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Dear Patients,
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Thank you, RG, for this idea!
Most good plans survive despite everyone being
focused on the part that is broken. So keep the
old plan in mind when working on a new plan. I
always have a plan! You may have a swollen eye
and only half an ear, but your arms and legs are
still working. So don't stop moving, defending
and throwing punches. Keep
focusing on that boxing analogy and watch this
(click the blue).
Keep moving forward! The plan is working!
What about wearing a mask?
You may recall from my earlier updates, I felt
it was likely we would see this as a soft
recommendation in nonclinical settings as well
as standard in clinical settings. This became a
reality yesterday. And why not? Wearing a mask
while out of the house makes it less likely,
while in potentially contaminated areas, that
you will touch your face. The barrier may help
to block inhalation of aerosolized droplets from
coughing and sneezing by infected patients.
Nevertheless, as long as you maintain social
distancing of 6 feet or greater, you are safe.
Yes it has been shown under experimental
settings that small amounts of virus can travel
up to 27 feet, science can always find extremes
of very low likelihood; this is one example. If
you did not watch this
video from my previous update, take 30
minutes to view it.
The numbers:
US: 278,458 cases
7,159 deaths 2.6%
fatality rate (up)
Maryland: 3,125 cases
53 deaths 1.7%
fatality rate (up)
(14% of tests in MD are
positive; 22,485 total tests; 821 have been
hospitalized)
Therapeutics:
- Hydroxychloroquine (HC)+Azithromycin+Zinc
therapy is being used with little to no
toxicity; time will tell us if used
early, whether it changes the course of
the illness.
- HC may have a role for prophylaxis
in health care workers. Studies are
on-going. I continue to be optimistic
that this is a good strategy.
- Keep passing the word about the use
of passive transfer of convalescent plasma
- click here. Patients who tested
positive for COVID-19 can donate their
plasma to be given to the severely
ill.
- Innovation is on-going; a variety of
approved drugs are being studied (TPA,
Gleevac, Ivermectin, HIV antivirals, and
biologics).
Diagnostics:
- In
Howard County, beginning next
Tuesday at the Columbia VEIP there
will be a drive-through test
center. Details are being worked
out and I will send out further
information once it is provided to
the public.
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Multiple antibody tests are in
development and have been approved.
These will be "look back" valuable.
After most viral infections, two
types of antibodies are detectable.
The first appears between 10-20 days
from the start of symptoms and is
the IgM class of antibody. The
second type of antibody confers
immunity and starts to rise at 3-6
weeks from the start of symptoms;
this is the IgG antibody. The
amount of the antibody is expressed
as a titer. Patients who are immune
will have a high titer concentration
of IgG antibody, and those patients
can donate their plasma to make a
hyperimmune product to treat
vulnerable infected COVID-19
patients.
On a musical note:
Sadly, Bill Withers passed away at 81
yesterday. I loved many of his songs,
in particular, Lean
on Me; it's okay for your plan to be
to lean on me.
On a lighter note:
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Reach out. Stay connected. Stay home. Save
lives. The power of one. Be well.
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Harry A. Oken, M.D.
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Office: 410-910-7500, Fax: 410-910-2310 |
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Cell: 443-324-0823 |
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Adjunct Professor of Medicine |
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University of Maryland School of Medicine |
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