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Showing posts from March, 2020

Life In The Hot Zone

This Cartoon was created by Alex Thomas, MD for the Annals of Internal Medicine.  It shows what many physicians are experiencing as the CDC and hospital organizations change the protocols on a daily basis to deal with the Corona Covid-19 Virus pandemic.  Doctors feel like they are human fodder.  (click on the image to see it larger)



Hydroxychloroquine and Covid-19

Thanks to a shout out by President Trump that Hydroxychloroquine would be a "game changer", this drug is all over TV and web as the possible treatment for Corona Covid-19.  Because this virus HAS NO KNOWN TREATMENT,  the FDA is fast-tracking pharmaceuticals and vaccines.  There are at least 22 known studies ongoing to test the effectiveness in humans and Corona Covid-19.  Here's what we know (today, March 28, 2020) about Hydroxychloroquine:


As a drug used to treat rheumatoid arthritis and lupus, Hydroxychloroquine works in a complex manner on cells and proteins to down regulate the immune response.It is also used to treat uncomplicated plasmodium malaria but is not effective against all malaria strains.The brand name for rheumatology use is Plaquenil and it can be found in the urine three months after taking.  It has a very long half life.The Journal of Antimicrobial Agents reported astudy of 26 patients receiving Hydroxychloroquine. Six patients were lost to follow up, …

What Patients Get Wrong About Covid-19 Virus

There is so much information, pop-ups, social media and gossip about Corona Covid-19 Virus, it is not a surprise that patients have some erroneous beliefs.  It is an evolving situation and we are learning new things every day.  Here are a few beliefs that people have wrong:  

                                  1. Only older people ( Old Boomers) get serious illness 
Wrong. As of March 16, the CDC reported the cases of hospitalized patients in the U.S. were:
Over age 85 -  9%
Age 65-84.  - 36%
Age 55-64   - 17%
Age 45-54   - 18%
Age 20-44   - 20%
< Age 19     -<1%

Until March 16, 80% of all deaths were in people over age 65.  Note these numbers are rapidly changing as the incidence grows.

    2.Any Symptom could be Corona Covid Virus
Wrong.  Covid Virus is always respiratory and its main action is in the lungs and bronchioles. The virus contains glycoprotein spikes that attach to receptors and enter cells in the lower respiratory tract of humans.  The symptoms include cough, fever,…

Home Made Cloth Masks For Corona Covid-19 Crisis

Everyone is aware of the shortage of Personal Protective Equipment (PPE) and the sorry state our health care workers are in without the basic infection protection.  Many industries use PPE but the current shortage with the Covid-19 Virus pandemic is a true crisis for health care.  The types of PPE are face shields, gloves, goggles and glasses, gowns, head covers, masks, respirators and shoe covers.

Healthcare organizations are asking for PPE donations from other industry and the federal government has promised to deploy equipment from the National Stockpile. Americans want to help and many have taken to their sewing machines to create homemade masks and gowns to supply medical professionals.

The British Medical Journal (BMJ) studied cloth masks ( two layer, made of cotton) vs.   medical masks (3 layer made of non-woven material)  in 2015 and compared the infection efficacy of the two. Participants used the mask on every shift for four consecutive weeks. They were asked to wash the cloth…

Beware of Scams with Corona Covid-19 Pandemic

Whenever there is fear, chaos and uncertainty, there are people who will take advantage of others.  Unfortunately the Corona Covid-19 virus creates a ripe environment for scammers and way too many people will fall for it. Here are some things to watch out for:

1. Pfishing emails - pfishing emails are cyber attacks that use fake emails as a weapon.  The goal is to trick the recipient into thinking it is real and have them click on a link or download an attachment.  The fact that people are hungry for real information makes them susceptible to any email that "looks official" and promises goods or information. These emails can place malware on your computer, get private personal information or even get the recipient to divulge passwords and financial information.

Remember, pfishing emails use popular brands to trick consumers.  The most popular are PayPal, Facebook, Microsoft, Netflix, Whats App, BofA, Apple, Chase....you get the picture.  They can be quite real appearing with…

Corona Virus Covid-19 Treatment

Yesterday (3/19/20), Donald Trump held a press conference and promised new treatments for Corona Covid-19 virus that would be a "Game Changer" and would be fast-tracked through the FDA and ready for use "soon".  Spoiler Alert for remainder of this post...There is no treatment. 

It is true that researchers across the globe are studying both new and old drugs in hopes of a treatment for the patients that have severe disease. But it was incorrect and frankly dangerous to say we have a solution that will soon be implemented.

Today, the New England Journal of Medicine (NEJM) reported on a study of the combination Lopinavir-Ritonavir (currently used for treating HIV) in treating Covid-19.  The combo had shown some effectiveness in other corona virus', SARS and MERS

Unfortunately the results did not show any benefit for hospitalized patients with severe Covid-19 infection using this combination and 14% of study patients could not finish due to side effects.   Further…

Corona Covid-19 Facts for You

Are you getting overwhelmed with Corona Covid-19 Virus 24/7 on the news, internet, social media and with friends? Its coming fast and furious now with more information than anyone can process.  With school and restaurant closures, no sport events and many cities sheltering at home, the anxiety levels are sky high.

Well, I'm here to add more by answering questions that I have been asked about the Pandemic.  Today is 3/19/2020 and this information is valid as of today.
Q: Why is everyone so worried with only 11,275 cases in the US and 80% of people showing only mild illness?
A:  Because it is a new human virus, nobody has protection or antibody to it.  Our bodies do not have a template to defend against the virus.  We have no cure and no vaccine developed to protect people. We have not been adequately testing people and we don't know the actual number of infections. The precautions are meant to slow the virus spread so our health services will not be overwhelmed with patients.  T…

Private Equity Buying Physician Practices

People ask me all the time if I can help them find a good doctor. Unfortunately it is not so easy.

In many affluent communities, most of the primary care physicians are now "concierge" and require a monthly fee for access. A new appointment for a specialty problem may take weeks and even then you may be seeing a nurse practitioner or a physician assistant. Many practices do not accept insurance and certainly not Medicare/Medicaid. From the doctor's point of view, these practice decisions may be understandable and I won't go into the changes in USA medicine that have driven it.

But there is a new game in town that will make affordable healthcare even more difficult. Private equity acquisition of physician medical groups.

This is a new frontier and no-one can predict how it will turn out for patients and health care costs.  Never before have medical practices been part of a merger and acquisition (M&A) portfolio but they are now and it's growing every year.   …

Covid-19 Social Media Crazy Fakery

As of this time and date (March 2, 2020) there are 91 reported positive cases of Corona Covid-19 cases in the United States.  Forty-eight of them were from the repatriated Diamond Princess cruise ship. There is no doubt that more cases will be reported, and as testing becomes more available we will see that number go up in most every community.  There is really no way to fully contain the spread of an airborne virus.

Everywhere I go people are talking about the virus, asking questions, posting on social media and innocently passing on erroneous information.  The 24 hour news channels finally have something besides Trump on which to focus, even though there aren't many "new" things to report.

It should come as no surprise that the internet is now full of Bots (automatic robots on the internet that often sow malicious information) that are posting all sorts of conspiracy theories, fake science and just inflaming fear and discord.  This misinformation is a very real danger…