Journal

In this section you will find any interesting information I have come across which I think is timely and at least somewhat urgent to know.

The current situation: In Windham and Tolland counties there are still a small number of cases that have been reported. Undoubtedly there are many more. I have seen estimates stating that for every case that is identified, there may be 100 more that have not been included in the count.

It has become very clear that unlike Influenza, which tends to present with a common pattern of symptoms, COVID-19 can present with a wide-variety of symptoms alone or in combination. While it still appears to be true that the vast majority of cases occur with no or very mild symptoms, there are some very unusual presentations, some of which can lead to death. MIS-C (for Multi-inflammatory syndrome – Coronavirus) is in the news now, with the occurrence of rare cases with cardiac and/or gastrointestinal or other severe inflammatory reactions in children and young adults.

Despite a lot of research and investigation, the science on COVID-19 is not complete, and many important questions remain unanswered:
— the availability of testing is still too limited
— the quality of available testing is variable, and the results are difficult to interpret. Unfortunately, neither a positive nor a negative test result may not always be true
–if antibody tests show the existence of antibodies, and that result is accurate, we still do not know whether this means that the person tested is immune

There are many other questions.

The Next Few Weeks: Northeastern Connecticut, while so-far having relatively few cases, may see a more rapid rise in the next few weeks. At least this is the projection from public health authorities, and our levels of caution should be high.

The “re-opening”: In the United States as a whole, public health officials are warning that it is too early yet to consider a broad-scale reopening. In more rural areas, a cautious resumption of “normal” activity may work out, but in more population-dense areas the risk for a “2nd wave” is higher. In my opinion, caution is advised, especially in Northeastern Connecticut and other more rural areas.

For a good discussion of some of the risks, see Erin Bromage’s blog post.

Alternatively, it is important to realize that the closing of much of our economy has created a huge amount of suffering in large portions of society. Furthermore, the suffering is not equally shared by all. There is much to think about here, and there are many important decisions that we need to make, individually and collectively, to emerge from this crisis and create a healthier environment. Much has been written about this. A column by David Brooks in yesterday’s New York Times is worth reading in this regard.

In general, I am not advising any changes from my prior recommendations. Influenza cases have dramatically declined across the country, and for those of you taking Influenzinum, you can stop.

I will continue to post from time-to-time.

COVID-19 4/13/2020

April 13, 2020

I have not posted in about a week, primarily as there was not much to report.  The international homeopathic community has been actively communicating online, with some of the top homeopaths in the world teaching about the homeopathic approach to epidemics, and their particular experiences in treating patients during this pandemic.

Of particular interest is a report from the American Institute of Homeopathy that just came in this morning, reporting on the experience of a physician for a nursing home in France:

On March 27th, as part of a report on the AIH COVID-19 Data Collection Project and given the urgency of the moment, I (the AIH project coordinator) included verbatim reports from physicians in France and Italy who were treating COVID-19 patients.  The French account was from a French physician reporting on events in a nursing home in Lyon France.  In that account, it was said that all 120 residents of the nursing home had tested positive for COVID-19.  I have received a subsequent report providing far greater detail.  Those follow:

“On March 15, the physician in charge of the Lyon nursing home heard of the beneficial use of Camphora in Iran, he gave one or two doses of Camphira 1M to 118 out of 120 pensioners. He said he followed the protocol indicated in the Iran report. The pensioners in this retirement home are as a rule between 85 and 105 years old and with rare exceptions are quite handicapped mentally (i.e., dementia) or physically (i.e., quadriplegic) 

This retirement home is on three floors: there are 27 pensioners on the ground floor, about 53 on the first floor and about 40 on the second floor. The day after Camphora, fifteen pensioners developed diarrhea, but only on the second floor and for only one day, nothing serious, he said.

On March 19, the first cases with flu-like symptoms made their appearance but only on the first floor. He thinks that eventually all 54 of the first-floor pensioners became infected. Of the first 6 that he tested four were COVID positive. He thinks the other two would have likely been positive, as if they both died of the typical COVID dyspnea. He tested only six pensioners as he had access to only 6 tests.

Incidentally, the two pensioners who refused to take Camphora were among the first ones to die of the 10 who have so far died of COVID. When he saw that the epidemic was taking hold of the first floor, he treated everyone affected with Bryonia. He said that they all got better. However, two days after he stopped Bryonia most relapsed. He resumed Bryonia and they all improved again. However, some of these became worse with time.

He has had no Covid cases on the ground floor or second floor. However, no staff can cross to the other floors from the first floor without changing their entire PPE (personal protective equipment)..

The latest report:  only 5 of the severely ill pensioners with COVID still need to be monitored hour by hour and all five were doing quite well by the end of the night last night. It appears the hemorrhaging of lives has stopped, as no one has died since last Tuesday, thanks to Bry. (3 patients), Carbn-o. (2 patients), Hyos. (one patient) and Op. (2 patients).” [end report from France]

The take-home message here is that Camphora and Bryonia remain the mainstays of treatment.  Camphora is for late-stage disease with sudden collapse, severe weakness, and severe internal coldness.  Even the breath can be cold. Of course there are other remedies that can be useful  Bryonia represents an earlier stage of the illness, and may be used as a preventative (although it is not clear that Bryonia is the best choice for the current situation in the USA).

This report from France illustrates why I’ve acted to attempt to provide my patients with at least some of the medications that might prove useful, although my real hope is that it will not be necessary to use them.

In my own experience, over the last few months (since mid-January) I have treated several people with unusual respiratory infections, none (except possibly one) of which fit the classic description of COVID-19, but all of which were accompanied by low-grade fever, cough, a prolonged course, great fatigue, and some with conjunctivitis.

The first person, who became ill in mid-January had a severe cough with shortness of breath while coughing, fever, strong fatigue (partly due to lack of sleep from coughing at night), responded very well to Kali carbonicum;
One person with chronic asthma (but no acute respiratory distress) needed Gelsemium and then Pulsatilla, with a very nice response;
One person had very low grade symptoms which resolved without treatment;
One person with strong fatigue and a severe conjunctivitis responded well to Bryonia (COVID test negative);
One person with a fever for 4 weeks (but no respiratory distress, but who started to feel fullness in the chest) responded very well to Petasites tussilago (I had to send a higher potency);
One other person, living in NYC, with a cough but no respiratory distress, and great sleepiness, did not respond to Gelsemium but had a dramatic improvement with Phosphoric acid.  I think it very likely that she had COVID-19 but she was not able to obtain testing.

Several of my American colleagues have over the years noted that maintaining a good level of vitamin D seems to provide a good level of protection for Influenza and seems likely to do the same for Coronavirus.  As you all know, Vitamin D is something that I have stressed for several years.

Although the number of cases in Northeastern Connecticut continues to be very low, computer modeling suggests that this may change in the next few weeks.

Please take all the proper precautions that have been recommended.
I will continue to post as needed.

I’ve attended two webinars today. The first, presented by Rajan Sankaran, a very skilled homeopath from India, was primarily focused on Camphora, which has been very helpful in severe cases in Asia, with sudden collapse, severe weakness, and severe coldness.

The second webinar included participants from Scotland, Belgium and several states in the USA. Of particular interest is the experience of a homeopath in Westchester County, NY, where the pandemic is severe, and who has been extremely busy treating COVID-19 cases.

She has given Petasites tussilago to a number of people, but in some cases (I don’t have exact numbers or a percentage) people have developed illness despite taking it. In those cases, the symptoms have been mild in most instances (which other participants have also noticed), but in some cases she has seen severe illness develop, and in those cases Camphora has been very helpful in a number of cases.

The other prominent remedies in her experience have been Phosphoric acid (also coldness and weakness but neither as intense as with Camphora, and with a desire for juices, refreshing drinks, carbonated drinks) and there can also be a sense of apathy in Phosphoric acid. I recently treated a patient with fatigue and sore throat who had a sense of apathy (indifferent) which was very unlike her normal state and she improved by the next day.

Bryonia is another remedy that she has seen several times (desire to be quiet, still, and undisturbed, irritable if disturbed, all symptoms worse from motion)

She has successfully given Croton tiglium if the only symptom is loss of smell and taste.

Arsenicum album has been only infrequently useful (as has been the experience so far in Belgium).

Gelsemium has been helpful in Scotland (only a few patients have been treated by that homeopath) but it has not been commonly used in Westchester County.

One homeopath became ill while in NYC in early March, and developed a severe and for her unusual headache with a sore throat, and she responded very well to Petasites tussilago. She has given out a lot of the remedy, and in families where one person has been more seriously ill, no other family member taking the Petasites tussilago has become sick in the past few weeks. This is not, of course, conclusive from a statistical sense.

At this point my sense of the effectiveness of the Petasites tussilago is favorable. In Westchester County, if people taking it still become ill, she will change the remedy, depending on the individual’s particular symptoms (again, Phosphoric acid and Bryonia have been common, but a number of other remedies have also come up.

I am prepared to dispense these other remedies. I can distribute these remedies as I have been doing with the Petasites tussilago. The next pickup date will be Tuesday March 31st and will continue through Thursday morning during normal business hours. If you wish to obtain them, you can email me and please copy Donna at donna@drshevin.com. Please be specific as to what you wish to have. Again, as before, there can be no assurance that any one individual will need any of these particular remedies. What I have described here is the first information I have seen which could be relevant to what our experience in Eastern CT is likely to be.

The most recent information that I see is here. Drive-through testing is available in Hartford, Meriden, Bridgeport, Norwich, and Torrington, through Hartford Health Care.

You will need to call them, have a telemed visit, and get a referral. I don’t know if this will be limited to people for whom HHC are already health-care providers.

As far as I can tell, I see no drive-through centers in Rhode Island as yet.

In Massachusetts, as of 3/19/2020 I only see a mention of a testing center being set up at Cape Cod College in Barnstable. I don’t know if that is operable.

We are not yet at the desired point of testing for everyone. All testing requires an order from a physician, and it appears that asymptomatic persons, or possibly people with mild illness and no known contact or underlying medical conditions will not be able to be tested.

I will continue to monitor that availability of testing and post these result.

As is obvious, the pandemic is affecting everyone. Please be sure that you practice proper social distancing, and otherwise comply with all the recommendations being made by the CDC and your state health department. I’m not including links because these are now easy to find.

I have not yet treated anyone who I think has COVID-19, although I’ve managed a few influenza cases with bad coughs over the last 6 weeks.

As far as Petasites tussilago, a possible preventive remedy, is concerned, I have distributed about 70 bottles and continue to do so. As I now realize that I underestimated my costs for the supplies and labor to meet the anticipated need, the new price will be $10 for pickup and $15 for mailing.

The international homeopathic community has been in contact regarding such clinical experience as has been accumulated. We think that there will be differences in the best remedies that will depend largely on climate and other local conditions. As far as the United States is concerned, we have not as yet treated patients that we know have COVID-19.

To summarize the remedies which have been found useful in other countries so far:

Influenzinum has been suggested as a possible preventive by good homeopaths in India, and of course this is already in use in my practice. See my article here.

Arsenicum album — restlessness, fear of contagion, a feeling of scarcity and a need to stock up on supplies, anxiety, desire to wash the hands, dry throat, fever, pneumonia and respiratory distress. This is interesting because fear and panic, and hand washing are all very common now. In Arsenicum cases, the combination of a great sense of weakness, with anxiety and restlessness are usually pretty obvious. Thirst can be high

Gelsemium — great fatigue is the most prominent, lassitude, muscular weakness, slow onset, chills (especially in the back), usually without thirst

Bryonia alba — also slow gradual onset, desire to be quiet and to lie still, irritable if disturbed, all symptoms are worse from any motion, dryness in the mouth usually without thirst

Eupatorium perfoliatum — Body pains are severe, often felt in the bones, even as if the bones were breaking.fever and chills with thirst

Veratrum album — Sudden sense or rapid progression to collapse, great coldness, restlessness, cold sweat, vomiting and diarrhea, great thirst for cold water.

Camphora — Also has rapid onset of weakness leading to collapse, mostly dry without much mucus, violent hacking cough, breath can be cold, icy coldness of the body. This has been a good remedy for severe cases in Iran.

Should any of the above remedies emerge here, I have these remedies and can distribute them in the same way as I am now doing with the Petasites tussilago.

3/16/2020 I have received and am ready to distribute a possible preventive remedy — Petasites tussilago. I use the word “possible” because, as I mentioned in a previous post, the choice of this remedy has not been arrived at through the usual homeopathic practice of seeing which particular remedy (or sometimes the top 2-3 remedies) are common in the actual epidemic.

It is important to realize that there is no guarantee that there will be any benefit from this intervention. The possibility of harm is extremely unlikely. Should you feel that you react to the remedy in some way, you should give me a call.

I am dispensing the remedy in a one ounce dropper bottle. 2 drops on or under the tongue is the dose which should be taken once a day for seven days and then once a week unless I direct otherwise, should the epidemic become severe. This should allow for prolonged dosing for a good number of people if we have to continue doing so.

The process will be as follows:
• Starting on Wednesday March 18 the remedy will be available in my office for pick-up. Because of the obvious problem of exposure to the virus, I ask that you knock on the door when you arrive. Do not enter the anteroom. Donna and I will be available Wednesday from 9-4:30 and Thursday from 9am to 2 pm. We will likely be gloved and will exchange the bottle for payment at the door. In order to protect you, Donna, myself and my family, please do not expect to enter the office, nor to use the bathroom.
• I will post pickup hours for Friday onwards, which will be of more limited duration until the office reopens the following Tuesday March 24th.
• I have to limit the distribution to one bottle per family, at least until I see the response to this offering. I have tried to anticipate the demand and to be prepared. If you have children at college who are still under my care I will mail the remedy to them, but will need their addresses. You can email that information to donna@drshevin.com.
• The fee for pickup will be $5.00, which should cover my costs. Please have that ready to give to Donna or to me. If you would prefer that I mail it out to you, the cost will increase to cover postage and handling, I don’t have a figure for that at the moment, but it shouldn’t exceed $10.
• This is intended for my patients only and I ask that you respect that. I cannot accept responsibility for people who are not under my care.
By picking up the remedy you are acknowledging that you have read and understand these instructions, and that you understand that positive results are not guaranteed.

COVID-19 3/14/2020

March 14, 2020

The day is young but the flow of information never ceases.

Tdday’s New York Times contains a very timely op-ed piece about the human spirit in the time of pandemics. I commend it to your attention.

Peter D’Adamo, a naturopth probably best known for his work on diet and blood types, has a site on which he tracks various supplements and their activity against viruses, including Coronavirus. The two color coded columns refer to activity against Coronoavirus. The left column (“Cyto”) refers to killing virus cells directly, and the right column (CorV) refers to affecting the activity of the virus.

It is abundantly clear that “social distancing” and widespread testing are crucial.
Social distancing is something that we will have to do voluntarily, unless something like martial law is declared.

Widespread testing is getting ramped up, but for now is significantly less available than it should be. Drive-in centers have been established at Greenwich Hospital, Waterbury Hospital, and Bristol Hospital, but a physician’s order is required. We need free testing for anyone who has reason to suspect that they are ill, without a doctor’s order. This has been very effective in South Korea. I don’t know when or if we will achieve that level of access to testing.

From the CDC site regarding advice to physicians on testing, accessed today:

Priorities for testing may include:

Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control.

Other symptomatic individuals such as, older adults and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (e.g., diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).

Any persons including healthcare personnel, who within 14 days of symptom onset had close contact with a suspect or laboratory-confirmed COVID-19 patient, or who have a history of travel from affected geographic areas within 14 days of their symptom onset.

There are epidemiologic factors that may also help guide decisions about COVID-19 testing. Documented COVID-19 infections in a jurisdiction and known community transmission may contribute to an epidemiologic risk assessment to inform testing decisions. Clinicians are strongly encouraged to test for other causes of respiratory illness (e.g., influenza).

Mildly ill patients should be encouraged to stay home and contact their healthcare provider by phone for guidance about clinical management. Patients who have severe symptoms, such as difficulty breathing, should seek care immediately. Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their physician early in the course of even mild illness.

A colleague of mine, Paul Herscu ND has written a post that I’d like to share with you. It is well worth reading, and can be found here.

Yale New Haven Hospital has created a telephone hotline for those who suspect that they may be developing a COVID-19 infection. Staffed by healthcare professionals, they can direct you to testing or appropriate care.

The number is 833 275-9644

On the prevention side, homeopathic practitioners in Taiwan and Hong Kong are finding that the most common remedies are Gelsemium, Bryonia alba, and Eupatoreum perfoliatum. They are currently recommending Gelsemium as the most likely preventive, but it could easily be either of these (or other’s as yet undetermined).

Gelsemium usually presents with profound weakness and fatigue. Even lifting a glass of water could be difficult. They do not want to be disturbed, but that is because they are too tired to participate in social interaction.

In Bryonia, there is usually a strong aversion to any kind of motion, which makes all symptoms worse. So they tend to lie still, and are very averse to being disturbed, usually reacting in an irritated way.

In Eupatorium perfoliatum, the most prominent symptom is strong aches and pains in the body and in particular the bones, sometimes described as “bone-breaking.”

I think that it is still a bit early to start prophylaxis, but that could change within a few days.

These particular remedies are not difficult to find locally (health food stores, some drug stores) but can also be obtained via mail order.

Washington Homeopathic Products and Hahnemann Labs are two US manufactures that I use.
The 30C potency will be adequate for this purpose.

Should you elect to use “homeoprophylaxis” I would suggest one dose (1-2 pellets) once a day for 7 days and then once a week. If the outbreak becomes widespread it can be taken once a day.

Until the situation clarifies, one could also consider Gelsemium 30C in the morning, and Bryonia 30C in the afternoon or evening, according to the above schedule. I usually don’t like using two different remedies at one time, but these are unusual times.

For those of you who are under constitutional treatment for any problems that involve recurrent contagious illnesses (flu, bacterial infections, etc) and are experiencing a good result, your present remedy may be the best preventive.

If you have questions, I will do my best to answer them. As the next week or two unfolds, there may be delays in my responding as I expect to be quite busy with all this. Email will be much better as a way of communicating.

Information regarding COVID-19 (the infection produced by the Coronavirus) continues to accumulate. There are reports in the medical literature of gastrointestinal problems (nausea, vomiting, abdominal pain) as early symptoms of infection, preceding the onset of upper respiratory symptoms.

An article in the New York Times this morning describes the health-care system in Northern Italy being overwhelmed, and not able to provide help to many people.

An op-ed piece by David Brooks in the same issue reviews descriptions of severe epidemic diseases in the historical record (plague, cholera, etc.) where societies instinctively adopted extreme social distancing and where some of the “worst” instincts of human beings came to predominate.

Social distancing is probably the most important thing that people can do to protect themselves individually but also society as a whole (by slowing the epidemic down, and hopefully not overwhelming the system with extremely high numbers of cases). But at the same time, we should not abandon compassion for others, and we should be aware that loneliness makes health problems worse.

A colleague of mine (Mitchell Fleischer MD), who is very knowledgeable about the nutritional aspects of health, suggests the following supplements as being potentially useful in the current situation:

Licorice root extract (with high Glycyrrhizin, glycyrrhizic acid or glycyrrhizinic acid content); proven to inhibit coronaviral replication. (Note: should not be used for people with high blood pressure).

Argentyn-23 colloidal silver – helps to safely kill bacteria, viruses, fungi and parasites without causing dysbiosis.

C-Aspa-Scorb – high potency buffered vitamin C with magnesium, potassium, selenium and zinc; no sodium or calcium.

MyCommunity Host Defense – powerful, organic, medicinal mushroom complex (made in USA); shown to be so effective that the DOD buys it in large quantities to distribute to armed services personnel stationed overseas in unhygienic regions, e.g., Middle East, Africa, etc.