#coronavirus CoViD-19 and Rumination #6

Guest post by Rud Istvan,

Rumination #5 developed possible explanations for two emerging observations:

-Why more CVN71 sailors did not test positive for the Wuhan coronavirus because their adaptive immune systems were not naïve;

-Why hypertension, diabetes, and obesity are the main NYC comorbidities    in the serious/critically ill under age 65 CoViD-19 patient cohorts.

This guest post extends those two ideas to new observational information about antibody testing, and a very recent mainstream media (MSM) observation that an abnormally high percentage of ICU CoViD-19 patients have various forms of thrombosis. As with guest post #5, there is a high reliance on the medical literature searchable at www.ncbi.nlm.nih.gov. The most relevant literature is referenced in what follows by PCM number. For those interested in further personal research, this post also provides key words and concepts for Google exploration.

Naiveté and serologic antibody testing

CVN71 sailors were tested for Wuhan virus using PCR, which looks for the active presence of Wuhan RNA. About 15% were positive; the remainder had no evidence for the virus despite the extreme ‘lack of social distancing’ that concerned the Captain so much he was removed from command. The naiveté hypothesis speculates that (recent) exposure to the four common cold coronas may have conferred a degree of Wuhan immunity; much like vaccination with cowpox provides immunity to smallpox. This would be especially true for the two ‘beta’ serotypes OC43 and HKU1, as Wuhan is also a beta serotype. This hypothesis would also explain positive but permanently asymptomatic cases (20% in South Korea); a weaker (older common corona cold?) but still a sufficient timely response by the alerted adaptive immune system.

BUT, if true, then this hypothesis also presents a potentially seriously confounding factor for the serologic antibody tests now being developed–so far with little to no regulatory oversight or rigorous independent evaluation. To the point, Roche’s CEO said publically last week that many of these ‘would be of no or little value’. To understand why requires three background science ‘facts’.

First, the antibodies being tested for come in two flavors. IgMs form early and decline ‘quickly’. They say you recently had the virus, but do not confer lasting immunity. IgGs form starting about 10 days into a viral infection, peak at about 21 days after infection, and are what confers any degree of lasting immunity.

Most of the antibody tests being developed are qualitative ‘color changing’ lateral flow tests for IgM, IgG, and a control strip (which if it does not change color means the test failed). They are the same in operating principle as home pregnancy test kits.

Second, these antibodies can work in two ways. The ‘minority’ way is as a ‘neutralizing’ antibody that binds to and directly inactivates a virion in some fashion. This is the hope behind the convalescent plasma treatments now in clinical trials. For coronaviruses, there are three targets that potentially neutralize:

  1. The N protein (the nucleocapsid coat) which, when interfered with by a neutralizing antibody, prevents the encapsulated RNA from ‘extracting itself’ to enable intracellular replication. As a sub-result of a separate pulmonary study concerning influenza, 105 adults with COPD were tested for N antibodies to the four common cold viruses. 104 tested positive to 229E, 105 to OC43, 103 to NL63, and 96 to HKU1. VERY HIGH. The Wuhan N is likely to be similarly highly specific, a good thing for serologic antibody testing as explained below.
  2. The S (spike) protein, which has two neutralizing antibody binding sites, S1 (the ACE2 receptor), and S2, which varies by serotype. S1 lets the virus latch onto a cell, after which S2 enables the virus to enter the cell. The problem is that Wuhan uses the same S1 for ACE2 as the common cold coronas—hence the naiveté hypothesis.

The ‘majority’ way antibodies work is just ‘binding’ somewhere to some protein fragment. Corona has M (membrane), E (envelope), and S other than S1 and S2 as possibilities. These do not inactivate the virus, but do signal adaptive immune system cells to eventually come clean up as they multiply in response. There has been a fair amount of work on the original SARS, showing that alveoli macrophages can ‘ingest and get infected’, but that the virus cannot replicate inside the macrophage. A ‘cleanup needed on isle 3’ announcement mechanism. What is not yet available in the literature is how similar/dissimilar these binding antibodies might be between the common cold coronas and Wuhan. The more similar, the more likely both IgMs and IgGs will be insufficiently specific.

Third is the sensitivity and specificity of the resulting antibody test. Sensitivity is how many true positives are missed. Specificity is how many false positives are generated. As of now, only a few manufactures have offered their internal (unverified by the FDA) estimates based on small samples of people. As one would expect, results vary. Becton Dickenson says their new test is 88% sensitive and 90% specific. The importance of this requires using the formal probability mathematics of Bayes Theorem. As an example from a very new clinical lab article, if you assume the true prevalence of Wuhan is 5%, then a 90% specific antibody test (BD as advertised) will produce 70% false positives and be essentially useless for CFR denominator and herd immunity purposes. (Evaluation.com, an on line journal for clinical labs, Cairn article from 4/22/20)

Unknown is how sensitive and specific these tests can be made by careful antibody selection. The widely cited new Stanford paper on 3300 Santa Clara residents said it used a lateral flow test of both IgM and IgG from Premier Biotech in Minneapolis that it had independently validated in a small sample as a combined (different methods) 80% sensitive and ~99% specific– without separately checking for common cold corona N. So I checked Premier. Turns out they are only distributing a test from Hangzhou Biotest Biotech, Ltd. And Biotest’s Chinese website doesn’t provide specificity and sensitivity estimates at all; the specifications page is blank.

The Roche CEO is correct—we have a ways to go yet with antibody testing.

Thrombosis

This deadly ‘new’ complication has been much in the news in recent days after Broadway star Nick Cordero, age 41, had to have his right leg amputated as a result of CoViD-19 induced deep vein thrombosis. Media reports are that the incidence is between 20-25% of all ICU patients. This could certainly be a further explanation for the number of cardiovascular deaths from ‘heart attack without atherosclerosis’ pointed out in #5.

One possibility is that propensity to clot is known to be disproportionately high in those with diabetes and hypertension, so just another sequelae of obesity. But Cordero was not obese and reportedly healthy, without hypertension or diabetes.

There is another. PMC3809294 points out that platelets must have roles in addition to clotting. The paper estimates that thrombosis requires about 10E+9 platelets/liter of blood, while typically there are about 250E+9 per liter. To initiate clotting, platelets must be ‘activated’.  PMC6048695 says that it is known that interactions between platelets and viral pathogens results in activation via plasma proteins called kinocidins. And finally, newish PMC4270245 has a detailed mapping of platelet activating receptors. It turns out that common cold coronaviruses directly active platelets via receptor GPV1, and that IgG antibody/antigen pairs directly activate platelets via the FcyR11 receptor.

As a result of this new knowledge, it would appear that adding an anticoagulant such as clopidrogel (Plavix) should become standard prevention therapy in serious/critical hospital cases. There is however as of today (4/23/20) no medical consensus on that, any more than about hydroxychloroquine plus zinc as a treatment therapy.

327 thoughts on “#coronavirus CoViD-19 and Rumination #6

  1. Again thanks for these updates. I think the takeaway so far is if you are healthy you have a good shot at getting through with little or no real after affects, but it isn’t a guarantee. If you have hypertension, diabetes or renal disease you REALLY might want to stay at home.

    The second takeaway is we have a ways to go to address those at risk. I will say the warnings about obesity and poor health have been out there for years. Like smoking, it is a choice.

    • In the US a shocking 40% of Adults are obese and a further 32% are overweight. In the UK the figures are 28% and 36% respectively.

      The scientific journal Nature stated on April 2nd: “Type 2 diabetes mellitus and hypertension are the most common comorbidities in corona virus.” These are often a direct by product of being obese or overweight

      To this can be added that age and being male also loads the odds against you, as does having asthma. I note that in the UK some 30000 people a year are said to die from diabetes.

      So the lesson for the optimum chance of beating CV and indeed all potentially debilitating health issues is surely to ensure you age as well as possible, by keeping fit, taking reasonable exercise, keeping the weight off by eating sensibly and er…by not being male.

      • Tony

        Please take this in the spirit given. As someone who has eaten in both countries I understand why the obesity rates are different. I remember some of the selections on the menu in the U.K. They weren’t the most scrumptious sounding. :)The taste was fine but it sure wasn’t deep fried chicken or chicken fried steak or chicken and waffles or bacon adorned doughnuts, or hamburgers with onion rings, bacon and French fries, all squeezed into a bun. Yuk.

        My wife is a very light eater. When we go out and she sees at another table such things as those hamburgers or plates heaped with food 3 inches high she almost gags.

        Another factor might just be how many meals are eaten outside the home in America. I’ve been shocked at how often families eat out or have takeout each week. When growing up it was a treat to go out a few times a year. Now it’s a regular occurrence each week. Our oldest daughter told us recently they eat out or takeout at least 4 times a week. No wonder they are broke.

        • Ceresco kid

          Watching big bang theory over the years I was struck by the huge number of takeaways they all had. It wasnt until late on in the series they even aquired dining room tables.

          Takeaways generally mean deep fried cholesterol ridden poor quality food in over large quantities.

          Personally I think there are far too many takeaway joints, do we say people should be able to eat what they want or should they take more responsibility for their health? Ultimately, in the UK it will be the state via the NHS that picks up the often substantial bill for their obesity related problems.

        • For dinner, I just ate a fried chicken sandwich with bacon, blue cheese, mayonnaise, lettuce, and tomato, with a large side of salty french fries.

          Of course, every meal isn’t like this. I balance the so called “bad” with the so called “good”. Sometimes I eat plain yogurt, sunflower nuts, and fruit for breakfast. Sometimes I eat rice and vegetables for dinner. Some weeks, I eat cake almost every day. Other weeks, no cake, but maybe chocolate candy every other day. I drink pure water, lots of lemon juice, fruit, vegetables. I walk and do serious stretching every day, sometimes chin ups on a tree limb, practice controlled breathing everyday.

          But I’m not afraid to eat whatever I want. I used to count and record and stress over every single calorie that I consumed, twenty or so years ago. I gave that up, of course. I never use scales to weigh myself, except for yearly physicals. I have my own blood pressure machine. My vital numbers and blood chemistry are good. I weigh 155 lbs at 6 feet tall. And I’m old. (^_^), but I used to be young, fanatically athletic, and obsessed with health.

          Now I’m just balanced and at ease about all this. Balance, variety, moderation, consistency, and tenacity have become mature reflexes.

          Oh, that chicken burger that I started out describing was about three and a half inches high, with some sort of hot sauce on it too.

          There is no absolute crap. What is crap is how you act with stuff over the long run.

          • I weigh 155 lbs at 6 feet tall.

            Good gracious Bob are you sure you’re alright there guy?

            I’m 5″ shorter than you are @ 45 lbs heavier. I’d be skeert to sneeze in your general direction lest the blast from me nostrils cause you a compression fracture somewhere.

      • Certainly people *should* take measures to stay as healthy as possible. But they are also free *not* to. And yes, they will likely suffer consequences. Nevertheless, let’s not forget that liberty includes the freedom to make lousy choices.

        It’s just a shame that health insurers can no longer screen for lifestyle & pre-existing conditions. Also a shame that taxpayers are forced to underwrite people’s bad choices.

        • Eustice, plus many. Obamacare prohibited explicitly such screening. I wrote about this in ebook The Arts of Truth, and almost produced a 40 page Policy monograph in 2011 for Romney before realizing it would fall on his deaf ears.

      • Being Californians are outdoors more and are generally in better health, on average then New Yorkers, I would guess this is a contributing factor in why deaths hasn’t spread as fast yet in California.

        It pisses me off that that the politicians want to give the credit to locking down earlier, as if that is the end all reason California is doing better.

      • Ar my height, 5 ft 6 inches, I would have to weigh LESS than 150 pounds to be considered not overweight. I’m 81 and the last time I was that ‘small’ I was well under age 40. I had a HARD time finding clothes that fit me and most pants just fell off! I’d have to be anemic to weight that, now! WHO decides these things, anyway?

      • So you throw together an increasingly obese, sedentary, ageing population, together within cramped and impoverished cities and then force them to cook within their hygienically sealed dwellings during an unusually long winter and what happens?

        As the intensive care doctors in New York pondered these patients were not responding to the ventilators, it was if they had altitude sickness. As one Veterinarian stated to the Australian Prime Minister it is as if the virus is causing the body to produce Carbon Monoxide.
        Or, just maybe, like many of the deaths from mechanically ventilating the elderly and the obese, some of these people are dying from what is a common winter killer Carbon Monoxide poisoning exacerbated from the lock down and increasing costs of electrical heating.
        The pieces of the puzzle all suggest something other than a Corona Virus Pandemic as there appears to be an absence of deaths in warmer climates and the data I have followed from University of Washington shows the virus has remained at 10% of people presenting with flu like symptoms. The peak of hospitalizations has ended with winter and the young, healthy and rich were largely asymptomatic.

    • Obesity has been largely caused by government guidelines to reduce fat from the diet, which had the unintended consequence of increasing carbohydrates.

      The medical community routinely blames the patient when medicine cannot solve the problem. The patient gets blamed for “lack of willpower” without considering that some foods stimulate the pleasure centers and is thus highly addictive.

      • Some carbs are good: fiber, for instance. The brain needs a minimum of 150 carbs a day just to function. The rest of the body, obviously, needs much more. Type of carb matters more than carb itself. A carb which has been mass produced in a short period of time does not allow enzymes to break it down into useful nutrients and energy: this is the problem with carbs. Lack of physical work is another problem with too many carbs.

        I will agree that fat is very important: especially natural fats. Some processed oils are okay — depending on how it is processed. Brain development and function need fat. Some processed oils supply vitamins we may not get enough of otherwise (vitamin E, especially) and other phyto-nutrients.

        Interesting report, though.

        Regards

        AK in VT

        • AK in vt
          I haven’t eaten more than 20 Grams of carb per day, usually less for a few years now.
          Your information is just plain wrong.

          • Of course, there are always anomalies in every study, yourself one, Billy: I am glad you have been able to do this. Perhaps there are hidden carbs you are getting which you do not consider carbs (such as from many plants and especially fruits which contain carbs in the form of fructose, which your body will break down into glucose: needed for many things including helping your liver cleanse the body by making glucaronic acid; further step is sucrose for immediate energy which is used almost immediately and often stored if you have excess).

            Being into holistic nutrition for over 12 years, I know I am not “just plain wrong.” I am only trying to “combat” the blanket statements made by many fads such as: Atkins, low-carb, paleo, gluten-free (except if coeliac), etc… diets which may work for some (either all the time or for a period of time) and do not work for others.

            Nutrition involves a lot more than just carbs, vitamins and minerals. Carbs only became “bad,” recently, and those carbs were called “bad” because we needed something to blame for our health problems and because “bad” industrialist grain growers supposedly lobbying governments (along with every other “bad” industry) to get us to eat more of their grains. Back in “biblical times” grain was exceedingly important and Moses stated the average lifespan was 70-80 years and this was approximately in 1000 B.C. Medicine and access to plenty of good food keeps us alive about as long and often longer. Wheat, maize, barley, rye, etc… do not kill us or make us ill unless we have sensitvities to them or the chemicals used to raise them and the same goes for fruit and vegetables, meat, fats, and oils.

            Protein is found in greater amounts in most whole grains than in meats (nuts are usually best, but need to be increased slowly). Grains are a lot less expensive to purchase than meat and nuts. I believe one of the most recent posts to WattsUpWithThat was relating to elite NGOs pushing for organics and their ideas of nutrition and raising food and how this is detrimental to the poor of the third world. Take away their grains, and you take away an inexpensive and healthy source of nutrition for these poor and malnourished people.

            Holistic nutrition provides different solutions for different persons (what’s good fr one is not necessarily good for all), not a firm concept all should adhere to. That was my point in the previous comment. I do not take any “dig” at you, Billy, and I hope you did not at me, either.

            Peace

            AK in VT

          • AK in VT

            Gluconeogenesis. The liver can produce all the glucose needed.
            There is no need to eat any. Grains are an emergency food for famine. Long term consumption leads to insulin resistance and diabetes.

    • I’ve just loaded the syringe with Lysol as suggested and also swallowed a few UV LEDs (and batteries of course).
      This virus is not going to kill ME

      I’ll report back (possibly)
      /sarc

          • Trump said “And is there a way we can do something like that”

            ..you guys saying this crap can’t be that stupid….and if you really are, it explains even more

          • Imagine the carnage during the pandemic. I’m thinking of Michigan’s governor on a national scale.

        • As Dr. Fauci explained, Trump is often “aspirational.” I think he hears something, partially misconstrues it, thinks, “what if?” something-or-other might work, and out of wishful thinking, shares his idea, thinking it might give hope or spur additional research. Unfortunately, he has neither the scientific background nor training in logic that I wish he had.

          • I think he has some people who he takes advice from who are not very good at telling him the whole story on technical issues, especially this one.
            Even the newspaper articles jumping all over the things Trump said do not spend one drop of ink explaining exactly what was misconstrued and why or how.
            It is widely reported, and has been recently reiterated, that UV, and in particular sunlight, is very efficient at destroying viruses. Heat does so as well.
            But the context is critical. These are not having anything to do with the virus inside of infected people, but on surfaces!
            The same with “disinfectants”.
            Someone who is not in teh habit of paying close attention to exact technical details might have misconstrued the statements from various public health experts that said things like “Sunlight is the best disinfectant”.
            This is somewhat hyperbolic, but for someone who does not have an autoclave and is uncertain about what sort of chemicals have what effect and at what concentration, it might be sort of like true.
            Sunlight will definitely kill this virus very quickly, and with minimal effort, and do so without making the object put into the sunlight become toxic or poisoned.
            You do not want to pour bleach on their N-95 mask. Or boil it, or place it in a hot oven.
            But putting it outside in the sunlight is a fine idea, and placing in inside a clear plastic container in the sun for a while after the direct sun has been on it will give enough heat to kill virus but not likely enough head to melt it.

            Another source of possible confusion is the recently much discussed link with vitamin D and immune health, and the finding that many people do not get enough sun exposure to make enough vitamin D to be healthy, especially in Winter and especially at high latitudes and especially if one has dark skin and especially if one wears clothing that leaves little sin exposed and especially if one wears sunscreen all the time when outside.

            That is a lot of “especially”.
            And yet they are all true and all additive.
            If one has many or most or all of the above apply to them, they will get very little or no vitamin D from being outside, and they will necessarily be at greater risk due to vitamin D deficiency, unless they take proper supplementation.

            The upshot is, I could understand if someone conflated details like “Get more Sun to strengthen immunity”, and “Sunlight kills viruses”.
            But one applies to sunlight causing our skin to manufacture vitamin D, and the other to using the UV in sunlight to kill virus on objects (fomites in medical parlance).

            It is not baseless. But anyone who has the job of informing and advising the president on such matters ought to be very careful to make sure he has airtight information. Not to say the President cannot express a hopeful opinion about something that is so far uncertain, like how much some treatment might help if you have COVID. But he ought to have been told in careful and emphatic language which things are ideas and opinions and hopeful possibilities, and which things are very well supported by evidence.

            Something similar regarding “disinfectants”.
            We speak of sick people as infected, and I think it is clear to many people that the term “disinfectant” is not synonymous with something you put in your body to fight infections.
            But maybe less clear to someone who is not technically or scientifically oriented.
            I can imagine that he may be having a lot of people telling him stuff, and someone might have given him the idea that disinfectants kill viruses without making clear the distinction between fomites and internal usage as an antimicrobial.

            Trump was closing borders and banning travel from places when his critics were scorning such measures and insinuating or saying outright that there was nothing to worry about.
            The leaders of the EU were mocking and scorning Trump anywhere from a hour to a day prior to following his lead on travel restrictions and warnings.
            The media and people who oppose him politically inside the US were even worse.
            These are the biggest hypocrites and scientific illiterates in the world.
            To this day they all call global milding an “existential crisis”, and the most dangerous problem in the world today.
            Now THAT is dumb.
            And they are that dumb regarding subjects they have had a very long time to become very well informed about.
            Personally, I thank God for President Trump, and I wonder how I could apply to be one of his science advisers with the job of making sure when he speaks, either he is on solid ground or he making clear he is speaking about something he is not an expert on but is offering an opinion.
            And maybe adds in at times “Or so I have been led to recently believe”.

            I do that here every time I comment and have done so for years and years.
            I have been very wrong about several aspects of this virus saga, but I can cite the reason for being wrong in each instance…like trusting that the CDC was indeed offering factual information on their site, that they had the situation well in hand, and that they would not be telling us there was nothing to worry about when in fact they had no way to know that because they were not doing jack squat to be sure of what they spoke.

            The CDC told us that asymptomatic transmission was unlikely to be occurring.
            But they did not mention that it is very well known that for many infectious diseases, it is very common for people to be contagious and infected while not themselves being in the least bit sick at the time.
            They told us there was no evidence of community transmission and we were not at risk, when they had no testing program in place, the test they had created was known to be contaminated (it was the ultrasterile water used to calibrate a negative result that was contaminated, and in fact the test itself was OK) and that this was the case because they flat out ignored their own rules for sterile manufacturing conditions.
            And furthermore, they were actively preventing testing on anyone not known to have traveled to China or contacted someone who did.

            They reacted almost not at all to indications that the latency/incubation period for people exposed to the virus was far longer than is typical.
            They reacted almost not at all to numerous early indications that since many people had mild or no symptoms, but could nonetheless spread the virus, and so it was likely that if it was spreading, it would be very hard to detect in real time without some active testing surveillance in place.
            A long list of such examples can be cited, regarding the numerous ways they and other public health officials and agencies utterly failed us, at the very time they have long known and warned it would be critical to react quickly and smartly.
            The CDC was trusted by a lot of people, when in fact they were disseminating suppositions and guesses and representing it as factual information.
            I think there is plenty of reason for a lot of people to be choking on a big slice of humble pie, and as usual, many of the ones who could use a plateful the most, are the ones who never seem to have even heard of it.

          • I searched google and got zero hits on Fauci for this “quote”.

            Looks more like fake news. Especially the quote about training in logic. Scientists have little or no training in the oral logic passed down from the Greeks.

          • I see Trump is now trying to say he was being sarcastic with his comments about disinfectant. Anyone on any side of the fence can see he is plainly lying here. I mean does he really think the American people are that stupid that they will swallow this?

          • Simon,
            Wait…are you seriously expressing outrage at the notion a politician may have said something not 100% believable to you?
            Can I ask…did you happen to watch the impeachment coverage?
            Heard a single word out of Nancy or Chuck’s mouth over the past few decades, perchance?

          • Nicholas McGinley April 24, 2020 at 12:55 pm
            Simon,
            “Wait…are you seriously expressing outrage at the notion a politician may have said something not 100% believable to you?”
            This is not about politicians being less than honest. That is a given. This is about a president thinking out loud, stuff that is not only utter nonsense, but is potentially dangerous. the end result being various producers of disinfectant have been scrambling today to say don’t put our product in to your body.
            And then he waits till the next day to point out he was only joking(being sarcastic). That’s after the Whitehouse tried to say he was misquoted (so throwing them under the bus). What??? What leader in their right mind jokes about putting disinfectant into your body during a briefing on the biggest risk to health in the last 100 years? Sorry there is no defending either what he said yesterday, or the pathetic excuse (lie) he gave today.
            The look on Dr Birx’s face said it all.
            https://metro.co.uk/2020/04/24/doctors-reaction-trump-saying-inject-people-disinfectant-sums-12603569/

          • No one thinks Trump is a doctor and he does not pretend to be.
            But Adam Schiff tries to undo an election based on a giant pack of lies a mile deep and up to the sky.
            So which is the really bad guy?

          • Simon
            April 24, 2020 at 12:16 pm

            I see Trump is now trying to say he was being sarcastic with his comments about disinfectant. Anyone on any side of the fence can see he is plainly lying here. I mean does he really think the American people are that stupid that they will swallow this?
            ———————————-

            Simon,
            People who pay no attention, do not ever learn.

            You not paying attention.
            Can not blame you for that, as it could simply be natural.

            If you wanted to learn something, you would have realized that Trump was saying something, which is a supported idea of others, kinda of experts there.

            Words and phrases and terminology Donald Trump used indicated the proposition of utilizing some novel tumor therapy for COVID-19.
            The President is not an expert in such medical propositions, only saying that other therapeutic solutions are considered… probably in consideration of expert advice.

            If you have a problem with public transparency and the terminology used, especially through dumb reporters, then that is you.

            If you payed attention, you would have realized that was about a subject of medical advice… where the terminology was for public consumption… put as simple as it could.

            Would you think a novel tumor treatment used for COVID-19 should be considered,
            where the catch phrase happens to be “disinfectant”!

            I definitely most ceirtanly, would not in the case of COVID-19, would you?

            🙂

            cheers

          • Dr. Fauci is a fool who should have retired long ago. His statements about covid19 have been consistently wrong since February. He is a typical government bureaucrat — more costs than benefits for the American people.

          • One thing is for sure, Trump stands in front of a hostile press and takes all questions in a way which is unprecedented for a politician, and most especially unprecedented for a President.
            The press has a podium full of medical people in front of them, but pepper Trump with deliberate “gotcha” questions they could have far more logically addressed to one of the medical people or other assembled bureaucrats.
            It is perfectly obvious why they do this…they are looking for a zinger, not answers to important questions.
            The proof is, they rarely ask an important question, and rarely ask the person in front of them who is most likely to have specific information about the issue they are inquiring about.

          • Markw
            “president Trump thinks out loud”… I think you are being kind there. He’s just loud.

        • We’re 0 for 2. No hope in sight for at least 12 years. It is likely that Trump will win a second term. The next president will be from the other party, and thus a socialist at best.

          • After Reagan won twice and GHW Bush won, all three times beating far left of center opponents, the Dems won when they sent a moderate to the general election.
            Clinton was the first D in forever who was at least pretending to be pro 2A, pro death penalty, tough on crime, a fiscal moderate (at least rhetorically and by comparison…recall fiscal conservatives-social moderates?), was only mildly prochoice (abortion should be legal, safe and rare…recall that?), and a list of other such mild stances compared to, for example, the guy who said he would oppose the death penalty for a guy who raped and murdered his own wife.

      • Oh by the way, the U. S. Government already advocates drinking bleach as a health measure. Google: “bleach potable water EPA”.

        • Ian W: Your video link was removed by You Tube for violating its community guidelines. You Tube now believes in political correctness and censorship. Other videos it doesn’t like can still be posted, e. g. on “Climate Change,” but it refers you to Wikipedia so you can get the “Correct” data. We need a new You Tube, don’t you think?

    • Yes, the Donald’s laryngeal mechanics engage way before his synaptic code has been interpreted.
      Is it possible for the engineers to get to that bug fix ?

  2. Immunity from the HCoVs 229E, OC43, NL63 or HKU1 will most likely give you NO immunity against SARS-CoV-2.

    There are even results that sera from patients with SARS are not very efficiently neutralizing SARS-CoV-2. (1, Fig.5; 2, Fig.6) And that is as closely related and as high chances as you can get for preadaptive immunity.

    The other HCoVs might compromise antibody test results though. There is a difference of an antibody to just bind somehow to a virus or really neutralizing it.

    (1) https://www.cell.com/cell/pdf/S0092-8674(20)30229-4.pdf?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867420302294%3Fshowall%3Dtrue
    (2) https://www.nature.com/articles/s41467-020-15562-9

    • Ron,
      B cells and antibodies are 1/2 the equation, and not the important half for fighting a virus infection of the lungs.
      You do not understand T cell immunity and how adaptive immune system of the huamn body works as s system. Not one bit.

      • Enlighten me then. Especially where I said the fact of insufficient homology is exclusively a problem for B cells mediated preadaptive immune response and not also for the other branches.

        My point is that just an infection of any of the endemic corona virus will likely not give you any kind of immunity against SARS-CoV-2

        • “My point is that just an infection of any of the endemic corona virus will likely not give you any kind of immunity against SARS-CoV-2”

          You simply demonstrate your lack of knowledge of the biology of T cell mediated immunity when you say things like that.

          Immunologists refer to sera-tests for antibodies specific to a pathogen as “correlates of immunity.”
          That is having a naturally-acquired IgG antibodies specific for SARS-CoV-2 (or H1N1 Influenza, or any pathogen) correlates with immune status.

          As we frequently criticize the climate scammers by frequently observing where they go wrong:
          Correlation is Not Causation.”

          To get IgG, a lot of very specific cellular and molecular biology dances have to occur in our immune system. CD4+ T cells that recognize viral peptides strings presented by antigen presenting cells (APCs, which activated B cells are also APCs) get specific stimulation from T cells that signals them to both undergo what is called “class switch recombination” (to their Fc portion of the antibody structure coding out from IgM/IgD to making IgG, IgA, IgE) and to undergo “affinity maturation” to make subtle substitutions to the amino acids of variable regions of the antibody binding sites to find the highest binding affinity possible and select for that B cell that successfully finds that optimal lock and key “solution.”

          B-Cells need help from CD4+ T cells to get to that high binding affinity neutralizing IgG. The CD4+ recognize peptide strings that have been snipped from the proteins of the virus, where many of those peptide strings come from regions of the virus that a very similar among closely realted viruses, like within the beta-corona virus group of the Coronaviridae (not a misspelling) family.

          CD4+ T cells specific for a pathogen “eptiope” diversify, so of the daughter cells become help for B cells, other become much directly cytotoxic T cells that attack and k1ll infected cells just like CD8+ T cells.

          What most of the folks making comments here, including Rud apparently, is they do not understand the role of T cells in both eliminating infected cells, in helping B Cells along in their maturation process that selects for B cell clones that make the highest binding affinity antibodies for effective virus neutralization (that then further differentiate into plasma cells), and in also forming a regulatory set of CD4+ T Cells that “polices” everyone and keep inflammation signals from running away unchecked (the cytokine storm, sometimes seen in patients, probably arises from not enough regulatory CD4+ T cell restraining the cytotoxic siblings pumping out pro-inflammatory cytokines.).

          And because T cells tend to recognize conserved epitopes across closely related virus strains, there is frequently cross reactivity in the T cell compartment. Sometimes this is good and sometimes it is bad as it leads to autoimmune disorders like Islets cell destruction in children who then become lifetime type 1 diabetics needing daily insulin, and in rheumatoid arthritis, to MS.

          This cross reactivity in the T cell compartment between closely related corona viruses is the leading hypothesis on why so many asymptomatic infections are being seen in COVID-19 with SAR-CoV-2.

          And since most commenters here apparently do not understand what that statement means, it means they are also getting lots of what they saying here flat wrong.

  3. Interesting thought experiment to project backwards in time to have an idea if lockdowns worked:

    https://t.co/EgumDVdk5C?amp=1

    Would be interesting to combine with growth rates and smartphone tracking data to see which effect was already on because people changed behavior already before the lockdowns.

    • It is never mentioned in the media but COMMON USE FACILITIES such as washrooms at events, production lines and washrooms in factories, kitchens at retirement homes…..are a common factor in CoVid outbreaks. Avoiding such congregating-with-questionable-hygienics places is a good way to reduce your probability of exposure.

  4. Zach Murphy MS DO PA, Ninja Nerd You Tube channel gives a perfect explanation of CoViD-19 thromboses in his most recent update.

    Per liter is an incorrect nonstandard unit for platelet concentration, should be per deciliter.

    Sunlight – UVC sterilization – mentioned yesterday. Today’s #FakeNews is full of #FactCheck denials, “No it doesn’t!”

    • Doug, I suppose that you mean that it is not a conventional unit of measure in medical science when talking about blood, but of course it is a valid unit of measure (cells per volume). Just as it could be cells per microliter, or cells per cubic mile. It’s easier for me to imagine a liter than a deciliter btw. Your comment is like saying that Hungarian is not a valid language, you need to use English.

      What’s the relevance? How in your mind does it change what Rud wrote?

      • I suppose that next you’ll point out that platelets are not true cells? Ok, make that platelets per volume.

  5. DOI is a better academic resource ‘locator’ reference. Sci-Hub.tw hops all paywalls.

  6. You’ll love this

    https://www.dailymotion.com/video/x7o1812

    “There is a battle playing out inside your body right now. It started billions of years ago and it is still being fought in every one of us every minute of every day. It is the story of a viral infection – the battle for the cell.”

    “The hidden life of the cell”

    Something the BBC can do

  7. “How coronavirus attacks your veins, heart, brain and blood – as well as lungs.
    We are seeing a range of illness; some people develop blood clots, others heart attacks or kidney failure,” said Prof Ajay Shah, BHF Professor and consultant cardiologist at King’s College Hospital, London.”
    The article is behind pay-wall, but if interested you can find text here
    http://www.vukcevic.co.uk/CV.txt
    Accompanying image is here

      • Scissor
        I had to google function of ‘endothelial cells’ and found this:
        “Inflammation is usually analysed from the perspective of tissue-infiltrating leukocytes. Microvascular endothelial cells at a site of inflammation are both active participants in and regulators of inflammatory processes. The properties of endothelial cells change during the transition from acute to chronic inflammation and during the transition from innate to adaptive immunity. Mediators that act on endothelial cells also act on leukocytes and vice versa. Consequently, many anti-inflammatory therapies influence the behaviour of endothelial cells and vascular therapeutics influence inflammation.”
        Thanks for the comment, some of us come here to learn too.

    • Vuk
      April 24, 2020 at 6:34 am

      The latest day madness, every thing wrong there happens to be due to Trump.
      Same stupidity madness with this latest viral infection disease.

      cheers

    • All of which strongly suggests COVID is a catalyst rather than a “cause”. Give it to healthy people and at worst they get a bad flu. Give it to some people with existing health problems and it exacerbates them sometime fatally.

      The numbers of people who have diedxwithout a health issue (being over 80 also being a health issue as nothing works well any more) disclose to zero, and as those deaths are investigated a number are being shown to have health condi8they didn’t know about.

  8. Anti-coagulants are beginning to be incorporated in covid treatment, but I have read that they don’t always work

    When RAS homeostasis (ACE/ACE2) is destabilized and skewed towards the ACE axis, which is what happens in covid patients, thrombosis risk increases. IMO that risk especially increases when ACE inhibitor treatments are stopped when patients are admitted to ICUs (if not earlier). Infection causes ACE2 to decrease, and stopping ACEi causes ACE to increase, throwing RAS out of balance towards the inflammatory axis and increasing thrombosis risk.

    Also, ACEi decrease production of PAI-1; PAI-1 inhibits tPA; tPA breaks apart blood clots. So removing ACEi causes increased PAI-1 production, which increases inhibition of tPA, which increases thrombosis risk.

    • Here is my guess on this:

      Changing BP medication after C-19 infection may risk exposing the ACE2 receptors.

      However, changing BP medication prior to C-19 infection could reduce the number of ACE2 receptors, if it was done early enough.

      For example switch from an ace inhibitor to beta blocker, then hunker down for a couple of months of fasting to get the weight down?

    • The fact that the side-effects of ACE inhibitors are the symptoms of COVID supports that. If COVID reduces ACE or the workings of ACE, you would see the same effects as an ACE inhibitor. Also, there is some evidence ACE inhibitors increase the amount of ACE2 on cells, making them more susceptible to infection by COVID.

  9. I think what we see here is the complete failure of the smartest people in the world establishment scientists to contain a disease.

    A big thank you.

    Andrew

    • The reality is the human body is vastly more complex than our rudimentary knowledge of its workings. Look at the history of previous pathogens and their related diseases, and how hard multitudes of scientists worked to find solutions, and how long they took. This is a new (novel) virus so only a politician or a simpleton would expect real solutions in a couple of months. At best we can expect better treatment regimens with existing medicines and technologies.
      This virus has given us a concrete example writ large of how nature is in charge and as always we have to reason our way to successful adaptations. Hubris towards mankind’s capabilities and the precautionary principle are impediments to those solutions. This is exactly the underlying problem with “climate change”.

        • It takes 12 to 18 months at a minimum to develop a new vaccine. Most of that time is spent in testing. There is nothing in the world that can speed up testing.

          Same process with drugs. You have to develop the drug. Then you test at low doses to make sure that the drug itself doesn’t kill the patient. (Just because it kills the virus in a petri dish does not guarantee that the drug itself isn’t worse than the disease) Then you test a higher and higher levels to find out how much drug is needed to kill the virus without also killing the patient.

          Real life isn’t a TV drama, we aren’t guaranteed a solution before the hour is up.

          • MarkW
            You remarked, “…, we aren’t guaranteed a solution before the hour is up.” You are if there is a House in the doctor. 🙂

          • “It takes 12 to 18 months at a minimum to develop a new vaccine. Most of that time is spent in testing. There is nothing in the world that can speed up testing.”

            That isn’t entirely true. Human Challenge studies are being debated to eliminate the “wait and see if someone gets infected over a certain period of time.”

            https://www.nature.com/articles/d41586-020-01179-x

          • Human Challenge studies could be a disaster if people in the placebo group die. Is it even legal to sign a disclosure for something like this being a healthy person?

          • One take on the ethics of placebos in vaccine trials.
            “The prospect of placebo-controlled trials in these situations often raises controversy among members of research ethics committees (RECs), drug regulators, and policy-makers, because current ethics guidelines generally recommend that placebos should not be used as a comparator when an effective intervention already
            exists. However, the panel of experts noted that some of the guidelines do not take sufficient account of the
            specific nuances of vaccine research and vaccine trials. The inconsistencies of current ethics guidelines also
            serve as a source of confusion for researchers – some guidelines state that scientific necessity, to establish
            Background
            10
            1 Use of placebos: The benefits, risks, burdens and effectiveness of a new method should be tested against those of the best current prophylactic, diagnostic, and therapeutic methods. This does not exclude the use of placebo, or no treatment, in studies where no proven prophylactic, diagnostic or therapeutic
            method exists (Brazil, Conselho Nacional de Saúde, RESOLUÇÃO CNS Nº 404, 2008).
            2 http://whqlibdoc.who.int/hq/2004/WHO_V%26B_04.04.pdf.
            3 Stakeholders are people or organizations affected by the outcome of a trial, negatively or positively, or those who can affect the outcome of proposed
            research. This includes the population that will be approached to participate in the trial, as well as communities and individuals who are not physically
            located where the research takes place, including advocates, activists, groups representing specific constituencies such as sex workers, drug users, treatment activists and others. In addition, key stakeholders can potentially include educators, medical professionals, media professionals and, in the immediate
            community, family members, and people whose age and/or gender make them ineligible for study participation. Policy-makers and leaders of countries
            where research is taking place are critically important to the research process. All of these groups can provide important input on how to build support for,
            and conduct an ethical, scientifically sound, and successful trial (Good participatory practice: Guidelines for biomedical HIV prevention trials. Geneva, Joint
            United Nations Programme on HIV/AIDS, 2007 (UNAIDS/07.30E/JC1364E)).
            USE OF PLACEBOS IN VACCINE TRIALS
            public health benefit, might justify particular research designs (including placebo-controlled trials) while some
            national guidelines strictly rule out the use of placebos in all cases where an established effective intervention
            exists.”

            https://apps.who.int/iris/bitstream/handle/10665/94056/9789241506250_eng.pdf;jsessionid=AA1AFE7A8814E4751C37D51C3E01781C?sequence=1

    • In your world, real life is like a tv drama, where the doctors always manage to find a cure before the hour is up?

      Only someone with no knowledge of the real world would be whining that the doctors should have been able to find a cure by now.

      • Mark W,

        You obviously have an axe to grind. I didn’t say anything about a cure. I said ‘contain’.

        Please read for comprehension.

        Andrew

        • Same comment applies to both. You apparently have never spent any time in the real world having to solve real problems.

          • I guess we could be like China and start welding doors shut so that everyone stays where the government told them to stay. Would that be enough to satisfy you?

          • MarkW,

            Your hostility is misplaced. We do have a complete failure to contain. Why you are unable to accept that is a personal issue for you.

            Andrew

        • So maybe you should clarify what you mean by contain. Certainly we have countries that so far have done a much better job of containing this than the US. Whether that will remain so for the long term is another question.

          • You guys are missing the point. We need leadership that has to be able to do better than to give us body counts on TV while we shut down our economies.

            Andrew

          • The “experts” and main stream media are very loudly saying that the very best thing we can do is to shut down the economy.

            Fear is contagious and right now the drum beat is saying the only option we have to a lockdown will be death.

            Trump has gone way out on a limb to reopen. If it fails sleepy Joe becomes president. If it succeeds sleepy Joe and the press will claim they were always in favor of reopening and Trump acted too slowly. That he should have reopened months earlier.

        • This virus was in all probability spreading all over the planet by the time anyone was aware it was a new virus and it was killing people.
          A look at the timeline and a few moments thought made that obvious to me.

    • “I think what we see here is the complete failure of the smartest people in the world establishment scientists to contain a disease.”

      …it’s beginning to look like it was pretty much out of control..for months….by the time China admitted we have a problem

      and even then…China said it was not contagious…and the WHO repeated it

      one day we might wake up..and stop treating China like an honest partner

      • Instead of reposting just the same link over and over, why not (with the link) quote the parts that you think are relevant so that we can have a discussion about them? The use of anti-inflammatories is controversial. I do like how that document plainly states that early intubation will cause the ARDS doctors (think they) are trying to treat. Maybe not always true, but I suspect that in the majority of patients it is.

        • I have pointed out in other posts

          Main point, everyone needs to see this, so I keep posting so everyone eventually sees it

          I tried to post general general article on this, but no response from from site editors

          There should be general article about this info from evms

        • Will take time to summarize.

          Back in March with all the bs and spin I had a telehealth appointment with my Dr. He read me verbatim the prevent treatment. Did not know source at time.

          By the way, I am 70 with asthma history

          In early April discovered source.

          On 20 April saw the last update, decided every one needs to see even if they do not want to wade into the details.

          Yes there should be a general article/post to have a good debate about all issues.

          Things are moving quickly, was informed by my local heath org they are sending nurses to homes now when needed

          I belive they are following the EVMS protocols

          I am assuming it is not if, but when I am exposed to sars-2

    • Andrew,
      Viruses like this one which have long incubation periods and low mortality rates can’t be contained or stopped because they spread too far and wide before they are detected. Maybe someday we will be able to detect them faster, but for now the best we can do is prepare for occasional pandemics and then ride them out until herd immunity kicks in or we develop a vaccine. All other choices, like economic suicide, are worse than the virus.

      Yes, lots of people will get sick, and yes a small percentage of them will die. But this is the reality of living on this planet: you must constantly be evaluating all the risks to your personal safety. You avoid the ones you can, and mitigate (to the extent you can) the rest. There’s nothing you can do about “bolts out of the blue” type events, so there’s no sense in worrying about them. Everybody has the right to make their own decisions in this regard. Absolute safety is an impossible state and you have no right to control others just so you can feel safer. Yes, you have a right to protect yourself from imminent harm, even to the point of using deadly force (depending on the circumstances), but not from potential harm.

      • Paul,
        “Viruses like this one which have long incubation periods and low mortality rates can’t be contained or stopped because they spread too far and wide before they are detected.”

        Exactamundo!

      • Viruses like this one which have long incubation periods and low mortality rates can’t be contained or stopped because they spread too far and wide before they are detected.

        This is demonstrably incorrect.

        Australia achieved it and there has been a non-trivial 6,675 cases detected so far. Maybe Australia was just lucky but I’d like to think that its because Australians on the whole took social distancing and hygiene seriously and they did it before it was too late.

        • Tim,
          Your whole argument depends on the words “detected so far”. What is the geographical spread of those known cases? How many people have even been tested? I think when you take a closer look, you will discover that:

          1) Too few people have been tested to say anything useful about the spread of Covid-19 in Australia.
          2) That the 6,675 cases you cited are not in just one little hot-spot in one city, but are spread around the country.

          This means that the virus has indeed spread to all of the places where the majority of Australians live, we just don’t know how many have been infected. As testing increases, so will detections. Let’s see what the numbers say in a month or two.

        • Paul writes

          Your whole argument depends on the words “detected so far”.

          Australia”s rate of testing is higher than that of the US and is finding nearly no COVID-19 cases. For example only 20 yesterday. Australia’s testing has expanded beyond testing those with obvious symptoms and high liklihood of showing positive results so is covering the wider community and is still not finding the virus.

          So far, for better or worse, Australia has contained the virus.

  10. The list of claimed covid caused symptoms etc is becoming unwieldy. If most disease is caused by viruses and bacteria and fungi etc gone wild, then I suspect a reason that apparently healthy people keel over periodically is that they’re loaded up with a particular ‘bug’ that as yet has been unsuccessful and the covid virus soaks up so much immune priority it lets the other bug run wild. It may not necessarily be covid wotdunnit.

    I think this is true in that for ages everyone thought cancer was caused by environmental factors and carcinogens and whatnot and then Ian Frazer figures out cervical cancer is caused by HPV and creates a vaccine for that. This says that HPV lives in a massive number of people and doesn’t express as cervical cancer until a certain density threshold is reached (somehow.) Cervical cancer is now recognized as an infectious disease, as is stomach cancer and some skin cancers.

    Given the number of reports of people dealing with all manner of symptoms etc and the reported success of zpacks then this would explain how/why the zpacks are addressing the problem. I have an issue with having viral colds devolve to bronchial infections which are bacteriological, which are cured with a zpack, and I reckon I can’t be the only such case of this.

    • “If most disease is caused by viruses and bacteria and fungi”

      In the US most disease isn’t caused by viruses, bacteria and fungi. Diet, lifestyle, and iatrogenesis are probably the top 3 culprits.

      • Funny thing, people have been getting sick forever, long before bad diets, bad lifestyle and iatrogenesis were even a thing.

        • Pathogens are a major problem in the undeveloped world, but improved sanitation/infrastructure, personal hygiene and improved nutrition has eliminated much of that from the developed world.

          • Pathogens are still everywhere. Last time I checked it’s not only fat people who come down with the flu.
            I’ve seen plenty of healthy people get cancer.

          • What I meant was, not pathogens themselves, but pathogenesis from pathogens. TB is the #1 infectious ki!ller in the world, but we really don’t see much TB mortality in the US, due in part to improved living conditions.

        • Mark,
          The more time goes by and the longer we all live for, the better we seem to have gotten at pretending if we can eliminate a few more causes of death, there will be nothing left to die from.

      • Lifestyle, diet, etc was blamed for stomach cancer for years until it was proven that it’s cured by an anti-biotic. Stomach cancers are caused by Heliobacter Pylori.

        Since the list keeps growing every day of bacteria fungi and virii causing these things (see the crohn’s disease cure published 2 weeks ago) it’s safe to assume that most stuff humans suffer from is anything BUT lifestyle and diet.

        • “Stomach cancers are caused by Heliobacter Pylori”

          An unproven hypothesis, as are all of the pathogen etiologies for virtually all (if not all) cancers. IMO cancers are nutritional and toxin-caused diseases.

          • It’s established that human papillomaviruses are linked to cervical cancer and this discovery was awarded with a Nobel Prize.

          • Virtually everyone who gets hepatocellular carcinoma is infected with the HBV or HCV viruses.
            People co-infected with both have a greatly exaggerated risk of getting the this liver cancer.
            Cancer is a progressive condition that is caused when a single cell accumulates enough mutations to allow it to reproduce out of control, while at the same time evading the preprogrammed cell death that usually prevents damaged cells from persisting, and the immune cells which typically mop up most of the rest of damaged or infected cells.
            It is caused by dysregulation between the natural processes of cell division and apoptosis.
            Genes that control and regulate cell growth, division, and differentiation must be altered from a normal state.
            (there are other ideas of why and how cancers occur, but this is the gist of the mainstream view)
            One huge question re carcinogenesis, where do malignant cells acquire the ability to cause neovascularization (growth of new blood vessels that provide nutrients and oxygen and carry away waste), without which a malignancy would not be able to survive past a certain small size?

            Example: “On average, for example, 15 “driver mutations” and 60 “passenger” mutations are found in colon cancers.”

            Source:
            https://science.sciencemag.org/content/318/5853/1108
            When malignant cells acquire the ability to move through through tissues, they can become metastatic.
            One theory is that this occurs by some sort of hybridization with immune cells called B cells, which are supposed to destroy damaged cells. B cells are one of the only type of cells that can move freely through the tissues of the body.
            Cancer is not a single disease, or anything like that.
            It is a class of cellular disorder.
            It is very likely that no two cancers are ever exactly alike.
            There are genes that can predispose for various reasons, infectious organisms that can predispose, environmental factors that can predispose, etc.
            Some people smoke cigarettes by the multiple packs a day and live to be 100 and never get cancer.
            Other times, little kids get cancer before they are old enough to walk.
            Sometimes the immune system becomes activated when a person is given no hope of survival, and a cancer will disappear from a patients body virtually overnight…although a longer period of time is more typical in cases of spontaneous remission.
            Many researchers estimate that the average person has dozens of malignancies that form in their bodies at some point in their life.
            This is one reason why body scans are not done to everyone on a regular basis…body scans typically reveal suspicious masses in virtually everyone scanned.
            In my family, no one can find anyone who has had cancer out of hundreds of people going back several generations, maternal and paternal.
            In other families, it seems nearly everyone gets cancer before they die.

    • Some diseases attack mostly one type of tissue. Others attack many types.
      At first it was thought that COVID19 mainly attacked the lungs. As the number of patients increases, doctors are seeing evidence that other tissues may be influenced as well.

      • We don’t know how many are attacked directly vs how many are attacked due to opportunity.

        For example, heart attacks are linked to bacteria living in the mouth; it’s known that some attacks are caused by them but not really how. Am suggesting a covid like pathogen can be an agent that allows things to run amok. There are covid reports of heart problems. May not be covid directly.

        The western world (poster icisil is an example) tends to believe that infectious disease is a thing of the past, and I’m saying that this isn’t true; humans managed to off the ones that were easiest. Sort of like the problem in physics where massive progress is made 1900-1950 and seemingly little progress since and the answer is that the easier problems have been solved, the harder ones are what we have now.

        • No, I didn’t say or imply that infectious diseases are a thing of the past in developed countries. Most diseases in developed countries nowadays are chronic inflammatory and metabolic diseases. There is a segment of society that wants to absolve themselves of any and all responsibility when it comes to their health and ascribe every illness to a pathogen.

          • They’re nothing compared to a growing segment of society willing to imagine and later absolutely convinced that their illness was caused knowingly and maliciously by monsanto, exxon, or apple pesticides; they are greatly aided by madness like Calif prop 65 wherein even a simple cup of coffee is claimed to be a carcinogen.

            Add to that the people who believe — strike that — KNOW that organic anything is superior to standard food because chemicals. According to them we proles not buying the organic fantasy are sick and somehow deserve to be sick. Because chemicals and because eeevil corporations. We all know who thinks corporations are evil.

            This is the segment of society wanting to absolve themselves of blame. Not the segment looking into infectious disease and trying to solve.

      • COVID enters cells via ACE2. Lots of cells have ACE2 sticking out but the highest concentrations are on lung cells.

  11. Rud, you may know this, maybe not. What effect would zinc deficiency have on ACE2, which is a zinc metalloenzyme? I’m wondering if it inhibits its expression.

    • The explanation I have read but not personally verified (yet) has nothing to do with the ACE2 receptor. It is that a zinc ionophore (like hydroxychloroqine or the flavenoid Quercetin) transports zinc into the infected epithelial (or cardiac, or renal) cell, where it then interferes with the Wuhan RNA polymerase, thus halting viral replication.
      This should easily demonstrable in vitro if true. Get live epithelial cells in a neutral plasma in two petri dishes. Add a known viral titer to both. Then add a zinc ionophore plus zinc to one. If the hypothesis is correct, then after 24 hours the treated sample should have a much lower viral titer than the control.
      I’ll look around and see if I can find a published experiment of this sort. This is the sort of thing Fauci’s NIH people should be all over, but apparently aren’t.

      • hang about is Wuhan RNA the same as china RNA the same as chicom RNA the same as Sars-CoV-2 virus. I wish people would stick to the same name it is so confusing.

        never mind I’ve got a pint of Brawndo to get through

      • “Then add a zinc ionophore plus zinc to one.”

        Whoa, wait a second.
        If you add two things to one dish, you only know that either one, or the other, or both, had an effect.
        You need to do a lot more than two dishes to narrow down if it is zinc, or the ionophore, or both, that had the effect.
        And even then you only know there was an effect…it does not prove any single hypothesis regarding the cause for the effect seen (or not seen).
        Confirmation bias can be hard to spot in our own thinking, so we have to be careful not to fool ourselves, as I know we are all abundantly aware.

        Besides for that, I have asked elsewhere and gotten zero response so far that I have seen, that the many assertions regarding HCQ being a zinc ionophore, have apparently all assumed this to be the case since CQ is one.
        Many articles with the assertion in many print and online media have even linked to the source for the assertion, and posted a link to CQ research, not HCQ, and nothing about why it should be assumed let alone proven that HCQ is, as well.
        Also, that research was not looking for antiviral effects, it was looking for anti cancer activity, or more precisely evidence for a reason to investigate such activity.
        What the research showed was, that zinc was introduced into lysosomes, which are not how this virus enters a cell.
        And the net outcome being researched was that this combination of zinc and CQ reduced autophagy, and stimulated apoptosis.
        IOW…it killed the cell, by inducing them to undergo programmed cell death.
        Adding zinc this way caused the cells to die, an important thing if you want to kill cancer cells.
        The research was done, BTW, on cancer cells.
        I can think of a lot of reasons not to assume a general systemic effect in a normal person who has a viral illness due to a finding in cancer cells in vitro.
        Here is a link to it:
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/

        There is other research on chloroquine and on zinc ionophores, but none, as far as I have seen, showing the same for HCQ.
        Although they are not vastly different in terms of their diagrammed structure, they are very different in when one examines the three dimensional shape.
        It may well be an ionophore, but just because the molecules are similar and both work as an antimalarial is very weak evidence for such. Nonexistent really. It is cause to suspect it might be, but we should keep in mind that experts in the relevant fields do not assert that the zinc ionophore effect is a fact, or even a leading theory of why and how these drugs work.

        Small changes in structure can completely alter how molecules behave in the body or within a cell.
        I have seen where many commenters on WUWT that asserted without evidence that the two drugs are equivalent, and that one is transformed into the other inside the body, or than one is the metabolite of the other.
        These are both false.
        How different can a molecule be just by substituting a OH for one of the H’s?
        How different are methane and methanol?

        For anyone who thinks that is an exaggeration, when one substitutes an OH for an H in the chloroquine molecule to make hydroxychloroquine, the melting point of the molecule goes from ~289°C to ~90°C!
        And the toxicity data alone demonstrates they are nothing at all like metabolically the same.
        The lethal dose for both compounds varies depending on whether man, woman, or an animal, as well as mode of administration (and it varies hugely) but for example in a child the oral LDsubL0 (lethal dose low, the smallest amount that can cause death under controlled conditions) is just ~38mg/kg for chloroquine, but 600mg/kg for hydroxychloroquine.
        That is a huge difference.
        There are other thresholds listed separately for mental effect, cardiac one, etc.
        There is far more toxicity data for chloroquine than HCQ, and it varies hugely for a given affect and a given animal, but in no creature are the number similar.
        Pharmacology reference texts say zip about zinc ionophore as a mode of action for any therapeutic effect.
        And in fact more and more data is showing these drugs do not kill this virus in a person.
        As one might well have surmised (and some of us have) if this result is confirmed, it will match data for in vivo activity vs all the other viruses they two have been tested on.
        Any therapeutic value most probably is limited to immunomodulatory and anti-inflammatory effects.

        References include 3d interactive diagrams of the two:
        HCQ
        https://chem.nlm.nih.gov/chemidplus/structure3D/viewer/118-42-3

        CQ
        https://chem.nlm.nih.gov/chemidplus/structure3D/viewer/54-05-7

        And toxicological data here:
        HCQ
        https://chem.nlm.nih.gov/chemidplus/rn/118-42-3

        CQ
        https://chem.nlm.nih.gov/chemidplus/rn/54-05-7

        Physical properties here:
        HCQ
        https://chem.nlm.nih.gov/chemidplus/rn/118-42-3

        CQ
        https://chem.nlm.nih.gov/chemidplus/rn/54-05-7

        And detailed human health related data:
        HCQ
        https://pubchem.ncbi.nlm.nih.gov/compound/3652

        CQ
        https://pubchem.ncbi.nlm.nih.gov/compound/2719

        Finally, I want to point out that anyone who goes back and reads the many lengthy discussions about these drugs here over the past many weeks, will find that the original reports and rave reviews and assurances that this was the cure, the whole debacle would evaporate in a few weeks, CQ cured 100%, back slapping etc.
        Only later did the focus widen to include HCQ.
        And only gradually did speculations and assertions regarding zinc become part of the story.

        There was nothing about using it only at the early stages, or using it with an antibiotic or forget it, or using it with zinc or it is a bullshit study, and especially not that HCQ was THE drug, not that crap chloroquine.
        And yet reading now we have people saying all sorts of such things, and acting as if this is common knowledge and anyone who does not know it is a dope.
        I have ben reading over threads on the virus from the past two months, and the comments from people then and now are in very few instances and for very few people even slightly reconcilable.
        I am not gonna name any names (yet), but few of the most prolific commenters here have stuck to the same story or beliefs, and at no time was there any declarations that new knowledge has caused a rethink.
        Instead, glib assurances have morphed into other glib assurances.
        Again, I am not gonna start calling specific people out (right now), but it sure would be nice for some of the people to please tell those they are berating when between then and now they acquired such knowledge and such surety.

        I have seen some of the people here on other blogs and sites sneering at medical doctors about how stupid they are, given that this commenter has astutely and through pharmacological acumen and encyclopedic knowledge of biochemistry and microbiology, handily cured themselves of COVID 19…but this person can be found a about 5 weeks ago saying that MAYBE they perhaps might have had the virus back in early December, and that one possible reason for a mild case may have been green powders from Costco and some extra vitamin D, with no mention of ionophore or zinc at the time, or even more than a hint of a possibility that the illness might possibly have been COVID.

        A similar evolution has occurred in numerous individuals, such that the conversations we are finding now are a case study in moving goalposts, confirmation bias, and non-evidenced certitude that would make a Warmista High Priest blush with shame.

        On the other hand, some have shown and yet retain what IMO is a highly evidenced degree of scientific thinking and willingness to abide by new information and to stick to the evidence.

        • “Only later did the focus widen to include HCQ.
          And only gradually did speculations and assertions regarding zinc become part of the story.”

          yep.

          it is predictable. Once people decided, ahead of the evidence, that Chloriqine was a cure
          then they must defend it to the end.

          and every bit of data that falsifies their belief, must be bad.
          or they change their hypothesis.

          its HCQ
          wait
          with zithromician
          wait
          with Zinc
          wait
          only given early
          wait
          only given to those with no comorbidity
          wait
          only for men
          wait
          only given in dose x
          wait
          only given on a tuesday

          There is no bottom to the number of ways that data can be rejected and hypotheses can be amended to preserve a belief.

        • Wow. Epic rebuke and takedown, Nicholas. (Anybody keeping score somewhere? If so, tinker to show yourself!)

        • From the link provided by Dave W,
          “Hydroxychloroquine also reduces the activation of antigen-presenting dendritic cells by blocking TLRs on their cell membrane.”
          Note that antigen presentation is how our immune system is activated to produce protective antibodies, and this report indicates that HCQ reduces that function.
          In fact, it has several effects which have a net result of down modulating the immune system…which may not be such a great thing when, you know, you are trying to fight off an infection.
          Dialing down immune system when cytokine storm is wrecking your body…might be good, but only if appropriately targeted.
          IL-6 blockers do this in a way which is known to save the life of some people undergoing cytokine release syndrome.
          HCQ…no such known specificity or efficacy.
          And given when the infection is just starting, or has not occurred yet?
          Might be a very bad idea.
          Giving a drug to a sick person is not the same as giving to a healthy person.

          https://www.sciencedirect.com/science/article/pii/B9780702071676000300

          And BTW…it is known at least at least 200 lupus patients in the US who take HCQ regularly for their lupus, have contracted COVID despite being on HCQ:
          https://twitter.com/rheum_covid/status/1245775580513140738?s=20

      • I agree with you, Rud.
        In vitro tests were done on SARS COV and many other viruses, but I cannot find any straight tests of Zn plus ionophore on SARS COV 2.
        See for example Velthuis, A. J. W. et al. “Zn(2+) inhibits coronavirus and arterivirus RNA polymerase
        activity in vitro and zinc ionophores block the replication of these viruses in cell culture.”

  12. The first bioengineered virus to make its way out of a lab, it’s no surprise that it comes with strange complications.

      • Yeah. And yet the fact that the CCP virus comes from a city in a CONUS sized nation of 1.2 to 1.4 billion people without this bat species, yet somehow has the only level 4 biocontainment labs only miles (or less) from where it is first identified, and they are experimenting with the same species Corona viruses.

        And thus your mere coincidence amounts my vulgar mythologizing? Or are genuine investigations – after evidence was destroyed, covered up, and conveniently lied about multiple ways and times is – sensibly demanded during the world greatest pandemic health crisis since the 1950s polio epidemic? I’m dying to know.

        • the chicom/cov-2/Wuhan virus RNA was encoded into the baseband frequencies by Huawei years ago and when 5G was commissioned first in China then in EU human cells softened by c h e m t r a I l s and HARP began to replicate the cov-2 rna. Hence the first cases were china and then EU. the rest is history – you in the usa can thank the president for stopping Huawei infiltrating the 5G network. This is the reason why the US has no covid-19 cases

        • Mark, gh,
          I have spent several hours reading over all of the old threads from February on about Flu Manchu, and I gotta tell ya, iffen you want a real hoot, go and do the same:
          https://wattsupwiththat.com/category/coronavirus/

          I’ll just say that you two are notable being calm and what I consider to be rational, along with some others who are a notable minority of commenters on the site.

  13. I just wanted to make a comment after getting about two parahraphs in: If the common cold strains of corona virus can confer immunity, I see this as possibly the best news we could have.
    If true, and if it works for everyone, or even a lot of people, all we need to do is innoculate people with common cold viruses. Might as well do them all, one at a time. After a few weeks to a month, one will have fresh antibodies to a whole bunch of corona viruses.

    BTW…I have to go back to early articles on this disease, because I raised this exact possibility as soon as it began to become clear that many people were getting mild cases or no symptoms at all.
    It was to me completely obvious that this is a very plausible explanation.
    Whether it is true or not…I suggest we find out.
    I would volunteer today right this minute to be given common cold virus inoculations.

    • You don’t need to be inoculated with corona cold viruses. They are the 2nd most common cold viruses next to Rhinovirus and represent about 1/5th of all cold viruses.

      You likely have suffered through a common cold due to corona viruses just in the last year or so, as has everyone else.

      • I have not had a cold in years, Klem.
        Just like many people.
        Maybe speak for yourself.
        BTW they are more like one in three colds according to most sources, in terms of frequency of illness.
        But that says nothing about who in particular has had one of them recently.
        It may be kids are doing much better because virtually ever one of them has had numerous colds in recent years, and likely coronavirus ones.
        Men may be at a disadvantage due to perhaps not spending as much time with young children (purely a guess, and IDK if this is the case but it may be) and thus not getting as many colds and thus being more likely to have not had a coronavirus cold in a long time.
        Generally acquired immunity wanes over time, which is why we need boosters for many infections, multiple shots over some time period, etc.
        Some viruses infect nearly 100% of people no matter if they ever had it or not, irrespective of antibody titer to that virus in their body.
        This is demonstrated by infecting human volunteers with live virus in clinical trials.
        (It was not always as difficult to get approval to do this. Ex: There are trials where people took oral stool of a person who had hep A)

        It is most certainly not true that “everyone else” has had a cold in the last year, let alone any particular one. Older adults get less and less colds as they move up in years, although at some advanced age this trend may reverse, or it might be they continue to get few but it becomes more likely it will be bad if they do get one.

        And example of how such immunity might change over time is seen with measles and chicken pox.
        When I was a kid everyone got these diseases (not sure if I got measles or was vaccinated, but I recall mumps and chicken pox clearly as long free Holidays. I got chicken pox after Thanksgiving , and by the time I was over it Christmas break started, so I was off school for many weeks in a row. Everyone else in my family [kids only] got it after me, and came down with it as the Christmas break was starting, and got cheated out of any free days off!)
        But now almost everyone, and for a while very close to everyone got measles vaccine, and the disease was absent from the US (except some very rare exceptions) for decades.
        But it has been found now that it has come back that many people who had it as kids have gotten it again, and some kids seem to have gotten it twice, and it seem to be worse than ever.
        The theory for this is that people, after getting something like measles, were exposed to the virus as it periodically went around, and thus their antibodies got frequent “boosters” via live virus into their system. They did not get sick, and instead had a restrengthened acquired immunity to measles.
        But after not circulating for so many years, for many people any immunity has worn off.
        The rhino and corona viruses mutate, and so few people may actually be completely immune per se, but for someone who has had numerous colds every year as a child and teenager, and gradually less so after reaching adulthood, there is so much and so many various antibodies and memory cells for the viral family, that it becomes less likely that any virus challenge can overcome the combine innate and acquire immune systems.
        Some people have great nutrition, are out in the Sun for hours everyday even in Winter, and are generally not the sickly type.
        We do not all get colds every year.
        I recall getting me a flu when I was on vacation in Philly back in about 2009, but I never knew who I got it from. Other than that, I can recall only a few minor instances of sniffles in the past 20 years.

        I went years without using a sick day at work, until I found out almost everyone else in the company mysteriously wound up getting sick exactly ten days a year at least, most often in December. I suggested to the owner that we all trade one sick week for the day after turkey day off every year, and that we be allowed to use sick time for regular doctor appointments.
        He agreed.
        Luckily for me, my coworkers never found out I had suggested this casually one day.

        • Another possibility is it is only one particular strain which helps with ‘Rona.

          And of course this is all hypothetical at this point, and the whole idea has obvious flaws in the logic, but this could simply be a function of not using the proper applicable logic.
          There is some reason or combination of reasons at work, and if no one is trying to think outside the box or consider all ideas, it will be harder and take longer to arrive at answers to questions, if they are amenable to being elucidated by inductive or deductive reasoning.

    • Just today, the German virologist Drosten told, that there may be a certain background immunity because of active T-cells, possibly from earlyier human cold corona virus infection . He spokes of about 34% of patients, not having had contact to SARS CoV2 before. Drosten participated at the study.
      But we shouldt not believe, that one third of population is immune.
      Ther other, second reason for asymptomatics couldt be the result of small load of viruse at the first load.

  14. Hi Rud

    Again, thank you! Extremely helpful post.

    Could you comment on the following document:

    [Previous WUWT Post]
    “terry April 23, 2020 at 2:27 pm
    For those who want to understand disease and treatment/prevention

    https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf

    How not to treat, read page 9/10″

    One statement from page 9:

    “It is essential to recognize that it is not the virus that is killing the patient, rather it is the patient’s overactive immune system. The flames of the “cytokine fire” are out of control and need to be extinguished. Providing supportive care (with ventilators that themselves stoke the fire) and waiting for the cytokine fire to burn itself out simply does not work… this approach has FAILED and has led to the death of tens of thousands of patients.”

    I do not have sufficient background knowledge to usefully gauge this document…your comments would be extremely appreciated.

    Thank you
    Ethan Brand

    • Ethan, it is only partly true. I read the EVMS protocol. Cytokine storms do exist, and can be triggered by Wuhan. They were also an explanation for why the 1918 flu disproportionately killed healthy young adults. They will typically cause multiple organ failure (like in septic shock, which killed Jim Hensen [Muppets] in 4 hours). They are somewhat treatable.

      I say only partly true because NYC is reporting simple respiratory failure from severely low blood oxygen measured continuously by PulseOx, cardiac arrest, renal failure, and thrombosis as causes of Wuhan death that are not cytokine storm related.

      • Rud, Thank you.
        In reading the EVMS protocol the jist of the treatment is to be more aggressive with strategies that would help ameliorate a cytokine storm event. I assume that the treatment regime otherwise is a “no regrets” path for the other problems…[embedded question…]?

        Layman’s summary of the EVMS:
        Aggressively try to head off a cytokine storm
        Be mindful of the thrombosis angle
        Don’t rush into intubation
        Don’t be afraid to try some “off the shelf” treatments (like Vit C, HCQ, etc)

        Rud, I can’t thank you enough for bringing thoughtful, understandable and rational discussion to the table. My information world has shrunk to a few posters (and commentators) here at WUWT. The “outside” appears to have completely abdicated any kind of rational/useful information dissemination.

        Ethan Brand

        • Reread pages9 and 10

          There are multiple ways this kill.
          In begining per WHO, do not use corticosteroids or antiguagulants.
          This was major mistake by WHO, CDC …

          Treatment much different now. Note, ventalators and ICUS no longer swapped
          This is why, but nobody discussing

          • This was major mistake by WHO, CDC …
            ==========/
            This really begs the question. Why has so much of the information put out at the time turned out to be completely, 180 degrees wrong. Not partially wrong, but fully wrong.

            The odds of this happening by pure chance are astronomically small.

            A more believable alternative is a “bad actor”. Someone in a position of influence able to inject misinformation at the highest levels.

            The virus might not have been manufactured. It could easily have been the response that was orchestrated.

          • At that point, is there anyone who does not believe it’s a scientific coup? A coup by “science” people against elected governments.

    • As I have mentioned before much of the EVMS dovetails nicely with this:
      web.archive.org/web/20200405061401/https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb

      I’m a layman but the damaged hemoglobin does seem to fit with what we see.

  15. “Serologic antibody tests now being developed–so far with little to no regulatory oversight or rigorous independent evaluation”
    Rud, thanks for a thoughtful post. Regarding “regulatory oversight”, this is not a good time. We need something to fight the virus with, and more approaches are better than fewer. Once things start working, there will be time for independent evaluation.
    Regulatory oversight is not the first line of defense. We may and up like the progressive city of San Francisco, among the first ones to ban single-use shopping bags, now banning reusable bags. Ban, BAN, BAN!!

    • Without independent verification how do we know that the tests are producing useful information.
      As a software engineer, I know the value of having someone else go over my code from time to time. It’s easy to become too focused and to miss the obvious. This is especially true when time is of the essence.
      It’s also good to have someone else go over your test results. The test that you forgot to do is usually the one that gets you.
      Bad data can cause doctors to waste resources.

      • I am lost – what does this have to do with the problem? Do you believe that serologic tests are being developed by individuals, not by team?

        • CG, they are being developed by teams inside companies that want fo sell them for a profit. About 70 companies have announced they just created or are creating such a test. But without reasonably high sensitivity and very high specificity they are useless. Hence the Roche CEO comment.

          • Preferably government-appointed outsiders. Will they sign a non-disclosure agreement?How long does it take for a government to appoint an outsider?

          • Where did I say anything about government?
            Outsiders can be as close as someone from another department, or another company that you have hired to review your work.
            The critical thing is it can’t be someone who has been actively involved in developing the product that they are reviewing. Someone too close is likely to have the same blinders that you do.

          • They should add one member to the team, regardless of the team size 🙂

            The composition of the team is a responsibility of the company. It will make it or break it for them. I am not qualified to advise them.

    • When the first successful vaccine is developed it will be interesting watching the NRA aficionados shooting their way to the front of the queue.

      seriously, how is the rationing going to be handled when it will be in short supply. 7 billion doses will take a time to generate

      • Once again, the liberal demonstrates that he sees others as nothing more than stereotypes, not real people.

        If anyone is likely to pull underhanded stunts in order to get to the head of the line, it will be you socialists.

      • How I wish there was a way to block people that make totally ridiculous comments like ghalfrunt.

        Rud I would like to thank you for your very useful comments and the time you have put into them.
        In relation to the measles. Your idea that the immune system getting a regular tickle keeps it active definitely seems logical to me.

  16. Even if it holds true that antibodies from endemic HCoVs are not protective against SARS-CoV-2 in terms of an infection a preadaptive priming of T helper cells might be an underlying cause for asymptomatic cases:

    https://www.medrxiv.org/content/10.1101/2020.04.17.20061440v1

    The authors stress the point that there is also one other possible effect that this priming might exacerbate the immune systems reaction and is making things worse not better. Maybe even both possibilities are true and different for each individual.

    It is also important to mention that this discovery doesn’t change anything when it comes down to CFR. It is just an explanation why people have very different symptomatic profiles and concentrations of neutralizing antibodies produced.

    As asymptomatic people are producing the same viral load as people with symptoms it doesn’t also change anything about who is infectious or not.

    • https://www.bing.com/search?q=flu+symptoms&form=QBLH&sp=-1&pq=flu+symptom&sc=8-11&qs=n&sk=&cvid=52029246BE9F424C8496267FCB092388

      Following are the symptoms of flu:

      Fever
      Malaise
      Headache
      Runny nose
      Postnasal drip
      Sneezing
      Reduced sense of smell
      Metallic taste in mouth
      Chills
      Cough
      Body pain or muscle pain
      Sore throat

      https://www.bing.com/search?q=common+cold+symptoms&qs=LS&pq=common+cold+sym&sc=8-15&cvid=65779DF90EEE42119D1BC22BF1369546&FORM=QBRE&sp=1&ghc=1

      cold symptoms
      Symptoms occur 1-3 days after viral infection. Symptoms include:

      Nose stuffiness
      Runny nose
      Sore throat
      Cough
      Congestion
      Mild headache
      Sneezing
      Malaise
      Fever

      • mwhite
        So you are saying that the diagnostic characteristics of the flu, which distinguish it from the common cold are:
        Reduced sense of smell
        Metallic taste in mouth
        Chills
        Post nasal drip versus Nose stuffiness

        It has been my experience that, while suffering with a cold, I have had a reduced sense of smell as well, and if dealing with allergies, perhaps post nasal drip. Chills are commonly associated with a fever. That really only leaves a metallic taste as the differentiator.

          • You left out an important detail about the cough. The cough associated with SARS is dry and non productive. That is different than what one see’s typically with influenza with a productive cough.

            Last fall I became so ill that for the first time in the 11 1/2 years I had driven for this company I had to call in sick.

            It started with a sore throat and head ache the came fever and dizziness. The fever progressed and then it was fever and chills with uncontrollable shivering. The came the
            SOB and the dry, unproductive cough. And to me that was the worst. Coughing trying and feeling like one needs to clear their airway and yet nothing comes up is a terrible feelingI have had the flu many times in varying severity and always worked through it. I had never had anything like that though and there was no working through it.

            Trip to the clinic resulted in a breathing treatment, prescription for an Ibuterol inhaler and 10 days of Amoxicillin, and referral to a respiratory specialist. I used all of the above except the referral.

            I called off on a Thursday and by Monday I was well enough to drive and went back to work. But for the next 4-5 weeks I had to prop up my upper torso to breath freely enough to sleep and used the Ibuterol inhaler at times, and especially before I laid down to go to sleep.

  17. Deep vein thrombosis (DVTs) may be more common than we think. I have somebody I have been Skyping with for a while and she has a history of peripheral neuropathy that existed long before I knew her. One night she noticed some swelling in one leg that wasn’t in the other so I suggested she see a doctor as soon as possible. She did so that night and was diagnosed with two DVTs then was put on Xarelto. Over the next few months, the DVTs were dissolved but she continued on a lower dosage to provide protection against a recurrence. A strange thing started to happen. Feeling was returning in her feet and a cloudiness in her mind cleared up. I came up with a theory that was verified by her doctor. If you can have major clots, you can also have micro clots that reduce the blood supply to parts of your body. The Xarelto was dissolving those and parts of the body that had been starved suddenly had a fresh blood supply. I suspect where possible, some healing took place with the net effect of the return of feeling and function.

    Many people may have the potential for developing DVTs but because of the lack of an injury or even a long stay in an airline seat may escape them until they are much older. There is a test called the D-dimer test that detect the breakdown of blood clots and indicates if your likely to develop DVTs. Possibly this test should not only be used when testing for the Corona virus but should be run on the healthy population to predict the likely hood of developing DVTs and pre DVT issues.

    • The problem with testing everyone is that it often costs a lot of money.
      Since there are a limited number of labs, doctors and resources, testing everyone for this means resources aren’t being used elsewhere.
      What medical tests and procedures do you want to give up in order to test everyone for this?

      • I was only talking about the D-dimer test and only those admitted to the hospital should be tested for it as an alternative to an anticoagulant. The newer anticoagulants don’t require the careful monitoring that warfarin requires however the modern anticoagulants cost a good deal more than the test. It would save a good deal of money to see if the patient is at risk of DVTs before giving them the medication as well as reducing the risk of a bleed out from somebody having the drug when they don’t need it. There is a drug that stops the action of Xarelto but it’s extremely expensive if you can find it. The high cost means very few places keep it on hand.

        In the general population, maybe the D-dimer test might be run a few times in your life unless you have a family risk factor including peripheral neuropathy.

        This isn’t a one size fits all solution. It requires a doctor’s judgement to determine the best path for the patient. If you only have minor symptoms, just monitor and see what happens. If your getting worst, use everything you have available. The final decision should be left to those with the best information as this is only one of many tools available to the doctors.

    • I concur that DVT are more common than most people realize. I had problems with closing in the last 10 years. At first the doctors treated and that’s it. but after 2 more episodes they put me on Warfarin for life. About 5 years ago a test became available to detect a genetic defect that could cause clotting issues. I was tested and found to have it. My brother have it. And separately another relative was tested for it and dyes she had it. For some reason we all lived fine with not clotting issues until about age 40 or 50. Fortunately it is easy to treat if identified. And my experience with pulmonary embolisms dose sound a lot like what many Covid 19 patients are experiencing. Also note clotting issues can also bee caused by high colestoral, and mineral deficiencies, and infections.x And Doctors can easily miss very small numerous clots. In my opinion doctors should look into this more and monitor Covid 19 patients for this problem.

  18. Under the standard of care, diabetes is not diagnosed until fasting glucose rises. Most people have had it for 20 to 40 years before they are diagnosed.
    Insulin resistance, hyperinsulinemia and metabolic syndrome are not diagnosed by doctors as there is no drug treatment. They are really the same thing as diabetes and are doing the same damage to the body.
    A younger person not being diagnosed as diabetic can still effectively have the disease.

  19. “-Why hypertension, diabetes, and obesity are the main NYC comorbidities in the serious/critically ill under age 65 CoViD-19 patient cohorts.”
    Hypertension and obesity are both symptoms and results of diabetes.
    Why is it that doctors don’t recognise this?

    • Billy
      “Hypertension and obesity are both symptoms and results of diabetes.”
      Never heard that before. Have you got a reference to a study or another source?
      Thanks

      • lb
        Just look up diabetes in the dictionary. You will see all of the related complications listed.
        Diabetes is really just the advanced state of insulin resistance. 2/3 of the population over 45 are insulin resistant. Doctors do not diagnose IR because there is no drug for it and the standard of care requires them to wait for high blood glucose. People are insulin resistant for decades before they are diagnosed as diabetic, if ever. IR means high insulin and high insulin directly causes obesity and inflammation. Obesity causes hypertension. Inflammation causes atherosclerosis. Every doctor tells the patient to lose weight, giving wrong instructions. There are studies that show that “eat less -move more” causes weight gain in most people.
        Insulin resistance (diabetes) also causes heart disease. The medical profession ignores this because they are obsessed with cholesterol theory. There is no hard evidence behind that, only weak associative studies.
        There are no studies, all of the research is based on cholesterol theory, ignoring the elephant in the room.
        Insulin resistance and diabetes can be reversed by diet, not drugs. You could look at Diet Doctor, Ivor Cummins, or Bart Kay.

        • Billy
          “Just look up diabetes in the dictionary.”
          Well just because diabetes often comes with hypertension doesn’t mean diabetes is the reason for hypertension. I just don’t buy that yet.

          “The medical profession ignores this because…”
          That the medical profession sometimes is wrong, and stays wrong for a long time, this I’ll accept.

          • lb
            I never had hypertension myself. I don’t have personal experience.
            I am pretty sure that any doctor will tell you that if you lose the adipose fat , BP will normalize. Adipose fat (belly) is a sure indicator of and is caused by insulin resistance , which is the first stage of diabetes2.
            Insulin is a fat storage hormone. It drives blood glucose into the fat and muscle cells. Body fat is inflammation .
            Chronic inflammation damages arteries. These things all go together, like chickens and eggs.

          • Billy
            Don’t know about diabetes enough to comment much, but this part seems strange:
            “Body fat is inflammation”

          • Hi Billy
            thanks for the links, gonna do some research.

            About the cholesterol, some of the doctors are less stuck than others. As somebody once said, in every profession 50% are below average (for a ‘mean’ kind of average) 😉
            Cheers

  20. Rud, thanks for this and the whole series of your detailed readable articles on what for most of us is unknown and highly complex territory. They provide an unusual live development of evolving data and shifts in thinking on covid19 (even the name of the bug evolved to ‘Sars 2’).

    One of my daughter’s family living in UK contracted it and thankfully they seem to have had a milder rendition and appear to have recovered from it. I told them to have a few gin and tonics each day advising that it may or may not help, but it might at least lift spirits a bit!

    I’ve been a bit perplexed by the seeming anecdotal successes with HCQ on one hand and the virulent and hysterical opposition to its use on the other. I agree that it’s not good to carelessly self medicate, but this drug and most of its related ones have had ‘clinical trials’ by hundreds of millions of people since the 1940s and long persistent side effects have been very low. Any thoughts on this?

    • I guess they don’t want an explosion of use of drugs on rumours and anecdotes-
      https://www.msn.com/en-au/news/coronavirus/experimental-virus-drug-remdesivir-failed-in-human-trial/ar-BB1391jv
      as some folks really need them for what they’re purposed for rather than burning them up as expensive placebos. May as well buy lots of vitamins and herbal remedies to make up for decades of bodily neglect and being at risk with Rona. Isn’t that what we usually do? So just up the tempo and your body will become a shrine of immortality.

    • Gary
      You remarked about the “seeming anecdotal successes with HCQ.” That is something that is overlooked in the discussions. Advocates for its use claim that it should not be used with those who are severely ill. Those are the ones most in need! On the other hand, in view of the large number of people with mild symptoms, giving it early may be giving it to people who would recover on their own. So, it becomes a trade-off of giving it when possibly not necessary, with the small but finite risk of dangerous side-effects. Rationalizing HCQ treatment with “But it won’t hurt anything.”, is not only sometimes wrong, but is similar to doing a rain dance to bring rain. In the case of a rain dance, it almost certainly won’t do any harm. However, that does not mean it isn’t a religious or superstitious response that is almost certainly not going to have the intended effect. But, it is interesting that there seems to be strong emotional involvement on both sides. My take is that the HCQ advocates are strong supporters of Trump, whereas the naysayers are more concerned about “First, do no harm.” The best approach to doing no harm is through the Scientific Method, not rationalizing actions that border on superstition.

      • “whereas the naysayers are more concerned about “First, do no harm.”

        Well since some of the patients they were trying it on were basically dead already (the Hail Mary trails at any rate)…..your statement somewhat falls on its sword 🙂

        See Rud’s excellent missive below…answers your concerns as well as Gary’s. Rud is the archetype excellent poster/commenter.

        Ethan Brand

        Ethan Brand

    • Gary, yes. I am somewhat guided by published results by Raoult in France and Zelenko in NY, plus the VA easily debunked retrospective ‘study’, the Brazil study of chloroquine phosphate, and the ongoing study between U. Minn and McGill, with an interim report just out reducing the design sample size and moving up the result date to end May—very promising.

      The brouhaha has two sources. 1. President Trump mentioned it, so TDS immediately set in. 2. There is no money in it for pharma if it works, unlike a vaccine. Fauci knows where his bread gets buttered.

      The high dose arm of the Brazil chloroquine phosphate study was discontinued because of induced cardia arythmias. Utterly expected, because a well known side effect. Low dose arm continues.
      Hydroxychloroquine is contraindicated in individuals with prolonged QT intervals, so just demanding it is ill advised. FDA just came out with a warning to that effect on both chloraquines.

      The key seems to be HQC plus zink, not plus azithromycin. So the negative VA retrospective was faulty for two reasons: older vets on ventilator is too late an intervention, no zinc. Media reports apparently did not read the report before gloating it didn’t work and orange man bad.

      The U. Minn/McGill study is well designed with three arms in each of two cohorts:
      Arms: Control (no treatment), HQC alone, HQC plus zink.
      Cohort 1, prophylaxis in those known to have had close exposure to an infected (e.f. family members, nurses). Endpoint no positive PCR test.
      Cohort 2, therapy in those PCR tested positive, and with mild symptoms. Endpoints: time to recovery, progression to serious/critical (that is about 20-25% of mild cases in NYC).

      The fact that they just announced they reduced the number of designed enrollees and will have results sooner means whatever they are seeing is significant so they don’t need the statistical power of larger enrollment as originally designed. Very hopeful.

      • Rud
        The other side of the coin is that history is replete with carnival healers that are in it for the money. However, some people will settle for their 10 minutes of fame.

        When a physician does not have oversight from those without a vested interest, selects who he treats with his personal regimen without a justified protocol, and has no impartial vetting for the results he claims, it is a recipe for an unscientific trial at best, and fraud at worst. He would not be the first physician to make claims that could not be replicated. When academics commit fraud, they might suffer the inconvenience of having to withdraw a paper. When a physician does the same, people may die based on unsound recommendations.

        • Clyde, all true. That is why the aforementioned U Mn/McGill study is so important. I am scientifically hopeful, as explained above

      • Rud
        You remarked, “2. There is no money in it for pharma if it works, unlike a vaccine.” Again, the other side of the coin is that HCQ will, at best, provide immunity to the 15% of people who become infected and survive. Whereas, a vaccine should give an equivalent immunity to everyone who gets vaccinated, developing herd immunity, and eliminating the virus. Perhaps it is best in the long-run for society to offer a financial incentive to Big Pharma to develop a vaccine, rather than relying on something in the back of the medicine cabinet that may or may not work well.

        • Past experience shows that vaccines almost never work well and mass vaccination almost always is an abject failure that is systematically denied.

          • niceguy
            Then how do you explain the eradication of smallpox and polio, and the significant reduction of rabies in First-World countries?

          • NG is a disinformation troll.
            No one can be serious about the garbage he spews.
            I am not sure I believe in AI bots roaming the interwebs, or that may be one explanation if it actually happens.
            At times he speaks with syntactically incorrect and silly sounding English, and at other times, usually on a different subject like politics, he does not do so.
            So either he is more than one person, is an AI bot, or he is a deliberate troll.
            In any case he ought to be ignored in any serious conversation.

          • Actually, Nice Guy should be treated as SPAM. Anyone who thinks that WUWT doesn’t publish most comments should be assured they do based upon his single focus attack against vaccines. I wouldn’t mind if WUWT took more liberty with spam and just delete certain people/bots who just try and muddle the waters and stir up mud. In fact, it is probably comments that NG make that will be used by critics of WUWT and all us commenters here, saying here is the proof we are all anti-vaxxers at WUWT. Delete Nice Guy…he adds nothing to the conversation here and in fact gives it a black eye. Freedom of speech for only so long. Vote him off the island.

        • Gee, Clyde, they didnt do double blind etc for the smallpox vaccine. They noted that “milk maidens” who had been infected with the milder cowpox didn’t contract smallpox – hence the miracle. To flesh out my point to answer some of yours:

          1) I consider the antimalarial stuff to have been proven at least safe in terms of incidence of long serious side effects. They have had better than a clinical trial with hundreds of millions of people having taken these drugs for 60yrs and drunk gin and tonics I believe in Victorian times. It was even used in the 17th Century and clearly by Peruvians and Spaniards long before that.
          https://www.mmv.org/malaria-medicines/history-antimalarials

          Despite this, I don’t support reckless self medication (except on myself – I’ve repaired broken fingers of my own and filled my own and others teeth in the remote Canadian bush going back to the 1950s). Hence gin and tonics or a doctor’s prescription.

          2) The drug is easily mass produced at a cost of ~10 cents a pill and following earlier startling anecdotal evidence, should have been ordered in quantity to ensure that lupus patients and other users don’t have their needs pre-empted and that there is a ready supply for doctors to prescribe. There were numerous responsible groups doing this research.

          3) Rud’s fine investigations reveal that we still are learning critical stuff about this disease. Ventilators may turn out to be killing us. The bug is proving to have people infected and contageous without a sign of symptoms, or late onset of same. Thromboses seem not to be a comorbidite, but rather one if the things caused by Covid.

          Dr. Fauci, who has an enterprise researching vaccines for this virus, triggered a poker player’s ‘tell’ when he jumped in almost hysterically to interrupt Trump on his interest in HCQ.

          Dr. Zelensky in NY may have cured more patients than any other doctor in the world with his HCQ+ concoction. Investigate this claim. First it doesnt make sense that all 700 patients were only at the earliest stages. Were they all in the hospital? Did he perform some terrible triage of patients? Do they not have hospital records? Can they not do seriological testing to vet the claims? Why is this ‘miracle’ not being vigorously followed up?

          At the stage of knowledge when I learned family was sick with it, and aware of the laissez faire of the UK government, I feel I, at that time was the best doctor available to them.

          • Gary,
            Because you have many points, I’ll address them in order.
            0) The development of smallpox vaccination had a control group — those who didn’t get a vaccine, and went on to get smallpox. This was before the concept of double-blind/placebo trials was invented and before the ethics of such trials was formally addressed. The bottom line, vaccination worked for what could be a deadly disease.
            1) Many HCQ advocates here are in denial that there are any short-term side-effects simply because they are unaware of them. The fact that there is a long list of specific side-effects, which users are cautioned to look for, demonstrates that they exist. The recent reporting of people dying while using it, or being taken off when they have cardiac issues, proves that some people are sensitive and cannot take it safely. While many (perhaps millions) have taken HCQ with few if any serious side-effects, these have largely been younger people in good health, such as those in the military. For ethical reasons, and caution over being sued for wrongful death, a prudent doctor would show restraint in casually prescribing HCQ for a use that it was not developed for.
            2) Being “startling anecdotal evidence,” it means there could well be other explanations for the recovery, such as giving it to people who would have recovered on their own, or that people benefited more from the zinc or antibiotic than from the HCQ! This is rain dance rationalization. I’m reminded of a story about Sitting Bull, who, after years of doing rain dances, finally ‘had his prayers answered.’ This convinced him of the power of the gods. It apparently never occurred to him that it was just coincidence, after years of failure.
            3) It is ‘telling’ that you can interpret Fauci’s reaction and not question whether your interpretation is subject to some kind of personal bias. Is it not possible that he was truly concerned about the harm such use might cause? After all, no responsible physician would suggest “disinfecting” one’s blood stream. While I support the financial and political positions of Trump, it is obvious he knows little about science and medicine.

            You ask several questions about Dr. Zelensky that are not readily answered. That alone should give any objective person pause about saying he “cured” them.

  21. Since viruses mutate, is there a possibility that each n-th generation may be a) less or b) more infective ?
    a) virus will after period of some months naturally extinguish itself
    b) return in far more deadly second go (as in the case of the Spanish flu)
    Considering that incubation period appears to be (on average) less than two weeks, current infections would be at least six to ten generations removed from the ‘bat woman’ case.
    Is there any information in the genome differences between the current and the early viruses?

    • Answer: yes. Although the tendency is that severer mutations ‘burn out’ sooner while ‘milder’ mutations can hang around forever.
      Answer: yes. Just published is a study showing ~40 mutations in just 5 months since the beginning. More severe Europe from China, and NY came from Europe. Less severe West coast from China.
      Implication: the eventual vaccine may end up having the annual flu vaccine hit or miss mutation problem. Wuhan and flu are both RNA viruses. Explained in my first post on this topic.

      • Thanks Rud, despite me having a very little knowledge of the matters bio-medical, I find your reviews help greatly in comprehending the complexity of the subject. Thanks again.

      • RNA mutations are meaningless as long as they don’t interfere directly with the host defenses’ or changing the amino acid sequence of the viral proteins that result in modified features. That actually is less likely for most viruses as one would think just because most mutations are detrimental to the virus and not beneficial.

        I bet the genetically engineered vaccine approaches are designed to target the parts of the known substrains that have no mutation at all.

        • “RNA mutations are meaningless…”

          Again, a thought totally unaware of the last 15 years of the RNAi revolution, and RNA structure function discoveries.

  22. Rud,
    I read this post of yours, not very intently, but the idea I got is the consideration of the overall picture discrepancies and especially the antibody test.

    Let me say this first;
    any tests viral plus antibody, properly productive and assisting for better understanding of the condition if applied properly during the disease period.
    The viral test completely useless when clearly outside the disease period, while the antibody tests usually
    still holding some value even outside the disease period.
    But sometime in special cases the antibody test still in proper value if the antibody that it tests for continues to be active even after the closure of disease period.

    You will see a lot of fights, very bad vicious ones against the antibody test for COVID-19, due to the persistence of corresponding antibody.

    First because the delaying, gains nothing,
    Second, because maybe the preliminary applications for the validation of this test may already show a very
    scary panicking results, where a considerable (high) number of sufferers for COVID-19 have not the corresponding antibody.

    In consideration that the antibody persist and does not go away, and when many diagnosed with COVID-19 do not have it, then the Occam states that most of COVID-19 disease, including severity and fatality of this disease, not caused by this new virus or this new virus infection.
    Quite strong, but hey there is a reason for the antibody test and it’s great support for seeing through the “dark”… it is a strong fundamental procedure.
    You “kill”it, for whatever reason, you do not learn, “history” keeps repeating.

    HIV does not cause the pneumonia disease.
    Similar with COVID-19… not the same though, but similar.

    Second there is two antibody responses to the same virus as it causes two diseases.
    The throat disease, and the lung disease.
    Clearly showing that the antibody response is to the disease not the virus perse.
    Meaning, that simply being infected, it is not a given for an antibody response, not always.
    Also indicating, that the disease, the termination of the incubation period may fail to trigger a immune response, due to the fact that the disease in not the only disease happening at the same time, and most probably the not prevalence one at the time.

    Again antibodies do not fight viruses… at least not directly… the immune response is to the disease not to the virus, even when triggered and upgraded by the virus.

    Life is stranger than fiction… greatly far far much beautiful.

    cheers

    • Antibodies respond to pathogens, not to the disease they cause.

      An antibody (Ab), or immunoglobulin (Ig), is a large, Y-shaped protein produced by plasma cells. The immune system uses these proteins to neutralize pathogenic bacteria and viruses. Via its fragment antigen-binding (Fab) variable region, the antibody recognizes a unique molecule on the pathogen, called an antigen. Structures on each end of the Y bind precisely with with corresponding features on the antigen, like a lock and key mechanism. This bonding allows the antibody to tag the pathogen for attack by other parts of the immune system, or direcctly neutralizes its function.

      Antibodies fight the disease by attacking its causative pathogen, or nip them in the bud before an infection can develop into a disorder.

      • John Tillman
        April 24, 2020 at 11:27 am

        John, hypothesis explanations and being stubborn about such as can not contest clear facts.

        Same virus two different antibodies, simply because two different diseases, one of the throat and one of the lungs, different tissue diseases, different antibody response…in the case of the SAME VIRUS… where the antibodies do not have also the same response time parameter.
        Fact, not hypothesis or academic hipper convulsive explanations.

        Antibodies, and the rest of the immune system responds to clear the disease, the pollution from the disease… even, again, when the proper response most of the time triggered by the virus.

        Now, as for hypothesis and guess explanations:

        “or nip them in the bud before an infection can develop into a disorder.”

        It is more like “nip them in the buttocks” by going for the pants, effectively, before the infection develops into considerable dysrhythmia… by striping them off and have them naked facing the harsh environment there.

        Wrong response, non efficient antibody response, leads to infection dysrhythmia, triggering an ever increasing aggressive response from immune system.

        External artificial factors effecting the overall immunity to the condition of seasonal dysrhythmia, lead to the wrong seasonal infection, to a more harmful one, due to dysrhythmia of overall
        immunity.

        Overall immunity consist as the immune system response and/+ the natural body efficiency of blocking and suppressing of the most “looser” but more “aggressive” dangerous viruses and the
        infection-disease from such as.

        Oh well, just hypothesis this second part…

        Thanks for your reply, John. Appreciated. 🙂

        cheers

        • “Same virus two different antibodies, simply because two different diseases, one of the throat and one of the lungs, different tissue diseases, different antibody response…in the case of the SAME VIRUS… where the antibodies do not have also the same response time parameter.
          Fact, not hypothesis or academic hipper convulsive explanations.”

          My apologies but this is just plainly wrong.

          There is always more than one antibody developed upon an infection. But that has nothing to do with the tissue where the infection is happening. The B-lymphocytes circulate through the whole body via the lymphatic system to ensure the antibodies are available everywhere. That is why you can get antibodies for testing from the blood where you can’t do the same for the virus as it’s not replicating there sufficiently for testing.

          • Ron, this is amazing.

            You, are a guy who have a specific antibody, without the virus, without the infection, without the disease… still fully active.
            Do you think your immune system is stupid or silly on keep activating fully that antibody? (without the virus present)

            Do you think that immune system response and antibody response exist primary due to response to infection and diseases?

            Ok, name a virus that you know, apart from this novel one, that does have in it’s belt the consideration of two antibody responses.
            Am not saying that this the only one, or that it is not the norm, but with this one is very clear, simply due to different time parameter response of the antibodies, which does not overlap and still corresponds to two different diseases, which connect but do not overlap.
            (or at least that is how I know it to be, in consideration of the data there;
            please feel free to correct me in this one if I have got it wrong)

            Are you saying that this virus causing two different diseases is a myth or an urban legend… or some made up staff?

            Do you know of any other virus that causes two different diseases corresponding and linked to each other as per the matter of full infection path?

            Yes there is a huge “melting pot” of infections and diseases there, a huge messy
            “antibody pot”, but failing to learn from the specifics and clarity of this novel
            infection-disease, when the fact is clear, but we don’t like it or appreciate it, is quite amazing.

            There is two antibodies in case of this virus, because of two different infections and two different resulting diseases.
            That is the fact you are contesting, not me.

            I simply concluding, with the only conclusion left there, in accordance of this fact;

            Two different antibody responses due to two different infections (not one infection) resulting in two different diseases (not one disease), of two different tissues.
            Response to the disease (“death”) not the virus.
            (any “death” has it’s own signature, the best response, including antibody, is tied to that signature,
            and again, please do feel free to correct me, if the fact in question not a proper one, or a result of misunderstanding in my part. )

            Now again, as per hypothesis and guesses;

            Your artificially acquired antibody still fully active in you, due to it being the best your immune system knows for dealing with a certain signature of “death” in your body,
            even when that “death” not due to the corresponding infection-disease of that antibody.
            The contiguous cellular death in the liver… which happens continually over time… regardless of a specific infection-disease.

            The immune system does not do lock downs, isolation, “social distancing”, or disinfection.

            The closer thing to “disinfection” is a last resort full response,
            a heavy “incineration” of
            the locality with the problem, meaning severity and high chance of fatality…
            usually, sometimes, triggered by “confusion” and “misreading” of the condition.

            Again this second part of my reply to you hypothetical, or a guess.
            Please do not confuse it with what considered as fact in this comment of mine.

            Please you do not need to apologize Ron.
            We just engaging in a public conversation.
            And I am prone to error and mistakes as much as the next one or anyone.
            And you being very civil, and cool. 🙂

            Ron, no hard feelings on my part, and appreciated.

            cheers

          • You need an infection first otherwise no antibody.

            Every antigen creates different antibodies through different lymphocytes. Always. This a singular event for each lymphocyte so there are a lot of different antibodies generated. You can actually isolate those different cells cause they have the capacity of replicating and generating clones. Then each clonal cell just produces only one specific antibody whereas the serum of the patient is full with a load of different ones.

            Please read https://en.wikipedia.org/wiki/Memory_B_cell about how the body manages to keep information of earlier infections. For each antigen many different cells are stored.

            These cells are either continuously expressing antibodies that can be directly detected or you test the immunity by challenging the present cells in a blood sample with the antigen in question to create more antibodies and measure those.

            “Are you saying that this virus causing two different diseases is a myth or an urban legend… or some made up staff?”

            Pathogens can cause different symptoms in different tissues. Sometimes tissues are prevented from being exposed to the pathogen through barriers and the pathogen usually has one specific list of symptoms in the tissues it can easily reach. Does the barrier get compromised for whatever reason the pathogen can cause another list of symptoms in different tissues.

            But that does not mean it’s a different disease. It is a different list of symptoms but still the same disease. So if one would have working antibodies from one or the other list of symptoms in one tissue one would be immune to the other list in another tissue in case of a second infection. Antibodies are recognizing the pathogen not the symptoms.

            The traditional clinical classification of diseases by symptoms is actually a mess. There are “diseases” that have a lot of different underlying causes but have been defined as the same based on the symptoms they share where other “diseases” have been classified as different ones though they have the exact same underlying cause but different symptoms. But these things are rewritten as knowledge grows.

            I hope this clarifies things.

          • Ron
            April 24, 2020 at 8:31 pm

            Thank you Ron.

            I see your point in your reply to me.

            But still, your explanation based in whole this messy hypothetical and terminology,
            still does not explain a fully activated antibody without the disease or the symptoms.

            You still have not refuted the validity of the fact, there, just tried to explain it away due to mostly terminology, the terminology of symptoms versus disease.
            I get the attempted rationale there, by forcing a point in the consideration of terminology, but still find it wrong.

            The school of thought you rely at in this case, propagates in consideration of cancelling out a conclusion due to terminology invalidating the fact… like in the science of AGW.

            The conclusion based in consideration of two different diseases not valid, according to your rationale, because of the clause of symptoms.
            where no symptoms no disease, or no significant symptoms no disease to consider, or no good enough to consider it.

            Clear symptoms, as by the book, then disease to consider.

            Ron there is stronger symptoms solely due to certain vaccinations, far far much considerable than in most of non hospitalizations of COVID-19, and same or even clearer in case of the other disease of this novel virus, the throat disease, which does not have even a name yet… as it can not be called a COVID-19, as that happens to be a lung disease.

            According to your rationale should we reclassify such strong symptomatic conditions due to certain vaccines as diseases?
            Actually, Ron, such strong symptoms have nothing to do with the meaning of disease in reality of life and nature.

            Disease consist as a condition of excess cellular death in the body, regardless of the symptoms, where symptoms are simply an indication of the disease due to the immune response, where sometimes the immune response to a disease does not result in detectable or orthodox specific symptoms…

            Again we are talking about viral infection-diseases, no need to pollute the argument by generalizing disease in relation of other conditions.

            I am not against orthodoxy, for as long as not overdone and therefor leading to contradictions

            Ron, a very clever way on trying to invalidate a conclusion by explaining away the fact as with no much value by merit of terminology, by refusing the condition of the disease clause.

            Ron, refreshing your memory;

            “There is always more than one antibody developed upon an infection.”

            That was your refutation.

            And the fact is related to two antibodies due to two different infections, throat and lungs.

            My point;

            “There is two antibodies in case of this virus, because of two different infections and two different resulting diseases.
            That is the fact you are contesting, not me.”

            If the orthodoxy proposition of terminology of symptoms V disease, prohibits you to consider the resulting condition of two different infections as diseases in this case,
            still the fact stands valid, as far as I can tell.
            and I can not see for best of me any other valid conclusion in that regard, can you?

            Besides, the antibody function consist of another major importance in the case of the immune system responding to “death” clause and disease.
            As the main information platform for the immune system communication, in alerting, measuring, tracking, “monitoring” and scaling up or down the response to the condition.

            No efficient or the wrong antibody activation, will very much jeopardize the whole response… where the performance of the immune response depends a lot in the performance of the antibody… very important in disease condition, the excess “death” of cells… where response is to the condition not the symptoms, where symptoms are an outcome of the response.

            Hopefully being clear enough, at least at the point that the argument offered is understood.

            The only way to properly invalidate the fact is by showing that it is not real,
            where the two antibodies in this case are related to only one infection and resulting condition, the lung one, the COVID-19 as known,
            and have nothing to do with the throat infection… simply solely both localized as a response to the lung infection.
            There made easy.

            cheers

          • whiten, I try to be as non-redundant as possible:

            Antibodies are produced against pieces of the virus. These pieces are generated from chopping the viral proteins. This mechanism is not any different between tissues. As the relevant pieces of the virus on its surface are also not any different between tissues an antibody that works in one tissue will work in another.

            The immune cells that are producing antibodies are maturing outside of the site of infection. Then they are invading back again.

            So there is mechanistically no way that antibodies from different tissues are any different by a directed mechanism. They can differ just by chance though but that they do anyway between different people with exactly the same site of infection and symptoms.

            With your other points I have to admit that I really don’t get what your hypothesis is.

          • Ron
            April 25, 2020 at 5:23 am

            Ron thank you again.

            Nice conversation, but you have to understand, the main point is the piece of fact.
            I am much interested on it’s validation than the theories or hypothesis contesting my conclusion.

            I am not sure how true and correct or valid that fact is, the rest is not that important to me, not that I do not enjoy the discussion of hypothesis.

            But any way, as you so much in hypothetical contest discussion, let me tell you that your hypothetical understanding of how antibodies are produced against pieces of the virus, can not be more wrong than that… totally backwards.

            The immune cells produce the antibodies.
            No virus info will be used to produce unless the “receiving address” on the envelope of the virus is that of a human cell, that immune system “knows” and has a record.

            The pure other species viruses have a non human cell “receiver address” which the immune cells are not interested at, as it is with no meaning.

            “Sender’s address” in that envelope does not matter if it is unknown (foreign), either to immune cells or
            the human cells that get infected by the virus.

            A known virus to immune cells does not get a second chance to enter the immune cell, unless the “receiver’s address” is that of the immune cell, like in the case of HIV.

            The key that unlocks a cell to a virus, for infection, is the matching of the actual cell’s “address” with “receiver’s address” on the envelope of the virus.
            Again the sender’s address being non human does not matter much.

            The COVID-19 virus has a double “sender’s address” (Pangolins, Bats, both far much older species than humans) and
            a double “receiver’s address” throat, lungs.

            In my understanding, two different “sender’s addresses” in the “envelope” definitely mean two different “receiver’s addresses” in that envelope,
            aka two different infections and to different possible diseases.

            Meaning, if there a COVID-19 disease, a lung disease there should be another
            COVID disease, like for the throat,
            kinda of called COVID-17 or even maybe COVID-16. 🙂

            The immune system cells do not care at all about the inner content of a virus unless the virus has a “receiver’s address” matching that of the immune cells.

            The “senders address” has only one meaning, utilized as confirming for only to block more than a same virus getting access to a cell, either in the case of immune cells or other human cell.

            It is only one penetration only once, of a given virus into a given cell, regardless,
            same as in the case of a spermatozoide, the life infection. 🙂

            A double “address” virus will infect two different types of cell’s, triggering a double antibody response for each different cell infection and disease.

            So the antibody production is all about the info on the virus envelope and time parameter response + the specific physical properties of the virus.

            Oh well, I like my hypothesis better than your hypothesis, must confess. 🙂
            But still the main point of my interest is further proper validation of the fact,
            or maybe the presumed fact.

            And as per this:

            “As the relevant pieces of the virus on its surface are also not any different between tissues an antibody that works in one tissue will work in another.”

            Yes, in most cases,
            “an antibody that works in one tissue will work in another.”

            Key, point though, only the proper corresponding antibody has the proper efficiency.

            One of the points I raised in the earlier reply to you, was about the antibody efficiency.
            Where a different antibody will work in the same disease, but will be not as efficient, as the proper produced corresponding antibody to the given disease.
            Where activation of not the proper antibody, could be so wrong due to the lack of required efficiency, that it could very much mean the difference between life and death in such circumstances.

            The immune system, due to life experience grows the antibody “library”, where there always are groups and classes of antibodies that work on the same cell tissue, respectively, in consideration of the same disease, but with different parameters of response and physical characteristics… as in consideration of time parameters and physical attributes of the virus responsible for infection-disease.

            Activation of an antibody, with low efficiency in consideration of a disease, is quite very dangerous…

            Oh, well Ron, hypothesis and theories have a strange history, of a colossal failure.
            🙂
            So I am not claiming any thing different than that historical fact.

            But you see, fact and conclusions are a different matter, much easy to validate or invalidate. No much fuss there, either it is or not valid or true can very easy checked.
            And some time, some conclusion can be indisputable in consideration of a valid fact, as the only one true to the meaning of the fact.

            Again, appreciated… 🙂

            cheers

          • “The B-lymphocytes circulate through the whole body via the lymphatic system…”

            Mostly correct Ron, and I do not want to distract from the point you are making, but I do want to point out that the network of lymph vessels is a one way street, returning fluid from the interstitial spaces to the heart.
            These vessels gather interstitial fluid (which contains the portion of blood plasma which exits the blood from capillaries and is not reabsorbed back directly into blood capillaries,) from the various tissues of the body, and move it towards the reentry points into the blood stream, via the subclavian veins.
            B cells, like some other types of immune cells, can move to the sites of injury or infection by chemotaxis.
            At any given time the vast majority of our immune cells are residing in tissues, not in the blood.
            And it seems likely (to me anyway) that they can even pass directly through cells, as well as than between them, since at many locations the cells have tight junctions. This occurs when the cells have to pass out of the circulatory system and enter the interstitial spaces, a process called diapedesis.
            In this process, called trans-cellular migration, leukocytes cannot pass between the cells of the epithelial lining, so they pass right through them: The cells are first invaginated and the migrating cell enters this invagination, which then closes behind the migrating cell and opens on the other side.
            In fact this once controversial idea is now being elucidated and demonstrated to be occurring.
            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811962/

            See also this interesting video, ten craziest things cells do:
            https://youtu.be/ooA0J6DWWTM?t=462

            Sorry about the digression, but it should be understood that the lymphatic vessels are not a circulatory system. More like a drainage system with many critical functions built into it.

    • Sweden may CLOSE bars and restaurants if people keep ignoring social distancing.
      Is this what you are referring to? Do you have a good link?

      • I did my bi-weekly grocery shopping today. About half the customers were not wearing masks of any kind. They mostly seemed to be young people. Ohio is set to loosen restrictions in about a week, but still recommending masks. I think that two weeks ago there were more customers using masks than there were today. Ohio has about 600 deaths with a population of 12 million. I’m not sure that everyone is taking this seriously.

          • Having been a painter I can tell you that the majority of masks are about as useful as tits on a bull. Where they do make a difference is when someone coughs or sneezes the mask stops the air shooting out at great force directly in front of that person and is diffused around them so may not travel as far. I also see people using the same mask time and time again which would also reduce their effectiveness. The nose is extremely efficient at filtering things out so breath through your nose and not your mouth. Years ago I heard of someone that was heavily medicated for asthma but they forced themselves to breath through their nose as they slept and within about two weeks were off the heavy medication.

          • That may be reason enough, there are certainly lot of people that don’t know they are spreading. Not that I like masks and not that I’m not aware about what you said concerning their ineffectiveness. But I realised, that other people in shops stay at distance 😀

  23. More men die than women. In general, men have significantly more red blood cells than women. When the body’s cells are destroyed during a virus attack, free heme enters the blood, leading to blockages.

    • You are not very specific. Red blood cell per microliter:
      men 4.7 to 6.1 million
      women who aren’t pregnant 4.2 to 5.4 million
      Waste your time as you please, but please don’t waste my time.

    • Free Heme Toxicity
      In contrast to the positive functions of heme, free heme excess can cause cell damage and tissue injury since heme catalyzes the formation of reactive oxygen species (ROS), resulting in oxidative stress. Heme that is not bound to proteins is considered the labile heme pool; this portion of heme is derived from newly synthesized heme that has not yet been incorporated into hemoproteins, or heme that has been released from hemoproteins under oxidative conditions. “Free heme” is an abundant source of redox-active iron that can participate in the Fenton reaction to produce toxic free hydroxyl radicals. ROS damage lipid membranes, proteins and nucleic acids, activate cell signaling pathways and oxidant-sensitive, proinflammatory transcription factors, alter protein expression, and perturb membrane channels (Vercellotti et al., 1994; Jeney et al., 2002). Heme toxicity is further exacerbated by its ability to intercalate into lipid membranes. Due to its lipophilic nature, heme may initially lodge within the hydrophobic phospholipid bilayer. Within this highly oxidizable matrix, iron catalyzes the oxidation of cell membrane and promotes the formation of cytotoxic lipid peroxide, which enhances membrane permeability, thus promoting cell lysis and death (Balla et al., 1991; Ryter and Tyrrell, 2000; Kumar and Bandyopadhyay, 2005; Tolosano et al., 2010). Additionally, heme is a potent hemolytic agent. It affects erythrocyte membrane stability as a result of ROS formation and oxidative membrane damage. Finally, heme is strongly pro-inflammatory since it induces the recruitment of leukocytes, platelets and red blood cells to the vascular endothelium, it oxidizes low-density lipoproteins and it consumes nitric oxide, thus impairing vascular function.
      https://www.frontiersin.org/articles/10.3389/fphar.2014.00061/full

      • Release of heme as a result of lung cell destruction and oxidative stress may explain the frequent sudden deterioration of the patient’s condition around day 10 of the disease.

    • Women live longer on average and have lower all cause mortality than men, and working on ladders over stairwells (for example) is only a tiny part of the reason.

  24. CPT Crozier was relieved of command of CVN-71 for widely distributing his communication over a “non-secure, unclassified” email sent to “20 or 30” additional recipients, beyond his immediate superior, the RADM commanding the Carrier Strike Group centered on USS Theodore Roosevelt.

    • The Navy and Navy Department are considering reinstating him.

      There wasn’t much the sea service could do to help the ship out, except for what it did, ie divert TR to Guam and try to find hotel rooms there to quarantine crew.

      Crozier says he chose to let sailors go ashore and to take on stores there because he was told that the virus had only been found in northern VN, not the center. But clearly it already was in Da Nang. TR steamed into Da Nang with just one escort. The rest of the strike group stayed away.

      • As for shore leave in Vietnam. Back in the late 60s and early seventies there was a deliberate effort to spread desease to the troops.

        Why is it such a stretch to see that this might have been deliberate…

        They should never have been allowed to leave the ship.

    • The U.S. Navy is now indicating they might reinstate Captain Crozier. I think this would be a huge mistake if they did. They will be sending the wrong message to the troops and everyone else. I wouldn’t have any confidence in a Naval Chief who would reinstate this man to his former position. I wouldn’t be the only one, either.

      • The CNO went along with Navy Department’s civilian political appointees, despite his having served as a Carrier Strike Group CO. Three and four star flag officers must often act as politicians in uniform. They almost never resign out of disagreement on principle.

        CPT Crozier violated both operational security and the chain of command. He was rightly sacked, IMO.

      • He was relieved of command for sending a message to a few dozen people, a message that would be leaked, by someone who made a speech with improper language to the whole crew (thousands), not expecting that it would be recorded and leaked… lol

  25. “As a result of this new knowledge, it would appear that adding an anticoagulant such as clopidrogel (Plavix) should become standard prevention therapy in serious/critical hospital cases”…

    Clopidogrel is not an anticoagulant – it is an antiplatelet. This distinction is often muddled, but I wonder if it makes a difference in this application, since both antiplatelet and anticoagulants are antithrombotics.

  26. A slight diversion – but something that has been puzzling me. Maybe someone on here (Rud??) has some insight:

    I think it is agrees that the way the virus infects human cells is via the ACE-2 receptors.
    I have seen claims that ARBs (Losartan, Olmesartan, etc.) might:

    a) Make matters worse.
    b) Provide some protection.

    I can see the protection happening. Maybe, depending on how these drugs work. They block angiotensin-II from attaching to the ACE-2 receptors — how? Is if interfering with the angiotensin-II itself? Or does is somehow “mechanically” block the receptors (by attaching to them itself??). If its the latter, I can see it interfering with anything that tries to attach, including the covid-19 virus.

    The claim that it could make people even more receptive to the virus I just don’t see … well, maybe … if the ARBs work by interfering in some other way that directly vlocking the ACE-2 receptors – which I suppose could leave more of the “open” for attack?

    Anyone have any words of wisdom on the subject?

    • As I understand it…

      Increased ACE2 expression likely increases risk of severe infection simply due to the increased number of infection points. Infection increase decreases ACE2 expression.

      ACE triggers inflammatory factors; ACE2 triggers anti-inflammatory factors. They counter-regulate to maintain RAS homeostasis.

      ACE inhibitors prevent ACE from converting angiotensin I (AngI) to AngII. AngII mediates inflammatory response through the AT1 receptor (AT1R).

      ACE2 converts AngII to Ang(1-7), which mediates anti-inflammatory response through the Mas receptor.

      ARBs block AngII from attaching to AT1R preventing mediation of inflammatory response.

      IMO the worst thing that doctors can do is take covid patients off of their ACE inhibitors and/or ARBs because that will allow more AngII to attach to AT1R and increase inflammation.

      • There is a clinical trial for an ARB to treat COVID.
        People taking any ACE inhibitor have a substantially reduced lifetime chance of ever getting pneumonia or any reason.
        I wonder how many people went off a A.I.’s after reading speculation from people taking WAGs based on no actual evidence or logical reason, but instead internet and social media rumormongering?

        It becomes less astounding after such events that authoritarian guvs and dictatorships throw people in jail for spreading rumors.

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394697/

        • Thanks for comments and link. On ace inhibitor myself.

          I am trying to track down original source to stop using.

        • It’s pretty accepted that increased ACE2 expression increases severe infection risk. Doesn’t take a genius to see that increased infection points increases risk of infection.

          ACE inhibitors may decrease risk of pneumonias per your study, but most pneumonias are bacterial, which have nothing to do with ACE2; so the data in that study are skewed.

          Other drugs control hypertension. ACE inhibitors aren’t used much in E Asian countries. So moving from ACE inhibitors before infection to something else that controls BP, but doesn’t increase ACE2 expression seems like a prudent thing to do. That’s what I would seek to do.

          However, stopping ACE inhibitors after infection is IMO possibly the worst thing to do because that would push RAS towards its inflammatory axis.

          • My study?
            Skewed how?
            It is a look at 37 longitudinal studies and data was mined.
            A so-called meta-analysis.
            Did you even look at it?

            You speak in absolutes a lot, and after starting with “As I understand it…”, then remove any qualifying remarks, and by the end you seem to regard your understanding and mischaracterizations as some sort of bedrock human knowledge.

            I never do that.
            This was a study looking at a giant number of people from all over the world, and one of the analyses was all cause pneumonia.
            All cause.
            Do any of the people dying of COVID have bacterial involvement?
            You seem to dismiss the entire notion, but you have also many times indicated a belief that the z-pak treatment is proven effective.

            From “my” study:
            “What is already known on this topic
            Angiotensin converting enzyme (ACE) inhibitors reduce morbidity and mortality in patients with cardiovascular disease

            These drugs also have secondary effects on the respiratory system, suggested to protect against pneumonia

            Most of the data on this issue are provided by heterogeneous observational studies with inconclusive results

            What this study adds
            In pooled results from both interventional and observational studies, ACE inhibitors, but not angiotensin receptor blockers (ARBs), showed a statistical and putative clinically significant protective role against pneumonia

            This result may discourage the withdrawal of ACE inhibitors in patients with tolerable adverse events—namely, cough

            This protective effect was higher among Asian patients and in those with previous stroke; patient populations that may benefit most from ACE inhibitors.”

          • Yes I read it the first time you posted it a while back, and and realized then that it doesn’t support what you say it does. You can’t extrapolate from that study that ACE inhibitors protect against pneumonia caused by a virus that targets ACE2 because most pneumonias are bacterial, and bacteria do not infect via ACE2. The data are naturally skewed towards bacterial pneumonia, which ACE inhibitors may protect against. But your assumption based on that study that ACE inhibitors protect against coronavirus pneumonia is just wrong.

          • I reached no conclusions.
            You did that.
            I post evidence, and this study was only one of many pieces of evidence I have looked at.
            I post evidence.
            You make unsupported assertions.
            You mischaracterize what others say, and rewrite your own opinions and in fact medical textbooks on a daily basis, based on what no one can say, because you never do.

          • icisil
            April 24, 2020 at 5:12 pm

            I have followed your ACE ACE2 relation explanations and conclusions.

            It has being very interesting to me.

            I understand (I think), your point:

            “You can’t extrapolate from that study that ACE inhibitors protect against pneumonia caused by a virus that targets ACE2 because most pneumonias are bacterial, and bacteria do not infect via ACE2.”

            I am just trying to learn about this specific detail.
            But I am still trying a figure out the consideration of the virus targeting ACE2.

            Outside the hypothesis or virtual scenarios, what actually in consideration of data and observations support this conclusion as put?

            Is this a colloquial expression of the given condition, or is it hands on observation?

            Indication of a strong correlation between a successful viral infection and the imbalance jumping in favor ACE versus ACE2, does not strictly mean the virus targeting or utilizing ACE2, I think… unless the targeting and utilization observed, clearly.

            Is any data there that support such as, in consideration of petri dish experiments?

            I do not know much of this only trying to learn and understand it better.

            thanks

          • whiten, I have no idea how they know what they know, but apparently this coronavirus, as well as the first SARS coronavirus, has spiked proteins that attach to ACE2 enzymes on cell membranes, and infects cells through that portal.

      • Hope everyone sees this concerning ace inhibitors.

        Yes there has been controversy on this subject. The latest recomendation(which has changed):

        Keep taking your you ace inhibitor..

        Will be disscusing with my Dr next week to verify.

        Directly from the EVMS team

  27. It would be interesting to know at some point what number of fatal COVID-19 victims had a type of blood condition known as Factor 5 Leiden? Patients already diagnosed with such might be on some sort of blood thinner that limits thrombosis and hence avoid the clotting issues that can lead to heart failure. Or in the reverse, how many victims of COVID-19 perhaps had undiagnosed Factor 5 Leiden that led to clotting and all those issues that present in deep viral pneumonia and/or heart disease, perhaps much sooner with the addition of COVID-19. Maybe something like this is completely missed in the scheme of things and why certain people succumb to the disease while others survive.

    https://en.wikipedia.org/wiki/Factor_V_Leiden

    https://www.mayoclinic.org/diseases-conditions/factor-v-leiden/symptoms-causes/syc-20372423

    • I don’t know about Factor 5 Leiden, but I do know that deceased covid patients have increased levels of AngII, which is profibrotic (facilitates blood clotting). ACE2 converts AngII to an antifibrotic mediator, but as virus infects ACE2 sites that capability decreases, and AngII increases, increasing thrombosis risk.

  28. Rud,

    1. How about daily low dose aspirin as a prophylaxis against clots due to c-19..

    2. Any difference in outcomes for c-19 if using ace1 vs ace2 inhibitors or arb’s or beta blockers.

    • There is a clinical trial for a drug that loosens mucus.
      Bromelain IIRC.
      Not available in the US, but we do have guaifenesin, available OTC.
      The idea is to prevent the initial stages of pneumonia where failure to breathe deeply over a few days causes pneumonia to initiate and then it progresses.
      It is well known that broken ribs can cause pneumonia, or being in bed 24/7 for an extended period. Even if someone has broken legs, very good idea to get up and walk at least a little bit every day.

      Would it not be amazing if people that treat cold symptoms by taking remedies available OTC are what prevents serious illness in some people?
      Personally, I never buy things like Nyquil.
      I get pills of each ingredient, generic in large bottle. Cheap as dirt.
      Antihistamines (drowsy and nondrowsy ones), nasal decongestants, mucus relief, cough suppressant, pain relief.
      Only treat what symptoms I have as needed.
      But it takes a little knowledge.
      Not a lot, just a little.

  29. The west is self immolating. I think the USA will survive as republican states will open up despite the media ands Trump who will be losing his base support unless he changes the whole CDC real quick. The democratic states can self immolate if they want NY with a lot of cases and California with absolutely virtually none is applying the same rules will also suffer much more and the democrats may dissappera as a party because of this. I am very worried about Australia my country (although I left years ago) as they think a victim number 78 a 96 years old woman with preconditions died from coronavirus is worth closing down the whole country and economy for another month. Australia will lose all its markets to China on which it had been dependent. BTW I dont think the Chinese pushed this virus I believe it is just a normal flu corona virus that exists everywhere everybody will get it or has it and it does not do anything to anybody but if it it infects very old people like NORMAL FLU viruses that are already dying in nursing homes yes it will kill them. People seem to be forgetting that old people die its normal we have no right to kill young people our daughters and children because of incredible stupid economic lockdown policies. Sweden and Brazil seem to be the onl;y smart people for christ sake 170000 old people die per DAY WAKE UP to date this virus has not been able to get even close over 5 months!!!

    • Except that all cause mortality, measured by weekly deaths, doubled in Spain; doubled in the UK; doubled in New You to; and even rose 20 to 25% in Sweden in recent weeks. We may reasonably infer that the majority of these cases, save Sweden, is because of Covid19 infections. (The NYTimes published these facts, recently.) And thus we do have the worst epidemic and pandemic of this century on our hands. And these costs in numbers of lives will be greater with a do nothing to mitigate policy.

      • Please provide evidence it’s a pandemic.

        And that the lockdowns (plus mass panic) are not the main cause of the increased death rates.

  30. In regards to Trump about possible use of sunlight for virus treatment. Maybe not so outlandish if you want to explore all possibilities. Consider the “Pulse Oximeter” operation. It uses a red light and an infrared light which ‘shines’ through your fingertip to measure the oxygen concentration in your blood. Who-da-thunk that? https://www.howequipmentworks.com/pulse_oximeter/

    Mine is powered by 2 (ea) AAA batteries. Someone had the open mind to give it a try! Is there a spectrum of ‘light’ that could kill a virus? If there is could the process be called a disinfectant?

    • It worked in Star Trek against the giant neuron brain eating creatures from planet Zlorch.
      (actually they never said where the neural parasite creatures that they found on planet Deneva came from, just that they were likely from outside the Milky Way.
      That is good enough for me!
      And heck, even a flashlight will shine right through your whole hand.
      Just go into a dark closet and place your hand over one while it is lit.
      Very astute observation, EOU!

      • “It worked in Star Trek against the giant neuron brain eating creatures from planet Zlorch.”
        That was good on its own.
        Your clarification for exactitude convinces me that the Big Bang Theory is a reality TV show.

    • Is there a spectrum of ‘light’ that could kill a virus?

      There sure is! UV-C works great against viruses, bacteria, fungi, pretty much anything with DNA. I have a UV-C sterilizer box made from a pair of fish tank sterilizers that I use to sterilize my cell phone, car keys, security badge, etc. almost daily.

      Unfortunately UV-C will also kill pretty much any other cell in your body so if you try to “disinfect” yourself with UV-C, COVID-19 will quickly become a minor concern.

    • I wonder what would happen if a bat infected with COVID-19 was placed outside in direct sunlight for a few hours and then tested for the virus? Simple, quick, and easy experiment. Could the normal lack of sunlight be the reason bats seem to harbor various corona virus’?

      • In consideration of the effects of such a test/experiment on the bat one should consider the impact on the bat. One result could be that the bat is cured of the virus and gets a suntan. The other is that the bat only gets a suntan.

  31. With regards to Trump about possible use of a disinfectant for virus treatment. Maybe not so outlandish if you want to explore all possibilities. Alcohol is claimed to kill the virus on surfaces in a matter of seconds. In a lung infection could a couple of breaths of vaporized alcohol delivered directly to the lungs where the issue is relating to the virus act as a disinfectant. Worse case is the patient may get A DUI if it is done on a drive thru basis!

    I only catch a cold or flu once every 5-6 years if that often. I inhale a salt solution thru my nose at the first sign of congestion. Then, as my grandfather would say, grab the whisky and have a little snort or kiss the baby (have a drink directly from the bottle). I can’t ever remember him having a cold or flu. Anyway, the threat of the flue is a good excuse to pull one! Oh yeah …. Vitamin C at about 4000 mg every 3-4 hours for a couple of days.

    • Judging by the number of times, in recent years alone, that Keith Richards has been found alive in a hotel room, it seems as though pickling has a tremendous preservative effect…but it HAS to be taken internally.

    • Anecdotally, I understand that the only medicines that Lewis and Clark took with them were some sort of laxative and rum. They lost one man to appendicitis. However, I think they made men tougher in those days — or, they just didn’t survive childhood.

  32. Cross-reactive T-cell memory responses among beta-corona viruses is a leading hypothesis on the “why” of asymptomatic individuals who have viral RNA shedding indications of being infected with SARS-CoV-2, even though they do not have the highly specific antibodies to SARS-CoV-2 proteins.

    For those with some immunology background and an understanding the T-cell/MHC nomenclature, then this review from 2017 is a good start:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113894/

    A number of the peptide epitopes in the Spike and N viral proteins are known for some of the common human MHC-1 (CD8+) and MHC-II (CD4+) types. This of course is useful to try and get vaccines to induce Tcells specific for those viral peptides. That simply making a CD8 or Cd$ T cell that engages those MHC-peptides is a long ways (immunology speaking) from getting to those T-cells to form a potent, long lived cytoxic T cell memory populations.

    The vital issue I have consistently warned about with the latest SARS-CoV-2 vaccine development using patentable mRNA and DNA vaccines to the Spike protein and the N protein is highlighted in that review article:
    Specifically, I would note the authors of that above referenced review WARNED (my bold for emphasis):

    “These studies demonstrate that T cells play a crucial role in SARS-CoV clearance and elucidate the avenues for vaccine development against other human coronaviruses, including MERS-CoV (Du et al., 2016, Wang et al., 2016a). However, some SARS-CoV vaccines led to the occurrence of Th2-type immunopathology in spite of antibody and protection against infection with SARS-CoV in mice (Tseng et al., 2012). Therefore, the application of a SARS-CoV vaccine in humans should proceed with caution.

    This point on immunopathology of Th-2 response to a viral lung pathogen by a vaccine that only induces antibodies is a big warning. Really big. Since COVID-19 is a deep lung respiratory pathogen, the development of a Th-2 response in the lungs and airways will certainly lead to a much worse outcome upon natural virus infection of the individual. Because the lungs and pulmonary airsacs are constantly hit by all sorts of otherwise benign, but foreign “stuff” we breath that is not a pathogenic virus, the lungs and the immune response there have to be very tolerant. But they still have to be able to form potent T-cell responses when a true pathogen is presented.

    These mRNA and DNA vaccines being developed I think are **UNlikely** to drive the potent development of a proper long-lived T-cell CTL memory response, IMO. The immunopathology is usually an eosinophilia that exacerbates airway/bronchial restriction and is essentially an allergic-type reaction (similar to asthma) at the same time the lungs and immune system are battling the virus. Really bad juju. This is what happened in the RSV vaccine of the 1960’s given to children. RSV is deep lung viral pathogen (like COVID-19) that is a common childhood virus. Attempts to make a vaccine used a formalin-inactivated RSV that did indeed develope a potent antibody response, but it failed to develop a memory T cell cytotoxic (called a Th-1) response essential to clear the virus-infected cells when the real virus was encountered and infected some children. This resulted in a Th-2 skewed response (insufficient Th-1 T cell cytotoxic response).
    ***Children died because of this RSV vaccine that was supposed to save them.***

    The RSV vaccine was an inactivated virus. That is it was thought very safe because it couldn’t replicate once taken into cells and use its RNA to translate to proteins and give all the anti-virus warning signals (pattern recognition sensors for various forms of viral RNA) for the cell’s internal defenses that primes a T cell response to be cytotoxic to that infected cell. There is very complex and increasingly described innate pattern recognition receptors (PRRs) inside all nucleated cells that triggers these key anti-viral responses (interferon release being one key component) and warning signals that are essential then to drive the downstream and proper priming of cytotoxic (Th1) T cell responses. Without these viral warning signals from the internal PRRs detecting viral RNA, signals that only come from a replicating virus, then the T cell response will either be weak, non-existent, or even tolerizing (really bad).

    It is not a coincidence that all the vaccines we give our children to common viral pathogens are Live-but Attenuiated virus vaccines. Measles, mumps, rubella, chicken pox, polio, Hepatiis-B vaccines are all live-attenuated viruses that form the vaccine response that produces both B-cell (antibody makers) and T-cells (“Cytotoxic” means that CD8+ AND CD4+ T-cells recognize viral peptides ofn the surface of infected cells and eliminate those infected cells by direct-contact and pumping them up with potent enzymes that force them to die.)

    All those childhood and respiratory virus vaccines mentioned above inject a live virus for each of those pathogens inside the body. That is a virus that can replicate, but attenuated because some of the virus’s abilities to evade the immune system have become deactivated/eliminated from its RNA or DNA coding. But that replicating virus still effectively primes both a potent memory B-cell/antibody response (the memory B-cell response forms highly differentiated population of B-cell clones called plasma cells. Plasma cells go hang-out in bone marrow throughout the skeleton where they then pump-out a steady supply of IgG to the blood stream for years to decades) and the needed T-Cell (Th1) cytotoxic memory cell formation.

    The big reason no one wants to make a live, attenuated virus vaccine for SARS-Cov-2 is there is no big money in a vaccine like that. Even though would be the quickest and likely most effective path to putting the COVID-19 out the pandemic business.

    • Joel
      You remarked, “… there is no big money in a vaccine like that,” That seems quite cynical. If a vaccine can be demonstrated that is effective against the current strain(s), then the almost inevitable mutations would require periodic tweaking to maintain the effectiveness. That is a lot like the razor blade marketing model. The bigger problem is whether an effective vaccine can even by created. I think that the effort needs to be encouraged in the way that corporations respond best in a capitalistic society.

      • You really didn’t get the gist of my argument. All those fancy “new” vaccine attempts with patentable approaches, not one of those modalities is currently an approved vaccine for anything.

        All our effective vaccines where the lungs are involved are Live, Attenuated virus vaccines. And SARS-CoV-2 is a deep lung pathogen. The likelihood of inducing a Th2-skewed immune response, rather than the needed Th1-response, with these mRNA and DNA vaccine approaches is high to very high IMO. The authors of the above reference Review article warn exactly of this outcome with a SARS-1 vaccine that do not prime a cytotoxic T-cell response. SARS-2 (SARS-CoV-2) will be no different.

        The only reason pharmaceutical and biotech companies are proceeding down those paths is because those modalities are patentable. They are being lured astray by visions of vast fortunes coming their way for a COVID-19 vaccine.

        Time is of the Essence. The World Economy is shedding Trillions of dollars of lost economic productivity with each week this goes on.

        And everyone is dicking around with mRNA vaccines, DNA- vaccines, virus-like particle vaccines, simply because that is where the *promise* of money is for those companies.
        We simply need a mass produced attenuated strain of SARS-CoV-2 virus to prime the Th-1 immune response to form both an antibody response and a Th1- T cell cytotoxic memory response.

        • Joel
          Your remarks sounds like someone who believes in “Good enough for government work!” I have no trouble with Big Pharma making drugs that are better than what exist, and making money doing it. That is how capitalism is supposed to work. Making a better mousetrap and charging more for it. I’m glad that I’m not forced to buy a Yugo and can buy a Corvette if I want one. Now, if you don’t want to use a patented drug that comes out, feel free to use HCQ.

  33. Re:

    hird is the sensitivity and specificity of the resulting antibody test. Sensitivity is how many true positives are missed. Specificity is how many false positives are generated. As of now, only a few manufactures have offered their internal (unverified by the FDA) estimates based on small samples of people.

    How do they arrive at this? What do they measure against?

    Somewhere I read that the main test for determining live virus (rt-pcr test) is wrong about 30% of the time.

    Yet, apparently one of the steps in the sewage anitbody analysis (being developed at Biobot) makes use of some of the same testing processes. Are the two tests interdependent?

    Thanks for the article.

  34. ‘cleanup needed on isle 3’ … Sounds like a presidential briefing. Please do not inject bleach into yourself or others. Although… internal use of ultraviolet light???

  35. EUROMOMO stats have been updated for week 14 and 15:

    https://www.euromomo.eu/graphs-and-maps/

    Sweden now at 10.91 in week 15. Might be adjusted further up. No decrease from week 14 and week 14 was adjusted upwards as well. Just 7.81 before when I checked.

    Week 16 is still delayed cause there is no way Belgium stays so low.

    Spain might have a lot of under-reporting of COVID-19 deaths as excess mortality is a lot above Italy which can not be deducted from COVID-19 reported deaths.

    Excess mortality has topped flu season 2018 in merely 5 weeks and still counting.

  36. ” age 41, had to have his right leg amputated as a result of CoViD-19 induced deep vein thrombosis.”

    He was put on a ventilator, dialysis and an ECMO (extracorporeal membrane oxygenation) machine,

    Just to be clear it is rare to amputate a leg for deep vein thrombosis complications.
    Usually it is an arterial thrombosis.
    In this case the patient had a cannula inserted in a leg artery, probably the right leg femoral artery, which thrombosed.
    Only speculation but highly likely not a DVT

  37. Rudd, enjoy your posts. Have you heard of ACE 2 blockers for hypertension as a possible preventative treatment? Would it be worth a try?
    Seeing as how the virus wants to attach there as well.

    • Definitely worth a try. Two approaches that I am aware of: 1) use recombinant human ACE2 as a decoy for virus to attach to rather than ACE2 on cell membrane; not sure if it’s IV or nebulized, and 2) use ARBs or ACE inhibitors to keep inflammatory ACE axis signaling from increasing.

  38. I wonder how the nicotine vapers went in their study or aren’t they telling?
    https://www.rt.com/news/486605-french-study-nicotine-resist-coronavirus/
    Assuming you’re not vaping THC with vitamin E acetate oil as well-
    https://athra.org.au/blog/2019/09/16/scaremongering-about-vaping-will-cost-australian-lives/

    With a rush on ‘nicotine substitutes’ naturally the French Govt had to jump on it although they don’t mention restricting nicotine ejuice-
    https://www.msn.com/en-us/health/health-news/france-restricts-sales-of-nicotine-substitutes-after-coronavirus-study/ar-BB139qyJ

  39. Post modern séance is as much about the things you don’t investigate as those that every true ologist must.

  40. Where is the risk in using a killed c-19 vaccine for the elderly TODAY?

    We already have the technology and the risk from a killed vaccine far outweighs the risk for the susceptible population.

    A live vaccine or genetically engineered vaccine I agree needs safety testing. But the worst you are likely to see with a killed vaccine is an allergic reaction, which are routine in any vaccine.

    Sure a killed vaccine is not going to yield perfect immunity, but for the vast majority of the elderly it could make the difference between a mild illness and death.

    Personally I’d rather have a good solution today rather than a perfect solution long after I needed it.

  41. Breaking …

    Ivermectin is looking more and more like it could be a silver-bullet drug that emerges to bail us out of our difficulties. The news regarding same is getting more and more interesting.

    https://mainichi.jp/english/articles/20200425/p2a/00m/0na/007000c

    Excerpt: According to the team, the death rate of coronavirus patients declined to about one-sixth, compared to the rate of death in those who did not use the medication.

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