Medical Update on CoVid-19 offered as a public service

As a physician with 40 years experience here is where we now stand and what we now know in regards to CoVid-19 understanding that with day 1 and patient zero we had essentially no knowledge of what this virus was capable of.

#1 This one of the most virulent infectious virus in the history of mankind and the worst infectious disease I have seen in 40 years. It is HIGHLY transmittable from person to person. It is bad as Ebola and Plague in the number of people it can infect. Many people feel that the Government and media are over blowing this infection in an effort to scare people for some prejudiced agenda. I can assure you this is NOT true and if anything the Government and Media is underplaying this pandemic in this regard. You hear a lot about the "R" value which is the number of people one person can infect if they have the virus. All public health officials report we want the "R" value to be 1 or less which means one person infects 1 other person or less. I can assure you the "R" value of THIS virus will eventually be proven to be much, much, higher. Dozens, hundreds of people have already been proven to have contracted the virus from 1 person resulting in a massive spread of the infection.

#2 The good news is that for the vast majority of people somewhere around 80% will not get sick from this virus and if they do it will be like the common cold. And as it continues to be reported the vast majority of infected people have no symptoms at all. Again the problem is that unknowingly they spread the infection far and wide and eventually susceptible people contract the virus and end up seriously ill.

#3 The bad news is somewhere around 5-20% of the population is at risk from dying from this virus and those people have either some genetic variant that makes them more susceptible or they are immune deficient for some reason. When they catch the virus they end up in the hospital stressing the health care system. There is no question as the number of infected people rises so will the number in the hospital.

#4 Other good news physicians and scientists are getting much better in reducing the death rate with proper and improved treatment. A major cause of death is cytokine storm which simply is even in patients with a deficient immune system the body's immune response goes overboard and causes generalized organ failure resulting in death. Recent research has shown proper use and timing of steroids and anti-immune drugs, more specifically dexamethasone and Acumed are showing great results. The problem is one of timing. If given too soon or too late neither drug helps as much. It is clear today that Hydrochloroquine does not really work and there are other and better treatments. In addition convalescent plasma transfusion from someone who has recovered from CoVid-19 is showing good results as well. So as treatments improve the death rate comes down but not the hospitalization rate which to me is the qualifying data experts should pay more attention to.

#5 Some scientists and physicians have predicted that every human being in the world is at risk and will eventually be infected with CoVid-19. Until the virus goes through the entire population of the world or we have an effective and safe vaccine there is little we can do to prevent ourselves, our friends, and our family from catching this virus but there are things we can do.

#6 Initially the CDC underplayed the use of masks. They did so out of fear hospitals would run out and be unable to protect doctors and nurses. Everyone is aware if all the doctors and nurses caught the disease and 20% died it would be a major issue. It was a mistake and they have admitted so. But that is water under the bridge. There is no question today that any mask made from any material will significantly reduce the spread and infection rate of CoVid-19. In general current research has clearly shown if a full 60% or higher of the population wears a mask it will reduce the infection by over 60%. If two people are across from each other and talking if both individuals wear a mask the risk of one spreading the infection to the other is less than 5%. No, masks do not 100% solve all the problems but along with washing our hands and not touching our faces it is the absolute best thing we can do to protect ourselves and others today. As an additional barrier that poses no risk, I recommend using a coffee filter within any mask you choose. It can't hurt.

#7 A word about testing. Testing is important but only so far as we can identify the people who have been in contact with the infected person and then isolating or quarantining those individuals for 14 days until the danger passes. Unfortunately there is no State in the Union that has the public health infrastructure and the bodies to do all this contact tracing and follow up. The only Country in the world that did was South Korea and only because they were scared to death by SARS 1(CoVid-19 is SARS 2)and subsequently put a robust public health system in place specifically to do contact tracing and quarantine. Testing won't help that much until we have enough people to contact trace exposed individuals and exposed individuals or infected individuals cooperating with public health mandates.

#7 Eventually the one thing that will stop this pandemic will be a vaccine. I support and wish well those labs and companies rushing to bring one to market and want them to succeed. If they can get it done by the end of the year it will be a miracle. I have to say however that I am concerned it can be done that quickly as issues of safety, effectiveness, and ability for mass production are questions that must be answered prior to using it on the public in mass quantities. In my medical career I have seen over a dozen miracle medicines pulled off the market after a few months or year because once used across the country those miracle medicines were killing and harming people and we did not discover that in the initial trials. Don't forget no treatment, no vaccine, no mask is 100% perfect. But what we have today is the best we can hope for.

Asian collector snaps up bottle of Gautier Cognac from 1762

One of the world’s oldest bottles of Cognac has been sold by Sotheby’s for £118,580. 

Louis XV was busy ordering the construction of the Petit Trianon at Versailles for his mistress Madame de Pompadour when the bottle of Gautier Cognac – one of only three surviving and still bearing its original label – was being bottled in 1762. 

Some 258 years later, it has been snapped up in an online auction by a private collector in Asia, setting a new record for the sale of Cognac at auction. Sotheby’s said the Cognac should still taste fine as the bottle, which has been kept in a family cellar for the past 140 years, was in good condition. 

Known as Grand Frère (Big Brother), the Cognac’s Petite Soeur (Little Sister) can be found at the Gautier Museum in France, while its Petit Frère (Little Brother) sold at auction in New York in 2014. The owner who put the bottle up for auction recalls that as a child, his grandfather forbade him to play in the cellar, where he kept his oldest bottles of Cognac. It was only many years later he learned the story behind the amber treasure. During the 19th century, his great grandparents fostered an orphan called Alphonse who, between 1870 and 1880, went to work in the Cognac region. It is thought his return home after 10 years was prompted by the phylloxera crisis which had decimated the vines and wiped out the production of wine and brandies. With him, Alphonse carried a cart loaded with bottles of Cognac, presumably given in lieu of wages. Among them were the three Maison Gautier Cognacs. In 1914, Alphonse was sent to war and sadly never returned. 

Jonny Fowle, Sotheby’s spirits specialist, said: “The Gautier 1762 is renowned and revered across the world as a Cognac that transcends the world of spirits collecting. This bottle represents not only an example of pre-phylloxera viticulture, but also of early cask maturation from the dawn of Gautier’s production and even precedes the French Revolution. This bottle contains a distillation not only of superb brandy, but also of Cognac’s history.” 

Reprinted from "Taste of France" magazine.

The Worlds 5 Oldest Wines

Many years ago Clark and I celebrated her 50th birthday with family and friends at the Graycliff resort in Nassau, Bahamas. It truly is a bucket list experience with the epitome of luxury and fine food and wine. They have an extensive cellar and within that cellar is what is called the million-dollar rack where their rarest wines are stored. They used to have a bottle of allegedly Thomas Jefferson's bottle of Lafite Rothschild from 1789 that allegedly was dropped and broken years after we visited. The wine that impressed me the most was the 1727 Riesling described in this article. I was taken aback by the pristine condition of the bottle in a wine that old. The Graycliff represented at the time that it was the oldest bottled wine in the world which today is no longer true as we will see. 

The Speyer Wine Bottle

The Speyer wine bottle is believed to be the oldest bottle of wine in the world and is dated to around 325-350 AD. The bottle was unearthed in 1867 and one of 16 found in a sarcophagus in the grave of a Roman nobleman and his wife – the bottle was the only one still intact. The liquid, which is no longer alcohol, has most likely survived this long because the bottle was sealed with wax and olive oil was poured into the bottle to preserve the wine. 

Since its discovery, experts have debated whether or not the wine should be opened and analyzed. For now, the bottle remains unopened as part of the Pfalz Historical Museum collection in the German City of Speyer. The concern is what will happen the minute the wine is exposed to air. 

Strasbourg Barrel France 1472

The wine cellar under the Strasbourg city hospital (Cave Historique des Hospices de Strasbourg) in France is home to the oldest barrel-stored wine in the world. The barrel is marked with a date of 1472 and the wine inside is still drinkable. The wine has been tasted only three times in its history which I find amazing. I wish I could have been there. Once in 1576 to celebrate the alliance between Strasbourg and Zurich; a second time in 1716 after the hospital burned down; and finally in 1944 when Strasbourg was liberated by General Leclerc during World War II. The wine was most recently transferred to a new barrel in 2014 after its original barrel started leaking.  A new handmade egg-shaped barrel was made for the wine by two of France’s most-respected coopers Xavier Gouraud and Jean-Marie Blanchard.  I find it interesting that they put it in one of the new egg-shaped barrels that were invented with the intention of better extracting and aging wines today.  I guess they figure even though it was made in 1472 it still has an opportunity for improvement!

Tokaji Royal Saxon 1650-1690

This bottle of Tokaji, dated between 1650 – 1690, was sold for an undisclosed amount in a 1927 auction that took place in the Saxon capital Dresden. During the auction, 62 bottles of Tokaji from the Royal cellar of Augustus II were sold. This wine is believed to be the oldest intact Tokaji bottle and was certified as authentic by the Foundation of the House of Wettin, which administrated the heritage of the former Saxon monarchy.

Made primarily from the Furmint grape, Tokaji wines are some of the most famous in the World, yet many people have no knowledge of them.  They are a very sweet wine, drank today primarily with dessert as well as with Foie Gras.  Originally these wines were produced on the island of Malvasia under the rule of Greece and then later Venice.  In 1358 Hungary's King Louis the Great received 30 barrels of the wine as a war indemnity.  Fast forward 200 years and Hungary began producing the wine and ever since Tokaji is known as a Hungarian sweet wine.  Tokaji has a long storied history.  Paracelsus, the famous Swiss alchemist, performed prolonged experiments with Tokaji's grapes attempting to extract gold from them.  The soil in Hungary that these grapes have grown in is known to have gold ore.  Early in the 20th-century physicians would prescribe Tokaji Aszu(the rarest and sweetest made) to patients in the belief that the gold rumored to be in the subsoil was responsible for the alleged health-giving properties in the wine.   As late as 30 or 40 years modern-day Rheumatologists were giving gold injections to patients with Rheumatoid Arthritis that actually treated the disease.  Today we have better drugs but not any cheaper! Another well-known story involves Catherine the Great of Russia who allegedly was paid tribute with Tokaji wines.  From 1733 to 1800 a company of Russian soldiers was regularly stationed in Hungary with the sole job of buying, shipping, and guarding these wines for the czar's court.

Apostelwein Wine 1727

The Apostelwein 1727 comes from the famous 12 Apostles’ cellar in the Bremer Ratskeller located in Bremen, Germany. The wine comes from 12 barrels of wines in vintages of 1683, 1717, and 1727, which were reduced in number due to evaporation – when there was only one barrel left, the wine was bottled in the 1960s. 

The most expensive bottle of Apostelwein 1727, valued at $200,000 belongs to the Graycliff Hotel in Nassau and is one of the rarest wines in the world. The wine is supposedly still drinkable due to its high sugar content. The picture is one I took at the Graycliff cellar. At the time I could not believe how new the label looked. Turns out I was right. The wine may be old but the wine was first bottled from barrel in the 1960's so the label is only around 60 years old but still in great condition for 60 years. It clearly demonstrates what a bottle of wine should look like when stored properly. 

Massandra Sherry 1775

In 2001, a bottle of the Massandra Sherry de la Frontera 1775 was sold at a Sotheby's auction for $43,500 in London making it the most expensive bottle of Sherry in the world. The wine was produced by the Massandra Winery, located in the Republic of Crimea, which is home to an extensive collection of valuable Russian and European wines. 

In 1922, after the Russian Revolution, the winery was nationalized and its cellars became a protected institution. In 2015, Russian President, Vladimir Putin, and former Italian Prime Minister, Silvio Berlusconi, allegedly drank from a bottle of Jeres de las Frontera worth $90,000. This picture shown is also a good example of what you might find when visiting cellars, especially in France. I have been in hundreds of cellars in France where you see bin after bin of dust-covered very old bottles usually with only the vintage year and the name of the wine on a plaque attached to the bin which on average stores 100 bottles I always ask the owner what they intend to do with the wines and the usual answer we open one bottle every year or two to make sure it is OK and someday in the future we might clean the bottles, put a label on them and sell them. The number of cellars with hundreds if not thousands of old and rare wine is mind-boggling. Every cellar I visited all had these cellars which are sometimes called their "library" selections. One vineyard I have visited in Bourgogne France is the Carillon vineyards whose original owner was born in 1520. I never got to see their "library" but I am willing to bet deep in their cellar are some very old and great wines even older than the ones I tell you about today. Then you consider the thousands of other family cellars in France alone and the potential for very old great wines is infinite.