Covid 19 is still widespread in the world. Countries including the US are pushing for another shutdown. Candida Auris is a new emerging multidrug-resistant fungus that is becoming a problem. The US elections are at complicated crossroads. Poland has tightened their abortion laws, citizens react in protest.
Global and US Covid Stats
Cases: 50,123,657 Deaths: 1,255,392
Deaths: 243,186 Recovered: 6,433,976
US Case Count
- Texas – 1,011,237
- California – 967,468
- Florida – 837,077
- New York – 562,036
- Illinois – 477,978
10/26 case count 1,364
-NY and IL have the most
Candida Auris is an emerging fungus that presents a serious global health threat. CDC is concerned about C. Auris for three main reasons:
- It is often multidrug-resistant, meaning that it is resistant to multiple antifungal drugs commonly used to treat Candida infections. Some strains are resistant to all three available classes of antifungals.
- Think of MRSA – methicillin-resistant Staphylococcus Aureus
- It is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management.
- It has caused outbreaks in healthcare settings. For this reason, it is important to quickly identify C. Auris in hospitalized patients so that healthcare facilities can take special precautions to stop its spread.
From the CDC website: “We don’t know if patients with invasive C. Auris infection are more likely to die than patients with other invasive Candida infections. Based on information from a limited number of patients, 30–60% of people with C. Auris infections have died.”
Hospital protocols for C. Auris
- No stethoscopes, equipment, or other items from outside rooms.
- Proper PPE (gown, gloves) Can’t enter without proper PPE for a “quick IV adjustment”
- Wipe down the work area with Oxivir or bleach x1 a shift. This includes IV pumps, computers, isolation cart & other services.
- No C-Auris patient should be paired with post-op patients, ECMO, CRRT, or other high-risk patients
- Wash your hands with soap, 20-sec scrub
How is it diagnosed?
- C. Auris infections are usually diagnosed by culture of blood or other body fluids. However, C. Auris is harder to identify from cultures than other, more common types of Candida.
- It can be confused with other types of yeasts, particularly Candida Haemulonii.
Who is at risk?
- People who have recently spent time in nursing homes and have lines and tubes that go into their bodies, such as breathing tubes, feeding tubes, and central venous catheters.
- Risk factors for Candida Auris infections are generally similar to risk factors for other types of Candida infections.
- Recent surgery
- Broad-spectrum antibiotic and antifungal use.
- Infections have been found in patients of all ages, from preterm infants to the elderly.
How do we treat it?
- Most C. Auris infections are treatable with a class of antifungal drugs called echinocandins. Some C. Auris infections have been resistant to all main classes of antifungal medications, making them more difficult to treat.
- In this situation, multiple classes of antifungals at high doses may be required to treat the infection.
- ⅓ people die due to complications caused by C. Auris
- C. Auris infections are more likely to die than patients with other invasive Candida infections.
- 30–60% of people with C. Auris infections have died. However, many of these people had other serious illnesses that also increased their risk of death.
How did it spread
- CDC conducted whole-genome sequencing of C. Auris specimens from countries in the regions of eastern Asia, southern Asia, southern Africa, and South America.
- Whole-genome sequencing produces detailed DNA fingerprints of organisms.
- CDC found that isolates within each region are quite similar to one another, but are relatively different across regions. These differences suggest that C. Auris has emerged independently in multiple regions at roughly the same time.
Poland Moves to Near Abortion
- Poland’s highest court ruled that abortions due to fetal defects are unconstitutional, moving the country towards a near-total ban on terminations and sparking angry protests in the capital Warsaw.
- Warsaw Mayor Rafal Trzaskowski said more than 100,000 people were in attendance.
- Police detained 37 people Friday, the vast majority of whom were football hooligans, Sylwester Marczak, spokesman for the Warsaw Police headquarter. Taking into account the huge number of participants, it was a “very peaceful” protest, he added.
- Around 98% of abortions in Poland had been conducted as a result of fetal defects, meaning the ruling bans virtually all termination procedures taking place in the country. It could force women to carry a child even if they know the baby will not survive childbirth
Hydroxychloroquine vs. Remdesivir The Verdict?
This is an interesting topic since it has been banned on social media from being posted. Hydroxychloroquine is a cheaper drug, can be obtained quite easily, and seems “safe” because it has been widely used for many years in the prevention of malaria.
Stephen Hahn, the commissioner of the Food and Drug Administration (FDA) on hydroxychloroquine. “A doctor and a patient need to assess the data that’s out there, FDA does not regulate the practice of medicine, and that in the privacy of the doctor-patient relationship is where that decision should be made.”
The price difference between Hydroxychloroquine vs. Remdesivir
The cost for hydroxychloroquine oral tablet 200 mg is around $37 for a supply of 100 tablets, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.
Gilead Sciences set the price for remdesivir, its antiviral drug that can shorten hospitalization stays for individuals ill with coronavirus disease 2019 (COVID-19) from SARS-CoV-2 infection, at $520 a vial, or $3120 per patient for a typical treatment course, for those with private insurance.
The price of those not covered by private insurance will be $390 per vial. A treatment course is 6 vials. The FDA approved the drug for emergency use in some patients and the company has applied for full approval.
The real story of Remdesivir
New information by Public Citizen estimates that taxpayers have contributed at least $70.5 million to develop the drug, nearly double a previous public estimate of $37.5 million. Initially tested by Gilead as a hepatitis C treatment, Remdesivir was refined, developed, and evaluated by federal scientists for Ebola and coronaviruses.
The research outlined below demonstrate how the U.S. Army, the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH)/National Institute Allergies and Infectious Diseases (NIAID) either conducted or funded much of the preclinical and clinical development of Remdesivir (formerly referred to as GS-5734)
Small sample but showed promising results for macaques monkeys. 2 samples of 6 monkeys in each. One was given IV Remdesivir the other one has a placebo. The study showed that Remdesivir monkey had
- Less respiratory disease
- Reduced virus replication in the lower, but not upper respiratory tract
- Decreased viral loads in the lungs
- Reduced pneumonia
A double-blind study examined the effectiveness of Remdesivir in 538 patients vs 521 in the placebo. The Remdesivir group had:
- Quicker recovery time, 11 vs 15 days
- Less mortality 7.1% vs 11.9 %
53 patients were given Remdesivir and results showed promising favor for Remdesivir.
- Clinical improvement was observed in 36 of 53 patients (68%)
- Including 17 of 30 patients (57%) receiving mechanical ventilation who were extubated
- 25 patients (47%) were discharged
- 7 patients (13%) died
An observational study in a cohort study of 1061 pts with COVID – 19 treated with hydroxychloroquine and azithromycin. Mean age was about 44
- Good clinical outcome and virological cure were obtained in 973 patients
- A poor clinical outcome was observed for 46 patients (4.3%) and 8 died (0.75%)
- Five patients are still hospitalized
- 98.7% of patients cured so far
412 started treatment with hydroxychloroquine and azithromycin and 224 refused
Medications. The mean age was 62.5. The patients were suspected to have COVID19 infection.
- Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group
- Showed that early use of hydroxychloroquine reduces hospitalization need.
Sample of 36 people where 20 were treated with hydroxychloroquine and 16 were the control. Smaller sample, unfortunately.
- At day6 post-inclusion, 70% of hydroxychloroquine-treated patients were virologically cured compared to 12.5% in the control group eventually reaching 100% clearance.
- Both HCQ and RDV were shown to inhibit the in-vitro growth of SARS-CoV-2.
- HCQ co-administered with azithromycin provides a virological cure and low mortality with no cardiac toxicity
- RDV shortens time to recovery but without any significant mortality benefit
These results show that both drugs have a positive impact on fighting COVID-19. All 6 studies above demonstrate results that both drugs show clinical improvement and inhibit the in vitro growth of COVID-19.
The Clean Network Program to Safeguard America’s Assets
Spearheaded by Secretary of State Michael Pompeo, the Clean Network Initiative was launched to little fanfare in early August. These programs are rooted in internationally accepted digital trust standards and built upon the 5G Clean Path initiative, announced on April 29, 2020, to secure data traveling on 5G networks into U.S. diplomatic facilities overseas and within the United States.
It would mean no Chinese apps in US app stores, no US data stored on the Chinese cloud, and no US apps on Chinese smartphones.
The five new lines of effort for the Clean Network are as follows:
- Clean Carrier: To ensure untrusted People’s Republic of China (PRC) carriers are not connected with U.S. telecommunications networks. Such companies pose a danger to U.S. national security and should not provide international telecommunications services to and from the United States.
- Clean Store: To remove untrusted applications from U.S. mobile app stores. PRC apps threaten our privacy, proliferate viruses, and spread propaganda and disinformation. American’s most sensitive personal and business information must be protected on their mobile phones from exploitation and theft for the CCP’s benefit.
- Clean Apps: To prevent untrusted PRC smartphone manufacturers from pre-installing –or otherwise making available for download – trusted apps on their apps store. Huawei, an arm of the PRC surveillance state, is trading on the innovations and reputations of leading U.S. and foreign companies. These companies should remove their apps from Huawei’s app store to ensure they are not partnering with a human rights abuser.
- Clean Cloud: To prevent U.S. citizens’ most sensitive personal information and our businesses’ most valuable intellectual property, including COVID-19 vaccine research, from being stored and processed on cloud-based systems accessible to our foreign adversaries through companies such as Alibaba, Baidu, and Tencent.
- Clean Cable: To ensure the undersea cables connecting our country to the global internet are not subverted for intelligence gathering by the PRC at hyper-scale. We will also work with foreign partners to ensure that undersea cables around the world aren’t similarly subject to compromise.
Momentum for the Clean Network program is growing. More than thirty countries and territories are now Clean Countries, and many of the world’s biggest telecommunications companies are Clean Telcos. All have committed to exclusively using trusted vendors in their Clean Networks.
The United States calls on our allies and partners in government and industry around the world to join the growing tide to secure our data from the CCP’s surveillance state and other malign entities. Building a Clean fortress around our citizens’ data will ensure all of our nations’ security.
5 Most Common Nutrient Deficiencies
Remember, supplements are never a substitute for a balanced, healthful diet
While it’s possible to get most of them from a balanced diet, the typical Western diet is low in several very important nutrients.
19–50 years: Male 8 mg Female 18 mg Pregnant 27 mg
Iron is an essential element for blood production. About 70 percent of your body’s iron is found in the red blood cells of your blood called hemoglobin and in muscle cells called myoglobin. Hemoglobin is essential for transferring oxygen in your blood from the lungs to the tissues.
According to WHO Iron deficiency is one of the most common nutrient deficiencies in the world, affecting more than 25% of people worldwide.
The most common consequence of iron deficiency is anemia, in which the number of your red blood cells and your blood’s ability to carry oxygen drops.
- Pale skin
- Cold hands and feet
- Brittle nails
- Weakened immune system
- Impaired brain function
Two main sources of iron
- Heme iron – This type of iron is very well absorbed. It’s only found in animal foods, with red meat containing particularly high amounts.
- Found in red meat, organ meats, shellfish, canned sardines.
- Non-heme iron – This type, found in both animal and plant foods, is more common. It is not absorbed as easily as heme iron.
- Leafy greens; kale, spinach, broccoli
Tip: Vitamin C can enhance the absorption of iron. Eating vitamin-C-rich foods like oranges, kale, and bell peppers alongside iron-rich foods can help maximize your iron absorption.
The daily value (DV) for iodine is 150 mcg for adults and children aged 4. The upper limit is about 1,100 in adults before toxicity can occur however it is rare.
Iodine is most commonly associated with the thyroid. People with iodine deficiencies are prone to having hypothyroidism. What many people don’t know is that when you have hypothyroidism you most commonly will develop a goiter. A goiter is an enlarged thyroid. In hypothyroidism tour TSH is high and your T3 and T4 are low.
Signs and Symptoms
- Fatigue and weaknesses
- Weight gain
- Hair loss, dry and flaky skin
- Trouble learning or remembering
- Feeling cold all the time
Main sources of iodine
- Seaweed has the highest concentration of iodine, 1 gram of kelp has over 500% of the daily value
- Fish: about 3-4 ounces can provide about 50-60% of DV
- Dairy: about 1 cup of plain yogurt can get you 50% of the DV
- Eggs: about 1 large egg can get you 16% DV
Vitamin D intake is recommended at 400–800 IU/day or 10–20 micrograms. However, some studies suggest that a higher daily intake of 1000–4000 IU (25–100 micrograms) is needed to maintain optimal blood levels.
Vitamin D is a fat-soluble vitamin that functions like a steroid hormone in your body.
It travels through your bloodstream and into cells, telling them to turn genes on or off. Almost every cell in your body has a receptor for vitamin D.
Vitamin D is produced from cholesterol in your skin upon exposure to sunlight.
Unfortunately, about 42% of the US population is vitamin D deficient with some populations having even higher levels of deficiency, including premenopausal women, those with poor nutrition habits, people over age 65, Caucasians who avoid even minimal sun exposure, and those who take prescription medication long term.
Symptoms of Vitamin D are not noticeable and take years to develop. Adults who are deficient in vitamin D may experience muscle weakness, bone loss, and an increased risk of fractures. In children, it may cause growth delays and soft bones (rickets)
The best source of Vitamin D is sunlight. Supplemental can be found in Cod liver oil, fatty fish and egg yolk. One large egg yolk contains 7% of the DV
Note that screening for Vitamin D deficiency is not part of the standard protocol in the US
Vitamin D & COVID
There is historic evidence that vitamin D supplementation prevented past respiratory virus pandemics. Molecular mechanisms of vitamin D action can prevent respiratory viral infections and protect against ARDS. Vitamin D’s direct effect on the renin-angiotensin-system (RAS), which in concert with additional effects, can modify host responses thus preventing a cytokine storm and SARS-CoV-2-induced pathological changes.
The study, titled “Estimated Inactivation of Coronaviruses by Solar Radiation,” looked at how effective UVB rays had been at inactivating coronavirus at various locations around the world.
90% or more of SARS-CoV-2 virus will be inactivated after being exposed for 11-34 minutes of midday sunlight in most US and world cities during summer.
Recommended DV of vitamin B12 for people above the age of 14 is 1.8 – 2.4. B12 should be slightly increased during pregnancy and lactation.
Vitamin B 12 is a water-soluble vitamin responsible for red blood cell formation, brain function, and nerve function. Vitamin B12 is found in animal food, this is why it is important for vegetarians and vegans to take a vitamin B 12 supplements.
It is interesting to understand that vitamin B12 is absorbed differently and it needs a protein called intrinsic factor. People that lack this need to get B12 injections or higher doses of B12.
Signs and Symptoms
- Megaloblastic anemia: blood disorder that lowers your RBC count while enlarging the RBC itself
- Fatigue, weakness
- Weight loss, loss of appetite
Main sources of Vitamin B12
- Shellfish: 3 oz of clams accounts for over 1000% of DV
- Organ meats: about 2oz of the liver has 1000% DV
- Meats: 6oz of beef can offer over 100% of DV
The DV of calcium of adult and children above the age of 4 is 1,300 mg
Calcium is essential for every cell in your body. It mineralizes bones and teeth, especially during times of rapid growth. It is also very important for bone maintenance.
Vitamin D helps with the absorption of calcium and phosphorus.
What many people don’t know about calcium is that it is also a signal molecule. Without calcium your heart can’t beat, your muscles can’t contract or relax, and your nerves can’t communicate. Your calcium is regulated in the blood if you have too much it is stored in your bones, if you have too little it is released from your bones.
Signs and Symptoms
- Osteoporosis: think of porous bone. Calcium gets pulled from the bone leading to weak and brittle bones
- Rickets: softening and weakening of bones in children
- Brittle nails, numbness in hands and feet
- Muscle spasms and cramps
- Changes in HR and rhythm and blood pressure
- Increased incidence of fractures
Main Sources of Calcium
- Boned fish. One can of sardines is about 40% of DV
- Dairy: 1 cup of milk is about 33% of DV
- Dark leafy greens: 1 oz of kale has about 5% DV
Blood types and COVID-19
Researchers compared Danish health registry data from more than 473,000 individuals tested for COVID-19 to data from a control group of more than 2.2 million people from the general population. Among the COVID-19 positive, they found fewer people with blood type O and more people with A, B, and AB types.
The study results suggest that people with blood types A, B, or AB may be more likely to be infected with COVID-19 than people with type O.
- A greater proportion of blood group A or AB patients required mechanical ventilation and CRRT compared with blood group O or B patients.
- Biomarkers of renal and hepatic dysfunction were higher in blood group A or AB patients. In our subcohort, there were no differences in serum inflammatory cytokines.
- The data indicates that critically ill COVID-19 patients with blood group A or AB are associated with an increased risk for requiring mechanical ventilation, CRRT, and prolonged ICU length of stay compared with patients with blood groups O or B.
Antibodies are in plasma blood Type
- Your blood type is a way to categorize your blood according to what’s in it: antigens, including the Rhesus, or Rh, factor.
- Antigens are a type of protein on red blood cells. Based on the type of antigen, your blood will be categorized as Type A, Type B, Type AB, or Type O.
- When antigens come into contact with substances that are unfamiliar to your body, such as certain bacteria, they trigger a response from your immune system. The same type of response can occur during a blood transfusion if your donor’s blood type doesn’t match with yours. In that case, your blood cells could clump and cause potentially fatal complications.
- The Rh factor is also a substance on the red blood cells. This is where the + and – signs next to your blood type come into play. If you have the Rh factor, you are considered Rh positive (+), and if you don’t, you’re considered Rh negative (-).
- The rhesus protein is named for the rhesus monkey, which also carries the gene, and is a protein that lives on the surface of the red blood cells. This protein is also often called the D antigen. When it comes to blood transfusion, anyone who is Rh positive can receive blood from someone who is Rh negative, but those with negative blood types cannot receive from anyone with a positive blood type.
- Important especially during pregnancy. This is because the mother’s and baby’s Rh status need to match, or the mother’s immune system may react as if it’s allergic to the baby. Severe cases of mismatched Rh status can lead to diseases such as anemia or brain damage in the baby. In the most severe cases, it can even be fatal.
- Group A: This blood group has A antigens and B antibodies.
- Group B: This blood group has B antigens and A antibodies.
- Group AB: This blood group has A and B antigens and no antibodies.
- Group O: This group doesn’t have either A or B antigens, but it has both A and B antibodies.
Crossmatching is a way for your healthcare provider to test your blood against a donor’s blood to make sure they are fully compatible. It’s essentially a trial transfusion done in test tubes to see exactly how your blood will react with potential donor blood.