Posts Tagged ‘covid-19’

Where Malaria is, Covid-19 is not (so far)

March 20, 2020

Just coincidence that countries with most malaria have least Covid-19?

Just coincidence that antimalarial drugs (such as hydroxychloroquine) seem to have very good effects in eliminating the Covid-19 virus?

Perhaps. But it sounds to me like good news.

An Effective Treatment for Coronavirus (COVID-19)

Summary

Recent guidelines from South Korea and China report that chloroquine is an effective antiviral therapeutic treatment against Coronavirus Disease 2019.  Use of chloroquine (tablets) is showing favorable outcomes in humans infected with Coronavirus including faster time to recovery and shorter hospital stay.  US CDC research shows that chloroquine also has strong potential as a prophylactic (preventative) measure against coronavirus in the lab, while we wait for a vaccine to be developed.  Chloroquine is an inexpensive, globally available drug that has been in widespread human use since 1945 against malaria, autoimmune and various other conditions.  

Chloroquine: C18H26ClN3


 

100 days and 4,000 deaths later in China ….

March 19, 2020

It is yet to be confirmed if this is just a quirk of numbers or whether the outbreak of coronavirus has truly been brought under control. Even if it has, China has used brutal and draconian measures to control the infection.

The question is whether Europe and the US are being smarter?

From the New York Times:

China’s National Health Commission (NHC) in its daily report said that no new domestically transmitted cases of the novel coronavirus disease were reported on the Chinese mainland on Wednesday. However, a total of 34 new COVID-19 cases were reported on the Chinese mainland on Wednesday, all of which were from those arriving from abroad, marking a sharp increase, it said. 

Of the 34 newly imported cases, 21 were reported in Beijing, nine in Guangdong Province, two in Shanghai, one in Heilongjiang Province and one in Zhejiang Province, the NHC said.

The overall confirmed cases on the mainland had reached 80,928 by the end of Wednesday. This included 3,245 people who died of the disease 7,263 patients and 70,420 patients discharged after recovery.

The NHC said the number of imported cases in China rose to 189 with 34 confirmed cases from the people arriving from abroad.

China has reported a total of 80,928 confirmed cases of the COVID-19, of which 3,245 have died and 70,420 patients were discharged after treatment.


 

Coronavirus: Flight first, but now comes fight

March 17, 2020

Today all 70+ in Sweden were advised to stay home. Many jobs are being threatened or already lost. But I also read today that manufacturing in China has restarted and is well on its way back. Two of the specialist corona patient hospitals that were opened in China have now been shut down for lack of patients. Trials of proposed vaccines have started in a number of countries. Existing medicines  which seem promising for supporting the immune system are being tested with infected patients. Some results in Australia have shown very good effects.

In almost all European countries the initial panic response was/is driven primarily, not in the first instance for the saving of lives already under threat, but for the avoidance of the health care systems being overwhelmed. Flatten the curve has become the guiding strategy. In the traditional sense this trying to run away or hide away and avoid the virus describes a classic flight response.

It strikes me that humanity as an organism shows the flight/fight response but initial flight is often to be able to marshal resources so as to fight again.

The initial flight reaction is now shifting to fight.

Flatten the Curve

I expect (perhaps a little optimistically) the world is shifting from flight to fight. But I think human resilience will not allow us to cower and hide and not fight back. That fight involves many battles on many fronts:

  • Modifying use or application of existing drugs
  • Developing new designer-vaccines
  • Increasing ICU places with access to respirators
  • Increasing availability of respirators
  • Improving treatment therapies to suppress the worst side-effects of the virus
  • ……..

It is always dangerous to be too optimistic too early. There are going to be many more deaths. I am sure we have a long recession ahead – perhaps six months. But it is not just doom and gloom.

There is a lot of gloom ahead but it is not doom.


 

Every ignoramus has become an expert on Covid-19 and epidemics

March 16, 2020

Every radio commentator has, overnight, become an expert. I can no longer listen for very long to radio news (and during the day I usually listen in the background to Swedish, UK and some US news broadcasts). Not only has every journalist become an expert, but every doctor, every politician and every member of the general public has also become an expert. When a journalist interviews a physician it is always about resources being insufficient. When a journalist interviews a politician it is always about why the politician got it wrong. Every posturing politician either attacks or supports the government actions depending upon whether his party is in power or not. Less than 10% of any broadcast is about reporting the latest news. The rest is inevitably taken up with opposing somebody. Even the “human interest” reports are focused on the human interest being a complaint or criticism of some kind.

So my background radio listening is now self-confined to the music channels (BBC Radio 3 or Swedish P2).

Fortunately, I don’t watch too much TV. TV commentators are a few orders of magnitude worse than their Radio counterparts. I tried last night. It took me less than 30 seconds to switch away from CNN and Fox, but BBC World News lasted over a minute. Rapport and Aktuellt were a little better but not by much.

The opinion columns in the “big” newspapers are not a lot better. The New York Times carried an article of some 2,000 words on Saturday entitled: How to Protect Older People From the Coronavirus.

I am an older person but this article is 2,000 words of drivel, signifying nothing. According to this nonsense verbiage, the way to protect older people consists of the following pearls of wisdom:

  • Familiarize yourself with guidelines and follow them.
  • Cancel nonessential doctor’s appointments if you can.
  • Beware of social isolation.
  • Have a talk with home health aides.
  • Bar visits to nursing homes.
  • Stay active, even in a pandemic.

There is not just one strategy, applicable to every population group or to every country, to limit infection and minimize fatalities. I take it on faith that all governments in power do have that as their objective. I am also taking on faith that government decisions to handle this crisis are themselves made in good faith with the best information to hand. However viruses are not so well understood that even all experts are of one mind. Even our most expert experts, whether on viruses or epidemics, are far from knowing everything.

We don’t even know whether viruses are living things or just a bunch of chemicals accumulated by chance. What we do know from the expert community (represented by the WHO) is

On 31 December 2019, WHO was informed of cases of pneumonia of unknown cause in Wuhan City, China. A novel coronavirus was identified as the cause by Chinese authorities on 7 January 2020 and was temporarily named “2019-nCoV”.

On 30 December 2019, three bronchoalveolar lavage samples were collected from a patient
with pneumonia of unknown etiology – a surveillance definition established following the
SARS outbreak of 2002-2003 – in Wuhan Jinyintan Hospital. Real-time PCR (RT-PCR) assays
on these samples were positive for pan-Betacoronavirus. Using Illumina and nanopore
sequencing, the whole genome sequences of the virus were acquired. Bioinformatic
analyses indicated that the virus had features typical of the coronavirus family and belonged
to the Betacoronavirus 2B lineage. Alignment of the full-length genome sequence of the
COVID-19 virus and other available genomes of Betacoronavirus showed the closest
relationship was with the bat SARS-like coronavirus strain BatCov RaTG13, identity 96%.

The best I can do, I think, for myself and the community is to rely on common sense.

  • Minimize my chances of being infected.
  • Minimize chances of my unknowingly infecting someone else.
  • Avoid hoarding.

 

The coronavirus dilemma lies between developing mass immunity and coping with the severe cases

March 15, 2020

As a layman I am still trying to understand the thinking which is leading to the political decisions surrounding the different country responses. This is just thinking aloud to get my own thoughts in order.

It seems to me that whereas it is desirable, in the long term, for as many as possible to be mildly infected (as with mass vaccinations) and develop immunity, right now countries are shutting down their borders because:

  • the infection wave would be uncontrolled, and
  • the number of resulting severe cases would also be uncontrolled, and
  • the health services may not be able to cope

I read that the virus cannot be killed off. It may die out as the human population develops immunity and the virus itself mutates. Most people who are infected, recover and develop immunity. However, for those who are severely affected (maybe 10-15% of those infected) there are no specific treatment therapies yet established. It also seems that most of those severely affected are the elderly or those who are in close contact with sick patients (doctors and nurses). A vaccine, when developed, would effectively spread immunity without the risk of severe effects, especially among those at risk. From the almost panicked reactions of so many countries I suspect that they have access to some worrying data. This is probably that

  • There is no great success in treating the risk groups who are severely infected, and
  • the fatality rate among these high-risk groups is much higher than with conventional influenza.

I discern a 3-Phase strategy being implemented.

  1. The drastic country lock-downs is Phase One. It is not so much an effort to prevent infection but an effort to prevent infection at such a rate that the severe cases are too high for the health services to cope. Probably the lock-downs will last about a month (or two).
  2. This buys time to develop some effective treatment therapies for the severely affected which then leads to Phase Two where infection is allowed to proceed “naturally” but where there is a preparedness for the severely affected.
  3. Phase Three comes when a vaccine is available and mild “natural” infection together with vaccination for those at risk, leads to the virus becoming just another “flu virus”.

The long term goal is then for populations to develop immunity (natural and by vaccination) and to have treatments for the severely infected. There is no goal to eliminate the virus (which is probably impossible).

In my lifetime, I have not seen anything like the response to the Covid-19 response. I was travelling extensively during the SARS and H1N1 and HIV scares, but the responses then were nowhere near as drastic as now. We have aged into the risk group. We travel much less now. Self-isolation causes minor difficulties but is not so very traumatic. Certainly I would prefer to get any immunity from a vaccine rather than an untreatable “natural” infection. A new risk for us, though, is that the serious but “routine” hospital care we rely on will be delayed or postponed.


 

Corona virus fatality rate: Playing with numbers

March 14, 2020
  1. Over the last 50 days (starting January 23rd), 5436 deaths around the world have been attributed to complications after being infected with the Covid-19 coronavirus. While the number of deaths yesterday was 448, the peak may not yet have been reached. Hopefully all the restrictions in place will lead to the peak being reached soon. The global number of deaths over this period has averaged about 110/day. A vast majority of the deaths are of people over 65.
  2. Around 152,000 people die every day (7.7/1000 of population). Around 65% of these die due to age related causes.
  3. Symptoms of influenza rarely lead to testing for the influenza virus. Every year an estimated 290,000 to 650,000 people die in the world due to complications from seasonal influenza (flu) viruses. This figure corresponds to 795 to 1,781 deaths per day due to the seasonal flu.

But:

  • In retrospect it seems that this coronavirus first appeared around November 2019. So some of the deaths attributed to influenza since then may have been due to Covid-19.
  • At least 145,000 people have tested positive for the virus. However people are not generally tested unless symptoms are severe. Many are infected and show no symptoms at all. Many are infected and recover without ever having been diagnosed.
  • The number of people infected is – as an estimate – around 10-20 times the number who have tested positive (1.4 – 3 million).

Even if the number of deaths due to coronavirus is certain, which it is not, the fatality rate depends entirely upon what number is used to divide by:

  • Around 0.07% of all daily deaths
  • Around 0.15 – 0.35% of those infected
  • Around 3.7% of those who have tested positive
  • Around 6 – 15% of daily influenza deaths

Numbers don’t lie but the same numbers can be used in many different ways. They can be used rationally or, more likely, to promote an alarmist agenda or a political agenda.

And they can be used maliciously.

I find the most significant statistic for my own behaviour (and since I am in the risk-age group) is that risk of death increases by a factor of about 50 if I get infected. However, even if I do get infected the chances of survival are around 10 times higher than the chance of dying. It makes sense to exert myself to avoid infection but I don’t need to kill myself to avoid being infected.


 

Covid-19 global lock-down is a mishmash of fear and precaution

March 12, 2020

Being over 70, I am apparently in the high-risk group if I get infected.

I am sure that all those who are currently battling with containing the outbreak are well-qualified and and are doing their best. But being well-qualified and knowledgeable are not always an indicator of wisdom.  Even given the same level of knowledge, there is a difference between a measured response and an alarmist response. The current panic response to the outbreak seems to me to be more alarmist than measured.

The Twitter and Facebook worlds are ideally suited to spreading alarm. Fact and fiction are blended with the ridiculous and the malicious to give a “tale told by an idiot, signifying nothing”.

  • Don’t touch your own face unless you have washed your hands.
  • Stock-up on toilet paper.
  • Stock-up with food for 14 days. Replenish every day.
  • Wash your hands every 20 minutes.
  • Don’t go to sports events. Complain if the match is cancelled.
  • Stay 1 m away from fellow passengers on public transport.
  • Viruses are necessary for biodiversity.
  • Ban the virus (except in cases of asylum).
  • Ban foreigners who may carry the virus from entering your country.
  • Your own citizens who carry the virus may enter freely.
  • Banning a foreigner carrying the virus is racist.
  • Children are the lowest risk group. Close the schools.
  • The old are at greatest risk. Don’t visit them / lock them up.
  • If you think you have a cold, self-isolate.
  • If you are tested positive, wait it out, don’t self-immolate.
  • If you think a household member is infected, self-isolate.
  • The old who are infected take up the most health resources. Let nature cull those over 65.
  • It is divine punishment for ……
  • Coronavirus transmission is ‘highly sensitive’ to high temperatures. Covid-19 pathogen appears to spread fastest at 8.72° Celsius.
  • Close the world until summer.

The fear-driven response is going to continue for a few months yet. There will be fatalities. But the deaths resulting from the Covid-19 outbreak are still well below the “normal” 1000+ deaths per day due to influenza. At the time of the peak in China in February, deaths reached about 150 in a day (mainly in Wuhan). Yesterday, March 11th, the peaks in Iran and Italy have given a world total of 331 deaths. Some say it is going to get worse.


 


 

Common influenza has killed 20 times more people than coronavirus in the last 2 months

March 8, 2020

The global mortality due to all strains of conventional influenza is greater than 1000 deaths per day (between 400,000 and 600,000 deaths per year). The flu season in northern climes runs from about September to March and most fatalities occur at this time.

The current Covid-19 coronavirus outbreak has resulted in 3,600 deaths, globally, in the last 50 days with over 2,000 just in China.

During the same period influenza has killed at least 50,000 (and more likely around 80,000) around the world.

The number of influenza deaths occur in spite of there being vaccines for some strains of the virus. There is no vaccine yet for Covid-19. There is no “cure” for influenza and neither is there a “cure” for Covid-19. However treatment of influenza is much better established than for the new virus.

Common influenza – even with vaccines available and with better established treatment –  has killed at least 20 times more people than Covid-19 in the last 2 months. So why the unnecessary and ridiculous panic?

I suspect it is because we have now been conditioned by Alarmism and are governed by fear. I note that cowardice is when actions are subordinated to fear (and bravery is when fears are subordinated to actions). The alarmist world has become a more cowardly place.


#coronavirus

Corona Safety

March 3, 2020

I like this presentation from Siemens.

Corona safety.pdf


 

Covid-19 and the culling of humans

March 3, 2020

It’s early days yet to have a clear picture of the effects of the Covid-19 coronovirus outbreak.

In all but being formally declared it is pretty close to being a pandemic.

But what is already pretty clear is that it targets and culls humans by age.

https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/

data from worldometers.info


 


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