COVID SURGE IN ARIZONA SOME HIDDEN ANSWERS
FROM THE ADHS.GOV
18 June 2020
"This morning at nine, we’ll be updating our COVID-19 data dashboard. Today, the Centers for Disease Control and Prevention (CDC) will be changing how they display data about cases and deaths on their dashboard, and ADHS will be changing ours to reflect this update. On our summary page, we will be breaking out confirmed and probable cases and deaths for COVID-19. Both confirmed and probable cases and deaths are included in our overall case and death count.
On the Summary section of our dashboard, we will display information about the total number of cases, as well as the breakdown by confirmed and probable cases. The view on this website will still show the information about the total number of cases and deaths of COVID-19 in Arizona, but when you hover your mouse over the number of cases or deaths in the Summary section, the breakdown will appear. In the same Summary section, clicking on a county of interest will filter the results in the summary boxes by county.
A confirmed case is defined as a case with a positive diagnostic test (PCR) reported to public health. A probable case is a case that doesn’t have a confirmatory diagnostic test but meets certain criteria that allow public health to classify it as a case. These criteria can include a positive serology (antibody) test and symptoms consistent with COVID-19 or a symptomatic patient with no diagnostic test that is a close contact to a confirmed COVID-19 case. This is consistent with the national recommendations for COVID-19 surveillance and reporting introduced by the Council for State and Territorial Epidemiologists (CSTE) and adopted by CDC. A small percentage of our total cases, approximately 1%, have been identified as probable cases.
A confirmed death is a death that has had a positive diagnostic (PCR) test reported to public health. A probable death is one that hasn’t had a positive diagnostic test but the physician cited a COVID-related cause as their cause of death. We started adding these deaths to our data counts at the beginning of May as a result of recent guidance by the National Center for Health Statistics (NCHS) on how states should certify deaths due to COVID-19 using death certificate surveillance. Approximately 7% of Arizona’s deaths have been identified through this process.
It’s important to note that the classification of cases is a surveillance tool used to better understand the burden of disease in the community. While this distinction is important for public health professionals during our investigation, it does not change the clinical care these patients are provided or the diagnosis provided by their health care provider. Public health case classifications are used for all reportable communicable diseases, including COVID-19, and ADHS maintains a case definitions manual, updated annually in conjunction with CSTE and CDC updates, to document the criteria for these classifications. In the case of COVID-19, confirmed and probable cases are given the same public health guidance and recommendations and are asked to self-isolate to prevent the spread of disease."
Cara M. Christ, M.D., M.S. became Director for the Arizona Department of Health Services in May 2015. Dr. Christ has served the agency for more than nine years. Among her many accomplishments at ADHS, Dr. Christ collaborated with health partners and stakeholders to develop strategic plans for infectious disease prevention and control including the Governor’s Council on Infectious Disease Preparedness and Response. She was involved in leading statewide efforts during the 2009 H1N1 pandemic, and worked with partners to find solutions to improve childhood vaccination programs. In 2012, Dr. Christ managed the development and implementation of 20 Articles of Arizona Administrative Code for Health Care Institutions allowing integration of physical and behavioral health services statewide. Dr. Christ obtained her master's degree in microbiology with an emphasis in molecular virology and public health. She earned her Doctor of Medicine from the University of Arizona College of Medicine. Follow the Director on Twitter @DrCaraChrist.
Up-to-Date Corona Virus Help
Great Summary of What to Look For and What To Do
Get answers and help. Also, read on. Some of your questions may be answered.
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To quickly review your symptoms use this interactive link: Coronavirus.gov or Self-Checker link
Warning: loss of smell or taste or blue or red spots on toes is considered an early sign.
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Hydroxychloroquine Controversy
Controversy over Hydrochloroquine is politically driven. Headlines that pose to summarize findings from various research are used to influence public opinion. The sensational warning that Hydroxychloroquine side effect of prolonged Q-T interval, an electrical anomaly that can cause fatal cardiac rhythms, is extremely rare. [Irodalmi adatok alapján a hidroxiklorokin extrém ritkán okoz hosszú-QT-szindrómát. >> Based on literature data, hydroxychloroquine extremely rarely causes long QT syndrome. See references on my home page]. Reversible nausea while taking the drug is the most common side effect. Damage to the retina is not found with hydroxychloroquine. Chloroquine, which is no longer in use, has this notoriety.
There are a number of so-called, FDA approved "off-label" drugs, prescribed under the discretion of a patient's physician to treat the symptoms of coronavirus. Evidence of safety and efficacy for one such drug is an anti-malaria drug called Hydroxychorquine has what is called "anecdotal" efficacy to reduce severe symptoms and help people recover from Covid-19 with a 60-100% success rate have been reported by doctors who have used this drug with their patients depending on the severity of the infection and comorbidities. These results are from clinical studies under the compassionate-use guidelines from the FDA. Please note that the three-phase double-blind clinical trials, the gold standard for drug approval, are expensive and take months to years to complete.
Hydroxychloroquine is an extremely low-cost generic version of Plaquenil and has been prescribed safely for 30 years as an anti-malarial drug for travelers and in malaria-prevalent countries like India, for longterm use to reduce the symptoms of lupus and rheumatoid arthritis. Hydroxychloroquine is used for up to 5 days is being used preventatively by first responders, early stages of coronavirus positive patients and in hospitals in hotspot cities like New York, New Orleans, and Los Angeles.
Call my office, 480 284-5240, to find out if Hydroxychloroquine is right for you.
Remdesivir was also being used in the critical care setting in hospitals can damage the liver and cause kidney failure. Double-blind clinical trials have been terminated due to these irreversible side effects.
All drugs have common and uncommon dangerous side effects. Only your doctor, who is trained to read and understand research, and uses clinical assessment tools can determine if medication of any kind is right for you.
Convalescent Plasma Infusions
The only known consistent results to relieve Coronavirus-19 symptoms is the intravenous administration of the antibodies contained in the plasma of people who had the illness. In other words, if you have overcome Coronavirus-19, (confirmed by lab testing), your plasma contains antibodies against Covid-19 and can be transferred to your loved ones who are very sick with this infection. To my knowledge, this is not yet being done because there are not the numbers to constitute large scale double-blind testing for safety and efficacy to implement this labor-intensive procedure.
Only serum antibodies directed against Covid1-9 can stop the disease. Compassionate use of the serum containing antibodies from COVID-19 survivors is being used by Mayo Clinics throughout the US. Donor serum is currently being tested and may become available by this summer. Serum antibodies will be commercially produced to contain antibodies against Covid-19.
As a licensed physician in the state of Arizona, I can prescribe Hydroxychloroquine to my patients. Required is a comprehensive assessment that can now be done on a Telemedicine call will determine if Hydroxychloroquine is right for you. Contact my office to arrange a Telemedicine call appointment. It is as easy as opening a browser to be conversing live in the comfort of your home.
A 15-day Self-Isolation Program issued by the White House Coronavirus Task Force, applies to everyone (as of March 22, 6 days into this guideline), This tactic will drastically impact the course of the infection by Covid-19. See the CDC published guideline here: CDC Coronavirus Fact Sheet.
Among the assembly of experts at the White House Coronavirus Task Force, which is headed by Vice President Mike Pence includes the Director of the Center for Disease Control, (CDC), Dr Robert Redfield Jr, an American virologist, and chief medical advisors, Dr Anthony Fauci, (MD an immunologist and recipient of the Presidential Medal of Freedom in 2008), Dr Deborah Birx, an HIV researcher, (former Director of US Military HIV Research Program).
If you have either been exposed to someone who is sick or if you have been in gatherings larger than 10 people, you are especially responsible to heed these guidelines.
You can interrupt the exponential growth of the spread of this very aggressive virus by virtue of time for it to die off and no longer be on surfaces and in the air as well as keeping people away from each other who might be carriers or have obvious disease. A new study reported by Bill Bryant, Acting Homeland Security Under Secretary of Science and Technology, reported results of a study on the effects of heat, summer sunlight and humidity on the half-life of coronavirus 19.
https://www.c-span.org/video/?c4871125/user-clip-outdoor-sunlight-amp-isopropyl-alcohol-kill-covid-19-virus-warm-moist-weather-research
Laundering or putting your mask in the direct sunlight from the sun will eradicate the virus.
It makes sense to get plenty of sunlight, staging exposure to your skin to prevent sunburn, and fresh air as these Naturopathic guidelines have always been the hallmark of a healthy lifestyle and immune system support.
As more testing becomes available, self-quarantine for people already infected and sick or recently exposed to someone who is infected and people isolated from those not yet infected and asymptomatic carriers can be given drug therapy or the vaccine (the vaccines will still take a year and a half to be available), will help us dominate control over the coronavirus pandemic. See the FEMA website for test availability updates. Click here -> FEMA.gov
A vaccine is currently being tested and perfected and can be available by the Fall season, as long as Covid-19 doesn't mutate too quickly, the vaccine can prevent the spread to those not infected.
Stem cells are the most anti-inflammatory cell made in your body. There is emerging evidence that stem cell therapy can reduce lung damage and interrupt the cytokine storm responsible for people needing respirators. See link below about the NIH Clinical Trial.
What you can do
Slow the infection rate during the spring flu season
Heed the White House Task Force Coronavirus guidelines.
Wash your hands when touching contaminated surfaces. Clean surfaces with sanitizer cloths provided at grocery stores. Use disposable gloves and remove after touching doorknobs, shopping carts and public surfaces. Note: if you are wearing gloves while taking things off the store shelves you are potentially contaminating the very products you will take into your home. If you are already sick stay at home, isolate for 14 days after symptoms are completely gone.
If you are sick, wear a mask when coughing or cough into your clothed elbow. Note: disinfecting surfaces at home will help prevent spread to others at home, (aerosolized droplets from your breath especially coughing land on floors and surfaces). For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective. CDC about disinfecting and cleaning
If you are well, stay home, venture out only to shop for necessities and keep your distance (6-feet is optimal) The big deal about the Corona Virus-19, (Covid-19), infection is that it is more virulent than other viral infectious diseases, like influenza. Covid-19 can be transmitted from surfaces, airborne up to 30 minutes, as well as person-to-person from infected people whether or not they sneeze, cough or talk. Its contagiousness is owed to its typical insidious onset. In other words, people can be infected by others already carrying the virus without symptoms. WHO Q&A on coronaviruses (COVID-19)
If you have already fully recovered from Covid-19 your serum containing antibodies against Covid-19 can be used to help others who are sick. Contact me for updated information.
Boost Your Immune System - if you are not sick
Staying at home and home cooking may save you from getting sick. Make mustard-rosemary or oregano rubs for lamb, veal or beef roasts. These herbs have powerful antiseptic properties that have naturally protected people for years.
Get Your Raw Data SNPs Read
People with ACE2, MBL (Mannose-binding lectins) genetic SNPs may be more susceptible and should avoid contact with sick people and be more vigilant with nutrition and supplementation to boost their immune system
Supplements and diet for prevention
Grapefruit Seed Extract, Larch Arabinogalactan, Vitamin D, Mannose-binding lectin foods - Stinging Nettle Root, Urticaria dioica root, aloe, Elderberry flower; fresh crushed garlic, leeks, taro can be incorporated in recipes.
These herbs are customized in Traditional Chinese Formulas to treat various stages of infection: Andrographis herb, Isaditis root, Coptis, Scutellaria and Phelladendri roots, Chrysanthemum, Lonicera and Forsythia flowers, Fritillaria bulb and Trichosanthis fruit
Contagiousness
Touching your face with contaminated hands is instantaneous. Detectable for 3 hours in aerosol (in room air). Surface survival: up to 4 hours on copper, up to 24 hours on cardboard and up to 2-3 days on plastic and stainless steel. Note Reusable plastic shopping bags are major vectors called "fomites."
Course of Illness
The course of illness varies widely from person to person. Once a person has been infected the virus tricks the immune system while it infiltrates the body especially the lungs without severe symptoms for up to a week. People's experience is as little as malaise and feeling unwell to tidal fevers, high at night and normal by morning to low-grade fevers, cough from post-nasal drip to cough from the chest.
There can be as little as no illness symptoms to unfamiliar fatigue and just not feeling right, to spikes in a fever that go down like a roller coaster for days along with intermittent cough and feeling like you have the flu.
During this time the virus may be also attacking the kidneys, the liver, the heart, and the fetus if you are pregnant. It particularly is dangerous to people who's immune system or lungs are already compromised as with lung disease like asthma, COPD, diabetes, and heart failure,
Children are not immune, they catch it as easily when exposed in households where a family member is already sick, but typically weather milder symptoms and shorter course of illness.
In groups studied in China, the incubation period after exposure to COVID-19 was 4.8 days. They noted that 95% of those who develop symptoms did so within 14 days. Right now, and changing rapidly, simply self-isolation with surveillance of any emerging symptoms is the main prevention. About 90% of the individuals had either very mild or moderate symptoms, and only about 10% were severe. Of these, a small percent die. From Annals of Internal Medicine
Of those in the surveillance cohort, about 30% of the contact-based surveillance group did not have a fever, and 20% had no symptoms at all. The period when death occurred was between 35 and 45 days after onset. The duration depending on the person's ability to heal can be up to 3 months. Transmission is possible during incubation when there are no symptoms, (4.8 days after exposure) through the entire time of illness. Definitive zero sheddings of the virus is after two consecutive swab tests negative, 24 hours apart.
Cytokine Storm poses the greatest risk to permanent scarring to the lungs, Respiratory Distress Syndrome requiring ventilator and oxygen assistance in the intensive care unit, death.
Cytokine Storm is the huge inflammatory response to Corona Virus-19, which makes the lung tissue itself swell (in tiny mini acute inflammatory reactions) gradually reducing the surface area of the lung tissue involved in carbon dioxide and oxygen exchange. The main symptom is increasing shortness of breath and feeling like you can't get enough air. Pulse oxygen percents drop as the lung tissue progressively swells. You can test your blood oxygen with a finger device that you can purchase for as little as $13. An oxygen percent below 92% should be treated immediately in the hospital intensive care unit.
Steroids are not helpful and can make the attack worse.
An anti-malaria drug in the form of "hydroxyquinone" which showed effectiveness in trials during the SARS-Covid pandemic, is now approved by the FDA for off-label use, is safe and can help the body cope with the cytokine storm, A few physician trials showed increasing survival and possible shortening the course of the infection by reducing the body's over-reactive immune system and swelling which would be blocking air exchange in the alveoli.
New monoclonal antibody drugs from the "Zumabs" class of drugs work to suppress the acute immune response seem to be effective in stopping the cytokine storm and are currently under clinical trial.
Resources
In Arizona, Poison Control is taking calls and screening your symptoms.
Poison Control +1 (844) 541-8201 is screening your symptoms and can direct you to participating testing sites as they are set up
Up to date spread John Hopkins University & Medicine https://coronavirus.jhu.edu/map.html
The best reliable and up-to-date worldwide and local tracking of this evolving pandemic is John Hopkins University & Medicine (https://www.hopkinsmedicine.org/coronavirus/)
John Hopkins University & Medicine Resource Center https://coronavirus.jhu.edu Interactive Map: https://coronavirus.jhu.edu/map.html
Evidence over hysteria -COVID-19
Clinical Trials using Stem Cells to treat Pneumonia
COVID-19 infection: origin, transmission, anc characteristics of human corona viruses.