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5 Ways to Best Take Care of Your Brain

5 Ways to Best Take Care of Your Brain

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When it comes to taking care of yourself, people often speak about daily skincare, weekly hair care or annual health checks. But what about the brain? When moods falter, depression strikes or worry intensifies, people are often asked to snap out of it. Increased research into mental health says otherwise. 

For our brains to be healthy, we need to take as much care over them as we do over other parts of our bodies. A healthy brain is something we should all care about – it impacts your daily activities, your attitudes, your moods, your creativity, your relationships – need we go on? Here we give you 5 hacks to incorporate into your daily routine to achieve optimal neural health.

1. Your food intake What you eat plays a big role in the state of your mental health. The modern diet, filled with sugars and unhealthy fats, don’t provide the adequate resources a healthy brain needs to perform at its best. The results can often be anything from sluggishness, inability to focus or even depression. This includes taking an omega 3 supplement or incorporating oily fish into your diet, eating leafy greens, having lots of berries and nuts, switching out the white flour or rice for whole grains and reducing your consumption of processed foods.

1. Your food intake

What you eat plays a big role in the state of your mental health. The modern diet, filled with sugars and unhealthy fats, don’t provide the adequate resources a healthy brain needs to perform at its best. The results can often be anything from sluggishness, inability to focus or even depression.

This includes taking an omega 3 supplement or incorporating oily fish into your diet, eating leafy greens, having lots of berries and nuts, switching out the white flour or rice for whole grains and reducing your consumption of processed foods.

2. Your water intake

Your brain needs a lot of water. If you’re feeling thirsty and your lips are dry, it means your brain is not able to optimally focus or concentrate. Aim to drink 2 litres of water a day. Keep a large bottle of water at your desk and drink through the day. A glass of water on your bedside table to drink first thing in the morning will help you start the day on the correct foot!

2. Your water intake

Your brain needs a lot of water. If you’re feeling thirsty and your lips are dry, it means your brain is not able to optimally focus or concentrate. Aim to drink 2 litres of water a day. Keep a large bottle of water at your desk and drink through the day. A glass of water on your bedside table to drink first thing in the morning will help you start the day on the correct foot!

3. Your exercise

Ever pushed back your workout till the next day because you’re too tired to move? We’ve all been there. Your brain cares about your movement so instead of waiting till you have one hour of energy to get that workout done, incorporate small bursts of movement to your day. A ten minute walk around your house or a quick set of jumping jacks by your desk (hey #wfh benefits!) is much easier to wrap your head around. And if you can spend half an hour or an hour exercising? Please do!

3. Your exercise

Ever pushed back your workout till the next day because you’re too tired to move? We’ve all been there. Your brain cares about your movement so instead of waiting till you have one hour of energy to get that workout done, incorporate small bursts of movement to your day. A ten minute walk around your house or a quick set of jumping jacks by your desk (hey #wfh benefits!) is much easier to wrap your head around. And if you can spend half an hour or an hour exercising? Please do!

4. Your breath

Your breath is an important part of your stress management, or lack thereof. When we are stressed we tend to hold our breath or take shallow quick inhales (or vice versa). This unconscious act keeps our brains forever on edge for the next “crisis”. Being mindful of how you breath can play an important role in calming your body and allowing your brain to rest and relax. Taking long, deep inhales and even longer exhales activates the parasympathetic nervous system that helps calm the brain. Try to practice the 5-5-5 breathing technique (inhale for 5 counts, hold for 5 counts, exhale for 5 counts) for 10 minutes at least once a day.

4. Your breath

Your breath is an important part of your stress management, or lack thereof. When we are stressed we tend to hold our breath or take shallow quick inhales (or vice versa). This unconscious act keeps our brains forever on edge for the next “crisis”. Being mindful of how you breath can play an important role in calming your body and allowing your brain to rest and relax. Taking long, deep inhales and even longer exhales activates the parasympathetic nervous system that helps calm the brain. Try to practice the 5-5-5 breathing technique (inhale for 5 counts, hold for 5 counts, exhale for 5 counts) for 10 minutes at least once a day.

5. Your screen time

2020 saw a substantial increase in the number of hours spent on devices. All the ways we use our devices – be it for apps, social media, messages or health tracking – has an impact on our brains. We become addicted to apps that provide us with a feel good hormone hit every time the notifications chime. In a stressed out, uncertain world, it has the potential to become an unhealthy emotional crutch. To break out of the cycle, schedule in no-screen time to your day, delete social media apps off your phone for a period of time, go analog (no digital devices) for 24 hour periods once a month, add a screen time widget to make you aware of how often you use your phone (and on what!).

5. Your screen time

2020 saw a substantial increase in the number of hours spent on devices. All the ways we use our devices – be it for apps, social media, messages or health tracking – has an impact on our brains. We become addicted to apps that provide us with a feel good hormone hit every time the notifications chime. In a stressed out, uncertain world, it has the potential to become an unhealthy emotional crutch. To break out of the cycle, schedule in no-screen time to your day, delete social media apps off your phone for a period of time, go analog (no digital devices) for 24 hour periods once a month, add a screen time widget to make you aware of how often you use your phone (and on what!).

  • These hacks are not exhaustive but if you can practice one or two of them each day, you will begin to build habits that will nourish your brain.
  • Feeling out of sync with your mental health? Want to discuss any of these tips in further detail or receive personalised recommendations? Speak to a Sri Lankan psychiatrist, counsellor or psychologist on the oDoc app from the comfort & privacy of your own home.
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5 Myths About Therapy

5 myths about therapy

“You don’t need therapy, it’s all in your head...”

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Seeking out professional help to discuss emotional issues, be it relationship conflicts, job stresses or strong feelings of depression, is still stigmatized heavily in Sri Lanka. The taboo around therapy is immense and the hushed preconceived notions towards people who seek out therapy heavily deters people from prioritizing their mental health. 

With the heavy stigma surrounding therapy, many misconceptions and myths about therapy have arisen and we’re here to give you the facts!

1. Therapy is only for “crazy” people or those who have been diagnosed with a mental disorder

Untrue. The typical person who goes to therapy struggles with many of the same issues that we all struggle with on a daily basis; self-doubt, self-confidence, work stress, relationship conflicts, life transitions, loneliness, depression and anxiety. Therapy is more than just treatment; it is a journey of personal growth and overcoming challenges.

Your therapist helps you develop healthy coping mechanisms when dealing with stressful situations so you can live a happier, more productive life.

2. Going to therapy is considered a sign of weakness.

Untrue. In a culture like ours, seeking help is often equated with weakness as we’ve been forced to believe that we can and should fix all our problems ourselves. In reality, acknowledging that we are not okay and asking for help shows great strength and courage. We don’t consider having a fever, breaking a bone, or getting acne as weaknesses and speaking to specialist doctors about such issues as failures. The same should be true for our mental health, be it stress, anxiety, addiction or any other obstacle that’s hurting us.

3. The doctor prescribes “crazy pills”

Untrue. Many forms of therapy start off with talk therapy and this may serve as your primary method of treatment. Depending on your specific issues, your doctor may prescribe medication which can play a part in helping you become healthier. If a doctor diagnoses a mild case of depression, for example, and believes that this may be short lived, they tend to stay away from prescribing antidepressants and focus on other forms of treatment such as counselling and lifestyle changes.

Both talk therapy and medication are effective ways of treating a range of mental health conditions. Your doctor will consider factors, including your symptoms, severity of symptoms, past experiences, and both you and your doctor can decide on the type of treatment that best suits you and helps your recovery process.

4. “I don’t need to speak to a therapist, I have my family and friends”

While having strong relationships with family and friends is an influential part of mental health, they don’t necessarily solve specific emotional problems. There is a difference in confiding to a loved one versus speaking to someone who is professionally trained in listening, problem-solving and providing objective, non-biased guidance to improve your well-being.

5. If you wait a little while, you will feel better soon

When experiencing emotional pain, we are conditioned to wait for it to go away on its own or suppress our feelings and try to continue with life as usual. Just like a cavity needs dental treatment sooner rather than later and chest pain needs to be discussed with a cardiologist immediately, our emotional trauma needs to be addressed with and given treatment, be it through regular counselling and if necessary, medication.

Seeking professional help from mental health professionals is a brave first step to recovery. You can get in touch with psychiatrists, counsellors or psychologists on the oDoc app who provide a safe space for you to talk about your feelings. You can even purchase an oMind subscription package which gives you unlimited access to mental health professionals so you have a doctor by your side, always.

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References:

  1. https://www.health.harvard.edu/mind-and-mood/should-you-use-an-antidepressant-to-get-through-a-difficult-time
  2. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/10-myths-about-mental-illnesses-you-must-debunk/articleshow/55386445.cms
  3. https://www.opencounseling.com/blog/therapy-vs-medication-your-decision-making-guide
  4. https://www.psychologytoday.com/us/blog/the-right-mindset/202005/10-common-myths-about-therapy

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200 million doses later: How have the vaccines fared in the real world?

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Busting Myths: Part 4

200 million doses later: How have the vaccines fared in the real world?

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By now, most of us have received a link to register for Sri Lanka’s mass COVID19 vaccination rollout. Whilst some of us have jumped on board, others may still be trying to decide. However, given the rumours and misinformation that are rife in society, we wanted to help our public make the most informed decision about vaccines.

In the fourth post of this blog series, we break down the results from the 200 million doses given around the world to decide whether these rumours have legs or are just misinformation.

Global vaccine roll out

Globally, 200 million doses of AstraZeneca, Moderna and Pfizer/BioNtech vaccines have been administered. Some countries like Israel have raced ahead (vaccinating 71 out of every 100 people ) whilst others haven’t even started yet.

Global Vaccination Campaign

Correlation does not mean causation

Media attention on these rollouts combined with social media have resulted in  widespread rumours about serious side effects or deaths due to vaccines. But what are the facts? We are talking millions of vaccinations. So even if the vaccines have a tiny 0.00009% likelihood of a severe adverse event (death or serious side effects like anaphylaxis) when the numbers inoculated are in the millions, we are bound to see one or two cases crop up. Before the agencies can investigate the event, the media publicises the cases for sensationalism without thorough fact-checking or scientific examination. The WhatsApp sharing mill goes into overdrive. What do we miss? The important principle that correlation does not mean causation.

Let us explain: Say ice cream sales increased in a certain small town, but the rate of drowning deaths in that town also increased sharply. Therefore we decide that consumption of ice cream causes drowning.

Dr Bownstein of Boston Children’s Hospital succinctly states(2) “We have to be very careful about causality,” Brownstein said. “There are going to be spurious relationships, especially as the vaccine is targeting the elderly or those with chronic conditions. Just because these events happen in proximity to the vaccine does not mean the vaccine caused these events.”

The critical question is: are these events happening at a greater rate in the vaccinated population than in the average population? To answer this question, agencies around the world investigate each event to decide what caused it.

Is anyone monitoring these vaccine drives?

The major regulatory agencies closely monitor the vaccine rollouts in each country. Before injecting a patient, vaccine centres must speak to patients and check for reasons to not inject the vaccine. Vaccine locations must also be prepared and stock supplies to treat and manage severe adverse effects like anaphylaxis.

Once someone is vaccinated in the UK, they need to stay at the location for 15 minutes to be monitored for immediate adverse reactions. The NHS uses technology for primary care providers to log all data related to each vaccination. All reactions have to be reported to the Medicines and Healthcare products Regulatory Agency (MHRA) which is then investigated. Deaths of any person who has been vaccinated are reported and investigated by the MHRA, including via post-mortem(3).

Similarly, the US CDC runs a Vaccine Adverse Event Reporting System (VAERS) which closely monitors post-vaccination adverse reactions. Since the immunisation drive began in the US in December 2020 up till January 3rd 2021, the CDC reports that 4,393 or 0.2% of the 1.8m doses administered have reported adverse reactions.  Only 175 cases or 0.00009% were marked as potential severe adverse reactions for further investigation. Twenty-one of these cases were anaphylaxis which began around 13 minutes post-vaccine administration with all recovering and being discharged(4). The remainder were classified as non-serious (rash, itchy throat, mild respiratory symptoms).

But what about long term side effects?

We covered side effects extensively in our article about vaccine safety with most side effects including fever, fatigue, chills, body ache that lasts one to three days on average. 

Once the vaccine ingredients do their job – aka present the spike proteins to the immune system so it can ramp up a response – the ingredients disintegrate or are broken down by that immune response. They don’t hang around in the body. 

Ultimately, it is difficult to say what’ll happen in 30 years but vaccine side effects are known to happen immediately and in the short term not years later. This comes from the experience of having vaccines for 24 diseases, most of which are part of Sri Lanka’s mandatory vaccination programs for decades. Also good to note that most of those vaccine trials had less enrollments than the COVID vaccine trials. 

The real risk-benefit toss up is between what appears to be a safe and effective vaccine or a deadly, unpredictable disease.

What’s happening in Israel & South Africa?

People’s hesitancy to sign up for vaccinations may be linked to partial information reported about Israel & South Africa.

Let’s look at Israel first:

Since December 19th 2020, Israel has vaccinated almost 71 out of 100 people with Pfizer/BioNTech. Priority was given to the over 60+ age group, the immunocompromised & the healthcare workers. This widespread vaccination can help scientists further validate the accuracy of the clinical trial data. Maccabi, Israel’s healthcare system, states that only 28 of the 128,600 with two doses have contracted COVID19. 

However, at the same time, it appears that Israel began its third and largest peak in deaths(5) leading to its third lockdown on January 6th. So what does that mean?

Short answer In layman’s terms: correlation does not mean causation. The overlap in time of the vaccine rollout and the increase in deaths does not mean vaccines caused deaths. It may be because deaths lag infections. The data shows less moderate to severe cases this time around than in the previous lockdown in Israel meaning that vaccines are probably helping people not fall sick!

Want more details? Read on:

Case reports suggest a trend that COVID deaths lag infections by 3-6 weeks. The spike in fatalities between December 11th and January 26th is possibly related to infections between 26th November-5th January, assuming the lower end of the lag range. The 7-day moving average of confirmed cases just before the 2nd and 3rd Israeli lockdowns look the same about three weeks before lockdown. 

Most importantly, the number of new moderate and severe cases in the 60+ population peaked six days after the third lockdown vs 14 days after the 2nd lockdown. This earlier peak & subsequent decline is attributed to the vaccines(6).

Next, South Africa, UK & Variants:

2021 has brought great news in terms of vaccines. Still, it has also resulted in the news of variants or mutations in the Sars-Cov-2 virus that makes it more infectious. The big question has been how do the vaccines stack up against these variants?

Alongside the British/Kent variant (B.1.1.1.7), we now see news of a highly infectious South African variant (B.1.351). There is no evidence that the South African strain causes more severe illness; however, more infectious means more people infected, more severe disease, and more deaths. The South African variant’s main issue is a mutation that may allow it to dodge the immune system and render the vaccines ineffective. 

As always, scientists look to prove their beliefs by conducting studies. An early study (not peer-reviewed) tested the Pfizer vaccine in the lab and have found it less effective(7). Whilst Moderna’s seem to hold up, in a 1,700 person Astrazeneca early study has shown to have “minimal” or 22% protection against mild and moderate disease caused by this specific variant(8). However, this trial was conducted on an average age group of 31 and so wasn’t created to find the efficacy on the severe disease. 

However having more vaccines is now proving to be better. NovaVax, another two dose US vaccine, was found to be 95.6% effective against the original variant, 85.6% against the UK variant and 60% against the South African variant in trials.The trials against the new variants are still ongoing. 

All vaccine manufacturers are working on conducting trials and creating boosters against the variants to improve effectiveness.

Finally, want to take the vaccines but have allergies?

Both The UK MHRA and the US CDC have recommended persons with histories of severe allergic reactions unrelated to vaccines or injectable medications to get vaccinated. 

However, those with allergies to polyethylene glycol (PEG) or polysorbate are recommended not to get the mRNA vaccines. Furthermore, the MHRA recommends not to get vaccinated only if you have a known allergy to a component of the vaccines. 

Please see the links below for ingredients of each vaccine:

To summarise, major agencies have recommended that the public get vaccinated. Only those who have known allergies to the vaccine ingredients do not get vaccinated.

How to weigh up the risk-benefits?

COVID19 has caused 2.4million deaths around the world(1) and over 400 deaths in Sri Lanka. One hundred six million people have been infected with the virus, which affects the lungs and multiple organs like the brain, heart, and kidneys, to name a few. Long COVID is a condition present in many “recovered” COVID patients. They experience fatigue, muscle weakness or body aches even six months post asymptomatic to severe illness. 

Vaccines undergo rigorous clinical trials, the data reviewed by multiple panels of experts & regulators searching for efficacy and safety data. Adverse events are most likely to occur soon after vaccine administration. With over 128 million doses being administered, there have been less than 0.005% reports of severe adverse reactions. Furthermore, the vaccine ingredients disintegrate and leave your body after 1-2 days.

To put simply, COVID19 causes a more considerable risk of death and illness than the vaccines. Suppose we want to achieve herd immunity and return to economic activity (or go on holiday to our favourite locations) sooner than later. In that case, we believe it is most prudent to take both the doses of the vaccine that will be soon made available to you.

Read our previous blog on Vaccine safety: Three (scientific) reasons why they are safe 

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Sources

  1. Bloomberg COVID19 Vaccine tracker
  2. Dr. Widmer (2021) Fact-check: No link between COVID-19 vaccines and those who die after receiving them. ABC News.
  3. Primary Care Pharmacy Network., Delivery of COVID Vaccination Services (2020)
  4. Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine — United States, CDC, December 14–23, 2020
  5. COVID19 tracker, Google
  6. De-Leon, A et al., (2021) First indication of the effect of COVID-19 vaccinations on the course of the outbreak in Israel. Preprint. MedXRiv.
  7. Xie, X et al (2021) Neutralization of SARS-CoV-2 spike 69/70 deletion, E484K, and N501Y variants by BNT162b2 vaccine-elicited sera. Preprint. BiorXiV.
  8. Oxford/AstraZeneca jab fails to prevent mild and moderate Covid from S African strain, study shows. Financial Times, Feb 2021
  9. Pfizer-BioNTech (2020).,Vaccines and Related Biological Products Advisory Committee Meeting., FDA Briefing Document.
  10. Moderna (2020).,Vaccines and Related Biological Products Advisory Committee Meeting., FDA Briefing Document.
  11. Information for UK recipients on COVID 19 Vaccine AstraZeneca, MHRA

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Vaccine safety: Three (scientific) reasons why they are safe

Busting Myths: Part 3

Vaccine safety: Three (scientific) reasons why they are safe

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With the impending mass COVID19 vaccination rollout in Sri Lanka, there are murmurs about vaccines causing allergic reactions or even deaths. It was only with its mass vaccination programs that Sri Lanka could eradicate diseases like measles or polio. It remains integral to economic recovery that there is public buy-in for a COVID19 vaccination scheme.

To that end, we break down the results from the clinical trials to see whether these rumours have legs or are just in fact, misinformation.

Clinical Trials Scientists design clinical trials to get enough data to decide whether vaccines are safe and effective for people. They seek to accurately find whether severe adverse events (e.g. allergies, deaths etc.) occur after people receive the vaccines. If adverse reactions occur, trials are paused, and safety data are reviewed by a board consisting of independent experts and international regulators. The trial’s integrity is of utmost importance; therefore, safety reviews are taken seriously. Sometimes, trials can be halted for months until a decision is reached. The safety board decides whether the adverse reaction was due to the vaccine or coincidental – and if due to the vaccine, whether the case is an outlier or requires the trial to stop. In September 2020, AstraZeneca paused its 30,000 volunteer study(1) as one person developed a suspected adverse reaction. No further doses of the vaccine were given whilst a safety board reviewed the data to determine whether the vaccine caused the reaction. After review, the board confirmed the trial was safe and gave the green light for it to resume(2).

How effective are these vaccines? Little recap from Part 1 of our Blog Series

Clinical trial data has shown that all of the vaccines authorised so far are very effective at preventing symptomatic illness. The table below gives a quick summary of the findings so far:

Importantly ALL the vaccines have 80%+ efficacy against preventing severe disease and 100% against deaths & hospitalisation. After 2.3million deaths around the world, this is welcome news.

1) The trials have 30-40,000 people each to mimic real-world conditions.

Phase III clinical trials are the most extensive, most time consuming and most expensive part of the development process. Scientists look to mimic real-world conditions (different ages, genders, cities etc.). They aim to see whether the vaccine effectively protects against the virus AND whether it causes any side effects in the wider population. 

AstraZeneca & Moderna enrolled 30,000 people each in their Phase III, Pfizer/BioNTech 42,000, Novavax 20,000 and Russia’s Sputnik 21,000. In comparison, the GlaxoSmithKline MMR vaccine Phase III trial only enrolled 5,000 participants and is now a widely accepted part of the Sri Lankan immunisation strategy(3). 

Sample sizes are large to reduce “sampling error”. Sampling error is the difference between the sampled results and the population’s results if the sample doesn’t represent the population accurately. By enrolling tens of thousands of people – each of these vaccine trials could reduce sampling error and thus be as accurate as possible in their data collection.

2) The trials showed mild reactions in mostly younger people which lasted a median of one day.

Every vaccine trial looks for occurrences of “local” (at the site of injection) and “systemic” (around the body) reactions to the vaccine. Local reactions include injection site pain, redness, swelling. Systemic adverse reactions include fever, fatigue, headache, chills, vomiting, diarrhoea, muscle or joint pain. If reactions occur, they happen within 1-2 days of getting the vaccine and last an average of one day. 

AstraZeneca separated its participants into three age groups: 18-55, 56-69, and 70+. In the table below, we can see which local and systemic reactions occurred in the study participants and how long they lasted. 

They were more common in the 18-55 age group with most complaints of fatigue, headache and muscle ache soon after getting the vaccine. For all age groups and all complaints, the reactions disappeared in a few days(4).

Pfizer/BioNTech saw younger people experiencing local and systemic adverse reactions more often and in greater intensity than the older age groups. They often felt pain at the injection site at a greater intensity than the older participants. Both groups complained of fatigue, headache and body aches. 

All of Moderna’s participants complained of local reactions with pain & temporary swelling of lymph nodes being the most common. However, most reactions only lasted 1 to 2 days. Fatigue was the most commonly reported systemic reaction followed by headaches, body ache, fever and chills for 1-2 days post-vaccination.

3) The vaccines rarely caused severe adverse reactions and showed to be 100% protection against death.

As Phase III is designed to mimic the real population, events such as deaths or heart attacks that will typically occur in the real population also occur in the trial groups. The safety boards’ responsibility is to review the data to decide which events were caused by the vaccine and which occurred naturally. For this, they look at rates of these events in the general population by age group and deep dive into each case’s particulars. 

None of the vaccine trials (including Russia’s Sputnik) has had a severe adverse effect resulting in death as a result of the vaccines (5)(6). Of the 84 severe adverse events (in 11,000 candidates) reported by AstraZeneca, only one classified as possibly related to the vaccine(4). This one case is 0.000085% of the total study population, a tiny percentage. 

All of the vaccines peer-reviewed so far shows to have 100% efficacy against death & hospitalisation.

Weighing up the benefits

COVID19 has caused 2.3million deaths around the world(8) and over 300 deaths in Sri Lanka. None of the COVID19 vaccines reviewed thus far has yet had a death determined to result from the vaccine. Adverse events are most likely to occur soon after vaccine administration. With over 128 million doses being administered globally, there have been less than 0.005% reports of severe adverse reactions. 

The choice is between contracting a virus known to cause lasting damage to the body (if not death) and taking a vaccine that is found to prevent death 100% of the time. Moreover, the vaccines reviewed thus far are not known to cause severe adverse events; the winner becomes abundantly clear. 

We would urge the Sri Lankan public to accept the AstraZeneca or Pfizer vaccines.

Read our previous blog on Do the vaccines actually work?

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Sources

  1. AstraZeneca Press Release (Sept 20) Statement on AstraZeneca Oxford SARS-CoV-2 vaccine, AZD1222, COVID-19 vaccine trials temporary pause.
  2. AstraZeneca Press Release, (Sept 20) COVID-19 vaccine AZD1222 clinical trials resumed in the UK.
  3. GlaxoSmithKline (2012) Consistency Study of GlaxoSmithKline (GSK) Biologicals’ MMR Vaccine (209762) (Priorix) Comparing Immunogenicity and Safety to Merck & Co., Inc.’s MMR Vaccine (M-M-R II), in Children 12 to 15 Months of Age. Clinical Trials.gov
  4. Ramasamy et al (2020)., Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial. The Lancet 396: 1979-1993.
  5. Voysey et al (2020), Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. The Lancet 399: 99-111.
  6. Pfizer-BioNTech (2020).,Vaccines and Related Biological Products Advisory Committee Meeting., FDA Briefing Document.
  7. Moderna (2020).,Vaccines and Related Biological Products Advisory Committee Meeting., FDA Briefing Document.
  8. Logunov. D et al (2021)., Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomised controlled phase 3 trial in Russia. The Lancet. Online first.
  9. Bloomberg COVID19 Vaccine tracker
  10. Dr. Widmer (2021) Fact-check: No link between COVID-19 vaccines and those who die after receiving them. ABC News.
  11. Primary Care Pharmacy Network., Delivery of COVID Vaccination Services (2020)
  12. Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine — United States, CDC, December 14–23, 2020
  13. COVID19 Vaccines and Allergic Reactions, CDC, January 2021
  14. Moderna: FACT SHEET FOR RECIPIENTS AND CAREGIVERS, FDA
  15. Information for UK recipients on COVID 19 Vaccine AstraZeneca, MHRA

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Let’s Talk About HPV

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Let’s Talk About HPV

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In Sri Lanka, sexual health is a topic rarely spoken about in the open. The taboo and social stigma surrounding this subject may inadvertently lead to sexually active Sri Lankans unaware of how to maintain a healthy sex life. Practicing safe sex is central to this as well as reducing the spread of sexually transmitted diseases (STDs), such as HPV.  

Perhaps you’ve heard about HPV but have been hesitant to ask about it with your loved ones or your doctor. Perhaps you’re sexually active and would like to know how to be safe with your partner, and having an understanding of HPV is one such way to do that.

Well, let’s talk about it!

What is HPV?

The human papillomavirus (HPV) is one of the most sexually transmitted infections in the world today. There are more than 150 different strains of HPV. Depending on the type of strain, HPV can cause warts anywhere on the body. Warts appearing on your genitals is very common. Up to 80% of sexually active adults will get an HPV infection of the genital area at some point in their lives, although many who carry the virus don’t even know it. 

You don’t need to panic if you find a wart on your body since the vast majority of warts are benign and non-threatening but speaking to a VOG doctor will ease your concerns. For a small number of women, certain strains of HPV can cause changes in the cervix that can become cancerous if not treated.

How do you get HPV?

HPV is spread by direct skin contact through vaginal, anal and oral sex with a partner who already has a genital HPV infection. Non-genital HPV infections can occur through skin to skin contact, such as shaking the hand of someone who has a wart on their finger.

What are the symptoms of HPV?

Symptoms of HPV, if they arise, typically appear in the form of a cauliflower-like growth called genital warts. They can also appear flat. Warts can be found around the vagina, anus, mouth and throat as well as the penis and groin. Symptoms usually take weeks or even months to develop after initial exposure. 

Non-genital warts can be found on the rest of the body, especially hands, face, neck, chest, and soles of feet. Some warts can be inside your body, therefore, impossible for you to notice. And in some cases, there might not be any symptoms at all.

How can your doctor diagnose HPV?

Your doctor can diagnose warts by examining the area. Most of the time, warts don’t need to be biopsied unless the doctor is concerned that the warts could be cancerous. A biopsy entails removing a small piece of tissue and examining under a microscope. 

If it’s possible that you have genital warts, your doctor will ask you about your sexual activity. 

  • For women, your VOG doctor will do a pelvic exam and pap smear. This includes removing cells from the cervix to test whether the cells are cancerous. An HPV test, which checks for the actual virus, can also be performed as well. 
  • For men, a physical exam can be performed. 

In the unlikely event that cancer is diagnosed, please speak to a doctor to further discuss the course of treatment.

How do you treat HPV?

Most warts can be treated at home with topical creams prescribed by the doctor. Other long-lasting methods of wart removal include:

  • Cryotherapy (freezing)
  • Cautery (burning)
  • Surgically removing the wart

In some cases, the wart may return. Therefore, you should take preventative measures to reduce the likelihood of getting an HPV infection.

How do you prevent an HPV infection?

Taking preventative measures is of critical importance when it comes to reducing your risk of infection or further spread of the virus. 

Practicing safe sex can greatly reduce the likelihood of getting an infection. This includes maintaining a low number of partners as well as the consistent use of condoms. 

The Centers of Disease Control and Prevention (CDC) recommends all children to be vaccinated before they become sexually active to prevent infection of high-risk strains of HPV. 

For all the ladies out there, an important preventative measure that you can take is visiting your VOG doctor on an annual basis for your routine check up. Your doctor may perform a pelvic exam to make sure everything is normal in your vagina, vulva, uterus, cervix, rectum, ovaries and fallopian tubes. Your VOG doctor might suggest performing a pap smear as well. Pap smears are important as it involves examining cells from the cervix under a microscope to identify any abnormal cervical changes such as precancerous cells. 

We hope you have a better understanding of HPVs now but if you have more questions or are concerned about other issues related to sexual health, you can get in touch with sexual health and VOG doctors on oDoc.

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