COVID19-047 – April 30,  2020
 

Dear Patients,

I love Broadway musicals! So often, they provide entertainment; additionally, the genre helps me appreciate relationships, happiness, frustration, adversity, tragedy, and loss, just to name a few.

There are so many great musicals; here are some of my favorites. Fiddler on the Roof gives voice to the full range of feelings of those who were living in the small settlements in Russia in the early 1900's. The story centers on Teyve, the father of 5 daughters, and his attempts to maintain his traditions as outside influences encroach upon the family's lives. In Wicked, two very different people find very different paths to fulfill their lives; Elphaba taking the hard road and Defying Gravity. In Dear Evan Hansen, a young man is growing up without a father and his mother is preoccupied with trying to survive and support her son. Evan is anxious, depressed and isolated and falls into a deep dark place until he gets caught in an unusual circumstance that causes him to invent a lie. The mistruth, via social media, goes viral, at first crowning him a hero and once the truth is known, he experiences utter embarrassment, shame and despair. In Beautiful, the story of Carole King, a gifted songwriter, her songs chronicle her life with her husband, Gerry Goffin, a manic depressive with a poly-substance abuse illness. Carole found her own truth and strength, left the marriage with her children, moved to California, and was reborn.

Broadway brings us life with so many lessons. As such, it challenges us to examine our lives and then move forward with perhaps more kindness and understanding for the people we care about. The shows above are just a few of my very favorites. If you are bored or sad or idle, if you are feeling anxious, get in the moment and distract yourself with a pleasurable activity. Stream your favorite Broadway hits. This link will give you access to a free 7-day trial.

The numbers:

Maryland:   21,742 cases -/- 1,047 deaths -/- 4.8% fatality rate

(+62 deaths from yesterday)

Locally, all remains stable.

The Maryland Ro: (see April 22 Update for explanation of Ro)

No real change, we remain in the green zone, 0.87; lower is better.

Early on, I was thinking that our national death total would not exceed 60,000. That was overly optimistic thinking on my part. Nevertheless, tragically the most vulnerable are people who make up the largest percentage of the death toll and we have not yet been able to protect them well. In Maryland, 48% of our deaths are in older patients who are in nursing care facilities. Tragically, COVID-19 ravaged these fragile people who had an aged immune system along with heart disease, diabetes, prior strokes, and were woefully immunocompromised. Furthermore, they reside in an environment with staff that was not prepared with personal protective gear or trained to use it. The projected national death toll as of April 29, by the Murray model, is 72,000.

 

Diagnostics and Therapeutics:

On a musical note:

Thank you, NH, (aka Anika) for this medley of Broadway hits!

 

Diagnostics and Therapeutics:

 
  • Remdesivir, a drug developed by Gilead, has antiviral efficacy and if given early and at a high enough dosage, ameliorates the infection and seems to improve outcomes.

  • Famotidine (also known as an over-the-counter acid reliever) at high intravenous doses (9 times normal) may affect intracellular viral replication.

  • Tetracycline has a similar molecular configuration to Famotidine and may also inhibit viral replication. Computer modeling helps select drugs for repurposing.

  • There are many vaccine trials in progress with daily forward progress.

 

On a musical note:

Thank you, NH, (aka Anika) for this medley of Broadway hits!

video

And on a lighter note:
graphic
 

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

Feel free to forward this on: spread the word, not the virus.

 
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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