Hello friends!  Just a few words about what's been up with me.

My apologies, I let up suddenly on blogging about Covid.  It seems there so much noise about that going around that people weren't really paying much attention to my take.  That's OK, I have other things to do.  I still have my share of opinions but I can keep them to myself.

I took a 3rd job.  On top of my private practice and my work at the NUNM medicinary (herbal pharmacy), my newest job is interpreting SIBO labs remotely for NUNM.  It's interesting and I'm learning a lot.  All this time I kind of ignored SIBO, thinking it was not that useful, but now that I've been made to study it more deeply, I see the utility in testing for it.  Sure, there are a million possible kinds of dysbiosis, but we do need ways to discriminate among them to target treatment.  So we do breath testing.  More on this another time.

In other news I got my second Moderna vaccine shot today.  I feel quite relieved to be vaccinated, even with variants spreading like grassfire.  Now I can visit my elderly parents without fear that I might kill them.  It's been a long time.  As I've said before, I suspect that I had the dread virus in January 2020, before anybody really expected it here.  My response to vaccination suggested that I had previously encountered that pathogen.  But now it's official.

I know I promised a post about enhancing vaccine response and typical to me, I'm still studying on that question.  I suppose I should just put something out with what I understand now, and update it later.  So stand by for that, soon, grasshopper, soon.

And last but not least, I've been really quite busy putting together a series of lectures on zoom about whitewater safety.  I'm the safety chair for the Lower Columbia Canoe Club and if you're curious, you can find a link to a recording of our last talk (and the password to access it), here.  It's about The Human Factor.  Humans are fascinating, whether it be in medicine or in play.

Hello friends.  That was a nice long break from posting.  It isn't that nothing is happening on the Covid front, I just got busy with work and posting fell by the wayside.  But right now a snow storm is settling over my home and I anticipate being trapped here for a few days, so I'll have time to put down a few thoughts.

Age x Obesity + Degree of Infection => Aerosols Released
https://www.pnas.org/content/118/8/e2021830118
The equation above oversimplifies, but it captures the gist of the findings.  Basically there are a few people who are superspreaders, and the scientists are starting to understand who and why.  In their words "exhaled aerosol particles vary between subjects by three orders of magnitude, with exhaled respiratory droplet number increasing with degree of COVID-19 infection and elevated BMI-years.  What this means to us is that it is still reasonable to keep staying away from most people, keep wearing masks, and find a way to lose weight if you've gotten fat.  I've got friends who've had great success with Noom, and others who swear by the Ketogenic diet or the Whole 30.  But there is no doubt that obesity is a huge risk factor for bad outcomes and also for being a superspreader.

KIDS CAN TRANSMIT COVID AFTER ALL---AND PRETTY WELL
https://www.princeton.edu/news/2020/09/30/largest-covid-19-contact-tracing-study-date-finds-children-key-spread-evidence
Remember how they were saying that children don't transmit the virus, so it's OK to send your kids to school?  Well that appears to have been wrong.  Best protect your kids from exposures so that they don't bring it home to you.

VACCINE TRACKER
https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-vaccine-tracker
Been dorking out about all the vaccines under development?  Yeah lots of people are.  Not me, so much, I'm just working and waiting.  My take on vaccination: we're going to want it, but we also don't want it to hurt us, so it's worth waiting.  If you end up getting a vaccine that works really well, great.  If you get a vaccine that kinda halfway works, get another one the next time you have a chance.  Do what you can to improve your immune response to the vaccine.  A future email newsletter will be about this subject.

MOST CONTAGIOUS STRAINS COME TO DOMINATE
https://todayspractitioner.com/covid-19/coronavirus-genetic-mutation-may-mean-it-is-more-contagious/#.X701_6pKjNZ
Lots of mutations have appeared in COVID-19 the ​ones that make it more contagious are a big advantage for the virus, meaning that more and more of the cases are the most highly contagious strains.  Which means that mask wearing is even more important, and during our current spike staying completely away from others may be of ultimate importance.  The study was done in Houston, TX: https://mbio.asm.org/content/11/6/e02707-20.

THE CURRENT SURGE IS WORSE THAN ANYTHING BEFORE
https://www.npr.org/sections/health-shots/2020/11/13/934566781/the-pandemic-this-week-8-things-to-know-about-the-surge
This article is 11 days old already but it documents how fast the case rate accelerated in the first half of November.  An increased case rate is inevitably followed by increased hospitalizations and deaths.  During this time when so many people have the virus, there is nothing you can do except stay away from people.  Even your dearest friends and relatives can give you the virus, or you can give it to them.  So take some time to hibernate, meditate, read books, and otherwise entertain yourself at home.  Don't even go shopping if you don't have to.  This situation could last all winter if lots of people ignore this advice, but you don't have to be the one dying or killing your dearest people.  Being a homebody is not the end of the world.  It's easier to be free when you are alive.

15% OF COVID DEATHS LINKED TO LONG AIR POLLUTION EXPOSURE
https://www.aljazeera.com/news/2020/10/27/new-study-links-air-pollution-15-percent-of-covid-19-deaths

EXCEL SPREADSHEET CAN'T CONTAIN UK COVID NUMBERS
https://www.bbc.com/news/technology-54423988
This is what happens when you have non-scientists in charge of big data projects.

IMAGE: SPIKE IN CASES IN MALHEUR COUNTY 10/3
(This from the Oregon Health Department Website)
Trusting non-scientific "information" doesn't serve anyone when a real pandemic is afoot.

DO WE WANT RAPID ANTIGEN TESTING HERE?  YES.
https://www.nature.com/articles/d41586-020-02661-2
These tests are quick and inexpensive, and help us detect people who have enough virus on board to be contagious.  While it is true that they won't detect very low level infections, they will give us a good clue as to who should be allowed to go to the grocery store, or work.  The CDC was wrong when they said only symptomatic people should be tested.  To control a pandemic that has so many asymptomatic cases you need to test everybody.  The goal is to keep people who are contagious from sharing air (or bathrooms) with others.  So yes, get the $5 test that's ready in minutes, and use it to decide whether or not you should quarantine yourself.  Push your employer and your local governments to get behind wide distribution of this simple technology. It will definitely help.

​

NEW REVIEW OF MANY STUDIES ABOUT COVID ANTIBODIES
​https://www.nature.com/articles/s41467-020-18450-4

Released 2 days ago, this synthesis review shows that immunity to SARS-COV2 behaves in a normal way.  When a person has been quite sick and survived, they will likely have high antibody levels for that particular sickness--for a little while.  These are the people from whom you might wish to get convalescent plasma, because it's probably full of antibodies that could help.  But these antibodies ramp down pretty quickly once you clear the sickness.  A person who had the virus months ago will not have as many antibodies in their plasma as a person who just cleared it last week.  This is why there aren't studies to prove that convalescent plasma is a good treatment: it depends on the person's immune response and on the timing. 

IgM is the first kind of antibody your body makes, and appears about a week into an illness.  After that your body switches over to making IgG antibodies.  The fact that IgM antibodies decrease after the illness is NORMAL.  The IgG antibodies that are made next are the keepers.  They keep being made, but at lower and lower levels if you aren't still fighting the same virus.  This is also NORMAL.  Your body does the same thing for ever flu it ever encounters.  The fact that your body KEEPS making antibodies has to do with its MEMORY.  The immune system has cells called Memory B Cells--the ones that know how to make antibodies for a specific condition--they are your body's memory.  As long as your memory B cells survive, your body has a blueprint of how to make more B cells that can more antibodies to fight that remembered infection--in other words, it can respond faster.  

Memory B cells can live a long time but eventually they die.  The rate at which they die varies by age and lifestyle and also by what other infections you get.  One really good reason to get vaccinated against Measles is that getting measles infection can kill your memory B cells, making you MORE susceptible to things that you've had before.  And that stinks.  I hope that you are vaccinated for measles (the MMR is available if you aren't) and that you also get vaccinated for the flu this year, because it's good to protect your lungs. 

As for the COVID vaccine, we're likely to have a lot of options with varying efficacy that are available to most of us next year.  I don't know for sure what will come out, but I will say that for myself I will try to get one vaccine/year, hopefully different kinds each year, to help my body build up resistance by exposure to lots of different parts of the virus.  For those who are worried about adverse effects from vaccines, let me just say that they really are rare, a lot more rare than the diseases. Also you can also minimize your risk of adverse effects to vaccines by improving your ability to detoxify your body.  I can help with that for sure.  Spring and fall are good times for a deeper detox!

CDC GUIDANCE ABOUT COVID-19 FLIES IN THE FACE OF SCIENCE
https://www.nytimes.com/2020/09/17/health/coronavirus-testing-cdc.html
Several of our most important government agencies have fallen prey to anti-science populist politics and can no longer be trusted to sort through the information and tell us what to believe or trust.  We need good-faith gatekeepers of information in this age of excessive and some false "speech" clouding every question.  In this case the scientists (especially the ones that study infectious disease) are telling us that to contain this pandemic we need to test EVERYBODY and make sure that all the asymptomatic carriers are quarantined.  The CDC just issued a report saying that we shouldn't be tested unless we have symptoms.  This is what we have been doing, and it has resulted in nearly 200,000 dead in this country alone.  If we continue with this method, and with the likely efficacy of vaccines being in the neighborhood of 50%, and with the likely avoidance of the vaccine by somewhere around 50% of the population, we can expect A MILLION DEAD in this country alone.  So the CDC, in line with the authoritarian administration that has perverted it, is setting us up for an ongoing pandemic disaster.  Best get some great time outdoors with friends this fall while the weather is still good, because when wintertime comes smart people will keep their indoor social circles tiny.  TINY.

WE NEED TO KNOW WHAT HAPPENED WITH THE ADVERSE EFFECT
https://blogs.sciencemag.org/pipeline/archives/2020/09/14/vaccine-transparency
It is not OK for vaccine manufacturers to hide the specifics of adverse effects, any more than it is OK for governments to hide the specifics of nuclear incidents.  If the people is to trust the makers of vaccines or the governments of countries, we need to hear prompt, factual information from them.

STURGIS WAS A MISTAKE
https://thehill.com/homenews/state-watch/515453-sturgis-motorcycle-rally-was-superspreading-event-that-cost-public
I understand that riding motorcycles is all about freedom.  We all want freedom.  But freedom involves being alive.  The people who traveled to Sturgis made a mistake.  The people who didn't wear masks when they were going to bars and concerts made a mistake.  The mistake causes innocent people to die.  I've been in Flagstaff AZ where a spike is happening, like many places, due to the mixing of college students.  One young man visited his father without realizing that he had the virus, and his father died.  This really does happen and it is a tragedy every time.

AGE IS STILL THE BIGGEST RISK FACTOR FOR COVID DEATH
https://www.nature.com/articles/d41586-020-02483-2
Of course there are the 100 year olds that survive the virus but they are outliers.  Basically the risk of mortality is near zero until age 50 and then it skyrockets.  This has been shown in lots of different human populations.  Protect your elders.