April 15th Bulletin

Greetings, Friends and Neighbors!

I hope everyone is hanging in there. We are getting through this. Slowly but surely. I promise. I would venture to say we have seen the worst days of it and are seeing the first bits of the other side. I’ve collected a few thoughts over this past week that I hope you might find helpful.

Photo project

I’ll start with my favorite bit of news. Stanford and UMASS are resurrecting a campaign called the PPE Photo Project. Imagine being ill in the hospital and separated from loved ones. Your caregivers come in and out in space-aged protective gear including eye shields, masks, gowns and gloves. Who are these people that are supposed to be helping me? It is alienating and scary for patients. We need connection with our care-providers. It matters a lot. In the Photo Project, caregivers have a photo taken of themselves showing the smile they wish they could give to their patients. A fairly large photo of their best smiling face is then worn on their jacket over their heart.  Transformational team-building accomplished!  I emailed the article about it to the Fairview Hospital management team this week.  It would be nice to have the whole health system take that on!  Great care, good press!
Standing Ovation

You might have heard that NYC applauds the hospital workers (like they do in certain areas in Italy) every night at 7pm. Many workers report leaving a shift and hearing the cheers. They find it really heart-warming.
Against the Odds

Doctors are finding that they can’t seem to help people in the ICU with COVID the way they are used to. The numbers of people that don’t do well are astounding. The ventilators aren’t helping like they usually do. We just don’t know how to save these people. It’s one of the many puzzles with this illness. But the most tragic. So, doctors are doing different things. Many are waiting longer before intubating, trying to avoid it. Some are reporting small case series using blood thinners more aggressively. This approach seems to be helping some. I hear different theories as to why people get starved for oxygen and ventilators are not making a big difference. The theories are promising and could open up treatment options. Godspeed, to the researchers!
On Your Stomach

Another beneficial trick being used in the hospital is to turn a patient stomach down. Other parts of the lung are engaged. This is not a new technique, but it appears to be helping people, ventilated or not.

We are building our repertoire.  There are some decent options.  Studies are ongoing.  We may not have found the big breakthrough, but there are many things that chip away at it. I will do my best to bring you in contact with the best that is being offered.  For example, I’m investigating Ozone injections about which I’ve heard some remarkable case studies.
Anosmia meets Toe Vesicles

There are some case reports of small blisters on the feet or toes being associated with COVID. It’s another possible clue. I’ve seen the lack of smell be a reliable predictor of a positive swab. I’ve never heard a patient report the foot blister, but it’s good to know. Keep your eyes peeled.
Artificial Intelligence will see you now

There are many symptom-analysis programs to help you see if you likely have COVID.  Buoy Health is one company behind an AI program that screens your symptoms for the likelihood of COVID and will make recommendations to you based on your interface with it. I checked it out, and I must say, it’s pretty good. I heard that an AI program can detect COVID based on the sound of a patient’s cough.  It’s getting real, like it or not.
The Bug vs the Terrain

I, like many, have dived into immunology, virology, and infectious disease like never before. There has to be something we can learn to make the difference. The biggest area of intrigue for me is the vast range of disease presentation. One person might not be able to smell their coffee one morning and have no other symptoms. Another might have nothing(!) but test positively.  Other cases can be relentless and lethal.

You know something, in the study of infectious disease this is common.  We see this broad range of presentation with many viruses! Considering this and the fact that viruses are not alive, the answer to the riddle as to who gets really sick really must lie mostly in the individual constitution and makeup and not as much in the infectious agent. The approach that keeps that in mind is interesting to me.  We should be looking at each individual as deeply as we can just as much as we study the virus and its characteristics, etc.

Along these lines, there is one main question: why do we get sick? Illness is an inevitable human experience. Illness as an enemy ignores the deeper reality of human illness. There is wisdom in illness.  The darkness of pain and disability never comes without light. They come in one package. Chaos and unrest demand our full and undivided attention. They heighten our consciousness. And that, my friends, is the point.

We are going to beat this thing.  It will drop off in May.  We have put in the hard work.   There are already too many people that have gone through it for it to regain any serious momentum. Be smart! Stay safe! Be optimistic!

You know how to reach us. Don’t hesitate to call.

Best Wishes

Dr Cooney and staff