What is Pain

Pain is a warning system for our bodies, letting us know that there is a risk of damage happening.

Pain is complex. It might be felt as mild discomfort, severe cramping, constant dull aches or short stabbing sensations.

Pain can be classified as acute pain or chronic pain. Acute pain is short term (less than 3 months) and may include tissue damage from a back injury or ankle sprain. Generally, people with acute pain are encouraged to stay active and gradually get back to doing all everyday things, such as work or physical activity.

Persistent pain lasting three months or more is generally called chronic because in this type of pain tissue damage is not the main issue.

People can experience acute and chronic non-cancer pain in many different parts of their bodies. Some Examples of Chronic pain include:

Nerve Pain

Low Back Pain

Ankle Sprains

Acute Knee Injuries

Period Pain

Headaches

Migraine

Arthritis

 

The Process of Pain

Pain all starts with the stimulus. It could be a mechanical stimulus, such as a heavy object falling on your legs or face! Or it could be a temperature stimulus such as touching a hot item. Our nociceptors send a signal to the brain via our neurons (nerve cells) that there is danger.

Nociceptors are like transducers in a microphone. A transducer converts sound energy into electrical energy. Likewise, nociceptors convert mechanical energy into an electrical signal in our nerves which we call pain.

However, our brain has a filtration mechanism. Our brains can diminish or amplify coming in signals.  This may explain why often, injury is not equal to the amount of pain that is perceived. This is why we often hear people have a different pain threshold. Each person’s brain is trained to amplify or diminish coming in signals!

 

Pain Threshold is a personal experience.

As mentioned above pain is a warning system for our bodies, and it happens and controlled by the brain. Also, pain signals coming to the brain can be diminished or toned down to produce less pain or no pain or they can be amplified or toned up to cause more pain. For example, Pierre and Mary may both hurt their backs, picking something up from the floor. However, Mary may just rub the area and return to her activity and pain is gone within hours. In contrast, Pierre, on the other hand, may stop moving and rest for several hours and take medicine to relieve the pain, and the pain continues for days or weeks!

 

The experience of pain is individual for many reasons that are not just physical – for instance, the type of injury or where the damage has happened.  But can emotional health, for example, feeling low and depressed or excited and alert, can affect how someone feels pain.

Cultural and social expectations can also influence how a person experiences pain.

One thing we all have in common is that wherever the pain is in our bodies, our brains play an important role. The brain takes all the influences described above and mixes them together. The result is the type of pain each individual feels and also how each person responds to the pain. And that will be unique to each of us.

Even though the brain is essential to the way we feel pain, that doesn’t mean pain is ‘all in your head’.

Pain is very real.

 

Chronic Pain

For a lot of people, chronic non-cancer pain has an explainable cause. It could be the result of surgery or an injury or a symptom of a chronic condition like osteoarthritis or migraine.

But sometimes the cause of chronic pain is harder to identify because the brain keeps on producing pain even after the body tissues are restored and out of danger! Some people say it still hurts, and they must have something wrong. But that’s is just it once anything dangerous is ruled out, health professionals can explain that most things in the body are healed as well as they can be by 3 to 6 months. So ongoing pain being produced by the brain is less about structural changes in the body.

So why is the brain producing more pain when clearly the danger is no longer there? The process is complicated, but our brains have a big part to play in diminishing or amplifying these danger signals.

 

Chronic Pain and the Brain 

We are learning that many of the brain regions overlap. The experience of pain overlaps with the same circuits that are involved with your emotions and your cognitions. Stress, anger, tiredness, fighting with your spouse or your boss those same circuits in the brain involved with that negative emotion are directly connected and overlapping with those in pain. That stress, that anger, that frustration all simply amplify your overall experience of pain.

 

Facts about the Brain and Pain

1. 500 areas of the brain are turned on when we were in pain. So this means some of these 500 areas might be responsible for other functions such as hearing or smelling or knowledge etc.… For example, someone with chronic knee pain may feel more pain when he hears a negative comment or may feel less pain when he hears a positive word. If the doctor says “your knee is stuffed mate” it might hurt more or if the doctor says “this is common and many people received treatment and function normally” it may hurt less.
3. Some brain parts overlap, this may explain why you may often hear “there’s a fine line between pain and pleasure”. It is because pain and pleasure are produced by the same part of the brain. This may explain why we seek out and enjoy unpleasant experiences, such as fear-inducing rollercoasters or sad movies!

 

3. There is no pain in the joints or muscles. They only send signals to the brain. The brain decides what hurts or what doesn’t. So the way our brains are trained, from our genes, upbringing, life experiences, etc.. will determine how much pain we feel. This is why a papercut hurts so much and hurt even more while we are at work! This may also explain why people who get attacked by sharks may not feel pain because the brain is in survival escape mode, NOT pain mode.

 

4. We are bioplastic. This means your body will change as you experience chronic pain. Your body will adapt. But the good news is our brains are changeable too. Our brains are continually changing and adapting to everything happening in our lives. The longer you have pain, the brain adapts to be better and better at producing pain. However, all hope is not lost. Although the brains of people with chronic pain have changed, bioplastic changes in the brain will continue to happen until the day you die.

 

5. Our brains act as an immune system. Our immune system will attack a foreign body such as infection such as a virus or bacteria. So our brains too once they receive signals we are in danger they send out pain signals to protect us from the threat.

 

Medicines and Chronic Pain

It’s unlikely that medicines on their own will be able to completely stop chronic pain.

Medical experts recommend them only in combination with treatments such as self-management, physical activity and psychological approaches.

The following medicines can be considered by your doctor when starting to treat chronic pain:

• paracetamol
• non-steroidal anti-inflammatory drugs (NSAIDs)
• antidepressants
• anticonvulsants/antiepileptics.

 

Opioids and Chronic Pain

Opioids can be used to treat acute pain and chronic pain caused by cancer. However, their role in the management of chronic non-cancer pain is limited.

Suppose you have tried the treatments and medicines recommended when starting to treat chronic non-cancer pain but have not had enough improvement. In that case, you may be prescribed an opioid.

Opioids can improve pain and the ability to do day-to-day tasks. But this improvement is small. In fact, it is so tiny that it may not be necessary for people with chronic non-cancer pain.

Harms from taking opioids, such as constipation, nausea and sleepiness, are extremely common.

The longer someone takes opioids, the more likely it is that they will experience side effects and need to increase their dose to achieve the same pain relief (this is called tolerance). Tolerance exposes them to a greater risk of overdose leading to death.

Every day in Australia, there are, on average, 3 deaths, nearly 150 hospitalisations and 14 emergency department admissions because of harm from opioids, with far more deaths and poisoning hospitalisations attributed to pharmaceutical opioids (including codeine and oxycodone) to heroin. While opioids can decrease pain and improve function in a select group of patients, there are still harms from their use.

 

Compounding and Pain

Compounding pharmacists have been helping patients with chronic pain by dispensing customised transdermal pain medications. While avoiding the use of addictive drugs, these medications may be customised to include different types of drugs, in various dosage strengths, that are delivered simultaneously in one application. Compounded medicines using customised delivery systems help patients get the most medication possible. Transdermal pain cream compounding provides analgesics through the skin, for example, which allows for smooth, continuous drug delivery and pain relief. Transdermal treatments also bypass the digestive tract to speed delivery and reduce stomach upset.

 

Compounding can also combine multiple medications such as simple analgesics and opioids in one transdermal cream. This will increase the likelihood of treating the pain and decreasing the chance of side effects such as constipation, fatigue and tolerance.

 

Talk to your health professional.

The aim of the blog to demonstrate pain is complex, and many factors will influence how much pain a person will feel. Discuss with your GP

• Benefits and harms of medicines
• develop a health plan
• discuss treatments that don’t involve drugs and other pain medicines that may help reduce pain and improve your quality of life and ability to do things

 

[vc_row][vc_column][vc_column_text]Natural supplements include vitamins, minerals, herbs and nutrients. Natural supplements are often grouped under the umbrella of complementary medicines. They have a role in complementing traditional medicines, maintaining health, preventing disease and easing disease. Complimentary Medicine therapy is best done in a partnership with your practitioner, as there are many factors to consider. This blog will discuss four main points:

1. Essential nutrients that our bodies cannot manufacture,
2. Variation in dosing and evidence of complementary medicines,
3. Drug interactions between complementary medicines and conventional medications and
4. Why compounding can be an excellent option for some people.

 

Essential Nutrients

 An essential nutrient is a substance that the body requires but which it cannot produce itself. Vitamins and essential minerals are used continuously by the body for multiple purposes such as

1. energy and metabolism
2. Making and maintaining blood, skin, muscle and bone,
3. Making Genetic material, proteins and enzymes to support cell growth and reproduction.
4. Supporting the body’s physical and cognitive capabilities.

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Essential Vitamins, Minerals and Fatty Acids include:[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/4″][vc_column_text]Vitamins 

Biotin

Folic acid

Niacin

Pantothenate

Riboflavin

Thiamine

Vitamin A

Vitamin B12

Vitamin B6

Vitamin C

Vitamin D

Vitamin E

Vitamin K[/vc_column_text][/vc_column][vc_column width=”1/4″][vc_column_text]Minerals 

Calcium

Chloride

Chromium

Cobalt

Copper

Iodine

Iron

Magnesium

Manganese

Molybdenum

Phosphorus

Potassium

Selenium

Sodium

Zinc[/vc_column_text][/vc_column][vc_column width=”1/4″][vc_column_text]Fatty Acids 

A-Linolenic Acid (Omega-3)

Linoleic Acid (Omega-6)[/vc_column_text][/vc_column][vc_column width=”1/4″][vc_column_text]Amino Acids 

Isoleucine

Leucine

Lysine

Methionine

Phenylalanine

Threonine

Tryptophan

Valine

Histidine[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Australian Health and Wellness Recommendations

The government recommendation is a minimum of five serves per day of vegetables and two serves per day of fruit to meet the recommended daily amount of vitamins and minerals required to help prevent disease.

Recent national nutrition surveys indicate that most Australians fall short of the recommended intake of many vitamins and minerals. Nutrient shortfalls have health consequences that could impact daily life and overall wellbeing.

The surveys sourced from the Australian Bauru of Statics (ABS) tell us 50% of adults and 68% of children ate sufficient serves of fruit, and 7% of adults and 5% of children ate adequate serves of vegetables. Adults aged 65–74, 60% had a sufficient fruit intake, and 11% had an adequate vegetable intake. Children aged 2–3, 97% ate enough serves of fruit, and 20% ate sufficient serves of vegetables. Overall, 5% of adults had an adequate intake of both fruit and vegetables. Women were more likely to eat enough fruit and vegetables than men (8% compared with 3%).

 

Dosing of Natural products

Many of the supplements available on the market are formulated as compounds called “salts”. For example, Magnesium Oxide is a different “salt” to magnesium citrate or Magnesium Glycinate. Each of these compounds will have an unusual amount of Magnesium in them, known as elemental Magnesium. For example, 1g of Magnesium Oxide will have a different amount of elemental Magnesium compared to 1g of Magnesium Glycinate. To be precise 1g of Magnesium Oxide contains 0.61g of elemental Magnesium (61%) whereas Magnesium Glycinate contains 0.141g (14.1%).

However, this does not mean that you get more elemental Magnesium from taking Magnesium Oxide. Your body will affect different chemicals in different ways, leading to less or more absorption into your bloodstream. Factors such as molecule size, the water solubility of the molecule, pH (acidity), etc.… will determine how much of the mineral will be absorbed. In fact, you are more likely to consume more elemental Magnesium out of Magnesium Glycinate than Magnesium Oxide because Magnesium Glycinate is a better-absorbed form of Magnesium.

 

Dosing and Indications

When you take a mineral or a vitamin, the dose matters. This is because simply a different dose is required for various ailments. For example, if we continue with the Magnesium example, Magnesium is indicated for multiple diseases. Each illness such as cramps, High Blood Pressure, PMS, migraines and others require a different dose of Magnesium.

These are some examples of the dosage required for different ailments.

Night Cramps: 300mg of Elemental Magnesium daily

Migraine Prevention: 300mg of Elemental Magnesium daily with other B Vitamins

High Blood Pressure: 300-600mg of Elemental Magnesium daily

PMS: 260mg of Elemental Magnesium Daily

 

The Evidence of Complementary Medicine

In Complementary medicine, as with all medication, knowledge was initially held by practitioners and based on careful observations collected over time, that education was practised. Eventually, practitioners wrote down their findings and some produced textbooks. However, in the last century with the advance of scientific evidence and research. The expectation of proof has been amplified. Today medications are expected to go through trials in the lab and if successful large-scale testing is performed on large patient numbers before the medicine is available on the market. However, complementary medicines still draw evidence from the traditional method that was gathered from observations by practitioners over the centuries before the scientific advances. However, there are large scale scientific studies with certain complementary medicines. Hence, as the reader can appreciate the level and quality of evidence will vary significantly from one complementary medication to another. Best to ask your practitioner what is the level of evidence before starting a complementary medicine.

 

Benefits

Combined with a healthy diet, the rational use of nutritional supplements may substantially contribute to health promotion and disease prevention at all stages of life. These are some examples:

1. Prenatal multivitamins with minerals are commonly prescribed to address increased nutrient needs during pregnancy and to protect against some birth defects.
2. Calcium and vitamin D help build optimum bone mass during childhood and adolescence and also reduce the rate of bone loss that naturally occurs with aging.
3. Vitamin and mineral supplements have been shown to improve immune function in adults and the elderly.
4. Antioxidant supplements have been shown to have a positive impact on eye health and cognitive function in the elderly.

In addition to treating nutritional deficiencies, nutrients can also be used therapeutically to address the many underlying physical factors that contribute to disease. Nutrients can regulate the levels of essential chemicals in the body, influence hormonal balance, reduce inflammation, improve immune function, reduce levels of toxic elements, reduce oxidative stress, and alter gene expression.

 

Drug Interactions

If there is one thing a patient/consumer should ask their pharmacist about complementary medicines, it is drug interactions. Complimentary medications can interact with conventional prescription or non-prescription medications.

Many different drug interactions could take place between complementary and conventional medications. Still, they can be categorised under 2 categories.

1. What the body does to the medication(s).
2. What the medication(s) does to the body.

 

1.What the body does to the medications drug interactions.

When a person takes a medicine (conventional or complimentary), the body will absorb it into the bloodstream. The body will distribute it to all different body parts. Break it down (metabolism) by the liver to remove any harmful chemicals and then excrete it through the kidney or the liver. As you can imagine, some medications can disturb these processes of absorption, distribution, metabolism and excretion. If a complementary medicine, for example, induces a liver enzyme by making it work harder, this may lead to an increased breakdown of a conventional medication. Such an instance occurs between St. John’s Wort and Digoxin. St. John’s Wort is a complementary medicine used for major depression, but it induces an enzyme called P-gp. P-gp is an enzyme system in the liver responsible for breaking down (metabolising) Digoxin, a medication used for patients with heart failure and heart rhythm disorders. By taking St. John’s Wort with Digoxin, this will lead to a decreased level of Digoxin. Since P-gp is induced by St. John’s Wort leading to a more rapid breakdown of Digoxin. In such cases, the patient may need to stop St. John’s Wort or find an alternative or increase the dose of Digoxin if the doctor wishes to continue the therapy of both medications.

 

2.What the medication(s) does to the body type of interaction.

The reason we take medication is to have a physiological effect on our body. Examples of such ideas may be to lower the blood pressure or dilate our blood vessels or increase the flow of urine etc….

For instance, taking a complementary medicine and conventional medicine which both dilate the blood vessels will have a doubling effect. Such example is Ginkgo Bilboa, a complementary medicine used as an anti-oxidant and Nifedipine, which is a prescription medicine used to lower high blood pressure. They both dilate our blood vessels. Taking them together will lead to a double effect. Having over dilated blood vessels may lead to headaches or a racing heart!

 

Compounding and Nutraceuticals

Compounding of complementary medicines, especially nutrients, can be of great benefit for some patients. Compounding can often reduce the number of capsules required, as multiple nutrients can be incorporated into one capsule or liquid. Compounding can also be used when fillers or sugars or preservatives or allergens need to be removed from a commercial product. Compounding can be of use even when a specific dose is required. Last but not least compounding can be used to adjust flavour and palatability.[/vc_column_text][/vc_column][/vc_row]

Introduction

The common cold and influenza (the flu) are viral infections of the upper respiratory tract. They have many overlapping symptoms. Both are acute illnesses, highly contagious and spread by respiratory droplets; and affect people of all ages. Your Pharmacist is ideally placed to assist you in managing your symptoms and provide education to minimise the spread of infection.

 

What is the difference between the common cold and influenza?

The common cold and influenza are caused by different viruses, and only influenza can be prevented by a vaccine.

There are over 200 viruses known to cause the common cold; the most common being rhinoviruses (30–50%), coronaviruses (10–15%) (NOT COVID-19), adenoviruses (5%) and respiratory syncytial virus. In contrast, influenza viruses belong to three types of influenza viruses that infect humans are influenza A, B, and C.

The common cold is the most prevalent, contagious disease in Australia. On average, adults develop between two and four colds each year, while children experience six to eight each year. There is no vaccine available to protect individuals against the common cold.

Colds and flu are both spread by inhaling airborne droplets expelled when an infected individual sneezes or coughs, or by direct contact with

infected secretions from contaminated surfaces.

Viruses of the common cold can survive for 2 hours to 7 days, while influenza viruses can survive for up to 2 days on inanimate surfaces.

 

Symptoms of the common cold and The Flu

Common Cold symptoms develop gradually. They can include a sore throat, nasal congestion and discharge, sneezing, cough, malaise, hoarseness and sometimes a headache and/or low-grade fever. Symptoms can vary between individuals and for different cold infections. In contrast, the symptoms of influenza present abruptly, and can include symptoms of a cold plus fever (≥37.8 °C), muscle aches, joint pain, chesty cough and loss of appetite. Diarrhoea, nausea and vomiting can also occur.

 

Complications of Colds and Flu

While colds and flu are generally self-limiting in healthy individuals, both can lead to complications.  Complications can include, middle ear infections (more common in children), bronchitis, pneumonia and sinus infections. Both can aggravate existing long term conditions such as asthma and chronic obstructive pulmonary disease (COPD).

While the common cold is rarely life-threatening, influenza can be severe and fatal. In Australia over the past five years, on average over 2,000 people have been hospitalised and 378 people have died each year from influenza.

 

Flu Vaccination

Influenza (the flu) is a very contagious infection of the airways. It can especially be severe for babies, people over 65 years of age and pregnant women.

Symptoms of the flu include sudden high fever (102°F/39°C to 104°F/40°C), chills, muscle aches, runny/congested nose, sore throat, dry cough, headache and extreme fatigue. Kids may also have other symptoms such as earaches, diarrhea, throwing up and leg or back pain.

Vaccination is a safe and effective way to protect you from serious disease caused by influenza.

By getting vaccinated against influenza, you can also help protect other people, especially people who are too sick or too young to be treated. The more people who are vaccinated in your community, the less likely the disease will spread, this is also known as “Herd Immunity”

 

One of the worst influenza seasons on record was in 2019, with over 308,000 confirmed cases of influenza in Australia. It was atypical, with the season hitting early and maintaining through the warmer months.

In Australia, influenza is a considerable burden, particularly in 2019, over 800 Australians died as a result of influenza.

 

Vaccination Time

Annual vaccination is recommended before the onset of each influenza season. Optimal protection against influenza occurs after two weeks and continues for the first 3 to 4 months following vaccination. Protection is generally expected to last for the whole season. Those over 65 receive a specially enhanced vaccine.

With the period of peak influenza circulation for the majority of Australia occurring from June to September, April is a suitable month for immunisation to commence. In saying that, it is never too late to vaccinate since influenza can circulate all year round.

People at high risk such as pregnant women, it’s also never too early in the season to vaccinate. It’s also important to note that receiving a second vaccination in a season is not contraindicated. Indeed Australians travelling during the Northern Hemisphere influenza season are strongly recommended to receive the current Australian influenza vaccine two weeks before leaving.

Those who have already received a current Southern Hemisphere influenza vaccine and are travelling later in the

year to the Northern Hemisphere are recommended to receive a second dose of an influenza vaccine within the same year.

 

Flu Vaccine Effectiveness

While vaccinating many of my patients, I realise they have high expectations, such as 100% effectiveness and no side effects! Unfortunately, the flu vaccine is NOT 100% effective, and it may take about 2 weeks to develop immunity following vaccination. But one thing is for sure, the FLU VACCINE will NOT give you the FLU!

The virus’ ability to change and mutate means that while it’s the most effective form of prevention, other measures such as hand hygiene and avoiding crowded areas when unwell, can all reduce transmission. Antivirals are all also available on prescription and can be used for institutional outbreak control as an aide to other measures. Ideally, it should be started within 24 hours after the onset of symptoms.

Adverse effects, such as sore arm and flu-like symptoms, are the most common side effects. There are other possible side effects which are discussed before vaccination. The flu vaccine can also be fatal, but this is rare.

 

Flu Vaccination and Allergy

Previously, the flu vaccination was not recommended for children with egg allergies; however, research has shown that it may be OK for many kids with egg allergies, and there are specific guidelines around this.

If your child has had a reaction to any vaccination before, has had any allergic or hypersensitivity reaction or known allergy to egg (including symptoms such as rash/hives, swelling or difficulty breathing), or has an allergy to any component of the vaccine, you should discuss flu vaccine options with your doctor.

 

Strengthen your immunity

To strengthen your immunity and increase your chances to prevent the cold and flu viruses, you should consider the following.

 

1. Get a flu vaccination
2. Wash your hands
3. Use Humidifiers/Vaporisers
4. Get plenty of sleep
5. Drink lots of water
6. Good nutrition
7. Regular Exercise
8. Spend time outdoors
9. Manage your stress
10. Avoid stimulants such as energy drinks

 

Compounding Options

Compounding Nasal Inhalations and Ointments using ingredients such as Menthol, camphor, eucalyptus oil, and chlorbutol may be an option during the cold and flu season. Traditional compounding formulas have effective multi-symptom relief from aggravating cold symptoms. Compounding is tailored based on the patient’s needs. Ask your Pharmacist for discussion on compounding options if commercial products are not available or suitable.

 

Complementary therapies

Complementary therapies commonly used for colds and flu include echinacea, vitamin C, zinc and probiotics.

 

Echinacea – Current evidence does not support the use Echinacea to prevent or reduce the duration of the cold

 

Vitamin C – A review found that regular supplementation with Vitamin C reduced both cold duration (8% in adults and 14% in children) and severity.

It also reduced the chance of getting a cold in marathon runners, skiers and soldiers who were exposed to extreme physical activity but the not the general public.

 

Probiotics – Low-quality evidence suggests that regular treatment may help reduce the risk of upper respiratory tract infections.

 

Zinc – Evidence suggests that doses of ≥75 mg/day, given in the first 24  hours of symptoms, reduce the duration of symptoms of healthy individuals

 

What is Coronavirus?

In December 2019. The Chinese authorities notified the world that a virus was spreading through their communities. In the following months, it spread to other countries with cases doubling within days. This virus is a severe acute respiratory syndrome. This virus is named coronavirus 2 (SARs was Coronavirus 1). Coronavirus 2 causes the disease Covid-19 and that everyone simply calls coronavirus.

 

How the Coronavirus Spreads

A virus is really just a hull around genetic material and a few proteins arguably not even a living thing. It can only make more of itself by entering a living cell. It may spread when people cough dropping droplets on surfaces. They could be in the air or on a surface that you touch before touching your eyes, nose, or mouth. That gives the virus a passage to the mucous membranes in your throat. Within 14 days, your immune system may respond with early symptoms like a sore throat, a fever, or a dry cough.

 

The Mechanism by the Coronavirus infects human cells.

A virus infects your body by entering healthy cells. There, the invader makes copies of itself and multiplies throughout your body.

The new coronavirus latches its spiky surface proteins to receptors on healthy cells, especially those in your lungs.

Specifically, the viral proteins bust into cells through ACE2 receptors. Once inside, the coronavirus hijacks healthy cells and takes command. Eventually, it kills some of the healthy cells.

The virus moves down your respiratory tract, which is your airways (mouth, nose, throat, and lungs). Your lower airways have more ACE2 receptors than the rest of your respiratory tract. So COVID-19 is more likely to go deeper than viruses like the common cold.

Your lungs might become inflamed, making it tough for you to breathe. This can lead to pneumonia.

 

How sick does the coronavirus make you?

For most people, the symptoms end with a cough and a fever. More than 8 in 10 cases are mild. But for some, the infection gets more severe. About 5 to 8 days after symptoms begin, they have shortness of breath (known as dyspnea). Acute respiratory distress syndrome (ARDS) occurs a few days later.

ARDS can cause rapid breathing, a fast heart rate, dizziness, and sweating. It damages the tissues and blood vessels in your alveoli, causing debris to collect inside them. This makes it harder or even impossible for you to breathe.

Many people who get ARDS need help to breathe from a machine called a ventilator.

As fluid collects in your lungs, they carry less oxygen to your blood. That means your blood may not supply your organs with enough oxygen to survive. This can cause your kidneys, lungs, and liver to shut down and stop working.

Some people who have COVID-19 also get dangerous blood clots, including in their legs, lungs, and arteries.

Not everyone who has COVID-19 has these severe complications. And not everyone needs medical care. But if your symptoms include trouble breathing, get help right away.

 

How bad is this pandemic?

Fast pandemic is a horrible pandemic and will cost many lives, a slow epidemic will not be remembered by history. This pandemic will only be harmful if it is allowed to spread fast. A fast outbreak begins with a very rapid rate of infection because there are no countermeasures in place to slow it down. Many people get sick at the same time if the numbers get too large, Healthcare Systems become unable to handle eight. There aren’t enough resources like medical staff, nor hospital beds nor equipment like ventilators to deal with it. Luckily in Australia, the pandemic has been slowed down by the fast action taken by the authorities.

 

Fast Pandemic cost lives

A fast pandemic means people will die untreated, and as more healthcare workers get sick themselves the capacity of Health Care Systems Fails, even further. If this becomes the case, then horrible decisions will have to be made about who gets to live and who doesn’t. As seen overseas, the number of deaths rises significantly.

 

Social Behaviour Saves Lives

To prevent such a scenario as a fast pandemic, this means we all need to do what we can to turn this into a slow pandemic. Especially in the early phase so that everyone who gets sick can get treatment and there’s no crunch point with overwhelmed hospitals since we don’t have a vaccine. We have to socially engineer our behaviour to act like a social vaccine. This simply means two things, not getting infected and not infecting others. Although it sounds trivial, the very best thing you can do is to wash your hands with soap. This is actually a powerful tool, the coronavirus is encased in what is basically a layer of fat, soap breaks that fat apart and leaves it unable to infect you. It also makes your hand slippery, and with the mechanical motions of washing, viruses are ripped away. The next thing is social distancing, which is not a pleasant experience. Still, the right thing to do, this means no hugging, no handshakes, and staying at home to protect those who need to be out for society to function from doctors to Cashiers or police officers.

There are quarantines which can mean different things from travel restrictions or actual orders to stay at home. Quarantines are not pleasant to experience and certainly not popular, but they buy us time. So if you are put under quarantine, you should understand why and respect it. None of this is fun. But looking at the big picture, it is a minimal price to pay.

The question of how pandemics end depends on how they start. If the epidemic starts fast with a steep slope, the epidemic ends badly. If the epidemic begins slowly with a not so steep slope, the pandemic end okay and in this day and age, it really is in all of our hands.

 

Flu Vaccination and COVID-19

Health authorities are predicting both the influenza virus and COVIC-19 will co-circulate during the Australian winter months. Both are infections that affect the lung and overlap in symptoms.

People should have the influenza vaccine before the onset of each influenza season. In most areas of Australia, peak influenza season is from June-September. People caring for young, older or vulnerable people should be vaccinated immediately. People aged over 65 or older should almost definitely be immunised with a particular flu vaccine Fluad Quad® boosting immunity. If unvaccinated while influenza viruses circulate, there is benefit in the vaccine, irrespective of time left in the season.

Revaccination later in the same season year is not recommended; however, for some individuals, it may be appropriate such as travellers and pregnant women.

 

Face Masks

Masks use effectiveness is controversial, and its role is limited. Face masks are associated with low adherence and may provide a false sense of security. Individuals not used to wearing a mask will likely touch their faces more frequently and increase the chances of infection.

Disposable respirators (e.g. P2, N95) are designed to protect wearers from infection aerosols. Respirators can filter approximately 94% of particles less than 5 microns in size.

Australian Government states individuals need not wear a face mask unless directly caring for a person with suspected COVID-19.

 

Hand Sanitisers

Handwashing remains the cornerstone of infection control for this coronavirus. However, alcohol-based hand rubs (Sanitisers) (containing between 60-80% v/v ethanol or equivalent) is effective in reducing virus transmission.

The TGA has made exceptions to the regulation of hand sanitisers due to the high demand of hand sanitisers during the pandemic.

The following is posted on the TGA website (https://www.tga.gov.au/hand-sanitisers-and-covid-19)

On 28 March 2020, specified hand sanitiser formulations were excluded from TGA regulation, as long as they only contain particular ingredients in particular quantities in the final formulation, and comply with certain manufacturing practices, and advertisement and labelling conditions. Provided that the exact formulation and other requirements are followed, this formulation is permitted for use in both healthcare facilities and consumer use.

This exclusion will facilitate the urgent and continued supply of large volumes of hand sanitisers in Australia.

The formulations are based on advice by the World Health Organization and similar decisions by the US Food and Drug Administration. The final formulation of the hand sanitiser must contain only the following ingredients:

• EITHER ethanol 80% v/v (pharmacopoeial grade or food standard grade) OR isopropyl alcohol 75% v/v (pharmacopoeial grade) in an aqueous solution;
• sterile distilled water or boiled cold water;
• glycerol 1.45% v/v (pharmacopoeial grade);
• hydrogen peroxide 0.125% v/v (pharmacopoeial grade); and
• does not contain any other active or inactive ingredients, including colours, fragrances or emollients.

There are strict requirements for labelling of these products. Manufacturers must also test the alcohol concentrations of each batch, manufacture under sanitary conditions and maintain production record-keeping. The legislation enabling production of these sanitisers is the Therapeutic Goods (Excluded Goods – Hand Sanitisers) Determination 2020.

The products will continue to be regulated as consumer goods under Australian Consumer Law. Manufacture of this product is not considered compounding.