Fever and Covid 19

Fever I believe could be a savior in COVID-19. 

Not all get fever when they get COVID-19. But for those who do what I have written below maybe life-saving. Please read it and if I can help in anyway let me know. 

130 years ago doctors got the first pill that gave them power to reduce fever when Bayer of Germany synthesized aspirin in 1890. 

Since then all have been treating fever first with aspirin then with Tylenol , ibuprofen etc. 

Since the time of Hippocrates it had been widely believed that fever was beneficial. Aspirin was new and it magically relieved fever AND pain. A firm conviction(without any specific research basis) soon took hold in doctors nurses and all humans that fever always needs to be reduced. Tylenol/Crocin also a fever and pain reducer was heavily marketed on TV and added to it. 

I have always believed reducing fever in infection routinely at the outset is almost always wrong. See my blog post from 2013 on this topic. Only for those with quite serious heart or lung or neurological disease and in infants is reducing fever warranted.

Fever is an ancient (600 million years) evolutionary response found in living beings that clearly helps fight infections. New research suggests that it also modulates the duration of the inflammatory response helping to turn it off. This latter becomes increasingly critical in a disease such as COVID-19.

I believe that not treating fever very well might be the difference between recovery from Covid-19 or it’s serious progression.

For myself in the first week of my own COVID19 illness. I have done the same for my 3 seasonal febrile flu like illnesses over the years. 

I would not take ANY fever reducing medication in the first 7 days of illness presuming all fever to be due to COVID-19 in this pandemic era.

Usual infections need to be kept in mind. Causes such as infections of skin, soft tissue, joints, bladder, lungs and acute abdominal heart or CNS infections come with symptoms and signs and labs that distinguish them from COVID 19. 

Benefits from high fever expected in COVID19 are

1) sustained fever of 102F increases production of INTERFERON the primary antiviral chemical our body makes. Fever ALSO helps turn off inflammation by modulating the HSR (heat shock response) a more recently understood part of our immune response. Ref available. 

2) FEVER helps ALL body systems fight infection by enhancing innate immunity. 

3)duration and degree of fever is a guide as to how illness is progressing. Lowering fever gives a false sense of security things have improved.

4) Fever makes us rest so reduces family and community spread. Ref available. 

5) PERSISTENCE of fever more than 100.4° F beyond 7 days in COVID 19 is of concern needing further evaluation. 

Other symptoms of concern can occur too. Please make sure you’re aware of details of Covid19 symptoms from the CDC or other sources.

When you leave fever in COVID19 alone in this way it generally stays continuously high 101 -104°. There is no reason to let the fever go above 103°F. Try to keep fever between 102 and 103°F with wet compresses as needed. This temperature is safe. Do not panic.

Take temperature frequently at least 4 -6 x day and night. RECORD. Trust me you will not remember what your temperature was the night before neither will your family. The daily highest fever level guides you as to your condition. 

Leaving fever alone is more comfortable than bringing temperature down with any agent (Tylenol or paracetamol Ibuprofen Crocin Aspirin etc etc ). It only goes up again and drains physically. You actually dehydrate more as you sweat profusely. The fever goes back up again and again as these pills wear off.

Cool compresses on forehead for comfort can be used. When the temperatures are high wet your skin from head to toe thoroughly with lukewarm water and lower your temperature easily. Do not use cool water so as to avoid shivering. 

Stay hydrated with fluid of your choice. I use water, coconut water or salted lime or lemon water. Keep track of fluid intake by counting of glasses/ bottles consumed.

Protocols for aspects of outpatient management other than fever are available from COVID-19 sites from various reputable medical institutions. I humbly but firmly disagree with the recommendation to reduce fever routinely that most sites state.

Stay safe.

If I can help in anyway please reach out to me. 

🙏🏽

Vinod Seth 

PS

Did you know that the Nobel prize for medicine in 1927 was given to an Austrian physician for fever therapy of an infection. This was prior to the availability of penicillin and fever therapy stayed the primary mode of treatment for dementia from generalized paralysis of the insane (neurosyphilis) for 20 years till penicillin.

PSS 

In the preantibiotic era fever was used as treatment in cases of pneumococcal meningitis in 3 patients. While no one survived dramatic reductions in CSF organism count was achieved. This paper was published in 1938. Reference available.

Facts vs judgement and empathy in doctors

Med students are made to study facts.
.........to regurgitate facts on demand.
.........are tested on facts.
So that becomes their goal in school.
On rounds the one who can regurgitate the most facts is commended.
In case discussion conferences fellows and faculty often are expected to do the same.

What thay need is to learn, judgement, discrimination, empathy and ethics.

That is difficult to teach .......to learn.......to model................to test.

So facts is where the focus remains.

Unfortunately facts in medicine change regularly, frequently.

Current system of medical education and training produces doctors who regurgitate facts on demand, score high on tests of old facts , believe those old facts and act decisively on that knowledge.

A focus on judgement is finally possible and very desirable in this era of vast amount of facts avaialable on finger tips.
Facts easy with iPads iPhone in hand and all the resources of the largest medical libraries just a tap away.
So ability to learn, research information, do a great history, physical eexam, develop decision making skills and judgement, learn ethics and spend time with patients and family so empathy for the sick becomes ingrained. is what
That is where medical school teaching should focus on, test on and 

Turmeric is good. Canadian Doctors studied curcumin presuming it was THE ONLY active ingredient

I am writing here about the recent New York Times article about the lack of efficacy for Turmeric in medical studies done in Canada in some surgical patients. What they had actually studied was Curcurmin in their patients with the presumption that curcurmin is THE active ingredient in turmeric responsible for all it’s beneficial effects.



The same mistake has been made in medical studies before wherein a natural product in this case turmeric is pooh-poohed when an ingredient that makes up less than 5% of the whole natural product -curcurmin is studied and the results are presumed to be applicable to the natural ingredient well accepted and known to be widely beneficial in Ayurveda in the first place. It is likely the reason curcumin was studied was that it has an enormous cost premium as compared to the natural turmeric powder widely available.



Two prior similar mistakes come to mind - walnuts and carrots



Walnuts consumption had been found to be helpful in some way for vascular disease. Medical doctors presumed that the active beneficial ingredient responsible for improved outcomes in walnuts was vitamin E. For many years doctors encouraged all to take over-the-counter vitamin E to help prevent vascular disease. That ended when subsequent studies showed no benefit of vitamin E. No one questions that walnuts are beneficial possibly Due to the omega-3 fatty acids in them.



The same story applies to carrots found to be beneficial in reducing certain cancers. In that case the active ingredient was presumed to be beta carotene which was subsequently studied and no benefit was found. The fallacy of presuming the nature of active ingredient in the natural product was brought forth again. I would like to remind the researchers in Canada of these two studies so that any further planned studies are done with turmeric powder rather than Curcurmin.



My goal here is also to help stop this confusion in the lay public. I believe the Canadian researchers are jumping to conclusions from lack of efficacy in their curcurmin study to questioning Turmeric’s many Long accepted beneficial effects.

My prediction in 2005 of decreasing lifespan in USA coming true

In August 2005 in a letter to the editor of the Washington Post I had brought up that life expectancy in America would be expected to drop. I was concerned about heavy consumption of trans fats in fast foods as well as most baked goods. To add to the toxic mix of transfat laden foods was consumption of liquid sugars in high calorie soda pop, energy drinks and juices. In my medical practice I had noticed more younger patients were being admitted to the hospital with serious infections then in prior years.


Increasing data over the last few years has corroborated my concern from 2005.


A recent study of 50 years of mortality data confirms that US life expectancy has not kept pace with other wealthy countries and is now decreasing. A significant increase in death rates in the prime years of life ages 25 and 44 is noted in ALL races. This study is by Stephen Woolf MD MPH and Heidi Schoomaker MAEd. JAMA2019(20):1996-2016. Eli:10.1001/jama.2019.16932

Search engine for $$ paid by Pharmaceutical Companies to your Doctor

Dollars for Docs

How Industry Dollars Reach Your Doctors

This is Pro Publica's search engine with data from over 2 million transactions in the public domain of $$ paid to your health care provider/ institution.

Use it to understand the consulting fees, meals, travel paid out. The data is part of the settlement from years ago that the drug companies agreed to furnish this data.

Pro Publica has put it in a much better searchable format.

Ask Doctor Vinod: McDonald’s Transfat Settlement Aug 24 2005- 2013 SUCCESS IN USA FDA MOVES TOTAL BAN

Ask Doctor Vinod: McDonald’s Transfat Settlement Aug 24 2005---- SUCCESS IN USA -- FINALLY 2013 FDA MOVES FOR TOTAL BANhttp://askdoctorvinod.blogspot.com/2006/07/mcdonalds-transfat-settlement-aug-24.html

Worship the sun for good health/Tan and live longer

All Asians want to be gora. White skin! Indians I knew about, but Chinese cherish white skin too.  Since forever.

So sun is shunned.  From childhood. Krishna, Shiva and Kali of dark skin have been forgotten. All want to be Sita and Ram.

And Asians, newly wealthy are the target for corporates. Money is to be made. Print, Radio and TV media tout western lightening creams and sun block creams. Articles expounding skin modern doctors, sun hating convictions, fill magazines and Cricket TV broadcasts. I ran across one just yesterday on my flight from Goa to Mumbai. "Just take Vit D supplements" it said and "cover yourself with sun screen". SPF - sun protection factors, of - different branded creams was conveniently listed.

Just such nonsense is likely what brought a young man to see me the other day. I was surprised he had severe Vit D deficiency despite hours in the sun, golfing. He diligently applied expensive sun block cream every time he golfed. Lately he had been tired, moody and had no energy. Extensive heart tests had been normal. D levels were low despite a year of supplementation. Was he still missing something? Read on!

Sun has been worshipped http://www.britannica.com/EBchecked/topic/573676/sun-worship by native peoples since the beginning of time. Sun temples abound in at least in Asia, Egypt, Sumeria and Central and South America and the sun dance of the Plains Indians,

 My friend Kaushik told me 40 years ago that after his bath he, fully bare chested, hands folded recited the Gayatri mantra slowly 21 times, facing the sun. Daily. I did it for a while over the years in the US.

Somehow, the new source of all knowledge and wisdom, the Western medical establishment has declared the sun to be the devil. All humans are to avoid the sun, or if perchance they cannot they are to put chemical potions to block the sun devil. These sun blocking chemicals(retinoyl palmitate? carcinogen; oxybenzone-hormone disruptor, pthalates), are absorbed into us from the skin. Dr Oz says "No published studies have shown a link with cancer". That would be reassuring except it took decades to prove asbestos a carcinogen.

For the white skinned the sun maybe the devil, but Asians, even the whiter among us, are better off being in the sun longer, so our darker skin can make Vitamin D along with sundry chemicals such as the mood elevating Serotonin, the blood pressure lowering and heart healthy NO, or nitric oxide among others.

Just taking Vit D thus is not enough. If a car is how you get around, assume that you are sun deprived. A Vit D level blood test can confirm that. Or just take my word for it.

Please fix that. Exposé your skin to the sun, protect your eyes and face and not between 10 and 2pm in the west. No SPF anything.

My father lived to 92. He loved gardening 2 hours every morning. My brother golfs without sunscreen. For me it is gardening, manual work or lately like my mother,  I just sit in the sun, 30 minutes a day.

Often I think of Sonali, how one day I stopped her from tanning herself like her white friends by our pool in Bismarck years ago. Just like most in 1990, I had been brain washed by the medical/industrial complex of the west. I had forgotten sun worship. Marketing does that.  I was wrong then.

So worship the sun. Save your life.

If you so believe, say the Gayatri 21 times slowly, hands folded, facing the sun.

Daily.