Monoclonal Antibody Survey (Bebtelovimab)

Since COVID, the FDA has granted EUA to multiple (4+) monoclonal antibodies. In our experience, monoclonal antibodies have led to swift improvement in COVID symptoms, but since we have a new strain of COVID and a new form of monoclonal antibodies, we are looking for feedback from our patients to assess how well they are working.

Please take two minutes and complete our survey. Feel free to share to friends and family. We will post results soon.

COVID - The Big Picture

At BreatheMD, the surge seems to be dying down. Our % positive rate was 1.5% last week, down from 11% a few weeks ago. We have seen quite a few cases of rhinovirus (detected on our 1 hour PCR) and a few cases of the flu in the last two weeks.

It’s hard to believe the pandemic has been going on for 18 months now, and as awful as it has been, I have learned so much from the experience.

We’re all seeing the pandemic through different lenses, but these are the biggest lessons I’ve learned.

  1. Live a simple, healthy lifestyle. Obesity is the #1 risk factor for death from COVID. Obesity is complicated and not an easy fix, but we all know what we’re supposed to do to stay healthy. Everyone I know is taking about 20 vitamin supplements a day but not paying attention to what they’re eating. Simplify your diet , eat fresh, cook at home - you’ll save money and won’t need all those supplements. Get your daily Vitamin D by taking a 20 minute walk everyday. Start today - the weather is perfect! Exercise more and you’ll sleep better… another very important but basic way to prevent COVID infection.

  2. Reduce your anxiety. Anxiety is the second highest risk factor for death from COVID. The best coping mechanism for anxiety is to have a plan and take action. If you are worried about COVID, set a weight-loss and fitness goal and connect with a doctor who will listen to you and take care of you when you get sick. I have many patients asking me for recommendations - if you love your primary care doctor, please mention his/her name in the comments below. I want the names of doctors that never shut their door during the pandemic and don’t judge people who aren’t vaccinated.

    Also, turn off the TV. A CNN producer was caught on video admitting that they have been purposely trying to invoke fear in the public during the pandemic to boost their ratings.

  3. Viruses are not immune to treatment. In medical school, I was taught to do nothing for most viral infections. COVID has thrown that lesson out the window. If you go to some of my previous blog posts, you can see what we are doing to fight COVID.

  4. Use independently-owned pharmacies. I’m one of those doctors who will prescribe ivermectin. In the last 3 months, I’ve spent an inordinate amount of time arguing with pharmacists at Walgreens, CVS, HEB, Kroger and Walmart over their refusal to dispense it. If you have an open-minded pharmacy you use, please mention it in the comments below.

  5. Respect people’s health choices. Doctors are trained to be dictators when it comes to their patients’ health. This didn’t fly well with me during my four pregnancies, hence as a doctor, I try to stay open-minded. I don’t argue with people over vaccines, ivermectin, etc. … we’re all drowning in information and have our reasons for our choices.

I’d love to hear your most important take-aways from the pandemic… please feel free to leave comments below.

How We Keep You Out of the Hospital

Our goal at BreatheMD is to do everything possible to keep people with COVID19 from going to the hospital. From the beginning, we have provided curbside breathing treatments and IV fluids and more recently, monoclonal antibodies.

We have now expanded our services to include treatments that are normally only done in hospitals: IV steroids (Solumedrol), IV vitamin C , IV Tylenol, IV famotidine (Pepcid), IV antibiotics, and oxygen. Dr. Bowden follows the FLCCC protocol and believes in aggressive treatment with safe medications such as ivermectin to help patients with COVID19.

For patients out of the danger zone, Dr. Bowden prescribes medications based on the FLCCC protocol and advises patients on nutritional supplements and other modalities to recover more quickly. She has both in-person and telemedicine appointments available for patients with COVID19 needing support.

Recommended over-the-counter supplements (updated):

Vitamin C 1000mg, twice a day (we offer injectable Vitamin C in our office)

Vitamin D 5000U + Magnesium + Zinc. It is important to take magnesium when you are taking Vitamin D as large doses of Vitamin D can deplete your body’s magnesium supply. We recommend this supplement: Magwell. The dose on the bottle is for 2 capsules a day - we recommend 3 - 4 capsules a day. The side effect to look for is diarrhea - lower your dose if this occurs.

Quercetin 250mg, twice a day

Zinc 50mg, once a day (take this in addition to Magwell)

Lactoferrin 100mg, once a day

Manuka Honey

Curcumin 500mg, twice a day

Black Seed oil (Nigella Sativa) 80mg/kg, twice a day

Melatonin 10mg before bed

Diet:

Follow a low-sugar diet. Viruses and bacteria feed off sugar - this is why diabetics are more prone to infection.

Drink 8 - 10 glasses of water a day. If you are dehydrated, you are more prone to fever and it becomes a viscous cycle. Come get IV Fluids and IV Tylenol at our office if you can’t get enough fluids at home.

Drink hot tea, chicken noodle soup. Warm salty fluids decrease swelling in your upper airway and improve circulation.

Exercise:

If you lay in bed, your lungs collapse. Rest, but don’t lay in bed. Get up at least once an hour. Take walks outside if possible. Buy an incentive spirometer (Amazon sells them) and use it every hour while awake (this device is a cheap and effective way to expand your lungs.)

Irrigations:

Gargle with a solution of Betadine and water three times a day. Add 2 tablespoons of 10% iodine/poviodine (Betadine) to a cup of water. Gargle but don’t swallow. Betadine is available in the first aid section of the drugstore.

Rinse your nose with saline + 1/4 teaspoon betadine three times a day.

Infrared Sauna:

If you are fever-free and not dehydrated, spend time in our infrared sauna at least 3 times a week. Infrared sauna has been proven to lower inflammation and increase circulation.

Respiratory Care:

Place a heating pad on your chest to increase circulation to the lungs.

Use a nebulizer or a humidifier to inhale salt water. Mix the water in a Neil-Med sinus rinse bottle using 2 packets of saline instead of 1 and add to your nebulizer or humidifier.

Take Mucinex with plenty of water to thin your mucous.

Spend time in our salt cave. We offer 1-week packages for patients with respiratory illnesses. The salt particles in the air absorb irritants and decrease airway inflammation. We also have therapists from BreatheFit lead private respiratory therapy sessions every Wednesday in our salt cave.

To schedule an appointment or learn more about how we can help you fight COVID19, please go to COVID Treatment and Recovery on our website.

Early Treatment for COVID-19

No one really knows what the best treatment is for COVID-19, but here’s what I would recommend for a loved one:

For a young, healthy person with minimal symptoms:

  • Vitamin D3 4000IU per day

  • Vitamin C 1000mg twice a day

  • Quercetin 250mg twice a day

  • Zinc 100mg per day

  • Melatonin 10mg before bed

  • Aspirin 325mg a day

  • Pulse oximeter - monitor blood oxygen level

  • Rinse nose with saline + 1/4 teaspoon Betadine three times a day

For anyone with severe symptoms or for high-risk patients with mild symptoms :

  • Everything listed above plus…

  • Ivermectin 0.5mg/kg, take once a day for 5 days

  • Fluvoxamine 50mg twice a day

  • IV Monoclonal Antibodies

  • Breathing treatments: Nebulized budesonide, albuterol and hypertonic saline

For prevention after exposure….

  • Vitamin D3 3000IU per day

  • Vitamin C 1000mg twice a day

  • Quercetin 250mg twice a day

  • Zinc 40 mg a day

  • Melatonin 6mg before bed

  • Rinse nose with saline + 1/4 teaspoon Betadine twice a day.

  • Ivermectin 0.4mg/kg x 1 and then another dose 48 hours later.

  • IM Monoclonal Antibodies (if high-risk for severe disease)

Recommendations are based off research and protocols developed by the Front Line COVID-19 Critical Care Alliance, https://covid19criticalcare.com.

Fluvoxamine is a SSRI used to treat depression which has been found to have anti-inflammatory properties.

Quercetin is a plant-derived supplement with anti-inflammatory and anti-viral effects.

We are currently providing IM and IV Monoclonal Antibodies , curbside breathing treatments, and IV fluids with IV Vitamin C, Zinc and Tylenol.

More on the T Cell Test for COVID-19

COVID-19 has graced the public with a crash-course in immunology - most of us are now familiar with the terms ‘PCR’, ‘rapid antigen’, ‘sensitivity and specificity’ and ‘antibodies.’   New to the syllabus is T cell immunity - a different arm of the immune system that has been largely ignored in the dialogue surrounding COVID-19 due to how difficult the T cell response has been to measure.  An innovative lab based in Seattle - Adaptive Biotechnologies - has figured out how to detect T cell responses and is the first in the world to offer this test to the public.  BreatheMD is proud to partner with Adaptive Biotechnologies to offer this breakthrough test to Houstonians.

What are T cells?

T cells are the first responders of the immune system and activate the antibody response.  They are highly specific (>99%) and respond to more than twice as many SARS-CoV-2 targets as antibodies.  T cells persist longer than antibodies with 95% detection 5+ months after PCR diagnosis compared to 52-71% detection with antibodies.

Who should get the T cell test?  

  • People who have tested positive for COVID-19 but have negative antibodies

  • People who have had symptoms of COVID-19 but tested negative on PCR

  • People who were exposed to COVID-19 but were never tested

More research is being done to determine how long the T cell response will stay positive.  Current data shows immunity to last at least 5 months in most people - 10 month data is on the horizon.  Additional research is ongoing to prove whether T cell immunity offers full protection against the virus; based on studies from other viruses, the assumption is that people with a positive T cell test are not susceptible to COVID-19.

The T cell test requires a blood draw and costs $250.  Results are back in 7 - 10 days.  The test is available in our office Monday - Saturday. 

COVID-19: Update

In the last five days, we have tested 65 patients. We are still waiting on results for the majority of these people, but so far all tests have been negative.

Our clinic is an outlier in that we are testing anyone who wants to be tested. LabCorp has been running the test since March 5th, but this was not publicized to the medical community. We only found out by doing our own research and started testing patients on March 13th.

One of the reasons we are not limiting testing is that we anticipate that early, aggressive respiratory intervention will prevent hospitalization in our patients who becoming ill. We do not agree with the hands-off approach most physicians are taking with their patients. We have seen many people who are in need of outpatient respiratory support in the form of inhalers, nebulizer treatments and/or antibiotics. We are taking extreme caution in our clinic, using the highest levels of sanitation we can, while also taking care of people who need to be cared for.

For evidence-based information on management of this virus, we highly recommend following the Center for Evidence-Based Medicine.

So that we can focus all our efforts on patient care, we are no longer scheduling patients over the phone; please use the appointments page on our website to make an appointment. We require everyone who enters our clinic to wear a mask. If you do not have one, we have non-disposable surgical masks available for $10.