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Covid Saliva Testing - Cheaper is Better

Saliva testing for Covid-19 may just be better than nasal swabs and cheaper too.  It's preliminary, but Yale University has published a letter in The New England Journal of Medicine that showed saliva testing from the mouth picked up more positive Covid-19 patients than nasopharyngeal swab testing.   The patients they studied were already hospitalized and had tested positive for Covid-19.  They re-tested them with nasal and saliva tests and found at 1 to 5 days after diagnosis  81% of saliva samples were positive compared to 71% of the nasal swabs.  And at 6-10 days after diagnosis, 76% of the saliva samples were positive, compared with 65% of the nasopharyngeal swab specimens. This is important because of the shortage of medical supplies, inability to self test nasal swabs, and the ability of using common and available reagents in the saliva test.  If one reagent is out of stock (or price gouging is going on), another can be used.  Yale is sharing their protocol so others can repl
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Covid-19 and Convalescent Plasma

This week, President Donald Trump announced the emergency use authorization (EUA) for convalescent plasma to be used to treat Covid-19.  The "groundbreaking therapy" was announced at the White House after he accused the deep state at the FDA of delaying approval of therapeutics to hurt his re-election campaign.   Folks, this is politics getting mixed up again with science.  The real question is: Is convalescent plasma effective in treating Covid-19? Health experts are saying the early results are promising but we don't yet know if it works.  Convalescent plasma is taken from the blood of people who have recovered from Covid-19 infection and have developed antibodies.  If it works, those transfused antibodies will help the recipient of the plasma fight off the infection. Currently there are fifteen randomized controlled clinical trials (and 54 other studies) looking at the effectiveness and one has shown preliminary success when given to patients under 80 who aren't on

Your Blood Type Doesn't Affect Covid-19

  We are at least eight months into the Covid-19 new pandemic and we are quickly learning about this virus and how it affects our bodies.  A few weeks ago there were reports that a person's blood type might protect them from getting the infection. We now know this is not true.  But first, a quick tutorial on human blood type. Each of us inherits our blood type that is carried by an antigen on our red blood cells (RBC).  The RBC is the largest quantity of blood cells in our body and is mainly designed to carry oxygen to our tissues.  Each of us is either Type A, Type B, Type AB or Type O with a protein that is either positive or negative and is called Rh factor.  We know that these types are critical in blood transfusions and receiving the wrong type of blood will cause a severe reaction.  Every time a person is administered blood they get a "type and cross" that checks the blood type and makes sure the proper transfusion is given.  People with Type O blood have no antigen

Don't Believe Mr. Pillow Guy

I'm rather disappointed that I even need to write this blog.  But this is the age of "Anti-Science" and it seems there are a lot of impressionable people - people who would believe a Mr. Pillow huckster- about how to deal with the Covid-19 pandemic.  So let me spare you reading and give you the cliff notes to this blog: DO NOT TAKE OLEANDRIN TO PREVENT OR CURE COVID-19. Nerium Oleander is a highly toxic plant.  I grew up with Oleander bushes as yardscapes because they produced lovely flowers, could be trimmed into hedges and grew like weeds.  But even I knew, as a child, that they were poisonous and all parts of the plant are dangerous if ingested by animals or humans. This should not even be a story, except that The My Pillow Guy, Mike Lindell, inventor, businessman, entrepreneur and friend of Donald Trump, claims he is inspired by the Bible to promote Oleandrin as a preventative and a cure for Covid-19. He has invoked Dr. Ben Carson, Secretary of HUD as a proponent also

Five Conditions That Are Risky for Covid-19

Why do some people get severe illness and even death with Covid infection, and others develop a mild illness or no symptoms at all?  One of the answers to that question is the five associated conditions that we now know lead to severe Covid -19 infections. These five underlying conditions increase the risk for severe Covid-19 and they are highest in counties in the Southeastern United States and in more rural counties and urban areas. People with one or more of these conditions had hospitalizations that were six times higher, ICU admissions that were 5 times higher and deaths 12 times higher that people without the conditions. High risk conditions for severe Covid-19: Chronic kidney disease (CKD) Chronic obstructive pulmonary disease (COPD or Emphysema) Diabetes Heart Disease Obesity, defined as having a body mass index (BMI) 30 or greater Now get this! In the United States the median prevalence of any of these 5 health conditions is 40.7%.  Some Counties were over 5

I Have Gout - Now What?

Any Doctor will tell you that in medicine, things come in threes.  As expected, I diagnosed three cases of gout this week.  If you have been told you have gout you may wonder "Now what?" Gout can affect anyone and it usually occurs quite suddenly, often at night.  It is caused by uric acid crystals that deposit suddenly in a joint, most commonly the big toe, but any joint can be affected.  Patients describe deep throbbing pain that is very intense and sometimes even a sheet touching the joint can cause exquisite pain.  The pain is worse within the first 12 hours. Uric acid is present in our blood and gout occurs when the urate levels are too high and deposit crystals in the joint.  Uric acid is made from purines that are broken down from certain foods such as steak, seafood and organ meats.  Alcohol and juices sweetened with fructose are also causes of excess purines.  Usually uric acid is excreted in the kidneys but if there is an excess in the blood or if the kidneys can

Why I Don't Check Covid Antibodies in Patients

We are (at a minimum) 5 months into the worldwide Covid-19  pandemic that has upended all of our lives.  We have been told "testing, testing, testing" is needed and will be our way out to get back to normal.  There is still massive confusion about testing so let's try and make some sense out of it. First some definitions: The Covid-19 nasal or throat swab test -  This is the test that we are promised "Anyone can get" and most of the time it will reliably diagnose Covid infection.  These tests are now provided in labs, drug stores, drive through testing and some specialized medical offices.  Because they deal with patients who might be infected, the front line testers have to have full PPE to protect against the virus.  Depending upon the test, the results are ready between 24 hours and up to a week.  This test has up to a 20% false negative rate, meaning it will say there is no infection, even if a person is infected.  The test has to capture the virus