Wednesday, October 28, 2020

Air purification from September, 2020 –April, 2021: Germs and Smoke

Germs and Smoke

October 28, 2020 

Paul Herscu ND, MPH

Herscu Laboratory

Air purification from September, 2020 –April, 2021: Germs and Smoke

 

This is a follow-up to the post on this topic from September, but an urgent one for two reasons. First, there are fires raging in the west of the United States leading to smoke entering homes irritating the respiratory tract of many people. And as importantly we are in the midst of a second wave of viral activity which has not come close yet to peaking. I am not focusing here on mounting virus activity or on changing morbidity/mortality rates, but suffice to say, the second wave has arrived, on schedule, as we predicted earlier this year.

 

The overall topic of this post is mitigation. Sometimes we find ourselves in situations where the water we drink, the food we eat, or the air we take in is less than optimal and if possible we need to mitigate or modify our exposures so the possibly harmful impacts are minimized. I would like to focus on air quality today and how both smoke and viruses impact air quality.

 

Over the past many decades, I have been impressed by public health infrastructure and work accomplished in the USA and abroad developing processes that help many people and communities, those with means and those without. It is impressive to examine the ability for governments to intersect with NGOs and stakeholders in an ever-evolving partnership to offer health and safety quickly and efficiently. 

 

And there are areas where we could do better and occasionally there are quick, easy, inexpensive do-it-yourself solutions for a challenging issue.

 

I describe here one such idea, born from current need: an economical, home-made, Box Fan - Air Filter System.

Tuesday, September 22, 2020

Fire and Smoke

Fire and Smoke

September 21, 2020 

Paul Herscu ND, MPH

Herscu Laboratory

 

I have, over the past many decades, been incredibly impressed by the public health infrastructure and work accomplished in the USA and abroad. In general, developing processes that help the many, those with means and those without means equally. And in general, it is impressive to examine the ability for governments to intersect with NGOs and stakeholders in an ever-evolving partnership to offer health and safety quickly and efficiently. 

 

That said there are at times gaps in this process. And often those gaps fall in what for lack of a better term I might fit within the ‘here is a quick and easy and inexpensive do-it-yourself solution’ for whatever the issue at hand might be. 

 

I bring this up as I received an email from a patient in California describing how bad the smoke is from the fires burning all around her city. And even though she does not go outside, it is in the apartment, and is irritating her eyes, nose and throat. She has tried several solutions in her space but the problem persists. And also, since she lives in a garden apartment, it costs too much to develop a central air solution for the owner, and even if he would want to, everyone who can do that work is already too busy and would be placed on a waiting list. But the problem exists right now. What to do? 

 

I would like to describe a very simple solution that almost everyone could do and afford. I think there may be a few public health authorities that might mention this but in fact this has not been generalized and most people do not know this. So, if you do know someone in that area pass this along. 

Thursday, September 3, 2020

2019 Novel Coronavirus (CoVID-19): Part XIV

 

2019 Novel Coronavirus (CoVID-19): Part XIV 

2019 Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019), COVID-2019 Pandemic:

 

September 3, 2020 update Part 14

Paul Herscu ND, MPH

Herscu Laboratory


This is the fourteenth piece of writing on the current epidemic. Please read Part 1Part 2Part 3Part 4Part 5Part 6 Part 7Part 8Part 9 Part 10Part 11, Part 12, and Part 13 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics.


One element at a time: Induction, or where should they focus

 

Back during the SARS epidemic, and then the Ebolavirus epidemic, I spoke a great deal on the topic of public health modeling. Specifically, and you can hear this on tapes of the day, I mentioned that, medically speaking, we are in the new era of germs. Every few months or years there will be a new germ discovered that is lethal to human or animals or crops. And that basically, as a species, we need to develop a better way to think about germs. Instead of thinking of germs as deadly and how they need to be eradicated, a better way may be to learn to adapt towards them and encourage the bug to adapt to become less virulent. But the bottom line is that we will discover more germs, the science is there for that capacity. And if we are not thinking of it in the right way, we are going to go insane worrying about all the germs constantly surrounding us. Enough said here for now.

 

One of the main points I made is that everyone, every single person, from about middle school onward, is able to greatly understand the underlying issues if you can present them with the science of epidemiology, of public health. More or less, everyone arrives at the same position then, and can make informed decisions. The problem is that these basic public health concepts are not taught to most of us. Many of you have attended lectures where I have presented the basics in a few hours talk. What I want to do here, now, is review that material, one important piece at a time. Yes, they apply to this particular epidemic, but if you understand the basic concept it will help you into the future and with any potential epidemic. Let’s start.

Tuesday, September 1, 2020

2019 Novel Coronavirus (CoVID-19): Part XIII

2019 Novel Coronavirus (CoVID-19): Part XIII 

2019 Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019), COVID-2019 Pandemic:


September 1, 2020 update Part 13

Paul Herscu ND, MPH

Herscu Laboratory


This is the thirteenth piece of writing on the current epidemic. Please read Part 1Part 2Part 3Part 4Part 5Part 6 Part 7Part 8Part 9 Part 10Part 11, and Part 12 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics.


 Eight months!

 

It has been, as one might count for the USA, roughly 8 months since SARS-CoV-2 virus causing COVID-19 has struck the world, and as I mentioned in the first of these blogs in January, February, and March, that it was probably earlier, but that is another story for another time! I wanted to catch us up to where we are, within the context of the past, as a way to help us gauge where we are going. As usual, I think understanding the underlying issues should make us be less lost when hearing or reading the bombarding news. I have conducted dozens of interviews, webinars, conferences on this topic, but since it has been a while writing here, please indulge me going into each of these matters, in brief. It should help! I will delve into them in the next updates, which will be posted soon. 

 

The Virus 

There are many things one could say. The main points I want to highlight are:

1.     The first point I made when this began is that we have to think of this virus as different than other viruses we have experienced. This is not one that is going to come and go by itself, rather, it is the ‘birth’ of a new virus that is going to be with us, with ups and downs, but be with our species for the time being. And the point I made is that for many of us, except for those dealing with AIDS) we have not really experienced this concept of a new disease as an epidemic. We really have not. 

2.     As discussed early on, while the virus mutates, like all viruses, the part that is most lethal to humans seems, unfortunately to date, resistant to change. 

3.     With these two points in mind, I urged us to consider that this is not something that we can wait out and it will not just go away but rather, we need to be proactive. There are essentially a few essential levers to pull here, as described earlier: 

a.     Vaccinations to make people either not catch the virus or not have it be so problematic (This is being worked on intensively)

b.    Develop nondrug therapies to make people either not catch the virus or not have severe symptomatology.

c.     Change the virus to make it less problematic (To my knowledge this is not being worked on. If it is, the likely place would be at military facilities)

d.     Wait until it evolves or we evolve, a coevolution so that it is less problematic to us (This does not seem practical)

e.     Develop drug therapies that can treat the unwell person (This is being worked on intensively)

f.      Develop nondrug therapies that can treat the unwell person

 

The main point here is that it is an unavoidable problem we have to come to decisions on how to address. This really has not changed. I know this had gotten politicized, early on, and it seems as though people are digging their heels in, as to how they would think about this virus. But the reality on the ground is still the same. I will come back to B and F above below. Onward. 

Monday, April 13, 2020

2019 Novel Coronavirus (CoVID-19): Part XII

2019 Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019), COVID-2019 Pandemic:
April 12, 2020 update Part 12
Paul Herscu ND, MPH
Herscu Laboratory

This is the twelfth piece of writing on the current epidemic. Please read Part 1Part 2Part 3Part 4Part 5Part 6 Part 7Part 8Part 9 Part 10 and Part 11 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics.

It has been a very long road, my friends, these past three and a half months. A lot has happened, and really, it has been a confusing period of time for many of us. In this Update, I focus on our natural medicine efforts over these months, on why I have urged us all to take these actions and then share my thoughts and hypothesis on why some people fall severely ill.

My main focus over the three and a half months has been, and will remain, on keeping people out of the hospital. I explain why below. Our first goal has been to keep people from developing the illness to start with. However if they do develop COVID-19, the goal has been to keep it the mildest version possible. Towards that end, the two main tools we use are natural therapies, mentioned in Update 7 and homeopathy described in Update 8. The idea is to have people react/adapt to the virus, move through the illness without becoming severely ill, and then move on with their lives. And if we do our job well, and the stars align, that is how it plays out. 

One of our main tools is to use homeopathy, as it helps people respond early to the virus and have only subclinical or minor manifestations of the illness. We have now treated 170+ folks that have tested positive for COVID-19. The people we put on this supplementation plan and were able to receive an individualized homeopathic remedy too have done well enough. No one has been admitted into the hospital yet (touch wood). This for me is a main, most important point. We need our patients to stay out of the hospital when possible. Partly that is to save personnel and resources for those already severely ill with COVID-19 and/or other unrelated complaints. Simply, I use the hospital admission as a proxy for how well or poorly things are going. 

To be clear. Obviously, if a person’s health deteriorates to serious condition, there is no better place to be than the hospital. If we can keep the person healthy enough to not end up in the hospital, we can avoid several unknowns. As a result, the main focus for Amy and I remains helping with prevention and keeping the disease in those who have it in its mildest form possible.

Tuesday, April 7, 2020

COVID-19 Thoughts and Recommendations: April 1, 2020

Dear family, friends, patients and colleagues,

We continue to hear from many of you wanting guidance at this time. Paul is publishing his ongoing work tracking the pandemic and sharing his public health and science thoughts. If you want to receive those as written, you can sign up here.

The bottom line is: the virus is ubiquitous, so it’s ever important to try to prevent exposure as much as possible by observing physical distancing, keeping your children and teens close and following all public health directives. Wear a mask and gloves when in a public. Wash your hands when you arrive home, and know that good old soap and water may be better for all of us in the long run.

It has become increasingly clear than many of us have become asymptomatic carriers and we may be inadvertently putting all sorts of people at risk without intending to. So! Please do not become paranoid, but put effort into being careful just as you would want others to do for you.

And we also know that when and if you fall ill, the better shape you are in beforehand, the better. Most people will have only a mild form of this illness, but working to build a resilient immune system now, will serve you well should you become exposed or do become sick.

In order to create the most resilient immune system possible, here are my recommendations for you and yours. Please know that for those with underlying or chronic disease, or who have compromised immunity (for whatever reason), or have an autoimmune disease, I would want to work with you individually as not all these recommendations apply. If you’re not sure, please schedule a time to “come in.” We are seeing patients via telemedicine and have had the chance to work with people from all over the globe. Linda, at our “front desk,” can help you schedule (860.763.1225).

Here we go, with regard to prevention:

Thursday, March 19, 2020

2019 Novel Coronavirus (CoVID-19): Part XI

2019 Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019), COVID-2019 Pandemic:
DON’T PANIC, be concerned, but don’t panic. It just makes everything worse.
March 19, 2020 update Part 11
Paul Herscu ND, MPH
Herscu Laboratory

This is the eleventh piece of writing on the current epidemic. Please read Part 1, Part 2, Part 3, Part 4, Part 5, Part 6 Part 7, Part 8, Part 9 , and Part 10 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics.


Well, That Was Quick

It has been only 24 hours since the last update and I just wanted to sort of breathe a sigh of relief. Finally! Yesterday, I mentioned that I think the government should rush through the vaccine and not wait 18 months. And I also said that I have really high hopes on a few drugs, especially chloroquine. Today President Trump said that he is going to rush through the vaccine AND rush through the testing for chloroquine. I mentioned from the start that this should be thought of as waves, and that we can really stop this first wave, which is how they began to discuss it this time. That, and a few other indications, make me feel like the White House is now reading these updates. And I am very happy with that. Primarily, as they describe in a simple manner where we are, why people are doing what they are doing, and the future direction of what could and should be done. This is really the fastest changeover I have seen. And if things continue as I think they could, and think they should, with fast action from now on, I still stick to my initial comments. If we do things right, from now on, instead of seeing 2-3 million dead as predicted, we will see in the hundreds, or a few thousand, in this first wave. Much, much less than others predict, much, much less than the flu, etc. But what I said at the start. I know this seems ridiculous to many right now, and really out of touch with the numbers given the feeling that since we have over let’s guess 30,000-50,000 infected (11,236 official confirmed) now and 161 that have died, that we would overrun the hundreds to thousands in the next week or two. But I do not believe this has to be the case. We still have enough time to implement well and divert a massive tragedy. So, whoever is giving the White House these updates, thank you, THANK YOU, and keep going!! To be clear we are not out of the woods, even by a long-shot. Decisions still need to be made and enacted properly and efficiently, but it does seem like that may be finally occurring. As they say, ‘We have all the time we need, if we start now!’

Wednesday, March 18, 2020

2019 Novel Coronavirus (CoVID-19): Part X


2019 Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019), COVID-2019 Pandemic:

DON’T PANIC, be concerned, but don’t panic. It just makes everything worse.

March 18, 2020 update Part 10
Paul Herscu ND, MPH
Herscu Laboratory

This is the tenth piece of writing on the current epidemic. Please read Part 1, Part 2, Part 3, Part 4, Part 5, Part 6 Part 7, Part 8, and Part 9 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics.


Person/Place and Time
When I teach on this topic of epidemics, I focus on the very important variables of Person/Place and Time. For example, if I mentioned west Africa 2014, you would say Ebola virus, and if I said early 1980s, San Francisco younger gay men, you would say AIDS crisis. In other words, when dealing with epidemics, we have to contextualize our comments, plans, and processes to the moment (the exact time we find ourselves in) place (are we talking about a city, a state a region, or the country?) and people you are talking about (and with COVID-19, thus far, the main variable has been old age, though, as I mentioned you will start to hear more about younger people soon).


Place and Time
As I mentioned originally, this whole epidemic could have been over before it started with proper local testing. Sadly, that time has passed. And where we are now is, for the most part, with local outbreaks throughout the country. But because of the extent and seeding that has occurred, I believe we will soon move from local to regional outbreaks as a way to think of it, and if we still do not work together properly, we’ll then have a national epidemic. More on this below. The main point is: what sounded like good public health procedures and recommendations before, will not necessarily work now. As of this writing, we have in the US 7,339 confirmed cases, and 116 deaths. I am guessing that the number is actually closer to 30,000 cases at this point (meaning that 340 million do not yet have this illness). Proper action now can still stop a galloping epidemic with most people not even knowing anyone that has fallen seriously ill, but soon this possibility may pass.

Sunday, March 15, 2020

2019 Novel Coronavirus (CoVID-19): Part IX


2019 Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019), COVID-2019 Pandemic:

DON’T PANIC, be concerned, but don’t panic. It just makes everything worse.

March 15, 2020 update Part 9
Paul Herscu ND, MPH
Herscu Laboratory

This is the ninth piece of writing on the current epidemic. Please read Part 1, Part 2, Part 3, Part 4, Part 5  Part 6 Part 7 and Part 8 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics

How the 2019 Novel Coronavirus (2019-nCoV; COVID-2019) ENDS:

Well, at this point from what we know:

 
Current Statistics
Regarding the current numbers in the USA, we have in less than a week confirmed cases went from 1,832 to 3,400 and, sadly, from 41 to 63 deaths. Personally, I believe at this point, the number most likely went from 7,000-8,000 to 12,000-14,000 infected. Until there are better tests available and widespread testing of everyone, we will not have accurate numbers. As an estimate of incidence, I suggested that the numbers might double each week. As you can see from official numbers that is what is being reported. My suggestion, is for approximating incidence rate, you could take the number who have died and multiply it by 200. That might be a closer approximation to the actual numbers in the USA for the coming period of time. We will know more when widespread testing is more available.

Friday, March 13, 2020

2019 Novel Coronavirus (CoVID-19): Part VIII


2019 Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019), COVID-2019 Pandemic:

DON’T PANIC, be concerned, but don’t panic. It just makes everything worse.

March 11, 2020 update Part 8
Paul Herscu ND, MPH
Herscu Laboratory


This is the eighth piece of writing on the current epidemic. Please read Part 1, Part 2, Part 3, Part 4, Part 5  Part 6 and Part 7 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics. At the end of this update, I describe how to think about homeopathy and its use at this time.
 
2019 Novel Coronavirus (2019-nCoV; COVID-2019):

WHERE WE ARE NOW.

The Use of the Word Pandemic
Ten minutes ago, the WHO called the current COVID-2019 situation as a pandemic. This is a milestone. The prior Pandemic of H1N1 influenza, as you may recall, was the last pandemic, though I believe calling it that was a mistake. This time it is not.

Why Use The Word Pandemic Now?
There are people walking around with COVID-2019 without knowing it since they are not tested. And at this point understandably, there is widespread anger that there are not enough test kits, to allow us to have accurate information about incidence. And I think this is important, ultimately this is one of the most important reasons why WHO finally called this a pandemic. There are numerous countries that are not taking timely, essential actions; defining COVID-19 as a pandemic will hopefully implore nations and communities alike to work in a more aggressive and coordinated fashion to stem the spread of this virus. Most importantly, even today, correct public health actions can stop this pandemic from turning into a real tragedy on a scale not experienced for a century. Even now, we still can turn this situation around, even without any advancements in new science, just by good governmental public health processes. We are all part of the solution.

Examples of Countries that Have Early, Consistent and Effective Response
In many respects the best example of this is Taiwan. While it is geographically close to mainland China, there are hardly any COVID-2019 cases (50) and very only one death. While it is the same virus, the main difference is the processes the Taiwanese government put in place since the SARS epidemic in 2003. Bottom line, it really is the time to just settle on what can be done, today, that we already know works, that can change the course of spread of disease. Though I should mention, also, one has to overlay the actual numbers to a standardized number. For example, in the number of cases per million. Taiwan is 2.1 per million, Italy is 292.1 per million, USA is 5.7 per million.

Monday, March 9, 2020

2019 Novel Coronavirus (CoVID-19): Part VII

2019 Novel Coronavirus
(2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019):


DON’T PANIC, be concerned, but don’t panic. It just makes everything worse.


March 8, 2020 update Part 7
Paul Herscu ND, MPH
Herscu Laboratory


This is the seventh piece of writing on the current epidemic. Please read Part 1, Part 2, Part 3, Part 4, Part 5 and Part 6 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics.

 2019 Novel Coronavirus (2019-nCoV; COVID-2019):

WHERE WE ARE NOW.

Well, there are things we know now, and things we still do not know. I want to start with the most striking comment, which I started with in the last update. Strong and clear public health measures greatly impact epidemic progression. I made this point numerous times, when discussing the predictive use of epidemic curves, as well as other tools that we have at our disposal. The clearest example was with the Ebolavirus in Western Africa where it was modeled that high death rates occur if public health measure go in one direction, nearing 30,000 death, and much lower rates occur when good public health measures occur, modeling out 3,000 dead. Same bug, different outcome. The solution is not a scientific one but a public health one. The best and strongest variable or actions that hasten containment are strong political leadership at the highest level, early detection and response, stepped up surveillance, public awareness of the facts, and international partnerships to help with both resources and to learn experience from success and failure using differing strategies.

Needless to say, some of this fell really short. In the USA, especially short. Of my prior ‘wish list’ items that would help hasten containment that I mentioned, most did not happen. Which sadly changes the equation. The best example I have of this, that I mentioned in an interview 2 weeks ago is that testing, as bad as it is (more on this below), is a fraction of what it should be. The example I used is that South Korea was reaching the number of 100,000 people tested, where the USA had only tested 200-300 people. The difference there should be stark to all of us. As of today, we have still only tested a very, very small number, whereas South Korea has tested nearly 110,000. Put differently, the USA has tested about 1 person per million whereas South Korea has tested 2,000 per million. A stark difference. At this moment 19 people have been identified as having died as a result of this virus, with 534 confirmed cases, but I think the actual carrying virus number, right now is most likely closer to 3,800 in the USA.

Thursday, March 5, 2020

2019 Novel Coronavirus (CoVID-19): Part VI

2019 Novel Coronavirus
(2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019):

DON’T PANIC

March 4, 2020 update Part 6
Paul Herscu ND, MPH
Herscu Laboratory 
 
This is the sixth, a short piece of writing on the current epidemic. Please read Part 1, Part 2, Part 3, Part 4, and Part 5 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics.

LASTLY, I am going to deliver a presentation this coming Saturday, March 7th at 3:30 pm at Bastyr University in Kenmore, Washington. This topic is part of a broader course we teach there, but this lecture will be on how to understand and address epidemics in general and this one in particular. Due to the current environment, this lecture is open to all. For more details and to keep up to the moment, please RSVP: http://tinyurl.com/herscu

 2019 Novel Coronavirus (2019-nCoV; COVID-2019):

Comments I shared here over the past weeks remain true. I want to highlight a few things here, with the hope that a bit of knowledge will calm the nerves. That said, this will be short so that you can get through it efficiently.

There are five specific points.

First, as I mentioned a few days ago, I was very worried about the exposure of the gentleman who worked in the nursing home. Really, it worried me because of the likely mortalities that would follow, which sadly have come to pass. I want to get back to this point just below, but first let me continue with the points from before.

Second and related, I finally had contact with both the CDC and with the quarantine area in Nebraska which is housing and treating the folks that were on board the Diamond Princess, to recommend they test for C1-INH levels as part of the immune system/inflammatory testing conducted. Hopefully, they will do this, as I believe such information is crucial as a way to save lives. I am not sure this will come to pass, so PLEASE, if you have contacts in the medical world, pass on the request to test patients in critical care for C1-INH.

Monday, March 2, 2020

2019 Novel Coronavirus (CoVID-19): Part V

2019 Novel Coronavirus
(2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019):

DON’T PANIC

March 1, 2020 update Part 5
Paul Herscu ND, MPH
Herscu Laboratory


This is the fifth, and so far, shortest, piece of writing on this current epidemic. Please read Part 1, Part 2, Part 3 and Part 4 for context and also, please read my other writing on this site for a larger context on the overall topic of public health and epidemics.

LASTLY, I am going to deliver a presentation this coming Saturday, March 7th at 3:30 pm at Bastyr University in Kenmore, Washington. This topic is part of a broader course we teach there, but this lecture will be on how to understand and address epidemics in general and this one in particular. Due to the current environment, this lecture is open to all. Join us if you can. For more details and to please RSVP: http://tinyurl.com/herscu

 2019 Novel Coronavirus (2019-nCoV; COVID-2019)
:

Comments I shared here over the past weeks remain true and are seen in the writings coming from across the globe. I want to focus on why this is of utmost importance to you and your patients!

There are three specific short points.

First, I am both really sad to hear that someone died of this disease in the United States, and that the gentleman who passed away yesterday worked at a nursing home. The highest mortality rate is in the older population and while he was only in his 50s, the folks he worked with are older, putting them at more risk. This is one of the first times I am very worried for them. Related, it is highly likely that many more people in that community will test positive for the virus over the next weeks. This places importance on healthcare worker knowledge and appropriate action.