Earlier this week I talked a little about Passover.  Today, I want to extend warm greetings to all of you who are celebrating Easter.


Both holidays are celebrations; both inspire us to think about our heritage and both usher in the seasonal change to spring.  And before our eyes, we are seeing the renewal and refreshment of nature.  Springtime means flowers, budding bushes and trees, singing birds and green grass.  Spring is a resurrection of life from the cold, dark and sometimes gloomy weather of winter.  The change of season reminds us about change being the constant of life.  In spring there is hope and although this spring we cannot shake hands, hug or stand close to each other, know that for sure there will be plenty of pleasant days ahead.  Get-togethers in the future will be more precious and more appreciated than ever.

I was recently interviewed for an article about stress and anxiety that you might find interesting (click on the blue): Stress and anxiety can cause similar symptoms to coronavirus—here's how to tell the difference.


The numbers
US:                530,006 cases          20,608 deaths            3.9% fatality rate (up)
Maryland:          8,225 cases              235 deaths          2.86% fatality rate (up)

In NYC, the daily number of hospitalizations is down; the death rate is lagging behind, as expected. Locally, at HCGH, the ER and hospital continue to be in good shape.  Nevertheless, the hospital is erecting an outside annex tent just in case it's needed - all contingencies.

Here is our model for Maryland. It continues to appear that we are well prepared and holding the line.  The expected surge of cases does not appear that it will overwhelm our resources.

Diagnostics and therapeutics:

• Hydroxychloroquine (HC) continues to be controversial.  Published yesterday, those hospital in-patients who were given HC alone, in an Italian study, faired worse than a control group.  Yes, get used to this back and forth.  That's why we call it the practice of medicine.  Part art, part science.
• Still no definitive word on using drugs like Ibuprofen (Advil) and Naproxen (Aleve). Based on my research, I presently favor judicious use of either for aches and pains in non-febrile situations.  Certainly more data to come.
• Remdesivir, a drug developed by Gilead, has been shown to be helpful in 2/3 of people receiving it.  Still, the death rate for patients requiring mechanical ventilation is 13%.  The therapy needed for these patients is not necessarily an antiviral, although it probably does help.  What is needed is a drug that re-orders the immune system that has been scrambled by the virus.

On a musical note (thanks DA for your friendship and suggestion):

Question by the Moody Blues  

This song is a concert mainstay of the Moody Blues from the Vietnam War era.  Justin Hayward (guitarist/vocals) says he never loses the emotion for it when her performs the tune.  It's also a song that has remained relevant.  Says Hayward: "There's no doubt that it still resonates, the lyrics reflect whichever generation you're in.  Whatever time you're in, people are experiencing those emotions.  And I find that people identify with it at any age."

And on a lighter note: (click the blue)

Wishing those who are celebrating, a very happy, although very different, Easter!

Reach out.  Stay connected.  Stay home.  Save lives.  The power of one.  Be well.