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The risk of surface transmission of Covid-19 is low, the US Centers for Disease Control and Prevention said Monday. Far more important is airborne transmission — and people who obsessively disinfect surfaces may be doing more harm than good..”CDC determined that the risk of surface transmission is low, and secondary to the primary routes of virus transmission through direct contact droplets and aerosols,” Vincent Hill, Chief of the Waterborne Disease Prevention Branch, said on a CDC-sponsored telephone briefing.Hill said the risk of transmission from touching a surface, while small, is elevated indoors. Outdoors, the sun and other factors can destroy viruses, Hill said.The virus dies “rapidly” on porous surfaces but can persist longer on hard, indoor surfaces.

Research also suggested that surface transmission was more likely in the first 24 hours after a person is infected, and that households where one person had Covid-19 did have lower transmission rates when the household cleaned and disinfected surfaces.So while keeping surfaces clean is not a waste of time, it’s not the only way or even the most important way to reduce risks, the CDC said. It’s updated its guidance for cleaning and disinfecting surfaces in community settings in light of this transmission risk.”In most situations, cleaning surfaces using soap or detergent, and not disinfecting, is enough to reduce the already low risk of virus transmission through surfaces,” Hill said. “Disinfecting surfaces is typically not necessary, unless a sick person or someone positive for Covid-19 has been in the home within the last 24 hours.”Hill said cleaning should be focused on high-contact areas such as doorknobs and light switches.

Household cleaners pose a danger

People may be using household cleaning products in order to protect themselves from Covid-19, but misuse can have dangerous consequences, Hill added.Frequent cleaning and disinfecting of surfaces may have minimal impact on viral transmission and contribute to “hygiene theater,” he added.”Putting on a show” to clean and disinfect “may be used to give people a sense of security that they are being protected from the virus, but this may be a false sense of security, if other prevention measures like wearing masks, physical distancing, and hand hygiene are not being consistently performed,” Hill said.

“It also could make people feel less need to engage in these other important prevention measures.”Additional data shows that the disinfectants themselves may pose a risk.”Public inquiries indicate that some people may purposely drink, inhale, or spray their skin with disinfectants, without understanding that use of disinfectants in this way can cause serious harm to their bodies,” he said.Hill cited CDC research from June of 2020 showing that, of those people surveyed, “only 58% knew that bleach should not be mixed with ammonia, because mixing bleach and ammonia creates a toxic gas that harms people’s lungs.”Get CNN Health’s weekly newsletter

And bleach itself can be harmful.”Nineteen percent wash food products with bleach, which could lead to their consumption of bleach that isn’t washed off, which can damage the body because bleach is toxic. Eighteen percent used household cleaner on bare skin, which can damage the skin and cause rashes and burns,” Hill said.Hill added that surveillance data show the volume of calls to poison centers in 2020 for disinfectants was higher than in either 2018 or 2019.Alternative disinfection methods can also be a waste of time or even risky, the CDC says in the updated guidance.”The effectiveness of alternative surface disinfection methods, such as ultrasonic waves, high intensity UV radiation, and LED blue light against the virus that causes COVID-19 has not been fully established,” the CDC says on its updated website.

Source: https://edition.cnn.com/2021/04/19/health/cdc-covid-guidelines-cleaning/index.html?utm_term=link&utm_content=2021-04-20T05%3A00%3A33&utm_source=fbCNN&utm_medium=social&fbclid=IwAR005fVudtrExopRe1qkQLxKsrnh6b2KxaONeONKBW1qWaYyeskJGMSm3FU

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They aren’t the same type of blood clot, nor do they require the same treatment—but experts say a slight comparison may help people understand that all medications come with risk.

Health officials from both the US Food & Drug Administration and the Centers for Disease Control and Prevention recommended on Tuesday a temporary pause on the use of Johnson &Johnson’s (J&J) COVID-19 vaccine over concerns about a potential link to a rare type of blood clot in six women who received the vaccine.

The pause is “out of an abundance of caution” and is meant to give the CDC’s Advisory Committee on Immunization Practices (ACIP) and the FDA a chance to further investigate these rare cases. The recommended standstill also serves as an opportunity to make health care providers aware of the potential of this type of clot after a vaccine, as it requires a unique type of treatment.

Blood-Clot-Risk-JJ-Vaccine-Vs-Birth-Control-AdobeStock_271637647-GettyImages-1148160913

CREDIT: ADOBESTOCK / GETTY IMAGES

The recommendation was a shock to most—especially those included in the more than 6.8 million people who had already received their single-shot dose of J&J’s vaccine at the time of the announcement. It also sparked many to flood Twitter with comparisons between the risk of blood clots linked to J&J’s vaccine and other medications—oral contraceptives (aka, the Pill), specifically.

It’s true: Generally speaking, your risk of getting a blood clot from birth control is significantly higher than the potential risk of developing a blood clot from the J&J vaccine—but the types of blood clots we’re talking about here aren’t exactly the same. All blood clots aren’t created equal, and there are actually several types out there, women’s health expert Jennifer Wider, MD, tells Health.

Here’s what you need to know about your blood clot risk as it pertains to the J&J vaccine, compared to your risk of getting a blood clot from oral contraceptives—and why it’s important to talk about these two with just a bit more nuance.

First: What type of blood clot has been linked to the J&J vaccine—and what’s the risk?

The type of blood clot that caused the pause on the J&J vaccine is called a cerebral venous sinus thrombosis (CVST), a rare type of blood clot that forms in the brain. A CVST forms in the venous sinuses—spaces in the skull that let blood drain from the brain. That can lead to a very rare type of stroke that impacts less than five in a million people every year, per Johns Hopkins Medicine.

So far, there are six documented cases of people who developed a CVST after getting the J&J vaccine, according a joint statement from the FDA and CDC. All six cases were women between the ages of 18 and 48, and each developed symptoms between six to 13 days after they were vaccinated. Those women also presented with thrombocytopenia, which the term for a low blood platelet count.

The more than 6.8 million doses of the J&J vaccine that have been administered in the US so far, makes the odds that any one person who received this vaccine would develop a CVST 0.00009%, or less than one in a million. And that’s if the adverse effect is indeed due to J&J’s vaccine, which has yet to be confirmed, hence the pause for investigation. The six out of 6.8 million—or less than a one in a million chance—is also not a hard-and-fast statistic, as this is only referring to reported cases.

OK, so what about blood clots and birth control pills?

Between three and nine women in every 10,000 who take oral birth control pills will develop a blood clot, according to data from the FDA. (That’s a 0.3 to 0.09% risk, if you prefer to think if it that way.)

The FDA also issued comparison data, showing that the likelihood of developing a blood clot when you’re not on the Pill is one to five in every 10,000 women. It’s a little higher when you’re pregnant—that’s five to 20 in every 10,000 women—meaning that, in this context, pregnancy has the highest risk of blood clots.

Here’s the thing: The data is talking about all blood clots here—not CVST in particular. Largely, blood clots linked to the Pill include deep vein thrombosis (DVT, where a clot forms in a deep vein, usually in your leg or pelvis) and sometimes pulmonary embolism (PE, where a clot breaks off, travels to your lungs, and causes a blockage in an artery there). “The mechanism [of DVT] is very different from the blood clot that was experienced after the Johnson & Johnson vaccine,” Dr. Wider says, adding that the same goes for a PE.

Another big difference is in the way these blood clots are treated. With DVT, a drug called heparin (an anticoagulant or blood thinner) is often used to help prevent the clot from getting bigger and to prevent additional clots from forming. However, regarding the blood clots and thrombocytopenia linked to the J&J vaccine, the FDA says heparin may be dangerous and so an alternative treatment must be given.

That said, it is possible to develop a CVST while taking oral birth control pills. A 2015 meta-analysis published in the journal Frontiers in Neurology looked at 861 studies on CVST and found that the risk of developing the complication is 7.59 times higher in women who take oral birth control pills than in those who don’t. Due to that, the study authors said that oral contraceptive pills “increases the risk of developing CVST in women of reproductive age,” but that more research is needed.

Should we be comparing these blood clot risks?

It’s difficult to directly compare the blood clots linked to the J&J vaccine and those linked to oral contraceptive use, but it can still be done in a responsible way—and may even be helpful.

“[The risks] need to be contextualized,” infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security, tells Health. “Yes, there are different types of blood clots, but this comparison helps the public understand that every medication has some risk,” he says, adding that these comparisons have value in helping people address the risks they find acceptable on a daily basis.

But sometimes those quick, unexplained comparisons can go too far. “We can misuse this comparison,” says Dr. Adalja, noting again that it’s difficult to directly analyze the risk of blood clots linked to J&J vaccine to those linked to birth control, since again, they are not the same type of clot nor do they have the same treatment options.

Dr. Wider agrees that the direct comparisons may not be entirely helpful, adding that there are also known risk factors for blood clots with birth control that aren’t recognized as risk factors for the vaccine. “Women who smoke, have obesity, and lead a sedentary lifestyle are at increased risk of a blood clot when they are on birth control,” she says. “At this point, these are not underlying risk factors for the very rare clot that occurred post-Johnson & Johnson vaccine.”

Overall, experts agree that the pause was necessary in the distribution of the J&J vaccine “because we don’t know yet if there is an association between getting the vaccine and developing blood clots in the brain,” Richard Watkins, MD, an infectious disease specialist and a professor of internal medicine at the Northeast Ohio Medical University, tells Health. With oral contraceptives, at least there is a known risk that people can weigh with their doctors before taking them, Dr. Wider points out.

Ultimately, your risk of getting a blood clot linked to the Johnson & Johnson vaccine is incredibly low based on the data that we have so far. And so is your risk of developing a blood clot when you’re on birth control—but the two can’t be compared quite as easily as they have been.

Source: https://www.health.com/condition/infectious-diseases/coronavirus/jj-vaccine-blood-clots-birth-control

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At first, baby Noah was all alone, growing beatifically in his mother’s womb.Noah’s first close-ups, taken by ultrasound at seven and 10 weeks into the pregnancy, showed 39-year-old mom Rebecca Roberts and 43-year-old dad Rhys Weaver the baby they had tried for more than a year to conceive.Then, at three months into the pregnancy, Noah suddenly had company.An ultrasound taken at week 12 showed that Noah had an unexpected little sister — fraternal twin Rosalie.”I got pregnant whilst I was already pregnant, which was absolutely crazy … because that’s not supposed to happen,” Rebecca said.Baby Noah was joined in utero by fraternal twin Rosalie some three weeks after Noah's conception.Baby Noah was joined in utero by fraternal twin Rosalie some three weeks after Noah’s conception.Called a superfetation, getting pregnant while already carrying a baby is so rare that one 2008 study found fewer than 10 recorded cases in the world.Doctors told the couple the babies were actually conceived about three weeks apart, Rebecca said.”They realized that the baby was growing at a consistent rate of three weeks behind the first one, andit was then that they said to me, they think this is a superfetation pregnancy,” she said.”I couldn’t believe it had happened to me,” Rebecca added with a laugh. “But it did — it’s lovely. It’s like winning the lottery.”Dad felt the same: “I was elated to be having one child, but even more so for twins. The job is done in one go! And then Rebecca did some research, and we realized how unique and how lucky we were.”

An incredibly rare event

Superfetations are rare for a variety of reasons, said Atlanta gynecologist Dr. Lillian Schapiro.First, women typically ovulate only once per cycle, releasing one or more eggs simultaneously. If fertilization by the man’s sperm is successful, the egg or eggs then implant in the uterus, the pregnancy begins and no further ovulation occurs.By being concieved while Rebecca was already pregnant, baby Rosalie was a rare "medical marvel."By being concieved while Rebecca was already pregnant, baby Rosalie was a rare “medical marvel.””If a woman has twins,” Schapiro said, “two eggs are released at the same time. And in the unusual case of triplets, those eggs are all released with one ovulation.” Identical twins happen if a freshly fertilized egg splits.In Rebecca’s case, the egg was fertilized and implanted during the first ovulation, and “somehow she ovulated again during that same cycle,” Schapiro explained. “Another egg was also fertilized — became another embryo — and at different times both embryos implanted in the uterus.”Another reason superfetations are exceptional, Schapiro said, is that once the pregnancy begins, the uterus is no longer a hospitable place for implantation. That means the second embryo “must have managed to implant and grow at a stage when we would not have thought it would be able to grow.””We have almost never seen where two embryos start developing at different times,” Schapiro said. “That is just nothing short of amazing.”Rebecca had just taken one dose of fertility drugs designed to stimulate ovulation before she conceived Noah. While that may be one reason for this rare occurrence, Rebecca said, it could also just be a “medical marvel.”

‘Tiny, tiny baby’

At first Rebecca and Rhys fretted over baby Rosalie’s development in the womb, worried that being so far behind her bigger brother might affect her health at birth.”It could go either way,” Rebecca said. “Because the baby is so much smaller, there could be something wrong with it and it might not surviveThat’s usually the case.”But they said this baby’s actually growing consistently,” she said. “It was a relief. It was a great relief.”Born by cesarean in September 2020, both babies did have to spend time in separate neonatal intensive care units (NICU). Rosalie, who was born at a tiny 2 pounds, 7 ounceswas sent to a specialty NICU about 15 minutes away from the NICU that cared for Noah, who was born at 4 pounds, 10 ounces.”She was a tiny, tiny little baby just fitting in our hands, and even though he was tiny, you could see that he was a much bigger baby,” Rebecca said.”It was very hard. I had a major operation and then our babies were in two separate hospitals as well,” she said. “So it was really hard work having to travel between them both.”At birth, Noah was nearly twice as big as his little sister.At birth, Noah was nearly twice as big as his little sister.Noah was able to come home in three weeks, but little Rosalie remained in intensive care for 95 days, coming home just before Christmas.Today, at close to 7 months old, Noah is still ahead of Rosalie, but Rhys said, “She’s a little trooper. She’s got her own little personality, but I have no real worries at all.”Noah’s rolled over and is “actually showing signs of trying to crawl, so he might be off soon, which will be fun,” Rebecca added.”They’re both talking, which is really really sweet, because they talk to each other. It’s lovely. They interact with each other really, really well. It’s beautiful to watch.”Noah is still ahead of Rosalie, but Rhys said, "She's a little trooper, she's got her own little personality, but I have no real worries at all."Noah is still ahead of Rosalie, but Rhys said, “She’s a little trooper, she’s got her own little personality, but I have no real worries at all.”

Source: https://edition.cnn.com/2021/04/16/health/woman-pregnant-while-pregnant-wellness/index.html?utm_medium=social&utm_content=2021-04-17T01%3A29%3A07&utm_term=link&utm_source=fbCNN&fbclid=IwAR01-ap1G8QMOQW8s1uaMX9idO1l4aCTHkpLABTRL3xtXyB8zMSnYOPACg4

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