General Wellness

Every morning, the news reports on some comments made or advice given by our governmental leadership which is becoming more and more ridiculous. Their behavior and example are ever more irresponsible and despicable. And it’s costing lives.

The scientific statistics are sad. We are officially in the fall/winter upsurge as Covid numbers climb and not a single state is now in the stable or decreasing numbers category. Some cities are setting up field hospitals in parking lots as they are already overflowing with patients.

For the Whitehouse to suggest that we just “let young people go about their business since they will weather the infection better and we can reach herd immunity sooner” is preposterous.

Tell that to the families whose young, healthy relatives have died from this infection.

Tell that to the patients I see who can’t smell or may have had some damage to their hearing because of the infection or need a tracheotomy because of respiratory failure.

Tell that to the “long haulers”, people who have had Covid and now struggle with chronic, debilitating side effects.

The fact is that almost half the country is in a “high risk” category when it comes to risks for Covid complications. Half of those are simply because they are older but the other half are under 65 but have a chronic condition.

As I have mentioned in previous posts, just being overweight increases the risks. In addition to the inflammatory compounds and hormones generated by extra adipose tissue, most overweight people, and certainly those who are obese, likely have some degree if insulin resistance, the precursor to diabetes. Studies have shown that even with normal fasting blood sugars, even with a normal HgBA1C, the indicator of the previous 3 month blood sugar average, as many as 30% of people have pre-diabetes and 10% have frank diabetes when they have a glucose tolerance test, the gold standard test indicating how well your pancreas is actually doing. A poor diet including excess fat and processed foods and adipose tissue in your body cause insulin resistance. In addition to Insulin resistance causing inflammation and immune dysfunction, diabetics have more FURIN on the surface of cells. This is an enzyme which “clips” the Sars Cov-2 spike protein once it attaches to the ACE-2 receptor. This then allows the virus to inject its RNA (genetic material) into the cell where it hijacks the cell’s genetic machinery and starts replicating itself.

As for herd immunity, this will not occur for a LONG time, if it happens at all. Again, we need at least 70-80% of people to be resistant to the virus AT THE SAME TIME for the virus to burn itself out. We have already seen that infected people’s immunity wanes in the months following infection, with some having been re-infected. In addition, the vaccine is months away, if it even works. Add to that the fact that, assuming that it is 70% effective, at least 70% of people need to get it for it to be of any value on a population level.

Herd immunity is a pipe dream.

We must focus on prevention and treatment to slow it down. We must to continue to follow the proven methods of prevention:

MASKS

DISTANCING

HAND WASHING

The other things help.

VENTILATE

VACCINATE

GET HEALTHY

Stay safe and be well.

AC

I listened to an interview with Dr. Fauci this morning regarding some immune aspects of Covid-19. 

In case anyone needs to be reminded, Dr. Anthony Fauci is a physician and immunologist who has served as the director of the National Institute of Allergy and Infectious Diseases since 1984. He has been at the forefront of the development of many vaccines including the 40 year attempt at developing one for HIV. Although our administration has access to this tireless and quite knowledgeable doctor and scientist, they are ignoring his advice. I’ll stop there because I could go off on another rant.

1. Vaccine status. Despite some recent setbacks with some trials being put on hold because of some side effects, keep the bigger picture in mind. The most recent trial to be put on hold involves a US trial of a single-dose vaccine (most are 2 doses vaccines), being tested on 60,000 people. What the reaction is not known yet and in addition, we don’t even know if this patient was in the vaccine arm or placebo arm. To put this in perspective, there was one complication for every 15 individuals treated with aspirin and one death for every 556 individuals treated. There is still lots of reason to be hopeful about a vaccine. Let’s just develop one, or likely more than one, safely, not because it is politically expedient.
   
2. Herd immunity. It may not be possible to achieve this but without a vaccine, this will most certainly be impossible. Not enough people have gotten sick or exposed. We need in the 80-90% range for this to occur and the state with the most positive cases, NY, only has 20% positivity, and only in localized areas. Most others are in low single digits. This does NOT mean that we should just open things up and let the chips fall where they may however. I had this conversation with a patient recently and when asked the question “How would you feel if your relative or child got really sick, had complications or even died?” There was silence. The risks are still low, but if it affects you or your circle of family and friends, it’s 100%. And it’s not just about minimizing deaths. As we have seen, there are many complications, some probably lasting for years if not lifetimes going forward.
   
3. Lasting protection after infection. The simple answer is that we just don’t know. Not enough time has passed and not enough people have gotten sick. In addition, our testing capabilities stink so we don’t have the ability to monitor and test enough to tell. If infections from the Coronaviruses which cause the common cold are any indication, there may be some protection, but it wanes after 4-6 months. The same goes for the flu. We don;t have immunization against coronaviruses, or other common cold viruses like adenovirus or rhinovirus, but we do against the flu. Any protection is better than no protection. 

There continues to be  a lot we are learning and the longer we can keep numbers under control, the more time we have to develop therapeutics and vaccines. Stay the course. Be safe, for yourselves, but more importantly for all those around you.

DISTANCE.

WEAR A MASK.

WASH YOUR HANDS. 

DON’T TOUCH YOUR FACE.  

VENTILATE.  

VACCINATE. 

GET HEALTHY.  

Stay safe and be well.  

AC