Updated Covid-19 Recommendations from CDC

 I have included update recommendations from the CDC issued today. We all need to fully comprehend that as each day passes we learn more and more about this virus. I am witnessing lots of people totally misunderstanding this virus and as a result, it is close to spreading out of control. I can assure you the following is accurate: 

1. COVID-19 is HIGHLY contagious and is being spread exponentially primarily by large crowds of people partying not social distancing and not wearing masks. Physicians are just as bad as the general population. This week close to 1/2 of the Anesthesia physicians in a hospital tested positive after an evening party in one of their homes. Talk about not leading by example. You continue to hear about the "R" value which is an indication of the AVERAGE number of people ONE person can infect. My estimation is that it eventually will be calculated at over 10. Seasonal flu is 1 or less. So COVID-19 to me is at least 10X more contagious than seasonal flu. The virus is contagious the first 14 days you have it, after 14 days for the most part people no longer spread it. That is normal and consistent with most viruses that are spread with the initial exposure and COVID-19 is no different from most viruses in that you are spreading them before you know you have them. Once you are sick, you generally no longer are infectious but even that is not 100% dependent on the virus. Ebola for example spreads from dead bodies days after death. 

2. The death rate for seasonal flu hovers around at about 0.2% of the population. As of yesterday the death rate for the USA as a whole was 7% and for Florida was 1.4%. So COVID-19's death rate even with the best-case scenario in Florida is 7X the seasonal flu. 

3. MASKS AND SOCIAL DISTANCING WORK PERIOD. There should be no discussion regarding this. I previously reported studies that said if only 60% of the population wore a mask in public and followed social distancing the virus would go away in weeks. In my opinion, if 100% of the public wore masks and conformed to social distancing the virus would be gone in two weeks. Italy for one has clearly proven it works. Yesterday there were only 5 deaths in Italy. Medical N95 masks are the best but truthfully any mask helps and is better than nothing. Masks, including N95, are now available online at reasonable costs. Seems like everyone is making them now. 

Updated CDC recommendations based on new data are here: 

Patients with confirmed SARS-CoV-2 infection DO NOT need to have two negative tests at least 24 hours apart to return to work, school, or receive medical care. CDC has reported that COVID-19 cases can continue to test positive for up to 12 weeks after their initial positive test, but that they are only potentially infectious to others for about 10 days. 

As such, for most individuals with COVID-19 illness, isolation can be discontinued 10 days after symptom onset and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with the improvement of symptoms (changed from "improvement in respiratory symptoms" to address expanding list of symptoms associated with COVID-19). 

The decision to discontinue isolation for patients with confirmed SARS-CoV-2 infection should be made using a symptom-based strategy, not additional testing: 

· Individuals who had a mild or moderate illness and are not severely immunocompromised can return to work after: 

o At least 10 days have passed since symptoms first appeared and 

o At least 24 hours have passed since last fever without the use of fever-reducing medications and 

o Symptoms (e.g., cough, shortness of breath) have improved 

· Individuals who had severe to critical illness or who are severely immunocompromised can return to work after: 

o At least 20 days have passed since symptoms first appeared 

o At least 24 hours have passed since last fever without the use of fever-reducing medications and 

o Symptoms (e.g., cough, shortness of breath) have improved 

Asymptomatic persons with confirmed COVID-19: 

· Who are not severely immunocompromised can return to work after 

o At least 10 days have passed since the positive laboratory test and the person remains asymptomatic 

· Who are severely immunocompromised can return to work after 

o At least 20 days have passed since the positive laboratory test and the person remains asymptomatic 

o Asymptomatic persons who test positive and later develop symptoms should follow the guidance for symptomatic persons above. 

Definitions of mild to moderate and severe illness, and of severe immunocompromise, as well as more information about the science behind the symptom-based return to work can be found at: https://www.cdc.gov/coronavirus/2019-ncov/community/strategy-discontinue-isolation.html

Please note, the recommendation of 10 days is specifically for those who test positive for the coronavirus and have self-isolated. It does not apply to people who need to quarantine to keep from potentially spreading the virus. The incubation period for the virus is 14 days, so anyone who has been exposed to the virus still needs to quarantine and monitor for symptoms.

How to make some Dough during the pandemic

M. Scott Peck published "The Road Less Traveled" in 1978.  The first line is "Life is difficult".  In the next 20 or so years, Dr. Peck wrote multiple other books developing a philosophy of life that speaks to living a full life with an emphasis on personal growth and many people agree as well as disagree with his philosophies.  In the end, he did not himself follow his own advice.  I bring him up here because one of his comments has guided me for years and it is this.  Like Dr. Peck, I have little to no mechanical abilities and frequently need to hire experts to do "Honey do" handyman jobs around the house as I seem to have no talent for it.  Even though I cook the same could also be said regarding my culinary abilities as my wife will let you know I am very messy and disorganized in the Kitchen.  Dr. Peck addressed this in his books admitting also to a lack of mechanical skills.  But he went on to discuss that was not really true for anyone.  What he discovered was that a lack of mechanical skills, or in my opinion, a lack of culinary skills is all about a lack of patience.  I have discovered the same during the pandemic.  When it comes to cooking or fixing things in truth I have no patience.  I want it fixed now, I want it done now, are we there yet?  The pandemic has given me the time to really get into cooking and understanding excellent food preparation and good cooking requires patience.  You cannot rush it.  When a recipe says to put the food aside to rise or rest there is a valid scientific chemical reason for it and if you rush the process it simply will not work and your food will be mush. 

 For the past 3 months, Clark and I have evolved our cooking and food preparation and have learned a lot.  We would like to pass on some of our new knowledge to you and as my blog is also about food, why not do this?  We have in fact found some valid short cuts that make food preparation easier and are able to open new doors to prepare foods you might not think you could ever do.  At the same time, I will emphasize those steps that do in fact require patience where you need to slow down, smell the roses, and let chemistry do the work it is intended to do.  For the first time in my life these past few months, I have now made homemade bread, biscuits, pizza dough/pizza, and pasta.  Dependent on what you want to make this lesson #1 is all about flour, water, and eggs, the basic ingredients of any dough.

 Up until the Renaissance, all bread products and pasta were made with water mixed with flour.  Somewhere after the 1600s or 1700s eggs were substituted for water and/or added to water.  In general, simple dough is flour and water.  You can find a lot of information regarding what flour is best for what purpose.  Suffice to say at home so far we have used generic all-purpose flour and so far everything has turned out well.  What we have discovered however is the ratio of solids to liquids in making dough is important.  Important enough to where we always measure now the ingredients. 

 Lesson # 1 300 grams of flour mixed with 180 grams of liquid, water, eggs, or water egg combination easily makes a dough ball that is easy to handle and then knead.  Obviously water weighs more than flour so if you mix based on the liquid volume the amount of water and flour as close to the same ballpark but you can look up the conversion.

 Lesson #2 mix any and all flour and any additional solids like salt for example in a food processor and then slowly add the liquid while the food processor is on.  In a very short time, it will make an obvious dough ball.  It is helpful to let the dough ball rest for a minute or two and then restart the food processor and do that 2 or 3 times.  You then remove the dough ball from the processor and it will be sticky but trust me it will be less sticky than if you started out using your hands to mix the flour and liquids. 

 Lesson #3 you do have to knead the dough ball and that is done by putting some flour on a counter to dry the outside of the dough ball a little so it reduces sticking to your hands and then fold and refold the dough ball onto itself.  You do this until the dough ball is smooth to the touch.  Almost every reference we looked at said you can never knead the dough too much.  But in general the best references we found said knead for at least 8 minutes and for all our recipes it worked out fine.

 Lesson #4 here comes the patience part.  After you finish kneading let the dough ball rest.  You just folded it and in a sense beat the crap out of it, it needs time to recover.  Every reference says it needs to rest for 30 minutes minimum.  You either put it in a bowl covered with plastic wrap or just wrap it in plastic wrap, either works.  We just made pizza dough last night and let it rest overnight with no problems.

 At this point, you can make whatever you are making and start cooking.  You cut the dough ball into a size that will meet your needs and the remainder can be wrapped in plastic wrap and frozen in the freezer where it can stay for around 3 months.  You can also put it in the refrigerator to use in the next 4 or 5 days.

 Those are the basics and so far to me easy to follow.  I do recommend you review a few YouTube videos to see how others do it and find the one that works best for you.  With anything, there is a learning curve but it took me only 2 or 3 tries to feel comfortable making anything and I hope it works out well for you.  We now make our own homemade pizza and it has been as good as delivery.  My next article will be making basic soups.

An Update on my Covid-19 Viral Load Article

I am providing in full an article just published that emphasizes why my previous article on viral load is so important. Bottom line the more virus you are exposed to and have in your bloodstream the greater the risk of death. As we speak the recommended behaviors of wearing a mask, social distancing, staying away from crowds, staying our of confined crowded spaces are all designed expressly for the purpose of reducing your exposure and hence your viral load. Why people will not follow these guidelines is beyond me.


Jul 8, 2020

SARS-CoV-2 Viral Load in Hospitalised Patients Correlates With Risk of Intubation, Mortality
By Denise Baez

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load among hospitalized patients is independently associated with the risk of intubation and in-hospital mortality, according to a study published in Clinical Infectious Diseases.

Reed Magleby, MD, NewYork-Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, and colleagues evaluated 678 hospitalized patients with coronavirus disease 2019 (COVID-19) and found that 35% of patients with a high SARS-CoV-2 viral load on admission died, compared with 17.6% of patients with medium viral loads and 6.2% of patients with low viral loads.

The findings suggest that using cycle threshold (Ct) values, which are available when results from reverse transcription-polymerase chain reaction (RT-PCR) assays are reported to clinicians, could identify patients at the highest risk of intubation and death and guide treatment accordingly.

“We found that admission SARS-CoV-2 viral loads, as determined by Ct values that are generated with standard-of-care diagnostic assays, are independently associated with intubation and death among hospitalized patients with COVID-19,” the authors wrote. “These findings highlight the critical role of viral load in SARS-CoV-2 pathogenesis and suggest that Ct values should be reported to assist clinicians in identifying patients at high risk for adverse COVID-19-related outcomes.”

Dr. Magleby and colleagues analyzed data from 678 patients who were hospitalized with COVID-19 between March 30, 2020, and April 30, 2020, at 2 hospitals in New York City. SARS-CoV-2 viral load was assessed using a cycle threshold (Ct) values from a reverse transcription-polymerase chain reaction assay applied to nasopharyngeal swab samples.

In-hospital mortality was 35% among the 220 patients with a high viral load (Ct <25), 17.6% among the 216 with a medium viral load (Ct 25-30), and 6.2% among the 242 patients with a low viral load (Ct>30). The risk of intubation was also higher in patients with a high viral load (29.1%), compared with those with a medium (20.8%) or low viral load (14.9%).

In a multivariate model that adjusted for age, race, coronary artery disease, congestive heart failure, cerebrovascular disease, hypertension, chronic obstructive pulmonary disease, days of symptoms prior to admission, symptoms upon presentation, initial chest x-ray findings, and level of oxygen support within three hours of arrival to the emergency department, having a high viral load was independently associated with increased risk of in-hospital mortality (adjusted odds ratio [aOR] = 6.05; 95% confidence interval [CI], 2.92-12.52; P< .001) compared with having a low viral load.

The risk of in-hospital mortality was also higher in patients with a medium viral load compared with a low viral load, but this association was not statistically significant (aOR = 2.06; 95% CI, 0.98-4.34; P = .058).

Compared with those with a low viral load, having a high viral load was also independently associated with increased risk of intubation (aOR = 2.73; 95% CI, 1.68-4.44; P < .001). The risk of intubation associated with a medium viral load did not reach statistical significance (aOR = 1.59; 95% CI, 0.96-2.63; P = .07).

Higher viral load was associated with increased age, comorbidities, smoking status, and recent chemotherapy. Patients with higher viral loads were also more likely to develop myocardial infarction, congestive heart failure, and acute kidney injury requiring hemodialysis.

“While prior studies indicated that viral load correlates with severity of COVID-19 presentation, our study of a larger cohort of hospitalized patients adds to this knowledge base by identifying that admission viral load has important prognostic implications,” the authors wrote. “Reporting
SARS-CoV-2 viral load based on Ct values from admission NP swab samples could, therefore, help identify patients who are at the highest risk of adverse outcomes and who therefore may benefit from more intensive monitoring. Identifying high viral load patients could also be helpful for allocating scarce therapeutic interventions such as antiviral agents.”

The authors noted that additional studies that evaluate viral loads and clinical outcomes among all patients who present to the emergency department are warranted prior to pursuing this strategy clinically.

Reference: https://academic.oup.com/cid/article-pdf/doi/10.1093/cid/ciaa851/33448916/ciaa851.pdf

SOURCE: Clinical Infectious Diseases

Cooking with an Air Fryer

Like everyone else, I am sitting around all day looking for things to do to break the boredom. On TV for a significant portion of my life, I have been bombarded with "infomercials" telling me about the latest and greatest home device that will save me millions of money and minutes of time. On occasion, I succumb to the pressure and buy something. Over the past few years with the advent of Amazon I have developed the habit of looking at online reviews before I buy anything. To my amazement over 90% of the things, I look up to turn out to have a high percentage of negative reviews in which case I don't buy the product, so the actual products I buy are minimal. 

Having all this time on my hands has led me to cook more and a larger variety of foods at home and usually I make a big mess as I am a messy cook. Being from the South I love beyond logic fried foods, especially fried chicken and French fries. So why not try those great foods. Alton Brown has a YouTube video on making fried chicken that seemed simple enough. Unfortunately, it takes quite a lot of time and when it was all said and done the kitchen was covered in grease and oil. Same thing with French Fries. Joel Robuchon has a great recipe but most people do not realize in order to make great fries you actually are supposed to fry them twice meaning twice as much oil and grease on the countertops. 

Over the past year, I have seen ad on ad for an air fryer. Emeril Lagasse has been heavily advertising his Emeril's 360 fryer for a couple of hundred dollars and of course, the ad says you can cook anything with no mess in 10 minutes or less, Right? So I spent close to the past 9 to 10 months researching air fryers. First, an air fryer is nothing more than a convection oven where hot air is circulated constantly around the food at a high temperature. If you read the reviews some are better than others and cheaper than others. They also vary in size as well as some having a Rotisserie. After months of thought, I settled on a Ninja air fryer pictured here. 

It was around $100 and had some of the best reviews and fewest negative reviews. We also have another Ninja product we purchased years ago that has been indestructible. This particular air fryer is one of the smaller ones so the first "con" is you won't be able to prepare a large amount of food for a large family or party. It prepares food for one or two but for us being only two in the household it works well for us. But I will say the main motivation for me was I didn't want to invest money in a larger one only to find out I did not like it so I got a smaller and cheaper one in case I decided to throw it out as a failed experiment. But that didn't happen and I am happy to report the air fryer we have at least is amazing! 

The big "pro" of this air fryer is cooking time is quick and the mess is small to nonexistent and clean up is simple. I'm fairly sure the first thing anyone makes is French fries and I was no exception. Freshly peeled and cut French fries were coated in oil and placed in the fryer and they came out crisp, golden brown, and no preservatives or additives. There is a small learning curve using an air fryer. Things you learn are cook with a higher temp and shorter times and midway through the cooking cycle, you need to pause the fryer and turn or shake the food up a little bit. You also need to preheat the air fryer for 3 or 4 minutes prior to putting your food inside.  So far we have made fried chicken, bread loaves, schnitzel, baked potatoes, fried fish and everything has turned out well and on many occasions as good as you would get if you went out. Our unit also has a roasting button and reheat button which increases the versatility of the unit. So overall we are very pleased with our purchase and for two people we can prepare a really nice meal is generally a half-hour serving fresh foods freshly cooked. What more could you ask for?

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.