Friday, April 30, 2021

To the world | Public health basics are the most important things

Singapore has got locally-transmitted cases down to near zero and topped Bloomberg’s COVID Resilience Ranking in April, 2021. It is worth to notice that only 20% of Singaporeans are fully vaccinated. Please check out this story: https://www.bloomberg.com/graphics/covid-resilience-ranking/


Right after the vaccines became available, many officials and experts kept emphasizing high coverage to achieve herd immunity. I wrote an op-ed article this January to remind that herd immunity may not be the only goal that COVID vaccination could pursue. I believe Singapore’s success helps justify my analysis.

(The op-ed article in South China Morning Post: 

https://www.scmp.com/comment/opinion/article/3118214/coronavirus-response-lessons-swine-flu-pandemic-show-need-focus )



I actually wrote another article last August to remind that, as of August 14, Singapore had around 20,000 new confirmed cases after lifting its first lockdown, but Singaporeans have switched to watch hospitalization rate carefully, instead of rushing to the second lockdown, and finally the death toll therefore increased by three only.

(This article in Pacific Daily News: 

https://www.guampdn.com/story/opinion/readers/2020/08/19/hospitalization-rate-not-daily-test-results-important-watch/3388973001/ )



So, once again, I’d like to say vaccines are a really powerful tool and we need to promote the vaccine rollouts. However, we also need to remember the public health basics are fundamentally the most important things to a successful pandemic response. Just like what the Bloomberg story emphasized, “if there’s one lesson from April, it’s that vaccination alone isn’t ending the pandemic.”





Wednesday, April 14, 2021

Thursday, January 21, 2021

To the world | Swine Flu Lessons Show Need to Focus on At-Risk Groups

An op-ed article titled "Swine Flu Lessons Show Need to Focus on At-Risk Groups" was published in South China Morning Post on January 20, 2021:

https://www.scmp.com/comment/opinion/article/3118214/coronavirus-response-lessons-swine-flu-pandemic-show-need-focus












Monday, January 18, 2021

Nutrition | Supplements Mentioned in the Newly-Released Dietary Guidelines

 


Supplements receive numerous mentions in the Dietary Guidelines for Americans 2020-2025 released by USDA and HHS on December 29, 2020 as the following.


Vitamin D for infants & kids


All infants who are fed human milk exclusively or who receive both human milk and infant formula (mixed fed) will need a vitamin D supplement of 400 IU pre day beginning soon after birth. Families who do not wish to provide a supplement directly to their infant should discuss with a healthcare provider the risk and benefits of maternal high dose supplementation options.


Even when consuming a varied diet, achieving adequate vitamin D from foods and beverages )natural sources) alone is challenging, suggesting that young children may need to continue taking a vitamin D supplement after age 12 months.



Vitamin D for adults


Close to 30 percent of men and 60 percent of women older than age 19 years do not consume enough calcium, and more than 90 percent do not consume enough vitamin D. Particular attention should be given to consuming adequate amount of foods with these nutrients during adult years to promote optimal bone health and prevent the onset of osteoporosis.


Some individuals may have difficulty producing sufficient vitamin D from foods and beverages, so a supplement may be recommended by a health professional.



Vitamn B-12 supplement during lactation


Human milk has sufficient vitamin B-12 to meet infant needs unless the mother's vitamin B-12 status is inadequate. This can occur for different reasons, including when the mother eats a strictly vegan diet without any animal source foods.


When the mother is at risk of vitamin B-12 deficiency, human milk may not provide sufficient vitamin B-12.In these cases, the mother and/or inant fed human milk may require a vitamin B-12 supplement.Parents, caregivers, and guardians should consult with a healthcare provider to determine whether supplementation is necessary.



Vitamin B-12 supplement for older adults


Vitamin B-12 is of concern for some older adults because the ability to absorb this nutrient can decrease with age and use of certain medications can decrease absorption. Some individuals may require vitamin B-12 dietary supplements.



Folic acid, iron and iodine for pregnancy


The United States Preventative Services Task Force (USPSTF) recommends that all women who are planning or capable of pregnancy take a daily supplement containing 400 to 800 mcg of folic acid. The critical period for supplementation starts at least 1 month before conception and continues through the first 2 to 3 months of pregnancy to prevent neural tube defects.


Iron is a key nutrient during pregnancy that supports fetal development. Women who are pregnant or who are planning to become pregnant are advised to take a supplement containing iron.


Adequate iodine intake during pregnancy is important for neurocognitive development of the fetus. Some women of reproductive age who do not regularly consume dairy products, eggs, seafood, or use iodized table salt, may not consume enough iodine to meet increased needs during pregnancy and lactation, and may need a supplement containing iodine.


Most prenatal supplements sold in the United States contain folic acid. Most prenatal supplements are also designed to meet the higher iron needs of pregnancy.


Many prenatal supplements do not contain iodine. Thus, it is important to read the label.


More information about Dietary Guidelines for Americans 2020-2025, please check out:

https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials



Monday, November 2, 2020

Monday, October 12, 2020

Nutrition | Vitamin D & Probiotic Are Clinically-proved Adjuvants to Help COVID-19 Recovery

Several clinical studies with nutritional ingredients on COVID-19 have been published in scientific journals. They proved that vitamin D and probiotic could be helpful when patients try to get recovered from COVID-19.


Vitamin D


In a newly published clinical study carried out in Spain, researchers gave calcifediol, an active form of vitamin D, to 50 people hospitalized with COVID-19. All of 76 patients were treated equally with hydroxychloroquine and azithromycin, but another group of 26 patients didn’t receive vitamin D. Only one (2%) of the patients treated with vitamin D ended up in the intensive care unit, while 13 (50%) of the untreated patients did.


In addition, of the 13 patients admitted to the ICU, two died and the remaining 11 were discharged. Of the patients treated with calcifediol, none died, and all were discharged, without complications.


The study published in the October issue of the The Journal of Steroid Biochemistry and Molecular Biology (Ref.1). Researchers from the University of Córdoba, Spain, studied 76 patients admitted to Reina Sofia University Hospital for COVID-19. Their findings suggest that calcifediol (three doses, in this study — .532 mg on day one, .266 mg on days three and seven) could reduce the severity of COVID-19 infection and lower the risk of complications.



Probiotics


A clinical study in Italy showed probiotics helped reduce COVID-19 symptoms in 7 days and also avoid severe illness that might require intensive care (Ref. 2).


The study enrolled seventy COVID-19 patients, hospitalized between March 9 and April 4, 2020 at Sapienza University of Rome. These patients had a fever and required non-invasive oxygen therapy. 42 of them received hydroxychloroquine, antibiotics and tocilizumab, alone or in combination. The other group of 28 patients received the same therapy added with an oral probiotic supplement.


Around 90% of 28 patients in the “probiotic” group actually showed remission of symptoms, including diarrhea, in 3 days. The percentage reached 100% on the seventh day while the one in the control group was lower than 50%.


The estimated risk of developing respiratory failure in patients treated with the oral probiotic supplement was eight times lower than those in the control group, according to the odds ratio statistics. The prevalence of ICU usage and mortality were both higher among patients who were not treated with the probiotic formula.


Dr. Giancarlo Ceccarelli, a specialist in infectious diseases at the university, told the media that “Our preliminary results evidenced on improved survival rate and a lower risk of transfer to an intensive resuscitation for patients supplemented with the probiotic compared with those on standard treatment only.”



Low Vitamin D Level is a Risk Factor


The University of Chicago’s research published in September actually showed vitamin D's possible role in COVID-19 prevention. Subjects with sufficient vitamin D status had a lower risk for getting tested positive (Ref.3).


In this cohort study of 489 patients who had a vitamin D level measured in the year before COVID-19 testing, the relative risk of testing positive for COVID-19 was 1.77 times greater for patients with likely deficient vitamin D status compared with patients with likely sufficient vitamin D status, a difference that was statistically significant.


In May, the cross-national analysis published by British researchers and Northwestern University both showed a significant relationship between low average vitamin D levels and the higher number of COVID19 cases, particularly COVID-19 mortality rates, per head of population. (Ref. 4)


Reference

  1. https://www.sciencedirect.com/science/article/pii/S0960076020302764

  2. https://www.frontiersin.org/articles/10.3389/fmed.2020.00389/full

  3. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770157

  4. https://link.springer.com/article/10.1007/s40520-020-01570-8