New UK SARS CoV-2 variant: “we see no evidence that the reported mutations would substantially increase reinfection risk or decrease vaccine efficacy.”

We must all be thankful for the immunologists who continue to stay on top of the pandemic. They have our backs.

Recent tweets posted by reliable experts who have evaluated the mutations in the B.1.1.7 strain.

We used our database of 579 COVID patient samples to evaluate immune evasion the UK variant (B.1.1.7). Overall takeaway is reassuring: we see no evidence that the reported mutations would substantially increase reinfection risk or decrease vaccine efficacy. (1/n)

Here is some data from the lab of Winn Haynes. @hayneswa

I would prefer this in a manuscript, but given the time of year and that I’m tired, I’ll just tweet the data regarding the UK #COVID19 variant: PRNT50 values from COVID patients for SARS2 WT WA1 vs a mutant that contains N501Y (among other spike mutations).

What does this mean?

In the words of Prof Akiko Iwasaki

As RT above, @TheMenacheryLab has shown functionally that the N501Y mutation in the RBD does not evade existing antibodies’ ability to block replication. (8/n)

Eric Topol:

The good news is that it is not anticipated the current vaccines, which rely on inducing neutralizing antibodies to the spike protein, will be affected by B.1.1.7 or N501Y

If you want to keep up on these issues I suggest you follow Akiko Iwasaki on twitter.

Prof. Akiko Iwasaki

@VirusesImmunity

Bottom line:

The vaccines should work for this new variant despite the mutations.

There is no evidence that the new strain is more lethal (time will tell).

It is probable that the new strain is more easily transmitted (greater affinity for the ACE2 receptor and recent epidemiologic data)

Masks, social distancing, hand washing will continue to work.

Improved ventilation (in-door settings) remains important.

If you want to visit and celebrate, DO IT OUTDOORS with masks and distancing.

Humans need social interaction, this can be done safely without ignoring hygiene recommendations. Socialize and exercise safely outside.

Super-spreader events (such as Whitehouse holiday parties) should be avoided.

Religious services should be held outdoors with precautions. Tents with distancing and masks work!

If you are sick isolate.

Remember, individuals are most infectious before symptoms develop and for the first 5 days after symptom onset. So even though you feel well, you could be a spreader.

Everyone is vulnerable.

Young previously healthy teens and adults are dying and suffering Long-Covid with significant chronic illness.

If you are obese, overweight, pre-diabetic, or have diabetes, now would be a good time to go low-carb with an anti-inflammatory diet. The benefits occur immediately even before or without weight loss.

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.

Happy New Year

Doctor Bob

COVID 19 Immune Response, How does it fail?

Dr. Akiko Iwasaki, an immunologist at Yale, has led an amazing research team from the start of this pandemic, analyzing the immune response of patients sick with COVID 19. She has co-authored a review of the immune response to be published in the January edition of Scientific American.

Iwasaki A, Wong P.  The immune havoc of COVID-19.  Scientific American, January 2021, 35-41.

Here is the link.

http://The Immune Havoc of COVID-19 – Scientific American

Before reading that article, a good place for a lay person to start would be her 8 minute youtube video, Immunology 101.

After watching that video and reading the Scientific American article, if you want a deeper dive into some of her team’s research, watch this video (28 minutes).

The Scientific American article discusses many of the unique characteristics of SARS CoV-2 compared to two previous corona viruses SARS CoV-1 and MERS. SARS CoV-2 which causes the illness called COVID-19, evades the human immune system in many ways. Those who become seriously ill, requiring ICU care, seem to suffer a time lag in their immune response compared to those who suffer less severe illness. In addition, the T-cell response in sicker patients is subdued and inadequate to clear the virus. Finally, a hyper-inflammatory response is present in most who succumb to the illness. Dr. Iwasaki discusses how the Cytokine storm of COVID-19 differs significantly from that seen with other viral infections and likely includes a new phenomenon referred to as a Bradykinin Storm which involves another major component of the immune system. There may even be an auto-immune component to this disease in some or many patients.

Early in the pandemic, physicians did detect elevated cytokines in patients, but the amount of these proteins and the subsequent inflammatory state they evoked differed from that of a classic cytokine storm.

We observed high levels of IL-5 and IL-17,cytokines not classically associated with antiviral immune activity. Instead these cytokines initiate a seemingly misguided
response—one better suited for infections by parasites and fungi.
We have yet to understand whether this response causes damage
to tissue or just diverts resources the body needs to fight the virus.

In the second video linked above Dr. Iwasaki describes how men and women demonstrate different immune responses with a higher fatality rate observed among men.

Much has been learned but much remains to be discovered as this pandemic continues to unfold.

There are a few clear facts emerging from multiple studies and observations.

Masks and social distancing work. Masks protect both the wearer and those around the wearer.

Most transmission occurs by droplets and aerosol (emitted from the nose and mouth).

Six feet of distancing is helpful but does not guarantee protection. Cases of transmission in restaurants via air flow from HVAC units have been described in which the infected person transmitting disease is far removed from the people becoming infected. (aerosol spread). Droplets and aerosol studies have demonstrated that coughing and sneezing can project infectious particles up to 26 feet.

The most dangerous circumstances for transmission include indoor confined spaces, with multiple people interacting for long periods of time (restaurants, bars, meeting rooms, parties, social gatherings).

Ventilation and air turnover are important factors.

This virus is unique in that higher viral loads and transmissibility occur BEFORE ONSET OF SYMPTOMS, rendering this virus more dangerous than previous pandemics. This can occur in patients who later develop symptoms or in people who carry the virus without ever developing any symptoms.

Some estimate that as much as 50% of transmission occurs from people exhibiting no symptoms.

Finally, “herd immunity” for infectious disease has never been achieved by reaching a critical number of infected people. “Herd immunity” has only been achieved in the past with vaccination programs. Herd immunity does not mean that disease transmission ceases, it means that transmission rates are very low.

What is herd immunity?

When most of a population is immune to an infectious disease, this provides indirect protection—or herd immunity (also called herd protection)—to those who are not immune to the disease.

For example, if 80% of a population is immune to a virus, four out of every five people who encounter someone with the disease won’t get sick (and won’t spread the disease any further). In this way, the spread of infectious diseases is kept under control. Depending how contagious an infection is, usually 50% to 90% of a population needs immunity to achieve herd immunity.

Most experts estimate that vaccination of at least 70% of the population will be required to reach some degree of herd immunity for COVID-19.

Here is a 2 minute discussion of herd immunity from Johns Hopkins before the Pfizer-BioNtech and Moderna vaccines were given Emergency Use Authorization by the FDA.

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

New COVID strain in UK: Is it more dangerous?

A new strain of the SARS-CoV-2 virus has been identified in an area of the UK. The media are reporting on this as a new, more easily transmitted or more virulent strain.

Hold on!

There are theoretical concerns that some of the many mutations identified in this virus might make it more contagious and/or cause more severe illness. But this has not been confirmed by clinical data. The case rate in this part of UK is accelerating, leading to more restrictive social measures, but it is not clear whether this is related to human behavior, virus mutations, or a combination of both.

Caution would be prudent.

Here is the link to the posted report.

Preliminary genomic characterisation of an emergent SARS-CoV-2 lineage in the UK defined by a novel set of spike mutations

This report appears on the website:

SARS-CoV-2 coronavirusnCoV-2019 Genomic Epidemiology

This strain is of concern for several reasons.

It presents an unusually high number of mutations.

One of these mutations increases the virus’s affinity to the human ACE2 receptor.

Another mutation has been linked to evasion from the human immune system.

This strain accounts for an increasing proportion of cases in parts of England.

The number of cases of this strain is growing, and the number of regions reporting this strain are growing.

This combination of facts should be a red flag and the authors of the post state:

The rapid growth of this lineage indicates the need for enhanced genomic and epidemiological surveillance worldwide and laboratory investigations of antigenicity and infectivity.

In other words, it needs to be studied and tracked to see if it is significantly more contagious and what impact it has on the pandemic (spread of spread, intensity of illness, morbidity-mortality).

The authors speculate on the possible causes for this large a number of mutations in a single strain. They suggest that the administration of antibody therapy to immune deficient-depressed chronically infected patients could create conditions of evolutionary pressure for rapid and diverse mutation. If that theory is correct, given that there is no data demonstrating reduced mortality rates with this form of treatment, we may be creating a problem with an unproven therapeutic intervention (iatrogenesis).

Convalescent plasma is often given when patient viral loads are high, and Kemp et al. (2020) report that intra-patient virus genetic diversity increased after plasma treatment was given.

Hmmmmmmmmmmmmmm!

Stay tuned for updates.

Also, please read my post from 12/18/20 on the Pfizer-BionTech vaccine. I have made a few minor corrections and clarifications since the original post.

Covid 19 Vaccine: Statistics, Safety, Efficacy, What is a Confidence Interval? | Practical Evolutionary Health (practical-evolutionary-health.com)

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

Who was the greatest scientist of the 20th century?

Many would say Albert Einstein, some might suggest Stephen Hawking. But arguably, the greatest might have been a little known, modest but ill-tempered and often vulgar-mouthed virologist named Maurice Hilleman.

Hilleman’s twin sister died at birth, his mother died 2 days later. His father gave him over to his aunt and uncle and he worked their farm in Montana. For want of funds he deferred college until his brother returned from divinity school and convinced him to attend Montana State. He was raised in a deeply religious family and was observed to read Darwin’s Origin of the Species while in church as a teenager.

He went on to graduate school for microbiology and discovered that Chlamydia, previously thought to be a virus, was an intra-cellular bacteria.

Shortly after graduate school and at the request of the US military he developed a vaccine for Japanese Encephalitis which was wreaking havoc with US soldiers in the Pacific during WW2.

He made a list of serious childhood illnesses and decided to devote his life to developing vaccines for all of them.

During his career he developed over 40 vaccines.

From Wikipedia:

Of the 14 vaccines routinely recommended in current American vaccine schedules, he developed eight: those for measlesmumpshepatitis Ahepatitis BchickenpoxNeisseria meningitidisStreptococcus pneumoniae and Haemophilus influenzae bacteria.[2][4] He also played a role in the discovery of the cold-producing adenoviruses, the hepatitis viruses, and the potentially cancer-causing[5] virus SV40.

The story of the mumps vaccine is fascinating. His daughter developed mumps. He swabbed her throat, took the sample to his lab and cultured the virus in chicken embryo cells. Over 2 years he developed a series of virus mutations in successive dishes of embryo cells. Each virus culture became less virulent for humans. This had never been done before. Eventually, he had a “live-attenuated” virus that could be used for human vaccination.

His work was performed under what would now be considered primitive scientific conditions but it was state of the art for his time.

It has been estimated that his work saves over 8 million lives every year.

Paul Offit MD, Director of Vaccine Development at Children’s Hospital in Philadelphia (U Penn.) a present day preeminent vaccinologist, spent 72 hours interviewing Maurice Hilleman when he was dying from cancer, to record his amazing history.

The folks who worked for Maurice Hilleman were intensely loyal. He was totally devoted to science and vaccine development. Yet on the day he died, Paul Offit walked into a room filled with pediatricians where he was giving a lecture and not one pediatrician knew who he was or what he had accomplished.

From Wikipedia:

Robert Gallo, co-discoverer of HIV, the virus that causes AIDS, once said “If I had to name a person who has done more for the benefit of human health, with less recognition than anyone else, it would be Maurice Hilleman. Maurice should be recognized as the most successful vaccinologist in history.”[14]

After Hilleman’s death Ralph Nader wrote, “Yet almost no one knew about him, saw him on television, or read about him in newspapers or magazines. His anonymity, in comparison with MadonnaMichael JacksonJose Canseco, or an assortment of grade B actors, tells something about our society’s and media’s concepts of celebrity; much less of the heroic.”[15]

A documentary film titled Hilleman: A Perilous Quest to Save the World’s Children, chronicling Hilleman’s life and career, was released in 2016 by Medical History Pictures, Inc

In 2007, Paul Offit published a biography of Hilleman, entitled Vaccinated: One Man’s Quest to Defeat the World’s Deadliest Diseases

Maurice Hilleman – NCBI – NIH

Maurice Hilleman | Nature Medicine

Maurice Hilleman – Wikipedia

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 Vaccine: Statistics, Safety, Efficacy, What is a Confidence Interval?

This week began the saga of vaccine implementation for the mRNA vaccine developed by the Pfizer-BioNtech partnership. The New England Journal of Medicine published a peer-reviewed article reporting the data from the RCT (Randomized Controlled Trial) and an Editorial appeared on the same day in the NEJM. You can view both here:

http://Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

http://SARS-COV-2 Vaccination — An Ounce (Actually, Much Less) of Prevention

If you go to the first link you can click on a link to a 3 minute video that summarizes the results. The video is informative and succinct.

Here is the most important table in the peer-reviewed article:

Age > 55 includes >=65 and >=75, Age >= 65 includes age >=75. If age>= 75 were not listed separately, all age groups would have statistical significance. This is why overall number of infections in the vaccine group is 8 but the total of the four age groups is 9. One of the 3 infections in age >55 was 65 or older. Got it?

Look at the third column labeled “Surveillance Time”. The first number in this column is described under the caption as “total time in 1000 person-years for the given endpoint..” So multiply by 1000 and you get a number that represents “person years” of observation. This is an odd number but a reasonable way to present information. The trial data covers a period of 6 months starting from when the first patient was vaccinated. The median duration of observation was 2 months after vaccination with the second dose. (50% of patients had been vaccinated for more than 2 months and 50% of patients less than 2 months)

The number in parentheses gives the number of people in each category of age, sex, race/ethnic group, country.

Notice that as we descend through the age groups from youngest to oldest, the number of participants decreases significantly in >= 65 and >=75 years old.

Now go to the last column labeled “Vaccine Efficacy, %”. The first number is the overall efficacy for that age group. But how confident are we about that efficacy % for each age group? The numbers in the parentheses represents a range or “confidence interval” which is determined statistically. This range is determined by the number of people in each (age) group and by the difference between the placebo and drug treatment outcome in that age group.

Note that the confidence interval widens as you go down from younger to older age groups. That is primarily because the number of people represented by the groups age >=65 and >= 75 are much smaller than the first two age groups.

For the age group > 65, the efficacy is reported at 94.7%. But that is an average number that shows that compared to the placebo group, the symptomatic infection rate in the vaccinated group was 94.7% lower. For the age group between >=65, there were 19 cases of symptomatic infection in the placebo group and only 1 in the vaccine group. 1/19 equals 0.0526. 1 minus 0.0526 equals 0.947 or 94.7% (rounding).

What is a 95% confidence interval?

The 95% confidence interval is the the range over which we are 95% confident the “true” value falls within. In other words, for age >=65 there is a 95% probability that the true vaccine efficacy falls somewhere between 66.7% and 99.9%. As more people age >=65 are entered into the trial, the confidence interval will get narrower for that age group provided the difference between the placebo and vaccine group remains the same. If the difference between placebo and vaccine groups increases AND the number of people in this age group increases, the confidence interval will shrink further.

This is a fantastic result!

But now look at the confidence interval for age >=75. It is -13.1-100. A minus number is in the range. That means we do not have enough people in the study age 75 or older to reach a “statistically significant” conclusion. There were only 774 folks who received the vaccine and 785 people who received the placebo in this age group. 5 in the placebo group got sick, 1 in the vaccine group got sick. This difference shows a “trend” but does not reach “statistical significance”. We need more data for this group.

But again, do not lose heart. Based on this data, which includes efficacy and safety overall, I recommend that my 92 year old mother-in-law receive the vaccine as soon as it is available.

What is “statistical significance”?

Simply stated, a result is “statistically significant” in a drug trial if the probability that the difference between the placebo group and the drug group occurred by accident (or by chance) is less than or equal to 5%. Or to put it another way, the probability that the difference between placebo and drug did not occur by chance but rather represents a true difference in outcome is 95% or greater. 5% is the standard cutoff point in medical trials. This is usually reported as a “p value”. If a p value is less than or equal to 0.05 the difference is considered statistically significant.

“Clinical significance” is another issue. For example, a drug might only decrease relative risk of an event by 5%, but the result could be “statistically significant”.

In the case of this vaccine, the clinical significance is outstanding.

Here is another important chart.

Protection begins at day 14 after first dose

This chart demonstrates that 14 days after the first dose of vaccine protection from symptomatic infection begins. The blue line shows infections in the placebo group, the red line is the vaccine group. They diverge at day 14. Thereafter the divergence increases. This makes sense. It is consistent with our understanding of how the immune system works. This time course is very reassuring.

Now let us look at side effects.

These are the usual side effects expected with any vaccine. Symptoms such as fever, malaise, local reaction at the injection site, muscle aches are all to be expected. This profile is a little worse than the flu vaccine, but less compared to the shingles vaccine.

So far 2 episodes of anaphylaxis have occurred in the US and in UK with the vaccine rollout. (millions of doses already given) This can happen with any vaccine, that is why 15 minutes of observation following vaccination is part of the protocol and the vaccine should only be administered in a location that has epinephrine available to treat a severe allergic reaction.

This vaccine time sequence is historically unprecedented. This was made possible by a combination of advances in science and incredible action on the part of the public and private sectors in response to a global crisis. Prior to this, the shortest time to develop an effective vaccine was 4.5 years (measles mumps, and that was done by Maurice Hilleman with the help of a few lab assistants, more about Maurice in my next post).

I received my first dose of the vaccine today (as a member of hospital medical staff). I was directed to a CDC website to register as a vaccine recipient. The CDC will send me periodic questions on side effects which I will answer. If everyone participates in this program more data will become available on safety and efficacy. So please participate when you get the vaccine (vsafe.cdc.gov).

Many questions remain. Here is a quote from the NEJM editorial:

  1. Will unexpected safety issues arise when the number grows to millions and possibly billions of people?
  2. Will side effects emerge with longer follow-up?
  3. Implementing a vaccine that requires two doses is challenging. What happens to the inevitable large number of recipients who miss their second dose?
  4. How long will the vaccine remain effective?
  5. Does the vaccine prevent asymptomatic disease and limit transmission?
  6. And what about the groups of people who were not represented in this trial, such as children, pregnant women, and immunocompromised patients of various sorts?

The logistic challenges of manufacturing and delivering a vaccine remain daunting. This vaccine, in particular, requires storage at −70°C, a factor that may limit its deployment in some areas. Nevertheless, the remarkable level of safety and efficacy the vaccine has demonstrated thus far make this a problem that we should welcome solving. What appears to be a dramatic success for vaccination holds the promise of saving uncounted lives and giving us a pathway out of what has been a global disaster.

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

LONG COVID, WHAT IS IT?

I recently read an outstanding review of the topic “LONG COVID”. This has been defined in various ways. It can include persistent symptoms and/or organ damage following apparent “recovery” from the illness. There is no agreed upon definition. Our understanding is evolving. Time will tell how long symptoms can persist. It is clear that persistent symptoms and/or organ damage can occur even after minor illness or subsequent to asymptomatic positive PCR.

Full report can be found HERE

The following are EXCERPTS from the full report. References provided in the full report:

It has become clear in more recent months that an increasing number of individuals have been afflicted with persisting symptoms following a SARS-CoV-2 infection. Of these individuals, who have been referred to as “long-haulers” or as having “long COVID,” many did not initially experience a severe case of COVID-19, but rather had mild symptoms or were asymptomatic (Marshall, 2020)

According to Harvard Health, COVID-19 “long-haulers” include two groups of people affected by the virus (Komaroff, 2020):

· Those who experience some permanent damage to their lungs, heart, kidneys, or brain that may affect their ability to function.

· Those who continue to experience debilitating symptoms despite no detectable damage to these organs.

A team from the United Kingdom estimated that roughly 10% of individuals who have had COVID-19 experience prolonged symptoms (Greenhalgh et al., 2020). A guidance published on September 7, 2020 by Public Health England indicated that roughly 10% of “mild” COVID-19 cases who were not admitted to the hospital reported symptoms lasting more than four weeks (Public Health England, 2020).

Examples of some of the symptoms reported include:

· Prolonged low-grade fevers that do not respond to standard fever-reducing medications

· Neurological manifestations, such as memory loss and changes in the ability to recall words in a primary or secondary language

· Exercise-induced fatigue from walking around the block that led to a relapse of symptoms

· Symptoms in the central and peripheral nervous systems, gastrointestinal symptoms, skin problems, cardiovascular system occurrences

Some of the more commonly reported symptoms of long-COVID include: fatigue, cough, dyspnea, loss of taste and smell, muscle weakness, muscle and joint pain, headache, confusion, conjunctivitis, chest pain, decreased mobility and falls (Marshall, 2020; Paice et al., 2020).

On November 10th, 2020, the CDC updated its report entitled, “LongTerm Effects of COVID-19” (Centers for Disease Control and Prevention, 2020) to include the following information on long COVID: The most commonly reported long-term symptoms include:

· Fatigue

· Shortness of breath

· Cough

· Joint pain

· Chest pain

Other reported long-term symptoms include:

· Difficulty with thinking and concentration (sometimes referred to as “brain fog”)

· Depression

· Muscle pain

· Headache

· Intermittent fever

· Fast-beating or pounding heart (also known as heart palpitations)

More serious long-term complications appear to be less common but have been reported. These have been noted to affect different organ systems in the body. These include:

· Cardiovascular: inflammation of the heart muscle (in a German study 70% of patients had evidence of this, 80% of those patients had not been hospitalized)

· Respiratory: lung function abnormalities

· Renal: acute kidney injury

· Dermatologic: rash, hair loss

· Neurological: smell and taste problems, sleep issues, difficulty with concentration, memory problems

· Psychiatric: depression, anxiety, changes in mood

An organized study from Italy assessed the prevalence and types of persistent symptoms observed in 143 individuals after they were discharged from the hospital (Carfì et al., 2020)

The mean age of participants was 56.5 years old, with a range from 19 to 84 years of age, and 37% were female. The mean length of hospital stay was 13.5 days, and while in the hospital, 15% had received non-invasive ventilation, and 5% of the participants had received mechanical ventilation. The assessment described in the report occurred a mean 60.3 days after the onset of the first COVID-19 symptoms, and 12.6% were completely free of any virus related symptoms. The researchers reported that at a mean evaluation time of 60.3 days following COVID-19 symptom onset, 32% of the participants still had one to two symptoms, while 55% were still experiencing three or more symptoms.

The concept of chronic fatigue syndrome has been observed in individuals following infection with both viral and non-viral micro-organisms (Hickie et al., 2006). A study describing survivors of a SARS outbreak in Hong Kong stated that 40% had chronic-fatigue problems after three years and 27% met the criteria for chronic fatigue syndrome. The fatigue, also called postexertional malaise, results from a severe multi-organ crash following even light activities like a short walk. Similar effects have been reported after other large disease outbreaks (Hickie et al., 2006)

In summary, because the COVID-19 pandemic commenced only months ago, rather than years ago, the relatively long-term sequelae of COVID-19 are unknown; however, it seems that not unlike prior coronavirus outbreaks, COVID-19 has yielded reduced pulmonary and physical function, compromised quality of life and emotional distress. Unfortunately, prior outbreaks – including the SARS-CoV-1 epidemic — suggest that these associated effects can last for years (Marshall, 2020).

Challenges for people experiencing longer term effects from COVID19 can include:

· Widespread perception that people either die, get admitted to hospital, or recover after two weeks; however, it is clear that some individuals experience ongoing, or long COVID.

· Long COVID is a multisystem disease; thus, the symptoms vary significantly among the individuals with persisting effects from COVID19.

· It is unknown why some experience a prolonged recovery while others do not.

· Many individuals with mild or asymptomatic COVID-19 cases experience long-term COVID-19, but oftentimes, they were never initially tested for a SARS-CoV-2 infection, and therefore have not been flagged for a positive test result.

· There is a lack of consensus on diagnostic criteria for long COVID.

· Lack of guidance for reaching a working diagnosis and code for clinical datasets.

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 update: Vaccines, Drugs, Good News and Bad News.

This week has brought good news and bad news.

First the good news, preliminary data on two vaccines (from Pfizer and Moderna) show 95% efficacy. Today Pfizer applied to the FDA for EUA (Emergency Use Authorization) for their mRNA VACCINE. Both vaccines use an approach never used before. The vaccines both involve injecting messenger RNA (mRNA) which enters human cells where the cell machinery produces a sequence of amino acids which reside on the spike protein of the SARS-COV-2 virus. The immune system then responds to that portion or the virus protein. Both vaccines reduced the rate of moderate to severe illness by about 95% compared to the placebo group. No study subjects were younger than 18. We do not yet know the age distribution or underlying medical condition profile of the vaccine and placebo recipients.

Data are being released to the medical community for review. Hopefully there will be a broad representation of our population in the study groups.

If approved for Emergency Use Pfizer estimates that about 40 million doses could be produced by year’s end. That would cover 20 million people (each person receives a series of two shots).

Cautions:

  1. So far safety looks good, but rare complications will not be known for a long time.
  2. Safety and efficacy in folks younger than 18 not known.
  3. The Pfizer vaccine requires very cold storage which is not available in pharmacies, doctor’s offices and clinics. Distribution logistics will be complicated and will require storage in hospitals or other facilities that have minus 70 degree F capability.
  4. We do not know if the vaccine reduces death rate with infection, that will not be known for at least a year or two.
  5. We do not know how long immunity will last.
  6. It will take more than a year to ramp up production and administer the vaccine to adequate numbers of people to achieve herd immunity.
  7. Even after large numbers of people are vaccinated, masks, social distancing and hand washing will remain important parts of protecting the public.
  8. If availability of a vaccine causes people to be less adherent to behavioral guidelines, the net effect could be greater illness and death rather than less protection.

You can listen to an interview with vaccine specialist Dr. Paul Offit here:

http://For COVID-19 Vaccines, ACIP Will Be a Critical Gatekeeper

A transcipt is also available at that site.

The interview describes how the vaccine trials were designed and discusses the independent groups of scientists and doctors who review data on vaccines. The important roles of the DSMB (Data Safety Monitoring Board) and ACIP (Advisory Committee on Immunization Practices) are discussed. Many areas are covered. They include problems with previous vaccines, realistic expectations about production and distribution, the many kinds of vaccines still under various stages of study, the process of EUA and the differences between EUA and FDA final approval.

There’s a DSMB for each of these phase 3 trials, which is a multidisciplinary group,
including people who are experienced with clinical trials, biostatisticians, bioethicists,
immunologists, vaccinologists, and virologists. You have this big crew, they’re reviewing the blinded data, and they have a pre-programmed time of review. Also, they have stopping rules that are defined ahead of time for both futility and for overwhelming efficacy.

Drugs for Covid:

Dexamethasone, an anti-inflammatory steroid, has been demonstrated to reduce death rates in very sick patients.

The study, published in The New England Journal of Medicine in July, found the drug cut mortality by a third among severely ill COVID-19 patients who were on ventilators, and by a fifth for patients receiving supplemental oxygen. It was found not to have any benefits for patients with mild illness, and there was some evidence of potential harm.

So far, no other drugs have been shown to reduce risk of death. Remdesivir at best reduces duration of illness.

But today a combination drug (Baricitinib plus Remdesivir), was granted an EUA by the FDA. Like Remdesivir, the combination reduced length of illness. In the case of the combination, the duration of illness was reduced by only ONE DAY which is less than the reduction previously reported with Remdesivir alone (3 days). This discrepancy has not been explained and it concerns me. Why would an effective drug combination produce less reduction in duration of illness than one of the drugs used alone? Hmmmmmmmmmmmm

But more importantly:

The odds of a patient dying or being ventilated at day 29 was lower in the combination group compared with those taking placebo + remdesivir, the press release said without providing specific data. For all of these endpoints, the effects were statistically significant.”

Data on the actual reduction in risk of death has not yet been released for scientific review.

Remember EUA was previously granted for Hydroxychloroquine, then revoked when larger controlled studies showed no benefit and possible harm. Likewise, use of convalescent plasma from recovered COVID patients was granted EUA but the data so far do not support its use.

So we have very hopeful preliminary data on 2 vaccines and we have dexamethasone and a new combination drug reported to reduce mortality in very sick patients. The data on dexamethasone is convincing. All we have on the combination treatment is a press release so far.

Now the bad news.

Hospitalization rates and infection rates are at record highs.

One out of five hospitals this week in the US anticipate a critical staffing shortage of health care workers within a week.

Last week I heard an interview with an ICU doctor in Billings Montana. The ICU COVID-19 cases were so great in number that in order to meet the demand the hospital did the following:

  1. Converted single bed ICU rooms to doubles
  2. Converted the cardiac care unit to a COVID ICU
  3. Converted recovery room beds to ICU beds
  4. Converted ER beds to ICU beds.

All of those ICU beds were full. The doctor said if the growth in cases did not slow down they would be left with “difficult choices”. Read that as triage. Patients most likely to survive get critical care, those less likely get comfort measures. Meanwhile non-COVID patients who need critical care may not get the level of service they need.

Doctors and nurses across the country are suffering burnout. Many have become infected. Some have died. The American Nurses Association report over 1200 nurses have died from COVID-19 in the US.

In a survey of hospital nurses conducted last week 80% reported inadequate PPE.

Interviews with nurses reveal that some patients dying of COVID do not believe they have the disease. There is a cult of Trump followers who believe his dangerous lies, misinformation and conspiracy theories. Despite death staring them in the face, some still refuse to believe the virus is real. Amazing.

So it will get worse before it gets better.

Next post will discuss “Long Covid”.

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 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.”

A good short read on the topic can be found here:

Desertification is turning the Earth barren – but a solution is still within reach by David R Montgomery. 

Finally, the scoop on methane produced by cattle and the difference between that and fossil fuel generated CO2 is discussed in this very brief animation.

How can livestock be a part of the climate solution? The natural carbon cycle explained. Often missed in climate change discussions is the natural carbon cycle. There’s a huge difference between fossil fuel carbon emissions and methane from cattle. Perhaps short animations like this will help change the narrative around meat.

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.

The following short animation explains the difference between methane from cows and CO2 from burning fossil fuels. The “natural carbon cycle” reveals the difference.

How can livestock be a part of the climate solution? The natural carbon cycle explained.

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