Motivation

My intent in blogging is to share symptoms, diagnosis, and treatment essentials. The what if, what to do descriptions can save you from preventable disease and help with chronic disease care. Health is always on our minds and having learned from my patients I continue to be a physician sharing knowledge and experiences. Some are rules that will make you realize that our bodies speak to us – we must listen! There are lessons you should not learn the hard way. There are rules that unless followed your body will revolt. The information herein builds while respecting the individual’s intelligence to pay attention and recognize their bodies’ needs.

DocHandal’s website present philosophy and our mission dictate what and how we share free medical information. We try hard not to become, nor appear to be commercial, regional, bias, nor political. 

We ALWAYS welcome reader comments and input no matter the topic.

The Senate Must Act

One out of 6 workplace deaths is due to violence!

I sincerely hope they will pass the Workplace Violence Prevention for Healthcare and Social Service Workers Act. This bill, also known as H.R. 1309, attempts to make hospitals safer for those who work in them. Even before the current pandemic, healthcare has always been a surprisingly dangerous field. According to data from the Occupational Safety and Health Administration (OSHA), healthcare providers experienced workplace violence at a rate that was four times higher than other employees in private industry. In fact, the number of workplace violence incidents in the healthcare industry exceeds that of almost every other industry combined.

COVID -19 By The Numbers

You should not rely on soundbites or headlines that incompletely or dictate reality, please use information you can gather, such as what I have mentioned below, as sources and form your own insights. A wonderful example is the constant mentioning of the fatality rate from this virus illness. You can read it is 7 % here, 4 % there but in reality, the fatality rate for non-nursing home residents would only be 0.1% or 1 in 1,000. And that includes people of all ages and all health statuses outside of nursing homes. To that end please read on and have a look at these sites, unless I am ‘preaching to the choir’.

How many cases are there? Many but one website is the go-to site listing the best available data regarding US number  COVID-19. I recommend John Hopkins University (JHU) US dashboard. The JHU’s Center for System Science and Engineering (CSSE) responsibly maintains this publicly accessible dashboard.

For worldwide numbers, I personally watch the JHU site by country listing.

To review your state’s case number, turn to the Health Department’s websites ex. my state -Arizona (AZ site). Some states may have varying useful and current data. It is important to look at what dates are of data. AZ site reporting customarily lags a week. Please look for the timestamp of the latest update. 

 

COVID -19 in Healthcare Providers

More than 600 nurses worldwide are known to have died from COVID-19, which has infected an estimated 450,000 healthcare workers, the International Council of Nurses based data from 30 countries. By the time you read this, the numbers will be greater. to my knowledge at present, there is no study for how many doctors nor paramedical providers have contracted the disease not have died.

On average, 7 percent of all cases of COVID-19, are among healthcare workers, if you due to the simple math from the more than 6 million reported cases worldwide the estimate of about 450,000 infections among healthcare workers.

The number of infected healthcare varies dramatically between countries, fewer than 1% in Singapore and more than 30% in Ireland Sadly in the US many states are not tracking the numbers of infected healthcare workers. 

YES, lack of equipment, fatigue that lowers immunity and emotional stress make this group especially vulnerable. This report also showed 72% of ill healthcare workers were women mean age 42. 

Please do not forget the Paramedical personnel the non-doctors and nurses are on the TRUE front lines of this pandemic. Doc Handal continues to author and co-author on relevant paramedical topics  – the latest publications are related to the pandemic of COVID-19. Journal of EMS publications include: ‘The Ethics of PPE and EMS in COVID-19 Era’ and ‘Paramedicine Strategic Planning‘.

Banned Masks!

California and Colorado, including many public venues and attractions, have banned face masks with valves, as reported by Forbes unless you can just put tape firmly over the valve!

N 95 Masks with valves are for industrial purposes not for medical use.

Don’t just see ‘N-95’ and buy the mask. N95 face masks with one-way valves are readily available to purchase. The valve filter allows your breath to be expelled. Yes, it is cooler and more comfortable in the summer months but not at all helpful. Yes, less restrictive than masks without a valve, but they are also useless in preventing the COVID-19 spread. The Centers for Disease Control (CDC) recommends covering your nose and mouth in order to protect yourself from infection but also to protect others from coming into contact with your respiratory droplets. These masks can put other folks in danger of catching the virus you exhale. Recall even if you have no symptoms you can expel virus. Studies say anywhere from 4-5 days of the virus living in your body to 14 days on average.

The eyes are the other site of virus entry, hence glasses or visors are part of healthcare personnel attire (PPE).

 

 

It is not ALL CLEAR

At present COVID-19 mortality rates is 50% to 62% for adults admitted to the ICU. The hallmark lung findings: dry cough and fever and then pneumonia is not found in everyone. COVID-19 doesn’t always go completely away ad you are back to yourself! It might linger for weeks in some and in others might leave permanent body organ damage.

However, the burden of COVID-19 infection in children was much lower compared with seasonal influenza, with CDC reporting (as of April 28)  eight deaths in children ages 14 and younger related to COVID-19 compared with 169 influenza-related deaths in the same age group during the 2019-2020 flu season.

Adults can suffer heart attacks when infected with the SARS Co-2 virus. Not all will have had hypertension or Diabetes Type 2 although these pre-existing conditions are commonly seen in these patients. Often no lung symptoms! This is from a retrospective study within a single health system in New York City.

To re-iterate my advice: You do NOT want to get this virus if you can avoid it. Please follow safe distancing and  not venturing out unnecessarily. Age, as well as other medical conditions, should make you more patient as we all wait for a worthwhile vaccine or at least until medical professionals decide upon the best treatment plans. 

This infection is so hard to recognize and treat as in every person the virus acts differently. Is it because of what shape our immune system is in? Hence you have read my recent blog on a current regimen to boost body defenses (immunity) it as well as in the media.

Want Out?

SARS Co-2 virus is not suddenly gone!!

Lockdown has been if nothing else different. No matter your housemates, children, roomies, or animals stress was inevitable. I am blogging because I feel strongly the economy should not take priority over health. In my humble and well-read opinion it is a bit rushed! The simple idea behind a lock-down, shelter in place, stay home whatever your jargon preference – is to allow the health care system to catch up. Do we have enough tests, testing, tracking, PPE (masks gowns, face, shields)? No definitely NOT! So when you see the term in headlines ‘second wave’ I fear it will be worst. and what about the healthcare providers? They are spent if not already ill (14% worldwide) if that is accurate, but I believe that number is most probably low. Can’t manufacture healthcare providers in a covered factory.

So if you MUST venture out, please consider the following:

How much time/exposure would the outing be

Outdoors is safer

Can you easily stay 6 feet apart

No lingering-it is safer to go to AutoZone to buy an oil filter versus sitting in a restaurant having leisurely breakfast.

Pre-entry thoughts are masks being worn, also are servers 6 feet apart, and are tables allowing for the same distancing.

From French Channel24same?

A recent (May 5,2020) University of MD. poll found that 78 percent said they would not be comfortable eating at a sit-down restaurant, and 67 percent said they wouldn’t be comfortable shopping in a clothing store. Only 18 percent of respondents were in favor of reopening movie theaters. So if you are like me you are not alone!

Hang in there are over 100 vaccines in development at this writing and many innovations being recognized. An intriguing one is using a fabric already approved by FDA for wound care, This polyester like fabric w metal dots of zinc and silver weaved into fabric used for masks that neutralize the SARS-Co2 virus in one minute.

COVID-19 New Reveals

Recall, I mentioned in an earlier blog, certain countries were hit harder – had more cases of this virus and more deaths. Yes, cities given their population density were postulated to have more cases just on that but now think mutations!

I also mentioned in a past blog there were a number of mutations postulated. Clearly now research shows  that COVID-19 mutated early on in the pandemic to create a more transmissive strain: the ‘G clade’, which may also be associated with a higher viral load. Sure enough, that is what was found in patients in Italy. At ‘home’ NY residents had a high percentage of the ‘G clade’ than found in other states. 

More news about this very complex virus is that its impact on the human body can last a very long time and leave many with permanent damage to organ function. Some individuals after as much as 50 days are struggling with symptoms. Children with COVID-19 can suffer an overwhelming inflammatory syndrome, a  version unique to children, attacking the heart and causing death. Naturally, children with a predisposing condition are at greater risk.

I would like to take an offensive approach and after research internationally and in US literature I want to share a few recommendations that make sense to me. Many medical opinions suggest boosting your immune system in the case. To that end recommendations have included relatively benign supplements*: 

Zinc -losenges best -75-100mg/day 

Vitamin C -500mg twice a day

Vitamin D3- 1-4000 mg /day

Melatonin, slow-release begin with 3 mg. and increase as tolerated (at bedtime) increase to 6-12 mg daily

 Quercetin 250-500 mg.  twice a day – an antioxidant, antiinflammatory found in plants

Some individuals have started to monitor with an oximeter (very hard to find to buy as most made in China) to monitor their oxygen saturation. Recall you % drops before you get dry cough and pneumonia.

I have not mentioned in detail, to date, the Hydroxychloroquine drug but its use is for when you believe you are infected. Must be started ASAP, 400mg twice a day then 200 mg twice a day for 4 days. French pulmonologists from early in outbreak to date recommend this medication. Because of clotting seen in many COVID-19 patients, ASA 81-325mg a day is another recommended drug.

 

*check with your healthcare provider prior to taking any supplements

SARS-CoV-2, the virus that causes COVID19

And more info:

  • still no cure &  no vaccine – please do not take false security when stay-at-home rules are lifted. 
  • compassionate use of different medications has occurred. Research continues around the globe into existing pharmacological ex. Pepcid into the vein at over 9 times higher dose than one takes for heartburn. Another is Remdesivir, an antiviral drug, many more but no definitive study has changed medical care.
  • the virus attacks multiple organs in the body, stroke in 30-40-year-olds is emerging as caused by the virus as it forms clots in brain blood vessels 
  • after recovery, what lasting damage this virus leaves you with is still unknown.
  • it has been reported to stay in a person’s stool for weeks after your test turns from positive to negative
  • remember as you leave the home that the virus stays on many surfaces for days, up to 9 in some instances, also pollution -particulates suspends the virus in the air more than the typical 3 hours when it is coming from an infected person’s mouth.
  • Perhaps pollution is why deaths are above trend in cities like Milan (worst pollution in EU) NY and the UK.