CORONA Main Coronavirus thread

Weft and Warp

Senior Member
Since it has been discussed often here, I thought this was the best place to post this article:
This past week Minnesota became the second state to reject regulations that effectively ban the controversial drug hydroxychloroquine for use by COVID-19 patients.

The decision, which comes two weeks after the Ohio Board of Pharmacy reversed an effective ban of its own, was rightfully praised by local health care advocates. “We are pleased that Governor [Tim] Walz lifted his March 27 Executive Order 20-23 restrictions on chloroquine and hydroxychloroquine,” said Twila Brase, president of Citizens’ Council for Health Freedom.

The reversal by Walz, a first-term Democrat, clears the way for doctors to prescribe hydroxychloroquine, a drug commonly used to treat malaria and other conditions but one the FDA has declined to recommend for COVID-19 treatment.

The decision is the latest development in the weird saga of arguably the most divisive drug in modern history. The acrimony began in March after President Trump tweeted that hydroxychloroquine had the potential to be “one of the biggest game changers in the history of medicine” as a treatment for the coronavirus.

The tweet and similar statements provoked an avalanche of media criticism, with many claiming that the president was going to get people killed. Critics pointed out that medical evidence suggests the medication is linked to a fatal arrhythmia and some trials show no benefits in coronavirus treatments.


Though his critics are likely loath to admit it, there’s reason to believe the president may have been on to something. In recent weeks a chorus of voices in the medical community has emerged to challenge the view that hydroxychloroquine is ineffective as a COVID treatment. Dr. Harvey A. Risch, a professor of epidemiology at the Yale School of Public Health, said a full analysis of the literature suggests hydroxychloroquine may be the key to defeating the coronavirus.

“Physicians who have been using these medications in the face of widespread skepticism have been truly heroic,” Risch wrote in Newsweek, adding that a full review of the COVID literature on the drug shows “clear-cut and significant benefits.”

Prescribing hydroxychloroquine in the early stages of the virus is key, Risch said, and others agree. Steven Hatfill, a veteran virologist and adjunct assistant professor at the George Washington University Medical Center, says the literature supporting hydroxychloroquine is overwhelming.

“There are now 53 studies that show positive results of hydroxychloroquine in COVID infections,” Hatfill wrote in RealClearPolitics. “There are 14 global studies that show neutral or negative results -- and 10 of them were of patients in very late stages of COVID-19, where no antiviral drug can be expected to have much effect.”


One of the positive studies, published by Henry Ford Health System, was a large-scale retrospective of six hospitals. Analyzing 2,541 patients, it found that those treated with hydroxychloroquine alone died at about half the rate of patients not treated with it.

It’s unclear if it was this research that prompted Walz to reverse his March ruling, which ordered the Board of Pharmacists to instruct pharmacists to not issue hydroxychloroquine prescriptions unless the diagnosis was “appropriate” -- which halted any off-label prescription requests.

The reason it’s unclear is that Walz has been mum on why he rescinded his order. There’s been no announcement or new stories. Local lawmakers told me they had no idea Walz had reversed course.

“There’s been absolutely no transparency here,” said Dr. Scott Jensen, a Republican state senator who criticized Walz’s approach. Jensen, who has practiced medicine for more than 30 years in Minnesota, told me pharmacists he’s worked with for years told him they could not fill a hydroxychloroquine prescription for COVID because of the March executive order.

He agrees that hydroxychloroquine is terribly misunderstood by the public and said politicians need to take a step back. “Hydroxychloroquine is one of the most studied drugs in the history of mankind,” Jensen said. “My wife was on hydroxychloroquine for 15 years. It’s been on the World Health Organization’s list of essential medicines for decades. It’s been in play since 1955, the year after I was born.”

Hydroxychloroquine might be politically controversial, but that hasn’t stopped some of its critics from taking advantage of the drug. In a May interview, former presidential hopeful Sen. Amy Klobuchar admitted her husband was successfully treated with hydroxychloroquine, a medication she had mocked on Twitter.

The politics of hydroxychloroquine are unlikely to cool before November’s presidential election. Yet, if Walz’s decision is any indication, at least some leaders are starting to recognize the ethical dilemma of using the long arm of government to stand between suffering patients and a drug that may have the potential to save them.

Jon Miltimore is the managing editor of Foundation for Economic Education (FEE.org).
 

Mixin

Veteran Member
The Kaiser Foundation publishes LTC info regularly. As of today, I counted 22 states in which the deaths were 50% - 79% of the total state deaths. Rhode Island is the state with 79%, Indiana has increased to 57%, Nevada has the lowest at 19%.

Report: Nursing home cases up nearly 80% in COVID-19 rebound
by: Associated Press
Posted: Aug 17, 2020 / 10:53 PM EDT / Updated: Aug 17, 2020 / 10:53 PM EDT

FILE – In this June 25, 2020, file photo, residents at the Southern Pines nursing home are separated and wear face coverings during their daily bingo game in Warner Robins, Ga. (AP Photo/John Bazemore, File)

WASHINGTON (AP) — COVID-19 cases in U.S. nursing homes jumped nearly 80% earlier this summer, driven by rampant spread across the South and much of the West, according to an industry report released Monday.

“The case numbers suggest the problem is far from solved,” said Tamara Konetzka, a research professor at the University of Chicago, who specializes in long-term care. She was not involved with the study.

Long-term care facilities account for less than 1% of the U.S. population, but more than 40 percent of COVID-19 deaths, according to the COVID Tracking Project.

The situation is a politically sensitive issue for President Donald Trump, who is scrambling to hold on to support from older voters as polls show disapproval of his administration’s response to the pandemic.

The White House announced in late July the release of $5 billion for nursing homes, while launching a program to equip each of some 15,000 facilities with a fast-test machine to screen residents and staff for the coronavirus.

Monday’s study from the American Health Care Association found there were 9,715 coronavirus cases in nursing homes the week starting July 26, a 77% increase from a low point the week of June 21. The group is the industry’s main trade association.

Weekly deaths, rose to 1,706 the week of July 26, an increase of nearly 25% from a low point the week starting July 5.

Nursing homes in Sunbelt states had more time to prepare than facilities in the Northeast that were hit in late winter and early spring, with grim results. But Konetzka and other researchers have been warning that once a community anywhere experiences an outbreak, it’s only a matter of time before the coronavirus enters its nursing homes. A leading theory is that staffers who don’t yet know they’re infected unwittingly bring the virus in. Inside, the coronavirus encounters an ideal environment in which to spread among frail older people living in close quarters.

“As the virus surges in Sunbelt states, there’s no reason to think it won’t affect nursing homes in the same way it did in states that surged earlier,” said Konetzka. “We have learned some things about how to minimize the effect in nursing homes, but providers need the tools to implement those best practices. This is the critical role of federal policy that has not been fulfilled— securing supply chains for (personal protective equipment) and rapid testing.”

The industry analysis illustrates the march of the virus across the U.S.

As of the week of May 31, fewer than one-third of the weekly coronavirus cases were from nursing homes in Sunbelt states. But by the week starting July 26, that share was 78%.

Deaths followed a similar pattern. Nursing homes in states across the South and parts of the West accounted for 28% of deaths the week of May 31. That share was 69% by the week starting July 26.

The Trump administration says it’s executing on its plan to provide fast-test machines to nursing homes and make sure that all facilities have the protective equipment they need. But Seema Verma, head of the Centers for Medicare and Medicaid Services, said states and nursing homes also have responsibility to safeguard residents. She called on nursing homes to step up their game.

“The reality is that (a) facility’s infection control practices is the number one factor leading to the spread of COVID within these facilities,” Verma said in a statement. Inspectors “have seen staff forgetting to wash their hands, congregating in break rooms, and wearing (protective equipment) improperly. All the testing in the world is for naught if staff don’t adhere to the basic, longstanding infection control practices that the federal government has had in place for years.”

Mark Parkinson, head of the nursing home trade group that produced the study, said the problem is bigger.

“The data indicate that this virus is spread by asymptomatic carriers and that even perfect infection control wouldn’t have stopped it,” he said. “The challenge with this virus is that because it is spread by asymptomatic carriers the prior infection control procedures didn’t work.”

Parkinson said that about 10% of facilities still report lacking an adequate supply of N95 masks, considered standard for hospital personnel.

He said the administration’s effort to distribute fast-test machines could be a “game changer,” but added “there’s still a long way to go.” Distribution is expected to be completed by the end of September.

In the meantime, Parkinson said it can still take three days, and sometimes more, to get results. “We continue to be plagued with a testing problem,” he said.

Guidelines call for nursing homes to test all residents at least once, and staffers on a regular basis.

Health and Human Services spokeswoman Mia Heck said, “We are prepared to exert our full authority to make sure the most vulnerable are being tested.”

The nursing home association is urging states struggling with the latest coronavirus surge to enact mandates for people to wear masks, saying it would indirectly benefit residents cloistered in such facilities. “There’s a direct link between COVID in the community and COVID in the building,” Parkinson said.

 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=D5Z6wdu1eI0
35:09 min
A Torrent of Good News
•Aug 18, 2020


Dr. John Campbell

New Zealand Ruled out Frozen food items or freight Burning ember Infection from returners https://www.health.govt.nz/our-work/d... Cases, + 13 + 7 + 13 + 9 + 12 = 1643 Hospitalised, + 1 = 6

Long term immunity It would be good if, Antibodies provide “real-world” protection Cellular immunity is long-lasting Memory B and T lymphocytes T helpers, suppressors, killers (cytotoxic) Even in mild cases. New Delhi 24% Mumbai 24% Moscow 21.7 % Stockholm 10 % New York 6.9 % London 17.5 % UK 6.2 % Marion Pepper, immunologist, University of Washington This is exactly what you would hope for

All the pieces are there to have a totally protective immune response Smita Iyer, immunologist, University of California, Davis This is very promising This calls for some optimism about herd immunity, and potentially a vaccine

Professor Danny Altmann, Department of Immunology and Inflammation, Hammersmith Hospital, Imperial College While this is a small study, it offers a remarkable, real-life, human experiment at a time when we've been short of hard-line, formal, proof that neutralising antibodies genuinely offer protection from re-infection In short, it’s good news https://www.telegraph.co.uk/global-he...

Neutralizing antibodies correlate with protection from SARS-CoV-2 in humans during a fishery vessel outbreak with high attack rate https://www.medrxiv.org/content/10.11... University of Washington IRB Identification of immunological correlates would help research Only animal models to date

Outbreak of SARS-CoV-2 on a fishing boat Attack rate on board of 85.2% (104/122 individuals) Predeparture serological and viral RT-PCR testing Repeat testing after return to shore Full data on 120 of the 122 crew (9 women) 18 day trip, crew member required hospitalization Median follow-up of 32.5 days 104 individuals had a positive antigen test or seroconverted during the follow-up period 101 developed IgG antibodies within 50 days Also Three crew members seropositive prior to the boat's departure None of these crew members with antibodies developed symptoms or tested antigen positive Lab studies also showed their antibodies had neutralising activity

Presence of neutralizing antibodies from prior infection was significantly associated with protection against re-infection (p=0.002). Robust T cell immunity in convalescent individuals with asymptomatic or mild COVID-19 Center for Infectious Medicine, Stockholm https://www.biorxiv.org/content/10.11...

Virus-specific memory T cells have been shown to persist for many years after infection with SARS-CoV-1 Acute phase SARS-CoV-2-specific T cells display high cytotoxic activity Correlated with various clinical markers of disease severity SARS-CoV-2-specific T cells were detectable in antibody-seronegative family members and individuals with a history of asymptomatic or mild COVID-19 Collective dataset shows that SARS-CoV-2 elicits robust memory T cell responses akin to those observed in the context of successful vaccines natural exposure or infection may prevent recurrent episodes of severe COVID-19 also in seronegative individuals. SARS-CoV-2 induces robust memory T cell responses in antibody-seronegative and antibody-seropositive individuals with asymptomatic or mild COVID-19. Functional SARS-CoV-2-specific immune memory persists after mild COVID-19 https://www.medrxiv.org/content/10.11... Study was approved by the University of Washington Institutional Review Board

The recently emerged SARS-CoV-2 virus is currently causing a global pandemic and cases continue to rise. The majority of infected individuals experience mildly symptomatic disease but it is unknown whether this can induce persistent immune memory that might contribute to herd immunity Longitudinal assessment Individuals recovered from mildly symptomatic COVID-19 To determine if they develop and sustain immunological memory Recovered individuals developed SARS-CoV-2-specific IgG antibody As well as virus-specific memory B and T cells In some cases increased numerically over three months following symptom onset Memory lymphocytes exhibited characteristics associated with potent antiviral immunity Memory T cells secreted IFN-γ (interferon Gama) and expanded upon antigen re-encounter Memory B cells expressed specific antibodies If you would like to donate to John's educational projects, please use the following link, thank you, https://www.paypal.com/cgi-bin/webscr...
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=yvLI4jfezV4
2:01 min
Simulated Spread of Germs During an Eye Examination
•Aug 18, 2020



JAMA Network

This video illustrates simulation of a patient cough with spread of respiratory droplets during an ophthalmologic slitlamp examination. A cardiopulmonary resuscitation manikin was placed at the chin rest of a slitlamp and a small latex balloon, compressed with oxygen and 1.25 mL of washable fluorescent dye, was run through tubing inside the oral cavity. The balloon was inflated until it burst at 5 pounds per 72 square inches, which has been previously reported as the force for a voluntary cough and laryngeal cough reflex. The simulation was performed under ultraviolet light conditions (light-emitting diode 395NM ultraviolet flashlight) to visualize emission of fluorescent small particles. Standard personal protective equipment and breath shields did not eliminate the simulated spread of droplets. Click https://ja.ma/2YbvxUB for more complete information.
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=bQrooawwhLI
18:33 min
Coronavirus Pandemic Update 102: COVID 19 vs. Influenza Symptoms; Sweden; Tocilizumab; Hawaii
•Aug 18, 2020


MedCram - Medical Lectures Explained CLEARLY

As "Flu" season approaches, new data sheds light on key symptom differences and timing between COVID 19 and Influenza. Dr. Seheult of https://www.medcram.com also discusses the pandemic strategy in Sweden, tocilizumab (Actemra), new coronavirus outbreaks in Hawaii, and the hierarchy of clinical data. The update concludes with images of some of the possible cardiac impacts of COVID-19 (This video was recorded August 18, 2020).

LINKS / REFERENCES: Johns Hopkins Tracker | https://coronavirus.jhu.edu/map.html Worldometer | https://www.worldometers.info/coronav... MedCram ECG Course | https://www.medcram.com/courses/ekg-e... Journal of Cardiac Failure | https://www.onlinejcf.com/article/S10... MedPage Today | https://www.medpagetoday.com/infectio... Frontiers in Public Health | https://www.frontiersin.org/articles/... The Lancet | https://www.thelancet.com/journals/la... Roche | https://www.roche.com/investors/updat... WebMD | https://www.webmd.com/lung/news/20200... Illustration of IL-6 | https://jitc.biomedcentral.com/articl...
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=G7TWiweluwA
53:34 min
Good News! Up To 50% Of Us May Be 'Pre-Immune' To Covid-19
•Premiered 4 hours ago


Peak Prosperity

What's this? Actual good news?!? A recent study shows that covid-19 may not be as "novel" a virus (i.e., never encountered before) as previously thought. And as a result, 20-50% of the population appears to have a degree of "pre-immunity" to the virus.

LINKS IN TODAY'S VIDEO: Common Cold Cross Reactivity https://science.sciencemag.org/conten... HCA + Az works https://www.sciencedirect.com/science... The Cheap Simple way https://www.nytimes.com/2020/07/03/op... Why everyone was wrong https://medium.com/@vernunftundrichti... Herd Immunity https://www.newsweek.com/herd-immunit... Herd Immunity at 40% https://science.sciencemag.org/conten... Fauci on the Ford HCQ Study https://www.metrotimes.com/news-hits/... Doctors Say Patients no longer trusting them https://www.insider.com/doctors-say-m...


 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=FoydmuSrs9Y
42:25 min
Coronavirus Update With Ezekiel J. Emanuel, MD, PhD
•Streamed live 3 hours ago


JAMA Network

Ezekiel Emanuel, MD, PhD, of the University of Pennsylvania's Perelman School of Medicine, Department of Medical Ethics and Health Policy, discusses recent developments in the COVID-19 pandemic. Recorded August 19, 2020. • Earn Free CME credits by watching JAMA Livestreams and completing a brief questionnaire. Claim 0.5 credits for each video at https://ja.ma/covidqa • Coronavirus Resource page from the JAMA Network: https://ja.ma/covidyt • To watch all the #JAMALive Q&A's Visit: https://ja.ma/covidqaytpl
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=pvmtT_XV4aw
21:17 min
Coronavirus Pandemic Update 103: Convalescent Plasma Treatment & the FDA; College Campuses Close
•Aug 20, 2020


MedCram - Medical Lectures Explained CLEARLY

Convalescent Plasma Treatment for COVID 19 has been widespread in the US. Following infection, many patients have donated their plasma containing SARS-CoV-2 antibodies to try to help patients with severe symptoms fight COVID-19. The big news today is that the emergency approval from the FDA for the use of plasma treatment is now on hold based on a lack of robust data that demonstrates efficacy. Dr. Seheult also discusses COVID 19 in India, Brazil, North Carolina, and college campuses that have experienced coronavirus outbreaks since resuming in-person classes (This video was recorded August 20, 2020).

LINKS / REFERENCES: Johns Hopkins Tracker | https://coronavirus.jhu.edu/map.html Worldometer | https://www.worldometers.info/coronav... USA Today | https://www.usatoday.com/story/news/e... University of North Carolina at Chapel Hill | https://carolinatogether.unc.edu/dash... EdScoop | https://edscoop.com/universities-clos... The Conversation | https://theconversation.com/coronavir... New York Times | https://www.nytimes.com/2020/08/19/us... CNN | https://www.cnn.com/2020/08/19/health... JAMA | https://jamanetwork.com/journals/jama... Journal of Clinical Investigation | https://dm5migu4zj3pb.cloudfront.net/... PubMed | https://pubmed.ncbi.nlm.nih.gov/32348... medRxiv | https://www.medrxiv.org/content/10.11...

 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=vwBMCX80NC0
36:02 min
Coronavirus Update With CDC Director, Robert R. Redfield, MD

•Streamed live 2 hours ago


JAMA Network

CDC Director Robert Redfield, MD, discusses recent developments in the #COVID19 pandemic and US response, including prospects for dual outbreaks of COVID-19 and influenza in the fall and winter. Recorded August 20, 2020. Topics discussed in this interview: 0:00 Introduction 0:26 New COVID-19 data 2:50 Outlook for fall 6:15 Seroprevalence 7:33 Herd immunity 10:07 Importance of flu vaccines 15:22 Vaccine access and delivery 19:25 Reopening schools and universities 24:34 US deaths 28:57 Importance of data at CDC • Earn Free CME credits by watching JAMA Livestreams and completing a brief questionnaire. Claim 0.5 credits for each video at https://ja.ma/covidqa
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=nbtUFxqHOEs
9:25 min
Reacting to Sex Advice during a Pandemic // Alternative Medical News
•Aug 20, 2020


Dr Hope's Sick Notes
(Dr. Ed Hope, Junior UK ER Doctor)

The impacts of the Covid-19 pandemic have been far reaching and it's easy to forget about our sexual health; in this Alternative Medical News I check out an article covering advice from UK sexual health charity Terrence Higgins Trust. Full guidelines from Terrence Higgins Trust: https://www.tht.org.uk/news/how-have-... UNILAD article: https://www.unilad.co.uk/news/people-...
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=YMr_X63tUN0
Premiering
Rapid & Affordable Testing For Covid-19 Now Developed -- Finally!
•Premiere in progress. Started 51 minutes ago


Peak Prosperity

GWow! We have even more good news to share in today's video. We could get used to this... First: several quick, cheap tests for covid-19 are rolling out. Finally, we should be able to do widespread testing that's not overly invasive, too expensive, or takes forever to get results. Second: Ivermectin continues to show statistical effectiveness against covid-19. It may be effective at later stages of infection than HCQ. Third: the XYZ+ Hypothesis is holding up strong as more data comes in. It really does seem that the world may indeed be past the worst of the deaths from this pandemic.

____________________ LINKS IN TODAY'S VIDEO: XYZ https://twitter.com/NateSilver538/sta... XYZ in Pakistan https://www.telegraph.co.uk/global-he... Rapid Tests on the way https://news.yale.edu/2020/08/15/yale... Rapid tests get FDA EUA https://news.illinois.edu/view/6367/1... Long-Term Sequelae even in younger patients https://nyheder.tv2.dk/samfund/2020-0... Kids More Infectious? https://www.msn.com/en-us/health/medi... Zithromax – Complex Mechanisms of Action https://www.sciencedirect.com/science... zithromycin anti-viral activity https://www.ncbi.nlm.nih.gov/pmc/arti.... Tetracycline MoA https://accpjournals.onlinelibrary.wi.... Both HCQ and Ivermectin https://www.medrxiv.org/content/10.11...
 

marsh

On TB every waking moment

Aug 17, 2020,03:24pm EDT
Covid-19 Can Cause Heart Damage—Even If You Are Asymptomatic
Robert Glatter, MDContributor

3D illustration of Heart, medical concept.

3D illustration of Heart - Part of Human Organic.

A lot has been written about “long haulers”—patients who have tested positive for SARS-Cov-2, the virus that causes Covid-19, who continue to experience ongoing symptoms such as fatigue, muscle aches, palpitations and difficulty breathing for months after their initial diagnosis.

Long haulers have drawn attention to complaints involving the lungs and respiratory system as some of the important systemic effects of the virus, but there is also a growing concern that the extent of its effects on the heart that have not received as much attention.

And while SARS-CoV-2 may lead to overt cardiac symptoms such as chest pain or shortness of breath resulting in heart attacks and blood clots, there is also the possibility that the virus may cause significant heart damage and inflammation—but without producing any immediate or more noticeable cardiac symptoms.
https://www.forbes.com/sites/katiej...lion-to-transform-behavioral-health-for-kids/
This concern was addressed in the findings of a new study published in JAMA last month, demonstrating that even if you are unaware of having any symptoms after recovery from Covid-19, there is the possibility that the virus may cause heart damage or inflammation that could put you at risk for complications including heart arrhythmias, heart failure and sudden cardiac death.

The study looked at 100 patients (median age of just 49) who recently recovered from Covid-19, most of whom were asymptomatic or had just mild symptoms. The researchers, who performed MRI scan of their hearts an average of 2 months after they first were diagnosed with Covid-19, uncovered some concerning findings: 78% of patients had ongoing heart abnormalities and 60 percent had myocarditis, inflammation of the heart muscle. Even more concerning was that the extent of myocarditis was not related to the severity of the initial illness or overall course of the illness.

While the study did have some limitations, and its overall significance is not yet apparent, it demonstrates that it’s relatively common for the heart to be affected in young adults and middle-aged people who have made a successful recovery from the virus. The extent of this damage may be just the tip of the iceberg. The study, if anything, argues for the need for ongoing monitoring for long-term cardiac effects of Covid-19. It also highlights the importance of ongoing testing in the population at large so that we can track and monitor asymptomatic patients who test positive for SARS-CoV-2 for long term cardiac effects after their initial diagnosis.

Researchers are still trying pinpoint exactly how SARs-CoV-2 leads to myocarditis. They believe that it may be a combination of 2 mechanisms: cardiac damage from the virus itself, along with the after-effects of the immune response that it triggers. In fact, the efficacy of some potent anti-inflammatory medications such as dexamethasone in helping to reduce death in some of the sickest patients could potentially be linked to its anti-inflammatory effects on the heart. Even with aggressive treatment, however, more severe cases of myocarditis from Covid-19 can lead to permanent heart damage, leading to ongoing heart failure and sudden death.

“The novel coronavirus can affect the heart directly and indirectly: it can invade the heart muscle cells causing inflammation or “myocarditis” which can reduce the heart’s pumping ability and make it vulnerable to arrhythmias,” said Holly S. Andersen, MD, Attending Cardiologist, Associate Professor of Medicine, Director of Education & Outreach, The Ronald O. Perelman Heart Institute, The New York Presbyterian Hospital, Weill Cornell Medical Center. “Many cases of stress-induced cardiomyopathy (Takotsubo) have been reported and this can lead to transient heart failure and sudden death.”

Andersen also explained that “the virus is also known to cause damage by forming blood clots in the small blood vessels of organs including the heart, may lead to serious lung disease which can put significant strain on the heart, and in some patients causes a “cytokine storm” where the body’s immune system causes damage to organs.”

The recent diagnosis of Covid-19- associated myocarditis in the top pitcher for the Boston Red Sox also illustrates how the virus can affect young and heathy people. Eduardo Rodriguez was all set to start this season when the 27-year-old tested positive for Covd-19. His symptoms progressed after his initial diagnosis—so much so that he didn’t have enough energy to throw even 20 pitches. He was told to stop and rest. Mr Rodriguez is now out for the season.

Some patients with myocarditis are asymptomatic, while other may have just mild symptoms at times, including occasional chest pain or difficulty breathing. But Rodriguez is not alone: there have been multiple reports of myocarditis among college football players, putting the season in jeopardy. Already the Mid-American, PAC-12 and Big 10 have cancelled or delayed the start of the fall season.

Brian Hainline, the NCAA Chief Medical Officer, said in a call with the press last week that 1-2% of athletes at NCAA schools have tested positive for Covid-19, and at least 12 college athletes had been diagnosed with Covid-19-associated myocarditis. As we know, college athletes and professional athletes have greater access to more frequent Covid-19 testing and monitoring to be alert for the signs of myocarditis that include fatigue, chest pain, and difficulty breathing.

But what about amateur athletes or average people who want to return to exercise after recovering from Covid-19? The short answer is that we don’t know the extent of the risk to those recovering from Covid-19 who want to routinely or occasionally exercise at this time—we need more studies to better determine the ongoing risk.

That said, even if just a small percentage of Covid-19 cases lead to cardiac complications, the pandemic will elevate the risk for millions of people who regularly exercise. As an example, the study indicated that patients with only mild Covid-19 symptoms developed myocarditis as often as those who were hospitalized, elevating the chance that those who are unaware they have Covid-19 could also be at risk.

This is relevant because athletes with myocarditis must stop all strenuous activity and workouts for many weeks, if not months, until the the inflammation in the heart resolves. The risks of not curtailing activities can result in dangerous arrhythmias, heart failure and death (cardiac arrest).'

But amateur athletes may not have the benefit of close monitoring by trainers and sports medicine physicians to evaluate for signs of myocarditis, which can be quite subtle. In some people, only mild fatigue, lightheadedness, mild shortness of breath or chest discomfort may be the presenting symptoms of myocarditis. Unless initial steps in the evaluation such as evaluation of cardiac markers (troponin) and an echocardiogram are performed, the diagnosis can be missed. It’s this window of opportunity that is critical, so that cardiac monitoring and full evaluation can proceed.

Needless to say, as we learn more about the varied effects of SARS-CoV-2, we need to be alert to the cardiac symptoms it poses to everyone. Vigilance regarding symptoms is essential, especially in those with a recent diagnosis of Covid-19 who are recovering, and subsequently develop chest pain, fatigue, and difficulty breathing. More broadly, we need to expand our thinking that Covid-19 is a disease that primarily affects the lungs to one that can impact any part of the body, including the heart.

At the same time, the importance of not delaying medical care in the emergency department for fear of Covid-19—especially in the setting of chest pain or stroke-like symptoms—is paramount. The American Heart Association’s (AHA) campaign, “Don’t Die of Doubt” was launched to address the significant drop in 911 calls for symptoms of strokes and heart attacks.

“The incidence of out-of-hospital cardiac arrest (OHCA) went up 400% the first week of April in New York City compared to the same time last year, so we know some patients are dying of their heart disease at home – trying to avoid ER’s for fear of contracting the virus,” explained Andersen.

In addition to the AHA’s campaign, the Myocarditis Foundation is helping to raise awareness and also provides research grants to help gain a better understanding of this devastating disease.
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=W_Fh8BT1wpg
LIVE
URGENT: President Trump Holds a News Conference LIVE - 8/23/20
•Started streaming 25 minutes ago


Right Side Broadcasting Network

Press Secretary Kayleigh McEnany tweeted last night about the news conference that it would be "concerning a major therapeutic breakthrough on the China Virus. Secretary Azar and Dr. Hahn will be in attendance." Sunday, August 23, 2020: Watch Live as President Donald J. Trump holds a news conference from the James S. Brady Press Briefing Room at The White House.
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=r_-XD0upvCg
11:31 min
Convalescent plasma and COVID
•Aug 24, 2020


Strong Medicine

A hot take on the evidence for convalescent plasma as a COVID treatment and the FDA's emergency use authorization. Effect of Convalescent Plasma on Mortality among 2 Hospitalized Patients with COVID-19: Initial Three3 Month Experience (i.e. the only evidence the FDA used for their EUA): https://www.medrxiv.org/content/10.11... A good discussion of the state of evidence for convalescent plasma (and why we've had no good RCTs!): https://www.wired.com/story/97000-peo... A discussion of relative vs. absolute risk reduction: https://www.ncbi.nlm.nih.gov/pmc/arti...
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=BY67HozpvU8
40:52 min
Coronavirus Vaccine Update
•Streamed live 4 hours ago


JAMA Network

Paul A. Offit, MD of the Children's Hospital of Philadelphia provides an update on #COVID19 vaccine development. Recorded August 24, 2020. • Earn Free CME credits by watching JAMA Livestreams and completing a brief questionnaire. Claim 0.5 credits for each video at https://ja.ma/covidqa • Coronavirus Resource page from the JAMA Network: https://ja.ma/covidyt • To watch all the #JAMALive Q&A's Visit: https://ja.ma/covidqaytpl
https://www.youtube.com/watch?v=utMREADbtAc
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=8nqgZn9Izv8
14:01 min
188 Coronavirus Autopsies (COVID-19) – Here are the BIGGEST Takeaways

•Aug 24, 2020


Doctor Mike Hansen


This video is a summary of all the autopsy findings that have been done on coronavirus patients. This is based on 8 published studies and/or case reports.

Here are the links to those studies: https://www.acpjournals.org/doi/10.73... https://www.acpjournals.org/doi/10.73... https://www.thelancet.com/journals/la... https://www.nejm.org/doi/full/10.1056... https://www.medrxiv.org/content/10.11... https://www.nejm.org/doi/full/10.1056... https://jamanetwork.com/journals/jama... https://www.thelancet.com/journals/la...

Lungs

SARS-CoV-2 exhibits selectivity for the lungs. Specifically, type II pneumocytes, meaning type II alveolar cells. Alveoli are the tiny microscopic air sacs of the lungs, which is the part of our lungs that is responsible for gas exchange. Air is brought down into the lungs, to the alveoli, and the oxygen diffuses from the alveoli into our tiny blood vessels there, called capillaries. At the same time, carbon dioxide, a waste product from our body, travels from the capillaries into our alveoli, and we then exhale out that carbon dioxide. Alveoli are made up of mainly type I alveolar cells. But to a lesser degree, they are also made up of type II alveolar cells, and these guys are sort of like the maintenance guys for the alveoli. They play a part in making surfactant, a sort of lubricant for the alveoli. But these cells also play a part in defending against foreign pathogens, like viruses and bacteria.

Well as it turns out these type II alveolar cells have the ACE2 receptors on them, and SARS-CoV-2 binds to this receptor, and that’s how it gains entry into these cells, and into our body. When the SARS-CoV-2 invades the type II alveolar cells, it precipitates a cascade of reactions that causes the body to react to it, with inflammation, and lots of damage to the alveoli, known as diffuse alveolar damage. Clinically, this is what we call ARDS, acute respiratory distress syndrome. This is what causes oxygen levels to go down, and what causes the so-called cytokine storm. When people die of COVID, this is what’s going. Also, there is a propensity for blood clots to develop, and some people with COVID died as a result of pulmonary emboli, meaning blood clots in their lungs. The capillaries in the lung surround the alveoli. Here, they serve to bring red blood cells in close proximity to the alveoli, to allow gas exchange to occur, like I mentioned earlier. The lining of these capillaries is called the endothelium, the cells that make up the endothelium here, also have ACE2 receptors. The virus, at least in those with severe disease, seems to be infiltrating the endothelium and causing inflammation and injury to the capillaries, not just the alveoli. This likely at least partially explains why this virus is causing blood clots to develop here.

So we are seeing a common theme here, and that is microthrombi that are being found in blood vessels of pretty much all the organs, including brain, kidneys, heart, liver, and of course lungs. This is likely all because of endothelial damage that occurs as a result of the virus binding to the ACE2 receptors that are located there. After all, in some of these autopsy studies, they used electron microscopy to find what appeared to be viral particles in the endothelial cells not only in the lungs, but also in the heart and kidneys.The endothelial damage serves to trigger the clotting process, something known as a coagulation cascade. But its also possible that the endothelial damage is mainly occurring in the lung capillaries, and that’s where the tiny clots first develop, and then they end up traveling to other parts of the body, eventually lodging in blood vessels of other organs. Or it could be both of these things. It's interesting to note that Endothelial cells are more vulnerable to dying in people with preexisting endothelial dysfunction, which is more often associated with being a male, being a smoker, having high blood pressure, diabetes, and obesity.

So overall, organ damage that occurs in severe COVID is likely a result of a multitude of factors, such as: 1) Directly viral invasion by means of the ACE2 receptor 2) Indirect damage that occurs as a result of cytokine storm 3) Indirect damage by means of blood clots 4) Indirect damage that occurs as a result of oxygen deprivation, as well as toxic effects of various drug treatments, and other factors as well


https://www.youtube.com/watch?v=yf8uYzgMsEw
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=c3a_paGrZNs
48:24 min
COVID-19 Partner Update Call: Health and Safety at the Polling Place
•Aug 25, 2020


Centers for Disease Control and Prevention (CDC)
Dr. McDonald shared updates on CDC’s COVID-19 response, including the latest scientific information and what everyone should know about protecting themselves and others. In addition, Dr. Kirby reviewed CDC’s updated considerations for election polling locations and voters. Comments on this video are allowed in accordance with our comment policy: http://www.cdc.gov/SocialMedia/Tools/... This video can also be viewed at https://www.cdc.gov/wcms/video/low-re...
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=5u7eyMU-tN8
PREMIERE
It's Confirmed: You CAN Get Re-Infected By Covid-19
•Premiere in progress. Started 21 minutes ago


Peak Prosperity
First the bad news: yes, it does increasingly appear that it's possible to get re-infected by a different strain of covid-19. Now the good news: not only is it exceptionally rare at this point, but the few reported re-infected patients have not been hit hard the second time around. The current Hong Kong patient currently in the media actually experienced NO symptoms during his second infection. Meanwhile, society is in the grip of "covid burnout", exhausted with all the precaution and ready to get back to regular life "virus be damned". As a result, we're seeing case spikes as students head back to school and life events like weddings start back up again.

____________________ LINKS IN TODAY'S VIDEO: Dutch re-infection https://nltimes.nl/2020/08/25/first-n... HK Re-infection https://www.statnews.com/2020/08/24/f... Back to school not going well: https://www.nbcmiami.com/news/local/u... https://indyweek.com/news/orange/unc-... Covid Burnout International Edition https://www.brusselstimes.com/news/be... https://www.hindustantimes.com/india-... Anatomy of a pandemic https://www.worldometers.info/coronav... HCQ works in Belgium https://www.sciencedirect.com/science...
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=DQ-YKYqxa8I
10:17 min
Convalescent Plasma Therapy for Coronavirus (COVID-19) – Does it Work?
•Aug 27, 2020


Doctor Mike Hansen


The FDA recently issued an emergency authorization use for doctors to treat COVID-19 using convalescent plasma from patients who’ve recovered from the disease. But researchers and doctors are concerned that this push to distribute convalescent plasma could undermine the clinical trials needed to determine whether it actually works against this coronavirus.

Link for absolute and relative risk reduction: https://bestpractice.bmj.com/info/too... Link to main study in video: https://www.medrxiv.org/content/10.11...

In order to understand the science behind what is going on with convalescent plasma, we first have to understand what it is, and how it works. Then I’m going to talk about my experience giving it to coronavirus patients, and what the studies are actually showing. When someone is infected with COVID-19, and they recover, they then develop antibodies, typically within a few weeks. How long these antibodies last, and how effective they are against the virus, is a whole nother conversation.

But these IgM and IgG antibodies are in the bloodstream, and when we draw blood from a patient who has recovered from COVID, that blood then gets spun in a centrifuge, and collected. A certain portion of that blood is called plasma. And in that plasma are the immunoglobulins, including IgG and IgM antibodies. The rest of the blood, mainly red blood cells and platelets, is used for…blood transfusions. So with the plasma that we collect, that’s what contains the antibodies to the virus, and then we give that to hospitalized COVID patients. They did this for some patients with SARS and MERS, and had good results. Then, in 2009, an observational study of over 90 critically ill patients with H1N1 influenza A, 20 of those patients received convalescent plasma. The ones who received the plasma had better survival rates.

In theory, the COVID patients who would most likely benefit from this would be the ones who get the plasma as soon as they are diagnosed with COVID in the hospital setting. The sooner they get it, the higher the likelihood of it being effective. At least in theory. Also, the higher the number of antibodies in the plasma, the more likely it is to be effective. At least in theory.

Although some US hospitals have already been giving plasma for COVID-19 in special cases, an emergency-use authorization from the FDA would make it easier to give it to more and more patients. My hospital is part of a clinical trial for CPT, and we’ve been giving it to COVID patients. Based on my experience, its hard to know if it makes any difference at all. I can tell you, that there has not been one patient who I’ve given it to, and all of a sudden, within a day or two, they are much improved.

I’ve given it to many patients, and there have been good outcomes and bad outcomes, and everything in between. For the patients who did improve, was this because of the CPT? Was it because of the dexamethasone they received? Or Remdesivir they received? Or tocilizumab? Or was it just a coincidence, and they were going to get better regardless? Or is it some sort of combination of these? Impossible to know.

The only real way to know if any of these treatments make any kind of difference, is to have randomized control trials that involves lots of patients. So far, there are no RCT for CPT. Based on the published observational studies we have so far, there’s little evidence to suggest that CPT actually helps patient

Convalescent plasma has been tested only in small trials without the statistical power to provide firm conclusions. Another consideration is that convalescent plasma from different people varies widely in antibody concentration, meaning different amounts of antibodies. So on person might receive less antibodies than someone else. And on top of that, we don’t even know how effective these antibodies are, meaning, are these antibodies ‘neutralizing antibodies.' The Biomedical Advanced Research and Development Authority (BARDA) in the US has provided convalescent plasma on this basis to more than 70,000 people, but this was done without having any control groups, meaning these were not RCT. But this statement is still inaccurate. Why? Because you can’t talk about relative risk reduction and absolute risk reduction unless it’s a randomized control trial.
 

marsh

On TB every waking moment

California Supreme Court Orders Gov. Newsom to Justify School Closure Orders
The governor has until Friday to respond

By Evan Gahr, August 26, 2020 7:50 am

The California Supreme Court has given Governor Gavin Newsom until Friday to respond to lawsuits seeking to enjoin his orders that bar schools opening for in-person learning.

The lawsuits, formerly known as “writ petitions” were filed by the Tyler and Bursch law firm on behalf of a coalition of parents, private schools, a charter school and the Orange County Board of Education.

Department of Public Health director Sandra Shewry was also named in the filings.

Attorney Robert Tyler told the California Globe that it was “fantastic wonderful news” that the Supreme Court had accepted their writ petition because most of those filed are denied.
“By closing the schools of California to in-person learning he [Newsom] is creating havoc for parents and children,” Tyler contended. “The California Constitution requires that all children receive an equal education. Our position is that he is creating an unequal burden on economically disadvantaged families.”

He said that poorer families don’t have the money to pay for learning pods that are popping up all over California. And that one of his clients is a single mother who works full time and can’t stay at home with her child for online learning. “For many single parents they have to choose between educating their child and putting food on their child.”

One writ petition was filed in the California Supreme Court on behalf of private schools: Immanuel Schools; Linfield Christian School; Calvary Murrieta; Calvary Chapel Of San Jose; Clovis Christian Schools; and parents Regina Bailey; Nicole Hill; Katie MacDonnell; and Jenny Pierce Heil.

The other was filed on behalf of the Orange County Board of Education, which wants to reopen schools and the Palm Lane Charter School. The parents represented in that case are Juaquin Cruz; Angela Miller; and Cecilia Ochoa.

The private schools case says that the policy discriminates against private schools as a class because they do not receive state funding that makes online learning possible.

“Governor Newsom’s defiance of the rule of law and disregard for the constitution usurped Private Schools’ contractual rights and detrimentally effected the learning of students across the State of California in violation of the Equal Protection Clause,” the complaint says.

It says that “the orders discriminate against an identifiable class, students who attend private schools in the State of California. Private school students are a unique and identifiable class outside of public schools as they do not obtain state funding and thus, cannot obtain the same benefits of distance learning which are facilitated through the governmental supplements.
Thus, private school students are at a disadvantage as a unique and identifiable class.”

Citing the low rates at which children spread the corona virus and get infected the request for relief also said the closure order can not survive the legal requirement of strict scrutiny because it does not serve any rational objective. “The Governor’s orders, even by scientific standards, fail to meet a strict or even a rational scrutiny as there is an absence of evidence and no medical basis for continuing to keep schools closed.”

It also says that the closure order violates the California constitution and the United States Constitution because of its “interference with petitioners contractual rights.”

That basically means sending your kids to a private school amounts to a contract and Newsom is interfering with the contract being carried out by ordering the schools closed.

“The Governor’s Executive Orders and the [California Department of Public Health} directives substantially impair these contracts as the mandatory implementation of distance learning impedes Petitioner’s ability to complete its contractual obligations which places some Petitioners in a position of serious financial jeopardy due to the failure to comply with their contractual obligations, loss of students, and the assumption of contractual liability stemming from hundreds of potential breach of contract allegations from parents.”

It says that Newsom exceeded his authority to issue the directive.

“Governor Newsom wields the Executive Powers under the State of Emergency like a sword, exercising greater discretion than that of granting a license or waivers.”

“Five months after the declared state of emergency, the Governor continues to suspend liberty rights, including those of students and private schools, for unlimited durations based on unproven projections and contrary to scientific reports from experts and the CDC.”

The complaint on behalf of public schools and public school parents says that the closure order violates the rights of special needs students under the Individual Disabilities Education Act because they need in person learning to meet their needs. “Thus, in order to meet the mandatory requirements of IDEA, public school districts must conduct in person instruction which is specially designed to aid disabled students and meet their specialized education needs in a manner which is consistent with the student’s IEP.”

It says the order also violates the federal Americans with Disabilities Act, which requires reasonable accommodations for anybody with disabilities, because it prevents them from going to schools and getting kind specialized instruction that can’t be achieved through online learning.

Echoing the complaint brought by private schools and private school parents the public school complaint says the closure orders have no rational basis. “The Executive Orders and subsequent directives cannot survive a strict scrutiny challenge where, as here, it is not the least restrictive means of furthering the government’s goal of reducing the transmission of coronavirus as demonstrated through the conceded development of scientific data relating to the transmission in minors, as well as studies reporting a low risk to students and indicating that less than 2% of COVID-19 transmissions occur in individuals under the age of 20.”

As Tyler told the California Globe, “the data and science shows the schools should be opened.”
 

marsh

On TB every waking moment

In stunning reversal, CDC abruptly changes position on when to get tested
Adm. Brett Giroir claimed President Trump wasn't involved.
By
Anne Flaherty
and
Sophie Tatum
August 26, 2020, 7:02 PM

CDC abruptly changes position on when to get tested for COVID-19



CDC abruptly changes position on when to get tested for COVID-19

After weeks of encouraging people to get tested if they may have been exposed to COVID-19, the Centers for Disease Control and Prevention is now telling the public testing might not be necessary.

After weeks of encouraging people to get tested if they may have been exposed to COVID-19, the Centers for Disease Control and Prevention abruptly changed course this week and is now telling the public testing might not be necessary.

The change in guidance, while voluntary, could dramatically decrease the number of tests conducted in the U.S. at a time when public health officials have said they are seriously concerned about young people without symptoms transmitting the virus.

Medical professionals and public health experts swiftly pushed back, calling the move baffling and dangerous because it would reduce the country's visibility on the virus ahead of flu season.

"The people in the trenches are horrified by this," a person who works with the White House coronavirus task force told ABC News Chief White House Correspondent Jonathan Karl. "It gives the impression that asymptomatic people cannot transmit the disease, which is not true. Community spread is driven by asymptomatic people."

The Trump administration's testing coordinator, Adm. Brett Giroir, defended the move as trying to prevent a "false sense of security" that some people have after getting a negative test result.

On a call with reporters Wednesday, Giroir also flatly denied any political involvement in the decision. He said the new testing guidelines came from the CDC with no intervention or direction from President Donald Trump.

"Let me tell you, right up front that the new guidelines are a CDC action," Giroir said.

"There is no direction from President Trump, the vice president or the secretary, about what we need to do, when," he said, referring to Vice President Mike Pence and Health and Human Services Secretary Alex Azar. "This is evidence-based decisions that are driven by the scientists and physicians, both within the CDC, within my office in the lab task force, and certainly amongst the task force members," Giroir continued, as reporters grilled him on the change.

PHOTO: Admiral Brett Giroir, Assistant Secretary for Health, speaks as U.S. Vice President Mike Pence and White House coronavirus response coordinator Deborah Birx listen during a Coronavirus Task Force press briefing in Washington, July 8, 2020.

Admiral Brett Giroir, Assistant Secretary for Health, speaks during a Coronavirus Task Force press briefing in Washington, July 8, 2020.

The new guidance directly contradicts what CDC Director Robert Redfield told ABC News last month: "Anyone who thinks they may be infected -- independent of symptoms -- should get a test."

Redfield's comments came as case numbers in the U.S. were on the rise and health officials worried that younger people -- attending protests and campaign rallies, as well as parties and bars -- were driving the transmission. He issued a new statement agreeing with the rules late Wednesday.

"Everyone who needs a COVID-19 test, can get a test. Everyone who wants a test does not necessarily need a test; the key is to engage the needed public health community in the decision with the appropriate follow-up action," he said, including the italics.

Richard Besser, who served as acting CDC director in 2009, told ABC News that the agency should be "out in front" on explaining the scientific rationale for the change. Besser said he believes the changes are coming from HHS and not CDC.

"Given that a larger number of people who get infected will not have symptoms, it is essential that people who have been exposed are tested," Besser said. "This change in guidance and the way it was released will decrease trust in our nation's public health agency at a time when trust is essential."

Giroir insisted the change comes because it doesn't do much good to have tests done in an area where there is no evidence of spread. A test result also is only valid for the day it's taken.

"Getting a negative test that three days is not totally meaningless, but pretty close to it. It should not give you a self assurance that you will be negative. It should not give you a false sense of security, you should not engage in risky behavior," Giroir said.

He said there were probably 20 drafts of the guidelines in a month and "lots of editing" from other task force doctors, including Dr. Anthony Fauci, the nation's top infectious disease expert; Dr. Deborah Birx, the White House coordinator on coronavirus; Stephen Hahn, head of the U.S. Food and Drug Administration; and Dr. Scott Atlas, a new adviser to the president.

"I worked on them. Dr. Fauci worked on them. Dr. Birx worked on them. Dr. Hahn worked on them. Dr. Atlas provided input. So, it's kind of hard to know how much was written by one person at this time, but it was a CDC product with lots of editing. Lots of input probably over about a month period of time," Giroir said.

At one point, Giroir noted "we all signed off on it, the docs" before political leaders saw it.

Fauci, though, said he did not personally sign off on the new guidance. The revisions were approved during a task force meeting on Aug. 20 -- the same day Fauci was under general anesthesia for surgery to remove a polyp from his vocal cords.

New York Gov. Andrew Cuomo said Wednesday on a conference call with reporters that the reversal from the CDC "strains credulity."

"The only plausible rationale is they want fewer people taking tests," said Cuomo.

PHOTO: A nurse with the Washington, D.C. Dept. of Health, administers a COVID-19 test on F Street, Aug. 14, 2020, in Washington.

A nurse with the Washington, D.C. Dept. of Health, administers a COVID-19 test on F Street, Aug. 14, 2020, in Washington.

The White House and CDC did not answer questions about the change, which was made quietly on the CDC website this week. Questions were referred to Giroir and CDC's parent agency, the Department of Health and Human Services, which is run by Azar, who as a Cabinet secretary reports directly to Trump.

Trump has said he thinks the U.S. conducts too many tests and falsely claimed that testing is what has caused a surge in cases in the U.S. Last June, Trump told supporters in Tulsa, Oklahoma: "When you do testing to that extent, you're going to find more people, you're going to find more cases. So I said to my people, 'Slow the testing down, please.'"

PHOTO: (FILES) In this file photo Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), speaks during a House Subcommittee on the Coronavirus Crisis hearing.

(FILES) In this file photo Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), speaks during a House Subcommittee on the Coronavirus Crisis hearing on a national plan to contain the COVID-19 pandemic, on Capitol Hill in Washington, DC on July 31, 2020. - A rare neurological condition that mostly affects children and mysteriously returns every two years is likely to flare up in the coming weeks and months, US health authorities warned on August 4, 2020.

A spokeswoman for the New York City Health Department told ABC News the city would make no change to its testing policies: "We've fought like hell to expand testing without any federal support and we're not slowing down any time soon!"

It's possible that the relaxed guidance will lend cover to other states seeing widespread transmission. While CDC guidelines are voluntary, many local officials use them to insist on people removing themselves from classrooms or work to await testing results. The new rules could be used to allow people, such as teachers, to remain in classrooms even after a known exposure.

In new guidance dated Aug. 24, CDC says that so long as a person doesn't show symptoms testing not necessary.

"You do not necessarily need a test unless you are a vulnerable individual or your health care provider or State or local public health officials recommend you take one," the CDC now states.

Fauci and Giroir told Congress last June that Trump had never asked them to slow down testing efforts. Giroir at the time said he was proceeding in the opposite direction.

"My purpose in leading is to increase the number of testing," Giroir told a House committee on June 23. "The only way we will be able to understand who has the disease, who is infected and can pass it, and to contact tracing, is to test appropriately, smartly, and as many as we can."

The quiet change comes amid questions on whether politics has leaked into public health guidance.

PHOTO: President Donald Trump speaks as Stephen Hahn, FDA commissioner, listens during a media briefing in the James Brady Briefing Room of the White House, Aug. 23, 2020, in Washington.

President Donald Trump speaks as Stephen Hahn, FDA commissioner, listens during a media briefing in the James Brady Briefing Room of the White House, Aug. 23, 2020, in Washington.

This week, the head of the U.S. Food and Drug Administration, Stephen Hahn, acknowledged that he overstated the benefits of convalescent plasma. With President Donald Trump at his side, he announced he was authorizing the treatment -- frustrating some researchers who say they wanted to continue to conduct placebo-controlled clinical trials to see if it worked.

Trump later bragged that he got the FDA to act, despite the agency's insistence that politics hadn't influenced its decision.

On Wednesday, Hahn said he wanted to work on building trust with the public ahead of the vaccine trial.

"We at FDA recognize that we must build public trust so there is confidence in future decisions about vaccines for #COVID19," he tweeted Wednesday. "I am concerned when I see public surveys that many people will decline taking a vaccine."
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=mWAp8BiuvJk
7:49 min
Second Stimulus Check Update & News Report Friday August 28
•Aug 28, 2020


ClearValue Tax


This is your Second Stimulus Check update, stimulus package update, and stimulus check 2 update and daily show news report as of Friday, August 28th. We cover the second stimulus check and the stimulus update. The stimulus package passed under the Trump Administration in March of 2020 was the HEROES Act. We discuss the stimulus check, the second stimulus check, stimulus unemployment, the SBA PPP Loan, and the EIDL loan. Please enjoy this second stimulus check update.
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=98RQ3QK-yCc
37:26 min
Scientific Integrity: A Major Casualty Of Covid-19
•Premiered 64 minutes ago


Peak Prosperity
___________________ LINKS IN TODAY'S VIDEO: Yale Faculty Rebuke Harvey Risch https://medium.com/@gregggonsalves/st... Israeli Vit D study https://www.timesofisrael.com/vitamin... Dr. John Campbell on HCQ https://youtu.be/2uzXHnUViro Italian study of HCQ = 30% reduction in mortality https://www.ejinme.com/article/S0953-... Vitamin C Works! https://www.medpagetoday.com/casestud... https://nypost.com/2020/03/24/new-yor... Ivermectin Works! https://www.medrxiv.org/content/10.11... HCQ at Peak Prosperity https://www.peakprosperity.com/forum-...


 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=3siQzuXP3qE
7:28 min
NEW Rapid Antigen Test for Coronavirus (Quick, Cheap, and Reliable)
•Aug 29, 2020


Doctor Mike Hansen


So there has been some big news when it comes to coronavirus testing. Recently, Abbott Laboratories came out with a new rapid antigen test called BinaxNOW COVID-19 Ag Card, and it got emergency approval from the Food and Drug Administration (FDA). An Emergency use authorization by the FDA is permission given to unapproved products to be used in an emergency to diagnose, treat or prevent serious or life-threatening conditions.

Link to FDA website for this test: https://www.fda.gov/news-events/press...

The test costs $5, and detects COVID-19 infection in 15 minutes. This new BinaxNOW rapid antigen test made by Abbott Laboratories uses a nasal swab in the same manner as a rapid flu test. Unlike most of the other nasal swabs used to test COVID, this one doesn’t have to be jammed all the way up in the nose. According to Abbott, and this is listed on the FDA’s website, the test has demonstrated 97.1% sensitivity and 98.5% specificity. These tests are compared to samples that tested positive with the PCR method, and they then compare the results. Also, I should mention that the NIH does independent tests to verify the accuracy of coronavirus tests, because its hard to trust a company’s own numbers. But these are the numbers that the company is claiming, and so far there aren’t independent test that have been done. The FDA said in a statement that negative results with Abbott's test may need to be confirmed with a lab test in some cases. For example, if there is high suspicion that someone has COVID based on their symptoms or exposure.

Also, I should add, that even if a test is perfect, lets say in theory its 100% sensitive and 100% specific, its still possible to get a false negative – not because of the test itself. Sometimes its due to the way the test is conducted, meaning poor technique is used. Sometimes, when it comes to coronavirus - some people can have the coronavirus in their lungs, without necessarily having it in their nose. This was actually proven, and I did a video on this, in a study of patients who died of coronavirus. 9 out of the 12 patients had the virus in their lungs but not their nose, and they used PCR testing for this. So that’s something else to keep in mind.

Another aspect of this BinaxNOW test, is that it will come with a free mobile app called NAVICA, which will allow users that test negative to display their results as a "digital health pass," This digital health pass would serve as a temporary, date-stamped result that is renewed each time a new test is taken. With the typical PCR tests that are done, meaning the ones that are lab-based, you get excellent sensitivity but they take time, a least a few hours or longer to get results. Since the start of the pandemic, nasal swab tests that are sent to a lab have been the standard for COVID-19 screening. While these PCR tests are considered the most accurate, they take at minimum a few hours before you get results. They’re also expensive and require specialized machines and chemical reagents, and shortages of these supplies have led to delays in getting results. But with this new antigen test, we can quickly identify COVID infections and get them into quarantine. Plus, it’s cheap, and is being mass produced…Abbott says that starting October they will ship 50 million tests a month. And following this announcement, the government said they will be purchasing 150 million of these tests from the company. This will allow for massive testing, moving one step closer to getting this pandemic under control, especially when it comes to getting schools and businesses reopened, and especially with the fall and winter coming, which means cold and flu season. And with such an overlap of symptoms between the common cold, flu, and COVID, this massive scale rapid testing will be all the more important. With this test, along with the other 3 FDA approved rapid antigen tests, they can’t be done at home, as they’re only allowed to be given by healthcare professionals. So basically, doctor's offices, emergency rooms, urgent care centers, pharmacies, drive-thrus, and some schools.
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=P2HPnlrJXwI
16:48 min
Should schools be open or closed due to COVID?
•Sep 1, 2020


Strong Medicine

A discussion of the many considerations when making a decision as to whether schools should be open or closed on account of COVID-19. This is an incredibly complicated topic; the relevant literature includes countless papers spanning medicine, public health, education, and economics. I know that I can't do it justice in 17 minutes.

As always, respectful discussion is welcome. Insults, profanity, and pseudoscience are not. These comments are moderated. Hospitalization and Mortality Data in Kids from the American Academy of Pediatrics: https://services.aap.org/en/pages/201... Hospitalization Rates and Characteristics of Children Aged [younger than]18 Years Hospitalized with Laboratory-Confirmed COVID-19: www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6932e3-H.pdf
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=01MRRop7OPs
17:38 min
Coronavirus Pandemic Update 105: FDA Authorized Treatments; COVID 19 Vaccine Update

•Sep 1, 2020


MedCram - Medical Lectures Explained CLEARLY

A review of current COVID-19 treatments authorized by the FDA plus coronavirus testing, lab values, and vaccine updates by Dr. Seheult of https://www.medcram.com Remdesivir, dexamethasone, and convalescent plasma each have emergency use authorization (EUA) from the FDA, and Dr. Seheult discusses his clinical experience with these medications as well as some of the data that supports their use. A key question for future research: should dexamethasone be used for more than 10 days in patients with severe COVID 19 infections? Other topics covered: Lab values of acute-phase reactants/proteins (CRP, Ferritin, LDH, D-dimer), Paper coronavirus tests, and an update on the novel oxford AstraZeneca adenovirus vaccine. (This video was recorded September 1, 2020).

LINKS / REFERENCES: Johns Hopkins Tracker | https://coronavirus.jhu.edu/map.html Worldometer | https://www.worldometers.info/coronav... Science Alert | https://www.sciencealert.com/lab-conf... LANCET Preprint | https://papers.ssrn.com/sol3/papers.c... NBC News | https://www.nbcnews.com/health/health... FDA | https://www.fda.gov/news-events/press... STAT on Implications of Reinfection | https://www.statnews.com/2020/08/28/c... Oxford Vaccine Group | https://www.ovg.ox.ac.uk/news/new-stu... Nature on Dexamethasone | https://www.nature.com/articles/d4158... NBC News on Remdesivir | https://www.nbcnews.com/health/health...
 

Deena in GA

Administrator
_______________
Thank you, marsh, for continuing to post Corona news! Your work is greatly appreciated!

And on the topic of whether or not schools should open or remain open, I saw a post on one of our county's FB pages today. Apparently a girl at the high school was tested to Corona, but while awaiting the test results, continued to go to school. She tested positive, so now they are having to go back and have everyone who was within six feet of her for at least 15 minutes go into a 14 day quarantine. I couldn't believe a parent would send a child to school while waiting for Corona test results. Crazy!
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=ZFNdsRHKUM4
34:20 min

Wait, Covid-19 Damages The Testicles??
Premiered 53 minutes ago


Peak Prosperity
First, let's talk about bad tests. The test kits currently being used to test for covid-19 infection are too different from one another, and many have sensitivities set so high that they are giving too many false positives. We need to standardize on tests that will actual give us accurate information. Second, let's talk bad testes. The data is in, and it doesn't look good for men who get sick with covid-19. Severe cases appear to do serious damage to the seminiferous tubules of the tests, which produce and regulate testosterone. We don't yet know what the effect, lasting or otherwise, this damage may have on fertility. But this underscores our longstanding advice: you don't want to get this virus if you can avoid it.

____________________ LINKS IN TODAY'S VIDEO: PCR test the wrong test? https://www.nytimes.com/2020/08/29/he... Cycle threshold values https://www.infectiousdiseaseadvisor.... About those second waves https://www.nytimes.com/2020/08/31/wo... Junk Science https://www.ajemjournal.com/article/S... Breaking Balls https://www.thailandmedical.news/news... Hypogonadism https://www.sciencedirect.com/science... Post-Mortem findings on testicular damage https://www.sciencedirect.com/science...
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=7jsxQWm93JE
2:59 min
COVID 19 Paper Strip Screening Tests: At-Home, Frequent, Rapid Results to Open Schools & Economy
•Sep 2, 2020


MedCram - Medical Lectures Explained CLEARLY

We've received requests for a short explainer video of how inexpensive, at-home, COVID-19 screening tests (results in 15 minutes) could be utilized to dramatically slow the spread of the coronavirus pandemic (and open up schools etc. in a faster and safer way). The research of Harvard epidemiologist Dr. Michael Mina and others has shown that COVID 19 test frequency and availability is much more important than test sensitivity (the ability of a test to pick up low levels of virus). See our previous MedCram videos that have featured Dr. Mina's research about COVID 19 testing and how quickly identifying individuals who are contagious (and who have high levels of SARS-CoV-2 virus) should be the primary focus.

2 INITIAL WAYS TO GET MORE INFO AND HELP: 1) visit https://www.rapidtests.org for more info, FAQ, and streamlined ways to contact your governor and representatives in Congress about at-home COVID 19 screening. 2) Please share this video with friends, colleagues, and elected officials.

MORE VIDEOS AND RESOURCES ON AT-HOME COVID 19 SCREENING TESTS A video summary and highlights of Dr. Mina's research and ideas in our MedCram COVID 19 Update 98: https://youtu.be/h7Sv_pS8MgQ A 5 minute summary with Dr. Mina of some key differences between COVID-19 antigen tests with rapid results: https://youtu.be/AZWuyvBAWWQ

A short explainer video on this topic produced by Dr. Allen (and the "contagious" graphic in this video was produced by him): https://www.youtube.com/watch?v=Af5Ru...

Summary Article Featured in the Atlantic about Inexpensive Rapid Testing: https://www.theatlantic.com/health/ar...

Dr. Mina's research paper: Test sensitivity is secondary to frequency and turnaround time for COVID-19 surveillance (Pre-print) https://www.medrxiv.org/content/10.11... TWiV 640: Test often, fast turnaround, interview with Michael Mina: https://youtu.be/kDj4Zyq3yOA

MORE READING: A Harvard Magazine article by Jonathan Shaw on August 3, 2020: "Failing the Coronavirus-Testing Test" has a summary of Dr. Mina's message https://www.harvardmagazine.com/2020/...

Selected excerpts from that article: “At the moment, the United States has no semblance of public-health testing,” says Michael Mina. Current tests for active infection with SARS-CoV-2 are highly sensitive—but most are given to suspected COVID-19 patients long after the infected person has stopped transmitting the virus to others. That means the results are virtually useless for public-health efforts to contain the raging pandemic. These PCR (polymerase chain reaction) tests, which amplify viral RNA to detectable levels, are used by physicians, often in hospital settings, to help guide clinical care for individual patients. In general, members of the public have not had access to such tests outside clinical settings, but even if they did, would find them too expensive for frequent use.

"The astounding realization is that all we’re doing with all of this testing is clogging up the testing infrastructure,” with results arriving a week or more after tests are administered, “and essentially finding people for whom we can’t even act because they are done transmitting," says Mina. “We need to change the whole script of what it means to test people,” he says. “In our country, we have always assumed that testing belongs in the clinical sphere, in the diagnostic sphere, and has to be run by laboratories or diagnosticians. The result is that we have a system for coronavirus testing…which is flailing, with raging outbreaks occurring.” What the country needs instead are rapid tests, widely deployed, so that infectious individuals can be readily self-identified and isolated, breaking the chain of transmission. So even though a saliva-based paper test wouldn’t register a positive result for as long as a half or even a full day after the PCR test, it would have great value in identifying pockets of infection that might otherwise be undetected altogether. The U.S. government has spent billions of dollars supporting attempts to develop vaccines and therapeutics. “Developing a good vaccine is very difficult to do,” he points out. “It’s a crapshoot that may or may not work. We’re putting billions more into developing therapeutics [treatments for COVID-19] which is really, really difficult.” With rapid testing, by contrast, “We have solutions, sitting in front of us right now, that are cheaper, would be much quicker to build, and much less risky to actually introduce and roll out."

------------------------------------------------------ Video produced by Kyle Allred, Co-Founder of https://www.medcram.com Contact Kyle or MedCram by emailing: customers@medcram.com Kyle Allred and MedCram have no financial disclosures related to this topic. We have a keen interest in curbing this pandemic and safely re-opening schools and our economy.
 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=XfDWjPxhKcE
38:33 min
Corticosteroids for COVID-19 – New Evidence of Benefit
•Streamed live 8 hours ago


JAMA Network

A conversation with Jonathan A. C. Sterne, MA, MSc, PhD of the University of Bristol, Todd W. Rice, MD, MSc of Vanderbilt University, and Janet V. Diaz, MD of the WHO on the latest research supporting the use of hydrocortisone and dexamethasone for treatment of COVID-19 ARDS. Recorded September 2, 2020.

Read the articles at https://jamanetwork.com/journals/jama... • Earn Free CME credits by watching JAMA Livestreams and completing a brief questionnaire. Claim 0.5 credits for each video at https://ja.ma/covidqa • Coronavirus Resource page from the JAMA Network: https://ja.ma/covidyt • To watch all the #JAMALive Q&A's Visit: https://ja.ma/covidqaytpl
 

marsh

On TB every waking moment
A Supercomputer Analyzed Covid-19 — and an Interesting New Theory Has Emerged

A closer look at the Bradykinin hypothesis

arlier this summer, the Summit supercomputer at Oak Ridge National Lab in Tennessee set about crunching data on more than 40,000 genes from 17,000 genetic samples in an effort to better understand Covid-19. Summit is the second-fastest computer in the world, but the process — which involved analyzing 2.5 billion genetic combinations — still took more than a week.

When Summit was done, researchers analyzed the results. It was, in the words of Dr. Daniel Jacobson, lead researcher and chief scientist for computational systems biology at Oak Ridge, a “eureka moment.” The computer had revealed a new theory about how Covid-19 impacts the body: the bradykinin hypothesis. The hypothesis provides a model that explains many aspects of Covid-19, including some of its most bizarre symptoms. It also suggests 10-plus potential treatments, many of which are already FDA approved. Jacobson’s group published their results in a paper in the journal eLife in early July.

According to the team’s findings, a Covid-19 infection generally begins when the virus enters the body through ACE2 receptors in the nose, (The receptors, which the virus is known to target, are abundant there.) The virus then proceeds through the body, entering cells in other places where ACE2 is also present: the intestines, kidneys, and heart. This likely accounts for at least some of the disease’s cardiac and GI symptoms.

But once Covid-19 has established itself in the body, things start to get really interesting. According to Jacobson’s group, the data Summit analyzed shows that Covid-19 isn’t content to simply infect cells that already express lots of ACE2 receptors. Instead, it actively hijacks the body’s own systems, tricking it into upregulating ACE2 receptors in places where they’re usually expressed at low or medium levels, including the lungs.

In this sense, Covid-19 is like a burglar who slips in your unlocked second-floor window and starts to ransack your house. Once inside, though, they don’t just take your stuff — they also throw open all your doors and windows so their accomplices can rush in and help pillage more efficiently.

The renin–angiotensin system (RAS) controls many aspects of the circulatory system, including the body’s levels of a chemical called bradykinin, which normally helps to regulate blood pressure. According to the team’s analysis, when the virus tweaks the RAS, it causes the body’s mechanisms for regulating bradykinin to go haywire. Bradykinin receptors are resensitized, and the body also stops effectively breaking down bradykinin. (ACE normally degrades bradykinin, but when the virus downregulates it, it can’t do this as effectively.)

The end result, the researchers say, is to release a bradykinin storm — a massive, runaway buildup of bradykinin in the body. According to the bradykinin hypothesis, it’s this storm that is ultimately responsible for many of Covid-19’s deadly effects. Jacobson’s team says in their paper that “the pathology of Covid-19 is likely the result of Bradykinin Storms rather than cytokine storms,” which had been previously identified in Covid-19 patients, but that “the two may be intricately linked.” Other papers had previously identified bradykinin storms as a possible cause of Covid-19’s pathologies.

Covid-19 is like a burglar who slips in your unlocked second-floor window and starts to ransack your house.

As bradykinin builds up in the body, it dramatically increases vascular permeability. In short, it makes your blood vessels leaky. This aligns with recent clinical data, which increasingly views Covid-19 primarily as a vascular disease, rather than a respiratory one. But Covid-19 still has a massive effect on the lungs. As blood vessels start to leak due to a bradykinin storm, the researchers say, the lungs can fill with fluid. Immune cells also leak out into the lungs, Jacobson’s team found, causing inflammation.

And Covid-19 has another especially insidious trick. Through another pathway, the team’s data shows, it increases production of hyaluronic acid (HLA) in the lungs. HLA is often used in soaps and lotions for its ability to absorb more than 1,000 times its weight in fluid. When it combines with fluid leaking into the lungs, the results are disastrous: It forms a hydrogel, which can fill the lungs in some patients. According to Jacobson, once this happens, “it’s like trying to breathe through Jell-O.”

This may explain why ventilators have proven less effective in treating advanced Covid-19 than doctors originally expected, based on experiences with other viruses. “It reaches a point where regardless of how much oxygen you pump in, it doesn’t matter, because the alveoli in the lungs are filled with this hydrogel,” Jacobson says. “The lungs become like a water balloon.” Patients can suffocate even while receiving full breathing support.

The bradykinin hypothesis also extends to many of Covid-19’s effects on the heart. About one in five hospitalized Covid-19 patients have damage to their hearts, even if they never had cardiac issues before. Some of this is likely due to the virus infecting the heart directly through its ACE2 receptors. But the RAS also controls aspects of cardiac contractions and blood pressure. According to the researchers, bradykinin storms could create arrhythmias and low blood pressure, which are often seen in Covid-19 patients.

The bradykinin hypothesis also accounts for Covid-19’s neurological effects, which are some of the most surprising and concerning elements of the disease. These symptoms (which include dizziness, seizures, delirium, and stroke) are present in as many as half of hospitalized Covid-19 patients. According to Jacobson and his team, MRI studies in France revealed that many Covid-19 patients have evidence of leaky blood vessels in their brains.

Bradykinin — especially at high doses — can also lead to a breakdown of the blood-brain barrier. Under normal circumstances, this barrier acts as a filter between your brain and the rest of your circulatory system. It lets in the nutrients and small molecules that the brain needs to function, while keeping out toxins and pathogens and keeping the brain’s internal environment tightly regulated.

If bradykinin storms cause the blood-brain barrier to break down, this could allow harmful cells and compounds into the brain, leading to inflammation, potential brain damage, and many of the neurological symptoms Covid-19 patients experience. Jacobson told me, “It is a reasonable hypothesis that many of the neurological symptoms in Covid-19 could be due to an excess of bradykinin. It has been reported that bradykinin would indeed be likely to increase the permeability of the blood-brain barrier. In addition, similar neurological symptoms have been observed in other diseases that result from an excess of bradykinin.”

Increased bradykinin levels could also account for other common Covid-19 symptoms. ACE inhibitors — a class of drugs used to treat high blood pressure — have a similar effect on the RAS system as Covid-19, increasing bradykinin levels. In fact, Jacobson and his team note in their paper that “the virus… acts pharmacologically as an ACE inhibitor” — almost directly mirroring the actions of these drugs.

By acting like a natural ACE inhibitor, Covid-19 may be causing the same effects that hypertensive patients sometimes get when they take blood pressure–lowering drugs. ACE inhibitors are known to cause a dry cough and fatigue, two textbook symptoms of Covid-19. And they can potentially increase blood potassium levels, which has also been observed in Covid-19 patients. The similarities between ACE inhibitor side effects and Covid-19 symptoms strengthen the bradykinin hypothesis, the researchers say.

ACE inhibitors are also known to cause a loss of taste and smell. Jacobson stresses, though, that this symptom is more likely due to the virus “affecting the cells surrounding olfactory nerve cells” than the direct effects of bradykinin.

Though still an emerging theory, the bradykinin hypothesis explains several other of Covid-19’s seemingly bizarre symptoms. Jacobson and his team speculate that leaky vasculature caused by bradykinin storms could be responsible for “Covid toes,” a condition involving swollen, bruised toes that some Covid-19 patients experience. Bradykinin can also mess with the thyroid gland, which could produce the thyroid symptoms recently observed in some patients.

The bradykinin hypothesis could also explain some of the broader demographic patterns of the disease’s spread. The researchers note that some aspects of the RAS system are sex-linked, with proteins for several receptors (such as one called TMSB4X) located on the X chromosome. This means that “women… would have twice the levels of this protein than men,” a result borne out by the researchers’ data. In their paper, Jacobson’s team concludes that this “could explain the lower incidence of Covid-19 induced mortality in women.” A genetic quirk of the RAS could be giving women extra protection against the disease.

The bradykinin hypothesis provides a model that “contributes to a better understanding of Covid-19” and “adds novelty to the existing literature,” according to scientists Frank van de Veerdonk, Jos WM van der Meer, and Roger Little, who peer-reviewed the team’s paper. It predicts nearly all the disease’s symptoms, even ones (like bruises on the toes) that at first appear random, and further suggests new treatments for the disease.

As Jacobson and team point out, several drugs target aspects of the RAS and are already FDA approved to treat other conditions. They could arguably be applied to treating Covid-19 as well. Several, like danazol, stanozolol, and ecallantide, reduce bradykinin production and could potentially stop a deadly bradykinin storm. Others, like icatibant, reduce bradykinin signaling and could blunt its effects once it’s already in the body.

Interestingly, Jacobson’s team also suggests vitamin D as a potentially useful Covid-19 drug. The vitamin is involved in the RAS system and could prove helpful by reducing levels of another compound, known as REN. Again, this could stop potentially deadly bradykinin storms from forming. The researchers note that vitamin D has already been shown to help those with Covid-19. The vitamin is readily available over the counter, and around 20% of the population is deficient. If indeed the vitamin proves effective at reducing the severity of bradykinin storms, it could be an easy, relatively safe way to reduce the severity of the virus.

Other compounds could treat symptoms associated with bradykinin storms. Hymecromone, for example, could reduce hyaluronic acid levels, potentially stopping deadly hydrogels from forming in the lungs. And timbetasin could mimic the mechanism that the researchers believe protects women from more severe Covid-19 infections. All of these potential treatments are speculative, of course, and would need to be studied in a rigorous, controlled environment before their effectiveness could be determined and they could be used more broadly.

Covid-19 stands out for both the scale of its global impact and the apparent randomness of its many symptoms. Physicians have struggled to understand the disease and come up with a unified theory for how it works. Though as of yet unproven, the bradykinin hypothesis provides such a theory. And like all good hypotheses, it also provides specific, testable predictions — in this case, actual drugs that could provide relief to real patients.

The researchers are quick to point out that “the testing of any of these pharmaceutical interventions should be done in well-designed clinical trials.” As to the next step in the process, Jacobson is clear: “We have to get this message out.” His team’s finding won’t cure Covid-19. But if the treatments it points to pan out in the clinic, interventions guided by the bradykinin hypothesis could greatly reduce patients’ suffering — and potentially save lives.
 

Mixin

Veteran Member
Wastewater COVID-19 testing could help colleges and universities pinpoint outbreaks
by: Mike Sullivan
Posted: Sep 3, 2020 / 04:26 AM EDT / Updated: Sep 3, 2020 / 04:26 AM EDT

MUNCIE, Ind. — As college campuses continue to battle spikes of COVID-19 cases, the Indiana Finance Authority is working with local utility companies on a new way to track cases through wastewater.

“Wastewater has been used before, for sure, to test certain things like polio,” said Carmel Utilities Director John Duffy. “They’ve used waste water plants to test for drug usage.”

The 12-week study will test the COVID-19 samples from the wastewater in cities with a college or university that has more than 1,000 students; both Bloomington and Muncie are on the list. The results can be used to detect rising or falling surges.

“This is a very dirty sample, way dirtier than a blood sample or saliva sample,” said George Zhou, a professor at Purdue University. “It’s almost impossible to trace back the exact number of infections in the community. You are able to use that data to see the trend and the changes in currents of this virus.”

A specific location can be pinpointed if the samples are taken from a specific water line or manhole near a dorm or office building. This could allow administrators a chance to quarantine earlier.

“The beautiful thing about something like wastewater surveillance is you can detect it at the source as it is happening,” said Graham McKeen, assistant university director of public and environmental health. “Where as with a nasopharyngeal swab we might have a two to three day result before we can take public health action on that.”

Purdue and Indiana universities are not actively doing wastewater testing, but the Muncie Sanitation Department says their partnership with the Indiana Finance Authority will be testing Ball State dorms as part of the research.

 

marsh

On TB every waking moment
View: https://www.youtube.com/watch?v=XDYeCMj1Z88
1:56:09 min starts at 53:14 min
President Trump Holds a News Conference
•Streamed live 4 hours ago


The White House

_______________________________________

View: https://www.youtube.com/watch?v=PpgDCybgSKE
5:52 min
Jobs report 'vastly exceeded expectations': Trump economic adviser
•Sep 4, 2020


Fox News

Council of Economic Advisers Acting Chairman Tyler Goodspeed weighs in on the unemployment rate falling to 8.4 percent in August on ‘America’s Newsroom.’
 
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