Coronavirus Lockdowns Did More Harm Than Good

…at least in terms of deaths, according to researchers at the University of Southern California and the RAND Corporation. Lockdowns are also referred to as shelter-in-place orders, which were implemented with the mistaken idea they would reduce deaths from the COVID-19 pandemic. Note that viruses can kill, but so can lockdowns via social isolation, loss of jobs/income, delayed or no treatment for non-virus illness, etc. The study at hand looked data generated by 43 countries and all U.S. states.

artist rendition of coronavirus
Are you tired of this pic yet?

“…the implementation of shelter-in-place policies [SIP] does not appear to have met the aim of reducing excess mortality [deaths]. There are several potential explanations for this finding. First, it is possible that SIP policies do not slow COVID-19 transmission. As discussed earlier, prior studies find only a modest effect of SIP policies on mobility. A potential reason for the modest impact on mobility may be that individuals change behavior to avoid COVID-19 risk even in the absence of SIP policies. It is also unclear whether modest reductions in mobility could slow the spread of an airborne pathogen. Second, it is possible that SIP policies increased deaths of despair due to economic and social isolation effects of SIP policies. Recent estimates in the U.S between March and August 2020 show that drug overdoses, homicides, and unintentional injuries increased in 2020, while suicides declined. Third, existing studies suggest that SIP policies led to a reduction in non-COVID-19 health care, which might have contributed to an increase in non-COVID-19 deaths. For example, one study in the United Kingdom predicts that there will be approximately an additional 3,000 deaths within five years due to a delay in diagnostics because of the COVID-19 pandemic.”

Reference: https://www.nber.org/system/files/working_papers/w28930/w28930.pdf?utm_campaign=PANTHEON_STRIPPED&amp%3Butm_medium=PANTHEON_STRIPPED&amp%3Butm_source=PANTHEON_STRIPPED

The write-up at the Foundation for Economic Freedom may be more digestible for you.

Steve Parker, M.D.

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Ketogenic Diet Shows Promise in Alzheimer’s Disease

dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss
“Sweat Pea, it’s not too late to go keto.”

Here’s the abstract of an article in Advances in Nutrition:

Alzheimer disease (AD) is a global health concern with the majority of pharmacotherapy choices consisting of symptomatic treatment. Recently, ketogenic therapies have been tested in randomized controlled trials (RCTs), focusing on delaying disease progression and ameliorating cognitive function. The present systematic review aimed to aggregate the results of trials examining the effects of ketogenic therapy on patients with AD/mild cognitive impairment (MCI). A systematic search was conducted on PubMed, CENTRAL, clinicaltrials.gov, and gray literature for RCTs performed on adults, published in English until 1 April, 2019, assessing the effects of ketogenic therapy on MCI and/or AD compared against placebo, usual diet, or meals lacking ketogenic agents. Two researchers independently extracted data and assessed risk of bias with the Cochrane tool. A total of 10 RCTs were identified, fulfilling the inclusion criteria. Interventions were heterogeneous, acute or long term (45-180 d), including adherence to a ketogenic diet, intake of ready-to-consume drinks, medium-chain triglyceride (MCT) powder for drinks preparation, yoghurt enriched with MCTs, MCT capsules, and ketogenic formulas/meals. The use of ketoneurotherapeutics proved effective in improving general cognition using the Alzheimer’s Disease Assessment Scale-Cognitive, in interventions of either duration. In addition, long-term ketogenic therapy improved episodic and secondary memory. Psychological health, executive ability, and attention were not improved. Increases in blood ketone concentrations were unanimous and correlated to the neurocognitive battery based on various tests. Cerebral ketone uptake and utilization were improved, as indicated by the global brain cerebral metabolic rate for ketones and [11C] acetoacetate. Ketone concentrations and cognitive performance differed between APOE ε4(+) and APOE ε4(-) participants, indicating a delayed response among the former and an improved response among the latter. Although research on the subject is still in the early stages and highly heterogeneous in terms of study design, interventions, and outcome measures, ketogenic therapy appears promising in improving both acute and long-term cognition among patients with AD/MCI. This systematic review was registered at http://www.crd.york.ac.uk/prospero as CRD42019128311.

Source: To Keto or Not to Keto? A Systematic Review of Randomized Controlled Trials Assessing the Effects of Ketogenic Therapy on Alzheimer Disease – PubMed

I haven’t read the full study yet.

Steve Parker, M.D.

PS: h/t to Diet Doctor

PPS: If you have my Advanced Mediterranean Diet 2nd edition, you already have a ketogenic diet at your fingertips.

Vaccine Skepticism: Dr Hodkinson interviewed by Taylor Hudak

The Last American Vagabond posted an interview with what appears to be a well-qualified Canadian pathologist who is very wary of the mRNA vaccines against COVID-19. Essentially he says that we don’t know if they’re adequately safe, especially for women of child-bearing age, pregnant women, and young folks. Dr Hodkinson reminds us that the survival rate for COVID-19 is generally very high, so why take chances with a vaccine of dubious safety.

The interview above is 120 minutes. Here’s a 38 minute one with Anna Brees.

face mask, young womanartist rendition of coronavirus

COVID-19: Alternative Treatments

face mask, young woman
The government wouldn’t lie to us, would they?

Look, I don’t know for sure whether hydroxychloroquine is effective for prevention, early treatment, or late treatment of COVID-19. If you’re interested in the clinical studies regarding this issue, here’s a list of pertinent articles. I have no idea if the articles are comprehensive or cherry-picked. The authors of the list wish to remain anonymous, citing concern about death threats and loss of jobs.

I considered the few clinical studies available in Spring 2020 and was not impressed with the efficacy of hydroxychloroquine. The hospital where I work may not let me prescribe hydroxychloroquine even if I wanted to. I recently admitted a patient who needed the drug for a non-COVID diagnosis and the ordering software would not cooperate, which is very unusual. I had to go through the hospital pharmacist; the patient got the drug.

I do think it’s highly suspicious for politicians and others to second-guess and supersede the judgment of physicians. This, plus censorship and deplatforming by social media companies of folks who don’t toe the line of the authorities, adds fuel to the fire of conspiracy theorists. In my decades of medical pracitce, I’ve never seen anything like it.

We’ve seen enough government screw-ups and lies recently and over the years that you should always question the official narrative.

From the same authors of the first list, here’s their list of ivermectin articles. The also consider zinc, vitamin C, remdesivir, and several other therapies for COVID-19.

Here’s an assignment for an energetic investigative journalist. Find out who’s making money, and how much, on the development and distribution of the coronavirus vaccines.

Steve Parker, M.D.

h/t Paul Craig Roberts

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Semaglutide Now Available to Help With Weight Loss

Potential customers

Semaglutide was originally FDA-approved as a treatment for type 2 diabetes. The drug mimics a natural hormone called glucagon-like peptide-1 (GLP-1). It will be sold under the trade name Wegovy. The dose of this injectable medication must be increased gradually over 16 to 20 weeks to 2.4 mg once weekly to reduce gastrointestinal side effects. I have no idea how much it will cost. From the FDA:

Today, the U.S. Food and Drug Administration approved Wegovy (semaglutide) injection (2.4 mg once weekly) for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced calorie diet and increased physical activity. This under-the-skin injection is the first approved drug for chronic weight management in adults with general obesity or overweight since 2014. The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater. 

Click for the FDA news release.

The most common side effects of semaglutide include nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, eructation (belching), hypoglycemia (low blood sugar) in patients with type 2 diabetes, flatulence (gas buildup), gastroenteritis (an intestinal infection) and gastroesophageal reflux disease (a type of digestive disorder).  

Steve Parker, M.D.

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Eat Chicken Brains for Longer life

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Dexter Kruger, a retired cattle rancher, is Australia’s oldest-ever living man. He’s 111 now. He attributes his longevity (only in part?) to eating chicken brains. The article doesn’t say whether the brains are cooked or raw. I’m heading over to Allrecipes lickety split.

Steve Parker, M.D.

PS: The Mediterranean dIet is famous for prolonging life. No chicken brains involved.

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Mediterranean Diet Decreased Hospital Length of Stay, Reduced Mortality, and Cut Medical Costs of Elderly Patients

Somewhere on on the Mediterranean Sea

The study at hand involved 183 patients in Greece.

In multivariate analyses, hospital LOS [length of stay] decreased by 0.3 d for each unit increase of MedDiet score (P < 0.0001), 2.1 d for each 1 g/dL increase of albumin (P = 0.001) and increased 0.1 d for each day of previous admissions (P < 0.0001). Extended hospitalization (P < 0.0001) and its interaction with MedDiet score (P = 0.01) remained the significantly associated variables for financial cost. Mortality risk increased 3% per each year increase of age (hazard ratio [HR], 1.03; P = 0.02) and 6% for each previous admission (HR, 1.06; P = 0.04); whereas it decreased 13% per each unit increase of MedDiet score (HR, 0.87; P < 0.0001).

Conclusion

Adoption of the MedDiet decreases duration of admission and long-term mortality in hospitalized patients >65 y of age, with parallel reduction of relevant financial costs.

Steve Parker, M.D.

Source: Effects of Mediterranean diet on hospital length of stay, medical expenses, and mortality in elderly, hospitalized patients: A 2-year observational study – ScienceDirect

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Lack of Related Coronavirus Antibodies Linked to Severe Illness from COVID-19

artist rendition of coronavirus
Antibodies against human coronavirus OC43 help suppress COVID-19

My colleagues and I often wonder why we see otherwise healthy 35- to 50-year-olds come into the hospital pretty sick with COVID-19. After all, isn’t it the 65 and older crowd with multiple chronic illnesses the ones that develop critical COVID-19? A recent study provides at least a partial explanation why some folks get much sicker than others.

First off, note that 30-40% of head colds are caused by coronaviruses. Most of us get one or two colds a year. SARS-CoV-2 is the particular coronavirus that causes COVID-19. Another human coronavirus, called OC43, commonly causes infection, which leads to antibody production. It turns out that these antibodies help protect us from severe disease caused by the COVID-19 coronavirus. Some of these otherwise healthy but now critically ill middle-aged COVID-19 patients just don’t have antibodies to OC 43. So SARS-CoV-2 spreads through them more virulently.

Steve Parker, M.D.

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More Evidence for Effectiveness of Ivermectin Against COVID-19

No, you don’t have to inject the vaccine yourself

The May-June 2021 issue of American Journal of Therapeutics has a meta-analysis of various experiments using ivermectin both as prophylaxis against and treatment for COVID-19. I’m starting to think ivermectin is effective. Not only that, it’s inexpensive and relatively non-toxic.

From the aforementioned article:

Background: 

After COVID-19 emerged on U.S shores, providers began reviewing the emerging basic science, translational, and clinical data to identify potentially effective treatment options. In addition, a multitude of both novel and repurposed therapeutic agents were used empirically and studied within clinical trials.

Areas of Uncertainty: 

The majority of trialed agents have failed to provide reproducible, definitive proof of efficacy in reducing the mortality of COVID-19 with the exception of corticosteroids in moderate to severe disease. Recently, evidence has emerged that the oral antiparasitic agent ivermectin exhibits numerous antiviral and anti-inflammatory mechanisms with trial results reporting significant outcome benefits. Given some have not passed peer review, several expert groups including Unitaid/World Health Organization have undertaken a systematic global effort to contact all active trial investigators to rapidly gather the data needed to grade and perform meta-analyses.

Data Sources: 

Data were sourced from published peer-reviewed studies, manuscripts posted to preprint servers, expert meta-analyses, and numerous epidemiological analyses of regions with ivermectin distribution campaigns.

Therapeutic Advances: 

A large majority of randomized and observational controlled trials of ivermectin are reporting repeated, large magnitude improvements in clinical outcomes. Numerous prophylaxis trials demonstrate that regular ivermectin use leads to large reductions in transmission. Multiple, large “natural experiments” occurred in regions that initiated “ivermectin distribution” campaigns followed by tight, reproducible, temporally associated decreases in case counts and case fatality rates compared with nearby regions without such campaigns.

Conclusions: 

Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.

Parker here again. My understanding of Emergency Use Authorization, which applies to all COVID vaccines used in the U.S. today, is that they are authorized only if there are no other proven effective treatments available. In which case, the Big Pharma vaccine manufacturers may want to suppress the study at hand.

Steve Parker, M.D.

PS: There is no consensus on the dose of ivermectin for the patients I see, i.e, those sick enough to be in the hospital. Single dose of 0.4 to 0.15 mg/kg? Subsequent dose seven days later “if needed”? I see multiple different dosing regimens in the article.

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Resistance Training Improves Insulin Resistance in Overweight Men

Didn’t we already know this?

Insulin is a blood-borne hormone that the pancreas gland secretes in order to keep blood sugar levels from getting too high. (Insulin does many other things, but table that for now.) Insulin triggers certain body cells to absorb glucose from the bloodstream. “Insulin resistance” means that these cells don’t respond to insulin as well as they should, so either the pancreas secretes even more insulin (hyperinsulinemia) or blood sugar levels rise. Insulin resistance is a harbinger of type 2 diabetes mellitus. Most overweight or obese type 2 diabetics have insulin resistance. Many experts think hyperinsulinemia causes disease by itself, regardless of blood sugar levels. So it may be best to avoid insulin resistance and hyperinsulinemia.

The aim of the study was to investigate the effects of 6 weeks of resistance exercise training, composed of one set of each exercise to voluntary failure, on insulin sensitivity and the time course of adaptations in muscle strength/mass. Ten overweight men (age 36 ± 8 years; height 175 ± 9 cm; weight 89 ± 14 kg; body mass index 29 ± 3 kg m−2) were recruited to the study. Resistance exercise training involved three sessions per week for 6 weeks. Each session involved one set of nine exercises, performed at 80% of one‐repetition maximum to volitional failure. Sessions lasted 15–20 min. Oral glucose tolerance tests were performed at baseline and post‐intervention. Vastus lateralis muscle thickness, knee‐extensor maximal isometric torque and rate of torque development (measured between 0 and 50, 0 and 100, 0 and 200, and 0 and 300 ms) were measured at baseline, each week of the intervention, and after the intervention. Resistance training resulted in a 16.3 ± 18.7% (P < 0.05) increase in insulin sensitivity (Cederholm index). Muscle thickness, maximal isometric torque and one‐repetition maximum increased with training, and at the end of the intervention were 10.3 ± 2.5, 26.9 ± 8.3, 18.3 ± 4.5% higher (P < 0.05 for both) than baseline, respectively. The rate of torque development at 50 and 100 ms, but not at 200 and 300 ms, increased (P < 0.05) over the intervention period. Six weeks of single‐set resistance exercise to failure results in improvements in insulin sensitivity and increases in muscle size and strength in young overweight men.

Source: The effect of short‐duration resistance training on insulin sensitivity and muscle adaptations in overweight men – Ismail – 2019 – Experimental Physiology – Wiley Online Library

Steve Parker, M.D.

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