling ill with Covid-19. But that is based only on animal research suggesting that the drugs can boost the activity of ACE2 receptors.
Maddox and Antman stressed that no one should stop taking their prescriptions, since poorly controlled high blood pressure or heart disease would be dangerous – especially now.
A lengthy WhatsApp voicenote making some outrageous claims about the coronavirus crisis is spreading like wildfire in South Africa.
In an attempt to give the voicenote credibility, an accompanying message claims the voice is that of a Groote Schuur Hospital expert.
But the voicenote was definitely not recorded by the expert, Health24 has established.
The origin of the clip is unknown and the person speaking is yet to be identified.
The accompanying text message claims: “This is a voice note from Diana Hardie the Head of Virology, Grooteschuur Hospital, Cape Town. It’s her latest data on the Corona Virus and what she is preparing for… it’s doesn’t predict a pretty short term future… (sic)”
Not her
But Dr Hardie told Health24 that the voice in the clip was not hers.
In an emailed reply, she said: “I would like to put on record that this voicenote was not from me or any other virologist at Groote Schuur Hospital.
“The CEO of Groote Schuur has issued a statement distancing themselves from it.”
The statement, circulated by the Western Cape government’s (WCG) health department, reads: “We are aware of the WhatsApp messages doing the rounds of the Head of Virology speaking about the Covid-19 scenario.
“We wish to stress that this message did not emanate from our virology department and add that this message does not represent the views or policies of the WCG: Health.
“Management regrets the confusion caused by this. We should all adhere to being responsible and heed the call to stay home.”
Health24 asked the hospital for comment but Groote Schuur Hospital communication officer Alaric Jacobs referred us to the provincial health department’s statement and said Dr Hardie would not be available for comment.
When Health24 asked if the relevant departments would attempt to establish the origin voicenote, Jacobs said the department was unclear of the source of the message, but stressed that it informed the public that the content was not the health department’s view.
Don’t give it more air time
In the voicenote, which is nearly 16 minutes long, someone claims that “a lot of things have happened within the last two weeks and I’ve kind of just been told to keep a bit quiet so we could just see exactly where things are going.
“And obviously with the president’s Station of the Nation thing, we were allowed to then, all of a sudden, you know, institute a few things and talk about the disease process because I mean, you don’t want to drive havoc and fear into everybody.”
A little bit further along, it escalates dramatically and serious allegations are made: “And the big thing that everybody needs to know is that, like, we’re probably in this pandemic and crisis because of the fact that, though China delivers a lot of stats, they’ve kept this virus under cover, you know, not wanting the economy to be affected for a long time.
“I mean the first cases are already described by them, like in June of last year, and they only let the World Health Organisation know about the virus, probably about November/December where it kind of got to a point where medical staff were insisting upon having the rest of the world know about this.”
Health24 has listened to the entire voicenote but to avoid giving it anymore air time, will not publish it or any further quotes from it.
The government has warned of repercussions for people who create and spread fake news.
On the government’s website, it clearly says: “Anyone that creates or spreads fake news about the coronavirus Covid-19 is liable for prosecution. Verify the information before you share information.”
Social media giants to play their part
Business Insider South Africa reported on Friday that spreading fake news about Covid-19, or the government’s efforts to stop its spread, is already a crime in terms of South Africa’s disaster regulations.
A six-month jail term can be imposed if it is done with the deliberate attempt to deceive.
WhatsApp, the instant messaging giant which Facebook owns, is also expected to play its part.
Under new regulations which Communications, Telecommunications and Postal Services Minister Stella Ndabeni-Abrahams gazetted on Thursday, a broad range of telecommunications players have “the responsibility to remove fake news related to Covid-19 from their platforms immediately after identified as such”.
‘Fake news tends to be more dangerous than the virus’
The three people were the alleged source of two fake news articles which went viral on social media.
The articles were about Chinese people inside a building at the Lebombo border post, who were supposedly using corrupt means to enter South Africa after they were refused entry at OR Tambo International Airport in Johannesburg. The post labelled South Africa a “banana republic”.
The other fake news article was about Japanese nationals who flew to Mozambique and tried to buy their way into South Africa, the minister said.
“Fake news tends to be more dangerous than the virus itself because it worries people.
“Because of this, and because we are in possession of the original source of the picture, I’ve instructed my officials to lay a charge with the police.
“This is the first test case of whether people posting fake news can be charged or not,” Home Affairs Minister Aaron Motsoaledi said.
For people very sick with the new coronavirus, access to a mechanical ventilator can mean life or death. Trouble is, they’re in short supply in the United States and around the world.
Now, research suggests that a widely used clot-busting stroke drug might help coronavirus patients who can’t access a ventilator or who fail to improve even when they do gain access.
Blood-clotting disorder
The research focuses on a drug called tissue plasminogen activator (tPA), which is normally used to quickly dissolve blood clots that cause strokes or heart attacks.
New data from China and Italy suggest that people with Covid-19, the disease caused by the coronavirus, have a significant blood-clotting disorder.
Patients in respiratory failure develop blood clots in the lungs and tiny blockages in the lung’s blood vessels. These tiny clots keep blood from reaching air spaces in the lungs, and that’s where blood normally receives oxygen from the lungs.
“This is a way to repurpose a drug for which there is already widespread clinical utility,” said senior researcher Dr Michael Yaffe, a professor of biology and biological engineering at Massachusetts of Institute of Technology.
Dr Hunter Moore, a transplant fellow at the University of Colorado Denver, is a study co-author.
“Everyone is looking for ways to mitigate the threat of this disease, and there’s a lot of investment and interest in new drugs,” Moore said. “But if this disease gets out of control, those drugs won’t have had safety evaluations. TPA has.”
While well-studied in stroke and heart attack, the use of tPA for acute respiratory distress syndrome has mostly been investigated in animals. A small human trial was conducted in 2001 on people with severe respiratory distress who weren’t expected to survive.
Potential therapeutic value
Moore said tPA reduced the death rate in those patients from 100% to 70%.
The researchers noted that further studies haven’t been done because people typically improve well with the support of ventilators. But as Covid-19 overwhelms the health care system, there may not be enough ventilators for patients who need them.
“TPA may potentially hold therapeutic value in treating severely ill Covid-19 patients with acute respiratory distress syndrome that is unresponsive to typical ventilation strategies,” said Dr Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.
He said the science supporting its use is sound.
“Tiny clots block small blood vessels in the lungs, preventing adequate oxygenation and ventilation,” said Glatter, who wasn’t part of the study. “The drug also prevents clots from blocking blood vessels in the kidney and heart, leading to kidney and heart failure. TPA dissolves the clots, opening up small blood vessels, improving the ability of the lungs and other critical organs to function normally.”
A ‘compassionate trial’
While bleeding is a potential risk of tPA, Glatter noted that this didn’t happen in the one study that was done.
Yaffe said researchers are planning a “compassionate use” trial of the drug on Covid-19 patients, possibly beginning within a week, to see if tPA helps these patients. They will be assessing both intravenous tPA and inhaled tPA.
A compassionate use trial allows patients with a serious or life-threatening illness to receive an investigational therapy.
Patients selected for the trial will either be on ventilators or appear to need ventilation. They will be high-risk patients who have potentially deadly acute respiratory distress syndrome.
The researchers hope to test tPA in 12 people, but will evaluate its effectiveness and safety after four patients.
Extraordinary measures
The dose of tPA they’ll use is lower than that typically prescribed for stroke or heart attack patients. It will also be delivered over a longer time period.
Yaffe said tPA’s manufacturer, Genentech, is providing the study medication for free. If the trial is successful, the drug maker has told researchers it is prepared to ramp up production.
Given the increasing rate of Covid-19 infections, the researchers hope the trial might begin as soon as next week.
“Extraordinary times call for extraordinary measures. If an observational trial of this treatment in the first series of patients is effective and safe, the approach could be readily broadened. This would have multiple patient-related and public health benefits,” the researchers said in their study.
*Published online in the Journal of Trauma and Acute Care Surgery.
As Americans empty grocery shelves over fears of possible shortages during the coronavirus pandemic, one nutritionist says healthy eating doesn’t have to fall by the wayside.
There is no need to hoard because there is plenty of food in the United States and food distributors are working to keep shelves stocked, said Diane Rigassio Radler, director of the Institute for Nutrition Interventions at Rutgers University, in New Jersey.
However, it is a good idea to have plenty of food at home to reduce the number of times you have to go grocery shopping, she added.
When you go shopping, try to go at times when stores are less crowded so that you can maintain adequate social distancing. Another option is online grocery shopping.
Maintaining your immunity
Wash your hands as soon as you get home from grocery shopping. Then unpack your bags. Wipe off packaged foods with an alcohol-based paper towel or commercial antimicrobial wipe, and wash all produce. If you have reusable bags, wash them if possible or wipe them down with an alcohol-based towel.
Follow the same routine if you order groceries online, she noted in a university news release.
Stock up on canned, frozen and dried non-perishable foods, but understand the differences. Canned foods last for years, but generally have a higher sodium content than the others. Frozen foods will last for months, but could go bad if there are power outages.
Dried foods, including dried beans, pasta, shelf-stable milk, and root vegetables (carrots, potatoes) and squashes (such as acorn or butternut) are also good foods to have at home, Rigassio Radler said.
Moderate exercise can boost immunity
A healthy diet with lots of fruits and vegetables and adequate protein and grains can help you maintain your immunity. Limit your intake of added sugar and alcohol, she advised.
Drink plenty of water, try to get 150 minutes of physical activity per week, and stay well-rested. Moderate exercise can boost immunity, and lack of sleep can weaken your immune system, Rigassio Radler said.
If you decide to go to a restaurant, maintain social distancing. Choose cooked foods rather than salad or sushi. And, most importantly, she added, always wash your hands before you eat.
How can such a miniscule packet of genetics cause such chaos around the world? And why can’t we simply eradicate it? Those are the questions on everyone’s lips as the new coronavirus outbreak is having serious consequences for everyone around the world.
What exactly is a virus?
Viruses are resilient little entities made up of proteins and genetic material that can only replicate within an environment inside another living host (such as a human or animal). Microbiologists debated in the past whether a virus can still be seen as “alive” when it has no host to infect.
Prof Nigel Brown, a microbiology expert from the University of Edinburgh, simply defines a virus as a “gift-wrapped nucleic acid”, whether it’s a DNA or RNA or whether it is single or double stranded.
And what about the coronavirus?
We now know that the Covid-19 virus is a single-stranded RNA virus with a capsid (a little cap over the virus) that connects to its host.
While it’s essentially dead (well, dormant and zombie-like) on its own, the power lies in its ability to encode inside the host and spread through saliva or droplets. We also recently learned that this particular virus can survive for at least three days on hard, non-porous surfaces such as plastic and metal, making it easy to spread, especially when people are slack about hygiene.
But why can’t we simply kill it?
The fact of the matter is, the new coronavirus called SARS-CoV-2 found a host, and spread from that host to several other hosts – and ended up causing a worldwide pandemic. It gained a steady foothold in a huge number of hosts all over the world – whether symptomatic or not. (The lack of symptoms in many people is the reason why a lock-down helps to curb the spread.)
In the case of a respiratory virus such as the Covid-19 virus, the virus has a strong foothold in two places – firstly in the nose and throat, from where it easily spreads through saliva, cough droplets and mucus, and secondly from further down in the lungs, from where it is harder to spread, although it can cause fatal damage there, especially in people with preexisting respiratory conditions.
Why does it spread so easily?
In some people who contract the virus and suffer from mild or no symptoms, it means that the virus lodged and multiplied into the nose and throat, while in the more serious cases it lodges and multiplies in the lungs.
This virus is a double-whammy, according to an article in Washington Post – it’s as contagious as a cold (if not more), and has the potential to be as lethal as coronavirus which caused the SARS outbreak in 2003.
In the case of this new virus, the incubation period tends to be longer (anywhere between one and 14 days, the median being 5.1 days) and therefore people are contracting it long before they are even aware of it.
Another thing that favours the Covid-19 virus is its size and design. It is three times bigger than other pathogens that cause diseases such as dengue fever and Zika, and can reproduce and replicate much faster.
What about other pandemics?
While we can’t compare the current coronavirus outbreak to previous influenza outbreaks, the past pandemics in history had some things in common, making them easy to spread and hard to kill.
Just like all the other great outbreaks (some were classified as pandemics, some not) – the flu outbreaks of 1918, 1957, 1968 and 2009, Ebola, SARS and MERS, the virus started out as zoonotic, which means it lived in an animal host and jumped to a human. All these viruses encode their genetic material into RNA. According to Gary Whittaker, a Cornell University professor of virology, a virus as something that can easily switch between being dead or alive.
How will we be able to fight this pandemic?
As we know now, viruses are complex, extremely clever and resilient – an antiviral that stops activity in its tracks needs to be specific to that particular virus. Right now, we don’t have a targeted cure for the Covid-19 virus, but doctors have been treating cases with existing drugs.
Experts believe that this virus is still in its early, strong phase – the ultimate goal is that is becomes like seasonal flu – not as deadly, novel or serious. It will, however, retain the ability to replicate and hang around forever.
In the meantime, the best we can do is to rely on social distancing, practicing good hygiene and flattening the so-called “curve” of the virus to prevent the vulnerable among us from contracting it. We’re hoping, therefore, that although the virus might still be around, its RNA will change in such a way that although it will survive, it will merely cause a mild infection in its host.
The information on Health24 is for educational purposes only, and is not intended as medical advice, diagnosis or treatment. If you are experiencing symptoms or need health advice, please consult a healthcare professional. See additional information.
When young adults see their annual income plummet, more than their bank accounts may suffer: New research suggests their brains may eventually pay the price.
The study found that people in their 20s and 30s who experienced “income volatility” generally performed worse on tests of thinking and memory skills once they hit middle age.
Many influences ‘upstream’
Compared with their peers with more stable incomes, their scores on one set of tests were almost four points worse, on average.
Experts stressed that the study does not prove that income fluctuations are to blame. And it’s not clear what the ultimate impact on brain health, including dementia risk, might be.
“What this shows is that income volatility in young adulthood is related to how the brain works in middle age,” said Dr Joel Salinas, a neurologist at Harvard Medical School and Massachusetts General Hospital, in Boston. “That gives signals to other researchers that this is something to look at in future studies.”
Salinas wrote an editorial published with the findings in the online edition of Neurology.
A number of studies have found that lifestyle and environment – from exercise and diet to chronic stress – may help determine how well the brain ages.
But there are many influences “upstream” of those factors, Salinas said. Things like childhood experiences, education, job opportunities, income and race can all affect whether people face chronic stress, or have a healthy diet, or exercise regularly.
Short-term strategies
Research has already uncovered links between lower income and problems with memory and thinking skills later in life. The new study focused on income instability, in part, because it’s a problem that’s becoming more common, according to lead researcher Leslie Grasset.
More than one-third of US households said their income dropped by at least 25% between 2014 and 2015.
Plus, there are relatively straightforward ways to address those income fluctuations, said Grasset, a post-doctoral associate at the INSERM Research Center, in Bordeaux, France.
“Unemployment and wage insurance have been implemented as short-term strategies to offset the burdens of income shocks,” she said.
Programmes like food stamps and the Earned Income Tax Credit, Grasset added, might help families deal with sudden income drops, too.
For the study, Grasset’s team analysed data on nearly 3 300 young U.S adults who entered a heart-health study in 1990. Twenty years later, the participants completed standard tests of memory, information processing and executive function (the brain’s ability to focus, regulate behaviour, get organised and achieve goals).
Overall, 399 participants had at least two income drops of 25% or more during the study period. Those people typically performed worse on the tests of executive function and processing speed (but not memory), versus participants with no significant income drops.
A key limitation
Why? In theory, highly educated people might enjoy more stable incomes and better brain function. But Grasset said the differences were not explained by education levels.
Nor were the findings solely due to physical health conditions, like high blood pressure, or lifestyle factors such as exercise and smoking.
A key limitation of the study, though, is timing. The researchers do not know whether the poorer mental acuity actually came first – before any income instability.
“‘Reverse causation’ cannot be ruled out as an explanation for our results,” Grasset said.
Future studies can try to address that question, Salinas said. They could look at repeated measures of mental abilities, and whether they change after periods of income loss.
“Maybe we’ll learn that it’s income volatility, more than total income, that’s important to brain health,” Salinas noted.
Why would income stability matter? Chronic stress could be one way, according to Grasset’s team. So could disruptions in health care – including any medications a person may be taking to manage high blood pressure or other chronic conditions that can ultimately affect brain health.
I remember walking into the office sometime in February, finding our head of reservations chuckling over the irony of a virus being named after a beer.
“It’s called Corona. It must be pretty severe though; the Chinese are constructing hospitals in a matter of days.” As usual I was rushing somewhere, to meet someone about something and hardly paused to soak in what she was saying.
I remember thinking about Chinese construction wonders, and the few hotels I’d seen built within 90 hours. I never considered the fear, the economic impact and the change in communities.
Fast forward a few weeks, and I was destined for my annual work trip to Berlin, Germany, for the ITB Berlin Travel Show and Berlin Travel Festival. I was excited to see industry colleagues, travel agents, partners, learn about new trends, network and get some inspiration for my travel business.
The main show was cancelled
The cherry on top was an invitation to talk at the Berlin Travel Festival about Khwela Youth Tourism Stars, a tourism non-profit I co-founded two years ago in Cape Town, focused on teaching young South African women from under-resourced communities how to work and thrive in the tourism industry.
I was scheduled to speak on the Travelmassive stage with five other inspirational speakers, under the title “Travel Changemakers” about which the organisers had already briefed me.
Four days before my departure, the main show was cancelled. It was a hot debate for weeks, with industry people taking bets about whether it would continue. After all, a travel show with over 100 000 delegates is a big deal for tourism, and a huge deal for the Berlin economy. Despite the cancellation, the consumer show (Berlin Travel Fest) was not cancelled, so I decided to continue with my travel plans. I had booked a non-refundable ticket and was staying with a friend, so at the time it seemed logical to still go.
I left Cape Town early on Monday 2 March, heading to Munich. As I was leaving Cape Town, I was texting with the organisers and the moderator of the panel discussion. Due to the cancellation of ITB, and many travel professionals already in Berlin, my friend Ian started a WhatsApp and Telegram group called #StrandedinBerlin.
He built a website showing travellers which events were happening where, and how to get on travel party guest lists. Despite the cancellation, I was optimistic. By the time I landed in Munich, the Berlin Travel Fest had been cancelled. I was dumbfounded.
Berlin was no longer carefree
The first case of corona had arrived in Berlin, in the co-working space of the Berlin Travel Fest no less. Since my bags were already on their way to Berlin, I continued my journey. The next day was a blur as my friends and colleagues went into self-quarantine as a measure, and I tried to make the most of my business trip.
The mood in Berlin was not as carefree as I knew it. A smog of seriousness hung in the air. Hastily printed signs hung in the window of the corner Apotheke (pharmacy): “NO HAND SANITIZER”
People kept their distance and commuters buried their faces into layers of scarves. I remembered my hand sanitiser from home and was conscious not to shake hands, touch surfaces, or touch my face.
On the first evening I joined travel bloggers and industry colleagues at the local pub, and we talked business, drank beer, hustled to exchange business cards and got into a heated debate with a group of female bloggers about the realities of travel stalkers.
I can’t believe this was only two weeks ago! Coronavirus was still not the topic of every conversation.
By the end of that week, two of my friends whom I hadn’t seen had tested positive and were in self-isolation. Another friend was in self-quarantine, and had asked me help him move into a rental apartment – after all, collecting key, signing for the deposit is outright impossible without coming into contact with someone. I had to leave the keys on a windowsill and wave through the glass as he fetched them.
A case of FOMO
Even after all these encounters, I was still looking forward to the weekend girls’ ski trip in Austria with a dear friend. Westendorf, a small alpine village in Austria, holds a special place in my heart.
After finishing Matric I had gone to work in Westendorf as a ski instructor and barmaid. After four seasons working there over varsity holidays, I had made friends and knew the mountain like the back of my hand. I was excited to show it to my friend and spend time reconnecting.
Somewhere in the back of my mind was that voice: “Northern Italy is so close to Austria. Is this wise?” but the counter-voice responded, “It’s only the flu. The snow will be amazing! You’re not old, you’ll be fine if you catch it.” I’ve always had a bit of a FOMO (fear of missing out) streak, so in this instance, the second voice won the argument.
Fast-forward 48 hours: My colleagues in Europe were closing business units and retrenching staff – some closing their doors for the first time in decades.
72 hours later, and I almost couldn’t get out of Austria as all trains were cancelled, and the flight board at Munich airport displayed about a quarter cancelled flights. I gave myself an extra five hours to get to the airport and made it just in time.
By the time I landed in Cape Town, I was relieved to be on home soil – but nervous for what lay ahead. As I reviewed my mental to-do list, and disembarked the Lufthansa flight, I was surprised at how full the flight still was.
Saving the business
I passed the thermometer checkpoint and was one of the only passengers in the “South African nationals” queue. The foreign nationals queue was chock-a-block. Good news for business, I thought… we don’t know what is about to hit us.
The day I arrived back there were 17 confirmed cases in South Africa, and I felt like I had been to the future – according to my calculation South Africa was about two weeks behind Germany. A week earlier when I’d left there were just over 100 confirmed cases, and on the day I left there were over 2 000. Today (a week later) there are over 9 000 cases in Germany.
I just had to read that sentence again. That’s 90X in 2 weeks. I felt obliged to tell my family and friends how quickly the “k*k” had hit the fan and make a plan to save my business.
After dropping my bags at home, I checked in at the office and discussed my thoughts and actions with my team, and business partner. My business partner was destined to leave for Europe the next day, and we had a lot of decisions to make.
On my way to collecting my kids from school, I received a WhatsApp message from the principal asking all parents who had been abroad to self-quarantine for 14 days with their children in order to minimise any risk. I was outraged.
I don’t have time for this, I thought. I need to get going on the plan. I walked into the principal’s office to ask if this was true – after all I had been in Germany, not Italy.
Hardly any symptoms
I felt furious and frustrated. I knew it was probably for the greater good, but I couldn’t warrant the personal sacrifice. I took the kids to a playdate and went home to stew. Over dinner at a local restaurant we decided it probably was the right thing to do and stocked up our house with supplies. That was six days ago – it seems like a lifetime.
Our family doctor arranged the forms for me to get tested the next morning. My hope was to get the test, prove I was negative, and go back to work.
I went to a private laboratory in town and may have been one of the first handful of tests. The team were apprehensive, yet professional. I had to argue with the administrator to get tested as I was hardly displaying any symptoms.
I mentioned the dry cough I got from the airplane, and coughed a few times – she was not impressed. I explained my mission: I needed to get back to work. She continued that I didn’t fit the full criteria, and that there were limited tests available.
I lost my sh*t.
My parents are both doctors, and I knew with a phone call I could go to any other lab and get the test. I told her that I was getting the test today, with her or with their competitor. The name dropping and “strop” did the trick and she admitted me for the test. After the adrenaline died down I felt a bit skaam as I really did overdo it a bit.
A swab ‘halfway to my brain’
Within five minutes I was called in to the nursing cubicle. I kept thinking they were really under-dressed. The administrator wasn’t even wearing a mask or gloves. That was the first time I considered the implications of being a carrier, and how horrible I would feel if I managed to transfer the virus.
The nurse came in and was handed gloves and a mask. No hazmat suit. No blue goggles. He seemed nervous, but had kind eyes. The administrator offered to hold my head so not to move as the test could be painful. It was mildly unpleasant to say the least – a swab up my nose and halfway to my brain. The nurse called it “the sweet spot”. Then there was a throat swab that made me gag.
I suddenly realised how badly this could go if I were indeed positive.
I returned to life in self-quarantine, as we awaited the results. The school health advisory body was now in constant communication with me. I was preparing my arguments in advance to bring the kids back when I tested negative.
I felt the pressure mounting to make changes in the business, and struggled to keep up with the kids, housework, chores and calls with my team.
Self-quarantine for two weeks
On the first day of self-quarantine we had six hours of load shedding – Koeberg had lost a unit, and we had three blocks a day of no electricity, no WiFi and no cellphone reception. It was trying, to say the least.
Late on Friday night our physician called with my results: The test was positive.
I felt a wave of calm wash over me as we received the news and my husband took the lead in asking a barrage of questions: Could this be a false positive? No. Can we leave the house? No. What about the people I came into contact with? They would have to go into self-quarantine for 14 days. A health official will make contact tomorrow. I heard our doctor encouraging us not to stress, that she would help us monitor our health from afar, especially our three-year-old, who had had respiratory issues as a toddler.
At that point my heart stopped. I hadn’t considered the implications of him contracting the virus. I was suddenly terrified and overcome with guilt. Should I remove myself from the family? No. There are no reported cases of deaths or severity under nine years old, and the emotional trauma would be far worse if the kids and I were separated now.
Our doctor advised us to stay anonymous to the school, as the emotional impact of angry parents and potential stigma and bullying could be traumatising to our children. We, however, decided to take an open approach, and address the parents directly and ask their support.
Kids remain top priority
We have been inundated with offers of help and support, with parcels of flowers and food chucked over the wall. For this, and all the quiet words of encouragement I am eternally grateful.
I never believed I would test positive and have sobered up to the strength of the spread. While my husband John and I are reeling with how to deal with our businesses, our children remain out top priority and we are focusing on creating a routine, taking turns cleaning the house and trying to keep healthy and exercise.
The school subsequently closed, following a number of other cases of closed schools, and the parents and the school have been supportive throughout the whole experience.
From home schooling resources, child-friendly coronavirus explanations and homemade muffins and wine – the strength of the community has shone through.
I have a feeling that we may reflect back on this time as a turning point in our humanity.
Kim Whitaker is the CEO and co-founder of Once Travel – a youth travel company that operates experiences and hub hotels for adventurous travellers and storytellers. She has set up a fund for the Team of Once in Cape Town and Once in Joburg, where friends of Once can contribute https://www.once.travel/tribe-fund/
