COVID 19 AND SICKLE CELL DISEASE

Dr. Adesoye Tosin
Posted March 27, 2020 from Nigeria

 

COVID-19  DISEASE 

COVID-19 disease is an infectious disease which is caused by the new Corona virus also known as severe acute respiratory syndrome Corona virus 2 (SARS CoV 2) which was just discovered in 2019.   WHO recently declared COVID-19 a pandemic.Being a new disease that is recently exposed to humans, details about the spread,transmission,symptoms,treatment, complication will be updated as time goes on and more studies are being done.

Modes of Transmission 

1. Via Respiratory Droplets released while coughing and sneezing      These respiratory droplets coughed or sneezed out can stay on surfaces for hours . Touching such surfaces and then touching one's  face without washing hands or disinfecting  can transmit the infection

2. Via Direct  Contact: close contact with infected persons e.g touching or caring for an infected person can transmit the infection

Incubation period 

   This is the period between  exposure to infection and appearance of first symptom and this can be between 2  for 14days for COVID-19 

  Infected people should be more contagious after onset of  symptoms but due to how highly contagious COVID-19 is and the fact that a good number of affected people have no or mild symptoms ,there have been suspicions that there could be asymptomatic transmission of Corona virus and possibility of asymptomatic carriers so some studies are ongoing on these possibilities .

Symptoms of COVID-19 infection 

Fever, Cough, difficulty in breathing.  Other symptoms include fatigue, muscle pain,sore throat, diarrhoea, vomiting ,nausea,headache, nasal congestion,chills, loss of sense of smell or/and taste etc

Note: Many infected people only have  mild disease and  then recover but some end up having fatal disease which may lead to death .  Severe disease is common in people who are high risk like the elderly, people with chronic diseases,people on steroids or cancer chemotherapy, smokers,people living with sickle cell disease etc

Treatment  Treatment is mainly symptomatic and supportive  No drugs have been specifically approved for the treatment of COVID-19 but some drugs have been recommended by some national medical authorities for supportive treatment 

Complications  1. Pneumonia 2. Respiratory Failure  3.Multiple Organ Failure  4. Death 

SICKLE CELL DISEASE

   People living with sickle cell disease are categorized as high risk when it comes to COVID-19 disease because they have a high risk of having a severe disease if they ever contract COVID-19 disease regardless of their ages.This is because majority of people living with sickle cell disease are immunocompromised,the reason they have a low immunity is explained below

  Spleen is an organ which is part of the body's immune system. It's called a blood filter. It helps in the clearance of microorganisms that cause infections amidst other functions.   In sickle cell disease ,the abnormal sickled red blood cells that occlude blood vessels also impair blood supply to the spleen making it malfunction and causing it to die(splenic infarction). It starts by scarring then it shrinks and stops functioning; functional asplenia. Majority of sickle cell warriors lose their spleen before the age of 7yrs.    So the absent spleen or malfunctioning spleen as the case may be is responsible for  the low immunity in sickle cell disease.  

HOW PEOPLE LIVING WITH SICKLE CELL DISEASE CAN AVOID GETTING INFECTED   people living with sickle cell disease should employ the following prevention strategies:

1. SOCIAL DISTANCING 

i. STAY AT HOME WARRIORS!   As a high risk that you are, it is essential that you don't take chances.Put yourself on a personal lockdown 

Note: For those that work and are still expected to go to work    -if you can work from home,get permission to do that   -if not, get a medical report stating your health status and high risk state and why you need to be extra careful and stay at home   - If your management still doesn't grant your request, still stay at home regardless ‍♀️ you are more important   -For students, I'm aware all schools in the country are closed down at the moment ,so no issues.

iii. When you have to go out and interact with people, maintain a distance of at least 6fts . No hugging, no handshaking,no standing side by side to take pictures  etc Preferably, greet people by waving, nodding, bowing or namaste

iv.  Cancel all social gatherings and avoid crowded places 

2. Don't be in physical contact with anyone with travel history or contact with a person who has been diagnosed of COVID-19 disease if they have not been isolated or tested negative to Corona virus. 

3. HYGIENE 

a. Wash your hands with soap and water for at least 20seconds especially after blowing your nose,coughing,sneezing,before and after eating or cooking,toilet use,after touching surfaces ,

b. Use hand sanitizers with at least 60% alcohol in the absence of soap and water. Wash your hands with soap and water if it is soiled

c. Avoid touching your mouth, eyes and nose with unwashed hands 

d. Cough or sneeze into bent elbow or tissue then discard tissue 

e. You can also use face mask when you cough or sneeze, also stay at least 6fts away from ppl to avoid infecting others and don't forget to  seek medical attention.

f. Cleaning and disinfection of frequently touched surfaces

TIPS FOR A SUCCESSFUL LOCKDOWN 

1. Get all  your essential needs, food ,water, groceries   for like a period of 2months or more so that even if you will hardly need to go out 

2. Get your Doctor's phone number if you do not have it so that you don't have to visit the clinic except it is absolutely necessary 

3. Get your prescription drugs that will last you for at least 3 months ,this is very important 

ii. Stop visitations to your house and vice versa    Tell all your expected visitors that they are not allowed to visit you this period. Explain the fact that you are high risk if they refuse to understand your strictness with the lock down

4. Find ways to manage your health to avoid crises and hospitalisations this period by following the instructions below

a. Do not miss your routine drugs e.g folic acid, multivitamins ,antimalarial prophylaxis ,penicillin prophylaxis, hydroxyurea etc as it is applicable to you

b. Adequate hydration 

c. Eat a healthy and balanced diet

d. Try to sleep Adequately

e. Avoid all avoidable triggers of sickle cell crises like cold, stress,undue exertion,heat,emotional disturbance etc

f.  For those that can tolerate exercise , you can exercise within your limits but ensure adequate rest and hydration in between exercise.  For those that can't tolerate much exercise. Walking around the house for a period of time daily might just be enough exercise for you 

g. Sleep under insecticide treated net, use insecticide sprays,keep a clean and dry environment etc to avoid malaria infection 

5. There is a need to specially educate your family members that you live with on the pandemic,your high risk status,their need to follow all these guidelines carefully for themselves and for you.

TIPS FOR COPING WITH MENTAL STRESS AND BOREDOM DURING A PANDEMIC 

  A disease outbreak can usually be associated with panic,anxiety and fear, while staying at home is usually associated with boredom

 People living with sickle cell disease need to carefully handle the mental stress because emotional disturbance is a trigger for sickle cell crises which is the last thing we want during a lock down

1. As much as it is good to keep yourself reliably informed ,If too much fear is creeping in due to the pandemic ,you might consciously stay away from the news ,social media and info about the pandemic to keep your sanity for a period of time

2. Plan your daily activities to make it more interesting which could include reading , watching movies, exercising,writing,learning a recipe ,music , social media content production, online learning etc

3. Make a list of things you enjoy doing and deliberately include them in your activities 

4. Keep in contact with friends and family, talk to them via phones , video calls and social media in general. 

5. Activities like yoga,meditation ,religious prayers can also help ease mental stress

6. Exercise can also help (make sure you exercise within your limit to avoid triggering a crisis

7. Joining fun social media groups you can relate to might be helpful

8. If you still feel mentally stressed after doing all these then you should consider talking to a professional preferably over the phone.

                                          

Comments 10

Log in or register to post comments
Jill Langhus
Mar 28
Mar 28

Hi Dr. Tosin,

How are you and your family? Thanks for sharing this very informative, as well as solution-based post. I love that you included what to do for boredom and stress, as these are important factors to consider.

This is the link for the story call, if you would like to be considered, too:
https://www.worldpulse.com/raise-your-voice/dispatches-covid-19-pandemic...

Dr. Adesoye Tosin
Mar 28
Mar 28

Posted, do I have to delete this so that it won't be a duplication of posts

Jill Langhus
Mar 30
Mar 30

No, you don't need to delete it.

otahelp
Mar 28
Mar 28

thank you Tosin for sharing how to stay safe during this period. we appreciate you

Dr. Adesoye Tosin
Mar 28
Mar 28

Thanks

Anita Shrestha
Mar 29
Mar 29

Great sharing

Hello, Dr. Tosin,

Thank you for this information. I hope all is well with you and your family. Please continue to update us.

Dr. Adesoye Tosin
Mar 31
Mar 31

All is well, hope all is well with you too? Thank you

All is well with us here, too, Doc. Tosin. You are welcome. God bless you always.

Paulina Nayra
Apr 04
Apr 04

Dear Dr Tosin,
Thank you for this comprehensive information about COVID-19 and how we can protect ourselves especially those who are immunocompromised. Sharing this on World Pulse is a great way to spread the word to our sisters all over. Take care.
Hugggs.