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go to facebook to easily read this https://www.facebook.com/Dr-Louis-P-Coates-1998386763777604/ Dr Louis P Coates 13 hrs · Coronavirus Update 4/21/2020 - BTHO COVID-19 So today at the time of this writing there are 28,123 new cases today with 1,561 deaths. Cases appear that they are very slowly declining. with 29,057 yesterday and the mortality rate for today is down to 5.55% down again from yesterday. We also have 13,951 still in critical condition so the fatality numbers look better again today but might not continue with that many critical. Let's hope that it does though. We also have now had 74,797 people recovered still as this number didn’t change for some reason but will see if we see a bigger jump tomorrow. They should now be considered immune from this horrific disease. Locally, in Texas per the latest models we are now estimated that we have peaked yesterday. Let’s all hope that is true and we are starting on the downside of the curb. We had 484 new cases and 16 new deaths with a steady mortality rate of 2.6% In Dallas county we had 104 new cases with no new deaths. Harris county with 170 new cases and 4 new deaths. Collin county with only 5 new cases and no new deaths. Denton county with 1 new case and one new death. Brazos county reported nothing today. A whooping fatality rate of 9.5% and yes it is mainly a nursing home but this is really high. Travis county with 16 new cases and 2 new deaths. Now remember I still believe we have an overall fatality rate somewhere in the 0.3 to 0.7 range when finally correct the denominator. Opening up Texas since some of you had many more questions. On the topic of reopening. Many had some great suggestions such as taking temperatures at the door. Also asking which type of business can or should open like hairstylist, massage therapist, nail salons etc. I think all of those are more than appropriate as they are all contact with only a single person so risk is limited. I think most jobs that have contact with less than 10 people should be acceptable to open. The real test is the public doing the right thing. Florida was a perfect example of how not to open with the beaches packed with people. Avoiding crowds is the key to a safe opening. Remember we are only trying to keep the number of infections to a minimum as we continue to slowly get closer to herd immunity. The biggest key point will be to protect those most vulnerable to this terrible disease. This group is the elderly, diabetics, heart disease, lung disease and immunocompromised. Those of us who are not as likely to get severe disease will be out in the community slowly increasing the immunity. Everyone is still asking me about immunity particularly since the news is bringing up people getting reinfected, so let’s review it again? Let’s first go back to the study we discussed a few weeks back. There were 4 monkeys infected with the SARS-COV2 virus. Each monkey after infection showed symptoms of COVID-19 such as high fevers, fatigue and weight loss and all 4 had positive viral loads peaking in 3 days. The first monkey was destroyed and they looked to see where the virus was located inside the monkey. It was found to be distributed all over the place such as nose, mouth, muscle, heart, spine, bladder and lungs. but very high concentrations in the lung. Next we took the other 3 monkey’s and let them recover from the virus. After 28 days they checked viral loads and were negative. They then reinfected the 3 monkeys and while they had a brief spike in fever that quickly resolved. They also showed no other signs of the virus such as weight loss, fatigue, cough etc. Then they checked viral loads 96 times and they found no virus at all.. So this showed they were found to be immune. Now let’s review the testing we currently do in humans. There are currently two types of tests we are using. The first is a reverse transcriptase PCR test which tests for an active infection the nasal swab or new spit test. The second type of test is antibody testing which tests for IgM (a recent infection) and IgG (old infection and immunity). Now it's very important that everyone understands that both of these tests are not perfect tests by a long shot. They both have a significant false positive rate with a specificity of approximately 95% which we discussed as recently last week. Which based on the fact we have such a low true positive rate (people actually infected) this leads to a false positive rate of over ⅓ of the cases assuming 10% is actually infected, The false positive is even higher if there is even a lower actual percent of infected individuals. (Please review the previous post on this for the math if you are confused) It should be noted that these numbers are even with the FDA approved test. The non FDA approved have an even much higher percentage of false positives with much lower specificity. Knowing all of this information, the stories you are sending me about people getting re-infected in South Korea or other countries is likely just a false positive.. The percentage of peolple with supposed reinfection is way less than 2% and the PCR tests have a false positive rate at best of 5% and most even higher. The antibody test is essentially the same. So this is much more likely to mean they were simply a false positive the first time and now they have contracted the virus.. The coronavirus historically is not a rapidly mutating virus. There is NO current evidence of this and the media is simply trying to scare everyone at this point. That is not to say that the virus could not mutate and cause issues with immunity. But it is not very likely at all so let’s wait until we have some solid scientific evidence until we scare the hell out of everyone. Tomorrow I will address the Stanford study you have been texting me about. Yes I have seen it and read it. Too much to say tonight so tabling it for tomorrow. Since we are approaching the peak now, I will repost the supplements we have discussed. Zinc any amount is probably good but take what you can tolerate without making you feel bad upto 50mg. You do not want to be Zinc deficient as it is how many drugs like HCQ work. Quercetin from 250mg up to 1g twice per day Remember this is the Zinc ionophore. Green Tea either drink some or 1 pill per day Melatonin 1mg to 10mg at night. Take what you can tolerate and what helps you sleep without making you feel drugged or tired in the morning. Vitamin C 250mg to 500mg twice per day. Effects debatable in oral form but IV did help in China Vitamin D3 Take this if you are deficient but besure to stop it if you become sick as this drug works by increasing cytokines and potentially could exacerbate the cytokine storm. Sleep greater than 8 hours per night As always the information and understanding of COVID-19 is changing rapidly. This information is for education purposes only and you should never make changes to your health without consulting your personal physician. Make a virtual appointment with your physician and discuss your health and the best possible treatment plan for you. It is also important to reiterate that there are no clinically evidence-based integrative prevention or treatment strategies for COVID-19 infection. Let’s all keep praying for all that are ill with this virus in the world. Gig’em!