South Korea: 8,897 cases, 104 fatalities, 1.1% death rate

Germany: 23,129 cases, 93 fatalities, 0.4% death rate

In the US, our fatality rate has remained about level.

A request:  Necessity is the mother of invention.

I have learned from many of you that my emails are being forwarded on to your friends and family and that gives me great joy to hear that these words are hopeful and healing.  Pass it on!

Some of you may know that I have a special interest in Crohn's disease.  This interest opened a door for me to become involved in the resurrection of an old drug that got close to, but was stopped just short of FDA approval in the early 2000s.  This drug boosts immunity and stops unproductive inflammation.  For the past several years, my group has been looking at the drug as a remedy in auto-immune dysfunction diseases such as Crohn's Disease and Sarcoidosis.  However, we very quickly recognized that unproductive inflammation from COVID-19 viral infection is causing the infected lungs to be leaky and unable to allow oxygenation, thereby causing respiratory failure.

My colleagues and I have been trying to send the message to potentially interested parties:  pharmaceutical companies, academics, the FDA, the NIH, and the CDC.  So far, we've had no luck in finding an interested party to partner with us. For us, it is not about business, it's about sharing a potential life saving intervention.  I am hopeful, with this enhanced readership, perhaps this will strike a chord with one or more of you.  Please pass this to the right key people and have them reach out to me and we will share what we have and try to move this forward!

I believe this drug has promise if used early in COVID-19 respiratory insufficiency, maybe even a game-changer for those in the early stages of respiratory failure.

Is exercise mission critical?

Yes!  It is safe to workout outside during this quarantine time.  A few days ago, my wife and I attended an outdoor yoga class.  Everyone brought their own mat and we practiced at least 10 feet away from one another.  After the class, I ran home, which was about 3 miles.  During my run, as I passed other people, everyone practiced social distancing.  We cannot lose sight of the importance of taking care of ourselves.  We need to take care of ourselves first before we can take care of other people who depend on us, including our spouse, partner, children, and other colleagues.

You can increase your immunity by finding just the right balance of exercise.  The key is not to overdo it as overexercise can make you more vulnerable to most viral illnesses.  I recommend the 'Goldilocks and the 3 Bears' approach to exercise:  not too much, not too little, just the right frequency and level.

Some of the benefits of working out outdoors during this time are fresh air and sunlight.  In fact, open-air hospitals in Boston during the Spanish flu outbreak of 1918-1919 suggested that some patients and staff were spared the worst of the outbreak.  Nature, fresh air and sunlight makes us feel better!

Administrative issues

The office, of course, remains closed, I suspect at least for the next several weeks.  After hours, when the building is vacant, my staff is helping me check on faxes and incoming clinical communication.  I am available 24/7 by telemedicine.  On a case by case basis, for my protection and yours, I can and will meet you at the office for an necessary face to face issue.

Stairway to Heaven

A few years ago, in my role as the "Rock Doc" for Merriweather Post Pavilion, I was called to come to make an on-site visit for Robert Plant, the aging rocker and lead singer, songwriter, and guitarist for Led Zeppelin.  While I was writing this email, I was listening to some music and  Stairway to Heaven  came on.  I thought you might like to hear it.  Here is a quote that was published about the song that you might find relevant:

Robert Plant spent much of the '70s answering questions about the lyrics he wrote for "Stairway".  When asked why the song was so popular, he said it could be it's "abstraction" adding, "Depending on what day it is, I still interpret the song a different way - and I wrote the lyrics."

The lyrics take some pretty wild turns, but the beginning of the song is about a woman who accumulates money, only to find out the hard way that her life had no meaning and will not get her into heaven.  This is the only part Plant would really explain, as he said it was "a woman getting everything she wanted without giving anything back."

Stay home, be a hero, be safe, be well!

HAO

24/7