By Dr. Anthony Policastro

There are many kinds of diets. It seems that one is always in fashion. Low carb diets, gluten free diets and keto diets continue to make the rounds.

One of the newer ones is what is known as a Time Restricted Diet (TRE). It is also called Intermittent Fasting.

The idea behind it is that all meals are taken within an eight-hour period each day. The specifics of the diet are less important than the timing.

The logic is related to how we metabolize calories. When we eat, our bodies metabolize the recently eaten food. When that food is all metabolized, the body has to get energy from somewhere. It then begins to burn the sugars and fats that we have stored.

If there is a 16-hour a day fast, then it forces the body to burn off those stored materials. The logic is that each day some of that material will be burned off. Therefore, over time weight loss will occur.

A recent report from Great Britain looked at this dietary method in a group of obese volunteers. The number of people studied was only 52. Therefore, the results cannot really be used for what would happen in the general population.

The test subjects were asked to use TRE. They were evaluated after 12 weeks of doing so. The average number of days that the individuals actually followed the diet was between 5 and 6 days per week.

They found that 26 percent of the participants lost about 5 percent of their body mass during that time. Those who were able to follow the diet at least 5 days per week lost more weight than those who did not.

The conclusion was that the diet held some promise. Therefore, it needed to be studied in a larger group of individuals.

The positive of the diet was the fact that it was easier to follow than diets requiring a lot of advance meal planning.

The negative side of it was that the small numbers were not enough to reveal potential side effects from doing this over a long period of time.

The bottom line is that more research is needed. This will be worthwhile monitoring in the future.


The number of new cases remained low this week. They were more than 200,000 daily for most of December and early January. After January 25th they remained below 200,000 every day.

They are now hovering about 100,000 per day. There have not been more than 112,000 new cases since Feb 7th. So we have about half as many new daily cases as we had been having.

The same thing is true in Sussex County where we have been running about 100 new cases per day compared to 200 earlier. Thus the holiday surge appears to have doubled the number of cases for a six-week period. There does not appear to have been a Super Bowl surge of any magnitude.

Vaccines in the millions

We continue to average about 2 million doses of vaccine per day. We now sit at over 50 million doses given. The total number of doses will soon become less relevant. The more important number is how many people have received the second dose.

That is the number that is more relevant for the herd immunity figure. We currently sit nationally at about 4 percent of the population having received the second dose. Delaware remains at 10th place for total doses given per 100 people. However, our second dose rate currently sits at 42nd place tied with four other states.

Deaths could have been prevented

On February 11th the Lancet, a British medical journal, produced a report from a commission. It compared U.S. deaths to other high income countries in the world. In relation to COVID-19, they found that about 40 percent of U.S. deaths might have been prevented with better Federal governmental policies.

This is not a real surprise since we have the 7th highest death rate in the world. Our actions or inactions are the things that put us in the top 5 percent of countries in the entire world for COVID death rate.

Variant strains of COVID-19

Also in that same issue of Lancet was a study on the variant strains and infections in children. There was some concern that perhaps the new strains would cause more serious infections in children.

The findings were that the disease severity caused by the new strains was no different than the original virus. They compared things like ages. They compared things like ethnicity. They compared things like underlying health conditions. In all instances infection severity was the same.

Quarantine period exception

The recommendation for exposure to someone with COVID-19 infection has been for a 14-day quarantine period. Last week the CDC changed that recommendation for fully vaccinated individuals. There is no longer a recommendation for a 14-day quarantine for that group.

Fully vaccinated means two things. First the required number of doses needed to be received. Second there should be a two-week period after that before full immunity is reached.

Double masking recommended

The CDC has suggested double masking as a way of cutting down on inhaled infected particles. One thing is absolutely certain: any kind of mask is better than no mask at all.

The next certainty is that the tighter the mask fits, the more protection it offers. The idea of a second mask is more aimed at covering up openings in the first mask if it does not fit tightly.

Vaccine development

AstraZeneca is going to be doing a trial of its vaccine on children between the ages of 6 and 17. This is the first step in getting children immunized later this year.

A third vaccine from China has completed its Phase 3 study. It is a one dose vaccine. It is made by CanSino Biologics. It was found to be 66 percent effective against COVID-19 infection. Its effectiveness was at 90 percent for preventing severe disease.

The numbers are almost identical to the Johnson and Johnson single dose vaccine. That vaccine is also 66 percent effective against COVID-19 infection. Its effectiveness was at 85 percent for preventing severe disease.

Post vaccine risk factors

One vaccine question is whether an immunized individual who is exposed to the virus can still transmit it. Pfizer studied 1200 individuals. They found that the viral load in that group was lower than what is seen in usual infections.

Viral load is one of the keys in transmission. This suggests that the vaccine cuts down on that.

However, it was a relatively small number of patients studied. It also only suggested that was the case. It did not actually prove it. Thus masks are still needed. I suspect over time we will find that those immunized do not transmit virus to others. We just don’t know that for sure yet.

Do vitamins help?

A recent study reported in the Journal of the American Medical Association found that Vitamin C and zinc did nothing to provide protection against the virus.

For that reason supplementation is not needed.