New Covid-19 Thread

[shiny!]

Alabama Man Nearly Dies from Covid-19 in Early January

Did anyone else see this? https://uncoverdc.com/2020/06/25/an-...ek-in-january/

An Alabama Man Nearly Died From COVID-19… the First Week in January

-
June 25, 2020 - By Bill Rice Jr.

• Husband and wife have both tested positive for antibodies
• First symptoms emerged in mid-December – 2 weeks before Wuhan outbreak
• Tim McCain, who almost died, would have been first CV-19 fatality in world
• Story has received no national attention
• Couple – possible “Patients Zero” in U.S. – has yet to be contacted by health officials
• Wife never left hospital, saw first-hand the ‘nightmare’ critical COVID patients endure
• Hospital staffers who treated McCain will not comment on his case
• Director of nursing previously expressed opinion Tim McCain ‘definitely” had COVID-19
• Couple believes lessons from husband’s case could have saved lives
• Medical bill exceeds $2 million
• ECMO machine credited with saving husband’s life; possibly first case in world
• Medical records support COVID-19 diagnosis

Both McCains believe Tim nearly died after experiencing an extreme medical reaction triggered by the novel coronavirus. Evidence supporting the belief Tim McCain had COVID-19 in December is convincing.

First, both McCains have tested positive for COVID-19 antibodies (from the Abbott IgG assay).

Second, both of the McCains experienced virtually all of the COVID-19 symptoms, including more unique symptoms typically associated with COVID-19. In addition to Tim and Brandie McCain, at least four other people in the couple’s immediate circle of daily contacts also developed symptoms typical of those who have tested positive for COVID-19.

Third, numerous details of Tim’s clinical case history mirror those of COVID-19 ICU patients in Wuhan China (here and here) and later in the United States.
Four, according to Brandie McCain, many of those who cared for Tim soon came to believe Tim’s severe illness was indeed caused by COVID-19.

Until last month, the Alabama couple believed they might be the first confirmed, or likely, COVID-19 patients in the country. However, stories in The Seattle Times and The Palm Beach Post have identified at least 13 other people who had COVID-19 symptoms as early as November and December. Like the McCains, all 13 tested positive for COVID-19 antibodies. But none of these individuals came close to dying.

Hospital quarantine policies enacted six weeks after Tim was discharged from the Birmingham hospital preclude family members of COVID-19 patients from being with their loved ones. Because of this, Brandie McCain is perhaps the only family member of a critical COVID-19 patient in the United States who witnessed the “sheer hell” such patients endure.

Today, however, she’s “torn” about whether these loved ones would actually want to live
through the “nightmare” she and her family experienced.

“I know what they would see,” says Brandie, who never left the hospital during her husband’s 24-day hospital stay. “It is bad … It is bad.”
The McCains are also bewildered they’ve yet to be contacted by a single state or national health care official seeking information regarding the circumstances of their cases, including information on how and when they may have contracted the novel coronavirus and who else they may have infected.

“You would think that someone would be testing us for antibodies every week if for no other reason than to see how long these antibodies last,” says Brandie.

CDC officials have pushed back the date when “limited community transmission” of SARSCoV-2 may have begun in this country. However, this new timeline begins at least one month after Tim and Brandie McCain report the onset of their first COVID-19 symptoms.
more ...

[Chris Coles]

Re: Alabama Man Nearly Dies from Covid-19 in Early January

I remain convinced that not only myself, but others around me, had COVID-19 symptoms last Christmas. That opens the question; did someone set out to start a pandemic by spreading the disease across the planet?

[FrankL]

Re: Alabama Man Nearly Dies from Covid-19 in Early January

I remain convinced that not only myself, but others around me, had COVID-19 symptoms last Christmas. That opens the question; did someone set out to start a pandemic by spreading the disease across the planet?

You might want to keep tabs on when antibody tests become available on greater scale in the UK.

I'd be interesting to see the results of large-scale retroactive tests of blood samples taken from people with respiratory infections in Q3 and Q4 2019.
For all we know, the infection already had started months before people became aware of it.

[Southernguy]

Re: Alabama Man Nearly Dies from Covid-19 in Early January

Not the first case of early Covid19. Later I read somewhere scientists were disputing de case.

Did anyone else see this? https://uncoverdc.com/2020/06/25/an-...ek-in-january/

Coronavirus: France's first known case 'was in December'

• 5 May 2020

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• Coronavirus pandemic

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A patient treated in a hospital near Paris on 27 December for suspected pneumonia actually had the coronavirus, his doctor has said.
This means the virus may have arrived in Europe almost a month earlier than previously thought.
Dr Yves Cohen said a swab taken at the time was recently tested, and came back positive for Covid-19.
The patient, who has since recovered, said he had no idea where he caught the virus as he had not travelled abroad.
Knowing who was the first case is key to understanding how the virus spread.


The World Health Organization (WHO) says it is possible more early cases will come to light, and spokesman Christian Lindmeier urged countries to check records for similar cases in order to gain a clearer picture of the outbreak.
The French health ministry told the BBC that the government was obtaining confirmation on the case and that it would consider further investigations if they proved necessary.
France is not the only country where subsequent testing points to earlier cases. Two weeks ago, a post-mortem examination carried out in California revealed that the first coronavirus-related death in the US was almost a month earlier than previously thought.
What do we know about the new case?

Dr Cohen, head of emergency medicine at Avicenne and Jean-Verdier hospitals near Paris, said the patient was a 43-year-old man from Bobigny, north-east of Paris.
He told the BBC's Newsday programme that the patient must have been infected between 14 and 22 December, as coronavirus symptoms take between five and 14 days to appear.

• Listen to the interview

The patient, Amirouche Hammar was admitted to hospital on 27 December exhibiting a dry cough, a fever and trouble breathing - symptoms which would later become known as main indications of coronavirus.
This was four days before the WHO's China country office was informed of cases of pneumonia of unknown cause being detected in the Chinese city of Wuhan.
Mr Hammar told French broadcaster BFMTV that he had not left France before falling sick. Dr Cohen said while two of the patient's children had also fallen ill, his wife had not shown any symptoms.
But Dr Cohen pointed out that the patient's wife worked at a supermarket near Charles de Gaulle airport and could have come into contact with people who had recently arrived from China. The patient's wife said that "often customers would come directly from the airport, still carrying their suitcases".
"We're wondering whether she was asymptomatic," Dr Cohen said.

What does it tell us?

Could coronavirus have been circulating in Europe in late 2019, many weeks before it was officially recognised and declared a threat there? That is the suggestion being made after a French doctor has revealed that he treated a patient in Paris with all of the symptoms of coronavirus just after Christmas.
How does this change what we know about the pandemic? It might be that the test result is an error and so does not change a thing.
But it if is correct, it could mean spread of the disease was going unchecked in Europe while all eyes were on the East in Wuhan.
Certainly, any laboratories in Europe with samples from patients sick with similar symptoms around that time might want to run a test for coronavirus to see what it reveals so that we can learn more about this new disease.

Why does it matter?

Until now, what were thought to have been the France's first three cases of coronavirus were confirmed on 24 January. Of those, two had been to Wuhan - where the outbreak was first detected - and the third was a close family member.
Mr Hammar's positive test result suggests the virus was present in France much earlier.
The first human-to-human transmission within Europe had until now thought to have been a German man who was infected by a Chinese colleague who visited Germany between 19 and 22 January.
Rowland Kao, a professor of veterinary epidemiology and data science at the University of Edinburgh, said that if confirmed, Mr Hammar's case highlighted the speed at which an infection starting in a seemingly remote part of the world could quickly seed infections elsewhere.
"It means that the lead time we have for assessment and decision-making can be very short," Prof Kao said.
How was the new case found?

Dr Cohen told the BBC that he had the idea to look back at all patients who had been in intensive care units with suspected pneumonia between 2 December and 16 January.
He found 14 patients who had tested negative for pneumonia. He defrosted their samples and tested them for traces of Covid-19.

He said that out of the 14 samples, one tested positive for traces of Covid-19. A second test on that same sample also came back positive. He added that the patient's chest scan was also compatible with the symptoms of Covid-19.

A full report was due later this week, and would be published by the International Journal of Antimicrobial Agents, Dr Cohen added.

[Chris Coles]

Re: Alabama Man Nearly Dies from Covid-19 in Early January

I was in Paris last November attending a conference.

[shiny!]

60% of people naturally resistant to SARS-COV2

Dr. Michael J. Burry (remember The Big Short?) has been tweeting under several pseudonyms. Considering how he was treated by the gov't post 2008 financial crisis, I'd say he's totally justified in his paranoia. The following is from his https://twitter.com/RawParrots account.

Jun 12, 2020

STUDIES: 60% of people naturally RESISTANT to SARS-COV2 New research suggests majority of people may already have resistance based on previous infections

A new study has found that Sars-Cov-2, the virus linked to Covid19, maybe five times more widespread than previously thought, and therefore five times less deadly.
The research, conducted by a team of scientists at the University Hospital in Zurich, is titled: “Systemic and mucosal antibody secretion specific to SARS-CoV-2 during mild versus severe COVID-19”, and found that Sars-Cov-2-specific antibodies only appear in the most severe cases, or about 1 out of 5.

The authors infer from this that antibodies are inexplicably absent from the majority of mild cases of covid19. But, given the known inaccuracy of the diagnostic tests and the well-documented tendencies to over-diagnose by clinical observation, another potential explanation would appear to be that the absent antibodies were due to the fact the subjects had never actually been infected with SARS-COV-2 in the first place, and their ‘mild’ cold-like symptoms were due to some other pathogen, like…the common cold.

However, if the authors are indeed correct in their estimation, this might mean SARS-COV-2’s infection rate (IFR) would need to be revised downward yet again. If 80% of those infected really do not produce antibodies then there is a live possibility the virus is present in many more people than usually supposed. Which would in turn potentially reduce the IFR, possibly considerably.

In the early stages, the World Health Organization (WHO) estimated the virus’ IFR to be as high as 3.4%. The models based on those numbers have, however, been shown to be wildly inaccurate.

Many experts, such as Prof John Ioannidis from Stanford, predicted the WHO’s IFR numbers would be proven incorrect when the widespread population studies were finished.
The dissenting experts appear to have been vindicated by the serological studies, using blood tests looking for Sars-Cov-2 antibodies done across different populations all over the world, which routinely suggest that the IFR is closer to 0.3% than the WHO’s initial figure of 3.4%.

From Japan to Iceland to Los Angeles, the numbers returned were between 0.06 and 0.4. Within the range of seasonal influenza.

As a result of these studies, the US CDC’s most recent “estimated IFR” is between 0.26% and 0.4%. Roughly 1/10th of the initial estimates.

Another study from last month meanwhile has found evidence up to 60% of people may be partially resistant to SARS-COV-2 without ever being exposed to it.

Importantly, we detected SARS-CoV-2-reactive CD4+ T cells in ∼40%–60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating “common cold” coronaviruses and SARS-CoV-2.

In other words, large numbers of people may be immune or resistant to this virus because they have already been infected by other coronaviruses.

This may not be surprising, given the close relationship between most coronaviruses, but it is a further indicator that this virus, known to be harmless in the vast majority of cases, is neither especially unique nor especially dangerous.

The evidence continues to mount that the original estimates of the danger posed by this virus were massively exaggerated.
Swiss Policy Research continue to have detailed write-ups on this and many other developments.

[shiny!]

Re: 60% of people naturally resistant to SARS-COV2

Again, hat tip to Michael Burry.

Stanford doctor: Coronavirus fatality rate for people under 45 'almost 0%'

by Dominick Mastrangelo, Social Media Producer |
July 02, 2020 03:04 PM

Stanford University's disease prevention chairman slammed using statewide lockdown measures as a response to the coronavirus, saying they were implemented based on bad data and inaccurate modeling.

“There are already more than 50 studies that have presented results on how many people in different countries and locations have developed antibodies to the virus,” Dr. John Ioannidis said during a recent interview with Greek Reporter. “Of course, none of these studies are perfect, but cumulatively, they provide useful composite evidence. A very crude estimate might suggest that about 150-300 million or more people have already been infected around the world, far more than the 10 million documented cases.”
Ioannidis pointed out the mortality rate is low among young people who have contracted the virus.

“The death rate in a given country depends a lot on the age structure, who are the people infected, and how they are managed,” Ioannidis said. “For people younger than 45, the infection fatality rate is almost 0%. For 45 to 70, it is probably about 0.05%-0.3%. For those above 70, it escalates substantially.”

Since the pandemic began in February, more than 2.6 million people in the United States have contracted the virus, and 128,000 have died.

Several states have seen spikes in cases, especially in the southeastern part of the country, where lockdown measures were lifted earlier than in other states.

The mortality rate nationwide appears to be tapering, however, a trend U.S. health officials attribute to a younger age bracket in terms of infection. The national single-day death rate from the virus fell to a three-month low last month. Additionally, Massachusetts reported zero new deaths from the coronavirus on Tuesday for the first time since March.

Dr. Anthony Fauci, the nation's leading infectious disease expert, said last month that the increases in cases are partially due to an expanded national testing capacity and the phased reopening of local economies.

“If you test more, you will likely pick up more infections,” Fauci said. “Once you see that the percentage is higher, then you’ve really got to be careful — because then, you really are seeing additional infections that you weren’t seeing before.”

Ioannidis questioned whether the rate of infection and mortality rate were worth shutting down the U.S. economy for months.

“Major consequences on the economy, society, and mental health have already occurred," he said. "I hope they are reversible, and this depends to a large extent on whether we can avoid prolonging the draconian lockdowns and manage to deal with COVID-19 in a smart, precision-risk targeted approach rather than blindly shutting down everything."

[jk]

Re: 60% of people naturally resistant to SARS-COV2

This report is from a doctor at xxx hospital in xxx, California - a very wealthy area, home to retired presidents and celebrities. Imagine if it is that bad there, how will it be in your local community hospital?

From xxx Hospital.
WEAR YOUR MASK
From Drxxx, MD:

I'm in a hotspot hospital in a hotspot region. We just converted the entire second floor of our hospital to COVID-19 care yesterday, July 1. We have 65 inpatients with COVID-19 in a hospital with 368 beds. It is the same at our other 2 hospitals in the Valley. We spent yesterday deciding the ethical way to divide up limited remdesivir (30 patients' worth) for the hospital patients. My 20 incoming interns for our IM resident were exposed to COVID 2 weeks ago during their computer chart training; apparently 100% of our computer trainers had COVID19. One intern tested positive 7 days later and I insisted we re-test them all again, as there are almost certainly other cases with minimal symptoms. I raided my household and took my entire supply of face shields to the hospital for the residents to wear on their first day, and I paid $1000 of my own money to equip all of my residents with medical-grade face shields. I require all residents to wear a surgical mask or N95 with face shield if they are within 6 feet of another human, patient or coworker.

Roughly 20% of our inpatients die. Only 30% of our ventilated patients survive. (We try to avoid ventilation at all costs. Some people insist on being full code and decompensate despite high flow with face mask, proning, dexamethasone, antibiotics, and a cocktail of famotidine, zinc, Vitamin D, Vitamin C, NAC, and melatonin--we throw everything we can at each case, so long as it won't hurt them.)

My administrative assistant, who sits adjacent to the interns, just went home with COVID symptoms. Her test is pending.

In the Southwest, we are experiencing catastrophic exponential growth. I have had multiple families--siblings, parent-child, spouses--admitted with COVID-19. I had a 31 year old come in satting 78% on room air; he had been sequestering himself in his bedroom for a week to avoid infecting his elderly parents, with whom he lived. His sister, the only person he saw outside his immediate household in the 10 days prior to onset of fever, cough, and dyspnea, had also had fevers but had tested "negative" at our other large hospital so he thought it was safe to visit her. (Sigh. The Quest PCR test is about 80% sensitive, we think--it had emergency approval, so sensitivity data was not required. The Cepheid rapid COVID PCR test is 98.5% sensitive but is in short supply due to limited reagent availability.)

I'm glad some of you are sheltered from what unbridled COVID-19 looks like. It's a hell show. This is *July*. What do you think my hospital will look like in winter?...

This is real. Doctors in places with proper public health responses will see few cases in their hospitals--like UCSF--but let me tell you something: The laws of physics and biology don't change. If you're in an unaffected region, an introduction and poor governance and low use of physical distancing and masks will give you an exponential increase in no time flat (i.e. 2-4 weeks). That's pandemic math. And 20% of the population infected needs a hospital. You *will* run out of beds with an unbridled pandemic. There is almost ZERO pre-existing immunity to SARS-CoV-2. There may be some "priming" of T-cell responses due to exposure to other "benign" beta-coronaviruses, but we have no idea if that explains the 20-40% of people who seem to get minimal symptoms. Asymptomatic infected persons, however, can, and do, spread COVID to those who die from it.

By the way: I've seen scary looking CT scans of the lungs that look like terrible interstitial pneumonia in a patient who had ZERO symptoms and SaO2 94% on room air. She came in for palpitations and the intern overnight got a chest CT for cardiac reasons. We didn't know it was COVID until her test came back 36 hours later. So "asymptomatic" does NOT mean "no biological activity." The virus replicates furiously in people who feel fine. Kids can spread this as easily as grown ups, even if they feel okay.

Related: I've talked to two previously healthy patients ages 32 and 44 who are 3 and 4 months, respectively, post their acute COVID. They continue to have cough, nightsweats, fever, fatigue. How many survivors have "post-COVID syndrome"? We don't know. Less than 20% but we're not sure. I've asked my hospital to allow me to establish a post-COVID clinic to care for and study survivors. Both NIH and UW are planning similar efforts based on my dialogues with them.

Autopsies show anoxic brain injury in many patients who died of COVID, not to mention microthrombi throughout the lungs and megakaryocytes in massive infiltrations in their hearts and other organs. People get heart failure, lung fibrosis, and permanent kidney injury from COVID-19. This is a disease of the vascular systems, and it can affect any organ, with lungs and kidneys being especially at risk.

In early May, thanks to lockdown, our census of 55 came down to 10 COVID cases, and for a brief moment, I actually had hope that the worst nightmares I had about COVID, as a biohazard virology-trained hospitalist, would not come to pass. Then we re-opened, without test/trace/isolate systems anywhere close to adequate. Eight weeks ago my county decided to make masks "optional," despite 125 doctors begging them not to do that. Now we're worse than we were in April. And it's getting worse every day.

You wanna see if COVID is real? Come walk on my COVID ward with me. It's real. Hearing people talk about it as if it's an exaggeration is, well, rage-inducing, honestly. Denial is the most common reaction to a pandemic. Denial is how the US will wind up with 1.1 million deaths instead of 30,000. I saw AIDS denialists get killed by their belief that HIV "isn't real, it's a pharma conspiracy of the medical industrial complex." Yeah, right, if you say so. I watched patients with those beliefs die.

The hardest part about this is, every new case I treat exposes me. I have assiduous hot zone technique. But no technique is bulletproof. If you keep exposing me to case after case, eventually, the virus will get through my defenses. I'm a 50 year old hypertensive. I don't expect to do well if I get infected. For now, I keep going to work. I'm one of the few pushing forward on COVID clinical trials, basic science, public health messaging, and diagnostic studies at my hospital. I feel a responsibility to keep going. I wake up with nightmares every morning at 4am. But I'm going to keep going for now. I feel very alone a lot of the time. People are not taking this seriously, and it's costing lives. -R

I looked up Dr. xxx' credentials online. His CV on xxx website: graduated Cum Laude/xxx, Internship and residency at xxx Internal Medicine. He is board certified in Internal Medicine, completed a fellowship in HiV Clinical Care. He is published and has received many awards.

[Chris Coles]

Re: 60% of people naturally resistant to SARS-COV2

This report is from a doctor at xxx hospital in xxx, California - a very wealthy area, home to retired presidents and celebrities. Imagine if it is that bad there, how will it be in your local community hospital?

From xxx Hospital.
WEAR YOUR MASK
From Drxxx, MD:

I'm in a hotspot hospital in a hotspot region. We just converted the entire second floor of our hospital to COVID-19 care yesterday, July 1. We have 65 inpatients with COVID-19 in a hospital with 368 beds. It is the same at our other 2 hospitals in the Valley. We spent yesterday deciding the ethical way to divide up limited remdesivir (30 patients' worth) for the hospital patients. My 20 incoming interns for our IM resident were exposed to COVID 2 weeks ago during their computer chart training; apparently 100% of our computer trainers had COVID19. One intern tested positive 7 days later and I insisted we re-test them all again, as there are almost certainly other cases with minimal symptoms. I raided my household and took my entire supply of face shields to the hospital for the residents to wear on their first day, and I paid $1000 of my own money to equip all of my residents with medical-grade face shields. I require all residents to wear a surgical mask or N95 with face shield if they are within 6 feet of another human, patient or coworker.

Roughly 20% of our inpatients die. Only 30% of our ventilated patients survive. (We try to avoid ventilation at all costs. Some people insist on being full code and decompensate despite high flow with face mask, proning, dexamethasone, antibiotics, and a cocktail of famotidine, zinc, Vitamin D, Vitamin C, NAC, and melatonin--we throw everything we can at each case, so long as it won't hurt them.)

My administrative assistant, who sits adjacent to the interns, just went home with COVID symptoms. Her test is pending.

In the Southwest, we are experiencing catastrophic exponential growth. I have had multiple families--siblings, parent-child, spouses--admitted with COVID-19. I had a 31 year old come in satting 78% on room air; he had been sequestering himself in his bedroom for a week to avoid infecting his elderly parents, with whom he lived. His sister, the only person he saw outside his immediate household in the 10 days prior to onset of fever, cough, and dyspnea, had also had fevers but had tested "negative" at our other large hospital so he thought it was safe to visit her. (Sigh. The Quest PCR test is about 80% sensitive, we think--it had emergency approval, so sensitivity data was not required. The Cepheid rapid COVID PCR test is 98.5% sensitive but is in short supply due to limited reagent availability.)

I'm glad some of you are sheltered from what unbridled COVID-19 looks like. It's a hell show. This is *July*. What do you think my hospital will look like in winter?...

This is real. Doctors in places with proper public health responses will see few cases in their hospitals--like UCSF--but let me tell you something: The laws of physics and biology don't change. If you're in an unaffected region, an introduction and poor governance and low use of physical distancing and masks will give you an exponential increase in no time flat (i.e. 2-4 weeks). That's pandemic math. And 20% of the population infected needs a hospital. You *will* run out of beds with an unbridled pandemic. There is almost ZERO pre-existing immunity to SARS-CoV-2. There may be some "priming" of T-cell responses due to exposure to other "benign" beta-coronaviruses, but we have no idea if that explains the 20-40% of people who seem to get minimal symptoms. Asymptomatic infected persons, however, can, and do, spread COVID to those who die from it.

By the way: I've seen scary looking CT scans of the lungs that look like terrible interstitial pneumonia in a patient who had ZERO symptoms and SaO2 94% on room air. She came in for palpitations and the intern overnight got a chest CT for cardiac reasons. We didn't know it was COVID until her test came back 36 hours later. So "asymptomatic" does NOT mean "no biological activity." The virus replicates furiously in people who feel fine. Kids can spread this as easily as grown ups, even if they feel okay.

Related: I've talked to two previously healthy patients ages 32 and 44 who are 3 and 4 months, respectively, post their acute COVID. They continue to have cough, nightsweats, fever, fatigue. How many survivors have "post-COVID syndrome"? We don't know. Less than 20% but we're not sure. I've asked my hospital to allow me to establish a post-COVID clinic to care for and study survivors. Both NIH and UW are planning similar efforts based on my dialogues with them.

Autopsies show anoxic brain injury in many patients who died of COVID, not to mention microthrombi throughout the lungs and megakaryocytes in massive infiltrations in their hearts and other organs. People get heart failure, lung fibrosis, and permanent kidney injury from COVID-19. This is a disease of the vascular systems, and it can affect any organ, with lungs and kidneys being especially at risk.

In early May, thanks to lockdown, our census of 55 came down to 10 COVID cases, and for a brief moment, I actually had hope that the worst nightmares I had about COVID, as a biohazard virology-trained hospitalist, would not come to pass. Then we re-opened, without test/trace/isolate systems anywhere close to adequate. Eight weeks ago my county decided to make masks "optional," despite 125 doctors begging them not to do that. Now we're worse than we were in April. And it's getting worse every day.

You wanna see if COVID is real? Come walk on my COVID ward with me. It's real. Hearing people talk about it as if it's an exaggeration is, well, rage-inducing, honestly. Denial is the most common reaction to a pandemic. Denial is how the US will wind up with 1.1 million deaths instead of 30,000. I saw AIDS denialists get killed by their belief that HIV "isn't real, it's a pharma conspiracy of the medical industrial complex." Yeah, right, if you say so. I watched patients with those beliefs die.

The hardest part about this is, every new case I treat exposes me. I have assiduous hot zone technique. But no technique is bulletproof. If you keep exposing me to case after case, eventually, the virus will get through my defenses. I'm a 50 year old hypertensive. I don't expect to do well if I get infected. For now, I keep going to work. I'm one of the few pushing forward on COVID clinical trials, basic science, public health messaging, and diagnostic studies at my hospital. I feel a responsibility to keep going. I wake up with nightmares every morning at 4am. But I'm going to keep going for now. I feel very alone a lot of the time. People are not taking this seriously, and it's costing lives. -R

I looked up Dr. xxx' credentials online. His CV on xxx website: graduated Cum Laude/xxx, Internship and residency at xxx Internal Medicine. He is board certified in Internal Medicine, completed a fellowship in HiV Clinical Care. He is published and has received many awards.

Will you please ask him to add to his program of trials, Dr Paul Marik's (and others of considerable stature), MATH+ protocol? https://covid19criticalcare.com/
https://covid19criticalcare.com/treatment-protocol/

Thank you.

[Down Under]

Re: 60% of people naturally resistant to SARS-COV2

Hey jk, Thank you much much for posting the above. As should be clear from my handle, "Down Under", I live in Australia. We were doing quite well, until recently, when Victoria, one of our states, started having increased rates of infection after eliminating lockdown. As of midnight last night, the border between Victoria and New South Wales has been closed.

I have watched sum of Trump's tweets etc, and to me, from the other side of the world, it appeared that the US was a disaster waiting to happen. The US likes to be number 1 in every thing; well, unfortunately, it looks like it'll also be number 1 in this pandemic, as well.

What you have posted above, seems to confirm what I've been thinking.

[shiny!]

Current Charts

Charts showing rising and falling numbers on a state-by-state basis. Florida and Texas still going up; AZ going down. But as always, these numbers are confirmed cases only, not total cases which is an unknown:

https://www.npr.org/sections/health-shots/2020/03/16/816707182/map-tracking-the-spread-of-the-coronavirus-in-the-u-s

[shiny!]

Time for UBI?

My boss, who runs 15 companies, has been under quarantine at home with his family all week. He might be out all next week, too. His stepson and stepson's girlfriend felt sick and got tested. Everyone in the household had to get tested. The kids' tests came back negative but the rest of them can't leave the house until they get their results back, assuming they're negative, too. Their results might take up to 2 weeks!

So what happens when he's cleared to come back to work, then a few days later another member of his family feels sick and has to get tested? It's back under quarantine again while awaiting new test results!

This scenario is being played by the millions every day. No one can work like this. Businesses can't function like this. Society can't function like this. I think we're going to need some form of UBI to keep people fed, housed and spending money.

When a town gets wiped out by a freak flood, FEMA comes in to help. Few complain that FEMA is socialism and must be stopped. But whenever UBI is brought up, the right screams SOCIALISM! or, WE CAN'T AFFORD IT!

Trillions to bail out Wall St. No money to keep the serfs housed and fed during prolonged unemployment.

I see UBI like FEMA relief. I don't know how we'll pay for it. I'm sure it will be strutured in such a way as to have terrible consequences for inflation that will hurt poor people the most. But with current policies being what they are, I don't see any way around it.

Andrew Yang forsaw the need for UBI as technological advances make more and more jobs redundant. Covid-19 brought the timing forward by a few years. Given the maxim that nothing is as permanent as a temporary government program, I sure hope they do it right.

Comments?

[shiny!]

Hydroxychloroquine and azithromycin plus zinc

Interesting study with interesting comments:

Hydroxychloroquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients
https://www.medrxiv.org/content/10.1....02.20080036v1

[shiny!]

CDC Testing Data Creates Misleading Picture

Scientists Warn CDC Testing Data Could Create Misleading Picture Of Pandemic

May 21, 20205:16 PM ET

The Centers for Disease Control and Prevention has acknowledged that it is mixing the results of two different kinds of tests in the agency's tally of testing for the coronavirus, raising concerns among some scientists that it could be creating an inaccurate picture of the state of the pandemic in the United States.

The CDC combines the results of genetic tests that spot people who are actively infected, mostly by using a process known as polymerase chain reaction, or PCR, with results from another, known as serology testing, which looks for antibodies in people's blood. Antibody testing is used to identify people who were previously infected.

The CDC's practice was first reported by Miami public radio station WLRN on Wednesday and was confirmed by the agency in a subsequent email to NPR.

Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security, expressed concern that adding the two types of tests together could leave the impression that more testing of active cases had been conducted than was actually the case.

"Reporting both serology and viral tests under the same category is not appropriate, as these two types of tests are very different and tell us different things," Nuzzo wrote in an email to NPR.

Serology tests don't give real-time information about the number of new infections occurring. And combining the tests is problematic because it could leave governments and businesses with a false picture of the true scope of the pandemic, she says. That's important because sufficient testing is considered crucial for keeping the epidemic under control, especially as the nation starts to relax social distancing measures, experts say.

"Only [PCR] tests can tell us who is infected and should be counted as a case," Nuzzo wrote. "The goal for tracking testing is to understand whether we are casting a wide enough net to identify cases and only viral tests can tell us that."

In addition, combining antibody testing with diagnostic testing could reduce the number of tests that appear to be producing positive results, lowering the overall "positivity rate." That's another important benchmark. The World Health Organization has recommended a positivity rate of 10% or less as a signal of whether enough testing is taking place.

"I suspect it will artificially lower the percent positive," wrote Caitlin Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, in another email to NPR about the CDC testing data.

CDC spokeswoman Kristen Nordlund wrote in an email to NPR that the "majority of the data is PCR testing" but acknowledged that the agency's tally includes antibody testing because "some states are including serology data" in their testing numbers.

"Those numbers still give us an idea of the burden of COVID-19," Nordlund wrote.

She added, however: "We hope to have the testing data broken down between PCR and serology testing in the coming weeks as well."

Several states have acknowledged in recent weeks that they are combining both types of testing, but at least one, Virginia, then reversed that practice after it became public.

The criticism over how testing results are being reported is the latest in a series of controversies related to testing for the new virus. Many public health experts have criticized the federal government for failing to ramp up testing quickly enough to track and control the epidemic.

The CDC obtains testing data from several sources, including state public health labs, commercial testing companies and hospitals. Officials have been working to develop standardized criteria to alleviate complaints about confusion about reporting requirements.

[Southernguy]

Re: 60% of people naturally resistant to SARS-COV2

Thanks JK for this sobering story. Here in Uruguay 3 or 5 weeks ago we had 4 or 5 days with no new cases. We began to think we were out of the woods. Suddenly 2 hotspots appeared near the Brazilian frontier. They were controlled.
Few days ago several hotspots arised en private hospitals.
Our numbers are still very low (relative to population, as well as in absolute terms).
Economy is opening, but we are all the time under the threat of having to close again. This thing is dangerous indeed.