Critical Thinking for Oneself

A glimmer of hope…

Homeschooling and activity guide

I want start by sincerely thanking Rebecca Chou (one of the mothers in our practice) and Dr. Kato for helping to create a guide to homeschooling and fun activities to do at home. Please find the guide attached below. The resource list is truly wonderful!

Dear Families,

As time passes, and the more I learn, the less fearful I become. I am still aware, and as a family we are being cautious and responsible as requested. My family members are vulnerable and can come in harm’s way, so there is reason for extra care.

As time passes, public opinions are becoming more polarized as people become more convinced of their perspectives. As such, I would like shift from imposing my opinions to creating opportunities for you to critically consider for yourself and to form your opinions based on the conclusions your draw. The conventional perspectives are widely known, so I don’t feel the need to reiterate them. I feel that my job is to present the data in a different light.

Please take a moment to consider the following scenario if you wish:

We know 20,000,000 million people live in NY state. According to the MTA, there are 5,400,000 DAILY riders in the NY subways. Forget about the buses, taxis and Ubers. On March 1, Mayor de Blasio reported NYC’s first COVID-19 case. From what family in NYC tells us, people were still using the subways for 5-10 days AFTER COVID-19 was confirmed in NYC. We can presume ridership dropped by some amount, but we don’t know how much. Knowing that the virus lives for 2-3 days on plastic and metal (the surface of trains, busses, taxis, etc.), let’s presume the best case scenario, and consider the virus only lasted for 24 hours because every bus, train and taxi was scrubbed down…

Please do some math and imagine how many people YOU think could have been exposed during this period. Now please consider that these people riding were also socializing with family, friends, colleagues until society became aware enough to isolate.

What percentage of the 20,000,000 total inhabitants on NY state do YOU think were exposed? Please write down the total number (if 20% = 4,000,000…). One flawed study suggests 17%, but in all honesty, no one knows. But please entertain this exercise and write your number down.

As some of you have rightly pointed out, the horrible nightmare-like scene in New York is something no one wants. I absolutely agree. The numbers who have died in NY are horrifying. We have family in NYC, NY and NJ, and we are regularly checking in on them. 17,000 is a very large number, and everyone should pray that this number stops increasing. And each and every death means someone’s mother, father, brother, friend died.

With that said, I would like us to go back to our calculation. I would like you take the number you came up with and write this number below the 17,000.

             17,000           .     

Please take a calculator and divide 17,000 by your number and write down your percentage.

Now, we know that the death rate from influenza is 0.1%. Compare your number to this number. If you got 5%, then this suggests that COVID-19 is 50X as deadly as influenza. If you got 0.01% then perhaps it is 1/10 as deadly as influenza. I believe it is helpful for you to consider this equation for yourself to determine your own perspective on COVID-19.

The truth – the sad reality is that we really don’t know what this denominator is. We honestly don’t know how many have been infected OR how truly deadly this virus is. Our politicians don’t know. Our media does not know. AND SADLY WHILE EVERYONE IS OBSESSING WITH THEIR TRUTH, too few are talking about how little we truly know about this virus.

This exercise does is not to suggest that anyone should act irresponsibly to put themselves or others in harm’s way. I am not saying we should go against the law. We should follow the law and the requests of our public health experts. While we follow the law, I do believe it is still safe for us to engage in independent and critical thinking.

I think it is worth considering that experts believe that “herd immunity” will start developing when 60%+ of the population becomes infected and develops immunity (complicated discussion in of its own). If a sufficient number of people in NY became infected, inadvertently, they may be well on their way of developing accidently herd immunity. I, for one, am interested to see if how significant their “second peak” will be. I encourage you to watch what happens in NY come September and later. While other parts of the country start having secondary or tertiary surges, will they have a similar problem? Only time will tell.

Scary Kid Disease

As some of you know, Dr. Elisa Song created a wonderful post with so much invaluable information. https://healthykidshappykids.com/2020/04/29/kawasaki-ace2-covid-19/

In her post she says, “Kids are getting sick, and we need to be prepared. As many as 5.7-20% of children with COVID-19 may require hospitalization, and 0.58-2% may need ICU care (16).”

I want you to analyze this for yourself. As we saw above, every number MUST BE CONSIDERED IN THE CONTEXT OF ITS DENOMINATOR. So let’s explore where Dr. Song’s numbers came from.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e4.htm

Here the CDC reports, “Among 149,082 (99.6%) reported cases for which age was known, 2,572 (1.7%) were among children aged <18 years.” 2,572 total cases of COVID-19 in all children in our country??  Now the first question I want you to ask yourself is who were these children that were reported? To my understanding, unless a child was VERY ill AND presenting to a hospital or large urgent care, they would not be tested. Do we have an underreporting of cases of pediatric cases? You decide for yourself.

Now this CDC report goes on to say, “Among children with COVID-19 (the total of 2,572 in our country who were positive), 147 (estimated range = 5.7%–20%) were reported to be hospitalized, with 15 (0.58%–2.0%) admitted to an ICU.” So in other words, what Dr. Song said is that there were A TOTAL OF 147 hospitalized children thus far in the country, and another 15 who were admitted to the ICU. If my son or daughter were one of these children (as was her child), I too would be devastated. A child falling ill to any illness is a horribly sad sad sight to see.

I ask that you take these numbers and compare them to other CDC reported data.

https://www.cdc.gov/flu/about/burden/2017-2018.htm

https://www.cdc.gov/flu/about/season/flu-season-2017-2018.htm

2017-18 Annual Influenza

Hospitalizations                                  Deaths

0-4 years:        25,644                                                 115

5-17 years:      20,599                                                 528

COVID-19 so far has caused 15 ICU admissions and one death. As a parent, should you be more worried about influenza or COVID-19?

One of our dear families asked me about this report:

https://www.cnn.com/2020/04/29/health/rare-inflammatory-syndrome-us-covid-19/index.html

Kawasaki’s disease is a horrible condition where a child’s immune system starts attacking the heart’s blood vessels and causes them to dilate. It also hits the heart valves and causes them to fail. Sadly, one of the little ones in our practice suffered from this condition LAST YEAR from a viral infection unrelated to COVID-19. How do you know if your child has this disease? These children present with prolonged, high fevers and are VERY ILL APPEARING.

Somewhere around 3, 000 – 5,447 children PER YEAR are hospitalized from Kawasaki’s disease, often for reasons we still do not understand. https://www.cdc.gov/kawasaki/about.html

Does this mean you should be fearful of your child developing this disease from COVID-19? You judge for yourself.

Pulse Ox

As you may have heard, some patients (primarily elderly) who are infected by COVID-19 have a silent (AND dangerous) drop in their oxygen levels without other overt signs of illness.

https://blog.a4m.com/emerging-theories-that-may-help-us-solve-the-covid-19-puzzle/

This excellent blog discusses the role of oxidative stress (which we reviewed before in detail) as a possible underlying explanation for this hypoxia (oxygen drop). NAC and glutathione, are two compounds/products that can be very helpful to address this oxidative stress. As before, please make sure your family, especially the vulnerable, have a basic supplement kit (which includes vitamin C and glutathione) ready in case they get sick. Please see products below. I don’t believe the risk of hypoxia is significant for healthy adults. If you have underlying health problems or have any beloved elderly or other vulnerable individuals in your life, you may wish to get them a pulse oximeter (a device that measures oxygen levels). These devices take some practice to utilize effectively and a baseline level should be tested when one is healthy.

Co-Quarantining

Our Governor and public officials will decide when it is appropriate and safe to end the shutdown. Until that time, many have asked about co-quarantining. In this scenario, two groups of people who have been responsible and limiting unnecessary contact and have been healthy, start socializing together. I spoke to a smart infectious disease specialist who feels that if all parties are responsible, then co-quarantining may be an option. Obviously, there is increased risk of exposure, and this risk is something you and the other family must consider collectively. Co-quarantining can include nannies and hired help, depending on how much you trust them and how much exposure risk YOU believe they will subject your family to.

Speaking Out

Some of you have expressed your desire to speak out. If you feel it is appropriate, there is an even TOMORROW MORNING that may be worth considering.

https://openlanowandsafely.com/

Giving

If any of you are interested/able, the following site allows you to support some of our local restaurants while enabling them to support others. https://www.supportandfeed.com/

Farm Fresh Food

For those of you looking for farm-fresh produce, Sow A Heart may be a great resource for you! Mollie Engelhart (an amazing mom in our practice) has created this portal to help others have one other way to access amazing produce. https://www.sowaheart.com/

Testing

We will continue to explore COVID-19 antibody tests to be done at home. To be honest, I still question the accuracy of the tests we have carried thus far. Quest diagnostics is now offering blood antibody testing which should be FAR more accurate than our in-office tests. The test is $55 but does require a blood draw, which can be done at any Quest draw station. Please call the office if you are interested.

Our Office

In consultation with Dr. Kato, we have chosen to open the office to all families who wish to come in for well checks and vaccines. We have stripped the rooms of anything that cannot be wiped down and are staggering the schedule to avoid multiple people going through our waiting room at one time. This is entirely optional depending on what you are comfortable with and feel is appropriate for your family. As before, we will continue to offer video calls for all families who wish to take advantage of these services.

Products

Some of you have expressed frustration (or on the behalf of your family) that you have not been able to find quality products, including vitamin C, NAC or other compounds. For our members, we have started stocking some of these products with our regularly discounted member rates. Attached is products list with pricing. Our website also has some of these products for others outside of our families.