Sunday, April 26, 2020

Coronvirus - Test Your Knowledge!


Folks love quizzes and puzzles, especially now when most of us are spending most of our time hunkered down at home.  I had attempted to send one my kids a jigsaw puzzle that I ordered on line, only to discover a few weeks later that the item was out of stock.  Apparently, like hand sanitizer and foster dogs, jigsaw puzzles are in very high demand.

Scarcer than toilet paper.


In an earlier phase of my life, I prepared ‘quizzes’ that were passed around on holidays and family dinners when guests competed for valuable prizes such as stickers, packs of gum and other treasures that are sold at dollar stores.   Not only were these experiences ‘fun for the whole family’, but they were effective educational tools.   Ask a Kirsch kid even today whose portrait is on the $50 bill or how many neck bones are inside a giraffe’s neck, and he or she (I hope) will nail it.

So today, I will offer readers a lighter fare.  Here’s a coronavirus quiz based on recent news reports.  Rely upon your knowledge and judgment.  To relieve your performance anxiety, I have made this a True-False examination.   I could have constructed a multiple choice and even included an essay question, but my generous nature prevailed.  Good luck!
  • Coronavirus takes its name from Corona beer as the virus was first isolated in brewer’s yeast.
  • Coronavirus is named after Rosie, the Queen of Corona, who refused to practice social distancing and contracted the virus.  Julio, who wore a mask, escaped infection.
  • Gargling with Lysol. and followed by a Mr. Clean chaser. kills the coronavirus and also rids the body of various harmful germs and toxins.
  • Anthony Fauci takes a dose of valium before and after the daily Coronavirus Task Force press conferences.
  • Vice-president Mike Pence has shown America that he has a spine of steel.  He is his own man.   
  • Deborah Birx’s scarves are impregnated with a potent antiviral agent, which is the main ingredient in Ty-D- Bol toilet bowl cleaner.
  • President Trump’s scientific knowledge has been credited for the sudden spike in applications to college engineering programs.
  • Masks are for sissies.
  • 4 out of five dermatologists surveyed no longer recommend any sunscreen.  UV light wipes out coronavirus even better than Chlorox.
  • It has been inspiring to witness the seamless and harmonious cooperation between the state and federal governments.  

So, how did you do?  Scores of 80% or higher are prize worthy.  Of course, since we are in the midst of pandemic, you will have to settle for virtual trophy. 





Sunday, April 19, 2020

When Should We Open the Economy after Coronavirus?


In the weeks ahead, there will be growing tension between forces wanting to open up the economy and those who demand that we hold the line.  And no one can tell us now when it will be okay to pull the trigger.  It is so much easier to endure a challenge if there is a firm end date to focus on.   In this case, not only is there no clear trigger-date, but there will never be agreement on when it will be acceptable to pull back.  I’m no expert, but here’s a brief list outlining the complexities of this conundrum.
  • Public health experts will disagree on the economic relaxation date.
  • Corporate leaders will likely favor a sooner and broader opening of the economy.
  • Governors will have diverging views from national leaders about what actions their state should take.
  • Businesses who are not permitted to open may howl and protest as competitors are given a pass.
  • Can schools, for example, be reopened while we are still urged to maintain social distancing?
  • Will the nation accept being told that we are opening up the country when in reality only scattered pockets are being permitted a gradual loosening of restrictions?
  • What happens when COVID-19 rates rise as the economy is revived?   Will we have the tools and the will to do what is necessary?
  • As difficult as it has been to shut down the economy, it will be a much harder and longer process to bring it back to life. 
  • Will we be told, and will we accept, that we will not be able to return to the status quo ante?
The decision of when and how to open the economy will always involve risk.  Doctors and medical professionals understand this reality.   We may advise a patient that there is a choice of surgery or continued medical treatment, and both options have risks.  If we open up the country too soon, we risk a resurgence of the virus and a squandering of what we have accomplished.  If we wait too long until the last remnant of the virus has been vanquished, then we may have no economy left to resurrect.

A Cure for Termites?


If a house has termites, we can cure the infestation by burning the house to the ground, but would the homeowner celebrate this victory?

We will have to balance serious risks in an evolving situation with endless moving parts with no playbook to refer to and disagreements on how to proceed among experts.  Would you like to be making the decision? 




Sunday, April 12, 2020

Chloroquine and Hydroxychloroquine for COVID-19?

Kindly refer to the article linked below explaining my great concern over the massive hype over these 2 medicines that many are perpetuating.    MK

https://www.cleveland.com/opinion/2020/04/chloroquine-for-covid-19-not-for-this-doctor-michael-kirsch.html

Sunday, April 5, 2020

CDC Advises Cloth Masks for Everyone. Why Now?


I haven’t seen so many masks since I was a Trick or Treater.  Even as a physician, I have worn surgical masks very rarely as it was uncommon for me to be in an operating room, where masks and gowns are part of the dress code.  Until I embarked upon a transition to telemedicine recently, many of the patients coming to see me in the office were masked.

The official dogma on wearing masks during the pandemic is evolving. Experts at the Center for Disease Control and Prevention (CDC) the World Health Organization (WHO), the Surgeon General as well as many prominent public health officials had advised just recently that masks were not an effective barrier against coronavirus.  This is why asymptomatic individuals were not advised to mask up.  In contrast, we were told that these masks should be worn by symptomatic individuals who were coughing or sneezing as masks may reduce the risk that others will become infected.

Just days ago, there was a sudden change in policy.  Now the CDC and many of the president's advisors and others are recommending widespread cloth mask use to keep those who are silently infected from transmitting the germ to others. The WHO has not signed on to these revised recommendations. While it is still true that cloth face coverings are not likely to protect a healthy individual from infection, the hope is that such a barrier may prevent a asymptomatic infected individual from spreading the virus.  It's not clear to me why the revision was issued now as we have known for months that asymptomatic individuals can spread the infection.  The explanation for the policy change has been murky  


Could there be a downside?


It is confusing when an important safety recommendation undergoes dramatic and abrupt revision, particularly when there is already endemic anxiety.  The public needs consistent messaging.  It is unsettling when organizations, experts and government officials have different opinions on what precautions we should take.

Here are some of my concerns about widespread use of cloth face coverings:
  • Frequent adjusting of the cloth covering by new users will increase hand to face contact, which is a sure method of coronavirus infection
  • Individuals, despite CDC advice, may use medical grade masks which should be reserved for medical professionals
  • False sense of security of masked folks who may relax their social distancing practices, which every expert maintains is our paramount strategy to flatten the curve and save lives
  • Symptomatic individuals who should be at home might feel that a mask will allow them to enter out into the community risking transmission as they may believe that they are less infectious
  • Will mask wears know how to carefully remove the mask when they return home, clean it after every use and wash hands well when placing and removing the mask?
Don't misunderstand me.  I'm not qualified to opine on the wisdom of the policy.  I do think that the abrupt policy change and mixed messaging is confusing.   And, I don't think it's quite as simple as slap on a mask and all will be well.  I offered above a listing of some of my concerns that I do not think have been sufficiently considered or publicized.  .  
I worry that the expanded attention and use of masks may distract us from two measures that every expert unwavering insists upon.   Keep your distance consistently  And wash your hands often and thoroughly as if you have just touched the virus. 


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