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A Doctor Advises Doctors- RE: THE CORONAVIRUS

Fellow MFO members- While I have no personal knowledge of the author of this information, I did just receive it via email from my dentist, who has also been a personal friend for some sixty years. I thought that it might be helpful to share it with all of you. Bold or italic emphasis and spacing was added for visual clarity; otherwise it has not been edited.

OJ

Date: February 26, 2020 at 2:35:50 PM EST
Subject: What I am doing for the upcoming COVID-19 (coronavirus) pandemic


Dear Colleagues, as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.

The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April. Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:

1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.

2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.

3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.

4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.

5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.

6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.

7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!


What I have stocked in preparation for the pandemic spread to the US:

1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.

Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.

3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.

4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.


I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.

I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share this email. Good luck to all of us! Jim

James Robb, MD
Fellow of the College of American Pathologists.

Comments

  • Because of the importance of this information I am deliberately "bumping" the post into the "Discussions +" category. My apologies for bending that rule.
  • If it spreads like measles, most of that won't make any difference at all.

    Does Doc Robb know how it spreads?

    There may be enough hand gel for the world. But I doubt there are enough face masks.
  • edited March 3
    Thank you OJ.

    I've used the hand cleaning methods for a long time; especially during the flu season. And don't rub my facial area with my hands after being in public areas. A real nasty bacteria item, but with which our immune system apparently conquers is "paper/coin money". Although this may be to the gross side, I wonder where the $1 bill lived before arriving in my hand.........dropped onto a bathroom floor, in a horse stable or did it live the night before in the waist band of someone at a strip club. Okay, enough.

    Side note: A tv broadcaster in Michigan had his daughter return from a university foreign study program in Italy (many schools are returning students). He noted that there were not any precautions relative to screening upon arrive in the U.S. for her. ABC news (from NYC) had a similar report tonight, and the young lady stated that she was only asked whether she had traveled to China or Iran. Okay, cool. Pass through. And has since arrived home after passing through JFK to Atlanta.

    Good Evening,
    Catch
  • edited March 3
    My confidence in our government remains unshaken. If the president's emergency response team, headed expertly and appropriately by Mr. Pence, determines that traveling through Italy or other known major contagion areas doesn't need to be checked I'm sure that they know best and are totally on top of this incredibly great best-ever response effort.

    Only someone trying to spread a hoax and bring down the president with fake news would think otherwise! :(
  • edited March 3
    FWIW : I came upon article in WSJ which stated Purell was selling for over $100 for two 8 oz. bottle . Prior to out break the cost was less than $8.00 for the two.
    I can't verify this in my local. Checked Amazon & didn't find any over a $100, but still about 6 to 8 times as costly as prior to out break !
    Derf
  • This reminds of the 1995 movie "Outbreak" on Ebola-like virus.
    https://youtube.com/watch?v=Y5povsMKfT4
  • Old_Joe said:

    My confidence in our government remains unshaken. If the president's emergency response team, headed expertly and appropriately by Mr. Pence, determines that traveling through Italy or other known major contagion areas doesn't need to be checked I'm sure that they know best and are totally on top of this incredibly great best-ever response effort.

    Only someone trying to spread a hoax and bring down the president with fake news would think otherwise! :(

    +1
  • Gary1952 said:

    Old_Joe said:

    My confidence in our government remains unshaken. If the president's emergency response team, headed expertly and appropriately by Mr. Pence, determines that traveling through Italy or other known major contagion areas doesn't need to be checked I'm sure that they know best and are totally on top of this incredibly great best-ever response effort.

    Only someone trying to spread a hoax and bring down the president with fake news would think otherwise! :(

    +1
    Gary1952,

    Thanks for your detailed thoughts.

    Mona
  • @Mona - I don't think Gary understands the sarcasm spewing from OJ but I could be wrong. There is a Gary who is a strong 45 believer.
  • Mark said:

    @Mona - I don't think Gary understands the sarcasm spewing from OJ but I could be wrong.

    There is a Gary who is a strong 45 believer.

    1952

  • As a primary care internist with 30 years of medical practice I have to agree with all of the above, with some caveats about ZINC. This quote comes from one of the best professional online medical textbooks ( anosmia is lack of smell)

    "Zinc — Although zinc sulfate lozenges and syrup may decrease cold symptom severity and duration, we suggest not using zinc preparations because of uncertain benefits and known toxicities, including irreversible anosmia when administered intranasally. Systematic reviews have found that zinc intake is associated with a reduction in the duration and severity of cold symptoms [19-21]. In one review that included 16 therapeutic trials (five included only children and the remainder both adults and children), various zinc preparations were taken every 1.5 to 2.0 hours while awake for a minimum of five days [21]. Zinc administered within 24 hours of onset of cold symptoms, compared with placebo, resulted in a decrease in the proportion of participants who had symptoms after seven days of treatment (odds ratio [OR] 0.45, 95% CI 0.2-1.00). The trials used a variety of zinc formulations (syrup, tablets, lozenges) and doses, and no firm conclusions could be drawn about specific treatment recommendations. Another review found that zinc doses greater than 75 mg daily were effective in reducing the duration of symptoms, but lower doses were not [19]. Another systematic review of 17 trials found that zinc reduced symptom duration (mean difference -1.65 days, 95% CI -2.5 to -0.8) in adults; there was significant heterogeneity among trials [20]. Adverse effects, including bad taste and nausea, were common in the zinc group in all reviews.

    The US Food and Drug Administration (FDA) issued a public health advisory advising that over-the-counter zinc-containing intranasal products (Zicam) should not be used because of multiple reports of permanent anosmia [22]. Zinc is also available in a homeopathic preparation as intranasal zinc gluconate for the treatment and prevention for colds. This formulation has also been found to cause hyposmia and anosmia [23]. Zinc sulfate preparations that are syrup or lozenges seem to be better tolerated than some tablet forms [24]."

    I would caution that THIS AFFECTS SYMPTOMS ONLY. There is no data that ZINC prevents Covid 19 from infecting your lungs (where the respiratory failure etc occurs).

    The Chinese and the WHO report have documented people continue to shed the virus up to three weeks after they get sick and after symptoms disappear.

    Thus if using ZINC makes your symptoms disappear quicker and you think you are well and not infectious you may be mistaken and increase the risk to those around you.


  • Yeah, this aligns with the views of docs at the Harvard Health newsletter, one of whom recently wrote that while zinc lozenges may well shorten the length of cold symptoms by a day or so, he himself found it hardly worth it, given how crummy it makes many feel, with GI upset, bad coloring of taste, and more. He would prefer the extra day of cold.
    I did the zinc lozenge thing (significant dosing) a couple months ago and felt quite lousy from it, but then developed the 3-week cold from hell anyway. Fwiw.
  • Thank you sma3!
  • @Mark- I really would prefer "emanating" rather than "spewing". :)
    Thanks- OJ
  • The entire WHO report is worth reading and not to technical. It has a lot of data on incubation periods etc.

    https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf

    The WHO believes the Chinese extreme methods helped to control things, but predicts that most countries will be unable to follow the same steps.

    https://www.sciencemag.org/news/2020/03/china-s-aggressive-measures-have-slowed-coronavirus-they-may-not-work-other-countries

    As measure of public concern, the price of Purell on Amazon is $80 for two 8 oz bottles!

    USA TODAY says rubbing alcohol much cheaper ( 16 cents an oz) or better yet you can use vodka!

    https://www.usatoday.com/story/money/2020/03/04/hand-sanitizer-recipe-purell-shortage-2020-coronavirus-prevention/4947807002/

  • I'm sure that Gary1952 didn't realize that OJ's comments were snark! The phrase "incredibly great best-ever response effort" was a clear giveaway .
  • edited March 8
    ...
  • @johnN

    >> According to the left media : 70-80% will get it and die because they dont have universal insurance coverage. Trump did create and cause the virus /usa to be worsen. Mass casualties for sure and we should bunker up/head for isolation where there are no people

    jesus, give it up, man
  • edited March 8
    Sorry for insensitive comments above.

    Media might be overdrive/panicking and overkill. Think we may have more patients die annual from flu

    Talked to my internist whom knew specialist/ infectious diseases - they strongly recommended get annually flu vaccine, along with pneumonia vaccines (need updated once turn 65 years old, and pneumonia-23 if you already got the pneumonia-13vacc last year). Keep your immune optimized/healthy by drinking plenty fluids, restful mind/body maybe need centrum vitamins supplements, eat plenty of vegfies/fruits well balance meals and exercise. Quit smoking. These are few additional pointers maybe helpful to prevent problems especially if 60 years or older. Personally hygiene hand washings are very helpful

    Patients less 60 years old usually recover 99%

    Upwards 80s%-85s% atients show no symptoms or mild symptoms. Others may have more respiratory severe flu symptoms. No conclusive initial swab tests, some show false negative. Death 3.4% but maybe drastically reduced once have more data.
  • johnN said:


    Media might be overdrive/panicking and overkill. Think we may have more patients die annual from flu

    Patients less 60 years old usually recover 99%

    Meaning that 1% of patients under 60 don't recover - a euphemism for "die". Of course fatality rates for those over 60 are much higher (and about 21% of the US population is over age 60), but let's work with the 1% figure.

    The CDC estimates that over the past decade flu deaths in the US have ranged from 12,000 to 61,000.

    If the death rate of COVID-19 is "just" 1%, then for the number of deaths to be under 64,000, it would be necessary for more than 98% of the population not to contract the virus.

    2% getting the virus x 323M people x 1% fatality rate = 32,300 fatalities.

    "Think we may have more patients die annual from the flu". Perhaps you'd like to rethink that.
  • @old_Joe, There are experienced doctors who are being deploy to head up this effort. I came across this NYT article from Apple News. Dr. Deborah L. Birx who oversaw the global AIDS epidemic during the Obama administration is also involved.
    https://nytimes.com/2020/03/06/us/politics/coronavirus-trump-deborah-birx.html
  • @Sven- thanks very much for that article. It's reassuring to know that this administration has actually put a competent doctor in a responsible leadership position.

    Regards- OJ
  • edited March 13
    https://www.google.com/amp/s/www.mercurynews.com/2020/03/13/coronavirus-myths-and-misinformation-debunked/amp/

    Coronavirus myths, debunked


    So many myths out there

    Seems Many socialmedua-scientists now 'know' more about coronavirus now in few months compared to AIDS epidemic ( since late 1970s)
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