Yes it’s that time of year again when April showers have borne May flowers, and with that allergy season arrives in full bloom. Let’s hope you’re not allergic to puns. So if you’ve recently noticed a scratchy nose, watery eyes, and sensitive skin – not to worry, we can start from scratch to combat that sniff.
Caduceus has been itching to announce our new allergy testing: a skin scratch test available at all office locations. No needles, no pain, and no need to wait. Caduceus patients can sign up for testing today and receive their results within 1-3 days.
So, who should be tested?
The short answer is anyone. While allergies can occur at any age, typically they appear in childhood and peak in early adulthood. Typical symptoms include sneezing, runny or stuffy nose, itchy or watery eyes, itching mouth and skin, and fatigue. Less common symptoms could be unusual rashes, sinus headaches, swollen lips and tongue, and even behavioral changes.
You should also know that allergies generally come in three seasons – spring, summer, and fall – so we find ourselves right in the middle of peak exposure. And remember all that rain we had from January through March? Well Southern California experts project that the extra downpour will break up pollen and create a stronger season than usual once the winds of summer arrive.
Now what should you do if you think you have allergies?
First, get tested. As common as allergies are this time of year, many other conditions can mimic this histamine-driven response: an infection like the “common cold”, sinus infection, non-allergic rhinitis (runny nose), food sensitivities, and medication side effects.
So you can direct yourself for allergy testing – but make sure you discuss the results with your doctor to make an assessment and treatment plan.
Other proactive things you can do to keep allergies under control:
Saline sprays. These over-the-counter saltwater sprays can flush out your nasal passages. They help clear out pollen and other irritants.
Protection. Reduce exposure to pollen: Don't do outdoor activities when pollen counts are high. Most pollen peaks between 5 a.m. and 10 a.m. each day, and can also be high around midday when it’s warm and windy.
Helpful foods. Eating something spicy can thin mucus and clear congestion. A teaspoon of honey can soothe your throat if it gets irritated from coughing all day.
In summary:
Allergy season can be nearly year-along and affect anyone, and this year in Southern California could be especially itchy.
Caduceus offers on-site testing with a scratch test – no painful needles – with results in 1-3 days.
Make an appointment with your doctor to review these results and make a treatment plan – so you can stop and smell the flowers worry-free.
Nathaniel DeNicola, MD, MSHP, FACOG Chief Medical Officer | Caduceus Medical Group
PATIENT BLOG ORANGE COUNTY OZEMPIC
The Doubting Doc- Ozempic, Wegovy, Mounjaro...Oh My! Weight Loss FAQ's
Let’s play a short game of Jeopardy…
Answer: I need to lose weight I'm overweight I'm obese I'm fat I'm going to stop eating carbs No, meat No, gluten No, dinner I'm going to exercise more--at least twice a week
Question: What does a typical doctor hear 99 times a day from their patients?
Especially post Covid, we are seeing more obesity than ever. Recent studies put at 80% the number of people over their ideal body weight.
With obesity comes obesity humor. While its felt to be in poor taste to fat shame anyone, since MY BMI is teetering around 30, maybe I should poke fun at myself.
Why does me remembering my diet not kick in until my 10th donut? or My wife and I went on a diet and lost 10 pounds combined...she lost 20 just herself!
We define obesity as a BMI over 30. (All you need to calculate your BMI is your height, weight, and Google.) As doctors, our advice has been very simple over the years- diet, exercise, reduce stress, and if all else fails, have surgery to shrink the stomach.
But weight loss surgery seems a bit extreme for most, and diet pills had their share of issues- some are not safe or are addictive. Others have poor long-term results. Most were only good for 20 pounds. Few were FDA approved for weight loss.
Introducing…the current game changer for weight loss in patients who need to lose 25 or more pounds!!
GLP-1 agonists.
In plain English, they reduce hunger and food intake at the biochemical level. They are considered by the medical community to be safe and effective.
The three most popular choices are Ozempic, Wegovy, and Mounjaro. Since we don't have a horse in this race, let’s discuss each one to see if any may be right for you or a loved one. Remember, Caduceus never allows drug "detailing,” so no Laker tickets were used in preparation for this blog. Not even a coffee cup.
Ozempic (Semaglutide)
It is FDA approved for Type 2 Diabetes---it is NOT FDA approved for weight loss, but patients who take it tend to lose weight---10-15% of body weight is common. Many patients have been able to reduce or go off diabetic, lipid, and hypertensive medications with the weight loss. It requires a weekly shot and a monthly follow-up. Once weight loss is established, it is safe to continue taking it long term. In fact, going off of it risks returning to you to your original weight.
Wegovy (Semaglutide)
It is an identical version of the drug Ozempic - with a few differences. For one, the dose used can be higher, resulting in higher weight loss. For another, it IS FDA approved for chronic weight management, and NOT for diabetes. You will need a BMI of 30, or 27 plus a "co-morbidity" such as hypertension or high cholesterol for FDA approval and insurance payment. Otherwise the cost, weekly shots, and monthly long term follow-ups apply to both.
Mounjaro (Tirzepatide)
It is a GLP-1 agonist plus it inhibits a second peptide that curbs appetite and produces "early satiety"--i.e. you feel fuller faster. It is FDA approved for diabetes but has an application into the FDA for approval for weight loss. It is expected to be approved, which would give it the distinction of the only medication that is FDA approved for both diabetes AND weight loss. In fact, the FDA has agreed to "fast-track" its weight loss approval. It also is the same weekly shot story, but the dose can be pushed even higher than the semiglutides. In head-to-head studies, Mounjaro has the highest weight loss, but the most side effects. The cost is comparable.
There were "Hollywood whispers" that Adele, Rebel Wilson, and Kim/Khloe Kardashian all have used these medications successfully---but in fact all four, they deny it loudly, saying diet and exercise were the methods for their weight loss. Being trusting, we will take them at their word. We do caution our readers that it is very difficult to get a 30-pound weight loss (or more) with diet and exercise alone, especially keeping it off.
Since nothing is too good to be true, what are the downsides to taking these meds? I counted five right off the bat.
1. They are expensive unless you allow us to get insurance approval. About $450/week, maybe half that if you try to use a compounding pharmacy (see BEWARE below). That is just for the drug itself. Most office visits may be paid for by the insurance company if there is medical necessity.
2.They are so popular, no one takes them anymore (Thanks to Yogi Berra for the inspiration) --meaning their popularity has caused severe shortages in some areas. Finding the meds may be tough depending on the doctor and pharmacy you pick. Hopefully the shortages are being fixed.
3.The main side effects are GI- nausea, cramping, etc. Some report an intolerance for alcohol. Rare reports of hair loss. These seem more pronounced with Mounjaro.
4.To maintain the weight loss you probably will take the medication long term--and still diet and exercise. Seems there's no getting around that advice.
5. You ideally need an experienced provider who can help select the right medication, know how to get insurance approval if necessary, and correctly adjust the dose monthly.
And now for this commercial break---endorsed by the CEO and CMO of Caduceus:
At Caduceus and PDQ Urgent Care and More, we have trained providers to assist you if you feel you may benefit from these medications.
We can do most of the visits via Zoom telehealth if preferred.
We will assist in selecting the medication best suited for you depending on your health conditions and weight loss needed, plus the financial situation. Also, we will work hard to obtain insurance pre-authorization.
If a compounding pharmacy is to be used, we will vet them for you.
If you need a quick lesson in giving the subcutaneous shots, we will teach that to you.
My BMI is so high, when I contracted a case of flesh-eating bacteria -they died from exhaustion.
Certainly, there are various options for getting this prescription--let us offer a few cautions.
There are hundreds of "online weight clinics" offering these meds with a quick ten-minute video visit. There are too many other legit choices to resort to these; we plead you to use caution.
Many "clinics" offer just one drug, and have you enroll in a "subscription" model where you pay one monthly or even yearly fee to cover the compounded medication, office visits, blood work etc. Where subscriptions are great for your TV streaming, beware of using them with your health care. Most legit doctors do not need to resort to a subscription gimmick that ties you down to that provider long term.
Beware of providers that do not require blood tests, do not ensure you are up to date on your screenings, or decline to offer to teach you how to give the shots. These are signs of a "mill" and should be avoided.
"No need for preauthorization" advertised. Either they may be dispensing counterfeit medications, or using a compounding pharmacy that may or may not be legit.
The FDA has announced they will be investigating these meds from compounding pharmacies - why?
Semaglutide is governed by the regulations that restrict compounding pharmacies from making replications of patented therapeutics.
In defiance of these regulations, some compounding pharmacies have compounded semaglutides with other medications, thinking that gets around the FDA scrutiny.
It doesn't.
If this is all Greek to you, we get it. Just be very careful accepting "cheap" or "generic" semaglutides. If you cannot vet them, be sure your doctor can.
I for one, am not offended when I am called overweight-- I'm much bigger than that.
In Summary:
At least three newer medications are available to assist with chronic weight loss management and may be FDA approved and/or covered by insurance.
These medications are not addicting, not short term solutions, and recognized as safe and effective by most doctors.
They all require a weekly shot, a monthly follow up, and serial blood tests - as well as diet and exercise.
There is NO evidence any celebrity has ever used any of these medications.
Be aware of possible shortages, inexperienced doctors, shady online weight loss clinics, unvetted compounding pharmacies, or poor technique at giving your own shots.
I'm so obese my blood type came back "gravy."
Gregg DeNicola MD CEO & Chairman Caduceus Medical Group & PDQ Urgent Care & More
If you feel you or a loved one may be a good candidate for these medications, please reach out to us TODAY:
Call our dedicated appointment line at 844-807-8558
Request an appointment through your patient portal account
Live chat from the Caduceus website or app
PATIENT BLOG ORANGE COUNTY Colorectal Cancer Awareness
As we near the end of Colorectal Cancer Prevention Month, Caduceus would like to highlight for our patients that awareness of gut health is just the beginning. With proper education and screening, colon disease can be treated, defeated, or avoided altogether.
First, let's talk about the late form to be avoided: colorectal cancer. It's the third most common cancer in both men and women in the United States, but the good news is that it's also one of the most preventable. Screening tests can detect abnormal growths in the colon, such as polyps, before they become cancerous.
The US Preventive Services Task Force recommends that people with an average risk of colorectal cancer start regular screening at age 45. I know, that likely sounds too young for something like this. But for people with a higher risk, such as a family history of colorectal cancer, screening may need to start earlier.
Others who should be screened earlier are people with:
Inflammatory Bowel Disease
Personal or family history of colorectal cancer or colorectal polyps
Genetic conditions like familial adenomatous polyposis (FAP) or Lynch Syndrome
Now you might be thinking that screening sounds like a good idea, but you’re dreading that right of passage exam. We’re here to get you through to the other side. While colonoscopy is the most common and often the preferred method (yes with the option for medication), there are other routes including stool tests, flexible scopes, and virtual colonoscopy. These can be discussed with either your primary care doctor or your Gastroenterology specialist.
But screening isn't the only thing you can do to prevent colorectal cancer. You can also make lifestyle changes that can reduce your risk, such as:
Eating a healthy diet that's high in fiber and low in red and processed meats
Maintaining a healthy weight
Exercising regularly
Quitting smoking
Limiting alcohol consumption
You should also know that colon cancer has started to skew younger: a new study from the American Cancer Society found that 1 in 5 cases diagnosed today occurs in adults younger than 55, compared to 1 in 10 in 1995. While no one cause has been identified – genetics, the microbiome, and low screening rates are all believed to play a factor.
So in addition to keeping up with your screening be sure to watch out for worrisome symptoms: abdominal pain, unexplained weight loss, changes in the frequency, size, or appearance of stools, and rectal bleeding.
In the end, trust your gut.
Taking care of your colon is an important part of overall health. By maintaining a healthy lifestyle and getting screened regularly, you can reduce your risk of colorectal cancer.
If your health plan requires a referral, please schedule an in-office visit or Zoom call with your primary care provider (PCP). You can book directly from the button below or request an appointment through your patient portal.
If your health plan does not require a referral, you can book a Zoom call with our GI advanced care practitioner for your colonoscopy screening, that would be needed prior to booking your procedure. You can request an appointment from the button below or request directly through your patient portal.
Nathaniel DeNicola, MD, MSHP, FACOG Chief Medical Officer | Caduceus Medical Group
Fall Prevention Orange County
Keep the Spring in your Step
In a few weeks we will face that annual ritual of resetting our clocks while reciting, “spring forward, fall back.” But this year at Caduceus it’s “spring forward, fall not.”
That’s right, this spring we are making falls a thing of the past. Caduceus is proud to announce its Fall Prevention Program complete with clinical counseling, supply recommendations, and a free home inspection.
Why focus on fall prevention?
Well, first and foremost, falls are a common problem among senior citizens that can lead to serious injuries and reduced independence. According to the Centers for Disease Control and Prevention, one in four Americans aged 65 and older falls each year – and less than half tell their doctor! Since falling once doubles the chance of falling again, it’s time to talk about it.
The health risks of a fall may seem obvious – like broken bones in the arms, wrist, or hip – which can reduce independence and hinder daily activities, but there are other concerns. Head injuries can be especially dangerous for seniors or people taking blood thinners, which can exacerbate a brain injury.
Plus, even if you don’t actually suffer a spill, just the fear of falling can be a problem – people who limit activities become weaker and deconditioned, which among other things increases the chance that the dreaded dive occurs after all.
So let’s break the fall before it happens, and it helps to know who is at risk. Several factors can increase a senior's risk of falling, including:
Age-related changes in balance, coordination, and vision
Lower body weakness
Vitamin D deficiency
Chronic health conditions such as arthritis, diabetes, and dementia
Medications that can cause dizziness, drowsiness, or other side effects
Environmental hazards, such as uneven floors, poor lighting, and loose rugs or carpets
Remember it’s not only seniors who can get tripped up. Anyone recently discharged from the hospital, those recovering during postoperative care, and people who live alone should also use some extra caution. And let’s not forget about expectant mothers – as 1 in 4 pregnant women experience a fall during pregnancy, and 1 in 10 fall multiple times.
Ok, so how do you prevent this free fall from health and independence? We at Caduceus have you covered. First, you can take the following steps:
Exercise regularly to improve balance and strength. This can include activities such as walking, Tai Chi, or water aerobics.
Review and follow your medications with your doctor or health professional. Some medications can increase the risk of falls.
Remove tripping hazards from your home, such as loose rugs, cords, or clutter. Keep frequently used items within easy reach to avoid the need to climb or stretch.
Use assistive devices, such as a cane or walker, to help with balance and stability.
Make sure your home is well-lit, especially in areas you use at night, such as the bathroom and bedroom.
Wear shoes that fit well and have non-slip soles. Avoid going barefoot or wearing socks.
Have your vision and hearing checked regularly and wear glasses or hearing aids as prescribed.
Look into a medical alert system; some are covered by insurance.
Consider installing handrails or grab bars in your home, especially in the bathroom.
Second, get your home inspected! As a service to Caduceus patients we are offering a free home inspection with a safety score to help identify preventative measures and keep that spring in your step.
In conclusion, falls are a common problem among senior citizens that can lead to serious injuries and reduced independence. Many age-related and environmental risk factors can be mitigated with proper counseling and home safety checks. To schedule a home inspection email support.
Nathaniel DeNicola, MD, MSHP, FACOG Chief Medical Officer | Caduceus Medical Group
CMO PATIENT BLOG ORANGE COUNTY- RSV FAQ's AND WHO IS HIGH RISK?
Aw-chew! Uh oh. Well maybe it’s nothing…
Aw-chewww! Ok that was a good one. That’s it, get it all out of the system. Two sneezes and off to wor…
Aww-chewwwwy! Oh boy. What do I do now?
You’ve come to the right place. Here at Caduceus & PDQ Urgent Care we have you covered.
The first thing to know is that respiratory viruses are still on the rise – yes, other than COVID-19 – particularly Respiratory Syncytial Virus, or RSV. This is a highly contagious virus that can cause severe respiratory illness in children, pregnant women, and older adults.
RSV is a leading cause of bronchiolitis and pneumonia in young children and can be particularly dangerous for premature infants and those with underlying health conditions. Pregnant women and older adults with weakened immune systems are also at increased risk for severe RSV infection.
Symptoms of RSV infection may include coughing, difficulty breathing, and a runny nose. In severe cases, the virus can lead to hospitalization and, in rare cases, death.
But not to fear, because the next thing to know is that it is preventable. The best way to prevent RSV infection is to practice good hygiene, such as washing your hands frequently and avoiding close contact with sick individuals.
Best Practices To Prevent Transmission of RSV
-Wash your hands frequently with soap and water for at least 20 seconds, especially before touching your eyes, nose, or mouth. -Avoid close contact with people who are sick, and stay home if you are feeling unwell. -Cover your nose and mouth with a tissue or your elbow when you cough or sneeze, and dispose of used tissues immediately. -Clean and disinfect frequently-touched surfaces, such as toys, doorknobs, and light switches, daily to help prevent the spread of germs. -Avoid touching your face, especially your eyes, nose, and mouth, as this is how the virus can enter your body. -Avoid crowded public places, especially during peak RSV season, which typically runs from late fall through early spring. -Keep infants and young children away from people who are smoking or who have recently been in contact with smoke, as the virus can be inhaled in cigarette smoke. -Avoid placing an infant in a car seat or stroller with a blanket, as the blanket can trap smoke and other pollutants close to the infant's face. -If you are a parent or caregiver of an infant or young child, do not allow them to share pacifiers, bottles, cups, or eating utensils. -If you are a healthcare worker or caregiver for high-risk individuals, wear a mask and gloves.
Let’s examine more who should be most careful during this RSV season.
Children are at the greatest risk for RSV infection, especially those under the age of two. Premature infants and those with chronic lung or heart conditions are particularly vulnerable to the virus. It is important for parents to be aware of the symptoms of RSV and to seek medical attention if their child is showing signs of infection.
Pregnant women are also at increased risk for severe RSV infection, as the virus can be transmitted from mother to baby during delivery. Pregnant women should take extra precautions to avoid exposure to the virus, such as avoiding crowded places and washing their hands frequently.
Older adults, especially those over the age of 65, are also at increased risk for severe RSV infection. This is because the immune system weakens with age, making it harder for the body to fight off the virus. Older adults should take steps to protect themselves from RSV, such as getting vaccinated and practicing good hygiene.
GroupRisk for RSV infection-
-Children under 2 High -Premature infants High -Children with chronic lung or heart conditions High -Pregnant women High -Older adults over 65 High
In terms of treatment, it’s important to know that there is no specific cure for RSV infection; which is why prevention is so important. Early monitoring by a health professional for those at high risk is the best approach. You can augment your monitoring at home with a pulse oximeter: typical numbers should be above 95% – and contact your healthcare team right away for numbers less than 90%.
Supportive care for fever and pain can be provided with medications like acetaminophen (Tylenol) and non-steroidal anti-inflammatories (Ibuprofen, Advil, Motrin). Most individuals with the virus will recover on their own within a few weeks. However, severe cases may require hospitalization and supportive care, such as oxygen therapy and fluids.
Also remember, your cough and sneeze might not be RSV at all. As a recent LA Times article advised us, we are currently facing a triple threat of respiratory viruses: RSV, COVID-19, and Influenza. While the symptoms may be similar, there are some key differences between the three infections.
Symptoms of RSV infection may include coughing, difficulty breathing, and a runny nose.
Symptoms of COVID-19 may include coughing, difficulty breathing, and fever. Other common symptoms include loss of taste or smell, body aches, and fatigue.
Symptoms of influenza, or the flu, may include fever, body aches, and a cough. Other common symptoms include chills, fatigue, and a sore throat.
One key difference between the three infections is that some individuals with COVID-19 may not have any symptoms at all, while symptoms of influenza and RSV infection are typically present. Additionally, the incubation period (the time between exposure to the virus and the onset of symptoms) is typically shorter for RSV and influenza than for COVID-19.
In summary, RSV is a highly contagious virus that can cause severe respiratory illness in children, pregnant women, and older adults. To reduce the risk of infection, it is important to practice good hygiene and avoid close contact with sick individuals. To have that cough or sneeze examined we at Caduceus & PDQ Urgent Care are here for you with our online chat, same-day urgent care appointments, and telehealth checks from the comfort of home.
Nathaniel DeNicola, MD, MSHP, FACOG Chief Medical Officer | Caduceus Medical Group
CMO Covid Blog Orange County Natural Antibodies "Get No Respect"
Natural Immunity- The Rodney Dangerfield of Covid
"When I was born the doctor came out to the waiting room and said to my father, “I’m very sorry. We did everything we could…but he pulled through.”
"My mother had morning sickness AFTER I was born."
Rodney Dangerfield was born Jacob Cohen in New York in 1921. His first job was writing jokes for standup comics under the name Jack Roy. Making a living was hard so to support his wife and family he sold aluminum siding and finally quit show business altogether at age 30.
He was so little known he once said, "At the time I quit, I was the only one who knew I quit." At age 40, he tried comedy again. No one would book him. He was puzzled; he felt his jokes were good, so what was the problem? "I played one club—it was so far out; my act was reviewed in Field & Stream."
Then- an epiphany. His whole life he never had been shown respect--from his parents to his teachers, and then in his job. He was a 40-year-old loser. And this was in real life. He changed his name to Rodney Dangerfield and based his new act on a self-apparent truth- that he was a loser who got no respect.
The rest is comedy history. For the rest of his life, he would start off his act with four words that sent the crowd into hysteria--"I get no respect.”
"My mother never breast fed me. She told me that she only liked me as a friend." "My father carries around the picture of the kid who came with his wallet."
So now to discuss the Rodney Dangerfield of the Covid pandemic--Natural Immunity ("NI"). It's what you have in your blood to help prevent future Covid infections-IF you have had Covid.
Natural Immunity gets no respect. Multiple Studies show it is superior to vaccination immunity- But no one asks for proof of it. Concert Halls? The fat lady sings on NI. Ballparks? You're OUT, NI. Airlines? Take a flyin’ leap. Cruise Ships? Take a long walk off a short pier, natural immunity. They want to see your vaccine card. Natural Immunity? That and $2.50 will buy you a cup of coffee.
"My natural immunity test result fell in a sandbox--and the cat kept covering it up."
Even more disrespectful is when you go to events such as concerts and ball games. If you do not have your full vaccine card, they WILL accept a negative "rapid" test---which is useless. It is not even indicated in people without symptoms. In fact, it may be harmful, giving a false sense of security when in fact you are actively spreading Covid with a meaningless false negative test in your pocket. But try showing proof of natural immunity--you may as well be showing your Amazon gift card.
Clearly, being fully vaccinated AND the proud owner of natural antibodies would be ideal-but arguably unnecessary.
Teachers-doctors-pilots-and even the critical truck drivers and longshoremen we need for the supply chain have been fired despite having good proof of protection from natural immunity. Illustrating further the lack of respect for natural immunity - a booster six months old is considered protective-despite loads of evidence it may be worn off by then. Our public health officials and government have not even approved a needed 4th dose of the vaccine-- here is a CDC quote from a few days ago:
"At this time, CDC does not have a recommendation for a fourth dose/second booster for most Americans," said Scott Pauley, a CDC spokesperson, referring only to people who are not immunocompromised. Yet we see thousands of people contracting Covid with three doses, especially if the third dose is over four months old.
The CDC told natural immunity they weren't as good as vaccine immunity to prevent Covid. Natural immunity said, "I want a second opinion!" "Ok, you’re ugly too!" said the CDC.
Natural immunity gets no respect. NI works because the immune system works. Working as an alarm system that sends out soldiers when the alarm is sounded, the soldiers stay around after they neutralize the perpetrator. This is true of a true intruder (like Covid), or an impostor that tricks the alarm company to send out soldiers (like vaccines). In both cases they are sitting in your blood stream awaiting a new infection--making it difficult to get infected once the antibodies are in your system. The facts are that the soldiers are bigger and better from an actual Covid infection than the soldiers that responded to the imposter antigen. And yes, I have proof. Yet the natural immunity gets no respect. Just like Rodney. It makes sense that the antibody response is linked to length and severity of a Covid infection. A moderate to severe case, lasting two to three weeks with possible ICU admission will give a much higher level of natural immunity than a mild case lasting a few days. Hence the need for a blood level. Our public health systems have not yet come up with a number you should stay over to proclaim your protection.
Natural immunity--it gets no respect. CDC director Rochelle Walensky signed the John Snow Memorandum last fall which stated: "There is no evidence for lasting protective immunity to Covid following natural infection." Evidence? You say you want evidence?? Oh, I got your evidence!!! At the respected Johns Hopkins, a 2021 study showed 99% of post-Covid cases had antibodies TWO YEARS after infection. They also found natural immunity from prior mutations DID protect against Omicron. Meanwhile, Kaiser Southern California published a study showing Moderna antibodies fell to 60% and just 16% against Omicron only 6 months after the vaccine. For an unknown reason the CDC refused to release their data on reinfection from natural immunity ---- until now. It revealed natural immunity THREE times more effective of preventing hospitalization and almost FIVE times as effective in preventing Covid infections when compared to vaccination. The data is there- and it shows natural Immunity gets no respect. "Last night my wife met me at the front door. She was wearing a sexy negligee. The only trouble was, she was coming home." If you are still not convinced, we have good data to support using natural immunity as "protective," I will submit a list of studies that DO give natural Immunity the respect it deserves at the end of this blog -so as not to bore those of you who are believers. What is interesting is that all the studies showing the positive effect of natural immunity do NOT post "levels" as we have been advising since last year. At Caduceus and PDQ Urgent Care & More we increased the protective level to 500, but that appears to be more important in assessing the length of time the antibodies stay in VACCINATED patients. Except for very mild cases, natural immunity appears to always be over 500 for at least 6 months. (Our data only.) Why the cold shoulder from our public health officials and government? One may be the goal to have EVERY American vaccinated, and by giving credence to natural immunity, this goal may not be achieved. Which is noble, but not scientifically accurate. A second theory is that because there is no "number" to call the cutoff on antibody testing, and the liability so high if they get it wrong, they need to do much more research to allow for that magic number to be arrived at. Sounds reasonable-other than the fact that we now have TWO YEARS of data to determine an accurate number. Plus, ALL natural immunity appears to produce high antibody levels for quite a while, so in most cases of NI, the antibody count itself is less important. Also, the CDC does not even advise a second booster, no matter how long from the third shot it is. And our numbers show many of those patients suffered serious Covid infections this last December and January. Even cases that had to be admitted. To be logical, public health authorities should hold boosters and natural immunity to the same standard. Why the lack of respect for NI? Could it be that the government--who bought and distributed all the vaccines, and even all the monoclonal antibodies, are hesitating to advise anything they can't control and monitor? Ok -that one is for the conspiracy theorists among you.
Dr. Aaron Kheriaty, a professor of Psychiatry and Human Behavior at the medical school and director of the Medical Ethics Program at UCI Health, was termed in December because he declined to be vaccinated, citing his natural immunity was at least equal to the vaccine. Dr Kheriaty, as well as thousands of similar teachers, doctors and nurses should be reinstated -assuming they show proof of natural Immunity. There is precedent--Connecticut has suspended its vaccine mandate for state employees with natural immunity and Starbucks is rehiring staff that was terminated for being unvaccinated allowing natural immunity to do its job. Led by Dr. Marty Makary, a group of esteemed Johns Hopkins physicians have called on public health officials to recognize the data on natural immunity. The notion that ONLY the unvaccinated can spread the virus and ONLY the vaccination can prevent its spread is wrong.
We call on those in a position to do so - to research and give natural immunity the respect it deserves- -right up there with vaccinations.
We call on those states with vaccine mandates to recognize natural immunity as protective.
We call on our Military to restore full rank to soldiers dishonorably discharged because they only showed natural immunity.
It's time to give natural immunity the respect it deserves.
As Spike Lee would say--"Do the right thing."
As Rodney Dangerfield would say: "I told my doctor, “Doctor every morning when I get up and look in the mirror, I feel like throwing up. What’s wrong with me?" He said, “I don’t know, but your eyesight is perfect.”
Natural immunity asked the Public Health Official if it could go ice skating on the lake.
“Wait ‘till it gets warmer!” They said.
Gregg DeNicola MD Chief Medical Officer Caduceus Medical Group, PDQ Urgent Care & More, PDQ Telehealth
Epidemiological studies-
Lancet 2021 in a population-level observational study, people who had had COVID-19 previously were around 85% protected against reinfection.
Eur J Clin Invest. 2021 in a retrospective observational study using national Austrian SARS-CoV-2 infection data, people who had had COVID-19 previously were around 91% protected against reinfection.
Clin Infect Dis. 2021 In a retrospective cohort study in the USA, people who had had COVID-19 previously were 88% protected against reinfection.
MedRxiv. 2021 In a retrospective observational study in Israel, SARS-CoV-2-naive vaccines had a 13·- times increased risk for breakthrough infection with the delta (B.1.617.2) variant compared with those who had had COVID-19 previously.
MedRxiv. 2021 In a retrospective observational cohort of laboratory staff routinely screened for SARS- CoV-2, people who had had COVID-19 previously were 100% protected against reinfection.
Clinical studies- Lancet.2021 In a large, multicenter, prospective cohort study, having had COVID-19 previously was associated with an 84% decreased risk of infection.
Lancet Respir Med. 2021 In a prospective cohort of US Marines, seropositive young adults were 82% protected against reinfection.
Latest Covid Treatment FAQ's Orange County
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:
There is no treatment shown to prevent Covid
There are only five treatments showing respected data on treating Covid successfully.
Only one is a current viable option for outpatients- Monoclonal Antibodies. And they work.
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.
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
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 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
Quantitative Antibody FAQ's Orange County
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
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
