Update June 6, 2020- So far things are looking much better. The Case Fatality rate seems to be under 0.3% which is great news compared to early on. The studies about asymptomatic spread were based in incomplete information so seems like that is not really an issue anymore. What a relief. Still African Americans are disproportionately affected which is not a genetic issue and deserves full investigation to all possibilities related to that but over 47% of the deaths and higher in some states were in nursing homes. So the elderly need to still be protected and African Americans need to still be on alert. Meanwhile, use common sense, hand washing, avoidance of those with immune issues, elderly etc.
Update April 25, 2020- We are at the point of almost doing a slow open of the state. Praying that we find peace between all sides as there is a lot of emotion from every direction. The person who has lost a loved one or has a sick loved one that may die alone whether from Coronavirus or otherwise, has a lot of fear about opening up. The person who is about to lose everything, life savings, their business etc and they fear not being able to feed their families. Bankruptcy and poverty is directly associated with mortality and significant morbidity. Both sides are suffering real death and suffering so hopefully we can move out of our zones to recognize the fear and sadness of the other and work together. Currently a lot of politics and emotions is driving decision making. We need prayers and unity more than ever. Social media/regular media is driving us apart.
Update April 4, 2020, we are up to 58,000 deaths worldwide, we are on stay home status for 3 weeks. Lose Lose situation that we have and praying for everyone.
Update March 29, 2020- Things are heating up. I actually know of more people who have died from Coronavirus ( all family of people I know) than I have known to die from flu since I have been a doctor. Stay safe and keep up with the social distancing.
Update March 21, 2020- As expected, the numbers are higher and the ICU's are overcrowded in some hospitals and no one has enough protective gear to keep them safe. That means everyone from the doctors, nurses, medical assistants, respiratory therapists, to janitors. People's tempers are running short and everyone is afraid. Still the numbers look like about 2% mortality but Germany's is much lower because they have enough supplies for treatment and safety. Such a shame that the CDC pandemic team ( not to the fault of funding) did not plan for even basic things. So we have a lot of people suffering from lack of protection but as a result, also lost jobs, wages etc. We have to practice social distancing to help prevent the overwhelm of the ICU's but also we need to love one another to overcome these tough times. I really think the mortality rate will look lower if we actually had access to more testing. Currently we are only testing the sickest out there so the % is artificially elevated but 1% of 320 million is still a lot of people to consider but we also have to look for one another as bankruptcies could equally cause deaths, not to mention your local alcoholic where they have closed liquor stores. That can literally kill them. Let's love one another and try to help where needed, even with alcohol honestly for those alcoholics with no access. Such a mess.
Update March 15, 2020-
It is crazy what happens in a week. Doctors around the world are sharing experiences and studies like never before in history in social media groups. This is also time for us to come together and practice social distancing but also find ways to help those suffering from social distancing and all these cancellations. There will be consequences economically that we will not think of and especially for those in dire straights economically, that can increase depression, anxiety, suicides, abuse, hunger. We have to think outside the box but with all our hearts. We have to remember that we haven't canceled love, singing, dancing, going in nature ( away from others) etc.
I have updated the supplements in the original post below but also posting some new interesting options.
There is new interesting data on plaquenil and this is an interesting review on Plaquenil as well even though it is a fitness site.
I will list some supportive studies on Low Dose Naltrexone at the Bottom which is a compounded medicine.
On testing... The recommendations are all over the place depending on who you talk to. Now there is a national shortage of testing kits and also shortage of property safety gear for health professionals ( write to the CDC about their lack of helping us prepare for the pandemic properly) so there will be triaging use of those kids. There is also a fairly high false positive rate on the tests so be aware. I think as soon as we have enough test kits, everyone with any symptoms should be tested so we will be more likely to enforce self quarantine and slow the peak of this illness. It may not change the treatment per se but being aware will keep us home. So waters are kind of murky here too.
Update March 10, 2020
Italy is seeing pretty devastating effects from the Coronavirus and is literally rationing ventilators in some hospitals. This country has a very modern system and is not a very polluted city. They are also seeing really sick people down to the 50's on ventilators. It is still unclear as to the % mortality as so many people have mild disease as well that is not being counted in the statistics. They are beginning to quarantine the bigger cities now. The good news is that it seems to be dying down already in China and South Korea and I have read a report that it seems to be already mutating to a less virulent virus ( less severe).
I think it is worth getting some shelf stable foods like dry beans and rice just in case. My doctor friend in Rome is pretty level headed and she is getting nervous which makes me nervous.
I still blame the media and powers that be for blowing up other infectious diseases that clearly had other purposes like Zika for making us not trust them. Anyone hear the story of the boy who cried wolf? Seems like this Coronavirus could be the big bad wolf. If you plan travel, you may need to plan for the risk of being stuck somewhere if they stop air travel. Praying it all dies down soon.
__________________________-
So the end of the world is coming again with the Coronavirus! Or is it? I feel like every 6 months or so, there is another killer infection that is going to kill us all and then fortunately, for the most part, it doesn’t happen. So what do I think about this one? The jury is still out for me. I see legitimate news sources ranging from saying the death rate isn’t as bad as it seems and already decreasing in China to an increase in the death rate and the markets are going to crash. So many people may have mild illness so there are likely way more infected than we realize so the mortality rate may be overestimated. However China is not famous for its transparency so not sure whether we can trust their stats. I honestly am not sure what to think about the actual risk and I am also not convinced this is not some virus made in a lab in Wuhan which could be much more risky. Bill Gates has been predicting the next pandemic that will kill 65 million people and he just headed the Pandemic readiness event in November 2019 with Johns Hopkins for what that is worth.
China has tons of pollution and has more diabetics than we have people in the United States. That alone changes the risk factors of who will have more serious outcomes with this new virus. People ARE dying from this virus and often happens with new strains since we have no immunity to it but it affects more elderly and those with immune system issues. Children seem to be safe from it. Remember that Ebola has almost 90% fatality rate in Africa but when the folks infected were brought here for treatment, they did totally fine. There is a difference here or other modern countries versus other more polluted countries or countries without adequate supportive care. Now if we can get hospitals on board with IV vitamin C, we would be even better! Here is another link on vitamin C, and another and another.
What to do?
The quick and dirty of it is this- Wash your hands for at least 20 seconds with good soap and water. If you travel, wipe down the seat and anything you touch with antiseptic wipes which are not perfect but may help. Put some Neosporin inside your nose with maybe a touch of Frankincense essential oil and thieves on your feet. Handwashing is preferable over hand sanitizers. If you are sick, stay home. Masks don’t seem to help much and don’t touch your eyes with dirty hands.
Supplements? Per the FDA, nothing can cure, mitigate, prevent, or treat the coronavirus so we have to just focus on supporting the immune system. The FDA says only a future vaccine and anti-virals can be considered legit but nothing natural. ;-). I have seen a lot of great articles with various herbals and vitamins to take but here are my favorites but not an exhaustive list. These are just meant to support your immune system in general not as a treatment or prevention. Consult with your doctor related to Coronavirus treatments.
I like Sufficient C powder- Take 1-2 scoops twice daily and for kids ½-1 scoop twice daily but any buffered vitamin C should be really good and easy to tolerate.
Astragalus – comes in a pill and tinctures so kids can also take it
Liver support like milk thistle and dandelion. I like Puri T liver by Life seasons.
Liver support like milk thistle and dandelion. I like Puri T liver by Life seasons.
Elderberry- I have seen mixed reviews but mostly on the theoretical possibility of “cytokine storm” but there have not been case reports of that yet. So I would vote to take for its anti-viral properties unless you feel you may have had issues in the past. However there are enough other options that maybe now isn't the time to risk it if you have never tried it plus it is picking up steam in the media against it. However this article by a well respected herbalist gives some clarity from an herbalist's perspective. My favorite is our local Sweet's Syrup but for coronavirus maybe take a pass unless you are sure you do well.
NAC- I love this one because it increases glutathione, your body’s most potent antioxidant but it also thins mucus and protects the liver. You can take 1 four times per day or a little more often if needed. This site lists a lot of good evidence and various benefits.
Cod liver oil- Take this once daily and when sick, double it for up to a week or so. It has natural vitamin A and D. Your grandma was right. Check out the VitaminD Wiki link
For immune support like like Monolaurin and Olive Leaf Extract as well. Those could replace the elderberry syrup for those who are concerned. Olive Leaf also has anti bacterial properties.
Licorice (not the sugar filled kind) has anti viral properties.
If you have asthma or other lung conditions- it is probably worth taking some magnesium glycinate or other Tri-Mag
2-3 Brazil nuts per day for Selenium support (approximate 55 mcg daily)
zinc 15-25 mg daily ( can do zinc lozenges)
Quercitin has anti viral properties.
Melatonin seems to be a great option too and maybe will help us sleep if we are worried.
Homeopathy- per my favorite homeopaths- The top remedies seem to be Arsenicum, Gelsemium, Bryonia, Thuja and some other obscure ones I couldn't find even listed on Amazon.
Stinging Nettle has exciting data against Coronavirus. You can get this in capsules and tea. Stinging nettles has a lot of neat uses.
Another interesting option is methylene blue. Some doctors are working on studies Methylene Blue IV , photobiomodulation and maybe hyperbaric chamber therapy. Some use it orally but IV is better. Methylene blue mechanism can also help given the recent thoughts that the COVID 19 has effects on the hemoglobin when people get really sick. That last link gives gives multiple uses for MB. For oral use-As a daily tonic 1 or 2 drops in water daily. As an antiviral- 6 to 10 drops in water 2 to 3 times daily with about 10 to 15 minutes of sunlight each time.
If you end up needed chloroquine or hydroxychloroquine, it is helpful to have already some zinc on board to prevent certain side effects. You cannot do high dose zinc though for a long time without also supplementing with Copper in a 2:1 Zinc to copper ratio.
Avoid Tylenol because it decreases Glutathione and avoid anti inflammatories like ibuprofen because they are reporting it worsens the situation.
Regarding fever...See the following blogs on fever here , here
For immune support like like Monolaurin and Olive Leaf Extract as well. Those could replace the elderberry syrup for those who are concerned. Olive Leaf also has anti bacterial properties.
Licorice (not the sugar filled kind) has anti viral properties.
If you have asthma or other lung conditions- it is probably worth taking some magnesium glycinate or other Tri-Mag
2-3 Brazil nuts per day for Selenium support (approximate 55 mcg daily)
zinc 15-25 mg daily ( can do zinc lozenges)
Quercitin has anti viral properties.
Melatonin seems to be a great option too and maybe will help us sleep if we are worried.
Homeopathy- per my favorite homeopaths- The top remedies seem to be Arsenicum, Gelsemium, Bryonia, Thuja and some other obscure ones I couldn't find even listed on Amazon.
Stinging Nettle has exciting data against Coronavirus. You can get this in capsules and tea. Stinging nettles has a lot of neat uses.
Another interesting option is methylene blue. Some doctors are working on studies Methylene Blue IV , photobiomodulation and maybe hyperbaric chamber therapy. Some use it orally but IV is better. Methylene blue mechanism can also help given the recent thoughts that the COVID 19 has effects on the hemoglobin when people get really sick. That last link gives gives multiple uses for MB. For oral use-As a daily tonic 1 or 2 drops in water daily. As an antiviral- 6 to 10 drops in water 2 to 3 times daily with about 10 to 15 minutes of sunlight each time.
If you end up needed chloroquine or hydroxychloroquine, it is helpful to have already some zinc on board to prevent certain side effects. You cannot do high dose zinc though for a long time without also supplementing with Copper in a 2:1 Zinc to copper ratio.
Avoid Tylenol because it decreases Glutathione and avoid anti inflammatories like ibuprofen because they are reporting it worsens the situation.
Regarding fever...See the following blogs on fever here , here
This is an amazing article to read for more details. Elisa Song MD is fantastic!
Stay calm and wash your hands.
Low dose naltrexone studies.
Naltrexone Inhibits IL-6 and TNFα Production in Human Immune Cell Subsets following Stimulation with Ligands for Intracellular Toll-Like Receptors
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504148/
Increased production of IL6 is associated with cytokine storm and worsening of viral symptoms TL4 receptors also in microglia and LDN effective in decreasing neuroinflammation
Some references including human:
Parkitny, L., & Younger, J. (2017). Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia. Biomedicines, 5(4), 16. https://doi.org/10.3390/biomedicines5020016
Bolton, M. J., Chapman, B. P., & Van Marwijk, H. (2020). Low-dose naltrexone as a treatment for chronic fatigue syndrome. BMJ Case Reports, 13(1). https://doi.org/10.1136/bcr-2019-232502
Younger, J., Parkitny, L., & McLain, D. (2014). The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clinical Rheumatology, 33(4), 451–459. https://doi.org/10.1007/s10067-014-2517-2
Parkitny, L., & Younger, J. (2017). Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia. Biomedicines, 5(2). https://doi.org/10.3390/biomedicines5020016
Low dose naltrexone studies.
Naltrexone Inhibits IL-6 and TNFα Production in Human Immune Cell Subsets following Stimulation with Ligands for Intracellular Toll-Like Receptors
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504148/
Increased production of IL6 is associated with cytokine storm and worsening of viral symptoms TL4 receptors also in microglia and LDN effective in decreasing neuroinflammation
Some references including human:
Parkitny, L., & Younger, J. (2017). Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia. Biomedicines, 5(4), 16. https://doi.org/10.3390/biomedicines5020016
Bolton, M. J., Chapman, B. P., & Van Marwijk, H. (2020). Low-dose naltrexone as a treatment for chronic fatigue syndrome. BMJ Case Reports, 13(1). https://doi.org/10.1136/bcr-2019-232502
Younger, J., Parkitny, L., & McLain, D. (2014). The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clinical Rheumatology, 33(4), 451–459. https://doi.org/10.1007/s10067-014-2517-2
Parkitny, L., & Younger, J. (2017). Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia. Biomedicines, 5(2). https://doi.org/10.3390/biomedicines5020016
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