Coronavirus in perspective.

7/9/2020: To date there have been 544,739 deaths due to the coronavirus.

To put this in perspective see the following from:

Influenza A is one of the deadliest infectious diseases in human history, and it can be ranked equally with the bubonic plague in the ability to create large-scale fear and terror despite the great effort of humans to control it.1-3 From the first outbreak in 1918, called the “Spanish flu” and caused by the H1N1 strain, influenza A has killed 4 to 5 times more people than the number of casualties in World War I.

The following site estimated 50 million died, one-third of the world’s population at that time.

In 1957, the Asian flu, caused by influenza A H2N2, began in China and spread around the world, killing 1.1 million people in total.3

Ten years later, a new strain of H3N2 lead to the eruption of a new pandemic called the “Hong Kong flu” that caused the death of 1 million people.3

In 2009, the strain that caused a deadly pandemic in World War I returned with a new type called H1N1pdm09; the result was approximately 575,000 deaths.3 Along with the deadly strains that infect humans, other strains, like H5N1, cause problems that can indirectly and catastrophically effect humans.4 The H5N1 outbreak appeared in Vietnam in 2003 when a massive avian infection led to the forcible killing of poultries, crippling the agriculture industry.4

Le KP, Do PC, Amaro RE, Le L. Molecular Docking of Broad-Spectrum Antibodies on Hemagglutinins of Influenza A Virus. Evol Bioinform Online. 2019;15:1176934319876938. Published 2019 Sep 16. doi:10.1177/1176934319876938.

Any relevance to Today?

This ancient proverb may have some relevance today.

Cursed shalt thou be in the city, and cursed shalt thou be in the field.

Reference for the proverb, causation and the conditions thereof upon request.

Consider the Source

5/23/2020: Considering the Source is more important today than ever before. There seems to be more agenda driven information, hidden agenda stuff, conspiracy theories, deception, deceit and out right lying than ever before. One does not have to look very far for confirmation.

This has forced me to return to the common denominator; consider the source. I want to learn about the source and “where are they coming from?” Knowing the source allows me to put in perspective the information. Most false information has some plausible factual basis weaved into the story line. This serves as the “hook” to get us to buy into the argument. Discernment is necessary to avoid advancing to the “line and sinker” stage, the response the author is seeking.

We are searching for the “truth of the matter”. Interestingly, the ancient literature indicates that truth is a person. (John 14:6) Truth is not the end result of reason or scientific research. It is a person; really? Test the hypothesis and settle this for your self.

Jerry Sloan; one of my first famous athlete patients

5/22/2020: I saw in the press that Jerry Sloan, famous basketball player passed away.

He was one of my first famous athlete patients to undergo arthroscopy in the mid 70’s. I remember it well as I was lecturing at a meeting in Chicago suburb and his agent arranged for me to come down town and perform a diagnostic arthroscopy under local anesthesia. I did not tell anyone where I went and as my custom I created no publicity. I forgot about it until today.

Malaria Drug? Yes or No?

5/22/2020: Malaria drug; yes or no? The results are based upon patient selection, the common denominator of medical treatment.

That is why reports and opinion are widely diverse on the use of hydroxychloroquine; yes or no. The latest today in very respected journal: Lancet.

The conclusion was no benefit and in fact worse results than not using it.

The subjects (research word for patients) were all sick enough to have been placed in the hospital. They were not patients who showed early symptoms of coronavirus infection. Those so sick they are hospitalized: NO!

Those treated early in the disease get a YES when this is the patient selection criteria.

Allow me to give you an analogy. Aspirin has been reported as beneficial as a preventative for heart disease. Aspirin is not the primary treatment for a patient hospitalized in heart failure.

Michigan Governor’s Folly Continues

5/21/2020: Michigan governor’s response to the Midland flood is that she will sue the responsible party.

Guess who? The State of Michigan who has oversight and determined the structure was sound.

The following responsible party information from:

“Following the federal government’s 2018 license revocation, the Michigan Department of Environment, Great Lakes, and Energy (EGLE) took oversight of the dam, which involved temporarily lowering the lake by 7 feet.[11] EGLE determined that the dam was structurally sound.[12]”

“[12] Erin Ailworth; John D. Stoll (May 20, 2020). “Failed Michigan Dam Lost License in 2018”. The Wall Street Journal. Retrieved May 21, 2020. After its license was revoked by FERC, regulation of the Edenville dam was taken over by the Michigan Department of Environment, Great Lakes and Energy in 2018. Spokesman Nick Assendelft said the agency inspected the dam in October 2018 and found it structurally sound.”

Incomplete data analysis on Coronavirus Incidence

5/20/2020: The incidence of coronavirus cases are increasing because the frequency of testing is increasing. That should not be surprising nor unexpected. The magnitude of the condition is not reported; asymptomatic or symptomatic patient, just positive or negative test.

The incidence of coronavirus cases with hospital admissions are high perhaps for this contributing reason.

Reimbursement has always been the name of the game in medical economics. Now there is bonus money for coding as COVID-19 for billing purposes. Medicare will pay hospitals a 20% “add-on” to the regular DRG payment for a billing coding of a patient with the new government COVID-19 billing codes.

Medicare has determined that a hospital gets paid $13,000 more if a COVID-19 patient on Medicare is admitted and $39,000 more if the patient goes on a ventilator with the coronavirus diagnosis.

This is in addition to the base reimbursement. What you incentivize you will get more of. Ever wonder why the high incidence of COVID-19 patients?

The real numbers may never be known.