Intermezzo: Covid-19: to Fear or Not to Fear, Part 1

An Inhaled Cortico-Steroid (ICS) medicine is now being presented as a possibly effective treatment for Covid-19 Coronavirus.  However, the nature of clinical research is to always tread carefully and wait for conclusive results before broad acceptance of an outcome.  This is especially true for entrenched researchers with reputations to protect.

Dr. Richard Bartlett, a Primary Care and ER doctor in Odessa, Texas does not have that pressure of certainty before espousing a cure for Covid-19, but rather a concern for his and others’ patients, going so far as to call ICS “a silver bullet.”  His less than “clinical trial” technique of treating his 12 patients with Inhaled Cortico-Steroids (ICS) is impressive and is being widely investigated, even before his paper has been peer-reviewed. (

Few researchers will go out on the limb Dr. Bartlett does until thorough-going and detailed studies have been done to not only proffer results but to understand mechanisms.  You can get a copy of his paper pre-publication by emailing Debbie Georgatos at


But Dr. Bartlett is a practitioner, and not a researcher, and his interest is in saving the lives of his patients.  His only purpose in getting his results into print seems to come from his deep concern for others’ patients that can benefit from EARLY ICS treatment.

The Recovery Trial referenced above has already reported death reduction by one-third, and this is in severe cases!  As of June 16, 2020 the researchers concluded, “the survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients.”

2020-07-14 State of FearReading several journals about the dexamethasone, aka Budesonide, inhaler therapy, the evidence to support much wider use of ICS inhalers or nebulizers is growing, and I hope Dr. Bartlett will be recognized for his contribution to the research that may save thousands of lives, not to mention the relaxation of overblown fears.  (If you want to read an interesting novel in your spare time [🙄 haha], check out State of Fear by Michael Crichton, how politicians and eco-terrorists use fear to advance their agendas.  The concepts presented here parallel much of the fear associated to the Wuhan Virus.)

A scientific American article is particularly encouraging.  However, it warns about self-medicating with ICS at home, and I would echo this, to do so under a doctor’s supervision.  One of the absurd tales of woe associated to Hydrochloroquine was of a man who took the drug without medical supervision and died.  That said, if you ever suspect you have the Wuhan Virus, find a doctor like Dr. Bartlett who will supervise your use of ICS! 😊

Per Dr. Bartlett’s concern, NIH is already recommending ICS, but only for severe cases, and recommending against using in patients that do not require supplemental O2!  Why?  They state that they are waiting for further analysis and for more results from the Australian/UK study to be completed.

I could only find one study in England that disputes these findings, but they only used the Inhaled Cortico-Steroid on Covid-19 patients with COPD or Asthma which would be significantly confounding conditions.  Furthermore, the abstract at admits that unmeasured disease severity may have skewed their results.

Interestingly, another study the British are doing at Queensland University College in conjunction with Oxford University is looking at using ICS as an early intervention, such as Dr. Bartlett does.

Unfortunately, Dr. Bartlett sounds too much like a salesman in the interview (partly the interviewer’s fault), but his message is spot-on.  No cure is likely to be 100% effective as there is too much to our “fearfully and wonderfully made” bodies that we do not know about.  He has been very fortunate (and maybe some Spirit’s guidance?😇) that he has not had any failures or even adverse effects.  Lots of medical research is guesswork and whoever seems to hit on the best guess and has the best “story” for how it works wins the Nobel Prize!  Let’s hope that Inhaled Cortico-Steroids is the “silver bullet” Dr. Bartlett sees.

Tomorrow, I will present another Intermezzo blog on whether we should fear Covid-19.