Area health provider Scott Miller discusses COVID-19

Physician assistant suggests area residents should boost their immune system and focus on facts

This last winter was probably one of the crazier years Scott Miller experienced in his Washougal pediatric medicine clinic. “I saw some of the sickest adults that I have seen in the last five or six years,” said Miller.

Miller, a physician assistant, said he was having families coming into his clinic who were moderately sick, but their symptoms lasted far longer than expected. These patients tested negative for influenza or bacterial etiologies for their illnesses. 

“In April, I started ordering antibody tests for COVID-19 and I found it interesting how many came back positive for the antibodies,” he said. 

These patients had been sick for two-to-three weeks with non-specific symptoms, apart from shortness of breath or just having a harder time getting a full breath. They had no wheezing, all treatments failed, and after around two and one half to three weeks, the symptoms just disappeared. 

Miller’s experience indicates that SARS-CoV-2 was circulating through the country as early as November or December of last year. 

Dr. Scott Miller is a pediatrician in Washougal. He encourages patients to boost their innate immune system to protect against COVID-19. If they get the virus, they should ask their healthcare provider to prescribe known mediations early to stop viral replication. Photo by John Ley
Scott Miller is a pediatric physician assistant in Washougal. He encourages patients to boost their innate immune system to protect against COVID-19. If they get the virus, they should ask their healthcare provider to prescribe known medications early to stop viral replication. Photo by John Ley

“We have treatments that we have known about for years that mitigate viral replication of SARS-Cov-2 within the nucleus of our cells within 48 hours,” he said. 

Miller shared that vitamin D is critical for boosting a person’s innate immune system. A low dose of melatonin will help mitigate the pathway and allow for decreased interleukin 6 activation. Most providers talk about the benefits of vitamin D, vitamin C, zinc, and NAC.

“I think that we haven’t done a very good job about getting this information out,” he said. “There’s so much disinformation about these things. This isn’t political; this is about making sure everyone has accurate information on things that can be done to make sure that we don’t have negative outcomes from this virus or from any infection.”

Miller shared that some of these things are things we can do to just help our bodies in general, in reference to his recommendations of vitamin D, vitamin C, and melatonin, especially for older people.

Miller asked why treatments that have been known to prevent significant morbidity as well as mortality, have been removed. 

“We know that ivermectin can inhibit viral replication in the nucleus by 5N within 48 hours; yet it is rarely prescribed,” said Miller. He also spoke positively about hydroxychloroquine. 

A mom called him last month. Her husband had been sick for five days, had gone to Legacy Urgent Care earlier in the day and was diagnosed with COVID-19. He was told to go home and quarantine. 

This stunned Miller. The woman’s husband is a morbidly obese, Type 2 diabetic, with poorly controlled asthma, and vascular issues. The woman and her 79-year-old grandmother were also symptomatic for the virus.

“I got her husband’s demographics, made him a patient, and immediately sent prescriptions for dexamethasone, budesonide, azithromycin, and ivermectin,” said Miller. “I sent in similar prescriptions for his wife and grandmother, along with vitamin D 50,000 iu, and advised them to start on 1 mg of melatonin twice a day, NAC 1000 mg twice a day, zinc 100 mg, and liposomal vitamin C.” 

The woman called four or five days later and said that by day three, all symptoms were gone. Miller acknowledged that is just one anecdote, “but it’s way better than death, which is what the woman feared when her husband was sent home from the hospital without medication or treatment.”. 

A fundamental issue for healthcare providers should be to boost the innate immune system for each of their patients. “No one should be told to simply go home, cross their fingers, and if the symptoms get worse by day 10 or 11, to come back to the ER,” said Miller. “There is more that we can do besides just going home and quarantining and just saying, I hope I get better.”

On the handling of the pandemic overall, Miller said “none of this has anything to do with science. It has to do with fear. People are just fine going to Costco or Walmart to buy groceries, but their life’s in jeopardy going to a polling booth to vote, or if they send their children to school?” Miller asked.

He believes the focus on the number of COVID-19 cases is very wrong. He remarked that we don’t focus on the number of flu cases each year, let alone shut down schools or restaurants or places of work when an arbitrary number of cases happen.

Miller said he is driven by data. 

“We should be focusing on hospital admissions” he said. “Most people have forgotten that the only reason the initial lockdown was proposed, was for one goal only. That was to prevent the complete and total collapse of our healthcare system. Within about a week, we realized that that wasn’t going to be the case. And then it (the metric) just went to new cases.

“The word case shouldn’t even be a word that’s used,” said Miller. “New cases are two words that mean nothing. It’s like saying there was a traffic accident. If there were 18 traffic accidents, do we need to change all of our traffic laws?”

Miller suggested those who are symptomatic of the virus and go to urgent care or an emergency room and aren’t given a prescription, should call their primary care doctor. 

“If they don’t recommend anything, you need to keep searching because there are medications that are therapeutics that anecdotally, we know can be extremely important,” he said.  

Miller mentioned several medications. Ivermectin is one that he’s seen a decrease in viral replication within 48 hours. It’s anti-parasitic, but it can be vital for especially at-risk patients, and it’s very affordable. Hydroxychloroquine, done responsibly in therapeutic doses early on in a disease. Dexamethasone can be a game changer for average people according to Miller.

Miller believes that 50 percent of the COVID-19 mortality could have been mitigated if people had adequate vitamin D levels. “I’ve spent quite a bit of time looking at the CDC numbers where 90 percent of the deaths were in people with vitamin D deficiencies; in only 4 percent were they vitamin D adequate.”

Miller hasn’t tracked down the veracity of all of those statistics, in terms of their accuracy. “But if 10 percent could have been mitigated by doing supportive care measures to help our body’s immune system, that’s a lot,” he said. “And nobody was talking about it.” 

Here in the Pacific Northwest, from September to the end of February, residents don’t make vitamin D from exposure to the sun because they live above the 45th parallel. Miller recommends anyone living above the 38th parallel should take vitamin D supplements during the winter to boost their immune system.. 

“This is about literally having the immune system’s ability to mitigate a pathogen early on before that viral replication kicks in,” he said. “I always recommend the melatonin just because of its impact on our innate immune system and then NAC because it’s such a potent antioxidant,” in addition to the vitamin D, C and zinc.

An Aug 2020 article in Women’s Health affirmed Miller’s melatonin recommendation:

“Melatonin is a special kind of ‘clean’ antioxidant, meaning that it’s able to protect cells without triggering production of free radicals. This appears to be important for immune cells, including phagocyte cells. Think of phagocyte immune cells as little Pac Men traveling through your bloodstream gobbling up pathogens. Studies show that melatonin helps to optimize phagocyte action.

“Children, who are much less likely to have severe COVID-19 symptoms, have as much as 10 times the amount of natural melatonin production as older adults. Now, there are also other factors that give children healthier immune function, but this may go a long way toward explaining why youth is so protective when it comes to coronavirus risk.”

Miller mentioned how inexpensive hydroxychloroquine is and how long it’s been used safely around the world. 

“Anecdotally, you’ve got all of these providers around the world that have been using hydroxychloroquine,’’ he said. “They are saying this has been saving lives, thousands and thousands of lives. And anecdotally, I’ve had patients who were sick. They got one dose and after the first dose, they were 100 percent better the next day.”

Miller addressed the fact that the Centers for Disease Control (CDC) did not recommend hydroxychloroquine. “I spent quite a bit of time looking at all of the data on hydroxychloroquine,” he said. From what he read, he believes they waited too long before administering hydroxychloroquine to COVID-19 patients, and then gave them very high doses. 

“There was nothing randomized about it,” said Miller. “They waited until these patients were either on ventilators or pre-ventilator, and then they were giving them high doses of hydroxychloroquine. They waited 12 to 14 days into the disease process, until their bodies were completely overwhelmed.” 

CDC data indicates people have a very good chance of surviving COVID-19. Recent news reports indicate: “Two new peer-reviewed studies are showing a sharp drop in mortality among hospitalized COVID-19 patients. The drop is seen in all groups, including older patients and those with underlying conditions, suggesting that physicians are getting better at helping patients survive their illness.’’

“We find that the death rate has gone down substantially,” says Leora Horwitz, a doctor who studies population health at New York University’s Grossman School of Medicine and an author on one of the studies, which looked at thousands of patients from March to August.

The key to this virus is boosting your innate immune system, says Miller. It is early diagnosis and treatment; not sending people home to isolate and hope.

“Wash your hands, take moderate doses of vitamin D and vitamin C, high dose zinc, NAC, and if you are my age or older (48), 1 mg of melatonin twice a day to help boost your innate immune system,” he said. “It’s one of the reasons why children are virtually unaffected by this virus. Their immune system handles this virus very, very well.”