The Corona Chronicles: Alone Together

News, facts, thoughts, and advice from Dr. Maurice Beer and the IMNY Team.


Most people seem to be getting the message- social isolation protects you and everyone else. Stay home, don’t the spread virus. A majority of people also seem to understand that we will need to do this for another 6-10 weeks.


As new information comes out daily the biggest challenge is sorting the accurate from the rumors and unsubstantiated information. See below.


THE BAD


Latest mortality rate in the US has increased to 1.5%


Health care workers feeling overwhelmed, betrayed and disheartened, their ranks depleted by illness, as conditions in hospitals get worse. In some cases, even health care workers with symptoms can’t get tested.


Penetrance of the infection (what part of the population is infected) is the same both in densely and sparsely populated regions.


The Federal and State governments continue on different tracks and actually competing with one another for supplies and equipment.


Yesterday we had the most reported deaths since the beginning of the pandemic. More than 400 people died on Friday


More than 90% of mayors say they don’t have enough masks or test kits.


Politics and economics insert themselves into the discussion daily. Makes personal decision making more difficult. Choose your information sources carefully. I try to adhere to that concept, but it can be challenging.


THE GOOD


President Trump has invoked the Defense Production Act, requiring GM to manufacture ventilators after negotiations with GM failed.


All over the country, homebound Americans are crafting thousands upon thousands of face masks to help shield doctors, nurses and many others from the coronavirus.


There are many examples of people helping and supporting one another. Hundreds showed up with their cars in a hospital parking lot, headlights on and while seated in their cars praying for the health care workers in that hospital.


Naval hospital ships (The USNS Mercy and Comfort) are being dispatched to NYC and LA, each with 1,000 bed capacity and up to 1200 medical personnel to care for non COVID patients.


Rapid test kits expected to be available later this week.


COPING


Two tools to help you decide whether you need medical attention.


· Thermometer: fever greater than 100.4 degrees


· Pulse Oximeter: these are for sale online for about $30 or you can download an app to your smart phone for $4.99. It’s from digiDoc technologies.


Pulse oximeter reading of less than 95% with fever greater than 100.4 degrees and shortness of breath should prompt a medical visit.


An interesting update on using NSAIDS in COVID 19. An article in Wired raises questions about the possible contribution of medications like Advil to corona virus pneumonia. Experts are walking back the warning and stating that evidence linking the use of Advil and worsening illness does not exist.


So make your decision based on this news. Here are links to the articles that address this issue:


The Ibuprofen Debate Reveals the Danger of Covid-19 Rumors


A viral text warns taking Advil could make COVID-19 symptoms worse, but experts say it’s unfounded


I think there is an important message tucked into these articles. The advice about Advil included the recommendation to use acetaminophen instead for symptom relief. But concerns about the possible risks of using acetaminophen were not emphasized. The functional medicine approach largely eschews symptomatic treatments. For example, suppressing a fever may be counterproductive as fever acts a protective response as high temperatures suppress viral replication. Because of the high fevers seen in COVID illness there is a risk of “therapeutic misadventure.”


Perhaps we should manage fevers with increased hydration to encourage sweating and sponge bath with water and use a fan allowing evaporation to bring down a high fever.


There is a risk of acetaminophen overdose and liver damage. Acetaminophen is a major cause of liver failure (thousands of cases of liver failure and hundreds of deaths each year). With the widespread inclusion of acetaminophen in various over the counter products it is possible to inadvertently overdose on acetaminophen. The risk of liver injury is increased even more with alcohol consumption and with infections that may be affecting the liver.


The solution is straightforward.


· Limit use of symptomatic treatment with medications whenever you can.


· Read the labels and keep track of your total exposure to acetaminophen. We recommend limiting acetaminophen to a maximum of 3,000 mgs a day.


· Don’t drink alcohol if using acetaminophen (also called paracetamol)


· N-Acetyl Cysteine (NAC) is used in the hospital to treat acetaminophen liver injury so taking 600 mgs of NAC with acetaminophen can provide a protective effect.


HUMOR


    Don't forget to wash your hands


                                     The New Heroes