Like many of you, I continue to follow the coronavirus situation closely, for personal and professional reasons.
Given the dismaying surge in COVID cases over the past several weeks, this week I devoted part of my twice-monthly Helping Older Parents members call to this topic, and I have decided to share this part of the call below.
This video covers:
- The coronavirus situation today
- Are we better at preventing COVID?
- Are we better at treating COVID?
- Current COVID treatments available in the hospital
- My take on hospitalization for frail older adults with COVID
- Useful resources and my recommendations for this summer
The video is below, or get the audio-only through the podcast here.
(For those who have asked about transcripts: I wish I could but right now we are too short on funding; transcripts cost $1.25/minute to produce plus more time to format and finalize.)
Please stay as safe as you can, and take care!
Related resources:
Resources:
- Uptodate.com COVID-19 Resources & Tools (Coronavirus Resources)
- What is a pulse oximeter
- Center to Advance Palliative Care COVID Response Resources – see info in the symptom management section.
- TheConversationProject.org:
- PrepareForYourCare.org
- POLST.org
- Learn how POLST helps frail and seriously ill adults get better care, and find out what is available for your state.
- Institute on Aging Friendship Line
- This free service provides trained volunteers to talk to older adults who are lonely or depressed; they are also qualified as a crisis line for anyone contemplating harming themselves
Questions? Comments? Helpful ideas to share? Please post below!
Richard Ailes says
I listened to Dr Kernisan’s update on Covid-19 yesterday and found it very helpful as I find all of her podcasts.I just became aware of a protocol for handling the disease developed by Paul Marik and his staff at the Eastern Virginia Medical School. I watched a video interview with Marik and came away impressed by its results, and seeming practicality. Could you or Dr. Kernisan comment on this protocol. It can be found at this web address:
https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf
Thanks
Nicole Didyk, MD says
Thanks for sharing that information.
There’s a lot to digest there, and my specialty is not critical care or pulmonology. However, in a nutshell, Dr. Marik has been a proponent of using Vitamin C and quercetin for the treatment of sepsis for many years. Recently, with the COVID-19 pandemic, his group has developed a protocol called MATH+ (Methylprednisolone, Ascorbic acid (Vitamin C), Thiamine, Heparin and others (Melatonin, Vitamin C, Famotidine, Magnesium and Zinc)). The protocol involves preventing infection with a “cocktail” of the vitamins mentioned, and high dose methylprednisolone (a corticosteroid) and intravenous vitamins for those sick enough to be hospitalized, along with a form of heparin, a blood thinner. The theory is that there are increasingly inflammatory stages of the COVID-SARS illness and giving anti-inflammatory treatments will reduce the likelihood of the illness progressing or overcoming the host.
Currently, some aspects of the protocol are being used for those with severe COVID-related illnesses, like the use of a steroid (dexamethasone), and heparin (which is a standard part of most hospital admissions, to reduce the risk of a blood clot in the lower limbs). The rest of the protocol is not part of the mainstream recommendations at this point, which you can review here on the Up to Date website.
Are there risks to taking supplements of zinc, B vitamins, Vitamin C and melatonin in an effort to prevent COVID-19 infection or illness? Well, the risks are probably low, although there is some expense and burden of taking these pills, sometimes a few times per day. And even “vitamins” and “natural compounds” can interfere with prescribed medications and medical conditions for some individuals.
My bottom line is that the theoretical underpinnings of the protocol seem to make sense, but we don’t have evidence at this stage to broadly recommend it. I hope we can look forward to some rigorous study and discussion to determine if there’s a role for MATH+ to prevent death and illness from COVID.
Zora says
Hello
Is that true that Covid 19 Vaccines may not work on older people?
Nicole Didyk, MD says
Like influenza vaccines, there may be a lower efficacy in older adults, but it will probably provide some protection. If we look at the flu vaccine, for example (although COVID is different from the flu), a vaccine with only 40% effectiveness in adults 65 and over, would still prevent the need for 60 000 hospitalizations, by some estimates.
Janet says
Thank you for this update.
My question is should we be concerned about 2nd smoke being inhaled? Can the virus be transmitted by smokers?
Nicole Didyk, MD says
Smokers can transmit coronavirus just like anyone else, by exhaling droplets, which another person could inhale, or accidentally absorb through touching eyes, nose or mouth. This could happen during smoking, but I don’t think the virus can “live” in cigarette smoke.
Laura Frankenstein says
Thank you very much. Exactly what I was looking for.
Nicole Didyk, MD says
So glad you found it helpful!
lela daVia says
I am a 77 year old woman and although I receive excellent care from my primary Dr I find Leslie’s information so helpful and often mention what I learn to my Dr.
Thank you so much for clear, thorough information presented in such a caring way
Nicole Didyk, MD says
I’m so happy to hear that you find the site helpful! Your feedback is very much appreciated.
Gert says
A friend offered to drive me (age 82) a few miles to a park trail where we could walk 6 feet apart. I would sit in the back seat of a clean car, with the window open. Aside from my wearing a mask and gloves, what precautions would you recommend to me (the passenger) and driver? Or is it not advisable at all?
Nicole Didyk, MD says
You are the only one who can make the decision about which activities are right for you, but here are a couple of questions to consider:
1. Is your community a “hotspot”? In communities where there’s a very high number of infected individuals, the risks of going out is higher than in areas which don’t.
2. Is there anything in your own health history that would make infection more risky or likely? Are you currently ill or immunocompromised?
In general, outdoor activities are lower risk and exercise is a great thing for overall health. For many older adults, a short car ride and a socially distanced walk outdoors would be a low risk activity and a reasonable thing to do.