えはら医院Ehara Clinic

Is
To spread energy throughout the world.

We will help you to cure your illness.
When you are not feeling well, a little encounters and interactions here will be the beginning for your recovery.
And to have positive feelings and fulfilling your time regained.

We hope that our being could be a source of peaceful mind for everyone.

【Notice】
※ We announced the epidemic forecast at Japan for next year on May 24 of【COVID-19 Updates】, as follows,
“There will be little or no epidemic or small outbreaks from summer to fall during 2020, although small clusters may occur. After the end of this year or during the spring and summer of 2021, there will be a relatively large second wave or no outbreak.”　See text for commentary

【COVID-19 Updates 】
[May 30] 　　All the tests are already completed with just saliva. RNA detection kit using genome editing technology can bring results within one hour at home without sending saliva to lab. It will cost around ＄1~2 and replace PCR test (77). Antigen testing has also become possible with saliva (78). Antibody testing for herd immunity has become possible with saliva as well (79). These kits become available soon before we move to the next stage.
(77)Rapid home-based coronavirus tests are coming together in research labs — we’re working on analyzing spit using advanced CRISPR gene editing techniques/The Conversation
(78)Japan to approve quick antigen, saliva-based coronavirus tests/Xinhua
(79)COVID-19 serology at population scale: SARS-CoV-2-specific antibody responses in saliva/medRxiv
[May 30]　　 The first thing we learned after the peak of pandemic was that it is impossible to stay home forever (75). Second, obtaining immunity without vaccines is time-consuming and costly (76). In order to resolve these conflicting issues, we are now in the stage of discussing from a new perspective what is really important and what is needed.
(75)So, What Can We Do Now?/The Atlantic
(76)Coronavirus: Has Sweden’s herd immunity strategy failed?/as
[May 29]　　 RNA concentration in sludge of sewage treatment facility changed ahead 3 days for hospital admissions and 7 days for new cases, which could be a surprisingly accurate predictor for the number of new infected cases ( 74). It is an epoch-making method that can predict the actual scale of infection one week ahead, including the number of infected cases who are leaked from PCR test. It must be very useful when it is difficult to read the trend as if the number of infected cases is increasing just as now.
(74)SARS-CoV-2 RNA concentrations in primary municipal sewage sludge as a leading indicator of COVID-19 outbreak dynamics/medRxiv
[May 28] Vaccine development stops if clinical trials cannot confirm its efficacy while the virus is present (71). One of the vaccines that could reach that level is the vaccine that uses adenovirus, among more than 100 types of vaccines being developed. one of clinical trials of this vaccine showed significant effect, but 80% or more had adverse reactions and 9% had strong ones (72). Side effects of commonly administered vaccines are 0-25%. Moderna's vaccine does not prevent growth of virus in the respiratory tract and has not yet reduced its infectivity (50). Even if development reaches the goal, immunity to cold viruses such as coronavirus may be able to sustain for only a few months. Additionally, influenza vaccines can be effective for less than 30% in some year (73).
(71)The mysterious disappearance of the first SARS virus, and why we need a vaccine for the current one but didn’t for the other/The Conversation
(72)Safety, tolerability, and immunogenicity of a recombinant adenovirus type-5 vectored COVID-19 vaccine: a dose-escalation, open-label, non-randomised, first-in-human trial/Lancet
(73)The world needs Covid-19 vaccines. It may also be overestimating their power/STAT
[May 27] 　　　The effectiveness of Remdecivir has been presented under robust scientific manner (70). While this alone is not enough to control the virus, the fact that the first surely effective drug has been found means that more and more effective treatments will be found one after another in future.
(70)Remdesivir for the Treatment of Covid-19 — Preliminary Report/NEJM
[May 27] In children group of age under 20, infection rate was roughly 44% compared to adults. On the other hand, it is still unknown how children could become the source of infection (69). Unfortunately, at the moment, we have no choice but to make trial and error to evaluate the impact of reopening school.
(69)Susceptibility to and transmission of COVID-19 amongst children and adolescents compared with adults: a systematic review and meta-analysis/medRxiv
[May 27] Virus was detected in breast milk. However, it is unclear whether the newborn was infected due to being with an infected mother or through breast milk. There is still no answer as to whether feeding breast milk from infected mother may be possible (68).
(68)Detection of SARS-CoV-2 in human breastmilk/Lancet
[May 26] SARS-CoV 2 virus has been shown to grow in human intestines as well as bat ones(65). Like SARS, we get infected in restroom. Infections here bypass contact tracing application. Ideally, you should disinfect restroom each time. McDonalds in UK decided to implement cleaning restrooms every 30 or 15 minutes before reopening stores (66). This may set a new standard. Furthermore, it is natural to provide proper guidelines before reopening stores and public facilities (67).
(65)Infection of bat and human intestinal organoids by SARS-CoV-2/nature　medicine
(66)mcdonalds.com
(67)Reopening Guidance for Cleaning and Disinfecting Public Spaces, Workplaces, Businesses, Schools, and Homes/CDC
[May 25] 　40-60% of people without COVID-19 had immunity to other coronaviruses other than SARS-CoV2, which was also effective against SARS-CoV 2 (63 ). This may be one reason why about 35% of people infected with COVID-19 were asymptomatic (64).
(63)Targets of T cell responses to SARS-CoV-2 coronavirus in humans with COVID-19 disease and unexposed individuals/Cell
(64)COVID-19 Pandemic Planning Scenarios/CDC
[May 24]　 This is an epidemic forecast in Japan for the next year based on the epidemic model published in Science Journal, although there are pros and cons regarding suggesting a prospect (60).
The epidemic curve is supposed to be most affected by population immunity, or in other words, susceptibility to infection (61). Successful clinical trials of more than 100,000 vaccines in the US starting in July or later are likely to lead to rapid changes in population immunity associated directly with effective number of reproductions (62).
We takes into account many variables that have persistent recursive effect on the effective reproduction numbers or susceptibility to infection. Impact of climate on virus spread is minimal (61). Changes in human cognition and behavior, changes in timing of government intervention, and real economic dynamics that affects human migration and population density. It also assumes that social distancing measures are maintained unless there is effective vaccines or treatments.

“There will be little or no epidemic or small outbreaks from summer to fall during 2020, although small clusters may occur.
After the end of this year or during the spring and summer of 2021, there will be a relatively large second wave or no outbreak.”

Above is a prediction at this moment.
(60)Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period/Science
(61)Susceptible supply limits the role of climate in the early SARS-CoV-2 pandemic/Science
(62)Exclusive: U.S. plans massive coronavirus vaccine testing effort to meet year-end deadline/Reuters
[May 22]　 However, when second wave that has a higher probability than big tsunami comes, you should be able to simulate what you can actually use and what you need and how much we need. It's no surprise that they're already in the process of securing inventory and supply chains (59).
(59)HHS Proposes ‘IT Control Tower’ to Manage Strategic National Stockpile
[May 21]　　Unless the unfortunate gene mutation occurs, it will not be so bad after 2nd wave. This is because Japanese people have learned about fear of epidemics. There should be much to learn from progress of the 2nd wave in Jilin (56). Susceptibility to infection complies with natural law of fractal, so that cluster measures were effective in Japan (57). However, system capable of using routinely saliva PCR tests should be prepared, in order to rebuild healthcare system already disintegrated and prevent further economic disruption (58).
(56)After New Coronavirus Outbreaks, China Imposes Wuhan-Style Lockdown/NYT
(57)Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19)/medRxiv
(58)Saliva as a non-invasive specimen for detection of SARS-CoV-2/JCM
[May 20] Closing the school has reportedly reduced the peak of outbreak by 40 to 60% (54). However, it is not clear yet how much the actual infection rate of children is different from that of adults and whether they pass it on to other family members. These data are needed to determine when and how schools should be reopened, and what the school should be like in the future. Scientific research is underway(55).
(54)Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China/Science
(55)Study to determine incidence of novel coronavirus infection in U.S. children begins/NIH
[May 19] Antibodies against SARS-CoV in 2003 can be used for preventive administration and treatment before the onset of SARS-CoV 2 infection. It is also effective against similar viruses that may appear in the future(53).In order to control diseases, it is necessary to develop methods that can be available immediately and are effective, one by one.
(53)Cross-neutralization of SARS-CoV-2 by a human monoclonal SARS-CoV antibody/Nature
[May 18] It has been clear that there were many smokers among seriously ill and dead. This time, evidence was presented at the genetic level that smoking history is the clear cause of aggravation (52). It is an important paper suggesting that tobacco is no longer allowed in the post-corona era, in terms of limited allocation of medical resources and economy.
(52)Cigarette smoke exposure and inflammatory signaling increase the expression of the SARS-CoV-2 receptor ACE2 in the respiratory tract/Developmental Cell
It is reported that kidney function starts to decline before admission. More than 30% of the hospitalized patients already have a kidney failure(51).
(51)Kidney disease is associated with in-hospital death of patients with COVID-19/Kidney international
[May 16] One of COVID vaccines under phase 1 trial showed the required efficacy and safety in rhesus monkeys(50). This is the first step.
(50)ChAdOx1 nCoV-19 vaccination prevents SARS-CoV-2 pneumonia in rhesus macaques/bioRxiv
According to research data from Ehara Clinic, Kawasaki disease is an immune overreaction triggered by viral infection. It is not surprising that SARS-CoV 2 virus causes severe Kawasaki disease in children in Europe and the US who do not have momentum of immunosuppression(49).
(49)An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study/Lancet
[May 15] It is a report that BCG does not suppress the number of people infected(48). However, regardless of whether or not BCG is susceptible to infection, I think that BCG has the effect of preventing serious illness and death even after infection. It turns out that more research is needed to come up with the answer.
(48)SARS-CoV-2 Rates in BCG-Vaccinated and Unvaccinated Young Adults/JAMA
[May 14]　 It is possible that your pet may carry a virus because it has been alerted for some time. You will also need to isolate your pet(47).
(47)Transmission of SARS-CoV-2 in Domestic Cats/NEJM
[May 13] Obese people are more likely to have fatal systemic inflammation called cytokine storm, which causes serious illness and mortality rate(46).
(46)Targeting the Adipose Tissue in COVID-19/Obesity
Tokyo is already in a convergence period. The chances of getting infected are much lower. However, the virus has not disappeared from humans and society. The way of moving from here is unexperienced for living human beings now, so trial and error will continue to be more difficult than ever.
[May 12] What was hoped for from February 1 was the participation of interdisciplinary researchers who could analyze data. Finally, I found one of the most moving answers, "K '" (45). Thank you.
(45)Novel indicator of change in COVID-19 spread status
[May 11] It is the good news that saliva PCR will be approved in Japan this month. I would like to expect that what is absolutely necessary to maintain society will be diffused in no time.
[May 10] While the SARS-CoV 2 virus was spreading in Japan, the number of children with Kawasaki disease decreased, and there were no children with COVID-19 who had Kawasaki disease (44). This is the opposite of the fact that there are many infected children with Kawasaki disease in Europe and the United States. The answer derived from the genetic analysis data of Kawasaki disease at Ehara Clinic is that BCG is effective for pediatric COVID-19. Japan has a very good BCG. Be sure to inoculate as soon as 5 months.
(44)Japan Kawasaki Disease Society
[May 9] SARS-CoV 2 seems to change its shape in a very short period of time (42). It is highly possible that COVID-19 will not work immediately even if a vaccine is developed. From next year, it may be possible to get the corona vaccine with flu shot every year at the same time. Conversations such as "What type of COVID is going this year?" "Type A2."
(42)Global Spread of SARS-CoV-2 Subtype with Spike Protein Mutation D614G is Shaped by Human Genomic Variations that Regulate Expression of TMPRSS2 and MX1 Genes/bioRxiv
In the US, self-collected saliva PCR testing has begun (43). In the future, this safe method is indispensable, and it should be introduced and disseminated as soon as possible, in the future, where we cannot help living with COVID-19.
(43)DHHS Letterhead/FDA
[May 8] New infectious diseases always start quietly and rush like angry waves. If you do not deal with it at a speed that is not defeated, you will end up without gaining anything. Today there was a high quality report from Italy. Treatment that suppresses male hormones is effective. Neutralizing antibody therapy has already been reported by researchers in the US, Belgium and Germany (41). With the provision of effective treatments, it becomes possible to control infections.
(40)Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2/Annals of Oncology
(41)Structural Basis for Potent Neutralization of Betacoronaviruses by Single-domain Camelid Antibodies/CelPress
[May 7] Children are less likely to get seriously affected by COVID-19 because they still have a young immune response (37). Since the reaction is less likely to occur in adults, it is easy to become severe and at the same time, antibodies cannot always be produced (38, 39). Even if you take it once or if you get immunity, it is quite possible that your antibody levels will not rise. I have found that immune passports from antibody tests are useless.
(37)Type I IFN immunoprofiling in COVID-19 patients/Journal of Allergy and Clinical Immunology
(38)IFITM3 Affects the Level of Antibody Response after Influenza Vaccination/Emerging Microbes & Infections
(39)Type I interferon shapes the quantity and quality of the anti‐Zika virus antibody response/Clinical & Translational Immunology
[May 6] Smoking causes blood clots. With COVID-19, blood clots can cause cerebral infarction in young people (37), or they die because blood does not reach the internal organs necessary for life support (38). Smoking clearly increases the risk of death (29). The key is to reduce the severity of the disease and the number of fatalities. To that end, it is desirable to investigate whether smoking out or continuing social distance is more economically viable.
(37)Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young/NEJM
(38)COVID-19 and its implications for thrombosis and anticoagulation/Blood
[May 6] RNA viruses containing SARS-CoV2 have been incorporated into the chains of human genes and have helped to expand human diversity (33). There is also a theory that AIDS is cured when the body's immune reaction to eliminate the virus does not occur, and at the same time, the virus is completely incorporated into the chain of human genes (34).
(33)Endogenous non-retroviral RNA virus elements in mammalian genomes/Nature
(34)HIV infection en route to endogenization: two cases/Clinical Microbiology and Infection
The excess immune reactions seen in SARS, post-transplant rejection, sepsis, and Kawasaki disease mimic each other, and many immune-suppressing drugs have been shown to be effective. COVID-19, which has become more severe, has a similar condition, but the use of immunosuppressants seems to help rather cause symptoms (35). It is better for the body not to fight the virus, and medicine for coexisting with the virus is rather useful. It has also been shown that drugs used in rheumatism to suppress hyperimmunity are highly effective (36).
(35)COVID-19 in long-term liver transplant patients: preliminary experience from an Italian transplant centre in Lombardy/Lancet G&H
(36)Effective treatment of severe COVID-19 patients with tocilizumab
[May 5] SARS and SARS-CoV2 are actually quite similar to Kawasaki disease. When extreme inflammation occurs throughout the body, multiple immune cells, which play a role in eliminating viruses, are suppressed in the same way as HIV / AIDS. This makes it more difficult to eliminate viruses (30).
At the same time, the extreme inflammation occurs in blood vessels throughout the body, blocking blood flow to the heart and limbs (32).
It is inferred from the treatment of Kawasaki disease that mortality and sequelae may be reduced by administering a drug that cuts off such a flow earlier. This is the same as if you do not administer Tamiflu early in the flu, it will not be very effective.
(32)ACUTE ACRO-ISCHEMIA IN THE CHILD AT THE TIME OF COVID-19/Case report
[May 4] In the case of infectious diseases with a long incubation period, there are no infectious diseases that could be suppressed in a short period of time simply by changing human behavior. It is very difficult to control the spread of infection while relying only on social distance. This is clear from the history of the HIV / AIDS virus, which has similar characteristics to SARS-CoV2 (30) (31). First of all, the number of infected people will decrease remarkably only when the drugs that are expected to be effective can be used in general medical institutions and then the more effective drugs are used.
(30)High-dimensional immune profiling by mass cytometry revealed immunosuppression and dysfunction of immunity in COVID-19 patients/Cellular and Molecular Immunology　　　
(31)Antiretroviral Drug Discovery and Development/NIH
[May 3] There were concerns that the most commonly used blood pressure medication would increase mortality (28). However, it has been shown that mortality may increase due to heart and vascular deterioration and illness caused by poor control of blood pressure, rather than blood pressure medications (29). There are actually many men over the age of 25 who have advanced hypertension and cardiovascular deterioration without being aware of it.If you have a slight high blood pressure or feel palpitation, Treatment should be started.
(28)Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?/Lancet
(29)Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19/NEJM
[May 2] Ultraviolet rays are harmful to eyes and skin, but far-ultraviolet lamps can inactivate coronaviruses that are aerosolized or adhered to the surface of an object in a few minutes, while at the same time, they do not affect the human body. Since it is harmless, it may be generalized as lighting for public facilities in the near future. Looking at the ceiling, it may be a normal sight to see a line of magenta lamps lined up (27). Vaccines are effective against only one pathogen, but this light is an excellent one that is likely to be effective even if new pathogens emerge.
(27)Far-UVC light efficiently and safely inactivates airborne human coronaviruses/Virology
[May 1] It has gradually become clear that men's mortality rate is more than twice as high as women's, and why they may become infected and become infertile without knowing it (26).
(26)Delayed clearance of SARS-CoV 2 in male compared to female patients: High ACE2 expression in testes suggests possible existence of gender-specific viral reservoirs/MedRxiv
[April 30] SARS-CoV 2 causes the primitive and powerful inflammatory reaction seen in infants, but despite this, the virus continues to escape immune attack by some mechanism and remains indefinitely (24)(25).
(24)Pathological evidence for residual SARS-CoV-2 in pulmonary tissues of a ready-for-discharge patient/Cell Reserch
(25)Heightened innate immune responses in the respiratory tract of COVID-19 patients/CellPress
[April 29] The fact may be a discovery of genuine value that ivermectin, a long-time safe drug actually used in humans, has been shown to be highly effective (21). We hope that what you can expect will be available soon.
Infection of children with SARS-CoV 2 may lead to Kawasaki disease (22). It is also likely to result from a study of Kawasaki disease at Ehara Clinic (including unpublished data) (23). At the same time that the child's body clears the virus, it can cause the symptoms of Kawasaki disease.
And ivermectin is believed to be a drug that enhances this viral clearance.
(21)Usefulness of Ivermectin in COVID-19 Illness/SSRN
(22)Health chiefs ‘unaware’ of children’s deaths from new illness linked to coronavirus/Metro
(23)Early activation does not translate into effector differentiation of peripheral CD8T cells during the acute phase of Kawasaki disease/Cellular Immunology

Online appointment is available for medical consultation, immunizations, and checkup for infants
Online appointment
042-336-7676

Consultation : 9:00 to 12:30 and 15:00 to 17:15
Immunization : 9:00 to 12:00 and 15:00 to 17:00
Health checkups for infants : 9:00 to 12:00 and 15:30 to 16:30

How to get to us
3-35-7 Wakamatsu-cho, Fuchu-shi, Tokyo
10 minutes walk from Tama Cemetery Station on Keio Line
15 seconds by car after entering Sengenyama Street from Koshu Kaido
20 parking lots