Coronavirus, How to Protect Ourselves

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Coronavirus, How to Protect Ourselves

by Jeffrey Dach MD

Corona Virus Has Changed the World as We Know It

The arrival of the corona virus pandemic has changed the world.  Many of these changes are obvious as we practice social distancing, and wear gloves and mask in public. Our routines at the gym, tennis and golf course, workplaces and places of worship are all disrupted, as many of these have closed their doors to prevent large social gatherings which could spread the virus. Many businesses are suffering from the economic slow down and have drastically reduced income.  The markets are undergoing a series of spasmodic gyrations not seen in years.

How to Protect Ourselves From the Corona virus

First of all I would direct you to a very good video by Dr David Price from Weill Cornell Hospital in New York who explains basic measures how to protect ourselves from the coronavirus.

Click Here for video.

1) Always know where your hands are and keep them clean…
2) use Purell hand sanitizer…
3) wash hands …
4) do not touch your face after coming into contact with outside objects such as door handles, shopping carts, gas pump handle, surfaces etc…
5) wear a mask to prevent oneself from touching face. does not need to be a medical mask
6) know your hands are clean. do not touch face. …
7) distance between people..stay away 3-6 from people..reduce the size of your social circle.

Boosting the Immune System with Supplements

Secondly, I would direct you to Dr. David Brownstein’s recommendations for boosting the immune system with supplements to prepare for dending against a viral infection:

Dr. David Brownstein writes:

“At the first sign of any illness, I suggest my patients take:
100,000 U of vitamin A (NOT beta-carotene),
50,000 U of vitamin D3
5-10,000 mg of vitamin C per day for four days.
Pregnant women should not take high doses of vitamins A and D. Vitamin C can be increased to bowel tolerance” end quote Dr. Brownstein.

Iodine: 25-100 mg/day and more if ill. 

Good Hydration !!!!

I would add to this list good hydration. Remember to drink plenty of fluids with your vitamin C while convalescing from any viral illness.

Link to full article on Dr. Brownstein’s Blog

Hydroxychloroquine, Azithromycin (Z-Pack) and ZInc                         

Dr. Zelenko’s Recommendations

Dr. Vladimir Zelenko has now treated 699 coronavirus patients with 100% success using Hydroxychloroquine Sulfate, Zinc and Z-Pak

Thirdly I would refer you to Dr. Zelenko’s for his recommendations.  My son, Benjamin lives in New Jersey with his family and knows Dr. Zelenko, a local MD who has successfully treated more than 700 patients for coronavirus with repurposed drugs and supplements.(35-48)

1) Hydroxychloroquine (Plaquenil requires prescription) 200 mg tabs one tab twice a day for 5 days. Plaquenil was originally FDA approved as a treatment for malaria, and commonly used by rheumatologists for autoimmune disease.  Seven million prescriptions for Plaquenil (r) were written in 2017 by US physicians.  Adverse side effects are rare, and usually associated with long term use greater than ten years. (91-93)(35-48)

2) Azithromycin (Z-Pak 250 mg tabs two tabs first day and one tab daily for next four days.)(35-48)

3) Zinc sulfate, gluconate or acetate (lozenges or capsules10-30mg at the vitamin store).  Zinc inhibits viral RNA polymerase. (49-54)(96-101)

The early addition of zinc to the hydroxychloroquine and azithromycin adds significant benefit to the protocol in hospitalized COV-19 patients according to a recent study by Phillip Carlucci at NYU hospital.(98)   Dr. Carlucci studied the hyroxychloroquine/azithromycin protocol with and without added zinc.  The addition of zinc reduced the mortality or transfer to hospice by approxinately 50%., Dr Carlucci writes:

“zinc sulfate increased the frequency of patients being discharged home, and decreased the need for ventilation, admission to the ICU, and mortality or transfer to hospice for patients who were never admitted to the ICU….After adjusting for the time at which zinc sulfate was added to our protocol, an increased frequency of being discharged home (OR 1.53, 95% CI 1.12-2.09) reduction in mortality or transfer to hospice remained significant (OR 0.449, 95% CI 0.271-0.744). (100)

Update : May 27, 2020: Risch, Harvey A. “Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” American Journal of Epidemiology (2020).

“Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy.   Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is <20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe.” end quote Dr Risch.

Dr. Ivette Lozano   Update 5/9/20 :  Dr. Ivette Lozano speaks at Texas rally about her dramatically successful use of Hydroxychloroquine Sulfate, Zinc and Z-Pak for her COVID-19 virus patients in her Texas medical clinic.

FDA Issues Emergency Use Authorization for Hydroxychloroquine

On March 29, 2020, the FDA issued an Emergency Use Authorization for hydroxychloroquine as treatment for COVID-119.

Mechanism of Drug Action Against Corona Virus

Both Hydroxychloroquine and Azithromycin are autophagy inhibitors which alter the acidity in lysosomes.  The virus uses lysosomes for replication.  By altering acidity in the lysosomes, corona virus replication is prevented.

This is explained in this article:Yang, Naidi, and Han-Ming Shen. “Targeting the Endocytic Pathway and Autophagy Process as a Novel Therapeutic Strategy in COVID-19.” Int J Biol Sci 16.10 (2020): 1724-1731.

Governors Hall of Infamy – Banning Hydroxychloroquine with Executive Order – Shame on these governors !!!!!

Governor Steve Sisolak (D-NV)

Gov. Gretchen Whitmer (D-MI) (later reversed)

Gov. Cuomo (D-NY)

Ohio Gov Mike DeWine – limits use

This is America where our governors are free to practice medicine without a license, even if they are wrong. These Governors should be promptly voted out of office !!!!

Coronavirus Drug Treatment References Click Here.

Antiviral Herbals

Dr. Stephen Buhner is the world’s expert on antiviral herbals, and in his book, he recommends :

1) Chinese Skullcap (Scutellaria baicalensis)(6-12)

2) Licorice Root Extract (Glycyrrhiza) (13-18)

3) Elderberry Syrup (Sambucus)(19-22)

4) Quercetin (5-7)

For more, see this article on Antiviral Herbals

Intravenous vitamin C for Severe Cases

For those unfortunate enough to develop viral pneumonia and require treatment in the ICU on a ventilator, many of these patients can be saved by intravenous vitamin C.  Intravenous vitamin C is being used in these severe corona virus ventilator patients in New York Hospitals with success. Demand your doctor give your family member I.V. vitamin C in the hospital. It can save a life.(23-34)

Link to article on Dr. Andrew Weber New York Post:

Treating Corona Virus with IV Vitamin C in New York City

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Corona Virus is NOT Typical ARDS (Adult Respiratory Distress Syndrome)

Ventilators Are the Killing The Corona Virus Patients !!!!

Dr. Carmeron Kyle-Sidell, an ICU specialist and ER doctor in NYC made the observation that patients with corona virus and hypoxia in the ICU do not have typical ARDS.  They have severe hypoxia, with low O2 Sat, yet are talking and responding normally.  Dr Sidell says that in his opinion , placing these patients on ventilators simply because of a low PO2 on pulse oximetry is a mistake and causes more harm.  Dr Sidell says the correct treatment is high flow oxygen by mask or nasal canula without positive pressure mechanical ventilation.  Use of ventilators should be delayed as long as possible.

Dr. Carmeron Kyle-Sidell : You tube presentation can be found here.

In agreement with Dr Kyle-Sidell is Dr. Luciano Gattinoni from Italy: Here is his publication on the topic.

Gattinoni, Luciano, et al. “Covid-19 Does Not Lead to a “Typical” Acute Respiratory Distress Syndrome.” American Journal of Respiratory and Critical Care Medicine ja (2020).

Also in agreement is the Eastern Virginia Medical School, Dr Paul Marik Protocol for ICU Covid-19 patients:  Click Here.

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Higher Mortality Rate of 15% for the elderly over age 80, while NO MORTALITY in children under 9.

Elderly Should Avoid Contact with All Possible Asymptomatic Carriers of the virus.  That means everyone, except essential care givers !!!!

While mortality rates under age 70 are quite low, there is a striking increase in mortality from CoVID-19 (coronavirus) for the elderly over the age of 70.  The Chinese Data on Covid-19 Mortality based on age can be found in two references listed below (1-2).  Here are the data charts.

While the elderly over the age of 80 have a high mortality rate of 15%, children under 9 years of age have virtually no deaths from corona virus.  One might then ask why such a dramatic difference in mortality based on age. In my opinion, this increased mortality in the elderly is related to the high prevalence of dysphagia among the elderly.  Over 50 per cent of the elderly have oropharyngeal dysphagia. (3-4)

Dysphagia is trouble swallowing caused by neuromuscular disorders of the esophagus such as stroke and dementia. These elderly people have esophageal in-coordination and in fact are intermittently aspirating during meals. Intermittent aspiration causes aspiration pneumonia.  If the patient has a viral illness, this leads to aspiration of viral particles into the  lungs, and viral pneumonia.  Dysphagia is also associated with nutritional deficits which impair immunity. In 2012, Dr. Sura writes:.

“Dysphagia is a prevalent difficulty among aging adults. Though increasing age facilitates subtle physiologic changes in swallow function, age-related diseases are significant factors in the presence and severity of dysphagia. Among elderly diseases and health complications, stroke and dementia reflect high rates of dysphagia. In both conditions, dysphagia is associated with nutritional deficits and increased risk of pneumonia. Recent efforts have suggested that elderly community dwellers are also at risk for dysphagia and associated deficits in nutritional status and increased pneumonia risk.”(3)

According to Dr Clave in 2015, oropharyngeal dysphagia is highly prevalent in the elderly occurring in 50 per cent of the elderly population.

In 2015, Dr. Clavé writes:

“Although oropharyngeal dysphagia is a highly prevalent condition (occurring in up to 50% of elderly people and 50% of patients with neurological conditions) and is associated with aspiration, severe nutritional and respiratory complications and even death, most patients are not diagnosed and do not receive any treatment.” (4)

Elderly and Hypothyroidism, Immune Dysfunction

Thyroid function is important for proper functioning of the immune system.  This is explained in the article: Hypothyroidism and Risk for Infection. Because of the reduced immunity in hypothyroidism, hypothyroidism is an underlying risk factor for increased mortality from any type of infection, including viral infection.  In the elderly, undetected hypothyroidism is quite common.  And, this prevalence of hypothyroidism is another reason the elderly have increased mortality from corona virus infection. (55-64)

Iodine, Selenium and B12 Deficiency

The elderly have increased prevalence of gastric atrophy , and are at greater risk for micro nutrient deficiency involving iodine, B12 and selenium, all involved in immune function.(65-74)

Protecting the Elderly from Corona Virus

These are a few of the many reasons why special precautions should be taken with the elderly to avoid contact with anyone who might be an asymptomatic carrier of the corona virus, influenza virus, respiratory syncytial virus  or any other respiratory virus, for that matter.(75-84)

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Ozone Therapy for Viral Illness

Ozone can be used to clean your swimming pool.  As a matter of fact our pool has an ozone water cleaning system.   Ozone bubbles through the pool, cleaning the water.  You can also clean your blood stream using medical grade ozone which kill viruses on contact.  Medical Ozone Therapy is a form of oxidative therapy and is highly curative for viral illness, including corona virus. However, this modality is completely ignored by mainstream medicine.  The practitioners I know personally using ozone with considerable success for corona virus are:

1) David Brownstein MD
2) Frank Shallenberger MD
3) Robert Rowen MD
4) Howard Robbins DPM in Manhattan NY 
5) Sano Via Wellness Toronto Canada

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Protect Yourself from the News Media  Corona Virus Deceptive Reporting

The Reality on the Ground is Vastly Different

Now that you know how to protect yourself from the corona virus. Next you need to learn how to protect yourself from the news media:(85-87)

Click Here for You Tube Video The Corona Virus “War Zone” by Dana Ashlie

Click Here for You Tube Video: Colleen Smith and Elmhurst Hospital in Queens. The Disconnect between the reality on the ground and the news media hype.

Citizen Journalist Visits the Hospital Corona Virus “War Zone”- Waiting Rooms and Tents Are Empty. !!!!  Click Here for Video Link

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Doctor Says Government Shut Down is Wrong Approach-Mitigation an Containment are Abject Failures- Instead We Need Herd Immunity

I quite agree with Dr Martin Dubravec writing for the the America Association of Physicians and Surgeons.  His point is that the corona virus is just one of many viruses that circulate every year, and shutting down the economy and the country with draconian “shelter in place ” legislation is the  wrong approach by the government and more disastrous than the virus.  Government policies of mitigation and containment are abject failures.   Dr. Martin Dubravec says that the number of deaths are similar to previous influenza viruses over the years, with the increased mortality among the elderly and those with pre-existing conditions.  Younger people below age 65 have a 99.6% recovery rate. With the measures outlines above, this should be 100% recovery rate. Containment policies are failures because this doesn’t prevent the virus from circulating.  Dr. Martin Dubravec suggests stop the shutdown, and let the virus circulate, creating “herd immunity” in the population, same as previous viruses over the years.   Eventually enough people will develop immunity to the virus and it will be over.  Dr Martin Dubravec writes:

“This is why the concept of herd immunity is so important.  With herd immunity, significant amounts of the population will have exposure to the virus and become immune to it.  They are no longer able to spread the virus as their immune systems kill the virus before it has a chance to grow and multiply.  That individual then becomes not a source of viral spread but a source of killing the virus.  The virus has nowhere to go and it disappears.  Public Policy is Making Things Worse… Unfortunately, our so-called public health experts have pushed for containment and mitigation…. Mitigation is the concept that if you slow the spread of the virus, it will blunt the surge of cases and prevent us from overwhelming hospitals with seriously ill patients. Mitigation efforts have included ordering people to stay in their homes, closing non-essential businesses, and restricting where people can go to locally. This has had no impact on the virus nor should it, as these mitigation efforts are incomplete. …Therefore, containment and mitigation are abject failures. They do not help the situation because they are not being practiced! Nor can they be; our borders are thousands of miles long. Our population needs to eat and get medicines and health care. It is completely unrealistic to believe that mitigation efforts can succeed in a country this big. In totalitarian China, a wall was literally built around Wuhan, the epicenter of the epidemic, to contain and mitigate the virus. Unless we want to become a totalitarian state, we can’t do that here. If we can learn anything from this epidemic is that mitigation efforts that destroy our economy were some of the biggest boondoggles every foisted on the American people. Even worse, they aren’t necessary. We have better ways to combat this virus….What can be done to end this epidemic? The answer is herd immunity. Let those who will not die nor become seriously ill from the disease get infected and immune to the disease. Don’t close schools – open them up! Don’t close universities – reopen them! Let those under the age of 65 with no significant health problems go to work. Their risk of death is very close to zero.“  quoted from (85)  Coronavirus COVID-19: Public Health Apocalypse or Panic, Hoax, and Anti-American? Martin Dubravec, MD

Update: April 24, 2020
Fatality Rate for Covid-19 About the Same as Influenza:
Estimated Covid-19 infection fatality rate of 0.12-0.2%

Bendavid, Eran, et al. “COVID-19 Antibody Seroprevalence in Santa Clara County, California.” medRxiv (2020).
Prevalence of coronavirus antibodies of 1.5 percent. Likely prevalence ranged from 2.49 to 4.16 percent.
“these prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April, 50- 85-fold more than the number of confirmed cases.”

“Using these data, the researchers calculated the infection fatality rate, that is, the percent of people infected with the disease who die: “A hundred deaths out of 48,000-81,000 infections corresponds to an infection fatality rate of 0.12-0.2%,” they report.* That’s about the same infection fatality rate the Centers for Disease Control and Prevention (CDC) estimates for seasonal influenza.” end quote

Conclusion: The Corona Virus has changed the world as we know it.  However, armed with relevant knowledge, we can protect ourselves and loved ones from the virus, the deceptive news media hype about it, and the misguided containment policies of the government.  The infection fatality rate is about the same as influenza, which means the draconian shutdown is a colossal mistake.

Update 4/28/20: Two Urgent Care Physicians discuss the new data and the lack of scientific justification for the corona virus lockdown orders.  The video went viral, reaching over 5.46 million views, and sparked debate over recommendations to lift the shelter-in-place order.  This video was censored, i.e. “taken down” by You Tube. Click Here to watch video: Video interview with Dr. Dan Erickson and Dr. Artin Massihi taken down from YouTube.

Update BioRxiv (2020):   “is unlikely to be fortuitous in nature.”

“We found 4 insertions in the spike glycoprotein (S) which are unique to the 2019-nCoV and are not present in other coronaviruses. Importantly, amino acid residues in all the 4 inserts have identity or similarity to those in the HIV-1 gp120 or HIV-1 Gag…is unlikely to be fortuitous in nature.” Pradhan, Prashant, et al. “Uncanny similarity of unique inserts in the 2019-nCoV spike protein to HIV-1 gp120 and Gag.” BioRxiv (2020).

Update: 5/15/20 Spiked Interview with Knut Wittkowski
‘We could open up again and forget the whole thing’
Epidemiologist Knut Wittkowski on the deadly consequences of lockdown. For 20 years, Wittkowski was the head of Biostatistics, Epidemiology, and Research Design at The Rockefeller University’s Center for Clinical and Translational Science.

Articles with related Interest:

Intravenous Vitamin C Saves Man Dying of Viral Pneumonia

Anti-Viral Herbals

Vitamin D Prevents Viral Influenza

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Summary
Coronavirus How to Protect Ourselves
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Coronavirus How to Protect Ourselves
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How to Protect Ourselves from the Corona virus using common sense measures.
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jeffrey dach md
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4 thoughts on “Coronavirus, How to Protect Ourselves”

  1. March 26 at 12:42 PM
    Repost from another person. Interesting read.

    “I am an ER MD in New Orleans. Class of 98. Every one of my colleagues have now seen several hundred Covid 19 patients and this is what I think I know.

    Clinical course is predictable.
    2-11 days after exposure (day 5 on average) flu like symptoms start. Common are fever, headache, dry cough, myalgias(back pain), nausea without vomiting, abdominal discomfort with some diarrhea, loss of smell, anorexia, fatigue.

    Day 5 of symptoms- increased SOB, and bilateral viral pneumonia from direct viral damage to lung parenchyma.

    Day 10- Cytokine storm leading to acute ARDS and multiorgan failure. You can literally watch it happen in a matter of hours.

    81% mild symptoms, 14% severe symptoms requiring hospitalization, 5% critical.

    Patient presentation is varied. Patients are coming in hypoxic (even 75%) without dyspnea. I have seen Covid patients present with encephalopathy, renal failure from dehydration, DKA. I have seen the bilateral interstitial pneumonia on the xray of the asymptomatic shoulder dislocation or on the CT’s of the (respiratory) asymptomatic polytrauma patient. Essentially if they are in my ER, they have it. Seen three positive flu swabs in 2 weeks and all three had Covid 19 as well. Somehow this ***** has told all other disease processes to get out of town.

    China reported 15% cardiac involvement. I have seen covid 19 patients present with myocarditis, pericarditis, new onset CHF and new onset atrial fibrillation. I still order a troponin, but no cardiologist will treat no matter what the number in a suspected Covid 19 patient. Even our non covid 19 STEMIs at all of our facilities are getting TPA in the ED and rescue PCI at 60 minutes only if TPA fails.

    Diagnostic
    CXR- bilateral interstitial pneumonia (anecdotally starts most often in the RLL so bilateral on CXR is not required). The hypoxia does not correlate with the CXR findings. Their lungs do not sound bad. Keep your stethoscope in your pocket and evaluate with your eyes and pulse ox.

    Labs- WBC low, Lymphocytes low, platelets lower then their normal, Procalcitonin normal in 95%
    CRP and Ferritin elevated most often. CPK, D-Dimer, LDH, Alk Phos/AST/ALT commonly elevated.
    Notice D-Dimer- I would be very careful about CT PE these patients for their hypoxia. The patients receiving IV contrast are going into renal failure and on the vent sooner.

    Basically, if you have a bilateral pneumonia with normal to low WBC, lymphopenia, normal procalcitonin, elevated CRP and ferritin- you have covid-19 and do not need a nasal swab to tell you that.

    A ratio of absolute neutrophil count to absolute lymphocyte count greater than 3.5 may be the highest predictor of poor outcome. the UK is automatically intubating these patients for expected outcomes regardless of their clinical presentation.

    An elevated Interleukin-6 (IL6) is an indicator of their cytokine storm. If this is elevated watch these patients closely with both eyes.

    Other factors that appear to be predictive of poor outcomes are thrombocytopenia and LFTs 5x upper limit of normal.

    Disposition
    I had never discharged multifocal pneumonia before. Now I personally do it 12-15 times a shift. 2 weeks ago we were admitting anyone who needed supplemental oxygen. Now we are discharging with oxygen if the patient is comfortable and oxygenating above 92% on nasal cannula. We have contracted with a company that sends a paramedic to their home twice daily to check on them and record a pulse ox. We know many of these patients will bounce back but if it saves a bed for a day we have accomplished something. Obviously we are fearful some won’t make it back.

    We are a small community hospital. Our 22 bed ICU and now a 4 bed Endoscopy suite are all Covid 19. All of these patients are intubated except one. 75% of our floor beds have been cohorted into covid 19 wards and are full. We are averaging 4 rescue intubations a day on the floor. We now have 9 vented patients in our ER transferred down from the floor after intubation.

    Luckily we are part of a larger hospital group. Our main teaching hospital repurposed space to open 50 new Covid 19 ICU beds this past Sunday so these numbers are with significant decompression. Today those 50 beds are full. They are opening 30 more by Friday. But even with the “lockdown”, our AI models are expecting a 200-400% increase in covid 19 patients by 4/4/2020.

    Treatment
    Supportive

    worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%. Our hospital has had 5 deaths and one patient who was extubated. Extubation happens on day 10 per the Chinese and day 11 per Seattle.

    Plaquenil which has weak ACE2 blockade doesn’t appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell. With Plaquenil’s potential QT prolongation and liver toxic effects (both particularly problematic in covid 19 patients), I am not longer selectively prescribing this medication as I stated on a previous post.

    We are also using Azithromycin, but are intermittently running out of IV.

    Do not give these patient’s standard sepsis fluid resuscitation. Be very judicious with the fluids as it hastens their respiratory decompensation. Outside the DKA and renal failure dehydration, leave them dry.

    Proning vented patients significantly helps oxygenation. Even self proning the ones on nasal cannula helps.

    Vent settings- Usual ARDS stuff, low volume, permissive hypercapnia, etc. Except for Peep of 5 will not do. Start at 14 and you may go up to 25 if needed.

    Do not use Bipap- it does not work well and is a significant exposure risk with high levels of aerosolized virus to you and your staff. Even after a cough or sneeze this virus can aerosolize up to 3 hours.

    The same goes for nebulizer treatments. Use MDI. you can give 8-10 puffs at one time of an albuterol MDI. Use only if wheezing which isn’t often with covid 19. If you have to give a nebulizer must be in a negative pressure room; and if you can, instruct the patient on how to start it after you leave the room.

    Do not use steroids, it makes this worse. Push out to your urgent cares to stop their usual practice of steroid shots for their URI/bronchitis.

    We are currently out of Versed, Fentanyl, and intermittently Propofol. Get the dosing of Precedex and Nimbex back in your heads.

    One of my colleagues who is a 31 yo old female who graduated residency last may with no health problems and normal BMI is out with the symptoms and an SaO2 of 92%. She will be the first of many.

    I PPE best I have. I do wear a MaxAir PAPR the entire shift. I do not take it off to eat or drink during the shift. I undress in the garage and go straight to the shower. My wife and kids fled to her parents outside Hattiesburg. The stress and exposure at work coupled with the isolation at home is trying. But everyone is going through something right now. Everyone is scared; patients and employees. But we are the leaders of that emergency room. Be nice to your nurses and staff. Show by example how to tackle this crisis head on. Good luck to us all.”

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