ISPP 2015

Career Opportunities in Pharmacy


welcome to another MedCram lecture
we’re going to talk about the coronavirus update and we see here
75,000 total confirmed cases based on the data from the w8 show and CDC coming
out of China total deaths over 2000 total recovered 14,000 772 if we look at
the roll domitor as it’s correctly pronounced we can see here there’s
active inactive cases the closed case is sixteen thousand eight hundred and
fourteen eighty eight percent of those have been recovered or discharged and 12
percent deaths in the closed cases so far
of course these numbers are been reported as most of those cases were mild cases
however if we break those cases down again into the difference between what’s
going on in China what’s going on outside of China we can get another
picture you can see here the trends is that every day there seems to be more
and more new cases whereas inside of China the number of cases are actually
diminishing as we can see here overall if we go up to total deaths over 2,000
deaths total I want to talk a little bit about what’s going on in terms of what
the labs are doing to fight coronavirus the kovat 19 disease specifically nice
interview here on NPR regarding antibodies first one to talk a little
bit about antibodies and how they’re made so you have these b-cells and they
each have different receptors on these b-cells these b-cells are made to do one
thing really and that is to make antibodies and these receptors on the
cells are there to receive any type of antigen that you might come in contact
with an antigen could be a protein of a virus or approaching of a bacteria etc
etc and what is really quite amazing is that you have so many different types of
receptors on millions and millions of b-cells that’s just about any kind of
foreign protein that gets introduced into your body will make a b-cell
against that and so here we can see that each b-cell has a different antigen
receptor and the antigen receptors of only one b-cell will combine with that
antigen so if you have a virus that virus is going to stimulate its
particular b-cell and it will activate and it will get help from t-cells
cytokines and it will cause this cell to divide and rapidly enlarge into a huge
clonal representation of that b-cell so you have thousands millions of these
b-cells and all these b-cells do is they produce antibodies and these antibodies
go out and attack cells that have the virus in it or the virus itself and
finally when the action is done then these b-cells just
kind of go away but there’s always a certain amount of a population of these
b-cells ready to strike again if that virus comes again and this is typically
how it works with a particular virus so if you get a vaccine against the virus
like polio if you get a vaccine against the virus like the hepatitis B virus
that vaccine goes through the same way here you get an antigen stimulating a
b-cell of course when we give a vaccine in some of the cases we give a vaccine
that has just the protein without the virus so you don’t get the actual
disease and that causes your b-cells to make a lot of these antibodies in
preparation for if you ever were to be infected with that virus you’ll be ready
to make an immune response of course sometimes what happens is the virus may
mutate and so that the proteins are different enough that the antibodies
that you have against those proteins may not be as effective and this is kind of
what happens with colds you might get multiple colds in a year and it’s
possibly because while it could be a different virus a rhinovirus versus a
regular corona virus or it could be a rhinovirus that’s mutated enough so that
the former immunization that you got against the virus is no longer effective
because it’s mutated well going back to this interview what they’re looking at
is drugs that will prevent the virus from replicating but there’s an
interesting company that they’re looking at called AB cell era which they
identify antibodies from patients who have already recovered from infection
because they’re finely tuned immune systems have already figured out a way
to clear the virus and so what they can do is they can look through millions of
different immune cells and find the one that is right for corona virus in fact
what they’ve done and this is kind of amazing as they’ve taken mice and
instead of making Mouse antibodies these mice are actually using human immune
system cells to make not Mouse antibodies but to actually make fully
human antibodies and that’s just amazing so of course the next step is to inject
these corona viruses into these mice and start getting these antibodies out and
actually seeing whether or not they work testing them in trials and then
seeing whether or not this antibody against the coronavirus specifically the
one that makes the kovat 19 disease otherwise known as SARS of 2 is gonna be
effective so this is one of the treatments that’s on the horizon and the
reason why this is really important for us to get as we see here in this USA
Today article looking again at that data from China that we talked about
yesterday they’re looking at statistics here and they’re saying that the corona
virus is 20 times more lethal than the flu based on the case fatality rates as
the death toll as we talked about passes 2000 we can see here that based on the
calculations that they were doing the global death toll from the virus was
listed at 2009 as of Tuesday evening and that the total infections rose to more
than 75,000 that if you do the calculation the overall death rate for
the virus was 2.3 percent however the seasons flu death in the United States
was at about 0.1% making this of course a more deadly than the regular flu but
not as deadly as the SARS outbreak back in 2002 which was at around 10% unfortunately we have to talk about
another physician who’s died in China dr. leo
he was the director of Chinese hospital at the epicenter the corona virus
outbreak and was one of the neurosurgeons as well so these b-cells
and how they become plasma cells and how they secrete immunoglobulins or
antibodies it’s all very specific and distinct including how viruses infect
the human cells this is something that would like to go into a little more
detail there’s been a lot of questions about immunity and what happens after
someone recovers and we’ve seen some examples in the United States of people
who have recovered specifically the gentleman in Washington but there’s been
some questions some rumors and some claims that people can get the virus
twice and that for instance people can have a lot worse reaction the second
time around and that there may not be immunity I haven’t seen any reports of
that and so it’s very difficult to come up with an answer to that question I
think it might be a little early in the course to see if that is in fact
happening and one thing I will make a point of however is that oftentimes when
someone gets a viral infection their ability to withstand secondary bacterial
infections is reduced and so it’s not uncommon to have secondary bacterial
infections when someone has a severe viral infection and so I want to end
this update with an excellent article that was published on the 12th of
February 20 20 on the practical recommendations for critical care and
anesthesia teams caring for novel coronavirus
patients and I will put a link in the description below this article that is
written in Canada talks about their experience with the SARS virus back in
2002 and it talks about very practical things to do for instance in the
intensive care you know what kind of personal
protective equipment to be wearing how the flow of air in these rooms whether
or not they’re negative or positive pressure rooms are very important for
instance if you are doing generally speaking an operation that’s in an
operating room in that room is run under positive pressure ventilation something
that of course you would never want to have happen if you’re doing an operation
on somebody with this kind of virus and so they talked about switching those
kind of patients into negative pressure rooms to do the operations so that you
don’t infect other people in the hospital and so I think it’s an
excellent read for physicians health care providers who are going to be
taking care of these coronavirus or kovat 19 patients it also talks about
when to use and 95 masks versus these powered air purifying respirators
otherwise known as poppers and who should be wearing them and talking about
for instance hot zones warm zones and cold zones hot zones being in the
patient’s rooms specifically where there’s negative pressure ventilation
warm zones when you’re outside the patient’s room but still in the
intensive care unit and then finally cold zones when you’re outside of the
intensive care unit so I think this is really important information and again
we will put a link to it in the description below thanks for joining us

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