Members get a daily Covid-19 topic focused on Covid in Tennessee.
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Several things to talk about tonight: Convalescent plasma, and South Africa Covid quarantines.
First, I heard this morning about a preprint study of about 1,100 people randomized to placebo or convalescent plasma, but given early in symptoms.
So a little history from early-mid 2020 is in order. Back then, the FDA issued an Emergency Use Authorization for convalescent plasma to be given in severe Covid.
Recall that convalescent plasma is essentially a way to get antibodies against Covid that are being made by someone who has recovered from Covid and giving them to a person who needs them.
So let's review how we can have success when treating viral diseases such as Covid and influenza. In order for any treatment to work against a virus, it must be given very early in they symptomatic phase of the illness, or after exposure but before symptoms. (This discussion is not about HIV or Hepatitis C, as they can now be treated quite successfully well into their chronic phase.)
We know this. We've known this for many years about influenza.
And we found it to be the case with monoclonal antibodies.
But health care "authorities" managed to forget it in the context of Remdesivir (an antiviral widely given in severe Covid, with minimal success), and in the context of convalescent plasma.
But, lo and behold, the light came on a couple of years into this plague and some Johns Hopkins researchers decided to do an RCT correctly on a perfectly logical early treatment, and, wonder of wonders, it worked, cutting hospitalization by 50% in the treatment group.
With big antigenic shifts such as the omicron variant, early treatment with convalescent plasma is more likely to match current variants than a monoclonal antibody preparation targeted to the early variants.
This study, now in preprint, had a treatment protocol that administered treatment or a placebo in patients with less than 8 days of symptoms, similar to how monoclonals have been used.
So I'll keep watching this development.
Our inability to do effective things early is a big part of our death toll, in my opinion. I hope that we're going to see more sensible treatment protocols soon. Between abysmal management of testing availability and usefulness, and treatment protocols that ignored any early treatments, I blame bureaucracy more than the virus for much of the death toll.
And in South Africa, quarantine is going away for asymptomatic patients with positive tests, and people with known Covid exposure. Omicron has apparently ended their pandemic. I hope we are a few weeks behind them on the same road.
Stay healthy!
I'm on a weekend night call schedule this weekend, which always leaves me feeling under-rested and generally icky.
But I wanted to remind you that outdoor exercise without screens is really good for your mental health.
Go outdoors, preferably into the woods.
Get in tune with those surroundings, the sights, the sounds, the smells, even the movement of air and the varying temperatures as you walk.
We were made to be outdoors.
We were definitely not made to work in cubicles.
One Degree!
What you want from your body will dictate what you need to set as goals, and the goals will determine what you'll end up having to change to attain them.
I've spoken many times about systems being better than goals, and my position has not changed.
But goals are easier to discuss and to understand, so for this week, we'll be very specific about goals.
Do you want more muscle mass?
Do you want to be stronger?
Do you want to run faster?
Do you want to gain weight?
Do you want to lose weight?
Do you want to improve general fitness?
Do you want longevity?
Do you want strong bones?
Do you want to earn a Black Belt?
Understanding the benefits and costs of each particular goal may help you decide what you want.
For example, if you want to compete in body-building competitions, you'll not be doing the same thing as if you were focused on longevity. Same with strength competitions.
But general fitness and longevity go fairly well together.
Running is great but will increase the likelihood of needing knee or hip ...
I'll make this one short and to the point.
Spring time change is hard on all of us. Having to get up an hour early doesn't make going to bed an hour earlier much easier.
Yes, it's nice to have more productive time in the evening.
But it's at the cost of forcing us out of be an hour earlier, as we all know.
Our challenge is to adjust our circadian rhythm to match the world's expectations around us.
My main strategy is supplementing with a dose of melatonin about a half hour before I need to be asleep. It helps most people fall asleep more readily.
If you need a nap during your day, take it between mid-morning and early afternoon. Limit it to 20 minutes.
Taking a longer or later nap may make it even harder to get off to sleep in time.
All of the other normal advice applies even moreso:
- Take a 20-minute walk after supper.
- No screen time for the last hour before bed.
- Listen to calm music after supper.
- Don't eat for 2 hours before bed.
- Don't have conflict-laden conversations ...
