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We are the movements heartbeat! John shouted. Youre cutting out your heartbeat!To which another speaker, an earnest young woman named Linda, responded, I have a clarifying question. How is it that one group can claim to be my heartbeat?The first night that I stayed at Zuccotti Park, bodies were laid out like tiles, head to toe, in circles and blocked out in squares and the occasional heap. There were street sleeping pros, homeless and crusty punks, wrapped up in tarps, a few people on air mattresses with fluffy pillows. I didnt actually sleep. I paced among the tarp covered bodies, sat on the steps, browsed the library, drank coffee from the food trucks open 24/7. The second night, after beers with LaGreca and a few other occupiers, I followed his friend Austin, a college dropout a casualty of his student loans who works with autistic children, to the Comfort Station for some bedding of my own. Well set you up on the margins, said Austin. That way you can get out if you need to. Twice I woke up. Once when a squat woman with dreads down to her knees shuffled by with a broom, a cleaning detail, and woke another sleeper, who stood up with his sleeping bag wrapped around him, stumbled, and gave up, letting it drop to reveal a sculpted body, naked but for dog tags.
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pdf . At the same time, there has been no discussion of oral antiviral strategies, apart from a recent response to an article in the British Medical Journal calling for protection for healthcare workers against infection . Properly designed clinical trials that address this issue are currently lacking in the literature. Current WHO interim guidance on clinical management of SARS CoV 2 in the home is focused on the use of personal protection, including face masks, along with hand, clothing, and surface sanitation, to reduce risk of airborne and direct spread of the virus, but does not mention oral hygiene . Thus, its utility in the setting of SARS CoV 2 has not been considered systematically, and there is a lack of either positive or negative robust clinical evidence. Mouthwashes vary widely in composition; however, some commercially available formulations contain ethanol at 14%27% w/v in the United Kingdom, Europe, and the United States. Prompted by this, we reviewed the available scientific literature to establish whether oral treatment using ethanol based or other types of mouthwashes could present a strategy to either dampen or reduce viral load, to potentially restrict virus transmission in the current pandemic situation, particularly for vulnerable individuals or healthcare workers. We found that there is a paucity of data systematically testing the impact of lower less toxic ethanol concentrations on enveloped virus inactivation, with most simply reiterating the use of the higher concentrations described above. 18,20,21,2326 We also found a paucity of robust clinical studies in this area that address in a randomized double blind manner the impact of oral rinsing on objective measures, specifically neutralization of enveloped viruses, including coronaviruses. It is becoming increasingly recognized that the throat is a major site of replication and shedding of virus in COVID 19 illness, and that viral load is important. 27 Throat and sputum are abundant in particles, which peak 56 days after symptom onset, and decline thereafter.
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