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Antibiotics: Abuse, Side Effects, and Resistance

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Antibiotics are one of the numerous categories of prescription drugs, commonly misused in this part of the world. 
A 2019 study showed that only 68.3% of adults in Nigeria used antibiotics following a doctor’s prescription.
It was also found that only 42% of Nigerian adults complete their prescribed antibiotic regimen.

The Corona Virus pandemic has contributed further to this vice, as there have been widespread reports of panic buying and hoarding of all sorts of prescription medication (antibiotics inclusive) since the pandemic started.  It is also no secret that many people have recently resulted to self-diagnosis at the slightest sign of a sore throat or fever.

What are Antibiotics?

Antibiotics are drugs used to slow down the growth of bacteria and treat bacterial infections, by stopping them from reproducing or destroying them completely. Antibiotics cannot be used to treat viral infections like flu, most coughs, and COVID-19.

It is important to note that, as much as antibiotics fight bacteria, they may also harms us slowly in ways we don’t even notice. Shocking right? “How could something so helpful be harmful at the same time?” you might ask.

dangers of misusing antibiotics

Well here’s a thought – While some bacteria can cause infections, most species are harmless or perform beneficial functions, such as aiding digestion. These beneficial bugs are called commensal bacteria – one of the most important functions of commensal bacteria is boosting the immune system. This is a major reason why excessive use of antibiotics can be harmful to the human body.

Ever heard of the hygiene hypothesis?

Well, this is a theory that states “in early childhood, exposure to particular microorganisms such as; Gut flora, and Helminth parasites can protect against allergic diseases by contributing to the development of the human immune system”. What this simply means is that early exposure of bacteria to the human system will give the white blood cells a fighting chance against that bacteria.

Interesting isn’t it?

Now consider what happens when antibiotics are abused, and these bacteria that could help the immune system, are eradicated completely.

Antibiotic Resistance

Excessive use of antibiotics helps certain harmful bacteria develop higher resistance, and reduces the potency of the drugs in fighting against them. This occurrence is called antibiotic resistance.

The result of this occurrence is that these drugs that would normally kill or inhibit the growth of such bacteria, no longer work effectively.

Medical professionals believe that the growing number of bacterial infections that are developing resistance to antibacterial medication, has largely been caused people overusing antibiotics.

This is not a complete shock however, as Alexander Fleming (the man who discovered the first antibiotic) predicted this occurrence in his Nobel Prize acceptance speech in 1945, where he said:

“Then there is the danger that the ignorant man may easily under-dose himself and by exposing his microbes to non-lethal quantities of the drug, make them resistant.”

According to the World Health Organization (WHO), antibiotic resistance is one of the biggest threats to global health, food security, and development today. It results in longer hospital stays, increased health costs and higher mortality.

Additional research by WHO has shown that a growing number of infections – such as pneumonia, tuberculosis, gonorrhea, and salmonellosis, are becoming harder to treat, as the antibiotics used to treat them become less effective.

Antibiotic resistance is natural and can affect anyone, regardless of age or location. However, the abuse of antibiotics in humans and animals is accelerating the process.

Side Effects of Antibiotics:

As with many other drugs, there are side effects that can occur when using antibiotics. They include:

  • diarrhea
  • nausea
  • vomiting
  • rash
  • upset stomach
  • with certain antibiotics or prolonged use, fungal infections of the mouth, digestive tract, and vagina

Other less common side effects include:

  • formation of kidney stones, when taking sulphonamides
  • abnormal blood clotting, when taking some cephalosporins)
  • sensitivity to sunlight, when taking tetracyclines
  • blood disorders, when taking trimethoprim
  • deafness, when taking erythromycin and the aminoglycosides

Need a second opinion on some antibiotics, or any medication at all?

You can talk to a licensed doctor right now using the Tremendoc mobile application, and get professional advice on dosage and any other concerns you might have.

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How To Cope with Stress Effectively – 6 Expert Tips

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Your phone is ringing nonstop. Your inbox is overflowing mails. You’re 45 minutes late for a deadline and your boss is knocking on your door, asking how your latest project is going. It seems impossible to cope with all the stress.

These are some examples of acute stress, which may not last beyond your workday. However, if your life feels like this every day, you may be experiencing long term or chronic stress. 
This kind of stress can be potentially harmful to your health if you do not find ways to cope with it properly.

Major stressors include money troubles, job issues, relationship conflicts, and major life changes, such as the loss of a loved one. Smaller stressors, such as long daily commutes and rushed mornings, can also add up over time.

Here are 6 simple ways you can effectively cope with stress better:

1. Exercise

exercise often to cope with stress

Exercise is one of the most important things you can do to cope with stress. Physical activities such as walking or jogging — that involve repetitive movements of large muscle groups can be particularly stress relieving.
Regular exercise can help lower stress and anxiety by releasing endorphins and improving your sleep and self-image.

2. Reduce your caffeine intake

reduce your caffeine intake to cope with

Caffeine is a stimulant found in coffee, tea, chocolate and energy drinks. High doses can increase anxiety, although people have different thresholds for how much caffeine they can tolerate.
If you notice that caffeine makes you jittery or anxious, consider cutting back.

3. Write it down

Write down the things that stress you out

One way to cope with stress is to write things down. While recording what you’re stressed about is one approach, another is jotting down what you’re grateful for.
Gratitude may help relieve stress and anxiety by focusing your thoughts on what’s positive in your life.

4. Chew Gum

chew gum to cope with stress

According to several studies, chewing gum may help you relax. It may also promote wellbeing and reduce stress. One possible explanation is that chewing gum promotes blood flow to your brain.
Additionally, one recent study found that stress relief was greatest when people chewed more strongly.

5. Learn to Avoid Procrastination

avoid proscastion to reduce stress

Another way to take control of your stress is to stay on top of your priorities and stop procrastinating. Procrastination can lead you to act reactively, leaving you scrambling to catch up. This can cause stress, which negatively affects your health and sleep quality.
Work on the things that need to get done today and give yourself chunks of uninterrupted time, as switching between tasks or multitasking can be stressful itself.

6. Take a deep breath

take a deep breath to cope with stress

Mental stress activates your sympathetic nervous system, signaling your body to go into “fight-or-flight” mode. During this reaction, stress hormones are released and you experience physical symptoms such as a faster heartbeat, quicker breathing, and constricted blood vessels.
Deep breathing exercises can help activate your parasympathetic nervous system, which controls the relaxation response.

Everyone experiences stress from time to time. In the short term, acute stress can give you the motivation you need to power through a tough situation or meet a pressing deadline. However, long-term (chronic) stress can negatively affect your health.
If you feel run down, or like your health might be negatively affected by stress, you can speak with any of a licensed doctor on the Tremendoc app and receive professional advice on the appropriate steps to take, to minimize the effect of stress on your health

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Updated WHO guidance on the use of Face Masks – What’s New

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“Are fabric face masks effective in protecting myself from COVID-19?”

“Should I wear a mask if I don’t have the virus?”

“How do I know the right mask to wear?”

These are only a few of the numerous questions commonly asked by people since the use of face masks became an essential part of our everyday lives, in order to control and slow down the spread of COVID-19.

Based on new research and discoveries, the World Health Organization (WHO), announced updated guidelines on the use of face masks for the prevention or management of COVID-19, which helps answer some these commonly asked questions.

  "Masks alone will not protect you from COVID-19."  -  WHO Director-General, Dr. Tedros Adhanom Ghebreyesus
 “Masks alone will not protect you from COVID-19.” – WHO Director-General, Dr. Tedros Adhanom Ghebreyesus

“Today, WHO is publishing updated guidance on the use of masks for control of covid-19,” said the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, at a press briefing on Friday, June 5th, 2020.

Here’s What’s New:

  • In areas with widespread transmission, WHO advises medical masks for all people working in clinical areas of health facilities, not only workers dealing with COVID-19 patients
  • In areas with community transmission, people aged 60 years and above, or with underlying health conditions should wear medical face masks when physical distancing is not possible
  • WHO has also updated its guidance on the use of medical face masks by the general public. Dr. Tedros advised that governments instruct people to wear medical face masks in areas where there is widespread transmission and physical distancing is difficult, such as on public transport, in shops, or in other confined or crowded environments.
  • Based on academic research requested by WHO, the health body has also provided new information on the composition of fabric masks. WHO recommends that fabric face masks should consist of at least 3 different layers of material – an inner layer being an absorbent material like cotton, a middle layer of non-woven materials such as polypropylene (for the filter) and an outer layer, which is a non-absorbent material such as a polyester or a polyester blend.

Dr. Tedros also went on to add that “masks are not a replacement for physical distancing, hand hygiene, and other public health measures.” It is possible for people to infect themselves by using unsanitized hands to repeatedly take off and put on face masks.

Prevention of COVID-19 is a 360-degree effort, and while the use of masks is an important part, doing so in isolation could still leave you susceptible to infection.

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Could Telemedicine Help Manage Health Anxiety?

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What is health anxiety?

Health anxiety is an obsessive, irrational worry that you have a serious medical condition. Many people with this condition find it difficult to live normal lives or function normally due to their preexisting fears. Bodily functions like breathing and heartbeat, or physical oddities and discomfort like rashes, headaches or lightheadedness, can trigger them to worry excessively and create more elaborate problems that frankly do not exist.

People with health anxiety tend to worry about specific organs (the heart, or brain), or diseases they heard of or read about. For example “Covid-19 is infecting people all over the world, it’s only a matter of time till infects me.”

The severity of health anxiety may fluctuate, and increase with age or during stressful life events.

Anxiety is a Protective Mechanism

Anxiety is a protective mechanism and scanning the body for an illness seems like the right thing to do to protect ourselves. However, when we are preoccupied with something, we tend to notice it even more normal. For example, when you are looking to purchase a new car, you tend to suddenly pay extra attention to every car on the road that catches your eye, when previously, you wouldn’t have even looked twice. Looking for symptoms makes you notice subtle sensations you might otherwise ignore.   When you become preoccupied with bodily sensations, those sensations become amplified and last longer.

To further understand what living with health anxiety is like, imagine the alarm at your front door went off every time someone randomly walks past. The door alarm would be misinterpreting passersby as visitors. This is similar to what happens with health anxiety. The person’s mind constantly interprets sensations that could be seen as normal, to be potentially life threatening

Types of health anxiety

There are two kinds of health anxiety:

  • Illness anxiety disorder: this occurs when the person has no physical symptoms
  • Somatic symptom disorder: this particularly occurs when the person has symptoms that are perceived as distressing to them or if they have multiple symptoms

Causes and contributing factors

Experts are yet to pin point the exact cause of health anxiety, however, it has been observed that the following factors contribute:

  • Poor knowledge of diseases and body sensations
  • Being around family or friends who worry a lot about their health or your health
  • Past experiences dealing with serious illnesses in childhood. The trauma from such experience may cause people to worry about something similar reoccurring in adulthood.
health anxiety signs

Warning signs of health anxiety

Health anxiety is typically characterized by preoccupation with the idea that you are seriously ill, based on normal body sensations (such as a noisy stomach) or minor signs (such as a minor rash). Signs and symptoms may include:

  • Checking the body for a disease over and over
  • Dodging doctor’s appointments to avoid diagnosis with a serious illness
  • Avoiding people, places or activities for fear of health risks
  • Constantly talking about your health and possible illnesses
  • Frequently searching the internet for causes of symptoms or possible illnesses
  • Worrying excessively about a specific medical condition or your risk of developing a medical condition because it runs in your family    

Who’s At Risk?

Health anxiety disorder often starts during early adulthood and could get progressively worse with age. In older people, the common fear is potential loss of memory. Other risk factors are:

  • Childhood abuse
  • Having a worrying personality
  • Going through a stressful period in life

How Can Telemedicine Help?

With telemedicine, people with health anxiety can access care instantly through video call, audio call text or email, and receive reassurance from medical professionals. This provides them a more helpful alternative to searching online for their symptoms. If the worries still persist despite constant reassurance (which often happens), it would be necessary for such a person to see a clinical psychologist and begin cognitive-behavioral therapy, which has proven to be the most effective treatment.

Luckily, mental health support is also available via telemedicine platforms. Due to the fact that people living with health anxiety, tend to avoid conventional hospital visits, online therapy would be the ideal medium to provide necessary support to them.

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Tremendoc provides Hygeia HMO Enrollees access to Online Doctors

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Tremendoc is pleased to announce its partnership with leading health insurance and medical aid provider in Nigeria, Hygeia HMO. This partnership comes on the heels of the Coronavirus pandemic and its overarching effects on the healthcare sector. With the rise in the number of infected people in the country, and social distancing becoming the new normal, the need for Nigerians to access doctors online has never been more apparent.

The Nigerian government had previously imposed a total lockdown to prevent further spread of the virus, which has since been relaxed. However, there is great fear and paranoia surrounding visiting hospitals and health care facilities.

What does this mean for Healthcare in Nigeria?

Tremendoc’s strategic partnership with Hygeia HMO seeks to provide a solution to the fears many people have currently. Nigerians can now easily consult with licensed doctors on the Tremendoc app, from the comfort of their homes. Enrollees of Hygeia HMO can now take advantage of the simplicity and ease of the Tremendoc app. By accessing licensed doctors online, who can provide round the clock medical assistance.

What does the mean for Tremendoc?

“We are excited to partner with Hygeia HMO” Said Ugochukwu Chikezie, CEO of Tremendoc. “It is clear that at this time, people, especially Nigerians need quick access to quality healthcare without having to risk their health or disobey the lockdown order. With the Tremendoc app, we have taken steps to provide a solution that allows people to chat with or call a doctor online, and get the medical help they need. With Hygeia being a leader in the healthcare sector, we are very confident that this partnership will help provide easy and quick access to medical care to as many Nigerians as possible through their extensive customer network.”

Nigerian HMO gives access to online doctors

What does the mean for Hygiea?

Obinnia Abajue, CEO of Hygeia HMO, says “Hygeia HMO’s focus is always to provide affordable access to quality healthcare and our telemedicine offering makes this possible especially during this unprecedented crisis. With a Hygeia HMO plan, you get access to Telemedicine, and we’re excited to partner with Tremendoc for this service”.

At times like these, there is a need to further embrace technology as it opens up a door of opportunities for improved access to healthcare, and better health outcomes. Through telemedicine apps like Tremendoc, Nigerians can significantly reduce hospital visits during this pandemic while getting the right medical assistance through home monitoring programs, facilitated strictly online by licensed doctors.

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Easing the Coronavirus Lockdown in Nigeria: Pros & Cons

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easing the corona virus lockdown in nigeria

The World Health Organization has warned that countries run the risk of an aggravated second wave of coronavirus infections, if previously imposed lockdowns are lifted prematurely.

The Global health body has advised that countries be very careful of relaxing restrictions, despite the fact that economies are facing extreme adversity.

WHO director general speaking on coronavirus (COVID-19)

Speaking at a news briefing in Geneva, The WHO director General, Dr Tedros Adhanom Ghebreyesus, said in the virtual conference that the organization has been working with countries to set up safety guidelines for reopening. Although he went on stress that this would have to be approached with a high level of caution, to prevent a “deadly resurgence” in infections.

This however, is easier said than done in developing economies, where many families depend on income generated on day-to-day basis and stimulus packages are not available.

The Coronavirus Lockdown Situation in Nigeria

Nigerian President Muhammadu Buhari addresses the nation on the coronavirus disease (COVID-19), in Abuja, Nigeria March 29, 2020. Nigeria Presidency/Handout via REUTERS

Following 4 weeks of lockdown induced by the coronavirus in Nigeria, President Muhammadu Buhari expressed what seemed like an inevitable consequence, when he stated that the restrictive measures had come at “a very heavy economic cost,” which invariably left the government with few options.

As a result, plans were set in motion to ease the lockdown in Lagos, Ogun state, and the FCT, starting Monday, May 4th, in an attempt to save the economy from completely plummeting.

While this is understandable from an economic perspective, several question marks have been raised from a public health stand point, and rightly so, as the country recorded an alarming 125% increase in number of active cases during the week leading up to the lockdown being eased.

A total of 1256 active COVID-19 cases were discovered by the NCDC between Monday 27th April and Sunday, May 3rd, compared to 556 the previous week, taking the country’s total confirmed cases to 2675, as at Sunday. If this upward trend is anything to go by, it sure seems like the number of new cases does not appear to be tailing off.

Consequences of Easing the Lockdown Prematurely

Although a few restrictive measures including curfew between 8pm — 6am, and the ban on large gatherings are still in place, many still fear that in the coming weeks, Nigeria could be faced with an exponential increase in active cases. Similar to neighboring country Ghana, who recorded a 60% increase in active cases 11 days after their lockdown was also lifted for economic reasons.

The lack of bed space in isolation centers and accredited hospitals across the country could create a “frightening scenario,” the Nigerian Medical association warned in a statement to the BBC.

While the Nigerian Union of Allied Health Professionals, said “the deficit of health professionals and medical facilities would not be able to handle whatever upsurge that may arise due to the high incidences of community transmission”.

These comments paint a picture of a healthcare system that could be potentially stretched to its limits, if the relaxation of the lockdown results in an exponential increase in infections.

What are the Positives?

The situations is definitely not all doom and gloom, Nigerians can take solace in the fact that more people are able to return to work, and businesses are reopening. Hence, there will be less families at risk of not being able to provide the basics.

A general health consciousness has now been instilled in the population which did not typically exist pre-lockdown. Nigerians now carry an awareness in the back of their minds, of the consequences small actions like forgetting to wash their hands, may have on their health.

Is it tougher to stay protected now than during the lockdown? It definitely is, most especially for people who now have to return to work.

In the video below, Tremendoc resident Physician, Dr. Yewande Alebiosu, gives some useful advice on how Nigerians can stay safe even as the coronavirus lockdown is relaxed:

You can now speak with Dr. Yewande and 200+ licensed doctors online, with Tremendoc. Click Here, to get started.

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Lockdown messing up your sleep pattern? Try these 5 Tips

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sleep pattern during lockdown

The coronavirus pandemic has cast the entire world, into a very uncertain and unfamiliar situation. Countless countries, are on lock down, economies are stagnant or moving at snails pace, and many people live in fear for themselves and their loved ones. As people are mostly worried about how soon a vaccine will be found, it’s understandable that the importance of a healthy sleep pattern might be overlooked by certain people.  

However, while we adjust to what is becoming the new normal, and try to remain healthy in a time of COVID-19, prioritizing sleeping properly can be of immense good. 

Sleep is an integral part of physical health and effective functioning of the immune system. It’s also an important component of emotional wellness and mental health, helping to manage stress, depression, and anxiety. 

Whether you’ve had sleeping problems before COVID-19 or if they’ve only come on recently, there are concrete steps that you can take to improve your sleep pattern during this global pandemic. 

1. Reserve Your Bed For Sleep

This means that working-from-home shouldn’t be working-from-bed. It also means avoiding bringing a laptop into bed to watch a movie or series. These habits condition the body into a state where it no longer recognizes your bed as the primary location for sleep, hence, adversely affecting your sleep pattern.

2. Set Your Schedule and Routine

Establishing a routine can facilitate a sense of normalcy even in abnormal times. It’s easier for your mind and body to acclimate to a consistent sleep schedule. When your sleep schedule is irregular, your body finds it a lot more difficult to fall asleep at the appropriate time.

3. Stay Active

It’s easy to overlook exercise with everything happening in the world, but regular daily activity has numerous important benefits, including improving your sleep.

4. Watch What You Eat and Drink

Keeping a healthy diet can promote good sleep. In particular, be cautious with the intake of alcohol and caffeine, especially later in the day, as both can disrupt the quantity and quality of your sleep.

5. Contact Your Doctor if Necessary

If you seem to be having prolonged trouble sleeping. We advise that you reach out to a doctor on Tremendoc, Nigeria’s top telemedicine app, and get a professional diagnosis on what could be hindering your sleep. Click here, to get the app for free now

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6 Tips to Stay Healthy While you Work From Home

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With the sudden shift to remote work, home office is the new normal for many workers across Nigeria. However, making the adjustment to working at home can be more challenging than many believe.

Here are some tips to help you make the make a healthy adjustment:

1. “Deskercise”

This is a great way to take a break between ultra-focused work sessions.

There are no co-workers to get up and speak to, much less a break room to stand around. And sitting down for hours on end is bad for your circulation, digestion, and back. So, stand up! Run in place, or get down for some crunches or push-ups. Working your abs can help prevent back pain.

2. Regularly Sanitize Frequently Touched Surfaces and Gadgets

While you work from home, it’s important to ensure you take preventive measures against COVID-19. This includes sanitizing your workspace, computer, and mobile phone. As the virus could easily rest on these surfaces and gadgets.

3. Stay Positive

Without a boss over your shoulder or co-workers sitting nearby, it’s easy to feel like you’re in your own little world. To counter the feeling of working alone, its important that you stay in regular contact with your team members and share any work challenges you face, with the appropriate colleague. It’s also great to keep a positive mindset by acknowledging your achievements (no matter how little).

4. Take Care Of Your Eyes

When you spend all day in front of screens, your eyes (and more) can suffer for it: dryness, headaches, even a stiff neck or shoulders. Take your eyes off your screen every 20 minutes and stare at a focal point at least 20 feet away for 20 seconds.

5.    Plan For Breaks.

It seems counter-intuitive, but when you take a short break from working, research shows you’ll be more productive when you’re back on the clock. Taking a lunch break is perfectly okay. You could use this time to clear your head, get something to eat, or even take a short walk.

6. Ensure You Have an Active Telemedicine Plan

The restriction of movement has greatly emphasized the need for telemedicine. Working from home could potentially trigger a few health conditions, ranging from body pains to constant headaches. Having an active telemedicine plan on a platform like Tremendoc means that you have a licensed doctor available on your phone anytime. And this could potentially save you from interrupting your workflow and making a long trip to the hospital. Download now, to get started

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Tremendoc partners with AXA Mansard Health Limited to provide virtual care to more Nigerians

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Tremendoc is pleased to announce a strategic partnership with Axa Mansard Health Limited. an arm of the AXA Mansard group of companies. This partnership allows Tremendoc, the nation’s leading telemedicine provider, to provide enrollees of Axa Mansard 24/7 access to licensed doctors on its mobile application through chat, audio call and video call features.

For Axa Mansard HMO, this is a significant move because it introduces an innovative approach to improving every patients’ experience, by providing remote access to medical advice, online appointment scheduling, tele-consultation, prescriptions, etc.

Where access to a hospital is a challenge, telemedicine is a truly valuable service, because a typical 10- or 15-minute tele-consultation may avoid a costly and protracted visit to the emergency room or doctor’s office.

 “Telemedicine is fast becoming the new normal” said Jay Chikezie, Founder/CEO of Tremendoc . “With telemedicine being relatively new and unproven, this is an incredible opportunity for us to demonstrate that telemedicine makes healthcare more cost effective.”

Amid rising demand, more health insurance companies are increasingly deploying virtual care as a path to expand instant access to high-quality care, improve affordability, and health outcomes of people in general.

The alliance between both companies creates a stronger unit for healthcare delivery across Nigeria, and further emphasizes the relevance of Telemedicine in the healthcare space.  

Tremendoc collaborates with the leading insurers, employers, organizations and health systems to deliver industry-leading virtual care.

The telemedicine market is growing worldwide and is expected to reach 226 billion dollars by 2026, compared with 38 billion dollars today. Tremendoc is part of a bulging telehealth care market that is forecast to hit over $5. 49 billion in Middle East and Africa by 2024.

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The Stage-By-Stage Symptoms Of The Coronavirus (COVID-19)

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The story of Cooner Reed, one of the first British citizens to contract Covid-19 gives a reasonable insight into how the Covid-19 virus develops.

Cooner Reed is an english teacher who lived in Wuhan, China, where Covid-19 was first discovered. At the early stage of his illness, during the last days of November 2019, he noticed his first symptom which was the common cold, but thought it was just that and did not take it seriously. He also experienced coughs, sniffles and pain behind his eyes.

Cooner was not aware he had been infected, but his symptoms only got worse from then, and this became a severe problem for him. So he visited a healthcare centre and was tested positive. He didn’t panic and then immediately commenced treatment.

With time, Cooner was able to recover from the virus by eating healthy and exercising. This helped in building his immune system. And today Cooner is free from COVID-19.

Here is a stage-by-stage breakdown of the development of his Covid-19 symptoms:     

  1. The first stage is the incubation stage, which takes around 1-14 days. During this stage, most people do not show any symptoms and feel perfectly fine, but might still be able to transmit the virus to other people.
  2. The second stage is where symptoms finally begin to show and it is very similar to the common cold. Like the word, it’s common, so most people don’t read much meaning into it, and carry on business as usual. But that should not be the mindset or way of approach. It’s the riskiest stage because the virus can spread easily, through droplets from sneezing and coughing. According to Cooner he experienced cough, eye pain, ear pain and sniffles, during this stage. “The problem with COVID 19 is, you get better before you get worse at every stage” Cooner explained.  So the signs of one stage start to disappear before the next one occurs.
  3. “The third stage feels like a really bad flu,” he continued. The ear pain increases, the cough becomes recurrent, which makes your voice fade, there would also be physical and mental weakness.
  4. The fourth stage which is the most painful, comes with Pneumonia. Cooner said he started to experience difficulty in breathing almost like he was breathing from one lung. He also had chest aches and a high fever. 

It is however very important to know that not everyone would show the same symptoms around the same period.