Tag Archives: Sterling Medical Advice

Concerns about the COVID-19 Fall Surge

Introduction

Let’s consider concerns you may have about the expected COVID-19 fall surge. That’s right. We’re expecting a surge. The pandemic is only about halfway through it’s expected duration. We don’t think it’ll end until an effective vaccine is developed or until about 70% of the population has been infected. Let’s admit that relative to decreasing the load of the virus causing COVID-19 throughout American communities, we’ve had a disappointing summer. It’s time to turn the corner. This Straight, No Chaser discusses the various factors that we should consider for what comes next.

COVID-19 Fall Surge Concerns to Consider

Schools are open.

It is younger people fueling the late summer and COVID-19 fall surge – not the elderly or immunocompromised, who are still considered high-risk. Dr. Fauci says many younger Americans, who typically have milder cases, have a “lack of appreciation” for the “dual responsibility” they have in keeping themselves safe so they can keep others safe.

Businesses are open.

It is still part of our concern that “essential workers” are too often those at the highest risks for bad outcomes from COVID-19. Our inability to provide sufficient prevention, testing and treatment poses the same risks now as they did months ago. This didn’t go away with the summer and will increase when folks are forced to travel and work within enclosed spaces amongst others.

Unemployment is still high.

Let’s acknowledge the effects of mental health. Unemployment in upwards of 50 million Americans will continue to take a toll.

Approximately 150,000 American families are mourning the loss of a loved one.

Again, stress comes in many forms. The trigger of death in our families and around us will linger and deteriorate our mental health as things expand in the fall. Lend a hand to a friend or neighbor.

Preventive efforts are not being ideally utilized.

If we continue along our current trend, people will continue to get sick, eventually needing hospitalization. If hospital beds are still being used for COVID-19 when influenza hits, there will not be enough space for both influenza patients and coronavirus patients seeking medical care—which would likely cause the death rate to rise.

Influenza is both an independent killer and a co-conspirator with COVID-19.

This combination likely will place a tremendous burden on the health care system. This includes bed occupancy, laboratory testing needs, personal protective equipment and health care worker safety.

There still is no effective treatment.

There is no effective preventive treatment. The efforts being made are for patients at death’s doorstep. This is not an effective approach to lessening disease burden.

There still is no effective vaccine.

Despite the ongoing discussions, the presence of a vaccine available for the general public isn’t likely to occur until the first or second quarter of 2021. Even so, surveys are suggesting that less than a quarter of Americans are inclined to take one, even if approved. Failures to be ready for the COVID-19 fall surge will limit public confidence moving forward.  Don’t think this pandemic has normalized! Let’s stay ahead of the upcoming dangers of the COVID-19 fall surge. Know better. Do better. Be better.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
 
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CDC Revision of Advice on COVID-19 Transmission from Touching Surfaces

Information

This post addresses COVID-19 transmission from touching surfaces. Today’s advice to you is not to confuse the reporting of science with information. Huh? The screaming headline of the day is an important piece of scientific nuance. Covid-19 is less likely than thought (and just unlikely to be spread) via contact with surfaces. However…

Simple Take Home Messages about COVID-19 Transmission from Touching Surfaces

Now what are you supposed to do with this information? Unfortunately, low-information users will ignore the nuance and declare “America is reopen. It’s back to business as usual.” That would be an incorrect use of the information. Here are the appropriate take home points.

  1. The disease’s primary method of transmission remains via respiratory droplets delivered from another individual within close proximity. This most likely occurs from sneezing, coughing or other means of expelling droplets (singing, yawning, kissing, etc.).
  2. Contact transmission does still pose a significant risk. If you touch a surface containing the live virus and then place your unclean hands in your mouth, nose or especially your eyes, you can become infected.
  3. Embrace your new habits of cleanliness. Perhaps you don’t have to be obsessive about it, but hand washing use of sanitizers and disinfectant wipes should be part of your new normal. Just not necessarily on your lettuce.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
 
Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

Challenges and Guidelines for Returning to School

Introduction

This Straight, No Chaser looks at challenges and guidelines for returning to school. First, here are two questions for your consideration. What would happen if all college students were asked to take a gap year during the 2020-21 academic year? Is that a better or worse scenario than accepting the risk of sending kids and young adults back to mass gatherings in the midst of a pandemic?

How Can We Come to the Right Decision?

Somewhere in between Notre Dame announcing a return to school schedule and Oxford University deciding that all of this academic year’s classes will be done online is where most schools will end up. However, what’s the right decision for you and your family? Colleges and universities are rather expensive. The college experience, inclusive of athletics, club activities, fraternities and sororities, is an important part of the equation. Most of that will be (should be) gone for the upcoming academic year. Even efforts to create a sense of normalcy are fraught with risk. Doesn’t the entire “go back to school thing” include a massive assumption that the pandemic environment will improve by the fall moving into the winter? Where is the evidence for that? Are you willing to accept that risk? At what financial cost? Aren’t schools about the easiest way you can imagine to rapidly extend and expand an infectious disease? Keep in mind that the presence of just one case will likely cause any given school to again shutter its doors. Remember, the issue isn’t that the students are at advanced risk for death. The issue is teachers, support staff and family members within proximity of commuter students may be.

CDC Guidelines for Returning to School

Even so, in acknowledging America’s ill-advised rush to return to normal, the CDC has put forth a list of 11 guidelines, all of which must be met before a school should even consider reopening.

Items to first consider

  • Will reopening be consistent with state and local orders?
  • Can the school protect children and employees at higher risk for severe illness?
  • Can students and employees be screened upon arrival for symptoms and history of exposure?

Are recommended health and safety actions in place?

  • Are capabilities for healthy hygiene practice in place?
  • Has the school intensified cleaning, disinfection and ventilation?
  • Are social distancing measures feasible and implemented?
  • Are employees trained on health and safety protocols?
  • Have measures for ongoing monitoring but put in place?
  • Are procedures to check signs and symptoms of students and employees on a daily basis in place?

Are procedures to have the sick stay at home in place?

  • Is there a regular communication strategy to engage students, employees, families and local authorities in place?
  • Are monitoring and student leave policies in place as needed?
  • Are coordination and communication strategies in place with local health authorities?

What to Do?

See, this is a high bar to reach, and it should be. Implementing these guidelines will be a Herculean task for any school, much less for all schools. It is foreseeable that the better course of action leans toward an emphasis on the educational component of school and less on the social component. Accordingly, the best reopening strategies will focus more on at a distance learning components than the more familiar in person scenarios. The very last thing any of us needs is a national panic based on a reemergence of the disease, based on seeding at schools and colleges. COVID-19 doesn’t care about your frustration or other priorities. Remember, the most likely of the optimistic scenarios is that a COVID-19 vaccine will be available during the summer of 2021. Until then, our actions will most likely worsen the situation, resulting in additional lives lost. Choices have consequences. Choose wisely.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

A Call to Adjust Priorities within our Healthcare System

Introduction

This Straight, No Chaser makes a call to adjust priorities within our healthcare system. Can we take a moment and reflect on how poorly designed our healthcare system is? If COVID-19 has done anything (besides killing over 80,000 Americans – and counting), it has shown us how our outcomes are the consequences of our choices and priorities. The American health care system is the world’s best at identifying and treating diseases and their complications. It is not nearly as good at promoting health and preventing disease. Clearly these last two considerations aren’t the same. Sadly, stressors like COVID-19 reveal how fragile our public health infrastructure is. The diseases display the limits of waiting for disease to appear to begin a response. This is true even before you address healthcare disparities, which exist between rural and urban areas, various ethnic groups and within socioeconomic classes. It’s time to stop just lamenting our current level of unpreparedness.

A Call to Change

I again make a call for a revisiting of our public health system and placing health promotion and prevention on an equal footing has curative care considerations. This is consistent with the modern need for patients to assume more responsibility for their own care between physician visits. Prioritizing this level of activity also strengthens individuals for those times when diseases arise. The COVID-19 pandemic must be viewed as not a once in a lifetime pandemic as much as an examination of our system. It reveals real opportunities for improvement but for transformation of our healthcare system. It’s time for innovation.

Enough With Only Addressing Sick Care

It’s time to stop viewing the emergency room as an appropriate portal of entry into the healthcare system for over 20 million Americans. This leaves individuals presenting with advanced disease in imminent risk of death. How can that be viewed as an acceptable option? It’s time to start reprioritizing health as a way of life. We must weave the notion of health promotion into the fabric of society and have individual communities educated, engaged and empowered. Let’s stop playing games and politics with that which translates into length and quality of life. Let’s stop primarily viewing healthcare as a driver of 17% ($3.5 trillion) of the US economy and start viewing its delivery as a fundamental part of what it means to have a society.

Imagining the Future

How can it be viewed as a bad thing to have an infrastructure in place that allows us to stay ready instead of having to get ready. Imagine an America with a national infrastructure inclusive of personal protective equipment (PPE) already in a state of readiness, as we do with military bases? Why not have a national screening apparatus in place waiting to be deployed? Instead of just slotting emerging healthcare professionals into curative care professions, let’s prioritize the development of exclusively preventive care professionals. These initiatives amount to way more than ounces of prevention. This reconfiguration of healthcare provides jobs, better health care outcomes and a more efficient system all around. I have recently created an organization along these lines. America’s first managed preventive health care organization, named SIMPCO, will be addressing these challenges in communities around the world. Doing so successfully will allow us to better address spontaneous eruptions like COVID-19 when they arise without hundreds of thousands of excessive lives lost beyond the unavoidable. Much of what we need to be successful lies in the hands of individuals to know better, do better and thus, be better. The future is upon us. Knowledge is health.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
 
Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

Dr. Sterling’s Recent Media Appearances

Introduction

This Straight, No Chaser features some of Dr. Sterling’s recent media appearances. View this, and get answers to many of your questions!

Recent Media Appearances

Recent Media Appearances on WGN

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
 
Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

CDC COVID-19 Update

Introduction

This Straight, No Chaser offers this week’s CDC COVID-19 Update.

Weekly Highlights

  • Nationally, the percentage of laboratory specimens testing positive for SARS-CoV-2 was similar but slightly decreased, compared to last week.
  • Nationally, visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline. They are now below baseline nationally and in many regions of the country. They remain elevated in the northeast and northwest.
    • The decrease in the percentage of people presenting for care with influenza-like illness (ILI) and coronavirus-like illness (CLI) may be due to a decline in COVID-19 illness. Reported levels of activity may be decreasing because of widespread adoption of social distancing efforts and changes in healthcare seeking behavior.
    • Little influenza virus activity has been reported in recent weeks.
  • The overall cumulative COVID-19 associated hospitalization rate is 40.4 per 100,000, with the highest rates in people 65 years and older (131.6 per 100,000) and 50-64 years (63.7 per 100,000).
    • Hospitalization rates for COVID-19 in adults (18-64 years) are higher than hospitalization rates for influenza at comparable time points during the past 5 influenza seasons.
    • For people 65 years and older, current COVID-19 hospitalization rates are similar to those observed during comparable time points during recent high severity influenza seasons.
    • For children (0-17 years), COVID-19 hospitalization rates are much lower than influenza hospitalization rates during recent influenza seasons.

More Data

  • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 23.6% during week 16 to 14.6% during week 17 which is still significantly above baseline. This is the second week of decline in this indicator, but the percentage remains high compared with any influenza season. The percentage may change as additional death certificates for deaths during recent weeks are processed.
  • Declines in some key indicators used to track COVID-19 from one week to the next could change as additional data are received but also may be a result of widespread social distancing measures.

All of this points out that things are still quite deadly but are slightly improving. Stay safe.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
 
Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

Why Testing for COVID-19 Still Matters

Introduction

This Straight No Chaser addresses why testing for COVID-19 still matters.

We’ve diagnosed 1 million Americans with COVID-19. The US is testing at a rate of 16.4 tests per 1,000 people (Comparatively, Spain and Italy – the countries with the second and third highest number of cases – have tested 22.3 and 29.7 tests per 1,000 people respectively). We’ve only tested 4 million citizens overall, representing 1.2% of the population. Simply put, we want to reengage.

Which Approach Will We Take?

There are two approaches to this.

  • We can essentially roll the dice and send citizens back into an unknown environment. Georgia did this, reopening without having met any of the criteria set by the governmental task force.
  • We can quantify the extent of disease and act accordingly.

This isn’t even about stay at home considerations at this point in the conversation. The goal here is to impart some intellectual honesty into the conversation. The goal is to make sure you understand that what happens in the fall is contingent on what happens now. There obviously is an equivalent of willful ignorance occurring at the federal level. Not only do we not have a sufficient number of effective tests, but there are ongoing shortages of the materials needed to run these tests.

There has been no serious implementation of the Defense Production Act that would compel business to create what’s needed. Without testing, we won’t detect new infections. We can’t engage in contact tracing. We can’t have intelligent discussions about when communities specifically need targeted isolation.

The Path Forward

The Rockefeller Foundation recommends expansion of the US testing capacity to 3 million tests per week for the next two months, followed by 30 million tests per week for the next six months. Yes, it’s calling for a marshaling of the nation’s resources to make this happen. It’s in the national public health and economic interest. Harvard has made a similar calling for ongoing testing.

Those would argue against vigorous testing at this point are not only being willfully ignorant but are contributing to the second wave of cases that will emerge in the fall. Forewarned is forearmed. If you live in one of the increasing places that are offering tests, please go get tested. It’s not just about you. Your apathy is directly contributing to the deaths of those most vulnerable. Know better. Do better. Be better.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
 
Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

Available Personal Protective Equipment – Last 2 Days of Free Shipping!

Available Personal Protective Equipment

Act now! Secure your families and your health with the following.

  • We’ve been offering 3-layer protective surgical masks for a few weeks now and continue to do so.
  • We’re now offering gloves because COVID-19 can be transmitted from surfaces to your hands. From there it can get within you through contact with your eyes, nostrils and mouth. Using gloves reduces the risk of this happening. Please use the gloves episodically instead of all day, lest you’re just transmitting germs the same as you would with your hands.
  • We’re offering two sizes of hand sanitizer: a 4 oz version with aloe vera and a 3.3. oz version without. Both exceed the 70% alcohol content necessary to be effective against COVID-19.
  • We’re also offering disinfectant wipes for you to clean your surfaces.
  • Finally, we’re providing no-touch digital thermometers. These should be a part of your daily routine as a screening device.
We’re taking preorders on all items, and they will ship as available. We expect to fill orders on all items on or before May 8th. Use the code SAFE for free shipping between now and May 1st. We hope you receive this in the spirit intended. Protect yourselves and your family. Behave as if you’re already infected and don’t want to spread it to anyone else. We can help. Order at www.jeffreysterlingmd.com. Stay safe.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd. Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

PPE For the Public!

Introduction

This Straight, No Chaser asks a straightforward question: Where’s the PPE for the public? Much has been made of the need to care for our first responders. I get that. I’m one of those, and I thank you for your support and encouragement. I am also concerned about first exposed. As data rolls in, we see healthcare disparities exist in certain communities and among certain socioeconomic classes. At this point, there hasn’t been much of anything said about getting personal protective equipment (PPE) into the hands of these individuals and the public in general. As many are preparing to reenter the workplace – or even if you aren’t – you are much better off with some basic supplies, which my team has arranged to be available for you.

PPE for the Public

These include the following:

  • We’ve been offering 3-layer protective surgical masks for a few weeks now and continue to do so.
  • We’re now offering gloves because COVID-19 can be transmitted from surfaces to your hands. From there it can get within you through contact with your eyes, nostrils and mouth. Using gloves reduces the risk of this happening. Please use the gloves episodically instead of all day, lest you’re just transmitting germs the same as you would with your hands.
  • We’re offering two sizes of hand sanitizer: a 4 oz version with aloe vera and a 3.3. oz version without. Both exceed the 70% alcohol content necessary to be effective against COVID-19.
  • We’re also offering disinfectant wipes for you to clean your surfaces.
  • Finally, we’re providing no-touch digital thermometers. These should be a part of your daily routine as a screening device.
We’re taking preorders on all items, and they will ship as available. We expect to fill orders on all items on or before May 8th. Use the code SAFE for free shipping between now and May 1st. We hope you receive this in the spirit intended. Protect yourselves and your family. Behave as if you’re already infected and don’t want to spread it to anyone else. We can help. Order at www.jeffreysterlingmd.com. Stay safe.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
 
Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress
ask your physician

Ten Recommendations to Get America Ready to Safely Reopen after COVID-19

Introduction

This Straight, No Chaser offers ten recommendations to help us be ready to safely reopen from the COVID-19 pandemic.

Question of the Day

I received a great question via social media. Here it is. “What would you do today going forward? What is past is over, we can hopefully learn from it, but we can’t undo what has occurred, so if you were President, what would you do now?”

Answers

The short answer: if you want to safely reopen, start from scratch. We still have to get our arms around the pandemic. It’s all about the fundamentals in anticipation of when we can reopen.

1. Start with enacting the Defense Productive Act and get masks, gloves and sanitizers for an entire damn nation. This would bring manufacturing and jobs back to America.

2. Nationalize a 21-day stay at home dictate.

3. Use the National Guard in large cities to enforce the stay at home dictate. Just say no to gyms and nail salons (love you when it’s safe, though!)

4. Use a stimulus to fully compensate individuals and businesses below a certain income level every month until recovery.

5. Test everyone with the risk factors translating into disproportionate deaths (which isn’t the same as “everyone”)

Here’s Five More

6. Use contact tracing and further quarantine these individuals as dictated by symptoms (in the absence of testing).

7. Incentivize America business to win the race for a vaccine and effective treatment.

8. Use this as an opportunity to decouple health insurance from employers.

9. Open up enrollment for the Affordable Care Act for everyone losing their job.

10. Expand hospital capacity in urban areas and ensure both rural and urban hospitals have sufficient ventilator supply. Do you think this sounds better than the alternative? If these were implemented by now, we’d have been well on our way to safely reopen.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting thes product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress  

The COVID-19 Endgame You Want to Avoid

Introduction

This Straight, No Chaser asks you to think about the COVID-19 endgame.

Remember the notion that COVID-19 will disappear with the warm weather? It’s a pretty embarrassing misapplication of logic and another illustration that correlation is not causation. The virus lives inside of us, and you’ll recall that our temperatures approximate 98.6 degrees, right? This virus doesn’t live and die based on a temperature-based light switch that you turn on and off, so please stop it with that line of rationale.

What’s important and more appropriate to state is there is a respiratory season in which certain diseases (e.g. influenza and COVID-19) are more common. The baseline of these diseases resets during the non-respiratory season. They then reemerge in the fall, often with mutations and new strains having developed. This is not the same as a disease being eradicated by warm weather. Please appreciate the difference.

Reopening is Reexposing

The backdrop of the current situation with COVID-19 is certain parts of the country are “reopening” to at-risk behavior. Let’s be clear. What we’re doing is reexposing the population. We are not declaring victory or giving the “all-clear” sign here. Based on what we know, this reexposure will maintain COVID-19 in the population at a higher baseline than would have otherwise occurred with sufficient stay-at-home and social distancing efforts.

Here’s the problem. When the next respiratory season begins, the curve will be launching from a higher baseline. Ideally, the number of cases year to year would resemble a series of curves. Instead, we are placing ourselves at risk for propulsion from the equivalent of a higher rung of a ladder. As infectious diseases go, this would allow a more trampoline-like effect than a gradual ascent.

As if that’s not enough, the CDC is now suggesting that the next launch of COVID-19 will occur in tandem with the launch of influenza. In other words, the next respiratory season will see us battling both diseases from the beginning of respiratory season.

All of this is to say our willful disregard of the past efforts we’ve made to defeat COVID-19 are quite dangerous. We aren’t close to being done or successful. We see states like Georgia, Tennessee and South Carolina rushing to reopen/reexpose outside of the federal COVID-19 Task Force’s recommendations. These choices will have consequences. Remember, there still is neither an effective vaccine nor an approved medical regimen. Just as was the case months ago, the future is predictable and foreseeable. What happens next is based on what we do now. Choose wisely, America. We really don’t want to do this again next year.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

When Stay at Home is the Wrong Choice

Introduction

This Straight No Chaser addresses when stay at home shouldn’t be governing your decisions in the midst of the COVID-19 pandemic.

When Time is Tissue

Let’s not get mixed messages about “Stay at Home.” COVID-19 is all the rage, but other diseases such as heart attacks, strokes and asthma will still end up killing more of us this year than the novel Coronavirus. When we ask you to stay at home, none of that should be interpreted as staying away when you have concerns about what could be an acute life-threatening emergency.

It’s great that people are becoming comfortable using telehealth and telemedicine to get minor concerns addressed and to obtain information and advice. Continue to do so. However, there are diseases for which “time is tissue,” meaning delays in diagnosis and treatment will likely be devastating. Below are a few links to Straight, No Chaser posts that help you appreciate when your first action needs to be getting to the emergency room instead of getting on the phone on the computer. Stay safe.

Straight, No Chaser Links for Critical Disease Recognition

When to Visit and Not Visit the ER

Stroke Recognition

Heart Attack Recognition

Asthma Exacerbations

Suicide Risk Recognition

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

Questions and Answers about Masks for COVID-19

ask your physician

Introduction

This Straight, No Chaser offers five questions and answers about masks to be used against COVID-19.

Wasn’t it first recommended that we not wear masks?

Yes, but that wasn’t based on science. It was based on prioritizing the scarce supplies of masks to the public. The supply sufficiently changed so that the recommendation changed. It was unreasonable to leave the public exposed with so many new cases and deaths occurring.

Why did the CDC recommend use of homemade masks?

The recommendation to wear scarves and homemade masks is also done in deference to healthcare and other essential workers, not because they work. The ideal public mask, inclusive of available supply, not exhausting needed supplies for hospitals and other essential workers, and effectiveness is a surgical mask. It is fair to assume that any next set of recommendations from national public health professionals will be along those lines. Don’t just take my word for it. Here’s Dr. Fauci’s comments: “When we get in a situation where we have enough masks, I believe there will be some very serious consideration about more broadening this recommendation of using masks…One of the best ways Americans can avoid infecting others — even if they aren’t showing any coronavirus symptoms — is to wear a surgical mask when they’re out in public.”

Aren’t N-95 masks better?

Yes, but you don’t need N-95 masks. The level of protection these masks offers is way above the concentration of virus to which you’re likely to be exposed. The extra percentages of protection come in handy in hospital and other treatment settings. Surgical masks hit the sweet spot for the public.

Are homemade masks effective?

They don’t offer the same level of protection as surgical and other types of masks. There are several studies that have found cotton mass only work about half as well as surgical masks. According to the CDC they are to be considered a last resort. The issue is homemade face masks don’t block some very fine particles in the air that may be transmitted by coughs or sneezes, so it’s not best for preventing someone who’s wearing one from contracting the airborne coronavirus. On the other hand, they do help to block larger respiratory droplets, they can keep you from spreading it to someone else. If you’re going to wear a homemade mask, ensure it’s made of thick cloth and creates a tight seal around the face.

How do you clean your cloth masks?

You’re best off handling them like a package. Consider them contaminated. Wash them in hot soapy water and occasionally sanitize them in bleach. This means if you’re using them, you should have quite a few that you use while you are washing the others.

It would be a fair prediction that everyone may soon be recommended to wear masks when out in public. The science for this is based on the ongoing ability to transmit the disease some 14 days after infection. Make sure you and your family are ready.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

Reopening America During a Pandemic: Phase One

Introduction

This Straight, No Chaser reviews the proposal criteria set by the Trump administration for phased reopening America and restarting the economy. This post reviews gating criteria for the states and Phase One of reopening.

Proposed State or Regional Gating Criteria

These are the criteria needing to be satisfied before proceeding to the phased opening.

Symptoms

  • Downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period
  • Downward trajectory of COVID-like syndromic cases reported within a 14-day period

Cases

  • Downward trajectory of documented cases within a 14-day period
  • Downward trajectory of positive tests as a percent of total tests within a 14-day period (flat or increasing volume of tests)

Hospitals

  • Treat all patients without crisis care
  • Robust testing program in place for at-risk healthcare workers, including emerging antibody testing

Guidelines for All Phases: Individuals

Continue to Practice Good Hygiene

  • Wash your hands with soap and water or use hand sanitizer, especially after touching frequently used items or surfaces.
  • Avoid touching your face.
  • Sneeze or cough into a tissue, or the inside of your elbow.
  • Disinfect frequently used items and surfaces as much as possible.
  • Strongly consider using face coverings while in public, and particularly when using mass transit.

People Who Feel Sick Should Stay Home

  • Do not go to work or school.
  • Contact and follow the advice of your medical provider.

Phase One for States and Regions that Meet the Gating Criteria

Phase One: Individuals

  • All vulnerable individuals should continue to shelter in place. Vulnerable individuals are the elderly and individuals with serious underlying health conditions, including high blood pressure, chronic lung disease, diabetes, obesity, asthma, and those whose immune system is compromised such as by chemotherapy for cancer and other conditions requiring such therapy.
  • Members of households with vulnerable residents should be aware that by returning to work or other environments where distancing is not practical, they could carry the virus back home. Precautions should be taken to isolate from vulnerable residents.
  • All individuals, when in public (e.g., parks, outdoor recreation areas, shopping areas), should maximize physical distance from others.
  • Social settings of more than 10 people, where appropriate distancing may not be practical, should be avoided unless precautionary measures are observed.
  • Avoid socializing in groups of more than 10 people in circumstances that do not readily allow for appropriate physical distancing (e.g., receptions, trade shows)
  • Minimize non-essential travel and adhere to CDC guidelines regarding isolation following travel.

Phase One: Employers

  • Continue to encourage telework, whenever possible and feasible with business operations.
  • If possible, return to work in phases.
  • Close common areas where personnel are likely to congregate and interact or enforce strict social distancing protocols.
  • Minimize non-essential travel and adhere to CDC guidelines regarding isolation following travel.
  • Strongly consider special accommodations for personnel who are members of a vulnerable population.

Phase One: Specific Types of Employers

  • Schools and organized youth activities (e.g., daycare, camp) that are currently closed should remain closed.
  • Visits to senior living facilities and hospitals should be prohibited. Those who do interact with residents and patients must adhere to strict protocols regarding hygiene.
  • Large venues (e.g., sit-down dining, movie theaters, sporting venues, places of worship) can operate under strict physical distancing protocols.
  • Elective surgeries can resume, as clinically appropriate, on an outpatient basis at facilities that adhere to CMS guidelines.
  • Gyms can open if they adhere to strict physical distancing and sanitation protocols.
  • Bars should remain closed.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

The Other Upcoming Pandemic

Introduction

This Straight, No Chaser looks at mental health as an equivalent of an upcoming pandemic.

The general American population (and perhaps the world in differing amounts) is about to get a up close look at what is known as social determinants of health. With another 5.2 million Americans filing for unemployment (raising the number to over 22 million over the last four weeks), we are reaching a critical mass of economic hardship. As a result, someone (everyone) needs to prepare for the mental health ramifications of this.

Mental Health Challenges

Here are some predictable scenarios, each with mental health consequences:

• Depressions (and even suicide rates) will explode.
• Individuals prone to post-traumatic stress will have flare ups. Also, others will develop an equivalent of it.
• Americans will be forced to choose between food and medicine. Unfortunately, others won’t have either as an option and will become ill (and die) as a result.
• We will become angry. Anger will be expressed; in some cases rightfully so, and it will be displaced inappropriately. Predictably, we have already begun to see demonstrations.
• In some instances, there will be violence. This will range from domestic violence to outward expressions. Sadly, everyone’s fuse is shortening.

How Will You Cope?

There’s so much more, but you should get the point. The question, of course, is how will you cope with the upcoming pandemic of mental health issues? Do you have the means, inclination and access to get help? Let’s start with self-help measures you can take. From there, just being mindful that these issues will be arising may convince you to get help when you need it. Also take the time to look after those you care for. Actually engage people in conversations about their mental health. For years, I’ve told patients that when I asked them how they were doing, it wasn’t a pleasantry but an actual inquiry. Care enough to do the same. We’re all in this together. When things “return to normal,” maybe show a little empathy for those for whom this has always been their normal.

Straight, No Chaser Posts on Mental Health

Stress Management

Developing a Stress Management Plan

Post-Traumatic Stress Syndrome in Communities

Depression: How to Avoid it and When to Get Help

Suicide Risks and Prevention

How to Escape a Domestic Violence Situation

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

Lingering COVID-19 Questions, from Reinfection to Reopening

Introduction

ask your physician

This Straight, No Chaser looks at some lingering COVID-19 questions. Many of these have been prompted by a recent study. According to Reuters, S. Korea has reported that at least 116 people who were thought to have recovered from COVID-19 have tested positive for it again. This is an introduction to the reality that there still remains much that we don’t know about this virus.

Consider These Distinct Possibilities

  • The virus could be mutating in real time. Patients are getting reinfected.
  • Instead of patients getting reinfected, the virus is reactivating. In effect, it finds a way to “come back to life.”
  • These events are simply a result of testing errors. Some percentage of false positive tests will occur. Over millions of tests, the expression of false positives become realized as these cases. Furthermore, if a patient’s treatment is stopped too soon as a result of a false positive test, the reemergence of symptoms will appear to be a reinfection.

Lingering COVID-19 Questions

These events throw what we know and believe into uncertainty. Here are a few questions that now come to mind that are the focus of upcoming research efforts.

  • Does positive antibody testing mean we’re immune? That is understood to be the case. However, if the novel coronavirus actually has the ability to rapidly mutate, if additional strains develop, or if a reactivation mechanism exists, this may not be so. In other words, whereas we would be immune to “what was,” we might not be immune to a changed virus.
  • Is there a possibility that even in the presence of a positive antibody test, the virus could exist in a latent state and could still be transmitted to others, creating an infection, a la chicken pox/shingles? This is truly a worst-case scenario but is extremely unlikely. Unfortunately, based on the nature of the novel coronavirus, it has to be considered.
  • When will a vaccine will be ready? An effective vaccine would be a game changer. A vaccine that only works against the current strain in the presence of a virus that is able to mutate and/or develop additional strains would not be as effective.
  • When will preventive and curative medicines will be made available? There are current emergency provisions in place for certain medicines in the face of seeming life-threatening progression of the disease. Last minute use of experimental medicines can’t be the standard or sole recourse we have. The process of clinical research must continue.
  • Are we seeing a curve or a wave? Believe it or not, this is yet to be determined. If the exercise of removing the stay at home orders too soon isn’t precisely timed, the number of infections and deaths will go back up. We have seen this occur in other countries around the world. This is why it’s key to engage in community testing, contact tracing and antibody testing – still.

Until these lingering COVID-19 questions are answered, our understanding will be limited at best. Until we know these things, our ability to reopen the country for business and life approximating “normal” will be limited. We cannot currently say that we can answer these questions with certainty.

Perhaps you’ll take comfort in knowing where the standard lies. Generally, those that have recovered from COVID-19 will likely be immune if a second wave hits. According to Dr. Anthony Fauci of the White House coronavirus task force, “Generally we know with infections like this, that at least for a reasonable period of time, you’re going to have antibodies that are going to be protective…If we get infected in February and March and recover, next September, October, that person who’s infected –– I believe –– is going to be protected.” Stay tuned.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

Specific Reasons for Overrepresentation of COVID-19 in African Americans

Introduction

We’ve previously quantified the overrepresentation of COVID-19 in African Americans. This Straight, No Chaser offers a few specific reasons for those disparities. We hope policy makers and public health professionals continue to identify and address these root causes of medical and social determinants of health. These are among the main reasons for the vicious health care disparities now being revealed.

Individual Reasons for the Overrepresentation of COVID-19 in African Americans

  • Clustering in America’s most populous cities
  • Disproportionately poor
  • Disproportionately represented in front line “essential” jobs (janitors, cashiers, bus drivers, etc.)
  • Greater presence of preexisting conditions
  • Inadequate housing and higher representation in homeless population
  • Increased neighborhood risks (exposure to pollutants and toxins, less green spaces, less healthy food options, less safety), many of which lead to lowered immunity
  • Less access to care (health facilities are less available in African American communities)
  • Less access to testing (testing facilities are less available in African American communities)
  • Need to utilize public transportation (representing 25% of users)
  • Overrepresentation in the incarcerated population
  • Unequal levels of care received due to an “empathy gap” by physicians caring for African Americans
  • Perceived criminalization (yes, the perception of Blacks wearing masks actually is inhibitive to the use of personal protective equipment in the community)

These conditions don’t excuse the presence of disease or absolve individuals from exerting their best efforts toward health self-empowerment. However, it helps to appreciate factors that stack the deck for or against specific groups of individuals. Furthermore, doing so allows health professionals to create and adjust plans accordingly. Stay safe.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

The Rationale for Not Using Hydroxychloroquine and Azithromycin to Treat COVID-19

Introduction

Before looking at the rationale against the use of hydroxychloroquine and azithromycin to treat COVID-19, think about what’s being asked here. There are two option. The first is you’re potentially asking for a patient requiring critical care to benefit from a miracle cure. The second is you’re asking for an antiparasitic medication with a dangerous side effect profile to work in preventing the spread of an especially virulent virus in patients who mostly recover on their own. It’s as if the cards were stacked at the beginning of the conversation. In case you haven’t done so, review the previous post on the rationale for using hydroxychloroquine and azithromycin.

There’s a difference between hope and false hope. To quote Dr. Fauci’s comments on physicians and persons endorsing this combination without evidence, “We don’t operate on how you feel. We operate on what evidence is, and data is…we’ve got to be careful that we don’t make that majestic leap to assume that this is a knockout drug.”

Meanwhile, President Donald Trump, in his self-described capacity as a cheerleader, has notably encouraged using these drugs, saying “What do you have to lose?” Well, physician don’t operate that cavalierly with your lives. We operate under the mantra “Do No Harm.” Let use these opposing premises as the starting point for a review of the arguments against the proposed uses of hydroxychloroquine in treating COVID-19.

The Research

There really are four topics that constitute the arguments (“evidence” if you will) for use of hydroxychloroquine in treating COVID-19. Let’s review them.

Small studies performed on laboratory cell cultures

A Chinese study demonstrated that hydroxychloroquine prevented proliferation of the COVID-19 in a lab setting. Anyone who has ever taken a high school science course should recall the difference between in vitro and in vivo. What happens in a petri dish is a long way away from having the same effect on and having benefits in living beings. Furthermore, efforts specifically meant to replicate the lab (in vitro) success have not been successful. Per the academic journal Antiviral Research: “Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success.” Simply put, the drug has shown no benefit when tested on any animal in clinical studies.

Comments of Chinese Health Officials

Chinese health officials assert “chloroquine might improve the success rate of treatment, shorten hospital stay and improve patient outcome.” That sounds good, but this Chinese consensus statement provided no data to support the assertion. For example, one such paper was titled “Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies.” It cites as its primary source an audio recording of a news briefing from the State Council of China. That’s propaganda, not science.

The French Study

A single French study that suggested the combination of hydroxychloroquine and azithromycin was effective against COVID-19. (This is the study Trump references in his tweets.) The study’s conclusion states “hydroxychloroquine is efficient in clearing viral nasopharyngeal carriage of [the novel coronavirus] in COVID-19 patients in only three to six days, in most patients.”

This paper has been criticized widely. Here are some of the cited concerns.

The study contained 20 people, thus lacking the statistic power to make extrapolations of the data that supporters have made. Also, this study was published without underground the peer review process that subjects these things to medical scrutiny.

This was not a double-blinded study. The doctors and the patients were aware of patients’ group status within the study. This is a failure by itself. Also, only a quarter of the placebo patients actually had their viral load measured! So how was the conclusion of reducing nasopharyngeal COVID-19 quantified? By the way, even if “clearing of the virus” occurred, that doesn’t necessary equate to “better clinical outcomes.” There is no suggestion one set of individuals fared better than the other.

Furthermore, six (a pretty substantial proportion) of the patients from the group who had been receiving the drug quit the trial. Three of them ended up in intensive care. One died. These likely were failures of the drug to work against the virus, but this data wasn’t considered or reported as such in the results.

Dr. Vladamir Zelenko’s 699 Patients

Many are enamored with Dr. Vladamir Zelenko’s claims that he has treated 699 patients successfully with hydroxychloroquine and azithromycin (with zinc). Here’s all you need to know to analyze his efforts. Zelenko’s claims are exactly that: claims. He has published no data. He has described no study design. There has been no analysis reported. His anecdotes are not close to being scientific proof.

Pushback

In fact, there has been an actual controlled clinical trial from China that showed no statistical differences in health outcomes between a control group and patients who received hydroxychloroquine after seven days. However, because of its small size, it also can not be deemed conclusive.

Still, and in case you didn’t know, the preponderance of evidence (or lack thereof) has compelled the Centers for Disease Control and Prevention to pull back its guidance for hydroxychloroquine usage for COVID-19. It no longer offers recommendations for its dosage. Also, the CDC has also deleted all information on those aforementioned early studies of the drug from its website. Its “off-label” use for emergencies is left to the discretion of individual physicians. It is of note that multiple prominent institutions, such as Northwestern Memorial Hospital in Chicago, have declined to offer it.

Summary

What this all means is, at best, “the absence of evidence isn’t evidence of absence.” It is indisputable that the research thus far is below the medical and scientific standard. However, because of some of the theoretically plausible benefits and the actual absence of any meaningful data, the drugs are worthy of undergoing the scrutiny of the scientific method of research. And thus, legitimate clinical studies have begun.

It is unfortunate that the attention paid to hydroxychloroquine and azithromycin (and their unfounded positioning as miracle drugs) could be distracting from other possible solutions. It certainly is a distraction from the need to focus on wider testing and preventive strategies. What has also been lost in the fervor is the combination of hydroxychloroquine and azithromycin could be dangerous for individuals, particularly those with some heart conditions. However, you will note that looking at side effects wasn’t even necessary to demonstrate the use of these medicines is premature at best. In the spirit of “do no harm,” let’s finish back with Dr. Fauci, who was asked if he would take the drug if he were stricken with the virus. His response? “Only if it were part of a clinical trial.”

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Order are now at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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The Rationale for Using Hydroxychloroquine and Azithromycin to Treat COVID-19

Introduction

This is the first of a two-part Straight, No Chaser view at the rationales for and against using hydroxychloroquine and azithromycin to treat COVID-19.

Perhaps the distraction of the US President trumpeting (no pun intended) this combination has turned some away from the possibility that these medicines could be helpful. Maybe the well-publicized deaths of individuals taking the medicine has caused concern. Perhaps the robust criticism of the most-commonly cited study used as evidence has led many in the medical and scientific communities to be dismissive. Still, there has to be scientific reasons for putting forth the medications and the combination, right? In fact, there are.

Hydroxychloroquine and Azithromycin

Let’s review the ways the drugs work and the scientific rationale for their use against COVID-19.

Hydroxychloroquine

Hydroxychloroquine (HC) is a derivative of an older drug (chloroquine). Both drugs are best known as drugs used to treat malaria, which is a disease caused by a parasite spread by mosquitos. HC has the following properties as a drug:

  • It disrupts the ability of parasites to reproduce and proliferate by blocking a chemical needed to digest proteins. It’s basically starving the parasites. This mechanism doesn’t appear to have applicability in viruses.
  • Even though HC is not an anti-viral medication, it has effects that could combat the way viruses in general replicate, thus slowing its spread.
  • There is evidence that HC inhibits cells’ ability to secrete substances known as cytokines. This is relevant because one of the most devastating effects of COVID-19 isn’t found in the activity of the virus itself. It’s the immune system’s response to the virus. In severe cases, there’s an overreaction by the immune system within the lungs by these cytokines. This by itself can cause fatal damage. This concept should be familiar to those with autoimmune diseases. Sometimes the body is just so exuberant in attacking foreign agents within us that damage occurs to us in that fight. Therefore, if HC activity blocked that cytokine release process, it conceivably would be helpful.
  • COVID-19 appears to bind to hemoglobin, the molecule that transports oxygen. COVID-19 seems to force hemoglobin to release its oxygen molecule. This reduces oxygen-carrying capacity, which ultimately contributes to feelings of shortness of breath. Most importantly, the lack of oxygen within the body’s cells contributes to their death. Furthermore, that unbound iron is a free radical and oxidant. In this state, it causes damage to lung cells (wanting to avoid this process is why so many of you take “anti-oxidants”). Hydroxychloroquine appears to inhibit the binding of COVID-19 to hemoglobin, theoretically reducing much of this.

Azithromycin

Azithromycin is an antibiotic, meaning it is used against bacteria. You likely have taken it and know it as a “Z-pack.” It does not work against viruses. However, there are many situations in which a viral infection lowers the body’s immunity, and bacterial infections take advantage of the situation and “jump” on you. These are called secondary bacterial infections or co-infections. In these situations, azithromycin could be of use because it’s treating the secondary infection.

The Combination

There is actual case history for the use of hydroxychloroquine with and without azithromycin. It is used in China, South Korea and a few other countries. In fact China asserts that chloroquine might improve the overall treatment’s success rate and subsequent outcome, along with shortening hospital stays. Also, there are scattered physicians in the US who have (in)famously cited miraculous success using these drugs.

Summary

Many of those in the pro-camp for the use of these drugs also cite various studies that have shown promise for the use of these medicines. However, as we’ll discuss in the next Straight, No Chaser, those studies actually are support against the current use of these medicines. However, one recalls that penicillin was discovered on a mold that was stopping bacteria from growing on a petri dish.

Even with the theoretical benefits of these drugs having nothing to do with direct anti-viral properties, the indirect efforts are sufficient to suggest that robust research should be conducted within the medical tradition to establish if and how these medicines may be used in patients with COVID-19. It is not inappropriately hopeful to think hydrochloroquine could have a role in the more severe patients. Its indirect effects may prove to be a means of slowing down the march of COVID-19. It is most correct to say that there is insufficient evidence to advance its use, either as prophylaxis or treatment. It is equally important to note that all such evidence is either theoretical or anecdotal.

To that end, in late March, the WHO announced that hydroxychloroquine was among four treatments being analyzed as possible tools in this fight. There is a lot more to come and to be said.

The next post reviews the case against the use of hydrochloroquine and azithromycin in patients with COVID-19.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Order are now at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

The New COVID-19 Normal – Three Steps to Safety

Introduction

This Straight No Chaser offers you a “Three Steps to Safety” approach for what will become the new normal.

Think about the next COVID-19 Outbreak.

I’ve been wondering what next year looks like. Consider this a thought exercise, based around three questions.

  • How long can we endure the current way of life?
  • Under what conditions would we be comfortable going back to work, back to church, back to the beaches, back to what once was “normal?”
  • What will we do next year when next year’s outbreak begins?

These questions take me back to influenza. How is it that we’ve become comfortable with allowing an infectious disease to kill 35,000 Americans a year? Would you be comfortable with COVID-19 killing year after year?

The thing with COVID-19 is it imparts a level of horror that influenza doesn’t. It has required social distancing and self-quarantine activities. Could our nation do this for 3-6 months every year?

Even if we could, we wouldn’t want to. So how do we get there?

Three Steps to Safety

I propose these “three steps to safety.”

  • What we’ve learned about masks, handwashing and social distancing will and should become the new normal. There are several countries in which it is considered an insult to be in public without a face mask. That’s actually a fairly prudent standard. I doubt that we’d get to the extreme of banning public gatherings, but risk minimalization by social distancing is a strategy to be used whenever possible.
  • Presumably, there will be a vaccine available sometime within the middle to end of the next respiratory season (say at the turn of the year). Will you get it? Hopefully we’ll do a better job with this than we do using the influenza vaccine. Of course this will need to be coupled with testing that’s at least as available and the influenza vaccine currently is.
  • The problem with the current influenza strategy is people get the vaccine, and we then make assumptions about its effectiveness. In other words, the vaccine by itself isn’t enough. That isn’t good enough for influenza, and it certainly won’t be good enough for COVID-19. I call for routine antibody testing to become part of the medical evaluation process. Antibody testing allows individuals to know that they are immune from the disease, and it can be done from the convenience of home. That’s the level of confidence needed to reengage the workplace and normal activities.

This isn’t that complicated. As is often the case, the devil is in the implementation. Stay safe.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being accepted at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

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