Coronavirus March 15th Update

March 15th: Overview of the **Updated** Current Situation

My initial March 2nd guidelines on the corona virus situation were well received and widely re-shared. We were able to share this information to around 10,000 persons not including those that were shared by our readers. I am very glad to find that they were helpful to so many. Thank you for those who shared. I believe now more than ever that this is all vital information that could be helping persons and saving lives right now.

The clinic has uploaded these updates to make them widely available. We again encourage you to ‘like’ and ‘share’ and spread the word. These guidelines are for information only, and while they inform our daily clinical practice and may save the life of you or a loved one, they should not be construed as individual medical advice.

Please discuss these interventions with your Naturopathic Physician or other health care provider.

It is my sincerely held belief that neglecting these guidelines as a foundation of care will result in more and worse infections and a greater loss of life. Likewise, it is my sincerely held belief that following them will help to lessen cases, reduce infection complications, improve infection outcomes and save lives.

Eric Blake ND, MSOM, Dipl. Ac.

The previously published guidelines on overview, prevention,  and treatment were accurate.  This update will focus on what to do now and how our clinic - which will remain open - is responding to the changing circumstances.  


If you have not read those previous guidelines they are here - please read them.
Overview
https://www.holistichealthpc.com/blog/coronavirus-naturopathic-guidelines-covid-2019-part-1overview

Prevention
https://www.holistichealthpc.com/blog/coronavirus-naturopathic-guidelines-covid-2019-part-2-prevention

Treatment
https://www.holistichealthpc.com/blog/corona-virus-naturopathic-guidelines-covid-2019-part-3-treatment

 

What new information do we have about Corona Virus?

There is more clear information now about when persons are likely to show symptoms of infection after exposure.  

Very few people are symptomatic within the first 2 days.  Most are symptomatic by day 5.  Almost all persons become symptomatic by day 12, and almost all remaining persons become by day 14. 
This confirms our initial advice to be active in prevention now and especially after any exposure to someone ill. It also confirms our initial advice to treat aggressively at the first signs of any infection.
https://www.jwatch.org/na51083/2020/03/13/covid-19-incubation-period-update?fbclid=IwAR2NPjlOt4TesxwuWV9ASCdQ2niog7ORu3z5APjnl8r8XutjghkhUYcQf3s

What is the status of testing for CoVid 2019?

Testing is now becoming more widely available.  The guidelines of the Multnomah, Oregon Health Department have been updated to reflect the changing situation.  Previously the county health department had rules in place that significantly limited testing.  These rules included requiring county approval for testing and stringent criteria to be met for approval. They largely required a specialized hospital setting for testing.  These limiting rules have been lifted and they are asking and encouraging clinics like ours to screen and test based on their guidelines.   

Why was testing so restricted previously? 
The US head of infectious disease has admitted that this initial approach to testing was a failure. 
https://www.nbcnews.com/health/health-news/it-failing-let-s-admit-it-fauci-says-coronavirus-testing-n1157036

There were several reasons for the limitations that were previously in place. 
Three important ones, but not the only:

One was simply the lack of kits being available. Production is now picking up.

A second reason was that laboratories were restricted from developing their own testing processes.  This restriction has now been lifted and is helping solve the availability hurdle.

A third reason is that the facility requirements to collect samples were restricted to hospital settings. This has been lifted so that outpatient clinics like ours can test. So distribution of testing services is now more widely available. 

How did the lack of testing and aggressive quarantine affect our current number of known cases?
For some time public health authorities believed that containment of the virus was a possibity.  You may remember that it was considered newsworthy only a few weeks ago that a Harvard public health professor believed we were past the point of containment.
https://www.straitstimes.com/singapore/health/covid-19-beyond-containment-but-singapores-efforts-will-slow-the-spread-harvard-don

However, this unrealistic perspective of containment, along with the lack of  early widespread testing and aggressive quarantine, coupled with asymptomatic transmission, led to a widespread occult seeding of the easily spread virus. The 5 to 14 day window to symptoms eventually caught up and the numbers began climbing rapidly.

The reality is setting in that this pandemic CoVid 2019 will spread to around 40-70% or more of the population this year.  Most of us will be exposed.
https://thehill.com/changing-america/well-being/prevention-cures/482794-officials-say-the-cdc-is-preparing-for


Why are the public health authorities advocating social distancing?

You may be hearing social distancing called 'flattening the curve' of the outbreak. This essentially means that we are slowing the inevitable social sharing of this new member of the ubquiquitous family of nasal viruses.  So rather than an escalating rate of spread, it is slowed down, so a rapid curve upward is flattened and spread out over time.

The goal of social distancing is not the elimination - containment - of the diseace. The goal is to slow the speed of the outbreak to reduce overwhelming the capacity of the health care system.  https://www.npr.org/sections/health-shots/2020/03/13/815502262/flattening-a-pandemics-curve-why-staying-home-now-can-save-lives

The following link is also a very good and compelling overview of the current crisis, worth reading.  These leaders of public health are advising patients to have a supply of 3 months of medications on hand in case of supply chain interruptions that may occur as this spreads. 

https://medium.com/@hjluks/covid-19-update-3-14-2020-a-message-from-concerned-physicians-33d00b88eefd

Again, this is why we have been advocating our prevention and treatment guidelines to improve immune system responses to infection and to lessen the severity of diseases and to hasten recuperation. This is also part of our contribution to 'flattinening the curve'. Again please share this information.

Will the clinic be open at this time?

Yes. We are open for clinical care.  We are still delivering our normal care and are adapting to the environment. As our patients know we are a comprehensive care clinic - primary care, specialty care, and urgent care for our established patients. 

The Board of Health is asking clinics like ours to stay open to provide our routine care as well as be a part of the management of this pandemic.  If we were to close the burden on the health care system goes up and not down. This is in tandem with the strategy to reduce the burden on healthcare systems by 'flattening the curve'.  We are taking additional numerous precautions at this time to keep our patient and staff population well -  including and even beyond those recommended by the the Board of Health. 

Are we still in the flu season?

Yes, we are still in the flu season. Currently there are also cases in Portland of whooping cough. And the likelihood that respiratory infections are caused by the flu or the many other types of viruses or bacteria that we are commonly exposed to is still present.

It is essential that we do not miss the forest for the trees and that we incorporate overlapping approaches to protect ourselves. Because corona virus does not offer and clearly differentiating symptoms early in the process and we are already in a respiratory infection season we are continuing our recommendations of  a more vigilant response to acute onset of symptoms.

Will CoVid 2019 testing be available and does this mean confirmed cases will be in the clinic?

Yes, CoVid 2019 testing will be available at the clinic.  However, in order to avoid spread, flatten the curve, and to protect our patients and staff, the doctors conferenced and we are following more stringent guidelines regarding our clinic testing procedures, our cleaning protocols, our scheduling and seperation of populations. 

We will be managing confirmed cases with telemedicine and home treatment at this time.

At this time, if you have these symptoms and have not been tested for CoVid 2019:
1) Shortness of Breath, accompanied by a
2) high fever and
3) a cough


Please contact the office.  You will be scheduled to speak with a doctor  as soon as one is available for a telemedicine appointment.  We will want to speak to you on the telephone as soon as possible. If needed , testing will be coordinated along with a treatment plan.

We are developing our protocol for testing and we are working with the building to coordinate a drive up plan if possible.  In that case you will be directed where to park and the doctor will come down in appropriate personal protective equipment, to collect the sample, deliver medicines etc. 

If you are in need of emergency care please contact emergency medicine services. 

Why are we not treating confirmed CoVid 2019 cases at the clinic at this time?
We believe that clinical treatments such as Bio-Thermal Therapy (R) and our bedside management would be even more effective for confirmed cases than home management.  This along with IV Nutrient therapy such as High dose nutrient Vitamin C therapy as in our Anti-Viral Immune Drip could be signifcantly helpful. The Shanghai Government has conducted clinical trials and now recommends IV Vitamin C in the treatment of CoVid-2019.
http://orthomolecular.org/resources/omns/v16n16.shtml

It is likely that these treatments will become necessary for this population - especially because as you will see below there is not much offered conventionally until hospitalization is required.

However, we serve a wide population of persons under active care.  For now, once we have confirmed cases at this early time in the pandemic we will be working to create a firewall at the clinic to 'flatten the curve'.  That is our current priority.

If we do eventually need to treat clinically as this pandemic evolves we will make special accomodations to keep cases seperated and to block out specific times for their care - and we will alert you to this.  We already treat influenza and other endemic periodic infections routinely.  Again, at this time we are not treating confirmed cases inside the clinic nor even collecting test samples within the clinic walls.  We are planning on treating via telemedicine and will be testing in a drive thru fashion.

What is the treatment being advised conventionally for CoVid 2019?

The only conventional guidelines for treatment are isolation and 'supportive care' unless and until symptoms become serious enough to require hospitalization.  Conventionally 'supportive care' is primarily fever suppressing medications   This is not biologically sound. Section 3 - fever and infection guidelines explain more.

French doctors are observing that ibuprofen (medications such as Advil, Motrin, etc) may worsen CoVid 2019 and are observing clinical worsening.  We would expect that actually. 

https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection

Instead French doctors are recommending Acetaminophen (Tylenol, Dayquil, NyQuil, Paracetamol).  However we do not agree that anti-fever medications , whether aspirin, acetaminophen, or ibuprofen , etc. are the primary approach to be relied upon. It is not biologically plausible or sound.

In pandemic viral models all anti-fever medications increase mortality by 1% for pandemics and 5% for seasonal flu and increase the viral spread and transmission- ie they will raise the curve and not flatten it while worsening case outcomes. This is incredibly important information to understand.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906934/

Aspirin was part of the cause of the significant loss of life in the Spanish Flu. 
https://academic.oup.com/cid/article/49/9/1405/301441

Another recent study provides further evidence that use of acetaminophen is in respiratory infection associated with decreased lung function and an increased risk of asthma and COPD. 
https://www.atsjournals.org/doi/full/10.1164/rccm.200409-1269OC?fbclid=IwAR2jtQBJ7QzudgOFzrPlogaZJEKtvOWlxxCUn65bNkQF56cJoKEOtUWiGTM

Why does there seem to be so much fear and confusion in the news and from health authorities about what to do for treatment?

 There is no FDA approved treatment at this time. This is encouraging despair and hopelessness, fear and panic.  At the same time the one consistent advice - anti-fever medication- is not biologically sound and research says will increase loss of life and increase spread of the infection.

 We do not agree that there is nothing that can be done - please see our treatment guidelines. As mentioned earlier the Shanghai Government has conducted clinical trials and now recommends IV Vitamin C in the treatment of CoVid-2019. http://orthomolecular.org/resources/omns/v16n16.shtml

There are numerous natural evidence based approaches that are safe and non-toxic that have potent anti-viral effect including against the corona virus families, immune benefit for the clearance of infection and prevention of complications, etc.  

Please review our treatment guidelines.  Please share them and this information. 
https://www.holistichealthpc.com/blog/corona-virus-naturopathic-guidelines-covid-2019-part-3-treatment

 

 

 

 

 

 

 

 

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Author
Dr. Eric Blake Medical Director of Portland Clinic of Holistic Health

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