COVID 10

Rick Hodes, MD, MACP 

JDC-Ethiopia

info@rickhodes.org

Newsletter #10:

Dear Friends and Colleagues: 

I wish I had better news to report from the US, but our rolling epidemic continues in various stages, in various places. Some places, like New York, are doing “well,” though they get 600 new cases/day. They peaked at over 11,000 in April. 

Consult this chart for details:

https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

There is no significant change in therapy, but there is some confusion. A randomized, controlled study of tocilizumab found that it was not helpful, while another more observational study found that it was somewhat helpful. Even among patients who received the drug, there was a 49% mortality rate. So it is far from a magic bullet. 

Prone position, steroids, and convalescent plasma seem to help, combined with later intubation than previously. 

We are now seeing SARS-CoV-2 as a multisystem/vascular disease, far-more complex than a respiratory pathogen. 

I am including several interesting articles.

If you only read 1, I’d choose “Where are we now?” from Stat News. 

Others include:

a)    Aboard the Diamond Princess

About the spread of the disease by microscopic droplets. This reminds me of measles. This condition is certainly worse than measles. 

b)   Abstracts: About how physical distancing, facemasks, and eye cover help decrease spread. 

c)    COVID myocarditis: This is a significant problem, including in many people who seem asymptomatic! 

d)   COVID myocarditis2: This is the scientific paper on the topic, from JAMA. 

Here is a short youtube video on the topic: https://www.youtube.com/watch?v=g8-55pUwdY4

e)    Dexamethasone study – this is an article reporting the randomized, controlled data. If you’d like the original, drop me a note and I’m happy to pass it on. 

f)     Immunity to COVID: This is good news: it seems that even mild cases give us immunity.  The antibody situation is not 100% clear – we all know that having HIV antibodies does NOT give protection against HIV. 

g)    New Zealand – This is a cautionary tale, for sure.  On one hand, New Zealand succeeded in not having a case in 103 days. Last Thursday it had 13 cases. This may indicate that it was being transmitted asymptomatically for a few months. I am sure they will take isolation of cases and contacts quite seriously. 

Feel free to contact me with questions, concerns, or suggestions. I wish you success and good health. 

Sincerely,

Rick Hodes, MD, MACP
JDC-Ethiopia