Inside Medicine. What Are You Seeing? [COVID-19 medical news]

You’re assuming without evidence that there is a different infection fatality rate for African Americans than for Latinos. There might be, but both groups appear to be at a considerably higher risk, and there are a lot of Latinos in the Santa Clara Valley. Indeed, the Latino fatality rate for Covid here is scarily high compared to other groups.

It doesn’t seem so bad: Whites make up 32% of the deaths with 31% of the population and Latinos make up 34% of the deaths with 25% of the population, so that doesn’t seem terrible. But the median age of Latinos is 27! This is a young, young cohort to be dying so much. Why aren’t we doddering whites, median age 45, the ones doing more of the dying?

Latino people generally have lower income than the overall population. Lower income people tend to have more pre-existing health conditions that increase COVID-19 risk. In addition, lower income people who are still working are more likely to be working in higher exposure jobs that cannot be done remotely (e.g. grocery store, delivery). Lower income people tend to have less money (obviously) that could be used for medical care and are less likely to have good medical insurance (and may have lost it if they lost their jobs). Lower income people may also be living in denser housing, so exposure to neighbors may be greater, and households have less ability to socially distance a household member who has a job with a high risk of exposure.

@“Cardinal Fang”

fata

No, I am questioning why you are assuming without evidence that the infection fatality rate from Covid 19 in NYC would be the same as the rate in Santa Clara County

You also seem to be assuming, without evidence, that the predominant strains of Covid-19 in Santa Clara is the same as the predominant strains in NYC, and/or that all variants of Covid 19 have the same degree of lethality. (There is very clear evidence of different strains - https://nextstrain.org/ncov/north-america )

MODERATOR’S NOTE: We’ve given more leeway in this thread than others because people have managed to stay on track. Please stay out of debate territory so it can continue. Thanks!

In #184 I asked if any drs had seen a connection of severe illness and low vit d levels. I asked bc it is a discussion I have seen in terms of the differing severity rates amg various groups. Google African Americans or Italians and low vit d and you’ll see pages of research in general about the deficiency.

Here is one about the possible covid relationship

https://www.wsj.com/articles/vitamin-d-and-coronavirus-disparities-11587078141

That article was chosen at random. I have read articles discussing the how diets high in fish are high in vit D. (Hence lower case numbers in Asia). People in the southern States are more likely outside than in NYC.

If there is a relationship, seems like taking supplemental vit d and getting outside would be a general positive. Is that an actual medical conversation or just a fringe theory?

@MaineLonghorn Thank you!

@Mom2aphysicsgeek Isn’t it generally true that it D strengthens immune system?

Yes. But, do you think the discrepancy of outcomes in this illness is typical to others in general amg people with general low levels of vit d? Maybe. I don’t know. I am not a dr.

@“Cardinal Fang”

IMO, the reason doddering whites aren’t is because more of us have the luxury of staying home. That’s my guess.

Here is more info:

https://www.hsph.harvard.edu/nutritionsource/2020/04/01/ask-the-expert-the-role-of-diet-and-nutritional-supplements-during-covid-19/

@Mom2aphysicsgeek - I’ve been taking 5000 iu of vitamin D for years, on the advice of my neurologist. I live in the south, garden a lot, walk my dog, and have light skin, but still my vitamin D levels were found to be below the range of normal in bloodwork. She started me on 10,000 iu, but that pushed me above the range of normal.

Vitamin D is very hard to absorb from nature. We don’t get enough sun, or we are wearing sunscreen and hats (which we should), and so it is an essential nutrient that was added to milk products to prevent rickets, back in the day. It’s worth checking your vitamin D levels when you have blood work done.

Vitamin D is a very powerful anti-inflammatory. I have MS and it is helpful with that (according to my Dr. and others). Decades ago, a doctor studied rates of MS around the world and found it seemed to be linked to a higher saturated fat diet. The difference was most striking in Norway, where coastal people had very little MS and inland people had lots of it. The coastal people had a diet low in saturated fat, mainly fish. The inland people were eating a lot of dairy products, some beef, and lots of wheat. The differences could be from saturated fat, or could be from exposure to things that are inflammatory (dairy, red meat, wheat) or anti-inflammatory (cod, herring, etc.). Who knows?

Tl,Dr - get your levels checked the next time you do bloodwork and take a small dose of vitamin D now. It won’t be a miracle but a small dose can’t hurt and at least you won’t get rickets, lol.

My state Ohio was pretty progressive with stay in place and shutting down schools and businesses. Michigan was always a few steps behind us. I know that is not the only factor but the compared statistics are shocking to me. I work for a health system and get daily stats for both Ohio and Michigan because we service both states…Michigan continues to exceed Ohio #'s in cases/deaths etc. multiple times over. It’s crazy.

Last nights stats show Ohio with 451 Covid deaths; Michigan is at 2,227.

I’m a Michigander at heart and this is disturbing to see.

From my records, Ohio shut down on 3/23 and Michigan on 3/24. Was Ohio just luckier that the virus hadn’t gotten any significant spread there yet?

Fish are also a source of vitamin D.

I think shut down dates are for the total shut down. Ohio may may been shutting down locally earlier. That’s the case in my state. Statewide shut down quite a few days later than my own county. If Ohio was shutting down selectively, it should have helped. Same in CA. The Bay Area shut down sooner but the shut down date shows when the governor shut the entire state.

Friends in Detroit area report that one of the main problems was folks flying into the Detroit airport from abroad. Or entering from Canada.

That was not happening as much in Ohio, and may be part of the reason Ohio has seen less numbers.

I wrote some dates down yesterday of the different dates things shut down between Ohio and Michigan because the cases are so dramatically different.

Michigan for the most part shut down parts of the state right after Ohio. I know it’s been pointed out to me that beauty salons shut down later but it was 3 days later and that was the biggest difference I found. Schools and restaurants shut down 1 day later. Stay at home order, one day later.

3 things stood out to me. Ohio shut down a big gathering at the beginning of March. I did not see an equal sized gathering in Michigan that wasn’t shut down so I don’t know about that.

On March 10, Michigan held its primary. Ohio was later and was ultimately postponed.

On March 13, DTW was one of the 13 gateway cities for people returning from Europe. I did not see any airports listed in Ohio.

Here’s an article https://www.dailymail.co.uk/news/article-8111069/Americans-returning-Europe-wont-tested-coronavirus-asked-questions.html

Anyways, those were 3 that stood out to me.

Those three seem rather important, especially about banning large gatherings. There are many examples how hot spots got started from large gatherings… Ohio governor was also one of the most proactive governors in the country. I am sure they did something very early on.

@Iglooo, it could have been something or it could have been dumb luck?

Maybe it was the primary? Where there was a big turnout for the democratic primary? The places most affected are Democratic strongholds in the state.

Maybe it was a super spreader that came through Europe?

Maybe it was the cancellation of a big event in Ohio but I haven’t heard anything in the Michigan media about a large event that they saw a lot of cases from.

I hope some day that we will find out an answer.

I really think our governor has done the best she could and was more proactive than many. But still there are so many cases.

And yet - the current situation in Michigan looks very promising.

New cases are decreasing steadily. Today there were 600-some new cases in MI. About two weeks ago, the daily count of new cases was 1900.

Today’s new case count does not appear to be an anomaly, since Friday’s count was 760 and Saturday’s was 708. Progress!

A few weeks ago, Michigan was third in the country in total COVID cases. Today it’s in fifth place, maybe even sixth (depending on California’s count for today.) Progress!

Looks like the governor’s stay-at-Home policies may be working. Come on, Michigan, don’t mess it up!