What If We Already Have a Vaccine?

AS the world waits for a coronavirus vaccine, tens of thousands of people could die. But some scientists believe a vaccine might already exist.

Surprising new research in a niche area of immunology suggests that certain live vaccines that have been around for decades could, possibly, protect against the coronavirus. The theory is that these vaccines could make people less likely to experience serious symptoms — or even any symptoms — if they catch it.

At more than 25 universities and clinical centers around the world, researchers have begun clinical trials, primarily in health care workers, to test whether a live tuberculosis vaccine that has been in use for 99 years called the bacillus Calmette-Guérin, or B.C.G., vaccine, could reduce the risks associated with the coronavirus.

Another small but esteemed group of scientists is raising money to test the potential protective effects of a 60-year-old live polio vaccine called O.P.V. It’s counterintuitive to think that old vaccines created to fight very different pathogens could defend against the coronavirus. The idea is controversial in part because it challenges the dogma about how vaccines work.

But scientists’ understanding of an arm of immunology known as innate immunity has shifted in recent years. A growing body of research suggests that live vaccines, which are made from living but attenuated pathogens (as opposed to inactivated vaccines, which use dead pathogens) provide broad protection against infections in ways that no one anticipated.

“We can’t be certain as to what the outcome will be, but I suspect it’ll have an effect” on the coronavirus, said Jeffrey Cirillo, a microbiologist and immunologist at Texas A&M University who is leading one of the B.C.G. trials.

“Question is, how big will it be?” Scientists stress that these vaccines will not be a panacea. They might make symptoms milder, but they probably won’t eliminate them.

And the protection, if it occurs, would most likely last only a few years.

Still, “these could be a first step,” said Dr. Mihai Netea, an immunologist at Radboud University in the Netherlands who is leading another one of the trials. “They can be the bridge until you have the time to develop a specific vaccine.” The first evidence to suggest that live vaccines could be broadly protective trickled in nearly a century ago, but no one knew what to make of it. In 1927, soon after B.C.G. was rolled out, Carl Naslund of the Swedish Tuberculosis Society observed that children vaccinated with the live tuberculosis vaccine were three times less likely to die of any cause compared with kids who weren’t.

“One is tempted to explain this very low mortality among vaccinated children by the idea that B.C.G. vaccine provokes a nonspecific immunity,” he wrote in 1932.

Then, in clinical trials conducted in the 1940s and ’50s in the United States and Britain, researchers found that B.C.G. reduced nonaccidental deaths from causes other than tuberculosis by an average of 25 percent.

Also in the 1950s, Russian researchers, including Marina Voroshilova of the Academy of Medical Science in Moscow, noticed that people who had been given the live polio vaccine, compared with people who hadn’t, were far less likely to fall ill with the seasonal flu and other respiratory infections. She and other scientists undertook a clinical trial involving 320,000 Russians to more carefully test these mysterious effects.

They found that among individuals who had received the live polio vaccine, “the incidence of seasonal influenza was reduced by 75 percent,” said Konstantin Chumakov, Voroshilova’s son, who is now an associate director for research in the U.S. Food and Drug Administration’s Office of Vaccines Research and Review.

Recent studies have produced similar findings.

In a 2016 review of 68 papers commissioned by the World Health Organization, a team of researchers concluded that B.C.G., along with other live vaccines, “reduce overall mortality by more than would be expected through their effects on the diseases they prevent.” The W.H.O. has long been skeptical about these “nonspecific effects,” in part because much of the research on them has involved observational studies that don’t establish cause and effect. But in a recent report incorporating newer results from some clinical trials, the organization described nonspecific vaccine effects as “plausible and common.” Dr. Stanley Plotkin, a vaccinologist and emeritus professor at the University of Pennsylvania who developed the rubella vaccine but has no involvement in the current research, agreed.

“Vaccines can affect the immune system beyond the response to the specific pathogen,” he said.

Peter Aaby, a Danish anthropologist who has spent 40 years studying the nonspecific effects of vaccines in Guinea-Bissau, in West Africa, and whose findings have been criticized as implausible, is hopeful that these trials will be a tipping point for research in the field. “It’s kind of a golden moment in terms of actually having this taken seriously,” he said.

The possibility that vaccines could have nonspecific effects is brow-furrowing in part because scientists have long believed that vaccines work by stimulating the body’s highly specific adaptive immune system.

After receiving a vaccine against, say, polio, a person’s body creates an army of polio-specific antibodies that recognize and attack the virus before it has a chance to take hold. Antibodies against polio can’t fight off infections caused by other pathogens, though — so, based on this framework, polio vaccines should not be able to reduce the risk associated with other viruses, such as the coronavirus.

But over the past decade, immunologists have discovered that live vaccines also stimulate the innate immune system, which is less specific but much faster. They have found that the innate immune system can be trained by live vaccines to better fight off various kinds of pathogens.

For instance, in a 2018 study, Dr. Netea and his colleagues vaccinated volunteers with either B.C.G. or a placebo and then infected them all with a harmless version of the yellow fever virus. Those who had been given B.C.G. were better able to fight off yellow fever.


MAXWELL HOLYOKE-HIRSCH
Research by Dr. Netea and others shows that live vaccines train the body’s immune system by initiating changes in some stem cells. Among other things, the vaccines initiate the creation of tiny marks that help cells turn on genes involved in immune protection against multiple pathogens.

This area of innate immunity “is one of the hottest areas in fundamental immunology today,” said Dr. Robert Gallo, the director of the Institute of Human Virology at the University of Maryland School of Medicine and co-founder of the Global Virus Network, a coalition of virologists from more than 30 countries. In the 1980s, Dr. Gallo helped to identify H.I.V. as the cause of AIDS.

Dr. Gallo is leading the charge to test the O.P.V. live polio vaccine as a treatment for coronavirus.

He and his colleagues hope to start a clinical trial on health care workers in New York City and Maryland within six weeks.

O.P.V. is routinely used in 143 countries, but no longer in the United States. An inactivated polio vaccine was reintroduced here in 1997, in part because one out of every 2.7 million people who receive the live vaccine can actually develop polio from it.

But O.P.V. does not pose this risk to Americans who have received a polio vaccine in the past. “We believe this is very, very, very safe,” Dr. Gallo said. It’s also inexpensive at 12 cents a dose, and is administered orally, so it doesn’t require needles.

Some scientists have raised concerns over whether these vaccines could increase the risk for “cytokine storms” — deadly inflammatory reactions that have been observed in some people weeks after they have been infected with the coronavirus. Dr. Netea and others said that they were taking these concerns seriously but did not anticipate problems. For one thing, the vaccines will be given only to healthy people — not to people who are already infected.

Also, B.C.G. may actually be able to ramp up the body’s initial immune response in ways that reduce the amount of virus in the body, such that an inflammatory response never occurs. It may “lead to less infection to start with,” said Dr. Moshe Arditi, the director of the Infectious and Immunological Diseases Research Center at Cedars-Sinai Medical Center in Los Angeles, who is leading one of the trial arms.

THE science on this is still early days.

Several pre-prints — scientific papers that have not yet been peer-reviewed — published over the past few months support the idea that B.C.G. could protect against the coronavirus. They have reported, for instance, that death rates are lower in countries that routinely vaccinate children with B.C.G. But these studies can be fraught with bias and difficult to interpret; it’s impossible to know whether the vaccinations, or something else, provided the protection.

Such studies are “at the very bottom of the evidence hierarchy,” said Dr. Christine Stabell Benn, who is raising funds for a Danish B.C.G trial. She added that the protective effects of a dose of B.C.G given to adults decades ago, when they were infants, may well differ from the protective effects the vaccine could provide when given to adults during an outbreak.

“In the end,” said Dr. Netea, “only the clinical trials will give the answer.” Thankfully, that answer will come very soon.

Initial results from the trials that are underway may be available within a few months. If these researchers are right, these old vaccines could buy us time — and save thousands of lives — while we work to develop a new one.

SOURCE 

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An Alternative to the Lockdown Strategy in the Fight Against Coronavirus

The current coronavirus strategy of most governments is a recipe for a worldwide economic disaster. In many countries, the strategy of confinement and forcing shops to close is a sure-fire path to large-scale business failures. The cascade of economic and financial repercussions to come is likely to lead to another Great Depression.

The Costs of Prolongation

Italy, for example, already had a 135 percent debt-to-GDP ratio before the crisis. It is hard to imagine how it will be able to borrow more without a commitment from other European countries to jointly be responsible for more Italian debt—something the northern European countries are still strongly opposed to. The ECB is already printing money like crazy, and another Greece-like situation will make it ramp up the printing presses even more. We have been down this path many times before, where the cure is clearly much worse than the disease. The German hyperinflation of 1921-1923 created a resentful, impoverished middle class which ultimately led to Hitler’s rise to power.

The coronavirus (SARS-CoV-2) that originated in China is highly contagious. More than 80 percent of the patients show only mild flu-like symptoms but for the remaining 20 percent, mostly the elderly or people with preexisting conditions, the virus can be life-threatening. To save lives short term, the entire population in Europe is currently being held under house arrest and many businesses have been put into a pre-liquidation state by no longer being able to realize a profit due to inactivity.

The current strategy is not to stop the virus in its tracks but to spread out the contagion so that the peak is a level that will be more manageable for the health care system. Governments took the biased advice of health care professionals without a real weighing of all the pros and cons. This prolongation in time, however, will come at a steep economic and human cost.

Unemployment Correlates with Death

In the longer term, more lives will be lost if we continue this strategy. How many victims of financial ruin will end their own lives? In the modern era, for every one percent increase in the unemployment rate, there has typically been an increase of about one percent in the number of suicides. A study conducted by Brenner in 19791, found that for every 10 percent increase in the unemployment rate, mortality increased by 1.2 percent, cardiovascular disease by 1.7 percent, cirrhosis of the liver by 1.3 percent, suicides by 1.7%, arrests by 4 percent, and reported assaults by 0.8 percent (see here). How many lost lives out of 300 million in the USA does a 10 percent, 15 percent, 20 percent unemployment rate represent?

The use of the free market gives another strategy to control the spread of the coronavirus. For example, we now have strong evidence from trials in France and China that in 75 percent of the cases a combination of two extremely well-known antimalarial drugs (hydroxychloroquine in combination with the antibiotic azithromycin) can bring the viral load down to nearly zero after just six days (complications usually arrive after the 6th day). These drugs could make the latent effects of the Wuhan virus as mild for 20 percent as the other 80 percent, and they were recently cleared for use.

There are many other possible drug combinations that might offer similar results, but FDA and EMA regulations requiring long term testing make it much more difficult for these drugs to be available in time to treat the virus. Yet the world economy is at stake and we cannot sit and argue on the quality of the water while our house is burning down.

An obviously better solution than sinking the world economy into a great depression is a greater use of “laissez-faire.” The current lockdown strategy is a bleak choice of (allegedly) fewer short term deaths against a much larger long-term death toll. We must return to a business-as-normal situation as soon as possible. We need to free drugs from overbearing drug regulations and make them widely available (with appropriate dosages and warnings) everywhere at a market price without the need for a prescription. We need markets to be free so they can provide a wide choice of medications.

Market-Oriented Strategy

The argument is not for a non-strategy; it is for allowing the markets to define the strategy. For example, the elderly might consider taking chloroquine preventively; it has a long history of being taken to prevent malaria in Africa. It is naïve to think that people can’t inform themselves and take appropriate actions for their own health benefits.

It is also naïve to think that businesses and people won’t adapt to the perceived threat. Restaurants can seat patrons several meters apart. Waiters and cooks can wear masks and gloves. There is an infinite number of innovative ways people will adjust. Just because we cannot imagine a voluntary market solution does not mean one does not exist. South Korea is an example to emulate. Instead of an authoritarian locking down of its people, it took a much more libertarian approach to the problem and is already showing promising results.

This market-oriented strategy is obviously not without risks, but we must move away from the current defensive 16th-century bunker mentality and consider less disastrous economic alternatives.

SOURCE 

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For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH,  POLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

Email me  here (Hotmail address). My Home Pages are here (Academic) or  here  (Personal).  My annual picture page is here.  Home page supplement

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The Worldwide Lockdown May Be the Greatest Mistake in History

The idea that the worldwide lockdown of virtually every country other than Sweden may have been an enormous mistake strikes many — including world leaders; most scientists, especially health officials, doctors and epidemiologists; those who work in major news media; opinion writers in those media; and the hundreds of millions, if not billions, of people who put their faith in these people — as so preposterous as to be immoral. Timothy Egan of The New York Times described Republicans who wish to enable their states to open up as “the party of death.”

That’s the way it is today on planet Earth, where deceit, cowardice and immaturity now dominate almost all societies because the elites are deceitful, cowardly and immature.

But for those open to reading thoughts they may differ with, here is the case for why the worldwide lockdown is not only a mistake but also, possibly, the worst mistake the world has ever made. And for those intellectually challenged by the English language and/or logic, “mistake” and “evil” are not synonyms. The lockdown is a mistake; the Holocaust, slavery, communism, fascism, etc., were evils. Massive mistakes are made by arrogant fools; massive evils are committed by evil people.

The forcible prevention of Americans from doing anything except what politicians deem “essential” has led to the worst economy in American history since the Great Depression of the 1930s. It is panic and hysteria, not the coronavirus, that created this catastrophe. And the consequences in much of the world will be more horrible than in America.

The United Nations World Food Programme, or the WFP, states that by the end of the year, more than 260 million people will face starvation — double last year’s figures. According to WFP director David Beasley on April 21: “We could be looking at famine in about three dozen countries. … There is also a real danger that more people could potentially die from the economic impact of COVID-19 than from the virus itself” (italics added).

That would be enough to characterize the worldwide lockdown as a deathly error. But there is much more. If global GDP declines by 5%, another 147 million people could be plunged into extreme poverty, according to the International Food Policy Research Institute.

Foreign Policy magazine reports that, according to the International Monetary Fund, the global economy will shrink by 3% in 2020, marking the biggest downturn since the Great Depression, and the U.S., the eurozone and Japan will contract by 5.9%, 7.5% and 5.2%, respectively. Meanwhile, across South Asia, as of a month ago, tens of millions were already “struggling to put food on the table.” Again, all because of the lockdowns, not the virus.

In one particularly incomprehensible act, the government of India, a poor country of 1.3 billion people, locked down its people. As Quartz India reported on April 22, “Coronavirus has killed only around 700 Indians … a small number still compared to the 450,000 TB and 10,000-odd malaria deaths recorded every year.”

One of the thousands of unpaid garment workers protesting the lockdown in Bangladesh understands the situation better than almost any health official in the world: “We are starving. If we don’t have food in our stomach, what’s the use of observing this lockdown?” But concern for that Bangladeshi worker among the world’s elites seems nonexistent.

The lockdown is “possibly even more catastrophic (than the virus) in its outcome: the collapse of global food-supply systems and widespread human starvation” (italics added). That was published in the left-wing The Nation, which, nevertheless, enthusiastically supports lockdowns. But the American left cares as much about the millions of non-Americans reduced to hunger and starvation because of the lockdown as it does about the people of upstate New York who have no incomes, despite the minuscule number of coronavirus deaths there. Or about the citizens of Oregon, whose governor has just announced the state will remain locked down until July 6. As of this writing, a total of 109 people have died of the coronavirus in Oregon.

An example of how disinterested the left is in worldwide suffering is made abundantly clear in a front-page “prayer” by a left-wing Christian in the current issue of The Nation: “May we who are merely inconvenienced remember those whose lives are at stake.”

“Merely inconvenienced” is how the Rev. Dr. William J. Barber II, a Protestant minister and president of the North Carolina NAACP, describes the tens of millions of Americans rendered destitute, not to mention the hundreds of millions around the world rendered not only penniless but hungry. The truth is, like most of the elites, it is Barber who is “merely inconvenienced.” Indeed, the American battle today is between the merely inconvenienced and the rest of America.

Michael Levitt, professor of structural biology at Stanford Medical School and winner of the 2013 Nobel Prize in chemistry, recently stated, “There is no doubt in my mind that when we come to look back on this, the damage done by lockdown will exceed any saving of lives by a huge factor.”

To the left, anyone who questions the lockdown is driven by preference for money over lives. Typical of the left’s moral shallowness is this headline on Salon this week:

“It’s Time To Reject the Gods of Commerce: America Is a Society, Not an ‘Economy,'” with the subhead reading, “America Is About People, Not Profit Margins.”

And, of course, to smug editors and writers of The Atlantic, in article after repetitive article, the fault lies not with the lockdown but with President Donald Trump. The most popular article in The Atlantic this week is titled “The Rest of the World Is Laughing at Trump.” The elites can afford to laugh at whatever they want. Meanwhile, the less fortunate — that is, most people — are crying.

SOURCE 

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The Unintended Consequences of COVID-19 Lockdowns

There will be much still to learn when COVID-19 has passed. Books will certainly be written questioning the knee-jerk authoritarian response from most governments. Opinions championing a more modest approach to future pandemics are already emerging, even as this one continues to smolder. Dr. Michael Ryan, the WHO’s executive director for health emergencies, recently praised the Swedish government’s response, which largely resisted wide-scale shutdowns. Calm, rational heads will increasingly wonder if this situation should have been handled differently.

The financial devastation from forced lockdown will likely outlast the pandemic itself. While unfortunate (to put it mildly), most have argued that it has been necessary. The prevailing wisdom is that governments must choose either physical or economic health for citizens during this difficult time. Apparently, we cannot manage both ourselves. But believing that government actions have been justified also requires one to suspend reality and imagine that COVID-19 occurs in a vacuum. It requires one to pretend that nothing else factors into health and well-being. While the heavy hand of government has been intended to quell cases of COVID-19, it’s certainly worthwhile to examine the collateral damage directly resulting from its actions.

The pandemic has negatively impacted oncology services worldwide. Elective screening procedures (colonoscopies, mammograms, etc.) have been cancelled by government order. Naturally, this has led to a decrease in new cancer diagnoses. Obviously, new cancers haven’t stopped arising, but thousands of them have been neglected over the past few months. Those delays in diagnosis will equal delays in treatment. Even some patients with known cancers have experienced delays in therapy. A study from the University College London and the Health Data Research Hub for Cancer reports that in England and Northern Ireland, admissions for chemotherapy have fallen 45–66 percent and urgent referrals for early cancer diagnosis are down 70–89 percent, compared to pre-COVID-19 levels. Ominously, they predict that “Under conservative assumptions of the emergency affecting only people with newly diagnosed cancer … the model estimated 6,270 excess deaths at 1 year in England and 33,890 excess deaths in the US.”

It’s important to note that most of these deaths both here and abroad will be from delays in diagnosis and/or therapy, not COVID-19 infection. When considering total cancer patients living in England, they project the number of excess deaths could be up to 18,000 in that country alone. Dr. Alvina Lai, the lead author, claims the study demonstrates “the serious potential for unintended consequences of the response to the Covid-19 pandemic, which may negatively impact on patients with cancer and other underlying health conditions.”

Perhaps the greatest harm from this pandemic comes from the toll on mental health.

Oncology patients are not the only ones being negatively affected by shelter-in-place edicts. Visits to pediatricians are also down, according to the American Academy of Pediatrics. In an effort to decrease exposure to SARS-CoV-2, children are missing routine vaccinations. Data from the Physicians Computer Company (an electronic medical record company focusing on pediatric settings) shows that, across the U.S., “The number of vaccines administered for diseases including measles, mumps, whooping cough and HPV each dropped by at least 40% during the week of April 5, compared to a week in February of this year.” Dr. Eileen Costello, a pediatrician and the chief of ambulatory pediatrics at Boston Medical Center, claims that her center’s clinic volume was down approximately 80 percent last month. She fears that “We’ll be having pertussis and measles outbreaks in a couple months, which are going to be way more devastating.” Generally speaking, COVID-19 infections in children are asymptomatic. The desire to keep them from becoming asymptomatic carriers is valid, but if the end result is an increase in fatal (yet preventable) childhood illnesses, should this be considered a win?

Perhaps the greatest (and most difficult-to-measure) harm from this pandemic comes from the toll on mental health. During this time of financial ruin and forced isolation, it’s logical to expect that rates of depression and suicide will increase. The Disaster Distress Helpline, a service of the Substance Abuse and Mental Health Services Administration (SAMHSA), has reportedly seen an 891 percent increase in call volume when comparing March 2020 to March 2019. The psychological harm that accompanies bankruptcy and related crises cannot be understated. Dr. Glenn Sullivan, a clinical psychologist and professor of psychology at the Virginia Military Institute, warns, “If the U.S. [suicide] rate jumps in the same manner it did after the 1929 stock market crash, then … 2021 could see more than 54,000 deaths by suicide (versus about 48,000 in 2018). The 6,000 excess deaths … would be additional victims of the coronavirus emergency and its economic impact.”

Out of supposed necessity, heads of state in the U.S. and abroad have admittedly been picking winners and losers on the economic front. Will they ever admit that, indirectly, they have been choosing winners and losers on the health-care front, as well? Whether it’s a missed mammogram, a missed vaccine, or a suicide attempt spawned from forced bankruptcy, these are not trivial matters. In fact, some peoples’ economic and physical health are being greatly harmed by the government’s heavy hand during this time. The exact amount and scope of the collateral damage will only be known in hindsight. Unfortunately, the unintended consequences will be significant. With government serving as referee, this game may end up with more losers than winners.

SOURCE 

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‘Fear Is The Problem’: Stanford’s Dr. Scott Atlas Defends Reopening Stance

Dr. Scott Atlas, senior fellow at Stanford’s Hoover Institution and the former chief of neuroradiology at Stanford University Medical Center, defended his position, in the wake of rising model numbers, that Americans should reopen the country.

Atlas originally made national news after his column, “The Data Is In — Stop The Panic And End The Total Isolation,” was published at The Hill and went viral last month. In it, the Stanford doctor cites several facts currently “being ignored by those calling for continuing the near-total lockdown,” along with evidence behind each.

Before his introduction on Monday night’s “The Story with Martha MacCallum,” Fox News host Martha MacCallum pointed out “unsettling data” that points to “a very big jump” in predicted U.S. deaths by August.

“Do these rising models change anything about your headline, that we need to stop panicking about this?” she asked.

“No, in fact they underscore some of the very things I was saying and they reveal a lot of, again, the same sort of misconception about models,” Atlas responded before pointing out that such models “change all the time.”

However, he said the most “important point” is that “nothing has changed here.”

“We should look at the evidence,” he said. “We don’t need to rely on hypothetical projections. We have a ton of evidence, and the evidence is consistent all over the world that we know the fatality rate is much lower than what the models were based on originally.

“We know that we have flattened, the curves have been flattened and the curves, to note, are not the numbers of cases. The only curves that count are the deaths per day and the hospitalizations per day and when you take all that into account, including the very important things that are catastrophically destructive about total isolation, you come to the same conclusion that I and many, many people all over the world support,” he continued.

Atlas called the notion that current reopenings are driving any spike today “completely false.”

“If you open the doors today and you have deaths in three days, there is no correlation there,” said the Stanford researcher. “It takes 23 to 30 days on roughly average to have somebody [go] from getting the infection to dying. When the number of deaths goes up in three days in the state opening their doors, there is no correlation whatsoever. That’s just a false conclusion to be made.”

After making an argument for protecting nursing homes and regulating sanitation and hygiene in certain areas, Atlas called fear the “real contagion.” (RELATED: Staying In Place Is ‘Actually Harmful’: Stanford’s Scott Atlas Makes The Case For Herd Immunity)

“There is a new standard evolving from this, but you can’t really make policy based on fear and catastrophic projections and this is another thing that’s actually harming, even things like the food supply chain,” Atlas said. “It’s the fear that’s the real contagion here. The fear is the problem.”

Atlas finished the interview by criticizing the logic behind keeping schools closed by saying there is “little, if any risk” to those under 18 who emerging research may show are even “less likely to transmit the disease.”

SOURCE 

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For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH,  POLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

Email me  here (Hotmail address). My Home Pages are here (Academic) or  here  (Personal).  My annual picture page is here.  Home page supplement

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Under This Doctor’s Care, Most COVID-19 Patients Are Recovering. Here’s His Unusual Approach

One of the biggest hurdles in dealing with a pandemic caused by a completely new virus is grappling with the sheer amount of unknown information.

In the case of the novel coronavirus, SARS-CoV2, this was particularly difficult because the presentation of each patient seemed so vastly different from the previous case.

Furthermore, many patients seemed to improve clinically before deteriorating, requiring an admission to the intensive care unit for weeks at a time. The pernicious behavior of the virus made pandemic response that much more difficult, and the unpredictable nature of the disease consumed and strained health care resources.

Physicians who were treating COVID-19 patients took note and communicated to others by phone call, conference, or social media, but there was no central repository for their experiences, which ensured that the virus spread much faster than information.

Now, approximately four months since the first reported case in America, we are beginning to understand why.

Dr. Thomas Yadegar, a critical care physician for 20 years and now director of the intensive care unit at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California, has been on the front lines of the pandemic response.

The first time one of his patients deteriorated, he was completely stumped for the first time in his two decades in the ICU.

Many of his patients were in acute respiratory distress. But many other patients were experiencing abnormal coagulation, inflammatory heart disease, and some were even experiencing neurological deficits and weakened muscles.

“I have 20 years of critical care experience, and I can’t explain what just happened to my patient,” Yadegar said.

One evening after an exhausting shift, he sat down and pored over patient charts for all those cases, searching for a common thread. Finally, after one of the worst headaches of his life, he found it.

It was inflammation.

Early in the pandemic, Yadegar’s unit used treatment guidelines that came from doctors around the world, which recommended avoiding anti-inflammatory treatment and recommended early and aggressive use of ventilators to prevent patients from declining further.

But those guidelines were aimed at treating a severe viral respiratory disease by using a ventilator to assist with oxygenating the blood while the body uses its inflammatory pathways to mount a response to the virus.

Those guidelines did not address the treatment for when other organ systems began to fail.

In fact, using a ventilator is a highly invasive procedure, and the repeated and forced inspiration of air irritates the lungs, which feeds back into the inflammatory cycle. Many patients, once on a ventilator, never recover.

The only way to explain the highly complex disease course that seems to change from one patient to the next is that the virus is causing an autoimmune response, in which the body’s natural defense mechanisms go haywire and begin destroying the body they’re trying to protect.

The disease course is so unpredictable because every person’s immune system is unique to that person.

This phenomenon is not unheard of, and a common virus, Epstein-Barr virus, is known for potentially initiating the body’s inflammatory pathways to attack the nervous system and causing Guillain-Barre syndrome.

The main difference with SARS-CoV2 is that it’s much more efficient at doing this—and often in a catastrophic manner.

Yadegar and the ICU he manages have adjusted their protocols. Now, patients who test positive in his hospital for SARS-CoV2 are not sent home immediately, but tested for inflammatory markers.

Those with elevated inflammatory markers are kept in the hospital with a close eye on their oxygen saturation levels. If the patient begins to desaturate, the medical team evaluates the patient before starting a course of steroids and an IL-6 inhibitor.

IL-6 (interleukin-6) is a powerful mediator for the inflammatory pathway, so an IL-6 inhibitor would prevent a significant amount of inflammation from happening. Steroids have strong anti-inflammatory effects and also suppress the immune system more broadly.

The two of those do not treat the virus, but the potentially deadly autoimmune response it can cause.

But Yadegar cautioned that “you have to treat each patient within their own protocol.” Doctors must always treat the patients in front of them and cannot simply rely on these types of drugs for all critically ill COVID-19 patients.

That’s because using an IL-6 inhibitor with steroids would effectively strip the body of its immune response. If there’s a concomitant infection, which is extremely common in the hospital setting and even more so if a patient is on a ventilator, then using this combination of drugs will, almost certainly, kill the patient.

Still, Yadegar and his team have had remarkable success. They have not put a patient on a ventilator in at least two weeks, and the mortality rate in their ICU has been in the single digits, whereas nationally the mortality rate of critically ill patients has been between 40% and 70%.

There’s one thing we have known from the start about the COVID-19 virus, which is that it’s a tricky and pernicious one.

One of the important things that Yadegar has learned is that patients admitted to the ICU are often not coming in due to the direct effect of the virus, but rather from the out-of-control autoimmune process.

Information like that can only be had from front-line clinicians, and we should do our best to ensure they are heard.

The Centers for Disease Control and Prevention periodically hosts a Clinical Outreach and Communication Activity, in which clinicians are able to discuss their findings and experiences.

The CDC should be using those frequently to update information about COVID-19 and its multiple disease manifestations and to make the information easily and publicly accessible.

Furthermore, the CDC should be actively seeking this information from the front lines of COVID-19 hot spots, where the most relevant data will be found.

With steps like these, clinicians can be assured of clear lines of communication that may help drive down mortality rates in the future and ease the process of reopening the country.

SOURCE 

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Critically-ill coronavirus patient with 'very grim' outlook is saved after NHS doctors gave him promising arthritis drug that is being trialed worldwide

A critically-ill coronavirus patient was saved after getting a promising arthritis drug that is being trialled by doctors worldwide.

Leonard Whitehurst was admitted to the Royal Cornwall Hospital on March 16 with a confirmed case of COVID-19.

Over the course of his stay, his condition deteriorated until his prognosis was 'very grim', according to medics who treated him.

One of the 72-year-old's doctors decided to give him tocilizumab on compassionate grounds, after it showed promise in treating COVID-19 patients in Italy.

Tocilizumab, marketed as RoActemra or Actemra, is used to suppress the immune system of rheumatoid arthritis patients.

For COVID-19, it has the potential to stop the 'cytokine storm' that happens when the immune system goes into overdrive and starts attacking the body.

As soon as Mr Whitehurst was given the drug as a last-ditch attempt, his condition began improving. He is now recovering at home.

Dr Giorgio Gentile believes he is the first to have tried the arthritis drug in the UK back in March following the advice of worldwide doctors.

Now, tocilizumab is part of three major trials involving British patients - with the first results expected by June or July.

Dr Gentile, a consultant nephrologist from Italy, has worked at the Royal Cornwall Hospitals Trust since 2015, having moved here with his family.

He revealed that Mr Whitehurst needed 19 litres of oxygen but had not been put on a ventilator.

Dr Gentile said: 'Leonard was deteriorating quickly and escalation to intensive care for ventilation was not an option.

'As the patient wasn't prepared to be artificially ventilated, the outlook was very grim.

'I was desperate to try to save the patient. To me, tocilizumab seemed like the only viable option left to try and save his life.'

Dr Gentile had been regularly reviewing the medical literature of COVID-19 that was coming out from countries which battled the peak of their outbreaks before the UK.

He also maintained regular contacts with his network of colleagues involved on the frontline against COVID-19 in Italy - the only European country to record more deaths than the UK.

Doubts have been raised about the safety of tocilizumab, which has a long list of side effects including a cough or sore throat, blocked or runny nose, headaches or dizziness, mouth ulcers, high blood pressure, weight gain and stomach problems.

Tocilizumab has been shown to increase the risk of infections in patients with rheumatoid arthritis, including pneumonia and upper respiratory tract infections, according to Versus Arthritis.

Trials on patients with RA before approval were not designed to assess long-term efficacy and safety.

The Food and Drug Administration has received reports on 1,128 people who died after taking Actemra, according to a report by Stat News in 2017. It said the FDA declined to comment about Actemra.

Dr Gentile had become aware of multiple anecdotal reports of people in very severe conditions who had dramatically improved after treatment with tocilizumab.

'The AIFA, which is the Italian equivalent of the Medicines and Healthcare products Regulatory Agency, had just approved a large trial with tocilizumab and was actively recruiting people,' added Dr Gentile.

'The Italian experience seemed to mirror a preliminary yet promising experience from Chinese scientists, who used tocilizumab in 21 patients with very encouraging results.'

Another promising study of 20 patients in China, published in mid-March, claimed tocilizumab cured 95 per cent of critically ill patients.

Dr Gentile said: 'Our patient had all the laboratory signs of the so-called "cytokine storm", which I was aware of thanks to a paper published in the peer-reviewed journal, The Lancet.

'The same paper speculated that tocilizumab could be used to treat patients with severe COVID-19 pneumonia and hyper-inflammation, who are at high risk of progression towards acute respiratory distress syndrome and death.

'Luckily, we have brave, compassionate and open-minded leadership here at the RCHT. They gave me the green light to use tocilizumab on compassionate grounds. 'The patient agreed to receive the treatment, which was then quickly administered.'

The other drugs being looked at as a treatment for COVID-19 include a combination of Lopinavir and Ritonavir (known by the brand name Kaletra), which is used to treat HIV; low-dose Dexamethasone,a steroid used to reduce inflammation; azithromycin, a commonly used antibiotic which may have antiviral properties; and the steroid Tocilizumab.

Mr Whitehurst received two infusions of tocilizumab 12 hours apart from nurses.

Before the infusion, his oxygen saturation was 75 per cent. A normal reading should be between 80 and 100.

After the infusion, Mr Whitehurst's clinical conditions and his oxygen saturation improved very quickly, and then kept improving gradually and steadily over the subsequent days.

His oxygen requirement decreased gradually over time.

'At the time, we were at the very beginning of the COVID-19 crisis in the UK and the national lockdown had just been declared. So, it is quite possible that the RCHT has been the first NHS trust in the UK to successfully treat a patient with tocilizumab,' added Dr Gentile.

Mr Whitehurst was discharged from hospital last week 'smiling and overjoyed', having spent more than a month in the hospital.

Dr Gentile stressed that although tocilizumab worked for his patient, further evidence from rigorous randomised controlled trials is necessary to fully establish the role of the drug in COVID-19 pneumonia.

SOURCE 

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For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH,  POLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

Email me  here (Hotmail address). My Home Pages are here (Academic) or  here  (Personal).  My annual picture page is here.  Home page supplement

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Funeral Directors Blow the Whistle on Deaths Falsely Attributed to Coronavirus

“Basically, every death certificate that comes across our desk now has COVID on it,” said a funeral director in Williston Park, N.Y., on a recorded phone call with Project Veritas in a newly-released video. James O’Keefe has been asking for people inside the medical system to blow the whistle if they see corruption or inconsistencies in reports about the Chinese WuFlu known as COVID-19. In conversations with several funeral directors across New York City, O’Keefe uncovered a shocking narrative where, without fail, every director he spoke to expressed his or her concern that coronavirus deaths are being inflated and every death in NYC is being recorded as a COVID death with or without testing to confirm.

“They are putting COVID on a lot of death certificates because people who are going to their hospital with any kind of respiratory distress, respiratory problems, pneumonia, the flu — the flu-like symptoms lead into the COVID-19,” said Joseph Antioco of Schafer Funeral Home. “To me, all you’re doing is padding the statistics. You’re putting people on that have COVID-19 even if they didn’t have it. You’re making the death rate for New York City a lot higher than it should be.”

One funeral director talked about a family who is related to an unnamed Supreme Court Justice who insisted on a private autopsy that discovered their relative did not have COVID-19. “I had one that was autopsied because the sister was famous, and apparently, and I don’t know who the Supreme Court Justice is, but the Supreme Court Justice was related to this family, and she says I know my sister didn’t die of COVID-19,” said Josephine Dimiceli of Dimiceli & Sons Funeral Home. “She said she had Alzheimer’s and they didn’t suction her. You have to suction because they forget how to swallow. And right away they put down COVID-19 on her death certificate, and the Supreme Court justice, whoever it is, contacted the hospital. They did an independent autopsy; bingo. No COVID-19.”

Dimiceli had other shocking tales to share. One nursing home assumed all its patients were positive without testing. “The guy that I just buried a little while ago from Long Island National Cemetery, they called me from the nursing home. They said, ‘Did Raymond have COVID-19?’ She said, ‘Well, no. It was a failure to thrive. But we’re assuming they all have it.’ And I’m all, ‘Why would you assume? Why aren’t they all in the hospital?’ She had no answer. ‘I can’t answer you,’ she said. They put it down on Raymond’s death certificate,” said Dimiceli. “He didn’t have COVID-19.”

There are several more funeral directors with similar stories.

SOURCE 

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Coronavirus: ‘Flattening the curve’ to eliminate COVID-19 could be dangerous, researchers say

No one can say for sure how the pandemic will unfold, but our lives will certainly be changed for the foreseeable future.
New research suggests “flattening the curve” may not be the most effective way to fight the COVID-19 pandemic.

A team of international researchers, led by Peking University Professor Liu Yu, have projected that the “flatten the curve” approach could destroy economies while having not enough of an effect on cutting infections.

“The turning point will never come, the peak value of case numbers will remain the same as if there are no such measures,” the team said in a non-peer-reviewed paper released last week. “We strongly suggest they reconsider.”

WHAT DOES THE RESEARCH SAY?

“Flattening the curve” refers to shutting down non-essential businesses and issuing social distancing measures to ensure that a country’s health system can cope with the number of infections and deaths.

The research, first reported on by the South China Morning Post, looked at daily infections, the geographical spread of the disease, economic output and public transport to assess the effectiveness of social restriction policies on flattening the curve.

They found that only a few countries, including South Korea, Qatar, Norway and New Zealand, have been able to stop the spread with minimum disruption to the economy.

Others, like the United States, Britain, France, Italy and Spain, have suffered major blows to their economies while also struggling with soaring infections and death rates.

They found that China’s “elimination” strategy was most effective at suppressing the virus, but was unsustainable due to its heavy impact on the economy. In other words, “flattening the curve” produces too little but costs too much.

The researchers suggested that the disruption to the economy and social life did not align with the reduction in cases.

“This choice still incurs 20-60 per cent loss of economic output, but only achieves a 30-40 per cent reduction in the number of cases, an extent which is insufficient to overturn the epidemic curve,” the researchers said. “Our results show that this is usually the worst scenario in terms of cost-effectiveness.”

But the basis of the research has been questioned. Jaymie Meliker, professor of public health with the Stony Brook University in New York, said the research failed to put a value on each life lost to COVID-19. “I could not find how much they estimate a life is worth in their cost benefit model,” he told the SCMP.

“If the hospitals are overrun and more people are dying because of that, then we need to quantify that cost for a cost-benefit model. “That is needed for us to be able to evaluate the pros and cons of the different containment strategies.”

SO DOES THAT MEAN WE SHOULD LIFT THE VIRUS RESTRICTIONS?

In short, no it doesn’t.

Australia’s response to COVID-19 is proof that social distancing measures do work. The latter half of March saw virus cases increase more than ten-fold, from 376 cases on March 16 to over 4500 by the end of that month. Social distancing rules came into effect on March 21, and the case rate has been declining since the beginning of April.

On April 22, Australia recorded just four cases nationally, with several states recording zero new cases.

The researchers acknowledged that simply removing social restrictions, as US President Donald Trump has suggested, would be a dangerous way to go.

They warned relaxing lockdown measures without ramping up infection control capacity could prove disastrous and see countries’ death tolls skyrocket.

The solution, they said, is to only relax lockdowns while rapidly increasing testing and patient isolation.

The good news is that this is similar to Australia’s next move.

Prime Minister Scott Morrison has repeatedly stressed there are three criteria points that need to be met before our social restrictions will be lifted: increased testing, contact tracing and greater ability to respond to local outbreaks.

“If you're going to move to an environment where there are fewer restrictions, then you need these three things in place,” he said at an earlier press conference.

Even so, easing the lockdown will not be considered for a few more weeks.

“National Cabinet agreed that we will use the next four weeks to ensure that we can get these in place.”

Australia’s deputy chief medical officer Dr Nick Coatsworth explained that eliminating the virus was not a realistic option.

He told the ABC on Wednesday that Australia was “in a pivotal moment” of the fight against the pandemic, but that we cannot become complacent.

He said social restrictions will need to remain in place “for at least another three weeks to May 11” but “easing restrictions would, by definition, mean some of those numbers (of cases) could change”.

“Businesses and individuals need to prepare, though, that physical distance from one another will need to keep going,” Dr Coatsworth said.

“Great hand hygiene and cough etiquette will need to keep going, because we won’t have a vaccine. So, while some restrictions may be lifted, the way we behave has to stay the same.”

He rejected the notion that Australia could “eliminate” the virus.

“I’m using the word ‘suppression’,” Dr Coatsworth said. “I’ll tell you why I’m doing that. The problem with using words like ‘elimination’ and ‘eradication’ is that we are a non-immune population.

“So, you have to be so sure that you’ve got to that point that you would need to extend your restrictions for so long to get to that point, that I think that that would lead to Australians having to be under social restrictions for too long to get there. That’s an honest view.

“If, in the process of suppressing, we get to the point of eradication, then that would be a magnificent outcome. But we must continue to build capacity and we must continue to contain the virus, and remember that we’re not immune from it. So, the word that — the strategy that we’re using — is to ‘suppress’ COVID-19 until there’s a vaccine.”

SOURCE 

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Study: Nearly all NY coronavirus patients suffered underlying health issues

A new study by a medical journal revealed that most of the people in New York City who were hospitalized due to coronavirus had one or more underlying health issues.

Health records from 5,700 patients hospitalized within the Northwell Health system -- which housed the most patients in the country throughout the pandemic -- showed that 94 percent of patients had more than one disease other than COVID-19, according to the Journal of the American Medical Association (JAMA).

Data taken from March to early April showed that the median age of patients was 63 years old and 53 percent of all coronavirus patients suffered from hypertension, the most prevalent of the ailments among patients.

In addition, 42 percent of coronavirus patients who had body mass index (BMI) data on file suffered from obesity while 32 percent of all patients suffered from diabetes.

The study also revealed that the overwhelming majority of patients who were on ventilators eventually died, and those who did more often had diabetes.

Data gathered from 2,634 patients who either died or were discharged from the hospital showed that 12 percent of them were placed on ventilators and of those who were, 88 percent of them died.

“Having serious comorbidities increases your risk,” said Karina Davidson, one of the study’s authors and senior vice president for the Feinstein Institutes for Medical Research, which is part of the Northwell Health system, according to reports by Time.

“This is a very serious disease with a very poor outcome for those who have severe infections from it. We want patients with serious chronic disease to take a special precaution and to seek medical attention early, should they start showing signs and symptoms of being infected. That includes knowing that they’ve been exposed to someone who has this virus.”

SOURCE 

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Governors Provide a Liberty vs. Tyranny Contrast 

Governors were in the driver’s seat in terms of setting policies for stay-at-home orders, and they will be the ones deciding when those orders end and Americans can begin getting back to normal. The federalist system America’s Founders designed is as brilliant now as it was then, in part because everyone’s able to see the comparisons and contrasts across the nation.

All but five states issued some level of stay-at-home order, and many of those orders will remain in effect well into May, if not longer. Some orders are more restrictive than others. New York is encouraging citizens to snitch on other citizens for not abiding by restrictions. Some states are monitoring citizens with Chinese-made drones. Others are cracking down on Christians meeting in parking lots.

As we noted last week, Michigan Democrat Gov. Gretchen Whitmer’s orders are so tyrannical that residents are protesting in the streets. She insists that makes her more likely to extend the orders. Protests have also flared up in Ohio, Minnesota, Virginia, Wisconsin, and elsewhere.

Likely thinking at least partly of Whitmer, who has been floated as a possible running mate for Joe Biden, President Donald Trump observed, “Some governors have gone too far. Some of the things that have happened are maybe not so appropriate.” Effectively ordering stores to rope off certain sections to prevent sales of items Whitmer deems nonessential is definitely an example of something being “maybe not so appropriate.”

It’s not just governors. House Majority Whip James Clyburn infamously said of last month’s massive relief bill that it was “a tremendous opportunity to restructure things to fit our vision.”

In short, one thing the pandemic has revealed is the authoritarian impulses of many politicians. Well before corona-anything was heard of, some governors, legislators, and bureaucrats — all egged on by a complicit news media — were already geared toward exercising control over the citizenry. The pandemic merely gave them “justification” for things they maybe couldn’t do previously.

Arguably the most revealing quote came from New Jersey Democrat Gov. Phil Murphy, who said of his shutdown order, “I wasn’t thinking of the Bill of Rights when we did this.”

It’s still too soon to give a true evaluation of the actions we’ve taken as a nation, but it will serve us well to contrast the heavy-handed crackdowns in Democrat-run states with the easier approach of many Republican-run ones

SOURCE 

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For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH,  POLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

Email me  here (Hotmail address). My Home Pages are here (Academic) or  here  (Personal).  My annual picture page is here.  Home page supplement

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The Unseen Death Toll of COVID-19 Measures

The accumulating death toll from COVID-19 can be seen minute-by-minute on cable news channels. But there’s another death toll few seem to care much about: the number of poverty-related deaths being set in motion by deliberately plunging millions of Americans into poverty and despair.

In the first three weeks since governors began shutting down commerce in their states, 17 million Americans filed for unemployment, and according to one survey, one quarter of Americans have lost their jobs or watched their paychecks cut. Goldman Sachs predicts that the economy will shrink 34 percent in the second quarter, with unemployment leaping to 15 percent.

Until the COVID-19 economic shut-down, the poverty rate in the United States had dropped to its lowest in 17 years. What does that mean for public health? A 2011 Columbia University study funded by the National Institutes of Health estimated that 4.5 percent of all deaths in the United States are related to poverty. Over the last four years, 2.47 million Americans had been lifted out of that condition, meaning 7,700 fewer poverty-related deaths each year.

It’s a good bet these gains have been completely wiped out, and it’s anyone’s guess how many tens of millions of Americans will have been pushed below the poverty line as governments destroy their livelihoods. It’s also a good bet the resulting deaths won’t get the same attention.

And that doesn’t count an unknown number of Americans whose medical appointments have been postponed indefinitely while hospitals keep beds open for COVID-19 patients. How many of the 1.8 million new cancers each year in the United States will go undetected for months because routine screenings and appointments have been postponed? How many heart, kidney, liver, and pulmonary illnesses will fester while people’s lives are on hold? How many suicides or domestic homicides will occur as families watch their livelihoods evaporate before their eyes? How many drug and alcohol deaths can we expect as Americans stew in their homes under police-enforced indefinite home detention orders? How many new cases of obesity-related diabetes and heart disease will emerge as Americans are banished from outdoor recreation and instead spend their idle days within a few steps of the refrigerator?

I have participated in many discussions among top policymakers in Congress and the Administration over the last few weeks. Such considerations are rarely raised and always ignored. Instead, policymakers fixate on epidemiological models that have already been dramatically disproven by actual data.

On March 30, Drs. Deborah Birx and Anthony Fauci gave their best-case projection that between 100,000 and 200,000 Americans will perish of COVID-19 “if we do things almost perfectly.” As appalling as their prediction seems, it is a far cry from the 200,000 to 1.7 million deaths the CDC projected in the United States just a few weeks before. And even their down-sized predictions look increasingly exaggerated as we see actual data.

Sometimes the experts are just wrong. In 2014, the CDC projected up to 1.4 million infections from African Ebola. There were 28,000.

Life is precious and every death is a tragedy. Yet last year, 38,800 Americans died in automobile accidents and no one has suggested saving all those lives by forbidding people from driving – though surely we could.

In 1957, the Asian flu pandemic killed 116,000 Americans, the equivalent of 220,000 in today’s population. The Eisenhower generation didn’t strip grocery shelves of toilet paper, confine the entire population to their homes or lay waste to the economy. They coped and got through. Today we remember Sputnik – but not the Asian flu.

It’s fair to ask how many of those lives might have been saved then by the extreme measures taken today. The fact that the COVID-19 mortality curves show little difference between the governments that have ravaged their economies and those that haven’t, suggests not many.

The medical experts who are advising us are doing their jobs – to warn us of possible dangers and what actions we can take to mitigate and manage them. The job of policymakers is to weigh those recommendations against the costs and benefits they impose. Medicine’s highest maxim offers good advice to policymakers: Primum non nocere -- first, do no harm.

SOURCE 

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Boss of tiny Oxford firm is 'extremely optimistic' over one-a-day pill it has developed to combat coronavirus

A tiny British company could beat the world’s pharmaceutical giants in the race to defeat Covid-19 after developing a one-a-day pill that is as convenient as aspirin.

Thousands of scientists at the world’s drug giants are battling to find ways of combating coronavirus, but experts at BerGenBio, a British-Norwegian company with just 38 staff, believe they have found the key.

Their bemcentinib drug, originally developed for cancer, defends against coronavirus by stopping it from entering cells and preventing it ‘switching off’ one of the body’s most important antiviral defence mechanisms.

Bemcentinib has been fast-tracked to be tried on NHS hospital patients in Government-backed trials, one of only a dozen or so drugs to be picked.

Last night, BerGenBio chief executive Richard Godfrey told The Mail on Sunday that he was ‘extremely optimistic’ the pill would save lives. ‘I think there’s an 80 per cent probability of it working and being of benefit to patients,’ he said.

When US drugs firm Gilead last week announced that tests of its antiviral treatment remdesivir helped patients recover four days earlier from the virus, stock markets in the US and Asia soared.

But the impact on death rates is less clear, with eight per cent of those given it dying, against 11 per cent of those who did not get the drug. The difference was not big enough for scientists to be sure it was having an effect.

But Mr Godfrey said of bemcentinib: ‘I’m expecting something bigger because it’s so different to anything else that’s been tried. We are stopping the virus surviving.’

 When the drug was used in the laboratory on live SARS-Cov-2 – the coronavirus that causes Covid-19 – it showed ‘some very big effects that dwarf what I’ve seen’ from other drugs, said Mr Godfrey.

‘So I’m extremely optimistic and think there’s going to be something quite profound [in human trials].’

Two-thirds of BerGenBio’s staff are based in Oxford, with the rest in Bergen, Norway.

Mr Godfrey said the drug had been tested on 300 cancer patients, had a good safety record and was relatively easy to manufacture.

It works by stopping the virus from utilising a naturally occurring protein called AXL, which it uses to trick cells to allow it entry. The virus also uses the protein to cut production of interferon, the body’s own antiviral substance.

The drug should stop coronavirus ‘hijacking’ AXL, making it harder for it to replicate and leaving it more vulnerable to the immune system.

The first of the 120 trial patients is due to be given the drug at Southampton General Hospital in the next few days. Results are expected at the end of June.

SOURCE 

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Incredible scenes at Michigan Capitol as anti-lockdown protesters armed with rifles storm Senate gallery while lawmakers wearing BULLETPROOF VESTS vote against extending Gov. Gretchen Whitmer's state of emergency

Lawmakers were seen wearing bulletproof vests as armed protesters stormed Michigan's Capitol in Lansing just moments before the state's House of Representatives denied Gov Gretchen Whitmer's request to extend her state of emergency. 

Photos from inside the Michigan House Chamber showed elected officials wearing bulletproof vests while men holding guns stood above them.

'Directly above me, men with rifles yelling at us. Some of my colleagues who own bullet proof vests are wearing them. I have never appreciated our Sergeants-at-Arms more than today,' Sen Dayna Polehanki tweeted Thursday afternoon.

In Michigan, guns are permitted inside the state's Capitol as long as they are visible and carried with lawful intent.

Protesters, who weren't wearing masks, were seen yelling within inches of officers from the Michigan State Police.

Others were heard chanting: 'Let us in! Let us in!'

The 'American Patriot Rally' which was organized by Michigan United for Liberty, drew in hundreds of residents who carried pro-Trump banners and held anti-Whitmer signs while protesting outside of the Capitol.

Demonstrators began descending on the Capitol at 9am Thursday morning while lawmakers were trying to decide whether to extend Whitmer's state of emergency request for 28 more days. 

Ultimately, the lawmakers denied the governor's request and passed a resolution authorizing the Speaker of the House to commence legal action, which will challenge the governor's actions during the pandemic. Whitmer is unable to veto the resolution. 

Whitmer has acknowledged that her order was the strictest in the country.

Protesters, many from more rural, Trump-leaning parts of Michigan, have argued it has crippled the economy statewide even as the majority of deaths from the virus are centered on the southeastern Detroit metro area.

Organizers of a mid-April protest in Michigan took credit when Whitmer recently rolled back some of the most controversial elements of her order, such as bans on people traveling to their other properties.

Whitmer's stay-at-home order is set to continue through May 15, though she has said she could loosen restrictions as health experts determine new cases of COVID-19 are being successfully controlled.

On Wednesday, she said the construction industry could get back to work starting May 7

The slow reopening of state economies around the country has taken on political overtones, as Republican politicians and individuals affiliated with Trump's re-election promoted protests in electoral battleground states, such as Michigan.

SOURCE 

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Almost 18,000 more people could die of cancer due to coronavirus, study shows

Research has shown that amid the crisis, one in 10 people would not contact their GP even if they discovered a lump or a new mole that remained for a week

There could also be a 20 per cent spike in fatalities of newly-diagnosed cancer patients, according to research by University College London (UCL) and DATA-CAN, the Health Data Research Hub for Cancer.

The figures stem from real-time hospital data for urgent cancer referrals and chemotherapy attendances, which have experienced a 76 per cent and 60 per cent fall respectively.

While England’s top cancer doctor has urged people to not hesitate in seeking help or being checked.

The advice from Professor Peter Johnson, the NHS clinical director for cancer, comes after worrying research showed nearly half of the public have concerns about seeking help.

Moreover, the poll by Portland revealed one in 10 people would not contact their GP even if they discovered a lump or a new mole that remained for a week or more.

After analysing data from 3.5 million patients, experts predicted before the Covid-19 crisis that approximately 31,354 newly-diagnosed cancer patients would die within a year in England.

But the pathogen could lead to at least 6,270 extra deaths in newly-diagnosed cancer patients — a rise of more than 20 per cent.

While the figure jumps further to 17,915 excess deaths if all people currently living with cancer are included.

There have been 21,678 fatalities from the virus at the time of writing, including more than 100 NHS staff and care home workers.

The main reasons for the increased likelihood that the public would ignore symptoms stems from a fear of contracting the virus itself by leaving quarantine.

There is also the selfless feeling from some that notifying their GP would further burden the NHS during this unprecedented time, though this has been rebuffed by Professor Johnson, who insists the opposite may be true if the public fail to seek help.

“NHS staff have made huge efforts to deal with coronavirus but they are also working hard to ensure that patients can safely access essential services such as cancer checks and urgent surgery,” said Professor Johnson.

“From online consultations to the roll-out of cancer treatment hubs, we are doing all we can to make sure patients receive the life-saving care that they need.

“We know that finding cancer early gives us the best chance to cure it, and ignoring potential problems can have serious consequences now or in the future.”
SOURCE 

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For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH,  POLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

Email me  here (Hotmail address). My Home Pages are here (Academic) or  here  (Personal).  My annual picture page is here.  Home page supplement

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Five facts that suggest lockdown is a mistake

The tragedy of the Covid-19 pandemic appears to be entering the containment phase. Tens of thousands of Americans have died, and Americans are now desperate for sensible policymakers who have the courage to ignore the panic and rely on facts. Leaders must examine accumulated data to see what has actually happened, rather than keep emphasizing hypothetical projections; combine that empirical evidence with fundamental principles of biology established for decades; and then thoughtfully restore the country to function. Five key facts are being ignored by those calling for continuing the near-total lockdown.

Fact 1: The overwhelming majority of people do not have any significant risk of dying from Covid-19. The recent Stanford University antibody study now estimates that the fatality rate if infected is likely 0.1 to 0.2 percent, a risk far lower than previous World Health Organization estimates that were 20 to 30 times higher and that motivated isolation policies.

In New York City, an epicenter of the pandemic with more than one-third of all U.S. deaths, the rate of death for people 18 to 45 years old is 0.01 percent, or 10 per 100,000 in the population. On the other hand, people aged 75 and over have a death rate 80 times that.

For people under 18 years old, the rate of death is zero per 100,000. Of all fatal cases in New York state, two-thirds were in patients over 70 years of age; more than 95 percent were over 50 years of age; and about 90 percent of all fatal cases had an underlying illness. Of 6,570 confirmed Covid-19 deaths fully investigated for underlying conditions to date, 6,520, or 99.2 percent, had an underlying illness. If you do not already have an underlying chronic condition, your chances of dying are small, regardless of age. And young adults and children in normal health have almost no risk of any serious illness from COVID-19.

Fact 2: Protecting older, at-risk people eliminates hospital overcrowding. We can learn about hospital utilization from data from New York City, the hotbed of Covid-19 with more than 34,600 hospitalizations to date. For those under 18 years of age, hospitalization from the virus is 0.01 percent, or 11 per 100,000 people; for those 18 to 44 years old, hospitalization is 0.1 percent. Even for people ages 65 to 74, only 1.7 percent were hospitalized. Of 4,103 confirmed Covid-19 patients with symptoms bad enough to seek medical care, Dr. Leora Horwitz of NYU Medical Center concluded “age is far and away the strongest risk factor for hospitalization.” Even early WHO reports noted that 80 percent of all cases were mild, and more recent studies show a far more widespread rate of infection and lower rate of serious illness.

Half of all people testing positive for infection have no symptoms at all. The vast majority of younger, otherwise healthy people do not need significant medical care if they catch this infection.

Fact 3: Vital population immunity is prevented by total isolation policies, prolonging the problem. We know from decades of medical science that infection itself allows people to generate an immune response – antibodies – so that the infection is controlled throughout the population by “herd immunity.”

Indeed, that is the main purpose of widespread immunization in other viral diseases – to assist with population immunity. In this virus, we know that medical care is not even necessary for the vast majority of people who are infected. It is so mild that half of infected people are asymptomatic, shown in early data from the Diamond Princess ship, and then in Iceland and Italy.

That has been falsely portrayed as a problem requiring mass isolation. In fact, infected people without severe illness are the immediately available vehicle for establishing widespread immunity. By transmitting the virus to others in the low-risk group who then generate antibodies, they block the network of pathways toward the most vulnerable people, ultimately ending the threat. Extending whole-population isolation would directly prevent that widespread immunity from developing.

Fact 4: People are dying because other medical care is not getting done due to hypothetical projections. Critical health care for millions of Americans is being ignored and people are dying to accommodate “potential” Covid-19 patients and for fear of spreading the disease. Most states and many hospitals abruptly stopped “nonessential” procedures and surgery. That prevented diagnoses of life-threatening diseases, like cancer screening, biopsies of tumors now undiscovered and potentially deadly brain aneurysms. Treatments, including emergency care, for the most serious illnesses were also missed. Cancer patients deferred chemotherapy. An estimated 80 per cent of brain surgery cases were skipped. Acute stroke and heart attack patients missed their only chances for treatment, some dying and many now facing permanent disability.

Fact 5: We have a clearly defined population at risk who can be protected with targeted measures. The overwhelming evidence all over the world consistently shows that a clearly defined group – older people and others with underlying conditions – is more likely to have a serious illness requiring hospitalization and more likely to die from Covid-19. Knowing that, it is a commonsense, achievable goal to target isolation policy to that group, including strictly monitoring those who interact with them. Nursing home residents, the highest risk, should be the most straightforward to systematically protect from infected people, given that they already live in confined places with highly restricted entry.

The appropriate policy, based on fundamental biology and the evidence already in hand, is to institute a more focused strategy like some outlined in the first place: Strictly protect the known vulnerable, self-isolate the mildly sick and open most workplaces and small businesses with some prudent large-group precautions. This would allow the essential socializing to generate immunity among those with minimal risk of serious consequence, while saving lives, preventing overcrowding of hospitals and limiting the enormous harms compounded by continued total isolation. Let’s stop underemphasising empirical evidence while instead doubling down on hypothetical models. Facts matter.

SOURCE 

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Coronavirus patients can’t relapse, South Korean scientists believe

South Korean scientists have concluded that coronavirus patients cannot relapse after recovering from the disease, despite hundreds of recovered people testing positive again.

The new findings suggest that rather than indicating reinfection, the positive results were caused by shortcomings in the standard virus test. They will greatly reassure governments threatened by the nightmarish prospect of a never-ending cycle of infection and reinfection.

Positive test results on people who had tested negative were the result of “fragments” of the virus lingering in their bodies, but with no power to make them or ill or to infect others, according to South Korea’s central clinical committee for emerging disease control.

A total of 277 patients appeared to have relapsed

SOURCE 

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The forgotten Trump

Liz Crokin

Donald Trump is a racist, bigot, sexist, xenophobe, anti-Semitic and Islamophobe -- did I miss anything?....Yup: he is also deplorable. The left and the media launch these hideous kinds of attacks at Trump every day; yet, nothing could be further from the truth about the real estate mogul.

As an entertainment journalist, I've had the opportunity to cover Trump for over a decade, and in all my years covering him I've never heard anything negative about the man until he announced he was running for president. Keep in mind, I got paid a lot of money to dig up dirt on celebrities like Trump for a living, so a scandalous story on the famous billionaire could've potentially sold a lot of magazines and would've been a Yuge feather in my cap.

Instead, I found that he doesn't drink alcohol or do drugs. He's a hardworking businessman.

On top of that, he's one of the most generous celebrities in the world, with a heart filled with more gold than his $100 million New York penthouse.

Since the media has failed so miserably at reporting the truth about Trump, I decided to put together some of the acts of kindness he's committed over three decades which have gone virtually unnoticed or fallen on deaf ears.

 *  In 1986, Trump prevented the foreclosure of Annabell Hill's family farm after her husband committed suicide. Trump personally phoned down to the auction to stop the sale of her home and offered the widow money. Trump decided to take action after he saw Hill's pleas for help in news reports.

 *  In 1988, a commercial airline refused to fly Andrew Ten, a sick Orthodox Jewish child with a rare illness, across the country to get medical care because he had to travel with an elaborate life-support system. His grief-stricken parents contacted Trump for help and he didn't hesitate to send his own plane to take the child from Los Angeles to New York so he could get his treatment.

 *  In 1991, 200 Marines who served in Operation Desert Storm spent time at Camp Jejune in North Carolina before they were scheduled to return home to their families. However, the Marines were told that a mistake had been made and an aircraft would not be able to take them home on their scheduled departure date. When Trump got wind of this, he sent his plane to make two trips from North Carolina to Miami to safely return the Gulf War Marines to their loved ones.

 *  In 1995, a motorist stopped to help Trump after the limo he was traveling in got a flat tire. Trump asked the Good Samaritan how he could repay him for his help. All the man asked for was a bouquet of flowers for his wife. A few weeks later Trump sent the flowers with a note that read: We've paid off your mortgage.

 *  In 1996, Trump filed a lawsuit against the city of Palm Beach, Florida, accusing the town of discriminating against his Mar-a-Lago resort club because it didn't allow Jews and blacks. Abraham Foxman, who was the Anti-Defamation League Director at the time, said Trump put the light on Palm Beach not on the beauty and the glitter, but on its seamier side of discrimination. Foxman also noted that Trump's charge had a trickle-down effect because other clubs followed his lead and began admitting Jews and blacks.

 *  In 2000, Maury Povich featured a little girl named Megan who struggled with Brittle Bone Disease on his show and Trump happened to be watching. Trump said the little girl's story and positive attitude touched his heart. So he contacted Maury and gifted the little girl and her family with a very generous check.

 *  In 2008, after Jennifer Hudson's family members were tragically murdered in Chicago, Trump put the Oscar-winning actress and her family up at his Windy City hotel for free. In addition to that, Trump's security took extra measures to ensure Hudson and her family members were safe during such a difficult time.

 *  In 2013, New York bus driver Darnell Barton spotted a woman close to the edge of a bridge staring at traffic below as he drove by. He stopped the bus, got out and put his arm around the woman and saved her life by convincing her to not jump. When Trump heard about this story, he sent the hero bus driver a check simply because he believed his good deed deserved to be rewarded.

 *  In 2014, Trump gave $25,000 to Sgt. Andrew Tamoressi after he spent seven months in a Mexican jail for accidentally crossing the US-Mexico border. President Barack Obama couldn't even be bothered to make one phone call to assist with the United States Marine's release; however, Trump opened his pocketbook to help this serviceman get back on his feet.

 *  In 2016, Melissa Consin Young attended a Trump rally and tearfully thanked Trump for changing her life. She said she proudly stood on stage with Trump as Miss Wisconsin USA in 2005. However, years later she found herself struggling with an incurable illness and during her darkest days, she explained that she received a handwritten letter from Trump telling her she's the bravest woman, I know. She said the opportunities that she got from Trump and his organizations ultimately provided her Mexican-American son with a full-ride to college.

 *  Lynne Patton, a black female executive for the Trump Organization, released a statement in 2016 defending her boss against accusations that he's a racist and a bigot. She tearfully revealed how she's struggled with substance abuse and addiction for years. Instead of kicking her to the curb, she said the Trump Organization and his entire family loyally stood by her through immensely difficult times.

Donald Trump's kindness knows no bounds and his generosity has touched and continues to touch the lives of people from every sex, race, and religion. When Trump sees someone in need, he wants to help. Two decades ago, Oprah Winfrey asked Trump in a TV interview if he would run for president. He said: If it got so bad, I would never want to rule it out totally because I really am tired of seeing what's happening with this country.

That day has come.

Trump sees that America is in need and he wants to help. How unthinkable!

On the other hand, have you ever heard of Hillary Clinton or Barack Obama ever doing such things with their own resources?

Now that's really unthinkable!

SOURCE 

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IN BRIEF

Sanders and Biden reach convention compromise — the deal helps avoid a potentially messy intra-party fight over delegates (Politico)

Nearly 900 workers at Tyson Foods plant in Indiana test positive for coronavirus (Fox News)

Tiny airports rake in big cash after botched stimulus formula (Politico)

Narrative buster: My Native American father drew the Land O'Lakes maiden. She was never a stereotype. (Robert DesJarlait, The Washington Post)

Taiwan thankfully emerging from pandemic with a stronger hand against the ChiComs (Bloomberg)

Policy: Ten steps America should take now to respond to the China challenge (The Heritage Foundation)

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For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH,  POLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

Email me  here (Hotmail address). My Home Pages are here (Academic) or  here  (Personal).  My annual picture page is here.  Home page supplement

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