Is Ibuprofen Really Risky for Coronavirus Patients?

But there was no research to back up the contention. “No data,” said Dr. Michele Barry, director of the Center for Innovation in Global Health at Stanford University. There is no reason to think that infected patients should avoid temporary use of ibuprofen, she added.

“It’s all anecdote, and fake news off the anecdotes,” said Dr. Garret FitzGerald, chair of the department of pharmacology at the Perelman School of Medicine at the University of Pennsylvania. “That’s the world we are living in.”

“Until there is evidence, there is no reason at all to be issuing public health guidance” about Nsaids and the coronavirus, he added.

There are reasons to worry about long-term, heavy use of Nsaids, which have been linked an increased risk of kidney damage in some patients. People taking blood thinners also should avoid Nsaids.

But for infectious disease specialists, the greater concern is that when Nsaids and acetaminophen reduce fever, patients may be more comfortable but their lower temperatures can short-circuit the body’s main defense against infection.

Studies have found that if people infected with a variety of viruses and other microorganisms bring their fevers down, with Nsaids or with acetaminophen, their symptoms may last longer and they continue to shed virus for a longer time — meaning they may be contagious for longer periods.

“Everything that walks, flies, crawls or swims on the face of this earth makes fever,” said Dr. Paul Offit, an infectious disease expert at the University of Pennsylvania and Children’s Hospital of Philadelphia. Even lizards, he added, which crawl to the top of rocks and sun themselves when they are ill to bring their temperatures up.

The immune system works better when the body’s temperature is higher, enabling it to more efficiently kill viruses and bacteria. Dozens of studies — in animals, reptiles and humans — have found that fever is beneficial in fighting infections.

But there is a trade-off. For every 1 degree centigrade that the body’s temperature rises, the metabolic rate increases by 12 percent. “We don’t want to pay that metabolic price when we don’t have to, so we only make a higher temperature when we need it,” Dr. Offit said.

A very high temperature, edging toward 104 degrees Fahrenheit, is not good for babies, pregnant women or people with cardiovascular disease. And everyone with a fever that high feels miserable.

But taking a drug to reduce fever can lead to longer periods when people are infectious with viral infections, like the flu and or infections with other microorganisms, said Dr. Myron M. Levine, associate dean for global health, vaccinology and infectious diseases at the University of Maryland School of Medicine.

There is at least a theoretical danger the fever-reducers — including acetaminophen — may have a similar effect in patients ill with the coronavirus. Although there is no research yet, “my personal gut feeling,” Dr. Levin said, is that it might be reasonable for a person infected with the coronavirus to avoid both kinds of painkillers.

A drug like acetaminophen or ibuprofen can bring a fever down, but you don’t want to keep taking it constantly, said Dr. Marguerite Neill, an infectious disease expert at Brown University. Let the fever do its job.

“A single dose of an Nsaid when the temperature is 103 or 104 in an adult who has the flu — I’m not saying that’s wrong,” Dr. Neill said. “But don’t keep pumping it in if the fever is lower.”

She quoted an 18th-century English physician, Dr. Thomas Sydenham: “Fever is nature’s engine which she brings to the battlefield to vanquish her enemies.”

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Trump Is Tested for Coronavirus, and Experts Ask: What Took So Long?

The ambassador had already self-quarantined, after learning of Mr. Wajngarten’s infection, and is now extending the measure for two more weeks.

Other politicians who met with members of the Brazilian delegation — including Senator Rick Scott, Republican of Florida, and Senator Lindsey Graham, Republican of South Carolina — quarantined themselves.

But Mr. Trump did not alter his routine.

On Thursday, he met with the prime minister of Ireland, Leo Varadkar. At a news conference on Friday, he stood before a clutch of infection-control experts and business leaders in the White House Rose Garden.

The president shook hands with almost all of the business executives as he invited each to a shared microphone. Neither the handshakes nor the mic seemed particularly sanitary. One medical company executive was prepared — and offered his elbow even before Mr. Trump extended his hand.

The president responded with an elbow bump, saying, “I like that, that’s good.” Mr. Trump said Saturday that he was trying to break the habit of shaking hands, but that it was deeply ingrained.

“It’s a natural reflex,” he said, adding that he used to be a “non-hand-shaker,” but that “people walk up to me and want to shake my hand.”

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People who were exposed to a known coronavirus case should be asked to stay home and to monitor their health for 14 days, and be tested if they develop symptoms, according to the Infectious Diseases Society of America.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a member of the White House Coronavirus Task Force, went further in a televised interview on Friday.

Any individual who has been exposed to someone infected with the coronavirus should be tested, he said. If testing is not possible, “you should try as best as you can to self-isolate,” Dr. Fauci said.

He declined to say whether Mr. Trump should be tested for the infection, however, adding that was up to the president and his White House physician.

At 73, Mr. Trump risks developing particularly severe illness should he become infected. Officials of the White House Task Force were at pains this week to note that older Americans and those with underlying conditions should be particularly vigilant.

The president has made very little personal health information public. But he is known to take medication to lower cholesterol, and obesity — his reported weight is 243 pounds — is one of the underlying conditions that can increase the risk of severe illness.

Some medical experts are calling on the president to curtail face-to-face meetings with heads of state, business leaders and health officials. Mr. Trump’s news conference appearances on small stages packed with nodding officials, even as large American companies send employees home to work, unnerve some scientists.

“It would make sense for him to do some social distancing,” said Dr. Peter Rabinowitz, a professor of medicine and global health at University of Washington in Seattle. “He could set a good example.”

A lower threshold for testing should apply to the president and vice president, who was also in the photo with Mr. Bolsonaro’s aide, because of their critical roles in leading the country, said Dr. Judith N. Wasserheit, co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security.

The president has two health obligations, said Lawrence Gostin, a professor of global health law at Georgetown University: “Number one, keep himself and the cabinet safe, and number two, to keep the American people safe.”

“No individual, president or not, has the right to expose others to a dangerous virus,” Mr. Gostin added.

The president’s physician, Dr. Sean P. Conley, said on Friday that Mr. Trump’s exposure was “extremely limited” with one individual later found to be infected. Although the president spent more time “in closer proximity” to a second individual who later tested positive, “all interactions occurred before any symptom onset.”

People who are infected may not show symptoms for days, however; they may transmit the virus to others during this period, studies have shown.

Other administration officials have brushed shoulders with people who subsequently tested positive. Attorney General William P. Barr and the president’s daughter, Ivanka Trump, met last week with Australia’s minister for home affairs, Peter Dutton, who later said he was infected with the coronavirus.

Senator Ted Cruz, Republican of Texas, who decided to self-quarantine after mingling at a conservative political conference where an attendee had tested positive, is “probably doing the right thing, because as a politician, he is in some cases like a physician or anybody else who sees a high number of people every day,” said Kelly Hills, a bioethicist and co-founder of the consulting firm Rogue Bioethics.

Prime Minister Justin Trudeau of Canada secluded himself even before his wife tested positive for the coronavirus on Friday, and a Spanish deputy prime minister also did so.

Ms. Hills added that “if politicians, in general, are still planning on interacting with the public — glad-handing, kissing babies, whatever — then any politician who has possibly had exposure should probably take quarantine steps.”

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