The coronavirus may have been around for quite a while before it turned virulent!
March 30, 2020
The genomic analysis of SARS CoV2 looks like it may have been around longer than we think in humans. It subsequently seems to have undergone natural selection with some genes winning out and thus becoming more deadly to humans. In an interesting article in the Journal Nature Medicine, Dr. Anderson and colleagues tried to answer the question of origin. It is an interesting read see the link below.
There is not much new information out there about the coronavirus, therefore, I thought that I would take this time to look at these events in the context of which they offer us insight into life in general.
Coronavirus Update 5
April 2, 2020
Preamble note continues to not change significantly: 98-99.34% of us are not at risk for a bad outcome, which I define as death, if we follow the CDC guidelines. Take solace in that notion, however, the sand continues to change under our feet as the healthcare system gets stressed, this could change. Please do not use any of the following information as a license to be cavalier with other people's health as we do not know enough yet to make counter decisions. Continue to follow the CDC guidelines and the Stay at Home directive as it will help those at risk. Section 2 is a very deep dive into why nutrition can be a life saving decision for the foreseeable future.
Covid Prevention from a Functional Immune Perspective
April 2nd, 2020
Warning - very technical piece. However, it explains a lot about risk and lifestyle choices mechanistically. We are learning a lot rapidly. There is no time to waste to reduce your risk and be a part of the 99%.
As we looked at last week, prevention of a bad outcome, death, through lifestyle modification is imperative for our health as it relates to SARS2. After looking at ways to support the immune system through lifestyle choices and some targeted supplements, this week we are going to go a lot deeper into the science behind the immunology of the inflammatory response that is driving disease that we see as ARDS or adult respiratory distress syndrome and multi organ failure.
Remember from earlier posts that the SARS2 virus enters the lungs via the type 2 pneumocyte and an angiotensin converting enzyme receptor.
SPA Plans for COVID
April 2nd, 2020
SPA Covid Plans
Salisbury Pediatric Associates is working very hard to mitigate the risks of Coronavirus illness for patients that need care. We will remain open as long as the NC State government allows us to care for children.
The Silver Lining
April 6, 2020
There is a beautiful silver lining in the difficult world of COVID-19!
Time spent.
It has been an interesting few weeks with family, nature and self while primarily in quarantine when not at work. It has been a very long time since I lived two lives simultaneously. The stress of dealing with a medical career in a pandemic while caring for children and our staff's health and economic sanity mirrored against time spent in the yard gardening with my wife, playing cards and chess with the kids or generally lounging around as a family TOGETHER
Coronavirus Mental Health
March 26th, 2020
How are you coping with COVID and quarantine? Many people are stressed and frustrated with the risk, fear, isolation and the mixed messaging that is emanating from the government and media. In times like this, it is time to access the village. Since social distancing is the norm and should be, it is time to invoke FaceTime and Skype to feel close to those in your support village. Say hi daily to those that you love and respect. Talk through your fears and worries. Look around you for those in a stressful state and offer kind words, balanced thoughts and love. Together, we can make it through anything that comes at us. History has proven this fact time and again.
Covid Prevention
March 26th, 2020
Preventing COVID from being a killer in your body is a critical decision we all must make. What does that mean?
In my reading of the data and the various hypotheses to date, the biggest risk for a bad outcome is age and comorbid diseases like metabolic syndrome, diabetes mellitus and hypertension/CV disease. What is the common link to all of these states? Excessive inflammation and a weakened immune response pre infection to kill the virus which allows the virus to replicate rapidly and cause an immune dysfunction called an inflammatory cytokine storm. These are the conditions that inflammation based diseases produce.
Coronavirus Update
March 9, 2020
Coronavirus COVID-19 continues to get a ton of attention in the national media. The sensationalism of it all is a bit hard to swallow. It is a serious issue, but the way it is being portrayed is a bit beyond the pale. In a recent opinion piece by David L. Katz in the New Haven Observer, we see a modicum of tempered realism in this sea of media sensationalism. I highly encourage everyone to read this entire piece. Following the traditional media is not the best idea at this point, instead follow the Center for Disease Control.
Here are some of the highlights from Dr. Katz's piece:
SPA Covid Plans
March 26th, 2020
Salisbury Pediatric Associates is working very hard to mitigate the risks of Coronavirus illness for patients that need care. We will remain open as long as the NC State government allows us to care for children.
Catawba College Environmental Summit for High School Students
February 17th, 2020
Three leading organizations - the Center for the Environment at Catawba College, Rocky Mountain Institute, and the Environmental Working Group - are partnering to provide an opportunity for young environmental leaders to learn, create, share, interact, grow, connect, and build relationships. You know you have unique talents and particular interests; at Redesigning Our Future, you will learn the skills needed to use your passions to create a sustainable world.
Cholesterol Lipid Hypothesis Part VII - Wrap up
February 24, 2020
What do you do if you have tried everything as discussed so far and have not achieved a sufficient reduction in your risk through lowering your number of LDL hypothetical cars in circulation and/or also have issues with inflammation residually?
This is the intersection where lifestyle changes meet medicine needs. There are some instances where, in 2020, we are still dependent on medicine to help us stay alive despite our best attempts otherwise. Again, I turn to the experts for an understanding of the medicines and their role in disease. Sometime this year I will take a look, this will not be an exhaustive look at all of the medicines, but more a tour through the most beneficial to date.
Quick Hits
February 24th, 2020
1) Dr. Kandola and colleagues looked at sedentary behavior and teenage depression risk overtime in a new study out of Lancet Psychiatry. They looked at 4257 adolescents over a 6 year period. They found that total physical activity decreased between 12 and 16 years of age overall for the depressed group at age 18 years old. Depression scores were lower at 18 years old for every 60 minutes per day of extra movement over the study period.
Milk Reboot Part I
March 2, 2020
Milk has been a cornerstone of childhood nutrition for as long as one can remember. Our children are expected to drink milk at home, in school and at restaurants. The positive health benefits of milk have been touted by the dairy council and the federal government for years. Is this propaganda or rooted in science? What does the data say? Do we really need milk after we stop breastfeeding? Is there a logical precedent evolutionarily for this belief of need? Not all physicians agree that it is that good or even necessary for all. I am steadfastly in this camp along with Frank Oski and many others that have looked over the data.
Physical Activity with Dave - a new random series
March 02, 2020
Exercise Rights and Wrongs or the Do's and Don't's
Life and time have taught me that there is no single correct way to exercise. Age, outcome desire, physiological makeup and other variables play into the calculations of trainers to provide the best workout regimen for you.
Based on years of experience, here are some ideas to help identify the best way for you to exercise and succeed at your stated goals.
Milk Reboot Part II
March 9, 2020
Over the past 60 years, Americans have been taught that milk is necessary for complete nutrition. That it is an important source of vitamin D and calcium. I am one of a growing voice of providers of care that emphatically disagree. I believe that the best way to achieve this nutrient goal is to spend a half hour in the sun without sunblocking creams and eat a diet rich in green leafy vegetables that are loaded with calcium, such as kale, greens, spinach and broccoli everyday.
In Brief
March 09, 2020
1) Air pollution in the news as it relates to disorders of attention deficit, asthma, autism, premature infants, low birth weight infants and lower IQ infants. Dr. Shea and colleagues analyzed medical costs related to childhood and maternal exposures to particulate matter of 2.5 micron sizes from air pollution. The authors state, "These estimates range from $23,573 for childhood asthma not persisting into adulthood to $3,109,096 for a case of autism with a concurrent intellectual disability."
Milk Reboot Part III
March 16th, 2020
Continuing on the dairy and outcomes storyline, let us review healthy bowel patterns. Bowel patterns are a great window into our nutritional and metabolic health. We all know the stool caliber of our diaper bound children, but we start to lose this knowledge around the 3 year old age range as our children begin to defecate on their own. Why does this matter?
As the microbiome data continues to push medicine into new understandings, bowel patterns are a great window into food reactions, food composition and thus nutritional and metabolic sufficiency.
Coronavirus Update 2
March 16th, 2020
Coronavirus SARS2/COVID-19
SARS2 Severe adult respiratory syndrome coronavirus is the viral name
COVID 19 is the disease name
Preamble note: 99% of us are not at risk for a bad outcome. Take solace in that notion. Please do not use that as a license to be cavalier with other people's health.
Intergrative Medicine and COVID 19
March 23, 2020
The prevention aspect of Integrative Medicine lends itself well at times like this to help the human frame prepare to battle the Coronavirus when and if it shows up in your body. I recently received an email from my friends at the University of Arizona Center for Integrative Medicine regarding this exact topic. My good friend Dr. Victoria Mazes has given me permission to share this excellent document with you all.
Here are some of the highlights as copied:
"While the pathogenicity of COVID-19 is complex, it is important to understand the role of inflammation in this disease. The virulence and pathogenicity (including acute respiratory distress syndrome) associated with SARS corona viruses develops as the result of viral activation of cytoplasmic NLRP3 inflammasome.
Coronavirus SARS2/COVID-19
March 23rd, 2020
SARS2 Severe adult respiratory syndrome coronavirus is the viral name
COVID 19 is the disease name
Preamble note: 99% of us are not at risk for a bad outcome. Take solace in that notion. Please do not use that as a license to be cavalier with other people's health.