#coronavirus Wuhan Coronavirus Guest Post Four

Guest post by Rud Istvan,

I have been following this closely for a number of previously explained reasons, while mostly self-isolating with my significant other in South Florida (groceries once a week0. This post updates global WUWT readers with new facts and maybe new ‘knowledge’, some for sure now as controversial as climate change stuff. Incorporates all past facts, plus some important stuff buried in previous comments to other’s related posts. There are a number of separate fact categories itemized below.

Post 1 explained my ‘qualifications’, explained virion shed via a lot of basic virology 101, and concluded a US pandemic was unlikely thanks to effective quarantine, unlike flu—WRONG.

Post 2 explained why #1 was wrong—conclusive proof of pre-symptomatic/asymptomatic ‘spreaders’, completely unlike SARS 2003 where there was NO asymptomatic spread and the peak virion shed was 4 days after symptoms appeared. Unlike SARS, there is no way for a CoViD-19 symptom (fever>100.4) test at borders to contain infection. Very Bad News.

Post 3 analyzed the two most hopeful therapeutics, including my Remdeisvir adenosine drug analog RNA nucleic alphabet ‘A’ brain cramp—each of those ‘alphabets’ is only 4 letters. RNA ACTU, DNA ACTG. Adenosine is “A” in both. Not the exactly 20 amino acids that build all proteins in all of life based on their four alphabet coding. Each RNA/DNA ‘ three letter word’ codes for a single ‘amino acid’ to build onto the eventual protein —the complexity comes with newly discovered non ‘coding’ DNA epigenetics (regulating gene expression frequency). See my illustrated musings on MesoAmerican dried beans over at Judith Curry’s Climate Etc some years ago if you want to ‘view’ the current roughly understood state of epigenetic ‘knowledge’.

Comments to other’s previous posts are also redeveloped here, using two continually revised related math models of fatalities, making them easier to find. The issues that new data shed insight on are: infectivity attack rate (seasonality?), asymptomatic infectives, mild/hospitalizations, S/C hospital ratio, number of C dying, and intervention efficacy. We deal with each changing factor in turn.

Attack rate

We previously derived a projected Korean viral attack rate (AR) of about 2.6% and a related projected case fatality rate (CFR) of about 2.0% with extreme contact tracing, massive testing, and a capable (un-overwhelmed) medical system. Now stable tested Korean attack rate is still 2.6%. and the resulting CFR is now 1.9%, and projecting forward will settle finally at ~1.7%. The final viral attack rate CFR in US is unknown, except that it must still be much worse than Korea now. Lets compare that to known common flu in US at about 0.1% CFR after variably effective seasonal vaccines. >10x Not Good.

This AR depends on R0. Which we do not know, because depends on how we societally ‘bend the curve’. Initial US valid estimates were 2.6-3.0. Very bad. Now, much less for sure but by how much we dunno because of ‘bend the curve’ measures that for sure temporarily also kill the economy.

But lets assemble and project some simple ‘math’ outcome models, previously derived only in comments. We know from their extensive Korea testing data (then about 39600k then to find about 9.6K then positives as of last weekend) that the Korean AR is about 2.6%. We also know now from Korea that the asymptomatic/total is about 20% AFTER 14 day positive test quarantine. Those are potential “Typhoid Mary’s”, which make the pandemic difficult to control absent an effective vaccine, still probably at least 18 months away. Two potential vaccines in US have now started initial human phase one trials.

And from NYC/NOLA last week we know that hospitalized ((serious~=oxygen/critical=~ICU and probably a ventilator) is about 0.12, while the hospitalized/critical ratio is about 0.3. The most recent figures this past Friday as opposed to last Friday, 0.14 and 0.26 — giving about the same end fatality result via more hospitalizations for supplemental oxygen but a bit less deaths in the ICU. And per a NOLA critical care pulmonologist, about 50% of ventilated ICU criticals eventually die. It was anecdotaly higher (~80%) in Wuhan. So the end fully diagnosed (by testing) US math plus Korean CFR will land somewhere between 1.7% and 1.9% based on current data.

That is real bad, as the US Surgeon General said earlier this week (4/5/20). Attack rate >2.6% * about 327.2 million legal US citizens (dunno illegals) * optimistic 1.7% CFR implies 145,000 deaths in next few months. The president is not exaggerating, as some conservative blogs have implied.

There is a second way to derive this death estimate without CFR. Asymptomatics 0.8. Hospitailzation of symptomatics 0.14 (this past Friday). Criticals of hospitalized 0.26 (this past Friday). Deaths among criticals 0.5 (could be higher). Then:

327000*0.026*0.8*0.14*0.26*0.5= 124 thousand deaths next few months.

Now overload the ICU (>0.26 spike), and/or increase the viral attack rate because US is NOT Korea with strict contact tracing and testing, and Dr. Fauci’s recent horrible projected worst case 240K deaths is plausible.

Viral Load

We know generally that infectivity depends on the viral load ingested. We do not know what that load is per unit time to symptoms.

When a person becomes originally infected, it could be from a single virion per day or from (say) a titer of 1000 per day. If the one virion infects a cell and eventually creates 10 viables (previous comment post RNA transcription error example) then it takes 1E3 replication times (whatever those are) to equal the other initial infection viral titer. Immune system has 1000x more time to respond to a minimal infection titer than to a high initial titer. That compounds if exposure happens equally each day, like in a hospital. Fully explains observational clinical asymptomatics, plus a mean incubation of 5.1 days and a 97.5% symptom display of 11.5 days.

If the initial viral load is E+3 in ‘one’ dose (an un-self-distanced cough), then in the same dimensionless time example the immune system has to respond in a E-3 time frame but cannot. Voila, fast symptomatic infection.

Seasonality

Dr. Fauci now says probably. I still say probably not, for reasons explained previously in guest posts and comments to others. Facts/logic before assumptions follow.

Fact: Common colds are still common in summer (albeit less common than in winter thanks to winter contact proximity); summer flu is almost non-existent.

Reason is simply explained by differential route of infection (See previous posts and comments, not worth explaining in detail yet again). In short, flu aerosols dry in dry winter indoor air, so remain circulating longer, so the main route of transmission is infected aspirate inhalation. In humid summers they remain wet, so heavy, so sink, so are not inhaled. Fu becomes winter seasonal. Colds are different, (including all three types: rhino, corona, adeno), because their main transmission route is contact (hands/face), so much less seasonal. Seasonal flu/cold data is incontrovertible.

Fauci thinks Wuhan virus may be seasonal– flu aerosol spread assumptions– based on ‘new’ science observations. I think not based on historic facts. An artificially high virus titer from his nebulizer experiment by NIH ALSO found a virus half life (not like nuclear, just remaining RNA independent of possible infectivity) of Wuhan (just remaining RNA found, not infective envelope found) of about 1.5 hours in air, 3.5 hours on cardboard, 5.5 hours on steel, and about 6.8 hours on plastic. Now, since the infective minimum viral titer is not yet known, this is all speculative. But strongly suggests low aerosol spread and much more close contact viral transmissivity, implying without much seasonality. Translation, social distancing and frequent hand washing works, DIY masks don’t.

And previous media reports on this same experiment of 3 days max viability on plastic did NOT cite the viral half life factors above bearing on minimum infectious titer, so overstate the unknown contact residual viral titer infection scare (heck, me too) (hand washing and face touching at 6 hours half life still says real important). All good for social distancing and frequent hand washing to ‘bend the curve’.

Second cited evidence, the WA massive spreader church choir event. Except, my late Dad was in a much smaller such church choir. They greeted each other weekly with hugs and handshakes. Aerosols not needed. Just usual church choir enthusiasm. Discounted ‘science’.

Basic observational Fauci seasonality

The common cold is caused by about ~100 naked rhinovirus serotypes (abut 75% of common colds), exactly four enveloped humanized coronaviruses (about 20%) and about 20 of about 60 enveloped DNA adenoviruses, of which about 20 (~5% infectivity because of immunity against DNA mutation) cause common cold symptoms. The other ~40 adeno serotypes are much worse (e.g. various forms of conjunctivitis).

There is no evidence that the common cold (4 coronas included) is seasonal. It is more common in winter simply because people are in more confined spaces so there is more contact transmission. Summer colds are common. Summer flu is rare.

So Dr. Fauci speculates a case based on flu analog aerosols, when his own epidemiological mask message says the opposite, as does the data on common cold coronas. He is publicizing a dubious message based mostly on tenuous non-observational science. We have seen that before in climate ‘science’.

This corona virus is unlikely to be seasonal, because its main route of transmission is not aspirate aerosols, just like other corona common colds.

Mask efficacy.

There is much present internet nonsense about face masks. Lets clarify. IF Wuhan coronavirus is spread by breath aerosols and therefore seasonal (defined as less than 5 micron droplets) (doubtful biologically, see above), then N95 will by definition intercept 95% (their definition is <=0.3 micron 95% stopped), and likely drop the viral load below infectivity. All else will not.

So IF Covid-19 is actually seasonal, then everything else except N95 masks is USELESS. So then why the new public home made cloth mask recommendations? Like climate change renewable deals, makes you feel good while being practically useless.

Now IF the route is cough sneeze, not aspirate aerosol, then nose/mouth coverings make sense—for the infected only. And the advice already is, if you have symptoms, stay home and self isolate. So either way the public face mask recommendations are mostly ‘feel good’ rather than effective

Interventional efficacy

There is much new data.

First is the viral attack rate. This number is not a constant. It depends on many other societal measures like contact tracing, testing, and social distancing: ‘bend the curve’ stuff. Korea is down to 2.6%. US must be worse despite current efforts.

The second and third factors are what happens to those identified as infected/hospitalized/criticals. There, we have real time updated data. To a first approximation last week based on NY and NOLA, we had the following: (.12*0.3*0.5)

This week we had on the same data basis 14% of cases would become serious/critical (s/c, serious defined as needing supplemental hospital oxygen, times 0.26 critical defined as ICU (ventilator)). Half of those in ICU die. Run the alternative last week /this week math math per 10000 infected, is 0.12*0.3*0.5 or 180 deaths per 10000 symptomatic. Or, 0.14*0.26*0.5 = 182 deaths per 1000. Close into the zone of Korea actuals noted above–Rough closure is a good enough approximation.

Therapeutics

On the HCQ/Z pac/Zinc ‘Trump cocktail,’ the Orthodox Jewish doctor’s successful NY treatment of his 699 patients has now explained his thinking and gives an alternative therapeutic pathway. X-pak antibiotic is only for opportunistic bacterial infections. His supplemental zinc enhances a possible secondary HCQ mechanism of action. I previously posted that the first was via the same liposomal enhanced pH mechanism as it’s use in RA, deforming the ACE2 receptor.

There may be a second. HCQ is a zinc ionophore—extra zinc into the intracellular metabolism inhibits RNA viral reproduction. Dunno for sure, but a cursory review of the medical literature says his idea is very plausible.

HCQ is also zinc ionophore for sure. Extra zinc transported into a cell’s interior is a known RNA Polymerase inhibitor (common colds). So, the azithromax antibiotic in the “Trump cocktail’ may be a secondary bacterial against Wuhan, and the doctor’s extra zinc loading is a primary agent. Maybe.

Now, why this is important is that there are two other known non prescription zinc ionophores, EGC in green tea extract, and the flavonoid quercetin in gingko biloba extract (both are in varying degrees in both, and in many other greens plus apples). Both are proven cellular zinc ionophores. So there may be OTC treatments cheaper than generic hydroxychloroquine for treating WuFlu.

Dunno. Do know green tea is good no matter what. Salud.

187 thoughts on “#coronavirus Wuhan Coronavirus Guest Post Four

  1. I asked this question on one of the other Chi-Com Flu articles, and I will ask it again here. It may be nothing or it may be significant. I am not an MD or a Pharmacist.

    It just occurred to me that, like every other Vietnam war veteran, I spent a YEAR taking the anti-malaria medication QUININE…actually for a little over a year. Is it possible that taking it has provided some level of immunity to this dreaded pandemic?

    • Two thoughts.

      First, probably not, as any ‘immunity’ eventually ‘wears off’ unless the disease itself ‘dies out’ (smallpox). Why if you hurt yourself on a farm you get a tetanus shot every 5 years (been there, done that, much more than once).

      Second, it is not clear that the early antimalarial quinine works on Wuhan the same as chloroquine, which may have two separate mechanisms of action: liposomal elevated pH, and zinc ionosphore.

    • Salute!

      Thanks, TEWS, I, too, have been hoping that was the case. From what I have read on other sites, seems the half-life for the protection isn’t long enuf for us.

      A second point that you can back up is we had millions of GI’s taking that damn pill once a week over a ten year period, but I’ll be damned if I saw or heard or read about folks having all kindsa side effects than an upset stomach. Willis can back us up on that, as we were told to take the pill with a decent meal. The dispenser was on the entry door at the mess hall. At the time I had first tour, we didn’t have a regimen upon coming back to the states. We just stop taking the pill.

      We aviators went thru many medical exams and I am sure USAF or USN or USA or USMC would have found something.

      Gums sends…

      • Back atcha….yeah, I was afraid it was too good to be true. Same here on the upset stomach if you didn’t take it with food. Oh, well, back to the drawing board.

        Oh, I wore my N-95 mask and my Nitrile “one size fits most” surgical gloves that I bought at Walmart and a beanie cap with a propeller on top that I bought at Dollar Tree to the grocery earlier today and got lots of thumbs up and laughs. Hey, if we are supposed to beclown ourselves in public, might as well do it right.

      • Dosage.
        You said it yourself…one pill a week.
        Far higher dosage for this protocol.
        And why does anyone think quinine is chloroquine is hydroxychloroquine?
        Did any one ever get a virus back when millions took it all the time?
        Would someone have noticed ya think?
        Are there people paying attention to such things?
        Yes, there are.

        • Mr. (Dr.?) McGinley: Thanks for continuing to follow this and continuing to post here. As you may recall, I thought you too cautious re: HCQ and CQ, but we politely carried on. As I recall, your concerns included dosage and side effects, you have been very consistent and a solid source of info. You also don’t parade credentials even though you obviously have them (or knowledge or both), which is why I follow your posts and still don’t know, thus my intro. Also why I come here often, this site attracts such learned comments and fine posts. Thanks again.

          • Thank you Paul.
            I appreciate your comment very much.
            I noted in many of my earlier posts back in February I think it was, that when it comes to this type of research, contradictory findings from one study to another are amazingly common. Which is one reason, many years after these drugs were first suggested as possible antivirals, there remains a great deal of caution and little hard evidence one way or the other.
            I wish I could be sure the question will be settled after all we have seen lately…but I am really wondering.
            Honestly, I hope they work as advertised, not just for the sake of anyone who gets COVID-19, but because if the results of trials are similar to past in vivo research, my guess is many will simply not accept the result as valid.
            On the other side of that coin, this time there will be a huge number of people at various stages of illness who are in a hospital and getting them, and so presumably there will be excellent data from at least some of the places using this treatment on patients.

            I keel looking at Belgium, and other countries who have had these drugs in the official task force treatment guidelines, for confirmation by way of study data or by a drop off in fatalities…but I am not seeing much there to be encouraged. Deaths are still rising sharply in these countries, as much as a month after the malaria drugs were advised to be used on all patients presenting with…
            Here, rather than me saying it again, April 7th revisions included:
            https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_InterimGuidelines_Treatment_ENG.pdf

          • Paul, in case you are still checking here…the first Remdesivir results have been written up.
            Published Friday the 10th in the New England Journal of Medicine:
            “Compassionate Use of Remdesivir for Patients with Severe Covid-19”

            https://www.nejm.org/doi/full/10.1056/NEJMoa2007016

            I can say these results align very closely with what, I have said numerous times, was what could be expected.

        • Salute!

          Actchually, Nick, most of us read the bottle or were briefed by the doc.
          It was chloroquine, and not sure if the “hydro” version was on the street or used by the military. We only got “quinine” in small doses when at the bar, but made us feel good after a good day of being shot at.

          The lasting effects upon flu back then were not even considered, best I know. But my first case in my life before the mandatory flu shots was bout two years after zi got back on first tour.

          Gums sends…

          P.S. Tnx for being our super, duper fact checker, Nick. Can you now start with grammar and spelling and syntax?

          • Well Gumsy me lad…
            If you follow along with comments on this topic closely, you will have noted that there are a great many commentators who have done exactly that…conflated all of these drugs together as if they are equivalent. I am sure some have done so just as a sort of shorthand, but others clearly seem to be under the impression that what does for one, goes for them all regarding efficacy as therapeutic agents.
            And several times we have seen the leap to assuming that any anti-malarial could be assumed to work as an antiviral, if one of them might.
            This is not fact checking, it is called clarification, particularly since it has also been clear that at least some people are now taking these pills under the assumption that they are in fact equivalent in this regard.
            So sure, make fun of me all you like, and have at it with gusto.
            I am not amongst the ranks of the thin-skinned, and it is like water on a duck’s back to me.
            What I know is that at least some people understand what I am saying and why, and occasionally some people glean some useful information.

            Mosher,
            You may have noted that as something of an avowed anti-pendant, I have said straight up on numerous occasions…I include misspellings on such occasions on porpoise (as opposed to just for the halibut*), believe it or dunce. I mean don’t.
            I for one was not correcting anyone’s grammar or spelling or performance…I was pointing out that the dosage for malaria prophylaxis is a tiny fraction of the dosage used for malaria treatment, lupus or RA treatment, or in the protocol being used to treat COVID patients. Taken once a week.
            Not, IMO, a minor point, and one which has been overlooked by many.

            * Three Stooges fans may appreciate the reference.

        • Salute!

          Actchually, Nick, most of us read the bottle or were briefed by the doc.
          It was chloroquine, and not sure if the “hydro” version was on the street or used by the military. We only got “quinine” in small doses when at the bar, but made us feel good after a good day of being shot at.

          As a good fact checker, Nick, what do you think our dose was? Willis may know, as he was taking the pills back then for the same reason and a few times of actually fighting off the critter.

          The lasting effects upon flu back then were not even considered, best I know. But my first case in my life before the mandatory flu shots was bout two years after zi got back on first tour.

          Gums sends…

          P.S. Tnx for being our super, duper fact checker, Nick. Can you now start with grammar and spelling and syntax?

          • “Actchually, Nick, most of us read the bottle or were briefed by the doc.
            It was chloroquine,”

            ‘P.S. Tnx for being our super, duper fact checker, Nick. Can you now start with grammar and spelling and syntax?”

            One thing is certain. Every comment that makes a comment about other people’s
            performance errors in spelling and grammar contains spelling or grammar errors.
            Glass house, stone throwing thing

    • Quinine *might* increase your uptake of Zinc while taking it, but it will not lead to an immune response (immunity) – that requires an infection. I have not seen anything definitive about Quinine working to increase zinc uptake like hydroxychloroquine – but it might.

      Hydroxychloroquine likely works by allowing more Zinc, if it’s available in the fluids outside of the cell, to be taken up by the cell. Zinc inhibits the reproduction of one or more key proteins the virus needs to build copies of itself, thus dramatically slowing down the rate at which it can spread through the body. This gives the body’s immune system time to mount a very effective attack against the virus. Now you have immunity because you were infected.

      Once you stop taking a drug like hydroxychloroquine, your cellular zinc uptake will return to normal and so no additional benefit after it is cleaned out of the body.

    • Quinine has a half-life in the body of ~18 hours, so after 5 or so days, it’s below testable levels. It only imparts a prophylactic effect when present in sufficient levels in the body.

      I started by pre-dosing with 83 mg / day of quinine, then increased that to 110 mg / day. I’ve been exposed by a guy at work coughing all day as I worked with him (he thought it was just a cold… I want to catch the colds, so I can get over them quickly, so I didn’t mind the coughing). We now have three people at work out with Covid. I’ve been trying to catch Covid, so I could get it done and over with and gain immunity, but the worst symptoms I had was a slight tickle in my throat and a feeling of general tiredness for a day, then it was gone.

      I’m no young buck, I rarely get enough sleep, I slug down 1 L per day of Mountain Dew, I’ve chewed tobacco since 4th grade (I’m a farm boy)… about the only things I do which are good for my health is eat healthy food, take a daily multivitamin, and work a physically demanding job. I’m not obese (190 pounds, 6’1″), my job keeps me pretty muscular. I obviously don’t have diabetes nor any other health maladies (except for nerve damage in my feet from walking too much in steel-toed boots while carrying heavy equipment in a multi-million square foot building, so the soles of my feet always tingle… but that’s another (long) story about a shite-head boss who increased our work load (with make-work) for no good reason and with no net effect, all to ‘get back at’ a supervisor he didn’t like… that boss is now gone… I swear, I had nothing to do with his being fired). 😉

      Anyway, here’s my research…
      Quinine was used in India in the form of a drink known as Indian tonic water to treat / prevent malaria. The British, colonizing India at the time, added gin, giving us gin and tonic.

      Chloroquine is an amine acidotropic form of quinine that was synthesized in Germany by Bayer in 1934 and emerged approximately 70 years ago as an effective substitute for natural quinine [4]. Natural quinine was so cheap that mass production wasn’t sufficiently profitable until after 1941.

      By the 1930s Dutch plantations in Java were producing 22 million pounds of cinchona bark, or 97% of the world’s quinine production. When Japan invaded Java in 1941, natural quinine supplies dried up, necessitating mass production of synthetic derivatives. [8]

      Chloroquine *is* quinine produced synthetically and altered slightly to produce a new molecule for patenting purposes. The end product in the body is still quinine. Newer molecules (such as hydroxychloroquine) decrease toxicity due to rapid absorption by making the molecule harder for the body to break down, allowing longer dosage schedules.

      Quinine is eliminated mainly by hepatic metabolism [1]. Seven metabolites have been identified with 3-hydroxyquinine being the major metabolite [1]. Other majority metabolites are (10R)-10,11-dihydroxyquinine and (10S)-10,11-dihydroxyquinine [2].

      Quinine acts against malaria by targeting its purine nucleoside phosphorylase enzyme (PfPNP) [3], but it has other effects in the body which act against coronavirus.

      Namely, it targets angiotensin-converting enzyme 2 (ACE2) [4], interfering with sialic acid biosynthesis [4]. SARS, MERS and Covid-19 use sialic acid moieties as receptors, so quinine (and its synthetic counterparts) prevent viral attachment to cell receptors.

      Hydroxychloroquine / Chloroquine / quinine can also act on the immune system through cell signalling and regulation of pro-inflammatory cytokines. [4]

      It also acts to increase zinc uptake, which has anti-viral effects. Quinine used to be sold, prior to the FDA banning it for this use, as a treatment for leg cramps. The mechanism of action is increased uptake of zinc, calcium and magnesium by reducing hepatic metabolism [10]. Now it is recommended to directly ingest zinc, calcium and magnesium for leg cramps rather than taking quinine. [9]

      This may be why people infected with Covid-19 experience a loss of the sense of taste (and smell, since the two senses are intricately connected) [11][12]. They become zinc deficient.

      It generally takes 4 to 5 days to completely flush quinine from the body [5]. The consumption of 10 oz. of tonic water can result in a quinine positive urine sample for a period of up to 96 hours (4 days) after intake. [5] Approximately 20% of quinine is excreted unmetabolized [6]. It has a half-life of approximately 18 hours [6].

      Quinine in tonic water in the US is limited to 83 mg / liter [7].

      Thus, we can make a simple linear extrapolation, assuming a half-life of 18 hours and ingestion of 83 mg / day. This means that after 24 hours, approximately 27.67% of the amount from the prior day remains in the system. Thus it accumulates until the body is excreting as much as is ingested. That occurs after approximately 5 days, when the dosage varies between 124.5 mg immediately after ingestion to 41.5 mg immediately prior to the next ingestion.

      https://i.imgur.com/zYZFjYL.png

      Is that enough to have a prophylactic effect?

      Well, the National Institutes of Health state that chloroquine is “a potent inhibitor of SARS coronavirus infection” [13] and since SARS binds to the same cellular receptors as Covid-19, and since chloroquine is a synthetic version of quinine, it would appear that it should work.

      Pretreatment with 0.1, 1, and 10 μM chloroquine reduced infectivity by 28%, 53%, and 100%, respectively. [13]

      The EC90 value of chloroquine against the 2019-nCoV in Vero E6 cells was 6.90 μM, which can be clinically achievable as demonstrated in the plasma of rheumatoid arthritis patients who received 500 mg administration. [14]

      Interpolating the dosage of 500 mg to 6.9 μM concentration, for a dosage of 124.5 mg daily (83 mg from tonic water, the remainder being that remaining in the body from prior dosages), that should give a concentration of ~1.71 μM, reducing infectivity by ~60% immediately after ingestion of 1 L of Indian tonic water, decreasing over the next 24 hours to ~.47 μM, with a reduced infectivity of ~40%, per [13].

      That would be more effective at ‘flattening the curve’ than any measures taken thus far. Covid19 has a R0 of ~2.2… so we could conceivably reduce that (assuming an average reduced infectivity of 50%) to ~1.1, effectively completely ‘flattening the curve’.

      Given that no doctor is going to give you chloroquine or hydroxychloroquine as a prophylactic measure, using Indian tonic water containing quinine to reduce infectivity would seem to be a prudent preventative measure.

      The wrap-up: It would appear that quinine interferes with sialic acid biosynthesis, which the Covid19 virus takes advantage of to attach to cell receptors. If the virus has a more difficult time attaching to cells, that allows the body to clear the virus without having to simultaneously deal with a rapidly-spreading infection.

      [1] https://www.drugs.com/npp/quinine.html

      [2] https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2710.2007.00788.x

      [3] https://blogs.sciencemag.org/pipeline/archives/2019/01/22/quinines-target

      [4] https://www.sciencedirect.com/science/article/pii/S0924857920300881

      [5] https://friendslab.com/quinine-use-and-detection/

      [6] https://www.drugbank.ca/drugs/DB00468

      [7] https://en.wikipedia.org/wiki/Tonic_water

      [8] https://en.wikipedia.org/wiki/Quinine

      [9] https://healthfully.com/287838-leg-cramps-magnesium-calcium.html

      [10] https://www.webmd.com/drugs/2/drug-19765/cal-mag-zinc-ii-oral/details/list-interaction-details/dmid-455/dmtitle-aluminum-and-magnesium-antacids-quinidine-quinine/intrtype-drug

      [11] https://academic.oup.com/jn/article/131/2/305/4687001

      [12] https://www.businessinsider.com/coronavirus-symptoms-loss-of-smell-taste-covid-19-anosmia-hyposmia-2020-3?op=1

      [13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

      [14] https://www.nature.com/articles/s41422-020-0282-0

      My not-so-patented technique for getting over pretty much any cold or flu quickly:

      1) Antihistamine if your nose is running… it works just as well for colds and flu as it does for allergies. For mild colds, it removes nearly all of the symptoms for me. You’ll have to experiment to see which antihistamine works best for you… Loratadine 10mg / day works wonders for me.

      2) Hot showers… and I mean hot… if you can stand under the water without dodging around to prevent the water stinging you, it’s not hot enough. Breathe deeply, that water vapor loosens any mucus in your lungs, allowing you to cough it out more easily.

      3) 4 thick blankets… this takes a bit of experience to get right. The first few times, you can easily overheat yourself. When going to sleep, lift your feet to tuck the blankets under them, then roll left and right to tuck the blankets under your left and right sides, then cover your head and sleep in your little cocoon. Regulate your temperature (and allow enough oxygen in to breathe) by peeling back the top 3 blankets to about chest level, adjust their height if you get too hot or cold, or if you need more oxygen. Try to maintain ~104 F body temperature. Once you’ve done it a few times, you’ll know where to position the blankets. The first few times, though, use an oral thermometer and monitor your temperature. You’re going to sweat a lot… a plastic liner on your mattress is recommended.

      4) This is a new addition for coronavirus infections… quinine in the form of tonic water. 2 L per day for the first 4 days (loading stage), then 1 L per day after that (maintenance stage). Right now I’m doing 1 L per day, along with a 12 ounce can (because my wife found some Trader Joe’s lime-flavored tonic water in 12 oz. cans and bought it to try, and no one else wants to drink it… I hate lime, it tastes vile to me, but I slug it down in a couple drinks to avoid the bad taste) as a prophylactic measure against WuFlu.

      5) Zinc and vitamin C supplementation. Don’t take more than the RDA for zinc. If you start getting diarrhea, you’re taking too much vitamin C… that starts happening for me at around 10 grams (10,000 mg) per day, so I generally take 4,000 mg / day when a cold or flu is in the incipient stage. Costco has a really tasty chewable vitamin C tablet (Kirkland Signature Chewable Vitamin C, 500 mg).

      6) If you start getting lung congestion, sleep with your head lower than your feet, to allow gravity to assist in moving the mucus out of your lungs. An inversion table works wonders set at 45 degrees or steeper, but you have to get used to the blood rushing to your head. Even just putting 4×4 wood blocks under the foot-end of your bed will help a bit. If your nose is running, this’ll make it run even more, so the antihistamine is a necessity.

      Most colds I’m over and done with in less than 3 days… the last flu I caught was brutal, I had lung congestion so bad that I was short of breath, but I got over it in 3 days. It hit me like a load of bricks… one minute I felt fine, a half hour later I felt terrible, with alternating hot and cold flashes. I finished the work day, went home, dosed up on vitamins and water (this was before I started using tonic water), and went to sleep for two days. Woke up with lung congestion, took a hot shower, coughed out huge amounts of phlegm, ate some food, dosed up on vitamins and water again, went back to sleep, and was back to work the next day feeling fine.

      • Interesting post.

        Thank-you very much for the Indian Tonic water suggestion to increase the amount of zinc in our cells that stops the covid virus from binding to a key molecule in our cells. I going to follow up on that.

        Here is another suggestion which is a no brainer for everyone.

        http://joannenova.com.au/2020/04/perhaps-solve-the-other-pandemic-vitamin-d-deficiency-to-help-beat-coronavirus/

        Treating vitamin D deficiency has been shown to reduce the deaths from all diseases by roughly 50%. Reduction of incidence of breast and prostate cancer by 70%.

        The maximum safe daily amount of vitamin D is 4000 UI/day. My wife who is a small person takes 2000 UI/day as do her small informed friends. I take 4000 UI/day as I am larger and I do not want to get prostate cancer.

        Vitamin D is converted in the body to a hormone that is used in 200 microbiological processes including the immune systems ability to produce antibodies.

        • A number of years ago a severe vitamin D deficiency caused all sorts of problems. They eventually test for vitD and found barely detectable levels. I was on a 50,000units/1 week for several years before it got back inside the normal range. I’ve been taking 8,000 units/day for years simply to keep the level within the ‘normal’ range.

          For most nutrients the optimum levels can vary widely by patient. I believe the recommended 4000 units/day is based on a no detectable effect level of 0. The FDA is very careful not to recommend levels of any nutrient that have any chance of resulting in problems for so small fraction of the population. i.e. just enough to prevent symptoms in the most sensitve individuals.

      • #13 is the study that found the the drug works in cell cultures, in other words in vitro.
        The quoted link contains the following passage:
        “Together with data presented here, showing virus inhibition in cell culture by chloroquine doses compatible with patient treatment, these features suggest that further evaluation of chloroquine in animal models of SARS-CoV infection would be warranted as we progress toward finding effective antivirals for prevention or treatment of the disease.”

        Right?
        So the paper was asking a question and suggesting further research to see if it has the same effect in actual animals with a virus infection.
        The entire paper was a detailed looked at methodology IN CELLS IN A DISH.
        Not in animals.
        So, what became of this research?
        Well, the question was investigated as to if it would work as an antiviral in animals with a virus infection.
        And was answered here:
        “Anti-inflammatory agents, chloroquine, amodiaquin and pentoxifylline, were also inactive in vivo, suggesting that although they may be useful in ameliorating the hyperinflammatory response induced by the virus infection, they will not significantly reduce the replication of the virus”

        So, the NIH does not say it works against infection in an actual living organism.
        Because further research has proven it is inactive regarding viral replication in living hosts.

        Read all about it:
        https://journals.sagepub.com/doi/abs/10.1177/095632020601700505

        A welter of other studies looked at humans with a long list of viral infections.
        All results were disappointing, and the research was dropped after several years of fruitless investigation.
        Of course, with a new virus that has no known cure of proven efficacy to date, the dusty drawers were reopened and another look is being taken.

        Also worth noting, that the cell culture studies used a combination of antibiotics, because cells in a culture will generally have no defense against bacterial infections. Many of them use at least two powerful antibiotics as a matter of course when doing cell culture studies of any sort.

    • They could easily do all sorts of database queries but the Deep State doesn’t want to know the answers. All they want is to destroy America. Yes folks, Trump was right, they don’t just want to destroy him, they want to destroy YOU.

    • friends an ex PNG worker he took it for blackwater fever n malaria decades ago as well
      I seriously doubt carryover benefits as the washout period stated is around 56 days?
      he and some ld mates think the same re immunity
      personally I d say no

    • TEWS
      My rheumatologist told me that the half-life of HCQ is less than a month. At that rate, it should be pretty much washed out of your system after a few months. That is the good news. The bad news is that if you are someone who does not tolerate it well, you have to live with it and any damage done for months following. One of the recent concerns expressed is cardiac issues among the elderly who already often have heart problems.

      While you or Gums may not have personally known anyone with serious side effects, they are serious enough, and common enough, that besides the literature provided with an HCQ prescription, the label on the bottle warns against exposure to the sun and advises notifying the prescriber about mood changes because of a risk of suicide. In my case, my rheumatologist required a battery of tests for my vision to have a baseline to compare against should vision changes occur.

      While most people seem to tolerate HCQ well, the issue is the small percentage who don’t. You don’t want to make the cure worse than the disease.

      • A rheumatologist with over 40 years of expeience treating patients with hydroxychloroquine said he was shocked at all the people coming out claiming hydroxychloroquine has serious side effects. He said in all his years, he has never had to admit a patient to the hospital for a bad reaction to hydroxychloroquine.

        The dangers are overstated, according to one of the chief rheumatologists in California . There are no dangers for most people at the doses being discussed for use on Wuhan virus.

          • I dont think he is lucky, he is experienced.

            His name if Dr. Daniel Wallace. He was on Dr. Oz’ podcast a couple of days ago.

          • If he did not do extensive testing for contraindications and side effects he was lucky.
            Lots of people have been harmed by these drugs over the years.
            Many RA and lupus patients cannot take them.
            There is a long list of conditions and other drugs that contraindicate their usage.

          • I do not know whether I was lucky but I developed recurrent malaria more than 60 years ago and I had regular attacks for five or six years. I was treated with quinine, which in those days was the only treatment around, it seemed to have worked as I have had no further attacks for more than fifty years.
            I do not recall any major (or minor) side effects – except for a loathing of tonic water due to the vile taste of quinine which was delivered in a ampoule which had an even worse taste.

    • It wasn’t quinine.
      It was a combo pill of Chloroquin and Plaquinil.
      Plus a once a week Dapsone pill.

      • Correction
        The Combo pill was Chloroquin an Primaquin.
        Earlier 60’s may have included quinine with chloroquin, but was deemed less effective against resistant strains of malaria.

  2. Starting to look like this may be more of a hemoglobin issue than respiratory issue. Would explain some of the benefits of chloroquine.

  3. Right. Off to see about my MS in virology, biology and chemistry. Maybe after these I could have a basic understanding to ask some basic questions . . .

    • I’m always looking for a good reason to drink coffee. It has quinine, zinc and I think caffeine itself might has act similarly to quinine.

      • It is very encouraging that so many possible treatments have been found to show efficacy at killing this virus.
        The next logical step is to line patients up against the wall and just throw the kitchen sink at them.
        They ones too slow to jump out of the way in time were not going to make it anyway, so…

          • Interestingly, the very next day after I first made this comment, it was reported in NYT:
            The resident emergency doctor at New York-Presbyterian said more patients than usual are dying while on the machines. The exact numbers were still not known while the epidemic rages and with hospitals sometimes working in chaotic conditions.

            Some of those hospitals are experimenting with unproven drugs in hopes of helping patients, including the anti-malaria medication hydroxychloroquine.

            “We’re essentially throwing the kitchen sink at these patients,” the New York-Presbyterian resident said.”

            😉

      • COVID 19 Quarantini: half ounce Cointreau, one Orange slice, one and half ounce Vodka, fill shaker with Ice, half ounce Dubonnet. Shake 19 times and pour. Advertise the Quinine in the Dubonnet…. all useless but will make you feel like you’ve done something good.

  4. $2,200,000,000,000 in stimuless
    $5,400,000,000,000 in lost productivity (2020 GDP)

    Divide that by the number of deaths they said shutting down would save (at the initial time of discovery it was about saving about 160,000 lives. Now that number keeps decreasing the more they “know” about the disease.
    Right now they expect about a total of 60,000 American deaths. This is about how those deaths will work out…

    These are cumulative as you go down
    .03% are 5 and under
    .15% are 24 and under.
    1.03% are aged 34 and under.
    3.42% of American deaths are aged 44 and under.

    These are absolute
    96.58% of deaths are aged 45 and above.
    90.5% are 55 and above.
    78.41% are 65 and above.
    55.34% are 75 and above
    37.7% are 85 and over.

    The average age of death is 74.4 years old.
    The life expectancy of an average American is 78.7 years.
    4.3 years younger than average for the nation. But they are sicker than the average American…

    Of those who die
    3% have no diagnosed comorbidities.
    22% have one serious comorbidity.
    27% have 2 serious comorbidities.
    48% have 3 or more comorbidities.

    Comorbidities almost always lower the life expectancy of the group with it. People with cancer, diabetes, heart disease, hypertension all die younger on average than the average society wide age of death. So you can reduce that 4.3 years that the above numbers indicate are being taken away by some amount. Is it lesser by 1 year or 4 years. It would take more research and more importantly, it would require that the government provide the list of comorbidities of those who die by the age they die.
    Someone with type 1 diabetes has a life expectancy of 58 years. Type 2 diabetes has a life expectancy of 68 years. ALL cancers combined reduces life expectancy on average down to 68 years. I cannot find easy numbers for hypertension, but it is likely to reduce life expectancy by at least a year or two.
    Generally speaking, the people who are dying of this disease are likely starting out a few days to a few months from their otherwise unavoidable death. This disease just simply brings their death forward a few days to a few months.
    Once this epidemic subsides, there will be several months where the rate of death for these diseases is lower than typical.

    All this shut down for a mere $50,000 per American worker today and once the full unemployment comes about $71,800 per American worker.

    • astonerii get it. “Once this epidemic subsides, there will be several months where the rate of death for these diseases is lower than typical.”

      There are almost no heart attack deaths for a week or two after a good sized earthquake in sunny California.

    • So using your numbers and saving only the under 24’s because the rest aren’t worth saving that is 0.18% or 108 of the 60,000 deaths.

      So now a fortune teller tells you that you are going to be one of the 108 … do we still not shutdown?

      • Yes, that’s what we are saying. Everyone over 24 isn’t worth saving. Just shoot them all — it’s quicker! /sarcasm

        Why would you think that pointing out that this disease kills people who are old and dying means we only care about young people? Why? How can you possibly think that? Oh, right, because you aren’t actually capable of understanding other people.

        Death is a part of life. Death is good. Death clears the way for renewal. Everything we eat comes from death: we kill other living things to live. We have to. Old people die. You will die, I will die, every single person living on the earth will die.

        This necrophobia we have in the West is fairly horrifying. It’s what leads to people being kept alive in hospital beds, tied to machines. Why? To make the living feel better?

        The question wasn’t asked of me, but if I was one of the 108 doomed to die, would I consider shutting down the entire American economy a fair trade for my life? NO! Death comes to us all. If me dying stops the whole country from imploding financially, then so be it. Living at all costs, at all levels of suffering and privation? No thanks. Living at the expense of the well-being of millions of people who become unemployed and under house arrest due to a shut down? No thanks.

        You can take your moral high horse, kill it, cook it, and eat it, LdB. You aren’t making a moral argument or taking a reasonable position at all. You are assigning motives that don’t exist and refusing to even consider that there is a cost to be paid for what we are doing. Refusing to consider costs is wrong and short-sighted.

      • No. or in answer to you question Yes, we do not shutdown.

        Do we shut down highways because under 24’s are at a higher risk of dying in car accidents?

        • Actually, the shut-down is having an unintended consequence: motor vehicle deaths are spiking (at least in my state) due to people driving too fast on the nearly empty highways. Most of these drivers are young.

          • Thanks for the assist Paul.

            Using LdB’s logic, in order to save those who have died on the highway we need to barricade the on ramps. It is morally right and anyone who disagrees with shutting down the highways wants young people to die.

            I am so sick of these SJWs attitudes and prescriptions I think i am going to wretch. Their overreaching remedies to save a few will make life unlivable for all. Of course exemptions go to the officious bureaucrats but that is a different story.

      • If I was in the hospital and they said they needed to spend $500,000 to save my life, I would turn down the offer and die. I am not going to make my children poorer as a consequence of extending my life.
        Right now we are spending in excess of 100 times that amount of money. I think you can answer your own question of whether or not I would be OK with that level of effort being spent to save me. I happen to sit in the over 50 and sicker than average group of people. So, if I get the disease, I have a reasonable chance of dying to it.

  5. I’ve seen some discussion of the quasi-suppressed (ok, grasping for the proper term here) monocyte levels that characterize Chi-Vie infection, and seem responsible in part for the rapid onset of criticality in an infection that has been going on for days. The suspected culprit – IL-6 levels are insufficient to “alert” the system.

    So .. just passing that on, and this – and asking your opinion. I found it looking for the “other” ways (akin to yours – zinc being an ionophore) that azithromycin could be having effect. Sorry to throw you the monkey, but I’m not nearly as up on the science here as you are. Thanks.

    Oh .. here’s what I found: https://erj.ersjournals.com/content/36/3/646.short

  6. I have been wondering if coronavirus stressing of the immune system can activate latent TB, which is then misdiagnosed as covid (many immigrants from countries with endemic TB have latent TB; one survey of immigrants in N Italy found a prevalence rate of over 500 per 100,000, which is really high). Now I have my first data point that suggests there may be something to this.

    I live in Sweden and those who suffer most from the virus are actually immigrants from the Third World, Swedish elderly people on retirement homes and nurses on the hospitals.

    https://twitter.com/OnsalaBob/status/1247887368079564802

    The reasons I think this is significant and needs looking at is because 1) most immigrants are probably pretty young, and 2) treating tuberculous pneumonia as viral pneumonia could produce bad results. So I wonder if immigrants who test positive for covid are being tested for TB.

    • As one with latent TB confirmed by a Quantiferon test in 2016, I have been on guard against any changes in my lungs no matter how small. TB is caused by a bacteria and can be cured taking a combination of two drugs over a 6-9 month period. However, at my age (65+) my Pulmonologist decided against the treatment. His estimate was that I had a 1-2% chance of TB going active and about a 30% chance of dangerous liver damage from the drugs. The Quantiferon test is very expensive and must be done within 24 hours of the blood draw. I doubt there are enough facilities to do this on a large scale and in a timely manner. Monitoring for side effects would required monthly checks would also require enormous effort on a large scale.
      I suppose you could start with a simple PPD test but that is just an antibody test which much of the world will test positive. You would then have to move on to the Quantiferon test. Lots of time and effort for most likely very few real cases.

    • “most immigrants are probably pretty young”

      And pretty black, living now in a cold country … that could count.

      • Never considered that aspect, but they would most likely have less vitamin D from sunshine than ethnic Swedes would simply from having more melanin.

    • one trial IS using the old TB vaccine to see if it produces results n raised antibodies BCG made by various companies Older off patent vaccine

      as for the immigrants well bad nutrition before they exmigrated and got all the handouts cash etc
      doesnt mean they live any cleaner(see swedens no go zones ditto france italy n spain as well)
      pretty much filed over border thanks to muttis open door policy, health checks basic n cursory at best

    • SurferDave
      April 8, 2020 at 7:30 pm

      The clause of proper effective response, the sane one:

      “No bigy problemi, then no bigy responsi.”

      Yes, surprising that in nature, as naturally “managed”, “jumping the gun” is not the first reaction to respond,
      Where the success of preemptive response actually consist as averting or blocking the proposition of self-destruction.

      The point that the antibody is present, means that the immunity is gained, aka the immune system response has gained the actual proper matching one ready to go… when needed and as needed.

      “Oh no, the fire brigade is no good at all , these guys know not what they are doing.
      Have not actually brought the lake with them to extinguish this tree fire… and by the way where are the planes, why no planes, the tree is in fire… and the army is nowhere to be seen…
      oh no, the end is nigh!”

      cheers

    • yup saw that so if they wanna use plasma to save the ill theyd have to get it fast
      wondering if kids levels remain higher?
      if we could make lasting antibodies to corona viruses or the others then we wouldnt keep getting colds

      • The antibodies and the immune system response, or even the overall immunity do not stop either the infection, reinfection or the disease… some thing like waste treatment and waste recycling does not stop waste.

        cheers.

  7. Masks do provide people with a reminder not to touch their face.

    Anyway, I’ve been following Colorado vs Arizona coronavirus stats, and Arizona has fewer than half the cases and deaths, despite having a significantly higher population. Demographics are similar. Colorado has a major international airport, as well as skiing, which attracts tourists from all over.

    So, could weather be a factor (e.g. vitamin D from sun exposure)? What else might be a factor?

    I would add that stats for Florida are relatively low given its population and older demographics. Even Ohio vs Michigan would be an interesting comparison, Michigan having about 4 times the cases and deaths as Ohio, which has 2 million more people than Michigan. I could make a case that one is better off living further South all other factors considered.

    • “So, could weather be a factor (e.g. vitamin D from sun exposure)? What else might be a factor?”

      That was my first thought. What’s the air like in Denver now? I remember a nasty brown smog over the city in winter many moons ago.

      • It’s been good air in Denver for decades, though it’s especially clean now. The brown cloud mostly disappeared with wide use of catalytic converters. We still have a rare temperature inversion and in winter wood smoke and dust can accumulate.

    • Population density is another factor, especially in major cities.
      More hands to touch surfaces, more people coughing & sneezing etc.

      Re face masks, I think Rud has that one wrong, Czechia are using home made masks, their case increase is nearly the same since 29th of March as those countries in Europe that have had lock downs for weeks ie
      US cases increased by 3.5 times
      Italy by 1.5 times
      Spain by 1.9 times
      Germany by 1.9 times
      France by 3.0 times
      UK by 3.1 times
      Sweden by 3.1 times
      Czechia where they wear face masks by 2.2 times
      Czechia does not have lock down, just social distancing.

  8. I haven’t seen any discussion of the efficacy of UV A/B/C on SARS-CoV-2 virus eradication. Seasonal attacks of flu viruses are strongly mitigated by UV intensity. Here in Houston 4 hours in UV index 6-8 eradicate most bacteria and viruses outdoors. Indoors not so much, but anyone who’s spent time outdoors has generally been scrubbed. The entire Southern band of the US has a lot of UV over the spring/summer/fall seasons. An example would be the handles of shopping carts. 15 minutes in the full sun reduces almost any bacteria or viral carry. At one time, long ago and far far away, I had a spreadsheet copied from some research study showing how effective insolation was for UV sterilization. Unfortunately I no longer have access to that spreadsheet. I would love to have posted it.

    • I’ve read that it is only UV-C that kills the SARS-CoV-2 virus. Sunlight will not kill it but will do in other viruses via UV-B (A is not effective). The equipment makers of UV-C sterilization equipment are doing a booming business. A lot depends on the intensity and distance.

  9. Thanks Rud
    Some challenging statistics just out suggest COVID-19 is far more infectious than flu etc. Furthermore, only about 6% of infections are actually detected – suggestion most are asymptomatic or had low grade symptoms confused with the flu.

    R0 from CDC reanalysis is now 5.7 ! Increasing 23% to 33% per day.
    High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2

    Results show that the doubling time early in the epidemic in Wuhan was 2.3–3.3 days. Assuming a serial interval of 6–9 days, we calculated a median R0 value of 5.7 (95% CI 3.8–8.9)

    COVID-19: on average only 6% of actual SARS-CoV-2 infections detected worldwide

    Their data shows that countries have only discovered on average about 6% of coronavirus infections and the true number of infected people worldwide may already have reached several tens of millions.

    • “R0 from CDC reanalysis is now 5.7 !”

      This might mean a lot of Americans are already immune to the Wuhan virus and don’t know it.

      We need an antibody test to determine immunity ASAP. The immune people can resume their lives.

      I heard an estimate that 50 percent of New Yorkers may already have had the Wuhan virus and may now be immune. That’s a sizable workforce.

      Rapid, antibody tests are needed rapidly! 🙂

      • of course people who doubt PCR tests will lose all doubt when it comes to antibody testing

  10. I read these reports of where virus titers using a plaque-forming assay come up zero, but the PCR for the RNA comes up with many thousands of copiesRNA/mL of sputum/saliva. The viral immunologiost in me worries about that.
    One huge problem with a corona virus is it is +sense, full genome length RNA virus. I have done hundreds maybe thousands of virus plaque titers, so I know what textbook infectivity is for properly formed viruses. I also understand the problem of defective interfering (DI) viruses when viruses are passaged at high titer. But those have always been with DNA viruses (Pox viruses,) and with negative strand viruses (mostly influenza). Positive strand viruses are essentially mRNA ready to run on a ribosome though, if they can ONLY get inside the cell. Regardless of how the genome got there will likely be infective if they get access to a cell cytoplasm.

    Mind you our environment is filled with RNase’s (enzymes made by bacteria and eukaryotes that degrade RNA quite efficiently) that degrade naked RNA. RNases are ubiquitous around. This is a sub-microscopic biomolecule world few are aware of. Any one who has ever done RNA-extraction/quantification biochemistry understands how labile naked RNA is.
    So with any Corona Virus (as a full length +strand RNA virus,) I worry when I read reports of people with RNA+ PCR results but zero infectious virus from plaque assays.

    • Joel O’Bryan
      April 8, 2020 at 7:54 pm

      I worry when I read reports of people with RNA+ PCR results but zero infectious virus from plaque assays.
      —————

      Thanks for your very informative comment.

      Yes, I agree with the case of being worried, but still can not figure out the specific point.

      It is reasonable to worry when considering a novel virus, especially a full length +strand RNA virus, failing or refusing to multiply in a petri dish…
      I understand that, but any further specifics there in relation to further concerns as for this condition?

      Thank you

      cheers

  11. Wow (again). Good stuff, keep’em coming!

    Belarus will be an interesting case study. If their death per capita is the same then 90% of the shutdown was unneeded.

    • You won’t get proper statistics out of there, so it is moot. The deaths will be whatever Lukashenko says they are.

  12. After much reading on the topic, I came across an interesting paper that asserts that the process of flooding a cell with zinc via a zinc ionophore was thought to be very promising as a cancer therapy.
    Most of the cell lines in which this research was done were cancer cells.
    It is that putting all that zinc in a cell shuts down autophagy and induces apoptosis.
    Very good if you can get the stuff to mostly concentrate in the tumor cells.
    Maybe good if you can get virus infected epithelial cells to commit cellular harikari.
    But do these drugs concentrate in epithelial tissues?
    I have seen no evidence it does.
    Anyway, here is that research paper:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/

    A lot of clinical trials have been done over the years testing the chloroquines on various cancers, and on numerous viruses.
    The results have generally been very disappointing.
    A huge number of compounds have an effect in vitro, and even sometimes in animal models, but fail to work in people.
    Remdesivir wipes out Ebola and all sorts of other viruses extremely rapidly and completely, in vitro.
    It works in small animals.
    It even works very well in primates.
    In people…not so much, unless given right after exposure and symptoms.
    It could be because Gilead saw signs of toxicity (all of these antivirals are a form of chemotherapy, giving cytotoxic chemicals in the hope they will kill one specific cell or microorganism faster than the host) at higher dosage regimes and so used a minimal dosage in the Ebola trials. This has been carried forward in the COVID trials.
    In fact this is always the problem with translating in vitro studies to animals and then people.
    Nothing ever tested in people has not first been tested in cell cultures and animals first, both for issues with side effects and cytotoxicity, and for efficacy. And yet the vast majority never get approved.
    Also common is promising results in anecdotal type usage, followed by lack of confirmation in humans with a disease or medical condition.
    Anyone who has followed new drug development in any detail for any length of time knows how often this happens.
    Very often there are proponents who are certain it works.
    Very often are drug company people sounding very confident the cure is right in their hands, just as soon as we get the trials out of the way.
    Lots of things seem to be working in phase one and phase two trials, then wash out in larger cohorts in phase three trials.
    It is literally a hackneyed playbook.
    This is why so many people are waiting for clinical trails.
    It has nothing to do with what such people hope, or wish for.
    It is from seeing the same thing happen again and again.
    This is why the process is so long and so strict and so carefully evidenced.
    Why do double blind trials?
    Because it is known even having the people treating the patients in the trials choosing who gets placebo, or even if they do not choose, just knowing who does, has been shown over and over again to taint the results.
    You wind out with expectations and wishes coloring the treatment and care of the patients.

    I hope like hell that this two drug plus zinc thing works out in trials.
    But considering the history of the testing of these drugs on just about every condition ever described (for one thing because people are already taking malaria drugs in places where viral diseases are widespread and awful), it is gonna take a miracle for this to be as the promoters are assuring us is the case.
    How did anyone ever get the idea of using hyroxychloroquine and z-pak together against a virus?
    Because there is a long history of trying them on other diseases.
    I am just gonna post one more time a very carefully designed study of numerous existing drugs on the SARS virus in mice, including specifically chloroquine:
    “Anti-inflammatory agents, chloroquine, amodiaquin and pentoxifylline, were also inactive in vivo, suggesting that although they may be useful in ameliorating the hyperinflammatory response induced by the virus infection, they will not significantly reduce the replication of the virus, the inducer of inflammatory response. Thus, anti-inflammatory agents may only be useful in treating virus lung infections if used in combination with agents that inhibit virus replication.”
    https://journals.sagepub.com/doi/abs/10.1177/095632020601700505

    Lets all hope it works like magic, but not decide ahead of time that it is some trick or drug company scam if the results are just like numerous other results with these drugs.

  13. Hello Mr Istvan. Thank you for this very thorough and informative post although I must confess that I didn’t read all the way to the end.

    I have a question. Is there a genetic factor here? Are the European and East Asian (Chinese, Korean, Japanese) races more at risk than the other races? If so, what is it that is common in these two races that makes them different from the other races?

    • Just based on what I’ve seen, I suspect not. The only thing I’ve seen that may be a minor factor is some Chinese have the type of haptoglobin that depletes vitamin C to some degree.

      However, incidence may vary among and between ethnic groups based on things like lifestyle behaviors, diet, pharmaceutical treatments, environmental factors. For example, blacks and hispanics in the US seem to be affected more, but they also are more prone to be diabetic and hypertensive, which are two of the highest risk groups. Whether that is due to their conditions or their treatments (i.e., ACE inhibitors/ARBs) is a matter of debate.

      Another example would be Chinese in heavily polluted Wuhan being hard hit, but Chinese in lesser polluted Taiwan experiencing much less morbidity/mortality. Heavy air pollution can and does cause pneumonia and pneumonia is normally common in Wuhan.

    • One thing I think E Asians have going for them is their preference for calcium channel blockers (CCB) to treat hypertension. Americans/European doctors prefer ACE inhibitors/ARBS, which are said to increase ACE2 expression in respiratory cells. Those frequently produce a dry cough side effect in E Asians, so CCBs are used as a first line of defense instead.

  14. great analysis of the available data … too bad none of it has date of infection … since many of your calculations are timeframe related how can you possibly calculate anything when the data is from mixed dates of infection and unknown …

  15. “strongly suggests low aerosol spread and much more close contact viral transmissivity”

    “Now IF the route is cough sneeze, not aspirate aerosol, then nose/mouth coverings make sense—for the infected only. And the advice already is, if you have symptoms, stay home and self isolate. So either way the public face mask recommendations are mostly ‘feel good’ rather than effective”

    I think the main route is droplet spray from speech, and touching maybe, but not breathing except in confined spaces. I could be wrong.
    infected: quarantine
    possibly infected: get tested and stay home
    asymptomatic: quarantine
    not infected: mask not needed (unless you are near infected, and then you need a really good one)

    But you can’t tell the difference between the asymptomatic and the not infected, so you have to wear a mask just in case you might be asymptomatic or early stages, to protect your friends and others.

    • There is no way around it.
      Asymptomatic cases being able to transmit the infection means no one can know who has it, so everyone has to wear a mask.
      This virus has spread all over the country with almost no one I have heard of encountering a single outwardly sick person prior to testing positive.

  16. There has been a lot of media speculation that there are 10 to 100x more people infected than our testing has uncovered. If this were true, then why aren’t we seeing catastrophic death rates and hospital systems being overwhelmed in third world countries?

    Could there be a similarity to polio, in that countries with much more day to day hygiene are more susceptible to the more dangerous outcomes of catching Covid-19?

    There was some speculation that fecal/oral transmission, leading to diarrhea as the first noticeable symptom provides some lead time for the body’s immune system to learn how to attack the virus, whereas those that get the virus in their respiratory system first end up with major lung damage occurring for days before their first symptoms (breathlessness) and then the immune response causes phlegm and pneumonia on a weakened respiratory system.

    Does this lack of third world deaths and overwhelming of their medical systems lend credence to this theory, or do they truly have lower infection rates despite the fact that their social and economic systems would appear to be perfect vehicles for this virus to spread quickly?

      • The people who argue for BCG are those BRAIN DEAD vaxxers who were putting forth AXIOMS such as:

        – autism is not caused by anything in life;
        – immunity cannot be enhanced by any vitamin, supplement, or anything in life. It’s silly to try to make it better.

        Yet those same vaxxers promoted a study that found a statistically significant link between vaccines and autism; crazy vaxxers even promoted it because non vaccinated children were more at risk of autism.

        And now a vaccine can enhance immunity? They really don’t know what they believe in.

          • Id be extremely concerned about follow on effects from the vax IF they even manage one
            all prior SARS ones were duds and dangerous to the animals trials halted.
            because most will be gmodded rna i gather effects ongoing..?
            people dont realise just cos it got to phase 3 n released the ongoing effects and wider use events ARE phase 4 of trials and WE are the guineapigs
            and boy do they hate adverse event reporting!
            it should be mandatory but many places getting it reported at all is a fight

        • Yeah we do, its science. Love to hear that anti-vaxxers explain where all the diseases we vaccinate against have gone if its not the vaccines – and how the disappearance miraculously correlates with the vaccine each time.

          • The diseases are still around, even in vaccinated people who become asymptomatic carriers. The incidence of most, if not all (excepting maybe a few bacterial), diseases plummeted before their vaccines were introduced.

          • As usual, no evidence, no example, nothing.

            You can’t even cite one vaccine with evidence of usefulness.

      • India is a bit 50/50. You can have highly urbanised rather advanced sections that show similar patterns to the US, that would overwhelm the hospital systems and still seem like lot of people are dying, while other parts, show little impact.
        I expect better clarity from countries with very small sections of first world sanitation.

      • Roy Spencer has noted that countries with malaria have little coronavirus. link

        In Ecuador, the coronavirus is mostly in Guayaquil, which has little malaria. link The rest of the country, excluding Quito, does have malaria. I wouldn’t be surprised if the prosperous urban regions suffer from coronavirus while the rest of the country is relatively safe. Anyway, India has a very low incidence of coronavirus given its huge population.

    • Or the fact that most of those countries have Malaria and therefore take anti-malarials?

      • The taking of anti-malarials is less widespread than you might assume. Many of them are not recommended for long term use, even at lower prophylactic levels of dosage. Spraying with DEET and mosquito nets are prevalent in areas where malaria has evolved some resistance to the simpler drugs. Then again, it is very striking that Indonesia, Malaysia and Singapore, which are neighbouring countries with very different standards of health care and differences in levels of testing all see extremely low death rates.

    • Or maybe the speculations are WAG’s and not anything akin to a fact?
      Nothing wrong with admitting we do not know, since in fact we do not know.
      Pretending we know things because we dream them up is not knowledge.
      It is worse that ignorance.
      No one knows the rates of infection.
      But the proportions of people tested are known in many places and many test types.
      We know we do not know what we don’t know.
      Let’s find out, instead of flights of imagination and ever more tenuous speculations.

      • We do know that we aren’t seeing reports of massive death rates in underdeveloped countries, despite poor hygiene and poor personal separation. You’d think they would be the perfect place for rapid spread of Covid-19 and for death rates due to lack of treatment options that would far exceed what we are seeing in the developed world.

        Ignoring observable facts while waiting for the results of peer reviewed double blind studies is likely to kill tens of thousands of people. As doctors in NY have stated, they are literally throwing the kitchen sink at this disease in the hope of finding an effective treatment. They aren’t waiting.

    • “There was some speculation that fecal/oral transmission, leading to diarrhea as the first noticeable symptom provides some lead time for the body’s immune system to learn how to attack the virus, whereas those that get the virus in their respiratory system first end up with major lung damage occurring for days before their first symptoms (breathlessness) and then the immune response causes phlegm and pneumonia on a weakened respiratory system.”

      I was wondering about this yesterday. What happens if the egg biscuit I just ate was contaminated with coronavirus by the fast food worker? It bypasses the respiratory system and maybe infects my gut developing immunity. Not a bad deal.

      • “whereas those that get the virus in their respiratory system first end up with major lung damage occurring for days before their first symptoms (breathlessness)”

        Is this true? Everyone who shows Wuhan virus symtoms already has major lung damage?

        • Not quite what I wrote.
          Showing symptoms isn’t the same as getting the virus in your respiratory system.
          There are many symptoms that can occur without any respiratory infection.

          • “There are many symptoms that can occur without any respiratory infection.”

            Thank Goodness! 🙂

  17. Two things:
    1 – The main benefit of an ineffective mask is that it keeps you from touching your face. In that regard, eye protection also helps. Even an ineffective mask decreases the possibility that you will spread the disease.
    2 – I grew up on the great plains where it is rather dry. I don’t remember having a seasonal cold until I moved to southern Ontario where it is a lot more humid.

    • During the first half of the (now cancelled) municipal elections in France, we saw many election officials who had gloves (but not masks). In the very few images of them waiting for something, you could see a few of them touching their faces with their gloves, or putting of a glove then back on…

      It was a complete disaster from the safety standpoint.

  18. Over here on the west coast of Florida in the Venice/Englewood area we have very few cases. Venice/Englewood is the oldest age per capita region in the US. Nobody has died yet although there have been a couple of deaths in nearby Sarasota and Port Charlotte. I suspect it is because both towns are right on the Gulf with constant fresh, clean Gulf air coming ashore. I notice the most hard hit areas have the most air pollution, perhaps years of breathing this bad air has damaged lungs enough to allow the virus to gain a strong foothold in those people. We were right in the middle of snow bird season with many people in town from the north. Most have gone now so perhaps this region has avoided the worse.

  19. “We previously derived a projected Korean viral attack rate (AR) of about 2.6% and a related projected case fatality rate (CFR) of about 2.0% with extreme contact tracing, massive testing, and a capable (un-overwhelmed) medical system. Now stable tested Korean attack rate is still 2.6%. and the resulting CFR is now 1.9%, and projecting forward will settle finally at ~1.7%. The final viral attack rate CFR in US is unknown, except that it must still be much worse than Korea now. ”

    Korean case load distribution is skewed young because of the infection in the cult.

    Go here

    https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030

    Next to see the sources of transmission click

    https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030&act=view&list_no=366773&tag=&nPage=1

    96% of cases tracked. Not hard

    Age distribution. the elderly are 4.5% of the cases and ~50% of the deaths.

    read that AGAIN. 5 % of the cases, 50% of the dead.

    57% of the cases are under 50. But they are 2% of the dead.

    https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030&act=view&list_no=366772&tag=&nPage=1

    So I would caution against using a simple CFR, especially one from Korea.

    or you could argue that everyone under 50 should get back to work while us older folks
    take a social break.

    • “or you could argue that everyone under 50 should get back to work while us older folks
      take a social break.” – LOL. I like that idea. We get to sit on a beach and everyone else back at it? I’m good with that.

    • Being well over 50 and somewhat a hermit, I have no problem with that. All though we could not have the sibling gather with those rule no groups larger than ten, I am one of eleven and seven of us still have spouses. I might also add my financial situation is rather well taken care of but I did take a good hit with the stock market going down, people below 50 would fix that rather quickly, I feel.

  20. Very well done. Thank you.

    I myself suspect the virus will slow down in it’s spread as warmer weather approaches, because that is how it’s close cousin (SARS-CoV(-1)) behaved.

    While your belief in WHY warm weather affects the Flu virus is a popular one, there are other viable hypotheses out there – I for one acknowledge it could be any or all of them, I just don’t know. If warmer, wetter air impacts the virus outer shell, then it will slow down in infection rate. This is an easy one to test…wait two months for data.

    Again, well done.

  21. “So, the azithromax antibiotic in the “Trump cocktail’”

    More like, the Pr Didier Raoult cocktail!

  22. If my take on this is correct, the Wuhan virus reproduces by taking over cells in the lungs. I can see why those inflicted with bronchitis or other respiratory illnesses would be in dire straits if they contracted the virus but, why is it said that those with hypertension, diabetes, and coronary conditions are also more susceptible?

    • IIRC The virus attacks through ACE2 sites found in the lungs and the GI tract.
      People with hypertension are routinely prescribed ACE inhibitors or Losartan
      People who are diabetic are routinely prescribed Losartan to protect renal function
      These drugs appear to work with the virus.
      This is based on my understanding and is necessarily brief. The evidence is also scant.

    • 11/3/20

      Tiziana, meanwhile, will start assessing the drug in patients as soon as is practicable and will administer TZLS-501 using its proprietary formulation technology.

      It said the features of its drug candidate should provide it with distinct advantages other anti-IL-6R mAbs such as Actemra and Kevzara in treating severely affected COVID-19 patients.

      The aforementioned advantages are TZLS-501s dual mechanism of action to inhibit signalling by the membrane-bound and soluble IL-6 receptors along with the rapid depletion of circulating IL-6 cytokine, a major cause of lung damage.

      We are excited to move forward with our clinical development plan to expedite evaluation in patients as soon as possible”, said Tiziana’s chief executive Dr Kunwar Shailubhai.

      Gabriele Cerrone, chairman, added that Tiziana only became aware of the potential of its anti-IL6R mAb after people in Naples with lung problems caused by coronavirus started to respond to treatment with Actemra.

      We are sitting on one of best anti-IL6R monoclonal antibodies on the market but had no idea it could be used for Covid-19 complications on the respiratory system as no-one had ever tried it before.

  23. The cure found?
    Ivermectin kills 99.8% of the virus load in 48 hours.
    In Vitro.
    First clinical tries with humans

  24. this segment of The Ingraham Angle needs to go VIRAL. Birx/Fauci get called out too.

    19m29s to 25m27s : Laura re Italy’s COVID numbers being only 12% of the official total. then she speaks to Dr. Scott Jensen re CDC’s guidance on COVID deaths:

    Youtube: Laura Ingraham 8 Apr 2020
    https://www.youtube.com/watch?v=iGlMHPWkL2k

    more from Dr. Jensen:

    9 Apr: Gateway Pundit: HUGE! MN Senator and Dr. Reveals HHS Document Coaching Him on How to Overcount COVID-19 Cases — WITH COPY OF DOCUMENT (VIDEO)
    by Cristina Laila
    Dr. Scott Jensen, a Minnesota physician and Republican state senator said he received a 7-page document coaching him to fill out death certificates with a COVID-19 diagnosis without a lab test to confirm the patient actually had the virus.
    “Last Friday I received a 7-page document that told me if I had an 86-year-old patient that had pneumonia but was never tested for COVID-19 but some time after she came down with pneumonia we learned that she had been exposed to her son who had no symptoms but later on was identified with COVID-19, then it would be appropriate to diagnose on the death certificate COVID-19,” Dr. Scott Jensen said.

    Dr. Jensen explained that this is not a normal procedure.
    Dr.. Jensen said for example if the same patient had pneumonia during flu season and he didn’t have a test confirming the patient also had influenza, he would never diagnose the patient with influenza on the death certificate…
    The document is here (LINK)…

    As TGP reported over the weekend, the amount of Americans who are reported to have died from the Coronavirus is based on a CDC coding system that will “result in COVID-19 being the underlying cause more often than not.”
    Dr. Birx confirmed this on Tuesday during a COVID-19 task force briefing…
    Dr. Birx on Tuesday told a reporter during a Coronavirus task force briefing, “We’ve taken a very liberal approach to mortality.”…
    https://www.thegatewaypundit.com/2020/04/huge-mn-senator-dr-reveals-hhs-document-coaching-overcount-covid-19-cases-copy-document-video/

  25. I’m just an old fool, so bear with me, please.
    US population is 330 million (round figure)
    US life expectancy is 80 years (round figure)
    So deaths per year should be 330 million / 80 = 4.1 million
    So deaths per week should be 80,000
    So deaths per day should be about 11,000

    Now, coronavirus in one form or another has been around since Jesus was walking about in short pants.
    It happens that this one SEEMS more deadly than previous ones but that may be because previous versions were not identified as something different to the common cold. My understanding is that the coronavirus test actually detects ALL flavours of coronavirus, not just COVID-19. Can anyone confirm or deny that?

    If that is true, then lots of people diagnosed as COVID-19 positive, may just have the innocuous flavours, not COVID-19.

    Put these two things together.
    1) I suggest that if someone with access to the stats were to plot the daily death rate for Feb & March for the last ten years, he would find little difference in against this year’s figures (and what difference there is may be explained by weather). Any takers for that piece of work?
    2) If loads of people are being mis-diagnosed of dying from COVID-19 it doesn’t really matter – from a public health standpoint – as long as the daily death rate is unaffected compared to the last decade. It matters a lot from a public-policy “stop the economy” point of view, though, if lots of people think the crisis is worse than it really is

    • Of you think people making tests for a new virus are stupid fools who know less than someone who knows nothing about what they do, you can assume you have it all figured out with a few minutes or hours of internet jackassery watching.necessary

  26. I’m just an old fool, so bear with me, please.
    Let’s try not to over-analyse this.

    US population is 330 million (round figure)
    US life expectancy is 80 years (round figure)
    So deaths per year should be 330 million / 80 = 4.1 million
    So deaths per week should be 80,000
    So deaths per day should be about 11,000

    Now, coronavirus in one form or another has been around since Jesus was walking about in short pants.
    It happens that this one SEEMS more deadly than previous ones but that may be because previous versions were not identified as something different to the common cold. My understanding is that the coronavirus test actually detects ALL flavours of coronavirus, not just COVID-19. Can anyone confirm or deny that?

    If that is true, then lots of people diagnosed as COVID-19 positive, may just have the innocuous flavours, not COVID-19.

    Put these two things together.
    1) I suggest that if someone with access to the stats were to plot the daily death rate for Feb & March for the last ten years, he would find little difference against this year’s figures (and what difference there is may be explained by weather). Any takers for that piece of work?

    2) If loads of people are being mis-diagnosed as dying from COVID-19 it doesn’t really matter – from a public health standpoint – as long as the daily death rate is unaffected compared to the last decade. It matters a lot from a public-policy “stop the economy” point of view, though, if lots of people think the crisis is much worse than it really is.

  27. The CFR will be well below 1% and possibly below flu. Very few places are measuring anything other than a fraction of cases and people who die whilst infected. Thus the numbers are unusable. What we do know is that no country is seeing any excess deaths yet. In the UK total deaths for 2020 YTD are 3,000 below average, deaths in people under 65 are exactly average, respiratory deaths are below average – COVID deaths have pretty much replaced flu deaths in the respiratory numbers.

    We are overwhelming our ICUs by putting very elderly, very ill people in them who have almost no chance of survival and who we wouldn’t normally treat in that way. Weekly UK deaths are still 1,000 or more below the worst March weeks in 2018 when we have no explination for why those weeks were bad.

    COVID certainly kills a very small number of young, healthy people, but so does any number of infections each year. A large number of elderly, frail people will die eith it, but they die with an infection every year. We have taken extraordinary steps to stop a phantom.

  28. For some viruses virtually the whole population is infected at a young age. Roseola is one where most people infected before the age of 3. Another is coronavirus NL63 where one study showed 75% of children ages 2.5 to 3.5 years old had NL63 antibodies. Possibly covid19 will eventually be the same where whole population gets infected early in life and re-exposed to virus multiple times later in life so people will generally have some type of immunity as they age. It could be the main problem with covid19 is because people have never been exposed earlier in life they have no immunity. If the older people dying from it now we’re instead exposed multiple times to it at a younger age they would have some immunity and be less likely to die. I bring up coronavirus NL63 because it is believed to come from bats and civets and it also uses ACE2 to enter the cell.

  29. There is some good news out there: An Australian group has reported interesting results with Avermectin (a macrocyclic ionophore) having already shown activity against several alphaviruses. In vitro cell culture: 5000 fold reduction of viral RNA within 48 hours is mentioned (see https://doi.org/10.1016/j.antiviral.2020.104787 or https://www.sciencedirect.com/science/article/pii/S0166354220302011).
    The drug is already registered, cheap and available in large amounts in most countries.

    • about 82$au for a 2litre bottle at farmsupplies, sheep drench
      must be IVOMEC not ivomax or dectamax.
      dose is around 2.5ml for a 50kg animal ie follow the sheep /dog dose rates
      the horse ones are a tad high
      its got about 6mths protection and youll be worm free as a bonus;-)
      been used for decades orally OR dermally for scabies in aboriginals so human doses are well known

      usa can get a scabies pill form BY scriptonly at a rude 70 or so usd$ I read.

    • Check the concentration of the drug that was used in the cell cultures, vs the amount that will kill a person.
      Lots and lots of things kill viruses in cell cultures.
      Our body is nothing like a dish full of immortal cancer cells, or, as was used in this study, abnormal kidney cells from a green monkey that were genetically modified by using plasmids to add a gene.
      But even if one assumes cells are cells are cells, getting a drug into a cell is way different than adding them to a dish.
      This virus is not floating around in blood much, if at all.
      It infects cells on the surface of the airways in a person.
      Also to be considered is where a drug will concentrate after oral administration.
      For the chloroquines, for example, although the target cells for the virus are airway epithelial cells, the drug becomes some 200 to 700 times more concentrated in the liver, kidney, spleen, and lungs than in blood plasma. The drugs also tends to accumulate in leukocytes.
      The nerves and brain have about 10 to 30 times the amount in plasma.
      But it is most highly concentrated in tissues of the eye, particularly the pigmented tissues of the eye, the iris and the choroid, also in the retina but less intensely. These explain many of the toxicity issues.

      It is amazing how quickly people who know little of pharmacology or human physiology read a report of an in vitro effect and no matter how many times anyone explains it, they will not accept that this means very little regarding the possible efficacy when given to a sick human being.
      And many of them are the same people who in other contexts are screaming at the top of their lungs about how dangerous the wrong kind of food is, or the tiny amount of preservative in a vaccine.
      They are experts in ignoring details that conflict with what they want to believe, is how it seems to me.
      Think of it…on the one hand are things with a long history of trials and study shown to be highly beneficial to most but very occasionally about one in a million people might have an adverse event.
      In that case, the stuff might have saved hundreds of thousands of lives out of every million people, but it is rejected and vilified because of that one in a million allergic reaction or whatever.
      But then there is an extremely cytotoxic chemical with a narrow therapeutic window that has been implicated in all sorts of harms, is known to be extremely dangerous for substantial subsets of people, and is so toxic a dose of about twice as much as prescribed for a treatment will be fatal.
      But there are reports of some benefit to some people, although the people promoting it are shady and unprofessional, the results misstated to omit the people that died or got worse, and in fact the people who got it were not known to be ones that were in danger to begin with.
      Suddenly concerns of toxicity are no where to be found, and these same people INSIST everyone in the world be given a bottle of the pills and they should take them even if they are not sick in the off chance they might become infected…even though NONE of the studies looked at such a usage!

      But point out just the simple facts and a reminder to be cautious with drugs in sick people, and suddenly the people who actually know the difference between safe and dangerous, between proven and suspected, now suddenly the people who were ignored when they presented evidence that vaccines are mostly safe and mostly effective, are scorned for being concerned about safety and prove of effectiveness.

      So…what is the common thread?
      Ignoring evidence!
      Deciding what is what, instead of learning what is what by using established methods to elucidate factual data in an objective fashion.

  30. I have a question.
    It seems a safe assumption that the larger the dose the more likely to get sick, because a small dose may give the immune system time to fight it before the infection becomes too big.
    Can we say that the bigger the dose, the worse the patient gets the disease?
    We know that many only get a mild case. Is that because they got a small dose, or at least one factor?
    What about the asymptomatic — did they get an even smaller dose?

    Is there some level of dose where the immune system fights off the virus successfully and there is no sickness at all — and no virus shedding? If that is the case, then herd immunity might be possible with a lower level of deaths.

    • I reasonably suspect that it’s not just larger doses that would be problematic, but also the prevalence of greater ACE2 expression in the host respiratory system (lungs, sinuses, etc). Parallel (lots of available infection sites) is always faster than serial (waiting in line for your turn) when it comes to throughput (rate of infection). It’s been known since 2005 that SARS-1 infection was significantly greater in cells with elevated ACE2 expression.

      • Aah, OK…you are rating your own suspicion on this as “reasonable”.
        So, have you ever met anyone who offered an opinion that very person considered unreasonable?
        Does anyone ever think of any of their own ideas as unreasonable?

        And should we assume that when you do not specifically say so, your ideas are unreasonable, since you will announce ahead of time when you have one which you do consider to be reasonable?

        Just wondering.
        It is amazing after all, is it not, for someone to think of their own “suspicions” as reasonable?
        In fact you know nothing about virology that is not contain in soundbite sized internet speculations dressed up as science.
        You could spend a few days or weeks reading about it as much as you comment here…you know, actual research or education involving textbooks and appraising yourself of the state of the science, what is known and what is only speculation, and when an idea is not even that.
        But it is complicated.
        One could spend a lifetime even reviewing what a multitude of people speculate about in a single year.
        One thing such education does though…one learns that research papers are not facts, and opinions are not either.
        Few things are as complex and opaque as the particulars of how a new virus does what it does.

        • You seem to be very threatened by the idea that increased ACE2 expression in cells increases their risk of coronavirus infection.

          • You seem to be very sure of something because you readed about it on the interwebs.

  31. Another fine read on the subject, Rud, thanks. Re Zn in your greens, it is actually a good tool for hunting for metallic deposits using biogeochemical prospecting.

    https://www.researchgate.net/publication/227744855_Biogeochemical_Prospecting_of_Sulphide_Minerals_in_Winder_Valley_Balochistan_Pakistan

    You sample leaves or twigs of certain species of natural shrubs and trees with taproots or other deep rooted structures crossing geological trends, ash the samples, and analyze for a suite of metals. Zn is one of the more easily taken up metals. You have to discount or reject anomalies of most metals in samples if they are high in Mn, though, as this metal is a ‘scavenger’ of other metals in soluble form. This can be seen in the phenomenon of manganese modules on the seafloor that attracted attention some decades ago as potential sources for a fair number of metals.

  32. Rud, you have made no mention of ivomectin tests and previous use as anti viral medication.

  33. Thanks for this article. Best yet in my opinion on this subject on WUWT. I don;t know if you are aware of or participating in the “COVID-19 Healthcare Coalition”, but if not we could benefit from adding another individual of your capabilities to that group.

    Keep up the great work!

  34. “Run the alternative last week /this week math math per 10000 infected, is 0.12*0.3*0.5 or 180 deaths per 10000 symptomatic. Or, 0.14*0.26*0.5 = 182 deaths per 1000.”

    Am I being stupid, or is there a 0 wrong somewhere?

    • They are habitual liars. They got exposed for lying about swine flu, and then kept lying about it.

      • So wait…if COVID is not even as bad as flu…why are we willing to use a suite of toxic compounds to treat people, when with influenza, even the astonishingly small risk of a adverse event is reason enough to swear it is a conspiracy to poison us all?
        You are really gonna have to explain all of these contradictions.

  35. Another rats in a lab experiment:-

    60% of 223 infected but NO SYMPTOMS (well tested positive – maybe some will develop symptoms later?)

    3% showed symptoms – and presumably <3% of those would die (so 0 or 1 given the small number involved)

    https://www.startribune.com/most-people-on-antarctica-cruise-ship-have-the-coronavirus/569440442/

    Something just doesn't stack up. Certainly if this is representative, it doesn't justify destroying the world economy. The recent H1N1 pandemic was vastly worse in 1st year deaths (not to say CV19 won't catch up – although it will have to go some), but the statistical infectious/death rates etc. of that H1N1 version are supposedly much less bad than CV19.

  36. I’m not a doctor, but I’m pretty sure you are supposed to swab up the NOSE for the Chinese virus test.

    • This doctor said he has found low sats with low serum partial pressures (from thickened air sacs; ARDS) in his patients, which seems to contradict what some other doctors have found, i.e., low sats with high lung compliance (flexible air sacs that allow O2 diffusion and higher serum partial pressures).

  37. Istvan, you can hypothesize all you want about the “possible” mechanisms, what “would,” “could,” or “might” be happening, but until the double blind randomized trial is conducted, you don’t even know if these drugs are effective.

  38. Hi Rud. Thank you. Another very interesting missive. I like the lots of “dunno”. One specific analog comment:
    “So IF Covid-19 is actually seasonal, then everything else except N95 masks is USELESS. So then why the new public home made cloth mask recommendations? Like climate change renewable deals, makes you feel good while being practically useless.

    Now IF the route is cough sneeze, not aspirate aerosol, then nose/mouth coverings make sense—for the infected only. And the advice already is, if you have symptoms, stay home and self isolate. So either way the public face mask recommendations are mostly ‘feel good’ rather than effective”

    As many have noted, the mask issue has a lot of moving parts. You highlight the obvious mechanical filtration efficacy (and or lack thereof). The other parts relate to habit changes…reminder to not touch face, reminder to keep distance, reminder to suppress and or monitor coughs and sneezes. In the world of us non linear humans I suspect these behavior changes may have value.

    Again, thank you,
    Ethan Brand

  39. Question: Are the tests actually testing for an identified virus, a virus that’s been purified and visualised, that satifies Koch postulates?

    Andrew Kaufman, M.D. says the answer is No. (38 min video presentation here: https://www.youtube.com/watch?v=Xr8Dy5mnYx8 )

    He maintains the Chinese determined the disease as a viral induced pneumonia based on symptoms, and other criteria including body temperature rising, lymphocytes and white blood cells decreasing, new pulmonary infiltrates on chest radiography, and no obvious improvement upon 3 days of antibiotic treatment.

    What did they do to prove a virus? They took bronchoalvelolar (lung) fluid samples from 7, only 7, out of the initial 200 patients showing symptoms, found and separated genetic material from the samples, sequenced the genetic material “rapidly developed a qualitative PCR detection” (diagnostic test) but did not purify the virus first.

    He states that the Covid-19 RT-PCR test only tests for an RNA sequence, not the virus, there is no ‘Gold Standard’ Covid-19 has never been purified and visualised. Only visualised from one patient inside a human cell (exosome cell) the RT-PCR test has no gold standard. Thus accuracy of test unknown (estimated 80% false positive rate)

    The pictures of Covid-19 widely displayed in media are pictures of Exosomes (normal cells part of the immune system). The physical characteristics of ‘covid-19’ match exactly with those of normal exosomes.

    Dr. James Hildreth, M.D. President & Chief Executive Officer of Meharry Medical Collage, Former Professor at John Hopkins, prominent HIV researcher says: “The Virus is fully an exosome in every sense of the word”

    Any help with my question would be appreciated, I’ve spent the last week deep diving into all sorts of research trying to understand this, I think exosomes seem to be on the cutting edge of medical research, besides being part of the immune system they can harbour some auto-immune/nervous system diseases (e.g. MND/ALS) so I wonder weather the Chinese simply got things wrong when they published the RNA sequence, or weather the conversation has just been ‘dumbed down’ for public consumptioon, weather anyone in the western world has actually checked, and weather the worlds scientists working on Covid-19 vaccines/tests have been wrong-footed at an early stage and may be trying to ‘cure’ the wrong thing. Thanks.

    • “Andrew Kaufman, M.D. says the answer is No. (38 min video presentation here: https://www.youtube.com/watch?v=Xr8Dy5mnYx8 )”

      he is a shrink FFS

      And has zero clue what he is talking about

      ‘He states that the Covid-19 RT-PCR test only tests for an RNA sequence, not the virus, there is no ‘Gold Standard’ Covid-19 has never been purified and visualised. Only visualised from one patient inside a human cell (exosome cell) the RT-PCR test has no gold standard. Thus accuracy of test unknown (estimated 80% false positive rate)”

      Wrong.

      • With all due respect Sir, could you explain how he’s wrong please.

        He is a former Medical Instructor of Hematology and Oncology at the Medical University of South Carolina, which indicates he does in fact have some clue what he’s talking about,

        Dr. James Hildreth, M.D. President & Chief Executive Officer of Meharry Medical Collage, Former Professor at John Hopkins, prominent HIV researcher seems to agree with him.

        Thanks.

        • “He states that the Covid-19 RT-PCR test only tests for an RNA sequence, not the virus”

          that is literally all the virus IS. its RNA encapsulated by a lipid shell.

          tests have a sensitivity of 96%

          • That’s the point, if the virus has not been purified, visualised, and Koch postulates fulfulled, how can they say it’s definately THE virus responsible for the symptoms and they’ve not sequenced a regular exosome? (which is little more than RNA encapsulated by a lipid shell)

            I can find reference to the sequence being close to H1N1, SARS, and MERs, but it turns out they used the exact same methods to find those too, again failing to fulfil Koch postulates, not to mention the WHO scandal surrounding the swine flu debacle.

            I can also find papers where they propose adjusting Kock postulates so they can use RT-PCR to idientify a novel virus, highlighting how this is not ideal, but the guy who won the Nobel Prize for inventing RT-PCR says it can not be used to isolate novel virus.

            Is there a refernce for the 96% sensitivity that explains asymptomatic positive results? I read one of the problems with RT-PCR was to define a standard number of runs, if it’s too high all samples come back +ive, and there’s no defined standardised number of runs, so it seems a bit hit and miss, even if they did find the correct RNA sequence in the first place.

  40. I was shown a rather informative article, “COVID-19 Had Us All Fooled, But Now We Might Have Finally Found Its Secret” from Libertymavenstock. The article was published April 5th, and apparently posted on the 8th. Searching for it on Google results in an angry negative; the article is too complementary toward Mr Trump and less than complementary toward the MSM and their political friends.

    I am in no position to judge this article, but I do think it should be put out there, across the world by you, for as much critical examination and comment as possible. It is quite interesting and explains COVID-19, its effects and its treatment in a way I have yet to see.

    • It is pure science by assertion.
      No where is the source of these assertions given.
      But someone that writes in this style can sound very persuasive, even if everything they say is malarkey.
      The writer says that every medical professional on the planet has no idea what they are doing…but the write knows everything about this virus and this disease.

  41. Rud – I enjoyed your article as always. I went to bed wiser, or at least more knowledgeable, than when I woke up. Regarding your views on masks. When one looks at the Worldometer daily stats both Japan and South Korea have very low death stats. And both countries, particularly Japan is known for mask wearing in a situation like this pandemic.
    The inference would seem to be that masks are effective in both these countries. Could you – or others – comment on this please?

    • “ERROR
      410
      This account is under investigation or was found in violation of the Medium Rules.
      There are thousands of stories to read on Medium. Visit our homepage
      to find one that’s right for you.
      Take me to Medium”

      looks like the article you linked has been removed…

  42. So either way the public face mask recommendations are mostly ‘feel good’ rather than effective.

    My little foray into personal research on this confirms that statement. The studies I have looked at use a lot of “may”, “could”, “more research needed”, “not well understood”, “might be less effective if”, ….

    … you get the gist — ignorance framed in academic dressings and published, with final conclusions based on the hopeful side of “may”, without the actual confirmation of solid evidence.

    Do you KNOW how small a coronavirus is?
    Do you KNOW how reflexive most human behaviors are?
    (e.g., vet tech looses mask off face in parking lot, picks it up, puts it back on her face, germaphobe client sees it, cancels appointment from fear of catching COVID-19 — true story)
    (e.g. #2, lady in food market pulls mask from face, resting it on neck, touching items on shelf, presumably putting it back on her face later, with hands having touched stuff — I witnessed this)
    (e.g. #3., lady in home improvement store walks about the isles with mask covering only her mouth, with nose over top of mask — I witnessed this also)

    Oh, and let’s not forget our eyes — mucus membranes, ducts leading down inside our sinuses, aqueous humor acting like a water magnet for saliva droplets with SARS-Cov-2 riding on them. In other words, what about eye coverings? — oops! — guess we overlooked that. So, not only N95s, but also a good face shield might offer some real diverting of the little demons. And proper, meticulous care in sanitizing these and placing these correctly, both on and off your face to prevent contamination is a must. There’s that human-behavior issue again. Are people really going to do this? Can people reasonably be expected to do this? Even people who know and have trained how to do this are prone to reflexive behaviors in a split second.

    • Seen on French news TV channel: during “élections municipales”, 1st round (2nd was cancelled), a voting official has gloves, but at a point in time he has nothing to do, so he does what inactive people do: he rests his face on his gloved hand.

      Solution: keep hands of voting official busy at all times.

      • It does seem to address the observation that patients with low blood oxygen levels do not benefit from ventilation as would be expected and further that HCQ is so effective at resolving the symptoms, how would you explain this away?

  43. https://cliffmass.blogspot.com/2020/04/flying-blind-on-coronavirus-why-random.html
    Cliff Mass says “Epidemiological projection, like numerical weather prediction, is an initial value problem. You start with an estimate of the initial state and your model, which contains information about the processes of the phenomena in question, attempts to project the initial state into the future. If your initial state is uncertain, so is your forecast.” But testing is inadequate for this. “The current testing regime leaves decision makers poorly informed. How many individuals currently have active infections, with or without symptoms? How many people have had the virus and are now potentially immune? We don’t know. And without such information, it is nearly impossible to project the future.”

    “Extraordinarily serious decisions are being made without key information

    “Washington State is rapidly getting out of this terrible situation due to the combination of social distancing and the building immunity of the population. But we are pretty much ignorant about the magnitude of the herd immunity because we do not know how many have had and currently have the virus.”

  44. Rud. Thanks again for your efforts on this.

    I would note that even if homemade facemasks are probably ineffective, they probably aren’t dangerous for most people most of the time. (Inevitably, i imagine somebody somewhere will manage to get one tangled up with some massive machine and rip an ear off). And they are only a bit uncomfortable. So why not wear them until we are sure they are useless?

    Something I haven’t seen much mentioned by anyone is parallels with the Spanish flu of 1918. That was, of course, an H1N1 influenza, not a coronavirus so it’s not exactly the same. But I came away from the lengthy Wikipedia article with two concerns.

    1. There were two waves of Spanish Flu and the second was more lethal than the first. We probably shouldn’t blithely assume that can’t happen with COVID-19.

    2. Apparently some of the deaths attributed to Spanish Flu might actually have been caused by the notion at the time that massive doses of Asprin were a cure/preventitive for the disease. It wasn’t. And Asprin can kill you if you ingest enough. Perhaps a bit of caution is indicated in gulping down large amounts of potentially toxic substances. At the very least, folks should probably look up recommended dosages and overdose symptoms for their home cures.

  45. Rud, thanks for this series you’ve done. That’s a lot of research to have done.

    “N95 will by definition intercept 95% (their definition is <=0.3 micron 95% stopped)"

    0.3 microns or 300 nanometers. This is the rating for N95 masks. However, this corona virus should be around 125 nanometers, which is significantly smaller. The N95 stops 95% of particles 300 nanometers or larger. With the virus being significantly smaller than 300 nanometers, relatively speaking, there's no way it would stop 95% of this virus when aerosolized. That's something to think about. It's my understanding that typical hospital surgical masks are ineffective with this virus, which makes sense. It seems like even with an N95, it's a significant risk of infection with exposure.

    • The virions are not generally thought to be floating free as a virion and nothing else.
      And it is only one virion.
      Rather, it is small droplets containing a large number of virions.
      And with a mask, they are less likely to be breathed deeply into the lower airway…they are more likely to be deposited on surfaces of the mouth or the lining of the nasal epithelium, where the infective dose is far larger than the lower airway surfaces.

  46. Dr. Istvan,
    When I first read this essay I was immediately struck by your explication of the viral infective dose effect on the course of disease progression in a host.
    Very few people have touched on the details of this aspect re why it is so.
    I was going to post a comment I had made a few hours prior on another comment thread, in which I ran through a brief synopsis of one reason why viral dosage at first infection matters.
    But it was stuck in moderation for several days, so I could not do so.

    I had many of the same thoughts as you have expressed here, although lacking the quantitative aspect.
    It has now appeared, and here it is:
    “It is intuitively obvious that anything is better than nothing.
    If you found yourself in a burning room with heavy choking smoke, would you put a cloth over your face?
    The largest particles from a sneeze or cough carry enough virus to cause a flu infection in one single microscopic droplet.
    And breathed into the lower airway, the infectious dose is far lower than the same virus spread onto the nasal epithelium.
    In other words…you get sick far easier if you breathe more and large droplets, than if virions are on your nose.
    Also it must be considered the possibly huge effect that the actual number of virions a person ingests by any route has on the course of the disease in that person.
    This is a much unappreciated fact of the way our immune system works.
    A large number of virus particles will necessarily infect a larger number of cells and begin replicating in far larger numbers, than a smaller number of such virus particle.
    Our various layers of innate immunity can mop up a certain number of any invader, and dispose of a certain number of infected cells, per unit of time.
    But the antibody response that is what allows us to eventually overcome any infection begins gradually and takes a certain amount of time to even get started, and then to ramp up. The more virions and the more infected cells cranking out more virions that the infection has in it’s head start in the process, can have a hugely consequential effect on how sick a person comes, how widespread the infection is at any stage, and hence on how many cells in the host are destroyed, and how vigorous a level an immune response must ramp up to and max out at to overcome it.
    The two things that seems to make this disease so dangerous for so many…even those it does not ultimately kill outright…are the length of time a person spends being sick, and the reaching of a stage of immune activity that winds up being highly damaging in itself…the cytokine release syndrome like end stage of viral pneumonia

    We have many layers of innate immunity to infectious organisms, no one of which can do the job by itself.
    We help ourselves when we add more layers.
    It makes the job much easier for the other layers.

    Anything is better than nothing, and the protection offered by a mask may be poorly understood and understated in certain instances.

    Besides for decades of studies demonstrating the effectiveness of barrier protection…there is the obvious example of the countries where they are wearing masks faring far better than the places that do not.”

    https://wattsupwiththat.com/2020/04/08/boris-johnson-in-intensive-care/#comment-2959599

    I did, as can be seen, come to a different conclusion regarding the usage of masks, that you yourself have done.
    I think there is certainty room for differences of opinion on this.
    The literature itself from the clinical trials on mask usage says as much, and many of the authors have found contradictory results, at least some of which related to how individuals adhered to best practice in their usage of masks.
    But I think on balance the research indicated that masks can be beneficial, but that this benefit is directly related to the type of mask and how fastidiously they were used.
    In a series of comment posts after the one I linked to above, I added links to several studies and article pertaining to the usage of masks, in particular during pandemics.

    In any case, I have appreciated all you have done to keep this issue at our attention, and to inform us, keep us up to date, and move the conversation forward.
    I am a big fan, and look forward to your next essay.

    BTW…it does not seem to have made much in the way of headlines, so in case you missed it, Gilead has written up the first of the results from remdesivir compassionate use patients in the NEJM:

    https://www.nejm.org/doi/full/10.1056/NEJMoa2007016

    A careful read gives much cause for hope.

  47. Mods, I have a comment gone to moderation, perhaps for including multiple links.
    Thank you.

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