• Will face masks protect me from COVID-19?
    “It is a misunderstanding to state that asymptomatic transmission globally is very rare” – the WHO has had to clarify its statements.
  • CORONAVIRUS: How long to self-isolate?
    How long do we self isolate if we are sick? This is an important question because it determines how long we have to stay isolated in a room in our house to protect others!
  • FDA Emergency Authorization: is Remdesivir a COVID-19 Treatment?
    This means remdesivir remains an investigation drug with no approved use, but because of the COVID-19 crisis, emergency use is being allowed to severely ill hospitalized patients.
  • Now should I wear a mask? Can I wash them?
    CDC recently recommended everybody wear a cloth mask in public. San Francisco announced Friday a general requirement for the public to wear face masks. To be safe and comply, let’s Discuss why the change in general face mask recommendations. How to safely reuse face masks. Can we wash them? We want to use methods that…
  • Is social distancing effective? When 6 feet is not enough – UPDATED
    UPDATE: many readers have pointed out the data from the cited simulation is a pre-print and has not been peer-reviewed yet. Many have cited an article in Vice condemning the media attention garnered by these researchers. I want to be clear the purpose of this post is to help reduce transmission risk by raising awareness…
  • Did it work? First randomized clinical trial of hydroxychloroquine in treating COVID-19
    We need to discuss the latest updates in COVID-19 treatment options given the “pre-release” results of a hydroxychloroquine intervention from a randomized clinical trial in Wuhan, China (not peer-reviewed). Note that this represents the “gold standard” evidence for medical interventions. I reviewed the first study outside of China using hydroxychloroquine in a previous post –…
  • How long can SARS-CoV-2 last in body specimens? 2 new studies.
    I wanted to share two recent studies that question our understanding of how long SARS-CoV-2 can live in various body specimens, both with and without humans actually displaying symptoms. Study 1) In Beijing, a small study of 16 mostly young, healthy, male patients showed positive viral PCR throat swabs despite symptoms resolution. Half (8 of…
  • Treatment success of Dr. Vladimir (Zev) Zelenko
    I’m sure many of you heard of this family practice physician in New York state who has reported 100% success in treating COVID-19 patients using a drug “cocktail”. I just want to clarify that his reports, while helpful, do not represent any rigorous clinical evidence for a COVID-19 treatment. Based on his open letter, it…
  • Convalescent plasma as COVID-19 treatment
    A new study from the Journal of the American Medical Association from China (reference below) reports the use of convalescent plasma as a treatment for COVID-19. What is convalescent plasma? It is a component of blood taken from patients who have recovered from COVID-19, meaning the blood has antibodies to SARS-CoV-19. The theory is that…
  • Can we quantify the success of social distancing? Yes! Is it worth it? Yes!
    Countries across the world are implementing social distancing. While it is common sense that distancing would decrease the rate of community spread of COVID-19, given the significant societal consequences, we should ask how “worth it” this approach is. While any modeling efforts have significant assumptions, most importantly, the basic reproduction number (R0), we can still…
  • Case Fatality Rate in Italy – Reasons for Overestimation
    Readers may start seeing news headlines about alarmingly high mortality rate in Italy. I want to explain why we think this number may (hopefully) be an overestimation of the true fatality rate. Let us first define what the case fatality rate (CFR) is: CFR = number of deaths with COVID-19 / number of COVID-19 cases…
  • COVID-19 Treatment Review
    @docintegrative COVID-19 Treatments? Please don’t call your doctor for any! ##medical ##COVID19 ##shelterinplace ##bayarea ##docintegrative ♬ Sum 2 Prove – Lil Baby Hello all, here is a timely review of COVID-19 treatments currently being investigated. Everything is still under investigation, but we have reason to be hopeful! Hydroxychloroquine (study underway in South Korea) Traditionally used…
  • Evidence of hydroxychloroquine and azithromycin: quick breakdown
    Much media buzz about these well known medications as possible COVID-19 treatments, particularly after an announcement by the president to increase availability. In short, evidence is only preliminary from a study in France: Design: non-randomized; controls were patients from a different center refusing the proposed treatment protocol N = 20 patients with adequate follow-up (treatment…
  • COVID-19 and pregnancy
    We do not yet know the exact susceptibility of pregnant women to infection, nor the chance of adverse pregnancy outcomes. Similar coronaviruses have been observed to result in miscarriage and stillbirth. First trimester high fevers can increase the risk of certain birth defects. Breastfeeding if infected? We don’t know if it’s safe, and it should…
  • Home test kits
    With the availability of tests increasing many are asking if they need to be tested. Short answer: home test kits are NOT recommended at this time. Why? Home kits may not be validated (what good is bad data?) Results are unlikely to affect your decisions (symptoms are more important than test results in guiding decisions…
  • What happened in Italy?
    Italy experienced a complete “lockdown” to control the rapid virus spread and significant morbidity and mortality associated with the contagion. We don’t know why Italy had such a severe reaction, but there are multiple likely explanations: Spread likely began before the first patient was formally identified (several severe pneumonia cases are suspected to have been…