Corona Virus Update #22 from CIYC Fleet Surgeon Zoran Barbaric Oxnard

 

 

 

By Dr. Zoran Barbaric

Drugs:

Hydroxychloroquine:


Ivermectin
: A group of pulmonary specialists and practicing physicians reviewed the existing world literature on efficacy of ivermectin in prophylaxis and treatment in early and hospitalized patients. Their conclusion in a 28-page comprehensive article citing 80 references is that ivermectin significantly reduces infection rates after exposure, significantly shortens the course of the disease, and significantly decreases the need for oxygen. It also reduces hospital stay and mortality. https://covid19criticalcare.com/wp-content/uploads/2020/11/FLCCC- Ivermectin-in-the-prophylaxis-and-treatment-of-COVID-19.pdf 

A group of physicians presented to an FDA panel data from 18 randomized controlled trials that included over 2,100 patients regarding ivermectin. Trial results demonstrated that ivermectin produces faster viral clearance, faster time to hospital discharge, faster time to clinical recovery, and a 75% reduction in mortality rates. The FDA panel will issue their conclusions and recommendations in February. (Lightning speed during a pandemic?) And what is it they do in India? They distribute this kit (see below) to communities and, if one getsI am posting this table again (Eastern Virginia School of Medicine) because it clearly disagrees with the CDC and promotes early treatment. Some of you wanted to see this list again. You can follow whatever recommendation you choose – following your own favorite scientist – but always consult your doctor, not your politician. Statistically, the chance your doctor will prescribe ivermectin after reviewing the above study (in red) is about 10%.

 

sick, it is there for early treatment. Category I mild symptoms, Category II more severe symptoms. Both start with ivermectin for three days and Doxycycline. And vitamins C, B-complex, and D3 (although the dose listed seems too high).

Antibody drugs: There is a narrow window in which these drugs are helpful and that is in the early stages of the disease and before hospitalization. Eli Lilly’s and Regeneron’s antibodies are intravenous drugs. A doctor can’t just call it in for a patient to get from a pharmacy – a nurse or technician has to administer the drugs at a clinic by intravenous drip. A coronavirus antibody drug treatment costs about $1,250 for each dose. President Trump declared that the drug will be free. But patients and doctors and, apparently the CDC, are unaware, and although the drugs are given emergency approval and shipped throughout the country, 80% are unused. People who received Eli Lilly’s drug in trials were nearly 75% less likely to need to be hospitalized. If you get COVID, be sure to ask your doctor about it, early on.

 

Fluvoxamine: The COVID-19 Early Treatment Fund (CETF) announced the publishing of the WUSM St. Louis double-blind, randomized, controlled clinical trial that investigated the potential of fluvoxamine if taken within seven days of first symptoms of COVID-19. It can reduce the risk of respiratory degradation. Of the 80 participants who took the drug, 0% developed breathing problems compared to an 8.3% rate in the 72 patients who took a placebo. An expanded study involving 800 patients is ongoing. Fluvoxamine is a drug for treatment of various psychiatric disorders and right now, it seems, we could all use some of that stuff.

 

Vaccines:

In the graph are the results from Pfizer vaccine stage III trials. After 7-14 days, vaccinated individuals seldom get        infected (blue),          compared            with              placebo volunteers                 (red).  It  is  obviously  very  effective. https://www.statnews.com/2020/12/08/fdascientists-endorse-highly-effective-pfizer-biontech-covid-19- vaccine-ahead-of-key-panel

The FDA also approved the Moderna vaccine. A third candidate from Johnson & Johnson, which would require just one dose, is working its way through the pipeline, probably by February. Coming down the pike also is the candidate from AstraZeneca and Oxford University which is already approved and administered in Great Britain. Novavax is finishing a fully enrolled Phase 2b trial in South Africa and a Phase 1/2 continuation in the United States and Australia with its vaccine. Phase Ill trials begin early January.

Expect these side-effects to Pfizer & Moderna vaccines: Very common (Likely to affect more than one in ten people) Pain at injection site

Tiredness Muscle pain Chills

Joint pain Fever Headache

Common (Likely to affect up to one in ten people) Injection site swelling

Redness at injection site Nausea

Uncommon (May affect one in 100 people)

 

Enlarged lymph nodes Feeling unwell

Very uncommon (one in 90,000)

    *    Anaphylactic shock Unusual (Moderna)

    *    Swelling at the sites of cosmetic fillers

 

Talk to your doctor regarding these, as well as any contraindications or questions.

Although both approved vaccines are highly efficacious in preventing symptomatic COVID-19, there is not yet enough available data to draw conclusions as to whether the vaccine can impact SARS-CoV-2 transmission. In other words, can one be infected and be protected from developing symptoms but still could potentially infect someone else? This is why it is still recommended to mask up until this issue is further investigated.

To make things more interesting, 60% of nursing home workers in Ohio are refusing vaccination. Up to 40% of health care workers in Los Angeles and 50% in Riverside County are refusing shots, according to the Los Angeles Times. You can follow distribution and inoculation rates on the CDC site tracker.

Recently Dr. Fauci predicted that the U.S. may reach “very close to a degree of normality” by next fall but emphasized that this is dependent on getting the “overwhelming majority” of the population vaccinated. Now he is talking 90% vaccinated, compared to his earlier estimate of 70%. Dr. Fauci also said in an interview that inoculation will ‘quite possibly’ be required for school or travel.

How long will the protection from the vaccine last? Moderna Inc says its COVID-19 vaccine likely protects people from the deadly disease for a ‘couple of years.’

 

Asymptomatic individuals with positive PCR test. Are they infectious?

There are contradictory studies. You choose.

The CDC claims that about 59% of all COVID-19 transmissions came from patients without symptoms. Of that 59%, 35% was from individuals who are presymptomatic, and 24% from those who never develop symptoms. JAMA Network Open. Therefore, according to the CDC, strict mitigation measures are justified.

Not according to a Chinese study involving 10 million people: “All close contacts of the asymptomatic positive cases tested negative, indicating that the asymptomatic positive cases detected in this study were unlikely to be infectious.”                                                       https://www.nature.com/articles/s41467-020-19802- w?error=cookies_not_supported&code=43a3444a-ec9d-448d-825c-6f3375685ad4.

 

What about household transmission? (JAMA Network Open) Researchers from the University of Florida analyzed 54 studies with more than 77,000 participants reporting household secondary transmission of coronavirus.

Overall, 16.6% of those infected with COVID-19 passed the disease on to household members where three or more people lived together.

The transmission rate was 18% among people who had symptoms.Among asymptomatic testing positive, the transmission rate was only 0.7%. More than one-third, or 37.8%, of symptomatic patients infected their spouses. This is when only two people are in the household. Looking on the positive side, 62% did not transmit the disease to their spouse.

Another household meta-analysis of 45 published studies showed the highest transmission rates were found where  the  duration  of  household  exposure  exceeded  5  days,  compared  with  exposure  of  5  days  or   less. Transmission rates related to familiar and prolonged close contacts, such as social events with family and friends,  were  higher  (5.9%)  than  those  related   to   low-risk   casual   contacts,   such   as   strangers   (1.2%). Estimates for asymptomatic index cases transmission were approximately two thirds of those for symptomatic index (3.5% vs. 12.8%, p<0.001). https://www.imperial.ac.uk/mrc-global-infectious-disease- analysis/covid-19/report-38-transmission/

 

Many of these studies contradict early estimates in March and April when it was thought 80% of the transmission was due to asymptomatic, or rather pre-symptomatic, individuals. Most lockdown political decisions stem from this high and now disproven number.

 

Lockdowns: As a strategy, even WHO does not recommend lockdowns. At risk of starvation are 130,000,000 people worldwide because of lockdowns. Deferred health care for diabetes, cardiac disease, and cancer screening will result in increased deaths. Mammograms declined by 80% nationwide. So did colonoscopies. Public health officials should consider all aspects of medical care, not only the virus.

Bill Gates says he expects that coronavirus-related lockdowns could drag on into 2022 with restaurants closing their doors for the next six months.

 

Pre-diabetes and diabetes: Once hospitalized, those with elevated blood sugar have a higher chance of dying proportionally to their blood sugar levels. For example, of those with blood glucose of 140 mg/dl, 16% died; of those between 140 – 180 mg/dl, 34% died; of those above 180 mg/dl, 41% died. Obviously, a population with this co-morbidity is at high risk and their glucose levels should be brought under control. https://trialsitenews.com/study-of-11000-patients-at-university-regional-hospital-of-malaga-reveal-blood-sugar- levels-markedly-increase-covid-19-death-rates/

 

Vitamin D and C: 81% of African Americans have vitamin D3 deficiency. Also 60% of Hispanics and 40% of Caucasians. The military and retirees in nursing homes are all vitamin D3-deficient. Having a vitamin D blood level above 30 nmol/l reduces chances of catching COVID by 50%. Try to keep it around 50 nmol/l. Ask your doctor for a D3 blood test. Also consider taking vitamin C 500 mg twice a day as a prophylactic measure. A larger dose than that cannot be absorbed and may cause diarrhea.

 

Testing: In Florida, the Department of Health issued an order requiring all labs to report PCR test cycle thresholds. This is because a cycle threshold over 35 is meaningless (Dr. Fauci). As a doctor from Nebraska stated: “What we have is a pandemic of false positives.” One can even find tap water positive for the virus if using more than 40 cycles.

In a July podcast that resurfaced earlier this month, White House coronavirus adviser Dr. Fauci admitted PCR tests pick up harmless fragments of the coronarvirus, resulting in many false-positive cases that result in overstating the threat. In August, the New York Times examined PCR testing data in three states and found “up to 90 percent of people testing positive carried barely any virus.”

How about dogs? Dogs already are being used in experimental trials at airports in Finland, Lebanon, and the United Arab Emirates, and being trained in Hawaii to identify COVID-19 in sweat wipes used on airline passengers exiting a flight. Preliminary findings in Finland suggest that dogs can be trained to detect the virus faster and more accurately than nasal swabs tested in laboratories. But don’t expect to see disease-sniffing dogs widely in the real world any time soon. In real life it would be difficult to scale up the effort. Also, scientists don’t yet know exactly what molecule the dogs ’noses are picking up on when they identify a coronavirus.

 

Pregnancy: Pregnant women who catch the coronavirus do not pass it on to their unborn children, according to data from a new study. US-based researchers followed 64 women who tested positive for SARS-CoV-2, the virus which causes COVID-19, between April 2 and June 13. None of the babies tested positive for Covid-19 after they were born, and no coronavirus was detected in the placenta.

 

Asia and Africa: Compared to the rest of the world, countries on these two continents are experiencing lower incidence and lower mortality rates from COVID-19. Take Cambodia, for example. They had zero deaths. Not in the last month, but from the beginning of the pandemic. Overall health, Vitamin D levels, age, or low obesity levels – or T-cell immunity – are possible explanations. And very likely ivermectin.

 

Mutations: The coronavirus has mutated thousands of times since it was first discovered, but none appear to have fundamentally changed how it behaves. The UK has alerted the WHO of a new variant (B.1.1.7) which appears to be accelerating the spread of Covid-19, saying it now accounts for some 60% of cases in London and is potentially 50-70% more infectious, compared to the old variant. The new COVID-19 variant has a mutation in the spike where amino acid asparagine (N) has been replaced with tyrosine (Y). Just switching two amino acids. More than 64 cases have been diagnosed in the US as of today.

No evidence that the new variant is associated with higher disease severity, but there is a clear risk that future epidemic waves may be larger – and hence associated with a greater burden for hospitals and society – than previous                                waves.                                https://cmmid.github.io/topics/covid19/reports/uk-novel- variant/2020_12_23_Transmissibility_and_severity_of_VOC_202012_01_in_England.pdf

Another new mutation (501.V2) in South Africa is potentially even more infectious than the British mutation. This one is driving a massive second wave among young people in the country. It is expected to be in the US by summer. Pfizer announced their vaccine is effective against both British and South African strains.

Yet another new variant of coronavirus (P681H) has now emerged in Nigeria and a new one in Brazil.

Another mutation was also found in mink on pelt farms in Denmark, several other European countries, and in the US. Millions of animals were culled. An infected mink recently escaped an Oregon pelt farm which was under quarantine. Traps are being set in efforts to recapture the fugitive.

 

Hospitals: High amounts of the novel coronavirus can be found in the air in several hospital settings, a new study suggests. Researchers found that one-quarter of all ICU rooms with COVID-19 patients were contaminated with genetic material of the virus. What’s more, more than 20% of samples from toilets and bathrooms, as well as more than half of samples from hallways, came back positive.

 

Deaths of despair: Those are Americans who lose their lives due to drugs, alcohol, and suicide during the pandemic. Projections of additional “deaths of despair” ranged from 27,644, assuming a quick economic recovery and the smallest impact from unemployment, to 154,037, assuming a slow recovery and the greatest impact from unemployment. Deaths of despair have been on the rise for the last decade, and in the context of COVID-19, deaths of despair should be seen as the epidemic within the pandemic.

 

Flu: It practically disappeared this season. The reasons? Masks, social distancing, and hand washing mitigates flu as well as Covid. Flu may be misdiagnosed as Covid. And flu usually starts with children. School closures may mitigate infections.

 

Tourism: International tourism dropped to the level of 30 years ago. There are 900 million fewer tourists, compared to 2019. The Asian-Pacific region had the biggest decline at 82%, the Near East 73%, Europe and Africa 69%, and South and North America 68%.

 

LA: Skid Row is experiencing a surge in Covid-19 infections with homeless sites in Downtown Los Angeles now ‘overwhelmed’ by the virus. Cases have exploded among the homeless people who live in this area, which is known for having one of the largest populations of homeless people in the United States. Between December 11 and December 18, there were an average of 73 coronavirus cases a day recorded among the county’s homeless population. In comparison, in late October this number was just five a day, highlighting the dramatic jump.

 

Five Los Angeles County hospitals are turning patients away. Their old oxygen delivery systems freeze pipes because of high flow. Also, they don’t have enough oxygen canisters to send home with discharged patients. So the patients are held in the hospital longer, adding to overcrowding. The hospitals in the county are so overwhelmed they do not accept patients who are unlikely to be resuscitated after a cardiac arrest. ICU units are filled to capacity.

 

Ventura County: Case fatality rate is 0.66%. Case hospitalization rate is 3.62%. The number of hospitalized patients is more than 5.5 x that of the first peak in late July and is still going up. There are no ICU beds available.


Dr. Zoran Barbaric, MD is a Diagnostic Radiology Specialist in Los Angeles, CA and has over 55 years of experience in the medical field. He graduated from Fac Med U Belgrade medical school in 1966.  He is also fleet surgeon at the Channel Islands Yacht Club


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