Tag Archives: There are 72 Hours in a Day

A Voice for Strategically Reopening Schools

Introduction

This Straight, No Chaser addressing the challenge of reopening schools during the COVID-19 pandemic. 

America’s futility in addressing Covid-19 has left us with an unavoidable choice. We could fight our individualistic instincts and economic realities and attempt a restart along public health best practices, but our personal and governmental COVID-19 choices render that choice practically unavailable. As such, any success we have in normalizing life will be found while simultaneously fighting the virus. We are left to prioritize meaningful activities that need to be reengaged.

Reopening Schools? Follow the Science

Put me on the record. It’s time for precollege students to be able to return to school (but by no means in the way you were used to – more on that later). For those of us whose rallying cry has been “follow the science,” here we go. Shall we focus on the opportunity and not the obstacles? Let’s begin with the American Academy of Pediatrics’ (AAP) policy position that it’s medically safe for children to return. Folks, this is not an insignificant declaration. The AAP is the medical organization most charged with safeguarding children.

This is based on two considerations. Children have both low infection and transmission rates. This sets the bar for what’s possible. Follow the science, remember? Perhaps even more importantly, there are scores of data relative to the current level of damage occurring by children not receiving the socialization skills obtained by schooling. Let’s be clear: kids of all ages and levels of native/baseline intelligence are being developmentally delayed as a result of the ongoing isolation. This by itself is creating a series of long-term consequences that must be factored into the equation. From the AAP President: “We know that children learn more in school than just reading, writing and arithmetic… They get social and emotional skills, healthy meals and exercise, mental health support and other things that you just can’t get with online learning.”

Safely Reopening Schools

Thus, if the science states there is a rationale for children needing schooling, and it presents a relatively low threat to others, the obvious next question is “How can this be done safely, especially when considering teachers and others needed to operate schools who may be at heightened risk?” First, realize that there is a completely different question and set of considerations than the issue of whether children need to and can go back to school. The answers aren’t that difficult to fathom if you’d just avoid rejecting the premise out of hand. Consider the possibility if just these five considerations were fully implemented (shortened for the purposes of a briefer discussion).

A Few Safe Schooling Options

  1. All teachers don’t need to be physically present to teach. Honest, frank conversations need to happen about what level of risk is necessary and acceptable to continue to be a teacher. Also, flexibility in how teaching is performed should be accommodated when needed. All teachers should be paid, but those choosing to opt out or who are at risk can be given opportunity to teach via video conferencing, while younger, less at-risk assistants monitor the classrooms. No teacher should be forced to place themselves at risk without every assurance that protections are in place.
  2. All students don’t need to be physically present to learn. Homeschooling has been accepted forever. Videoconferencing either in total, every other day or for certain portions of the curriculum shouldn’t be an issue. It certainly would assist with the challenges of social distancing or those at advanced risk.
  3. Social distancing can be accomplished with some creativity. This begins by using the school and classroom sizes to determine the maximum safe occupancy capacity. Subsequently, schools can utilize tele-learning and staggered attendance to accomplish the goal. They can consider a longer school day and school year if needed.
  4. Some activities will need to be avoided or dramatically modified. Physical education, singing and theater activities come to mind, unless creativity can accommodate social distancing concerns.
  5. Testing, tracing, screening and utilization of PPE are a must. Frequent, visible and thorough cleaning activities must be performed and made known. Students should be screened daily and tested with some agreed upon schedule (e.g. weekly), with a commitment to not only subsequent isolation but implementation of contact tracing. The risks of kids becoming seeds for community infections must be minimized and cut off as soon as possible.

It’s Time for American Ingenuity

It’s the American way to face our challenges, not cower from them. In this example, there are compelling reasons to have this group of essential workers perform an essential function for our children. The science suggests we can do so relatively safely if we meet the challenge with creativity. It’s time. The world has changed. We must adapt. I welcome your thoughts and challenge you to ask your schools which of these basic considerations have been accommodated. If you’re interested, here is a full list of CDC recommendations on the topic.

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

We’re All Making COVID-19 Choices

Introduction

This Straight, No Choices address our COVID-19 choices. We’ve focused a lot on our failures getting the fundamentals of public health implemented, both nationally and within most states. However, let’s not be so smug as to believe all problems that have and will manifest are the problems of the political right. This is not to excuse but explain and warn. We still have a long way to go, and there’s not much indication that we’ve yet begun to get there. The data points in the wrong direction, and it’ll bleed into the next respiratory season with a trampoline effect on cases.

COVID-19 Choices: Freedom

Americans treasure independence, free will and what’s left of what were our freedoms. As related to COVID-19, we all seem to have a line drawn as to where we won’t do what’s necessary to protect ourselves and the general population. It certainly is (but it’s not just) failure to honestly implement the Defense Production Act, to order a national shutdown, testing and contact tracing programs, holding rallies, persistent dishonesty about the data and reporting (I could go on…).

COVID-19 Choices: Look at Our Actions

COVID Choices

However, there’s more that we, the people, say and do every day, and there’s things we support that make no sense if the goal is to eliminate this virus. Here are a few.

  • Our youth are all over the beaches.
  • People are traveling on airplanes, buses and trains.
  • Schools and businesses are opening.
  • Professional sports are restarting.
  • We refuse to participate in contact tracing over concerns about our privacy.
  • We continually speak to how we don’t take the vaccine that’s forthcoming, regardless of which the data shows and what the medical community recommends.

If you think about the demographics of these activities, you’ll realize they encompass the full political spectrum and multiple demographics. Let’s just take one example. Everyone’s been awaiting the development of a vaccine, but if upwards of 70-75% of us don’t take it, it won’t produce a desired mass effect of reducing the viral load and producing herd immunity.

Where Does This Leave Us?

All of this leads me to conclude that the challenges of COVID-19 will continue for a long time. See, if we each have a line that’s drawn, we all will ultimately contribute to the ongoing and rising level of deaths. Americans have rights and individual freedoms, and you’re expressing them with your actions. Choices have consequences. Can you be as honest about that as we’re demanding our leaders be honest about what they aren’t willing to do? Are you ok with what that will mean for the foreseeable future?

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!). www.jeffreysterlingmd.com or 844-724-7754. 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

Dexamethasone in Treating COVID-19

Introduction

  Dexamethasone in treating COVID-19   In the news, this Straight, No Chaser reviews new findings on the use of dexamethasone in treating COVID-19. Dexamethasone is a commonly used steroid that has sixty years of use behind it.

Findings on Dexamethasone

  1. Dexamethasone is a steroid. Steroids reduce inflammation. COVID-19 kills largely through inflammatory reactions caused by the infection. Thus, there is a theoretical basis by which steroids could be used in treating COVID-19.
  2. In a study of more than 6,000 severely ill COVID-19 patients, dexamethasone was found to cut deaths by up to one-third.
  3. It’s not for everyone. On the positive side, after a month, it had reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those needing supplemental oxygen. Unfortunately, it did not appear to help less ill patients.
  4. Dexamethasone has side effects. It inhibits the body’s immune response to the virus, which could be deadly in some patients, although not overall. Steroids, in general, may cause some severe side effects, such as new or worsening diabetes, as well as psychosis or emotional disturbance. These potential side effects must be weighed against the real life threat being faced in real time.
Dr. Fauci, head of the U.S. National Institute of Allergy and Infectious Diseases has noted “This is a significant improvement in the available therapeutic options that we have.” This is significant, but you’re missing the point if you think this is the way forward. COVID-19 is a disease you want to avoid, not treat. Your best options will always be to take preventive measures and avoid the need to hope steroids pull you out of the fire. 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

When a Virus Becomes Politics

Introduction

This Straight, No Chaser addresses the notion of when a virus becomes politics, aka you’re too close to the source.
 
I can’t recall a situation (even including HIV), in which scientific information was being researched, discovered, information released and information politicized in plain view on a daily basis. I would suggest this level of transparency (subjecting research to the hourly news cycle) is not a good thing.

The Scientific Discovery Process

Scientific and medical consensus are rarely based on an individual research study, regardless of the quality of the study. Each study builds upon that which came before it, forming a medical consensus. Subsequent to forming consensus, recommendations and policies are announced to the medical and public health communities, which undergo additional analyses. It is usually at this point that information is released to the public in a mass fashion.
 
What you’re seeing with COVID-19 is both how the sausage is made and what happens when a virus becomes politics. Scientists aren’t close to being perfect. Studies are flawed, and interpretations are constantly (and sometimes successfully) challenged. This isn’t occurring any more or less frequently with COVID-19 than it ever has. It’s just occurring in a far more public manner that it has been previously, and it’s being done in a more premature manner than it should.
 
The scientific method is not well suited for public consumption. The public wants certainty. You correlate certainty with competence. That’s not what we’re seeing. Episodes ranging from hydroxychloroquine, to both the CDC and WHO’s statement on masks, and to the evolving evidence or case fatality rates are being interpreted as confusing by the public, and they are. However, this is closer to the norm than you’d imagine. You just haven’t been excessively exposed to this.

Health Empowerment is the Key

Don't panic when a virus become politics

Overall, in the spirit of engaging, educating and empowering the public, this isn’t a bad thing. You need facts to help you determine your own best course of action. However, perhaps the biggest challenge is to avoid misinformation. Yes, there are those presenting information through a political slant, and there are those are imposing a political spin on every piece of new information. I want you to appreciate that facts themselves don’t come with a political bend. It is what it is. Perhaps you’re reading this information through a political filter. That’s on you.
 
Science follows the facts. Individuals decide what to do with the information. Hopefully, you’ll prioritize matters of health and not live your lives subjecting your health to the priority of adhering to a political ideology. When a virus becomes politics, everyone loses.
 
Stay safe. Make good choices. Ask good questions. Lives are in the balance.

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
 

Revisiting the COVID-19 New Normal

Introduction

This Straight, No Chaser revisits what could become the COVID-19 new normal. Have you wondered why and how the United States has become comfortable with annual deaths from influenza between 30,000 and 70,000?  Well, you’re witnessing how this happens.

Using Influenza’s History for Clues about the New Normal

Influenza has been around since 1580 and has caused several pandemics. At some point, the world accepted its existence and, to some extent, its permanence. Still, we are not left defenseless. Outside of pandemics and epidemics, the death rate is largely determined by compliance with immunization recommendations. We face a similar scenario with COVID-19. It will likely be around for the foreseeable future. It will cause an undetermined number of annual deaths. The number is going to be a factor of our willingness to engage in health prevention and ultimately, compliance with taking a vaccine. It remains to be seen if a treatment can be developed to prevent or treat this disease prior to advanced illness occurring. Somehow, health prevention has become politicized such that the basic preventive strategy of wearing a mask is being viewed and defined (by no less than the US president) as a sign of “weakness.” It is notable that the two countries assuming this posture (the US and Brazil) lead the world in active COVID-19 cases. This isn’t necessary.

The COVID-19 New Normal

The evolving COVID-19 new normal is such that the term “preventable deaths” will become a prominent part of the American vernacular. The political divide and the decisions made by the population on testing, social distancing, hand washing and sanitizing, disinfecting objects, mask wearing, isolation, testing, contact tracing and vaccination independently and collectively will determine the number of total deaths and independent deaths. This will occur in the same way compliance with vaccination has for influenza. Our populations are already rolling the dice in deciding whether or not to comply with these maneuvers. Choose your decisions and actions wisely. There is a killer among us. Whether we come out of this first wave better or worse off is very much to be determined.

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

(Relatively) Safe Church Reopening Strategies

Introduction

 

This Straight, No Chaser addresses how you can access safe church reopening strategies.

Between Sterling Initiatives and SI Medical Supply, we’re providing consulting and services for several houses of worship in anticipation of the time at which in-person services resume. Given the differences in each state and, in fact, each location, it is frankly irresponsible to offer a blanket set of recommendations as to how churches and other houses of worship should prepare beyond recommending adherence to CDC guidelines for reopening.

However, I’m always inclined to point out that it’s not just knowing what to do that creates success. Implementing best practices is what creates outcomes of interest. As such, Sterling Initiatives is offering the first fifty (50) houses of worship that reach out to us free consultation toward lowering the risks of Covid-19 infection. As time permits, we’ll do this through the end of the month. Are you or your house of worship is interested in discussing these steps? Reach out to us at 844-724-7754. You can also reach us at sterling@sterlinginitiatives.com.

Scope of Services

We’ll discuss some of the following, at no cost to you:

  • Making opening decisions
  • Review of risks and best practices
  • Facility preparedness
  • Communication strategies
  • Worship capacity
  • PPE needs
  • Medical preparedness
  • Risk mitigation

We’re here for you. Be ready so you don’t have to get ready. Embracing safe church reopening strategies is a must. You don’t want to face the alternative.

#KnowledgeIsHealth #HealthSelfEmpowerment

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  

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

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.

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

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

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