Coronavirus Comments from a Doctor… Or are they?

The following was sent to me. I’m not sure I agree with some or even most of the points here.  Unlike most, however, I have a number of highly reputable resources with which to dispute the errors. 

I address each point, in turn, prefaced by ***:

Easy to  read and not too “medical”.

***  Possibly written for the general populace at large.  Then again, it could have been written by someone “not too ‘medical’ ” themselves.

A professor of Pharmacy at U of Toronto sent this clearly worded update to his family.

***  Appeals to authority which do not cite the authority are often fake.

For this pandemic there’s a greater chance of survival for those getting infected 6 months later….say,  September 2020 versus 6 months earlier, say February 2020. The reason for this is that doctors and scientists know more about Covid-19 now than 6 months ago and hence are able to treat patients better. I will list 5 important things that we know now that we didn’t know in February 2020 for your understanding.

***  Partly true.  Yes, treatments have improved.  The original treatment protocol was to do nothing but palliative care hoping the patient’s body would throw it off.  Further action wasn’t taken unless and until the patient started going downhill, which for many patients, was often too late.  The other reason, however, is that viral load varies by patient.  Viral load is the amount of virus which must be inhaled before the first layer of the immune system is overwhelmed and the virus enters a cell and begins replicating.  The first layer of the immune system is the mucous lining airway.  Those with a healthy consistency of and content in their mucous and active villi can stand a much higher viral load before the “one in a thousand” make it past and begin infecting cells.  Many of those whom were most susceptible to it because of their much lower viral load thresholds have already contracted it.  I strongly suspect many of those who have significantly higher viral load thresholds have been exposed it it, lightly, on multiple occasions.  The case infection rates have begun falling off their epidemiological curves.

1. COVID-19 was initially thought to cause deaths due to pneumonia – a lung infection and so Ventilators were thought to be the best way to treat sick patients who couldn’t breathe. Now we are realizing that the virus causes blood clots in the blood vessels of the lungs and other parts of the body and this causes the reduced oxygenation . Now we know that just providing oxygen by ventilators will not help but we have to prevent and dissolve the micro clots in the lungs. This is why we are using drugs like Aspirin and Heparin ( blood thinners that prevents clotting) as protocol in treatment regimens starting in June 2020.

***  The blood clots are secondary to the damage the virus causes blood-carrying tissues like those lining the lungs.  If you’re already on coumadin, heparin or aspirin (even baby aspirin) and start feeling ill, it’s very important you continue to take it without missing any doses in order to prevent the likely clotting that results when a person doesn’t ease off blood-thinning medication.

2. Previously patients used to drop dead on the road or even before reaching a hospital due to reduced oxygen in their blood – OXYGEN SATURATION. This was because of HAPPY HYPOXIA where even though the oxygen saturation was gradually reducing the COVID-19 patients did not have symptoms until it became critically less, like sometimes even 70%. Normally we become breathless if oxygen saturation reduces below 90%. This breathlessness is not triggered in Covid patients and so we were getting the sick patients very late to the hospitals in February 2020. Now since knowing about happy hypoxia we are monitoring oxygen saturation of all Covid patients with a simple home use pulse oximeter and getting them to hospital if their oxygen saturation drops to 93% or less. This gives more time for doctors to correct the oxygen deficiency in the blood and a better survival chance since June 2020.

*** “drop dead on the road” is a prime example of why I do no believe any medical doctor wrote this, and probably not a university professor.  Both are thoroughly practiced in the linguistic arts of using far more professional and refined speech, usually to the point where it’s ingrained.  Professionals also tend to avoid the use of all-caps under any circumstances.  Neophytes pretending to be professionals, on the other hand, tend to use all-caps quite a bit.  

***  Here’s another reason I do not believe it was written by either an M.D. or university professor:  As any bona-fide medical doctor and probably most university professors can tell you, breathlessness isn’t caused by lack of oxygen, but rather, by either a build-up of CO2 or hyperacidosis.  Symptoms of chronic and worsening oxygen deprivation (progressively worse over hours) include fatigue, numbness / tingling of extremities, nausea, and cerebral anoxia.  The following treatments are standard and effective against both HACE and HAPE (either/or/together “acute mountain sickness”) as well as other causes of hypoxia:  Nifedipine.  Dexamethasone should also be administered.  Phosphodiesterase type 5  inhibitors such as sildenafil and tadalafil are also effective. FiO2 should be titrated to maintain arterial oxygen saturation of greater than 90%.

***  A drug commonly given to climbers, divers, and others who are experiencing hypoxia is Acetazolamide (Diamox).  If the guy who wrote this was an M.D. or professor, how and why did he not know this?

***  Since 2009, my O2 sats have usually been below 93%.  Probably the altitude…

3. We did not have drugs to fight the corona virus in February 2020.  We were only treating the complications caused by it… hypoxia. Hence most patients became severely infected. Now we have 2 important medicines FAVIPIRAVIR & REMDESIVIR … These are ANTIVIRALS that can kill the corona virus. By using these two medicines we can prevent patients from becoming severely infected and therefore cure them BEFORE THEY GO TO HYPOXIA. This knowledge we had in JUNE 2020… not in February 2020.

*** I recall reading about the use of antivirals against coronavirus back in January.  In fact, antivirals have been around for decades.  

4. Many Covid-19 patients die not just because of the virus but also due to the patient’s own immune system responding in an exaggerated manner called CYTOKINE STORM. This stormy strong immune response not only kills the virus but also kills the patients. In February 2020 we didn’t know how to prevent it from happening. Now in September 2020, we know that easily available medicines called Steroids, that doctors around the world have been using for almost 80 years can be used to prevent the cytokine storm in some patients.

*** True, and multiple news sources revealed that one of President Trump’s courses of treatment involved steroids.
5. Now we also know that people with hypoxia became better just by making them lie down on their belly – known as prone position. Apart from this a few months ago Israeli scientists discovered that a chemical known as Alpha Defensin produced by the patients White blood cells can cause the micro clots in blood vessels of the lungs and this could possibly be prevented by a drug called Colchicine used over many decades in the treatment of Gout.

***  Indeed:  “Alpha defensins are a family of mammalian defensin peptides of the alpha subfamily. In mammals they are also known as cryptdins and are produced within the small bowel. Cryptdin is a portmanteau of crypt and defensin.  Defensins are 2-6 kDa, cationic, microbicidal peptides active against many Gram-negative and Gram-positive bacteria, fungi, and enveloped viruses,[2] containing three pairs of intramolecular disulfide bonds.”

So now we know for sure that patients have a better chance at surviving the COVID-19 infection in September 2020 than in February 2020, for sure.

***  While the current Resolved Case Mortality Rate here in the U.S. is 4.1% is less than the world’s 6.1%, half that of Mexico, a fourth that of the U.K., and a sixth that of France, it remains higher than that of many other countries.  For example, for Russia it’s 2.1%, for India it’s 1.8%, and for South Africa, it’s 2.7%.  Bottom line, the treatment in the U.S. has been too heavily politicized to settle in on the most effective treatment.  A few countries, including Iceland, have managed to wrestle that down to less than 1%.

Going forward there’s nothing to panic about Covid-19 if we remember that a person who gets infected later has a better chance at survival than one who got infected early.

***  Panic, no, but concern, absolutely, as people are still dying.  I absolutely do NOT want to risk contracting COVID-19!

Let’s continue to follow precautions, wear masks and practice social distancing.

*** Wise, to include handwashing and protective eyewear (ordinary glasses work well for this), and sanitation of clothes, groceries, and anything else brought in from outside after having been exposed to potential COVID-19 sources of contamination.

Updated: October 16, 2020 — 10:48 am