Update 89: Infection Rate Rising in Many States; Dexamethasone Cautions

Medcram.com wasn’t another medcram covid-19 updates here. We can see the dashboard for the Johns Hopkins coronavirus resource center. And if we click on this link here critical Trends and click on have States flatten the curve what we see here is a really nice virtual map if you will of the United States and you can see where the hot spots are here currently Arizona if we click on that we can see here the graph and you can see how

Serious, this is here in Arizona.

And the way to look at this is see whether or not cases over a two-week period of time are going down or going up and if they are going up you can see an orange Hue to it if they’re going down. You’ll see a green Hue to it will take a look at some of these here we go back out here. We can see some of the states that are actually improving we can look at for instance, New York.

Let’s see very nicely that. The number of cases have been decreasing here for the last couple of weeks.

If we go to Massachusetts next door also see a similar pattern go to Florida we can see that cases are increasing their and the other two hot spots are California. We can see that cases are dramatically increasing and I’m too keenly aware of that. But we can also see that here in Idaho where cases have started to increase.

And if we look at Texas as well, we can see here that cases are also increasing pretty dramatically and if we go to our worldometer website we can see here with daily new cases in the United States and if we look at the seven day moving average we can see that that has taken a definite increase here over the last week or so.

however, if we look at Daily deaths in the United States, and we look at the seven day moving average clearly, there’s been a consistent decrease since that time, of course, there could be a number of reasons for this including the average age of the population being infected the fact that there is a bit of delay between when someone dies and when someone gets infected with coronavirus could also mean that the virus could be weakening that we could be also improving our care in terms of hospitalizations because of

Medications that have come out could be the summertime there could be more vitamin D. I mean there’s a number of reasons why this could all be we don’t know exactly what the reason is or if this trend is even going to continue. The other thing that you can do back on the Johns Hopkins coronavirus Resource Center homepage is go to testing here at the top and under the testing. You can click on a particular State and you can see here different graphs. We can see about terms of new cases and we look at the seven day.

Average if it’s green, it’s coming down. If it’s orange. It’s going up test per 1,000 people and percent positive. And typically they want to keep the percent positive around 5% or less based on the recommendations and you can see which of the states currently are falling in that range and which ones are not falling in that range at a quick glance.

In terms of what’s going on out there in the vaccine world. Don’t forget to check out wraps as well, which is keeping track of the covid-19 vaccines and there’s an update here with some preprint papers for the Oxford vaccine that is showing some promising results at least in the first phases of the vaccine development. There’s also some updates in terms of all of the vaccines as you can see here. They update Jun 2015.

To include new information about the following companies. So this has been an interesting week for treatment in the covid patient. It’s been about the fourth straight week that I’ve been in the covid unit and I’ve been able to see treatment recommendations being used for patients being able to implement in real time the recommendations of steroids. I think it’s too early to tell whether or not it works course anecdotal evidence is pretty weak, but there seems to be some reaction now we’re getting the who according to NBC news here updating.

Covid-19 clinical guidance stressing that steroids should not be used as prevention. They say here. It’s exceptionally important that this drug is used under medical supervision. It’s pretty important that patients do not take steroids unsupervised at home. There’s a lot of complications a lot of dangerous potentially fatal complications that can occur if people start taking steroids without supervision none at the least of which is

If you take steroids for more than two weeks and then all of a sudden stop it there is a potential chance of adrenal insufficiency, which could be fatal in the longer you take steroids and stop them all of a sudden the more dangerous and likely it could be that you could have adrenal insufficiency. This is not to mention the side effects that occur with long-term steroid use such as osteoporosis are erosion of the stomach lining diabetes thinning of the skin cataracts etcetera Etc. So

Ali what we’re talking about here is supervised use in the hospital typically for no more than 10 days to help patients with covid-19 who are hypoxemic or on the ventilator again, we wait for the peer-reviewed article which will probably appear in a major publication here in the next few weeks. We did give you the link in the last update to the preprint released from the recovery trial in the UK out of Oxford.

And I did want to thank one of our viewers for passing along this information to us in case you thought that there was no way to connect this steroid Wing here to the vitamin D Wing. Well, you’re wrong because here’s a paper that was published almost 10 years ago, which solidifies the connection that shows that dexamethasone. Yes, the very same medication that was used in the recovery trial that showed a statistically significant benefit in mortality in

19 patients. Yes that same dexamethasone has been shown to enhance the active metabolite of vitamin D which is 1 Alpha 25 dihydroxyvitamin D 3 otherwise known as calcitriol. It does enhance its activity by increasing the transcription of the vitamin D receptor. So the receptor that accepts that vitamin D usually inside the cell that goes into the nucleus. It causes transcription of

Other factors has been shown to be increased by dexamethasone just to warn you. This is a very very technical paper. If you want to look at it. It is published in the Journal of biological chemistry and it is not Light reading in the least. They do prove the point pretty effectively that dexamethasone regulates the vitamin D receptor at the transcriptional level, and it does increase it.

Now whether or not this is associative or whether or not this is any relation to why there is an association with patients with covid-19 and vitamin D levels and the fact that this very same medication dexamethasone improves survival. We don’t know that at this point, but it is certainly interesting and a certainly a DOT that needs to be put on the paper to see whether it gets connected at some point down the line.

Of course, there are other groups that are also looking at Vitamin C. There’s Paul Merricks group out of Eastern Virginia and the math plus protocol, which I think has Merit, of course that raises a bunch of other questions that we could ask about a bunch of other protocols and things of that nature. So interesting week as we wrap up wanted to remind you that we are still planning on doing a live session on Sunday evening 6:00 o’clock Pacific time. We’ve got some interesting articles to cover next.

Next week, but if you want to join Kyle and myself for a live video stream and answering your questions, whether it be about covid-19 or any other medical disease or whether or not it’s my personal experience with covid-19 patients. We will be available six o’clock Pacific time until then. Thanks for joining.


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