COVID19-027 – April 9,  2020
 

Dear Patients,

 

Yesterday, I discussed the mental fortress: you own your thoughts, and you control your thoughts, and your thoughts control how you feel.

So what else is in the toolbox to help stay centered?  If you are feeling unglued, in addition to eating well, getting rest and exercise, activate your vagus nerve.  This nerve is connected into your brain and runs from the head down into the belly.  When you activate it, it tells your fight or flight system to simmer down now (Want a laugh?  Watch this old SNL).  In medical terms, this means it deactivates your sympathetic system (fight or flight) which causes panic, fast breathing, cold hands, GI disturbances, racing thoughts, elevated heart rate, etc.  So what do you do?  Sit in a quiet room and take 10 slow deep breaths; fill your chest and let your belly expand.  You will feel better.  Want some information about the vagus nerve that wanders with many branches from the head down into the belly?  Click here!

The data:

Today, some very encouraging news.  Our models, based on daily incoming data, strongly suggests our plan of staying home is having the expected impact.  Previous models were predicting that the surge of new and severe COVID-19 patients was going to cause a total decompensation of our health care system.  This seems unlikely now. I do not want to diminish the horrendous situation still going on in New York City as well as additional hot spots being reported today. Nevertheless, the original prediction was for 250,000 deaths; now, the death toll prediction is 61,000.  This is still a huge number (the same number as drug OD's or suicides in the US in 2018).  Find some comfort in that fact that sheltering at home, social distancing, hand washing, etc, are all working!

The numbers:

US:                 432,438  cases           14,808  deaths             3.4%   fatality rate (up)

Maryland:         6,185  cases                138  deaths           2.23% fatality rate (stable)

                     (17.5% of tests in MD are positive; 35,344 total tests; 1,348 have been hospitalized)

Diagnostics and Therapeutics:

·     Hydroxychloroquine (HC)+Azithromycin+Zinc therapy - more data any day; I am encouraged by preliminary info. Published today however was some constructive criticism about the original French 20 patient study.

·     Japan's influenza drug, Avigan, is in clinical trials and also looks promising.

·     Israel has an intervention using pluripotential cells that re-order the immune system.  This is showing excellent success in very ill patients with respiratory failure.

·     My group is closer to the FDA taking notice of us, but we are not there yet.  Our drug, a steroid compound, could be used in the 20% of the infected people who are either transitioning toward respiratory failure or on a ventilator.  Thanks to all of you who have given us leads to get this in front of the right person.

On a musical note:

Relax while you listen to this song by Enya.

On a lighter note: (thank you LJ)

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Reach out.  Stay connected.  Stay home.  Save lives.  The power of one.  Be well.
HAO
24/7
 

Harry A. Oken, M.D.

Office: 410-910-7500, Fax: 410-910-2310
Cell: 443-324-0823
 
Adjunct Professor of Medicine
University of Maryland School of Medicine
 
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