Sharing an exchange, no names, no identification, so clinicians here & public get some valuable information for the clinicians & specialists & COVID experts I work/informed with/by & do save lives
by Paul Alexander
Dr. Vladimir Zev Zelenko was one of them who saved thousands of lives, tens of thousands on his very own.
Fingertip pulse oximetry for pulse pO2 remains a sensitive tool; the public should ensure they have this little fingertip device from the drug store, especially if elderly, family should always monitor this even outside of COVID.
Clinician treating COVID patients: Most I am aware of no longer use the tests---they base Rx on clinical presentation alone and the current variant. Dr. XXXX in S. Africa claims that waiting until crepitus is heard is dx'ing too late with B.A.4 or 5. If a patient feels winded while talking, tired from walking 10 paces in her office, etc. she assumes lung involvement (uses a simple flow meter as well)---she does not bother with CT or any PCR or rapid tests (due to false positivity and false negativity levels). She also sees mostly unvaxed patients (only 30% in S. Africa are vaxed) but does not treat differently on that basis. In Brazil where almost all are vaxed, Dr. XXXX also treats early (day 1-2 if possible) due to the far higher replication rate of these variants compared with Delta (which was 100X faster than earlier strains). …
These doctors agree that the viral inflammatory and clotting phases (subsequent to the initial viral replication phase in the first week to two) occur much earlier compared with any prior variants and so they start high-dose steroids and anti-coags sooner (starting with ASA and moving up the scale depending on D-dimer levels (D-dimer is a test used to detect blood clots, micro thrombi). It appears clear based on current data plots that the vaxed are at much higher risk of infection and hospitalization compared to unvaxed (Portugal vs S Africa).
Dr. XXX in S. Africa …claims he detects early pneumonitis earlier in a fair number of cases which still have normal pO2 and treats them accordingly and early for best results---with steroids and antibiotics as more develop bacterial pneumonia on top of viral fairly early compared with prior variants. Uses Doxycycline and Erythromycin.