Category Archives: health policy

COVID-19 UPDATE: Masks, social distancing much more important than cleaning surfaces.

Today’s update from the Johns Hopkins Center for Health Security:

An editorial published in Nature discusses the need to shift focus away from surface decontamination as a mechanism to reduce SARS-CoV-2 transmission risk. Multiple studies have found that transmission of SARS-CoV-2 via contaminated surfaces, or fomites, is relatively rare compared to respiratory transmission via droplets or aerosols. Despite the evidence supporting respiratory exposure as the overwhelming driver of community transmission, numerous public health entities, including the WHO and US CDC, continue to emphasize the importance of surface decontamination, which can cause confusion among the public regarding transmission risk and appropriate protective measures. Notably, surface decontamination efforts, while highly visible and easy to recognize, are costly and likely not effective means of reducing transmission risk. The editorial calls for increased focus on improving ventilation and air filtration capacity to reduce respiratory exposure. Additionally, proper physical distancing and face mask use remain key tools in mitigating exposure and transmission risk for individuals.

The key to reducing the risk of symptomatic infection, especially moderate to severe illness and death appears to be vaccination.

While vaccination clearly reduces the risk of severe illness and death, we do not yet know whether or how much vaccination reduces the risk of carrying and transmitting the virus. So even after vaccination, an asymptomatic or minimally symptomatic person can still transmit the disease to others.

50-60% of viral transmission appears to be from asymptomatic individuals. So wearing a mask, social distancing, and avoiding unventilated crowded indoor spaces remains extremely important.

DOUBLE MASKING IS MORE EFFECTIVE THAN SINGLE MASKS.

A TRIPLE LAYER MASK OF TIGHTLY WOVEN FABRIC IS MORE EFFECTIVE THAN a SINGLE OR DOUBLE LAYER MASK.

N95 MASKS ARE MOST EFFECTIVE BUT THEY MUST FIT THE FACE WITH A TIGHT, SNUG FIT. 

TO IMRPOVE THE BARRIER FUNCTION OF MASKS WEAR A SNUG FABRIC MASK OVER A SURGICAL MASK OR OVER AN N-95. THIS WILL PROTECT BOTH THE WEARER AND THOSE AROUND THE WEARER. The fabric mask over a surgical or N-95 mask provides two mechanisms of protection. It adds an extra layer and it provides for a tighter fit of the underlying mask.

Doctors and nurses in hospitals and clinics often wear a surgical mask over an N-95. 

Face shields do not protect you or those around you from infection. Face shields and goggles (more so) likely decrease the risk of infection transmitted from aerosols that hit your eyes but do nothing for the most important mechanism of spread, breathing aerosols or droplets into your nose. Aerosols spread around a face shield into your nose. 

Think about smelling the pleasant odors of food cooking in a kitchen. Face shields will not block those aerosolized food vapors from entering your nose, but tightly fitting masks will do it to some degree.

SARS-CoV-2 virus is at least 10 times more lethal than an “average” case of influenza. Newer circulating variants have mutations that have probably increased the mortality rate.

SARS-CoV-2 is at least 10 times more easily transmitted compared to most respiratory viruses. Newer circulating variants have definitely increased ease of transmission by at least 30%. As a result, herd immunity will likely require 85-90% vaccination of a given population.

10 times 10 equals 100 TIMES MORE SERIOUS.

In addition, compared to other respiratory viruses, this virus will more frequently cause long lasting or even permanent damage and disability involving one or more organs (heart, lung, kidney, brain). Long-COVID can occur following minimally symptomatic illness and even after asymptomatic illness.

This virus is unique in that TRANSMISSION OCCURS MOST FREQUENTLY FROM ASSYMPTOMATIC INDIVIDUALS.

This occurs for two reasons.

1. Unlike most other respiratory viruses, there is a long time from the onset of when a person becomes infectious to when they become symptomatic. (an average of 5 days)

2. Some individuals never develop symptoms but are still highly infectious for up to 2 weeks.

Restaurants, bars, churches, meeting rooms, cafeterias, parties in closed spaces are situations for SUPERSPREADER EVENTS. An this includes SUPER BOWL PARTIES.

Studies in hospitals show that transmission to health care workers occurs most frequently in the cafeteria and in meeting rooms, not at the bedside where providers are wearing PPE.

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml. (read this Open Letter)
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Vitamin D for All, the time is right

On Dec 7, 2020 a group of more than 100 scientists signed a letter recommending that governmental agencies and major medical organizations endorse their recommendation for universal Vitamin D supplementation at adequate doses in order to decrease the risk of COVID-19 infection and death.

https://vitamindforall.org/letter.html

The letter cites multiple converging sources of data from several studies that should no longer be ignored.

To all governments, public health officials, doctors, and healthcare workers,
[Residents of the USA: Text “VitaminDforAll” to 50409 to send this to your state’s governor.]
Research shows low vitamin D levels almost certainly promote COVID-19 infections, hospitalizations, and deaths. Given its safety, we call for immediate widespread increased vitamin D intakes .
Vitamin D modulates thousands of genes and many aspects of immune function, both innate and adaptive. The scientific evidence shows that:
● Higher vitamin D blood levels are associated with lower rates of SARS-CoV-2 infection.
● Higher D levels are associated with lower risk of a severe case (hospitalization, ICU, or death).
● Intervention studies (including RCTs) indicate that vitamin D can be a very effective treatment.
● Many papers reveal several biological mechanisms by which vitamin D influences COVID-19.
● Causal inference modelling, Hill’s criteria, the intervention studies & the biological mechanisms indicate that vitamin D’s influence on COVID-19 is very likely causal , not just correlation.

I have previously discussed the relationship between low Vitamin D levels and COVID-19 infection.

https://practical-evolutionary-health.com/2020/05/02/covid-19-link-to-vitamin-d-status-should-doctors-prescribe-sunshine/

Since that post several more studies have been published strengthening the evidence that low levels of Vitamin D are not only ASSOCIATED with increased risk of infection, severe illness and death from COVID-19, but that this relationship is CAUSATIVE.

80% of patients requiring ICU care for COVID-19 infection have low vitamin D levels (25-OH Vitamin D levels less than 30 ng/ml)

“The data strongly suggests that vitamin D is the safest, easiest, and most important anti-pandemic measure the world is failing to prioritize,” says Karl Pfleger, Ph.D., biotech investor, former Google data scientist, and one of the organizers of VitaminDforAll.org.

More than 80 percent of COVID-19 patients are deficient in Vitamin D, studies show.

But how much vitamin D should an adult take and in what form?

As discussed in the letter, 3875 IU (97 micrograms) of Vitamin D3 daily is required for 97.5% of adults to reach a level of 20 ng/ml. 6200 IU (155 mcg) are required for 97.5% of adults to reach a level of 30 ng/ml. These doses far exceed the RDA (minimum daily requirement) necessary to prevent rickets.

On a sunny day, not too far from the equator, adult humans are capable of generating 10,000 units of vitamin D per day from the interaction of sunlight with skin. Human studies have demonstrated NO TOXICITY with daily supplementation of 10,000 units Vitamin D3 per day. Because of the risks of skin cancer, common use of sun block, distance from the equator, and a decrease in the ability of humans to make vitamin D from sunlight as we age, too many people have chronically low levels.

Vitamin D is a fat soluble vitamin. On a given daily dose it takes about 3 months to reach a steady state (stable tissue levels).

The point of that open letter and similar letters which have been published in major medical journals is the following. There exists today enough data to support universal supplementation with safe doses of Vitamin D3, well above the RDA, in order to decrease the risk of COVID-19 infection, risk of severe illness, and risk of death with the infection. Any further delay, waiting for more data is senseless. The risk benefit calculation based on present data is a “no-brainer”.

My wife and I have been supplementing with 4000 IU per day. Fauci is reported to be taking 6000 IU per day. We take it with food in order to maximize absorption. Our levels have been measured. Our levels are >30 ng/ml, <40 ng/ml on this dose. These are protective levels.

The amount of supplementation necessary to achieve these levels varies from person to person, season to season, and varies with distance from the equator. Some individuals will require less, some more to achieve levels above 30 ng/ml. But adults can safely take the daily amount recommended in VitaminDforall, http://HTML version.

The suggested protocol for those not already receiving the recommended intake is 10,000 IU (250mcg) daily for 2-3 weeks (or until achieving 30ng/ml if undergoing testing), followed by taking 2000-4000 IU daily thereafter.

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml. (read this Open Letter)
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID-19 and Death Certificates, Trumps Allegations

Trump has recently accused doctors of falsifying death certificates for financial gain. Let’s be clear.

  1. If a patient is hospitalized with viral pneumonia and dies, the cause of death has ALWAYS been listed as the viral pneumonia, no matter what complications occurred, no matter what the pre-existing conditions were. Viral pneumonia can cause heart attack, stroke, kidney failure, multiple organ failure but the proper cause of death to be listed is the initial presenting causative agent.
  2. Doctor’s caring for COVID-19 patients in the hospital do not get paid more because of the diagnosis. Hospitals may get extra payment because of the pandemic circumstances, doctors do not. Recently the AMA has recommended additional payment to OFFICE PRACTICES for the extra expense of COVID-19 precautions. This does not impact hospital doctor payment.
  3. Death is not the only bad outcome. “Long COVID” is a state of persistent symptoms and disability that can occur even after mild illness not requiring hospitalization. Post viral syndromes such as this have long been recognized and can last a lifetime. Consequences can include shortness of breath with minimal exertion, chronic fatigue, heart failure, kidney failure, chronic pain to name a few. A recent study from Germany demonstrated MYOCARDITIS (chronic heart inflammation) in 70% of patients “recovered” from COVID-19. 80% of those patients were not hospitalized. We do not yet know the extent of long term morbidity caused by this virus. Viral Myocarditis is a common cause of cardiomyopathy that can lead to heart transplant, shortened life, and decreased quality of life.
  4. Misleading and untruthful statements that downplay the serious nature of this pandemic, especially by national leadership, cause great harm to our nation, bringing unnecessary death, suffering, and economic ruin. Such lies result in many people defying necessary and effective public health measures such as wearing masks, washing hands, social distancing.
  5. In any pandemic public health recommendations change as more information becomes available. This is to be expected. Trump has dangerously and tragically criticized our public health leaders for changing recommendations as new information and new circumstances have evolved.
  6. The greatest nation in the world still has not implemented an adequate TEST-TRACE-ISOLATE infrastructure. Our testing is inadequate, takes too long, has too many false positives and false negatives. Similarly, tracing and isolating are not widely and effectively implemented. This requires NATIONAL COORDINATION AND LEADERSHIP. It also requires that all Americans take this seriously. Trumps denial of the truth has led many Americans to disregard the necessary steps to safely reopen our economy.
  7. By now business shut downs and severe restrictions would be unnecessary if America had instituted early and effective TEST-TRACE-ISOLATE. By now, our economy would be out of trouble. Instead lies, deceit, and incompetence has led to unnecessary death, suffering, chronic illness, and economic disaster.
  8. Even after a vaccine is available, MASKS, HAND WASHING, SOCIAL DISTANCE, will still be necessary for a long time.

The Republican leadership has consistently failed to call out TRUMP on this issue and many others. The Republican leaders have failed to fulfill their sworn duty to protect our citizens from harm and instead placed party over country. This deplorable behavior threatens Balance of Power and Democracy itself.

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Soil vs Dirt, our future depends on REGENERATIVE FARMING AND RANCHING.

If we continue to grow crops and raise animals the way we presently do, our topsoil will be gone in 20 years! There will be another dustbowl but this time it will be NATIONWIDE.

Shocking? Yes.

Fake news? NO.

Watch this 2.5 minute trailer to understand the scope of this problem and the simple proven solution that will not only lead to carbon sequestration in the ground but will create soil and improve the profitability of farming and ranching.

Watch this movie to understand why we must create soil with regenerative farming and ranching.

When we destroy soil and turn it into dirt we release CO2 into the atmostphere.

When we create living soil, returning insects, microbes, viruses, worms, fungi and water to their proper ecosystem role, we capture CO2 from the atmosphere and sequester it in the newly created soil through the crops. Moving CO2 from air to plant to soil through the roots, that is the path to saving out planet and providing for world-wide food security.

Biosequestration is the process of using plants, trees, and techniques of farming and raising animals, to capture carbon and store it in the soil. Restoration of grasslands along with regenerative agriculture can accomplish this much quicker and with greater return on investment than planting trees. Of course restoring forests should also be part of a global effort to save our planet from destruction. But the quickest, most efficient way to solve multiple problems at once is to convert present day mono-agriculture system that destroys soil releasing CO2 into the air with the opposite and more profitable system of regenerative agriculture and ranching.

But what about eating meat and raising cattle? We have heard that is bad for the planet. THE SCIENCE SAYS OTHERWISE.

You can watch this BRIEF TRAILER:

That is the science.

Plants capture CO2 and put it back into the soil. Plants and soil capture and sequester rain water as well as CO2, further preventing erosion and runoff. But to create soil we need ruminant animal poop!!!!!!!!!!!

Regenerative agriculture and ranching avoids fossil-fuel based fertilizer and toxic chemicals and uses instead manure from grazing animals to fertilize crops and convert dirt into living soil. This process creates life and habitat for numerous species of animals, plants, microbes etc.

This is a win-win scenario.

What stands in the way?

Ignorance, habit, and Federal subsidy of corn, wheat, soy.

Most (>90%) of the (subsidized) grains grown in the US go into feeding cattle and pigs which are raised on factory farms. After grazing naturally during their early life, most cattle are then moved onto feedlots to be fed GMO glyphosate-resistant grains which degrade the quality of their fat and protein and transfer toxic glyphosate from grain to animal. Those cattle stand in their own excrement and require antibiotics to fend off the inevitable infections that come with feedlot conditions.

The pigs live their lives in a warehouse standing on grated floors dropping their excrement into methane producing lakes of pig poop which overflow into streams and rivers when heavy rains fall.

Antibiotic resistant organisms are created in our feed lots and contribute to our epidemic of antibiotic resistant infections in humans.

But it need not be that way.

After viewing the trailers linked above, watch the movies KISS THE GROUND (already released and available on Netflix) and Sacred Cow (soon to be released) you will learn the path to recovering the health of our planet and the health of our human population.

If you still do not believe this narrative or want to dive deeply into the science, read the book:

Filled with scientific references.

Visit the http://The Carbon Underground and read their decisive scientific review:

https://regenerationinternational.org/2020/09/28/regenerative-agriculture-and-the-soil-carbon-solution-new-paper-outlines-vision-for-climate-action/

The full PDF for a deep science dive is here:

Regenerative Agriculture and the Soil Carbon Solution

“Data from farming and grazing studies show the power of exemplary regenerative systems that, if achieved globally, would drawdown more than 100% of current annual CO2 emissions.”

That is a very bold but hopeful statement, backed by solid science. It will improve the bottom line for farmers and ranchers by increasing production per acre with non-toxic, soil producing simple farmer’s almanac based technology already being practiced and proven today.

“Actual yields in well-designed regenerative organic systems, rather than agglomerated averages, have been shown to outcompete conventional yields for almost all food crops including corn, wheat, rice, soybean, and sunflower.”

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Regenerative Agriculture: A potential “cure” for climate change.

In a previous post I praised the recently released book SACRED COW which discusses regenerative agriculture, creation rather than destruction of soil through better farming models, the need for cattle (ruminants) in soil creation, the myths concerning vegetarian diets-saving-the-planet, and many issues related to nutrition and health of the planet.

A recently published white paper on the topic of regenerative agriculture states “there is hope right beneath our feet” to address the climate crisis and global food security at the same time.

You can read about this topic here:

https://regenerationinternational.org/2020/09/28/regenerative-agriculture-and-the-soil-carbon-solution-new-paper-outlines-vision-for-climate-action/

You can download a PDF for the full paper here: http://Regenerative Agriculture and the Soil Carbon Solution (pdf)

The most profound conclusion of this paper provides hope for the climate crisis:

“Data from farming and grazing studies show the power of exemplary regenerative systems that, if achieved globally, would drawdown more than 100% of current annual CO2 emissions.”

Regenerative agriculture is

“a system of farming principles that rehabilitates the entire ecosystem and enhances natural resources, rather than depleting them.”

Comparing regenerative agriculture to present day industrial farming an eco-artist has created this image.

Mono-agriculture on the left, Regenerative agriculture on the right.

“In contrast to industrial practices dependent upon monocultures, extensive tillage, pesticides, and synthetic fertilizers, a regenerative approach uses, at minimum, seven practices which aim to boost biodiversity both above and underground and make possible carbon sequestration in soil.

  • Diversifying crop rotations
  • Planting cover crops, green manures, and perennials
  • Retaining crop residues
  • Using natural sources of fertilizer, such as compost
  • Employing highly managed grazing and/or integrating crops and livestock
  • Reducing tillage frequency and depth
  • Eliminating synthetic chemicals”

“When compared to conventional industrial agriculture,” the authors write, “regenerative systems improve”:

  • Biodiversity abundance and species richness
  • Soil health, including soil carbon
  • Pesticide impacts on food and ecosystems
  • Total farm outputs
  • Nutrient density of outputs
  • Resilience to climate shocks
  • Provision of ecosystem services
  • Resource use efficiency
  • Job creation and farmworker welfare
  • Farm profitability
  • Rural community revitalization

A movie KISS THE GROUND, highlights the importance of a transition from present day mono-agriculture to a Regenerative approach. You can view the trailer here.

Along these lines, be on the lookout for a similar movie version of the book SACRED COW.

The US military has determined that the greatest threat to global security is CLIMATE CHANGE.

Alternative energy sources and elimination of fossil fuels can cut our carbon emissions but will not sequester the carbon in our atmosphere. REGENERATIVE AGRICULTURE can sequester carbon, create new living soil, and feed the planet a healthy diet.

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID 19: Masks and Distance not enough, where we have faltered and failed

  1. Test
  2. Trace
  3. Isolate

That is where we have failed. Those countries that rapidly instituted masks, social distance, frequent hand washing, PLUS Test/Trace/Isolate succeeded in limiting the speed of spread, protected the Medical Care (hospital) system from being over-run, and protected it’s citizens and economy. Those countries bought time to learn enough about the virus to lower the mortality rates by developing treatments that decrease risk of death AND probably disability and to ramp up the hospital care system and PPE.

The US has failed to meet the challenge.

Death may not be the worst outcome, depending on one’s views relative to the balance between longevity and quality of life. Chronic disability (such as congestive heart failure, severe pulmonary insufficiency, kidney failure requiring dialysis, stroke, etc.) can be lifelong and devastating following this infection. Some may consider that shortness of breath after walking 100 feet, requiring a rest before moving on, or kidney dialysis 3 times per week the price one must pay to survive a serious infection. Others may think this sort of severe disability is not acceptable. Many in our society are clueless about these potential outcomes (usually that means they are in denial, a very common defense mechanism used to deal with a terrible threat).

This did not have to be our present state, but it is.

In December US intelligence agencies (including the CIA) and the US military intelligence were already issuing reports about an emerging deadly respiratory virus in China. This went up the chain of command but was ignored by the Whitehouse. In January, Doctor Fauci, at the annual BIOTHREATS CONFERENCE in Washington DC, announced to the bio-tech industry representatives in attendance that this virus was already “beyond containment” and stated that aggressive biomedical development (drugs, vaccines, etc.) would be required. He told attendees that the NIH would “find the money” to support these efforts and that this was a national and global emergency.

Undoubtedly, this was reported to the Whitehouse. These early warnings were not only ignored, they were also widely denied publicly by our highest public official. (The warnings issued in senatorial and congressional committee meetings however, prompted many privileged senators and congress people to sell pandemic-sensitive stocks very early in the “denial phase”).

It is clear that masks and social distancing are effective in limiting spread. Super-spreader cases, case studies of spread in restaurants (China) , call centers (South Korea), and choir rehearsals (Washington State) suggest that both droplet and aerosol transmission occur in non-medical procedure settings.

We already knew that aerosol spread occurred in operating rooms when nasopharyngeal surgery and similar aerosol generating medical procedures were performed. In one operating room event, all 11 doctors and nurses who spent any amount of time in that operating room (despite everyone wearing N95 masks) became infected and the surgeon died from the infection (he had the most exposure). This was reported early on documenting aerosol spread in medical settings.

For those who have not read my previous discussion of aerosol vs droplet spread:

Aerosol = very small lighter-than-air particles containing infectious virus that float in the air and can be recirculated through air-conditioning vents or linger suspended in the air, especially indoors where the air is still.

Droplets = larger particles that fall quickly onto surfaces but can also with a cough, sneeze, scream or singing be transmitted to someone in very close proximity before falling .

Then we learned that carriers/transmitters of the virus can either remain completely without symptoms or develop symptoms as late as 10 days after initial exposure, all the while transmitting the virus to others around them. Assymptomatic transmission makes COVID 19 different from and more dangerous than most other viruses that infect humans.

Let me say that again.

Aerosol transmission makes this virus more dangerous than most other viruses.

Asymptomatic transmission makes this virus more dangerous than most other viruses.

And finally we have learned that this virus is more lethal than most other viruses. For example, COVID 19 is 25 times more lethal than the H1N1 influenza pandemic (references provided in previous post).

https://practical-evolutionary-health.com/2020/07/12/covid-19-update-what-have-we-learned/

To summarize, the combination of easy transmission, asymptomatic transmission, and high mortality rate make this virus exceptionally dangerous and difficult to control.

How did the US respond?

Instead of rapidly ramping up PPE, testing, tracing, and isolation public health capability we instead had national leadership that said this was just like “another flu” virus and would “go away”. The narrative constantly shifted, but more importantly, effective action was not taken, and still has not been taken.

Testing remains woefully inadequate.

In many areas of our country it can take 5 days to schedule a test and 10 days to get the results. Such tests are useless. To effectively implement TEST/TRACE/ISOLATE we need rapid and widespread testing, rapid reporting, and a system to then trace contacts and isolate infected and exposed individuals. The US still shamefully lacks these essential services.

John’s Hopkins University early on developed an on-line contact tracing training program. But public funding to hire such trained individuals has been inadequate.

Isolation requires facilities in which exposed or infected individuals have their own bathroom and bedroom, have food provided, and are medically supervised until they are no longer infectious.

The US does not have such facilities. Individuals, unless they are financially very secure, do not have access to a home or other environment where this is possible. Worse, those essential workers (meat packers, food delivery, nursing aids, etc.) who earn the least, usually live in cramped housing conditions with multi-generation households in which isolation is impossible. Such individuals often live from paycheck to paycheck, so staying home from work means the family does not eat or the rent is not paid. So they go to work infecting others.

The result has been not just death and disability but horrible economic consequences.

Our shutdowns could have been shorter had we acted quickly and effectively.

Had we responded rapidly and appropriately, we would not be in our present economic predicament. So ironically and tragically, those that complain that shutdowns “were not necessary” and masks “are not necessary” contribute to the worsening economic consequences. As the virus surges following relaxation of restrictions, further restrictions and economic consequences become necessary.

Compounding this situation is the denial on the part of many individuals regarding the science and facts about this virus. Part of this denial is the result of our con-artist in chief, (and some governors) misrepresenting the facts to the public and displaying inappropriate behavior (such as refusal to wear a mask until most recently).

The other component of this denial is based on the natural tendency of humans to ignore data that is threatening and not consistent with personal ideology and beliefs. Beliefs such as “the government lies, the government is not to be trusted, the government cannot tell me what to do” presents obstacles to social behavior that would protect not just oneself and family, but the community (and economy) in general.

Contact tracers have reported that sometimes people hang up on them, refuse to cooperate, sometimes saying that it is an “invasion of privacy” or a “government hoax”.

Such beliefs and behaviors are encouraged by misinformation in the social media, shock-jocks such as Rush Limbaugh, conspiracy theories, and supported by dangerous politicians who have placed party over country, ideology over science, the next election over the good of the country.

The best way to mitigate the dire health and ECONOMIC CONSEQUENCES of this pandemic include all those components that have worked in other countries:

  • MASKS4ALL
  • SOCIAL DISTANCE
  • FREQUENT HAND WASHING
  • SOCIAL BUBBLE

TEST/TRACE/ISOLATE

This is a sad state. In the meantime what can you do?

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Fat Fiction: this movie could save your life

The USDA Dietary Guidelines are about to be published again with an update. Unfortunately, despite much input from the scientific community requesting that the dietary guidelines address the epidemics of obesity and diabetes, it looks like nothing will change. More than 50 scientific papers that support a Very Low Carbohydrate approach to address obesity, diabetes and pre-diabetes will be ignored.

But if you want a more scientific perspective I suggest you watch this movie. You can watch it free on Amazon Prime.

If you have read Good Calories Bad Calories by Gary Taubes or Big Fat Surprise by Nina Teicholtz. then you have already been exposed to the sad history of dietary recommendations in the United States and the tragic results.

Both books are well researched and present accurate science. The movie Fat Fiction reviews the sad history of dietary advice in the US. It presents many examples of patients whose lives were changed and improved by following the advice of nutritionists and physicians who have instead, followed the science and abandoned the ideological-unscientific USDA dietary guidelines.

The American Diabetes Association has finally recognized a VLC ketogenic diet as a valid approach to treating type 2 diabetes. In fact, a ketogenic diet is the only diet that has ever been documented in controlled clinical trials to reverse diabetes type 2 and get patients off insulin and oral medications used to treat diabetes.

Unfortunately, the USDA guidelines and the American Heart Association recommendations continue to recommend unhealthy inflammatory refined “vegetable oils” (processed/refined oils from corn, soy, safflower, peanuts, cottonseed, etc.) and high carbohydrate/low fat meals. The high carb/low fat approach to cardiovascular disease, obesity, and diabetes has been an absolute failure, increasing rather than decreasing the risk of heart attack and stroke as well as contributing to the explosive epidemics of obesity and DM2. The low fat dogma has fostered the obesity and diabetes epidemics since this dogma was first introduced in the mid 20th century. The low-fat ideology remains fully supported by financial contributions from the processed-food industry, creating a financial conflict of interest for the AHA and similar organizations.

In the context of the COVID 19 pandemic, where obesity, insulin resistance, pre-diabetes and diabetes type II are major risk factors for death from the infection, it is even more imperative that individuals suffering from these risk factors stop using medications to treat problems created by food and instead clean up their diet.

You can’t throw drugs at a nutritional disease and expect it to work” (Dr. Sarah Hallberg, TEDtalk)

You can fight systemic inflammation with the anti-inflammatory diet I present on this website, but if you have obesity, diabetes or pre-diabetes, the very low-carb version is the most effective and sustainable nutritional approach. Full fat dairy is optional (although technically not part of our evolutionary nutrition) and if you are obese, overweight, diabetic or pre-diabetic and full fat dairy is necessary for you to achieve a ketogenic diet, then go for it. But make sure you include an abundance of non-starchy vegetables which are an important component of a healthy ketogenic diet.

In the context of our present pandemic I will repeatedly say:

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory vegetable oils from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID-19, Lifestyle interventions more effective than drugs.

So far drug intervention trials for treating COVID-19 have been disappointing. No studies have shown benefit for hydroxychloroquine, with or without azithromycin. This topic has been covered in previous posts. Remdesivir has been FDA approved based upon one study that showed reduction in duration of symptoms. The mortality rate with Remdesivir, however, did not demonstrate a statistically significant difference when compared to “usual care”. https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

Another study published in Lancet failed to show any clinical benefit from Remdesivir.

“No statistically significant benefits were observed for remdesivir treatment beyond those of standard of care treatment. Our trial did not attain the predetermined sample size because the outbreak of COVID-19 was brought under control in China. Future studies of remdesivir, including earlier treatment in patients with COVID-19 and higher-dose regimens or in combination with other antivirals or SARS-CoV-2 neutralising antibodies in those with severe COVID-19 are needed to better understand its potential effectiveness.”

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

But we do know that certain underlying conditions such as obesity, diabetes, pre-diabetes (insulin resistance) and hypertension significantly increase risk of DEATH AND COMPLICATIONS with COVID-19. Since there are lifestyle interventions that can quickly and effectively mitigate these problems (diet, exercise, sleep, stress reduction….) now would seem like a good time to take our epidemics of obesity and diabetes in hand with aggressive lifestyle interventions to decrease the mortality rate of COVID-19 infection. Such measures do not require expensive drugs or expensive drug trials, they simply require knowledge, guidelines and the will to implement change in our daily habits. Yet there has been little discussion about this in the media or on the part of public health officials.

Lets look at obesity in the US.

From 1999–2000 through 2017–2018, the age-adjusted prevalence of obesity increased from

30.5% to 42.4%, and the prevalence of severe obesity increased from 4.7% to 9.2%.

The most effective tool for addressing obesity and diabetes is a very low carbohydrate diet.

Effects of the Low Carbohydrate, High Fat Diet on Glycemic Control and Body Weight in Patients With Type 2 Diabetes: Experience From a Community-Based Cohort

https://pubmed.ncbi.nlm.nih.gov/32193200/

This study was a done in a community-based program, not an academic practice setting. That is significant since it demonstrates feasibility outside of academic centers with standard community resources. The results of this study confirmed the results of many previous studies done in academic settings including better blood sugar control, reduction or elimination of diabetic medications, and significant weight loss.

All patients following the LCHF diet who initially took
insulin had either a reduction or discontinuation of
this therapy by their healthcare provider when clinically
indicated, compared with less than a quarter of
those receiving usual care.

In another study done in Italy, significant weight reduction (7 kg), waistline reduction (7 cm.), fat mass reduction (3.8%) and systolic blood pressure reduction (10.5 mmHg) were achieved in 3 months with a Very Low Carbohydrate diet.

Middle and Long-Term Impact of a Very Low-Carbohydrate Ketogenic Diet on Cardiometabolic Factors: A Multi-Center, Cross-Sectional, Clinical Study (https://pubmed.ncbi.nlm.nih.gov/25986079/

Nina Teicholz had an opinion piece published in the Wall Street Journal on May 30, discussing the USDA dietary guidelines that have largely ignored a massive body of evidence supporting a Very Low Carbohydrate Diet for obesity and diabetes. She cites many studies that have been ignored by the USDA dietary guidelines committee. Here is here opening statement.

“Americans with obesity, diabetes, heart disease and other diet-related diseases are about three times more likely to suffer worsened outcomes from Covid-19, including death. Had we flattened the still-rising curves of these conditions, it’s quite possible that our fight against the virus would today look very different.”

You can read the full article here:

https://www.wsj.com/articles/a-low-carb-strategy-for-fighting-the-pandemics-toll-11590811260

But think about that simple statement, THREE TIMES MORE LIKELY TO SUFFER WORSENED OUTCOMES FROM COVID-19. Yet these conditions are highly responsive to lifestyle interventions that not only mitigate obesity, insulin resistance and high blood pressure, but also enhance immune function.

More from Teicholz’s opinion piece:

Other studies have found that dietary changes can rapidly and substantially improve cardiovascular risk factors, including conditions like hypertension that are major risk factors for worsened Covid-19 outcomes. A 2011 study in the journal Obesity on 300 clinic patients eating a very low-carbohydrate diet saw blood pressure quickly drop and remain low for years. And a 2014 trial on 148 subjects, funded by the National Institutes of Health, found a low-carb diet to be “more effective for weight loss and cardiovascular risk factor reduction” than a low-fat control diet at the end of the 1-year experiment.

In a recent letter to the editor published in the journal METABOLISM, Dr. Casey Means points out:

A diagnosis of diabetes has been a key indicator of the severity of
COVID-19, and in this regard, the virus has relentlessly highlighted our
global Achilles heel of metabolic dysfunction, and points to a prime opportunity
to fight back.
That fight, however, is not going to be won with Clorox, Purell,
masks, or anti-IL-6 drugs. The fight will only be won through a serious
commitment to improving everyone’s foundational metabolic health,
starting with the lowest hanging evidence-based fruit: dietary and lifestyle
interventions.

Read the full letter here: https://www.metabolismjournal.com/article/S0026-0495(20)30118-9/pdf

In 2 pages the letter describes multiple benefits of better glucose control relative to COVID -19 infection and the immune system as well as reduction of factors that lead to cytokine storm (terminal event for many COVID-19 patients). The letter also discusses the benefit of reducing environmental toxins (discussed in previous posts about COVID-19 and other health problems) that would likely benefit COVID-19 patients.

Research published April 18th, 2020 found that patients exposed to
highest amount of environmental nitrogen dioxide (NO2) had increased
risk of death fromCOVID-19, and that long-term exposure to this pollutant
may be one of the most important contributors to fatality by
compounding lung inflammation [20].

Minimizing exposure to environmental
pollutants may serve a role in quelling the underlying pro-inflammatory
state that characterizes metabolic disease and COVID-19 associated
cytokine storms
.

Other environmental toxins, including persistent organic pollutants
(POPs) found in air, water, and food generated from pesticides
and industrial chemicals, are also strongly implicated in the pathogenesis
of metabolic syndrome; promoting “clean living,” toxin-avoidant
strategies for patients as simple as emphasizing organic foods, home
air purification, and non-toxic home supplies could be considered, although
the clinical utility of these measures in the acute setting is unknown
[21].

In discussing the white elephant in the room he states:

What is starkly missing is the clear, simple, and strong recommendation for no added
sugar or ultra-refined carbohydrates, both of which are known drivers
of postprandial hyperglycemia and inflammation. As a medical community, we must not miss the opportunity to serve patients with straightforward, evidence-based nutritional and lifestyle strategies to assist in glycemic control.

I would encourage you to follow the link and read the 2 pages supported by multiple peer-reviewed references.

Evidence based nutritional and lifestyle strategies, so often discussed on this website include:

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

If you have obesity, diabetes or pre-diabetes the Very Low Carbohydrate version of the anti-inflammatory diet linked above would be the fastest and most effective intervention you can immediately employ to reduce your risk of succumbing to COVID-19. (Of course wear a mask, follow good hygiene with hand-washing frequently, and practice social distancing)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID-19: Hydroxychloroquine and Chloroquine, BAD NEWS.

The most comprehensive study on the use of these 2 drugs, including 96,032 patients in multiple hospitals and multiple countries shows increased risk of death with either of these two drugs in patients hospitalized with COVID-19. This was a retrospective study but offers the most amount of data to date on the issue of clinical efficacy and risk. You can read the full article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext.

TreatmentDeath rateventricular arrhythmia
No drug9.30%0.30%
Hydroxychloroquine18%6.10%
Hydroxychloroquine plus Macrolide23.80%8.10%
Chloroquine16.40%4.30%
Chloroquine plus Macrolide22.20%6.50%
Macrolide is an antibiotic like Zithromax.
Differences between no drug and all drug treatment categories statistically significant.

This was not a randomized prospective controlled clinical trial. However the data were adjusted for:

age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity.

So far it is the best information we have available.

There have been many physicians who have supported the use of these drugs without randomized controlled trials based on anecdotal reports in the medical literature. Given the desparate situation without a known effective drug that is understandable.

The authors note:

The absence of an effective treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has led clinicians to redirect drugs that are known to be effective for other medical conditions to the treatment of COVID-19. Key among these repurposed therapeutic agents are the antimalarial drug chloroquine and its analogue hydroxychloroquine, which is used for the treatment of autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis.

However, the use of this class of drugs for COVID-19 is based on a small number of anecdotal experiences that have shown variable responses in uncontrolled observational analyses, and small, open-label, randomised trials that have largely been inconclusive.

 The combination of hydroxychloroquine with a second-generation macrolide, such as azithromycin (or clarithromycin), has also been advocated, despite limited evidence for its effectiveness.

This study is an important milestone, disappointing but illustrative of a common phenomenon in medicine.

Previous warnings about potential lethal heart rhythm issues were viewed with skepticism by armchair pundits claiming that there was not much data on sudden death related to use of these widely used drugs. Those pundits failed to understand that sudden death caused by prolonged QT interval (effect of these and many other drugs) cannot be diagnosed without an EKG during the event. When this occurs outside the hospital setting, or even in the hospital without a continuous EKG monitor on the patient, it goes unrecognized.

An important dictum in medicine is “first do no harm” (primum non nocere).

In the meantime, we do know what reduces risk:

Test/Trace/Isolate, social distance, MASKS4ALL, wash hands frequently, disinfect surfaces, show consideration for others. To understand why and how these measures can make a big difference you can go to this website. https://www.erinbromage.com/

In addition you can read a great article about the same topic here. https://www.newyorker.com/science/medical-dispatch/amid-the-coronavirus-crisis-a-regimen-for-reentry

I will close with the sermon on lifestyle and COVID-19.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. You must follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID-19 Sweden vs Other Countries

5/21/2020 deaths/ million 7 day running average doubling time
cumulative deaths/million/day days
SWEDEN 379 3.3 46
Norway 43.6 0.13 241
Finland 54.9 0.52 138
Denmark 95.6 0.49 120
USA 282 4.02 49
NZ 4.3 0 598
stay home test-trace leadership
isolate example
SWEDEN no yes ?
Norway yes yes good
Finland yes yes good
Denmark yes yes good
USA late/variable POOR poor
New Zealand yes excellent excellent

Sweden was a source of controversy for the choice against instituting a stay-home policy. As you compare Sweden with other Scandinavian countries above you will see a dramatic difference in deaths per million (cumulative), running 7 day average deaths per million per day, and doubling time. The higher the doubling time (in days) the more a country has slowed the spread. New Zealand is the obvious winner. Early and aggressive action, effective test/trace/isolate, excellent leadership and example by the president are the hallmarks of success in New Zealand. Of course New Zealand is a small island with minimal international business and tourism so the comparison is not fair. HOWEVER, their success and strategy are obvious.

The US failed (and continues to fail) on test/trace/isolate despite the bluster and misrepresentations from the Whitehouse. California and Washington instituted early measures with respect to stay-home but without adequate test kits all of US states have been unable to execute the test/trace/isolate strategy proven effective in other countries. President Trump promised California 100,000 nasal swabs per week three weeks ago. They have not arrived. (California Department of Public Health)

Thus comparing USA to Sweden we see that with adequate social distancing, test/trace/isolate, Sweden did almost as well (or as poorly) as the US where stay at home was employed on a variable time line and to different degrees between the states.

You can review worldwide data, download spreadsheets, choose countries for comparison here.

Test/Trace/Isolate + Social distance + Masks4all + cooperation = SUCCESS

Had the US responded early and effectively, stay-home could have ended very quickly and safely with much less economic disruption.

Poor Management = inadequate Test/Trace/Isolate and other measures.

The New England Journal of Medicine published an article discussing the failure of the
USA relative to Test/Trace/Isolate.

Failing the Test — The Tragic Data Gap Undermining the U.S. Pandemic Response

 

The importance of  Reviving the US CDC after annual cuts by the Trump Administration is discussed here.

On March 25 the NEJM published an editorial on responding to the pandemic.

We did not follow the recommendations.

The AMERICAN ENTERPRISE INSTITUTE, a conservative think-tank, published a comprehensive Roadmap to Reopening.

Unfortunately we have not followed that roadmap.

So boost your immune system and meet the challenge with your personal behavior. Be smart.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. You must follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob