Yearly Covid Vaccines and Gonorrhea!

There has been a dramatic increase in the number of advertisements for diabetes drugs as well as the use and availability of CGMs, continuous glucose monitors. This is not surprising since most Americans are fat and have diabetes. Not that the two are necessarily linked… but they are! 10% of Americans have type 2, formerly called “adult-onset” diabetes. It’s no longer an adult disease. We see it in kids all the time, not surprising since 40% of 5-11 year old American kids are already obese! There are many more people walking around who don’t know they have diabetes. Another 30% of Americans have pre-diabetes, again with an even greater number of people not knowing they have it. The diagnosis of “pre-diabetes” is idiotic to me because it makes it sound like you don’t have a problem YET, but that is absolutely wrong. Diabetes is a spectrum. It starts with insulin resistance (IR), where your insulin is not working well but well enough that you get by, which can go on for decades before routine blood work starts to give clues that there is a problem. The cause of IR is simple; crappy, fatty diet and being overweight.  It’s not because of too much fruit!! There is no question that crappy sugar, in the form of hyper processed foods also contributes, but it’s mostly the fat, which impairs insulin’s function and the cellular signaling required for insulin to work. If you want to dive deeper into this, check out www.masteringdiabetes.org. The estimates are that if you add all these three conditions together, diabetes, pre-diabetes and insulin resistance, ~80% of Americans are actually affected. That’s insane. Although I think CGMs can give you great information about the impact of the food you eat has on your blood sugar levels, the commercials promoting them suggest that if you simply know your level, and that it’s not too bad, you can go ahead and eat that piece of cake or french fries at the restaurant! That’s not what they are for! They are not to check your present blood sugar so you can decide if you can continue to eat junk! The medical establishment needs to do a better job teaching the public about how to reverse diabetes rather than how to better treat it!

What does this have to do with Covid? Well, diabetes is a significant risk factor for getting a bad case of Covid but the point is that the messaging is wrong. These commercials send the wrong message, and I think that the news of a single dose vaccine being developed may be too early to suggest, or even talk about.

Although simplifying treatment protocols for any disease is a great goal, I think it is dangerous to do so if it dilutes the importance of proper behavior and the emphasis on prevention and diminishes the impression of the potential severity of a disease. At this stage, given how much this virus mutates along with the fact that protection wanes significantly by 6 months, this unhelpful messaging is what hoping for a yearly Covid vaccine would do.

The CDC argues that a yearly shot, based on a prediction of what the virus might look like, as we do with the Flu, would do the following:

1. Simplify the product, making administration less complicated,
2. Decrease administration errors.
3. Encourage more people to get it and improve compliance.

1. Let’s start with the first issue. We have plenty of diseases which are treated with a variety of medications and protocols. Just look at how many blood pressure and diabetes meds are on the market. If we can’t handle a few different types of vaccines given twice a year, we shouldn’t be in practice. We don’t need to simplify, just educate and promote the importance of getting the shot in the first place.

2. As a doctor who tests for and treats allergies, I am well aware of the fact that “user error” is the most frequent cause of severe and lethal reactions when administering allergy tests or shots. Wrong dose… wrong patient… mixing errors… poor attention to other risk factors at the time of giving the shot… all things that careful people review before giving shots. Compared to that complexity, giving a vaccine in the arm is not rocket science! Decreasing administrative errors is an irrelevant reason to give a vaccine in a less than ideal regimen.
   
3. People will not change. The information is out there. There is a lot of confusing information admittedly, but there is a big difference between listening to a social media influencer and a medical institution or a quack trying to sell you a supplement and someone without an agenda other than helping people. Telling people that now they only need one shot a year will not make much difference in convincing them to get it.

In addition, Covid is NOT the flu. It is not seasonal. When do you time the shot? It mutates at a significantly greater and less predictable rate. It is evolving all over the world. We know that even the effective bivalent booster’s efficacy wanes. Antibody levels can measurably drop even a few weeks after vaccination. They remain elevated enough for at least 90 days and we do develop permanent B and T cells, but efficacy wanes, certainly by 6 months, to a point where boosters are necessary, at least for now.

MEASLES. Speaking of vaccines, with the decreasing routine vaccination of children by ill-advised parents, it’s not surprising that we are seeing measles outbreaks. In Ohio, there is an outbreak of measles presently which has affected at least 85 kids, 32 of which had to be hospitalized. 74 of these kids were not vaccinated at all and the rest were only partly vaccinated (it’s a multi dose vaccine). The rest just didn’t trust the doctors or the science. Less than 1% of all unvaccinated kids have a legitimate vaccine exemption and this group was no exception. The rate of vaccination may seem high (93%) but this is below the threshold believed to be important for herd immunity (95%). The same decreasing rate has been seen for other vaccines like those for Pertussis, Chicken pox and sadly Polio, and we’ve seen a recent Polio outbreak in NY last summer. In NY in 2018, there was a measles outbreak of 650 cases. These are not benign diseases and can have many complications, whereas the very effective vaccine is extremely safe. Don’t gamble with your child’s health. Get them vaccinated.

GONORRHEA. Admittedly, this was mostly a click-bait issue, however, there is a real problem. Drug resistance. In Massachusetts, there were 2 recent cases of multi-drug-resistant gonorrhea. An STD for which there is no cure. And in addition to the pain one experiences you-know-where when you pee, there is a serious risk of infertility and joint destruction from this infection. The issue of drug resistance in general is continuing to increase worldwide. I deal with it every day when trying to treat even run of the mill sinus and throat infections. Most of the time, I try to get people to just ride it out with conservative measures but we are an impatient and drug-obsessed society, and increasingly, a drug resistant and overmedicated one as well. Although overuse of antibiotics is a significant contributor to this problem (estimates are that 70% of all antibiotic prescriptions in the US are inappropriate), an even greater and more insidious cause is eating animal products, which are laced with antibiotics, used to promote growth and decrease risk of disease, all to increase profits. You don’t just eat the animal. You also eat what the animal eats. And animals, land, air and sea, all consume massive amounts. 80% of all antibiotics produced worldwide are given to animals. It’s in their flesh and it makes its way into their waste, eventually making its way into the water system.

CHINA and COVID. As the “official” toll starts to be acknowledged (73,000 Covid deaths and what they estimate is over 80% of the country being infected), the statistics from more reliable sources are also coming out. This along with eyewitnessed scenes and an assessment by independent organizations paints an even grimmer picture. If they are accurate, that 80% of the country really has had Covid, their dead should count over 2 million, not just 73k. Their numbers don’t jive. The estimates, based on Western organizations, is that about 35,000 Chiese are dying a day, with a total thus far of 880,000. This is an insane amount, but would not be surprising based on how poorly they have prepared for this inevitable outbreak, once the draconian “zero-covid” policies were lifted, along with the Lunar New Year occurring with over 2 billion trips expected. These trips are predominantly from the big cities to more rural areas where medical facilities are significantly less sophisticated and robust. 

If one includes the situation in China, the number of new cases and daily death rate today dwarfs the previous worldwide peak in January 2021.

China is not the only hotspot. Japan is just coming out of their worst wave since the start of the pandemic. Hong Kong is also emerging from, not the worst, but a pretty bad wave nonetheless. Sweden’s numbers are on a significant rise.

Back home in the US, test positivity (i.e. reported cases) and hospitalizations are on a slow downward trend but deaths remain stable at 540/day, again, 3rd leading cause of death, almost tripling gun deaths.

California has been rocked recently by numerous mass gun shootings. These are tragic and we see these way too often in the US. More than anywhere else in the world by an order of magnitude. But we must also keep things in perspective. The last year we have accurate gun data is 2020 when there were just over 45,000 gun deaths in the US. 45% were murders, 54% were from suicide and 3% were accidental. This amounts to 124 deaths a day. Covid continues to kill over 500 people a day. Both terribly sad. Both preventable.

The main Covid strain in the US is the XBB1.5 subvariant, accounting for just over 50% of cases. Unlike most of the other variants we have contended with, this one developed in the US, and like all of our other bad habits, we exported it out to the rest of the world.

Vaccines, especially the bivalent booster, remain a very effective way to avoid serious disease, hospitalization and death. Adoption of the bivalent booster has been the lowest of all the boosters thus far unfortunately, and I see so many cases of people getting covid, despite receiving the first shots, but who neglected to get boosted. 

Lewis Carroll said “When you don’t know where you are going, any road will get you there”. Covid is like this. There is a lot we know, like how to protect ourselves from getting the disease and a lot we don’t, but are learning about. 

Sometimes doctors don’t bother telling people about how to heal themselves because they are convinced that people won’t bother doing it, and in most cases, they are correct. I read a survey of people with various chronic conditions who were asked whether or not they were willing to make lifestyle changes if it meant getting rid of their disease and being able to stop their medications. Sadly, 70% said they’d rather take the pill. Can’t help those people but we should not let that sad statistic impact our desire to try to help the remaining 30% who are willing to change. I’ve seen it.

Keep being careful out there.

MASK UP where appropriate.

DISTANCE where appropriate.

PRACTICE PRACTICAL HYGIENE.

GET HEALTHIER.

ENGAGE WITH OTHERS.

GET VACCINATED.

Have a great weekend.

Go EAGLES!!!!!

Stay Safe and Be Well

AC

Covid, along with other viral infections such as RSV, Influenza, Adenovirus and other Coronaviruses, continue to cause a lot of illness and misery. Although the numbers of infections of RSV and the flu remain fairly stable, the Covid situation is worsening once again.

In the last 2 weeks, rates of Covid related death, hospitalization and ICU admission have increased. Excluding China, from which data is not reliable, worldwide deaths have risen to 2700 a day, the highest it’s been since over a year ago. In the US there are now 580 daily deaths a day accounting for 22% of the total worldwide deaths. This is a significant rise from the average of ~420 we had for many months. Furthermore, hospitalizations are up by 17% and ICU admissions are up 15%.

Currently, the dominant variant nationwide is BQ.1.1 (34% of cases) followed by XBB.1.5 (28% of cases). Both are much more infectious than the original form, which is all but gone now, and both cause less severe disease. But as I have said many times, a small percentage of a large number is still a large number. I continue to see many patients in the office with back to back infections, some of which involve COVID but mostly, these remain undiagnosed run-of-the-mill viral infections.  Nonetheless, people are having significant symptoms. I’m also seeing long-term post Covid symptoms. Ringing in the ears, persistent congestion, coughing… I also see a lot of alteration in taste. The loss of smell is much preferable to the phantom smell of rotting flesh or the cardboard taste people have with everything they eat. This is now thought to be a central (brain) alteration in smell and taste perception. Not much to offer these patients other than some smell exercises and supplementation with Alpha Lipoic Acid, Vitamin D3 and Omega 3 fatty acids, and these have limited benefit. 

Covid 19 is not “just a cold”.

The situation in China remains, at least on paper according to “official” reports, not particularly significant. But this is a lie. There is a disaster going on over there. All outside independent information suggests the opposite.  Hospitals are full. People are dying at home, with families not being able to dispose of bodies for up to a week. Even satellite imagery shows parking congestion around morgues along with new such facilities being constructed to deal with all the dying patients.  Beijing morgues are incinerating 4x more bodies than normal. There are reports of “scalpers” selling tickets for hundreds of dollars for spots in the waiting line to cremate loved ones at overrun morgues. People are waiting in lines outside for days. The estimates are that about 19,000 Chinese people are dying a day from Covid a day, far greater than previous worldwide peaks of 14,000 and the US peak of 3300 deaths a day. It does seem to be tapering off, at least in the big cities, but the small villages are just getting affected now. And China has a LOT of small villages.

As I mentioned in the previous blog, the Chinese government has a very strict definition of what constitutes a death secondary to SARS-CoV-2. To count as a Covid-death, patients must die in a hospital from a strictly respiratory cause and test positive for Covid. It does not count any other cause of death and we know how this virus can affect the heart, kidneys and even the brain. Deaths which occur outside of the hospital are also not counted! 

It’s a cauldron for brewing a nasty variant! It’s inevitable. Travel restrictions will not help us, especially with the upcoming lunar Chinese New Year, which is widely celebrated with the most massive human migration of any event on the planet. Over 2 billion trips are estimated to occur in the upcoming 10-14 days!

Despite all the illness out there, people back here continue to behave as if nothing is going on. Virtually no masking and minimal distancing. It’s a bit nuts. Either we adapt and change how we live (continued appropriate masking, distancing, vaccination…) or the viruses will force us to adapt when we get sick. Pay now, or pay more later.

VACCINES

Recent studies CLEARLY show that the bivalent vaccine booster dramatically reduces severity of Covid disease and minimizes risks of hospitalization and death. I have seen too many people who skipped the last booster and subsequently got pretty sick. It is also still not too late to get your Flu vaccine. The season stretches well into April.

COVID MYTHS

There was a recent newspaper piece about how vaccination may be driving virus variant development. This is a complete myth. What causes mutation is replication. The more the virus spreads and reproduces, the more it mutates. In addition, the longer and the more a virus divides, meaning the sicker someone is and the longer they are sick, the greater the risk of mutation. Vaccine reduces risks of infection as well as duration of disease. Vaccine REDUCES mutations. It doesn’t cause them. It’s completely ridiculous. This kind of misinformation is horrible, reprehensible and dangerous. But people believe it. 

The other crazy rumors have to do with the vaccine contributing to Buffalo Bill’s player Damar Hamlin’s cardiac event on the football field as well as the death of the reporter Grant Wahl during the FIFA world cup. Wahl’s tragic death was from a ruptured aortic aneurysm. Rare and in most cases unsurvivable, but not Covid or vaccination. Hamlin plays an extremely violent sport which causes traumatic brain injury in 100% of the players. Don;t let your kids play football!!! Cardiac arrest after the kind of hit he suffered is well known to occur. This has occurred on the baseball and soccer fields as well. It wasn’t Covid and the vaccine did not weaken his heart making him more susceptible. More ridiculousness.

PLANT BASED NUTRITION (aka a healthy vegan diet – Coke and Oreos are vegan but clearly not healthy)

It was nice to finally see some mainstream press praising the benefits of plant-based diets. Click here for a link to one such piece from CNN. The original JAMA article is here. What they reported was that people who consumed plant-based diets had a 20% lower chance of premature death while living with significantly less chronic disease simultaneously. Although they have a hard time bringing themselves to say that a strictly whole food plant-based diet is the healthiest, they at least acknowledge that cutting back on animal products and increasing fruits and vegetables is the path to the longest and more importantly, healthiest life. All of these healthiest diets also eliminate added sugar and severely limit processed foods. Some reports also acknowledged the Blue Zones, areas in the world where people are known to live the longest, with life expectancies 10 years or more than the rest of the world, while living with virtually no dementia, heart disease or other chronic conditions. 4 of the 5 established Blue Zones do consume animal products, but it constitutes less than 5% of their calories. Another way of looking at that is that maybe 1 meal a week contained animal products. Never cow’s milk. Mostly fish or the family goat. The Blue Zone with the overall best outcomes however was strictly vegan and is actually in Loma Linda, California.

I came across a very interesting physician/nutritional scientist named Gil Carvhalo, MD, PhD. He is a research scientist at USC and UCLA. He has a YouTube channel named “Nutrition Made Simple”. There, he discusses various nutritional topics such as the dangers (and lack thereof) of seed oils as well as how dietary cholesterol affects blood cholesterol (spoiler: it does). He is vegan but acknowledges that a small amount of non factory farmed animal products are necessarily bad for you. He recently had a couple of videos where he interviewed world renowned paleoanthropologist and evolutionary biologist Peter Ungar who specializes in evolutionary nutrition. His research lab has published hundreds of articles about what and how our ancestors ate. He dispelled various popular beliefs like ones suggesting that we ate mostly or exclusively meat with little carbohydrates, as is promoted in the Paleo or Meat-only diets. He dismissed a strictly vegan ancestral diet as well. The most important take-away from these videos is that human beings are the most adaptable creatures on the planet. We can survive living anywhere, eating pretty much anything. We ate what was available and what would allow us to survive. That meant we ate everything. 

That having been said, gathering and consuming plants was a heck of a lot easier and safer than hunting other animals, most of which wanted to eat us also. Fossil records suggest that we ate grains as far back as 200,000 years ago or more, not when the agricultural revolution began 10,000 years ago. He also highlighted the fact that until the last 150 or so years, humans ate strictly unprocessed, seasonal and local foods rather than hyper processed, sugar and fat laden man-made foods.

Nutrition aside, there are a few other very important reasons to shift to a mostly plant-based diet. Climate change and ethics. 

You have to have your head pretty far up your butt not to appreciate that our climate is changing, unless of course you also believe the Earth is flat and that Democrats drink babies blood. I don’t think that anyone affected by the California floods doubts the existence and impact of climate change. And the animal agricultural industry is the single greatest contributor to global warming. According to some reports, as much as 86% of it. You can deny it until you are blue in the face, but it’s a fact and unless we cut back, allowing land to re-wild which will absorb CO2 and decrease the number of ruminants, primarily cows, which produce massive amounts of methane which is a 28x more potent greenhouse gas than CO2, our planet’s future is bleak. Of course we need to develop clean energy and cut back on burning non-renewable fossil fuels and recycle and stop buying plastic…. also, but all these measures will not save us unless we massively cut back eating meat and consuming dairy. 

From an ethical perspective, the number of land and aquatic animals we torture and kill annually is mind boggling. 10 billion land animals are slaughtered each year in the US alone. 99% of them are raised on factory farms enduring all kinds of abuses. An additional 47 billion aquatic animals are killed each year. Americans consume 1 million chickens every hour! These animals live miserable lives and there is no such thing as “humane” slaughter. Killing is killing. No animal wants to die. It’s hypocritical to be outraged by cultures which raise dogs and cats for consumption, but think nothing of raising pigs and cows for the same thing. It’s hypocritical to imprison someone who abuses a dog, but do nothing to a pig farmer who can legally kill a piglet by slamming its head into the concrete or a chicken farmer who puts live baby chicks into a macerator because they are the wrong sex.

Enough rambling and soap boxing.

What we need in this world is more compassion. Not just for ourselves and our loved ones, but everyone and everything around us. Everything is connected and we are all in this together.

Please continue to be careful out there and please get your bivalent Covid booster. 

Despite the denials, proper masking also makes a huge difference. But it has to be proper masking. Wear a good mask, preferably N95 or KN95, and wear it properly.

Please work on your health. In addition to some pretty sick people I’ve seen recently, I have also seen a few who have taken some real control of their health, one having lost over 140 pounds and who was able to stop a few medications! You can do it. It just takes work and consistency.

I’m off for a week. Hitting the Mexican sun. It’s a very safe place.

Stay Safe and Be Well

AC