NY Times featured Pulmonary and Critical Care Specialist | Physician Leader | Author and Blogger | His latest book is “Code Blue,” a medical thriller.


New research says, “Yes. Absolutely.”

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A natural question asked with respect to vaccination is whether a vaccine is necessary if one has already recovered from COVID. If I already have natural immunity, do I really need a vaccine? Two studies, published in the Lancet on February 25, answer in the unequivocal affirmative.

The first study examined healthcare workers in the UK who received the Pfizer/BioNTech vaccine and compared the antibody response of those who were previously infected or uninfected with SARS CoV-2. The healthcare workers who were previously infected with SARS CoV-2 had antibody responses that were way higher than that of natural immunity. …


We cannot let down our guard, not even for a minute

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The news has been great as of late: Covid cases have continued to fall, vaccines are ramping up, and in a very encouraging study out of Israel, the real world experience with the Pfizer/BioNTech vaccine is as good as the controlled trial.

At the same time, there are warning signs, and while I don’t want to rain on people’s parades, it is so very important that we keep up our vigilance. What has gotten me so concerned? Cases in the U.S. have stopped falling.

For every death, there are countless others affected

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This past week, our country passed an horrific milestone: more than 500,000 people died of COVID-19. It should not have happened. It is a tragedy many times over, for many different reasons.

The statistic is truly staggering: more than one half million people have died. It is very hard to wrap one’s head around this ugly reality. Yet, the death of a patient from COVID is not the end of a tragic story. It is actually the beginning of further tragedy.

Surrounding each of those deaths are friends and loved ones who are mourning. Yes, they are living on, and…

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It has to burst forth eventually
The pain
It is too much to bear internally
The rain

Day after day, you fight
Swimming against the stream
Day after day brings fright
And makes you want to scream

They look to you with hope
Because they call you, “Doctor”
We give them to hold a rope
And a chance to breathe easier

But we keep losing the battle
We can’t keep them from dying
Too often we see death’s rattle
So eventually, we can’t stop the crying

And we cry, we scream, we fall Feeling that we’ve failed once more We…


We need to follow the science, folks

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Doctors — myself included — have been treating patients with Vitamin C and Zinc since the very beginning of this pandemic. Yet, does it work? New research says, “No.”

Researchers randomized 214 outpatients to receive either zinc, very high dose vitamin C (8000 mg), both, or neither and compared their outcomes. There was absolutely no difference, and the vitamins did not significantly decrease symptom duration.

Now, believers in Zinc and Vitamin C will point out that the vitamin group did get better about a day sooner on average: 5.5 days for the ascorbic acid group, 5.9 days for the zinc…


It increases the urgency to vaccinate as fast as possible

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Just as we are beginning to have hope that the end of this pandemic is near, news emerges of the development of new mutant strains of the SARS CoV-2 virus. There have been new mutations that have emerged in the U.K., South Africa, Brazil, and even Southern California.

The concern over these new variants is that they have the potential to cause new surges of infection, hospitalization, and death. Worse, these new variants may evade the protection conferred from natural and/or vaccine-mediated immunity and cause reinfection.

A new report from France, accepted for publication in the journal Clinical Infectious…


It is amazing how the mind can skew one’s reality

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It’s been almost a year since our first case of COVID-19 showed up in our hospital. It has not been pretty. A lot of patients have died, many more than we have been used to, and we are very used to death in the ICU.

If you were to ask any one of us — the doctors and nurses in our ICU — the question, “What is the mortality of our patients with COVID-19?”, most of us would say “80–99%”. Personally, I thought our ICU mortality was at least 80%.

New research says that two masks can reduce transmission by more than 96%

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The U.S. Centers for Disease Control (CDC) — in its flagship publication the MMWR — published new research doubling down on the importance of wearing masks. They conducted an experiment to see how double masking or knotting and tucking a medical procedure mask affects how they work (see figure below).


This could lead to another wave of infections if we are not vigilant

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There has been great concern on the part of scientists and health experts about the various mutant strains of SARS CoV-2, the virus that causes COVID-19. These variants are much more contagious, and there is some concern, especially with the South African variant, that natural- or vaccine-induced immunity may not be as effective against these mutant strains. There is even greater concern that the UK variant may even be more deadly.

Given that these mutants are more contagious, experts worry that these new strains may become the dominant ones causing infections in the United States. The CDC has been warning…


We are so tired of this…but we also still care

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Lather. Rinse. Repeat.

That is what it feels like taking care of Covid-19 patients for almost a year now. It is the same thing: they get sick, they come to the hospital, they get worse, they come to the ICU, they go on a ventilator, they stay on a ventilator for weeks, and then they die.

Lather. Rinse. Repeat.

Sure, we have had some successes. But they are very few and very far in between. I think I can count on one hand the number of patients who actually made it alive and well after critical illness due to COVID-19.

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