COVID-19

High Blood Sugar Increases Risk for Complications in COVID-19

  July 18, 2020   

A study from Wuhan, China showed that non-diabetic COVID-19 patients with high blood sugar levels on admission to the hospital were more than twice as likely to die within a month and four times more likely to suffer the most serious complications caused by that disease (Diabetologia, July 10, 2020). The authors concluded that on admission for COVID-19, a fasting blood glucose level higher than 125 mg/dL (7.0 mmol/l) is an independent predictor for death within 28 days in patients with COVID-19 without a previous diagnosis of diabetes.

A study from the U.S. also showed an increased death rate for COVID-19 patients admitted to hospitals with high blood sugar levels (J Diabetes Sci Technol, May 9, 2020). Several previous studies show that diabetics are at markedly increased risk for dying from heart attacks, strokes, cancer and infections (Lancet, 2018;391(10138):2430–2440), and people who have high blood sugar levels on admission to a hospital for pneumonia are at increased risk for dying in the hospital (BMJ, 2012;344:e3397).

How High Blood Sugar Increases Risk of Death
COVID-19 can cause clots to form in and destroy the lungs, heart, kidneys, brain, liver and other parts of your body. High blood sugar can also cause clots, increasing the risk of this complication in patients with COVID-19. High blood sugar can prevent blood vessels from widening so the clots are more likely to block the flow of blood. High blood sugar can also cause the immune system to produce inflammatory cytokines, leading to “cytokine storm” where the body attacks its own cells and tissues rather than just fighting off the virus. The cytokine storm can eventually kill a patient.

My Recommendations
We do not completely understand why COVID-19 is a relatively benign disease for many people and very serious or even deadly for others. We do know that you are at risk for complications if you have any defect in your immune system, such as diabetes, heart disease, an auto-immune disease, lung disease, kidney disease, cancer, high blood pressure, a chronic infection and so forth.

You are at increased risk for serious complications from COVID-19 if you have high blood sugar after meals or have an obese belly, which specifically causes high blood sugar levels. This is one risk factor that you can improve immediately just by avoiding the foods that cause high rises in blood sugar: sugared drinks and sugar-added foods, and any processed food made with refined carbohydrates. See my report Restrict Added Sugars to Reduce Heart Attack Risk.

JULY 17

High Blood Sugar Increases Risk of Complications in COVID-19 

A study from Wuhan, China showed that non-diabetic COVID-19 patients with high blood sugar levels on admission to the hospital were more than twice as likely to die within a month and four times more likely to suffer the most serious complications caused by that disease (Diabetologia, July 10, 2020). The authors concluded that on admission for COVID-19, a fasting blood glucose level higher than 125 mg/dL (7.0 mmol/l) is an independent predictor for death within 28 days in patients with COVID-19 without a previous diagnosis of diabetes.

A study from the U.S. also showed an increased death rate for COVID-19 patients admitted to hospitals with high blood sugar levels (J Diabetes Sci Technol, May 9, 2020). Several previous studies show that diabetics are at markedly increased risk for dying from heart attacks, strokes, cancer and infections (Lancet, 2018;391(10138):2430–2440), and people who have high blood sugar levels on admission to a hospital for pneumonia are at increased risk for dying in the hospital (BMJ, 2012;344:e3397).

How High Blood Sugar Increases Risk of Death
COVID-19 can cause clots to form in and destroy the lungs, heart, kidneys, brain, liver and other parts of your body. High blood sugar can also cause clots, increasing the risk of this complication in patients with COVID-19. High blood sugar can prevent blood vessels from widening so the clots are more likely to block the flow of blood. High blood sugar can also cause the immune system to produce inflammatory cytokines, leading to “cytokine storm” where the body attacks its own cells and tissues rather than just fighting off the virus. The cytokine storm can eventually kill a patient.

My Recommendations
We do not completely understand why COVID-19 is a relatively benign disease for many people and very serious or even deadly for others. We do know that you are at risk for complications if you have any defect in your immune system, such as diabetes, heart disease, an auto-immune disease, lung disease, kidney disease, cancer, high blood pressure, a chronic infection and so forth.

You are at increased risk for serious complications from COVID-19 if you have high blood sugar after meals or have an obese belly, which specifically causes high blood sugar levels. This is one risk factor that you can improve immediately just by avoiding the foods that cause high rises in blood sugar: sugared drinks and sugar-added foods, and any processed food made with refined carbohydrates. See my report below on the link between sugar-added foods and heart attacks.

JULY 12

Why Obesity Increases Risk of Death from COVID-19 or Influenza

  

A review of 4,103 patients found that obesity and its resultant inflammation, heart disease and diabetes are the most common conditions found in patients requiring hospitalization with COVID-19 (Physician’s Weekly, pre-print, April 14, 2020). Another study of 3,615 patients found that in patients under 60 years of age, being obese more than doubled the chance of needing to be hospitalized (Clinical Infectious Diseases, April 9, 2020). Other studies show that obesity (body mass index or BMI greater than 30) is a major risk factor for dying from COVID-19 (Lancet, April 1, 2020), and the more you weigh, the more likely you are to need to be put on a ventilator which markedly increases your chance of dying (Obesity, April 9, 2020). This should scare you into action because more than 40 percent of North Americans are obese.

The 2009 Influenza A virus pandemic was caused by a virus very similar to the one that caused the 1918 Flu pandemic, and obesity was associated with increased risk of severe disease, hospitalization and death (PLoS ONE, 2010; 5:e9694). During the 1957-1960 Asian flu and the 1968 Hong Kong flu, both obesity and diabetes were associated with a marked increase in prolonged illness and death (Prev Med, 2013;56(2):118-123), even in those who were apparently healthy before they got the flu (Influenza Other Respiratory Viruses, 2019;13:3-9).

How Does Obesity Increase Risk for Death from COVID-19?
Obese people suffer increased risk for complications from infections because obesity leads to an overactive immune system called inflammation (Adv Nutr. 2016;7:66-77) that interferes with their body’s ability to kill invading germs (Epidemiology, July 2015;26(4):580-589). An article in Acta Diabetologica (April 5, 2020) explains how obesity causes inflammation:
• A major cause of obesity is inability to respond to the hormone, leptin (Am J Physiol Regul Integr Comp Physiol, 2009 Mar; 296(3):R493–R500), just as type II diabetes is caused by insulin insensitivity.
• Leptin is a hormone made by fat, intestinal cells and red blood cells.
• Leptin inhibits hunger by telling your brain that you are full so that you stop eating, don’t take in too many calories, and therefore do not fill up fat cells with excess fat.
• Obese people have very high blood levels of leptin because they do not respond to leptin (leptin insensitivity), and keep on eating long after they are full.
• High levels of leptin turn on your immune system to cause inflammation, and reduce levels of adiponectin, a hormone that reduces inflammation.
• Obesity-related chronic inflammation prevents your immune system from producing cells and cytokines to kill invading viruses (Environ Toxicol Pharmacol, 2015;40(3):924-930).
• People who have high levels of leptin and low levels of adiponectin suffer from inflammation to cause diabetes (insulin insensitivity), infections (high white blood cell counts), and heart, liver and kidney damage (Nat Rev Immunol, 2011;11(2):85-97).

Lack of Exercise
Lack of exercise causes the same harms as obesity. Each of the changes listed above are also promoted by lack of exercise (Nature Medicine, 2019;25:1761-1771). Lack of exercise increases risk for insulin resistance (Acta Physiol, 2019;226:1-16), and prevents your body from responding to infections and mounting a full attack on invading viruses (Cell Physiol Biochem, 2015;37:735-746).

My Recommendations
The COVID-19 pandemic is probably keeping you at home more and away from many group activities, so you are stuck with lots of food and limited opportunities for exercise. Eating more food and exercising less sets you up to gaining extra fat weight.
• Try to exercise at home or outdoors as long as you are not close to other people.
• Avoid bringing the foods that are most likely to make you fat into your home, particularly those with added sugars and refined carbohydrates (breads, crackers, cookies, and other foods made from flour).
• Drink water or other fluids that contain no calories.

Protecting Yourself from COVID-19

  July 5, 2020   

As businesses and activities are re-opening, many people have decided to relax their precautions to avoid infection with COVID-19. If you are a person who is at high risk for complications from this virus, I believe that you should continue to be on guard. You are at increased risk for complications if you have any defect in your immune system: a history of heart attacks or heart disease, cancers, diabetes, auto-immune disease, kidney disease, obesity, high blood pressure, a chronic infection or any other serious illness. People with an existing lung disease (asthma, bronchitis, COPD, emphysema, and so forth) are at high risk for complications.

The vast majority of COVID-19 infections are caused by breathing respiratory droplets indoors. A study from China found that only two of 1245 cases were acquired outdoors (MedRxiv, published online April 7, 2020). The remainder were transmitted in various indoor environments — homes, public transportation, shopping and so forth. Another study from China showed that family members of an infected person are at very high risk for infection (Lancet Infect Dis, May 2020;20(5):534-535). Coughing, sneezing, and talking can spew infected droplets into the air from people who may have no symptoms whatever. The droplets spread usually for 3-6 feet, but some reports have extended the distance as far as 30 feet.

Contaminated Surfaces in a Hospital
Detailed analysis of contamination in hospitals during the COVID-19 epidemic can teach us a lot about how the virus spreads in other indoor spaces. A study reported in Emerging Infectious Diseases (July, 2020;26(7)) found that:
• The virus was widely distributed on floors, computer mice, trash cans, sickbed handrails and other surfaces, and was detected in the air 12 feet from patients.
• The highest concentration of virus was in the intensive care unit.
• Floors of the entire hospital were loaded with virus, because gravity settles the respiratory droplets there.
• Fifty percent of the shoe soles of medical personnel were covered with virus.
• Masks were loaded with virus — a sign that they are working, but need to be washed or discarded after every use.

Try to Avoid Public Restrooms
Restrooms can be a major source of infection, and the highest concentrations of virus in a hospital were found in toilets (Nature, April 27, 2020;582:557–560). The virus can live in stool and aerosol droplets can rise three feet above a toilet when it is flushed (Physics of Fluids, June 15, 2020). If the toilet has a lid, close it before flushing and get away from the toilet immediately after flushing. If you have to use a public restroom:
• Wear a mask.
• Carry a paper towel or tissue and use it to open doors or touch any handles or anything else.
• Flush with your foot if possible.
• Leave as quickly as you can. This is not the place to comb your hair, fix your make-up, chat with friends or anything else.

Rules to Live By (For Now)
• Wear a face mask any time you expect to be around people who are not members of your household. Masks protect others from your secretions, but they do collect virus droplets, so you have to wash your mask after you use it (or use a disposable mask). See Should You Wear a Mask When You Exercise Outdoors?
• Stay at least six feet away from other people.
• Avoid everyone with respiratory symptoms.
• Use 20-second soap hand washes after you touch anything (if you can), and frequently throughout the day.
• Try not to touch your eyes, nose or mouth, the primary sources of viral entry into your body.
• If you feel sick, stay home.
• If you have to travel, try to go by car. If possible, avoid group travel such as trains, planes, buses and boats.

My Recommendations
These are times that will pass when we have a vaccine early next year. For now, realize that you can become infected anywhere an infected person has breathed or coughed out the virus. I am using the good news about low rates of infection outdoors to inspire me to spend lots of time riding my bicycle.

JULY 4

Covid-19

Protecting Yourself from COVID-19

As businesses and activities are re-opening, many people have decided to relax their precautions to avoid infection with COVID-19. If you are a person who is at high risk for complications from this virus, I believe that you should continue to be on guard. You are at increased risk for complications if you have any defect in your immune system: a history of heart attacks or heart disease, cancers, diabetes, auto-immune disease, kidney disease, obesity, high blood pressure, a chronic infection or any other serious illness. People with an existing lung disease (asthma, bronchitis, COPD, emphysema, and so forth) are at high risk for complications.

The vast majority of COVID-19 infections are caused by breathing respiratory droplets indoors. A study from China found that only two of 1245 cases were acquired outdoors (MedRxiv, published online April 7, 2020). The remainder were transmitted in various indoor environments — homes, public transportation, shopping and so forth. Another study from China showed that family members of an infected person are at very high risk for infection (Lancet Infect Dis, May 2020;20(5):534-535). Coughing, sneezing, and talking can spew infected droplets into the air from people who may have no symptoms whatever. The droplets spread usually for 3-6 feet, but some reports have extended the distance as far as 30 feet.

Contaminated Surfaces in a Hospital
Detailed analysis of contamination in hospitals during the COVID-19 epidemic can teach us a lot about how the virus spreads in other indoor spaces. A study reported in Emerging Infectious Diseases (July, 2020;26(7)) found that:
• The virus was widely distributed on floors, computer mice, trash cans, sickbed handrails and other surfaces, and was detected in the air 12 feet from patients.
• The highest concentration of virus was in the intensive care unit.
• Floors of the entire hospital were loaded with virus, because gravity settles the respiratory droplets there.
• Fifty percent of the shoe soles of medical personnel were covered with virus.
• Masks were loaded with virus — a sign that they are working, but need to be washed or discarded after every use.

Try to Avoid Public Restrooms
Restrooms can be a major source of infection, and the highest concentrations of virus in a hospital were found in toilets (Nature, April 27, 2020;582:557–560). The virus can live in stool and aerosol droplets can rise three feet above a toilet when it is flushed (Physics of Fluids, June 15, 2020). If the toilet has a lid, close it before flushing and get away from the toilet immediately after flushing. If you have to use a public restroom:
• Wear a mask.
• Carry a paper towel or tissue and use it to open doors or touch any handles or anything else.
• Flush with your foot if possible.
• Leave as quickly as you can. This is not the place to comb your hair, fix your make-up, chat with friends or anything else.

Rules to Live By (For Now)
• Wear a face mask any time you expect to be around people who are not members of your household. Masks protect others from your secretions, but they do collect virus droplets, so you have to wash your mask after you use it (or use a disposable mask). See Should You Wear a Mask When You Exercise Outdoors? 
• Stay at least six feet away from other people.
• Avoid everyone with respiratory symptoms.
• Use 20-second soap hand washes after you touch anything (if you can), and frequently throughout the day.
• Try not to touch your eyes, nose or mouth, the primary sources of viral entry into your body.
• If you feel sick, stay home.
• If you have to travel, try to go by car. If possible, avoid group travel such as trains, planes, buses and boats. 

MAY 31

As the coronavirus pandemic unfolds, health experts are finding interesting connections between low vitamin D levels and severe COVID-19 symptoms.

Researchers out of Northwestern University in Illinois looked at countries with high COVID mortality rates, such as Italy, Spain and the UK., and found, on average, patients had lower levels of vitamin D in these counties when compared to patients in other areas of the world that were less affected.

Another study done in the UK backed this claim. Researchers there found that Finland, Norway, Denmark, and Sweden had higher levels of vitamin D and lower rates of COVID-19.

Vitamin D is a common supplement many people take due to insufficient levels. Now many are paying even more attention to the recommended dose.

“Vitamin D has been shown to have different roles,” says Dr.Montano-Loza, the Associate Professor of Medicine at the University of Alberta. “Specifically, it has an immunomodulatory role, that in one way helps our immune system to fight infections, [and] at the same time, it also has an anti-inflammatory role. So that means it regulates the immune response, so we do not have a state of acute inflammation.”

VITAMIN D CAN PREVENT A ‘CYTOKINE STORM’

Severe inflammation has been noticed in many patients with COVID-19. Doctors believe that low vitamin D levels can trigger a cytokine storm in a patient fighting a virus.

“A cytokine storm can happen in some patients who have COVID-19” explains Dr. Montano-Loza. “It’s an acute state of inflammation — it’s basically an excessive release of molecules that exacerbates inflammation. This can then trigger several organ dysfunctions. These patients are in the hospital with advanced support.”

When vitamin D levels are normal, the presence of this vitamin can regulate the body’s response to a virus.

RESEARCHERS EAGER TO START STUDY IN CANADA

Since researchers are keen on the idea of low vitamin D levels being a problem, it’s now time to test regulating levels in patients who are deficient and are suffering from COVID-19. This type of testing is scheduled to happen in Alberta.

“In Alberta, we are going to measure vitamin D levels in all patients who have infections with COVID-19,” says Dr. Montano-Loza. “In the patients who have low vitamin D levels in their blood, we are going to give them a higher dose. We are aiming to normalize the vitamin D level in a short period of time — between one to two weeks. We will be monitoring if this has a positive impact on clinical outcomes.”

In order to complete the study, the university needs at least 70 patients that fit their criteria. The medical team at the University of Alberta hopes to have preliminary results by fall.

SHOULD I BE TAKING A VITAMIN D SUPPLEMENT?

For Canadians looking to boost their own vitamin D levels Dr. Montano-Loza suggests the following:

“I think all Canadians should be taking a vitamin D supplement. The current recommendation is to take from 600-800 international units every day. I think during a situation like this one, during a pandemic, I think it is a good idea to increase to 1000-2000 international units a day, no more than that.”

Vitamin D deficiency - check list

Why Obesity Increases Risk of Death from COVID-19 or Influenza

A review of 4,103 patients found that obesity and its resultant inflammation, heart disease and diabetes are the most common conditions found in patients requiring hospitalization with COVID-19 (Physician’s Weekly, pre-print, April 14, 2020). Another study of 3,615 patients found that in patients under 60 years of age, being obese more than doubled the chance of needing to be hospitalized (Clinical Infectious Diseases, April 9, 2020). Other studies show that obesity (body mass index or BMI greater than 30) is a major risk factor for dying from COVID-19 (Lancet, April 1, 2020), and the more you weigh, the more likely you are to need to be put on a ventilator which markedly increases your chance of dying (Obesity, April 9, 2020). This should scare you into action because more than 40 percent of North Americans are obese.

The 2009 Influenza A virus pandemic was caused by a virus very similar to the one that caused the 1918 Flu pandemic, and obesity was associated with increased risk of severe disease, hospitalization and death (PLoS ONE, 2010; 5:e9694). During the 1957-1960 Asian flu and the 1968 Hong Kong flu, both obesity and diabetes were associated with a marked increase in prolonged illness and death (Prev Med, 2013;56(2):118-123), even in those who were apparently healthy before they got the flu (Influenza Other Respiratory Viruses, 2019;13:3-9).

How Does Obesity Increase Risk for Death from COVID-19?
Obese people suffer increased risk for complications from infections because obesity leads to an overactive immune system calledinflammation (Adv Nutr. 2016;7:66-77) that interferes with their body’s ability to kill invading germs (Epidemiology, July 2015;26(4):580-589). An article in Acta Diabetologica (April 5, 2020) explains how obesity causes inflammation:
• A major cause of obesity is inability to respond to the hormone, leptin (Am J Physiol Regul Integr Comp Physiol, 2009 Mar; 296(3):R493–R500), just as type II diabetes is caused by insulin insensitivity.
• Leptin is a hormone made by fat, intestinal cells and red blood cells.
• Leptin inhibits hunger by telling your brain that you are full so that you stop eating, don’t take in too many calories, and therefore do not fill up fat cells with excess fat.
• Obese people have very high blood levels of leptin because they do not respond to leptin (leptin insensitivity), and keep on eating long after they are full.
• High levels of leptin turn on your immune system to cause inflammation, and reduce levels of adiponectin, a hormone that reduces inflammation.
• Obesity-related chronic inflammation prevents your immune system from producing cells and cytokines to kill invading viruses (Environ Toxicol Pharmacol, 2015;40(3):924-930).
• People who have high levels of leptin and low levels of adiponectin suffer from inflammation to cause diabetes (insulin insensitivity), infections (high white blood cell counts), and heart, liver and kidney damage (Nat Rev Immunol, 2011;11(2):85-97).

Lack of Exercise
Lack of exercise causes the same harms as obesity. Each of the changes listed above are also promoted by lack of exercise (Nature Medicine, 2019;25:1761-1771). Lack of exercise increases risk for insulin resistance (Acta Physiol, 2019;226:1-16), and prevents your body from responding to infections and mounting a full attack on invading viruses (Cell Physiol Biochem, 2015;37:735-746).

My Recommendations
The current COVID-19 pandemic is probably keeping you at home and away from group activities, so you are stuck with lots of food and limited opportunities for exercise. Eating more food and exercising less sets you up to gaining extra fat weight.
• Try to exercise at home or outdoors as long as you are not near other people.
• Avoid bringing the foods that are most likely to make you fat into your home, particularly added sugars and refined carbohydrates (breads, crackers, cookies, and other foods made from flour).
• Drink water or other fluids that contain no calories.

APRIL 23

Potential Drugs, Treatments and Vaccines for COVID-19

We have no drugs yet proven to prevent or treat COVID-19, although one drug, Remdesivir, appears promising, as do transfusions of blood donated by people who have recovered and are now immune. The virus is spread from one person to another; it has not been shown to be spread from animals or food. Until we have a safe and effective vaccine, the only way we have to slow down the pandemic is to keep infected people away from those who have not yet been infected. To do this, we need to develop antibody tests to find who has already been exposed to the virus and may be immune.

We Need Both Antibody Blood Tests and a Vaccine
Antibody blood tests tell if a person has antibodies in his bloodstream from having been infected with COVID-19. Many companies are working to develop these tests, and so far the FDA has approved four of the tests. After a person is infected with the virus, his immune system produces antibodies that help him kill the virus now and in the future. We don’t yet have studies to show that people with antibodies in their bloodstream are protected from getting the infection again, or how long that protection will last. However, based on our knowledge of other coronaviruses, the odds are very strong that having antibodies will prevent re-infection. When we are able to tell who has been infected and recovered and has the antibodies that may prevent re-infection, we will be able to send people who have recovered from COVID-19 back to work, to treat and help sick people, and be safely out in society.

However, we can’t wait for everyone to get COVID-19. Most of all, we need a vaccine to help people develop antibodies that will make them immune without getting sick and possibly dying from COVID-19. Normally it takes as long as five years to develop a new vaccine. Researchers have to spend months trying the vaccine in culture bottles to see if it harms and damages cells. Then they have to spend time trying the vaccine in animals to see if it harms them. Only after the vaccine has been shown to be safe in animals can the vaccine be tried in humans to see if it is safe in humans and effective in preventing the disease. The government is now in the process of speeding up research and relaxing restrictions so we can have a vaccine as soon as possible. Eleven companies have been approved by the FDA to start developing potential vaccines, and according to the World Health Organization, more than 70 different vaccines are already being tested.

Drugs Being Tested for Treatment of COVID-19
The U.S. federal government has approved more than 424 different clinical trials to find effective treatments for COVID-19. Treatments being investigated include blood pressure drugs, immune suppressants, immune stimulants, antiviral drugs, anti-malarial drugs, supplemental oxygen, nitric oxide to widen blood vessels, many different antibiotics, stem cells, anti-cancer drugs, nasal washes, steroids, vitamins C and D, zinc, honey, Chinese herbs, breathing machines, CPAP machines, anti-clotting medicines, anti-flu drugs, anti-HIV drugs, bone marrow transplants and many others.

So far, no controlled scientific studies have proven that any drug helps to prevent or treat COVID-19.
• Several recent papers show that the leading drug is Remdesivir made by Gilead in Israel. We still have no studies with placebo controls because the drug is being given on a compassionate basis and not compared to placebos.
• Temple University has just started a clinical trial to evaluate gimsilumab, an artificially synthesized monoclonal antibody that suppresses an overactive immunity that causes cytokine storm in which a person’s own immunity destroys a person’s own body instead of just attacking invading germs.
• Hydroxychloroquine (Plaquenil), chloroquine and azithromycin: Studies from France and Brazil found that these anti-malarial drugs have not been effective in killing COVID-19 and they can cause deadly irregular heartbeats. Chloroquine has been shown in 62 patients to shorten the course of disease. Chloroquine and hydroxychloroquine both suppress immunity, so they may help a person who is at risk of dying of cytokine storm (Journal of Zhejiang University, March,2020 ). Some uncontrolled studies show that hydroxychloroquine and azithromycin reduced viral load in sick patients (International Journal of Antimicrobial Agents, preprint April 2020).
• Antiviral Lopinavir-Ritonavir has not been shown to be effective for COVID-19 (N Engl J Med, Mar 18, 2020).

What Can We Expect in the Next Two Years?
Social distancing and isolation strategies are likely to continue off and on until a significant percentage of the population has antibodies either from having had the disease or being immunized. Some of the habits we are learning in this traumatic period may become permanent as protection against future epidemics. For example, hand-shaking and cheek-kissing of strangers are likely to be replaced with other greeting gestures. Variations on working from home and remote schooling may become more popular options for people who have found that they prefer them.

We already have some blood tests, and will have many more, to see who has had COVID-19 and may be immune so they can most likely return safely to society. We could have a vaccine in a year because companies have been given permission to speed up the testing process, and the winners of this race are likely to make a lot of money.

APRIL 10

Okay, so I know I said I wasn’t going to talk about it anymore, but Covid 19 is in the news and most everywhere you look it’s bad and worse.

So here is some good news and something that every doctor who is working is this area should really consider.

Dr. Eric Berg is a good friend and associate. This video is very compelling on what should be done.

Please watch it now: https://www.youtube.com/watch?v=zer6omW0vnU

Also, I received this update regarding Ozone Therapy treatments in Italy, from another colleague of mine. The data is from an Italian article and was originally translated using Bing Translate by Dr. Antonio Gaspari. He warns that the translation is not perfect, but you’ll get the main points:

From the first report of the first two hospitals that started therapy (to date we are at 15 hospital facilities), where Oxygen Ozono Therapy is being practiced according to the Protocol of the Scientific Society of Oxygen Ozono Therapy (SIOOT) 11 patients in condition ”serious” and ”very serious” have had a rapid and decisive improvement.

After just five treatment sessions, one of the five intubated has improved to the point where it is exhumed and the others are improving significantly. The patient with the least serious conditions, after a few sessions of oxygen ozone therapy, healed and returned home.

The only one who died in the group was in a largely compromised condition. As an extreme attempt, only two sessions of ozone oxygen were practiced, but his condition was too compromised.

In the technical report, doctors wrote that after 5 treatments with Oxygen Ozono Therapy, as per SIOOT protocol, patients are all much better off.

Doctors observed after practicing Oxygen Ozono Therapy:

  1. General improvement of clinical conditions.
  2. Normalization of body temperature.
  3. Reactive C Protein Reduction (PRC)
  4. Heart rate normalization
  5. Improved saturation and reduced oxygen support
  6. Normalization of kidney function (creatine).

To better understand the significance of this data, we interviewed Prof. Marianno Franzini, President of SIOOT International and promoter together with Prof. Luigi Valdenassi of the treatment protocol..

According to Dr.Franzini the most important fact is that the improvements are remarkable and have occurred in only five days of therapy.

To try to better assess, Franzini asked his four colleagues who work directly in the care of Covid-19 patients, and all confirmed that these are very important results, because in five days no one among the people affected by Covid-19 has an improvement as fast and so stable as that seen in patients treated with Oxygen Ozone.

“A doctor who is treating Covid-19 patients,” Franzini said, “has revealed to me that no treatment protocol is giving results like those of Oxygen Ozono Therapy.”

When asked why Oxygen Ozono Therapy is so effective, Franzini explained that autopsies of the deceased due to Covid–19, show that the virus immediately attacks the microcircle causing a scattered thrombosis.

And it is there, in addition to the antiviral effect, that ozone oxygen is even more decisive precisely because it reactivates and strengthens the microcircle.

“Considering the goodness of these early data, it would be very important, Dr.Franzini stressed, to ensure that the therapy was practiced at the beginning, when the test proves positive, so that we can cure them before they get worse, thus managing to shorten hospitalizations.”

Dr. Antonio Gaspari

Source: [http://www.ossigenoozono.it/IT/News/3506/PRIMO_REPORT_-_OSSIGENO_OZONO_SIOOT_NEI_PAZIENTI_RICOVERATI_CON_COVID-19?fbclid=IwAR0QbmXV7PeYEKkmLw093_PlpCejWAm1QTUBNjLs6WDcnonVcUozOlOkUxY](http://www.ossigenoozono.it/IT/News/3506/PRIMO_REPORT_-_OSSIGENO_OZONO_SIOOT_NEI_PAZIENTI_RICOVERATI_CON_COVID-19?fbclid=IwAR0QbmXV7PeYEKkmLw093_PlpCejWAm1QTUBNjLs6WDcnonVcUozOlOkUxY)

APRIL 10

Joe Diffie and Many Other Musicians Have Died from COVID-19

I have no data to show that popular musicians are at greater risk of death from COVID-19 than the general population, but we note the headlines marking the passing of many beloved artists just in the past few days:

Joe Diffie, a Grand Old Opry country music singer and songwriter who had been voted best all-around male athlete in high school (football, baseball, golf and track) but chose music over sports and his planned career in medicine. He had 35 singles on the Billboard Hot Country Songs. He died in Nashville on March 29, 2020, at age 61, two days after he tested positive for the coronavirus.
Adam Schlesinger, 52, Emmy and Grammy award–winning musician, died of COVID-19 complications at a hospital in Poughkeepsie, New York. He had been hospitalized and placed on a ventilator for a week prior to his death on April 1.
Ellis Marsalis, Jr., 85, a New Orleans legend as a jazz pianist and teacher, died on April 1. Of his six sons, four became noted musicians: Branford, a saxophonist; Delfeayo, trombonist; Jason, drummer; and Wynton, trumpeter and composer

APRIL 10

Why You Should Exercise During the COVID-19 Pandemic

Committed exercisers should try to continue to exercise during this COVID-19 pandemic, but they should realize that both too much exercise and exercising while sick increase risk for medical complications, such as irregular heartbeats, and death (Brit J of Sports Med, Sep 4, 2009;43(9):722-725). We have strong evidence that even a single workout improves your immune system (Med Sci Sports Exerc, 2004;36(8):1321–7), which will help you fight off COVID-19, as long as you don’t exercise too much (Brain Behav Immun, Sept 2005;19(5):377-80), or increase your risk for exposure to a COVID-19 infection by going to a gym used by other people, exercising too close to people, breathing air breathed out by infected people, or touching equipment used by others. Remember to wash your hands before and after you exercise, don’t exercise near anyone else (particularly one who is sneezing or coughing), and rub an alcohol wipe over exercise equipment before and after use. Skip your workout completely if you feel sick.

Don’t Exercise If You Feel Sick
COVID-19 can be a very dangerous virus that starts in your mouth and nose and then can travel down into your lungs with potentially severe consequences, so it is not a good idea to exercise if you have symptoms of a COVID-19 infection, particularly any evidence of lung involvement such as coughing, wheezing or shortness of breath. With this virus and most other upper respiratory infections, you may be able to exercise when you have a stuffy nose or sneezing, but it is very risky to exercise when the infection has passed down into your lungs. If you try to exercise and don’t feel better in 5 to 10 minutes, you should take the day off. Whatever you do, when you are sick, you should not exercise intensely. Take off if you have any of the following: feeling sick or weak, coughing, being short of breath, having muscle aches and pains, having a fever higher than 98.6°F or 37°C, nausea, diarrhea, vomiting or stomach cramping.

Evidence that Exercise Benefits Your Immune System
As long as you are healthy and are not experiencing symptoms of a possible infection, any form of exercise will be beneficial.
• Working out regularly has been shown to decrease the risk of many chronic diseases (Compr Physiol. Apr, 2012;2(2):1143–1211) such as diabetes (Diabetes Care, Dec 2010;33(12)) or cancer (Exerc Immunol Rev, 2013;19:120-43).
• Elite marathon runners report fewer days lost from work than non-exercisers (J Sports Sci Med, 2014 Dec 1;13(4):929-33).
• A study of 25,000 Chinese who died during the 1998 Hong Kong flu epidemic found that those who exercised moderately three times a week were far less likely to die (Exercise Immunology Review, December 2019;26:8-22; PLoS ONE, 2008;3(5):e2108).
• Rats that ran moderately on a treadmill for 30 minutes a day for several weeks were far more likely than non-exercising rats to survive rat influenza (Brain Behav Immun, Sept 2005;19(5):377-80).
• Exercise-trained mice injected with germs immediately after running on a treadmill are less likely to become sick and die than those who do not exercise, because vigorous exercise causes immune cells to surround and attack invading germs, rather than having their immune cells scattered throughout their bodies and not attacking the invading germ (Eur J Physiol, May 20, 2020;472:235–244).
• Mice that exercised regularly for three months prior to an induced infection suffered significantly less severity and duration of illness and lower blood virus levels than non-exercising mice (J of Infect Dis, Oct 2009;200(9):1434–1442). The same results occurred for both obese and normal weight mice.

Don’t Exercise Too Much
A large increase in exercise intensity or duration can reduce your immunity (Exerc Sport Sci Rev, Oct 2009;37(4):157–164) and increase risk for severity and death when you have respiratory disease (Scand J Med Sci Sports, 2006;16(4):287–93). Exercising improves your immune system, but too much exercise increases risk for infections. For example, over a five-month period, people who did not exercise suffered twice the rate of upper respiratory infection suffered by recreational exercisers, but elite athletes training near their maximum suffered the most upper respiratory infections of all — three times the rate of upper respiratory infections that recreational exercisers did (Med Sci Sports Exerc, Apr 2007;39(4):577-86). You may be stressing your immune system when you take workouts that:
• last longer than 90 minutes, especially without taking food and fluids,
• are of very high intensity, greater than 85 percent of your maximum effort, and
• fail to allow adequate recovery periods between intense workouts (Journal of Applied Physiology, Aug 1, 2007;103(2)).

How Fast Will I Lose My Fitness If I Don’t Exercise?
Within two weeks after healthy, young people reduced their walking steps from more than 10,000 steps a day to fewer than 2,000 steps, they had higher blood sugar levels and cholesterol levels, and lower insulin sensitivity (Diabetologia, 2018 Jun;61(6):1282-1294). Four weeks after marathon runners reduced their mileage after a marathon, they had lower blood volume and reduced ability of their hearts to pump blood, which markedly slowed their ability to run fast on a treadmill (J of Appl Physio, April 1, 2018;124(4)). On the other hand, after just six weeks of running up and down stairs for 20 seconds three times a day, people increased their aerobic fitness by about five percent (Appl Physiol Nutr and Metab, Jan 16, 2019;44(6):681-684).

My Recommendations
Most healthy people, particularly those who exercise regularly, should try to exercise during stay-at-home periods of the current pandemic. You can exercise in your home or yard, and most of these orders allow for outdoor exercise as long as you maintain the required distances from other exercisers. You should not:
• exercise within six feet of other people
• exercise in a gym used by other people
• share exercise equipment with people other than those in your household
• use any exercise equipment without first cleaning it off with alcohol wipes
• share drinks or eating utensils
• overdrink fluids (it is not possible to “flush out toxins”)
• exercise to exhaustion
• exercise when you have flu-like or other symptoms of illness (described above)

Latest Advice on the COVID-19 Pandemic

  April 4, 2020   

  1. Tight restrictions in the United States will continue. The president has announced that federal guidelines requiring most Americans to avoid non-essential travel, non-essential work, eating at bars and restaurants, and gathering in groups of more than 10, would be extended at least through April 30, 2020. Many states and local governments have stricter directives that take precedence over the federal guidelines. When restrictions are removed, the rate of new infections may start going back up.
  2. Stay away from people as much as you can. The primary route of infection is person-to-person. The most common source of the virus is the air that you breathe near an infected person, since a sneeze or cough can carry respiratory droplets six feet away, and the virus can remain in the air up to three hours before dropping to the ground or the nearest surface.
  3. Wash your hands every time you touch something. The virus lives longest on hard surfaces such as metal, glass, cardboard or plastic. One study showed that it can live on most metals for about 3 hours, copper-4 hours, cardboard-24 hours, stainless steel-13 hours, and plastic-16 hours (NEJM, Mar 17, 2020). However, most virus particles break down in minutes or hours outside a living host, and you are far more likely to acquire the virus directly from another person. The most effective way to get the virus off your hands is to use soap and water and wash for at least 20 seconds every time you touch surfaces such as a door handle, ATM machine, toilet flusher, shopping cart and so forth. Do not wash your hands with very hot water or alcohol as they can damage your skin.
  4. Wear homemade face masks in public places. Most face masks will not prevent the virus from entering your mouth or nose, but they can discourage you from touching your face with hands that may be contaminated. They can also help to keep you from infecting other people, since they will block your coughs or sneezes from becoming airborne. Medical-quality masks are in short supply and should be reserved for health care workers, so ordinary citizens are now being encouraged to make their own cloth masks, which can be washed in soap and water after each use. A variety of designs and instructions for making masks are available on YouTube, and even a bandana is more effective than nothing. The CDC may soon issue new guidelines for wearing homemade masks whenever a person is out in public. Plastic or rubber gloves and disposable gloves are not very practical since they need to be washed or changed every time you touch something that might be contaminated with the virus, but you may want to use them in high-risk environments.
  5. At this time there are no drugs that have been proven to cure COVID-19. The FDA has authorized use of the anti-malarial drugs, chloroquine phosphate and hydroxychloroquine (Plaquinil, also used to treat rheumatoid arthritis), even though they have not been proven effective or safe for COVID-19. More on studies of these drugs below.  Pain medicines such as Tylenol or ibuprofen can help patients feel better but do nothing to hasten healing, and some studies suggest that they may hinder the person’s immune system in its fight against the virus (BMJ, March 17, 2020;368:1086).

Many other drugs and combinations are being studied. For one of the best reviews I have seen on what we know so far about drugs to treat COVID-19, go to Management of Patients with COVID-19. The World Health Organization (WHO) maintains an “Outline of designs for experimental vaccines and therapeutics“, which lists drugs currently being tested.

Intravenous hyperimmune globulin injections from the blood of recovered persons, and monoclonal antibodies, look like they will be very effective and will be available very soon (JAMA, published online March 27, 2020). Blood from patients who have recovered from COVID-19 contains IgG and IgM antibodies that can kill the virus (JAMA editorial, March 27, 2020) Blood tests will soon be approved to see if a person has been infected with COVID-19 and is therefore now immune. These people may then be able to treat people who are currently infected, and to donate blood with the antibodies that could be helpful in treating COVID-19 patients.

Trials for a vaccine for COVID-19 will start in May 2020 (NIH News, March 16, 2020), and we should have a vaccine to prevent infections in 12 to 18 months.

Symptoms and Progression of COVID-19
• When you are infected, you may have no symptoms at all. Symptoms usually develop 2 to 10 days after you acquire the virus. Symptoms may begin like the flu but go on to develop fever, cough, and shortness of breath. The virus lives in your nose and throat and then can go down into your lungs. You may also suffer belly cramps and diarrhea, and the virus can be transmitted in the stool (Gastroenterology, accepted Feb 27, 2020, not yet published).
• COVID-19 is dangerous because it can infect your lungs and fill them up with mucus to smother you. It can cause your immunity to become so active that the same cells and chemicals that attack germs can attack you (called “cytokine storm”). The people most likely to suffer severe consequences from this infection include people over 65 and those who have diabetes, high blood pressure, heart disease, lung disease, kidney disease, asthma, immune defects, HIV, bleeding or clotting defects, or auto-immune diseases. Possible effects on pregnancy or unborn children are not yet known. Some patients appear to suffer long term heart damage after COVID-19 infections (Lancet, March 28, 2020;395:11054-1062).
• Infected people keep the live virus for an average of 20 days (Am J of Resp and Crit Care Med, Mar 23, 2020), and can continue to be contagious for up to 37 days, even if they have no symptoms (The Lancet, March 11, 2020). Sputum samples remain positive up to 39 days and stool samples for 13 days (Annals of Internal Medicine, March 30, 2020).

More on the Studies of Drugs to Treat Serious Cases of COVID-19: Six studies now show that three of the drugs currently being tested are helping to save lives in some of the most dificult cases of COVID-19:
• chloroquine, discovered in 1843 and used to treat malaria,
• hydroxychloroquine (Plaquenil), approved in 1955 for various autoimmune diseases as well as malaria, and
• azithromycin (Zithromax) approved in 1980 and used to treat bacterial infections.

1. Dr Stephen Smith, of East Orange, NJ, reports that he has treated 72 COVID-19 patients, most of whom were morbidly obese (over 300 pounds), diabetic or prediabetic, with hydroxychloroquine and azithromycin for five days. None of the patients required intubation (a ventilator). This followed a Seattle study of 40 patients, of whom half were diabetic or prediabetic, using the same drug combination. None had to be put on a ventilator, but two of the 40 patients developed irregular heartbeats.

2. A French study found that five days of this same drug combination completely eliminated the virus from the nose and throat in 30 patients, compared to 10 percent in the control group and 50 percent of those receiving only chloroquine (J of Antimicrobial Agents, March 17, 2020).

3. Chloroquine has been reported to reduce symptoms and hasten recovery in several small studies (Biosci Trends, Mar 16, 2020;14(1):72-73).

4. A Chinese study of 62 patients showed a marked reduction in fever and cough in patients receiving hydroxychloroquine. This is a preprint and has not yet been published.

5. Hydroxychloroquine was found to be significantly more potent than chloroquine in killing COVID-19 (Clinical Infectious Diseases, March 9, 2020). A loading dose of 400 mg twice daily of hydroxychloroquine given orally, followed by a maintenance dose of 200 mg given twice daily for four days, reached three times the potency of chloroquine given 500 mg twice daily for five days

6. Unpublished work by Dr. Vladimir Zelenko of Monroe, NY, reports that he has successfully treated patients with a five-day course of hydroxychloroquine 200 mg twice a day, azithromycin 500 mg once a day, and zinc sulfate 220mg once a day.  I am concerned that both hydroxychloroquine and azithromycin can cause irregular heartbeats, and close to 10 percent of North Americans are at risk for irregular heartbeats. We will await future studies on the effectiveness and safety of this combination of drugs.

APRIL 5

During this time of social distancing where our health and fitness facilities are shut down please remember to STAY ACTIVE You can still walk or run or ride ar bike,Kettlebell ,swim  For any of the folks who attend my classes (or any friends)if you want a workout or two to do at home with no needed accessories,  message me and I will be happy to send you some challenging yet doable workouts. You can just pretend I am on your shoulder pushing you through your paces!

And we all should be moving our bodies to keep our immune system strong!

March 17, 2020 (Extra)Good News: Healthy People Can Recover from COVID-19 in Three Days

Researchers tested the immune response to COVID-19 in an otherwise healthy woman in her 40s, who required hospital admission (Nature Medicine, March 16, 2020). Three days after the patient was admitted, her immune system produced huge amounts of several immune cells that are used to show that a person will recover from a seasonal influenza infection. This indicates that she had recovered in three days. Even though COVID-19 is caused by a brand-new virus never seen before, an otherwise healthy person was able to develop a healthy and normal immune response that signifies recovery. This helps to explain why more than 80 percent of COVID-19 cases are mild-to-moderate. However, other studies show that people can continue to shed the virus for 10-37 days (The Lancet, March 11, 2020), so they may still be contagiousDr Mirkin