Hello again,

Are you tired of Covid yet? Feeling that way actually has a name - it's been called Covid Fatigue, similar to any compassion fatigue.

Yet, it is predicted that 60% of us will get it. In Texas, on June 24th, new cases topped 5500. In Houston, 97% of ICU beds were occupied on Tuesday, with over 1/4th of these having Covid-19. In San Antonio, ventilator availability dipped below 70% for the first time.

So, if we are of the age or have the health concerns that make our risk greater, we need to keep thinking on it. An upsurge began in nearby Kerrville about 3 weeks ago, with the Sid Peterson ER having five positive cases in one day. And yesterday, in my husband's primary care office there were 8 positive cases. So if you live in Fredericksburg, Covid is here.

Main Street is bustling again and about 1 in 20 people have a mask on. Probably the shopkeepers!

Lately, a retired pathologist was in my office who said it is quite hard for even him, as a physician, to know how to prevent, test and treat himself should he or his wife get the illness. The studies just keep coming in adding to what is known about this virus.

In light of recent positive cases in our area, I have several things to share with you.

A Testing recap and update: In my last email, and also from the links I've shared about testing, the most helpful test continues to be a positive antigen test that viral RNA is being shed. Then you know you have it. Some confusion comes in that viral RNA shedding can last a few days beyond the end of the virus actually being shed. However, you'd have to assume that if you test positive, then folks you've been in contact with may have been exposed to infectious particles.

The false negative rate on the naso-pharyngeal swab samples makes this test, though it's the best we've had, less than ideal. In part, this is due to sampling error, but also the virus seems to elude even good swab technique. I heard of a case wherein the woman patient was negative for the Covid-19 antigen in the ER on her first visit, negative a few days later, negative in the ICU once she was admitted, and then after she succumbed, a positive test was only found on autopsy!

So, as I mentioned last email, an alternative collection method has surfaced that I believe will be more reliable than the Naso-pharyngeal sample method because it is taken from an early morning saliva sample. Originally, I tried one company to get an "at-home" salivary collection kit for the viral RNA, and they couldn't supply Texas. But I have found a company that does: Go here. This is a "wellness" company, and I was able to obtain a test kit to have at home, just in case. After ordering, it came within a week. They are ready with online instructions as to how to collect the sample. The cost was $150.

If you are interested in obtaining one, there is a qualifying online symptom questionnaire which, depending on your answers may prompt advice to seek a doctor instead, and stop your ordering their kit. Just FYI.

What about antibody tests? A positive antibody test has the problem of that other common corona-viruses, such as the common cold, may cross react and give a positive result. A negative antibody test can be more useful to you. For example, say you had an upper respiratory illness perhaps 14 days ago, and you tested negative for Covid-19 antigen, so you wanted an antibody test to know if you might have had a false negative antigen. The antibody test turns out negative so the illness you had was not Covid-19, and yes, you'd assume you were still vulnerable to catching Covid-19.

Antibody tests, if positive, offer some reassurance, but not certainty. If you test positive, it is not known how long of a protective period the antibodies offer. At this point, I think the antibody tests are more helpful if negative. I can order one for you and help you get it collected here at the office, or send it home with you. It is a dried blood sample. You prick your finger(s) and drop blood onto a card, and ship it back to the company. Cost again is $150.

This one, available through my office, is as accurate as possible for Covid-19, testing for four Covid-19 specific proteins, but still has limitations, as discussed.

~

Lessening our susceptibility to the Covid-19 cytokine storm is the bottom line. Functional Medicine is positioned to offer significant help because helping folks with chronic illnesses to get healthier is what we are all about.

If there was ever a time to get healthier, this is it.

Though we have had relatively few cases here, the questions from patients, friends of patients, and even small business owners have kept me busy. As I sit with each patient, anti-inflammatory programs color my thinking, and anti-viral supplements are on now on my shelves.

The menacing economics of this disaster come into view for me as well, so I am offering as economically as possible the following:

My hope is to help save folks' lives and money. Adding up the costs of testing, potential ER visits, and, if shortness of breath develops, any hospitalized treatment -- costs will mount up, and though mine is an out-of-network, cash-based practice, my understanding at present is that any Covid-related visits and labs will be either counted toward your deductible or reimbursed by your insurance company ... even Medicare. My office will help you with filling out those needed forms. See: Info on the CARES Act.

If you are interested in optimizing Covid-protective strategies, go here: Send my office staff an email.

God bless you all,