Monday, February 3, 2020

2019 Novel Coronavirus (2019-nCoV): Part II

2019 Novel Coronavirus (2019-nCoV):
February 2, 2020 update Part 2
Paul Herscu ND, MPH
Herscu Laboratory

This is the second piece of writing on this current epidemic. Please read Part 1 for context and also, please read my other writing in this site for a larger context on the overall topic of public health and epidemics. For this epidemic, I will keep the sections consistent.

First Things First. The Immune System with Relation to the 2019 Novel Coronavirus (2019-nCoV)

Over this period of days, we have seen more and more articles from medical journals moving in the direction previously highlighted. Both focusing on your immune system, and highlighting that people who had worse outcomes were people who already had a disease burden that made them susceptible. This will remain true. Supporting your immune system to be the most efficient and effective it can be remains important and is a place where you and your patients have some control. Today! Read what Dr. Rothenberg and I mentioned here last time.

2019 Novel Coronavirus (2019-nCoV):

Comments I shared here last week remain true and are seen in the writings coming from across the globe. I want to focus on why this is of outmost importance to you!

Wednesday, January 29, 2020

2019 Novel Coronavirus (2019-nCoV):

January 27 2020 update Part 1
Paul Herscu ND, MPH
Herscu Laboratory

In writing about epidemics over the past 3 decades, my first goal has been to create information scaffolding for readers so that you have sound context to receive and understand the bombardment of information about any epidemic. If you want a broad and deep understanding of the concept of epidemics, which I strongly suggest, take some time to review the highlights here.

First Things First. The Immune System with Relation to the 2019 Novel Coronavirus (2019-nCoV)

In understanding a patient’s reaction to the 2019 Novel Coronavirus (2019-nCoV), it helps to think of the challenges it presents as twofold. First there is the damage that the virus causes by itself upon the body. Secondly, and perhaps more importantly, there is the damage, which may be lethal, which is caused inadvertently by one’s own immune system responding to the virus.

This is a very important point to highlight. Though the virus is particularly virulent at this moment, not everyone dies. It is thankfully, only a very small fraction of those exposed who perish. There is an additional small fraction that become quite ill, and the rest become ill in a usual flu manner. And for some people, the damage that the immune system causes upon the individual, is perhaps worse than the insult caused by the bug itself.

There are different professions that have focused, since their inception, on supporting the immune system, and helping patients develop an appropriate immune response. Naturopathic physicians form one such profession. To be clear, this is not to claim that we have experience with the killing of this virus. What we do have, for over a 100 years, is a great deal of experience with helping the immune system respond appropriately, read: not over-respond or under-respond, to certain situations. And while the germ has its own virulence, which I discuss below, what I want to highlight is that helping the immune system develop an appropriate response is paramount. This is something we can support our patients doing and do for ourselves. While on the one hand this is a lifelong exercise for everyone, there are some things to do right now. 

The simplest one is to make sure that your immune system is not being stressed by other illnesses. In other words, try to get other chronic ailments under good control. In most years, those with prior chronic illnesses are more at risk of a lethal form of any influenza or virus than those that were previously healthy. Please see Dr Amy Rothenberg’s writing on how to help here, including diet, botanical, nutritional supplements, sleep, etc. By so doing, if exposed to this virus you will hopefully suffer a lesser course of the disease rather than the lethal course. This part is within our control. To be sure this will not be enough by itself, absolutely not enough, but it will help! It’s not nothing!

While this has been the main domain of naturopathic physicians, most other medical professions have also taken up this call. Homeopaths since the time of Hahnemann, osteopathic physicians, chiropractic doctors and increasingly medical doctors are offering whole-person, natural medicine modalities  as non-pharmaceutical interventions for some of our most troubling chronic conditions, focusing on appropriate immune response. This is important work overall and becomes even more important during times of epidemics.

Highlights of Writing on Epidemics by Paul Herscu ND, MPH

In 2004, I wrote that I was taking a hiatus from epidemic updates, until and if there were to be a serious reason to write again. I was running myself down with work and family and late night reading and research on epidemics. To say that I had to stop my hiatus almost as soon as it started is not an exaggeration. I have followed these world and local events closely for three decades and most often delineated the steps that should be taken, often weeks to months before they were finally adopted. We have so much to understand about the way epidemics arise and what best strategies for treatment are. 

Naturopathic Recommendations

The 2019 Novel Coronavirus (2019-nCoV)
Amy Rothenberg ND

The 2019 Novel Coronavirus (2019-nCoV) was first identified in the Wuhan province of China late in 2019. Genetic analysis of 2019-nCoV is in process to confirm the origin of this virus, likely from animals. Historically, SARS, another coronavirus, originated with civit cats. MERS, which also impacted humans, arose from camels. There has also been noted person to person spread of these various Coronaviruses. For the current germ, symptoms vary greatly from mild respiratory illness, fever and cough, to more severe symptoms like difficulty breathing and death. According to the CDC, symptoms can develop 2-14 days after exposure. There is currently no vaccine for 2019-nCoV.

Here are basic concepts to help avoid exposure and exposing others to any virus including this one:
  • Avoid large crowds and places with poor ventilation.
  • If you cannot avoid such places, use a properly fitted mask, though research on some more commonly used masks lacks efficacy. Regardless, if using a mask, change frequently as they harbor bacteria. 
  • Prioritize handwashing more often, with soap and water for twenty seconds, especially before eating. 
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Use alcohol-based hand sanitizers when handwashing is not possible.
  • Limit handling doorknobs and other public surfaces without gloves. If in the midst of a severe epidemic, consider using gloves whenever outside to limit contact. Wash gloves daily. 
  • Avoid people who are sick.
  • Cover your cough or sneeze with a tissue and discard or sneeze into your bent elbow.
  • Please stay home if you are sick!

Monday, January 6, 2020

Upper Respiratory Tract infections during the first week of 2020 (Part II)

January 6, 2020 
Paul Herscu ND, MPH 
Herscu Laboratory

These three observations involving the current viral illnesses follow last week’s observation. Please read those first here:

Tuesday, December 31, 2019

Upper Respiratory Tract infections during the last week of 2019

December 31, 2019
Paul Herscu ND, MPH
Herscu Laboratory

There are three specific observations I would like to make now, involving the current viral illnesses.

The first involves what is likely the common cold. Unlike the cold that I reported on a few years ago which led to numerous first time asthmatic crisis, in people who did not previously have asthma, this one seems to mostly present in the common fashion. What is unique about it though is how bad It is. The symptoms that we see are a runny nose, mostly with a bland clear discharge, a great deal of frontal sinus pressure, which leads to a congestive headache, extreme weakness, wiped out, exhausted, and some body aches. Low fever of 99-I00.5. In many ways, this is a slightly altered version of the remedy Gelsemium. My main comment here involves what happens after you take Gelsemium. Most often when you take the remedy at this time, the next day it appears as though ‘nothing happens’. You are still sick. And this is why I want to highlight an error here.

But first, as background, here are some numbers for what is typically found in the common cold, what the natural progression is:
1.     Fever can last up to 7-9 days.
2.     Sore throat can last up to 9 days
3.     Cough can last 2 weeks and even more.
4.     Runny nose can last 2 weeks and even more.
5.     The body aches can last 10 days to a couple of weeks.

Tuesday, January 22, 2019

Epidemic Update January 2019

January 22, 2019
Paul Herscu ND, MPH
Herscu Laboratory

Well, this is turning out to be an extremely busy winter season! There are several influenza-like-illnesses, as well as influenza, currently raging through the US and Europe. This is just a short update, building on many previous pieces written on this topic. I write here with an assumption that you understand the topic of the genus epidemicus (see Herscu Letters #33-38 to review the topic of the genus epidemicus,) the difference between acute and chronic prescribing at any given time in your patient, and of course that you know how to keep your patients safe. 

Currently, there are several common presentations: