Update on Corona Virus Pandemic with Dr Peter

10/11/21 71st update

Dr Peter hoping the March of 2022 may be our last Covid update of this kind.

Lessons from the past:

Very interesting story from one famous historian – How influenza pandemic of 1918 was a key factor in starting WWII.

Things we know now:

The pandemic started in chickens and jumped to humans.

An H1N1 variety of influenza (there are many different types)

In the US, cases arose in the midwest in 1917. Initially it wasn’t severe, but then a more significant wave hit and spread through military camps. It was “exported” on troop ships that went to Europe.

Very little understanding of what they were dealing with. There were significant deaths on the troop ships. Then it became worldwide.

Nov 1918, WWI was beginning to wind down. Woodrow Wilson, who was president, went to Versailles for the peace treaty. He wanted to build on this moment in history and create the League of Nations and help Germany recover from the war. But influenza was beginning to ravage Europe, especially in Paris. His daughter contracted influenza and died. His ideas about supportingGermany in recovery after the war were not supported by other nations, who had stronger ideas of punishment and reparations from Germany for harm done. At a critical point in the peace talks, Woodrow Wilson became ill with influenza and was confined to bed with 103 fever. Some of the other representatives came to see him and try to talk him into their point of view and he held fast to his desire for treating Germany more fairly but eventually gave in because he was so ill and weak. He then backed off his opposition. Germany was never able to recover from WWI because of the severe financial reparations that were demanded. This resulted in the failure of several forms of government and the eventual national socialist power that took over and Hitler in control.

Many historians have pointed out that WWII could have been avoided if the end of WWI was handled differently and the turning point was when Wilson contracted influenza. Wilson never fully recovered from the illness and had several strokes and was in invalid in his later years.

Interesting to see the effects of these huge health “shocks” have echos for years after the risks of the disease pass.

Many of the things we have talked about with Covid 19 also occurred in the 1918 pandemic. Many of the deaths occurred after the viral replication was stopped, but there was a huge inflammatory process after. This over activated immune response caused many severe complications. This happened with the flu pandemic as well. There were a surprising number of people who survived the influenza and had cognitive impairments and other effects after. As late as the 1950s, it was not unusual for neurologists to be treating people with Parkinson’s disease that was brought on by the influenza pandemic.

Interesting to think that our current political picture may have looked differently without Covid 19.

Economic Consequences of a Major Disaster

A major shock of any disaster, including health shocks, will affect the economy and disrupt the economy for 2-5 years after. The years after 1918 were definitely affected by the flu pandemic. After 1921 things improved and became “the roaring twenties”, followed by the Great Depression in 1929.

We can expect that there will be an economic “echo” for 2-5 years following Covid 19.

It is possible that somehow the US and developed countries manage to walk the razor’s edge and keep a balance of the economy worldwide. There are very positive things looking forward, but it is a very risky time. Supply disruptions are a reality, and other issues that could just be annoyances, but may develop into significant issues.

Covid 19 Treatment Options

Good success treating with Regeneron for people early in their illness. (This passively gives people antibodies against the virus.)

Limited in other kinds of early treatment for those not sick enough to be hospitalized. Ivermectin is still in “wait and see” and hoping that something comes of that option. This would be a significantly inexpensive treatment but we don’t have enough data. Pressure on doctors to NOT use it. They could have their license threatened. Ivermectin alone is actually pretty safe and tolerable, but the dilemma is that if people take massive doses, it can be a problem and there is so much controversy, it may never get used.

Anviral medication, Molnupiravir, is an oral med, taken twice daily for 5 days. Was developed for influenza. If taken early in a case of Covid 19, it would decrease viral replication and viral load. Not effective after the viral replication period is past, like Remdesivir. Course of treatment may cost around $700. Still being investigated.

Not much change in treatment for people who are hospitalized. Oxygen treatment, some ventilators, monoclonal antibody treatments, dexamethasone. Echmotherapy is a treatment where the blood is shunted outside the body and oxygenated. But you may not be able to get them off the treatment if the lungs don’t recover.

Hospital Staffing

Hospital staff are tired, suffering from “compassion” fatigue and vaccine mandates in health care settings have had a huge effect.

Vaccines

No real new word on new options. Novovax hasn’t come out. Pfizer MRNA and Moderna MRNA available for 12 yr old and up. Probably will hear that Pfizer will be available for ages 5 and up soon. Children under 5 will probably not be given vaccines anytime.

Recommended 3rd shot for 65 and older or under 65 with significant health factor or significant risk environment. Seems to be well tolerated. The reaction to the second shot is related to the virus’ “second look” at the virus. If someone was infected with Covid prior to the first shot, their reaction to the first shot may be more severe, since it was the virus’ “second” look, and the second shot may not produce a strong reaction.

There is not a final answer about a booster with the Moderna vaccine. Probably it will be similar to the Pfizer recommendations, but haven’t heard yet.

Johnson and Johnson will probably also have a booster, but that is not spelled out yet.

All three vaccines have been very effective.

Had 3 people in their NC practice that got Covid twice without vaccination. A handful of break through cases – people who have been fully vaccinated who get infected.

85 – 95% of hospitalized Covid patients in the local hospital have been unvaccinated consistantly.

Vaccine Mandates

Probably will become more common and severe. Canada has had a significant Delta surge and will be mandating travel restrictions, requiring vaccination. Probably will happen here for domestic travel.

This will probably not let up. It is a problem in health care support staffing. Over 95% vaccination rate with physicians, which is remarkable to see doctors agreeing on that level.

Data Results around the world

Hard to interpret the kinds of information coming out about effectiveness of vaccines in other countries. This is complicated and unclear information. Recommend giving information time to get sorted out, even after studies are given review. Huge populations of whole countries are very complex data and findings are complex.

What is our spiritual test in all this?

Can we continue to work together harmoniously? This has turned out to be the biggest challenge in every area. The cornerstone is empathy and respect for others and their freedom to be wrong.

We have to keep our hearts open and realize there is a lot we don’t know. Looking back ten years from now we will be able to see all the things we got wrong.

May be some surprises

There still may be surprises with Delta and we need to maintain protecting ourselves and others.

Not sure how the next 6 months will look like. Possible another major surge or possible it will continue to decline. Hopeful that next spring will look different. Maybe there won’t be a new variant. There are still developing countries with only 2% vaccinations.

Local Stats:

In the point where hospital cases and ICU cases are going down, with increased deaths. More deaths in people younger than 60.

In Nevada County, 5.4% R0 is coming down.

In local zip code: Increase cases in the last two months. 40% of cases in have been in the last two months.

US: 45 million cases. ICU cases down to 17,000 Daily case rates falling. Now under 100,000

500 – 2500 deaths per day.

Jyotish and Devi

Bharavi told them the LA Auto Show (which was cancelled last year) is staying on this year. They will require a vaccine or negative test. Free rapid tests available will be offered at the gate. This will be helpful since kids can’t get vaccinated.

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