Today my office got a “1 star” review from a person who isn’t even a patient. She was upset that I do not require my staff to be vaccinated. So, I thought I would lay it out there so that you and all my followers can understand my thought process on this whole vaccine issue.
I Support the Use of Safe Vaccines
First and foremost, let me state that I am a proponent of vaccines. I have been fully vaccinated with every other vaccine under the sun (I was in the military and we were given EVERYTHING) and was adamant about getting my flu vaccine until 2016 when I had a severe anaphylactic reaction to the influenza vaccine.
I’m Personally Allergic to the Components of COVID-19 Vaccines and Influenza Vaccines.
Thinking this was just a hypersensitivity issue, I got my yearly flu vaccine in 2017 and my reaction of hives and inflammation were worse. We concluded that I am allergic to the base in the vaccine polyethylene glycol (PEG) or polysorbate. In doing a great deal of research trying to find out what it was I was reacting to, I changed my position on the need for the yearly influenza vaccine. (It causes a 36% increase susceptibility to coronavirus infections. You can read about that information here.)
Polysorbate or PEG is a component of all three COVID-19 vaccines, and is a contraindication to getting the COVID-19 vaccines (listed right on the CDC website – as there is NO package insert on any of the vaccines to date), so I have been very leery of getting vaccinated with anything containing these chemicals.
I’ve Already Had COVID-19 Twice
Near the end of March 2020, I had six patients (3 couples) come off of a cruise to the Caribbean, and had symptoms that we thought were Parainfluenza virus, but later turned out to be COVID-19. 2 weeks later, I and the majority of my staff became ill with COVID-19. I had classic symptoms of COVID-19, however, my symptoms only lasted about 3 days, many of my staff members were sick for 1-2 weeks, and my wife was sick for 3 weeks. It was about this time that nasal swab testing became available.
Over the last 18 months, we have treated over 400 positive COVID-19 cases outpatient. I have an active patient population of about 8,000 patients. Between myself and my PA, we see about 13,000 patient visits per year, so we are a busy practice. The average age of my patients is 65 years old and the majority of these patient have insulin resistance and/or diabetes. My concern was that we have a huge practice susceptible to severe COVID-19 infections. However, amazingly in the first 12 months of this pandemic we only had 12 hospitalizations for COVID-19 infections and those were the patients who were not following a low carbohydrate or ketogenic diet and were not controlling their blood sugars or insulin levels.
As predicted, and like any coronavirus, yearly resurgence of the infection will re-occur. We’ve seen about 15 new cases of COVID-19 in the office in the last four weeks which appear to correlate with the Delta Variant being seen in the hospital across the street from my office. In the last month, we have seen a resurgence of COVID-19 infections, and five of my staff members were out of the office due to positive COVID-19 infections. Symptoms lasted 3-14 days in my staff. All of these patients and my staff were treated with my protocol and none have been hospitalized.
I personally came down with a reoccurrence of the infection and had symptoms of sore throat, headache, sinus pressure, loss of taste & smell, and productive cough resolve within 72 hours following our treatment protocol. Like the flu with over 600 variants, there are already 160+ variants of the COVID-19 virus around the world. So, it is to be expected that we will see this yearly, much like we’ve seen the flu.
Because of my position on this particular vaccine and the influenza vaccine, many members of my church (who has heavily supported this vaccine) and the medical community have ostracized me and my family, as I’ve raised concerns and been vocal about this issue. And yet, a recent real world study in Israel of over 800,000 people demonstrates that those with natural immunity to COVID-19 have 13 times greater protection than those that are vaccinated.
I’ve Seen More Adverse Reaction to COVID-19 Vaccine Then Any Other Vaccine
In January, when the vaccine came out, I was interested in using this in our practice, but I had concerns regarding the untested delivery mechanism that this vaccine used and I was concerned that there were no clinical trials established at the time to know what to expect from this vaccine.
About 30-40% of my practice opted to get vaccinated. And about 30% of my staff opted to get vaccinated as well.
Of great concern to me is that I have started seeing strange long-term vaccine reactions in those patients that got vaccinated:
I have three patient that had profound fatigue – literally could not get out of bed for 4-5 months after getting vaccinated. Two of these patients are still experiencing these symptoms today.
I have two patients who had pericarditis/myocarditis from the vaccine (Now a Black Box Warning for these vaccines)
I have seven patients with persistent elevated D-Dimer levels 3-6 months after vaccination predisposing them to blood clots and pulmonary emboli. Two actually had life threatening blood clots in the lungs. (Blood clots is also a Black Box Warning on these vaccines)
Four of these seven had colitis that persisted for 6-8 weeks that was unresponsive to antibiotic therapy.
And, one of these patients has symptoms of severe fatigue & tachycardia (rapid heart rate) upon standing that has yet to resolve.
I have two others that had spontaneous bruising over their lower extremities for 6 weeks associated with severe fatigue.
95% of the people that get vaccinated in my clinical experience seem to have no problem. 5% of patients have profound symptoms of illness as if they had a mild to moderate case of COVID-19 that can last up to 7 days.
When I have commented about what I am seeing to my colleagues, they roll their eyes at me and blow it off. And, behind my back, they tell others that I’m just blowing things out of proportion. Yet, the patients I have seen above are real and these symptoms have dramatically affected their lives, their families and their ability to work and provide a living for themselves.
Am I against getting vaccinated? No, but I want people to clearly understand the risks and benefits of vaccination. To date, there is still no package insert that is given to those receiving the vaccines, providing any warning, including the Black Box Warnings. And, the patients that have had adverse reactions have told me that they would never have considered getting vaccinated if they knew about the symptoms they were potentially going to experience.
I’ve had thousands of patient’s ask about the COVID-19 vaccine and whether they should consider taking it or not. At the outset, let me make it clear that I am not opposed to vaccines, nor am I an anti-vax proponent. I am very much a proponent of safe and effective vaccines and therapies. I present this information so that my patients and readers can make an informed choice about their individual health. Many of my patients have chosen to get vaccinated, and many have not. Many are still on the fence.
This information is continually changing and I will try to update this post when important information is available. You can find a summary and links to recent research on a previous blog post here.
Any time you use a therapeutic, medication or vaccine, you need to evaluate it with three guidelines in mind:
Is it safe?
Is it effective?
Do you actually need it?
Survivability Points to Ponder
Currently, children under 18 years old have a 99.998% chance of survival if they get COVID-19 and are untreated. Why would you inject a child with a vaccine when there is no need for treatment? Yet this vaccine is being pushed upon our children 12 years of age and older by schools, sports programs and government officials.
The risk of death in a young adult who contracts COVID-19 between the ages of 19 to 44 years old is 99.95%. Again, why would we force vaccination or treatment upon anyone who’s risk is 0.05%?
If everyone on the planet were to get COVID-19 and not get treated, the global death rate would be less than 0.5% of the global population. That is identical to influenza. After you read the information below, you need to ask yourself: Does the potential risk of the COVID-19 vaccine warrant force vaccination the entire global population?
If we have effective outpatient treatments, and the risk of death was no greater than the flu, why would you consider use of a vaccine with significant sides effects and poor overall effectiveness?
How Does the COVID-19 Vaccine Work?
As of today, the Pfizer/BioNTech, Moderna and Johnson Johnson COVID-19 vaccines consist of a snippet of genetic code directing production of an immune response identical to what the actual virus causes to occur. This response stimulates the production of a coronavirus spike protein. In the Pfizer.BioNTech & Moderna vaccines, it is delivered in a tiny fat bubble called a lipid nanoparticle. Some researchers suspect the immune system’s response to that delivery vehicle also causes some the short-term side effects, and may post greater risks in the long term.
What we know today, is that the spike proteins, whether produced by the virus or by the vaccine is the “toxic” portion to the body. A percentage of people have significant adverse responses to this spike proteins. This protein binds to those tissues with the highest concentrations of ACE2 receptors on their cell membranes. The binding of ACE2 receptors by spike proteins causes a release of inflammatory cytokines (protein signals to stimulate the body to fight infection). However, this cytokine release is amplified significantly when T cells are suppressed or not functional. We know that obesity, diabetes, prediabetes and insulin resistance states cause a suppression in T cell function. Within four hours of blood sugar and insulin levels spiking and staying elevated, something that commonly occurs in diabetic, pre-diabetic and obese patients, T cell immunity is suppressed and cytokine levels, like IL-6, are elevated.
A recently uncovered Pfizer study in Japan identified that these proteins and the nano-particle transport system concentrate and bind at the spleen, bone marrow, liver, adrenal glands, mesenteric lymph-nodes, and ovaries within 48 hours of vaccination (1). Originally, it was thought that the vaccine only concentrated in the deltoid muscle where the vaccine was given. According to Dr. Robert Malone the creator of the mRNA technology, the spike proteins are biologically active. Because of this distribution throughout the body, and according to Dr. Malone, there is significant potential for leukemia, lymphoma and female fertility issues 1-3 years from vaccination and auto-immune disorders 2-3 years from vaccination. Because we have no data in humans at the 2-3 year mark, the actual risk of this is still unknown.
Is The Vaccine Effective?
Currently the only data we have on the vaccine effectiveness comes from a brand new package insert released on the 23rd of August, 2021. Studies in 44,000 people demonstrated it has a 94.7% confidence interval over 6 months. That means, in lay terms, that the vaccine will decrease your likelihood of caching COVID-19 by an “estimate” of 94.7% within six months of your first shot. However, data coming out of Israel where 85% of the population has been vaccinated for the last eight months shows that that this effectiveness drops to 39% by the eighth month. Anything less than 40% effectiveness is considered no more effective than placebo.
If you’ve never had a COVID-19 infection, then this vaccine will give you short term protection for 2-8 months as it’s protective effect rapidly wears off. Hence, Pfizer and Moderna have recommended a third dose of the vaccine starting in September. However, there is no information about the risks and benefits of a third dose. And, if a third dose is necessary, will there be a fourth? And a fifth?
In the short term studies (two month period of time), vaccine manufacturers stated that there was a 66% reduction in hospitalizations due to COVID-19 with the vaccine use. This is not what is being seen in Israel, where 85% of their population has been vaccinated. In fact, people vaccinated in January had a 2.26 times greater risk for a breakthrough infection with the Delta variant than those vaccinated in April.
The rate of infection and hospitalization rates remain the same as the unvaccinated as you can see in the graphic below:
In another study just released on August 25, 2021, as a pre-print in the British Medical Journal (BMJ), data from Israel paints a very interesting picture of what happens when the majority of the population is vaccinated. This real world observational study of over 800,000 people compares the unvaccinated to those with prior COVID-19 illness, those with prior COVID-19 + 1 dose of vaccine and those who are vaccinated with two doses.
This study demonstrates that those who received the COVID-19 vaccine (two shot series) have a 13.06 times GREATER risk of infection with the COVID-19 Delta variant compared with those who were unvaccinated but had previous infection with COVID-19 alone.
Additionally, those who received the vaccine had a 6.7 fold greater risk for admission to the hospital compared to those with natural infection. The conclusion in this, the largest real world vaccination study on COVID-19 to date, is that natural immunity confers a 13 times greater protection than the vaccine.
Acute or Short Term Issues:
First these vaccines contain a black box warning for people under age 55 years old. This warning is that there is a significant increased risk of a forms of inflammation of the heart called myocarditis and fluid build up around the heart called pericarditis. This risk was set at 13 per million, or one person in every 76,900 doses given. As of August 20th, 2021, Moderna’s vaccine is being evaluated for an even greater risk seen from Canadian data. “There might be a 2.5 times higher incidence of myocarditis in those who get the Moderna vaccine compared with Pfizer’s vaccine,” Reuters reported.
Second, Blood clot formation is the number one risk of these vaccines. The spike proteins that form from the vaccine are identical to the same proteins caused by the virus itself. It’s not the virus that’s the problem, it’s the spike proteins that act like a toxin. The Salk Institute has identified that these spike proteins bind to the ACE 2 receptors on multiple organ tissues, damaging the lining of blood vessels and increase the risk of blood clot, stroke and heart attack. The increased risk of clots is most dramatic in the first week after a vaccine is given, however, this risk is elevated as long as these proteins are circulating in the blood stream.
Given this information, and the number of blood clots I and many others have seen clinically post vaccination, this vaccine has been aptly called “The Clot Shot.”
Third, data demonstrates that patients given this vaccine in their 1st trimester of pregnancy have an increased risk of miscarriages from 10% to 80% above the average. This is likely due to spike protein deposition in the uterus, however, this is still under evaluation.
Sub Acute Issues:
In all other attempts at making a coronavirus vaccine in the last 25 years, animal studies have show the development of antibody dependent enhancement (ADE). This is where re-exposure to the virus causes a 10 fold immune response above the norm. This also causes what is called cytokine release syndrome. However, because this vaccine was released under an Emergency Use Authorization, these animals studies were never performed on this vaccine to determine the potential for these syndromes to arise.
I am seeing signs that ADE is starting to happen in a percentage of my patients who have been vaccinated with both the first and second doses of vaccine.
Long Term Issues:
There is definite scientific evidence that these spike proteins may damage ovarian function. There is definite evidence that they may lower sperm counts. There is definite evidence that they will effect autoimmunity in a percentage of the population. There is definite evidence that it may cause various forms of cancer.
According to a recent article by Talotta et at., “Young patients and female patients who are already affected or predisposed (e.g. immunological and serological abnormalities in absence of clinical symptoms, familiarity for immune-mediated diseases) to autoimmune or autoinflammatory disorders should be carefully evaluated for the benefits and risks of COVID-19 mRNA vaccination” (4).
Lipid nano-particles have been shown to concentrate themselves in the ovary with a 16% decrease in fertility that was identified in the animal studies recently made available to the public.
Recent research from Read et al. demonstrates that vaccinating people with vaccines that do not completely stop transmission actually increase conditions that promote more severe strains of the virus. “Our data show that anti-disease vaccines that do not prevent transmission [vaccines that don’t completely stop transmission] can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts” (5).
What is the Actual Risk Of:
Infertility
Autoimmunity
Cancer after getting this vaccine?
We JUST DON’T KNOW!
Who Should NOT Receive the Vaccine:
The Centers for Disease Control and Prevention (CDC) has issued an update on those who should not receive mRNA COVID-19 vaccines. Recommendations cover:
Patients who have had a severe allergic reaction to a COVID-19 vaccine.
Patients who have had an immediate non-severe allergic reaction to a COVID-19 vaccine.
Patients who have had an allergic reaction to polyethylene glycol (PEG) or polysorbate.
Patients who have had an allergic reaction to other types of vaccines or an injectable therapy.
Patients who have had allergies not related to vaccines (food like shell fish, nuts, etc).
Common Side Effects that can and will occur with both versions of the vaccine (lower side effect profile in Pfizer/BioNtech version):
Fever up to 104 F (40 C) for 24 hours in 2-4% of participants.
Severe fatigue in 4%- 9.7% of participants
Muscle pain in 8.9%
Joint pain in 5.2%
Headache in 2%-4.5%.
That’s a higher rate of severe reactions than people are accustomed to, and it occurs because the vaccine is actually producing the same toxin in the system that the virus does – spike proteins.
The likelihood of a severe problem if you get a COVID-19 infection is about 0.5%.
Where the likelihood of side effects from the vaccine is 1-10%.
With those odds, you be the judge.
Additional Cautions in Pregnancy/Breast Feeding:
Directly from the CDC website: “Observational data demonstrate that, while the chances for these severe health effects are low, pregnant people with COVID-19 have an increased risk of severe illness, including illness that results in ICU admission, mechanical ventilation, and death compared with non-pregnant women of reproductive age. Additionally, pregnant people with COVID-19 might be at increased risk of adverse pregnancy outcomes, such as preterm birth, compared with pregnant women without COVID-19.”
“Based on how mRNA vaccines work, experts believe they are unlikely to pose a specific risk for people who are pregnant. However, the actual risks of mRNA vaccines to the pregnant person and her fetus are unknown because these vaccines have not been studied in pregnant women.” However, as noted above, vaccination in the 1st trimester of pregnancy increases miscarriage rate up to 80%.
“There are no data on the safety of COVID-19 vaccines in lactating women or on the effects of mRNA vaccines on the breastfed infant or on milk production/excretion. mRNA vaccines are not thought to be a risk to the breastfeeding infant. People who are breastfeeding and are part of a group recommended to receive a COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated.” Yet, in light of these assumptions by the CDC, studies in this group has NOT been completed, so we just don’t know the answer.
For those outside of the United States, the UK government’s safety instructions recommend that “no pregnancy or breast feeding should be planned within two months of each COVID-19 vaccine dose.”
Does the Benefit Outweigh the Risk?
Does the benefit of two to six months of protection outweigh the risks that are being seen with these vaccines? Ultimately, that decision is yours. My profession opinion is that the risk is greater than the benefit. Especially when we have effective, inexpensive treatments available.
The NIH, CDC, Hospital Associations, Health Systems and big Pharma have spent hundreds of millions trying to convince the American public that these vaccines are safe. As of December 2020, prior to completion of any safety studies on these vaccines, the US government alone had spent $250 million dollars trying to convince you and me that these vaccines are worth the risk. Yet, as a physician who weighs risk to benefit outcomes of treatments with 20-30 patient’s every day, those risks just don’t add up.
When in the history of mankind have you ever heard or seen such powerful propaganda regarding health and safety of every soul on the planet? The only time I have heard or seen anything remotely similar is in the 1940’s.
Hitler rose to power by convincing the entire nation of Germany that the Jewish population carried typhus, an infectious bacteria that was perceived as an imminent threat to the country. The typhus vaccine was developed in 1939 in Poland and was in use during WWII. In order to stop the spread of typhus three things occurred:
Those at risk (mainly the Jews) were quarantined.
Everyone in the nation was required to carry papers documenting full medical history, travel history, vaccination status and typhoid risk.
Those that were not compliant were excluded from socialization and work, or were they were imprisoned.
After graduation from medical residency, I served for four years as my AirForce Reserve unit’s biological/chemical weapons expert & physician. My job was to understand the risks of all the known biologic and chemical weapons that could be used on a human being, including severe viral and bacterial diseases that could pose a threat. My training was specifically focused on how to prevent and treat the effects of these illnesses in those under my care, military or otherwise.
I spent four years reading and researching where and when various types of masks, respirators and protective equipment would and should be used. Never once was a surgical or cloth mask ever found to be effective. Even N95 masks failed the rigors of these encounters.
This week our fearless Dr. Fauci says it’s “common sense” to wear two masks. So, my question to him and all of the other emperors of medicine is, what about three masks?
Even better yet, 10 masks makes even more “common sense!!” Where does this stop? (I stop at 11, because, my ears flop over at 12 masks.)
I’m thinking that 100 masks is 100% effective right?
I guess those filtered gas masks really aren’t essential then?!
One surgical mask decreases risk by 1-2% (yes, that’s the benefit of a mask that we’ve been required to wear). You’re more likely to have a 40% COVID risk reduction by throwing salt over your shoulder when you leave the house . . . (that’s the actual placebo effect).
The whole reason for mask wearing is to decrease “asymptomatic” transmission of COVID-19. That means, masks are supposed to decrease your risk of spreading or inhaling this virus when you or the person near you have no symptoms. Initially, we recommended wearing masks, because we did not know how infective the COVID-19 virus was to humans. We also knew that there was limited access to the N95 masks used in the hospital setting.
However, in the last 12 months, we’ve learned a great deal and we have a tremendous amount of data about treating this virus in the outpatient setting. You can follow Dr. Nally’s COVID-19 treatment protocol here.
How Contagious is COVID-19?
What’s the actual risk of spreading the virus when you have no symptoms? It’s about 0.06% if you have prolonged contact (3 hours continuous face-to-face) with a person within six hours of that person having onset of symptoms (i.e. – fever, sore throat, fatigue, headache, loss of taste or smell, or runny nose). It is very rare to be infected at all with COVID-19 asymptomatically if you contact a person 6-9 hours before they have symptoms.
In fact, a recent study revealed there were no positive tests (or asymptomatic spread) among 1,174 close contacts of asymptomatic cases. So, why are we still wearing masks? Because it is politically convenient, increases fear, and increases your likelihood of getting a vaccine.
Are There Unintended Consequences of Mask Wearing?
Is wearing a mask to decrease a minimal risk by 1% more worth the risk? Increased bacterial and fungal infections that are on the rise as a consequence of chronic and continued daily mask wearing.
I’m seeing patients with increased frequency of facial rashes, fungal infections, non COVID-19 induced bacterial infections. Reports are coming from my colleagues, all over the world, that suggest bacterial pneumonias are on the rise.
Why? Because we are wearing and re-wearing of dirty masks. Untrained members of the public are wearing medical masks, repeatedly… in a non-sterile fashion… They’re becoming contaminated. They’re pulling them off of their car seat, off the rearview mirror, out of their pocket, from their countertop, and they’re reapplying a mask that should be worn fresh and sterile every single time. And, there is no way around this when 330 million people are required to wear a mask to go to Wal-Mart or Costco.
In a recent report in Emerging Infectious Diseases, the U.S. Centers for Disease Control and Prevention (CDC) suggests what experts have stated all along: There is no conclusive evidence that cloth masks protects users from coronavirus, especially since most people do not use them correctly and do not keep them clean.
The report actually says, “To our knowledge, only 1 randomized controlled trial has been conducted to examine the efficacy of cloth masks in healthcare settings, and the results do not favor use of cloth masks. More randomized controlled trials should be conducted in community settings to test the efficacy of cloth masks against respiratory infections.”
Before you answer that question let me ask you a question. Did you know that the influenza viral strain has multiple sub-types? The Influenza A viral strain that has 198 different sub-types and influenza B has just as many, meaning there are at least 400+ different strains of Influenza. Oh, did I tell you that we have recently identified Influenza C & D sub-types as well? Yes, this means that there are over 600+ sub-types of influenza.
Herd Immunity
You might be able to immunize the herd if the average age of those in the herd lived for 200 years. Anyone telling you getting your flu shot improves herd immunity doesn’t understand virology. Herd immunity goes out the window with influenza and with most mRNA viruses like coronaviruses.
In order to vaccinate the population against influenza 33%-44% of the population must have immunity to all viral types in a given year. With COVID-19, the estimate is 60-75% must be immunized to all 170+ known strains of coronavirus.
You may have antibodies to one of those flu strains, yet what about the other 400-600 strains you might be exposed to next year? Just because you have antibodies, doesn’t mean you are immune. This applies to Influenza and it applies to coronaviruses.
The influenza vaccine (which only covers 4-5 of the 600+ influenza strains possible). Which one do you pick this year? Hence the CDC cartoon.
Does the Influenza Vaccine Reduce Risk of Hospitalizations?
Over 20 years, the percentage of seniors getting flu shots increased sharply from 15% to 65%. It stands to reason that flu deaths among the elderly should have taken a dramatic dip due to increased flu vaccination each year. And at over 40% of the population being immunized, herd immunity should have been achieved.
Instead, flu deaths among the elderly continued to climb. It was hard to believe, so researchers at the National Institutes of Health set out to do a study adjusting for all kinds of factors that could be masking the true benefits of the shots. But no matter how they crunched the numbers, they got the same disappointing result: flu shots had not reduced deaths among the elderly. It’s not what health officials hoped to find.
The two studies below demonstrate that yearly flu vaccine for those over age 65 does nothing to decrease influenza related death. These studies funded by the government in 2005 and 2006 were suppressed. Your doctor and I never heard anything about them. Yet, the CDC still says “Get your flu shot.”
mRNA Vaccines Increase Risk of Other Viruses
Last, the influenza vaccine actually increases your susceptibility to coronavirus infection. Yes, you read that correctly. A recent study by Wolff demonstrates that influenza vaccinations are not benign. Influenza vaccine increases risk of Coronaviruses by 36%, non-influenza viruses generally by 15%, and human metapneumovirus by 59%.
And, a second study trying to confirm the findings above reveals increased risk of parainfluenza virus in adults (increased by 4.6% of vaccinated adults and only 2.6% of unvaccinated adults.
So, what is the answer? Waiting for the perfect vaccine or an antibody test is not the answer. Anyone telling you this is selling something.
Please be aware, I am NOT an anti-vaccine physician. Vaccines are life saving. But, it is essential that you and I understand the pros and cons of each and every vaccine we use or recommend. I am a huge proponent of most childhood vaccines, pneumonia vaccines and the new shingles vaccine, because they work. The science confirms their effectiveness. The science does not confirm the effectiveness of the influenza vaccines.
The answer is protect yourself. Wash your hands, stay home when you are sick, clean and sterilize frequently touched surfaces. Keep yourself healthy and understand how to reverse hyper-insulinemia (the one factor that makes this and coronaviruses significantly more severe.)
Over the last few months, our fearless infectious disease leader, Dr. Anthony Fauci, and the Ivory Tower of medical journals, the New England Journal of Medicine, have clearly informed us that mask wearing by the healthy is little more than symbolic ‘Virtue Signaling.’
For those Karen’s and Felicia’s who have tried to shout me down like a Tourette’s tick with ‘Social Media Science,’ in Wal-Mart, in the big box stores, at the gas station and at the burger shop, lets look closely at what the New England Journal of Medicine said on May 21, 2020.
We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to COVID-19 as face-to-face contact within 6 feet with a patient with symptomatic COVID-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching COVID-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic.
So, why have we been ordered to wear are masks everywhere by mayors and governors and city officials across the country? Symbolism. Pure and simple symbolism. From that same NEJM article:
It is also clear that masks serve symbolic roles. Masks are not only tools, they also serve as a talisman [an object that acts as a charm to avert evil and bring good fortune] that may help increase health care workers’ perceived sense of safety, well-being, and trust in their hospitals.
The Surgeon General was widely mocked and ridiculed for suggesting in March that masks might even increase the spread of the virus. Yet, here, in the “journal of all medical journals,” the NEJM provides the same warning to mask-wearers:
What is clear, however, is that universal masking alone is not a panacea. A mask will not protect providers caring for a patient with active COVID-19 if it’s not accompanied by meticulous hand hygiene, eye protection, gloves, and a gown. A mask alone will not prevent health care workers with early COVID-19 from contaminating their hands and spreading the virus to patients and colleagues. Focusing on universal masking alone may, paradoxically, lead to more transmission of COVID-19 if it diverts attention from implementing more fundamental infection-control measures.
However, suddenly on June 17th, 2020, Dr. Fauci suddenly changed his tune, and contrary to all the scientific evidence and over 50 years of medical literature on the subject, said wearing a mask is “better than nothing.” Within weeks, executive orders for mask wearing were signed across the nation.
The argument should have been over. Anyone advocating for universal mask wearing by the healthy, according to all the mask wearing literature, is merely engaging in virtue signaling, not actual public health.
Cities and states across the nation have mandated mask wearing (some even advocate using bananas). I’m not telling you to break the law. I am saying that the mask mandate has done nothing to “slow the spread” as so many people have now bought into. Research demonstrates that homemade masks do little to stop the spread of viral infections. It also demonstrates that properly fitted surgical masks worn correctly decrease this risk of viral spread in a highly controlled setting at the very best by only 2-5%.
In the most recent comprehensive review of the mask wearing literature, the authors stated, “The evidence is not sufficiently strong to support widespread use of face-masks as a protective measure against COVID-19. However, there is enough evidence to support the use of face-masks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.”
What is effective is washing your hands regularly with soap and water, avoiding those who are actually sick or have fevers over 101 degrees, eating a healthy diet that prevents diabetes risk and getting adequate sleep. Those at high risk for infection can and should be vigilant about avoiding exposure to those who are sick.
For the rest of us, it’s time to unmask. I, myself, struggle daily to maintain enough virtue in my bones for myself, let alone signal others about it all day long.
Isn’t it interesting, back in April and May, 2020, those of us closely watching the data stated that this virus would look much like the influenza pandemic of 1918. Look closely at the numbers of deaths in St Louis (who participated in the 1918 quarantine – red line) and Arizona, who has done much the same in our approach (in the 2nd graphic below).
The death count curves are nearly identical. Interestingly, the numbers of those that died St Louis are almost identical to Arizona’s graph below, directly from the Arizona Department of Health Website. We know that the rates of infection differ between the two viruses and a number of things including domicile proximity, health of the city or state, transportation methods, sanitary condition, etc. play a significant role in the infection rates. My point is not to compare the two viruses, but to point out that the effect of quarantine did exactly what we expected it to do.
We expected the resurgence of the virus. Let’s say that again. We expected it. However, the media and many health professionals that I interact with seem horrified that it occurred.
We predicted this pattern months ago.
I am surprised at the number of health professionals that are just beside themselves about this virus. I recognize that, in its most severe form, this virus can be deadly. And, so is the flu, RSV and other RNA viruses. Do these professionals not read history? Do they not read the actual scientific literature? Do they not see the patterns that diet and control of hyperinsulinemia have on this virus?
Instead, these medical professionals have remained quiet, and in some cases cheered, as our government over-reach and personal liberty infringement took place. We’ve lost our ability to travel, participate in group gatherings and church services. Quarantine, mask wearing and social distancing has essentially done nothing for our community in the last 3 months.
Our initial reasoning for quarantine was to take the peak off of hospitalizations. That was done. Yet continued suppression of personal liberties has done nothing for the overall health of our society. The second wave of infection was going to occur no matter what we did.
Instead, the media fear mongering, social distancing and force wearing of masks has lead to increased risk of suicide, overdose and drug addiction. Estimates are as high as 150,000 deaths due to the effects of quarantine and social distancing mandates. In fact, much of the anxiety and PTSD that is expected will not be seen until 4-6 month after the quarantine occurs.
According to a recent JAMA report, “It is possible that the 24/7 news coverage of these unprecedented events could serve as an additional stressor, especially for individuals with preexisting mental health problems.” Our routines have been completely upended and even things like wearing a mask or waiting in lines at the grocery store can make you feel tense.
Some common signs of pandemic-induced stress are:
Fear and worry about your own health and the health of your loved ones
Changes in sleep or eating patterns
Difficulty sleeping or concentrating
Worsening of chronic health problems
Worsening of mental health conditions
Increased use of alcohol, tobacco, or other drugs
What we know from research after the SARS outbreak is that post-traumatic stress (PTSD) is possible, especially in front line healthcare workers. In one particular study, about 10 percent of the hospital employees had had high SARS-related PTSD symptoms post-outbreak. And about half of them still had symptoms three years later. Other studies have shown that when a person’s PTSD symptoms persist for more than 6 months after an event, they are very likely to continue to persist over the long term.
A significant part of the problem in both the lay public and among health care workers is confusion about actual risk of disease, what can be done to prevent/treat the disease, and how to access treatment. I see this confusion today in many physicians and nurses I interact with in my community.
If you are having symptoms of anxiety, stress or depression, don’t be afraid to reach out for help. Knowledge is power. The more you know, the less fear and anxiety you will have.
Wear your mask if you want. Initially, when we didn’t know how invective this virus was, I was all for using any protection available. But, since the end of April, the data has changed my mind. Wearing a mask isn’t doing anyone any good.
Some cities and states have mandated mask wearing. I’m not telling you to break the law. I am saying that the mask mandate has done nothing to “slow the spread” as so many people have now bought into. Research demonstrates that homemade masks to little to stop the spread of viral infections and surgical mask that have been properly fitted and worn correctly decrease this risk of viral spread by only 2-5%. In the most recent review of the mask wearing literature, the authors stated, “The evidence is not sufficiently strong to support widespread use of face-masks as a protective measure against COVID-19. However, there is enough evidence to support the use of face-masks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.”
What is effective is washing your hands regularly with soap and water, avoiding those who are actually sick or have fevers over 101 degrees, eating a healthy diet that prevents diabetes risk and getting adequate sleep. Those at high risk for infection can and should be vigilant about avoiding exposure.
In order to fully understand the current “pandemic” coronavirus (COVID-19) infection, it is essential that one understands some basics about the immune system. Second, we will look at how a poor understanding of the immune system has duped many about how the body actually responds to this virus.
Normal functions of the immune system include defense against infections and detection and destruction of malignant or abnormal cells. As our immune system ages and these capabilities decline, there is increased susceptibility to infections and cancer and an increased incidence of autoimmune disorders. The study of age-related changes in immune function is a relatively new area of investigation, which is limited by incomplete understanding of the complexities of immune mechanisms in general. These age related changes make it clear why COVID-19 is mild in some and severe in others.
July 5, 2020 – ADHS -Data Dashboard – COVID-19 Deaths by Age Group
The coronavirus tends to be more problematic in those over age 55. In fact, 87% of all deaths in Arizona due to COVID-19 are in those over age 55. The clinical presentation of infections in older patients may be different from that in younger patients. Older adults with severe infections tend to have fewer symptoms, and fever is absent or blunted in 20 to 30% of those over age 55 years old. This suggests a decreased ability to mount inflammatory cytokine responses (small proteins used as signaling molecules between cell) in the face of infection. Signs of infection in older adults can be nonspecific and include falls, delirium (confusion), anorexia (loss of appetite), or generalized weakness (Norman DC, Clin Infect Dis. 2000;31(1):148).
The immune system is divided into innate and adaptive immunity. The innate immunity refers to immune responses that are present from birth and not learned, not adapted, and not refined as a result of exposure to micro-organisms/antigens. In contrast, adaptive immunity, which consists of the responses of T and B lymphocytes, is generated and then refined over the lifetime of a person as a result of repeated exposure to antigens from bacteria, viruses or fungi. Aging affects both innate and adaptive immunity, although innate immune mechanisms are better preserved overall (Weiskopf D, Weinberger B, Grubeck-Loebenstein B,Transpl Int. 2009; 22(11):1041).
Innate Immunity
The innate immune system consists of epithelial barriers (skin, gastrointestinal and respiratory protective lining), macrophages, neutrophils, natural killer (NK) cells, natural killer T (NKT) cells, dendritic cells (DCs), and complement proteins. Additional normal defenses include production of mucus in the proper quantity and viscosity, local antimicrobial proteins, and normal sweeping function ciliary cells.
Though some innate immune mechanisms are decreased in the adult over 55 years old, other mechanisms appear to be more active.. The result of these changes is a propensity to develop chronic inflammation. The result of aging of the innate immune system may be most accurately characterized as a state of immune dysregulation characterized by low-grade, chronic inflammatory changes (Shaw AC, Joshi S, Greenwood H, Panda A, Lord JM, Curr Opin Immunol. 2010;22(4):507). This is why many of my patients feel that the “Golden Years” are full of lead.
Adaptive Immunity
Adaptive immunity consists of the functioning of two types of white blood cells: T and B lymphocytes. T and B lymphocytes mediate control cellular and humoral immune responses, respectively.
Cellular Immune Response and the T Cells
There are several key changes that occur to T cells during aging.
T Cells Change Over Time – T cell receptors become less divers after age 65. The production of new T cells is dramatically reduced in the very old. T cell populations are largely composed of persistent long-lived lymphocytes. Age-related defects in the signaling pathways of CD4 T cells have been identified due to changes in T cell receptors (Li G, Yu M, Lee WW, Tsang M, Krishnan E, Weyand CM, Goronzy JJ. Nat Med.,2012 Sep;18(10):1518-24. e-pub 2012 Sep 30).
T Cell Numbers Decrease – There is a decrease in the numbers of (helper) CD4 T cells, an increase in CD8 T cells, and a decrease in CD28 with aging. Reduction in CD28 results in an impaired ability of T cells to proliferate and secrete IL-2, an essential cytokine in promoting growth of T cells (Kaltoft K, Exp Clin Immunogenet., 1998;15(2):84). Because (helper) CD4 T cells are important in stimulating B cells, the ability of T cells to help B cells grow, expand and produce antibodies diminishes with aging (Haynes L, Maue AC., Curr Opin Immunol, 2009;21(4):414. E-pub 2009 Jun 6).
Decreased Cytokine Signaling – T cells respond specifically to cytokines like IL-2, IL-6, TNF-alpha. With aging over 50 years, production and signaling of these cytokines diminishes and has been found to be directly correlated with degree of frailty in older adults (Marcos-Pérez D, et al., Front Immunol. 2018;9:1056. Epub 2018 May 16).
Humoral Immunity
B Cells – B cells produce their own surface membrane immunoglobulin and differentiate into plasma cells, which then make immunoglobulin for the blood or secretions. These immunoglobulins are the mediators of humoral immunity. B cells respond to antigen exposure (protein markers or flags on the surface of bacteria or viruses) by producing antibodies, which then bind to antigens to fight concurrent infections or prevent future infections. B cells produce primarily the immunoglobulin IgM. Upon stimulation with and antigen, B cells switch to the production of IgG, IgA, or IgE. The ability of B cells to respond to antigens and produce antibodies is their main job.
Memory B & T Cells – The generation of long-lasting protective immune memory is one of the most unique and important characteristics of the adaptive immune system. Memory is essential for individual defense from infections to which you have previously been exposed. As the thymic output declines, individuals rely more on re-expansion of experienced memory cells for defense against infections.
An example of this was seen during the 2009 H1N1 influenza pandemic, in which older adults were better protected from H1N1 infection than middle-aged adults, probably because of the persistence of memory lymphocytes producing antibodies generated in response to an H1N1 virus that circulated prior to 1957 (Hancock K, Veguilla V, Lu X, Zhong W, Butler EN, Sun H, Liu F, Dong L, DeVos JR, Gargiullo PM, Brammer TL, Cox NJ, Tumpey TM, Katz JM. N Engl J Med. 2009;361(20):1945). The antibody avidity for 2009 H1 was higher in older adults than in middle-aged adults (Monsalvo AC, Batalle JP, Lopez MF, Krause JC, et al. Nat Med. 2011;17(2):195. E-pub 2010 Dec 5).
Mechanism of COVID-19 infection. ( https://pediaa.com/difference-between-innate-and-adaptive-immunity/)
Information about the coronavirus has dramatically changed in the last six months since it was discovered. Initially, it was suspected that humoral related antibodies were essential to mount an effective attack against COVID-19. This is why the focus has been directed at screening for active infection, quarantine and measurement of antibodies.
What we now know is that most individuals with asymptomatic or mild symptoms generate a highly functional T cell response. In fact, 50% of those who have been exposed to coronavirus formed a T cell (cellular immunity) response without activation of B cell response (humoral immunity) and had no antibody formation (Li X, Geng M, Peng Y, Meng L, Lu S. J Pharm Anal. Apr 2020; 10(2): 102-108).
A large Swedish study demonstrated that twice as many exposed family members and healthy individuals who donated blood during the pandemic of COVID-19 generated memory T cell responses (cellular immunity) versus those generating antibody responses (humoral immunity). This imply’s that the seroprevaleance (presence of antibodies like IgG & IgM found on B-cells) as an indicator has grossly underestimated the extent of population level immunity against SARS-CoV-2 (COVID-19). And none of these patients with this type of immune response have experience further episodes of COVID-19 to date (Sekine T, Perez-Potti A, Rivera-Ballesteros O, et al. bioRxiv (Biology) Jun 2020; e-pub: 174888).
What this all means is that 50% of people get exposed and form immunity with T cells, instead of B cells an may never even know they’ve had the virus.
Increased Susceptibility to COVID-19
As you can see above, age over 55 places one at greater risk for severe COVID-19 infection and complications. This is due to the effect age has on the immune system.
Three additional maladies (hypertension, diabetes,elevated cholesterol & coronary artery disease) are also significant risk factors for severe COVID-19 infections. These are also are the four most common medical problems that I see in my clinic, and they affect 85% of the people in my practice. All four are caused and driven by hyperinsulinemia.
Hyperinsulinemia is defined as an elevated insulin production (2-30 times normal) when ingesting any form of carbohydrate or starch. It starts 15-20 years before the onset of diabetes and is the cause of hypoglycemia, elevated fasting blood sugar, pre-diabetes, metabolic syndrome, chronic kidney disease, idiopathic neuropathy, hypertension and coronary artery disease.
Elevated insulin, even small elevations, puts a load on the immune system. The higher your insulin response to starches or sugars, the more likely you are to have hypertension, diabetes and heart disease. We found that those with elevated insulin levels and those over 45 years old with stressed immune systems are the most susceptible to severe COVID-19 infection.
We know that just four or more hours of elevated blood sugar and insulin increases the cytokine IL-6 significantly. This has a suppressive effect on T cell immunity. The body raises insulin chronically to protect itself from the damage caused by chronic elevation in blood sugar. Chronic elevated blood sugars can lead to severe inflammation and clotting disorders. The body attempts to raise insulin to protect angainst these issues, however, the chronic elevation in insulin leads to chronic elevation in the cytokines IL-2, IL-6, TNF-alpha, PAI-1, NF-kB, ROS and eventually IL-33.
Innate immunity affected by elevated glucose, insulin and PKC (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130196/#R56)
Should We Be Waiting For A Vaccine?
As a preface to this section, please be aware that I am a very strong proponent of safe and effective vaccine use. Because the RNA vaccines are so new, long-term efficacy, safety and adverse reaction studies are essential before these vaccines can be recommended across the board. It takes at least 4-5 years to 1) bring a vaccine to market and 2) complete adequate safety studies.
Let’s start by looking at the effectiveness of current RNA viral vaccines. The most common RNA vaccine currently in use is the influenza vaccine, quadravalent (four flu strains) and high dose (five flu strains) versions. Over the last 20 years, the percentage of seniors getting flu shots increased sharply from 15% to 65%. It stands to reason that flu deaths among the elderly should have taken a dramatic dip due to increased flu vaccination each year.
Instead, as you can see above, influenza deaths among the elderly continued to climb. It was hard to believe, so researchers at the National Institutes of Health set out to do a study adjusting for all kinds of factors that could be masking the true benefits of the shots. But no matter how they crunched the numbers, they got the same disappointing result: flu shots had not reduced deaths among the elderly.
It’s not what health officials hoped to find. I was shocked when I read these studies. Two studies, here and here, demonstrate that yearly flu vaccine for those over age 65 does nothing to decrease influenza related death. These studies funded by the government in 2005 and 2006 were suppressed and I never heard about them. Yet the CDC still emphasizes to the elderly, “Get your flu shot.”
One reason these vaccines are ineffective is that viruses like influenza and corona-viruses are highly antigenic. That means that there are hundreds of strains and the virus is changing rapidly. Influenza has over 600 strains. Our current high dose vaccine only covers five of these strains.
SARs-CoV-2 (COVID-19) is known to have over 160 strains. “There are too many rapid mutations to neatly trace a COVID-19 family tree.” Said Peter Forster, geneticist at the University of Cambridge. “We used a mathematical network algorithm to visualize all the plausible trees simultaneously.” (Proceedings of the National Academy of Sciences, 2020). Dr. Forster’s research identifies 160 genomes within the hundreds of additional variants of the three central COVID-19 strain variants.
A second reason, as stated above, is that 50% of people who are exposed to COVID-19 mount a T cell immune response without ever forming antibodies through B cell immunity. And, the antibodies that do form only give 3-4 months of protective effect.
Another other very fascinating concern found when making RNA virus vaccines is the potential to increase susceptibility to other viruses. In a Department of Defense study, looking at 6000 military personal vaccinated in the 2017-2018 season, those who got the influenza vaccine demonstrated an increases susceptibility to corona-viruses by 36%. Those who were vaccinated with the flu vaccine had additional increased susceptibility to non-influenza viruses by 15%, and increased susceptibility to human metapneumovirus by 59%.
A second influenza study demonstrated an increased risk of para-influenza virus in adults (increased by 4.6% of vaccinated adults and only 2.6% of un-vaccinated adults.) Though the researchers dismissed it as calculation error, the p value reflects that the vaccine played some roll (P=0.04) in the increased susceptibility.
Herd Immunity?
As with any other infection, there are two ways to achieve herd immunity: A large proportion of the population either gets infected or gets a protective vaccine. Based on early estimates of this virus’s infectiousness, we will likely need at least 70% of the population to be immune to have herd protection.
If the Penn State study is correct, the up to 50% of the U.S. population may have already been exposed as of the first week in March 2020, and by today, we may already be at Herd Immunity levels. This may be why we are now seeing continued drop in death rates across the country, despite increase infection counts (due to increased testing frequency).
Should we push for a vaccine? Do the math on a vaccine that covers only four out of 600+ strains like the quadravalent influenza vaccine. For a vaccine to create “herd immunity,” currently being touted across the airwaves as the way to return to normal, it would require the average human to be vaccinated every year for 100 years, and would take 200-400 years to create any semblance of herd immunity. And, that’s after 4-5 years studying the safety of a vaccine in large populations.
Influenza and HPV, the two most widely used RNA vaccines, still have a number of post-market adverse reactions including: Guillain-Barré syndrome (GBS), convulsions, febrile convulsions, myelitis (including encephalomyelitis and transverse myelitis), facial palsy (Bell’s palsy), optic neuritis/neuropathy, brachial neuritis, syncope (shortly after vaccination), dizziness, and paresthesia (tingling of the extremities) (Package-Insert—Gardasil.pdf; Package-Insert—Fluzone High Dose.pdf). Though these adverse events occur more rarely, it is essential you and I understand the risks of these newer RNA vaccines. Because it is an RNA virus, any coronavirus vaccine will come with similar risks.
What Can You & I Do?
First, our focus should be continued protection of our elderly and immune-compromised. Our focus should be placed on improving the immune systems of those at risk through diet, hand washing & quarantine of the ill. The evidence does not support quarantine of the healthy. Evidence does not support general public mask wearing. And there is no evidence that continued business closure is beneficial.
Reduce your risk of hyperinsulinemia. Follow a carbohydrate restricted diet, exercise, control blood sugar, blood pressure, cholesterol and limit risk factors that suppress your immune system. Quit smoking, vaping, etc.
For my patients with insulin resistant/hyperinsulinemia, I recommend Berberine 500mg twice daily with meals. (Talk to your doctor before you add any supplements or medications.)
Use over-the-counter Zinc 10-30mg once daily – this has been shown to improve T cell control of viral replication.
Use over-the-counter Melatonin 5-10mg nightly – this helps in sleep recovery and strengthening the T and B cell immune response.
If you have been diagnosed with COVID-19, using Vitamin B3 (Niacin) has been show to be protective on the lungs. Niacin is found in meat, fish and eggs (there’s reason for that ketogenic diet, again!)
Ensure your loved ones, especially the elderly and immune suppressed, understand the truth about their risk of infection.
Make a list of the things this pandemic has taught you. What can you do to better protect yourself in the future?
We live in a society with a limited supply chain.
We have become excessively dependent upon foreign business and supply
We have become dependent upon “just-in-time” and over-night delivery systems
We have a number of local and Federal deficiencies in our health care system
How important to your health, personal liberty and constitutional rights is defense of the borders?
How has freedom of speech, freedom of religion and freedom of assembly affected your family and your physical, emotional or spiritual health?
Consider the following poem in all of this:
Don’t be afraid to go outside and be a human being again. And, pass the bacon.
COVID-19 testing in Arizona as of June 21, 2020 (azdhs.gov).
The media keeps stating that corona virus has “spiked” in Arizona. What they’ve not been saying is that the frequency with which Arizona doctors and hospitals are testing went from 2500 tests per day to almost 15,000 tests per day just after the first week in May. In fact, 17,663 tests were reported on yesterday alone.
Our testing frequency increase 600% in the last 6 weeks. Of course we are going to see increased numbers of positive tests. That is to be expected. Additionally, what you are not being told is that the number of positive tests has remained consistent around 8-10% of all those tested. We are not seeing a “spike.” We are getting a much clearer picture of the prevalence of this virus. And, the large majority of those being tested are under 45 years old, those with the least likelihood of severe symptoms.
The Virus Can Be Lethal, But So Is Influenza and Childhood Pneumonia
Don’t get me wrong, this virus has the potential to be lethal in 1-2% of those that are infected, those who are immuno-compromised, but the majority of those getting positive tests (98-99%) will quickly recover without significant problems. That is identical to influenza. And you can see from the graphic below that the majority of those who have died in Arizona are those over 65 years old with significant other disease risk factors.
As of this week, the CDC’s provisional death counts for COVID-19 from January to June 2020, excluding influenza, are 45,524. That’s still less than influenza numbers above.
809,000 children died in 2017 from bacterial pneumonia in 2017. That’s 2200 children that die every day from preventable pneumonia, yet we haven’t mandated masks for this epidemic.
As you can see below, death from COVID-19 has continued to decline, despite what the media is saying. If it were truely spiking, we would have seen a rise in COVID-19 deaths around June 6th-15th (Arizona’s Quarantine Orders ended on May 31st), giving a 7-14 day incubation period after people began working and interacting. Yet that isn’t what the Arizona Department of Health is reporting. The number of deaths continues to fall.
Death from coronavirus in Arizona as of June 21, 2020 (azdhs.gov)
12,285 people died in Arizona from heart disease in 2017 and 11,719 died from cancer. We know that high carbohydrate intake combined with high fat foods is the number one risk factor for both of these diseases, yet there has been no city or state mandate on these risk factors. And, we know that hyperinsulinemia (the underlying cause of diabetes, hypertension, heart disease, and most cancers) is the primary risk factor in severity of illness in COVID-19 patients.
I have yet to hear Governor Ducey or Mayor Hall issue an executive order on time spent in a bakery or proximity to Krispy Kreme.
Is Hospital Bed Space Still an Issue?
Possibly, but during our low point in hospitalization at the beginning of April in Arizona, hospitals were still at 60-70% of capacity. As of the writing of this article, Arizona is at 85% of capacity. This was to be expected.
Will we reach capacity over the next 2-4 weeks? Epidemiological projections claimed that even with quarantine of the state we would max out our hospital capacity in April. We didn’t even come close.
A Rise in COVID-19 Cases is Expected
St. Louis vs Philadelphia Quarantine vs No Quarantine – 1918 Spanish Flu Deaths
If you look at history, the only time where viral infection quarantine was incorporated into a city versus one that was not (St. Louis & Philadelphia), you will see that a rise in viral infection and death naturally occurred after removing the quarantine orders. This is visible in the red indicator at 80-110 days in St. Louis. Our rise in COVID-19 cases and fatalities is to be expected.
The whole point of this was to unload burden on hospital facilities, not stop the spread of infection all together, as that will never happen. The goal of decreased hospital burden has been accomplished.
Why All the Hype?
Your guess is as good as mine. I have wracked my brain as to why our leaders persist in forcing the average healthy American to feel anxious, fearful and insecure over a virus that is no more problematic than the flu.
Why would mandates for mask wearing occur 6 months after the outbreak of the virus occur when death rates are falling and data shows us that many people have already had this infection without knowing it? If you look at the cities in Arizona where mask and social distancing mandates have been enacted in the last week, you may recognize that these are the more progressive left leaning cities. This push to change the way we live our lives seems to come from this group and is amplified by the left-leaning media. Motive may revolve around the poll box in November.
Though you and I have felt this deeply in our homes and wallets, liberals running for office at all levels across the state and nation likely feel they have politically benefited from the outbreak of the coronavirus. The subsequent regulations on social distancing, mask wearing and business closures gave Democrat elected officials more power over individual lives and business operations than they have ever had before. Combine that with the ability to blame our current president for the economic consequences of the virus and you can see why some would salivate for another outbreak to rescue their hopes for unseating this president.
Is This A Method to Move Us to Main Streamed Contact Tracing?
A second reason for the hype could be a desire to move people to allow wide spread “contact tracing.” This is much like facial recognition software that we see used so often in the latest spy thrillers. However, contact tracing uses the GPS in your phone to track your location, travel and your contacts.
As of last month, contact tracing software was added to Android and IOS phones. Apple released iOS 13.5 and iPadOS 13.5 for iPhones, iPods, and iPads on May 20th. They went live alongside minor software updates for Apple TV and HomePod devices. The iOS update mainly adds new health-related features—most notably the much-discussed Exposure Notification API that was co-developed with Google to help local, regional, and national governments enact contact-tracing strategies to battle the COVID-19 pandemic. These are not automatically turned on, but you can find them under the privacy settings of your phone. Added without your consent, contact tracing and facial recognition cameras used individually or in coordination are arguable violations of human rights and rights to privacy.
Several Supreme Court cases have recognized a right to travel. For example, in Kent v. Dulles (1958), the court wrote, “The right to travel is a part of the ‘liberty’ of which the citizen cannot be deprived without due process of law under the Fifth Amendment. . . . Freedom of movement across frontiers in either direction, and inside frontiers as well, was a part of our heritage. . . . Freedom of movement is basic in our scheme of values.”
In addition to the right to travel, in Toomer v. Witsell (1948), the Supreme Court asserted that the act of shrimping (and, more generally, pursuing one’s livelihood) was protected by the Fourteenth Amendment’s Privileges and Immunities clause. (“Shrimping” means to fish for shrimp.)
And in the well-known case of Meyer v. Nebraska, the Supreme Court determined that constitutionally protected liberty “denotes not merely freedom from bodily restraint but also the right of the individual to contract, to engage in any of the common occupations of life, to acquire useful knowledge, to marry, establish a home and bring up children, to worship God according to the dictates of his own conscience, and generally to enjoy those privileges long recognized at common law as essential to the orderly pursuit of happiness by free men.”
There is a strong argument that the Constitution protects the freedom to move, travel, and do business. However, constitutional interests are not absolute, and argument arises that this could be limited by pressing public health interests, especially during a state of emergency. Hence the need for cities and states to declare “state of emergency” before enacting these orders.
In order for liberty-infringing public health laws to be constitutional, they must be the least restrictive means of protecting health. With regard to the novel coronavirus, this may not be the case.
A Change of American Values
There are those on the left who have a profound dislike for what you and I see as the traditional American culture and political mores of the United States. Remember Barack Obama’s words about those who “cling to Bibles and guns,” Hillary Clinton’s labeling of Trump supporters as “deplorable,” and the recent emphasis across the nation by many to get “transformational change?” Understand that it is not just mere reform or improvement the Democrats desire, they want a wholesale difference in the way Americans interact with each other, think and operate day-to-day.
Fear of your neighbor, because of unseen illness or skin color, makes you and I more likely to accept governmental regulation and vote for help at the ballot box. History has demonstrated this fact for hundreds of years. When the government appears smarter than your doctor, you’re more likely to vote for single payer health care. Think about it.
(Note: Author Updated this article on January 31, 2021)
I’ve been accused of writing this article because of my personal political motivation. That is not the case. I write this article because my patient’s expect me to treat them based on the actual science that exists, not the interpretative politics and non-evidence based health mandates that so many have recently cowered under, or used as a virtue signaling security blanket. A number of my patients, and potential patients, have notified me since I first published this article that I upset or angered them, because I haven’t conformed to “everyone else’s opinions.” My intent in writing this is not to anger anyone, agree with your opinion or to put forth a political agenda. Just because the media, politicians or city bureaucrats repeat something over and over doesn’t make it true. I share with you the actual science that has been recently made available so that you and I can make an educated judgement on how to act. Without an understanding of the actual evidence how are you and I to respond when there are so many voices sharing so many differing opinions? If you can’t trust your doctor to follow updated scientific evidence, then who can you trust?
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After graduation from medical residency, I served for four years as my AirForce Reserve unit’s biological/chemical weapons expert & physician. My job was to understand the risks of all the known biologic and chemical weapons that could be used on a human being, including severe viral and bacterial diseases that could pose a threat. My training was specifically focused on how to prevent and treat the effects of these illnesses in those under my care, military or otherwise.
I spent four years reading and researching where and when various types of masks, respirators and protective equipment would and should be used. Never once was a surgical or cloth mask ever found to be effective. Even N95 masks failed the rigors of these encounters.
This week our fearless Dr. Fauci says it’s “common sense” to wear two masks. So, my question to him and all of the other emperors of medicine is, what about three masks?
Even better yet, 10 masks makes even more “common sense!!” Where does this stop? (‘Cause my ears flop over at 11 masks.)
I’m thinking that 100 masks is 100% effective right?
I guess those filtered gas masks really aren’t essential then?!
One surgical mask decreases risk by 1-2% (yes, that’s the benefit of a mask that we’ve been required to wear). You’re more likely to have a 40% COVID risk reduction by throwing salt over your shoulder when you leave the house . . . (that’s the actual placebo effect).
The whole reason for mask wearing is to decrease “asymptomatic” transmission of COVID-19. That means, masks are supposed to decrease your risk of spreading or inhaling this virus when you or the person near you have no symptoms. Initially, we recommended wearing masks, because we did not know how infective the COVID-19 virus was to humans. We also knew that there was limited access to the N95 masks used in the hospital setting.
However, in the last 12 months, we’ve learned a great deal and we have a tremendous amount of data about treating this virus in the outpatient setting.
How Contagious is COVID-19?
What’s the actual risk of spreading the virus when you have no symptoms? It’s about 0.06% if you have prolonged contact (3 hours continuous face-to-face) with a person within six hours of that person having onset of symptoms (i.e. – fever, sore throat, fatigue, headache, loss of taste or smell, or runny nose). It is very rare to be infected at all with COVID-19 asymptomatically if you contact a person 6-9 hours before they have symptoms.
In fact, a recent study revealed there were no positive tests (or asymptomatic spread) among 1,174 close contacts of asymptomatic cases. So, why are we still wearing masks? Because it is politically convenient, increases fear, and increases your likelihood of getting a vaccine.
Are There Unintended Consequences of Mask Wearing?
Is wearing a mask to decrease a minimal risk by 1% more worth the risk? Increased bacterial and fungal infections that are on the rise as a consequence of chronic and continued daily mask wearing.
I’m seeing patients with increased frequency of facial rashes, fungal infections, non COVID-19 induced bacterial infections. Reports are coming from my colleagues, all over the world, that suggest bacterial pneumonias are on the rise.
Why? Because we are wearing and re-wearing of dirty masks. Untrained members of the public are wearing medical masks, repeatedly… in a non-sterile fashion… They’re becoming contaminated. They’re pulling them off of their car seat, off the rearview mirror, out of their pocket, from their countertop, and they’re reapplying a mask that should be worn fresh and sterile every single time. And, there is no way around this when 330 million people are required to wear a mask to go to Wal-Mart or Costco.
In a recent report in Emerging Infectious Diseases, the U.S. Centers for Disease Control and Prevention (CDC) suggests what experts have stated all along: There is no conclusive evidence that cloth masks protects users from coronavirus, especially since most people do not use them correctly and do not keep them clean.
The report actually says, “To our knowledge, only 1 randomized controlled trial has been conducted to examine the efficacy of cloth masks in healthcare settings, and the results do not favor use of cloth masks. More randomized controlled trials should be conducted in community settings to test the efficacy of cloth masks against respiratory infections.”
So, why, again, are we wearing these masks?
Should We Still Be Hiding In Our Homes?
Six months after the the largest variant of the five coronavirus sub-types appeared with it’s ugly little glycoprotein envelope and infective RNA fusion peptide coating, many states and countries are still in a quarantine or lock-down. Initially, because of the rapid infection rate that was seen in Italy and China, health experts recommended quarantine of the general population in order to keep hospital systems and medical providers from being overwhelmed. However, the “overwhelm” has been quite underwhelming. This begs answer to four very important questions:
Should we still be quarantined?
Should we still be wearing a mask when in public?
Should businesses still be shut down?
Should we wait for a vaccine?
This is the first time in history that large scale quarantine of the healthy across the country was ever used. The sole purpose was to control the number of severe cases requiring intensive care and ventilator use. Multiple mathematical models predicted that hundreds of thousands would die based upon statistics seen in Italy and China.
In early February, 2020, we were concerned that risk of death as high as 5.5% in our initial data from Italy and China. Limited N95 masks and protective equipment was available. In agreement with the CDC and WHO, I recommended everyone wear a mask, take drastic infection precautions and quarantine to prevent risk of transmission (Davies A, et al., Aug 2013).
Because viruses like COVID-19 and influenza are so small, a single layer cloth mask and or surgical mask has only been shown to decrease your risk of viral infection or transmission to others by 1-2%. Triple layer cloth masks with central interfacing layer give 3% – 20% reduction of infection risk based on the studies we have in the medical literature (Disaster Med Public Health Preparedness. 2013;7:413-418). At the time we learned about this virus, our understanding was that any protection was better than no protection.
Underwhelming
Yet, as this virus crossed our shores, traveled over the amber waves of grain and ascended the majestic purple mountains of majesty, the overwhelming number of patients hitting the hospital in droves isn’t what we saw. A few areas like New York and Washington State were hit hard, but not nearly as predicted. The large numbers of deaths seen in these states is because of their decision to send thousands of recovering COVID-19 patients into nursing homes, exposing those over 65 at greatest risk for death, to this virus.
The ONLY reason to quarantine an entire population was to decrease the load on hospitals and medical providers. Since the corona-virus entered the US, only 2% of those who actually get infected have required hospitalization. Our fears never came to fruition. The hospitalization load never even reached full capacity in 99% of hospital facilities across the country and many facilities began furloughing employees in April 2020. In fact, this weeks estimate by the CDC is that the fatality ratio for COVID-19 is 0.004. That means if you get the infection, you have a 0.4% chance of dying from coronavirus. Remember, influenza has a fatality ratio that fluctuates between 0.002-0.005 depending on the year (0.2%-0.5% fatality risk). In layman’s terms, your risk of death from a coronavirus infection is no greater than the flu.
The population with the greatest risk for death with any infection is that group over 65 years old. Your overall risk of getting this infection in the United States and dying, if you are over 65 years old, is 0.04% based on our current population and fatality rates. Your overall risk of getting the flu and dying, if you are over 65 years old, is between 0.03%-0.05% depending on the severity of the year.
Arizona Department of Health Services COVID-19 Dashboard – June 18,2020
As of June 18th, eight weeks from the time we began opening up businesses, elective surgeries and letting people go back to work, the death count from COVID-19 continued to fall. If social distancing and mask wearing was really effective, significant rise in infections and COVID-19 deaths should have escalated in mid-May (5-6 days after exposure). Yet, in states like Arizona COVID-19 death counts continued to fall.
Quarantine of the Healthy
In all of history, we have never seen any benefit to quarantining the healthy. In fact, quarantine of the healthy has been demonstrated to be unhealthy for a “well population” (Brooks SK, et al., Lancet, Feb 2020). Based on scientific evidences we have today, despite what our politicians say, there is no reason to quarantine those that are not ill. Seeing all this data over the last two weeks dramatically changed my perspective on this virus.
Asymptomatic Transmission
“Oh no, Dr. Nally! You can’t say that, because this virus can be transmitted when you’re not symptomatic!” Yes. I’ve heard that argument for the last three months. And it is unfounded.
The main reason for quarantine was the fear of asymptomatic transmission. Early editorial reports (these were not actually controlled studies, they were opinion reports based on a case review) showed that the virus “may” be spread prior to a person showing symptoms via respiratory secretions. Initial data in seven very small presumptive editorial case reports out of China, Singapore and Germany postulated that this could occur in 40-50% of those infected (1,2,3,4,5,6,7). Yet all of these articles were case reports of 1-10 people and the exact mechanism of transmission was observational only and is still unknown.
The CDC made its recommendations on wearing masks based on these seven presumptive editorial cases between January and May, 2020. Recent nursing home case report data from April and May looked at 76 people in two nursing homes, 50% of those with positive infections were asymptomatic for the first 5-6 days. The report implies that those with COVID-19 must have had the potential to spread the disease 3-4 days before onset of symptoms. All of our social distancing and mask wearing has been based on upon these seven very small presumptive case reports and/or medical editorials. Never in medical history has sweeping health recommendations or mandates been made on editorial reports alone.
It is very important to note a recent larger population study of 455 patients was performed looking at infected members of families and those living in close quarters over 2-4 weeks. The researchers findings were opposite that of the seven small case reports above and concluded that the likely hood of asymptomatic SARS-CoV-2 transmission was “weak.”
The assumption that viral infections can be transmitted in the asymptomatic state comes from the Ghandi study, and others, that 30-50% of asymptomatic influenza patients can spread the flu a full 3-4 days prior to showing any symptoms, and in some cases up to 7 days prior to symptom onset. We’ve assumed that is the case with COVID-19, but that isn’t what the larger study demonstrated.
Have we or do we currently quarantine the healthy or institute social distance because of asymptomatic influenza spreading risk? No.
Do we quarantine the healthy or social distance because of the highly contagious croup or whooping cough (that is still prevalent on our southern border)? No.
But, these are the same editors and journals that have been telling us for the last 50 years that eating fat makes us fat. So, we must trust them, right? Wait, didn’t the New England Journal of Medicine and the Lancet both just retract “ground breaking” articles on COVID-19 because of falsified data that was never peer reviewed?
The fear of asymptomatic spread is therefore a mute point, as it is roughly identical to the flu. And it has infectious similarities to other infectious diseases like whooping cough (pertussis) and the croup (para-influenza virus). If the only actual large study of COVID-19 demonstrates that asymptomatic droplet based spread is weak, then why have we created fear and economic collapse for a virus that is less likely to spread in the asymptomatic person than the flu, croup, or whooping cough?
Risk Factor for Disease Severity
These three maladies (hypertension, diabetes & coronary artery disease) are the three most common medical problems that I see in my clinic, and they affect 85% of the people in my practice. All three are caused and driven by hyperinsulinemia.
Hyperinsulinemia is defined as an elevated insulin production (2-30 times normal) when ingesting any form of carbohydrate or starch. It starts 15-20 years before the onset of diabetes and is the cause of hypoglycemia, elevated fasting blood sugar, pre-diabetes, metabolic syndrome, chronic kidney disease, idiopathic neuropathy, hypertension and coronary artery disease.
Elevated insulin, even small elevations, puts a load on the immune system. The higher your insulin response to starches or sugars, the more likely you are to have hypertension, diabetes and heart disease. We found that those with elevated insulin levels and those over 45 years old with stressed immune systems are the most susceptible to severe COVID-19 infection.
We know that those who do get severely ill are those over 45 with immune system compromise and/or hyperinsulinemia. A very interesting fact was published in The Lancet. The authors found that the highest rates of death occurred in those with current hypertension, diabetes and/or coronary artery disease (heart disease or atherosclerosis of the arteries).
Interestingly, Italy, Spain and Portugal have the highest incidence of metabolic syndrome (hyperinsulinemia) across all of Europe. It stands to reason that they have also been hit the hardest with a virus that is focused on this form of immune-compromise.
Corona-Virus is Quite Common
The corona-virus, traditionally, causes a simple common cold. In fact, 2% of the population are asymptomatic carriers of the six corona-virus strains that are known to infect humans. And this class of virus is responsible for 10% of respiratory infections yearly around the world (Cascella M, et al. 2020 Apr 6. In: StatPearls.).
Should We Still Be In Quarantine?
Should we still be in quarantine? The answer is therefore “no.”
What we should be focused on is limiting exposure to those with the greatest risk like those in nursing homes, care centers, populations of elderly (over 65 years old), and those with known risk for suppressed immunity. Our focus, efforts and funds should be spend keeping these populations from exposure to COVID-19.
Should we still be wearing masks in public?
As noted above, cloth masks provide only very minimal (20-40%) protection from bacteria and almost no protection (1-2.3%) from viral infections. The two studies that do exist about effectiveness of mask wearing during viral infections to prevent spread demonstrate that adherence is very difficult and that transmission of viral infections is not statistically different between those wearing masks and those not wearing masks (MacIntyre CR et al., Cowling BJ et al.). Because we now know that this virus is similar to influenza in risk for death, general healthy populations should have no need to wear masks. Wearing of a mask actually increases the likely-hood of infection by increased frequency of touching your face. It also perpetuates a climate of risk and fear. It, also, implies that if required, mask should be a covered cost of medical provision at the State and Federal levels. As you can see, even the NIH director over NIAID, Anthony Fauci, MD, the one person in the country with the most experience in pandemic infectious disease, has trouble wearing a mask in public.
Second, there are a number of other medical problems including exacerbation of headache and migraines that occurs with chronic use of both surgical and N95 masks. For those who have COPD, mask wearing can exacerbate hypercapnia (increased carbon dioxide levels causing slowed respiration, confusion and fatigue). Mask wearing can also cause chronic hypoxia (reduced oxygenation) which has been shown to increase risk of cancer growth. In cases where patients with pulmonary fibrosis or impaired lung function wear masks for prolonged periods, syncope or loss of consciousness has been documented.
Therefore, wearing a mask for prolonged periods of time when it is not medically justified is not recommended and in many cases dangerous to your health.
Despite this, and the fact that there is significant doubt as to asymptomatic transmission of this virus, mandates to wear face masks in public were decreed across Arizona today.
Should businesses be shut down?
If our ultimate goal was to “flatten the curve,” and protect hospitals from being overwhelmed, then we were successful at doing that in mid-April. Some communities rightfully extended that quarantine to the end of April. However, there has been no justifiable evidence to suggest that healthy people cannot go back to work, feed their families, pay their mortgages and provide for themselves. In fact, multiple states including Wisconsin, Kansas, & Michigan have had Federal courts overturn draconian quarantine measures enacted by over-reaching emergency gubernatorial orders.
How accurate are the tests anyway?
The accuracy and predictive values of SARS-CoV-2 tests have not been systematically evaluated, and the sensitivity of testing likely depends on the precise RT-PCR assay, the type of specimen obtained, the quality of the specimen, and duration of illness at the time of testing.
In a study of 51 hospitalized patients in China with positive SARS-CoV-2 RT-PCR test (mainly on throat swabs), 15 patients (29 percent) had a negative initial test and only were diagnosed by serial testing [Fang Y, et al., Radiology 2020]. In a similar study of 70 patients in Singapore, initial nasopharyngeal testing was negative in 8 patients (11 percent) [Lee TH, et al. Clin Inf Dis 2020]. In both studies, rare patients were repeatedly negative and only tested positive after four or more tests.
Seven additional studies (including two unpublished reports) that evaluated RT-PCR performance, the estimated rates of false-negative results were 100 percent on the day of exposure, 38 percent on day 5 (estimated as the first day of symptoms), 20 percent at day 8, and 66 percent at day 21 [Kucirka LM, et al., Ann Int Med 2020].
And even though manufacturers are pushing the new antibody testing, antibody testing with IgG and/or IgM tests are frequently falsely positive [Guo L, et al., Clin Infect Dis 2020] and have been shown to be erroneous 20-30% of the time. The accuracy and time to antibody detection vary with the particular test used. Studies evaluating the specificity of serologic tests in a broad population are lacking; in particular, the rate of cross-reactivity with other coronaviruses is a potential concern, and IgM tests are prone to false-positive results.
In the first week since symptom onset, fewer than 40 percent had detectable antibodies; by day 15, IgM and IgG were detectable in 94 and 80 percent, respectively.
In the United States, several serologic tests have been granted emergency use authorization by the FDA for use by laboratories certified to perform moderate- and high-complexity tests [FDA.gov]. The FDA highlights that serologic tests should not be used as the sole test to diagnose or exclude active SARS-CoV-2 infection. The sensitivity and specificity of many of these serologic tests are uncertain.
Should We Wait For A Vaccine?
As a preface to this section, please be aware that I am a very strong proponent of safe and effective vaccine use. Because the RNA vaccines are so new, long-term efficacy, safety and adverse reaction studies are essential before these vaccines can be recommended across the board. It takes at least 4-5 years to 1) bring a vaccine to market and 2) complete adequate safety studies.
Let’s start by looking at the effectiveness of current RNA viral vaccines. The most common RNA vaccine currently in use is the influenza vaccine, quadravalent (four flu strains) and high dose (five flu strains) versions. Over the last 20 years, the percentage of seniors getting flu shots increased sharply from 15% to 65%. It stands to reason that flu deaths among the elderly should have taken a dramatic dip due to increased flu vaccination each year.
Instead, as you can see above, influenza deaths among the elderly continued to climb. It was hard to believe, so researchers at the National Institutes of Health set out to do a study adjusting for all kinds of factors that could be masking the true benefits of the shots. But no matter how they crunched the numbers, they got the same disappointing result: flu shots had not reduced deaths among the elderly.
It’s not what health officials hoped to find. I was shocked when I read these studies. Two studies, here and here, demonstrate that yearly flu vaccine for those over age 65 does nothing to decrease influenza related death. These studies funded by the government in 2005 and 2006 were suppressed and I never heard about them. Yet the CDC still emphasizes to the elderly, “Get your flu shot.”
One reason these vaccines are ineffective is that viruses like influenza and corona-viruses are highly antigenic. That means that there are hundreds of strains and the virus is changing rapidly. Influenza has over 600 strains. Our current high dose vaccine only covers five of these strains.
SARs-CoV-2 (COVID-19) is known to have over 160 strains. “There are too many rapid mutations to neatly trace a COVID-19 family tree.” Said Peter Forster, geneticist at the University of Cambridge. “We used a mathematical network algorithm to visualize all the plausible trees simultaneously.” (Proceedings of the National Academy of Sciences, 2020). Dr. Forster’s research identifies 160 genomes within the hundreds of additional variants of the three central COVID-19 strain variants.
The other very fascinating concern found when making RNA virus vaccines is the potential to increase susceptibility to other viruses. In a Department of Defense study, looking at 6000 military personal vaccinated in the 2017-2018 season, those who got the influenza vaccine demonstrated an increases susceptibility to corona-viruses by 36%. Those who were vaccinated with the flu vaccine had additional increased susceptibility to non-influenza viruses by 15%, and increased susceptibility to human metapneumovirus by 59%.
A second influenza study demonstrated an increased risk of para-influenza virus in adults (increased by 4.6% of vaccinated adults and only 2.6% of unvaccinated adults.) Though the researchers dismissed it as calculation error, the p value reflects that the vaccine played some roll (P=0.04) in the increased susceptibility.
Herd Immunity? Maybe in 200 Years
Do the math on a vaccine that covers only four out of 600+ strains like the quadravalent influenza vaccine. For a vaccine to create “herd immunity,” currently being touted across the airwaves as the way to return to normal, it would require the average human to be vaccinated every year for 100 years, and would take 200-400 years to create any semblance of herd immunity. And, that’s after 4-5 years studying the safety of a vaccine in large populations.
Influenza and HPV, the two most widely used RNA vaccines, still have a number of post-market adverse reactions including: Guillain-Barré syndrome (GBS), convulsions, febrile convulsions, myelitis (including encephalomyelitis and transverse myelitis), facial palsy (Bell’s palsy), optic neuritis/neuropathy, brachial neuritis, syncope (shortly after vaccination), dizziness, and paresthesia (tingling of the extremities) (Package-Insert—Gardasil.pdf; Package-Insert—Fluzone High Dose.pdf). Though these adverse events occur more rarely, it is essential you and I understand the risks of these newer RNA vaccines.
Conclusion
In summary, our focus should be shifting to protecting our elderly and immune-compromised. The evidence does not support quarantine of the healthy. Evidence does not support general public mask wearing. And there is no evidence that continued business closure is beneficial.
What can you and I do?
Reduce your risk of hyperinsulinemia. Follow a carbohydrate restricted diet, exercise, control blood sugar, blood pressure, cholesterol and limit risk factors that suppress your immune system. Quit smoking, vaping, etc.
Actively engage your congressman or congresswoman. What are they are doing to assist/protect the seniors, nursing home patients, and shut-in’s in your area?
Let your governor or mayor hear your voice. What damage has quarantine has done to your livelihood and those of your family?
Get educated about your civil liberties and do not let anyone take them under the guise of an emergency.
Ensure your loved ones, especially the elderly and immune suppressed, understand the truth about their risk of infection.
Don’t be afraid to go outside and be a human being again.
I’ve taken a tremendous interest in the recent deaths caused by the corona-virus infection. The reason for my interest is high C-reactive protein (CRP), high interleukin-1 (IL-1), high interlukin-33 (IL-33) and high interleukin-6 (IL-6) levels in patients with this illness. Recent data, literally hot off the press, demonstrates that those with the greatest risk of death had the highest CRP, IL-6 and IL-33 levels.
I have a large population of metabolic syndrome, hyperinsulinemia and diabetic patients in my practice. About 85% of my practice has hyperinsulinemia. They over produce insulin between 2-30 times normal in response to any form of ingested carbohydrate (simple and complex sugars, fruit, pasta, cereal, oatmeal, etc.) High insulin causes elevated CRP, IL-6 and IL-33.
Why is this a problem?
A very interesting fact was published four days ago in The Lancet. They published a study looking at 191 patients in two hospital centers in China. The authors found that the highest rates of death occurred in those with current hypertension, diabetes, elevated cholesterol (high triglycerides and LDL) and/or coronary artery disease (heart disease or atherosclerosis of the arteries). This virus traditionally causes a simple common cold. Seeing this data in this particular viral strain dramatically changed my perspective on this virus.
These maladies (hypertension, diabetes, elevated cholesterol & coronary artery disease) are the four most common medical problems that I seen in my clinic, and they affect 85% of my practice population. All four are caused and driven by hyperinsulinemia. The higher your insulin response to starches or sugars, the more likely you are to have hypertension, diabetes, elevated cholesterol and heart disease.
Insulin Raises Cytokine Levels
This elevated insulin in response to eating any starch or sugar, hyperinsulinemia, causes a rise in molecules called cytokines. C-Reactive Protein (CRP), Interleukin-1 (IL-1), Interleukin-6 (IL-6) and Interleukin-33 (IL-33) are the cytokines that are abnormally and chronically elevated in hyperinsulinemia. These cytokines are responsible for mediating the inflammatory response to illness, injury and stress in the body. They control how your body responds with release of white blood cells, macophages, and other immune cells. These molecular hormones are ALWAYS chronically elevated in patients with hypertension (elevated blood pressure), pre-diabetes, diabetes, elevated cholesterol, coronary heart disease and obesity.
C-Reactive Protein
CRP is a reactive protein produced by the liver in response to inflammation. It is an “acute phase reactant” signaling the body’s immune system to respond to stress, inflammation or infection. The presence of insulin directly raises CRP. In my clinical experience, CRP normalizes within about three days of insulin returning to a normal level.
Interleukins (1,6, & 33)
IL-1,IL-6 & IL-33 are all cytokines. They stimulate increased body temperature, regulate fevers, modulate macrophages and stimulate other immune cells to function in various parts of the body when infection or inflammation occurs. These dual acting hormones are produced by a number of cells, but predominantly by the adipocytes (fat cells) and pneumocytes (lung cells).
IL-6 has a negative feedback on the liver’s ability to sense the presence of insulin. Elevated insulin levels over time cause increased size of fat cells. This causes abnormally high levels of IL-6 production from the adipocytes and decreases the signal of insulin on the liver – leading to insulin resistance, pre-diabetes and diabetes. Elevation of IL-6 often persists until the fat cells shrink back down to a non-obese size. IL-6 can also stimulate elevated CRP as well.
Elevated insulin on top of the presence of a viral infection in the lungs stimulates additional increase in IL-33. A normal rise in IL-33 increases fluid and cells like macrophages around the lungs causing a normal immune response. This is part of the healing process, but if IL-33 is already chronically elevated in hyperinsulinemia, then a burst of IL-33 leads to the pneumonia, hypoxia and blood clotting that commonly occurs in those with severe coronavirus infections. IL-33 has been implicated as one of the drivers in the “cytokine storm” found in severe coronavirus infection patients. The presence of IL-33 increases production of IL-6 leading to a “storm of hormones” (cytokine storm) being overproduced from the lungs and fat cells.
Risk of Death
Patients with elevated IL-1,IL-6, IL-33 and CRP were at much greater risk of mortality when exposed to COVID-19. Those that died, all of them, from this viral infection had IL-6, IL-33 and CRP levels twice as high as those who recovered from the illness. That is profound.
Temporal changes in laboratory markers from illness onset in patients hospitalized with COVID-19.
Temporal changes in lab markers from illness onset in Chinese patients hospitalized with COVID-19
What does this mean?
What does this mean to you and me? It means that those with elevated interleukin levels are more likely to experience a severe complication if exposed to this virus. That means that 85% of my practice, if not controlling hyperinsulinemia, is at higher risk of mortality. That’s what got my attention. Hopefully, it gets your attention.
But, don’t stress out. As of the writing of this post, 9-10% of the population may get sick (that is the current statistical data we have over the last three months). Relax , because 92% of people who get the virus won’t be severe enough to warrant hospitalization. And, only 0.4% of people will die from COVID-19. That’s actually lower than the current influenza numbers of 0.43% mortality. (Statistics taken from https://www.worldometers.info/coronavirus/) .
A recent paper written by Qasim Bukhari and Yusuf Jameel, both from the Massachusetts Institute of Technology, analyzed global cases of the disease caused by the virus, COVID-19. They found that 90% of the infections occurred in areas that are between 37.4 and 62.6 degrees Fahrenheit (3 to 17 degrees Celsius), and in areas with an absolute humidity of 4 to 9 grams per cubic meter (g/m3). Absolute humidity is defined by how much moisture is in the air, regardless of temperature. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3556998)
Arizona just hit temperatures of 100 degrees Fahrenheit this week, the last week in April. This means, if the research is correct, there should be a notable decline in the transmission and number of infections in hot and/or humid areas of the country like the south and south west regions.
What can you and I do?
What can be done about it? Follow a ketogenic lifestyle. Studies published in November, 2019, reveal that a ketogenic lifestyle has an enhancing effect on immunity by suppressing viral replication and barrier effect through γδ T cells in the lung.
This dietary approach is, also, the only one that I have seen clinically lowering CRP and IL-6 when using it long term. Ketosis may be the perfect prevention. Over the last 16 years of using ketogenic lifestyles, I have seen this pattern improve thousands of times. The presence of ketones immediately suppresses the production of IL-6 and improves the stimulus for CPR production at the liver. Cutting out carbohydrates lowers insulin back to a normal baseline within 3-7 days for most people. CRP returns to normal within three days of fixing your diet. And, IL-6 begins to decline immediately. In my obese patients, it can take 18-24 months for IL-6 to return back to normal.
Additional Measures
Don’t stress. The overly hyped fear mongering produced in the media in the last two weeks raises your stress level. Turn off the T.V. and stop listening to the 24 hour news cycles. Over the next couple of weeks, while the risk of viral exposure is the highest, the following precautions are essential:
Limit exposure to those who may be carrying this illness through social distancing. If you have a fever, stay home. If you are ill, wear a mask out in public.
Get good sleep (six or more hours of restful sleep)
Taiwan and Hong Kong have instituted strict quarantines and you can see their effect in the graph below.
Above all, enjoy some bacon. Seriously.
You can’t eat bacon? Have a nice rib eye. Either way, based on the data above, your ketogenic lifestyle is the very best thing you can do to avoid serious infections, including COVID-19.
I talk about this an much more here on my YouTube video:
I’ve had multiple people send me links to people and/or “supposed experts” recommending the use of quinine to prevent coronavirus or COVID-19. In my perspective, this is really bad advice and borders on malpractice.
Quinine was and still is used for the treatment of malaria. Yet, there are some significant reasons using quinine is, and should continue to be, limited. Anyone recommending liberal daily use of quinine does not have any grasp of the potential for harm and death that can arise with the use of this substance. I have seen quinine toxicity on a number of occasions in my 20 years of medical practice, and it ain’t pretty.
There is NO Evidence that Quinine Prevents COVID-19
There is absolutely no evidence that using quinine prevents infection from coronaviruses or COVID-19. Quinine differs in its mechanism of action from hydroxychloroquine, one of the drugs currently under investigation for use with COVID-19. Please, DO NOT confuse the two.
Even Small Amounts of Quinine Can be Deadly
Quinine use is the most common cause of immune-mediated drug induced thrombotic microangiopaty (DITMA), a life threatening condition caused by small-vessel platelet clots. In a systematic review of all published reports describing drugs and other substances as a suspected cause of thrombotic microangiopathy (TMA), quinine was responsible for 34 of 104 cases in which there was definite evidence for a causal association (33 percent) [1].
The Oklahoma Thrombotic Thrombocytopenic Purpura-Hemolytic Uremic Syndrome (TTP-HUS) Registry found quinine-associated TMA in 19 of 509 patients (4 percent) referred for a possible TMA over a 25-year period and found quinine as the cause of DITMA in 20 of 23 patients (87 percent) for whom a drug could be implicated as having a definite or probable causal association with the TMA [2, 3].
A 2017 report describing the 19 individuals included in this registry found the following features [3]:
All were white. This is distinctly different from Thrombotic Thrombocytopenic Purpura (TTP), in which approximately one-third are black (seven-fold higher than the reference population).
Eighteen (95 percent) were women. This is greater than the increased frequency of women (75 percent) among patients with TTP.
Eight (42 percent) had a prior history of quinine-related symptoms (nausea, vomiting, fever, chills, headache, confusion, ataxia).
Thirteen (68 percent) could recall the precise timing between quinine ingestion and symptom onset (all ≤4 hours).
Eighteen (95 percent) were caused by a quinine tablet; one was caused by quinine in tonic water of a vodka/tonic drink.
Eighteen (95 percent) had evidence of quinine-dependent antiplatelet (or antineutrophil) antibodies.
All had acute kidney injury; 17 of 18 required dialysis; three developed end-stage renal disease; and two underwent kidney transplantation.
One died from complications of central venous catheter insertion. Of the remaining 18, eight died a median of nine years following diagnosis, five from cardiovascular disease or stroke that may have been related to the TMA.
Quinine is implicated in causing neutropenia (decrease of white blood cells in the immune system). When it occurs, neutropenia is often accompanied by other organ-system findings that may include thrombocytopenia (low platelet count), microangiopathic hemolytic anemia (the most common being DITMA referenced above), rash, acute kidney injury, fever/chills, and others. The mechanism in many cases appears to be an acute, immune-mediated reaction to the drug. Evidence to support these associations was evaluated in a 2016 systematic review of published reports, which found neutropenia in 24 (17 percent) of the 142 patients who had an immune-mediated quinine reaction.
Quinine + Sugar is A Perfect Storm
The problem that many physicians find is that quinine tablets may be borrowed from a friend or family member, or the exposure may occur from a beverage like Schwepps (eg, tonic water, bitter lemon). And tonic water is loaded with sugar or high fructose corn syrup. This high carbohydrate content, in combination with quinine is a perfect storm for kidney failure.
Schwepps Tonic Water
In the United States, the only available quinine tablet (Qualaquin) requires a prescription, and the only approved indication is for malaria treatment. This restricted availability of quinine tablets may explain why we have not seen a patient with quinine-induced TMA since 2009 [3]. There are also several over-the-counter tablets and herbal remedies for leg cramps available in the United States that may contain quinine, and quinine tablets can be purchased over-the-counter in Canada and other countries. Quinine may also be added to drugs of abuse such as cocaine.
Just One Dose of Quinine Can Be A Trigger
Importantly, TMA from quinine can be triggered either by a single ingestion (eg, one quinine tablet, one quinine-containing beverage) occurring many months or years after a previous exposure, up to 10 years in our experience. This is because the drug-dependent antibodies can persist for many years, but they cannot react with target cells in the absence of the drug. Acute immune-mediated tissue damage can occur within hours of re-exposure. It is not known whether the homeopathic doses of quinine present in remedies for leg cramps in the United States can trigger TMA, but in principle, immune-mediated DITMA can occur with extremely low levels of re-exposure.
Chronic kidney disease is common following quinine-induced TMA [3].
So, please, don’t follow bad advice about using quinine from people who have no concept of what these drugs can really do.
Please see my Coronavirus Page for information and recommendations on prevention and treatment.
References:
Al-Nouri ZL, Reese JA, Terrell DR, et al. Drug-induced thrombotic microangiopathy: a systematic review of published reports. Blood 2015; 125:616.
Reese JA, Bougie DW, Curtis BR, et al. Drug-induced thrombotic microangiopathy: Experience of the Oklahoma Registry and the Blood Center of Wisconsin. Am J Hematol 2015; 90:406.
Page EE, Little DJ, Vesely SK, George JN. Quinine-Induced Thrombotic Microangiopathy: A Report of 19 Patients. Am J Kidney Dis 2017; 70:686.
Should you and your family members be wearing a mask to slow the spread of coronavirus (COVID-19)? This is a hotly debated topic and one that may not soon be agreed upon by everyone. Over the last few weeks, a number of voices are saying “Yes.”
I am, also, one of those proponents of dawning a mask. And, that’s no April Fool’s joke.
Dr. Nally in the office
The head of the Chinese Center for Disease Control and Prevention, Dr. George Gao, is also one who has been very vocal about using a mask. “The big mistake in the US and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role — you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth.” Gao said in his interview in Science.
Because coronavirus is a droplet based infection, and not an aerosolized infection, wearing a face mask can more effectively prevent the droplets that carry the virus from escaping and infecting other people. However, I don’t recommend using the medical grade masks. Save those for those that must have face to face contact with COVID-19 positive patients and persons with direct exposures. For the lay person in the grocery store who must get essentials and may have brief contact, I recommend using a specially designed homemade mask.
Masks Actually Help
Recent research shows that some people infected with the COVID-19 virus who don’t have any acute symptoms can still spread the virus. This means that the person in line with you to buy toilet paper, might just be infected and not know it. Research also shows that even wearing a proper homemade mask can reduce silent transmissions of bacteria and viruses in these situations.
In fact, this has been the recent topic of discussion at the CDC, and the use of homemade masks were reviewed in great detail in yesterday’s Washington Post article here.
Homemade Masks Make a Dent in Viral Spread
Wearing a homemade mask has become the norm in Czechia. The government of Czechia mandated the wearing of masks on March 18th, 2020. Jeremy Howard of #Masks4all has collected and summarized 40 published scientific research papers that show wearing masks actually does work. One 2011 meta-analysis shows, when coupled with strict hand washing, masks have the greatest impact on reducing virus spread.
Mr. Howard states that this action of the Czechian government has flattened the curve of the pandemic in his country. You can read the article in Prague Morning.
What Kind of Mask Should I Wear?
So, what kind of mask should I wear? The what, where and how of homemade masks that I am recommending to my patients can by found in my youtube video below.
How can you avoid contaminating the mask and yourself?
The main objection of the mask naysayers is that the mask itself becomes contaminated. Carelessly using the mask and not cleaning it can become of source of viral transmission. The benefit of a homemade mask is that it is cheap, washable and re-usable.
Here are some steps to follow to ensure that you and your family remain healthy while using a homemade mask:
Wash with soap and water, or sanitize your hands well, before making any mask.
Wash and sanitize your hands before putting the mask on.
When removing the mask, do not touch the front of the mask with your hands; take it off by the ties or elastics. Then wash your hands.
Immediately after use, do not put the mask on any surface. Put the mask into the washing machine or a sink of hot soapy water and clean well. Some data shows that you can also bake fabric masks. However, the temperature must reach 180F° (82C°) for 20 minutes to cleans it.
If you have made a disposable mask out of paper towels or coffee filters, throw it out into a plastic-lined waste bin with a lid.
After discarding, or sanitizing the mask, sanitize your hands again.
Any time you are wearing a mask, do not touch the mask, your face or rub your eyes.
Wearing any mask over the next 3-4 weeks will help protect you from passing the virus on to others at greater risk. It may also decrease your risk of someone else passing the virus on to you.
This will help reduce the number of infected people from overwhelming our healthcare system, first responders, and healthcare workers.
There are a number of confusion and mixed messages in the community about wearing or using protective masks while out and about in the community while getting your essentials. Dr. Nally talks about the pro’s and con’s of wearing masks, the type of mask he recommends using currently and where you can find a pattern to make one. Check out his latest YouTube video below:
