"Give me Liberty or Give me Covid!"

People should be careful what they ask for, Covid is no laughing matter. Our numbers in Maryland continue to go down. Todays numbers: 447 in hospital, 160 in ICU and 127 deaths across the state. Unfortunately that is not the situation in most other states. The cavalier attitude that has been rampant is now catching up with them. Even Mike Pence is now seen wearing a mask. Remember when he said “I’m the Vice president I get tested daily so I don’t need a mask!” Things are bad in the South and West and getting worse by the day. I read about a family that got together for a big birthday party and 18 family members got Covid. 9 hospitalized, grandpa fighting for his life on the ventilator. I don’t understand why people cannot learn from what others have experienced as opposed to actually needing to feel the burn themselves. It is truly frustrating that people continue to die needlessly from mishandling and disinformation. The good news is that these will not be my patients. I know you are all wiser than that and will not go crazy just because it is July 4th. There will be many July 4ths to come, missing out on one could keep you alive! Please, it is up to you to make sure that our area does not back track making another compulsory lock down inevitable. I really look forward to the day when I can write about other healthcare issues besides Covid but for now we must all be patient. For those who are interested I made a video on Vitamin D: https://youtu.be/PANxger2_nM And for those who have forgotten what they should be taking at a minimum, here it is again: Vitamin D 4000 units daily Zinc 50 mg daily Elderberry or Echinacea Vitamin C 2000mg We have all these items in stock in the office if you can’t find them. For those at high risk we can give you a short course of antibiotic to keep at home in case you develop the characteristic cough. I am so pleased none of my patients have died. Let’s keep it that way!

Maryland hospitalizations continue their downward trend!

Corona Virus Testing If you are interested in being tested for the corona virus in my office, either by the blood antibody test or the nasal swab please give us a call.

Why you can't get enough Vitamin D from the sun

Here is a video about Vitamin D and why you need it
Also known as the sunshine vitamin, you cannot get enough from sunshine alone!

https://youtu.be/PANxger2_nM

Vitamin B12 deficiency and how to take Vitamin B12

Political Rallies, Beach Parties and other Nonsensical behavior

GOOD NEWS....................sort of! Following up on the good news from last week our numbers in Maryland continue to decline. On June 11th we had 902 people in the hospital and 358 in the ICU. On June 21st we had 608 in the hospital and 230 in the ICU, and today, less than a week later, there are 511 patients in hospital and 209 in ICU. Why in the world would we quit now? Come on Maryland, we cannot do anything about what other states are up to but let’s not quit while we are ahead! Beach parties and indoor dining right now is madness, same thing with indoor cinema. Please don’t shoot me I am only the messenger who brings the truth. Don’t relax, I know its hard but you have to stick with it. Many more are going to die but it doesn’t have to be here because we have followed the rules and science will prevail. I want to make special mention of young adults. Yes, those ‘invincibles’ between the age of 23 and 39 who are the fastest growing segment of corona infected persons. In many places they make up a third of the infected population now. I believe one of the reasons for this is the initial misinformation that it is little more than a flu in young people and they hardly get sick. These young people have clearly not had good public health education. If they did, they would know that they are the key vessels for spreading the virus. People that aren't sick spread the virus the most. When they pass it on to a buddy who takes it home to their grand mother they now become responsible for the death of another human being. If you have a young person in your family or social circle please spell it out for them. It’s not just about how they feel or selfish behavior. For the rest of you avoid these folks like the plague! Just kidding, but you get what I mean. They are not as harmless or healthy as they may look. Especially if they won't wear a mask. I keep hearing slogans like “we are all in this together” but what does that mean if half the people “in it” don’t get it? I personally would love to see the Governors put a tri-state embargo on travel so that all these other non-compliant states couldn't send us more Covid-19 and send us into a second wave and lockdown. (Avoid out-of-towners too!). Anyway, have a plan for yourself and your family. I think it is finally safe to move into phase one. Continue to take your Vitamin C and D and Zinc. Keep washing your hands and wearing your masks. Using ‘common sense’ saves lives! Please stay well.

Its time for 'Phase one' no more lockdown!

GOOD NEWS!



And now for the good news: reviewing Covid-19 numbers in Maryland: Hospitalizations are down to 608 for the first time and ‘only’ 230 people in ICU.

We are ready! 

Have a plan for yourself and your family but I think it is finally safe for you to move to whatever you consider as 'phase one'. 

This could mean trips to stores or out to the park while maintaining social distancing of course.

Continue to take your Vitamin C and D and Zinc. Keep washing your hands and wearing your masks. Be conscious of other people especially the less fortunate. We are getting there.

Maryland is fortunate to have a wise governor who considers science and the health of the citizens when making decisions. (Many states in the country still have rising numbers of cases).

Using ‘common sense’ saves lives (my grandfather used to tell me common sense is very uncommon!)

Racism is a Public health Crisis

I want to talk about racism.

Many of you know that in addition to a Medical degree I also have a Masters in Public Health (plus a bachelor’s degree in Human Biology) and so I am particularly interested in the social causes of morbidity and mortality especially those that can be prevented.

Public health is “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals.” This is the most quoted definition of Public Health by CEA Winslow a bacteriologist and seminal figure in public health circles in America and throughout the world.

It is clear that the context of peoples lives determines their health and we, as a society, must have an interest in ensuring people can be healthy.

There is a lot of research that supports the idea that 80 to 90% of a person’s overall health is determined by factors outside of clinical medical care. Some of the social things that affect it are: the quality of air and water, the type of work they do, where they live and access to resources and education.

My sense is that this is a watershed moment in America for a variety of reasons, one of which is the pandemic. It feels like finally something has shifted in the American psyche and hopefully the genie cannot go back into the bottle. I am referring to the sudden acute awareness of racism and as the headline in the Harvard School of Public Health magazine last week stated “Racism is a public health crisis”. Apparently sometimes it takes a visual demonstration of man’s inhumanity to his fellow man for things to become undeniably obvious. Facts and figures that have long been long known can no longer be denied.

Racism affects every aspect of the lives of African Americans today resulting in many lives being cut short. Racism affects both the morbidity and mortality of minorities in this country but because it seems too hard a problem to tackle its easier to ignore it.

 “The racial caste system of slavery that operated until the 1960s (known as Jim Crow) and 401 years of systemic racism and structural societal inequality still live on in every aspect of our daily lives. Nowhere is this more apparent than in health outcomes. It has taken a global pandemic—coupled with the visceral, horrifying deaths of George Floyd, Breonna Taylor and Ahmaud Arbery—for many Americans to acknowledge the truth: racism is deadly. This fact is inescapable in the midst of a pandemic which is killing black Americans at nearly three times the rate of white Americans. This disparity is not because of innate susceptibility to the disease; it is because of a wide range of inequalities that have plagued the black community since long before this health crisis began.” Michelle Williams PhD, Dean of the Harvard Chan School of Public Health. 

Montgomery county has the highest Covid -19 infection death rate in Maryland and latino patients are 5 times more likely to be admitted for Covid-19 with a much worse prognosis.

Here are some current stats for Maryland:

Hispanics 32.9% of the cases even though they represent 9% of the population.

African Americans 35% of the cases they make up 30 % of the population. A total of 68% of the cases are therefore minorities, yet whites make up 59% of the population and only 24% of the cases.

The minorities have the ‘triple threat’ to contend with: 1. More exposure, doing essential functions (only 13% of Latinos do jobs that can be done from home). 2.They have more underlying health conditions from poverty and lack of opportunity. 3. Less access to health care and uninsured.

Some one forwarded this video to me and I found it very helpful in understanding the history of racism in this country. It answers one of the questions of why ‘they’ are so angry and suggests we should all care.

It is a little long (15 minutes) but relatively concise considering how much he is trying to cover. I think it is worth watching.

https://youtu.be/AGUwcs9qJXY

 Rather than lecturing people on how to express their anger maybe we could all try to remove the cause. It won’t be fast or easy, it was after all 400 years in the making but every journey starts with the first step.

Update on Covid-19

Testing is available in our office

For anyone who is interested in getting tested for the corona virus, testing is available in our office as well as in the labs: Quest and Labcorp, if you don’t want to go to the testing stations.

It is highly recommended that those who took part in the totally justified demonstrations last week get tested this week, just to err on the side of caution.

Healthcare workers suffer major losses

In the US about 600 frontline healthcare workers died from the corona virus. According to the Kaiser Foundation and The Guardian most of the workers identified as African American or Asian/Pacific Islander. The CDC notes 375 deaths among Healthcare “Professionals” but acknowledges that this is probably an undercount.

Worldwide, according to the International Association of Nurses more than 600 nurses lost their lives to Covid-19 as of June 3rd.

Its not over yet!

Its been a rough 3 months so far and we are almost there. Don’t lose patience.

We in Maryland are lucky to have a Governor who relies on science and commonsense to lead, he has saved many lives with his precise directions.

Please don’t quit while we are ahead.

Our hospitalization numbers and deaths are down even though in 19 states the number of cases are still increasing. Currently Maryland has 902 people in hospital of which 358 are in ICU. Nationally there have now been in excess of 112,000 deaths.

Even though things are ‘opening up’ please be cautious and don’t go overboard. Just because you can sit inside in restaurants now doesn’t mean you need to.

Buyer beware! Your nails can wait another two weeks

Taste and Smell in Covid, not an old wives' tale!

Not an old wives' tale after all!

I had previously mentioned that loss of taste and smell were symptoms of Covid-19 based on clinical observations but a report in the Harvard Gazette this week confirms that these are significant predictors of the disease.

A recent collaborative study between Boston and London in which 2.6 million people used a smartphone app to log their symptoms daily showed that these odd symptoms — loss of smell and taste — was one of the best predictors, and one that scientists said should be including in screening guidelines.

They found that loss of taste and smell were reported by most of those tested, about 65 percent, and that the most predictive group of symptoms was loss of smell and taste, fatigue, persistent cough, and loss of appetite.

Also interesting is that this can occur up to 5 days before the onset of other Covid symptoms like fever.

"I Can't Breathe", the Demonstrations and Equal Opportunity Virus Myths

The Demonstrations

“I can’t breathe” the final words of George Floyd before his life was taken by a police officer kneeling on his neck. Also coincidentally, the same phrase used by Eric Garner in 2014 as he died at the hands of the police. To be honest, as a physician I can hardly breathe when I watch the video of these men being asphyxiated!

The demonstrations are without doubt justified and the obscene number of deaths inflicted on African Americans in this country is a public health issue, and a valid source of outrage, as are all forms of violence and social injustice.

I have a big concern right now for the protestors because there may be an increase in Covid infections among them. I realize that in the heat of the moment Covid precautions may not be top of mind but in my opinion they need to be. Clearly there is no social distancing and many are not wearing masks. In addition, shouting increases the spread of droplets which may contain the virus. They should also be wearing gloves if they are going to be in such close proximity. Perhaps those trying to disperse them could use something that would deter the spread  of the virus rather than tear gas which increases the likelihood of injury to the mucous membranes and hence increases Covid spread!

The wearing of a mask has now been politicized, have we as a country just gone plain crazy? How does doing something to protect yourself and those around you become a partisan issue?

The number of hospitalizations and deaths in Maryland and DC is starting to level off. Virginia is still on the rise. My gut, and positive thinking, tells me that we should be on the other side of this in a couple of weeks but then again, now we have the riots! Let’s see how they impact us.

Myths

It is beyond comprehension that myths about Covid still persist after 105,000 deaths but unfortunately they do.

So let’s go over some of them again because our lives depend on the truth.

1.  “Masks don’t help”

(Reuters Health) –“ Cloth masks may help prevent transmission of the SARS-CoV-2 virus by at least partially blocking droplets expelled by people when they speak, cough and sneeze, researchers say.

While the weave of cloth masks may not be tight enough to block individual virus particles, most virions spread in aerosols (smaller than 5 micrometers) or larger droplets, and there is ample evidence that the masks can prevent such droplets from getting into the air or onto surfaces, the authors argue in an opinion piece published in the Annals of Internal Medicine last week”

(Cloth Masks Can Help Stop Spread of COVID-19 - Medscape - May 27, 2020.)

Let me break that down for you: Most virus particles are not floating around in the air, they are usually in droplets which are bigger than the actual virus. These droplets are stopped by having something covering your nose and mouth period!

This issue really needs to be put to bed so we can move on.

2.  “Regular people will not get sick from Covid if they don’t have underlying conditions”.

The Covid-19 virus also known as the SARS-2 19 virus is an equal opportunity virus. Anyone, anywhere, any age can get it and get very sick from it. There are of course other factors which determine if someone is going to die from it. Some of which I have gone over before.

3.  “Just as many people die from the flu”. Actually when you die you usually don’t care too much about the cause. This is how frivolous this argument is. Literally hot air nonsense!

Globally, about 3.4% of reported COVID-19 cases have died. By comparison, seasonal flu generally kills far fewer than 1% of those infected.

105,000 people have died in 3 months from Covid! Which means that if you add up all the deaths in 2018 of the 46,000 Americans who died from opioid overdoses, the 36,500 who died in traffic accidents and the nearly 40,000 who died from gun violence  we can expect more than that with another 3 months of the pandemic. Just so you can understand how devastating this is, and will continue to be if we don’t turn it around.

4.  “You are usually only really sick for a week” and then you recover.  Some people even talk about getting it so they can “get it over with”! No, you don’t necessarily live happily ever after,14 days later.

There is a Post-Covid syndrome in some people which lasts for a month or more after they ‘recover’.

People continue to shed the virus in their stool for over a month. We don’t know yet if they are still contagious. The average time a patient stays in ICU with Covid is 14 days if they need a ventilator, if not it is 11 days. It costs between $10,479 and $4000 per day in the ICU. $1500 a day on the regular floor.

5.   “Social distancing is just a hoax to keep us separated (or from rallying)”. A study out of Minnesota lasts week showed conclusively that social distancing is responsible for 40% or more less deaths nationwide than those predicted by models in different cities across the US. Enough said: like the slogan says Just Do It! Why would you not? I understand... a demonstration but you need to be alive to make an impact.