2 + 1 + 1

Mar 27, 2020

Two fever reducers PLUS one in a thousand PLUS one did you know?

1. What should we know about acetaminophen and ibuprofen?

You might have heard in the past three weeks that you should not take ibuprofen if you suspect that you have Covid 19. However, I wanted to get to the story behind the story.  Like much of what has happened in a fast moving pandemic that suspicion becomes rumor and then rumor becomes fact, a commonly used fever reducer became a villain. In this case, a suspicion originated in a medical commentary, then rumors of four deaths that occurred in young people that coincided with their use of ibuprofen, which became a causal fact when this suspicion was then supported by a Tweet (seriously what is up with this tweet issue) by the French Minister of Health that ibuprofen should not be given to patients with COVID 19.

Today I asked my pharmacist about this topic and this “fact” was what she quoted back to me. Ibuprofen makes the disease associated with COVID 19 much worse. The FDA published a statement clarifying that no scientific data has been identified to support not using ibuprofen in the setting of COVID 19.  This is where the danger of making medical tweets based on suspicion can occur.  In fact, the World Health Organization originally directed patients NOT to take ibuprofen based on the French recommendation and they reversed the policy soon thereafter. 

The problem is even in a fast moving pandemic we cannot forget that science is science for a reason.  It balances efficacy with adverse outcomes which takes time. What is a fact that  the use of ibuprofen, should be used with caution in those with kidney disease as it is cleared by the kidney. 

Meanwhile, acetaminophen (trademark Tylenol or generic paracetamol) can be potentially toxic to the liver where it is processed. You would not want to take this in the setting of liver disease. Both of these medications in excess can cause potentially fatal complications. 

It is important to read what is included in any symptom remedy which you might be taking and to make sure that you are not overlapping the same medications and potentially developing toxicity. It is also important to know your underlying medical conditions and make sure that you choose the right fever reducer. 

2. What does she mean by one in a thousand?

I have to admit that I am a big fan of Dr. Fauci and Dr. Birx, in fact, a superfan, as I am sure many of you are as well. However, it is the data driven Birx that I stay glued to because it is data that guides her statements. When data given incorrectly or too early based on models can create fear and it is data based on realities that will either bring confirmation of our worst fears or help alleviate fear. 

Dr. Birx unequivocally stated that models have not accurately predicted the realities they are seeing in real time.   This is in great part due to the mitigating strategies countries have taken around the world.  However, most importantly she stated that NO country (other than the very smallest, i.e. Monaco) is seeing greater than 1 per thousand attack rate. This is great, great news!!! This means that it is not as transmissible as once thought.


Did you know that Gratitude positively affects our health? Keeping a gratitude journal results in 16% fewer physical symptoms, 19% more time spent exercising, 10% less physical pain, 8% more sleep, and 25% improved sleep quality.

Sweet Esther in this photo thinks that she was 108. However, at 108 she couldn’t read her Bible. When I handed over my reading glasses and she could read, she lit up with gratitude and gave me one of the firmest hugs I have ever received. Perhaps her ability to have complete gratitude in life helped her live that long life.

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