There are different conflicting messages on the media regarding the use of these medications as potential cure for Covid-19. I have been asked by different patients also to prescribe these medications.
We can not ignore research!
A double-blind study is one in which neither the participants nor the experimenters know who is receiving a particular treatment. This procedure is utilized to prevent bias in research results. Double-blind studies are particularly useful for preventing bias due to demand characteristics or the placebo effect.
Any medications is a potential lethal substance because of adverse effect, the reason they do the double sided blind study and mandate approval by FDA is to minimize adverse effect before releasing it to the public.
So not all people infected with Covid-19 come down with full blown disease, the ones that do, the main organ it affects that eventually leads to death is the respiratory system.
Here is the challenge! Some of the People who develop Covid-19 Pneumonia have trouble with breathing, if this is mild some gets oxygen support through Nasal Canula, and sometimes they might need high flow like venturi mask or even the non- rebreather. The moderate to severe cases of the Covid pneumonia would end up on Bipap, or even Mechanical Ventilators .
Here is another challenge with the Covid-19 Pneumonia. Normally gaseous exchange takes place at the alveolar level. Where oxygen crosses in through the thin membrane and co2 gets expelled out simply by diffusion, but the covid affect the thin membrane and makes the membrane thick so that co2 is not able to cross the membrane ,hence leading to to accumulation of co2 then resulting into co2 Narcosis( hypercarbia) .Simultaneously the Oxygen can’t enter , hence leading to Hypoxia – remember we need oxygen as a fuel for energy . That is why they was a lot of uproar about the mechanical ventilators shortage. This device helps to mechanically force out carbon dioxide and force in oxygen.
The downside to this is that if the membrane ( alveolar membrane ) and the airway is so damaged due to inflammatory responses by the covid-19, the use of the mechanical ventilator becomes counterproductive. this could lead to barrotrauma, That leads us to the last option ECMO- Extra Copporal Membrane Oxygenation. This is just a mechanism of bypass your lung bringing all the blood in your body out through a big bore tubing to get oxygenated and then returning this back to the body for the cells to make use of the oxygenated blood. At this time you are allowing the damaged lungs to heal.
The only medicine that helps with all this inflammatory response is dexamethasone 6mg IV. It is a steroid and it helps to suppress inflammatory response .
There is no role for zinc, no role for Azithromycin (except Mycoplasma antigen test is positive, then you can use this to treat the atypical bacteria infection, remember this is not treating covid-19, just treating co-infection) and Hydroxychloroquin, has no role!
Those that survived depend on their immune response to this major attack to the virus. If they could mount adequate immune response, they would survive even with the worse case of the Covid-19 Pneumonia.
Please wear the mask, the social distancing and also remember that the virus is airborne!!
Dr Joseph Taiwo
HOW WE KEEP YOU SAFE!
When you visit 1st Class urgent care , your safety is our number one priority .
All our staff wear full PPE (protective personal equipment) masks, gloves and we have routine cleaning according to CDC guidelines
We have also made changes to our waiting room to accommodate more spaces for social distancing to minimize contacts.
Also while you are in the exam room being tested or examined, our providers wear protective clothes mask and face shield when they collect the samples.
Joseph Taiwo MD