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Latest Covid Treatment FAQ's Orange County

By editor
January 5, 2022

ANNOUNCEMENT from CMO-


A woman calls a law firm,
"This is Schwartz, Schwartz, and Schwartz. How may I help you?"
"I would like to talk with Mr. Schwartz."
"Oh sorry; he is in court all day."

"OK, in that case let me speak to Mr. Schwartz."
"Apologies. He is on vacation."

"Then let me speak to Mr. Schwartz." "Speaking!"

(With thanks to Henny Youngman.)

As this story illustrates, there are times you really don't want to answer a question. But eventually, you have no other choice.

You have a sore throat. Cough. Maybe a fever. You test positive for Covid. You contact us and ask, "What can you give to treat it?"

A very legitimate question. But not so fun to answer.

Because it is frequently followed by a request for Hydroxychloroquine. Or Ivermectin. Or a Vitamin combination.
Lately, CoQ10 is a popular request.

You may be tempted to mimic the formula unsuccessfully used by
quarterback Aaron Rodgers. He declined to disclose his secret formula, but did state in an interview prior to his positive PCR he was taking a cocktail of Hydroxychloroquine, Ivermectin, CoQ10, zinc, Vitamin C, and D.

NONE of these treatments have been shown through ANY valid study to prevent or treat Covid. Hence Rodger’s recent Covid infection.

So what DOES prevent Covid?
Only one thing...a vaccine. And unlike vaccines we are used to, it has a relatively high failure rate. Their main advantage is they DO prevent severe cases, hospitalizations, and my personal favorite thing, to prevent-death.

And what DOES treat Covid? Well, none of those modalities mentioned above. Going into our third year of dealing with this virus, five therapies appear to have passed the tests of efficacy (working) and safety.

  • 4 of the 5 have FDA authorization, either emergency or standard approval.
  • 2 of the 5 are indicated only in hospitalized patients with severe cases.
  • 1 of the 5 is not currently available, at least in Orange County.
  • 1 of the 5 is very difficult to access, at least in Orange County.
  • 0 of the 5 "cure" Covid; they all reduce symptoms, and risk of death.

Here they are:

1. Remdesivir and 2. Baricitinib.
They are only given in the hospital. They are very effective in reducing days in the hospital, days on high flow oxygen, chance of needing intubation, and of course risk of death. So, unless you are tucked into your hospital bed, 2 of the 5 are off the list.

3.  Paxlovid and Molnupiravir, oral outpatient anti-viral agents just approved by the FDA. So why not prescribe these to our patients calling?

  • They are NOT to be used for prevention.
  • They must be used within five days of symptoms starting, which is a very narrow window to get a positive test, which is also required.
  • They are ONLY indicated in cases with a high likelihood of progressing to severe disease, hospitalization or death. Which limits to whom they can be prescribed.
  • But the biggest issue--it simply isn't available. We have called dozens of local pharmacies - nada. Some expect to not have it in common use until spring.

4.  Which leads us to the only other FDA approved (emergency use) treatment- Monoclonal Antibodies (MAB).

So far, they appear to be game changers. Safe, few side effects, and a very high success rate.

In fact, almost every case we have followed up on were improving. We do not specifically check for Omicron, but the MAB’s appear to be working in current strains we are seeing in Orange County.

And they are free, thanks to our federal government cutting a deal with Regeneron labs to supply the country with them. (A reasonable administration fee is allowed to be charged.)

Monoclonal antibodies are laboratory-produced molecules that act as substitute antibodies that can restore, enhance, or mimic the immune system's attack on viruses--in this case Covid.

A fair analogy is vaccines have the SWAT team waiting for the Covid perpetrators and neutralize them on entering the nose--I mean house. With MAB’s the SWAT team rushes the house once the perps have already entered. Either way, antibodies are doing the work.

PDQ Urgent Care, in partnership with Infusion IV Hydration & Injection Therapy, in conjunction with Caduceus- has been approved to administer MAB’s and has given approximately 50 doses in the last few weeks. However, allocations are sparse, and we run out quickly. We never know if more allocations are coming, since it is in short supply nationwide.

Recently it was reported the entire Houston area would run out of MAB’s and unsure if they can get a new allocations soon. With no other proven therapies, demand is far ahead of supply.

(Conspiracy theorists: I have been unable to verify the head of Houston MAB distributions is a Dodger fan.)

To answer the many questions about receiving MAB, let’s skip the questions and go straight to the answers:

  • To receive the MAB’s, you need to be referred by a PDQ provider. This is done via a video visit. Easiest way to do this is via the PDQ app, or live chat on the website at pdqurgentcareandmore.com. If they are closed, I suggest a Mouse Call, also available on the app or website.
  • You also agree to a follow-up video visit a few days after the MAB infusion.
  • (Advice- download the PDQ app. You can do all your Covid stuff anywhere your phone is via live chat. PDQ is then literally in your pocket.)
  • You will need to be positive by either a PCR or Antigen test and present the test at the time of the infusion.
  • You will need to be mildly to moderately ill, with a high likelihood that you may progress to a hospitalization. If you already have a severe case, you should go to the ER for possible admission to receive Options 1 and 2 above.
  • If you have Covid but are relatively healthy and improving, you should not receive MAB’s.
  • With supplies so limited, we are giving priority to our own loyal patients. It is not required to be a preexisting PDQ or Caduceus patient, however.
  • Your costs for MAB’s are modest. The two video visits are billed to your insurance. If you do not have insurance, they are under $50. The infusion fee is paid at the time of administration and is NOT billed to insurance. It is currently around $200-300.

What if you qualify for MAB’s but cannot find it? Or you are sick, but do not meet the criteria for MAB’s? We have looked and found one other therapy to replace MAB’s if needed.

Enter Option 5- Fluvoxamine aka Luvox. This is actually a type of psychiatric medication, meant for OCD in the category of drugs known as "SSRI’s.”

Luvox acts by increasing levels of the brain chemical serotonin. In addition, the drug has other biological properties that could quell inflammation triggered by COVID-19.

Why is this different than the other off label drugs touted by social media?

Well, this one has actual peer reviewed studies to support it. Yes studies--as in multiple ones. Its main claim to Covid fame is it prevents the cytokine storm responsible for the severe double pneumonias, ARDS, ventilators, and even the “long hauler” symptoms. 
And the studies are not in obscure journals. It was given passing marks from both
JAMA and The Lancet.

It is not FDA approved, and at least one local pharmacy told us they will not fill prescriptions for it until it is. But it has been taken by millions of patients over the last 30 years with a good safety profile.

Since it is an off-label use, many physicians will be resistant to use it, given the drama of Plaquenil in 2020. But our Covid team will consider it if all other options hit a dead-end.

Again, you will need a positive Covid test, and a video visit. It is NOT for prevention, and only for higher risk patients.

That's about it.

Five treatments with decent supporting data. But to review, only MAB’s are a realistic treatment to prevent hospitalizations and death.

Of course, having the antibodies ALREADY lying in wait for the dreaded spike protein is much preferred--and that means taking the vaccine, AND a booster OR check your antibody counts every 4-6 weeks as we have been advising. (Ok, nagging.)

In summary:

  1. There is no treatment shown to prevent Covid
  2. There are only five treatments showing respected data on treating Covid successfully.
  3. Only one is a current viable option for outpatients- Monoclonal Antibodies. And they work.
  4. Get vaccinated and boosted, or at least check a total antibody count regularly as your best bet to stay out of the hospital -or worse.
  5. PDQ, in partnership with Infusion IV Hydration & Injection Therapy and Caduceus, is an approved site for MAB’s. Allocations are sparse and there is no guarantee they will continue.

Just ask Houston.

We began with Henny, let’s end with Henny.

A man goes to his doctor and says "Doctor, I have Covid and I'm afraid I am going to die!"
The doctor says, "Nonsense! You'll live to be 80!"
"But I AM 80!" says the man.
"See? What did I tell you!!!!" 

Sincerely,

Gregg DeNicola MD Chief Medical Officer
Caduceus Medical Group


Monoclonal Antibodies Now Available Through PDQ Urgent Care & More Orange County

By editor
December 21, 2021

ANNOUNCMENT from CMO-


Caduceus Medical Group’s urgent care PDQ Urgent Care & More, in partnership with Infusion IV Hydration & Injection Therapy, have arranged for monoclonal antibodies from Regeneron (Casivirimab/Imdevimab) to be available to its eligible patients with Covid-19.

As they say on Channel 13, supplies are limited; we are optimistic we can continue to replenish our allotment when needed.

This is an important addition to our regime against Covid-19. As we strive for best outcomes during the current large spike in cases, these antibodies may mean the difference between home and hospital.

Perhaps even life and death. Here is what you need to know.

  1.  Monoclonal antibodies are FDA authorized via emergency use, but not yet FDA "approved.” Our experience at Caduceus has shown excellent results to date.

  2.  Strict criteria must be followed. There are quite a few, but the Big 3 are:

  • Age 12 or over.
  • Given no more than 10 days from start of symptoms.
  •  For mild to moderate PCR positive cases that have a strong likelihood of progressing to a severe cases.

   3.  Two telehealth visits are required- one prior to treatment to qualify, and a second a few days after treatment for follow up.

   4.  The antibodies themselves are at no charge. The telehealth visits are billed to insurance (or charged a reasonable cash price). The actual infusion is performed through Infusion, (makes sense right?), at PDQ Urgent Care & More and incurs an administration fee. Insurance is NOT billed for the infusion fee.

   5.  The antibodies are delivered through IV infusion, or via injection. Most experts feel the IV infusion is preferred.
 
It has been very difficult for our Covid-19 team to find centers offering the antibodies within that 10 day window. We are pleased to offer this Christmas present to our loyal patients, although hopefully it’s a present you won’t have to open.

Remember it is important to get your vaccination, or booster, or at least check your antibody counts before your holiday gatherings. It is no coincidence this current surge is three weeks from Thanksgiving. Let’s not see a January surge among ourselves. It’s easy to get protected.

But now, should you be unfortunate enough to test positive, we may be able to treat you with monoclonal antibodies at PDQ and keep you out of the hospital.

To arrange for this treatment, go to Live Chat on the PDQ Urgent Care & More website or PDQ app or email our Covid team.

To ask any medical questions about this therapy, send us a MouseCall.


Sincerely,

Gregg DeNicola MD Chief Medical Officer
Caduceus Medical Group, PDQ Urgent Care & More, PDQ Telehealth


Santa Visits Caduceus 4 Kids Yorba Linda

By editor
December 14, 2021

Santa Claus is coming to town and parking his sleigh this week at Caduceus 4 Kids at the Packing House in Yorba Linda (18200 Yorba Linda Boulevard- First floor on right upon entry. Parking is on south side of the building by main roll up entrance.)

Santa Hours:

  • Wednesday, December 15th  2:30-4:30
  • Friday, December 17th 12-2 

Although masks are required for entry into the practice, children and Santa can remove their masks for photos.  Santa is fully vaccinated.  Parents can snap their own photos and we will also have Santa's helpers there on request to take family photos from your mobile device. 

All children participating receive a special gift from Santa!  Caduceus 4 Kids will also have a table set up to draft and mail a letter to Santa. 

This holiday season, Caduceus is also participating in the 29th Spark of Love Toy Drive to support the Los Angeles County Fire Department, ABC7, Toys for Tots, and Southern California firefighters.  We hope you can help us collect new unwrapped toys and sports equipment for underserved children and teens in Los Angeles, San Bernardino, Orange, Ventura, and Riverside counties. Any contributions are always appreciated but not required for a visit with Santa.  

No reservations needed and the event is open to the public.  


December 2021 Patient Newsletter Orange County

By editor
December 2, 2021
Meet Our New Orthopedic Physician 

We welcome board certified orthopedic surgeon Dr. David Flood to Caduceus Specialty Yorba Linda.  He is certified in both general and sports medicine by the American Board of Orthopaedic Surgery. 

He has served as a team physician for the San Diego Chargers, an orthopaedic consultant for the U.S. Olympic Training Center in San Diego, and at the Naval Hospital in Camp Pendleton.
 
Read Dr. Flood's Bio
Reserve an Appointment with Dr. Flood
Have You Booked Your Annual Physical? 

Can you believe December is already here? If you’ve met your deductible and/or out-of-pocket maximums for the year, your medical costs could be covered and at a lower to no out-of-pocket cost to you. Here are some tips to guide you in getting the most out of your insurance benefits as you hit the end of the year.

1. Schedule any medical visits before December 31st. With your deductible being met, your insurance plan will pay some, or all, of the covered expenses at this point. Now is the time to get in for the routine physical and/or other procedures you may have been delaying like a colonoscopy, mammogram, or cervical cancer screening. 

2. Utilize your Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA). Your FSA and HSA accounts were funded by YOU and is YOUR MONEY, so don't let it go to waste. If you lose it every December 31st, then it is time to use it! Most FSA and HSA accounts will let you use this money on a variety of medical expenses. Check what terms your account has and make sure you use your money and don’t let it go to waste.

3. Get ready for next year. Now is the time to pre-plan your healthcare needs for next year. Having a good plan in place can not only take a lot of stress off your plate but help save your family money. If you can plan your needs for next year, it can save you the struggle of running to get it all done next December. By planning, you can have a better focus on the things you need and can budget yourself to include all your healthcare needs. You might also realize things like needing more or less money in your HSA/FSA account for the year. By sitting down and planning, you can see your expenses for the year. Looking at these past expenses will allow you to determine if you need to increase, decrease, or leave the amount you defer the same to help cover next year’s healthcare needs.

Please also remember if you changed your insurance during open enrollment, upload your new card to your patient portal account or present it at check-in at your next visit. With these tips, we hope to help you better utilize your healthcare benefits and maximize your savings! 
Reserve an Appointment- In-office or Telehealth
In Southern California, we experience astronomically high pollen counts starting in December/January. 

Seasonal allergic rhinitis symptoms can mimic the common cold but are caused by the body’s response to allergens instead of a virus. Seasonal allergies impact people during specific times of the year depending on when plants release pollen and when mold counts peak.The most common complaints of seasonal allergy sufferers are runny nose, sneezing, cough, itchy, watery, and/or puffy eyes, and nasal congestion. Symptoms may persist without much improvement for weeks or even months, as opposed to a cold, which should clear up in seven to ten days.Seasonal allergies can exacerbate asthma symptoms and also result in more frequent sinus infections (sinusitis) and ear infections.

We are here to bring you relief from seasonal allergies.  Learn more about adult and pediatric allergist Dr. Christine Panganiban
Reserve an Allergy Appointment
Flu Vaccines Still Available

Protect yourself this holiday season as cases tend to peak between December and February.  The CDC recommends annual influenza vaccinations for everyone age six months or older. Vaccination is especially important for people at high risk of influenza complications, including:

-Pregnant women
-Older adults
-Young children
-People with weakened immune systems

No appointment necessary and available at all locations while supplies last.  

Quantitative Antibody FAQ's Orange County

By editor
November 24, 2021

Since the blog last week advising antibody counts to help predict vaccine failures, we have had many questions. Let’s answer a few now.

-Caduceus and PDQ Urgent Care and More can draw the counts during an office visit of any type or at their draw stations. Due to high demand, we have specific times we are drawing total antibody counts. They are as follows:

-Caduceus at the Packing House 18200 Yorba Linda Blvd. - 

  • Caduceus Family Physicians (Red Cross tent)- 8:30-5
  • Caduceus for Women and Caduceus 4 Kids (Candyland)- 8-5


-Yorba Linda PDQ Urgent Care & More 18220 Yorba Linda Boulevard, Suite 301-

  • Mon-Fri 8-8 Sat/Sun 9-5


-Orange PDQ Urgent Care & More 7630 E Chapman Ave, Suite B.-

  • Mon-Fri 8-8 Sat 9-3


-Irvine- Caduceus Jamboree and PDQ Urgent Care and More 19742 MacArthur Blvd. Ste 100-

  • Mon-Fri- 8-5


-Laguna Beach- Caduceus on Thalia 333 Thalia 

  • Mon-Fri 8-6 Sat 9-3


-If you are a registered Caduceus or PDQ patient, you do not need a doctor’s order. If not, a quick video visit will give the order. 

-The tests are sent to Labcorp, which uses a different system than Quest.  The readings for counts cannot be compared against the two. Our ranges are for Labcorp only.

-We are aware there are many different types of antibody tests at Quest, Labcorp, and other labs. Our recommendation is ONLY for the TOTAL antibody count through Labcorp. It is the best way for us to compare apples to apples.

-We have NO affiliation with Labcorp, and do NOT receive any type of financial reward to use them. They were the first to offer the test to our patients, and with thousands of their tests to study and review that we have ordered, we continue to use them. 

-If just the total antibody screen is ordered, and insurance doesn't pay, the cost has been $40-50 for most patients. Caduceus simply sends the blood to Labcorp, which bills the patient or insurance.  Caduceus is not liable or responsible for billing questions or disputes with Labcorp.

-What Caduceus data shows are that if the TOTAL count from Labcorp is over 400, it is highly unlikely you will contract Covid, and if you do it would be a mild case.
Almost all our positive PCR tests are in patients whose antibody counts are under 300, even if vaccinated or having recovered from Covid.
We are NOT making a scientific conclusion, simply sharing our data. 

• It is a reasonable assumption that keeping your antibody count over 400 will help protect you against contracting Covid. 

• If you are under 300, we advise a vaccination or a booster.


-From our data, it does not seem to matter how you get these antibodies. There are only two ways to have anti-Covid antibodies in your blood.
1. Recover from a Covid infection
2. Receive a Covid vaccine or booster

-We do not profess a strong opinion which antibodies are "better.” Our data tells us natural antibodies last longer in our patients than vaccine antibodies. But both fade in time, thus our advice to check antibody counts regularly.

-The experts seem to agree that high antibody counts are protective, but do not agree on the best values. We anxiously await their research to be published.  Until that time, we stand by our data to help guide our patients. 


Gregg DeNicola MD
Caduceus Medical Group, PDQ Urgent Care & More, PDQ Telehealth


Antibody Quantitative Testing- Orange County CMO Covid Blog

By editor
November 19, 2021


In a world that keeps on pushin' me around  
I'll stand my ground 
And I won't back down. 
 
Tom Petty 
 
Let’s present the actual real-life case of a Caduceus married couple I will call Donald and Daisy.  (It’s real except their names of course.) 
They are both in their 60’s. 
Both were vaccinated in Feb/March (the brand isn't important). Being fully vaccinated, they assumed they were safe to travel to the Caribbean in late September. 
They needed to show proof of vaccination, which of course they had. 
 
They were gone two weeks, returning early October.  
On their second day at home they both began coughing. Coming to our Caduceus drive through curbside testing, they both tested positive for Covid in Mid-October. Daisy was moderately sick for two weeks.  Donald developed Covid pneumonia and was hospitalized and is still on home oxygen.  But both survived, thank God. 
 
Daisy's antibody level on diagnosis? 269. 
And Donald's?  27. 
 
What happened? Easy. The antibodies produced by the vaccine faded. Went away. Disappeared.   
In Donald's case, it was as if he wasn't vaccinated at all.  
 
Donald had "Mouse Called " Caduceus in mid-September asking if it was ok to travel. We advised to have an antibody count. They declined due to a busy schedule. Had they checked the levels BEFORE the trip they could have had boosters or perhaps postponed the trip. 
 
We continue to advocate for regular antibody level testing. When we began offering this in early summer, it was purely data gathering. But now, after several thousand tests, we can tell you our findings, and make reasonable assumptions. 
 
A disclaimer--we will be simply giving you data from our own Caduceus patients. We will not draw scientific conclusions. We won't claim proof or speculate on data from other groups. 
 
For example, if I tell you the street corner by my house has intersecting traffic stopping when the signal light is red, every day I drive by it, I'm just giving you factual data. I am NOT concluding red lights prevent accidents. That's for the statisticians and scientists to do their thing.  
 
Yet, it IS a reasonable assumption. But it's not valid proof. All I can say with certainty is all traffic stops at the red light by my house.  
 
So, Mr. Petty I am taking your advice.  
 
I’ll stand my ground. 
 
At Caduceus we have been advocating to check antibody levels monthly, since that appears to be an accurate way of telling if you are protected. 
 
Antibodies work.  
 
No matter how you get them- vaccine or natural. Whether Moderna is better than J&J or a vaccine is better than natural isn't the point. It doesn't matter. What DOES matter is how high your antibody count is. At least that's a reasonable assumption based on our numbers. 
 
Over 400, good shape. 
Under 300, beware---mask, avoid large gatherings, and get vaccinated and/or get a booster. 
300-400 appears to be the dreaded gray zone. 
 
More data to chew on; if the antibody count is over 400, we have had ONE symptomatic  Covid infection. Mind you, some patients do not allow us to check their antibody level when they are first diagnosed, but that is what our data is telling us. 
 
What about an antibody level under 300? Dozens of new cases. In fact, ALL but one of our new Covid cases who had been vaccinated had levels under 300. 
 
Again, I caution that this is just Caduceus data. It has not been analyzed by a Chi square, confidence interval, or signed off by Dr. Fauci. 
 
And there IS good data from our medical researchers showing a definite link to high antibody levels and Covid protection.  
 
However, a recent JAMA article called antibody testing a "flawed science.”  They acknowledged high levels appeared to be protective, but the exact thresholds were still in question. We agree. That is why we give our data here, without making a conclusion. 
 
About six months ago I made a prediction- we will reach herd immunity by Halloween. I rarely make predictions, since I feel NO ONE can look into the future. Yet in this case I had a good feeling. 
 
Since both Caduceus and California are experiencing a surge in new cases, it’s easy to say---I was wrong. But was I?  
I'd say yes and no. 
 
Explanation- People think herd immunity is having Covid go away. 
Not at all. 
 
Herd immunity occurs when a significant portion of a population is immune to an infectious disease, thereby limiting disease spread. For those who are not immune, they are indirectly protected because the ongoing disease spread is small.  
With herd immunity, masks, social distancing and even showing proof of vaccines should all go back to normal- whatever that was. 
 
In California, our numbers tell us 2/3 of adults are vaccinated. And another 20% have had Covid but not yet vaccinated. That's 86% protected, and we are thus at herd immunity.  So I was right, and you can pay me your losing bets when next see me. 
 
But wait. Cases are RISING. Especially in states with the HIGHEST vaccination rate. Pretzel logic, right? (That's for you, Steely Dan fans.) 
 
To explain we need to get three things straight. 
 
1. Vaccines work (by producing antibodies.) 
At Caduceus, 60% of our recent new Covid cases were in vaccinated people. That's right. Over half. So, do vaccines work or not? 
 
Answer: Vaccines do not prevent Covid infections. Look at Donald and Daisy -they were two of many vaccine failures.  Neither does having previous Covid infections.  
 
ANTIBODIES work. 
 
Now in fairness, the vaccines do trigger the antibodies. And a Covid infection also triggers antibodies. So how does that explain the lack of herd immunity? 
 
Think of guns. To quote an old political argument...Guns don't kill people. Actually people don't kill people either.  
BULLETS kill people.  
Saying I am going to protect my house by buying a gun means nothing if you don't have bullets.  
To illustrate- Just ask Alec Baldwin. The gun didn't kill Halyna Hutchins. A bullet did. 
 
Now work with me on this analogy. What if bullets actually let’s say, melted after a while? Or turned into blanks? Some in three months, others in a year. You would not be able to defend yourself until you checked for this and then got MORE BULLETS!  Not more guns! 
 
So, in my weird analogy, the bullets are the ANTIBODIES. No bullets, no protection. Vaccine or not. Previous infection or not. 
 
2. The CDC says that those with natural antibodies are five times more likely to be hospitalized with a second Covid infection than those that are vaccinated. Yet at Caduceus, you want to guess how many new infections were in patients with natural antibodies over 400? 
 
One. 1. Uno. 
 
And that patient had no symptoms. She had a PCR in hopes of attending a friend’s wedding.  
 
What about "natural antibodies"? Our data show with a low viral load (mild case) natural antibodies last three-six months. But a high viral load (as in hospitalized and ICU patients)? OVER a year.  
 
Caduceus data would suggest you are much better off -i.e. have more antibodies- having been in the hospital in January than having the vaccine in January. 
So why is our experience so much different than the CDC’s? 
 
Well, many more people have had mild cases of Covid, i.e. low viral load. And this is word for word from the study: 
 
"The study only examined adults who had tested positive more than three months ago.” In other words, they stacked the deck against natural antibodies by picking patients whose antibody counts would be lower. No such restriction was placed on the vaccinated group, however. They also excluded the J&J vaccine! 
 
Could it be the CDC and others want to downplay the efficacy of natural antibodies so that more people will vaccinate?  (I am asking for a friend.)  
 
Now let’s address #3. 
 
"I have an immune system, thus do not need a vaccine," or in the case of Aaron Rodgers, "I bolstered my immune system using a technique championed by that famous immunologist Shailene Woodley.” 
 
The problem with that is that all your immune system does is produce antibodies AFTER the alarm goes off to your ADT alarm system.   
  
Once your body sends out the troops, Covid may have already made it into your lungs (speaking from personal experience). Having a "good “immune system doesn’t mean you have anti-Covid antibodies already in the house waiting to attack the Covid perpetrators as soon as they enter your nose.  
 
But wait----is there any way we CAN have the troops already there--waiting to neutralize (kill) the infamous spike protein without needing to first send an alert to your immune system? 
Yes!!! 
Can we Have antibodies ALREADY in our system -Designed to kill Covid right off! That'd be so cool if we can arrange that! 
But how? OMG, I know! Take a vaccine -it produces anti-Covid antibodies!   Or actually recover from Covid and let those antibodies you sent out hang around and protect you from a second Covid infection. 
 
This is immunology 101. Taught accurately in every high school, college, and medical school in the country for decades. But for some reason, between politics, and stupidity, antibodies are not recognized as what is needed for herd immunity. Or to get into a venue for that matter. 
 
In some diseases, antibodies (either vaccine or natural) last a long time...maybe even a lifetime such as Measles and Chicken Pox. 
In other cases, maybe five-ten years, such as Tetanus. And in other viruses only one year---like the annual flu vaccine we take.  
 
Here is what we have found at Caduceus.  
 
Vaccine antibodies last 3-10 months. 
Moderna- 6-10. 
Pfizer- 4-9. 
J&J- 3-6. 
Then they are gone. As in- you have NO antibodies once they disappear. 
 
This is how previously vaccinated people are getting Covid now. If they were vaccinated in early 2021, there is a good chance their antibody count is low or zero. 
Here's the irony. To get into a concert tonight at the Performing Arts Center, I must show my proof of vaccination. But if I was vaccinated in the spring, there is a good chance I'm NOT immune. Yet I am welcomed into the venue. 
But if I bring my trusty antibody count I do every month showing tons of good anti Covid antibodies (from BOTH my infection plus my vaccine), I would be banished to return home. Although I am VERY protected.  
 
For this I blame our leaders and giant organizations such as the CDC and WHO for not doing the simple research that will prove this.  
 
To summarize:  
1. Antibodies work. Whether from vaccines or natural immunity. 
 
2. Having no or low antibodies puts you at high risk of contracting Covid. No matter if you have been vaccinated or had a previous Covid infection. 
 
3. We advise all Caduceus patients to check their antibody counts every four-six weeks, regardless of vaccination status or past Covid infection, at least until we do reach herd immunity. 
 
I advise to not get hung up on whether you need a booster. Or if you had J&J in March. Or if you have natural immunity from your Covid infection in 2020. Or if it’s safe to travel if you’ve had the vaccine. 
 
Just check your antibodies.  
 
If your count is under 300, we advise full vaccination, including receiving boosters as needed. 
 
Caduceus can draw your antibody level anywhere they draw blood. Most insurance covers this; if not the cost is reasonable. No visit is needed if you are a registered Caduceus patient. To discuss the findings with a doctor, a video visit can be easily arranged from the comfort of your home or office. 
 
We won't back down. 


Gregg DeNicola MD
Caduceus Medical Group, PDQ Urgent Care & More, PDQ Telehealth


Long Haul Covid Treatment Orange County

By editor
October 19, 2021


I am Dr. Gregg DeNicola and I am a Covid Long Hauler.
I had my first positive PCR on December 13, 2020.
I entered the hospital with double Covid pneumonia December 22, 2020 and was transferred to the Covid ICU.
I was discharged December 31, 2020.

I tested negative January 25, 2021.
I was unable to leave the couch and walk around the house freely-still on oxygen - until January 30, 2021.

I was able to stay off oxygen for 24 continuous hours for the first time on February 28, 2021. Yes, 10 weeks tethered to a plastic tube up the nose.
I was able to leave my home and run errands unattended March 13, 2021.
Exactly three months after testing positive for Covid.

I felt I had been given my life back.

On Christmas Eve and Christmas Day 2020 I knew I was truly fighting for my life. New Year’s Day I couldn't walk or even stand up by myself.
But by St. Patrick’s Day, I was able to shop alone for the corned beef, make Reubens unassisted for dinner and even enjoy a green beer "or two!"

I was cleared of blood clots, cardiac, or lung complications in April.

Life was good, God was great, and I could finally start planning the next chapter of my life.

What do "they" say about if you want to make God smile, tell Him your plans?
"They" are so right.

My first sign of Long Haul Covid was a mid-day fatigue, a new thing I experienced in April. I didn’t think much of it- I just needed an afternoon nap. I should have known something was up, since I had never taken an afternoon nap, even as a kid. It got worse. I was ok for 3-4 hours, then BOOM- I needed to lie down and snooze. Totally out of character for me.

In May, I noticed short anxiety episodes. Less than 10 minutes. Once or twice a week. In June they were 2-3 times a week, and morphed into agitation, and even anger.

The symptoms have continued unabated. On three occasions, I lashed out in anger so severe I had to formally apologize to my colleagues and family. Not for what I was angry about- I meant what I said. But loud outbursts complete with cussing was not my style and I was concerned and ashamed by them. They were totally spontaneous and unpredictable.

Even at their worst, these agitation attacks were short, rarely over 45 minutes, then -Boom-back to normal.

In June I noticed I was tearing. I thought it may be pink eye. But since I also felt hopeless and sad, I knew it was another Long Haul finding- Depression. Instead of two times a week, like the agitation, these episodes were daily. But less than an hour, sometimes only 10-15 minutes. I called them "depression attacks,” and once passed, all was good again. In my years of practice, I was unfamiliar with depression being an "attack.” But we are now finding with Long Haul PTSD, they are relatively common. They could come morning or evening, whether I'm alone or at work, and in response to nothing. They resolve spontaneously, even if I am just sitting looking at the floor.

In July, the third Long Haul symptom appeared- insomnia. Sometimes it took three hours to fall asleep. Other times, I'd awaken at 3 AM and lie there until sunrise- eyes wide open the whole time.

Turns out, mental health complaints are the becoming most common form of Long Haul Covid. Experts are calling it a type of PTSD. It is linked to how severe your Covid case was. Mild cases, mild Long Haul. More severe cases, more severe Long Haul.

Overall, if you have had Covid, you have a 20% chance of having a Long Haul case.
Hospitalized patients have a 50% chance of getting Long Haul Covid.
ICU patients? Up to 90% in some studies.

Short attacks of agitation, anger, depression, and brain fog are a common presentation. It appears to be linked to neurotransmitters that have gone haywire from the spike protein in Covid.
Besides anxiety, depression, and insomnia there are two other PTSD symptoms noted with Long Haul Covid.

It figures the “Man Upstairs” chose not to give me the one I actually wanted - anorexia and weight loss. I’d have traded all of my symptoms for a good 10 pound trim.

And the last symptom may be the most common- the "brain fog" or memory loss. My brain still has its fast ball, and I am fortunate to have avoided this one since hanging on to your brain was my most important goal post Covid.

Long Haul Covid has several definitions from the experts. A consensus indicates symptoms are 12 weeks past a negative test and lasting anywhere between 2-12 months. It does not appear to be a permanent condition.

Treatment is individualized. For the cardiac, pulmonary, and blood clotting issues, medications are available and work well. For the fatigue and mental issues, especially brain fog, no therapies are proven successful, except anecdotally.

So simply taking a Xanax for anxiety, Zoloft for depression, and Ambien for sleep is not currently advised.
Bedrest, psychotherapy, and anger management? Nah.
The best and safest treatment is simply “TOT”-Tincture of Time.
Yup, just waiting for those pesky neurotransmitters to fall in line and quit bouncing around.

At Caduceus, we diagnose Long Haulers often daily. We even found ourselves creating a protocol and treatment algorithm specially for Long Haulers.
To be sure, our “Long Haul Clinic” is growing rapidly.
Many times, patients are surprised to finding out other Post Covid patients have the same weird issues. Depression attacks, memory loss, appetite loss, heart palpitations or a persistent cough can be symptoms to start a support group.

Despite increasing numbers, health care providers don't know the long-term answer. Since Long Haul has only been a "thing" this year, we don't have a lot of data on it. As more people recover from Covid, the data will increase exponentially. Until then, "Long Haul Clinics" such as the one at Caduceus will be working hard to accumulate that data.

Of note, the NIH has just been granted $1.5 billion to study and make recommendations about Long Haul Covid.

In Summary:

  • "Long Haul Covid" is diagnosed when symptoms appear 12 weeks or longer from testing negative
  • Symptoms of Long Haul are:
    • Fatigue
    • Blood clotting 
    • Cardiac symptoms, especially palpitations 
    • Pulmonary symptoms, especially cough and shortness of breath       
    • Mental health issues, i.e. PTSD symptoms
  • These can last 2-12 months
  • Neurotransmitter errors are involved
  • Treatment currently is trial and error


And regarding PTSD symptoms are:

  • Anxiety/agitation/anger
  • Depression
  • Insomnia
  • Anorexia/weight loss
  • Brain fog/memory loss
  • Typical medications for these symptoms are probably not effective.
  • Unlike non Covid anger and depression conditions, these can be daily, appear suddenly without provocation, and last under an hour.
  • These symptoms appear to be strongly linked with high intelligence and good looks. (OK OK… just seeing if you're paying attention!)

I share my story in hopes other Long Haulers -who have been hiding their symptoms- will talk about them. Yes, it is difficult. Yet in many ways, friends and family support can be healing. In fact, I am feeling a little better just writing this blog.

In my case, the PTSD symptoms have not changed since they peaked in August. I was pretty excited this week when I had not had a depression attack in three days! But yesterday and today it returned and now I am back to square one. This year I'm hoping for the best Christmas present God can give me- no more Long Haul symptoms by Christmas Day. Considering the scare I had last Christmas, it would be fitting.

Maybe Jerry Garcia was being prophetic about Long Haul Covid when he sang:

Sometimes, the lights all shining on me
Other times- I can barely see!
Lately it occurs to me
What a long, strange trip it’s been!


Gregg DeNicola MD
Caduceus Medical Group, PDQ Urgent Care & More, PDQ Telehealth

Learn more about Long Haul Covid treatment and how we can help.


Medicare Open Enrollment... Are You Ready?

By editor
October 14, 2021
Open enrollment yellow traffic sign with fall foliage and street behind the sign
Medicare Open Enrollment Starts October 15... Are You Ready?

Medicare open enrollment – also known as Medicare’s annual election period – runs from October 15 through December 7 each year. 

During this annual window, Medicare plan enrollees can reevaluate their coverage – whether it’s Original Medicare with supplemental drug coverage, or Medicare Advantage – and make changes or purchase new policies if you want to do so.

During the Medicare open enrollment period, you can:

-Switch from Original Medicare to Medicare Advantage (as long as you’re enrolled in both Medicare Part A and Part B, and you live in the Medicare Advantage plan’s service area).

-Switch from Medicare Advantage to Original Medicare (plus a Medicare Part D plan, and possibly a Medigap plan).

-Switch from one Medicare Advantage plan to another.

-Switch from one Medicare Part D prescription drug plan to another.

-Enroll in a Medicare Part D plan if you didn’t enroll when you were first eligible for Medicare.

If you haven’t maintained other creditable coverage, a late-enrollment penalty may apply.

If you didn’t enroll in Medicare when you were first eligible, you cannot use the fall open enrollment period to enroll. Instead, you’ll use the Medicare general enrollment period, which runs from January 1 to March 31.

We are here to help!  A licensed Medicare representative will be on-site at Caduceus at the Packing House in Yorba Linda, along with community partners from Optum (Healthcare Partners, Monarch, and Applecare), Regal Medical Group, & Providence/St. Jude. 

The Medicare representative is offering complimentary consultations and the events are open to the public.  You do NOT have to be enrolled with one of the community partner health plans in order to receive help navigating your options! 

Medicare Annual Election Period Open House Events:

-Optum- Wed. Oct. 20, 1-3 pm & Wed. Oct. 27, 1-3 pm

-Regal Medical Group- Wed. Nov. 10, 10 am-2 pm

-Providence St. Jude- Tues. Nov 9, 10 am-2 pm & Tues. Nov. 16, 12:30 pm-2:30 pm

The address for Caduceus at the Packing House is 18200 Yorba Linda Blvd.  You can park in the parking garage or on the south side of the Packing House building.  You will also enter the building on the south side first floor main entrance and the information booths will be easily accessible and visible in the open public space on the first floor.  

Light refreshments will be served and you can enter to win raffle prizes on-site at the time of each event.  No appointments are needed, however, if you do wish to reserve a specific time for a consultation, please RSVP by email here or call 714-646-8058.  
 

Blog- Monthly Covid Antibody Testing

By editor
August 11, 2021


Yesterday I bought a new Koi for the Caduceus 4 Kids koi pond. I named him "Jeopardy". That way when people ask me his name I can say in a booming voice: "This! Is! Jeopardy!"
 
Since the passing of Alex Trabek there has been an increased interest in the Jeopardy TV show, with multiple guest hosts. Since we attempt to be on the leading edge of what is popular, let’s try using that format to impart important information to our patients. 
 
Remember, each response must be in the form of a question.
 
Answer #1:
Over 300
 
Question #1:
How many cases of Covid were diagnosed and/or treated at Caduceus or PDQ Urgent Care in the past 4 weeks?
 
That may not seem too bad. But it is more than we had in April, May, or June COMBINED! Compared to June there was over a 1000% increase in cases.
 
In the last week alone we are averaging 20 new cases a day, compared with 5 a WEEK in the Spring. 
 
So we are not yet ready to be talking about herd immunity. I will stick to my prediction of herd immunity by Halloween. 
 
Of these acute cases only 5 were hospitalized.  None had been vaccinated.  All developed pneumonia. None had been diagnosed with Covid previous thus no antibodies.
 
In the past month we have had over 60 pediatric cases, from 9 months of age up to 15 years old.  None needed hospitalization, most recovered quickly.  None of the pediatric cases had antibodies or vaccines. 
 
So far we have not had single documented case of Covid in a patient who had Covid previously documented. A victory for natural immunity.  Luckily, most past Covid victims that checked their antibodies and found them gone, went ahead and took the vaccine. 
  
Many of our new cases were diagnosed just after a trip out of town. There are simply too many places to catch Covid while traveling- airports, planes, taxi/Uber, restaurants, crowds, shopping, parties, etc.
 
At Caduceus, we are actively discouraging all non-essential travel until herd immunity has kicked in. 
 
This advice is sage even if vaccinated. 
 
Answer #2:
 
Ivermectin and Hydroxychloroquine (Plaquenil)
 
Question #2:
 
What therapies have not shown beneficial effects treating Covid after initially showing promise? (This data is Caduceus data only.)
 
In 2020, hundreds of patients contacted us for help prescribing Plaquenil for their Covid. 
 
In 2021, that paradigm has switched to Ivermectin, a known treatment for worms and scabies. Initial data looks hopeful, but just not enough of it. And now, with increased usage, over the objection of the FDA, CDC, and WHO we receive requests for Ivermectin daily. However, it may not be any more effective than placebo. 
 
I see 2 possibilities with these drugs.
 
1. There was definite initial improvement, but mutations and variants caused resistance to both of them.
 
Or
 
2. We just got lucky at first, and they have no effect.
 
Since March 2020, Caduceus and PDQ have diagnosed and treated over 4000 cases. Not as many as large medical centers, but enough to give us some expertise in what works and what doesn't for our patients. 
 
And here is what we have found.
 
Outpatients: Oral Decadron if we suspect an evolving pneumonia. 
 
Aggressive Pulmonary Hygiene especially with incentive spirometry.  We work hard to minimize pneumonia or any fluid in the chest. 
 
Yes we still use Zpaks, Zinc, and Vitamin D.  But the real winners are Decadron plus pulmonary hygiene -hands down in the presence of worsening lower respiratory congestion.
 
Inpatients: High flow oxygen. And Remdisivir with Decadron. Plus one more wild card: Baricitinib
 
On August 2, the FDA authorized administering Baricitinib (Olumiant) by itself to treat COVID-19 in hospitalized patients age 2 and older who require supplemental oxygen or mechanical ventilation. The emergency use authorization previously required administering Baricitinib with Remdesivir (Veklury). 
 
Convalescent serum, monoclonal antibodies, a slew of experimental anti inflammatory meds as well as other random therapies have not shown to be effective over a broad scale.
 
However the FDA on August 2 did approve monoclonal antibodies for use in certain patients who cannot mount an antibody response from the vaccine- for prevention, not treatment. 
 
Answer #3:
No or minimal symptoms
 
Question #3:
If I am vaccinated, and then still contract Covid, how ill will I become?
 
We hear a lot about people, especially celebrities and politicians, that had 2 doses of the vaccine, yet still tested positive for Covid later on. Many of these are incidental pickups, and were tested only attempting to travel or work. Some have a mild sore throat and low-grade fever for a day or two, and test as a precaution. 

At Caduceus, about 25% of our new Covid patients WERE vaccinated. But all either had no symptoms, or mild sneezing and sore throats, with minimal fever. 
 
As mentioned above, NONE of the vaccinated patients who contracted Covid had been diagnosed with Covid previously. 
 
In our opinion, the CDC should stop flip flopping on masks, and concentrate on getting the country vaccinated. Masks will not bring on the end of this nightmare, but vaccines will.
 
Answer # 4:
Because the country and big companies are not run by doctors.
 
Question #4:
"I have recent proof of natural immunity to Covid with antibody testing. They still demand proof of a vaccine! Why wont the government or large companies recognize this?"
 
This opens the door to the question: Which is more protective against Covid if exposed? Vaccines or natural immunity?
 
Some studies support natural immunity as superior to vaccine immunity. Others show vaccines are superior. Yet NO official agency has endorsed natural immunity as protective against Covid.
 
Our experience at Caduceus shows both to be effective, with a large edge given to natural immunity. The accurate answer probably is related to how high your antibody level is, no matter the source of the antibodies. 

A high antibody load is very protective. A low one, not so much. Typically, antibodies will drop slowly months after recovering from Covid or receiving the vaccine. 
 
This is why.
 
It is assumed that both natural antibodies and vaccine antibodies have approximately a one-year life to them. We will not know for sure until 2022. But when Covid occurs in either a vaccinated or past covid patient, the odds are the antibody count fell below a critical level.
 
Nonetheless, we are constantly being contacted by angry patients that have natural antibodies but still must show proof of vaccine to travel, enter certain venues, or even ironically enter an ER. We have done letters "certifying" that their antibody levels are equally protective as a vaccine, but that only occasionally works.
 
It is about time that natural immunity is recognized by all regulatory agencies as being protective against Covid.
 
Answer #5:
Antibody testing
 
Question #5:
I believe I need Covid testing. What is the most important Covid test to ask for?
 
During this current Delta surge, we are overrun by requests for the Rapid in-house swab and the more accurate PCR swab.
 
Yet as we have pointed out, the antibody test is equally or even more necessary. If it is positive, you know you will either have a negative PCR or if that is positive, at least a minor case. We have been advising a monthly antibody test to our patients and that advice hasn't changed
 
Antibody testing does not require a video visit and is an important tool in navigating through the pandemic as we are close to herd immunity.

It isn't always paid by insurance but both Caduceus and PDQ have reasonable cash prices for it. You can walk into any PDQ and ask for it.
 
To summarize:

1. Caduceus and PDQ are experiencing a surge in Covid cases at this time. Avoid all non-essential travel. Mask and social distance until further notice.
 
2. In lieu of Ivermectin and Plaquenil, early treatment is crucial to avoiding hospitalizations and death. Caduceus has an experienced Covid team; let them guide you. 
 
3. Vaccines work.
 
4. Natural immunity works, despite being ignored by the WHO, CDC and FDA
 
5. Check your antibodies regularly, whether you have had Covid or a vaccine. They will allow us to better guide you through herd immunity.
 
Ok, one more:

Answer:
Hickory Dickory Dock
 
Question:
Where do you go if your Hickory Dickory is hurting?
 

Gregg DeNicola MD
Caduceus Medical Group, PDQ Urgent Care & More, PDQ Telehealth


The Deets on Delta- FAQ's on Covid Variant

By editor
July 15, 2021

I have been asked when, as CMO, I would "declare" herd immunity for Covid and we can then move ahead and party like it’s 2019.
 
I earlier announced we should see herd immunity by Halloween, or even Labor Day, and I’m sticking with that forecast. Yet I fear I must announce another "surge" in cases, at least within Caduceus and PDQ Urgent Care & More as well as most of Orange County.
 
We were down to around 5-10 new Covid cases a week, compared to 25 or more per DAY last December. But now we are averaging 5-10 new cases a DAY, so clearly something is up. The Delta variant explains what we are seeing throughout California. 
 
Let’s review five things to know about Delta in our culture, and then five things to know about this variant.
 
1. In 1972, country songwriter Alex Harvey wrote a song for country music diva Tanya Tucker called "Delta Dawn." It was immediately covered by Helen Reddy to become a massive early 70's hit. It told the story of a long ago rejected southern Belle who could not shake the memory of a suitor who jilted her. As the song goes, “In her younger days they called her Delta Dawn.”
 
“Prettiest woman you ever laid eyes on,” who paired up with the wrong type of guy. It was actually based on his mother who committed suicide over this failed relationship. 
 
The Delta variant (mutation) was first noted in India in December 2020.  It spread like wildfire primarily because India was very poorly vaccinated. Yet, it has been found to be much more contagious and transmissible, and its "penetrance" very high. Almost as if Covid knew it was being "rejected" by masks and social distancing.
 
So Fact #1 is that it is VERY contagious.
 
2. Two years previously, a backup singer with singer Leon Russell's band became the muse for a song he wrote called "Delta Lady.”  Ironically, that singer, Rita Coolidge, sang backup vocals on the actual song. A year later, Leon left her, yet always referred to her as "My Delta Lady."  Why that name? Hard to say, but in chemistry a delta reaction is one where you add heat to the reaction.
 
Hey, do you have a better guess? 
 
With the Delta variant, we are seeing "regional outbreaks" in areas of the country with low vaccination rates. So it’s adding "heat" to those areas. If you visit or live in one of these regions, beware.  Orange County is NOT one of these regions, yet we are definitely seeing a surge.
 
It brings up the question of whether a third "booster" of Moderna or Pfizer would help keep Delta away. There is not enough data to support that theory. It does appear the antibody levels will fall off around the 11-12th month mark, so a 2022 booster will be advised I suspect. If you are immunized, no need to worry about another shot, but you may want to mask up and social distance until we know more about the Delta variant. 
 
3. In 1928, a new airline was founded in the Mississippi delta region, hence the name "Delta.”  It grew rapidly and went through several mergers and acquisitions, always as the surviving entity.
 
But in 2005, Delta was forced to declare a Chapter 11 bankruptcy.  Unlike its competitors, Delta did not lock in long term fuel contacts when prices were low. In 2005, fuel prices skyrocketed, and Delta was unprepared. Needless to say, Delta learned its lesson and now locks in lower fuel prices whenever able.
 
With the Delta variant, it has also caught certain patients unprepared- namely those unvaccinated. Even more specifically, kids and young adults are the main victims now.
 
At Caduceus, over 80% of our new cases are in patients under 35. Very few seniors are catching the Delta variant, presumably because they are vaccinated. One wonders if, like Delta Airlines, the youth will learn its lesson and get vaccinated.
 
4.In 1980, David Crosby wrote his last song as a part of Crosby, Stills and Nash. Its name? One guess. 
 
"Delta" was an escape song, revealing his weariness over the fast paced world of music executives and big cities. He longed to be in a boat drifting down the Delta (presumptively the Mississippi Delta).  As the lyrics say, "It seems as if time stops on the Delta."
 
For those researching, investigating, and treating Covid daily, it is easy to get weary of the "authorities" who downplay the protection of natural antibodies- obtained by actually contracting Covid. At Caduceus, we have had two out of over 3500 cases in patients who had Covid previously. But neither allowed us to check antibodies. Conversely, we have had over a dozen cases of Covid diagnosed in patients who were vaccinated. Even that comes to a less than 1% failure rate, mirroring what is being seen across the country.
 
So do antibodies---either natural or via vaccines-protect from the Delta variant? 
Yes.
 
There is concern Delta is more contagious, thus more likely to infect even the vaccinated. But so far, the local outbreaks and surges appear to be mostly in the unvaccinated or un-antibodied. (Yes, it is permissible for writer’s privilege to allow making up new words.)
 
And like David Crosby-once things calm down-I want to escape to the Delta, where time stops.
 
5. How can we leave out the most famous Delta of all???
 
In 1977, Harold Ramis told us a story we would never forget.  In the year 1962, two freshmen seek to join a fraternity. Finding themselves out of place at the prestigious Omega Theta Pi house's party, they visit- next door- the chaotic, grungy and irreverent "Delta House.” 
 
The frat they joined was made up of rejects, nerds, IQ challenged, and the heaviest partiers in the history of fraternities.  All on academic probation, riding motorcycles up stairs, engaging in toga parties, wild food fights, and destroying the homecoming parade.  They wreak havoc on everyone in their way.
 
Sound familiar? The Delta variant is THE "Deltas" of viruses. If John Belushi were a virus, he would be the Delta Variant. But is it really that different than the plain vanilla Covid?
 
Yes.
 
Where Covid was known for a cough and loss of taste and smell, the Delta presents more with headaches, sore throat, and fever. It appears equally likely to cause pneumonia and death however. So far, mortality rates have not been proven to be higher with Delta. 
 
In summary, here is what you need to know about the Delta variant:
 

  1. It is more contagious, especially in younger people and children. In areas with low vaccination rates, be aware of regional outbreaks.

 

  1. It may not present the way Covid did last year.  Headache, sore throat, and fever are now the main symptoms to watch for.

 

  1. Antibodies appear to be effective, but remember, nothing except total quarantine is 100%. If you are unvaccinated, or have no natural antibodies, you are at high risk.

 

  1. If you are vaccinated, you do not need another booster. If you have natural antibodies, vaccination is reassuring but may give more side effects since there are plenty of natural antibodies already in the blood stream. A booster now will not protect you more against Delta. 

 

  1. If you are high risk (Lung disease, cancer, immunocompromised) please continue to mask and social distance.  It might save your life.

 
 
Herd immunity is close. But will that mean Covid is over? Remember the words of the most notorious Delta of all:
 
“What? Over? 
Did you say over? 
Nothing is over until we decide it is! 
Was it over when the Germans bombed Pearl Harbor? Hell no!”
 
-Bluto the Delta 
 

Gregg DeNicola MD
Caduceus Medical Group, PDQ Urgent Care & More, PDQ Telehealth