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DocLightning
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The respiratory viruses -- make it stop!

Thu Dec 08, 2022 9:44 pm

I'm a primary care pediatrician working on the "front lines." And right now, I'm just hating life.

Presumably, the underlying cause is that the nonpharmacological interventions employed over the last two years to control SARS-CoV-2 also very effectively stopped the spread of most other respiratory viruses. 2020-2021 and 2021-2022 barely had any influenza, barely any RSV, barely any other viruses, and so two years of young children were not exposed to these things. So now the restrictions are off and there are three years worth of kids who have never seen any of these viruses before, as opposed to the one year worth of kids that we'd "normally" have (whatever "normal" means anymore). And so the viruses have just gone nuts.

Personally, my son coughed nonstop from August until this last weekend, when he finally stopped. And then last night he started coughing again. Fortunately, it's a mild cough, but still... At one point he got sick on Monday, was able to go back to school on Wednesday and then was sick again on Friday.

Our flu cases have exploded earlier in the season than any other season on record and they are also higher than they've ever been before. And there is no sign of a turn in the peak. It's just shooting straight up like a homesick angel. To make it even worse, in a normal flu season one of the two Flu A strains predominates, either H3N2 or H1N1. But this year approximately 20% of the cases are H1N1 and 80% are H3N2, so you can get flu and then turn right back around and get flu again. The only good news is that this year's flu shots are extremely well-matched to circulating strains (96% for the H1N1 and 97% for the H3N2) so please get your flu shots. I beg you.

But flu isn't the only virus troublemaker. RSV, which causes wheezing and respiratory distress in infants and young children, has also exploded to historic levels. Children's hospitals are at capacity. They're putting kids in hallways. One of our children's hospitals (I'm in the SF Bay Area) had to transfer a child down to Children's LA for lack of capacity. Another child had to be sent to University of Washington in Seattle. One of my patients had to get shipped off to Reno. There is no vaccine for RSV and no specific treatment (there's a monoclonal antibody that can be used for prevention but because of the expense it is only reserved for extremely high-risk children, such as preemies born before 29 weeks and children with major congenital heart defects).

And then there is metepneumovirus, parainfluenzavirus, adenovirus, rhinovirus and my absolute favorite (this is sarcasm), norovirus. Norovirus is the "stomach flu" where you can't stop vomiting and I could show you your very favorite food and you'd shove it away in disgust...and then the diarrhea comes. We've all had it and it's dreadful.

Parent after parent has been calling in asking for various tests "because my kid has been sick since August." There's nothing wrong with the kids, per se, other than they didn't get exposed to anything in the last two seasons. The entire idea of a "well child examination" (a physical or check-up) has become a quaint and obsolete concept because literally every child is sick. I had one mother come in sick herself with Flu A...and a two-day-old infant. Newborns typically handle COVID-19 pretty well, but flu is extremely dangerous for them.

And to make it even more fun, there are shortages of multiple needed medications. There's an amoxicillin shortage (PLEASE stop prescribing amoxicillin unless you are carefully following AAP guidelines!), an albuterol shortage, a TAMIFLU shortage, and just for fun an ADDERALL shortage (I do a lot of ADHD management). We also ran out of RSV tests for a while. Now flu tests are running short.

I'm so tired, guys. Please make it stop.
 
LittleFokker
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Re: The respiratory viruses -- make it stop!

Thu Dec 08, 2022 9:49 pm

My son ended up in the PICU in August with one of these viruses. Have been on high alert with any respiratory issues with him ever since. He's been vaccinated against COVID, but I don't believe he's gotten a flu shot yet. I will credit this thread for reminding me to get him one.
 
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DocLightning
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Re: The respiratory viruses -- make it stop!

Thu Dec 08, 2022 9:51 pm

LittleFokker wrote:
My son ended up in the PICU in August with one of these viruses. Have been on high alert with any respiratory issues with him ever since. He's been vaccinated against COVID, but I don't believe he's gotten a flu shot yet. I will credit this thread for reminding me to get him one.


Ugh, I'm so sorry, but yes, please get the flu shot. This is not the year to skip it.
 
ACDC8
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Re: The respiratory viruses -- make it stop!

Thu Dec 08, 2022 10:32 pm

We've had a few children die from various respiratory illnesses over the last couple of weeks, some of that is the result of poor treatment from our failing healthcare system in BC. But from a medical standpoint, now that nature is playing catch up after 2 years of restrictions and such, are the chances that next year would be a bit more normal (assuming we don't implement restrictions this year) when it comes to respiratory illnesses seeing that the kids are now being exposed to these viruses? I'm just curious as there is talk of possible restrictions/mask mandates by some medical experts, but wouldn't that just postpone this again until next year?
DocLightning wrote:
Norovirus is the "stomach flu" where you can't stop vomiting and I could show you your very favorite food and you'd shove it away in disgust...and then the diarrhea comes. We've all had it and it's dreadful.

I had that for a month straight about 10 years ago - lost about 60lbs, just sitting up was enough to make me puke, let alone trying to eat anything, and yes, as you said, the diarrhea, oh my, the diarrhea - good Lord, literally every 15 minutes I had to run off to the toilet. Funny thing is that it started up about 2-3 weeks after I quit smoking, always wondered if there was a correlation between the two.
 
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seb146
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Re: The respiratory viruses -- make it stop!

Fri Dec 09, 2022 2:20 am

Unfortunately, respiratory viruses will happen. We are all tired of them. It sucks. It is worse seeing our loved ones go through them. I wish they could stop, too, but they won't.
 
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TWA772LR
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Re: The respiratory viruses -- make it stop!

Fri Dec 09, 2022 9:57 am

I saw an article that RSV has skyrocketed for babies. I'm 6'2" 250ish and love babies almost as much as I love aviation and just the thought of all those sick babies almost brought me to my knees. Thank god I was at work or I would've broke down really hard.

I hate hearing about babies in distress, it makes me sad when they cry. So please people, take the precautions not for you or me, but for humanity's purist.
 
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casinterest
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Re: The respiratory viruses -- make it stop!

Fri Dec 09, 2022 1:28 pm

It looks like it is goingt o be a very busy year for DocLighting and especially the elderly care doctors. Covid is still leading the pack, but the flu is coming on strong.

Based on NCHS mortality surveillance data available on December 1, 2022, 9.7% of the deaths that occurred during the week ending November 26, 2022 (week 47), were due to pneumonia, influenza, and/or COVID-19 (PIC). This percentage is above the epidemic threshold of 6.4% for this week. Among the 1,801 PIC deaths reported for this week, 792 had COVID-19 listed as an underlying or contributing cause of death on the death certificate, and 99 listed influenza. While current PIC mortality is due primarily to COVID-19, the proportion due to influenza is increasing. The data presented are preliminary and may change as more data are received and processed.


Image

Image


https://www.cdc.gov/flu/weekly/index.htm
 
sierrakilo44
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Re: The respiratory viruses -- make it stop!

Fri Dec 09, 2022 2:19 pm

DocLightning wrote:
I'm a primary care pediatrician working on the "front lines." And right now, I'm just hating life.

I'm so tired, guys. Please make it stop.


1. Acknowledge that the restrictive controls to Covid were a lot of times an overreaction, and by locking down cities, closing borders, restricting travel, banning people from seeing friends and loved ones etc all we did by trying to stop one virus was to build up every other of the thousands of viruses out there, like damming a river, and when we opened up the dam again we had all these other viruses rush at us all at once. Along with the delayed diagnosis of cancers and other ailments, delayed surgeries and mental health effects. The pandemic management should’ve been a holistic approach involving all health but most of the time it wasn’t. Authorities were solely focused on Covid.

2. Re-invest properly in healthcare. You’re from the US right? Then you need a universal healthcare system, the health of the population of the poor can affect the upper and middle classes as well. As well as proper mandated sick leave for all jobs. People shouldn’t be forced to come to work when sick and spread illnesses. This may mean you need to increase taxes, politically unpopular in the US but maybe necessary.

3. Look at vaccine mandates. In Australia you are required to have children vaccination against a range of diseases or you won’t receive government childcare subsidies or be allowed to attend kindergarten. This may not fly well in more libertarian America but it works here.
 
leader1
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Re: The respiratory viruses -- make it stop!

Fri Dec 09, 2022 3:51 pm

sierrakilo44 wrote:
DocLightning wrote:
I'm a primary care pediatrician working on the "front lines." And right now, I'm just hating life.

I'm so tired, guys. Please make it stop.


1. Acknowledge that the restrictive controls to Covid were a lot of times an overreaction, and by locking down cities, closing borders, restricting travel, banning people from seeing friends and loved ones etc all we did by trying to stop one virus was to build up every other of the thousands of viruses out there, like damming a river, and when we opened up the dam again we had all these other viruses rush at us all at once. Along with the delayed diagnosis of cancers and other ailments, delayed surgeries and mental health effects. The pandemic management should’ve been a holistic approach involving all health but most of the time it wasn’t. Authorities were solely focused on Covid.


Most of my relatives in Canada are doctors in their healthcare system. They think that this "overreaction" to COVID was a necessity, especially in the beginning. Toronto had a lockdown for over a year, but they had one of the better COVID success rates compared to other Canadian provinces and many US states. Was it excessive? Maybe, but it saved a whole bunch of lives. You have to pick and choose your battles and when resources are limited, you need to allocate them based on urgency. And COVID was the most urgent crisis facing the healthcare system for two years. It applies to other countries, too. I don't know what you do for a living, but it doesn't seem like you're a medical professional, so it isn't fair for you to judge from afar without being in their shoes and having to sometimes make triage-like decisions.

2. Re-invest properly in healthcare. You’re from the US right? Then you need a universal healthcare system, the health of the population of the poor can affect the upper and middle classes as well. As well as proper mandated sick leave for all jobs. People shouldn’t be forced to come to work when sick and spread illnesses. This may mean you need to increase taxes, politically unpopular in the US but maybe necessary.


These same relatives also don't think that universal healthcare or mandated sick leave in Canada is preventing their places of work from being overwhelmed, which they are. This is a global problem and universal healthcare systems are also buckling.

https://globalnews.ca/news/9327496/onta ... hospitals/

3. Look at vaccine mandates. In Australia you are required to have children vaccination against a range of diseases or you won’t receive government childcare subsidies or be allowed to attend kindergarten. This may not fly well in more libertarian America but it works here.


I agree with vaccine mandates. They absolutely work. US states and Canadian provinces that have more stringent vaccine requirements have better health outcomes.
 
leader1
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Re: The respiratory viruses -- make it stop!

Fri Dec 09, 2022 4:08 pm

DocLightning wrote:
I'm a primary care pediatrician working on the "front lines." And right now, I'm just hating life.

Presumably, the underlying cause is that the nonpharmacological interventions employed over the last two years to control SARS-CoV-2 also very effectively stopped the spread of most other respiratory viruses. 2020-2021 and 2021-2022 barely had any influenza, barely any RSV, barely any other viruses, and so two years of young children were not exposed to these things. So now the restrictions are off and there are three years worth of kids who have never seen any of these viruses before, as opposed to the one year worth of kids that we'd "normally" have (whatever "normal" means anymore). And so the viruses have just gone nuts.

Personally, my son coughed nonstop from August until this last weekend, when he finally stopped. And then last night he started coughing again. Fortunately, it's a mild cough, but still... At one point he got sick on Monday, was able to go back to school on Wednesday and then was sick again on Friday.

Our flu cases have exploded earlier in the season than any other season on record and they are also higher than they've ever been before. And there is no sign of a turn in the peak. It's just shooting straight up like a homesick angel. To make it even worse, in a normal flu season one of the two Flu A strains predominates, either H3N2 or H1N1. But this year approximately 20% of the cases are H1N1 and 80% are H3N2, so you can get flu and then turn right back around and get flu again. The only good news is that this year's flu shots are extremely well-matched to circulating strains (96% for the H1N1 and 97% for the H3N2) so please get your flu shots. I beg you.

But flu isn't the only virus troublemaker. RSV, which causes wheezing and respiratory distress in infants and young children, has also exploded to historic levels. Children's hospitals are at capacity. They're putting kids in hallways. One of our children's hospitals (I'm in the SF Bay Area) had to transfer a child down to Children's LA for lack of capacity. Another child had to be sent to University of Washington in Seattle. One of my patients had to get shipped off to Reno. There is no vaccine for RSV and no specific treatment (there's a monoclonal antibody that can be used for prevention but because of the expense it is only reserved for extremely high-risk children, such as preemies born before 29 weeks and children with major congenital heart defects).

And then there is metepneumovirus, parainfluenzavirus, adenovirus, rhinovirus and my absolute favorite (this is sarcasm), norovirus. Norovirus is the "stomach flu" where you can't stop vomiting and I could show you your very favorite food and you'd shove it away in disgust...and then the diarrhea comes. We've all had it and it's dreadful.

Parent after parent has been calling in asking for various tests "because my kid has been sick since August." There's nothing wrong with the kids, per se, other than they didn't get exposed to anything in the last two seasons. The entire idea of a "well child examination" (a physical or check-up) has become a quaint and obsolete concept because literally every child is sick. I had one mother come in sick herself with Flu A...and a two-day-old infant. Newborns typically handle COVID-19 pretty well, but flu is extremely dangerous for them.

And to make it even more fun, there are shortages of multiple needed medications. There's an amoxicillin shortage (PLEASE stop prescribing amoxicillin unless you are carefully following AAP guidelines!), an albuterol shortage, a TAMIFLU shortage, and just for fun an ADDERALL shortage (I do a lot of ADHD management). We also ran out of RSV tests for a while. Now flu tests are running short.

I'm so tired, guys. Please make it stop.


My wife runs the pharmacy department of a major hospital in Westchester County. I remember from your older posts that you used to live in the NYC region, so I'm sure you're familiar with the area. Her hospital is seeing an increase in influenza and COVID cases, but RSV seems to have stabilized. No issues with drug shortages...yet. She is worried about the coming months, especially after the holidays. They're not overwhelmed at the moment, but she described the situation as "not good".

And my sister works as a healthcare economist for a healthcare system in the Bay Area. She's not a healthcare professional, but most of her friends and colleagues are. Yes, you guys are getting slammed out there. Is it much worse there compared to other areas?
 
M564038
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Re: The respiratory viruses -- make it stop!

Fri Dec 09, 2022 9:33 pm

It’s crazy, my 3 year old has been coughing since August, too. Luckily kindergarden stayed open most of the pandemic, so they had quite a bit of the usual stuff doing the rounds. We’ve had so many viruses in the family this fall I can’t even count. We get everything since all of us are exposed to a lot of people at work/school/kindergarden. The whole family got the flu last week. Wife was 41C even with the shot and out for 3 days, I, also vaccinated, was out for 2 days without a fever, the teenagers got the full 5 days with max fever. The 3 year old got away from the full flu this time for some reason, even if she’s never had it, running around with the samme running nose as the whole of last year.

Kindegarden says they have twice the amount of sick kids compared to a normal year.
 
ACDC8
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Re: The respiratory viruses -- make it stop!

Fri Dec 09, 2022 10:25 pm

leader1 wrote:
Most of my relatives in Canada are doctors in their healthcare system. They think that this "overreaction" to COVID was a necessity, especially in the beginning.

I agree, mainly because we didn't exactly understand what we were dealing with.
 
afcjets
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Re: The respiratory viruses -- make it stop!

Fri Dec 09, 2022 10:34 pm

DocLightning wrote:

And to make it even more fun, there are shortages of multiple needed medications. There's an amoxicillin shortage (PLEASE stop prescribing amoxicillin unless you are carefully following AAP guidelines!), an albuterol shortage, a TAMIFLU shortage, and just for fun an ADDERALL shortage.


When I was a kid almost all of my doctor visits were for sore throats and they actually cultured for strep throat back then (and it was before rapid tests were available they had to grow it overnight). If it was negative, nothing was prescribed and if it was positive, you had to come back and get a shot and it was not fun. I was jealous of a family friend who went to the same doctor and she was lucky enough to be allergic to penicillin and got prescribed pills instead. When I got older I learned of friends with other doctors who prescribed pills for strep and they weren't allergic to penicillin. The last time I had it I was 14 and my doctor agreed to prescribe me amoxicillin but I had to get re-cultured after the 10-14 days or however long it was and damn if it wasn't still positive and I still had to go in for a shot. I don't think I cried that time and it had been years, ironically I didn't cry when I was really young either because I thought we were going out for ice cream but made a quick detour lol. I knew something was wrong though because my older sister was really crying!

Now it seems obvious the pharmaceutical industry believes culturing is unnecessary and it's in their best interest not to.
(I mean in general not for strep) A few years ago on Christmas night (2019 actually) I had to unexpectedly go to the ER (options were limited because of the timing) and it turns out the pulsatile tinitus (I heard a loud turbulent sound which was actually my pulse it was really strange in hindsight I think it's possible it might have been C19. I also spontaneously developed debilitating headaches that magically disappeared along with the pulsatile tinitus after a week or two) I was misdiagnosed with an ear infection and prescribed amoxicillin. The next day I thought I wonder if I can get my ear cultured because I don't want to take antibiotics if it's indeed not bacterial. I called the ear nose throat specialist and got a last minute cancellation and they vacuumed the remaining wax instead of flushing like at the ER. The young brilliant doctor immediately told me I don't have an ear infection the redness which used to be what diagnosed one was no longer valid and likely came from them trying to get the wax out ((they had to make several attempts) So I never had to take the amoxicillin. I still liked and have a lot of respect for the ER doctor she obviously sees a lot more variety and serious issues, but I liked this specialist better and will go back to see her.
 
sierrakilo44
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Re: The respiratory viruses -- make it stop!

Sat Dec 10, 2022 1:04 am

leader1 wrote:

Most of my relatives in Canada are doctors in their healthcare system. They think that this "overreaction" to COVID was a necessity, especially in the beginning.


I didn’t say it was all an overreaction, but we should’ve gone back to normal once the elderly people were vaccinated in first world nations in early 2021. There were too many controls applied in winter 21/22 when the vaccine was mostly preventing death, and now we are seeing the after affects.


These same relatives also don't think that universal healthcare or mandated sick leave in Canada is preventing their places of work from being overwhelmed, which they are. This is a global problem and universal healthcare systems are also buckling.


So what’s the solution then? I’m trying to help out the OP. Otherwise the solution to me just seems to be more money invested in healthcare (universal healthcare being one part of that). Which will mean more taxes, cuts to other services, or ending of benefits, raising the retirement age etc. None of which will be politically viable. So basically we have the system we have now struggling to cope.

Asian nations that have a culture of mask wearing seem to have better luck at coping with outbreaks of respiratory illnesses, unfortunately Western nations have a more individualistic culture and shy away from it. You could try mandate masks but eventually people would revolt.
 
leader1
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Re: The respiratory viruses -- make it stop!

Sat Dec 10, 2022 1:25 am

sierrakilo44 wrote:

So what’s the solution then? I’m trying to help out the OP. Otherwise the solution to me just seems to be more money invested in healthcare (universal healthcare being one part of that). Which will mean more taxes, cuts to other services, or ending of benefits, raising the retirement age etc. None of which will be politically viable. So basically we have the system we have now struggling to cope.


I’m not out here pretending to know or offer solutions, and neither should you because you’re not an expert. I brought up an example of a universal healthcare system that has buckled, which disproves your assertion that it would have solved the problem the author, a doctor, faces.

And the US spends more per capita on healthcare than any nation, so healthcare infrastructure is not the issue. The way it is accessed it, but that’s another topic entirely.

Asian nations that have a culture of mask wearing seem to have better luck at coping with outbreaks of respiratory illnesses, unfortunately Western nations have a more individualistic culture and shy away from it. You could try mandate masks but eventually people would revolt.


Many of the global respiratory diseases originated in Asia. SARS really started the culture of mask-wearing over there and it’s more or less continued since then.
 
SEAorPWM
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Re: The respiratory viruses -- make it stop!

Sat Dec 10, 2022 5:55 am

What can people do other than stay up to date on vaccinations and stay home if sick? :?
 
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NIKV69
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Re: The respiratory viruses -- make it stop!

Sat Dec 10, 2022 6:07 am

As a physician don't you understand that during Flu season or at any time that the things we need to do like staying home and not going into work or population when feeling ill, washing hands more, using hand sanitizer, covering mouth and or turning head when coughing are all things that is common courtesy. We don't need local or federal government to mandate it. Flu shots help but the biggest thing is not to leave your house when you feel sick. It's why the flu was just about zero during covid. Now that we are back to bad habits it's back.
 
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Aaron747
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Re: The respiratory viruses -- make it stop!

Sat Dec 10, 2022 7:33 am

NIKV69 wrote:
As a physician don't you understand that during Flu season or at any time that the things we need to do like staying home and not going into work or population when feeling ill, washing hands more, using hand sanitizer, covering mouth and or turning head when coughing are all things that is common courtesy. We don't need local or federal government to mandate it. Flu shots help but the biggest thing is not to leave your house when you feel sick. It's why the flu was just about zero during covid. Now that we are back to bad habits it's back.


Not leaving home is fine for those of us in employment situations where bosses have empathy and the company understands healthy people are more productive. Not everyone is so lucky.
 
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readytotaxi
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Re: The respiratory viruses -- make it stop!

Sat Dec 10, 2022 11:57 am

In the UK we are currently seeing a rise in deaths from strep A, 47 adults and 15 children.

https://www.bbc.co.uk/news/health-63903051

"Seasons with high cases can occur every three to four years. But social distancing measures during the pandemic may have interrupted the cycle and that could help explain the recent increase, health officials say."

And with the NHS under terrible stress winter is not looking good.
 
ltbewr
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Re: The respiratory viruses -- make it stop!

Sat Dec 10, 2022 12:31 pm

I have a niece who had a child at 24 weeks of development. He as well as her have to take extra precautions to prevent infection with RSV and other infections as he has not yet fully developed due to his prematurely and her with the medical procedures to deliver the baby causing complications. Many hospitals in the USA have seen higher than pre-pandemic normal for respiratory problems with babies and infants.
 
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DocLightning
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Re: The respiratory viruses -- make it stop!

Sun Dec 11, 2022 6:35 am

leader1 wrote:

My wife runs the pharmacy department of a major hospital in Westchester County. I remember from your older posts that you used to live in the NYC region, so I'm sure you're familiar with the area. Her hospital is seeing an increase in influenza and COVID cases, but RSV seems to have stabilized. No issues with drug shortages...yet. She is worried about the coming months, especially after the holidays. They're not overwhelmed at the moment, but she described the situation as "not good".

And my sister works as a healthcare economist for a healthcare system in the Bay Area. She's not a healthcare professional, but most of her friends and colleagues are. Yes, you guys are getting slammed out there. Is it much worse there compared to other areas?


So in "normal" years (whatever that means anymore) the yearly RSV epidemic starts in the Western US in November and then works its way east, peaking on the East Coast sometime in Feb/March. We do not know what causes this pattern (the seasonality of viruses is still a poorly-understood phenomenon, but presumably it's a complex emergent property of multiple factors), but if that pattern has returned this year, then I'm afraid your wife has a whole lot of hurt coming her way. I sincerely hope she doesn't, but I'm pretty sure I'm right. :cry:

afcjets wrote:
Now it seems obvious the pharmaceutical industry believes culturing is unnecessary and it's in their best interest not to.


I send cultures for all sorts of things all the time. The trouble is that cultures typically take 48 hours to result (if they're positive they'll sometimes result sooner). And sensitivities take another day. So for some common infections (strep, UTI), I have rapid tests that can give me an answer in minutes. But if it's a UTI I always send off a culture because if there is antibiotic failure, I want guidance on which one to use. But for example, for an otitis media (middle ear infection, common in kids), the only way to culture is to do needle tympanostomy (stick a needle in the tympanic membrane and aspirate out the fluid). That's a procedure that would require a minimum of conscious sedation even in some adults. So you're often left with treating empirically based on clinical guidelines, which actually work pretty well because they're based on large studies.

sierrakilo44 wrote:
1. Acknowledge that the restrictive controls to Covid were a lot of times an overreaction, and by locking down cities, closing borders, restricting travel, banning people from seeing friends and loved ones etc all we did by trying to stop one virus was to build up every other of the thousands of viruses out there, like damming a river, and when we opened up the dam again we had all these other viruses rush at us all at once. Along with the delayed diagnosis of cancers and other ailments, delayed surgeries and mental health effects. The pandemic management should’ve been a holistic approach involving all health but most of the time it wasn’t. Authorities were solely focused on Covid.


I think it's important to understand that when those actions were taken, we really didn't understand what we were dealing with and also, literally NOBODY alive had ever lived through a pandemic like this save a few people who were very small children in 1918-1921. So everyone was basically making it up as they went along because there really wasn't anyone to give, say, Tony Fauci any advice. But I think it's also important to remember that the hospitals were dealing with the adult version of what we pediatricians are dealing with now. So everyone was doing the best they could based on an absolute lack of information. It's all well and good to make such statements with 20/20 hindsight (if you'll pardon the pun), but at the time we were all flying blind. So I don't see how acknowledging anything like that is the least bit helpful now.

sierrakilo44 wrote:
2. Re-invest properly in healthcare. You’re from the US right? Then you need a universal healthcare system, the health of the population of the poor can affect the upper and middle classes as well. As well as proper mandated sick leave for all jobs. People shouldn’t be forced to come to work when sick and spread illnesses. This may mean you need to increase taxes, politically unpopular in the US but maybe necessary.


Well, you'll get no argument from me. But I will point out that in this specific case, even universal healthcare systems are buckling under the stress. There just aren't the resources. PICUs take highly-trained personnel and the lead time on those personnel is years. For a PICU Intensivist, the lead time is fourteen years (four years of college, four years of medical school, three years of pediatric residency and three years of PICU fellowship). PICU RNs and RTs have shorter lead times, but it's still 3-5 years. So there's no quick fix for this year.
 
melpax
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Re: The respiratory viruses -- make it stop!

Sun Dec 11, 2022 11:00 am

Same thing happening in Melbourne at the moment. It's almost impossible to get a same-day appointment with a local GP, not unusual to have to wait 1-2 weeks for an appointment. So hospital ED's are currently flat out. The Royal Children's Hospital in particular has asked parents not to take their kids to their ED for non-urgent matters. Several hospitals have also stopped elective surgeries for a short while with a lot of staff having to isolate with COVID as well....

3 years in, and it's still crazy times for the medical profession. No wonder burnout is through the roof...

https://www.theage.com.au/national/vict ... 5c57g.html
 
frmrCapCadet
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Re: The respiratory viruses -- make it stop!

Sun Dec 11, 2022 3:16 pm

Our local hospital have more or less been running on a crisis basis for the last two years. While it is a national and state problem we have too much of our own local incompetences. Last month the emergency room had to call 911 for help. Yes, I wrote that right, nurses were so overwhelmed with patients in the hallways, on the floor, and ambulances lined up the head nurse dialed 911. The local fire department sent EMT help. Health care in our county has been captured by one of the religious oriented chains, and so near as I can tell they are committed to empire building, and health care be damned. The doctors, nurses and other people working on the front lines are both heroic and besieged.
 
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Phosphorus
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Re: The respiratory viruses -- make it stop!

Sun Dec 11, 2022 3:17 pm

Aaron747 wrote:
NIKV69 wrote:
As a physician don't you understand that during Flu season or at any time that the things we need to do like staying home and not going into work or population when feeling ill, washing hands more, using hand sanitizer, covering mouth and or turning head when coughing are all things that is common courtesy. We don't need local or federal government to mandate it. Flu shots help but the biggest thing is not to leave your house when you feel sick. It's why the flu was just about zero during covid. Now that we are back to bad habits it's back.


Not leaving home is fine for those of us in employment situations where bosses have empathy and the company understands healthy people are more productive. Not everyone is so lucky.


These bosses would do well to think that a single person, showing up with a flu, can knock out their entire operation with contagion.
Sometimes it's not only about individual productivity, right?
 
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DocLightning
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Re: The respiratory viruses -- make it stop!

Sun Dec 11, 2022 10:07 pm

Phosphorus wrote:
These bosses would do well to think that a single person, showing up with a flu, can knock out their entire operation with contagion.
Sometimes it's not only about individual productivity, right?


They would do well to think... but they don't.
 
leader1
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Re: The respiratory viruses -- make it stop!

Mon Dec 12, 2022 12:47 am

DocLightning wrote:
Phosphorus wrote:
These bosses would do well to think that a single person, showing up with a flu, can knock out their entire operation with contagion.
Sometimes it's not only about individual productivity, right?


They would do well to think... but they don't.


I have an example of that. One of my soon to be former clients is a small legal aid nonprofit. During the height of the pandemic, the organization's president wanted people to go into the office (she lived out of state, so it didn't apply to her), even though NY State forced everyone other than essential services to work remote. The president registered that nonprofit as an "essential service" (a lot easier to do than you'd think) and forced employees to go in at least a few times a week. Of course, they groaned and complained, but they didn't have much choice in the matter. Anyways, they started going in and half of them them got sick from COVID, with one almost dying. After that, they "paused" in-office activities for a while (an ongoing lawsuit from that really sick employee sort of forced them to) until their board started insisting that they at least go hybrid six months later, before vaccines became available. Absolute height of irresponsibility and, considering that organization mostly consists of lawyers (including their board), they should have known better. There's a reason I'm dropping them as a client.
 
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lightsaber
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Re: The respiratory viruses -- make it stop!

Mon Dec 12, 2022 3:16 pm

DocLightning wrote:
Phosphorus wrote:
These bosses would do well to think that a single person, showing up with a flu, can knock out their entire operation with contagion.
Sometimes it's not only about individual productivity, right?


They would do well to think... but they don't.

I'm the boss and it is hell getting people to go home this year. I just (this morning) came down with a cold and am working from home. People are asking me to come in anyway... No. I cannot have my whole team sick.

We've gone back to the "hero" working through illness. Ugh.

Lightsaber
 
vikkyvik
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Re: The respiratory viruses -- make it stop!

Mon Dec 12, 2022 5:08 pm

DocLightning wrote:
Personally, my son coughed nonstop from August until this last weekend, when he finally stopped.


First of all, congrats, I didn't realize you had a kid! How old?

My son (almost 4 now) has coughed on-and-off since....I want to say March or so. Just about when he started preschool (go figure). Some weeks are bad, some weeks are not-so-bad, and every now and then he'll have a week where he's not coughing at all, which is like, heaven.

His pediatrician thinks he has childhood asthma, that gets triggered by whatever else. I'm not so sure about that.

He has also had numerous ear infections, and also got diagnosed with RSV several months ago. But I think he may have a sinusitis or something that a week-long course of antibiotics just isn't getting rid of. He's just finishing his latest 10-day round of antibiotics, and his coughing actually got worse over the last couple days.

It's difficult to know whether to be worried or not. But for the most part, he seems happy and upbeat, and doesn't act very "sick", so again, difficult to determine how worried to be. Hopefully he'll just outgrow whatever this is....

I'm not a big fan of his current pediatrician, so that doesn't help. My health insurance changes on Jan 1, at which point hopefully we'll be able to go back to his previous pediatrician, who we really liked.
 
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NIKV69
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Re: The respiratory viruses -- make it stop!

Mon Dec 12, 2022 5:31 pm

lightsaber wrote:
I'm the boss and it is hell getting people to go home this year. I just (this morning) came down with a cold and am working from home. People are asking me to come in anyway... No. I cannot have my whole team sick.

We've gone back to the "hero" working through illness. Ugh.

Lightsaber


I am in the same boat but my guys can't work from home and have to be present. I scratch my head since this pandemic has given us the Zoom etc ability to work from home. Why not take advantage when you shouldn't be in population to do this?
 
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lightsaber
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Re: The respiratory viruses -- make it stop!

Mon Dec 12, 2022 7:27 pm

NIKV69 wrote:
lightsaber wrote:
I'm the boss and it is hell getting people to go home this year. I just (this morning) came down with a cold and am working from home. People are asking me to come in anyway... No. I cannot have my whole team sick.

We've gone back to the "hero" working through illness. Ugh.

Lightsaber


I am in the same boat but my guys can't work from home and have to be present. I scratch my head since this pandemic has given us the Zoom etc ability to work from home. Why not take advantage when you shouldn't be in population to do this?

I don't understand why people do not stay home. I'm calling into my staff meeting and hearing three people cough.

200 hikers and rafters have norovirus in grand canyon.
https://www.msn.com/en-gb/travel/tripid ... r-AA150oeK

A number of cruises have had norovirus outbreaks:

https://en.mercopress.com/2015/04/16/no ... california

https://thenewdaily.com.au/news/nationa ... uises/amp/

My, this an intense season.
Hospitals are full:
https://www.nytimes.com/interactive/202 ... r-you.html

For some of my friends, the direct link doesn't work. Search for "How full are hospital i.c.u."

About one in 5 U.S. hospitals with intensive care units, or 579 total hospitals, recently reported that at least 95 percent of their I.C.U. beds were full. In the week ending Dec. 8, an average of 77 percent of intensive care hospital beds were occupied

By my interpretation, it looks like California, Mississippi, and Texas are filling up hospitals.

Lightsaber
 
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DocLightning
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Re: The respiratory viruses -- make it stop!

Mon Dec 12, 2022 8:17 pm

vikkyvik wrote:
DocLightning wrote:
Personally, my son coughed nonstop from August until this last weekend, when he finally stopped.


First of all, congrats, I didn't realize you had a kid! How old?


He just turned 3!
 
bhill
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Re: The respiratory viruses -- make it stop!

Mon Dec 12, 2022 11:25 pm

I hear you Doc, I work at one of the hospitals in Seattle, not Childrens, and we are having to set up Peds units just in case for overflow. I wondered about the efficacy of this years' flu vaccine, thanks for sharing those numbers.
 
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rmoore7734
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Re: The respiratory viruses -- make it stop!

Mon Dec 12, 2022 11:49 pm

I have taken 3000 milligrams of vitamin C and 10000 IU of D3 with K2 daily since spring of 2020 and NO flu, Covid, colds not even a sore throat since I have been on that regiment.
This I think will solve a lot of this.
One last thing avoid or limit sugar intake as best you can because it will lower immune system up to 8 hours.

Try this regiment because I use to get cold, flu etc. often before I did this.
 
Toenga
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Re: The respiratory viruses -- make it stop!

Tue Dec 13, 2022 4:10 am

Covid vs the flu in New Zealand
https://www.rnz.co.nz/news/national/480 ... s-compared.
So deaths where covid is either, the underlying cause of death, or a contributing cause of death, is shaping up to be our 2nd biggest killer, 3 times that of influenza.

NZ countered covid in the early stages of the epidemic, prior to vaccines being deployed by closing the border and lockdowns.
This resulted in minimal illnesses and deaths right up to the end of the delta outbreak very early this year, by which time all who wanted vaccination had had time to get three doses minimum.
It was then the borders fully reopened, and very near all final restrictions were removed.

As China has demonstrated the incredible infectiousness of Omicron, and now subsequent variants, would have rendered ongoing stringent restrictions very largely ineffective anyway.

We are now in summer and covid is circulating very freely, my wife had her first infection two weeks ago, probably from a visit to the hairdressers, and I followed a week later. A short lived but absolutely vicious sore throat. But nothing much else. My wife had antivirals, but because of weekend supply impediments I did not. I think there was a trade off between intensity and duration, My wife had less, but more persistent symptoms,
Anyway not a recommended way to boost immunity.

So probably about 80% of our population has now had covid, and reported reinfection rates are approaching 30% but are actually probably higher.
 
bhill
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Re: The respiratory viruses -- make it stop!

Wed Dec 14, 2022 11:17 pm

rmoore7734 wrote:
I have taken 3000 milligrams of vitamin C and 10000 IU of D3 with K2 daily since spring of 2020 and NO flu, Covid, colds not even a sore throat since I have been on that regiment.
This I think will solve a lot of this.
One last thing avoid or limit sugar intake as best you can because it will lower immune system up to 8 hours.

Try this regiment because I use to get cold, flu etc. often before I did this.


You DO realize you are pissing away most of that Vitamin C.....right? And you may want to have your calcium levels and kidney functions checked. Doses that high should be monitored by a Doc.
 
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DocLightning
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 5:45 am

rmoore7734 wrote:
I have taken 3000 milligrams of vitamin C and 10000 IU of D3 with K2 daily since spring of 2020


Those are toxic doses. Please see a physician.
 
LCDFlight
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 9:19 am

Respiratory virus implies that it is happening to a breathing animal. So perhaps it’s actually a good sign that we are alive, at least for now…
 
Redd
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 10:04 am

DocLightning wrote:
rmoore7734 wrote:
I have taken 3000 milligrams of vitamin C and 10000 IU of D3 with K2 daily since spring of 2020


Those are toxic doses. Please see a physician.


What's the best cocktail of vitamins (or anything else helpful), when one starts noticing flu symptoms, in your opinion?
 
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Phosphorus
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 11:40 am

DocLightning wrote:
rmoore7734 wrote:
I have taken 3000 milligrams of vitamin C and 10000 IU of D3 with K2 daily since spring of 2020


Those are toxic doses. Please see a physician.


oh yes...
I've chronical deficit of D3, and doc's bumped me to 20 000 IU of D3 per WEEK.
I know a fella in Israel, with a documented hereditary D3 deficiency. He's above 70, he takes 5600 IU per day of D3 (legal upper limit in Israel, from what he says), with monthly blood tests, and MANDATORY month per year, when he takes none, in the middle of summer, to allow his metabolism take a bit of rest.

self-prescribing 10000 IU of D3 per day is looking for trouble.

And those vitamin C doses... Wouldn't that be more like a crash dosage, in the onset of a cold or a flu, for a day or two maximum? And still, people would limit themselves to a gram maximum.

hypervitaminosis is a thing, just like avitaminosis
 
bourbon
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 11:41 am

Redd wrote:
DocLightning wrote:
rmoore7734 wrote:
I have taken 3000 milligrams of vitamin C and 10000 IU of D3 with K2 daily since spring of 2020


Those are toxic doses. Please see a physician.


What's the best cocktail of vitamins (or anything else helpful), when one starts noticing flu symptoms, in your opinion?

A shot of bourbon, some soup and bed rest.
 
StarAC17
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 3:32 pm

DocLightning wrote:
rmoore7734 wrote:
I have taken 3000 milligrams of vitamin C and 10000 IU of D3 with K2 daily since spring of 2020


Those are toxic doses. Please see a physician.


How much Vit D should an adult take?

I usually take 2000 UI in the summer and and 3000-4000 UI in the winter.
 
StarAC17
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 3:34 pm

bhill wrote:
rmoore7734 wrote:
I have taken 3000 milligrams of vitamin C and 10000 IU of D3 with K2 daily since spring of 2020 and NO flu, Covid, colds not even a sore throat since I have been on that regiment.
This I think will solve a lot of this.
One last thing avoid or limit sugar intake as best you can because it will lower immune system up to 8 hours.

Try this regiment because I use to get cold, flu etc. often before I did this.


You DO realize you are pissing away most of that Vitamin C.....right? And you may want to have your calcium levels and kidney functions checked. Doses that high should be monitored by a Doc.


Get your Vit D levels checked and see where they are at.

There was a ton going on about it when Covid started and then Joe Rogan went on about taking high doses and while true many people are deficient I would get it checked to see if that is the case with you.

If you live in an area that gets sun all year around and are deficient, you might just need to go outside more.
 
Newark727
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 4:00 pm

bourbon wrote:
A shot of bourbon, some soup and bed rest.


Well of course you would say that. :D
 
N1120A
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 4:02 pm

Do they still give out awards for "perfect attendance" in school? Cause that should have stopped long ago, and certainly with COVID.

Employees and students should be encouraged, not penalized, to be absent when sick.
 
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DocLightning
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 4:24 pm

StarAC17 wrote:

How much Vit D should an adult take?

I usually take 2000 UI in the summer and and 3000-4000 UI in the winter.


In the absence of a deficiency or known VitD absorption issue, 2000IU is plenty.

And megadose vitamin C can crystallize in the kidneys and cause stones.
 
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casinterest
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 4:25 pm

DocLightning wrote:
StarAC17 wrote:

How much Vit D should an adult take?

I usually take 2000 UI in the summer and and 3000-4000 UI in the winter.


In the absence of a deficiency or known VitD absorption issue, 2000IU is plenty.

And megadose vitamin C can crystallize in the kidneys and cause stones.


Note to self....back off the vitamin C a bit.

Thansks for the info.
 
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DocLightning
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 4:27 pm

Redd wrote:

What's the best cocktail of vitamins (or anything else helpful), when one starts noticing flu symptoms, in your opinion?


There is no good evidence that any combination of vitamins taken at the onset of an illness alters its course. There is some evidence that pre-existing vitamin d deficiency can make one more prone to respiratory viruses, and certainly there is no reason to be walking around with a vitamin D deficiency, but well-done studies on COVID Show that vitamin D taken early in the course of the illness doesn't seem to have much of an effect.

So while I'm all for reasonable vitamin D supplementation (since deficiency is common, at least in industrialized nations), we should understand what it can and can't do.
 
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rmoore7734
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 9:22 pm

I appreciate the advice and I did some research https://m.youtube.com/watch?v=gjJdzHIwDDU

It appears that 10000 IU is safe for daily maintenance but when you get over 100k…..200k of vitamin D3 over months to a year is where you get into trouble but also taking it with K2 helps mitigate that problem as well.
 
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rmoore7734
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 9:37 pm

As far as vitamin C is concerned this article from Mayo Clinic that not much harm can be caused by from too much vitamin C.

https://www.mayoclinic.org/healthy-life ... q-20058030

What you want to do is micro dose the vitamin c during the day to avoid bowel intolerance.
Example 1000 milligrams in morning maybe another around lunchtime and one more near bedtime
 
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rmoore7734
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Re: The respiratory viruses -- make it stop!

Thu Dec 15, 2022 9:59 pm

Why vitamin k2 is important when taking vitamin D3 together

https://us.betteryou.com/pages/vitamin-d-and-vitamin-k

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