Why bother getting vaccinated for Covid-19 if the efficacy is only 66%?

What is the purpose of vaccination? I get a lot of questions about Covid vaccines and I try to put out information as often as I have time to. I hope you find this helpful. There seems to be a misconception about the purpose of the Covid vaccines. First let’s look at a vaccine you are familiar with, the flu vaccine. In this day and age no one thinks that getting the flu vaccine will eradicate influenza. There is a clear understanding that even if you get the shot, you can still get the flu but if you do, it will be less severe. We  humans have learned to co-exist with the influenza virus every winter and we will have to do the same with Covid. The Covid vaccine will not stop you from catching the corona virus or stop you from passing it on to someone else, but it will stop you from getting a severe case of Covid-19 or dying. Which is  basically what you want. Vaccinating everyone in the country will not eradicate the Covid corona virus but it will certainly make it a lot more manageable. Now the good news: ALL the Covid vaccines are 100% effective at reducing the severity of the disease and stopping deaths. This is fabulous news, this is what we want. If we have to have a minor ‘cold’ for a week so be it. So when people ask about the difference in efficacy of this vaccine of 95% vs that vaccine 88% or even 65% that’s not what they should be focusing on. That is not what makes one vaccine ‘better’ than the other. The best vaccine for you, right now, is the one you can get your hands on. In the spring we may have more time (and more choices) to be picky. The idea of a ‘one shot’ vaccine is a nice one but is more likely to materialize as an annual shot like the flu vaccine, it has to change with the variants as well. Other interesting covid facts: Older people have less side effects from the current vaccines than younger people. Why? It is thought that younger people have a more active immune system which sometimes kicks into high gear and creates more allergic reactions. In Germany, people over 65 are not going to receive the vaccine. Their strategy apparently is to create herd immunity in the younger crowd and thus help ‘protect’ the seniors. They say there is limited data that it works in seniors and they don’t want to ‘waste’ the (AstraZeneca) vaccine. Speaking of the AZ shot the first injection of the AZ vaccine has now been shown to give 10 to 12 weeks immunity. Therefore in the UK they are focusing on getting the first shot into everyone and the interval to take the second shot has been extended. Johnson and Johnson have now applied to the FDA for Emergency Use Approval (EUA) if they get approved as fast as the other two we could have a third shot available in March. The more the merrier! It is unclear what is holding up the AZ vaccine in this country. There is a study going on in Washington state at a university, on Luvox (Fluvoxamine). A race course doctor in California noted that taking Luvox at the beginning of getting Covid prevented hospitalizations and serious disease. He had heard this from somewhere else and so tried it on patients from the racecourse community who were willing to take it. There were 200 people in all, none of the people who took the drug had to be hospitalized. 3 who chose not to had to be hospitalized and 1 died. Fluvoxamine is an SSRI antidepressant. Interesting huh?

Remember to take vitamin C, D and zinc and call early if you get a positive Covid test so we can work on keeping you OUT of the hospital. Until the next time be safe and be well.  ‌

2020 Covid-19 Reality Check!

 Vaccine Update and other critical news:

"The death of one man: this is a catastrophe. Hundreds of thousands of deaths: that is a statistic!" This is a quote often attributed to Stalin but he was apparently quoting someone else. It supposedly points out that when there are a few deaths we can comprehend the horror of it but once there are too many it just becomes numbers. I think America is on its way to that point.

Do you remember in the summer when I told you that there could be up to 300,000 deaths by the end of the year? Well so far, we have passed that number by 35,000.

With more than 20 million people in this country having been infected with the virus SO FAR.

Despite reports that 200 million Americans would be vaccinated before the end of the year, so far only 1% of that number i.e 2 million have been vaccinated. There are only 3 days left in the year.

There were more people than that passing through Reagan National airport last weekend! They must not have got the memo yet.This is why I persist in writing these emails.

We doctors are past the point of exasperation now. What does it take to get the message across? I hate to say it but you are not special (even though you are to me), and you could die if you do not keep up your guard.

Right now the number of additional deaths projected for the US by April is up to 250,000.

The numbers are huge but they are true. Do not become so numb to the numbers that you allow yourself to become vulnerable. It is nice to think and talk about the vaccine but the vaccine will not help those people who got infected last weekend nor those who hang out for the New Year.

When the vaccine is closer to reality for most people I will once again explain the difference between them for you.

Meanwhile just relax and watch the senators and congress get their vaccines and be consistent with your prevention methods. Your turn will eventually come, make sure you are still around when it gets here.

Some bright news:

Just in time for Xmas all my face products are buy one get the second one half off!!! You will need to call the office for this offer as it is not available on line. The face and hair serums make great gifts and the ‘facial’ cleanser can be used by the whole family (all over the body). Your friends and family will thank you!

Please be safe and hang in there the holidays should be back to normal next year if we all do our part.

Which Covid-19 vaccine would you choose? Covid vaccines, let's look under the hood :)

 FOLLOW THE MONEY and other controversies about the Covid vaccine.

Behind the scenes in the Covid vaccine business!

When you read about vaccines and corona virus remember everything can be spun. When people don’t like the spin, its labeled one way and when it suits their purposes it is labeled differently. It is d particularly difficult as a lay person to cut through the spin to the facts.

But do you have questions about the new vaccines that are coming? Here are some to consider:

Where will the vaccine be made? Where is it made now? Where was the vaccine tested and on whom? Why does the FDA have a definite date for approval (December 10) when supposedly the data is still being evaluated? Is approval automatic? Is that why Pfizer is already flying in millions of vaccine on dry ice from Brussels? Who paid for what? Why did one company claim they did not get government funding? Who is confirming that the ‘not for profit’ vaccine really is the case? What is the cost of each vaccine, which costs the most which costs the least? Based on the information we have so far which is the best vaccine for my community? Why are people spinning information (you know the answer to that :). And on and on……………

I know it seems a little overwhelming and I will not attempt to answer all of them. If I did, this email would become so long no one would read it. I would however like to spark some curiosity, enough that you research some of the answers to your own satisfaction, well in advance of having a needle stuck in your arm.

There are many Covid-19 vaccines under development, over 30 have moved to clinical trial and are being tested on humans. Research and development of new vaccines can take on average 10 years under normal circumstances, although some have been developed faster as seen with some previous outbreaks such as SARS and Ebola. There is good reason why it takes so long to develop a new vaccine, basically they have to be safe and effective. It is clear that right now we cannot wait for business as usual and all eyes are on the scientists and their amazing contributions. Of course it makes sense to throw everything at them to build on their capacity to get a successful vaccine. And then once they get it to make sure those who need it get it as quickly as possible.

Although normal vaccine development takes years, lucky for us, researchers aren't starting from scratch to develop a COVID-19 vaccine. Past research on SARS and MERS vaccines identified potential approaches and so they were able to build on this research fairly quickly.

So let’s look at a few of the controversies surrounding the earliest corona vaccines. There are three so far: Pfizer/BioNtech (PF), Moderna and Oxford University/AstraZeneca (AZ).

Money

A friend of mine told me last night, she would take the Pfizer vaccine “because Pfizer didn’t take government funds ” to make the vaccine. Hmmm, yes and no! Pfizer got a $1.95 billion deal with the government’s Operation Warp Speed (the multiagency effort to rush a vaccine to market) to deliver 100 million doses of the vaccine. The arrangement is an advance-purchase agreement, meaning that the company won’t get paid until they deliver the vaccines. Pfizer did not accept federal funding to help develop or manufacture the vaccine, unlike the other two front-runners Moderna and AstraZeneca.

“Although it’s true that Pfizer and BioNTech had been working on a vaccine all year before the companies struck their deal with the U.S. government in July, a $1.95 billion deal is nevertheless a significant incentive to keep going. In fact, international health organizations have long used such market guarantees to encourage for-profit manufacturers to supply vaccines to the developing world”.

The other thing is that if you do not take money to ‘create’ the vaccine, in the free market you can set the price of your vaccine wherever you want it. Pfizer is talking about selling their vaccine starting at $20 per dose. Multiply that by however many millions you want and the distribution will be through the warp speed deal.

Oxford/AstraZeneca (AZ) said they would not make any profit from their vaccine until the pandemic is controlled. Sounds good, but Doctors Without Borders (MSF) are demanding that in writing, and that there be an oversight body to make sure this really happens. They want the vaccine to be free in the developing world as well as the US.

"MSF welcomes AstraZeneca's commitment to sell the vaccine at a 'no-profit' price during the pandemic, but the reality is that it's an empty promise unless we're able to substantiate these important claims with data," said Roz Scourse of medical group MSF, also known as Doctors Without Borders.

The money is also an issue with Moderna:

 Moderna now says it will charge $32 to $37 per dose for smaller volume sales agreements, the highest price yet announced for a potential vaccine. Public Citizen and Knowledge Ecology International (KEI) wrote to the federal government Friday, noting that Moderna has been ignoring public disclosure provisions in its vaccine development funding contract. Public Citizen also found the U.S. government may co-own the vaccine candidate with Moderna. 

“Moderna is taking taxpayers for a ride – and the Trump administration is doing nothing about it. Taxpayers are paying for 100% of Moderna’s COVID-19 vaccine development. All of it. Yet taxpayers may wind up paying tens of billions more to Moderna to buy our vaccine back, if it proves safe and effective.The so-called Moderna vaccine belongs in significant part to the people of the U.S. We paid for it. Federal scientists led the way. It ought to be the people’s vaccine, not a new taxpayer burden”                                                                                      

Statement by Peter Maybarduk Director, Public citizens access to medicines.

Price

Remember: The prices for the vaccines are moving targets, dependent upon the amount ordered.

All three vaccines require 2 doses, 28 days apart.

Moderna is talking about selling the vaccine for $25 to $37 per dose. Compared to the $20 for Pfizer, and Astrazeneca will cost $3 a dose and can be made very quickly and in bulk.

Johnson and Johnson is working on a vaccine that only requires one shot and is predicted to cost $10 per dose.

The vaccines

The AZ vaccine is different from the other two. It is made (via chimpanzees) from an adenovirus like the common cold virus. So we know it is very safe because this is the technology that has been used for decades for other vaccines. Pfizer and Moderna use recombinant RNA technology which is very new.

The Pfizer vaccine has a major problem. It must be stored at -70 degrees. There are very few facilities including hospitals that have the capability of storing something at this temperature. If the cold chain is broken along the transport route the efficacy of the vaccine cannot be guaranteed. For example, in my office, our vaccine suppliers know that on Fridays I may be in the Laurel office and they cannot ship vaccines to me after Wednesday. This is for regular vaccines that are stored in a simple refrigerator. If Fedex drops off a shipment with my neighbors on a Friday, we come in on Monday and return it to the distributors who understand it is their fault, pay for return shipping and ship us out another batch. This is routine for regular vaccines, how much more a vaccine that is supposed to be kept 3 times colder than your freezer. It’s a problem, even on dry ice, I think the logistics will be difficult.

Distributing Pfizer's vaccine to larger population centers is problematic, not just because of its temperature, but because the smallest amount you can order is 975 doses (usually its 100 doses or fewer) which cuts down the size of the facilities that will order it.

Statement of Peter Maybarduk, Director, Public Citizen’s

The efficacy of the vaccines and approval

On November 16, a week after Pfizer’s announcement, Moderna issued a preliminary data readout out of its COVID-19 vaccine, suggesting an efficacy rate of 94.5%. Unlike the PF vaccine, however, the Moderna vaccine is stable at 36 to 46 degrees F, about the temperature of a standard home or medical refrigerator, for up to 30 days and can be stored for up to six months at -4 degrees F. It is expected to go to the FDA for consideration for an EUA within days.

On November 23, AstraZeneca and the University of Oxford announced high-level results from an interim analysis of their COVID-19 vaccine, AZD1222. The analysis was from the trials in the UK and Brazil and demonstrated efficacy of up to 90%. The vaccine was effective at preventing COVID-19, with no hospitalizations or severe cases in people receiving it. The AstraZeneca vaccine can be stored, transported and handled at normal refrigerated conditions for at least six months and administered within existing healthcare settings.

But the devil is in the details: 28 days after the first shot immunity was 62% and after the second shot it went up to 70% but…. Wait, before you jump for a different vaccine: if the person got only half a dose as the first dose then the efficacy increased to 90% with the second shot! Go figure. No one knows why this is the case. The thought is that the half dose ‘primes the pump’ so to speak and then the body responds really well to the second shot. I am really pleased that AZ was honest enough to share this detail as opposed to just stating the “efficacy is up to 90%”. More transparency is always good. Two advantages of the half dose approach: The body has an opportunity to acclimatize and the cheapest vaccine becomes even cheaper because it only needs 1.5 dose to get 90% immunity.

Pfizer was the first to announce their vaccine and they have already applied to the FDA for Emergency Use Approval (EUA).

Pfizer said their vaccine was 90% effective but when Moderna came out the following week with their 94.5% figure, Pfizer changed its press release to 95%.

The FDA approval decision will be announced on December 10 and Pfizer is poised to start delivering vaccines on the 11^th.

Here’s the problem I have with that: How did the FDA come up with a fixed date? Usually they let you know when they are satisfied after scrutiny, then they deliver an approval. Scrutiny usually includes going back to the applicant with questions and sometimes requests for additional testing. You normally cannot predict how long that should take. I almost feel like it is a ‘done deal’. A rubber stamp if you will. Elements of the FDA have been suspect for quite a while now. I think they should always maintain professional decorum irrespective of political pressure. Is anyone else with me here? (please let me know).

Meanwhile: United Airlines Holdings Inc. on Friday began operating charter flights from Belgium to position doses of Pfizer Inc.’s Covid-19 vaccine for quick distribution if the shots are approved by regulators, according to people familiar with the matter. If PZ is incurring all that expense (the planes had to carry more dry ice than aviation rules usually allows) they must be pretty confident they will have approval. I understand they want to be first in line since the early bird usually catches the worm.

So currently there are 3 vaccines on the table. Do we know everything about them? The short answer is No. I may have made it more confusing so here’s a summary:

Pfizer/BioNtech Covid vaccine is a recombinant vaccine, efficacy 95%, will cost $20, EUA already requested from FDA, must be kept at minus 70 degrees centigrade (-94 degrees farenheit).

Moderna has a recombinant vaccine, efficacy 94.5%, will cost $32 to $37 can be kept at normal refrigeration temperature. Funded by the federal government. Poised to request EUA.

Oxford/AstraZeneca has a vaccine based on Adenovirus (like a cold virus), efficacy up to 90%, will cost $3, can be kept at normal refrigeration temperatures. Will apply for EUA possibly January 2021

All these three require 2 shots one month apart. Lastly there is another vaccine in the pipeline:

Johnson and Johnson, vaccine based on Adenovirus also. EUA date March or April 2021, normal refrigeration. Costs $10, needs only one shot.

Hopefully this information helps you to understand the ins and outs of the vaccine issues. Meanwhile watch this space

Love

Dr. Tuakli

Thanksgiving and gratitude in spite of the horror

 When I first came to this country I used to say "I don't celebrate Thanksgiving, its not a tradition I grew up with" and other ignorant statements.

I didn't see how this holiday, which is supposedly based on the kindness of the native Americans, related to me. So for a while it had as much significance to me as the UK 'Bank Holidays' basically, just a day off.

But over the years I have come to understand and appreciate the uniqueness of this American holiday.

I used to say to my American friends "well, you know in England Christmas is the biggest holiday, that's when we all get together". But it isn't the same. The exchange of gifts and all the shopping and the glitter, take front and center stage at Christmas.

Thanksgiving is a day when family and friends gather and share food and love. Nothing more, nothing less.

It is interesting that the whole world has taken on the concept of 'Black (read money) Friday' but not the essence of the day before. The day, when Americans of all stripes go any distance to be with their families and all their family members show up warts, family tension and all. 

It used to amaze me when I would hear on the TV how, 3 times more people travel in the US for Thanksgiving than Christmas. But now I understand it and its significance, it is truly the best holiday and worthy of celebration. Even if this year it has to be done by zoom.

This morning a patient touched me deeply when she thanked me for my emails and my work. It made me realize that I too should say thank you. This kind of encouragement keeps me churning these out.

I truly appreciate and am honored by all the trust and support I have received over the past 30 years.

I am deeply grateful that I have a loving and supportive husband. He always allows me to do what I feel I need to, for my patients (it's his birthday today :).

I am grateful to be alive when many of my colleagues and nearly 1.5 million people have died from Covid. People who had no idea that they would not be here this Thanksgiving.The depth of this plague is mind boggling but it is up to us to defeat it, hopefully sooner than later.

Enjoy the festive season and let's hope 2021 is better for the whole world. I will certainly try to do my part.

Love 

Dr. Tuakli

 

Yesterday we celebrated change, now we need to get back to work. 240,000 deaths in the US. 10 million cases.

 The United States could soon report more than 200,000 coronavirus cases per day as infections continue to surge across the country, according to CNN.

The US reported 100,000 new cases 7 days in a row last week, and that total will likely continue to increase.

"We are watching cases increase substantially in this country — far beyond, I think, what most people ever thought could happen," Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told CNN.

Osterholm and his team have created accurate forecasts for COVID-19 cases throughout the pandemic. He was named to President-elect Joe Biden's Transition COVID-19 Advisory Board on Monday.

"It will not surprise me if, in the next weeks, we see over 200,000 new cases a day," he said.

On Monday, the national 7-day average of new cases was nearly 120,000, which is triple the average from mid-September.

The number of hospitalizations in the United States are up as well, according to The COVID Tracking Project. On Monday, 59,275 people were in hospitals for COVID-19, marking the country's highest total since July and slightly lower than the April 15 peak of 59,940.

Deaths are on the rise, too, CNN reported. Last week, more than 1000 COVID-19 deaths were reported for 5 days in a row, which hasn't happened since August.

"We're going to see, by far, the darkest days of this pandemic between now and next spring when the vaccine becomes available," Osterholm told CBS This Morning on Tuesday.

"We have a perfect storm coming together," he said. "We have pandemic fatigue...we have pandemic anger...we just are not taking this virus seriously."

WebMD Health News © 2020 

Cite this: Carolyn Crist. US Could Hit 200,000 Daily COVID-19 Cases Soon - Medscape - Nov 10, 2020.

This article should cause you to sit up and take notice. The number of cases are rising throughout the country again, including Maryland.

Current hospitalized cases in Maryland 761, in total we have had 156,709 cases. Our positivity rate is back up to 5.24% total death count 4084.

One of my biggest worries is that this is happening BEFORE Thanksgiving and the onset of the flu season. In a few weeks it could be way worse. Please do not allow “Covid fatigue” to let your guard down. It is not in your best interest and all it takes is being careless.

Maybe things will start to improve now but only if everyone plays their part. We haven’t even begun to turn the corner yet but maybe we can in January now that all the crazy rallies are over.

2 positive things: A new presidential task force (which includes people from my alma mater, yay!) and the imminent release of a vaccine.

Pfizer released their report yesterday that their new recombinant vaccine is 90% effective. Unfortunately there hasn’t been the usual time for ‘peer review’ because they said they would not have been able to keep it secret for the usual month it takes for that process. None-the-less the numbers still have to be examined and then cleared by the FDA. I worry that the media attention will pressurize the FDA to allow emergency clearance which will lead to distrust on the part of the public.

Anyway, as I have said many times, this is not when you need to be focusing on the vaccine. Focus on your life style choices which is something you have control over.

So “Happy Thanksgiving!” is in words only. I really don’t mean it literally.

If it makes you feel better, they plan on using the vaccine on us (medical workers) first. Whoopee!

Yesterday's shocking display. Sets us back on road to pandemic recovery

  Just for the record!

What happened yesterday was outrageous and disgraceful and I hold the doctors completely responsible. Being quarantined and in isolation does not mean going for a joy ride as a photo op!

The doctors are trained to manage patients with infectious diseases with a responsibility to both the patient and the community. They failed miserably. I question their principles and medical ethics.

Any patient can sign out of hospital AMA (against medical advice) that is their right. If this occurs with someone who is harmful to others the doctors should then notify the health department and seek  legal recourse with law enforcement up to and including a legal injunction.

Please understand, this is NOT “Ha Ha, look what just happened!”

It is nonsensical and should be condemned but the entire medical and public health community.

For the record that is how I would handle any of my patients who are ridiculous enough to behave in that manner.

Is convalescent plasma the next silver bullet for Covid-19

 Is Convalescent Plasma the next silver bullet for Covid?

Last week I heard on the news that convalescent plasma (CP) had been approved in record time by the FDA as a treatment for Covid-19. This makes a little more sense than rushing through hydroquinone as an unresearched treatment for Covid with it's potential for deadly side effects.

Let me explain what this is exactly:

The use of convalescent plasma (CP) collected from previously infected individuals to passively transfer antibodies in order to protect or treat humans dates back almost 100 years. CP has been used for the treatment of different kinds of viral infectious diseases, especially in times of outbreaks for example polio and pandemics. Other examples of CP use include rabies, hepatitis B, measles, influenza, Ebola and hemorrhagic fevers^.

CP for Covid treatment is thus made from the blood of people who have already had Covid. This requires Covid survivors to be willing to donate their blood.

If you think about it, the logistics and practicality of this would be no easy task assuming that convalescent plasma actually works. It has not been proven.

Why? First of all getting enough regular blood for all the people who need it is hard enough. There is always a shortage.

Although an estimated 38 percent of the U.S. population is eligible to donate blood at any given time, less than 10 percent do so annually. According to studies, the average donor is a college-educated white male, between the ages of 30 and 50, who is married and has an above-average income. This may not necessarily be the profile of the average Covid-19 survivor.

So now we would need to keep tabs on everyone who has had a Covid infection and convince them to donate their blood.

 The donor and the patient must also have compatible blood types. Once plasma is donated, it is screened for other infectious diseases, such as HIV. Then hopefully made available in a timely fashion for the sick person.

The good thing about CP is that over the decades it has been proven to be relatively safe so long as the recipient does not have an allergic reaction (which is basically the same risk as having a blood transfusion). Another good thing is that it will be available a whole lot faster than a vaccine !

At the end of the day this is not a ‘new’ therapy as touted and the availability is currently quite scarce. Once again forget the wonder treatments. The only thing you can really hang your hat on is making sure you don’t get Covid in the first place. Yep, same ole same ole! Wash your hands, use hand sanitizer, wear your mask, stay inside, social distance. Take your vitamin D, zinc, vitamin C and you can add echinacea or elderberry if you like.

Stay well. Please let me know if you have questions.

Do-It-Yourself Covid Testing!

 I want to highlight an article I read today in the Harvard Gazette about a new approach that has not been suggested before. This idea is from Michael Mina a Harvard epidemiologist and expert in disease testing. He is calling for a shift in strategy toward a cheap, daily, do-it-yourself test that he says can be as effective as a vaccine at interrupting coronavirus transmission. He believes it is currently the only viable option for a quick return to a normal life.

Dr. Mina, is an assistant professor of epidemiology at my alma mater the Harvard T.S.Chan School of Public Health. He suggests that this would be a better strategy than closing down the economy and keeping schools closed which is really the only other viable option.

These paper-strip tests (similar to the popular pregnancy tests) have already been developed and their shotgun approach to testing cheap and widespread provides a way back to the workplace, classroom, and other venues.

The strategy, “could put hundreds of millions of tests in the hands of consumers within weeks, at a cost far less than repeated rounds of economic stimulus” Mina said. Several companies have produced these tests which can be produced for less than a dollar. With tests like these, ordinary people can perform their own tests each day or every other day. They are not as accurate as the current diagnostic tests but they are effective at detecting virus when a person is most infectious. If everyone who tests positive stays home, the thought is that the widespread effect would be similar to that of a vaccine because people would stop the transmission chains across the country. If people are concerned about false positives they could then follow up with a formal test with their doctor and stay quarantined meanwhile.

So whats the catch ?

First of all unless the tests are FDA approved and federal government sanctioned, companies are not going to invest and produce these tests in the numbers that would be required to be effective.

The currently available tests take time and are expensive. Which makes them impractical for daily in- home testing. These tests may not be perfect but the nation’s current testing strategy catches less than 3 percent of cases early enough for a person to proactively prevent transmitting the virus. Now if those testing positive stay home, “a cheap, at-home testing regimen has the potential to provide a kind of artificial herd immunity, interrupting enough transmission nationwide to cause the pandemic to stall”

Another catch is one that relates to all fields of prevention: it still requires people to take some level of responsibility and motivation to actually do the test and then follow through if the results are positive.

According to Dr. Mina what’s needed, is the federal government’s financial and organizational clout to both provide resources and get companies working together. Though even a $1 per day test gets expensive, if the federal government provides them free to all Americans, the cost would be far less than recent stimulus efforts. We could get these tests up and running right now unlike the vaccines.

“It will stop the vast majority of transmission and it will cause these outbreaks to disappear in a matter of weeks,” Mina said. “This is something we can actually do at warp speed.”

If you would like to read the full article you can read it here:

https://news.harvard.edu/gazette/story/2020/08/cheap-daily-covid-tests-could-be-akin-to-vaccine/

Its not over yet! The 'state' of the state.

There have been 3600 deaths in Maryland so far with huge differences between the counties. For example: deaths in Howard county 106, PG county 741 and Montgomery county 767.

Presently there are 488 people hospitalized in the state, 117 in ICU.

We were doing so well until the July 4th holiday when people became very lax.

I know you are tired of the restrictions but please don’t quit while we are ahead!

We now have to look forward and figure out how to keep our children safe as people press for a return to the classroom.

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.

Your nails can wait another two weeks, two months if they have to!

Covid misinformation and actions that you need to take to stop the pande...

The 7 Best Things about Covid-19

“When something bad happens, something good will follow”. That’s one of those old sayings that isn’t particularly useful like “good medicine has to taste bad”. We’ve had a lot of bad this year so I’m sure everyone is ready for some good to follow, so I decided to look for the silver lining. It is after all, a good strategy in life to always try to see some positives even in a bad situation.

So here goes:

1. I think the best thing about Covid-19 is that it is preventable.

We know what causes Covid-19 and we know how to prevent it. Having the will to do what is necessary is a personal decision however.

Imagine how bad things would be if one had no options.

Fortunately this isn’t the plague where you are just a sitting duck. It is not rocket science either. There was a spike in cases and hospitalizations after July 4^th  as expected. At this point, everyone knows what to do. We have no choice but to put life on hold until they do it.

2. The seniors got the memo! The death rate in the elderly is decreasing because they are being more careful. Maybe we should all take a leaf out of their book.

3. You never have to get the flu ever again! As a scientist I am thrilled to see that people finally understand how viruses are spread. Now people are careful about what they touch and are very generous with their use of hand sanitizer. This winter should be like no other. People are already asking me for the flu vaccine. No more chasing folks. I love hearing lay people using all the old epidemiological terms like ‘co-morbidities’, risk factors and infection rates. They sound like pros now.

4. People now understand why organizations like the CDC exist and why disbanding or defunding public health is a bad idea.

People also understand how the health in one country can affect people on the other side of the globe. Yes, the World Health Organization is an important component of a stable planet and the world economy.

5. The racial and socioeconomic disparities in health care are as obvious as a sore on your face. Not just that, people finally realize that we are all interconnected and that it is in everyone’s best interest for even poor people to be healthy.

Disease can spread from the bottom up, even when the rich people hide in the Hamptons they still need ‘essential’ (aka menial) workers.

Maybe universal healthcare for all isn’t such a bad idea after all! Imagine how much money we would have SAVED this year alone not to talk of lives and productivity.

We can no longer pretend healthcare is not political. We hear nothing from our current administration about their plans for providing healthcare to the underserved, only scare tactics about people losing their health insurance. Of course having health insurance requires you to be healthy enough to have a job!

6. Many people have enjoyed working from home. Less gas, less traffic, less pollution, less wear and tear on their bodies. Fewer outfits, less dry cleaning etc! I think that genie is out of the bottle. It behoves us to accommodate this new reality. (By the way have you tried digital medicine yet?)

7. I believe Covid-19 has been a wake up call for a lot of people.

Hopefully we are now more appreciative of what we had and what we are now missing.

These are just some of my thoughts.

Please, at least take the uptick in cases seriously or we could continue this pandemic until the end of the year. It is predicted that at the current rate of increase America will lose another 30,000 people in the next 2 months. A very sobering thought, positives not withstanding.

The Phantom of the Mask, the Myths!

THE SWEDISH MODEL OF 'PREVENTION' :THE RECENT INCREASE IN COVID CASES Do masks work? In a word Yes! But before we get into the myths surrounding the wearing of masks let’s talk about preventive measures in general. Yes, the same ones I have been harping on for 4 months now. The good old social distancing, hand washing, hands off the face and hand sanitizer stuff. How do we know they work? Well, first let’s look at Sweden. Sweden has captured international attention by conducting an unorthodox, open-air experiment. It has allowed the world toexamine what happens in a pandemic when a government does not institute rules. Sweden was the only Scandinavian country that decided not to lockdown or quarantine when the corona virus hit Europe. This is what has happened: Not only have thousands more people died than in neighboring countries, thatimposed lockdowns, but Sweden’s economy did not fare better. Per million people, Sweden has suffered 40 percent more deaths than the United States. Sweden who chose not to lockdown, has 358 deaths per million compared to Norway 44, Finland 53 and Denmark 93 (The US is 267 per million and rising). But Sweden’s grim result showed that a failure to impose social distancing, costs lives, jobs and does not stop the economic consequences of Covid. This disaster is now playing out in the United States, there are states particularly in the South that decided to follow the ‘Swedish model’. Florida for instance currently has 7,000 people in the hospital and has had 4241 deaths and the numbers are rising daily, exponentially. Texas is another state with complete disregard for social distancing. Maryland on the other hand, where masks and social distancing is mandated, continues to have a decline in hospitalizations (Current total 410, ICU 143). Please do not quit while you are ahead! Here we are 4 months in and we are still on high alert, with numbers rising in areas were people insist on being in denial. Who would have thought that because of such lack of political leadership this would still be going on? Even China were it began has pretty much gone back to normal. My neighbor told me a joke the other day: The patient asks the doctor : “Hey Doc how long is this Covid  problem going to last?”  The doctor says:  “I don’t know, I’m not that much into politics!” THE MYTHS OF THE MASK: "Wearing a mask is accepting defeat" : False, it is a sign that you are a responsible citizen. "Wearing a mask implies you are a ‘Liberal’":False, last I checked anyone, of any political persuasion can be infected (and die). Carbon dioxide from exhaling gets trapped under the cloth and can make you sick.  False: this is not true, false science. "Cloth face masks are not effective." False: they create a barrier between your mouth and nose and those around you. This makes it more difficult for the droplets that spread coronavirus through coughs, sneezes and talking to reach other people. Cloth masks are highly effective for the general public. According to the CDC, a cloth face mask needs to have the following in order to be fully effective: ·      Cover both your nose and mouth ·      Fit snugly but comfortably against the sides of the face ·      Be secured with ties or ear loops ·      Have multiple layers of fabric ·      Allow for unrestricted breathing ·      Able to be laundered and machine dried without damage or shape changes "If you've had coronavirus, you don't need a mask". False: If you've had coronavirus before or had an antibody test come up positive, you may believe that you don't need to wear a mask. Unfortunately, at this time, there is no way to know whether having coronavirus once provides immunity from the virus infection again or how long that your immunity might last. This means that you could potentially catch the disease again and spread it to others. Everyone should wear a cloth mask when in public unless they have breathing problems, are under age two, or can't remove the mask without assistance. "You don't need to wear a mask outside". False: At this time, being outside is generally considered safer than being inside. When taking a stroll or participating in other outdoor activities by yourself or with people you live with, a mask isn't required. However, when you find it difficult to maintain at least six feet of distance from people you don't live with – such as passing someone on a sidewalk or eating out at a restaurant – it's important to have your mask on. You should always have your mask on hand when you leave your home. Everyday health in extraordinary times: We are staying open so you can stay healthy! We have special protocols in place in the office to keep you safe and minimal waiting. No walk-ins. Anyone who doesn’t have a mask waits in their car until their appointment. Extra sanitation procedures daily and hand sanitizer for everyone! Come on in! It’s a great time to lose weight especially with our 10% off sale on the Weight Reduction Program. You have plenty of time to focus on your goal (and quit snacking). Other reasons why this is a good time to visit the doctor: Make self care a priority so you can be there for your family and handle your responsibilities better. Schedule that physical exam and pap smear you can never get around to when you are working. Keep your medications up to date and current prescriptions refilled. Pick up your Vitamin C, D and zinc, Echinacea Take off that mole you have been worried about. Get your shots updated. Get a cosmetic consultation. Balance your hormones so you can handle stress. Last but not least manage those co-morbidities that put you at higher risk of Covid-19