Archive for November, 2021

KEEPING THE CONSUMER SAFE; LIVING WITH COVID Segment 9: Covid Story 2 Part 1; The Dallas Story

Healthcare Consumer Navigator Center is a Healthcare Consumer Advocate Organization that helps consumer navigate the healthcare maze. The following Series “KEEPING THE CONSUMER SAFE; LIVING WITH COVID”.  Our goal is to provide a commonsense approach to living with covid with general healthcare information.

My covid story is what happened to one of my family members.  It all started on January 5, 2021, with covid symptoms. The following are the events that occurred:

1/7/2021:  Went to get tested for Covid

1/10/2021:  Test came back positive

1/11/2021:  Contacted the Primary Care Physician and had a Telemedicine visit The Telemedicine visit did not check the oxygen level or lungs which is critical to Covid.  Doctor prescribed Ivermectin.  Doctor did not recommend any other treatments that were available such as Monoclonal Antibody Therapy.

What is Ivermectin:  Ivermectin is an anti-parasitic drug that is used to treat river blindness and intestinal roundworm infection in humans and to de-worm pets and livestock. Lotions and creams containing ivermectin are also used to treat head lice and rosacea.

Here’s What You Need to Know about Ivermectin

• The FDA has not authorized or approved ivermectin for use in preventing or treating COVID-19 in humans or animals. Ivermectin is approved for human use to treat infections caused by some parasitic worms and head lice and skin conditions like rosacea.
• Currently available data do not show ivermectin is effective against COVID-19. Clinical trialsassessing ivermectin tablets for the prevention or treatment of COVID-19 in people are ongoing.
• Taking large doses of ivermectin is dangerous.
• If your health care provider writes you an ivermectin prescription, fill it through a legitimate source such as a pharmacy, and take it exactlyas prescribed.
• Never use medications intended for animals on yourself or other people. Animal ivermectin products are very different from those approved for humans. Use of animal ivermectin for the prevention or treatment of COVID-19 in humans is dangerous.

1/13/2021:  Had Telemedicine visits with the Doctor.  Continue with Medication was on the medication for 3 days…no real improvement

1/14/2021:  Family member found out a Covid Treatment called Monoclonal Antibody Therapy was approved and was available locally.   (Trump had the treatment)  Family member contacted the clinic that provided the treatment.  Obtain necessary authorization forms for the Primary Care Doctor to fille out.

1/15/2021 Had Telemedicine visit.  Family member asked about the Monoclonal Antibody Therapy treatment and did not get a favorable answer.  Family member insisted the doctor fill out a preauthorization for the treatment.

How does monoclonal antibody therapy work?

Monoclonal antibody (mAb) therapy, also called monoclonal antibody infusion treatment, is a way of treating COVID-19. The goal of this therapy is to help prevent hospitalizations, reduce viral loads and lessen symptom severity.

This therapy can be extremely effective, but it’s not a replacement for vaccination. The community still needs to step up and get vaccinated to break the virus’ chain of transmission.

Who is eligible to receive monoclonal antibody therapy?

Monoclonal antibody treatment is available to individuals who:

• Are high risk** for developing severe COVID-19 and
• Have a positive COVID-19 test and have not yet been admitted to the hospital and
• Are 12 years of age or older (and at least 88 pounds)

Post-exposure preventive monoclonal antibodies are available to those who have been exposed (consistent with the CDC’s close contact criteria)* and who are:

• High risk** for developing severe COVID-19 and
• 12 years of age or older (and at least 88 pounds) and
• Not fully vaccinated or vaccinated but immunocompromised

1/16/2021:  Received preauthorization

1/17/2021 Contacted the Treatment Center to schedule treatment; Family member getting worse

1/18/2021; Decided to go to the Emergency Room.  ADMITTED TO THE HOSPITAL AND SENT TO THE COVID ISOLATION UNIT.  ADMITTED BECAUSE THE PATIENT’S OXYGEN LEVELS WERE IN THE MID 70’S. NORMAL IN THE 90’S.  COVID NOW IN THE LUNGS.  Family members wife tested positive; ER doctor contacted the clinic providing monoclonal antibody therapy and scheduled an appointment on 1/20/2021. Prevented a more serious medical event.

Primary Care Never followed up….

TAKE AWAYS:

Clearly the treating doctor was not informed as to how to treat Covid.  Never recommended the Monoclonal Antibody Treatment.  Family member had to explain and insisted the doctor complete a preauthorization form.

Telemedicine visits are good but not with Covid.  Oxygen Levels, Blood Pressure, etc. cannot be performed on a telemedicine visit to determine if the patient has issues.

Use common sense…if your condition is not improving, go the Emergency Room

MORE TO COME….THE HOSPITAL EXPERIENCE.

KEEPING THE CONSUMER SAFE; LIVING WITH COVID Segment 8: Watching the Sausage Being Made

Healthcare Consumer Navigator Center is a Healthcare Consumer Advocate Organization that helps consumer navigate the healthcare maze. The following Series “KEEPING THE CONSUMER SAFE; LIVING WITH COVID”.  Our goal is to provide a commonsense approach to living with covid with general healthcare information.

“There are two things civilized Man should never see being made: Sausages and Laws.”

Otto von Bismarck

I’ve decided there is a third item to be added to this quote. Modern medical innovation.

As I continue wandering through the maze of news stories on COVID-19, this one caught my attention, “COVID Has Killed 5 Million People, But Only Hundreds Have Been Autopsied.”  Once again let me declare I’m not a pathologist, scientist, physician or associated with any other clinical profession. In fact, I ran across the aforementioned article on the Bloomberg Businessweek website. Frankly, the headline was shocking to me based upon my limited understanding of how advancements in medical care have been made over history.

My first journey into this murky world occurred many years ago when I was doing research on a speech about hospital acquired infections and policies about clinicians hand washing. It’s ironic how relevant that story is to the current environment but that will have to wait for another day.

For most lay people, our medical knowledge has been gained through prime time television.

Hollywood has done a masterful job taking us from City Hospital (1952-53) to Dr. Kildare (1961-1966) to Medical Center (1969-1976) to ER (1994-2009) to Grey’s Anatomy (2005-Present) and too many more to list. Medical discovery and innovation for centuries have been united/conflicted by complex interrelationships of science, art and politics. Oftentimes these relationships have been reflected on our television screens. For example, I’m a fan of NCIS and have become accustomed to the marvels of medical science, performed in the context of autopsies, to provide the clues to seemingly unsolvable murder mysteries. This is why the aforementioned headline struck me as unbelievable.

So let me summarize (and translate) the article (if you want more accurate details, find it on the internet) for you. Once upon a time, autopsies were how medical professionals figured out why/how people died-this was the application of scientific discovery in medicine. More recently “sophisticated diagnostic tools and health-system budget cuts have made them (autopsies) a dying practice.” (Pardon the pun that’s a quote from the article.) The numbers currently are over 5 million deaths world-wide and somewhere in the hundreds of documented autopsies. According to the head of a forensic lab in Australia, the cost of an Autopsy is between $2,000 and $4,000. My calculation shows if we’d autopsy approximately half of the deaths (2,500,000) at the full retail price of $4K the price tag would be $10 trillion world wide. While this sounds  astronomical, let’s compare this to the economic cost of COVID world-wide (for we don’t know how much longer) and add whatever value you’d like on the loss of life. Then one must figure long before we get to the 2.5 millionth autopsy someone figures out how to “cure” the virus. I don’t have much hope under the current scenario we’re going to get to this solution anytime very soon.

This brings me to a much more serious concern. Who the hell is in charge? Why isn’t the CDC or some other agency mandating autopsies on a certain number of people each month. Where the hell is the data? We continually hear “follow the science”! Well, science is facts and data! I continually hear on local news media outlets worthless counts of infection rates, deaths and hospital occupancy related to COVID cases. Who cares? Shouldn’t we know which hospitals have developed best practices and have reduced mortality rates? Who has the best outcomes? Where are the best COVID hospitals? If I need cancer care, I can find the best cancer hospital, if I want breast implants I can find the best plastic surgeon. If I have COVID, how do I know where the BEST Hospital is? There could be all sorts of criteria established to find answers to these and hundreds of other questions people have. The current approach seems random at best and dysfunctional at worst.

There is a growing divide in this country about vaccines. As I’ve reported before-I’m vaccinated and have had COVID post vaccine. At the time, given my age and current underlying medical conditions, I thought the vaccine was the right approach. Having acquired the virus hasn’t made me regret my decision. I’m even considering getting the booster. Here’s the But! I’m becoming more willing to listen to those opposed to being vaccinated because I’m becoming more and more alarmed at what isn’t being done regarding how we’re addressing the virus. The lack of autopsies is just the first of these discoveries. I’m willing to listen because I’m now more and more curious about hearing the “whole” story. Let’s not forget the same medical, industrial complex that gave us Opioids is giving us the COVID vaccine. They are also the ones spending millions on lobbyists in Washington and making billions are providing the vaccine.

Stay tuned…next up COVID data gathering or the lack thereof…!

KEEPING THE CONSUMER SAFE; LIVING WITH COVID Segment 7: Do We Have Immunity?

Healthcare Consumer Navigator Center is a Healthcare Consumer Advocate Organization that helps consumer navigate the healthcare maze. The following Series “KEEPING THE CONSUMER SAFE; LIVING WITH COVID”.  Our goal is to provide a commonsense approach to living with covid with general healthcare information.

My latest COVID pondering relates to immunity. We’ve all heard the term but not sure exactly what it means. I decided to find out. Starting with the CDC website and entering “COVID Immunity” in the search box, I got my first surprise. What popped up was a list of articles all related to COVID vaccination. After digging around a little more on the website, I discovered this interesting tidbit, “Antibody tests for COVID-19 look for the presence of antibodies made in response to a previous infection or vaccination. They are an indicator of the body’s efforts to fight off the SARS-CoV-2 virus. (Here’s the important part.) None of the currently authorized SARS-CoV-2 antibody tests have been validated to evaluate specific immunity or protection from SARS-CoV-2 infection.” You might want to reread that last sentence a few times and let it sink in for a minute. I quickly reflected on all of the times I’ve heard some “expert” on radio or TV talking about immunity and all the articles I’ve seen making reference to immunity. And my internal response is WTF!

After the aforementioned declaration, there follows a great deal of scientific mumbo-jumbo I won’t repeat here. You’re welcome to go to the CDC website and read it for yourself. Finding the above somewhat of a dead end. My approach needed to change, so ground zero for the immunity chatter I’ve been hearing about for the past 9 months became my new objective. “Herd immunity” is a concept continually mentioned in the media, so I decided to investigate.

From JAMA Patient Page, dated October 19, 2020,  “Herd immunity works to control spread of disease within a population when a specific amount of that population (threshold) becomes immune to the disease through vaccination or infection and recovery. When the immunity threshold is reached, susceptible individuals are protected from infection because ongoing spread of the disease is limited.” In a more recent article on the AMA website, dated August 21, 2021, titled “What doctors wish patients knew about COVID-19 herd immunity.” This article goes into further discussion about what herd immunity is and what it is not. Suffice it to say two experts on the topic are quoted in the article and let me sum it up this way, “we’re a long way from herd immunity.” Again, I’ve summarized for the sake of brevity and encourage those with an inclination toward statistics and sampling theory to go to the article.

Moving on. Surely there must be some basis for the vast amount of discussion that relates to immunity. If immunity is the ultimate Holy Grail in finding the path back to normalcy, my search continues.

Cue the National Institutes of Health (NIH). In a article dated January 21, 2021, “Lasting immunity found after recovery from COVID-19.” The summary states, “the immune systems of more than 95% of people who recovered from COVID-19 had durable memories of the virus up to eight months after infection.” I’m confused, how does this information relate to the aforementioned CDC information? To be completely honest I have no idea. The NIH information was based on a sample size of 200 people conducted by the La Jolla Institute for Immunology. My completely uneducated guess is the sample size isn’t large enough or there are other variables making the study unusable for making more blanket statements. Which has me pondering a host of new thoughts and questions. I’ve now decided we are in for what’s going to be a very long journey back to what I consider normal. For example, as I’m writing this and wearing my mask,  I’m awaiting a flight that’s now originating from the airport I’m at but is delayed for 2 hours. I’m sure it has something to do with COVID but knowing won’t change the departure time so I’m not seeking the answer. The flight is 3 hours, I arrived at the airport, as required, a hour before departure and will have to wear this damn mask for about 7 hours. Sucks! I digress.

The ranges for herd immunity are from anywhere from 85 to 95% depending on the source. We’re currently at roughly 50% for the US. How long before we have herd immunity is anyone’s guess. If there’s another variant to the virus, do we start all over?  How long it will be before we have anti-body testing that’s “valid” for determining immunity is currently unknown. From where I’m sitting, we’re moving at a glacial pace from the unknown to the known. From disinformation to useable information.

As a part of my journey down the immunity rabbit trail, I accidentally stumbled on to another extraordinarily interesting topic. My teaser for my next article is “autopsies.” Stay tuned.

KEEPING THE CONSUMER SAFE; LIVING WITH COVID Managing Your Symptoms Segment 6

Managing your symptoms is critical with Living With Covid.  Below is a link that will direct you to a Power Point Presentation that will help the consumer  understand different symptoms for various illnesses.  The summary was compiled from non clinical web sites.  The consumer needs to be aware that this doesn’t  represent medical advice or guidance.   This is simply a laymans view.

Covid Series Release 6

KEEPING THE CONSUMER SAFE; LIVING WITH COVID Segment 5: To Boost or Not to Boost

Healthcare Consumer Navigator Center is a Healthcare Consumer Advocate Organization that helps consumer navigate the healthcare maze. The following Series “KEEPING THE CONSUMER SAFE; LIVING WITH COVID”.  Our goal is to provide a commonsense approach to living with covid with general healthcare information.

As previously documented in this space, I have had two doses of the Moderna vaccine. My second dose was in February 2021.

So the question I’ve now faced is whether or not to get a booster shot. I was infected with the COVID virus mid-September and had no symptoms (asymptomatic). I have spent hours on the internet searching for an answer to what I thought was a pretty simple, straight-forward question, “Should a 67-year old, vaccinated individual, recently recovered from COVID get a booster shot?”

Here’s what I’ve learned.

I’m now in a category called “breakthrough cases.” According to the CDC website, “COVID-19 Vaccine Breakthrough Case Investigation and Reporting,” a vaccine breakthrough infection is defined as the detection of SARS-Cov-2 or antigen in a respiratory specimen collected from a person > 14 days after they have completed all recommended doses of a U.S. Food and Drug Administration authorized COVID-19 vaccine.

According to the website as of October 18, 2021, 41,127 patients with COVID-19 vaccine breakthrough infection were hospitalized or died. Thankfully, I don’t fall into either of those categories. The breakdown was 10,857 deaths and 30,270 hospitalizations. I wonder how large the overall number might be? The website goes on to explain the data is incomplete and this is only a snapshot of the breakthrough cases. To date, no unexpected patterns have been identified.

In a single sentence, I seemingly found what I was looking for…”Currently, CDC is recommending that moderately to severely immunocompromised people receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine. I continued to search for a specific reference to someone having COVID and a specific recommendation for this condition because of all the “immunity” discussions that exist on the web. I didn’t find any.

As a last resort, I contacted a physician and she recommended getting the booster.

Frankly, this doesn’t feel all that scientific to me. The more I researched the more I learned there is a great deal of studying and data gathering ongoing that haven’t yet produced what one would consider “scientific” results.

According to the CDC, “more than 189 million people in the US have been fully vaccinated as of October 18, 2021.” The approximately 11 thousand reported breakthrough deaths translates to .0058%. So in my unofficial, unscientific capacity the vaccine seems to be working.

My own personal experience demonstrates the vaccine greatly mitigated my bout with COVID.

I can attest researching COVID can be a very frustrating and time consuming endeavor. While one will find many references to “following the science.” In reality, for mere mortals understanding the science can be daunting.

Here’s my unsolicited advice from my own experiences.

-Be attentive about potential COVID symptoms in yourself and others. Vaccinated people can become infected and be asymptomatic or have very mild symptoms. They

are contagious. It’s how I became infected.

-Consult your physician about getting a booster shot if you fall in the CDC recommended eligibility group.

-If you are immunocompromised, get a pulse oximeter to monitor your oxygen levels.

If your number drops below 93%, see a physician. Do not wait! My partner went from

92% to 76% in a day!

-Find a website you trust, presents in understandable language and stays up to date so you can routinely follow to stay current on COVID. The more you know the better off you’ll be. This is very much an evolving subject.

-People are still dying from COVID that shouldn’t so don’t let your guard down!