THE curve is starting to flatten. A major factor that has reduced the viral spread, the infections, and hospitalizations is people’s final compliance with the behavioral modification recommended by the medical authorities, which is encapsulated in this acronym:
Cover face to scratch, sneeze or cough
Omit non-essential travels
Intensive hand washing
Distancing is now social
In dealing with infectious diseases, discipline is essential, or even existential. As COVID-19 has taught us, it could be a matter of life and death. This is a DIY common sense strategy basically saying “get out of the war zone to avoid bullets and bombs.” No brainer! Wisdom and discipline are still the most effective weapons in avoiding any infectious diseases, preventing spread, and reducing risk of death.
Studies have shown that a mask alone does not provide effective protection against any virus for the wearer. Social distancing on top of using a mask (properly, to cover nose and mouth, as snugly as possible) affords much better protection, both for the person and those around, at least 6 feet away. Doubling the mask, or with coffee filter under the mask, is even better, even home-made ones, using tightly knit cloth material (the less sunlight going thru it, the better), in double or triple layers. Plastic face cover or large clear plastic goggles, even over prescription glasses, are very useful protective gear, combined with a cap, mask, and gloves. Masks and gloves may be washed with hydrogen peroxide or UVC sterilization lamp.
Civil rights during a war?
Remember those students on spring break on the Florida beaches who challenged the “stay home” advice, claiming they had civil rights to do what they wanted to do with their body and to enjoy as they wish, some of them had tested positive for COVID-19. Also, if some people want to risk their life, they have the right to, even to kill themselves, but they have no right to cause harm or death of others, especially the most vulnerable ones.
Last Saturday, a struggling man was hauled off, literally carried out of a bus by several police officers in Philadelphia for refusing to wear a mask, which was mandated in that city. These are the people with twisted thinking who were responsible for the massive spread of the COVID-19 infection, more than 2 million and 125,000 deaths around the world, more than 600,000 cases with greater than 25,000 deaths in the United States, and more than 5,300 cases and more than 340 deaths in the Philippines. And counting…
Had everyone followed the do-it-yourself C-O-V-I-D strategy and stayed home (for those who could), since the first week of March, the mitigation of the spread would have been curtailed to about half of what it is today. Indeed, common sense dictates that to save lives during a deadly pandemic like COVID-19, all of us have to do our share in society and sacrifice some of our liberties that get in the way of fighting and defeating a vicious killer enemy. During a war, a lot of sacrifices must be made to achieve triumph.
Hopefully, all of us (almost 7.8 billion on planet Earth) have learned a great lesson on discipline and human survival during this global catastrophe and are now armed with more wisdom for the remainder of COVID-19 and for future calamities.
To clarify some subtlety in the ongoing debate on the treatment for COVID-19, using hydroxychloroquine, a safer derivative of chloroquine, an old drug since 1934 which was used during WWII for malaria, later for lupus, rheumatoid arthritis. It is being tested now as an off-label use for COVID-19, as suggested by President Trump, because clinical studies in France, Italy, China, and Korea show hydroxychloroquine plus azithromycin, and zinc, were an effective trio for COVID-19 patients. While it is ideal to have randomized, double-blind clinical studies on drugs and an approval from FDA, its urgent use is recommended in the absence of any proven effective drug against COVID-19 and vaccines are a year-and-a-half or two away. This is a global emergency and time is of the essence. Patients die by the hundreds each day. Since hydroxychloroquine, azithromycin, and zinc are all FDA-approved drugs for decades, and the foreign trials revealed they could save lives, it makes sense to try this regimen on an emergency situation, which has infected more than 2 million around the globe.
Hydroxychloroquine was, in fact, used during the MERS and SARS pandemic, and the mother compound, quinine, was used in the 1918 Spanish Flu pandemic that killed about 500,000 million, about one third of the world population then. Some antiviral drugs, remdesivir, favipiravir are also being tried in various nations today. In the absence of a definitive cure, it is logical to try reasonable drugs in our armamentarium to save lives, while more than 70 vaccines are being studied right now.
Azithromycin, the antibiotic approved in 1991, is knowingly used with hydroxychloroquine to treat the bacterial complication of pneumonia, which is the final killer of COVID-19 patients. The lungs become inflamed, then scarred and stiffened, and stop allowing oxygen transfer, causing the shortness of breath that starts as mild progressing to very severe, necessitating the aid of a ventilator. When the lung damage affects most of the lungs, even the ventilator is unable to provide oxygen and the patient expires.
The less known good side-effect of azithromycin and another antibiotic, doxycycline, is their ability to inhibit protein synthesis, which then disables viral replication. This inability to replicate itself will deactivate and destroy the virus. Washing hands with warm water and foamy soap destroys the protective fat around the virus, leading to its deactivation and destruction. This virus, SARS-CoV2, causing COVID-19, is actually very easy to destroy, as virulent and deadly as it is. But our attack against it should be early, pro-active, and pre-emptive.
A side note: Azithromycin, doxycycline, even metformin (for diabetes), have properties that inhibit mitochondrial activities, thus acting as anti-cancer and also prevents cancer metastases (spread). With those same properties, these three drugs could also destroy senescent (senile) cells and act as anti-aging agents.
We have received several questions as to which disinfectants are effective against the virus causing this pandemic. The SARS-CoV2 virus, as we stated earlier, is easily destroyed by foamy soap and warm water. For countertops, desks, cellphones, tablets, etc., isopropyl alcohol at least 70 percent (91% is better, even as on-the-go hand-sanitizer), 3% hydrogen peroxide, chlorine preparation (spray, wipes) are all effective. If needed, a mixture of 2 tablespoonfuls of chlorine bleach added to 1 quart water, or 5 tablespoonfuls (1/3 cup) of bleach in one gallon water is useful against SARS-CoV2 virus. After applying any of these solutions for cleaning, make sure you wash your hands with water thoroughly. None of these is for body application. There are many other formulated brands of disinfectants on the market.
Contrary to fake news, alcoholic beverages and most hand sanitizers are ineffective for viruses since the common ones have lower than 75% alcohol content. Kitchen vinegar, usually 5%, is useful for regular cleaning at home, as antibacterial, antiviral, anti-calcium, but there is no evidence it is effective against SARS-CoV2 virus. WARNING: Beware of fraudulent claims and scammers peddling false cures.
The use of inactivated convalescent plasma (ICP) obtained from the blood donated by patients who have recovered from COVID-19 was found to be effective in patients in China, as reported by a study in the Proceedings of the National Academy of Sciences. Two hundred ml. of the ICP was infused to patients with severe COVID-19 and “all symptoms in all patients disappeared or largely improved within 1 to 3 days. Viral load was undetectable within 7 days in seven patients who’d had viremia. There were no serious adverse reactions.”
This, too, is being tried in the United States, and many other nations around the world with encouraging results. An old version of this regimen, same principle, has also been used in the 1918 Spanish Flu pandemic.
The statistical curve is starting to flatten, but we cannot let our guard down yet. We do not know who among the millions of untested individuals are positive and infectious. After another 4 weeks, they would either be well or be symptomatic. Then we will know and continue our vigilance, together with the authorities, till COVID-19 completely disappears, albeit reinfection/resurgence are possible.
Let’s pray and have more patience and endurance. This, too, shall pass.
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 protected]