This is the advice of Canada’s chief medical officer. This makes sense from a Covid transmission point of view. We have known that Covid adds to the other risks of sexual contact. The risk is for you to get the disease and pass to others. Let Adelante know if you think this is romantic. J
PrEP: CHANGE FROM DESCOVY® BACK TO TRUVADA®?
It is wonderful that many are preventing HIV transmission by taking PrEP but the downside is that the cost is rising and prices are rising. Truvada® is going off patent and will be generic and low cost soon. Descovy® is newer and will be high-priced compared to the generic Truvada®. Some insurers and university clinics are recommending changing back to Truvada from Descovy® due to:
High cost of Descovy®
The benefits of Descovy® (with more time and research) on bone and kidneys are confirmed but are weak.
Descovy® has been associated with weight gain and lipid (cholesterol and triglyceride) negative effects. More studies are pending.
COVID TESTING, BACK OR FRONT OF NOSE OR SALIVA?
Currently Borrego is using an approved front of nose swab instead of the awkward back of nose test. A new study has come out that saliva may be just as good as the nasal swabs.
A fishing crew in Seattle all tested negative when they left port. 85% of them tested positive when they returned. This shows that sometimes the tests don’t show who is positive, especially very early in the infection.
However, the three who had recovered from Covid before sailing did not get the infection again on the ship, showing that immunity had protected them.
So far, the studies show:
The less severe the infection the shorter the future protection by antibodies
Milder infections may protect you up to 6 months
More severe infections may have protection for a year
The second infection is often milder than the first.
FACIAL FILLER INJECTIONS IMPROVED WITH NEW SYRINGE
A smart syringe is available that detects blood vessels, muscles, and fat so that the filler won’t be injected into the vessel, cutting off blood supply and causing death of tissue. Some have gone blind with these injections. Usually when injecting, we all pull back to see if there is blood and move the needle tip and try again if blood is detected. The fillers are thicker and can block this blood flash so the detection of a blood vessel may be in error.
ASTHMA AND COVID
It was announced earlier that asthma was a risk for faster deterioration if a person has Covid 19. Now there is evidence that this increased risk is slight. Still we see these risks: age >(60?)65, history of strokes, heart attacks, heart failure, cancer, chronic kidney or lung disease, obesity, diabetes, and sickle cell disease.
FIRES AND HEAT WORSEN YOUR ASTHMA?
People die from asthma so I don’t hesitate to refill inhalers. Many of my patients are having to use their inhalers more with the heat and smoke from large fires. You can search for “air quality” near your city to see if you should avoid going outside or exercising. Asthma is also a slight risk factor for worse Covid 19 symptoms. There are immediate relievers and longer acting relievers. Discuss your asthma with your provider before it becomes an emergency. I take my inhalers with me on any trip away from home, including work. Even though it is rare for me to have an attack, I don’t want to be without my inhalers.
OVER SEVENTHOUSAND OF HEALTH CARE WORKERS HAVE DIED FROM COVID 19
Medscape has 1800 of those who have died worldwide listed by submission with web links to learn more.
“Healthcare workers are on the front lines of the global effort to care for patients with COVID-19, while putting themselves at risk for infection. Thousands have already died, from dozens of countries, professions, and specialties. Here we honor them all.
Physicians, nurses, assistants, technicians, orderlies, administrators, volunteers, drivers, porters, EMTs, firefighters, and more — fresh on the job or retired — they are all remembered here. In some cases, we include names of people who did not die from COVID-19, but whose deaths were clearly related to the stress and demands of the pandemic.”
Stop the dying, let people go back to school and work: Please wear a mask covering your nose and mouth.
PLEASE REGISTER TO VOTE AND THEN VOTE IN NOVEMBER.
If you didn’t vote last time, maybe now you want things to improve. I realize many of you readers may not be citizens but others you know are and you should push them to vote to improve your situations. Make sure a politician’s actions benefit people like you. Words are Cheap.
Keep those questions coming, Be safe!
Daniel Pearce, D.O., FACOI, AAHIVMS
Clinical Associate Professor of Medicine, Loma Linda University School of Medicine
Adjunct Professor of Internal Medicine and HIV, Touro University California College of Osteopathic Medicine and Midwestern University Arizona College of Osteopathic Medicine
HIV, Hepatitis B,C, Transgender, Suboxone Specialist, Borrego Health (Riverside, San Bernardino, San Jacinto)
Member, Coachella Valley Clinical Research Initiative