NYC Coronavirus Guide

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The COVID-19 virus has our country paralyzed with fear – rightly so. This novel virus has never been seen before and its rapid infectiousness and mortality rate are alarming. As an immunologist- and a student of medical history- I know this pandemic will resolve with time. However, all the critical guidelines from the CDC and local health authorities are meant to slow down the number of cases and hopefully decrease the potential fatality rate. As of May 2, there have been 318,239 cases and 24,140 deaths in the state of New York related to coronavirus with 117,595 cases and 18,126 deaths in NYC.

In NYC some drastic measures are being taken to help reduce the spread of Coronavirus such as the recent announcement by Gov. Andrew M. Cuomo to halt subway service every night between 1am and 5am so trains can be disinfected. NYC schools are remaining closed throughout the rest of the school year, residents have been under lockdown for well over a month now and a hospital was created in Central Park. But there is light at the end of the tunnel. This week in Manhattan 7 miles of streets in and around parks were closed to give pedestrians and cyclists more space to spread out and enjoy the outdoors.

COVID-19: A Serious Holistic Approach to Battling This Virus

Disclaimer: the following information is available at references below, but no one should treat themselves without checking with a physician that any of the information discussed is appropriate for them. This is because every one as I like to say is “ an experiment of one” and while many of these recommendations are good for many of us, that doesn’t mean they are appropriate for everyone. I do hope you find this information valuable.

Coronavirus Discussion on News12 Long Island

Stone Grissom, on News 12 Long Island, has Dr. Dean Mitchell on his call-in show to answer viewers’ COVID-19 questions.

Stages of COVID-19

One of my esteemed colleagues in Florida, Dr. Mitchell Ghen, outlined an approach to treating the various stages of COVID-19; and I’ve found his treatment concurs with many recommendations of the Functional Medicine Institute that released its own protocols.

The stages of COVID-19 are essentially:

1. Stage 0 – you are infected by asymptomatic (days 1-5)
2. Stage 1  – you are infected and have a mild fever or cough or other mild viral type symptoms (diarrhea, sore throat, loss of taste, and smell* – days 5-14)
3. Stage 2 – you have worsening symptoms – shortness of breath, chest tightness, cough, high fever and general body aches (days 4-21)
4. Stage 3 – severe shortness of breath, a decreased oxygen level and imminent organ failure due to inflammation (days 14-21)

The stages are important because intervention depends on the stage of illness.

STAGES 0 & 1 TREATMENT

We should all, in truth, treat ourselves as stage 0 patients, even without the virus in order to boost our immunity if we are infected.

Key Supplements:

• Curcumin 500 – 1000 mg twice a day: it reduces inflammation and decreases viral activity.
• Quercetin 1000mg twice a day: decreases viral growth.
• Zinc Gluconate 30 – 60 mg: zinc long known to have anti-viral effects.
• N-Acetycysteine (NAC) 600 – 900 mg: increases glutathione production, a potent antioxidant for immune function.
• Vitamin D3 5000 IU liquid under the tongue daily: enhances immune function.
• EGCG (Epigallocatechin gallate) 225 mg or 4 cups of Green Macha tea daily: blocks down key NLPR3 inflammatory molecule.
• Reservatrol 100 – 150 mg a day: lessens virus potency.
• Vitamin A 10,000 – 25,000 units a day: discuss with your doctor.
• Melatonin 5 – 20 mg at night: discuss with your doctor.
• Vitamin C 1000 – 3000 mg a day: potent viral defender.

STAGES 2 & 3 TREATMENT

These stages require aggressive action in the opinion of experts from the Front Line COVID-19 Critical Care Consortium. You may have to advocate for a loved one to ask the treating doctors to offer these therapeutics.

• High dose Intravenous Vitamin C (ascorbic acid): 3000 mg every 6 hours for a total of 7 days.
• Low Molecular Weight Heparin 1 mg / kg every 12 hours: prevents clotting of the blood until discharged; many COVID-19 patients get clotting of the blood.
• Intravenous Methylprednisone 60 mg once a day for 7 days: then switch to oral prednisone which can be tapered over 6 days; this will reduce cytokine inflammation.
• Oxygen Low Dose (and increased as needed): start with nasal canula and then face mask for higher flows. Turn patient on his or her stomach to improve oxygen saturation; our lungs have most of the volume on our back.
• Oral Hydroxychloroquine 400 mg every 12 hours for one day; then switch to 200 mg every 12 hours for 4 days.

As testing becomes more wildly available – we are getting the rapid testing and the antibody testing at Mitchell Medical Group with offices in New York City and Rockville Centre, Long Island. It will be imperative to not just wait and see if you recover from the virus.

We are currently doing Virtual Consultations to provide the latest information on how to best protect yourself.

How to Reduce Your Risk of Getting Coronavirus

Medical teams are still working on gathering more information on how the virus spreads but there are 4 factors that experts agree most likely plays a role in contracting Coronavirus:

1. how close you get
2. how long you are near the person
3. whether that person projects viral droplets on you
4. how much you touch your face

A few ways to protect you and your family include:

• Wash your hands – scrub with soap and water for at least 20 seconds and then dry them with a clean towel or let them air dry.
• Keep distance from sick people – try to stay six feet away from anybody showing flu or cold-like symptoms. Don’t go to work if you are sick.
• Prepare your family and communicate your plan about evacuations, resources and supplies. Experts suggest stocking at least a 30-day supply of any needed prescriptions. Consider doing the same for food staples, laundry detergent, and diapers if you have small children.

Springtime Allergies & Coronavirus

What do allergies have to do with COVID-19 infection?

SYMPTOMS

For starters, the symptoms of a COVID-19 infection can be similar to typical springtime allergy symptoms: sneezing, scratchy throat, runny nose and coughing. The key distinction between the virus and allergies would be having an elevated temperature, 99.6 or above and of course a higher fever and chills. Itchy eyes, nose or throat would indicate an  allergic response.

TESTING

Either way, if you are concerned get tested for the virus with a simple nasal swab and if it’s negative, check with your doctor about being allergy tested. The nasal swab test which will be available at doctor’s offices, drive by testing sites will give you a rapid answer as to whether you are infected and need to be isolated.

If you are negative for the virus, then getting allergy testing makes sense so you can get some peace of mind that it’s only your allergies and you are not contagious to other people. This is so important because if others see you sneezing, blowing your nose or coughing they won’t want to be within a mile of you. But if you can say with assurance it’s just your allergies you may see their dirty looks turn to a smile of sympathy.

ALLERGY TREATMENT

Allergy sufferers are more fortunate than Coronavirus sufferers as there is an effective safe treatment for allergies – immunotherapy. Allergen immunotherapy whether by injections of sublignual drops can build a patient’s tolerance to the allergen. This is important because if your allergies are under control than the rest of the immune system is stronger.

The most common allergens in NYC are tree pollen in March, April and May; and grass pollen in May, June and July.

Coronavirus Treatment

The sad thing is that right now there is no treatment for the Corona virus, and avoidance is the only protection. Hopefully, with scientists worldwide working on vaccines and medications there will be an effective treatment. Remember, our medical researchers have overcome plagues of the past: syphilis, influenza, tuberculosis and many others.

Be smart and follow all the CDC COVID-19 guidelines and practice “social distancing” until this Coronavirus is under control. This may take several months so be patient. On the other hand, taking care of your allergies doesn’t need to wait.

Hope & Immunology: The Antidote

I remember vividly, that when I wrote my essay for admittance to medical school in 1982 that it was about how medical immunology inspired me to become a doctor.

Brief History of Immunology

The science of medical immunology began with Edward Jenner in England. Jenner noticed that during the epidemic of smallpox, the horrible disease that caused blistering lesions all over the body and death, that farm maidens appeared not susceptible to the illness. He noticed that these farm maidens did have mild lesions on their hands that was due to milking the cows. He scraped the lesions from the hands of these maidens and made it into a solution that he injected into subjects and found that they were protected – in essence, immune to smallpox.

Later as virology and immunology evolved it was discovered that the maiden’s hand lesions were cowpox (vaccina) which was similar in its makeup to the smallpox virus; and the immune system built up antibodies that protected against both smallpox and cowpox.

A century later, Louis Pasteur, the famous French chemist, saved the life of a boy bitten by a rabid dog. Dr. Pasteur crushed the spine of the rabid dog and filtered it to make a serum which he injected into the boy and miraculously cured him from rabies, which was known to be a 100% deadly disease. What made Dr. Pasteur’s vaccine so amazing is that it not only prevented people from developing rabies, it was also able to help them recover.

Fast foward to this century: the Ebola outbreak just a few years ago was close to 100% deadly. The hemorrhagic (bleeding) lung affects were almost like a horror film. Fortunately, through outstanding public health measures it dissipated. However, if you remember the few Americans that contracted it – one was a Christian missionary, another a doctor who received a special vaccine that augmented their immune response and helped them recover.

What Does This Have to do with the COVID-19 Pandemic?

I truly believe the solution to this crisis will be in utilizing the serum of patients that recover from the disease and that can be made into a vaccine that can be used for future patients that become ill with this novel Corona virus. In addition, purifying the proteins from the virus in these patients will lead to a preventive vaccine.

Remember this final thought: the term immunology comes from the Latin immunitas. Immunitas was used in legal terms to explain that once a person was tried and acquitted of a crime he couldn’t be tried again for the same crime. The term immunology for medical use was based on the historical observations that individuals that contracted a contagious illness, once they recovered could no longer develop the disease- and in fact, they were the ones that were safe to care for the sick with this illness.

My hope is that we all pull together to get through this medical and financial crisis- and the only way we can do it is by sharing and caring for others. I heard on CNN that in New York they are already accepting blood donations of patients recovering from COVID-19 and will try to implement and fast-track this vaccine without clinical trials.

NYC Coronavirus Resources

NYC COVID-19 Citywide Information Portal

New York State has extended NYS PAUSE meaning all non-essential workers must continue to work from home and everyone is required to maintain a 6-foot distance from others in public.

Starting Friday, April 17th, all New Yorkers are required to wear a mask or face covering when out in public and in situations where a 6-foot distance from others cannot be maintained.

ABC 7NY – COVID-19 Help, Information & Resources

New York, New Jersey and Connecticut have set-up drive through sites for testing for people who are sick or at risk of having contracted the novel coronavirus. At Mitchell Medical Group, we can also provide testing for Coronavirus and virus anti-bodies.

New York testing sites – the FDA has approved New York State to authorize the state’s 28 public and private labs to begin manual, semi-automated and automated testing for novel coronavirus or COVID-19. Testing is free to all eligible New Yorkers as ordered by a health care provider or by calling the NYS COVID-19 hotline at 1-888-364-3065.

– Dr. Dean Mitchell

About the Author – Dr. Dean Mitchell, M.D.

Dr. Dean Mitchell, M.D. is a Board Certified Allergist and Immunologist based out of NYC. He graduated from the Sackler School of Medicine and completed training at the Robert Cooke Allergy Institute in New York City. He is also a Clinical Assistant Professor at Touro College of Osteopathic Medicine, a fellow of the American Academy of Allergy, Asthma, and Immunology, and the author of Dr. Dean Mitchell’s Allergy and Asthma Solution: The Ultimate Program for Reversing Your Symptoms One Drop at a Time. Dr. Dean Mitchell, M.D. has also been featured in The New York Times, The Huffington Post, Fitness Magazine, Dr. Oz and News NY 1. Dr. Mitchell also hosts the podcast The Smartest Doctor in the Room – a combination of a lively, personal and in-depth interview with top healthcare specialists.

REFERENCES

The Functional Medicine Approach to COVID-19: Virus-Specific Nutraceutical and Botanical Agents. April 1, 2020. https://www.ifm.org/news-insights/the-funcitonal-medicine-app.

Front Line COVID-19 Critical Care Consortium. April 6, 2020, New York, NY.

Vitamin C May Reduce the Duration of Mechanical Ventilation in Critically Ill Patients: a Meta-Regression Analysis. Journal of Intensive Care, 2020.

Children’s Hospital of Chicago- Vitamin C/B1/hydrocortisone, 43 patients-mortality decreased from 28 to9 percent in 30 days. American Journal of Respiratory and Critical Care Medicine, 2020.

Vitamin C/ Vitamin B1/hydrocortisone, 47 patients-decrease in mortality from 40.4 to 8.5%. Marik, Chest: American College of Chest Physicians.