CV🦠News, Week of August 24, 2020 – The Village Doctor

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CV🦠News, Week of August 24, 2020

CV News fire

Be well, stay safe, TVD friends,

For those of us living in California, much less the San Francisco peninsula, this has been a harrowing week of smoke and fire, of asthma flairs, evacuation alerts, and for some, the loss of house and home, of so much that we all hold dear. My friend Margaret, pictured above, dodged the lightening-fire bullet, but not everyone else was so fortunate. Please be reminded that it “takes a village”, and reach out to your friends who live in or near fire ravaged areas. Consider opening your checkbook, perhaps supporting a local eatery who are feeding firefighters (looking at you, Alice’s Restaurant), or a number of agencies supporting our first responders and their families. To that end, was there ever a better moment to support our volunteer firefighters up the hill on Kings Mountain by visiting (virtually) the King’s Mountain Art Fair? Not to mention the Elementary School! You can learn more here, or register for this year’s virtual event here.

NOTE: CV🦠News is a labor of love. If you enjoy reading this, please share widely! Was this forwarded to you by a friend? Please subscribe here.

What happens when you stop smoking?

CAN VAPING INCREASE YOUR RISK OF COVID-19?

We know that vaping causes lung injury and that injured lungs are more susceptible to infection, so since the pandemic began, there has been suspicion that vaping increases one’s coronavirus risk. While there were no formal studies, both the FDA and the NIH issued warnings in the early weeks of the pandemic given the concern that “coronavirus could be especially serious to those who smoke or vape.”  Stanford University has now done a study that confirms the suspected correlation. The study, which was published August 11, showed that people “ages 13 to 24 who use e-cigarettes are five times more likely to be diagnosed with Covid-19 than their non-vaping peers [and that] those who are dual users—people who smoke both traditional and electronic cigarettes—are seven times more likely to test positive for the virus.”  Even one of the co-authors, Bonnie Helpern-Felsher, admitted that she didn’t expect the relationship to be that strong. The study looked at two questions: “Were e-cigarette smokers more likely to get tested for SARS-CoV-2? And were they more likely to test positive? [ and] “the answer was soundly yes” to both parts of the question,” says Halpern-Felsher. The researchers aren’t entirely sure why vapers were more likely to get tested (maybe they confused effects of vaping with COVID-19 symptoms?), but found that “the high rate of positive test results may indicate that vapers are more vulnerable to the virus itself.”

More studies are needed to prove causation, but the authors and other researchers believe the increased risk may come from lung damage itself, suppression of the respiratory immune responses, the fact that vapers touch their hand to their mouth more frequently (and potentially share vape pens), or because the virus is easily aerosolized and thus spread when vapers exhale. So while we don’t yet know if there is a specific biological susceptibility, we still recommend that you DO NOT VAPE during the pandemic (or really any time).  Read more here.

old medicine for covid treatment

ARE THERE ANY OLD MEDICINES BEING CONSIDERED FOR NEW COVID TREATMENT?

There are no FDA-approved drugs to treat COVID-19. All treatments are being actively studied to accumulate evidence and gather safety information. We know people can become gravely ill once infected with coronavirus, and the race to try older medications as a potential treatment for COVID-19 is on, but this race can be dangerous. We only need look back a few months when hydroxychloroquine was announced as an effective early treatment to later being found to have no significant therapeutic effect.

Most hospitals around the world have internal protocols to treat mild, moderate and critically ill patients affected with COVID-19. Many protocols include medications that have FDA approval for other diseases and are now being studied and given to patients with COVID-19 after showing early benefits. Some of the names may sound familiar to you and you may be wondering about them especially if you are currently taking one for another condition.

One of these medications is Pepcid (famotidine) which is used to treat mild heartburn. The studies with famotidine are observational and noted that those patients who received famotidine had improved outcomes. The idea is that perhaps the drug inhibits the virus from replicating. 

Another drug in many hospitalized patients is Stromectol (ivermectin). For decades ivermectin has been used as a potent drug for parasitic worm infections. There is only tentative evidence for its benefit but it’s being used around the world. This study in ScienceDirect shows the antiviral properties of ivermectin in laboratory cells in Australia.

Decadron (dexamethasone) is a cheap and widely available steroid. It blunts many types of immune responses and doctors use it for allergies, asthma and many illnesses. In June this study  showed that use of dexamethasone reduced COVID-19 deaths. That study included more than 6,000 people, and found that dexamethasone reduced deaths by one-third in patients on ventilators, and by one-fifth in patients on oxygen. It may be less likely to help patients who are at an earlier stage of COVID-19 infections, however.

Next up is Colcrys (colchicine) which is a familiar drug to those who suffer from gout. It is used for arthritic inflammatory diseases and has a relatively good safety profile. There is limited data on its benefits; this Greek study observes the effects of colchicine on hospitalized patients.  

The NIH has published its current treatment guidelines here. This document includes many of the drugs mentioned above and others that are being tried in many hospitals in the United States.

If you are interested in keeping up with emerging drugs in the fight against COVID-19, The New York Times keeps an ongoing drug and treatment tracker here, that is updated weekly.

There you can find information on drugs that are promising and warrant further research, and others which have been tried but found to have little benefit.

The landscape of COVID-19 is changing with each day and we hope we will have more drugs in our arsenal to fight back.

WHAT IS “CONVALESCENT PLASMA” AND HOW DOES IT TREAT COVID-19? 

During the 1918 flu pandemic, doctors found that giving blood from those who had recovered to those currently suffering from the flu could provide useful antibodies to help fight the infection.  Since then, convalescent plasma treatment has been used to treat many infections, including severe flu, MERS, SARS, and now with some success SARS-CoV-2. 

On August 23rd the FDA granted emergency use authorization (EUA) for convalescent plasma to treat COVID-19 patients. The decision should provide more patients in hospitals around the country with access to receive this treatment. Prior to the EUA issuance, doctors could use the therapy only if their patients were enrolled in a clinical trial studying the treatment, if they applied for special investigational use of the therapy (for very sick patients), or if their hospital was one of the approximately 2,800 participating in the expanded-use program through the National Convalescent Plasma Study.

While over 70,000 patients have received convalescent plasma treatment for COVID-19 infection to date, early data from smaller studies did not show significant improvement in those treated with it. More recent data from the National Convalescent Plasma Study is more promising and suggests early treatment (within 3 days of hospitalization) with plasma that has high concentrations of antibodies is associated with improved survival. One issue with the National Convalescent Plasma Study data, as pointed out by Dr. Francis Collins, Director of the NIH, and Dr. Anthony Fauci, Director of the NIAID, is that all of the participants were transfused with plasma from recovered patients, with no control group. Ongoing research is needed to make a clear assessment as to the safety and efficacy of convalescent plasma treatment.

If you have tested positive for COVID-19 and are interested in donating plasma, please see our article on this topic here for more information on local donation sites, including Stanford Blood Center.hand sanitizers

THE FDA HAS RECALLED MORE HAND SANITIZERS

The Food and Drug Administration has recalled even more hand sanitizers with a newly identified, deadly toxin — bringing the list to 150. This new toxin is known as 1-propanol, which can cause depression of the central nervous system and cause death if ingested. “FDA is warning consumers and health care professionals about certain hand sanitizer products, including those manufactured by Harmonic Nature S de RL de MI in Mexico, that are labeled to contain ethanol or isopropyl alcohol but have tested positive for 1-propanol contamination,” the agency said.

“1-propanol, not to be confused with 2-propanol/isopropanol/isopropyl alcohol, is not an acceptable ingredient for hand sanitizer products marketed in the United States and can be toxic and life-threatening when ingested.”

See updated FDA List of “Do Not Use” hand sanitizers at the bottom of this newsletter*.

HOPE AND GRACE

If you have made it this far, time for a reward, something to lighten your day, and acknowledge the human spirit. Find some escape, or perhaps even inspiration, in this ever growing collection of works and perspectives gathered from around the world. Please contact me directly if you have come across something that has lifted your heart today.  Dr. Eric Weiss

miniature calendar

Miniature Calendar! For almost a decade, Japanese artist Tanaka Tatsuya has spent every single day crafting miniature scenes made of everyday objects and tiny figurines. However, ever since the COVID-19 pandemic, Tatsuya has opted for incorporating objects that reflect the “new normal.” In his latest works, disposable face masks, toilet paper, and other health and safety essentials are repurposed as props for miniature outdoor adventure scenes.

Again, CV🦠News is a labor of love. If you enjoy reading this, please share widely! Was this forwarded to you by a friend? Please subscribe here.

*****

Yours, in health and resilience,

Eric and the TVD MD team…

 

*Current list of Hand Sanitizers recalled by FDA:

Agavespa Skincare Hand Sanitizer

All-Clean Hand Sanitizer 

Andy’s 

Andy’s Best 

Assured Aloe 

Assured Instant Antiseptic Hand Sanitizer with Aloe and Moisturizers 

Assured Instant Antiseptic Hand Sanitizer with Vitamin E and Aloe 

Assured Instant Hand Sanitizer (Aloe and Moisturizers) 

Assured Instant Hand Sanitizer (Vitamin E and Aloe) 

Assured Instant Hand Sanitizer Aloe and Moisturizers 

Assured Instant Hand Sanitizer Vitamin E and Aloe 

Be Safe Hand Sanitizer 

Bersih Antiseptic Alcohol 70% Topical Solution hand sanitizer 

Bersih Hand Sanitizer Gel Fragrance Free 

bio aaa Advance Hand Sanitizer 

Blumen Advanced Hand Sanitizer 

Blumen Advanced Hand Sanitizer Aloe 

Blumen Advanced Hand Sanitizer Aloe, with 70% alcohol 

Blumen Advanced Hand Sanitizer Clear 

Blumen Advanced Hand Sanitizer Lavender, with 70% alcohol 

Blumen Advanced Instant Hand Sanitizer Clear 

Blumen Advanced Instant Hand Sanitizer Clear Ethyl Alcohol 70% 

Blumen Advanced Instant Hand Sanitizer Lavender 

Blumen Aloe Advanced Hand Sanitizer, with 70 Alcohol 

Blumen Antibacterial Fresh Citrus Hand Sanitizer 

Blumen Clear Advanced Hand Sanitizer 

Blumen Clear Advanced Hand Sanitizer with 70% Alcohol 

Blumen Clear Advanced Instant Hand Sanitizer 

Blumen Clear Advanced Instant Hand Sanitizer Aloe 

Blumen Clear Advanced Instant Hand Sanitizer Lavender 

Blumen Clear LEAR Advanced Hand Sanitizer 

Blumen Hand Sanitizer Fresh Citrus 

Blumen Instant Hand Sanitizer Aloe Vera 

Blumen Instant Hand Sanitizer Fragrance Free 

Born Basic. Anti-Bac Hand Sanitizer 65% Alcohol 

Born Basic. Anti-Bac Hand Sanitizer 70% alcohol 

Britz Hand Sanitizer Ethyl Alcohol 70% 

Cavalry 

CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol 

CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol 

Cleaner Hand Sanitizer Rinse Free 70% 

Clear Advanced Hand Sanitizer with 70% Alcohol extra soft with glycerin and aloe 

DAESI Hand Sanitizer 

Earths Amenities Instant Unscented Hand Sanitizer with Aloe Vera Advanced 

ENLIVEN Hand Sanitizing Gel 

Esk Biochem Hand Sanitizer 

GelBact Hand Sanitizer 

Hand Sanitizer Disinfectant Gel 70% Ethyl Alcohol [manufactured in Mexico]

Hand Sanitizer Disinfectant Gel 70% Ethyl Alcohol Rinse Free Hand Rub [manufactured in Mexico]

Hand Sanitizer Gel Alcohol 70% [manufactured in Mexico]

Hand Sanitizer Gel Unscented 70% Alcohol  [manufactured in Mexico]

Handzer Hand Sanitizer Rinse Free 

Hello Kitty Hand Sanitizer 

Herbacil Antiseptic Hand Sanitizer 70% Alcohol 

Herbacil Antiseptic Hand Sanitizer 70% Alcohol 

Herbacil Antiseptic Hand Sanitizer 70% Alcohol 

Jaloma Antiseptic Hand Sanitizer Ethyl Alcohol 62% with Vitamin E 

KLAR and DANVER Instant Hand Sanitizer 

KLAR and DANVER Instant Hand Sanitizer 

Kleanz Antibacterial Hand Sanitizer Advanced 

Lavar 70 Gel Hand Sanitizer 

Leiper’s Fork Distillery Bulk Disinfectant per 5 gallon and Leiper’s Fork Distillery 16 oz bottle 

LumiSkin Advance Hand Sanitizer 16 oz 

LumiSkin Advance Hand Sanitizer 4 oz 

Lux Eoi Hand Sanitizing Gel 

Medicare Alcohol Antiseptic Topical Solution 

Modesa Instant Antiseptic Hand Sanitizer with Moisturizers and Aloe Vera 

Modesa Instant Antiseptic Hand Sanitizer with Moisturizers and Vitamin E 

Modesa Instant Hand Sanitizer Moisturizers and Vitamin E 

Mystic Shield Protection Hand Sanitizer 

NeoNatural Hand Sanitizer

NEXT Hand Sanitizer 

NuuxSan Instant Antibacterial Hand Sanitizer 

NuuxSan Instant Hand Sanitizer 

Optimus Instant Hand Sanitizer 

Optimus Instant Hand Sanitizer 

Optimus Lubricants Instant Hand Sanitizer 

Parabola Hand Sanitizer 

Plus Advanced Hand Sanitizer

Purity Advanced Hand Sanitizer 

QualitaMed Hand Sanitizer 

Saniderm Advanced Hand Sanitizer 

Sayab Antisepctic Hand Sanitizer 100 

Scent Theory – Keep It Clean – Pure Clean Anti-bacterial Hand Sanitizer 

Scent Theory – Keep It Clean – Pure Clean Anti-bacterial Hand Sanitizer 

Selecto Hand Sanitizer 

Shine and Clean Hand Sanitizer 

The Good Gel Antibacterial Gel Hand Sanitizer 

The Honeykeeper Hand Sanitizer 

TriCleanz Hand Sanitizer

TriCleanz Tritanium Labs Hand Sanitizer 

Urbane Bath and Body Hand Sanitizer 

Vidanos Easy Cleaning Rentals Hand Sanitizer 

Wave Hand Sanitizer Gel