Sunday, May 03, 2020
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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Friday, May 01, 2020
Gilead trial reveals more than half of life-threateningly ill coronavirus patients treated with Ebola drug remdesivir go from relying on oxygen to leaving hospital in two weeks
A trial of the antiviral drug remdesivir has produced 'positive data' for treating coronavirus patients, its maker, Gilead Sciences, said Wednesday.
Gilead announced the results of a clinical trial testing the drug, which was originally developed to treat Ebola patients, in people severely ill with coronavirus.
Half of the 397 patients, who were sick enough to need additional oxygen, but not to be placed on ventilators, improved within 10 days of a five-day treatment course and those who were on a 10-day regimen were better by the eleventh day.
More than half of the patients were discharged from the hospital within two weeks, Gilead announced in a press release.
Meanwhile, Dr Anthony Fauci addressed reports of 'positive data' from the National Institutes of Health's (NIH) own trial of remdesivir in a pool meeting with President Donald Trump and Louisiana Governor John Bel Edwards, calling the findings 'very optimistic'.
The NIH trial is separate from Gilead's own, and details have not yet been officially released, though Dr Fauci said that eight percent in the remdesivir group died, compared to 11 percent in the placebo group.
Fauci added that the trial was proof 'that a drug can block this virus', and compared the finding to the arrival of the first antiretrovirals that worked against HIV in the 1980s, albeit with modest success at first.
The announcement of promising preliminary remdesivir results sent the Dow soaring by more than 500 points, though Gilead's own stocks were halted pre-trading ahead of the announcement of the trial's findings.
Remdesivir was developed by Gilead Sciences to treat Ebola, the deadly hemorrhagic fever that emerged in West Africa in 2014.
Remdesivir produced encouraging results earlier this year when it showed promise for both preventing and treating MERS - another coronavirus - in macaque monkeys.
The drug appears to help stop the replication of viruses like coronavirus and Ebola alike.
It's not entirely clear how the drug accomplishes this feat, but it seems to stop the genetic material of the virus, RNA, from being able to copy itself.
That, in turn, stops the virus from being able to proliferate further inside the patient's body.
NIH researchers in charge of the macaque study recommended that it move ahead to human trials with the new coronavirus.
Scientists have listened, and human trials for remdesivir first began in Nebraska.
Most recently, researchers trialing the drug at the University of Chicago reported that most of the 125 COVID-19 patients they'd treated with the drug had been discharged from the hospital, according to Stat News. Two patients died over the course of the trial.
Remdesivir has been among the top contenders of existing drugs being trialed for treating coronavirus, although World Health Organization documents leaked last week suggested it had failed to help patients in a more than 200-person trial recover.
Gilead defended the trial, saying it believed the leaked data was a 'mischaracterization' of the study's results. It's unclear whether the newly-announced results are from the same trial.
The NIH is also studying remdesivir in a randomized controlled trial of 400 patients, meaning about half of the group would take the Ebola antiviral, and the others would get a placebo drug.
In addition to the results of its own trial (which did not have a placebo arm, making its data less informative), Gilead hinted at promising results from the NIH trial.
Addressing these reports in a pool meeting at the White House, Dr Fauci said: 'So that's something that will go with 31 percent improvement, doesn't seem like a knock out, 100 percent, it is a very important proof of concept.
'This is very optimistic, the mortality rate trended towards being better in the sense of less deaths in the REM designate group. Eight percent versus eleven percent in the placebo group.
'So bottom line. You're going to hear more details about this this will be submitted to a peer reviewed journal, and will be peer reviewed appropriately.'
Timing mattered as well. People who were treated early - within 10 days of their first symptoms - fared better, with 62 percent being discharged from the hospital within 14 days.
But the trial's results suggest the drug may still be beneficial, even if given relatively late. Nearly half of those who received remdesivir 10 or more days after they developed symptoms were also released from the hospital by day 14.
Generally speaking, the drug appeared safe in the trial, regardless of the duration of the treatment course.
More than 10 percent of patients treated with the antiviral became nauseous, and six percent of the five-day treatment group and 10.7 percent of the 10-day treatment group were in acute respiratory failure (also a complication of the infection itself).
The greatest risk posed to the coronavirus patients treated with remdesivir was liver damage. Lab work showed enzyme build up in 7.3 percent of the patients. the risk of liver damage became great enough that three percent were removed from the trial.
SOURCE
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How Close Is US to Herd Immunity for COVID-19? What the Numbers Show
There has been considerable interest lately in Sweden’s response to the COVID-19 pandemic. According to Sweden’s top epidemiologist, Dr. Anders Tegnell, Sweden is expected to achieve herd immunity in several weeks’ time.
Sweden pursued a much more relaxed mitigation strategy, practicing social distancing while avoiding a national lockdown, and approximately 20% of Swedes may have been infected and may now be immune to the virus.
Herd immunity is the point at which a large enough percentage of the population is immune to a disease that new cases are not likely to spread to others.
In other words, it’s when there are enough people who are immune to the disease that the disease has nowhere to go and eventually dies off. Therefore, every person who has been infected and recovered, or infected and remained asymptomatic, will help contribute to herd immunity.
But how close are we to achieving this? Although several studies are suggesting that there are far more people with antibodies to the virus than we know of, it’s not clear that we are very close.
An earlier study of pregnant women found that 29 out of 33 women who tested positive for SARS-CoV-2 were asymptomatic at the time of the test, and 26 of them never developed any symptoms at all. That finding suggests that for every pregnant woman with symptomatic COVID-19, there were seven who were infected with the virus, but never developed the disease.
That also suggests that for every woman with symptomatic COVID-19, there may be up to four other women who were infected, but don’t show symptoms.
The study is difficult to generalize because the sample was small and because the study took place in New York City, where incidences are expected to be very high. Furthermore, women seem to be less susceptible to the COVID-19 disease, which would cause the numbers to overestimate the asymptomatic prevalence of SARS-CoV-2.
To get a better idea, the state of New York has been conducting antibody tests and announced preliminary results on April 23, which found that 13.9% of New York residents had the virus and recovered.
In New York City, that rate was up to 21.2%. In upstate New York, away from the metropolitan centers, the rate was much lower at 3.6%.
If those numbers bear out, approximately 2.6 million people have been infected in the state, including 1.7 million people in New York City.
As of this writing, the state’s health department is reporting that it has had 288,045 positive test results. Initial testing has focused on symptomatic patients, so the majority of the positive cases reported by the health department likely indicate a symptomatic case of COVID-19.
If that’s the case, there would be approximately nine asymptomatic infections for every symptomatic case of COVID-19. Granted, those are suppositions based on preliminary data that hasn’t been released in its entirety.
In one of the first complete antibody studies on prevalence, researchers from the Stanford University School of Medicine tested a representative sample of 3,330 people in Santa Clara County, California.
When adjusted by demographics to represent the county, it found that the estimated prevalence of the virus ranged from 2.49% to 4.16%, which would represent between 48,000 and 81,000 people.
If those estimates prove true, the actual prevalence in Santa Clara County would be 50 to 85 times greater than the number of confirmed cases.
However, some have raised issues with this study. The raw, unadjusted prevalence found in the study was 1.5%, representing 50 people testing positive for the antibody out of 3,330 study participants.
According to the manufacturer of the test, the false-positive rate for the test is 0.5%, which would correspond to 17 false-positives in this study. Based on that, a third of the positive results may in fact be false-positives, which would greatly inflate the estimated prevalence.
Still, the study of Santa Clara County echoes the studies from New York that suggest that actual prevalence of SARS-CoV-2 is likely much higher than the number of confirmed cases would lead us to believe (albeit likely not 50 to 85 times higher).
While Sweden’s 20% immunity corresponds to New York City’s estimated 21.2% immunity, the same is not true for the rest of the country.
There are nearly 1 million cases in the United States at this time, so even with the greatest estimated prevalence from the Santa Clara County study, there would be 85 million actual cases, each of which would result in a person being immune to the virus.
The obvious problem is that there are approximately 245 million Americans left to be infected.
Given that the Santa Clara County numbers are likely overstated even for the COVID-19 hot spot of Santa Clara, the actual number of Americans left to be infected is many tens of millions more than that.
Herd immunity is an unrealistic goal for the United States until there is a vaccine. Even if the virus proves to spread much faster than previously thought, that would only require a much larger proportion of Americans to get infected and develop immunity.
That’s not to say that we should hunker down until a vaccine comes, but rather that we should proceed with the assumption that we will not have herd immunity. That will require careful planning and deliberate steps, but it’s certainly possible.
SOURCE
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IN BRIEF
Andrew Cuomo's malfeasance: New York refused to send nursing home's COVID-19 patients to nearly empty and underutilized USNS Comfort, which is returning to Virginia (New York Post)
Senate Democrats — the same ones who feverishly castigated Brett Kavanaugh — refuse to acknowledge sexual-assault accusations against Joe Biden (The Daily Caller)
Former Hillary Clinton adviser calls on Biden to drop out: "We lose all moral authority" if we don't take Tara Reade seriously (The Daily Caller)
This week, Colorado, Mississippi, Minnesota, Montana, and Tennessee will get their economies rolling again, Reuters reports. Last week, it was Georgia, Oklahoma, Alaska, and South Carolina.
Better late than never (but still maybe too late for her political career): Michigan Gov. Gretchen Whitmer extends stay-at-home order while liberating state of draconian bans (The Federalist)
States face $500 billion shortfalls as Congress debates aid (Washington Examiner)
Trump calls reports he may fire HHS Secretary Alex Azar "fake news" (The Washington Post)
Navy recommends reinstating Brett Crozier, who was ousted as commander of the USS Theodore Roosevelt (Fox News)
How noble of them: Saudi Arabia bans flogging as criminal punishment (New York Daily News)
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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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Thursday, April 30, 2020
“We’re all looking for answers”
Dr. Robert Cerfolio says his “aha” moment came at the bedside of a COVID-19 patient, who seemed literally to be suffocating to death on his own mucus. After hearing the code for a cardiopulmonary arrest, Cerfolio had rushed into the unconscious patient’s room and pulled out the thin ventilator tube delivering air into his lungs, to find it stopped up with discharge that had hardened to the consistency of concrete.
“Why aren’t we doing a bronchoscopy?” Cerfolio called out, referring to a procedure where physicians snake a thin scope through the tube in a patient’s airwaves and suck out obstructions. “This guy’s not dying of COVID. He’s dying of an obstructed tube!”
It was the early days of the crisis in New York City back when NYU Langone Health still had only a handful of COVID-19 patients. (The hospital declined to give a current number more precise than “hundreds and hundreds.” ) The answer that came back from the doctors in attendance was not what Cerfolio expected to hear. We aren’t allowed to, they told him. The procedure, which involved threading a smaller tube into the respirator conduit and down into the airways—and then pulling it out—could “aerosolize” the virus, dispersing it through the room and possibly infecting all the front-line health care workers around it. Which is why statements instructing against the procedure had been issued by a wide range of surgical and medical professional organizations.
Cerfolio, a thoracic surgeon whose many titles at the sprawling New York City medical center included senior vice president, vice dean and chief of hospital operations, was one of the few NYU Langone medical personnel in a position to override the directive. He was also the past president of the Thoracic Surgeons association, one of the organizations that had come out in opposition to the technique.
Cerfolio overrode the guidance. The patient lived. And Cerfolio and his colleagues at NYU Langone developed a new protocol for protective equipment and other precautions for doctors willing to do the procedure. They have since performed bronchoscopies on hundreds of COVID-19 patients.
Luis Angel, one of Cerfolio’s colleagues, invented a new self-contained method for tracheostomies that can sometimes keep doctors from putting critically-ill patients on ventilators, which requires them to be put in a medically induced coma. The procedure, which requires incisions into the lower neck, is known to place health care providers at risk, but if safely performed allows doctors to use a bigger tube than is used for ventilation, one that is easier to clean.
NYU posted a video demonstrating the procedure and Cerfolio’s phone lines lit up.
“I’ve been called by the head of thoracic surgery at the main academic institution in Spain, I’ve talked to a guy in Italy and we’re doing the exact opposite of what they have done there—even a friend at another hospital called me and said, ‘I heard you guys are doing traches, what the hell you doing?’” Cerfolio says. “We’ve done 63 of these and not a single doctor or nurse has gotten sick—not one. Sixty-two of the patients are still alive. We know we can do it safely and we know we are helping patents.”
As COVID-19 washes over the United States, doctors in hotspots across the nation are still deciding how best to battle a mysterious and deadly disease scientists don’t yet fully understand. And while many are looking to the experience of health care providers in China and Europe, they are also racing to develop new procedures of their own and debating best approaches—often on the fly. In a fast-moving pandemic, there’s not always time to wait for medical journals to publish. And the flood of reading material is growing so vast it’s hard for many to track. So every day, clinicians around the world are helping each other as they find their way, trading and debating tips through social media, over conference calls and even over old medical school email chains. Doctors at Columbia University Medical Center are cautious about the Langone procedures. “The experience we have from China, Italy, Spain, and Iran shows an increased risk to healthcare workers performing airway procedures and caring for patients with tracheostomy,” says Dr. Susannah Hills, a surgeon. “It’s crucial to learn from other countries that have been dealing with this for longer than we have.”
On the other side of the nation, Dr. Tom Yadegar, a pulmonologist and medical director of the intensive care unit at Providence Cedars-Sinai Tarzana Medical Center in California, had his first “aha” moment when he got his first patients last month.
In those early days, he treated both a 60-year-old patient and an 80-something man, both of whom arrived stable, with good vitals, and normal X-rays, then spiraled into a rapid decline for seemingly no reason. Both ended up on ventilators, which drove Yadegar to the literature.
Through his research Yadegar realized that what he was seeing was a “cytokine storm,” a violent inflammatory reaction that often kills the sickest COVID-19 patients. Soon he identified several blood markers, like the levels of ferritin, a protein that contains iron, that seemed to predict which patients were most likely to develop the overactive immune response. He wrote up protocol guidelines for his staffto follow that have them sometimes administering immunosuppressant drugs normally used to avoid organ rejection to patients who seem likely to get in trouble.
“Up until a month ago, I didn’t know about cytokine storms,” he says. “I wasn’t looking for it. And then to treat it, you’re doing something that you probably have never done in your life, which is to give a patient in the ICU strong medications to suppress the immune system. It’s totally counterintuitive.”
Though similar protocols had previously been reported in China, Yadegar’s experience was the first time many of his local peers had heard of the approach. He estimates he’s kept three critically ill patients offof ventilators and removed three more as a result of the protocol. Now he is overseeing COVID-19 response in two affiliated area hospitals. Yadegar shared his experiences with 50 or so fellow graduates of USC Medical School on a weekly call coordinated by his old program director. He then was interviewed about his approach on Fox and Friends, which prompted a flood of inquiries from other caregivers across the nation. “This is such a new disease that all of us are struggling just trying to figure out what’s going on,” he says.
Through these kinds of discussions and experimentation, unexpected observations are emerging that could transform care in the months ahead. One of the more significant is the debate about when best to place patients on ventilators.
Dr. Scott Weingart, a critical care physician at Stony Brook University Hospital, one of the busiest COVID-19 hospitals on Long Island, recently made an observation that he was literally able to broadcast out to the world. The key metric used to move patients to respirators is “oxygen saturation,” which measures how much oxygen is being held in a patient’s blood. Usually, when a patient receiving oxygen through a normal mask can’t get above 80 percent, doctors assume the lungs are compromised and the patient needs to be intubated. But Weingart was noticing that patients at levels that guidelines told him needed immediate ventilation weren’t behaving like patients who were suffocating. Many, though short of breath, were able to speak in complete sentences, give full medical histories and were even cheerful—a state he and his colleagues call “happy hypoxia.”
Although Weingart couldn’t explain the discrepancy, he began to suspect some unknown characteristic of the virus was distorting the results. He began second-guessing the protocols.
“These levels are at numbers that would scare the hell out of us before this,” he says. “But when we started holding off on putting those breathing tubes in and used simple measures like making the patient roll over in bed like you do every night while sleeping, all of a sudden there is a cohort, a group of these patients that didn’t wind up needing the breathing tube.”
Weingart, who hosts a popular podcast and blog followed by tens of thousands of ER doctors and critical care doctors, shared his experience on air and online—and heard from scores of others around the world who were noticing the same thing.
The finding is significant. Not just because it saves ventilators for sicker patients but because in order to go on a ventilator, the patient must be put in a medically induced coma, and there is anecdotal evidence that the pressure exerted by mechanical breathing machines can be injurious to the lungs of COVID-19 patients, Weingart says.
“Supportive care and watchful waiting have worked out in a lot of these COVID-19 patients, as opposed to what I call a knee-jerk response to sticking a tube down their throats,” he says.
For physicians just now seeing their first patients— or still waiting for the full brunt of the pandemic to hit their areas—the experiences of frontline providers like Weingart, Yadegar and Cerfolio are proving invaluable. Sometimes the tips are as simple as telling conscious patients in the hallways to lie on their stomachs, instead of their backs, which results in more effective oxygen delivery to the lungs involved in air-blood transfer. Some are learned through hard experience, such as that the use of the blood thinner heparin seems to help prevent potentially deadly blood clots in patients with a body mass index greater than 40, who seem to be at greater risk of dying. (Both additional modifications were recently adopted at NYU Langone). But the tips can also prove logistical.
In the weeks before she saw her first cases, Michelle Diaz, an ER physician who works at hospitals across New Hampshire through her company EMstaff, tuned in regularly to Weingart’s podcast and others like it where she learned about the changing views on the timing of intubation. She also picked up numerous tips about what to expect and how best to prepare for it through an email chain that had previously been used to announce baby births by colleagues she had met while doing her residency back in the late aughts at Brooklyn’s Kings County Hospital.
“One day somebody wrote that their hospital was still quiet and asked how everybody else was doing, and people just started posting stuff,” Diaz recalls. “People are just sharing their experience, they are saying, ‘I’ve seen this kind of clinical course, I tried this way of helping their oxygenation.’ But also people are sharing ideas about what they’re doing at their hospital to help with the volume and manage flow—‘we have a tent set out over here and we have this personnel over there.’”
For physicians seeing their first patients, the experiences of frontline doctors is proving invaluable. Diaz even learned how to convert a wall oxygen outlet into a makeshift ventilator if she were to run out of equipment. “It’s been really helpful to see these ideas being exchanged,” she says. “It’s not just informative, it’s inspiring.”
SOURCE
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Do Lockdowns Save Many Lives? In Most Places, the Data Say No.
Do quick shutdowns work to fight the spread of Covid-19? Joe Malchow, Yinon Weiss and I wanted to find out. We set out to quantify how many deaths were caused by delayed shutdown orders on a state-by-state basis.
To normalize for an unambiguous comparison of deaths between states at the midpoint of an epidemic, we counted deaths per million population for a fixed 21-day period, measured from when the death rate first hit 1 per million—e.g.,‒three deaths in Iowa or 19 in New York state. A state’s “days to shutdown” was the time after a state crossed the 1 per million threshold until it ordered businesses shut down.
We ran a simple one-variable correlation of deaths per million and days to shutdown, which ranged from minus-10 days (some states shut down before any sign of Covid-19) to 35 days for South Dakota, one of seven states with limited or no shutdown. The correlation coefficient was 5.5%—so low that the engineers I used to employ would have summarized it as “no correlation” and moved on to find the real cause of the problem. (The trendline sloped downward—states that delayed more tended to have lower death rates—but that’s also a meaningless result due to the low correlation coefficient.)
No conclusions can be drawn about the states that sheltered quickly, because their death rates ran the full gamut, from 20 per million in Oregon to 360 in New York. This wide variation means that other variables—like population density or subway use—were more important. Our correlation coefficient for per-capita death rates vs. the population density was 44%. That suggests New York City might have benefited from its shutdown—but blindly copying New York’s policies in places with low Covid-19 death rates, such as my native Wisconsin, doesn’t make sense.
Sweden is fighting coronavirus with common-sense guidelines that are much less economically destructive than the lockdowns in most U.S. states. Since people over 65 account for about 80% of Covid-19 deaths, Sweden asked only seniors to shelter in place rather than shutting down the rest of the country; and since Sweden had no pediatric deaths, it didn’t shut down elementary and middle schools. Sweden’s containment measures are less onerous than America’s, so it can keep them in place longer to prevent Covid-19 from recurring. Sweden did not shut down stores, restaurants and most businesses, but did shut down the Volvo automotive plant, which has since reopened, while the Tesla plant in Fremont, Calif., was shuttered by police and remains closed.
How did the Swedes do? They suffered 80 deaths per million 21 days after crossing the 1 per million threshold level. With 10 million people, Sweden’s death rate‒without a shutdown and massive unemployment‒is lower than that of the seven hardest-hit U.S. states—Massachusetts, Rhode Island, Louisiana, Connecticut, Michigan, New Jersey and New York—all of which, except Louisiana, shut down in three days or less. Despite stories about high death rates, Sweden’s is in the middle of the pack in Europe, comparable to France; better than Italy, Spain and the U.K.; and worse than Finland, Denmark and Norway. Older people in care homes accounted for half of Sweden’s deaths.
We should cheer for Sweden to succeed, not ghoulishly bash them. They may prove that many aspects of the U.S. shutdown were mistakes—ineffective but economically devastating—and point the way to correcting them.
SOURCE
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IN BRIEF
Trump lays out new coronavirus testing "blueprint" as states weigh reopening (NBC News)
U.S. District Judge Roger Benitez tosses California's "onerous and convoluted" ammunition purchase law (AP)
24th Judicial Circuit Judge Judge F. Patrick Yeatts says Gov. Ralph Northam's gun-range shutdown violates state law (The Washington Free Beacon)
Two more people come forward to corroborate account of Joe Biden accuser (Bongino.com)
Michael Flynn files court documents with evidence he was "deliberately set up" by the FBI (The Daily Wire)
Senate will return on May 4 to start Phase 5 coronavirus relief bill (The Hill)
New York cancels Democrat presidential primary, angering Bernie Bros (The New York Times)
Policy: Ending the lockdowns isn't about saving money. It's about saving lives. (Mises Institute)
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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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Wednesday, April 29, 2020
How sunlight may help us fight coronavirus
People with low levels of Vitamin D are almost twice as likely to get the extreme lung infections that are now killing COVID-19 patients.
Even before the pandemic, acute respiratory tract infections have been a major killer. They were responsible for 2.8 million deaths worldwide in 2015.
In Neale’s review, which encompassed 78,000 participants, it was found that those with low levels of vitamin D — the “sunshine vitamin” — were almost twice as likely as those with high vitamin D levels to get the type of extreme lung infections that now are killing COVID-19 sufferers, and they were even more likely again to be sicker for longer.
And so how does this translate to the pandemic? “Now, more than ever, is not the time to be vitamin D deficient,” Neale says from Brisbane’s QIMR Berghofer Medical Research Institute. “It would make sense that being vitamin D deficient would increase the risk of having symptomatic COVID-19 and potentially having worse symptoms. And that’s because vitamin D seems to have important effects on the immune system.”
Neale was speaking before US President Donald Trump weighed in with his comments last week about disinfectant and ultraviolet light being used to combat the virus. And, as bizarre as it may seem, there is reason to think the President is on to something, at least as far as the sunlight goes.
It’s a message that people seem innately to understand. The carpark at my local beach has been more full in recent weeks than it usually is in the middle of summer school holidays. People are out there soaking it all up, feeling sorry for all those city folk denied access to their shimmering sands, not even allowed to sunbake in parks.
For all vitamin D’s advantages, Neale doesn’t take vitamin D pills. She is cognisant of the emerging evidence that the sun provides more benefits than just the sunshine vitamin.
Those other benefits are varied. Dermatologist Richard Weller from the University of Edinburgh discovered more than a decade ago that the body got a shot of a molecule called nitric oxide when exposed to sunlight. He has been curious about the notion that nitric oxide and sunlight may have some effect on COVID-19.
Nitric oxide has been shown to cause blood vessels to widen, increasing oxygen flow and lowering blood pressure. The discovery of its role in the human body paved the way for Viagra.
“There are mechanistic reasons to think about benefit,” says Weller. “Ultraviolet light (which produces nitric oxide in the skin) lowers blood pressure and also markers of diabetes. Both of these are risk factors for death from COVID-19.” He points out that most viral infections wax and wane with the seasons, probably because of ultraviolet light, not heat.
The story of nitric oxide goes back to the 1990s when it was a hot molecule that won three scientists the Nobel prize. At that time, Goran Hedenstierna had a PhD student at Sweden’s Uppsala University who was among the first in the world to show that if you gave humans nitric oxide when they were suffering from severe constriction of the lungs, the lungs relaxed and oxygen levels normalised. During the severe acute respiratory syndrome outbreak of 2003-04, Hedenstierna had another student, Luni Chen, who wanted to go back to her home country, China, to see if nitric oxide worked to help patients dying of acute respiratory failure from that coronavirus.
“She went there in May 2003 when it was a most severe situation,” recalls Hedenstierna, Skyping from Sweden. “I organised things to be shipped — ventilators and bottles of nitric oxide gas. It took a lot of organising with the local authorities because it was a major intrusion on their crisis.”
Chen managed to get the nitric oxide treatment to six patients and she had eight in a control group receiving placebo. Five of the six who received nitric oxide were on ventilators when the study began. Only one was still on it by the end. Chest X-rays showed their lung congestion improved. One died.
Whereas in the control, six were on ventilators at the beginning and five were still being ventilated at the end. The X-rays showed only two improved, three stayed the same and three worsened. Two died.
The study was only small but Hedenstierna was surprised at the strength of the results. “We most often do see an improvement of oxygenation of 20 per cent or more in people with acute respiratory failure, but these SARS patients, they increased their PAO (the ratio of oxygen in the blood to oxygen that is breathed) almost threefold. I have never seen this big an increase. We never discussed that to any extent at that time.”
To understand why nitric oxide appeared so devastatingly effective against SARS, Hedenstierna was involved in a further study in a high-security lab in Brussels where it was shown that nitric oxide killed the SARS virus in a test tube.
“It had an antiviral effect which was what we had hoped to see in view of the improved chest X-rays. So it’s helping the patient breathe and it’s killing the virus,” he says.
The way forward
Such results are now being picked up. Nitric oxide, this molecule we produce naturally with sunshine, has been used by doctors in Italy with success to help COVID-19 patients, but not in a study format. A trial of 240 COVID-19 patients is up and running in Sweden, the US and Austria.
Weller says the doses of nitric oxide the patients will receive are much greater than what you could get from sunlight. But the other half of the equation is whether people catch the disease in the first place. He is running a study to see what effects UV radiation has on the flu because there’s still not enough data on COVID-19. “I hope that our epidemiological studies will show whether it (sunshine) makes any difference at population level.”
One of Weller’s collaborators, Prue Hart from Perth’s Telethon Kids Institute, has spent a career pursuing matters of immunity and ultraviolet light and vitamin D. She isn’t so sure that UV light will have a direct effect on the novel coronavirus.
“I think the greater benefits of UV radiation during this pandemic are about our brain health,” she says. “We all know how good we feel after time in the sun, and these good feelings cannot be replaced by vitamin D from a bottle. Now that it is autumn, and the sun is not so intense and burning, I think everyone should be encouraged to get exposed to more sun, as long as they never get sunburnt. In addition, whilst outside getting a little bit more sunshine, they will be exercising.”
She says while the link between sunshine, endorphins, serotonin and mood have been known for years, in 2018 Chinese researchers proved another important piece of the mental puzzle involving a molecule called urocanic acid that resides in the outermost layer of the skin. The researchers proved that after giving shaved mice the equivalent of 30 minutes of sunshine, urocanic acid was released from the skin into the blood, then crossed the blood brain barrier and went into almost all parts of the brain. In the brain, it is involved in making glutamate — the brain’s most abundant “excitatory neurotransmitter” — which has long been known to play an important role in learning and memory.
“This is another reason time outside in the sun is important for children who are now doing online learning at home,” Hart says. Food for thought as police shoo sunbathers out of parks and arrest people lying on beaches.
And it certainly will encourage Neale to continue with her five-to-10 minute routine of midday Brisbane sun. “I personally think the best way of getting vitamin D is sun exposure because we get the other benefits that might be there, but I accept there is a role for pills for people who can’t get out,” she says, adding that she always takes care not to burn.
SOURCE
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'It's a horror movie.' Nurse working on coronavirus frontline in New York claims the city is 'murdering' COVID-19 patients by putting them on ventilators and causing trauma to the lungs
A frontline nurse working in New York on coronavirus patients claims the city is killing sufferers by putting them on ventilators.
'It's a horror movie,' she said through a friend. 'Not because of the disease, but the way it is being handled.'
And she said relatives of the sick need to make it clear as soon as a person is taken to the hospital that they do not want them hooked up to the breathing machines.
The nurse, who has relocated to New York temporarily to help with the city's COVID-19 crisis, persuaded a friend — a nurse practitioner who is not working on coronavirus patients — to make the video for her in order to tell the world what she says is happening inside hospitals.
'I am her voice here. I'm going to tell you what she has told me,' said the nurse practitioner, who was identified only as Sara NP. 'She wants this to get out.'
'She has never seen so much neglect. No one cares. They are cold and they don't care anymore. It's the blind leading the blind.'
'People are sick, but they don't have to stay sick. They are killing them, they are not helping them,' added the friend in the video posted on YouTube.
'She used the word murder, that coming from a nurse who went to New York City expecting to help. 'Patients are left to rot and die — her words. People are being murdered and no one cares.'
Sara would not reveal which hospital the nurse is working in 'for the safety of those involved.'
More than 12,000 people have died from the virus in New York City, with another 4,300 dying in other parts of the Empire State, which is a far larger number than any other state in the country.
Republican Minnesota state Senator Scott Jensen told Fox News' Laura Ingraham that Medicare pays hospitals three times as much if patients are placed on ventilators.
'How can anyone not believe that increasing the number of COVID-19 deaths may create an avenue for states to receive a larger portion of federal dollars,' Jensen later posted on his Facebook page.
New York Governor Andrew Cuomo has said that around 80 percent of people who go on the machines die, although he's referencing patients who were already in dire conditions before being put on the machines.
This is not the first time the use of ventilators have been questioned for its efficacy.
In a YouTube video posted earlier this month New York emergency room doctor Cameron Kyle-Sidell said: 'I've talked to doctors all around the country and it is becoming increasingly clear that the pressure we're providing may be hurting their lungs.
'It is highly likely that the high pressures we're using are damaging the lungs of the patients we are putting the breathing tubes in.
'It's not our fault. We didn't know,' added Kyle-Sidell, saying that is the way other acute respiratory syndromes have been treated.
'We are running the ventilators the wrong way,' he said, calling for the protocols to be changed.
'COVID positive patients need oxygen, they do not need pressure. They will need ventilators, but they must be programmed differently.'
Kyle-Siddell did not return calls from DailyMail.com. He told Medscape on April 6 he stepped down from working in the intensive care unit at Maimonides Medical Center in Brooklyn because he didn't want to follow the hospital's ventilator protocol.
'I could not morally, in a patient-doctor relationship, continue the current protocols which, again, are the protocols of the top hospitals in the country. 'I could not continue those,' he said. 'You can't have one doctor just doing their own protocol.'
Maimonides also did not answer a request for comment.
Sara said COVID-19 patients are placed on ventilators rather than less invasive CPAP or BiPAP machines due to fears about the virus spreading.
She said: 'The patients don't know any better. They don't have family with them. There is no one there with them to advocate for them. So they are scared, and they give consent.
'The ventilators have high pressure, which then causes barotrauma, it causes trauma to the lungs', adding that the best way to survive is to 'buck the system.'
'Your loved one is not going to have you in there advocating for them once they go in, you're not allowed in. 'Do not give consent for intubation if you don't want to be intubated or for your loved one to be intubated… As soon as you give that consent, you might not come out of it.'
And she said if there is a specific medication — such as the hydroxychloroquine that President Donald Trump has touted, the best thing to do is lie.
'A tip from inside the system — if you want a medication to be given, you've got to report that it's an at-home medication, and that you demand that it be continued.'
Sara claimed patients who stop breathing are not resuscitated — again due to fear of the virus spreading. 'Full code, not doing compressions, family is not there. They have no one to answer to. No one is being held accountable.'
She said there are other problems in the 'crappy' hospital where her friend is working, such as lack of personal protective equipment.
'They stay in the same PPE all shift, except for the top pair of gloves… they're only changing the gloves on the outside.'
They keep the same gowns and masks on because the theory is that all patients on a COVID-19 floor will already have the virus. But she says that is faulty logic as some are there to see if the coronavirus can be ruled out.
'So even if they're rule-out COVID and they're not COVID they're going to get COVID because they're using the same PPE all shift and they're carrying that contamination to all of the patients
And she claimed some nurses who have been brought to New York are sitting in hotels never being called.
'Yet they're still understaffed and there are hundreds of people, hundreds of nurses in the hotels waiting to be called on to a shift. So there is manpower enough if the goal were to actually save people, but resources are not being utilized properly or to full capacity in a way that maximizes the patient benefit or improves the outcomes.'
The nurse practitioner also criticized some of the nurses who are risking their own health to treat COVID-19 patients.
'We have nurses being celebrated as heroes who are killing people,' she said.
'They're not heroes, and they're being brainwashed to think they're doing something great just by going to work because they're brave enough to go to work.
'But what are you doing at work? You're certainly not saving people if you're not even running codes. You're not even going into patients' rooms. You're a coward. You're hurting people, you're killing them, you're contributing to the problem.
The nurse practitioner said she knows she will receive hate messages for her comments. 'Frankly, I don't care because this could save someone's life.'
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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Tuesday, April 28, 2020
If Sweden is so wrong to keep pubs open why is its health chief's face the tattoo everyone wants?
Children are still in school, bars and restaurants are open, as are garden centres and shops; crowds of up to 50 are allowed, and no one is chastised for sunbathing, sitting on park benches or daring to flee to countryside boltholes.
It is a strategy aimed at allowing some exposure to the disease to build immunity among the general population, while protecting the vulnerable and ensuring hospitals are not overwhelmed.
But the country’s light touch has incurred criticism. Sweden has a reputation as a ‘moral superpower’ and commentators seize upon any death-toll spike as evidence of a foolhardy gamble that risks lives for the sake of the economy.
Sweden considers the big picture, though, and argues that part of its policy is aimed at preventing an economic crash, as mass unemployment will have dire health consequences. For example, after the 2009 debt crisis, suicides in Greece increased by up to 40 per cent.
But many Swedes feel as if outsiders enduring lockdown are willing them to fail. ‘It makes you defensive,’ says Anglo-Swede Alex McBeath, who works at the Tudor Arms. ‘I’m cautiously optimistic about the future. I support the way we have approached the crisis.’
So does the majority of the country. Anders Tegnell, 63, state epidemiologist with the Public Health Agency of Sweden and the architect of its Covid-19 response, fronts daily press conferences. Inevitably, he receives online vitriol.
Yet he is so popular that some in Stockholm have had his face inked on to their arms and legs. Tattooist Zashay Tastas, who designed the image, says: ‘Tegnell has become the face of Sweden’s approach. This is the first time a real nerd is being idolised.’
Or as Dr Tegnell himself puts it: ‘It is the first time in history that an epidemiologist has been considered famous.’ He modestly notes, however, that he is just one of 15 experts meeting daily to analyse data and make recommendations.
But have Dr Tegnell and his colleagues got it wrong? Is managing coronavirus impossible without a lockdown?
Sweden has recorded 2,192 deaths, more than twice as many as neighbouring Denmark, but it has almost twice the population, at ten million. In Britain, the toll has topped 20,000. So far Sweden has defied forecasts saying that, unless it changed course, it would suffer 50,000 to 180,000 deaths.
Arne Elofsson, a biologist at Stockholm University, initially estimated that the nation’s health system would be quickly swamped, but now concedes: ‘It appears the epidemic is plateauing and that the catastrophic scenarios predicted by some will never appear in Sweden.’
Dr Tegnell is cautious by nature but declares himself ‘satisfied’ the strategy appears to be working, even if there are some things he would have done differently, especially in care homes.
Nationally, the number of new cases rose sharply last week – due mainly to increased testing – and stands at 18,177. Most are in Stockholm and its suburbs, with very small numbers in the thinly populated areas elsewhere.
Every country, one way or another, has to reach herd immunity so the chains of transmission break, says Dr Tegnell. He believes Stockholm could do so in weeks – but acknowledges he doesn’t have all the answers as so much about the virus is still unknown.
In a way, the story of Sweden’s response to the crisis begins in Britain. Dr Tegnell studied in London and his team’s approach is based on models developed here.
In mid-March, both Dr Tegnell and Bjorn Eriksson, Stockholm’s director of health, believed Britain and Sweden ‘were on the same page’. On March 12, ITV political editor Robert Peston wrote about Government thinking, saying ‘herd immunity’ was the key phrase and warning against shutting schools.
But a fortnight later the UK abruptly changed tactics and imposed a draconian lockdown, having been unnerved by a study suggesting that without it, up to 250,000 people might die.
Today the Cabinet is divided between ‘doves’ such as Health Secretary Matt Hancock, cautious about easing restrictions, and ‘hawks’ led by Chancellor Rishi Sunak who want a quick end to lockdown.
Sweden stayed the course, based on the understanding that the disease can only be managed not eradicated. Social distancing and working from home were suggested, not ordered, as the elderly were encouraged to stay at home.
Stockholm’s mayor, Anna Konig Jerlmyr, told us: ‘We trust our citizens and treat them with respect. In return we expect them to take responsibility and I’m proud that the majority have done so. In other European cities I was saddened to hear how the police watch people and enforce rules. That is not our way. Also we are as transparent as possible. It is important to share information and all the figures.’
Anna Erdunbelau, a 46-year-old shopping in Stockholm last week, agrees. ‘We are generally a sensible people who usually do the right thing. We are treated like adults. And you have to understand this is all built on trust.’
Key to this is the independence of public bodies such as Dr Tegnell’s Public Health Agency. It ensures decisions are based on expertise, prevents ministers meddling and explains why it is Dr Tegnell leading press conferences while politicians take a back seat.
Politicians didn’t try to block his suggestion that schools remain open, a decision partly taken because younger children are not a major cause of the transmission, and partly so health workers don’t need to stay home to look after their children. ‘We need every healthcare worker we can get,’ says Mr Eriksson.
At the moment, hospitals are coping. Sweden had an enviable health care system in place before the outbreak, which has helped. And it hasn’t been beset by quite the same PPE shortages seen in the UK.
‘We think we are at a peak of infections in Stockholm and *we are not at full capacity in hospitals*, so I’m pleased,’ adds Mr Eriksson. ‘But we must not be complacent. The weather is getting warmer, more people will be outside and they will need to be disciplined about social distancing.’
Ministers have warned that bars and restaurants that failed to follow guidelines would be closed. But all around the city, people go about their business, shopping, cycling, watching the world go by while drinking outside bars and cafes.
‘It sometimes seems as if coronavirus doesn’t exist,’ says Andreas Hatzigeorgiou from Stockholm’s chamber of commerce. ‘Things are moving normally. People do observe social distancing – though we did it before Covid-19, it is in our DNA!’
He knows Sweden’s economy will suffer – it is doing so already – but believes it stands a chance of avoiding the kind of crash predicted elsewhere. Consumer spending is down 27 per cent, but’s that compared to 66 per cent in Denmark.
SOURCE
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California Docs Say Lockdown vs. Non-Lockdown 'Did Not Produce a Statistically Different Number of Deaths'
On Wednesday Dr. Dan Erickson and Dr. Artin Massihi, who own seven Accelerated Urgent Care facilities in Kern County, Calif., gave a press conference to local media. They extrapolated from their own COVID-19 data, along with data sets nationwide and globally. Using this data, their own medical knowledge and information gathered from conversations with their colleagues around the country, they presented a compelling case, which included unreported health risks related to sheltering in place, for ending the severe shutdowns.
Both doctors understand and support the initial reactions to the COVID-19 outbreak by the federal, state and local governments. It was a novel virus and there was very limited information. However, now they assert that the data is telling them that the disease pattern of COVID-19 is more like the flu. Dr. Erickson phrased it this way, “Millions of cases, a small number of deaths.” He specifically noted that the difference in the number of deaths between Sweden, with limited restrictions, and Norway, which locked down, is not statistically significant.
"Lockdown versus non-lockdown did not produce a statistically different number of deaths. That is the bottom line," said Erickson.
Throughout the briefing he emphasized that decision making going forward needs to be based on data, not predictive models. This echoes comments made by Dr. Anthony Fauci during press briefings. And we have all watched the predictive models be radically adjusted as actual data has been loaded into them.
Their data extrapolations, using a method similar to the one the CDC uses for influenza, suggest that death rates for COVID-19 are similar to those for the flu. According to their analysis, both Kern County and the state of California have likely experienced a widespread viral infection. They both agreed this is almost certain in New York as well. Based on their analysis, the death rate varies from 0.03% in California to 0.1% in New York state. This will be confirmed by additional testing finding new cases for the same number of deaths.
In addition to asserting that this is much more comparable to the flu than originally thought, the doctors present additional information to support their point of view. First, they discussed the rise in mental illness and abuse their clinics and local providers are seeing. This includes an increase in child molestation, domestic abuse, alcohol and drug-related emergencies, and mental health diagnoses.
Next, they were very clear on how self-isolation can actually compromise the immune system in otherwise healthy people. Dr. Erickson explained that the immune system is actually built by exposure to pathogens. Coming in contact with viruses and bacteria in the environment fires the body’s system for fighting infection. Additionally, the normal flora, or good germs we have on and in us all the time, also drop when we isolate.
Here Comes the Sun: The Good News about COVID-19 the Media Apparently Doesn't Want You to Know
The combination of reducing regular exposure to pathogens in the environment and lowering the good bacteria that helps us fight off infection, concerns both physicians. By reserving nearly all healthcare system assets to treat COVID-19, the available capacity of the system in their area has actually contracted. Two hospital floors are closed. Healthcare workers have been furloughed. In this environment, they worry about an increase in opportunistic infections that will strain the remaining resources as people get back to more normal activities if the isolation of healthy individuals continues.
Next, they say the current guidelines are not backed by science. Dr. Erickson repeated the finding that COVID-19 can live on plastic for three days. So, when you go to Costco or Home Depot, you pick up needed items that may carry COVID-19. He added that it is because of these fomites, inanimate objects that can carry and transfer disease, it is highly likely COVID-19 would be found if your home or car were sampled.
Additionally, there is no science that says it is safer to go to Costco than it is to go to the small local restaurant for lunch. In the opinion of both doctors, the current guidelines are not based on rational thinking. They also think people should absolutely be spending time outside. Dr. Massihi said keeping people indoors can cause Vitamin D deficiencies which further impact immune function and can cause a depressed mood.
Dr. Erickson then explained that the vast majority of people were dying with COVID-19, not from COVID-19. He said after viewing hundreds of autopsies in his career, people rarely die for one reason. A body that has been weakened by chronic disease is not as able to fight off infection. He compared this to deaths with the flu. Most often it is just one of a number of illnesses a patient is suffering with.
With the predictable negatives of self-isolation and the economic pain they are causing, the doctors are calling on political leaders to begin letting the healthy adults return to normal activities. They even say that this should happen without masks and other types of PPE. For those with preexisting conditions or who are immunocompromised, the use of PPE and self-isolation may still be the correct advice. However, for the 95% of individuals who will recover without significant intervention, they say it’s time to end the restrictions and continue testing.
Dr. Massihi said the fear of the unknown is understandable. But giving people accurate information is a way that fear can be reduced. According to the data on deaths for otherwise healthy individuals, the number of deaths is “infinitesimal.” He is equally worried about the person who has abdominal pain and fever and is too scared to seek care. So their appendix ruptures at home and they end up hospitalized with a severe infection. Or any individual with a minor medical problem that will have a bigger impact because care is delayed.
While most of the press conference remained focused on the science and medicine, they did share that their colleagues in emergency medicine around the country report they are being pressured to add a diagnosis of COVID-19. They did not speculate as to why this was happening, but indicated they found it odd.
And Dr. Erickson did hit back at journalists who were challenging his assumptions. At the end of the briefing, he was challenged on why he thought he was smarter than the Dr. Faucis of the world and state health officials. He was clear this was not about being smarter or right. He is using data and his own clinical experience to make these recommendations for his own community and others like them. Essentially pretending everyone is going to be New York is not the correct approach.
He also shot back at reporters who are being paid while their fellow citizens are not. His closing was also a caution worth taking note of:
Who says what’s safe? Are you smart enough to know what is safe for you? Or is it the government gonna tell you what’s safe for you? As soon as they use the word safe, that means control. 'We know what’s safe for you. You’re too dumb to understand disease. We know what’s safe.' And so, they are going to use this model for different things. 'We got a bomb threat from China. Everybody stay in their home for three months.' They [the government] are using this to see how much of your freedom can they take from you. Will you roll over and stay in your house? And it’s working.
Amen, sir. Let’s get America back to work.
SOURCE
*************************************
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
**************************
Children are still in school, bars and restaurants are open, as are garden centres and shops; crowds of up to 50 are allowed, and no one is chastised for sunbathing, sitting on park benches or daring to flee to countryside boltholes.
It is a strategy aimed at allowing some exposure to the disease to build immunity among the general population, while protecting the vulnerable and ensuring hospitals are not overwhelmed.
But the country’s light touch has incurred criticism. Sweden has a reputation as a ‘moral superpower’ and commentators seize upon any death-toll spike as evidence of a foolhardy gamble that risks lives for the sake of the economy.
Sweden considers the big picture, though, and argues that part of its policy is aimed at preventing an economic crash, as mass unemployment will have dire health consequences. For example, after the 2009 debt crisis, suicides in Greece increased by up to 40 per cent.
But many Swedes feel as if outsiders enduring lockdown are willing them to fail. ‘It makes you defensive,’ says Anglo-Swede Alex McBeath, who works at the Tudor Arms. ‘I’m cautiously optimistic about the future. I support the way we have approached the crisis.’
So does the majority of the country. Anders Tegnell, 63, state epidemiologist with the Public Health Agency of Sweden and the architect of its Covid-19 response, fronts daily press conferences. Inevitably, he receives online vitriol.
Yet he is so popular that some in Stockholm have had his face inked on to their arms and legs. Tattooist Zashay Tastas, who designed the image, says: ‘Tegnell has become the face of Sweden’s approach. This is the first time a real nerd is being idolised.’
Or as Dr Tegnell himself puts it: ‘It is the first time in history that an epidemiologist has been considered famous.’ He modestly notes, however, that he is just one of 15 experts meeting daily to analyse data and make recommendations.
But have Dr Tegnell and his colleagues got it wrong? Is managing coronavirus impossible without a lockdown?
Sweden has recorded 2,192 deaths, more than twice as many as neighbouring Denmark, but it has almost twice the population, at ten million. In Britain, the toll has topped 20,000. So far Sweden has defied forecasts saying that, unless it changed course, it would suffer 50,000 to 180,000 deaths.
Arne Elofsson, a biologist at Stockholm University, initially estimated that the nation’s health system would be quickly swamped, but now concedes: ‘It appears the epidemic is plateauing and that the catastrophic scenarios predicted by some will never appear in Sweden.’
Dr Tegnell is cautious by nature but declares himself ‘satisfied’ the strategy appears to be working, even if there are some things he would have done differently, especially in care homes.
Nationally, the number of new cases rose sharply last week – due mainly to increased testing – and stands at 18,177. Most are in Stockholm and its suburbs, with very small numbers in the thinly populated areas elsewhere.
Every country, one way or another, has to reach herd immunity so the chains of transmission break, says Dr Tegnell. He believes Stockholm could do so in weeks – but acknowledges he doesn’t have all the answers as so much about the virus is still unknown.
In a way, the story of Sweden’s response to the crisis begins in Britain. Dr Tegnell studied in London and his team’s approach is based on models developed here.
In mid-March, both Dr Tegnell and Bjorn Eriksson, Stockholm’s director of health, believed Britain and Sweden ‘were on the same page’. On March 12, ITV political editor Robert Peston wrote about Government thinking, saying ‘herd immunity’ was the key phrase and warning against shutting schools.
But a fortnight later the UK abruptly changed tactics and imposed a draconian lockdown, having been unnerved by a study suggesting that without it, up to 250,000 people might die.
Today the Cabinet is divided between ‘doves’ such as Health Secretary Matt Hancock, cautious about easing restrictions, and ‘hawks’ led by Chancellor Rishi Sunak who want a quick end to lockdown.
Sweden stayed the course, based on the understanding that the disease can only be managed not eradicated. Social distancing and working from home were suggested, not ordered, as the elderly were encouraged to stay at home.
Stockholm’s mayor, Anna Konig Jerlmyr, told us: ‘We trust our citizens and treat them with respect. In return we expect them to take responsibility and I’m proud that the majority have done so. In other European cities I was saddened to hear how the police watch people and enforce rules. That is not our way. Also we are as transparent as possible. It is important to share information and all the figures.’
Anna Erdunbelau, a 46-year-old shopping in Stockholm last week, agrees. ‘We are generally a sensible people who usually do the right thing. We are treated like adults. And you have to understand this is all built on trust.’
Key to this is the independence of public bodies such as Dr Tegnell’s Public Health Agency. It ensures decisions are based on expertise, prevents ministers meddling and explains why it is Dr Tegnell leading press conferences while politicians take a back seat.
Politicians didn’t try to block his suggestion that schools remain open, a decision partly taken because younger children are not a major cause of the transmission, and partly so health workers don’t need to stay home to look after their children. ‘We need every healthcare worker we can get,’ says Mr Eriksson.
At the moment, hospitals are coping. Sweden had an enviable health care system in place before the outbreak, which has helped. And it hasn’t been beset by quite the same PPE shortages seen in the UK.
‘We think we are at a peak of infections in Stockholm and *we are not at full capacity in hospitals*, so I’m pleased,’ adds Mr Eriksson. ‘But we must not be complacent. The weather is getting warmer, more people will be outside and they will need to be disciplined about social distancing.’
Ministers have warned that bars and restaurants that failed to follow guidelines would be closed. But all around the city, people go about their business, shopping, cycling, watching the world go by while drinking outside bars and cafes.
‘It sometimes seems as if coronavirus doesn’t exist,’ says Andreas Hatzigeorgiou from Stockholm’s chamber of commerce. ‘Things are moving normally. People do observe social distancing – though we did it before Covid-19, it is in our DNA!’
He knows Sweden’s economy will suffer – it is doing so already – but believes it stands a chance of avoiding the kind of crash predicted elsewhere. Consumer spending is down 27 per cent, but’s that compared to 66 per cent in Denmark.
SOURCE
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California Docs Say Lockdown vs. Non-Lockdown 'Did Not Produce a Statistically Different Number of Deaths'
On Wednesday Dr. Dan Erickson and Dr. Artin Massihi, who own seven Accelerated Urgent Care facilities in Kern County, Calif., gave a press conference to local media. They extrapolated from their own COVID-19 data, along with data sets nationwide and globally. Using this data, their own medical knowledge and information gathered from conversations with their colleagues around the country, they presented a compelling case, which included unreported health risks related to sheltering in place, for ending the severe shutdowns.
Both doctors understand and support the initial reactions to the COVID-19 outbreak by the federal, state and local governments. It was a novel virus and there was very limited information. However, now they assert that the data is telling them that the disease pattern of COVID-19 is more like the flu. Dr. Erickson phrased it this way, “Millions of cases, a small number of deaths.” He specifically noted that the difference in the number of deaths between Sweden, with limited restrictions, and Norway, which locked down, is not statistically significant.
"Lockdown versus non-lockdown did not produce a statistically different number of deaths. That is the bottom line," said Erickson.
Throughout the briefing he emphasized that decision making going forward needs to be based on data, not predictive models. This echoes comments made by Dr. Anthony Fauci during press briefings. And we have all watched the predictive models be radically adjusted as actual data has been loaded into them.
Their data extrapolations, using a method similar to the one the CDC uses for influenza, suggest that death rates for COVID-19 are similar to those for the flu. According to their analysis, both Kern County and the state of California have likely experienced a widespread viral infection. They both agreed this is almost certain in New York as well. Based on their analysis, the death rate varies from 0.03% in California to 0.1% in New York state. This will be confirmed by additional testing finding new cases for the same number of deaths.
In addition to asserting that this is much more comparable to the flu than originally thought, the doctors present additional information to support their point of view. First, they discussed the rise in mental illness and abuse their clinics and local providers are seeing. This includes an increase in child molestation, domestic abuse, alcohol and drug-related emergencies, and mental health diagnoses.
Next, they were very clear on how self-isolation can actually compromise the immune system in otherwise healthy people. Dr. Erickson explained that the immune system is actually built by exposure to pathogens. Coming in contact with viruses and bacteria in the environment fires the body’s system for fighting infection. Additionally, the normal flora, or good germs we have on and in us all the time, also drop when we isolate.
Here Comes the Sun: The Good News about COVID-19 the Media Apparently Doesn't Want You to Know
The combination of reducing regular exposure to pathogens in the environment and lowering the good bacteria that helps us fight off infection, concerns both physicians. By reserving nearly all healthcare system assets to treat COVID-19, the available capacity of the system in their area has actually contracted. Two hospital floors are closed. Healthcare workers have been furloughed. In this environment, they worry about an increase in opportunistic infections that will strain the remaining resources as people get back to more normal activities if the isolation of healthy individuals continues.
Next, they say the current guidelines are not backed by science. Dr. Erickson repeated the finding that COVID-19 can live on plastic for three days. So, when you go to Costco or Home Depot, you pick up needed items that may carry COVID-19. He added that it is because of these fomites, inanimate objects that can carry and transfer disease, it is highly likely COVID-19 would be found if your home or car were sampled.
Additionally, there is no science that says it is safer to go to Costco than it is to go to the small local restaurant for lunch. In the opinion of both doctors, the current guidelines are not based on rational thinking. They also think people should absolutely be spending time outside. Dr. Massihi said keeping people indoors can cause Vitamin D deficiencies which further impact immune function and can cause a depressed mood.
Dr. Erickson then explained that the vast majority of people were dying with COVID-19, not from COVID-19. He said after viewing hundreds of autopsies in his career, people rarely die for one reason. A body that has been weakened by chronic disease is not as able to fight off infection. He compared this to deaths with the flu. Most often it is just one of a number of illnesses a patient is suffering with.
With the predictable negatives of self-isolation and the economic pain they are causing, the doctors are calling on political leaders to begin letting the healthy adults return to normal activities. They even say that this should happen without masks and other types of PPE. For those with preexisting conditions or who are immunocompromised, the use of PPE and self-isolation may still be the correct advice. However, for the 95% of individuals who will recover without significant intervention, they say it’s time to end the restrictions and continue testing.
Dr. Massihi said the fear of the unknown is understandable. But giving people accurate information is a way that fear can be reduced. According to the data on deaths for otherwise healthy individuals, the number of deaths is “infinitesimal.” He is equally worried about the person who has abdominal pain and fever and is too scared to seek care. So their appendix ruptures at home and they end up hospitalized with a severe infection. Or any individual with a minor medical problem that will have a bigger impact because care is delayed.
While most of the press conference remained focused on the science and medicine, they did share that their colleagues in emergency medicine around the country report they are being pressured to add a diagnosis of COVID-19. They did not speculate as to why this was happening, but indicated they found it odd.
And Dr. Erickson did hit back at journalists who were challenging his assumptions. At the end of the briefing, he was challenged on why he thought he was smarter than the Dr. Faucis of the world and state health officials. He was clear this was not about being smarter or right. He is using data and his own clinical experience to make these recommendations for his own community and others like them. Essentially pretending everyone is going to be New York is not the correct approach.
He also shot back at reporters who are being paid while their fellow citizens are not. His closing was also a caution worth taking note of:
Who says what’s safe? Are you smart enough to know what is safe for you? Or is it the government gonna tell you what’s safe for you? As soon as they use the word safe, that means control. 'We know what’s safe for you. You’re too dumb to understand disease. We know what’s safe.' And so, they are going to use this model for different things. 'We got a bomb threat from China. Everybody stay in their home for three months.' They [the government] are using this to see how much of your freedom can they take from you. Will you roll over and stay in your house? And it’s working.
Amen, sir. Let’s get America back to work.
SOURCE
*************************************
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
**************************
Sunday, April 26, 2020
Eight reasons to support reopening our country
Several governors are beginning to engage in opening their states. Good. They should wait no further. As each day goes by, we learn more and more about the coronavirus and its effects, and the facts lead toward getting adults back to work and children back to school. We suggest a focus away from the blare and glare of raw death tolls and worst-case scenarios. Instead let’s look at less-alarming truths that are generally being ignored by a media more invested in shock and frenzy. Perhaps we should start with these:
The first numbers we heard were that the coronavirus would kill up to 2.2 million Americans. This dire prediction was the first out of the box and it stuck in too many minds, struck too much fear, and still lingers.
The correction came late in March, as we were told to expect between 100,000 and 240,000 deaths in the U.S. But the death toll estimates keep coming in lower and lower. We are being told this is because of mitigation and distancing orders. Forgotten is that those six-figure numbers included and factored in mitigation and social distancing orders. That is, experts and government officials now tell us our numbers are lower because we are doing what they told us to do, but social distancing was always part and parcel of their high predictions.
The same model used to predict 100,000 or more deaths now tells us to expect something closer to 60,000 deaths. Now, some health departments are artificially inflating their numbers. New York City’s Health Department is now counting “probable” COVID-19 deaths. As Dr. Deborah Birx put it, unlike other countries, “We’ve taken a very liberal approach to mortality . . . if someone dies with COVID-19, we are counting that as a COVID-19 death.”
The per capita infection and death rates and dates of lockdown in various states confirm our questioning of not only one-lockdown-fits-all policies, but also the effectiveness of lockdowns themselves. Lockdowns don’t appear to be highly correlated with infection and death rates. Look at the timing. California, our largest state by far, locked down only three days before New York. Per capita, California’s infection rate is 6% that of New York’s, and its death rate is 4%. Florida, also more populous than New York, locked down almost two weeks after New York. Per capita, Florida’s infection rate is 9% that of New York’s, and it has had 4% of its death rate. Ohio locked down one day after New York, and yet Ohio’s death rate is only 5% that of New York’s. Missouri locked down more than two weeks after New York, but its infection rate is 7% of New York’s, and it has 4% the death rate. The rest of the country is not New York.
A recent Stanford University study reveals the virus is 50-85 times less deadly than initially thought. The infection/mortality rate of COVID-19 is not the 2% to 5% rate others have surmised, wrongly, but one somewhere in the small hundredths-of-a-single-percent range. An even newer study done at the University of Southern California comes to the same conclusion for Los Angeles County.
The closing of our schools is an increasing curiosity. We drastically transfigured over 55 million children’s educational and social lives to protect them from a virus that affects them less than the annual flu. As of this writing, a total of three children have died from the virus in New York City -- each of whom had underlying health conditions. Fewer than 10 children have died nationally from COVID-19, although about 80 have died from the flu. The argument that children could spread the new coronavirus to adults is true, but that is true of the flu as well. This has put an additional burden on families, children, and, for our poorest, has ripped millions of them from nutritious meals and trusted adults and institutions.
All perspective was lost. We have needed to hospitalize just over 80,000 people for this illness. The previous two flu seasons in America required nearly half a million hospitalizations. As Dr. Jonathan Geach has written: “Our health care system is now underwhelmed and health care workers are being laid off and furloughed in droves as a result of health care centers having neglected patient care not related to COVID-19 in fear of a COVID-19 surge that failed to materialize on a nationwide basis. This means tens of millions of patients are failing to receive the medical care they need in a timely manner. Almost every hospital outside of the hot spots is empty.” At the Mayo Clinic, as one example, he reports “65% of the hospital beds are empty, as are 75% of the operating rooms.”
Our overreaction to this epidemic will create myriad other health problems. California Rep. Tom McClintock put it well: “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?”
If you don’t want to listen to a Republican congressman, how about the United Nations: “The economic hardship experienced by families as a result of the global economic downturn could result in hundreds of thousands of additional child deaths in 2020, reversing the last 2 to 3 years of progress in reducing infant mortality within a single year.”
The political posturing, while predictable, is hypocritical and often one-sided. The Trump administration did not neglect this virus. Instead, Democrats criticized the administration for doing too much and for too little at the same time. The travel ban from China was “xenophobic” in late January, but his declaration of a national emergency in early March was too late. Meanwhile, not one word about this virus was uttered at the February Democratic presidential debate in Las Vegas, even though China was brought up several times in other contexts, such as in trade and defense policy.
As late as Feb. 24, House Speaker Nancy Pelosi was telling people, “We think it’s safe to come to Chinatown and hope others will come.” And, on the last day of February, the principle expert on whom the president relies and the press reveres, Dr. Anthony Fauci, stated: “Right now, at this moment, there is no need to change anything you are doing on a day-by-day basis.”
Almost all of us are interested in the health, safety, and well-being of the American people. The daily death rate should decline dramatically in the next two weeks, and, by the end of the summer, most of this will be in the rear-view mirror. Already, we are being warned that a second wave of the virus will hit us in the autumn. Perhaps, but this is a certainty: There will be a second wave of this crisis that will result from massive unemployment and all the mental and social illnesses and deaths that will come from that and the other policies the lockdowns and shutdowns are bringing.
In short, there will be more pain and hardship -- and perhaps more deaths -- from the convulsing of our country as a result of the response to the coronavirus than from the coronavirus itself. The governors of our 50 states have real jobs — so do almost all other Americans. They should all be given them back while they still exist.
SOURCE
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Wuhan laboratory scientists 'did absolutely crazy things' to alter coronavirus and enabled it to infect humans, Russian microbiologist claims
A leading Russian microbiologist has claimed the coronavirus is the result of Wuhan scientists doing 'absolutely crazy things' in their laboratory.
World renowned expert Professor Petr Chumakov claimed their aim was to study the pathogenicity of the virus and not 'with malicious intent' to deliberately create a manmade killer.
Professor Chumakov, chief researcher at the Engelhardt Institute of Molecular Biology in Moscow, said: 'In China, scientists at the Wuhan Laboratory have been actively involved in the development of various coronavirus variants for over ten years. 'Moreover, they did this, supposedly not with the aim of creating pathogenic variants, but to study their pathogenicity.
'They did absolutely crazy things, in my opinion. 'For example, inserts in the genome, which gave the virus the ability to infect human cells.
'Now all this has been analysed. 'The picture of the possible creation of the current coronavirus is slowly emerging.'
He told Moskovsky Komsomolets newspaper: 'There are several inserts, that is, substitutions of the natural sequence of the genome, which gave it special properties.
'It is interesting that the Chinese and Americans who worked with them published all their works in the open (scientific) press. 'I even wonder why this background comes to people very slowly.
'I think that an investigation will nevertheless be initiated, as a result of which new rules will be developed that regulate the work with the genomes of such dangerous viruses.
'It's too early to blame anyone.' He said the Chinese scientists created 'variants of the virus … without malicious intent' possibly aiming for an HIV vaccine.
Professor Chumakov is also connected to Russia's Federal Research Centre for Research and Development of Immunobiological Preparations.
Vladimir Putin's spokesman warned this week against allegations that coronavirus was manmade. 'In the situation where there is not enough information that has been supported and checked by science ... we think it is unacceptable, impossible, to groundlessly accuse anyone,' said Dmitry Peskov.
SOURCE
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Mesoblast treatment achieves "remarkable" results for critical Covid-19 patients
An Australian-developed stem cell treatment has drastically increased survival rates in trials for ventilator-dependent patients suffering from acute respiratory distress syndrome (ARDS) due to Covid-19.
Melbourne-based regenerative medicine company Mesoblast (ASX: MSB, NASDAQ: MESO) has been engaged in trials with New York City's Mt Sinai hospital to intravenously infuse its product remestemcel-L in patients, and the early signs are promising.
The sample size of 12 patients may be small, but 83 per cent (10) of them have survived after the stem cell treatment compared to a 12 per cent survival rate for ventilator-dependent Covid-19 patients with the condition at a major referral hospital network in the city.
Mesoblast reports 75 per cent of the patients (9) were able to come off ventilator support within a median of 10 days, compared to a 9 per cent rate for patients treated with standard of care during March and April.
Seven of the patients, who were given remestemcel-L within five days under emergency compassionate use, have been discharged from the hospital.
Using bone marrow aspirate from healthy donors, Mesoblast's proprietary technology is currently used to treat a condition called acute graft versus host disease (aGVHD), which many suffer after receiving a bone marrow transplant (BMT).
But as the Covid-19 pandemic took centre stage, the company hypothesised Remestemcel-L would be able to treat what is known as a cytokine storm in the lungs that often occurs with serious Covid-19 cases.
The company then quickly mobilised plans for trials in the US, Australia, China and Europe.
"The remarkable clinical outcomes in these critically ill patients continue to underscore the potential benefits of remestemcel-L as an anti-inflammatory agent in cytokine release syndromes associated with high mortality, including acute graft versus host disease and Covid-19 ARDS," says Mesoblast chief executive Dr Silviu Itescu.
"We intend to rapidly complete the randomized, placebo-controlled Phase 2/3 trial in COVID-19 ARDS patients to rigorously confirm that remestemcel-L improves survival in these critically ill patients.
The company's chief medical officer Dr Fred Grossman emphasises a significant need to improve the "dismal survival outcomes in COVID-19 patients who progress to ARDS and require ventilators".
"We have implemented robust statistical analyses in our Phase 2/3 trial as recommended by the US Food and Drug Administration (FDA) in order to maximise our ability to evaluate whether remestemcel-L provides a survival benefit in moderate/severe COVID19 ARDS," he says.
SOURCE
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IN BRIEF
Republican states Georgia, Tennessee, and South Carolina announce plans to reopen some businesses, wind down coronavirus stay-at-home orders (Fox News)
Good news: Los Angeles County antibody study produces more evidence of widespread COVID-19 (Power Line)
Nearly three-quarters of adults fear losing personal liberties because of coronavirus (Washington Examiner)
Sixty percent of Democrats blame Trump more than Communist China for coronavirus (Rasmussen Reports)
Phase 4 relief emerges: $500 billion state and local bailout (Hot Air)
The Supreme Court correctly holds that jury verdicts in state criminal cases must be unanimous (National Review)
Publicly traded firms get $300 million in small-business loans (AP)
Feast or famine, part I: Walmart announces another huge round of hirings (The Daily Wire)
Feast or famine, part II: United Airlines posts $2.1 billion loss, seeks more federal aid (CNBC)
Historic buying opportunity: With oil below zero, Trump to fatten up Strategic Petroleum Reserve (Fox Business)
South Korea: No reason to think Kim Jong Un gravely ill despite U.S. media report (USA Today)
Policy: Why Has the Voice of America become a voice of confusion? (National Review)
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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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