Two monoclonal antibody treatments are conditionally approved by the FDA, seem to substantially help moderately severe cases of Covid-19, and are supposed to be available for use as outpatient infusions to prevent hospitalizations and deaths. In practice they are not actually available, as I found out this weekend trying to arrange an infusion for a patient. This is another fail of our health system.
We provide multiple brief updates about the state of the Covid-19 pandemic, the vaccines, the treatments or lack thereof, how you isolate, and what the future holds. Stay the course. Keep your guard up. Get your flu shot. We are in this for a long time.
I explain multiple and sometimes complex issues with the Covid-19 epidemic, starting with where we are in the infection epidemiology (new infections in Mass. are leveling off but are still high, deaths are growing). Then I explore the types and efficacy of biological tests (PCR and antibody), and why different people have different personal Covid risks and may make appropriately different responses in behavior and personal protective equipment. I tried to keep it short, but ultimately chose clarity over brevity.
The next six weeks will be risky for all of us as the Covid-19 epidemic continues to extend its reach. Nevertheless, I am convinced we can all stay safe with a high degree of probability during this time, whether by keeping in our circles of safety, or by careful use of personal protective gear, providing we are rigorous in our self-protection. I present and explain a graphical model of how and why the number of active cases will likely increase and by how much over April and May.
Today marked beginning of the third week of our collective quarantines. Our practice has had just several possible or likely cases of Covid-19. We will be in “lockdown” certainly through April and most likely through May. We are not providing any off label treatments at this time. Much more testing of active and past disease is needed to enable us to eventually come out of quarantine safely, as well as face masks for all. These of course are not available as yet. But a good card game to try is.
NDMA now contaminates ranitidine (Zantac), a common OTC antacid tablet. This is the same chemical that contaminated drugs for blood pressure.
Recent deaths from lung failure related to using vaporized nicotine or marijuana are of great concern. Do not use “vaping” products.
The sinuses are hollow areas in the bones of the face. When the lining is infected, the extra mucus produced causes a stuffy nose, pain in the face and yellow or green discharge. Sinusitis is really common in winter. Most cases are viral.
Influenza killed almost 80,000 people in the US last year, more than opioid overdoses, more than breast cancer, more than car accidents. The flu vaccine works and is benign. Get your flu shot with us before Thanksgiving!
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Calculating the Risk of Asymptomatic But Infectious Person in a Group
We use available state Covid-19 infection rates and other published data together with the binomial distribution to calculate the risk of unsuspected infections in small group gatherings. With our current high level of infections (20 times higher than summer) the risk is 5-10% for groups of 10 or 20. You DON’T want to gather indoors with other than household members this winter.