Dexamethasone Declared First Drug To Save Lives Of Coronavirus Patients
The title of this post, is the same, as that of this article in The Times.
These are the introductory paragraphs.
British scientists have hailed a “huge breakthrough” in the fight against Covid-19 after a cheap drug was declared the first to save lives.
Dexamethasone, a decades-old steroid that costs about 50p per day, was found to reduce deaths by up to one third for the sickest patients. NHS hospitals were advised to begin using it immediately.
According to a retired Senior Hospital Pharmacist friend, Dexamethasone has been around a long time and is used in shock. She added “So don’t know why not tried before.”
The Times article says this about previous use.
While it had been administered to Covid patients in China and elsewhere its use was controversial, with no definitive proof that it worked.
Could it be that the research was discounted on ageist grounds against the drug?
Wikipedia also says this about the drug?
it was the 259th most prescribed medication in the United States, with more than a million prescriptions.
That is about 1-in-327 of the US population.
Dexamethasone And Coeliac Disease
Out of curiosity, I typed “Dexamethasone and coeliac disease” into Google.
I found this page on SpringerLink, which is entitled The Role of Corticosteroids In Celiac Disease.
This is the first sentence.
Since Dickie first described the benefits of a gluten-free diet in the 1940s and 1950s, this diet is the standard of care for all patients with celiac disease. For patients with a new diagnosis, dietary compliance can be difficult to achieve, possibly resulting in a clinical course marked by delayed recovery and persistent symptoms. This is of particular concern for patients in the developing world, where gluten-free food items may be difficult to obtain or to identify. While dietary modifications are likely to remain the treatment of choice in celiac disease, the use of adjuvant corticosteroids in newly diagnosed patients is a topic that has been addressed previously.
I’m no medic, so what follows in the scientific report is beyond my limited medical knowledge.
However in A Thought On Deaths Of The Elderly From Covid-19, I estimated that there are around 120,000 undiagnosed coeliacs in the UK, who are over 65. I used data from Age UK and Coeliac-UK.
According to Joe West of Nottingham University, diagnosed coeliacs on a gluten-free diet have less chance of getting cancer!
Could it be that this group of people, of which I am one, have a strong immune system?
So could the reverse be true and that undiagnosed coeliacs on a typical gluten-rich diet have a compromised immune system?
My son was an undiagnosed coeliac, with a poor diet who smoked. He died at just thirty-seven from pancreatic cancer!
Could some of the patients, who recovered from COVID-19, when given dexamethasone, have been undiagnosed coeliacs?
I, of course don’t know.
But the role of coeliac disease in the recovery from COVID-19 must be investigated.
A quick way to test my theory would be to survey the catering departments of all hospitals and see how much gluten-free food was being sent to wards, where COVID-19 is being treated.
Coeliacs, whether diagnosed by doctors or self-diagnosed, will probably be vociferous in their need for gluten-free food. I certainly was, when I had my stroke in Hong Kong.
Give me the data and I’ll analyse it!
I would also like to hear from any coeliacs, who have been given dexamethasone!
Oxford And Cambridge Compared On COVID-19
In Is There A Link Between Historic Coal Mining And COVID-19?, I mentioned this article in The Times, which is entitled Pressure To Free London From Lockdown As Cases Fall.
The article gives an interactive table, which is entitled Number Of Cases By Area.
Three figures are given.
- Registered cases
- Cases per 100,000 of the population.
- Cases in the last two weeks.
These figures are for areas around Oxford.
- Oxford – 615, 399, 90
- South Oxfordshire – 358, 255, 36
- West Oxfordshire – 324, 295, 50
And these figures are for areas around Cambridge
- Cambridge – 222, 177, 20
- South Cambridgeshire – 206, 131, 10
- East Cambridgeshire – 111, 124, 12
- West Suffolk – 205, 115, 18
So why are COVID-19 cases in Cambridge so much lower than Oxford?
Consider.
- Both cities and surrounding counties have a similar character.
- Both have well-respected hospitals, medical schools and medical research.
- Air pollution appears to be low in both areas.
- Both cities probably have a similar ethnic mix and large student populations.
As I used to live near Cambridge, I have my own mad personal theory.
Addenbrooke’s Hospital
I have used several hospitals in my life, but only two changed my life totally.
- I had my vasectomy in the old Hackney Hospital.
- Addenbrooke’s, who with a simple blood test decided I was probably coeliac.
So perhaps, I’m biased.
But consider these possible facts.
- My coeliac consultant at Addenbrooke’s told me, that he had more patients with the disease than any other in the UK.
- The manager at Carluccio’s in Cambridge, told me that they sold more gluten-free food, than any other restaurant in the group.
- In 1997, I was diagnosed fast, because Addenbrooke’s were using a new genetic test. I was later checked using an endoscopy.
Could it be that someone at Addenbrooke’s had decided they wanted to find all the coeliacs in and around Cambridge?
What would be the effects of diagnosing as many coeliacs as you could find in an area?
- A doctor of my acquaintance talked of coeliac disease as the many-headed hydra, as it led to so many other medical problems. So extra diagnosed coeliacs might improve health statistics in an area.
- Personally, I have said good-bye to migraines, nail-biting and lots of joint pains, after going gluten-free.
- I also haven’t had a serious dose of flu since diagnosis. Since 2005, I’ve probably had the flu jab.
- Joe West at Nottingham University, has shown that coeliacs on a gluten-free diet have lower cancer rates than the general population.
Consider.
- Immunotherapy is a medical technique, where the patient’s immune system is activated or suppressed to help them fight a disease.
- Coeliac disease is an autoimmune disease, where gluten causes damage to the gut.
So could coeliacs on a gluten-free diet have a more powerful immune system?
Undiagnosed Coeliacs
Coeliac disease is genetic, with mine coming from an Ashkenazi Jewish ancestor from Konigsberg in the Baltic.
- Other roots of coeliac disease are Irish, Italian and black people, who have slaves as ancestors.
- There was no test for coeliac disease in children until 1960.
- There was no genetic test for coeliac disease until the late 1990s.
- Research has shown that coeliacs are at least 1-in-100 of the UK population, but could be higher.
If coeliacs on a gluten-free diet have a good immune system, do undiagnosed coeliacs have a poorer one?
Oxford And Cambridge Compared
Is the large number of diagnosed coeliacs around Cambridge, the reason the area has a lower COVID-19 rate than Oxford?
Conclusion
What do I know?
I’m just a mad engineer and mathematician with coeliac disease.
COVID-19 Pandemic In Cambodia
The title of this post, is the same as this entry in Wikipedia.
This is the introductory paragraph.
The first case relating to the COVID-19 pandemic was confirmed in Cambodia on 27 January 2020. According to Global Health Security Index’s report in 2019, Cambodia ranked 89th out of 195 countries in preparedness for infectious disease outbreak.
It doesn’t prepare you well for the remarkable statistics from the country, given in the Wikipedia entry.
- Confirmed cases – 123
- Tests conducted – 15,162 as of 17th May
- Active case – 1
- Recovered – 122
- Deaths – 0
The Wikipedia entry then lists all of the cases in detail.
I know we can say that any country with an important amount of revenue from tourism can massage the statistics, but I do feel that the data is reasonably scientifically correct.
So why are Cambodia’s statistics so remarkable?
I have never visited Cambodia, but Cambodian cuisine used to be recognised as completely gluten-free, when I was diagnosed as a coeliac by Addenbrooke’s hospital in 1997. I was told by a dietician at the hospital, who joked that someone should start a Cambodian restaurant in Cambridge
There is sufficient data on the Wikipedia entry to almost do a professional track and trace and it appears that several cases came from a cruise ship and others from foreign travel.
But even so, only 52 Cambodians have been admitted to hospital with Covid-19 and all have survived.
Could it be that their diet gives them a strong immune system?
I seem to remember reading somewhere, that a scientist postulated that one of the waves of plague that swept Europe happened, soon after high-gluten wheat started to be grown in great quantities.
Conclusion
The Cambodians are obviously doing something right!
Thoughts On Coeliacs And COVID-19
This article in The Times is entitled Covid-19: Being Black Does Not Put You At Greater Risk, Researchers Say.
This though is the significant paragraph in my view.
The documents also show that among younger people obesity raises the death rate fourfold, and for those in their fifties it more than doubles it.
As I am not by any means obese, it pleases me.
But it got me thinking about fellow coeliacs.
Most are built like whippets and many seem to be fit for their age.
So do we get a secondary protection against COVID-19?
How Many Diagnosed Coeliacs Have Caught COVID-19?
the coeliac charity; Coeliac UK, indicated to me, that they are doing research into the number of coeliacs, who have caught COVID-19.
Surely, one way to find out how many coeliacs are in hospital with COVID-19, would be to look at how many hospital cases are on a gluten-free diet!
Are Coeliacs More Risk-Averse?
I am coeliac, which means, that I am allergic to gluten!
So I have to be very careful about what I eat.
I have perhaps been glutened two or three times in the twenty years since I was diagnosed. With me it is nothing serious, but it does mean being close to a toilet for some hours.
If I look at my behaviour generally, I sometimes wonder, if I have become more risk-averse since my diagnosis.
I think too, that I’ve probably become more risk-averse since my stroke, after which, one of the world’s leading cardiologists told me, that if I got the Warfarin right, I’d never have another stroke.
I intend to prove him right! So I watch my INR like a Control Engineer would monitor reactor temperature in a nuclear power station.
I would assume that my risk-averse behaviour is fairly normal.
So if you have had a serious illness or near-death experience from which you have been able to almost fully recover, are you doing your best to make sure that you avoid COVID-19?
The Death Of My Son George
In some ways our youngest son; George, was more my baby, than my wife’s!
When you have three children under three, you have to devise a system so they can all be fed, watered and managed.
In the early 1970s, I was working at home, writing software for the likes of companies like Lloyds Bank, Plessey, Ferranti and others, usually by means of a dial-up line to a company called Time Sharing Ltd. in Great Portland Street.
- So most days George sat on my desk in a plastic baby chair, as I worked.
- C would look after the two elder children, generally taking them to the park or friends.
- George was still in nappies, real not disposable. We did use a nappy service!
- I sometimes wonder, if I can still install a proper nappy on a baby!
- I would feed him as I worked.
- George also used to come with me to visit clients, I had to meet at Great Portland Street. Usually, the secretaries would steal him away.
It was a system, that worked well for all of us.
Of our three children, George was the only one, that C thought could be coeliac, as I am. Mothers know their families! We once tried to test him with a self-test kit from the Internet. but the results were inconclusive.
I now believe he was coeliac for one genetic reason. His daughter was born with a severe congenital hernia of the diaphragm and research shows this can be linked to a coeliac father.
At least I was lucky with my three boys in this respect, but it points to George being coeliac.
George worked in the music business and was the sound engineer on some of the work of Diane Charlemagne. I met Diane once, when I stood on The Fourth Plinth in Trafalgar Square, which I wrote about in Fun and Games at the Fourth Plinth.
- Diane was working as the security guard and it was an amazing coincidence, that we realised our connection through George.
- She spoke highly of his work.
Sadly Diane died of kidney cancer in 2015.
George didn’t drink, but he smoked heavily and not just tobacco. He also lived on a very gluten-rich diet of Subways and the like.
I suspect that his immune system was as good as much protection as a chocolate colander in a tsunami!
I have discussed this with doctors, who specialise in cancer and they feel that it could have contributed to his death from pancreatic cancer.
- George died at home.
- He was not in much pain due to the morphine he was controlling through a pump and the cannabis he was smoking.
- One day, he was in bed and talking to my then aristocratic girlfriend and myself, when he just expired.
- There was no drama and he just went to sleep.
A few minutes later, my girlfriend and the housekeeper, laid out the body for the undertaker.
I had been at George’s quiet death, just like I had been at the birth of all three sons.
Looking Back
George died ten years ago and his death has left some marks on my mind.
- Because of our early relationship, some of my grief for George was more like that of a mother.
- George died a peaceful death, which with modern medicine should be almost a right for many!
- His death has driven me to fund and take part in medical research, especially for pancreatic cancer.
- I also feel strongly, we should steer clear of cannabis, eat sensibly and check as many as possible for coeliac disease.
But now above all, I have no fear of Covid-19 or death.
Thoughts On Coeliacs And Covid-19 In Cambridgeshire
I was diagnosed as a coeliac by Addenbrooke’s Hospital in Cambridge.
- One of the consultants there told me, that they had a very high number of coeliacs on the books and the number was one of the highest in the country.
- I also used to eat in Carluccios in the centre of Cambridge and the manager once told me that they did an Annual Dinner for the local branch of Coeliac UK.
- He also told me, that they had the highest gluten-free sales in the group.
I think it is fairly likely that Cambridge has a lot of diagnosed coeliacs.
But it is not a place with health problems, that jump out of the pages of the tabloids.
My theory is that because Cambridge does a lot of gastroenterology research, they have a good rate in finding coeliacs.
So how is Cambridgeshire doing in the COVID-19 pandemic?
In Five Eastern Counties, I said this about COVID-19 in Cambridgeshire and Suffolk, where a lot of patients go to Addenbrooke’s.
- Cambridgeshire – 673 of 852,523 or 0.08%
- Suffolk – 936 of 768,556 or 0.12%
Both seem to be low. How do they compare to Oxfordshire?
- Oxfordshire – 1515 of 887, 564 or 0.17%
I wouldn’t have thought that Oxfordshire would have a rate twice that of Cambridgeshire!
- The counties are similar in population.
- Both have proportions of industry, farming and academia
- The cities of Oxford and Cambridge are similar in character
Could it be that Addenbrooke’s has diagnosed most of the coeliacs in Cambridgeshire?
I’m no medical expert, but someone should look at it!
A Thought On Deaths Of The Elderly From Covid-19
It has been shown, that a lot of the deaths from Covid-19 are over seventy.
I am seventy-two and a coeliac, which was diagnosed when I was fifty.
As my GP practice nurse said at the time of my diagnosis, as we read my doctors notes together, the signs are there of coeliac disease in a lot of my visits to a doctor.
So why wasn’t I diagnosed earlier?
- There wasn’t a test for young children until 1960, so my early bad health couldn’t be diagnosed.
- No clue as to my problems was obtained until an elderly but extremely competent locum decided that my blood should be analysed as a fiftieth birthday present. I had no B12 and was running on empty.
- Eventually, I was sent to Addenbrooke’s and I was diagnosed by a blood test. I suspect it was a trial of a new genetic test, as I got the result by post in two days.
How many undiagnosed coeliacs are there in those over seventy, who because they are coeliacs, have a compromised immune system?
I would be undiagnosed but for that elderly locum!
How many other coeliacs are there in the UK population?
- Age UK has a figure of twelve million who are over 65 in the UK.
- If 1-in-100, as stated by Coeliac UK, in the UK are coeliac, that is 120,000 coeliacs over 65.
Note that as of today 177,388 have been diagnosed with Covid-19.
Conclusion
Many of those 120,000 coeliacs will have been born before 1960 and have a high probably of not having been diagnosed. for the simple reason, that a childhood test for coeliac disease didn’t exist.
Will these undiagnosed coeliacs have a compromised immune system, that makes them more susceptible to Covid-19?
It has been said, that a good immune system helps you fight Covid-19!
My Strange Skin
As a coeliac, a stroke survivor on Warfarin and a lab rat for a medical research centre, I’ve had my blood taken many times in the last ten years. I also have several injections a year for vitamin B12 and a yearly one for flu.
I never need a plaster, as despite being on Warfarin, once the needle is taken out, the skin seems to shut the hole tight.
On the other hand on a typical night, I’ll lose just over a kilo in weight, whilst I sleep. I once spoke to a sleep expert on the radio and they said that was normal.
But the funniest thing that happened, was one day not unlike today for weather with rain about and not cold, I fell asleep on the living room floor in my underwear.
About half-an-hour later, I awoke and thought for a moment, that I’d gone blind, as I couldn’t see a thing.
I then realised that the room was full of water vapour, as if I’d left the kettle on the stove. But I have an automatic kettle and there was nothing on the stove.
So where had all the water vapour come from?
There was only one place! It had leaked from my skin and the temperature and pressure, were just right for the fog to form.
My skin is often very dry and I usually start the day with a deep bath, when I put my head under the water and irrigate my dry eyes, which an eye surgeon, once described as the driest he’d seen.
Prue Leith’s Solution To The Flour Shortage
I was watching BBC Breakfast, when Prue Leith was interviewed about the shortage of flour.
When asked for her solution to the problem of making cakes without flour, her answer was forthright.
- She said the best thing to do, was to buy a gluten-free cookery book.
- She then gave some ideas for cakes.
As a coeliac I thoroughly approve.
The Anonymous Widower 