Erectile dysfunction primarily occurs when small arteries lose the ability to dilate and allow proper blood flow. It is more common in men with hypertension or declining testosterone levels.
“In our study, consuming a Mediterranean diet was linked with better exercise capacity, healthier arteries, and blood flow, higher testosterone levels, and better erectile performance,” says Angelis.
Creating a “National Pandemic Emergency” provided justification for such sweeping actions that override individual physician medical decision-making and patients’ rights. The CARES Act provides incentives for hospitals to use treatments dictated solely by the federal government under the auspices of the NIH. These “bounties” must paid back if not “earned” by making the COVID-19 diagnosis and following the COVID-19 protocol.
The hospital payments include:
A “free” required PCR test in the Emergency Room or upon admission for every patient, with government-paid fee to hospital.
Added bonus payment for each positive COVID-19 diagnosis.
Another bonus for a COVID-19 admission to the hospital.
A 20 percent “boost” bonus payment from Medicare on the entire hospital bill for use of remdesivir instead of medicines such as Ivermectin.
Another and larger bonus payment to the hospital if a COVID-19 patient is mechanically ventilated.
More money to the hospital if cause of death is listed as COVID-19, even if patient did not die directly of COVID-19.
A COVID-19 diagnosis also provides extra payments to coroners.
CMS implemented “value-based” payment programs that track data such as how many workers at a healthcare facility receive a COVID-19 vaccine. Now we see why many hospitals implemented COVID-19 vaccine mandates. They are paid more.
Because of obfuscation with medical coding and legal jargon, we cannot be certain of the actual amount each hospital receives per COVID-19 patient. But Attorney Thomas Renz and CMS whistleblowers have calculated a total payment of at least $100,000 per patient.
By no means do I agree with everything written and implied in the AAPS article. For instance, at my hospital we do everything we can to avoid intubation, and do it only if we think the patient is about to die in the next few minutes or couple hours if not intubated. If we thought intubation was futile, we wouldn’t do it.
The in-hospital mortality rate of intubated COVID-19 patients worldwide ranges from approximately 8% to 67%, but in the US, it is between 23 and 67%. There is substantial variability in the disease process, such that some patients rapidly deteriorate and die of severe respiratory failure or multiple organ failure within 1 to 2 weeks after intubation, while others recover, despite requiring mechanical ventilation.
The same source found the mortality rate of intubated COVID-19 patients within the two weeks after intubation at their hospitals was 45%. Unfortunately, the report doesn’t say what percentage of the initial survivors eventually died of COVID-19 anyway. That’s important information. The study at hand was done in New York early in the pandemic in 2020. I’d like to think we’re better at treating the disease now, 21 months later.
An Italian study, also done early in the pandemic in 2020, found that 43% of ICU (intensive care unit) COVID-19 intubated patients died in the hospital. If 57% survived intubation, that’s far from futile care.
If you find significantly different death rates in published studies, please share with a link in the Comments. I didn’t do an extensive search.
As far as I know, none of my hospitalist colleagues have ever been pressured to list COVID-19 as the cause of death when that was notactually the cause of death. Our death certificates are filed by us directly online with the State of Arizona.
What is very fishy about this illness is the degree to which hospital administrators, politicians, bureaucrats, and others have dictated how most physicians have to treat the illness and muzzled or attempted to muzzle dissident voices, disregarding the underlying science. In forty years of medical practice, I’ve never seen anything else like it.
Four out of 10 COVID-19 “cases” have no symptoms. I’m uncomfortable calling you a “case” of illness if you never have any signs or symptoms of being sick. The article authors are concerned that asymptomatic “cases” can and will spread infection and make others sick.
COVID-19, the disease caused by SARS-CoV-2, was first reported in December 2019.1 Globally, as of January 28, 2021, there have been 100 455 529 confirmed cases, including 2 166 440 deaths.2 The disease course of COVID-19 ranges from asymptomatic to mild respiratory infections to pneumonia and even to acute respiratory distress syndrome.3 Patients with no symptoms at screening point were defined as having asymptomatic infections, which included infected people who have not yet developed symptoms but go on to develop symptoms later (presymptomatic infections), and those who are infected but never develop any symptoms (true asymptomatic or covert infections).4,5 Owing to the absence of symptoms, these patients would not seek medical care and could not be detected by temperature screening. Presymptomatic transmission will also make temperature screening less effective.6 Only extensive testing and close contact tracing could lead to identification of more asymptomatic infections.7
Unlike SARS [sudden adult respiratory syndrome], which had little known transmission from asymptomatic patients, evidence showed that asymptomatic patients were a potential source of transmission of COVID-19.3,6 A previous study8 showed that the upper respiratory viral loads in asymptomatic patients were comparable to those in symptomatic patients. Meanwhile, the highest viral load in throat swabs at the time of symptom onset indicated that infectiousness peaked on or before symptom onset.9 Moreover, studies showed that asymptomatic infections might have contributed to transmission among households, nursing facilities, and clusters.10–13 As the pandemic has been contained in many countries and regions, travel restrictions have been lifted and public places have reopened. Asymptomatic infections should be considered a source of COVID-19 infections that play an important role in the spread of the virus within community as public life gradually returns to normal. The management of asymptomatic carriers was essential for preventing cluster outbreaks and transmission within a community.
Among nonhospitalized patients who were at high risk for Covid-19 progression, a 3-day course of remdesivir had an acceptable safety profile and resulted in an 87% lower risk of hospitalization or death than placebo.
I’d have more faith in this study if it weren’t funded by the maker of remdesivir, Gilead Sciences.
Participants who received a booster at least 5 months after a second dose of BNT162b2 had 90% lower mortality due to Covid-19 than participants who did not receive a booster.
This study was done in Israel in August and September 2021, when the delta variant was rampant.
Multiple studies published this week have suggested Omicron is far less dangerous than Delta, with a UK Health Security Agency report from Thursday saying the mutant strain is 70 per cent less likely to cause hospitalization than Delta, and 45 per cent less likely to require an emergency room visit.
Dr Robert Malone predicts that the Omicron variant will help end the pandemic because so many people will develop immunity by being mildly infected.
Stained glass window created by F. Zettler (1878-1911) at the German Church (St. Gertrude’s church) in Gamla Stan in Stockholm, depicting a Nativity Scene.
The oral drug is for those with documented COVID-19 infection who are at risk for severe COVID-19, meaning those at risk for hospitalization and death. It’s not for those already in the hospital. The drug allegedly reduces hospitalization and death by ~90%. Potential users are aged 12 years and up. Pediatric patients must weigh at least 88 lb or 40 kg.
Paxlovid is a combination of nirmatrelvir (two 150 mg tablets) and ritonavir (100 mg tablet) by mouth twice daily for five days. The drug prevents viral replication.
The most common side effects seem to be altered taste, diarrhea, high blood pressure, and achy muscles (myalgias).
The drug should be taken within five days of symptom onset.
Prescribers should be aware of potential drug interactions, and there are many common drugs that cannot be used with Paxlovid. Use with caution, if at all, in those with liver or kidney disease. Patients with moderate kidney disease may need a dose reduction.
Posted onDecember 22, 2021|Comments Off on Alcohol: Should You Do a “Dry January”?
Goodbye to you. Maybe see you in February.
I’ve run across a number of people who slowly increased their alcohol consumption over months or years, not realizing it was causing or would cause problems for them. Alcohol is dangerous, lethal at times.
From a health standpoint, the generally accepted safe levels of consumption are:
no more than one standard drink per day for women
no more than two standard drinks per day for men
One drink is 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of 80 proof distilled spirits (e.g., vodka, whiskey, gin).
Dry January was conceived in the UK in 2012 or 2014. The idea is simply to abstain from all alcohol for the month of January. The Alcohol Change UK website can help you git ‘er done. Many folks notice that they sleep better, have more energy, lose weight, and save money. There are other potential benefits.
If you think you may have an unhealthy relationship with alcohol, check your CAGE score. It’s quick and easy.
Alternatively, if you make a commitment to a Dry January but can’t do it, you may well have a problem.
Posted onDecember 19, 2021|Comments Off on Vitamin D and COVID-19: What’s the Connection?
With adequate sunlight, you can make your own vitamin D. Photo by Min An on Pexels.com
In the hospital where I work, most COVID-19 patients get vitamin D (cholecalciferol) 1,000-2,000 IU daily, hoping it will help fight the virus infection. Vitamin D is cheap and we haven’t seen any adverse effects from it.
It seems pretty clear that folks with deficiency of vitamin D who then develop COVID-19, have worse than usual outcomes. The only way to know if you have a deficiency is to get a blood level test. I recommend to my loved ones that they take supplemental cholecalciferol during surges of COVID-19 unless they’re certain they’re getting enough sunlight to generate vitamin D, or have a normal blood level. (I’m not recommending that to you; I’m not your doctor.) The dose is 1,000 or 2,000 IU daily, depending on body weight and other factors. I have seen a few people, usually little old ladies, develop hypercalcemia (high blood calcium) if they take that much vitamin D plus a calcium supplement, and that can be a problem.
“Molecular studies have demonstrated the importance of the exacerbated immune response to SARS-CoV-2 infection, called the cytokine storm, in more severe COVID-19. The pathophysiology is complex and involves several homeostatic factors; among them, a deficit of vitamin D draws attention because of its high frequency in the population. Some evidence suggests that people with low serum vitamin D levels have worse outcomes, often requiring intensive care. This review analyzed the studies available in the global literature addressing the benefits of vitamin D in COVID-19, relating serum levels to the severity of the disease, and indicating vitamin D as a possible prophylactic and therapy in infection.”
Read the article’s introduction for a list of vitamin D’s role in fighting infection.
The authors conclude:
“To our knowledge, there is still no robust evidence of the prophylactic and therapeutic role of vitamin D in COVID-19, and more clinical trials are needed to prove its efficacy against infection. Considering that its pharmacologic safety profile is well known, it is prudent to keep its mean serum concentration > 30 ng/mL in people with COVID-19 and the susceptible population.”
Another recent study in Nutrition compared the prevalence of COVID-19 with the prevalence of vitamin D deficiency in 20 European countries. They found no association one way or the other:
“Our analysis concludes that available data on the prevalence of Vit D deficiency among the European population do not allow for concluding that it constitutes a strong risk factor in the COVID-19 epidemic. However, these findings are not in line with outcomes of similar research works published recently.”
In some of the countries in the study, over 50% of the adult population was deficient in vitamin D.
Bottom line for me: Vitamin D supplementation doesn’t seem to hold as much promise in suppressing COVID-19 as I thought it would.
Cornell University reported 903 cases of Covid-19 among students between December 7-13, and a “very high percentage” of them are Omicron variant cases in fully vaccinated individuals, according to university officials.
The school’s Covid-19 dashboard was updated late Tuesday afternoon, accounting for the jump in case numbers reported.”Virtually every case of the Omicron variant to date has been found in fully vaccinated students, a portion of whom had also received a booster shot,” said Vice President for University Relations Joel Malina in a statement.
As of result, the school has decided to shut down its Ithaca, New York, campus, where it has about 25,600 students.
“While I want to provide reassurance that, to date, we have not seen severe illness in any of our infected students, we do have a role to play in reducing the spread of the disease in the broader community,” Pollack said.
Ninety-seven percent of people on campus are fully vaccinated, the university says on its website.
Those vaccines are really great, aren’t they?!
New York Governor Cuomo sent COVID-19 patients to nursing homes from the hospital, to help spread the infection, I guess.
As U.S. hospitals continue to grapple with a surge of COVID-19 patients and ongoing staffing shortages, the vaccine mandate debate is heating up once again.
Now, some of the largest U.S. hospital systems have dropped their vaccine mandate for employees.
Tenet Healthcare and Cleveland Clinic are among the companies dropping the mandates, according to information reported by The Wall Street Journal.Caption: Some of the largest U.S. hospital systems have dropped their vaccine mandate for employees, reports Lexi Nahl. (WPEC)
This comes as several hospitals deal with ongoing labor shortages due to burnout and increasing labor costs.
Cleveland Clinic and AdventHealth have also abandoned their vax mandates.
I hear that healthcare systems with a staffing crisis bring in “traveling nurses” to help fill the gap at a salary three times greater than the “healthcare heroes” that that have been there since the beginning. How would that make you feel if you were that loyal nurse who has been there for the long haul, but no change in salary and forced to take the vax?
Some hospitals will pay a “finder’s fee” of $2,000 or more if you refer a frontline healthcare worker that they hire.
From Steve Kirsch: This comes as no surprise to those of us who have been paying attention.
Next time you talk to your county health official, ask them why. The officials will then explain that they just follow orders. They don’t make public policy.
They are simply never going to figure this stuff out that their interventions are making things worse. It’s too embarrassing to admit. So they don’t talk about it and hope you don’t notice.
Supermarket chain Kroger announced Tuesday it will eliminate paid emergency leave for unvaccinated employees who contract COVID-19 in addition to requiring some of them to pay a monthly $50 health insurance surcharge starting in 2022, according to a company memo.
The country’s largest supermarket chain, which employs roughly 465,000 workers….
In a stunning admission, virologist Dr. Andrew Hill acknowledged in a zoom call that publication of his study could lead to the deaths of at least a half million people.
In defending his reversal on the effectiveness of ivermectin as a treatment for COVID-19, he discussed his “difficult situation” and said, “I’ve got this role where I’m supposed to produce this paper and we’re in a very difficult, delicate balance.”
Andrew Hill, PhD, is a senior visiting Research Fellow in Pharmacology at Liverpool University. He is also an advisor for the Bill and Melinda Gates Foundation and the Clinton Foundation. As a researcher for the WHO evaluating ivermectin, Hill wielded enormous influence over international guidance for the drug’s use.
Hill had previously authored a analysis of ivermectin as a treatment for COVID-19 that found the drug overwhelmingly effective.
On Jan. 6 of 2021, Hill testified enthusiastically before the NIH COVID-19 Treatment Guidlelines (sic) Panel in support of ivermectin’s use. Within a month, however, Hill found himself in what he describes as a “tricky situation.” Under pressure from his funding sponsors, Hill then published an unfavorable study. Ironically, he used the same sources as in the original study. Only the conclusions had changed.
Advanced Mediterranean Diet 