Some days I see the emails with the latest COVID news and I just hit delete.  I don't need to know every single thing.  I don't have to think about it every single day.  I am curious, and attentive, but the value of a media blackout for morale cannot be overstated.  I get so fed up with the "news cycle" and the hopeless and repetitive nature of political reporting.  And I get really sad when I study on COVID.  It is good for me to turn it off.

We can't be hypervigilant all the time.  We're designed to nap. 

"MILD" WRONGLY DEFINED AS NOT NEEDING HOSPITALIZATION
https://www.nature.com/articles/d41586-020-02335-z
People who don't get hospitalized don't get medical follow-up either. We all know that some seek hospital care more willingly than others.  Some of us refuse to go to the hospital; we know it is full of antibiotic-resistant infections and stressed-out doctors and staff. I had a pneumonia that could have been Covid but I did not go to the hospital; I self-treated at home. My pneumonia was not "mild". I thought about going in. Many people who've survived the virus at home are having longterm after-effects. This author is absolutely right that we need a better way of categorizing and tracking the cases that did not result in hospitalization.

THE KIND OF MASK YOU USE MATTERS
https://www.sfchronicle.com/bayarea/article/Does-your-coronavirus-mask-work-New-study-15473251.php
I've noticed that many police, highway patrol and fire department personnel are using what I would call "neck gaiters" for masks.  These are a single thin layer of polyester with some lycra for stretch. They drag the thing up over their mouths and noses when in close proximity with others. This kind of" mask" doesn't stay up well. Thin layers of fabric may stop large droplets but they are definitely not catching the aerosols which have turned out to be a major route of infection. Public servants who are in direct contact with the public should be wearing quality masks. Well, everybody should, but "should" doesn't get very far in America.

OVER 900 HEALTHCARE WORKERS HAVE DIED OF COVID
https://khn.org/news/exclusive-over-900-health-workers-have-died-of-covid-19-and-the-toll-is-rising/
POC's dominate the count and you can see from the photos that many victims of all colors are obese.  To reduce this grim outcome perhaps we should use front line workers who have fewer risk factors. Smokers shouldn't be on the front lines. People with hypertension, obesity, diabetes or a heart condition could (and should) be exempted from front line work. There's a great emphasis on PPE (personal protective equipment) and it is important, but the healthcare worker's baseline level of health and resilience is just as important.  People with immune compromise of any origin should not be expected to work with COVID patients. Period. There are so many obese nurses! They should not be put in this position. I heard on a podcast yesterday that 70% of our BMI is due to genetics: no point in punishing people for being heavy. We should evaluate the immune sufficiency of healthcare providers and place them accordingly. Those on the front lines of the pandemic should have top notch immune systems--and be most likely to survive the virus with minimal negative effects. Yes, I know there's a shortage, but seriously sending all these fine people to their deaths trying to help others?  This is murder.

ABOUT 10% OF COVID VICTIMS HAVE PROBLEMS AFTER 3 WEEKS
https://www.bmj.com/content/370/bmj.m3026
We're just starting to collect information about the after-effects of this virus but for a lot of people recovery is extremely slow.  This report has some excellent resources (links) for patients who are having trouble after they are supposed to have "recovered".  The list of possible lingering symptoms is long, and you are not malingering if you have chest pain or "lung burn" and would like to get some help.

A GREAT TIME TO QUIT SMOKING: EVEN YOUTH HIGH RISK IF SMOKE
https://www.jahonline.org/article/S1054-139X(20)30399-2/fulltext
Vaping is not protective. Using it just once in a while is not protective.  Inhaling smoke at all increases your risk, even if you're young. There has never been a better time to quit and quit for good.

SANTIZING OVER-RATED: MUST AVOID BREATHING SAME AIR
https://www.theatlantic.com/ideas/archive/2020/07/scourge-hygiene-theater/614599/
Now that we know that the primary way COVID is spread is via respiratory droplets, and that very little spread is via fomites (germs on things), we can adjust our priorities accordingly.

SEE-THROUGH MASKS COMING SOON
https://www.npr.org/sections/health-shots/2020/07/28/893071631/demand-surges-for-see-through-face-masks-as-pandemic-swells
This is very important for the hearing impaired and for children who may not be as good at hearing spoken communications as they are at reading the lips and face of the person speaking.

CHINESE VACCINE RESEARCH STRUGGLES TO FIND PARTICIPANTS
https://www.nature.com/articles/d41586-020-02244-1
Because they have largely controlled the virus, people aren't as eager to participate in vaccine trials.  I do not know if the people of China know about their previous vaccine scandals.

FRESH AIR AS COVID PREVENTION: LET'S TALK VENTILATION
https://www.theatlantic.com/health/archive/2020/07/why-arent-we-talking-more-about-airborne-transmission/614737/
When treating patients for the flu of 1918, one of the main practices of naturopathic doctors was to house the patients in individual tents, and to bring them outdoors whenever possible.  The belief was that fresh air was good for their recovery.  Now we know that fresh air is also one of the best ways to limit transmission.  Homeowners and businesses should consider the value of fresh air flow and do the work to enhance it before winter!!

Older Children Carry the Virus as Much as Adults
https://www.nytimes.com/2020/07/18/health/coronavirus-children-schools.html
The ultimate effect of this is that if we send kids back to school this fall, they will bring the virus home to families.  The children will most likely be OK, but the parents and grandparents may not be.  Home schooling is difficult but keeping your kids from mixing with too many other kids will save lives.

Keep Your Distance from Other People's Pets
https://www.biorxiv.org/content/10.1101/2020.07.21.214346v2
Dogs and cats in Italy were tested for antibodies to C19 and it was found that pets who live in households with prior COVID infections had antibodies in their blood.  In other words, if the people get it, the pets get it.  And if the pets get it, you don't want to go around letting other people's dogs "kiss" you.  If you are a pet owner, you could get the virus by letting your dog play with others at the dog park.
​
Israeli Kids Skip Masks During Heat Wave Causing Outbreak
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.29.2001352
​This is just the latest example of what happens when masks are not used.  There is no shortage of evidence that masks reduce transmission significantly.  Masks do make us hotter and are harder to tolerate when the environment is hot.  For the school in this report they would have been better off if they'd sent the kids home, rather than letting them go maskless.  It is also obvious by now that summertime is not going to bring relief from the pandemic.

India Hit Hard as every country will be if they relax
https://www.reuters.com/article/us-health-coronavirus-india/daily-coronavirus-cases-in-india-top-50000-for-first-time-idUSKCN24V134?utm_source

​​If You are Young or Not Worried About It
https://www.washingtonpost.com/health/young-people-are-infecting-older-family-members-in-shared-homes/2020/07/28/b8cdc810-cd0a-11ea-b0e3-d55bda07d66a_story.html
Please find your own place to live with other young or "not worried" people.  Don't live with your parents or any other vulnerable people.  Don't visit them.  You may be OK but you will feel terrible if your casual approach turns into the murder of your family members.

Sweden's Pandemic Strategy Didn't Work
https://www.nytimes.com/2020/07/07/business/sweden-economy-coronavirus.html
Sweden declined to shut down businesses thinking that their economy would fare better that way.  They have far more deaths than the neighboring countries and their economy is in the same rough shape.
​

One thing that has become increasingly apparent is that this pandemic virus is deadly to those who are already weakened by life, and harmless to many who are young and strong.  There are many possible explanations to this phenomenon, and I want to share with you my thoughts on why.

Very young children for the most part don't get the infection at all.  This is likely because their mucosal immunity is strong.  Mucosal immunity is the defenses that live in our noses, throats, and intestine, specifically defensin, cryptidin, and secretory IgA.  There are antibodies called IgA in our saliva.  These things are capable of disposing of a virus before it even gets started infecting our cells.  Most American adults don't have strong mucosal immunity, but in children it is highly effective.  "Secretory IgA can be measured directly in stool, saliva, and breast milk to assess the degree of mucosal immunity," but in modern medicine this parameter is rarely if ever measured.  It is however possible to make it stronger in adults, by the way that we live.

Older children and young adults can be infected and carry the virus but they are less likely to get badly sick.  This is at least in part because the T-cells of their immune system are strong and active and can find the virus and kill it, and because they have lower levels of inflammation so they don't go into cytokine storm.

Middle aged adults are starting to have more chronic health problems, and this is what makes a person susceptible to a very bad case of the virus.  Being obese is one of the worst risk factors.  In the news they talk a lot about heart conditions and diabetes, but these things are strongly linked to obesity.  Obese people have higher levels of inflammation throughout the body, including in the liver which clogged with fat, and the brain which responds by getting depressed. Obesity also impairs the immune system, reducing mucosal immunity as well as the T-cell response and letting the virus get a foothold and grow.

Older adults most often have an assortment of health conditions.  The ones who've gotten overweight or obese are unlikely to survive when they get the virus.  The ones that are lean and active might survive, like the 100 year old veteran in Portland who got it and came out topside.

The lesson from these patterns is clear.  If you are declining into the diseases of abundance which are so common in America, you are at risk.  Being medicated for your high blood pressure and excessive blood sugar will not save you.  If you maintain a healthy body weight and exercise vigorously you are less at risk.  Covid-19 is a lifestyle disease, it is sorting us out by our most basic level of health.

If you would like to work on your basic health, nobody is better suited to help you than a naturopathic doctor.  Conventional physicians are too busy fulfilling the requirements of their network and insurances to really study on diet and lifestyle.  They want to do what we do, but they can't, not in a 15 minute visit.  Changing your diet and lifestyle and increasing your base health, is a gradual process.  You can start today by cutting out some sugar and moving your body just a little bit more.  Good luck!! 

If you'd like a health assessment and tips on how to improve your particular situation, feel free to touch base with me.  I'll ask you to do a diet diary (you can download the form on the bring page in this website) first so I know what you eat.  I'll want a full list of the medications you take, and the supplements.  Then we can talk on the old fashioned telephone.

As you probably know my favorite form of recreation (and meditation) is whitewater kayaking, and my favorite place to do whitewater kayaking is in the deep wilderness.  Oregon is rich in lovely day runs and I have called it heaven for the whitewater kayaker.  One reason that Oregon is heaven is the proximity of Idaho.  Every year I make a pilgrimage to celebrate the rivers there. 

A man named Frank Church was a senator from Idaho from 1957 to 1981, and during his time in the senate he got a lot of bills passed that help protect wild places and things.  Some of the rivers we ran flow through a wilderness that bears his name.  Thanks, Frank.
​

We may not think often about how wilderness impacts our health but it does.  Undeveloped areas provide pockets of clean air and clean water for us and all the other species. Clean air is important to maintaining cardiopulmonary health and our sanity.  Clean water is key to most life processes in most living things.  Even just having a treed area nearby enhances quality of life for people in a city.

Idahoans know this.  They hunt and fish and camp and swim in the rivers more than most folks.  Some of them have fallen prey to misinformation about COVID-19 from the whitehouse, and I worry that they will not fare well when the virus finds them.  But they are proud people and the more they get out into the wilds, the fitter they will be and the higher their chances of surviving the dread virus when it arrives.

As I settle back into my city routine I will begin to post again about COVID-19.  Having taken a nice time-out my perspective has shifted a bit.

I hope you are getting outdoors.  I hope you pull your face out of the mobile phone screen long enough to take in the green.  I hope you see the crows fly and feel the cold water of a stream.  These things are strong medicine.

India's Low Death Rate Due to Many Undiagnosed
https://www.nature.com/articles/d41586-020-01865-w

Youth in America Have the Virus
https://www.nytimes.com/2020/06/25/us/coronavirus-cases-young-people.html

​The CDC says U.S. Case Count could be 10x more than Reported
https://theweek.com/speedreads/922103/cdc-estimates-may-have-actually-more-than-20-million-covid19-cases

Over A Million Stimulus Checks Sent to Dead People 
https://www.washingtonpost.com/us-policy/2020/06/25/irs-stimulus-checks-dead-people-gao/
​
Home Testing Won't Be Cheap but it Could Help
https://www.centerforhealthsecurity.org/our-work/publications/at-home-diagnostic-testing-for-infectious-diseases

Lung Injury from Vaping Can be Mistaken for COVID
https://www.cdc.gov/mmwr/volumes/69/wr/mm6925a5.htm

GIO = Global Immunological Observatory monitoring for future pandemics
https://science.sciencemag.org/content/368/6498/1413

​

8% Don't Seroconvert (Start Making Antibodies): The Mild Cases
https://www.medrxiv.org/content/10.1101/2020.06.07.20124636v2.full.pdf

​The U.S. and Brazil are leading the world in Abysmal Pandemic Management
https://www.nytimes.com/2020/06/22/world/coronavirus-live-updates.html

​Tyson chicken processing plant has Outbreak
https://apnews.com/9b2b24d3b3ed981041a7fe6ab499100c

Sweden's Herd Immunity Strategy Failing: Republicans Please Read
https://www.bmj.com/content/369/bmj.m2376

​Healthy Blood Vessels Matter in COVID infection
https://www.nature.com/articles/d41586-020-01692-z

COVID forces change in Medical Education: We Need Doctors
https://www.nejm.org/doi/full/10.1056/NEJMp2018570

Reimbursements for Telehealth Consults Expected to Fall After Pandemic
https://www.beckershospitalreview.com/telehealth/will-health-systems-sustain-telehealth-if-pandemic-pay-rates-coverage-drop.html

Still Trying to Pin Down the Fatality Rate vs the Infection Rate
https://www.nature.com/articles/d41586-020-01738-2

Overview of Ongoing Clinical Trials Seeking COVID Tx
​https://link.springer.com/article/10.1007/s00264-020-04625-7

Cluster Starters in Japan mostly 20-39yoa, Presymptomatic or Asymptomatic 
https://wwwnc.cdc.gov/eid/article/26/9/20-2272_article

Fragmented Global Governance Can't Coordinate Pandemic Response
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31405-7/fulltext

Anti-viral RBD-specific Antibodies will be Basis for Vaccine
https://www.nature.com/articles/s41586-020-2456-9

$7.3 Million More of Our Money Wasted by Continuing Incompetence 
https://www.propublica.org/article/the-trump-administration-paid-millions-for-test-tubes-and-got-unusable-mini-soda-bottles

​Mind Bender: How the Odds Change with Different Infection Rates
​https://www.scientificamerican.com/article/coronavirus-antibody-tests-have-a-mathematical-pitfall/

Cytokine Storm isn't the Whole Story: Immune System Can Underfunction
https://www.nature.com/articles/d41573-020-00110-3

America, We're not done with the First Wave
https://www.npr.org/sections/health-shots/2020/06/12/876224115/coronavirus-second-wave-nope-were-still-stuck-in-the-first-one
​
Oregon Pauses Reopening based on Reality
https://www.npr.org/sections/coronavirus-live-updates/2020/06/12/875961223/oregon-pauses-reopening-as-coronavirus-cases-rise

COVID hits the Prison System Where Blacks are Disproportionately Held
https://www.nytimes.com/2020/06/16/us/coronavirus-inmates-prisons-jails.html

​Dexamethasone (Cheap, Generic Steroid) is Saving Covid-case Lives
https://www.washingtonpost.com/nation/2020/06/16/coronavirus-update-us/

​CDC on what we learned from the Navy Air Craft Carrier Soldiers
https://www.cdc.gov/mmwr/volumes/69/wr/mm6923e4.htm

The Meat Packing Plant Story
​https://www.propublica.org/article/emails-reveal-chaos-as-meatpacking-companies-fought-health-agencies-over-covid-19-outbreaks-in-their-plants

US Hospitals More Adaptable than Expected
​https://www.propublica.org/article/how-americas-hospitals-survived-the-first-wave-of-the-coronavirus