Tag Archive for: COVID-19

The Dog Will See You Now

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The Memo title is from Malcolm Gladwell’s podcast about canine screening of disease, and I would urge you to listen to it. While the focus is on prostate cancer, the logical question comes up: could dogs be used to screen people for COVID-19? The answer is yes. No one knows for certain whether they can they smell the virus, but they can smell the proteins that are being made when the virus replicates in the body. Maybe it’s the spike protein, maybe a different one, but the tests indicate dogs can smell a person’s mask and identify COVID infections immediately with an accuracy of 83% and higher; some dogs approached 99% accuracy.

Will we see dogs checking folks at the door any time soon? I doubt it, whether for COVID testing or any other type of disease. Why not? Let’s take a look.

The Problem with Dogs

Science has shown that dogs can detect odors down to 1.5 molecules per trillion. They don’t even have to be purebred dogs; mixed breeds can be taught to do it. Therein lies the problem: training. It takes time to train the dogs to be able to distinguish that one unique scent among the hundreds of thousands they may encounter in an airport, a school, or a place of business.

They also get tired, not physically but mentally. They’re still dogs that want to run, jump, and play. They love to work, but they’re not like an inanimate testing device that accepts samples and tests them all day long without needing to be fed and given bathroom breaks. Dogs get fatigued, and that means they could make mistakes.

Those are just details that can be worked out. Dogs can screen up to 250 people in an hour at an estimated cost (including their handlers) of about $2 per person. Compare that with a PCR test for COVID-19 that can cost $200 per person. The real problem lies with humans.

The Healthcare Complex

It would be easy to criticize the medical community for not wanting to endorse this unconventional approach to medicine. The papers I read thought it was impractical to train dogs to do such screenings.

What they would rather do is develop an artificial neural nose that could do the job instead. One big problem with that: they have no clue what the dogs actually detect when they perform the screening. They admit that “clinical diagnostic techniques, artificial intelligence, and molecular analysis remain difficult due to the significant divide between these disciplines.” It could take years to come up with such an artificial nose, and then you’d need humans to manufacture, operate, and maintain those devices; I don’t even want to think what the costs would be. Dogs are already being trained that can be ready in a couple of months.

I’ll let you draw your own conclusions as to why the healthcare complex is resistant to pursuing the canine screening solutions. But I suspect health insurance companies and other organizations such as school districts that actually pay the bills will pay a lot of attention to the difference in price as well as the timeline.

The Bottom Line

If I could train a dog to identify a vitamin or mineral deficiency by sniffing the breath, the urine, or feces of humans, I wouldn’t waste time—I’d do it right now. It’s not a threat to what I do; it would be a powerful tool to use to help people address their nutritional deficiencies perhaps before they manifest in disease.

Do we want to get kids back in school? I’d love to know a dog was testing Riley and all his classmates, teachers, and staff every day before they walk in the building. Getting the subjects to not play with the testing equipment would probably be the biggest hurdle, but we’ve been teaching Riley to recognize dogs that are working and not to bother them. Yes, we’d need a lot of dogs, but we can get that done if we’re really committed.

Let’s hope the healthcare complex realizes they already have the noses they need to get the job done, and all the bearers of those noses want is to play with a ball as a reward for their hard work. I’ll say it again: it’s time to let the dogs out.

What are you prepared to do today?

        Dr. Chet

References:
1. J Travel Med. 2020 Dec 23;27(8):taaa131. doi: 10.1093/jtm/taaa131.
2. PLoS One. 2021.16(2):e0245530. doi: 10.1371/journal.pone.02455

Statistics and Lies

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The past year has been full of opinions about the COVID-19 virus, the treatments that people claim work, and even the number of deaths from the virus. I mean, people were full of it. And still are.

The story I heard most often from a variety of people was that people died from other causes, but physicians were told to put COVID on the death certificate by hospitals—all part of a conspiracy theory to make this innocuous virus seem dangerous. Except it wasn’t an innocuous virus. It was and is dangerous, and the preliminary mortality statistics show that: 345,000 people died from the virus in 2020.

The other lie was that there were no reported deaths from heart disease because everyone who died from heart disease was assigned COVID as the cause of death. That’s a lie; 691,000 people were reported to have died from heart disease. “They would have died from heart disease anyway,” I read again and again. I don’t disagree, but the question is when? Without the added factor of COVID, they might not have died for decades.

Do we have too many people with pre-existing conditions such as heart disease, hypertension, smoking, and type 2 diabetes? Absolutely. But solving that problem requires long-term solutions. Again, without COVID, there would have been many fewer deaths.

The Bottom Line

As I’ve said from the beginning of this pandemic, there’s no reason to fear the virus. You should respect it and do the things that reduce the risk of catching it, especially now with the serious mutations that are evolving. There’s talk of infrastructure legislation coming at some point. To me, we all need to evaluate our personal infrastructure, make a plan, and get our own bodies in order. That’s the way to deal with this pandemic and the next one.

Health is a choice. Choose wisely today and every day.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA. doi:10.1001/jama.2021.5469.

New Research on Vitamin D and COVID-19

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The research confirming the benefit of adequate levels of higher vitamin D (25-hydroxyvitamin D) blood levels keeps growing. In this Memo, I’m going to cover two of the most recent studies, both observational studies; the researchers were able to obtain vitamin D levels from medical records after subjects were admitted with COVID-19 infections.

Study One: Vitamin D and COVID-19

The first study was conducted at two medical centers in the Boston and New York City areas. Participants were hospitalized adults with confirmed cases of COVID-19 between February 1 and May 15, 2020; 144 patients, median age of 66, were included in the final analysis. Overall mortality for all subjects was 18%. However, in subjects with vitamin D levels greater than 30 ng/ML, the mortality rate was 9.2% versus 25.3% in those with vitamin D levels below 30 ng/ ML. The researchers concluded that patients with COVID-19 who had levels greater than 30 ng/ML had lower mortality rates and did not require mechanical ventilation to the same degree as those who did not have adequate vitamin D levels.

Study Two: Vitamin D and COVID-19

In the second study, researchers did a chart review of all COVID-19 patients over 18 who were hospitalized in a Boston Medical Center. All patients were positive for COVID-19 and had a vitamin D test in the prior year; 287 patients were included in the analysis. Of those, 14% of all patients died during the hospitalization; 100 out of the 287 had vitamin D levels greater than 30 ng/ML.

Focusing on those patients over 65, they found that patients with normal levels of vitamin D had a 67% decreased odds of dying, 78% decrease risk of acute respiratory distress, and 74% decrease in severe sepsis or septic shock. There was a similar relationship, even if subjects were obese as assessed by BMI greater than 30.0 kg/m2.

The Bottom Line

These two studies add to the body of work that suggest that adequate levels of serum vitamin D are essential for reducing symptoms and mortality for COVID-19, especially in those greater than 65 years of age. It does not mean that it’s time to start mega-dosing on even more vitamin D than you may be taking.

What it means is that you should get a vitamin D test to find out where you stand. We have no idea whether any of these people took vitamin D, and if they did, we don’t know how much they took. If you really want to age with a vengeance, then approach things in a stepwise manner. You don’t start on a solution before you know if you have a problem. So get a vitamin D test scheduled and then you can make an informed decision about whether you’re taking an adequate amount of vitamin D or you may need to up it a bit.

If you’re thinking, “Nah, COVID is almost gone,” think again. Yes, many of us are now fully vaccinated, but the new variants are so lethal that we can’t ignore them, and too many people seem to have “Superspreader” as their goal. Keep your defenses up, because you don’t want to be one of the very last people to die of COVID-19. Let’s finish this race strong—and then have a cook-out.

It’s time for spring break so Paula and I will be taking some time off. We’ll be back with the next Memo on April 13. Have a safe and healthy spring break and any holiday you may celebrate. What are you prepared to do today?

        Dr. Chet

References:
1. Mayo Clin Proc. 2021. doi: 10.1016/j.mayocp.2021.01.001.
2. Endocr Pract. 2021. doi: 10.1016/j.eprac.2021.02.013.

How Periodontal Disease Makes COVID-19 Worse

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Aging with a Vengeance is more than gaining muscle mass and losing fat around your waist; it also means that your immune system is robust. I think we often over-emphasize supplementation; while I think it’s necessary, it really should serve as support for other actions that are equally or even more important. For example, taking care of your teeth. By that, I mean regular checkups, brushing after meals, and flossing every day. Does that affect the immune system? You bet it does, and a recent study illustrates how significant that can be.

Researchers in Qatar conducted a study to see if people with periodontal disease had an increased risk of being in the intensive care unit (ICU), being put on a ventilator, or dying from COVID-19. Qatar Is a country of 2.3 million people with an advanced electronic medical records system; because dental records are a part of the medical records system, they were able to identify people with periodontal disease, sometimes called gum disease. In addition to the medical records on COVID-19 and how the subjects fared, they were also able to get data such as BMI, HbA1c, and CRP, among other health indicators.

As an observational study, researchers were able to find 568 people who were diagnosed with COVID-19 between February 2020 and the end of July. That number included 40 people with severe cases of COVID-19 that required hospitalization. The characteristics of those who had severe cases are similar to what we find in the U.S.: more were overweight or obese, had higher HbA1c levels, and had higher CRP levels.

Of those who had periodontal disease, 33 had severe cases of COVID-19; only seven people who had no periodontal disease had a severe outcome. When looking at the odds ratios, a person with periodontal disease had six times the risk of being admitted to the ICU, almost eight times the risk of being put on an ventilator, and a 17 times greater risk of death from COVID-19.

Why would having periodontal disease, an infection that appears to be limited to the teeth and gums, have such an overall effect? The reason is that it creates a state of higher inflammation that compromises the immune system. When exposed to the virus, the immune system is already stressed and the body does not have all the resources it needs to fight the infection.

The Bottom Line

Here’s my advice: if you’re overdue for your dental checkup, call and make the appointment, especially if your gums bleed regularly when you floss, if your gums seem inflamed, or if you have a very bad mouth odor. No excuses; gum disease should not be ignored.

I see many comments in social media about “all the talk being about vaccinations, masks, and social distancing.” “No one ever talks about diet and exercise, etc.” The reason, at least in my humble opinion, is that the last 50 years have clearly demonstrated that most people in the U.S. don’t eat well, don’t move enough, and eat more than they should.

Instead of criticizing people for their poor dietary and exercise habits, the current medical approach seems to be to meet people where they are. My hope is that by addressing some of the other issues related to health, such as periodontal disease and overall healthcare in our quest to age with a vengeance, all readers will see ways to make their immune system much more robust so it can do a better job of protecting them.

And if it has the side benefit of shutting up the naysayers that talk about long-term solutions only at the exclusion of the things that we know are working right now—such as vaccinations, masks, etc.—I’m good with that. As I said in May, not fear; respect.

What are you prepared to do today?

        Dr. Chet

Reference: J Clin Periodontol. 2021. DOI: 10.1111/jcpe.13435.

Vitamin C, Zinc, and COVID-19: Ask the Right Questions

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As we left off Tuesday’s memo, I suggested that both the researchers in the study that was halted as well as the physicians who used dietary supplements as part of their treatment were wrong in their conclusions. At this point we don’t know for certain whether vitamin C and/or zinc can help with COVID-19.

Let’s define which questions we’re asking. Are we trying to prevent people from catching COVID-19? Are we trying to help them recover from a COVID-19 infection? Are we trying to prevent hospitalization? Are we trying to prevent death? Those are all different questions.

The Videos

Let’s stick with helping people recover once they’ve been infected with COVID-19. At this point, we don’t have solid data as to how long the patients were infected before they sought treatment, how many days it took them to fully recover, or if they recovered without any further treatment of any type. We also get no data on the people who needed further treatment in the hospital.

It’s not reasonable to suggest that every patient seen in these physicians’ videos all recover and no one ever gets worse, but that’s never discussed.

The Research

As for the researchers, they didn’t ask two very valuable questions: what were the subjects’ vitamin C and zinc levels before the treatment began? Without that measure, they couldn’t know whether they needed supplements; maybe their levels were as high as needed, and they didn’t need any more.

Second, how did they administer the vitamin C? If they were familiar with the research, they’d know vitamin C is more effective when given intravenously. The subjects could have been given vitamin C on an outpatient basis to begin, and then used supplements for the rest.

The Bottom Line

Neither group really provides us with much information about vitamin C and zinc to help people recover from COVID-19. When it comes to the use of dietary supplements and COVID-19, there’s a difference between preventing a person from catching the infection at all, reducing the number of days that they’re infected with the virus, and reducing the risk of having the infection progressing to hospitalization and potentially death.

Where does that leave us? Now more than ever, we should support our immune system. Vitamins D, C, and the mineral zinc can help us do that, and at the first hint of illness I’d recommend the Immune Boost supplements. I’d also like to recommend getting tested for C and zinc as we do for D, but it’s not practical at present.

Most multivitamin-multiminerals can provide a baseline to get you started. Don’t forget food has nutrients as well, so a healthy diet may help you stay COVID free.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA Network Open. 2021; doi:10.1001/jamanetworkopen.2021.0369

Vitamin C, Zinc, and COVID-19

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Last week, a study was published in JAMA Online that did a randomized controlled trial using vitamin C and zinc to treat people diagnosed with COVID-19. Several longtime readers asked me to review videos posted by physicians and other healthcare professionals who’ve used vitamin C and zinc to treat COVID-19 infections. I did and I’ll comment on Saturday, but let’s look at the science.

Researchers from a well-respected healthcare organization, the Cleveland Clinic, requested volunteers from multiple locations in Ohio and Florida for a study. The purpose was to see if vitamin C (8000 mg), or zinc (50 mg), or vitamin C plus zinc would reduce symptoms associated with diagnosed COVID-19 when compared to a group taking no dietary supplements. The objective was to see if symptoms in the groups taking the supplements could be reduced by 50% within five days or less when compared with controls. They used symptom scales such as fever, cough, and shortness of breath, among others.

The researchers stopped the study early due to futility: there were no differences in any of the experimental groups compared to the controls after reaching 40% of the subjects they intended to recruit. Frontline physicians say supplements work against COVID; this research trial says they don’t. Who’s correct? I think they’re both wrong, and I’ll tell you why on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA Network Open. 2021; doi:10.1001/jamanetworkopen.2021.0369

Fighting the Mutants Among Us

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Unless you’ve been avoiding all information about COVID-19, you know that there are now variants or mutations of the original virus. The first mutation was identified in the United Kingdom; soon after, another was identified in South Africa, and finally, another in Brazil. Will there be more? Undoubtedly. Is it a big deal? Maybe.

If a variant doesn’t respond to current treatments or one of the current vaccines, that’s a problem. If we’ve had the virus and it doesn’t respond to the antibodies we’ve developed, we have to start over again. We don’t know if those problems will show up; at this point, we just don’t have enough data.

But there’s one thing that we can do. We can try to avoid catching the COVID-19 virus in the first place, no matter which variant we get. While we may get a mild form of the original or variant viruses, the longer the virus stays in our body, the more it replicates. And every time it replicates, it gets a chance to try something new: to mutate. With an increase in replication comes an increase in the odds of another successful mutation. The virus can learn how our bodies attack it and, simply by wildly reproducing itself, increase the odds a variant will survive. We spew the variant virus without knowing it, and voila, another mutant gets a chance to spread.

We are each part of the first line of defense: if we deny the virus a host, we remove its chance to replicate and mutate.

You personally could be the one person who stops the next deadlier mutation by not giving it a place to do its dirty work. That’s why we need to deny the virus a chance to get inside our noses and mouths; even if you’ve been fully vaccinated, do everything you can to keep the virus out of your body. Double up on masks, social distance, wash your hands—you know the drill. Apply the Swiss Cheese COVID Protection approach. In this case, we’re trying not to catch it, not to give it a chance to replicate and mutate, and not to spread it.

Be a hero: don’t give the virus a chance to invade and mutate.

The Bottom Line

I know if we had our druthers, we wouldn’t bother with masks and so on, but the overwhelming feeling I get is that we just want this to be over. Let’s all work to that end by doing what we have to do to stop the virus in its tracks.

The title of tomorrow’s Super Bowl Webinar is Aging with a Vengeance. Dealing with viruses and other health challenges is a part of that.

What are you prepared to do today?

        Dr. Chet

Double-Up for Safety

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This is Super Bowl week so let’s lead with a football analogy in the fight against the COVID-19 virus. “The best offense is a great defense” has been used as a way to deal with teams who have a great offense: if you stop them from keeping the ball, they can’t do much scoring. That appears to be a good strategy used to keep from getting COVID-19, especially as new strains appear.

The CDC does not recommend wearing two masks because there’s no science to support it, and I haven’t found a single study on double-masking. But it does make sense from this perspective: if wearing one mask is 50% effective, which it appears to be, wearing two may increase it to 75% effective. Remember the Swiss Cheese COVID Protection approach to reducing infection? No single approach works perfectly but put all of them together, and they can significantly reduce the risk of catching the virus.

I’ll take it one step further. Wear two masks when you’re going to be in one place for a long time. I double-mask when I work out: a cloth mask over a surgical mask. With restaurants opening in more states, it’s probably a good idea there as well. With shopping, if you’re standing talking with someone, yes. If you’re picking up and buying something like restaurant takeout, maybe yes and maybe no because you still may have to wait in line. Remember: respect, not fear.

Super Bowl Webinar

My 11th Annual Super Bowl Webinar is Sunday at 3 p.m. ET; Aging with a Vengeance is the theme. I’m going to provide attendees strategies on four aspects of aging and specific ideas on how to address each issue, all in about an hour. Join me Sunday afternoon, but if you can’t, I’ll have a replay available for viewing later. Sign up today. Members and Insiders: remember to sign in to drchet.com first to get your discount.

What are you prepared to do today?

        Dr. Chet

Using Melatonin to Treat COVID-19

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Today’s research paper is a type of study that uses large datasets to examine the relationship between successful treatments for people with COVID-19 and related viral infections. Let’s take a look.

Network-Based Drug Repurposing

To say that this is complicated is a tremendous understatement, but let’s give it a go. Researchers identified specific targets for the many different strains of COVID and SARS viruses, including all of the research on the receptor targets in the body for every COVID-related virus, such as the ACE2 receptor. Then they examined each drug that has been used to treat people with the virus to see how effective it was, along with drugs that had specific receptor targets when used for other reasons. Researchers weren’t looking for a cure; they wanted to determine whether specific symptoms in various parts of the body improved such as the lungs, the heart, fatigue, etc.

They started with dozens of receptors and over 2,000 FDA-approved medications, and after running the initial analysis, they reduced the number of drugs to 135. They ultimately came up with three pairs of medications that could be effective in treating COVID-19: sirolimus plus dactinomycin, mercaptopurine plus melatonin, and toremifene plus emodin. I would wager that five of those are medications you’ve never heard of, but you’re probably acquainted with melatonin. That’s what caught my attention, so let’s take a look at why melatonin would be included in a potential treatment for COVID-19.

Melatonin as an Antiviral

In their explanation, researchers said melatonin has been reported to have a potential for treating antiviral infection because of its anti-inflammatory and antioxidant effects. As suggested, melatonin can indirectly impact the ACE2 receptor, which is a key target of the COVID-19 virus. Mercaptopurine blocks specific papain-like proteases such as the ACE2 receptor; the hope is that the combination will block the ACE2 and other target receptors from the virus and reduce the inflammatory response.

The Bottom Line

The researchers say there’s a long way to go before this combination can be used to treat COVID-19—pre-clinical and clinical trials for sure to test whether this combination actually works to treat the virus.

When it comes to melatonin, it makes sense to add it to our immune-boosting regimen. Its mechanism of action is different from the zinc, vitamin D, and vitamin C we may already be taking. The question is how much? I don’t have a specific answer because there’s still so much research to review. But I’m going to begin with 6 mg. That’s not too much and even if it doesn’t work for immune boosting, the potential benefits for memory, etc., make it worth taking; take it at night, of course, because of its ability to help you sleep. When I’ve reviewed more research, I may be able to give you a more definitive answer. In the meantime, there’s no apparent downside to taking melatonin. If you feel you need the additional immune boosting—and who doesn’t—give it a try.

What are you prepared to do today?

        Dr. Chet

Reference: Nature. https://doi.org/10.1038/s41421-020-0153-3

Can Omega-3s Reduce Inflammation?

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Omega-3 fatty acids have been in the science news this week. In this Memo, I’ll take a look at a small study that examined the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on specific markers of inflammation in 21 subjects between 50 and 75 who had elevated levels of inflammation. Researchers had subjects follow a particular regimen: take three grams of either DHA or EPA for 10 weeks, cease all omega-3s for 10 weeks, and then take three grams of the other omega-3.

The study showed both omega-3s were effective; they just worked differently, and I can’t explain that without getting technical. It seemed that DHA reduced specific cytokines such as TNF-alpha, IL-6, and IL-10 to a greater degree than did EPA. One of the ways that may have happened was a reduction or replacement of the proinflammatory omega-6 arachidonic acid. The important point is this: however they worked and although they worked in different ways, both DHA and EPA were effective in reducing the inflammatory response in this small study.

Could adding high-DHA fish oil supplements to the diet reduce cytokine production in every case? Specifically, could it potentially have some benefit for the cytokine storm that’s associated with severe cases of COVID-19? We don’t know that yet because that specific research hasn’t been done. But since there are so many other well-documented benefits of omega-3s, make sure you regularly eat fatty fish or take fish oil supplements with DHA and EPA. It’s always a good bet.

What are you prepared to do today?

        Dr. Chet

Reference: DOI:https://doi.org/10.1016/j.atherosclerosis.2020.11.018