Advanced Mediterranean Diet

KUSI News in San Diego Posted a 6.5 minute interview with Professor Joel Hay way back on April 22, 2020:

USC Professor Joel Hay joined Good Morning San Diego to discuss his stance on how to get people back to work.

Hay said that there is no proof that social distancing works for diseases like coronavirus. He backed up this point by saying we have been social distancing for over a month, and there are no signs that it is helping us contain the spread of the virus.

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But, Hay says people with pre-existing conditions, elderly, etc. should isolate themselves. He doesn’t believe we need to isolate the young and healthy, as proven by Sweden.

Click to see if you’re at risk of death or serious illness from COVID-19.

Los Angeles County officials disagree with the professor. Their lockdown continues for another three months.

From CBS News May 7, 2020:

New York Governor Andrew Cuomo said Wednesday that most new COVID-19 cases tracked by hospitals in the state over the past few days were among people who were predominantly at home and not working. They were also mostly among people 51 and older.

He said that even “with everything we’ve done” there were still 600 new coronavirus cases in New York yesterday, “either walking in the door to hospitals, or people who are in hospitals who are then diagnosed with COVID.”

Some of you will say, “Well, they just weren’t social distancing the right way.”

Fortunately for us in Arizona, Gov. Ducy started opening up our economy a few days ago, six weeks later than he should have.

Steve Parker, M.D.

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Average age of COVID-19 deaths in Massachusetts is 82.
Life expectancy in U.S. overall is only 78.6 years.

Average age of COVID-19 deaths in Italy is 79, if memory serves.

You people under 60 who are panicking need to get a grip.

Steve Parker, M.D.

PS: You want to increase your odds of living longer? Quit eating junk, exercise regularly, and eat Mediterranean-style.

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The actual ventilator is out of the picture

SkepticalScalpel reports on death rates for COVID-19 among those on ventilators in the UK:

Data released on May 8 by the UK’s Intensive Care National Audit & Research Centre (ICNARC) shows the mortality rate for 4287 COVID 19 patients who received advanced respiratory support was 58.8%. This figure is much lower than percentages of 86% to 97% as reported in earlier studies included in my March 30 post on this topic.

Advanced respiratory support was needed in 71% of 6143 critically ill patients with reported outcomes and was defined as invasive ventilation, bilevel positive airway pressure (BiPAP) via endotracheal tube or tracheostomy, continuous positive airway pressure (CPAP) via endotracheal tube, or extracorporeal respiratory support (known as ECMO in the US).

For folks under 50, the mortality rate was 32%. Among those 50 and older, 65% died. These rates are much improved over the numbers we saw initially from China.

Body mass index in the obesity range wasn’t linked to higher mortality, unlike other studies we’ve seen.

Steve Parker, M.D.

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About damn time…

From The Daily Wire:

After months of deadly outbreaks that gave rise to nearly a third of all coronavirus-related deaths in New York state, governor Andrew Cuomo finally reversed a state order Saturday, requiring nursing homes and other long-term care facilities to take COVID-19 positive patients.

Last week, state authorities identified an additional, unreported 1,700 coronavirus deaths that took place in the state’s nursing homes but went uncounted in the state’s official death toll for a variety of reasons. The new report, released last Monday, showed that “at least 4,813 residents with confirmed or presumed cases of COVID-19 have died at 351 of New York’s 613 nursing homes since March 1, according to Gov. Andrew Cuomo’s administration’s new list,” according to Time Magazine.

Those deaths likely stem from a New York regulation requiring nursing homes to accept COVID-positive patients after they’d been released from the hospital or face the wrath of the state.

This is yet another macabre example of why we shouldn’t trust politicians with healthcare decisions.

Steve Parker, M.D.

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This can’t be a good prognostic sign

From WebMD:

“We have an epidemic with obesity in the southern United States,” [Dr Leonardo] Seoane says. “Treating obese patients in the ICU is not new to us, so when we first started to get inundated with severely infected COVID patients ending up in the ICU, it didn’t necessarily raise an alarm for us because we typically take care of many obese patients in the ICU,” he explains. “In time, we started to realize this was different, though, as it became clear that the majority of the younger people in the ICU with coronavirus were obese.”

That inspired Seoane and the Ochsner Center for Outcomes and Health Services Research team to gather data. They studied 3,000 patients who tested positive for the coronavirus in his hospital system and found that 59% of the hospitalized patients were obese with an average BMI of 33. He says obesity nearly doubled the chances that patients with COVID-19 would end up in the ICU.

New York Governor Cuomo was (still is?) sending COVID-19 patients to nursing homes from the hospital, to help spread the infection I guess.

A number of states have already reported alarmingly high COVID-19 deaths among residents of elder care facilities. What’s “alarmingly high”? Forty percent of coronavirus deaths.

This time it’s Illinois. From Chicago Sun Times:

Those tallies mean elderly care facilities have accounted for 44% of the state’s coronavirus deaths and nearly one in seven confirmed cases.

A total of 354 homes have at least one resident who has tested positive, with 75 reporting their first cases in the past week after previously having none. Almost three dozen facilities have suffered double-digit deaths; eight have more than 100 cases.

Cook County has seen more than half the state’s nursing home deaths, 603, and cases, 3,992.

The largest spike in deaths at one home in the past week came at Bria of Geneva in Kane County, where 15 people passed away of COVID-19. Only one person was reported dead there until this week. The medical director at that home told the Northwest Herald there was a “landslide of patients” and “it was pretty obvious we had a severe outbreak in the facility.”

Source: Coronavirus deaths double in one week at Illinois nursing homes; have surged past 1,000, data show – Chicago Sun-Times

When I read statistics like this, I’m never sure if the deaths occurred in the elder care facility or in a hospital where the patient was taken. Doesn’t matter unless the patient actually contracted the infection in the hospital.

Steve Parker, M.D.

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Post-viral apocalypse? Raccoon City?

The Center for Infectious Disease Research and Policy at U of Minnesota states that the COVID-19 pandemic could well be with us for another two years. Their main recommendations are:

• States, territories, and tribal health authorities should plan for the worst-case scenario, including no vaccine availability or herd immunity.
• Government agencies and healthcare delivery organizations should develop strategies to ensure adequate protection for healthcare workers when disease incidence surges.
• Government officials should develop concrete plans, including triggers for reinstituting mitigation measures, for dealing with disease peaks when they occur.
• Risk communication messaging from government officials should incorporate the concept that this pandemic will not be over soon and that people need to be prepared for possible periodic resurgences of disease over the next 2 years.

Scary stuff, huh?

The response of most politicians in the U.S. has been to flatten the economy with a hammer and sickle. We cannot tolerate this for another two years. Thirty million Americans have lost their jobs in the last four weeks. Make no mistake, our economic malaise has been caused by politicians, not a virus. Elon Musk recently referred to the ongoing government-mandated lockdowns as fascist. Benito Mussolini would agree with that. Others disagree.

Mike Whitney has a plan to revive the economy:

We start by allowing the younger, low-risk people to go back to work. (Older and infirm people should take the recommended precautions of self isolating as much as possible.) That allows the economy to restart while the virus spreads among a segment of the population that is least likely to die. If you’re under 40, your chances of dying are near zero, so it shouldn’t be a huge concern.

Also, you open up restaurants, primary schools, parks and some retail shops while–at the same time–monitoring the rate of new Covid-positive cases. If it looks like the health care system is going to be overwhelmed, you pull back by implementing new guidelines and restrictions on public activities and get-togethers. You don’t just send everyone back to work on Day 1 announcing “The coast is clear”. The coast is not clear and it’s not going be clear for quite a while, but at least the new policy will get us to where we want to go eventually. And that’s the point, because if we don’t chart a new course, we’re definitely not going to reach our destination.

What we need is immunity, which comes through human interaction. An infected person passes the infection along to a healthy person who develops the antibodies to fight the virus now and in the future. When the majority of the population develop these antibodies, they achieve “herd immunity” which is “a form of protection from infectious disease that occurs when a large percentage of a population has become immune through previous infections.”

I posted a similar proposal a month ago, on April 2. Agreed, the coast is not clear in New York City or New Orleans, but it is clear in many other places. We need to quit hiding under our beds from the bogeyman virus.

Steve Parker, M.D.

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One of these is healthy for age, the other is not. Should they take different precautions?

On April 21, 2020, a panel of experts at Charles University in Prague published some thoughts on the Coronavirus pandemic. I recommend the entire article to you; it’s not long. What particularly caught my attention was advice on social distancing for the elderly and other vulnerable populations:

5. ELDERLY CITIZENS NEED SAFE SOCIAL CONTACT, NOT ABSOLUTE QUARANTINE

The stigmatization and imposition of limitations on older people in the “fight against COVID-19” is baseless and unjustified and establishes age discrimination in public sentiment.

As part of the solution to the COVID-19 crisis, the public is being massively persuaded by fear of the extraordinary danger of infection for “older” people and the necessity of implementing identical emergency measures for this very heterogeneous group, including not leaving their apartments or having specific shopping times. At the same time, the public is finding out that it is precisely these seniors affected by COVID-19 that could overwhelm the health care system. Suggestions were even raised to classify patients based only on age. Defining “endangered old age” at 65+ has led to an unprecedented stigmatization of 20% of the population of the republic, including people who are healthy and not particularly endangered. Some became uncertain of themselves or had to suffer the manipulative behavior of their environment. Many of them suffer from exaggerated fear of infection, from reduced contact with families, isolation, loneliness, deprivation of communication, disruption of daily routines with serious psychological consequences, disproportionate to the risk and the potential for reducing it. Several weeks without going outside has endangered fragile people through loss of stability, mobility, and thus self-sufficiency. However, there is no reason for them not to move freely in open spaces while keeping a distance from other people.

It appears that worsening of the COVID-19 prognosis is mainly related to associated illnesses, not age as such. These include nutritional disorders, oncological and cardiovascular diseases, diabetes, possibly some medications. It is not primarily “the elderly” who are affected, but those who are “fragile and severely ill”. In this, COVID-19 is no different from any other stress factor, including disease, as we know from influenza epidemics, heat waves or freezing weather.

Particularly problematic are residential social service facilities (senior residences, assisted living homes) and long-term care facilities. This is an instance of risky concentration of exceptionally fragile people with a number of serious illnesses. Experience from other countries as well as the initial data from the Czech Republic show that these people probably make up the majority of all COVID-19 victims. This shows that one’s health potential (fitness, resilience, adaptability) is a much stronger predictor than age as such. Many frail patients succumbed to this infection as a non-specific stress factor, just as they would have succumbed to the flu or a major injury.On the contrary, even in the Czech Republic, not enough has been done to protect this most endangered group — residents of residential social services facilities. These include the quality of preventive measures, personnel training, quarantine training, sufficient protective and hygiene products, frequent staff testing, the main source of its [the pathogen’s] introduction, testing in case of suspicious symptoms and the immediate transport of infected clients to high-quality quarantine facilities with the necessary care available should difficulties develop, and so on.

Source: Academic Coronaskeptics in the Czech Republic | Gates of Vienna

Steve Parker, M.D.

PS: Diabetes and obesity are risk factors for severe illness from COVID-19.

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