SARS-CoV-2; CoVID-19; Coronavirus; Updates and Information

zeio said:

The Swedes want to embrace an evidence-based approach and past evidence for herd immunity is...

https://www.jacksonville.com/opinion/20200202/herd-immunity-is-key-to-preventing-infections


Anger in Sweden as elderly pay price for coronavirus strategy
https://www.theguardian.com/world/2...as-elderly-pay-price-for-coronavirus-strategy

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We will see where everyone ends up in a year. The thing is that you can't lock down the economy forever if you are a functioning democracy. The Swedes admit that it hit a few of their nursing homes and their nursing homes are larger than those in say Norway. But unless there is a major drop in the disease's virulence due to seasonal variation by summer, all you are doing is buying some people a couple of months. But people will continue to pile on the Swedes despite their death rates when all is said and done not being that bad and better than Switzerland and comparable though not better than Denmark.

BTW, all the broader sampling points to this being more similar in virulence to a seasonal flu. The Jacksonville physician is using the 3% number which is his prerogative. But most such high estimates are a result of not testing enough people or using statistics that only measure its impact on the serious cases or the elderly/high risk population. What is becoming plausible is that a lot of the contagion is being done by people who are visiting hospitals or people who are working at hospitals.

There is a precedent and warning from a very well documented previous event. Spanish Flu epidemic in Denver Colorado, 1918. The situation was virtually identical to present and they were hit by a massive second wave that killed as many people as the first wave.

Another thing worth mentioning is that a single focus on the binary choice of surviving vs dying ignores that some survivors are permanently damaged. Many will have permanently reduced lung function, some will have viral-induced heart damage that will later in life manifest as heart failure, and (engrave this prediction in stone) survivors are going to have significantly elevated incidence of chronic kidney disease down the road.

Baal said:

There is a precedent and warning from a very well documented previous event. Spanish Flu epidemic in Denver Colorado, 1918. The situation was virtually identical to present and they were hit by a massive second wave that killed as many people as the first wave.

Another thing worth mentioning is that a single focus on the binary choice of surviving vs dying ignores that some survivors are permanently damaged. Many will have permanently reduced lung function, some will have viral-induced heart damage that will later in life manifest as heart failure, and (engrave this prediction in stone) survivors are going to have significantly elevated incidence of chronic kidney disease down the road.

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All these things happen with the flu as well. So your predictions are entirely reasonable, and hopefully within that range and not distinctively serious.

You know the world is in deep *bleep* when even the well-mannered Japanese stop queuing.

Costco in Japan
https://twitter.com/ronken04/status/1250678894270660608

NextLevel said:

Most people are doing well it seems on Chloroquine and zinc combinations. Yet in the FDA driven world, there are zero trials. It makes me wonder whether the combo has something not going for it.

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I personally await a proper study, one that doesn't have to be retracted by the publishers of the journal. Be careful who you listen to.

The biggest proponent of chloroquine and HOCQ once owned a multi-level-marketing company (pyramid scheme) that sold "personalized" vitamin supplements based on the results of a urine test. This test was claimed to provide “a scientific window into your personal biochemistry.” The company hired a network of low- to middle-income salespeople who earned a commission from vitamin sales and from recruiting other salespeople --classic hallmarks of a pyramid scheme. These salespeople were charged thousands of dollars up front to get access to marketing materials and other “network benefits.” Nearly all those people lost their money.

Specifying massage parlors, tattoo studios, gyms and hair salons as businesses allowed to open on Monday in an area where cases are still increasing is a good example of the kind of decision people make when they listen to the wrong people.

Baal said:

I personally await a proper study, one that doesn't have to be retracted by the publishers of the journal. Be careful who you listen to.

The biggest proponent of chloroquine and HOCQ once owned a multi-level-marketing company (pyramid scheme) that sold "personalized" vitamin supplements based on the results of a urine test. This test was claimed to provide “a scientific window into your personal biochemistry.” The company hired a network of low- to middle-income salespeople who earned a commission from vitamin sales and from recruiting other salespeople --classic hallmarks of a pyramid scheme. These salespeople were charged thousands of dollars up front to get access to marketing materials and other “network benefits.” Nearly all those people lost their money.

Specifying massage parlors, tattoo studios, gyms and hair salons as businesses allowed to open on Monday in an area where cases are still increasing is a good example of the kind of decision people make when they listen to the wrong people.

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Makes sense. I will admit it is hard for me to be patient. A lot of testimonials from multiple countries about the importance of taking zinc with hydroxychloroquine. Yet no one seems to be studying that particular combination. I get that in a situation where a disease can resolve on its own, it is hard to tell cause and effect from placebo. Hopefully one of the trials will come through.

Do you know of any trial studying the hydroxycholoroquine and Zinc combination, Baal?

No I don't see one. I am however taking a Zn supplement (small dose though). I don't want to be deficient. There is a rationale based on its ability to lessen duration of common colds, which use a somewhat similar replicase but which are most of the time not due to coronaviruses.

The only rationale for the Zn-CQ combination is a single in vitro study. And the authors, if I recall correctly, suggested that chloroquine by itself functions as an ionophore (some antibiotics kill bacteria by forming ion-permeable pores in their membrane). However given the structure and MW of chloroquine I personally find it very unlikely that is acting that way. It would be far more likely that CQ increases the surface abundance of Zn-permeable channels or transporters by preventing their degradation in lysosomes. (My lab has seen that chloroquine increases surface abundance of some cation-permeable channels in cells, this was about a year before SARS-Cov-2 had been discovered, and there is nothing about that which was particularly exciting or novel). More Zn in cells could block the RNA replicase. That would be good. There are other ways chloroquine could be working to affect the virus. And it may not be working in people, as opposed to cultured cells.

The thing about the combination is that clinical trials are hard to run and very expensive (just getting the patients and randomizing them is hard), and a combination therapy study is even harder to design properly, since one would be guessing entirely about how much Zn. I suspect most clinicians would say that the rationale for the combination, a single in vitro paper unless I am missing something, is not sufficient. I glanced at it briefly several weeks ago. It seemed ok but I didn't read it with a particularly critical eye.

So all that to say right now pretty much everything about CQ, with or without Zn is up in the air. Hopefully we will know more soon. I keep saying that. But it's how it is. Same with remdesivir. It is definitely hard to be patient. I share that frustration!!

Here is another retrospective study from patients in VA hospitals (which are good for this kind of study because of their electronic patient record are convenient for researchers.. Thry found no benefit from oh-chloroquine with or without azithromycin, and patients receiving oh-chloroquine were more likely to die.. This is the second one of these that I've seen that reaches this conclusion. Again, not an ideal design.

Actually, their conclusion was pretty mild, they say that their results show dangers of widespread adoption of those drugs for Covid-19 in the absence of more definitive clinical trials.

https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf

Baal said:

Here is another retrospective pseudo-ramdomized study from patients in VA hospitals (which are good for this kind of study because of their electronic patient recordscsre con lenient for researchers.. Thry found no benefit from chloroquine with or without azithromycin. This is the second one of these that I've seen that reaches this conclusion.

https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf

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I love this part - sounds like they agree with you 100%:

"These findings highlight the importance of awaiting the results ofongoing prospective, randomized, controlled studies before widespread adoption of these drugs."

The lack of Zinc is a bummer tho...

Yes, in fact that was really their only conclusion, even though their data hint that chloroquine could be making things worse. .

It looks as though trials for a vaccine are taking place. They are asking for volunteers in Bristol.

https://covid19vaccinetrial.co.uk/participate-trial-bristol

Setting up any new clinical trials of hydroxychloroquine might be difficult now based on existing data. These have to be approved by what in the US are called institutional review boards. IRBs need to ensure that as much as possible research on human subjects will do no harm and that the rationale and potential benefits are sufficient relative to risk. The existing data from retrospective studies would at this time make that a very hard sell. ( Having done it before, I can attest that IRB review is very thorough). Existing studies will also be very watchful in case they need to terminate early. We might not even be discussing this except for bizarre political and media factors I will not elaborate on.

There are other drugs that to me seem more promising.

I am especially looking to see results for something called APN01. Also more on remdesivir.

Baal said:

Setting up any new clinical trials of hydroxychloroquine might be difficult now based on existing data. These have to be approved by what in the US are called institutional review boards. IRBs need to ensure that as much as possible research on human subjects will do no harm and that the rationale and potential benefits are sufficient relative to risk. The existing data from retrospective studies would at this time make that a very hard sell. ( Having done it before, I can attest that IRB review is very thorough). Existing studies will also be very watchful in case they need to terminate early. We might not even be discussing this except for bizarre political and media factors I will not elaborate on.

There are other drugs that to me seem more promising.

I am especially looking to see results for something called APN01. Also more on remdesivir.

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But can't they just use another drug to enable zinc to enter the cell? Something safer? We don't have to get too complicated if we know zinc works.

Increasing Zn2+ in cells would be potentially useful but we don't have a way to do it. Zinc dynamics in cells turn out to be really complicated. There are the following proteins that carry Zn into cells:ZnT-1, ZnT-5, ZnT-6, ZnT-7, ZnT-9, Zip1, Zip6, Zip7, Zip14, and TRPC6. There are also numerous Zn buffers such metallothionein-I and -II and it is found at higher concentrations in some compartments than others (such as in lysosomes), which suggests that drugs like chloroquine are likekly to increase cytosolic Zn by de-acidifying lysosomes.

Sodium pyrathione can function as a Zn ionophore in cultured cells. It is used as an ingredient in dandruff shampoos and it has anti-fungal activity but in terms of use in vivo there would be concerns about neurotoxicity among other things.

The community spreading in Santa Clara is quite a mess. The county reported that autopsy sample from a person died at home on Feb 6 was COVID-19 positive.
https://www.sccgov.org/sites/covid19/Pages/press-release-04-21-20-early.aspx


A COVID antibody tests said the population prevalence of COVID-19 in Santa Clara ranged from 2.49% (95CI 1.80-3.17%) to 4.16% (2.58-5.70%). These prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April.
https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1


From nextstrain, only 2 sequencing results were reported from Santa Clara, collected in late Feb and downstream of Washington community transmission chain. Basically the community spreading just happened and there was not much we can tell when and how it happened

rainneverever said:

The community spreading in Santa Clara is quite a mess. The county reported that autopsy sample from a person died at home on Feb 6 was COVID-19 positive.
https://www.sccgov.org/sites/covid19/Pages/press-release-04-21-20-early.aspx


A COVID antibody tests said the population prevalence of COVID-19 in Santa Clara ranged from 2.49% (95CI 1.80-3.17%) to 4.16% (2.58-5.70%). These prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April.
https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1


From nextstrain, only 2 sequencing results were reported from Santa Clara, collected in late Feb and downstream of Washington community transmission chain. Basically the community spreading just happened and there was not much we can tell when and how it happened

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Somehow we have very low infected cases ... probably due to limited testing capability.

https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx

This is in response to a thread over at MyTT where one of the notable virus skeptics suggested he wanted to move to Georgia so he could play again. In case there are people here who share similar thoughts, I figured I would post the following considerations here:

1. Odds of being infected by someone depends on how far you are away from them and ALSO how long a time you spend there. It also depends on how much of the virus someone near you might be spreading, which is obviously something you can't know and can't ascertain in any way. A recent paper in Nature Medicine shows peak contagioysness can occur before someone shows ANY symptoms. There are many "silent spreaders".

2. How sick you get may depend in part on the initial virus "dose" you get, which determines the number of cells that are infected, which affects the likelihood that the immune system wins or loses. Points 1 and 2 are why there are indications that healthcare workers on average appear to be getting more severe illness.

3. Coronaviruses enter the air (as an aerosol) and float around for quite a long time. A person doesn't need to cough or sneeze, although those things probably expel more virus. They just need to breathe (and see points 1 and 2).

4. You can be infected through your eyes. The virus can adhere to the moist surface of your eyes and get washed from there to your nose (the upper respiratory tract) via a drainage canal into an area that is rich in the ACE-2 protein that is the receptor for the virus.

5. There is the issue of the ball too.

6. The virus is unpredictable. Young fit people are succumbing to it, clearly not at the same rate as older people but nevertheless it happens. This thing can cause weird effects not seen earlier, like small blood clots that result in (a) strokes and (b) "silent" hypoxemias where blood O2 levels get very low even though the lungs seem to be ventilating ok, and other things too.

7. With experience hospitals are getting better at dealing with this (they know more about not making things worse and they know more about dangerous things to be watching for). But there are NO proven therapies as of today.

Ditto the points above about proning and initial load. I am interested because I am in the high risk group.
However I can't do anything about the medical aspects because that is not my field of expertise. Numbers are. However, the numbers are but the report numbers always seem to be disputed by someone because of poor record keeping, testing and categorizing.

Personally, I am an alarmist because I am in a high risk group. As a business owner I want to see things get back to normal. I have been watching the data on various CCP virus dashboards. I still think that number of future deaths is underestimated if you look at the death/(death+recovered) ratio then multiply that by the number of active cases. I do agree that the recovered number may be too low due to lack of testing. Some of those active case might be removed and put into the recovered column if there was testing for them.

I still think it is obvious that Dr Fauci has under estimated the death toll, due to the CCP virus, in the US. I am hoping my estimates are too high but I still think we will get to 100,000 deaths in the US or more. The number of deaths is still going up at a pretty good rate.

The business shut downs are killing businesses. Not mine, but if they kill enough business then mine will suffer too eventually. A more rational approach needs to be taken.

I am convinced that the decisions must be made at a local level, not state or country level. For instance my county has suffer 15 deaths in the last 3 months due to the CCP virus. My county has about 3600 deaths per year from all causes. If the death rate goes up significantly then there is a problem and it is probably due to the CCP virus. In a remote county a car accident can cause a significant increase in deaths. 1 CCP virus death would be lost in the noise. I think if the death rate doesn't increase much then businesses should open but people should wear masks if not able to keep the 6 ft distance.
My company is still open and we manage with precautions.

On the flip side, the New York Times has reported that the death rate in NYC has doubled. NYC has a problem and should be closed but there are remote places in New York state that could open with precautions.

Looking at rates of change in the death rate doesn't care about who has anti-bodies, who is tested, or how deaths are categorized. It will indicate something new is happening and how severe the problem is.

The one solution fits all will not work.

https://theconversation.com/blood-s...conventional-means-might-be-protective-136592

People continue to talk around the fact that metabolic issues especially those that have gotten worse with age are the #1 risk factor for having a serious case of this disease. I suspect that this is what drives the majority of the cases when younger people fall sick. But the whole processed food industry is built around sugar and processed foods. Cheap food is easy to store and sell.


The thing is that you can reduce your blood sugar and improve your risk factors in a matter of weeks. But people just don't talk about it. Not everyone will listen but some people will.