Tag Archives: Opinion

Covid-19: ‘mRNA Vaccine – How It Works’ (Video)

Its decision time for Covid vaccines, especially for 88-year olds. The choice is among live-attenuated vaccines, whole virus vaccines, Split virus vaccines, and RNA vaccines, and I prefer the latter because of its simplicity. It delivers just the mRNA coding for covid spike protein, without the risk of a live vaccine, and the extra substances in whole and split- virus vaccines.

mRNA utilization for a vaccine is not new technology. The idea has been floating around for decades in cancer immunotherapy research. The sophisticated understanding of the technology is reassuring. It has a high efficacy, approaching 95%. Between the Pfizer and Moderna mRNA vaccines, I prefer the Moderna vaccine, because the Company was already working on a mRNA platform for MERS, a Covid-family virus, and has developed their own lipid capsule as a vector.

The Moderna vaccine does not require the extremely low storage temperatures like the Pfizer product. With all production located within the company, Moderna will be ready to go if a new strain nullifies covid 19 vaccines, or if another virus spreads worldwide. Timing is important. The mRNA vaccine requires 2 doses. I intend to take the first Moderna dose when I can get it locally without standing in line.

Since I intend to continue Masking and Distancing until the cases in my community are low, I will probably delay the second dose until summer, to increase my likelihood of effective antibody levels this coming fall and winter. Also, there will be more information by that time on the Vaccine’s effectiveness and duration in the Elderly.

The pathogenicity of the English, or any other newly mutant strain will be hopefully known by Summer. The rapid Covid test using sputum, and outpatient treatment with monoclonal and convalescent antibodies for early cases will then be available. I want a treatment plan in case I get infected. This is a treacherous, nasty infection.

–Dr. C

Dr. C’s Journal: ‘Mutation’

Mutation is engrained in the very nature of life. Even if there were no X-rays, free radicals or toxic chemicals, mutation still would take place because of errors in the replication of DNA that occasionally escapes the proofreading mechanisms of meiosis and mitosis.

The majority of germline mutations produce LOSS OF FUNCTION, and are weeded out by evolution. In vertebrates, mutation is vital in producing the random changes in the DNA of germ cells of the ovaries and testes. If the mutation is beneficial, involving a GAIN OF FUNCTION, environmental selection acts to preserve the change, producing the diversity of organisms in the world, each exploiting a different environmental niche.

It is the rare species so versatile, like the shark, that can remain almost the same over eons without dying out. In the teeming unicellular world, mutation in the genome is similarly useful in allowing for variations which often prove useful for survival. The mutations thrive if the proper environment presents itself. For instance, antibiotic resistance may be encoded in a few members of a bacterial species, which become the dominant members in an infected patient on antibiotic treatment, and crowd out family members without the mutation.

In Viruses, RNA is often the Memory nucleotide. RNA is less stable than DNA. The resulting instability allows more mutations, and sometimes greater success. An example is the English Covid variant in the spike protein which leads to greater contagion. Hopefully, the spike protein change will not be so successful as to interfere with the effectiveness of vaccine-produced protective antibodies.

The Mutations we have been discussing refer to GERMLINE mutations, which occur in the gonads. In higher animals, germline mutations affect the offspring, which then carry the mutation. A GAIN OF FUNCTION mutation may confer greater adaptability and survivability, and perhaps may lead even to a different species, if the troop number is small and the environment demanding. Non-germ SOMATIC cell mutation may lead to undesirable effects like cancer, which is another discussion.

–Dr. C

‘INFECTIONS’: HOW WE EXPERIENCE INTERACTIONS WITH MICROORGANISMS

The RNA molecule is central to life. It is the information molecule of the Pandemic SARS CoV 2 virus, whose Messenger RNA specifying Spike proteins is the basis of 2 recently-released vaccines.

“RNA Life” is the leading theory for the Origin of Life itself, more than 3 Billion years ago. DNA evolved as the blueprint information molecule in cellular life, but the ubiquitous RNA may well have become the first viruses.

The stage was set for the ongoing battle of life: Parasite vs. Host, Pathogen vs. Target, but recent research reveals a much more nuanced picture. Viruses and bacteria can be BENEFICIAL as well as deleterious. We now speak of the MICROBIOME, usually referring to our host of resident BACTERIA, and the VIROME referring to all of our indwelling VIRUSES.

INFECTION is how we experience our interaction with microorganisms, their benefits unseen. Bacteria, viruses and parasites have always been with us, increasing in impact as Paleolithic man crowded into agricultural settlements.

Enlarging cities became more dense, favoring spread of infection and PLAGUES. The Bacterium, Yersinia Pestis,emerged in Roman times,
causing the Justinian plague, and resurfaced in the 14th C. as the Black Death. Viral Plagues, including Smallpox, were devastating during European adventures into the New World.

Malaria, a one-cell Eukaryotic Parasite, may be the greatest killer of all time. Modern Sanitation and improving medication have lately pushed bacterial infections into the background.

Viral infections such as Influenza and most recently Covid have become the Modern face of infection. Many Viruses reduce Immunity, however, paving the way for bacteria to invade: Haemophilus influenzae, a bacterium, may have caused much of the mortality of the 1817-1918
Flu epidemic.

IV drug usage has facilitated the spreading of the viruses causing Hepatitis and AIDS. The immune-compromising nature of the latter has reinvigorated TB and Syphilis, both bacterial infections. Only a few years ago, bacterial infection was thought to be conquered by antibiotics, and viral infection contained by Vaccines.

Microorganisms are constantly evolving, however, and often share their resistance factors. Infection is no more a thing of the past than War. The Battle continues.

–Dr. C.

DR. C’S JOURNAL: VACCINES, ADAPTIVE & INNATE IMMUNE SYSTEM AND HERD IMMUNITY

The adaptive immune system is the “big gun”, later evolved, big brother of the innate immune system. The innate immune system acts a little like prejudice does in society. There is INSTANT RECOGNITION of a salient characteristic of many common disease-producing organisms, that are not present in the person being infected.

For instance, ENDOTOXIN is a lipopolysaccharide present in many bacteria, and is immediately recognized by Toll-like Receptors (TLR-4) on dendritic cells and macrophages. This triggers the Natural Killer (NK) cells to destroy the invader. The problem is that the innate immune system is indiscriminate, reacting against whole classes of molecules like a shotgun, and may produce unwanted damage. It also fails to recognize many genuine threats.

The ADAPTIVE immune system is more complex, discriminant, and SPECIFIC, but is SLOWER to gear up, and takes several days to be effective. Once engaged, however, it has a MEMORY for the infection that is SPECIFIC to the organism involved. This memory makes a SECOND EXPOSURE response much more rapid and comprehensive, AMPLIFIED as it is BY ANTIBODIES.

This first experience can be PROPHYLACTICALLY accomplished by VACCINES, so that the second, real exposure generates a RAPID PROTECTIVE RESPONSE. ATTENUATED vaccines are weakened, but LIVING ORGANISMS, and usually provide a more DURABLE immunity, but because they are living, they are more worrisome.

SPLIT-PRODUCT Vaccines are safer, but expose the immune system to a narrower range of pathogen markers, and may therefore be less Protective.. The FDA is very dedicated to SAFETY. Like all Bureaucracies, it is relatively independent of Political pressure, of which I am increasingly appreciative.

When the COVID-19 VACCINE, for example, is released to the general public, it WILL BE SAFE. The vaccine-deniers are mis-informed people who should not, in my opinion, be allowed to interfere with the HERD IMMUNITY that comes with having a supermajority of the population vaccinated.

— Dr. C.

DR. C’S MEDICINE CABINET: “OVERVIEW OF METABOLISM”

“Life is nothing but an electron looking for a place to rest”.

Albert Szent-Gyorgy

Overview of Metabolism – Seeing an Essence of Nanosystems in the Hum of a Vibrant City; the Skyscraper as Catalyst, and Thought as Electron

What did it take to bring the world to its’ knees? SARS-CoV2? We will never know, because we instituted DISTANCING to control the virus because the projected number of deaths were unacceptable.

The distancing and isolation did hold the number of deaths, still large, below projection. However, it DEVASTATED our Economy.

OUR WORLD is a  massive, cooperative, interdependent system, with hubs, factories, supply chains and a myriad of products. It is a COMPLEX SYSTEM.

I would like to use the world as an analogy, and compare it to another Complex System, the HUMAN BODY.

Our bodies are essentially a large pile of chemicals (mostly proteins) in a sack, our skin. These chemicals are constantly interacting with each other. If they grow to larger, more complex chemicals in a process we call anabolism, we take in more chemicals and energy by eating, and get bigger. If our chemicals get less numerous and complex in a process we call catabolism, we lose weight and get smaller.

Some of the proteins in our bodies are ENZYMES, and bring other proteins CLOSER TOGETHER, so that they can LINK TOGETHER  become more complex and PRODUCE things. Enzymes are a sine qua non of life. Without enzymes, life would slow so much as to be impossible. 

Let’s go back to our Society, Before Covid. 

Vast numbers of people are cooperating in close proximity, working together with machines, often supplied by other people far away, making things. This process takes place most efficiently in CITIES, where people are in closest proximity, doing things together.

Enter Covid. This interdependent process stops. What things that are produced are made to fight Covid. It is just like one of our cells infected by Covid: we have been HIJACKED  by the virus!

Lets’ GO BACK TO OUR CELLS. Our METABOLISM is like our teeming, cooperative CITIES, with SUPPLY CHAINS, factories and products. Our PROTEINS NEED PROXIMITY to function.

Some Proteins are at a critical HUB, and comprise a RATE-LIMITING step in the production line.

Many Vitamins and nutrients are COENZYMES, and act to ACCELERATE critical supply lines.

If the Hubs are OUT OF BALANCE and OVERACTIVE, many MEDICATIONS act to BLOCK THE ACTION of an enzyme to bring the system closer to balance.

Thus coordination, cooperation and careful monitoring to PREVENT A PROBLEM is superior to letting it break down and correcting the imbalance.

I hope that this Overview will be helpful. I will go through my MEDICINE CABINET to discuss a few of the 20,000 or so Medications approved by the FDA. I will also VIEW THE TEST RESULTS from my LABORATORY TESTS. NORMAL results show a SYSTEM IN BALANCE. Abnormal results show inefficiencies in the metabolism (supply chains, hubs), which need correction to restore balance.   

— Dr. C

OPINION: FACE MASKS AND SHIELDS TO PREVENT COVID

My main exercise for the day is a 45 minute fast walk around my community.

Hat – check. Sunglasses – check, FACE SHIELD – check.

Yes, face shield. The shield has the advantage of allowing me to talk, plus being more comfortable to wear. I clean it with a woolen cloth on one side and cotton on the other, hoping for a condenser electrostatic effect (I’m open to suggestion from engineers).

If I cough, any large particles of mucus would impact the shield, leaving only tiny aerosol particles to escape around the edges into the environment to endanger others.

It is Saturday today, and I pass a man and a woman pushing a baby buggy, and give them wide berth. I don’t consider 6-feet far enough distancing. 12-18 feet would be better, since, at 88-years of age, I am at least 2-3 times more susceptible.

A 12-year old zooms by me on a scooter. His age predicts less viral effluent, and the exposure time is less. I then go by a large collection of 20-year olds, Wide berth again, and, holding my breath, continuing to walk fast.

As I walk, I breathe air in through my nose, and out through my mouth. I feel the warmth (and purity) of the exhaled air, which may push aside and dilute any contaminants coming from the outside.

Another group of young adults! Well, maybe the risk is not as bad as the numbers would indicate. Odds are there would be only one spreader in the group, and the healthy ones would act as particle filters for me.

So far, not a single young person had a mask on. They are probably just thoughtless young people, and not necessarily “objectors” believing that mask-wearing is a sign of submission. As Peggy Noonan said in her column in today’s WSJ:

“…IT’S A SIGN OF RESPECT, RESPONSIBILTY AND ECONOMIC ENCOURAGEMENT”.

Going forward, we must all do our part to reduce the likelihood of another Covid surge. WEARING A MASK PROTECTS OTHERS.

I finally spied 2 masks! They were fitted on 2 ceramic lions flanking a front door. It is true that felines can catch Covid. But ceramic ones?

I thought I was walking fast, but was overtaken from the rear by a long-legged young lady. She passed within 4 feet of me, and of course had no mask on. I only hope she didn’t have Covid, and that my shield worked.

On the subject of the effectiveness of wearing a shield, while walking I tune into the odors along the way. I use the odors as surrogate aerosols, especially a recently fertilized curbside flower bed, I compare walking by the flowers, with and without my face shield, and find that the shield reduces but does not eliminate the odor. For more distant odors, like a barbecue, it does not make a difference.

Perhaps the shield, like the prow of a ship, pushes aside STREAMS of particle-laden air. Like coughing or talking nearby. But if the particles (yes, odors are nanometer particles) are well mixed with the air, there is no effect. Air must be breathed, after all.

There are a couple of other things I practice on my walk. I exercise my EYES by looking into the DISTANCE as much as possible. I try to walk as erect as I can. Gravity, my friend in grounding many big Covid-containing mucus particles, tries to bend me over.

The BOTTOM LINE, until more information is available), is: SPREADERS WEAR MASKS, SUSCEPTIBLES  WEAR SHIELDS. Of course, hand-washing, social-distancing, coughing into your elbow, and staying at home, especially if sick, are all still important admonitions.,

-Dr. C.

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THE HEALING POWERS OF YOUR POSITIVE ATTITUDE

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

From “Do Not Go Gentle Into That Good Night” by Dylan Thomas

My brother recently sent me a video  featuring a confident man with a famous last name and a winning message: You beat Covid by fighting it. I would like to comment on several recommendations in his inspiring speech.

It is usually best to approach a problem with a POSITIVE ATTITUDE and a PLAN (1). This is particularly true with the ravages of old age (my area of expertise). Memory loss? Try to memorize poems. Balance loss? Practice standing on one leg. However………….

One person’s good experience is not a medical study. Medicine calls it a testimonial. This applies to my individual experiences as well. Going forward, I will be recounting many personal experiences with common diseases and conditions. Be careful about applying my solutions to your condition.. EXERCISE CRITICAL THINKING.

Be especially careful not to equate fame with medical expertise.

Mr. Cuomo’s result, if indeed the outcome was changed by his efforts, was most likely influenced by a powerful PLACEBO effect (2) which can be associated with striking outcomes, as we know from countless inspiring testimonials  of “hopeless” cancer and other terminal conditions.

Even if we KNOW a treatment is likely due to the placebo effect, it remains effective. I don’t believe I’m doing harm with my speculations.

A couple of generations ago, confidence in doctors was much greater than it is now. We had fewer effective treatments, but surprisingly good results. As medical information of various quality proliferates and medicine loses prestige, it it is losing a valuable tool. Still, we have the placebo effect.

Mr. Cuomo was fortunate to have a good, positive doctor, and to believe in him. Positive affect is powerful.

FEVER is not the virus incarnate, but the bodies RESPONSE to the virus. Fever survived the culling of evolution because it confers a survival advantage, and is helpful.(3) Viruses replicate less rapidly at higher body temperatures.

I always told my patients: “ if you are stuck with the infection, enjoy the fever”. Of course high fevers, above 104 degrees F should be reduced.

I’m not sure that Covid patients should hold their breaths to “fight the virus”, although the length of time you can hold your breath is a good measure of breathing difficulty.  Blood CO2, the main driver of dyspnea (shortness of breath), must not be allowed to accumulate. The accompanying hypoxemia (low blood oxygen ) is not desirable either.

I agree with most of the advice quoted by Mr. Cuomo. Lying on the back has proven dangerous in severe Covid. Taking deep breaths (even if painful) will help keep the alveoli (air sacs) expanded. Change of position is important for the same reason,  and adequate fluids, including water, is always beneficial.

So educate yourself as much as you can about your condition. Pick out the best doctor you can find (the subject of a future opinion piece) and place yourself in her care. Enjoy a sense of relief and confidence. Even physicians need the objectivity and support of their own doctor.

Finally, armed with a positive attitude, make the most of whatever placebo effect you are accorded.

—Dr. C.

OPINION: THE BENEFITS OF HIGHLY NUTRITIOUS DIETS

Vitamins and minerals, as we all know, are of critical importance to our health. Gone are the days when scurvy(vitamin C) was the scourge of the high seas, and rickets (vitamin D) was common in the children of smoke-filled industrial cities with insufficient sunlight.

We are in a state of such overabundance that many medical authorities feel that vitamin supplementation merely makes our toilets healthier.

Covid 19, with a deficit of prevention and treatment options, has forced a new appreciation of the role of our immune systems in fending off Covid, and future viral plagues that are certain to follow. Optimum Health has never been more important.

A May 4, 2020, British Medical Journal (BMJ) article highlights the role of vitamins C and D, and minerals, especially Zinc, in functioning of our immune systems. Here are several highlights from the article:

  • Foods that are naturally abundant in vitamin C such as broccoli (60 mg/100 g), blackcurrants (130 mg/100 g), fortified breakfast cereals (up to 134 mg/100 g) and oranges (37–52 mg/100 g)45  should be made accessible to older individuals who are most in need of their nutritional benefits.
  • In the UK 5.5% of men and 4% of women 65 years and over (around 1 in 20) presently have zinc intakes lower than the lower reference nutrient intake (the level below which deficiency could occur).46 The consumption of foods naturally abundant in zinc such as canned crab (5.7 mg/100 g), canned shrimps (3.7 mg/100 g), canned adzuki beans (≈2.3 mg/100 g) and boiled eggs (1.3 mg/100 g) should be encouraged as a supplementation strategy to reinforce immunity.
  • Tolerable upper intake levels (ULs) are intake levels which should not be surpassed as toxicity problems could appear.47 For vitamin D a UL of 50 µg/day is advised and for zinc a UL of 25 mg/day is recommended. 47 There is insufficient evidence to establish UL for vitamin C, but available human data suggest that supplemental daily doses of up to about 1 g, in addition to normal dietary intake, are not associated with adverse gastrointestinal effects.47 Not having an adverse effect, however, is not necessarily indicative of a benefit either, and ongoing trials are warranted.
  • Among those with established respiratory conditions or pneumonia, specific nutrients such as vitamin C, D or zinc could be considered as potential adjuvants to conventional treatment pathways.

Susceptible people, particularly the old, should use every safe measure to stay well.

– Dr. C

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