by Judith Curry
A thread devoted to technical topics, e.g. epidemiology, immunology, treatments. A more general thread will be coming shortly.
Gregory Rigano, Stanford University School of Medicine is in the media describing a treatment that appears promising. In France, a peer reviewed study confirmed that the anti malaria drug Hydroxychloroquine was effective as a Coronavirus treatment. Per study by infectious disease expert Didier Raoult, PhD., IHU Méditerranée Infection in Marseille.
Gautret et al. (2020) Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an openlabel non-randomized clinical trial International Journal of
Antimicrobial Agents – In Press 17 March 2020 – DOI : 10.1016/j.ijantimicag.2020.105949
A remarkably effective combination. It cleared the Chinese Wuhan coronavirus COVID-19 in 5 days. See Fig 2 p 24.
Results: Six patients were asymptomatic, 22 had upper respiratory tract infection symptoms and eight had lower respiratory tract infection symptoms. Twenty cases were treated in this study and showed a significant reduction of the viral carriage at D6-post inclusion compared to controls, and much lower average carrying duration than reported of untreated patients in the literature. Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination.
Conclusion: Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin.
How fast could malarial drugs & antibiotics be produced?
Chloroquine drug production is being ramped back up. Teva and Mylan to jumpstart production of old malaria drug to fight the novel coronavirus
You’re in a barnyard full of sick animals with BZZTW disease. 79 of them got very sick, but now appear to be recovering; 20 of them are dead, and 1 of them is still very sick. Desperate, you inject a dose of Trump’s Chloroquine into the sick animal. It lives. What conclusions are likely to be 99.99% correct:
1. the death rate in the herd was 20%
2. Trump’s Chloroquine did not kill the sick animal
3. It was going to live anyway
.01% – you discovered a miracle cure
JCH, your continued political snarkiness to all things COVID-19 is small ball to the extreme. “Trump’s Chloroquin”, really? Regardless, the focus here is hydroxychloroquine, not chloroquine. Will it prove out? I don’t have a clue, but you should hope so. Dr. Didier Raoult is a world renowned infectious disease expert. It’s a promising treatment, nothing more. Its being fast tracked in clinical trial, I hope it proves out.
Studies concluded that hydroxychloroquine was more potent than chloroquine, with a more tolerable safety profile. Preliminary results from a trial suggested that hydroxychloroquine is effective and safe in COVID-19 pneumonia, “improving lung imaging findings, promoting a virus-negative conversion, and shortening the disease course.”
David L. Hagen—It sounds very promising, fingers crossed it truly works to save untold numbers of lives. That aside, the multi trillion dollar hit to global economies is a stomach churning prospect, how it pans out is anyones guess.
Repositioning Chloroquine as Ideal Antiviral Prophylactic against COVID-19-Time is Now
Preprints Chang and Sun 16 March 2020
NY Gov. Cuomo, in his press conference; Hydroxychloroquine and two other drugs will begin trials in NY this coming Tuesday.
COVID-19 cases in USA
The USA has > 33,276 cases; New York State > 15,793 cases; Washington >1,996; New Jersey >1914; California >1,642; on March 22, 2020. See Johns Hopkins COVID19 stats.
Rapid testing will likely reveal far more.
Israel’s Teva has already donated 6 Million doses of hydroxychloroquine sulfate to US hospitals.
Gov. Cuomo announced that New York will begin testing 70,000 Hydroxychloroquine, 10,000 Zithromax, 750,000 Chloroquine on Tuesday March 24th. Should HCQ+Zmax prove effective, then rapidly ramping up production and distribution will enable rapid removal of public self quarantine.
From self isolation the Public to quarantining the Sick & close contacts.
The current public press panic and public self quarantine and economic shutdown is the most expensive means by far of dealing with this pandemic.
Successfully demonstrating effective treatment enables replacing public isolation with the far cheaper quarantine/isolation of actual COVID19 infected cases and close contacts.
The fastest recovery from the Chinese coronavirus will happen when effective medications like Hydroxychloroquine + Azithromycin treatment, and/or Chloroquine as Prophylactic are mass produced at an aggressive warfooting rate.
Coronavirus Treatment – New York
“There is a theory that the drug treatment could be helpful,” Cuomo said. “We have people who are in serious condition and (state Health Commissioner Dr. Howard Zucker) feels comfortable, as well as a number of other health professionals, that in a situation where a person is in dire circumstance, try what you can.”
COVID-19 Post-exposure prophylaxis/Preemptive therapy
Dr. David Boulware at the University of Minnesota is starting a:
COVID-19 Post-exposure prophylaxis
OR preemptive therapy within 4 days of exposure if asymptomatic
OR 4 days of symptom start if symptomatic.
Email email@example.com for details on how to enroll.
Open anywhere in the USA. Canada soon.
See David Boulware
Dr. Oz pieced together a number of anecdotal examples of treatments for COVID-19 using Hydroxychloroquine. It can be prescribed today actually, if a doctor feels it will work, and is safe for their patients; it’s referred to as off-label use in this capacity, but it is available. There are numerous clinical trials underway, including one by NIH, but others around the world.
The preliminary French study was small, 30 total. 20 of the 30 participants in the study received treatment. The subjects included a cross section of disease severity; from no symptom, upper respiratory, and severe lower respiratory. The results showed that while hydroxycholoroquine was effective on its own as a treatment, when combined with azithromycin it was more effective by a significant margin. No deaths.
Vitamin C has been shown through the ages to have anti-viral properties altready being demonstrated in China with success. What is holding efforts back?
It does appear that vitamin C has good efficacy in treating lung sepsis, as evidenced in clinical practice of Drs. Marik and Fowler (U.S.), some European doctors whose names I’ve forgotten, and several Chinese doctors who are embracing this treatment for COVID-19, apparently with good success. Yet, not a peep on the nightly news. It’s simply not on the radar of the mainstream medical establishment: doctors are steered away from vitamins as doing anything but preventing things like scurvy and rickets. Notice that we’re talking a lot about pharmaceuticals for treatment of COVID-19, which is all well-and-good, but it seems to me that we’re ignoring clinical practice ever since Dr. Jungeblut used vitamin C in treating polio around 1935. Since then it’s been used successfully by a handful of mavericks including Drs. Klenner, McCormick, Cathcart, and Riordan, but pretty much anywhere you look you’ll find authoritative statements that it just doesn’t work– and this contradicts the clinical experience of these doctors. Let me repeat: the authoritative statements, the supposed testing (designed to fail?) contradicts clinical experience. More recently Dr. Marik, apparently intrigued by Klenner’s clinical testimony, used vitamin C to treat lung sepsis with remarkable clinical success, and I think his paper on this is part of what sparked renewed interest in the vitamin, with Dr. Fowler confirming clinical practice, and the CITRIS-ALI double-blind placebo controlled study, although small, confirming a significant effect on mortality. The VITAMINS trial completely negated the CITRIS-ALI trial but this trial is controversial, and I view it as an establishment attempt to discredit a cheap, safe, and effective treatment that upsets the pharmaceutical-treatment paradigm that has been taught to doctors since day one of medical school. Vitamin C is a huge threat to that paradigm and to the sale of pharmaceuticals, because if it works, then what? Does that mean that claims of other vitamins, such as vitamin E for heart conditions, might also work? Vitamin D to tamp down inflammation? Would research be steered to look again more closely at vitamins and minerals? Would doctors start looking more to antioxidants in treatments and promoting diet to treat conditions, as many doctors in fact do today (e.g. Caldwell Esselstyn of Cleveland Clinic treating heart disease with a plant-based diet)? Would we look more closely at plant phytochemicals which are remarkably safe, unlike pharmaceuticals which, properly taken, are the fourth leading cause of death in the US? What would that do to sale of pharmaceuticals?
Anyhow, food for thought. Not going to get into this because my views have been expressed elsewhere on Climate Etc. and I don’t think we need to get into another fight over this. I’ll not be monitoring responses so good ahead and get a slug or two in if you want to.
In addition to chloroquine and the hydroxychloroquine, a number of antivirals are already in use in some countries – China and India, I believe. I don’t know how well tested they are.
For example, here is a translated document of Chinese COVID19 response guidelines from two weeks ago: https://www.chinalawtranslate.com/en/coronavirus-treatment-plan-7/
More information on chloroquine and Zinc.
And update from yesterday.
As of this article’s publication (19 March), the WHO reports that the virus has spread to 166 countries, areas and territories, with over 205,000 confirmed cases worldwide and the number of deaths exceeding 8500.
The speed of physics
Physics-based techniques play a huge role in the field of structural biology. The vast majority of biological macromolecule structures are obtained by X-ray crystallography, going back to 1934, when John Desmond Bernal and Dorothy Hodgkin recorded the first X-ray diffraction pattern of a crystallized protein, the digestive enzyme pepsin. William Henry and William Lawrence Bragg, who showed how to use a diffraction pattern to analyse the corresponding crystal structure. Hodgkin went on to win the 1964 Nobel Prize for Chemistry for her determinations by X-ray techniques of the structures of important biochemical substances.
Thanks to cryo-EM, Daniel Wrapp and Nianshuang Wang of the University of Texas at Austin, US, and colleagues were able to obtain the structure of an outer “spike” protein of SARS-CoV-2 that is believed to enable the new virus to weasel its way into host cells. From harvesting the protein to submitting a paper to the journal Science on 10 February, the entire process took just 12 days (10.1126/science.abb2507). “Without cryo-EM,” says the University of Texas’s Jason McLellan, an author on the paper, “it may not have been possible at all.”
A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data by John P.A. Ioannidis.
“John P.A. Ioannidis is professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanford’s Meta-Research Innovation Center.“”
Many people including Ioannidis doesn’t get this. It is not about the deaths. Fatality rate over total infections (including asymptomatic) might be 0.5-1%. Even though a tragedy, particularly in Western aged societies, we can take that (even if it includes me). It is not the end of the world and those most affected are those that already have lived longer.
This is about what it does to your health system when scores of people get seriously sick, scores of people get very seriously sick, and scores of people get critically sick all in a short span of time, including a great deal of health workers.
Unless contained it will raise general mortality from all causes and will deplete all general medical supplies. If you have a car accident you are out of luck, and so on. Do you think flu mortality is high? This is not only in addition to flu mortality, but has the potential to double flu mortality from lack of treatment. Life expectancy is going to go down significantly unless an effective vaccine and/or treatment becomes available.
A modern society doesn’t want and doesn’t expect to function without a functioning health system with people dying from non-lethal problems due to lack of treatment. Coronavirus pandemic will collapse (it’s already collapsing) our health systems.
I finally agree with Mosher on something. This is not about the deaths.
Well, it is both about and not about the deaths.
Deaths in excess (or not) of known statistical baselines confirm whether or not a (lethal) pandemic is upon us. Panicked populations can overwhelm health services in the absence of anything unusual going on. And that is part of the argument that Ioannidis is making:
If we had not known about a new virus out there, and had not checked individuals with PCR tests, the number of total deaths due to “influenza-like illness” would not seem unusual this year. At most, we might have casually noted that flu this season seems to be a bit worse than average. The media coverage would have been less than for an NBA game between the two most indifferent teams.
The data from this source appears for the time being to support that part of Ioannidis’ argument: Mortality monitoring in Europe
On the other hand, I concur with the broader implication of your reply (and if I may quote part of a comment I already left elsewhere): we should have health care systems designed in a way that anticipates the possibility of one day having to deal with a pandemic.
That means that adequately spare capacity should be inherent to the systems, as it currently and obviously is not, since we now recognize the possibility of seeing the current setups and available resources possibly being ‘overwhelmed;’ and also inherent to these forward looking health care systems, there ought to be permanent monitoring capabilities of the kind that Ioannidis argues we can and should have, but that we obviously do not.
In the meantime, there is no evidence that we are in the midst of an actual pandemic calling for the kinds of draconian countermeasures currently being rolled out, countermeasures that may actually be doing more harm than anything in which any actual pandemic might result, at least in so far as is suggested by the actually available evidence pertaining to covid-19.
The upshot of the opinion piece by Ioannidis is, then, that some things need to be done before we do others, and this isn’t happening.
To have effective countermeasures, you need to understand what it is you are dealing with.
But we don’t have that understanding because the means of attaining it have yet to be deployed.
But that’s what we should be doing: deploying the research that would help us grasp how we can effectively deal with any pandemic, rather than reacting in an unprepared, panicked and chaotic fashion, as is now the case.
Javier: It is not about the deaths.
Without the realistic threat of death, there’d be no overload of the health care system. It would be treated like knee scrapes and bruises in football, or paper cuts — or ordinary colds.
I think it is unfair to say “It is not about the deaths.” But it is also important to note the value of slowing the spread.
You’re right, Javier, it’s more about the people who will die from heart attacks, sepsis, trauma, etc. because the hospital beds are occupied by covid19 patients. The problem is not the mortality rate of the virus. The problem is that the other threats to life do not stop.
That there are 10 times or 100 times as many cases as are detected is actually our best hope. But then why did the health care system in Wuhan break down that much even as they imported 10000 or what health care workers from the rest of China and all the quarantine measures?
But I’d love to be positively surprised.
Just not to be misunderstood, these undetected cases are deemed to be more or less unsymtomatic.
I posted that link on a previous thread here, and I wholeheartedly agree with Dr. Ioannidis. He addressed the overwhelming the healthcare argument in the article.
I am not a doctor but I understand exponential growth. This virus has been running free in society for weeks. Assuming an R0 of 2.5, reasonable case generation lifetime and a start date of January 28th, there should be 100s of millions of cases now. On January 28th one estimate came up with 180,000,000 cases by February 21st. We have been conducting this experiment for weeks. We would have to believe that our actions have reduced R0 an incredible amount to not accept that the epidemiological models have failed miserably. How many must die due to the panic before we except that our models are badly flawed.
Meanwhile the great recession increased the suicide rate by about 1.5 per 100,000 each year from 2009 through 2011…that works out to more than 4000 extra deaths per year just due to suicide.
Agreed. And sadly, the manner in which the ‘social distancing’ measures are being enforced to ‘flatten the curve’ will only aggravate that collective distress, in that they are the real proximate causes of all the immediate dislocations in the real economy being directly experienced by ordinary people.
Lives are being wrecked not by this virus, but by the draconian measures being rashly imposed on people everywhere in response to it.
Yes, many of the over 70’s being asked to self isolate are often currently perfectly fit. They will emerge in 4 months time with their physical health severely compromised their mental health in tatters have long term health problems through lack of sun and no doubt many personal relations will be permanently fractured,s as happens during the short Christmas break when everyone is pushed together.
They have had decades of assessing likely risks so older people are perfectly capable of going out in a sensible fashion to exercise, walk the dog, socialise at a suitable distance and use local shops or sit outside cafes, as the biggest crowds are currently in the supermarkets not these other places
Yamin COVID-19 Epidemic Model
There is likely a 0.15% fatality & 50% max infection for COVID-19 using epidemic specialist Israeli Dr. Dan Yamin’s far more accurate epidemic model of Coronavirus / Chinese virus.
‘Trump Is Right About the Coronavirus. The WHO Is Wrong,’ Says Israeli Expert
e.g., Skrip, L.A., Fallah, M.P., Gaffney, S.G., Yaari, R., Yamin, D., Huppert, A., Bawo, L., Nyenswah, T. and Galvani, A.P., 2017. Characterizing risk of Ebola transmission based on frequency and type of case–contact exposures
Characterizing risk of Ebola transmission based on frequency and type of case–contact exposures. Philosophical Transactions of the Royal Society B: Biological Sciences, 372(1721), p.20160301.
Comments from other threads:
“Copper Kills Coronavirus. Why Aren’t Our Surfaces Covered in It?
Civilizations have recognized copper’s antimicrobial properties for centuries. It’s time to bring the material back.”
Fast Company, Mar 16 · 5 min read
View at Medium.com
Might be more prudent to just issue brass wire screen masks. Can’t hurt except maybe people will have green noses for a while. I’d be curious to the residual effects on Covid19 survival in their mucus. Copper does diffuse into a lot of stuff.
Can we still buy brass wire wool easily?
Comments14 | + Follow
I carry a sprayer in my pocket. I spray the door handle before opening and after. Then I spray my hands . I touch nothing. I was raised by hospital educated people and it can be done. It is not perfect but close to it. I have not been sick with the flu, a cold, or any other viri in 30 years. I practice good hygiene. I even have bidets in the 3 bathrooms in my home. I use bleach to spray the toilets. It can be done.
“Civilizations have recognized copper’s antimicrobial properties for centuries. ”
It is probably important to recognise the difference between a microbe and a virus !!
The study found SARS-CoV-2 survives for four hours on copper.
COMMENTS FROM THE WUWT THREAD at https://wattsupwiththat.com/2020/03/17/an-effective-treatment-for-coronavirus-covid-19-has-been-found-in-a-common-anti-malarial-drug/ :
Nicholas McGinley March 18, 2020 at 3:32 pm
Plus, right now in the US hundreds of people and more every day are either in trials or getting compassionate use of remdesivir.
It do not know how many, but it was in the several hundred getting compassionate use in the US alone of remdesivir, and there are a large number of trials in which hundreds of others are getting it as part of a clinical trail protocol.
The news will be coming any time now. Be patient.
Tom Abbott March 19, 2020 at 5:35 am
“The problem could be supply, but as I reported here over a month ago, Gilead has, since January, enlisted several facilities around the world to manufacture remdseivir, and switched one US factory from something else to full time remdesivir production, and another in the US that was idle was activated for purpose and has also been making it 24/7 since January…so hopefully there is plenty.”
Vuk March 18, 2020 at 2:44 pm
If true this could be very good news.
Daily Telegraph: A rapid test for coronavirus which could give a result in just 30 minutes for people at home, has been developed by Oxford University.
The super sensitive test, which can picks up the virus in its very early stages when it might otherwise have been missed, could be rolled out to testing centres within a fortnight and could soon be available for home use.
ian wylie March 18, 2020 at 4:33 pm
Vitamin C (ascorbic Acid) has excellent proven effectiveness vs. viruses and in particular flu viruses. There are dozens of peer-reviewed articles demonstrating this. The most effective doses (around 1000 mg/every 4 hours) are a kind “drug effect” by “armoring” the cells against virus penetration. The high doses are necessary to maintain the blood concentration because the body very effectively eliminates it in the urine. The most effective forms that cause little or no stomach upset are the calcium, magnesium and/or zinc ascorbate forms.
Eliminating solid food and doubling or tripling non-sugar liquid intake (and eliminating white sugar) can and should kill the virus in less than 2 days. I have done this many times with the seasonal flu. It is a strong supplement to the immune system.
And now for something completely different. (Comments are from the Reason magazine site):
lafe.long, March.16.2020 at 3:50 pm
The Protection of Mice against Infection with Air-borne Influenza Virus by Means of Propylene Glycol Vapor.
They have now extended their observations to the effect of propylene glycol vapour on influenza virus. Vapour was employed instead of an aerosol because it has been found that the glycols are much more active in this form, very much smaller amounts being required for effective air sterilization.
Preliminary experiments were made to determine the amount of atomized virus suspension required to produce regular infection of mice followed by extensive lung consolidation and death within 4 to 10 days. Mice were then exposed to this lethal concentration of virus in a chamber into which propylene glycol vapour had been introduced; they regularly failed to contract the infection.
Diane Reynolds (Paul.), March.16.2020 at 4:00 pm
So… vaping protects you from virus infection?
lafe.long, March.16.2020 at 4:12 pm
According to this study, at least for mice, it would appear so.
Thirty-two control mice all died in 6-10 days with extensive lung consolidation, whereas 32 mice exposed in the glycol chamber all remained well and showed normal lungs when killed on the 8th day.
Roger Knights (me), March.16.2020 at 7:48 pm
“So… vaping protects you from virus infection?”
I hope “Are You a Vaper?” gets added to questionnaires given to Covid-19 test-takers and hospitalizations. And that its results indicate a strong prophylactic property. And that the government is then forced to encourage the purchase of e-cigarettes and refills by compensating buyers for their costs. A scene I’d like to see.
Maybe a machine could do the vaporizing, in hospital rooms, say.
Here’s today’s collection of Covid-19 articles from the Reason magazine site:
Health Bureaucrats Botched the Response to Coronavirus. Trump Made It Even Worse.
How broken bureaucracy and poor political leadership combined to botch the rollout of COVID-19 testing.
By Peter Suderman at http://click1.e.reason.com/hcmfdfdrrbnzdcjwzsdhczlbjwzfvndgcbjlblnvffnvw_lgjdkwjwrmjqdndhqzz.html
Are We Battling an Unprecedented Pandemic or Panicking at a Computer-Generated Mirage?
A close look at the new study from Imperial College which models worst-case scenarios and makes the case for social distancing.
By Ronald Bailey at http://click1.e.reason.com/ahtlclczzdbnchrpnycthnvdrpnlmbcwhdrvdvbmllbmt_lgjdkwjwrmjqdndhqzz.html
Don’t Expect Millions To Die From Coronavirus, Says Richard Epstein
The NYU Law professor thinks we’re in for a mess of bad epidemiology, ineffective stimulus, and misguided quarantines.
By Nick Gillespie at http://click1.e.reason.com/bgqznznkkfdyngvqyjncgysfvqyzpdntgfvsfsdpzzdpb_lgjdkwjwrmjqdndhqzz.html
‘The Fear, the Panic, Is a Bigger Problem Than the Virus,’ Says New York’s Governor
The “panic” Andrew Cuomo has in mind is a rational response to the threat of an economically ruinous government overreaction.
By Jacob Sullum at http://click1.e.reason.com/cpdmsmsrrphfscvlfgsjcfkpvlfmthsncpvkpkhtmmhdt_lgjdkwjwrmjqdndhqzz.html
Truckers Are Rushing Supplies to Empty Store Shelves During Coronavirus Crisis. Will Regulators Get Out of the Way?
The churn of new emergency regulatory waivers and restrictions is causing confusion for American manufacturers and freight haulers.
By Christian Britschgi at http://click1.e.reason.com/ivycrcrkkvgwrmpdwbrnmwtvpdwcygrfmvptvtgyccghh_lgjdkwjwrmjqdndhqzz.html
Can Our Shuttered Auto Plants Make Ventilators for Coronavirus Patients? And Will the Government Let Them?
GM’s CEO is offering to help. She shouldn’t wait for the feds to figure out what to do.
By Scott Shackford at http://click1.e.reason.com/bfdznznkkfdyngvqyjncgysfvqyzpdntgfvsfsdpzzdlf_lgjdkwjwrmjqdndhqzz.html
Trump Suggests Anti-Malarial Drug Chloroquine Is an Effective Treatment Against COVID-19
FDA is reportedly cutting red tape to give expanded access to COVID-19 patients.
By Ronald Bailey at http://click1.e.reason.com/xvccycyllhgtyrkbtpyjrtnhkbtcdgymrhknhngdccgvp_lgjdkwjwrmjqdndhqzz.html
“Can Our Shuttered Auto Plants Make Ventilators for Coronavirus Patients? And Will the Government Let Them?”
1500 British manufacturing forms have responded to the UK govts call two weeks ago for them to make ventilators. Drawings and templates are currently being put together and people trained to use them
“1500 British manufacturing forms have responded to the UK govts call two weeks ago for them to make ventilators.”
Thanks. That call should have been made two months ago. Precautionary principle made it a no-brainer.
So, isolate in a test tube full of malaria drugs and you will get well.
Assessment by a Swiss doctor, a very important and factual read:
Not everything is as it appears to be!
I read the article. It is a sobering thought that even 50 years ago the cohort the paper mentions would not have even existed, as normal human frailties would have carried them off long before such an illness as corona virus would have struck them down.
As other reports also show this is essentially an illness of the very old and the very sick, most of which exist in the same cohort.
As regards Italy they are surely almost unique in Europe and perhaps the world, through their of age profile, range of illnesses, heavy smoking, resistance to anti biotics, poor air quality.
They are also a highly tactile people who often live in multi generational buildings or frequently attend multi generational gatherings, where their tactile nature, love of sharing foods and wide age ranges means that the passing over of infections from one group to another is common.
Spain, France and China exhibit many, if not all, of the same characteristics Much of the anglo sphere does not.
Tony, you’re in denial.
Trajectory of the disease has been the same everywhere, until measures are taken to socially isolate.
Whole article in case that graph doesn’t display.
Article link didn’t come through
In what population the outbreak starts can skew the initial death rates, and probably the speed of the spread. A little birdie has told me in Germany the initial community spread was among young party goers. They’re mobile; they do a lot of socializing in close quarters with a lot of different people. So quick initial spread, low death rate.
In China initial transmission was working families, and a lot of those households include elderly parents. So very fast spread at work, then at home: high death rate present from the very start.
Germany and US have a large group of elderly people who live alone, and who have very few visitors. Considered a societal problem. They started out with a quasi isolated elderly: skews initial death rate lower.
If isolation is not rigid and prolonged, the virus will eventually chew its way through the elderly, and the death rates will eventually be less disparate.
I see people breaking isolation and social distancing all over the place. A lot of people are not getting the message.
I am touched by your concern for me. Rest assured I am not especially sociable anyway so social distancing more than normal will not be a problem.
It does of course give me more time for ,me to write article for you to enjoy and learn from.
with sincere best wishes
I too hope you are doing fine.
I always enjoy your comments.
The one above is insightful and reasonable from local knowledge.
This is not the bubonic plague w/o antibiotics.
Seems like much of the panic is concern for future intensive care ventilators. Surge capacity is USA is based on free market agility.
Single payer in Italy and Britain provide a model and example for future analysis of response to crises.
Wishing you the best for shut in California.
Very tall guy. Your graph is singularly uninformative. Using totals on log graph everything just goes up and wiggles. You get nothing from the visualisation. Everything looks the same because it was made the same.
If you say all countries’ totals go up and then level off that’s an absurdly obvious thing to say which informs no one.
Germany has a very similar demographic to Italy but infections and death rate has been much lower. Germans are more rigorous by nature and have a well funded well equipped health service. That MAY be a factor.
S. Korea went up faster and faded out faster. Something to learn?
First of all you need to look at a daily cases to understand the evolution, not muddy everything together in totals.
South Korea COV19 cases dropped from 909/day peak to 64/day – with very high testing, tracking and individual treatment. Far cheaper than massive economic shutdown.
Just finished listening again to Ivor Cummins 2014 Youtube presentation: D is for Debacle-The Crucial Story of Vitamin D and Human Health. In 1 hour 23 minutes he gives you a complete history of its value to the body and shows the medical community has been very reluctant to raise blood levels shown to give optimum health. Within the lecture he explains why we have flu during the winter months. The medical community is very reluctant to raise the recommended supplementation and it is no doubt that older people confined to beds do not get blood Vitamin D levels over 30ng/ml and are the group with the highest death rate.The president should issue a national goal of getting the blood levels above the 30 level as an overall health goal. We will need better health to pay off all the promises. Larry Wilhelmsen
You are the one in denial. This paragraph from the Swiss doctor’s report makes things clear:
“Thus the most important indicator for judging the danger of the disease is not the frequently reported number of positively-tested persons and deaths, but the number of persons actually and unexpectedly developing or dying from pneumonia. This so-called excess mortality has remained very low so far (see below).”
“According to the latest European monitoring report, overall mortality in all countries (including Italy) and in all age groups remains within or even below the normal range so far.”
University of Southampton: “The research also found that if interventions in the country (China) could have been conducted one week, two weeks, or three weeks earlier, cases could have been reduced by 66 percent, 86 percent and 95 percent respectively – significantly limiting the geographical spread of the disease.” https://www.medrxiv.org/content/10.1101/2020.03.03.20029843v3
The proximal origin of SARS-CoV-2: “we do not believe that any type of laboratory-based scenario is plausible.” https://www.nature.com/articles/s41591-020-0820-9
“Our analyses clearly show that SARS-CoV-2 is not a laboratory construct or a purposefully manipulated virus.”
I suppose the claim that it is, will make the rounds.
The claim that it was planned and released is a test.
Self select which camp you’re in.
The suggestion is that SARS-CoV-2 was accidentally released by the BSL-4 in Wuhan, which had an expertise (gained in the US) in “gain-of-function” technology that converted ordinary viruses into superweapons. Such techniques were banned by the CDC in 2013 but lifted in 2017.
A problem with the BSL-4 lab hypothesis is that SARS-CoV-2 does not require that high a level of facility, and lower BSL labs are all over the place.
A strong case that SAR-CoV-2 was lab synthesized
Point by point rebuttal of the Nature claim for natural origins
It isn’t a effective biological weapon for military purposes since those of prime military age tend to shrug it off. What do you suspect the purpose of designing it was, to kill off their aging population?
stevereincarnated: What do you suspect the purpose of designing it was, to kill off their aging population?
Possibly it escaped before the developers judged it ready.
Possibly, but since there are viruses that already exhibit the required lethality and others that are already highly contagious it seems impractical to start from scratch when you could already have one of the desired features built in at the start. I’m going to have to mark the biological weapon hypothesis down as extremely unlikely.
This is total BS.
stevereincarnated: I’m going to have to mark the biological weapon hypothesis down as extremely unlikely.
At this time, every origin story for SARS COV-2 that I have read strikes me as extremely unlikely. But there were many opportunities, even in the open-air wet markets about which there have been at least a decade’s worth of warnings — along with claims that such warnings constitute a species of racism. Given many opportunities, lab-made and natural, unlikely events happen more frequently than most people expect.
Given that the virus has emerged, what are the relative weights of the evidence for and against each proffered explanation?.
As far as I’m concerned the fact that working on the virus as a biological weapon doesn’t make sense to begin with precludes me from wasting a lot of time on it but if you think differently then by all means dig as deep as you want.
I don’t think this virus was deliberately released; but I lean heavily towards it escaping from a lab setting near Wuhan, one that was experimenting with modifying viruses. Is there a common sense argument for how Chinese officials could be suspect enough to discover the virus within weeks of it causing its first casualties?
The Chinese story doesn’t add up because of these considerations. Why would Chinese officials have the situational awareness to suspect, then test for a new virus with so few deaths initially (under 20), especially considering these deaths came from one of the top 5 causes of death, pneumonia, with symptoms virtually indistinguishable from flu; and considering the sampling of deaths came from Wuhan’s population of 19 million. There must be many daily deaths from pneumonia in a population this size, so what was unique to have alerted authorities they were dealing with something new? Nothing. No country can afford to sequence the RNA from every pneumonia patients death just to make sure something new hasn’t arrived on the scene. There was foresight involved in China’s discovery, an expectation — they were looking for it because a lab warned the government it might have leaked from the lab. I need another common sense argument why this is a misguided conclusion besides fate.
This link describes the early chronology of the disease:
“Given what’s known about the pace at which viral genomes mutate, if nCoV had been circulating in humans since significantly before the first case was reported on Dec. 8, the 24 genomes would differ more. Applying ballpark rates of viral evolution, Rambaut estimates that the Adam (or Eve) virus from which all others are descended first appeared no earlier than Oct. 30, 2019, and no later than Nov. 29.”
Maybe a healthier environment will make humans more resistant and healthier? If the root problems are not addressed, any allopathic solutions will only enrich the parts of society involved in the original problem. We are electromagnetic beings. We don’t actually need 5G and we shouldn’t be living in cities.
You’re in denial.
Again, so much is unknown. Can we find any situation and over react? Yes. Can we claim the science is on our side? Yes. Can the executive branch take power and ‘deal’ with a problem? Yes.
Is anything being done a net positive? A few things. But it’s not clear every individual thing being done is a net positive.
> But it’s not clear every individual thing being done is a net positive.
It’s not clear that any individual thing being done is a net negative.
That’s what uncertainty’s about. Saying we should wait until certain to take action is taking an action.
“We will not waver; we will not tire; we will not falter, and we will not fail. Peace and Freedom will prevail.”
Mortality monitoring in Europe
I’ve just seen this paper, which suggests that much of the testing results in false positives.
Interesting. I didn’t find a way to get the paper. But… if the overall incidence is low in the population, the odds that any given positive result is correct is lowered.
In other words, imagine that only 1 person in 10 million had the disease, and you have a false positive rate of 1% and tested 10 million people. You would expect about 100,000 positive results, even though you should only get one.
billbedford, that is bad news:When the infection rate of the close contacts and the sensitivity and specificity of reported results were taken as the point estimates, the positive predictive value of the active screening was only 19.67%, in contrast, the false-positive rate of positive results was 80.33%. The multivariate-probabilistic sensitivity analysis results supported the base-case findings, with a 75% probability for the false-positive rate of positive results over 47%. Conclusions: In the close contacts of COVID-19 patients, nearly half or even more of the ‘asymptomatic infected individuals’ reported in the active nucleic acid test screening might be false positives.
I am sure that it won’t be the last word.
Harm to We The People & Children vs spike of Coronavirus Deaths
Actuary Gail Tverberg challenges readers with the larger perspective of considering the severe harm to most people and our economies and children’s future vs a short term highly publicized pulse of coronavirus deaths. We will all die. Quarantines will likely result in more children being born next year than die this from the Chinese virus. Are the enormous costs of massive quarantines really worth it?
It is easy to overdo COVID-19 quarantines
Easily overlooked issues regarding COVID-19
It Is Easy to Overreact to the Chinese Coronavirus
Beware of “Bad news sells”, and politicians desperately seeking election.
We should be skeptical. I am not saying what should be done. There are trade-offs. Sheltering in place. That’s not how we won WWII.
COVID-19, unlike influenza viruses and the coronaviruses of common colds, uniquely invades the ACE2 receptors of the lungs.
ACE2 is the angiotensin converting enzyme 2.
Angiotensin, as the name implies, is a factor of blood pressure and may be the link between hypertension and diabetes, both risk factors for COVID-19.
COVID-19 is also mentioned to invoke a ‘Cytokine Storm’. Overfilled fat cells are known to invoke a chronic inflammatory response, making them a target for an energized immune system trying to combat COVID-19.
Diabesity ( over-fat, insulin resistant, hyper-insulinemic, diabetic, heart disease, atherosclerosis, et. al. ) as implied by body fat percentage tends to increase with age and the average American ( 25% body fat for males, 32% body fat for females ) is obese and this tends to increase with age:
( https://en.wikipedia.org/wiki/Body_fat_percentage )
The slight decrease for those over 80 may be not a decrease of obesity, but removal of the more obese from the population through increased mortality.
At the risk of personifying the virus, by attacking the combination of elderly and those with metabolic syndrome, COVID-19 appears to target the wealthy developed world with its increased number of elderly and overfed.
Reasonably good news. From Wuhan Center of Virology p. 271. https://www.dropbox.com/s/5c72hbw18u5tam4/cell research.pdf?dl=0
“Our findings reveal that remdesivir and chloroquine are highly effective”. People more knowledgeable than me can comment on the quality of the study.
Chloroquine/hydroxychloroquine might thus be a valuable option to be tested in low-cost antiretroviral combinations, but correct dosages should be used, considering that the study participants should be regularly monitored to prevent retinopathy. Prospective randomised double-blind placebo studies are also needed to assess the contribution of chloroquine/hydroxychloroquine as part of an antiretroviral regimen. According to new in-vitro results, the antiretroviral effects of chloroquine are attributable to the inhibition of viral particle glycosylation.6 These effects appeared to be specific, since the chloroquine concentrations effective in vitro neither affected any other step in HIV-1 replication nor were cytotoxic.6
Vision damage including blindness.
Also, it is suggested some patients develop elongated QT. This is like lawyer junk food. They make billions. Basically, the patients does this odd thing, Shocking really, They up and drop dead.
And, the literature just brim full of highly successful test tube findings. And even rat findings. And then, poof.
Acetaminophen will cause liver damage if you take too much all at once or over time which can lead to death. You can still buy it OTC.
Doing nothing is also highly effective.
@billbedford re “much of the testing results in false positives”, Bayes Theorem and the Coranovirus https://wmbriggs.com/post/29761/
I don’t have time this morning to go through all the posts, so if this a repetition, my apologies:
‘Coronavirus disease 2019: the harms of exaggerated information and non-evidence-based measures’ – John P.A. Ioannidis
Sorry to reply with a non reply but the comment button seems missing.
I have just found a way tease out the effects of social restricitons in Italy which are not apparent in raw data.
Bottom line : doubling time for new cases has gone from 2.2 days to 5 days but it’s still exponential growth.
China is telling them how to actually lock down. They’re also in Iran. Run it on Iran.
CDC should improve and re-issue this report (March 18) showing “deaths (case-fatality percentages)” within each age group for people tested for coronavirus….. to be unbiased and to allay panic.
Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep. ePub: 18 March 2020.
(1) The improved report should clarify whether the reported deaths were deaths actually caused by coronavirus or, instead, were merely “case-fatalities” . . . (people who were tested positive for coronavirus and then died, possibly of other causes), similar to the reporting for Italy:
https://swprs.org/a-swiss-doctor-on-covid-19/ (and thank you, James, for posting this link, which pointed out that reporting problem)
(2) The bias in the sample of cases should be emphasized …. .this was not a sample of healthy people exposed to virus, but rather of sick people given the limited-availability tests.
(3) The rate of false-positive results for the test should be mentioned…. it may be so high that testing a lot of already sick and dying people might falsely identify enough corona cases to create an apparent epidemic.
(4) The omitted data should be shown.
“Cases among persons repatriated to the United States from Wuhan, China and from Japan (including patients repatriated from cruise ships) were excluded. ” Why excluded? These cases would likely be for healthier people who had been exposed and then tested positive… so these excluded cases are more relevant for assessing the risk to the general population.
(5) The missing data should be obtained…. no excuse.
CDC should follow up on cases to complete the missing data, and then re-do the analysis. Surely, surely the USA can afford the money to obtain the essential data for enough cases to do a proper analysis…. before they crash the whole economic system in response to biased results from (deliberately) inadequate data. (Hmmm… sorta reminds me of climate science, missing any effort to fund a proper hypothesis test for CO2 — same tactic of avoiding the proper analysis.)
(6) The hospitalization and death rates (case-fatality percentages) by age group should be compared to same/matched samples for the common seasonal flu, also by age group. The CDC has the data available to do this, and this matched comparison to common flu is what is needed to dispel the panic. This information is needed immediately.
Pingback: CDC Report on Coronavirus Death Rate – ScienceReview
The Global Health Security Index, a report from the Nuclear Threat Initiative, the Johns Hopkins Center for Health Security and the Economist Intelligence Unit released in October 2019.
The 195-country study finds national health security to be “fundamentally weak” around the world. No nation is fully prepared to handle an epidemic or pandemic, it says.
Which countries are best prepared?
The report uses public information to assess each country’s ability to prevent, detect and respond to health emergencies. The index measures countries’ capabilities from 0-100, with 100 representing the highest level of preparedness.
The Countries Best Prepared To Deal With A Pandemic
How countries around the world rank when it comes to dealing with a pandemic
On this scale, the US is the “most prepared” nation (scoring 83.5), with the UK (77.9), the Netherlands (75.6), Australia (75.5) and Canada (75.3) behind it. Thailand and South Korea are the only countries outside of the West that rank in this category.
What needs to be done?
Collectively, international preparedness is “very weak.” The index’s average overall score is 40.2, which rises to 51.9 for high-income countries – a situation the report describes as alarming.
So what can be done? The report emphasizes that health security is a collective responsibility.
It recommends governments commit to action to address health security risks, that every country’s health security capacity should be measured regularly and transparently, and that the international community works together to tackle biological threats, with a focus on financing and emergency response.
This kind of action will become even more necessary. The number and diversity of epidemic events has increased over the past 30 years, according to the World Economic Forum’s Global Health Security: Epidemics Readiness Accelerator.
The trend is expected to intensify. As globalization brings increasing trade, travel and population density, and as problems such as deforestation and climate change grow, we enter a new era in the risk of epidemic events, it says.
Stronger, unified responses to these threats – such as that displayed by the Coalition for Epidemic Preparedness Innovations when it moved to rapidly form partnerships to develop a vaccine for the novel coronavirus – will be of vital importance.
Hello, in the last few weeks I have been trying to find studies who could help against the coronavirus SARS-COV-2 infaction, and I think I might have noticed something promising, so I’m writing here my proposal for prevention of Covid-19 and possibly a treatment, to be tested:
Zinc Ascorbate proposed against Covid-19
Author: Valentino Cingolani
23/03/2020, Recanati, Italy
1. the combination of zinc ions and zinc ionophores at low concentrations inhibit the replication of SARS-COV in cell culture, via inhibition of elongation of RNA-dependent RNA polymerase and reduction of RNA template binding ;
2. in zinc ascorbate, ascorbic acid enhances zinc absorption into cells ;
Here I propose that zinc ascorbate supplementation could be effective in the prevention and cure of SARS-COV-2 infection and Covid-19 disease.
Zinc ascorbate supplementation is already used in diabetes and glycemic control in humans.
It is proposed that zinc ascorbate should be tested both in-vitro and in-vivo against SARS-COV-2.
Also, zinc ascorbate supplementation, given the high feasibility of a clinical trial and the potential immense benefit to people, should be tested as soon as possible, for the possibility of prevention and cure of Covid-19 disease.
 Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture – Aartjan J. W. te Velthuis 2011, PLoS Pathog https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1001176
 Zinc-chelated Vitamin C Stimulates Adipogenesis of 3T3-L1 Cells – C. Ghosh 2013, Asian-Australas J Anim Sci https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093222/
My proposal is available at https://drive.google.com/file/d/1x0DVGz303NiFmjy8hwDoA6SGht1NNAIG/view
(As I don’t have time to browse through this thread this morning, my apologies if this is a repetition)
Deserving of attention, because it speaks to the actual lack of specificity of the Drostens test for Covid-19:
Drostens test detects SARS-like viruses, that preexisted worldwide before Wuhan.
“These virus-positive samples stemmed from European rhinolophid bats. Detection of these phylogenetic outliers within the SARS-related CoV clade suggests that all Asian viruses are likely to be detected. “
(Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR)
Drostens test detects SARS-like viruses, that preexisted worldwide before Wuhan.
“These virus-positive samples stemmed from European rhinolophid bats. Detection of these phylogenetic outliers within the SARS-related CoV clade suggests that all Asian viruses are likely to be detected. “
(Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR)
The upshot? If you’re actually testing for something already widespread throughout the population, the so-called ‘pandemic’ is an artifact of the testing. It’s not the ‘virus’ that’s novel and propagating, but your test and its (consequently misleading) results.
These bat viruses are well known. SARS-CoV-2 which causes COVID19 is novel – in other words, it has never been in humans before. Genetic analysis shows that the necessary mutation took place near November 2019.
Right. And you know this how, exactly?
Impact of international travel and border control measures on the global spread of the novel 2019 coronavirus outbreak
antonk2, thank you for the link.
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