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Category Archives: Notes from Your Doctor
Lessons of the AIDS Epidemic
40 years ago today, the first domestic cases of a rare pneumonia in a few gay men were reported. Like the beginnings of many diseases, it flew under the radar. It was the summer of 1981 and the Yuppies were in bloom. Stonewall had been 11 years earlier, but gays were much more in the closet than out. Most people did not know that they knew a gay person. (Honest.) And initially, as “GRID” (gay-related immune deficiency) spread, it was ignored by most people since it was completely outside of their “worlds”.
Lesson 1: We are ALL connected.
By early 1982, we knew that AIDS was found in the blood supply, and could be spread that way, initially affected hemophiliacs. Again, a subset of the population. In his book “Reimagining AIDS”, Robert Root-Bernstein described even earlier cases of AIDS, dating back close to a hundred years. For a few cases, in the 20th century, there were saved tissue samples shown to have HIV. The rest is anecdotal. But we came to learn this disease came from Africa, zoonotic from monkeys, and likely entered the US during the 4th of July celebrations in 1976. For a clear and accurate history, Randy Shilts “And the Band Played On” (the book, not the movie) is highly recommended.
Tagged AIDS, Anthony Fauci, Larry Kramer
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Notes from your Doctor: Surviving the Next Phase of Coronavirus
As you know, case counts are rising across the country, at last count, in 23 states, with 15 states showing their highest case counts since before they shut down. In some places, hospitals are days away from being overwhelmed. And yet, no one is planning on new lockdowns, most are planning further re-openings. To be fair, Oregon and Utah are pausing moving forward.
There is no national policy on what to do, nor how to handle things, so states are left on their own. In some states, governors say things like “we expected that there would be more cases” as hospitals implement emergency plans. That gem is courtesy of Doug Ducey of Arizona. In addition, if you are one of those who go out, you’ve indubitably seen fewer people wearing masks and observing social distancing.
WHAT IS A PERSON TO DO???
Also posted in 2019-nCoV, Coronavirus, Coronavirus Tips, COVID-19
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Notes from Your Doctor: Can I Touch Surfaces?
The news reported last night that it was safe to touch surfaces. Um, not exactly correct.
The CDC website says:
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads, but we are still learning more about this virus. (emphasis mine.)
Also posted in 2019-nCoV, Coronavirus, Coronavirus Tips, COVID-19
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Notes from your Doctor: Markets and Medicine
The market has fallen one Fibonacci, we’re in correction territory. For those of us retired or close to retirement, who don’t have pensions — this can be scary. For the one percent, it’s a buying opportunity. As a member of the 99%, I have found that throwing my 401(k) statements directly in the fireplace is easiest on the nerves.
But I don’t really understand the market, and I am not a source of information on it, beyond being able to quote Goldman-Sachs which announced yesterday that if the market falls much more, it’s a true threat to the Orange Menace’s chances for re-election, so I’m cool with having to live on cat food.
The real problem, and one you need to be concerned with, is that the Chief Cheeto only cares about the market. And there is nothing he can do about it – the Fed needs to hold off as long as possible in dropping interest rates because they’re going to need that ability. They’ll get to zero and start quantitative easing again. The ONE AND ONLY THING over which the regime has power is to stop the flow of correct information relative to Covid-19 to endeavor to convince people that “everything’s okay”. Sadly for the cabal, “the market” isn’t that dumb.
Also posted in Coronavirus, COVID-19, Pandemic
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What if they gave a Convention and Nobody came?
Last evening the first community based US coronavirus case was announced. There is never just one. And so, just like flu hits different areas of the country at different times, there will be pockets and hot spots, and then they’ll clear and there will be others.
In China, the first cases arose in November of 2019. (Yes, that’s correct, not December.) It was noticed by medical personnel in December, who were silenced by the regime (and several later died), and not “believed” by the Xi regime until late January, when they began locking down China. It is now two months later, and China is still in partial lock-down. It will take another few months, at least, to get back to full speed.
The difference between China (and Italy, Iran, South Korea and Japan) is that we know it’s coming, and we are learning every day from what those countries do what works and what doesn’t. And we know the best possible thing to do is to test people, and the worst possible thing to do is to place large numbers of people in an enclosed space. Like, um, a political convention with people coming from all over the country, and journalists coming from other countries.
Also posted in 2020 Convention, 2020DNC, Coronavirus, COVID-19, Pandemic
Tagged 2020DNC, Coronavirus, COVID-19, pandemic
3 Comments
Notes from Your Doctor: Preparing for Pandemic
When not if…that was the word from CDC yesterday, and they’re correct. Covid-19, aka coronavirus is here, and it will at some point be “community based” meaning that it will spread from person to person amoungst people who have not been to any of the affected areas, and were not repatriated.
Is it time to panic? No.
It is, however, time to prepare.
Also posted in Coronavirus, COVID-19, Pandemic
Tagged Coronavirus, COVID-19, pandemic
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Notes from your Doctor: nCoV Update 2_2_20
There are now more than 100,000 suspected cases of nCoV worldwide, the majority in China, but the number of confirmed cases is less than 20,000. The count of confirmed cases, deaths and recoveries is updated hourly by the folks at Johns Hopkins at this link.
There are a lot of medical and public health concerns, but there are also political and economic affects that will impact all of us whether or not we ever come in contact with 2019-nCoV.
But first…since my first post on this a week ago, I’ve heard from people who are starting to panic. Now is NOT time to panic. It’s time to be smart, to ignore the falsehoods about this illness, and to follow standard infection controls that you should be following anyway….when it’s time to panic, I’ll let you know. So, NO this is not a bioweapon, and NO you can’t get it from drinking Corona beer, and NO there is no specific treatment made from saline solutions. You can check the list of all the fake news on 2019-nCov here.
Also posted in 2019-nCoV, Public Health, Uncategorized
Tagged Coronavirus, epidemic, nCoV, pandemic, public health
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Notes From Your Doctor: 2019-nCoV Update
As of 29 January, the number of infections in mainland China has now surpassed the total number of SARS infections, albeit with a death rate two-thirds lower. There are signs that this will soon be a pandemic, as the R0 number appears to be increasing.
The most disturbing thing I’ve seen comes from a study in The Lancet indicating some issues with the initial information from the Chinese government. Whereas China had said that all the initial infections were tied to the Wet Market in Wuhan, the Lancet article indicates that only 66% had visited the market, and that the onset of symptoms in the first patient was earlier than reported. With a two-week incubation, this sets onset back to November.
As an aside, I had never heard the term “wet market” until a few days ago. It turns out that it refers to any market that sells animals, dead animals or produce, as opposed to a “dry market” which sells only durable goods like clothing and electronics. Learning is life-long.
Also posted in Healthcare, Public Health
Tagged 2019-nCoV, Coronavirus, Wuhan
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Notes from your Doctor: Protecting Yourself
One of the microbiology journals recently reported on the transference of MRSA and C.diff in hospitals. Why do you care? Because you, or someone you love, is going to end up in the hospital and this may save a life. A group of researchers were puzzled about how secondary infections often showed up in patients who were in rooms where the patient a week earlier had had the infection. Over that week, the room was cleaned top to bottom, and possibly had an uninfected patient in said room. What they found was that MRSA and C.diff were washed down the sink, where the bacteria colonized and grew in the S-curve of the drain pipe and then worked its way up the drain, and ended up splashing out when someone washed his/her hands. How long did that process take? Yup, a week.
They’re still experimenting to see how to best take care of this issue. My guess is that they’ll need a viscous bleach that clings like drain cleaner to make sure all the bacteria is killed. But while they’re still working on it, what can you do? Personally, I’ll be pouring a cup of bleach down the sink in any hospital rooms I visit.
Next: The Muslim Ban may affect your health. Any idea how many doctors are from foreign countries? Tens of thousands. Of note, 8,400 are from Syria and Iran. And we need them, we have a huge doctor shortage because we don’t produce enough doctors to meet demand. (More on that further down.) The effects are in two general areas: newly minted doctors for hospital residency programs, and practitioners in Appalachia and the Rust Belt. If you think people won’t die because of the ban, you’re wrong. (Source 1, Source 2.)
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Hate in America
Last night, we in Philly heard that hundreds of headstones were turned over Saturday night at a Jewish cemetery, a week after similar vandalism in St. Louis. Many people are saddened, appalled and surprised. They should be sad and appalled, but not surprised. This is Trump’s America.
I have been working with Indivisible locally, and I am heartened by the number of people completely new to politics who are suddenly aware, and ready to take action to both resist the Trump agenda, and help elect people who will serve America, and not what is actually the Bannon administration.
I keep hearing two themes through my work with Indivisible. First, people are concerned about what they can do to stop hate. And by “hate” I mean not just the vandalism, but the verbal abuse people see foisted upon innocent people, just for the colour of their skin, The ICE roundups are another form of hate: people question what they can do to help those who will be caught up in the dragnets. Hate also in the form of the administration’s moves against sick people (“repeal Obamacare” and dismantle Medicaid), Hate in the form of transgender bathroom rights. I’m a doctor, and I’m telling you, the only thing that matters is that you wash your hands. (If you’re a long-term reader, you remember back to SARS and fingers, nails, fingers, fingers, fingers.) And let’s not forget the hate of literacy in terms of claiming the media is the “enemy of the people”. The hate is creeping down from the Cheeto Team, and up from the GOP state legislatures.
Also posted in Civil Rights, Donald Trump, Elections, Freedom of the Press, NoWallNoBan, Philadelphia, Politics, Rant, The Politics of Hate
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