Kokaubeam: June 2020

The only SARS-CoV-2 positive case I personally know did it right. Jo is 64 and active but has one risk factor -- chronic intermittent bronchitis. When she gets any cold, it turns into bronchitis every time and she will cough for months. She was given the nickname “BARK” because of her chronic barky cough. She was worried, rightly so, of getting sick during the pandemic so she did everything right. She took vitamin D 10,000 IU daily, as well as vitamin C and Zinc. She stayed at home with her husband, only going out for food. She kept her “social distance,” not interacting with others.

Four weeks ago, she suddenly got a fever of 100.5, and the worst headache of her life. She felt generally ill, so she went to the hospital to get tested. She increased her Vitamin D3 to 50,000 IU daily for four days, as well as Vitamin C 4,000 mg and Zinc 100 mg. The next day, the headache and fever were gone, but she still felt weak and sick, and she started getting a cough -- she was worried now.

That same day the test came back positive and the county health department called her, telling her to stay in quarantine for two weeks. They asked about her travel and ill contacts -- any potential exposure -- but she had none. The 48-hours prior to her illness were spent at home with no outside contact at all.

She continued the high-dose vitamins and zinc every day, and by the fourth day she was feeling better, (Plaquenil, or hydroxychloroquine, takes five days to work) and she decreased her vitamins back to baseline. She still had a cough, but it didn’t get worse, and she had no shortness of breath. The cough lasted for about a month, much less than usual, for her. She is now better, and was free to go to her daughter’s wedding, and visit family in New York. Her husband stayed home because he never got sick and wasn’t tested.

Historical Perspective
The most poignant lesson from history is that orthodox teachings are always wrong. Most prophets are rejected because they are unorthodox. Anyone teaching the truth who gets a following will be ostracized, censored, or killed. Nothing has changed. We like to think we’re enlightened because we have amazing technology, but we’re still learning, just like in eons past. Our official orthodox religion taught in every school and public organization is no different than ancient cults and religions, but, instead of mystical and powerful gods, we just use statistics. A quote from Mark Twain is relevant:

Figures often beguile me, particularly when I have the arranging of them myself; in which case the remark attributed to Disraeli would often apply with justice and force: "There are three kinds of lies: lies, damned lies and statistics."

- Mark Twain's Own Autobiography: The Chapters from the North American Review

We are no different. Our culture is not enlightened. Nothing has changed. In the 1700’s the orthodoxy believed that scurvy was caused by evil spirits or bad humors. People who had the disease were bled mercilessly, buried up to their necks in hot sand, given mercury or other toxic “medicine,” or insufflated with a smoke enema. The truth about vitamin C was rejected while people suffered and died for fifty years after the cure was discovered.

We are no different today. We continue with the same dangerous, toxic, and painful treatments for decades after we know they don’t work, and cures are discovered. Medical schools are still ten to fifty years behind the science in most areas. For example, a scientist at UCLA wrote a book a few years ago about his research on how to cure Alzheimer’s disease, but it isn’t found in medical schools, nor even on the website of the Alzheimer’s Association. I have not yet spoken with a neurologist who has read, or is even aware of, the book. I suppose those with the disease will have to suffer for fifty years like the sailors with scurvy in the 1700’s. It’s like Jean-Baptiste Alphonse Karr said:

Plus ça change, plus c'est la même chose.

In other words, if we base our beliefs on what everyone is saying, then we become part of the problem. Truth must not be made public; it must be kept in private so as not to offend the orthodoxy. So, as I may discern truth, I would like to share it with you, in private – my personal opinion. 😊

Beyond Toilet Paper – Be Prepared
The Boy Scout motto is appropriate for all times and all places. I am not a prophet, but those whom I know are prophets are telling us that COVID-19 is a harbinger of things to come. We have experienced a “test case” of what could happen if there is “germ warfare” on the planet. This was nothing, compared to what is possible. What we learn from this is essential to know:

· The “official” strategies for prevention and treatment are not based on science.
· Immune function is more important than treatment.
· What really works for prevention.
· How to prevent and treat “novel” illnesses.

The Science of Prevention – What Doesn’t Work

Masks:
Research since the 1970's tells us that within a few minutes of donning a mask, the output is the same as not having one. Research from 2016 may the most telling in that rather than just looking at output indicates the actual potential for infection. In this review, over 2000 cases comparing surgeons wearing masks with those not wearing them at all found no difference in the infection rate.[i]

In other words, the research indicates masks don’t prevent me from spreading infection to you, in spite of what we have been told by the CDC.[ii] Their “recent studies” to justify the recommendation to wear masks are found at the bottom of the web page, and have nothing to do with mask wearing. However, there is some evidence that wearing a mask may increase your risk of respiratory infections.[iii]

And if you think you can do better with an N95 mask, think again. One study compares N95 masks to surgical masks in healthcare workers, concluding:

“Conclusions and relevance: Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.”[iv]

So, there is more evidence that wearing masks is, at best, useless, and at worst, harmful. Face coverings are not going to protect you from infection. We are better off tying our bandannas around our waist so there is less touching of the face. Don’t put your trust in things that are not going to work.

Staying Home:
Taiwan, South Korea, and Sweden took proper measures and did not shut down their economies, putting millions out of work:[v] (click on the link for a series of graphs that compare the U.S., South Korea, Taiwan, and Sweden)

https://ourworldindata.org/covid-deaths?country=USA~KOR~SWE~TWN

So, staying home from school and work does not help prevent the spread of illness. We were told it would “flatten the curve,” but in no case did a curve get flat. In fact, where testing is done randomly in highly populated areas the cases have been many multiples higher than when only sick people are tested.[vi] [vii] Thus, the curve was not flattened, we just didn’t monitor enough people to see how many cases there really were. The examples where countries didn’t have “stay-at-home” orders did not have a steeper curve than those that did. (see above) Moreover, people who stay at home are at higher risk for getting severe illness.[viii]

Overall death statistics are equivalent to a normal flu season.

The primary issue with statistics is that people have a hard time distinguishing “absolute” from “relative” numbers. In analyzing thousands of medical studies over the years, I have found it best to start with the foundation, the raw numbers, or the absolute numbers. Once the statisticians start making relative numbers, they can show just about anything from the same raw numbers. For example, when I sent out the CDC statistics on the Coronavirus, people were confused. I was saying that this is just a normal flu season, but everyone was hearing about huge spikes in deaths due to Coronavirus. This I will explain:

Every year, we have a “flu season” where the death rate goes up, from November to May. During the summer months the death rate is always significantly lower. The CDC puts out the “expected” number of deaths for each “flu season” based on past experience and the current population. If the number of deaths exceeds that, it is considered a high “flu season.” It is also important to define “flu.” This refers to the cases of “flu-like illness” which includes pneumonia. The individual organisms, such as Respiratory Syncytial Virus, Coronavirus, Orthomyxovirus, Paramyxovirus, Adenovirus, Mycobacterium, and so forth, are not distinguished. So, Coronavirus has always been included in the statistic.

Now, if we look at the total expected deaths during the “flu season” of 2019-2020, we get about 100%.[ix] In other words, this wasn’t even a “bad” flu season – Just average. However, if we look at the cases of Coronavirus, as a percentage of the total number of deaths, it looks like an epidemic.[x] This is the difference between absolute and relative statistics. Why did the death from this one virus increase so much without increasing the total number of deaths? The CDC keeps statistics based on death certificates. A diagnosis of SARS-CoV-2 brings a lot more money to a hospital, especially if they are put on a ventilator. Thus, the number of diagnoses increased. You get what you pay for.

The point is, if you believe you are safe because you are wearing a mask or staying home you have a greater chance of becoming a statistic because it's the wrong thing. This is like wearing flowers to protect you from the Plague, or wearing a rabbit's foot to prevent Scurvy. Actually, the research indicates you may be better-off wearing a rabbit’s foot to prevent Coronavirus, rather than a mask.

Vaccines
While it may be that some vaccines are useful, one must be very careful to apply each to their own needs. In every case, you must weigh the risks versus the benefits of the vaccine. If a doctor or anyone tells you there are no risks, then find better information elsewhere.

For example, the influenza vaccine is made every year on a guess as to what might come to the U.S. The 2018-20019 season produced the following statistics:

Virus by Patient Age	No. Vaccinated/Total No. (% Vaccinated)		VE (95% CI), %
	Influenza-Positive (Case Patients)	Influenza Negative (Noncase Patients)
All influenza viruses
All ages	1316/2763 (48)	4065/7249 (56)	29

Again, looking at the real numbers, we have 48% of those infected with the influenza last year were vaccinated, and 56% of those testing negative were vaccinated. From here statisticians work their magic to show “relative” effectiveness of the vaccine put at 29%, meaning people are 29% less likely to test positive if they had the vaccine. [xv] Every year, about half of those who get influenza had the vaccine. A truly effective vaccine would have no positives.

I had a patient who started getting seizures after a flu vaccine, which really affected her life. Her case was not reported to VAERS (vaccine adverse event reporting system) so it is not part of the statistics. I suspect that most vaccine adverse events aren’t reported so we cannot rely on statistics to help us make decisions on whether to vaccinate. However, in the case of the influenza, knowing that the effectiveness is questionable, at best, and the rare complications include permanent neurological damage, it is easy to decide.

Keep this in mind when a “CORONA-VAX” is being peddled. Don’t look at the percentages or relative numbers, look at the absolute numbers.

Ventilators
Not everyone understands the difference between a respirator and a ventilator. A ventilator is a machine that breaths for us. It is the old “iron lung” in a small package. It requires a tube in the trachea (windpipe) that pushes air into the lungs. When people can’t breathe because their muscles are not working, these are amazingly useful tools. However, when there is fluid in the lungs, preventing oxygen from getting to the blood, these don’t work. Also, our normal way of breathing is to contract muscles in the ribs and diaphragm, causing negative pressure in the chest, sucking air through the nose and into the lungs. A ventilator uses positive pressure to push air into the lungs. The problems associated with this includes popping, and collapsing lungs. For these reasons, 88% of those infected with the Coronavirus died if they were put on a ventilator. In this “epidemic” more ventilators equals more deaths, fewer ventilators equals fewer deaths. Only one in ten survive the ventilator. Be careful of the treatment options.

Drugs that fuel the virus
Anything that inhibits the function of immune cells, especially innate immunity, will cause more infections and death. One interesting twist to this particular virus is the way it attaches to cells. It binds to a receptor called Angiotensin-Converting Enzyme 2 (ACE2). Interestingly, the cells of people who are taking blood pressure medications that inhibit this enzyme have five times the number of these receptors.[xvi]

The CDC shows that the most common co-morbid condition of those who were hospitalized for the Coronavirus infection is hypertension. This may be because lots of people have hypertension, or because they take ACE inhibitors and have more receptors for the virus.

Be careful of the medications you are taking; they may make you more susceptible to infectious diseases.

The Science of Prevention – What Does Work

Handwashing

For almost two centuries hand washing has been the most effective way to prevent illness in the health care industry. Studies specifically on viral illnesses like influenza show that it might help, but some studies failed to find a difference. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6461122/) Even the studies that showed hand washing could prevent respiratory illnesses and flu, the best one could do is a 50% reduction. In one study after people in a household got sick, hand washing was recommended, but it didn't work at all because it was instituted after one of them got sick. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465839/) So, hand washing might help, but can't be relied-on to keep you safe from illness. The best way is, by far, to have an intact immune system. This allows us to have contact with illness, develop immunity against it, and not get sick. Nevertheless, it is essential that we continue to wash our hands, and try not to spread illness around.

Immunity

Our immune systems are AWESOME! A fully-functional immune system will prevent ANY infection or cancer. If you think of the immune system as soldiers, you are only getting part of the story. Your immune system is more like a janitor, keeping the body clean, clearing up all the debris, and putting everything in its place. Yes, it does kill “foreign invaders,” but it’s like I told my daughter when she was feeling sorry for the spiders in our house:

We only kill spiders because they are in the wrong place at the wrong time.

Let that be a lesson to you!

Sometimes bacteria or viruses are welcomed by the body; our bodies make food (fucose) especially for them to grow. We carry around more of them, by far, than we do of “our own” cells. Most of the DNA we carry is from microorganisms. The blood is not sterile, but is constantly being cleaned by the immune system. There is a lot going on in the blood, so the need to clean is constant. In my kitchen at home I sweep the floor several times per day when people are there. I may run the dishwasher two or three times per day, and, of course, the carpets must be vacuumed regularly. It’s not that we don’t like dirt, but rather we want the dirt to stay outside, where it belongs, and not inside. Likewise, the efforts to keep the body clean are the constant domain of the immune system, keeping everything in its proper place.

So, how do we keep the immune system functional? Glad you asked!

Vitamin D
Some people get viral infections without symptoms because of their “innate” or “cellular” immune system. Before antibodies are ever made, the macrophages can take out infected cells before they become a virus factory, and then present it to the B-cells, which then make antibodies. Thus, the patient gets immunity without ever getting sick. The body makes “macrophage activating factor” (MAF) to start this process, which is vitamin D binding protein. This is why it is essential to have enough vitamin D, and also why “flu season” is in the winter, when we don’t make vitamin D.

I have tested many people for vitamin D levels and ask how much they take. Generally I find:

Dose of Vitamin D3	Blood level
400 IU (the RDA)	<30
2,000 IU	40
5,000 IU	50
10,000	70

The optimum level of vitamin D is 70-90 for the prevention of cancer and viral infections. Consider that twenty minutes in the sunshine on a summer day can net you 25,000 IU and you will understand what a physiologic dose is.

Vitamin C
Research with vitamin C shows that high doses can relieve the symptoms of viral illness, and supplementing with higher doses may prevent illness. For those with viral illnesses, vitamin C supplementation shortens the time of illness between twenty and fifty percent.

The white blood cells concentrate vitamin C from the blood over ten times. A healthy person absorbs about 200 mg per day of vitamin C, but when we get sick, we can absorb about 6,000 mg per day. Lower dosing during healthy times and higher dosing during illness seems to be best. During illness, those who had sufficient levels while healthy become relatively deficient, suppressing the immune response. Increasing vitamin C during a respiratory illness seems to prevent pneumonia in animals and humans.[xi]

Zinc
One common deficiency in the world is zinc, especially in men. Zinc is essential for function of the immune system. In this case, however, more is not better, you only need enough – until you get sick. Zinc shortens the time of infection significantly.[xii] [xiii]

The dose of zinc is tricky. People who take too much can get copper deficiency, which will cause other problems, because zinc and copper compete for absorption. The nutritionists recommend about 11 mg per day of zinc. Those who are vegetarian many need more zinc, partly because the food has less, and partly because of phytates that bind zinc in the intestines, preventing absorption. My personal belief is to take a supplement of about 100mg once per week.

Now, again, like Vitamin C, zinc will shorten the time of illness, and you can take much more during an illness. I recommend around 200 mg per day during the course of an illness. Then, when you feel better, go back to 100 mg once per week.

Avoid Sugar
A note about sugar is in order since we’re discussing the immune system. Avoid sugar like the plague! (pun intended) Because eating sugar suppresses the immune response.[xiv] It’s amazing that people will do something useless like stay indoors and wear masks to prevent an illness, but won’t avoid sugar. If you see something sweet, train yourself to immediately think of it as 8 hours of letting your guard down. This is high-risk behavior.

How to lower Stress
Watching TV creates fear. The purpose of TV news is to create an emotional response. The simplest response to elicit is fear. Fear is stress. Moreover, there are so many different voices it becomes confusing. The people I know who watch TV lose their ability to be discerning, not knowing what to believe. Don’t watch TV, especially the “news.”

There are a few other things that help us keep a normal circadian rhythm, which keeps the immune system functioning:

· Go to bed at 10 PM. The two hours of sleep before midnight are the most important for releasing Growth Hormone (HGH) to initiate the anabolic metabolism. This is the part of the day when you repair, cleanse, and detox from all the day’s activities.
· No food after 6 PM is a great rule so you have an empty stomach when you go to bed at 10 PM. The empty stomach makes GHRELIN (growth hormone releasing hormone) that allows repair of the stomach, intestines, and the whole body. This way you will be ready for the next day, able to absorb all the nutrition you need. You can do even better by eating two meals per day, ending at 3 PM.
· Eat breakfast by 8 AM. This starts the day, or the catabolic state. In fact, it is best to eat at 8 AM and 3 PM, and skip dinner altogether, giving you more time to be anabolic. This form of intermittent fasting works with your circadian rhythm to promote a fully-functional immune system.

Our Own Demise

Last, and most important, I would like to deal with death. As the medical director of a nursing home, this is something I deal with regularly. I sign a lot of death certificates. I think it is essential that the reality of your eventual demise be at the forefront of your mind at all times. Continually ask yourself, “Am I now doing everything on my ‘bucket list?’” Rather than neglect this reality, or try to postpone it, make it a part of your daily life. The sooner you deal with your mortality in a real way, the better. The reason this is so important is that when you hear some person on TV tell you that they will save you, you can know that it's not true and you won't get sucked into the vortex of lies.

I had a “wake-up call” about ten years ago when a colleague of mine died unexpectedly. He was my age. His patients, who were much older and all had “death sentences” (cancer) outlived him. We don’t know how long we’re going to live so we need to be prepared to go at any time. I believe that our days are numbered and we don’t extend nor diminish our time as mortals, but we can increase our enjoyment of whatever time we have by staying healthy.

Last week I had a patient in the nursing home who said he died twice in one day and was resuscitated. One of those times he remembers being outside his body, looking at what the doctors were doing, and was amazed at how good it felt to be out of pain. Then, they shocked him, and he was back in pain again. He said he’s not afraid to die.

I would not say that you shouldn’t hang on to life in any circumstance, but rather acknowledge your mortality and live every day to the fullest – “to live like you were dying.” (with apologies to Tim McGraw) I have people in my office who do nothing but try to prevent death. They take hundreds of dollars of vitamins every month, whether they need them, or not. One woman brought in two shopping bags filled with pill bottles. She wanted to discuss each of them. I asked her what she did all day, and she admitted that her life mostly revolved around supplements. The constant focus on preventing death really just prevents people from living.

So, when the next “pandemic” hits, you will be prepared, you will be able to take care of yourself, and you will not fear. You will have the right food, and enough toilet paper. You will have the right supplements and know how to take them. You will have a healthy circadian rhythm. You will not be swayed by media reports. You will not fear death, but continue to live your life in the best way you can. And, if you survive it, you will be a rock – like Jo. Jo is so happy to have had the virus because she now feels free. She no longer wears a mask (unless required), she is traveling and enjoying her life.

[i] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138271/

[ii] https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

[iii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662657/

[iv] https://pubmed.ncbi.nlm.nih.gov/31479137/

[v] https://ourworldindata.org/covid-deaths?country=USA~KOR~SWE~TWN

[vi] https://news.usc.edu/170565/covid-19-antibody-study-coronavirus-infections-los-angeles-county/

[vii] https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v2

[viii] https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html

[ix] https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm

[x] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html#mortality

[xi] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409678/

[xii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394849/

[xiii] https://academic.oup.com/advances/article/10/4/696/5476413

[xiv] https://www.quickanddirtytips.com/health-fitness/prevention/does-sugar-really-suppress-the-immune-system?utm_source=sciam&utm_campaign=sciam

[xv] https://academic.oup.com/jid/article/221/1/8/5609441

[xvi] James H Diaz. Hypothesis: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19. Journal of Travel Medicine, 2020; DOI: 10.1093/jtm/taaa041

Kokaubeam

Monday, June 22, 2020

The Ghost in the Machine

Saturday, June 6, 2020

Lessons from COVID-19