By Paul Henry / in , , , , , , , , , , , , , , , , , , , , , , , , , /


welcome to another MedCram lecture
update from the road I’m currently at a medical conference in Hawaii but will
continue to try to do these updates as they come up if we go to the world of
metre website we can see that they’ve breaking down the cases now into active
cases versus closed cases and you can see that they are still increasing
these numbers are printer represented we’ll get into more of that later then
we come to the graph of looking at the total cases outside of China and those
are still continuing to grow although it doesn’t appear as though it’s
logarithmic in nature we switch over to logarithmic we can see that it’s less
than linear if we look at daily cases excluding mainland China it seems to be
more sporadic with some days with up to 79 and the most recent at 22 and if we look
at these total death cases here going from the beginning of the year until
mid-february it’s quite obvious they’re still continuing to grow what’s unique
about this virus is that it has infected not just another mammalian species
specifically humans but as infected a species that can think act and retaliate
against this virus and that’s where we come to today and some of you have asked
us to talk about some of the medications that are being developed there’s a nice
article in nature that was published just a few days ago there’s more than 80
clinical trials currently launching to test chrony virus treatments and the big
thrust of this article is that there’s so many trials going on in China looking
at every single thing that you could possibly imagine see if it’s going to
work that there’s no standardization what
exactly is a recovery what is the definition of a recovery and if things
are not being blinded but things are being looked at is their nefarious work
they’re either intentionally or unintentionally so we’ll put a link to
this article in the description below but it talks about exactly what the
w-h-o is doing to try to standardize these trials to make sure that they can
be compared amongst each other and that the outcomes are true in nature and not
just to push medications or favorite drugs onto this coronavirus there are a
lot of medications and drugs for instance chloroquine phosphate which has
shown in vitro to have some pretty promising effects against the corona
virus it inhibits coronaviruses growth and currently this is being tested in
about ten hospitals and a hundred patients another drug that’s being
looked at is a VIP Rovere which is being looked at in a clinical trial of about
70 patients and of course the other one REM des aver and that is currently being
looked at in ten hospitals in Wuhan of course this one was developed for Ebola
and worked in vitro but it doesn’t seem to be working in vivo for Ebola but it’s
being used as a potential source of a medication to be used against this
corona virus another that they’re looking at is something
called convalescent plasma this is basically the plasma of patients who had
recovery from this corona virus so presumably there are antibodies that
have already been developed against the virus and if you take this plasma from
these donors and put it into patients who have severe infections of the corona
virus which all brings us to the big question
to really do the right research on this there has to be blind placebo randomized
controlled trials the question that I have and a lot of people have is if
people are saying already that things are looking promising that things are
getting better are they really conducting the right
kind of studies which leads me to the next thing I want to talk about that’s
what I do I’m not a epidemiologist I’m not an
administrator I don’t work for the WHL I’m just a pulmonary critical care
doctor takes care of patients so when patients are coming into the intensive
care unit and they’re crashing I’m the one that puts a central line in I’m the
one who puts the arterial line in we intubate the patient we do the
bronchoscopy so this virus has been a real interest for me so my full-time job
is taking care of patients and wanted to show you what’s been going on at least
what I’ve noticed in my practice in Southern California in the last month or
so I’ve seen personally at least three or four cases of influenza A let’s come
in and these patients have not done well recently had a young person come in who
went from just having reports of the flu to having severe pneumonia requiring
intubation within about two to three days and she went on to actually require
ECMO or ECMO which is where they do heart-lung bypass and what you’re
looking at here is a graph of the influenza positive tests by the CDC and
you can see the vast majority of these cases are h1n1 from 2009 which was a
very bad year we’re noticing that these patients have particularly bad cardiac
reactions to influenza I’ve seen a patient code and go a systolic
after being intubated I had another one who had ST segment elevation from a
biomarker Dittus the bottom line being is that this strain h1n1 is covered in
the annual vaccine that’s been covered since 2009 and so because I’m seeing
such a huge amount of this this is kind of a call-out to those who are
susceptible it’s not too late as you can see here the flu season still has some
weeks to burn through here to get vaccinated against this potentially
deadly strain of the influence a and for those of you who are
interested in our previous discussions where we talked about sleep boosting
your immune system please refer to our previous lectures and also to med cram
comm where we have numerous lectures on sleep insomnia sleep apnea and other
diseases that could be helpful in understanding thank you for joining us


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