2022  May.  FACE MASK RECALL.  

Alliance Face Mask- Blue  Product no.  211-P7030230    lot number Y591676   have been detected to contain MOULD. Aspergillus  Sydowi.  Please destroy any you have and do NOT USE THEM.

A New Begginning.     For many people,  Easter time represents a ritual of spring, a new beginning, a chance to renew and start fresh.   

This may be a difficult message with a different world full of unusual rules that we have suddenly found ourselves in.   Hopefully, we will find renewed ways to continue to monitor and maintain our health.  

We  would like to welcome Dr. Karthiha  Raveenthiran,   who will be joining our team to assist us in the clinic in the coming months.  Dr. Kujtan will continue to provide services and advice while he attends to health problems. 

As society continues to dwell and be refocused to a specific health issue, I think a short review of masking is in order.  It was largely a theoretical concept applied in the begining hoping to reduce an invasive species.  Three years later, it is difficult to see how this theory applies, and supportive evidence is unclear.

Humans Breath!  Air containing oxygen, spores, messengers, phermones, bacteria etc, is moved into our lungs,  and various waste products,  bacteria, organisms etc are moved out of the body.  They number in the millions on a hourly basis.  It is an almost perfect free standing system.  We even have natural self cleaning filters in our noses and airways,  along with a host of interactive surfaces to ensure things are working right.  As humans, it is important that we sample, recognize and learn from what is in our environment.

When there is a breach in our skin barrier such as occurrs in an operation or trauma, placing a barrier across our mouth helps redirect air away from the breach and reduces the amount of excretory junk that could by pass the breach and enter our body.   Most viruses work in conjuction with our systems, exchanging information and finding efficient ways to move on.  The traditional surgical or cloth mask, has fairly large pores that can trap some bacteria, droplets and dirt  but generally are too small to catch viruses.   If we are worried about a possibly harmfull virus, than we use very small, hot and thick filters sealed to our faces along with full body armour.  An expensive respirator is ideal.  Even then it is not a certainty.    The important points are that everything is discarded, and carefully destroyed after every use.  A costly and time consuming approach. 

Breathing works best when done outside, unobstructed and in a robust manner.  Obstructing your face with a surgical mask requires that your change  and dispose of it frequently due to accumulated bacteria, moisture, dirt and waste products.  Facial irritation has become common.  Even those that believe it traps all viruses, should realize that for this reason alone, they sould be discarded frequently.  It should be cause for concern and not comfort that accumulating  large amounts of virus loads in front of ones airway for any length of time may not be an optimistic thing.

A recently viewed news item left me with a sobering thought. It was a plea from environmentalists who have  noted the immense ocean pollution being aggravated by uncaring human behaviour.  Disposable monthly mask taly:  129,000,000,000  gloves: 64,000,000,000.  Yes, that is 129 and 69 billion waste products monthly, not counting disposable tests, wipes, gowns, and other products.    I felt compelled to pass this message on, since no person in authority, has mentioned a word about the impact. 

Obstructing your airway to accumulate all the waste and bacteria, should be restricted to brief periods of time. It carries health risks that you may not realize.  A fresh mask for every new social interaction should be used to see any benefit what so ever.   Used masks should be properly marked as biohazzard and destroyed.  Please act responsibly for the sake of our childrens future.

I cannot recommend 

1. Putting any mask on TWICE!

2.  Wearing one for more than a single social interaction.

3.  Using a mask to ignore minor symptoms of illness.

4.  Reusing any disposable or cloth mask.

2022   A Year of Stress.

   I had an opportunity to visit some close family in the United States whom I have not seen in a very long time. It was in a place where local authorities have been up-to-date with their assessments and balanced the entire health of the population against any proposed actions. I must say, it was amazingly refreshing to interact with people and to be able to see what people look like without a mask on. At the same time there was much more vigilance exercised by the general population in staying indoors when they feel unwell no matter what the cause. An interesting concept was the feeling that masks somehow provide a type of protection that allows people to function when perhaps they should not be. In any event, it was wonderfully relaxing to be in this environment and there is no medicine in the world that can improve my spirits and mood, then to visit loved ones in a relaxed environment.

    Coronavirus is not an invader that will simply disapper.  The Covid pandemic will slowly become integrated into the normal spectrum of health concerns that we face on a daily basis, new and more worrisome problems occur around the world. The terroristic actions of the Russian nation to openly declare genocide and commence brutal killing of innocent civilians in Ukraine has created a great deal of depression and worry amongst many people here who recognize that Russia is Canada's northern neighbour?? It is heartbreaking and a sense of numbness and disbelief adds to the ravages of lockdowns when viewing the emerging images of atrocities. Unfortunately, those in the know realize that we will be affected in many different ways and this will accentuate health problems that are already at critical and record breaking numbers in some spheres. Please take the time to discuss the significance of the situation with children, young people and those who may not have good insight into the wide reaching effects of such actions.  To feel that it is so far away and will not affect us or our health is shortsighted.  I had the opportunity to meet a young mother and children whose husband and son remained behind to do whatever it takes to secure their homes.  The blank hopeless expressions attest to the significant trauma such young people should not be exposed to. They also bring warnings of potential repercussions to all Western nations, based on history that has repeated itself several times in the last century. Iodine pills are not the answer.

   Unfortunately, it seems the stress of the last few years has dealt  another blow to my own health.  I will be working virtually and undergoing several months of treatment. We are in the process of bringing a new associate physician to provide on-site clinical care to our patients.   We wish you good health and pray for global peace.

2022 Where are we?

    Our lives have been affected in numerous ways with ongoing restrictions of movement, speech and interaction.   What began with a 10 day lockdown and a campaign to villify viruses has blossomed into a permanent fear and change of lifestyle for all.  As a  society we had an opportunity to use the time to learn about the entire field of virology,  improve lifestyle and acquire knowledge on prevention and improving our well being, but seem to have wasted this opportunity for many reasons.   We have reached a different peak where fear predominates and formulates false notions,  and bad science is mixed with the good for alternative motives, where our society has become more devisive,  angry  and vindictive  resulting in escalating health problems.  I detest the use of words like, war, victory, battle when applied to medical topics.  I cannot ever recall a "war" where the original "plan"  resulted in disaster more often than not.  The best military leaders are ones that are fearless in gathering good intelligence, visit the front lines often, analyse their data, and dont hesitate to change course based on new intelligence.   Those given the privledge to lead, report  and advise still seem to be unwavering from the original 10 day plan, now that we are in the 3rd year.

   In the course of my research doctorate, I was intrigued by the emerging fields of virology, and took courses in epidemiology, virology, and most importantly, participated in journal clubs where we learned how to asses a good study from a poor one, and openly discuss criticisms and improvements.

I encourage you to follow this link to a you tube video on introductory virology taught by a leading virology professor at Columbia University.  I hope it provides you with a perspective on how  viruses are part of our world.  You may be surprised by what you learn, and certainly hope that it may help mitigate your fear levels.

Virology 101  by dr Racaniello,  1st in a series of the course he teaches.

https://www.youtube.com/watch?v=jX3MhWWi6n4

From our Health Team, we wish you  a Merry Christmas and Happy New Year.    With the latest restrictions in place we will be taking a few days to celebrate the season. 

 Urgent care is available after 5pm and on Holidays and  weekends  from our Mississauga FHO partners.  Call

905-279-9322 for further directions and to receive phone or virtual advice.

As the Covid19 situation changes daily, doctors have been asked not to see respiratory illness in clinic.

We are still under Emergency Health Dept Directives, which have now been extended to March 2022.

The clinic is fully operational and we continue to provide virtual care and in person care when required.

Acute respiratory illnesses are mostly non covid in nature, but without testing, it is impossible to tell the difference.  We continue to use the services of the temporary colds clinic.   The problem for us is the need to follow isolation procedures when we encounter covid illness. This produces some choas as it results in quarantine and rescheduling of planned procedures.

If you need a medical service, please leave a message for Julie, who will triage and open an electronic health chit for the team to work on.  At this time of year, the requests are numerous.   We will try to handle them in priority sequence.    Please note that email without secure electronic features is not endorsed by health boards.  For this reason, it is used to move documents in a non confidential manner. Please remember this and protect your cofidentiality. Please avoid submitting lists of minor things, and help us deal with major issues in priority sequence. 

We are also priortizing routine cancer screening tests and you may get a call or letter to have a mammogram or colonoscopy etc.  Guidelines are found on our homepage.

Many of the referals being requested are in transit, but the focus on Covid illness has caused severe backlogs in all other areas of medicine. The most dire need  is for mental health services, addictions  and child health services.  All are currently taxed beyond capacity.  Please note that more frequently, our letter for consultation are met with long waiting lists, because specialties  rely on hospital facilities such as operating rooms, treatment rooms and items required to keep them functional.   Hospital staff are now stressed beyond previous records.   On the upside,  the influenza season that has regularly swelled our hopsitals into housing patients in every nook possible has not materialized once again. 

Please also realize that the we are being inundated with third party forms and requests for services.  Please realize that in most cases the pre printed guidelines and dates cannot be adhered to, given the pandemic limitations.  Please do not allow these unreasonable request flare up any anxiety. We endeavour to complete all requests submitted.

Things that help with cold season.   Vitamin C  500-2000mg daily,  Zinc 5-75 mg daily,  Vitamin D 1000- 4000 IU daily,  walks in the sunshine (which resp viruses hate due to their fragility), lots of smiles in the fresh air,   lots of fluids devoid of sugar, especially hi-fructose corn syrup (HFCS).

Finally.   We wish you a wonderful and Merry Christmas and hope that the spirit of the season will permeate and uplift your heart and that  your family enjoy good health.  

Its cold and flu season. Oct 2021.

Some good news.

   You have probably noticed a lot of young people with cold and respiratory symptoms, which occurrs annually at this time.  It is estimated that the human biome has learned to live with at least 8000 different viruses which also cohabit our planet.  Many of the respiratory viruses produce the same symptoms and it is difficult to tell them apart.  Most are minor and we recover from the majority of them.   There continues to be a plethora of covid testing still going on for numerous reasons.  I hope that the manner in which news media present their statistics does not cause too much fear or alarm.  Over Thanksgiving, I saw a "corona-score" flash across the TV of about 300.  That may frighten some, but you may be interested to know that everyday, about 20-30,000 tests get done in Ontario.  Subtract the 300 and that leaves you with 29,700 new cold type minor illnesses.  Otherwise stated, it means that 98.2 percent of kids, students etc, that go for testing daily dont have coronavirus illness, and the 1.7% that test positive do not define any severity. They majorty of even those are mild to moderate.    Hopefully, many worried parents may find some solace in that.

It does make running a clinic under health dept guidelines very challenging.  Social distancing and masking are critical for the sick exhibiting symptoms, and we try our best to not mix the sick and healthy, which is why virtual medicine is still a priority.

The flushots have arrived.  They are similar to the previous shots. They are not experimental or under emergency release protocols.  Influenza has dozens or more of different variants.  Manufacturers take a chance and predict which variant to put into their vaccine based on data from around the world documenting which variants are active.  Some years they guess right and some not.   There has not been much influenza  due to how the world responded to the covid virus.  The components in this years vaccine.     H1N1- A/Wisconcin/588/2019

                         H3N2-  A/Cambodia/e0826360/2020

                         B variants are the same 2 from last year.

Getting a flushot may help protect you from Influenza or make it less severe, or we may have to rely on our immune systems to do this as well if new variants appear.

We will attempt to run fluclinics in the next while, once we figure out how best to  administer shots to our patients in a safe efficient manner.  Please do not enter the clinic without an appt or within 5 minutes of your assigned time.  Wear a mask.  We are willing to vaccinate everyone in your circle of care at once, even if they are not registered patients, but have a valid OHIP card.  Please call for an assigned time.  If you miss you time or come LATE,  DO NOT ENTER THE CLINIC.  Return to your car or foyer and call for instructions or accomodation.   We cannot accomodate other health care requests at these times. Please pre-book these with out receptionist.

First flushot clinic will be held SAT OCT 23, 2021.

Things that help with cold season.   Vitamin C  500-1000mg daily,  Zinc 5-75 mg daily,  Vitamin D 1000 IU daily,  walks in the sunshine (which resp viruses hate due to their fragility), lots of smiles in the fresh air,   lots of fluids devoid of sugar, especially hi-fructose corn syrup (HFCS). 

Covid Questions and answers:

   Our clinic has been swamped with requests and questions.

Here are some of the common ones.  The answers are the best we have so far, and I try to re-evaluate incoming data on a regular basis.

1. Can I get a non- mRNA vaccine?     There are at least a dozen different vaccines around the world.  They work in different ways.   The traditional approach to vaccination was to use a killed virus vaccine which would produce an antibody response in the body to covid.   They were manufactured in China and Russia and are used in other parts of the world.  Canada, decided last year to go with the new experimantal technology being researched for Cancer and repurposed for covid by Pfizer and Moderna.  It is still released on an emergency basis and not liscened in Canada, but the rumours are that enough data may become available to move the process along. There are no traditional covid vaccines available in Canada at this time.   No vaccine works extremely well, but most vaccines do help keep that small fraction of people who develope the severe cytokine storm from spike protiens out of the ICU.  

2. Covid Antibody testing?    There is a blood test that is non OHIP covered ($100) , that can measure if there are circulating antibodies in your blood to covid.  However, it CANNOT measure inate immunity which is often is long lasting and more important.  This is similar to the traditional hepatitis shots or tetanus boosters.  Even though we see low antibody levels, if the body is challenged, it still mounts a good response in vaccinated individuals.

3. If I had COVID, why do I need the vaccine?  At this time, some estimates suggest  that between 10-35% of the population has had covid.  A great many of those recovered, work in hospitals, nursing homes and the health care sector.  Public health officials  felt it important to vaccinate everyone.   As with other illnesses such as chicken pox, roseola etc,  once you recover you are considered to have full immunity for quite some time.  More countries around the world are applying this rational observation.   It makes the so called passport program very difficult to use  as it would mean that those people would have be considered as immune and this makes it harder to count.  

4. How does one define that the pandemic is over?  Good question, and it seems that it will be a political decision with input from public health.  Covid will never be eradicated any more so, than rhinovirus cold symptoms have been eradicated or influenza.  Having a case of covid here or there will probably be permanent. However, I do believe that we will stop tracking the majority with minor symptoms, as it aids the media reports in a difficult to interpret manner.   For example, over the last few months, we have diagnosed,  tuberculosis,  listeria, influenza, strep throat, lyme disease and botulism but chances are that you have not heard one word about any of these things present in our community. 

5. Side effects.  We have side effects to all vaccines.  There are deaths after vaccines get administered.  Fortunately these are relatively infrequent occurences. The Americans track them carefully and share with the public.   We also do, but the data is much more difficult to interpret.   I think we have to admit that side effects exist and we must be mindful of them. 

6.  Can I get covid after vaccination?   Yes,  no vaccine offers full protection.  Majority of people get mild symptoms and recover no matter what preventions they employed.  Covid is a Fragile virus.    You may be surprised that UV light... ie sunshine can kill it, as can numerous other things,  the nitric acid in our noses,  the mucus in our lungs, etc.   I have used vit C, Vit D,  and Zinc during cold seasons for dozens of years and suffered no side effects.

Covid exemption criteria, update will follow shortly. 

We all need a break from all the COVID narration and talk.  The relationship between front line physicians, health departments, politicians, pharmaceutical companies, world health organization, center for disease control and others is a complex one.  There is no unified and correct front.  It would be nice if they could all sit around one table, discuss the evolving evidence and provide on-going advice in a scientifically approved manner, but many other issues, costs, profits, concerns etc.  make it difficult.  

  To take a break from all this, I decided to go back before my own time, and examine how the thalidomide issue evolved, and why it took so long to notice the obvious.  

Here is a link that gives a brief but interesting historic overview.   

https://www.youtube.com/watch?v=Erc6pLYE4fs&ab_channel=Dr.SamBailey

We are making some progress.   After months of pleading with our local hospital, the rest of our support staff have been scheduled for vaccination.  I am not certain why it was so difficult, and sympathize with the many similar stories shared by patients.  This is matched by a significant number that had no problem.

This will put us in line to be ready to expand from a mix of virtual and on site practice to more of what we once did, when the health department gives us the green light.

We wish you a truly wonderful and spiritual Canada Day.   We are very proud to be Canadian,  and can only wish more of the world could understand what this means.  

We will be out of the office for the first week of July, building up immunity, and making plans for the future as to how best to handle the accumulating backlog of requests, tests and appointments.  Auxillary staff members will be dealing with emergencies, and our after hour service is fully functional.

We hope to see your very soon.

After hours Urgent clinic schedule 5-8 pm

Monday July 5th  Dr. Vickers  

- Tuesday, July 6th – Dr. Agarwal

- Wednesday, July 7th – Dr. Nasir 

- Thursday, July 8th – Dr. Silver & Dr. Wong

- Saturday, July 10th - Dr. Sardana  

- Thursday, July 8th – Dr. Silver & Dr. Wong

- Saturday, July 10th - Dr. Sardana  

Pandemic Update June 21,2021

  As odd as it may sound, I wandered onto the parlimentary channel  during an important but neglected  News conference.  Open debate amongst scholars and respect of each others opinions leads down a path, where vital decisions can be modified or enhanced and new better directions emerge by looking at and discussing evidence.   The youtube link to this news cast  on June 17, 2021 on parliment hill by  MP Derek Sloan is found below, should you wish to view it.  My heart felt condolences go out to the victimized and I admire their courage for simply advocated for civility in society.   At the same time, front line physicians across the country were shocked to read an editorial in our own college publication  seemingly blaming and victimizing front line physicians and stopping short of placing outright blame for the immense mess and worstening choas about to be realized by society when we pull our heads out of the covid microscope and look around. Physician depression, burn out and suicide has  rocketed during the last 18 months.  The devastating mostly non -covid but some covid health consequences that have plagued practices has not gone unnoticed by this group.

https://youtu.be/vUrp5PlnBwQ

The evolution of a concept affecting entire populations and how it is handled in copy cat fashion by those in politics, media, pharma, regulatory bodies, big business, medical administration, public health etc is not new in our society. There are hidden agendas at every juncture. Public purses are drained empty.  It seems to take painfully long periods of time to recognize consequences and damage.  It simply gets forgotten when new younger generations feel they have better answers to what seem  to be new problems.  In my youth, I believed that I was an independent thinker.  It is only with age, that I sadly accepted the notion of hearing the same message over and over turns it into an accepted principle no matter which circumstance it occurrs in.  The human ego wields immense influence.

In the twilight of my career,  I still feel the burden of guilt  that blindly following concepts without good evidence, despite being trained as a scientist, can cause immense harm in society.   For most of my career  I too advocated for a healthy lifestyle based on "food guides" to prevent heart disease, obesity and diabetes. The exact opposite was the result in my generation.  We too  succumbed to fear of ridicule,  academic penalty and outright threats.  After my first cancer ordeal, I decided it was time to try and make some ammends and I finally accepted the words of my grandmother,  "sugar is bad for you".   A documentary was released last year  in 2020  entitled "FAT FICTION".   I advocate watching it and am very familiar with many of the scientists who made it.  As I viewed it, I realized vast similarities with how the covid concept is being handled.  I sincerly hope that in 50 years my grandchildren will  not be making a similar documentary about covid.