COVID vaccine - what is the story?
June 26th, 2020
Has there ever been a successful vaccine made against a beta coronavirus? Not to my knowledge despite the common cold being represented by 30% coronaviral etiology and efforts being made in the past. Dr. Peter Hotez and his group in Texas were apparently close for SARS1 years ago before the funding dried up. There are many groups working feverishly and competitively to be the first to succeed at this major task.
Great resources for COVID
First: My good friend Dr. Kathi Kemper has just published a lovely article on the HealthyChildren.org site about Mood boosting for children during the pandemic. Link
Second: Scientific American has done it again. An absolutely amazing pictorial experience regarding the many facets of SARS2 activity in humans. This website is a must visit for all of you. I am really serious. Awesome. Link
Coronavirus Update 13 Changing times repeat the uptick in cases in different locales
June 26, 2020
As occurred last March, times change rapidly in the world of COVID19. Latest numbers show that on balance COVID19 incidence and death is rising rapidly nationally with some of the bigger states getting hit hard with 5000 plus new cases a day. This is not a surprise as the realities of COVID are always a guessing game and close human interaction is skyrocketing. I reiterate that this is likely to be an infectious disease that keeps us frustrated for
June 22ud, 2020
I have spoken to many individuals that believe that they had a strange COVID like viral illness this winter. Most have told me that they have tested negative for the SARS2 virus. I had a similar experience back in March after a trip out west to Jackson Hole, Wyoming. My illness lasted 8 days and waxed and waned with the strangest cough that I have ever had. I had the classic lack of nasal congestion that COVID patient's experience.
Covid19 Quick Hits
June 22nd, 2020
1) In a news piece published in Nature a few days ago, the authors looked at the volume of people globally that are at risk of a worsened outcome from COVID disease. They propose that 1.7 billion people worldwide are at increased risk of having difficulty with SARS2 because they have at least 1 comorbidity associated with risk. They further predict 350 million hospitalizations based on their modeling. (a clear guesstimate based on known comorbid risk factors currently in circulation)
2) There is a 12 fold increase in the risk of death if a person has 1 or more comorbid chronic illnesses like diabetes,
Coronavirus Update 12 Children Centric Data
June 22, 2020
Latest numbers show that on balance COVID19 incidence and death is a mixed bag nationally with some areas showing significant increases in cases. This is not a surprise as the reopening of the local economies has increased close human interaction. This is likely to be an infectious disease that keeps us frustrated for another year or more until a vaccine is found
June 15th, 2020
In a recent Wall Street Journal article, Annie Gasparo looks at rising food prices amid the COVID experience. Food prices are rising faster than any time in the last 40 years. This poses serious problems for those already strapped by COVID related economic problems. The good quality nutritious foods are rising faster in price than the low quality highly processed indirectly government subsidized foods. Again, we find the deck stacked against the consumption of high quality low inflammation foods that shield us from disease.
Cross reactive immunity Psychological stress COVID19
June 15, 2020
COVID 19 continues to dominate the airwaves of medicine and Dr. Peter Attia just posted some excellent information worthy of your time.
Part 1) It appears that we may have a large subset of our population walking around with potentially protective cross reactive antibodies to SARS2 from other beta cotronaviral infections that we call the common cold.
COVID 19 Recent Updates
June 8th 2020
1) Cases are increasing slowly in certain states including North Carolina. We are in phase 2 of an economic reopening of businesses and activity which puts the pressure back on the healthcare system as hospitalizations are increasing. So far, the hospitals have capacity and are dealing well with the cases identified. Protective gear also appears to be fully available locally. The graph on this CDC page shows how clearly the death rate has plummeted nationally.
2) Sadly, North Carolina has had its first death in a child. An 8 year old female patient died of complications following
June 8, 2020
Is that time of year again and kids are starting to return to beaches and playing again with local friends outside within the framework of each states social distancing and contact avoidance rules. Flashlight tag, capture the flag, surfing, walking the beach and other great outdoor activities are back again to my pleasure. It is so awesome to see kids interacting verbally, socially and safely instead of interacting cyberly, restricted and suppressed as they were never meant to be for a prolonged time.
Troubled Times Call for a Change of Direction
June 8th, 2020
Salisbury Pediatric Associates, PA, mourn with our community locally and nationally. We are filled with sorrow at the senseless loss of life of Mr. George Floyd, Mr. Ahmaud Arbery and too many other minority men and women. The collective voices of the injured and disenfranchised are protesting racial injustice and we stand in solidarity with them throughout this struggle.
We, the providers and staff at Salisbury Pediatrics have spent our lives loving and caring for children of any race, color or creed and we believe wholeheartedly that:
COVID Risk Factors
June 1st, 2020
1) Blood groups matter for SARS2 infection risk. Ever since SARS1 occurred in 2008, researchers have been looking at human blood group antigens as a risk factor for coronaviral infections and morbidity. It appears from the literature that individuals with blood group A have the highest risk of contracting SARS while blood group O has the lowest risk. The antibody anti A which occurs with blood groups O and B is inhibitory to the coronaviral spike protein adhesion to the ACE2 receptor in humans. This effectively decreases viral cell penetration and replication making disease less likely.
Coronavirus Update 11 Poverty and COVID Part 2 Children
June 1, 2020
Latest numbers show that on balance COVID incidence and death is declining nationally, however, some areas are increasing. Thus, we are not out of the woods. Cases, deaths and ICU admissions are all on a downward trend which is great. We still do not have any reasonable IFR data. States are opening up and we will be watching closely for any uptick in cases locally. Humidity, higher ambient temperatures, social distancing and general precautions taken so far are likely causes for the trend.
Recap from last week. National poverty and mental stress issues are going to acutely worsen because of the unprecedented COVID19 lockdown.
Physical Education with Dave
May 25th, 2020
Exercise and Lower Back Pain
• Low back pain has many possible etiologies: muscles strains, structural/postural spinal anomaly (stenosis, scoliosis, kyphosis, lordosis), a ruptured disc, sciatica, arthritis, kidney infections, cancer of the spinal cord and more.
• Pain can be acute, subacute or chronic.
The Health Storm Podcast
May 25th, 2020
The Health Storm Podcast is a look into medicine from the business/innovation side with venture capilatist Vic Gatto. It is an excellent way for you to keep up with innovation trends in healthcare. I recently sat down with Vic to discuss a few pertinent health topics. Here is the link to the videos.
Jumpstart Health Investors Weblink to all videos
Obesity and Childhood Antibiotic Use
May 25, 2020
We have known for quite some time now that using antibiotics to treat infectious diseases carries secondary health risks. Medical providers and pediatricians in particular have been pushing antibiotic stewardship programs for the past 20 years primarily to fend of antibiotic resistance and the risk of bacterial infections that are untreatable. Unfortunately, the data keeps emerging that the bigger issue with antibiotic use is really the disruption of the intestinal microbiome's bacterial balance that existed pre antibiotic exposure.
May 18th, 2020
Continuing on the work theme, I just finished a fantastic article on the immunology and prevention strategies related to SARS2/COVID written by Dr. Sam Yanuck, DC and colleagues. Sam is a persistent, consistent, plodding, incremental, laborious, dispassionate, self-chosen, time independent worker that has provided for the best outcome and the most happiness for me as I learn the immuno-biology of the SARS2 world.
Work is the key to all things.
May 19, 2020
For the better part of 2 decades I have been willfully preaching work ethic to all of my teenage patients. The absolute key to success in all things, in my opinion, is work. It is that which is persistent, consistent, plodding, incremental, laborious, dispassionate, self-chosen, time independent work. The theater of the effort is irrelevant. Whether you are working at parenting, medicine, relationships, sport, nutrition and so on, the principles are identical.
I have yet to find a time where persistent, consistent, plodding, incremental, laborious, dispassionate, self-chosen, time independent work doesn't provide for
SPA Covid Plans revised
May 16th, 2020
Salisbury Pediatric Associates is working very hard to mitigate the risks of Coronavirus illness for patients that need care. We remain open and are performing many telemedicine visits to care for children.
TELEMEDICINE IS NOW AVAILABLE FOR WELL CHILD VISITS FOR MANY INSURANCE COMPANIES AND NC STATE MEDICAID.
FOR ANYONE THAT MISSED TH WHITEBOARD SESSION. HERE IT IS FOR ONE MORE WEEK.
May 16th, 2020
When I decide to try and understand a topic as complex as human immunity, I need to see the pathways in order to understand it all. Above, I present the latest analysis of immunity and lifestyle choices as it relates to COVID. You are welcome to copy this picture and study for yourself.
The highlights are as follows. In order to have a good host response to the virus, we want a robust T Helper cell type 1(TH1) and Natural Killer cell (NK cell) response in the beginning stages of the infection