hi for those of you who are new to my channel welcome my name is mike hansen
i'm a board-certified physician specializing in internal medicine pulmonary disease and
critical care medicine in this video i'm going to discuss updates with the covid surge that
is here controlling the pandemic immunity to the virus possible treatments on the horizon and more
the covid 19 pandemic is at its worst right now hospitalizations are the best measure of how the
nation is faring against the pandemic and surges and hospitalizations leads to surges and deaths
this pandemic is going to be at its worst in the next two to three months as of the making of this
video in the u.s there are 80 to 90 000 new cases per day texas has about eight thousand new cases
per day wisconsin over five thousand over the past week in the united states new cases have
increased 18 percent but the number of new tests being performed has only increased by four percent
in south dakota half the tests that are being done are positive to put that in perspective ideally
you want the test positivity rate at or below five percent for at least 14 days before you
reopen a certain part of the country of course south dakota is not closed the u.s total death
toll is now over 230 000 and how many people are there who got covid but now are recovering
with home oxygen or maybe they have a tracheostomy in their neck and now they require long-term acute
care i have a lot of patients who are three four months out from their covid illness
and they're still requiring supplemental oxygen but we still don't know the total number of these
long haulers because it's not being tracked or at least it hasn't been from the beginning and
as if covid 19 by itself is not bad enough it has a domino effect on the rest of our society
it's not just the economy that suffers it's also the rest of health care in general that suffers
and this is not to mention the increased rates of depression and suicide deaths during these times
if hospitals are overwhelmed guess what happens to the other care of patients who don't have
covid cancer treatment becomes delayed elective surgeries are being put off for things like
heart surgery hip replacement and more also who wants to go to a doctor's office or an er
or an urgent care center during these times and possibly get covid it's not like we don't know
how to get this pandemic under control it can be done look at how well other countries handled it
and how well they're doing and how well their economies are doing australia new zealand south
korea taiwan and even the country where it all started china china has a total of wait for it
less than 5 000 deaths total from covet what do all these countries have in common well they did
testing contact tracing quarantine distancing and masks this pandemic is only going to get
worse in the next couple of months and more and more hospitals will be overwhelmed the difference
between what's happening now compared to what happened during the previous spike in cases
is that the entire country is now a hot spot and because it's so widespread we will soon
reach a breaking point in our hospitals and our number of healthcare workers in all likelihood
one of three things is going to happen one there's going to be a federal mass mandate because not
enough people are wearing masks when they should be if this doesn't happen there will likely be
a shutdown of most of the country if neither of these things happen it will be millions of
deaths and an absolutely destroyed economy some people say doctors are inflating the numbers
our doctors get more money if somebody dies from helping you know that right
so this is not true part of my job as an icu physician is to complete a death certificate and
i have to write the primary cause of death and the secondary causes of death there's usually a chain
of events that causes someone to die lots of times there are multiple contributing factors that lead
to someone's death but usually we know the primary cause of death and with covid 19 it's pretty
straightforward for example let's say someone has diabetes high blood pressure and is obese
and they're a smoker let's say they get covid they get covid pneumonia and they develop ards
and they end up requiring a breathing tube in the hospital and eventually they die well they died
of cover 19. they have other medical problems as secondary contributors but the primary cause of
death in that instance it's obvious ultimately the question is did they die sooner than they would
have if they didn't have covid sometimes it can be somewhat of a gray area for example let's say
someone has covid 19 pneumonia they're severely ill in the icu requiring a breathing tube and
sometimes these patients get a secondary bacterial infection a secondary bacterial pneumonia and that
can contribute or hasten their death did they die of covid did they die of the bacterial pneumonia
well the answer is they died of both but it was primarily the covid 19 that was the driver
in that situation also regarding the claim that doctors get paid more based on the diagnosis
it's a lie plain and simple my paycheck is the same regardless of a patient's diagnosis
i don't get paid any more or less whether they have covid or something else are people immune
to the virus after they are infected antibodies are made by the body in response to a given
infection or a specific vaccine usually antibodies protect someone from future infection of that same
virus or bacteria and these antibodies that are developed are called neutralizing antibodies
researchers at mount sinai's health system between march and october looked at the antibody responses
of more than 30 000 people who tested positive for covid 19. these people who had covid had
either mild or moderate illness in that study they described their antibody responses as either being
low moderate or high more than 90 percent had moderate to high levels of these neutralizing
antibodies to the spike protein of the virus and the response was maintained for at least
five months so can you get infected with covid 19 twice based on this probably not if it does occur
it's the exception not the rule and this study also has implications when it comes to immunity
from a vaccine it's likely that a vaccine will provide immunity but for how long is another
question based on this study the answer is most likely at least five months but this is still
not known for sure it's also unlikely when this vaccine will become available it's most likely
going to be available for health care workers and the most vulnerable of the population come spring
of 2021 but what happens after that where it's available to the rest of the public
most likely a year from now and then there's the other question of how many people are actually
willing to get the vaccine you know a question that i get asked a lot is
are you willing to get the vaccine and the answer is yes as long as the scientific studies show that
it is both safe and effective in a recent study done at the university of maryland
people who were hospitalized for covid 19 who were previously taking a daily low-dose aspirin
had a significantly lower risk of covid 19 complications and death compared to those
who were not taking a low-dose aspirin meaning 81 milligrams of aspirin also known as a baby aspirin
the ones who took the baby aspirin they were less likely to require icu level of care
and less likely to require a breathing tube does this mean that everyone should be taking a daily
81 milligram dose of aspirin to prevent severe covid no at least not until they're randomized
controlled trials to prove that is both safe and effective generally speaking taking a daily 81mg
dose of aspirin is safe but does have a slightly higher risk of side effects such as bleeding
also on a related note now is really not a good time to be vitamin d deficient
and that's something to talk more about in two of my other videos on this channel so you can check
that out if you want there are over 70 monoclonal antibody treatments that are being looked at for
covid 19 they're in various stages of development the two that have the most potential right now are
the ones that are made by eli lilly and regeneron both of these companies have already applied
for fda emergency use authorizations eli lilly recently signed a 375 million dollar deal
with the government for 300 000 vials of this monoclonal antibody it's called bam lenivumab i'm
just going to call it the b word for short there's a recent study in the new england journal medicine
that looked at ben linovib or the b word and it seemed to decrease the risk of hospitalization
and eased some symptoms in this phase two trial that involved over 400 patients with either mild
to moderate covid 19. in this randomized control trial less than two percent of patients
who received the b word had symptoms progress enough to the point of requiring hospitalization
or a trip to the er and for those who received placebo it was six percent now for the group
of patients who are in the higher risk category defined as those who were obese or older than 65
4 who got the treatment were hospitalized compared to 15 percent in the placebo group
the primary goal of the study was to see if the treatment eliminated the virus by day 11
which it did for the vast majority of patients so overall the results of this study are encouraging
but there still needs to be a bigger study to know for sure its effectiveness
now in a different trial the b word was evaluated in more severe covid patients who were
hospitalized but the study was terminated early because it just wasn't working all right so what
about the other major monoclonal antibody made by regeneron called regn covi2 this is the same
treatment that president trump received well there was also a study done in which they gave regn
covi2 for covid 19 patients with mild to moderate disease but the details of the study were not
published in a medical journal and they've not been peer reviewed either according to regeneron
they said that the treatment significantly reduced viral load and it also reduced the need for people
to seek medical attention either at a hospital or doctor's office or an urgent care center so as of
right now we still don't have any great treatment for covid 19 especially when it comes to those
with severe disease also we might know a lot of the risk factors that put certain people at higher
risk of having severe covid but we still don't know or we still don't have a way to predict who's
going to become severely ill with cytokine storm and ards but just last week there was a new study
that can help us predict who will become severely ill with covid with a high degree of accuracy
and that's what my next video is going to be on so make sure you hit the bell notification
if you haven't done so already that way you can be notified of when that video is ready
and just want to say thanks for watching stay safe stay healthy and i'll see you in the next one
you