“Each of us has a vital role to play to defeat this invisible killer. And our personal behavior and action will impact the lives of countless others.”
More than 90,000
The total global cases of COVID-19 in 212 countries (Antarctica zero case) is about 4,300,000, and almost 300,000 deaths. The healthcare front liners infected with COVID-19 worldwide is about 250,000, killing more than 15,000 of them, The USA leads the list with almost 1.4 million cases of COVID-19 and 83,000 deaths, with New York at the top with about 348,000 cases and more than 27,000 deaths. China has almost 8,300 and more than 4,600 deaths. The Philippines has almost 11,500 and nearly 800 deaths.
The number of “despair deaths” in the United States could go higher than 150,000 (double the earlier projection) by alcohol abuse, drugs, and suicide, induced by this COVID-19 pandemic, if nothing is done, according to the Well Being trust and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care (MMN).
COV-Idiots fanning the flame
Irresponsible, selfish, and reckless members of society, are fanning the flames of this COVID-19, delaying its end and making the crisis worse, by not complying with the government guidelines to stem the spread of SARS-CoV2, and some even protesting on the streets, without mask and glove. The spike of cases in places which recently opened the small business seems to suggest the timing might still be premature in some States, and outbreaks might recur. The civil rights of the individual must be weighed against the civil rights of the majority, of society as a whole. If we let our guards down too soon, we shall lose all the progress we have made so far in defeating this pandemic, and kill thousands more. The economy is very important. And so are people’s lives. Wisdom and prudence are essential at this time.
COVID-19 cardiac damage
The SARS-Cov2 virus does not only targets the lungs, but the heart also, and other organs, eventually. Cardiac dysfunction is the common cause of death among confirmed COVID-19 patients, where inflammation of the heart muscles (myositis, with ST segment elevation in EKG) leads to heart failure, heart attack, and cardiogenic shock that kills the patient, besides the pneumonia.
Experiences around the world now shows hydroxycholoroquine is not effective to prevent or treat COVID-19, as a matter of fact some studies showed that this anti-malarial drug had cause cardiac deaths among some patients. A Veterans study in the USA has reported the same. Those COVID-19 patients who claimed to have been saved by this drug, obviously, would have recovered without it, and were healthy enough not to have had the fatal torsades de pointes.
Remdesivir not game changer
The world was rejoicing when Gilead announced its antiviral drug, remdesivir, won the FDA’s emergency approval for use in COVID-19. But a randomized, double blind, placebo-controlled study in ten hospitals in Hubei, China, among 237 patients, reported by The Lancet journal, found no significant statistical benefits among those patients treated with remdesivir compared to those on placebo. There were some numerical reductions in some clinical parameters but not enough to make a statistical difference in recovery and survival. More studies are ongoing around the world.
Children toxic shock from COVID-19
When novelCorona virus outbreak started, everyone thought it only affected seniors, especially those with health issues and people with compromised immune system. Now, we know more about this SARS-CoV2 virus and found out that young people (below 50, teenagers, and young children) could also be infected and die from COVID-19. Lately, in London, as in China earlier, reports came out in The Lancet medical journal about COVID-19 pediatric patients who developed hyper-inflammatory shock similar to deadly Kawasaki Disease shock syndrome in the United States.
Beware of Quack Hack
As we have warned our readers in our initial write-ups about COVID-19, various forms of scams and fraud are being perpetrated by the unscrupulous and greedy, taking advantage of this crisis, where panicky misinformed people are groping for any means of protecting themselves from this killer virus. There are dishonest practitioners around the globe prescribing their own “ingredients” as preventive or curative potion or lotion, or even injection, against COVID-19. These quack hacks are the snake oils of the past centuries. Thieves of every kind seem to exploit this current human tragedy, all in the name of money. The US-FDA has started to crack down on these fake products and price gauging. So far, 29 out of 42 fake products (drugs, testing kits, etc.,) investigated are no longer sold. People are requested to report any scam or fraud to the FDA. WARNING: At this time, there is still NO effective drug, herbals, substance, beverage, food or injectables that will effectively prevent or cure COVID-19. Nothing. So, don’t waste your precious money.
The preventive strategy
The only proven and free tactic in this war is to Fight COVID-19 with C-O-V-I-D, as we advocated with this acronym a few weeks ago in this column:
Cover face to scratch, sneeze or cough;
Omit non-essential travels anywhere;
Distancing is now social.
Blood thinner improves survival
One of the clinical observations with COVID-19 infection is that it promotes coagulation (thickening of blood, blood clots, and blockage of arteries and veins) which complicates the illness and contributes to mortality. This experience led to the use of blood thinner with good results (improved survival) among 3000 patients in New York, especially striking among those on mechanical ventilators, with almost 34 percent greater survival. There was also another study that involved 5,000 cases, confirming the same. The expert recommendation now is for “all hospitalized COVID-19 patients to receive prophylactic dose of low molecular weight heparin (LMWH), unless they have contraindication.”
Pepcid and SARS-CoV2
Gastric acid suppressor drug famotidine (Pepcid), use to treat stomach acid reflux, was recently touted to inhibit replication of SARS-CoV2 virus (COVID-19) and decreased by two-fold the COVID-19 deaths. The observation is still anecdotal and needs double blind randomized clinical trials to confirm or deny these claims.
Obesity increases COVID-19
The risk to acquire the COVID-19 infection and the mortality rate among obese patients are much higher than those with normal weight. This includes the “healthy obese,” overweight individuals without other health issues (high blood pressure, diabetes, heart disease, etc.) In general, more than 85 percent of the healthy obese would eventually develop high cholesterol levels, and those illnesses listed above. Exercise and diet are vital.
The experts believe a second or more waves of COVID-19 is possible, as they happened in the 1918 pandemic that wiped out more than 50 million people around the world, and the other pandemics thereafter. In Singapore, which had aggressively dealt with COVID-19 very early and had strict measures and contact tracing, there was a strong resurgence in crowded dormitories. The same recurrence in Japan and Korea.
Days after North Carolina relaxed some of its stray-home rules, a new high of 443 cases in one day was confirmed. The potential waves of COVID-19 will depend on people’s behavior and discipline. We, the people, are the transmitters/spreaders of this killer virus. This current pandemic might go beyond this year and early 2021 before it ends. In the meantime, it behooves each one of us to be wise, responsible, and prudent in following the guidelines, and stay safe. We cannot simply leave it to the government. Each of us has a vital role to play to defeat this invisible killer. And our personal behavior and action will impact the lives of countless others.
Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, a Health Advocate, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Websites: philipSchua.com and FUN8888.com Email: email@example.com