Analysis Of The Covid-19 Pandemic

Herschel Smith · 18 Mar 2020 · 37 Comments

UPDATE 3/29 A few links, a few comments about those links, and then a link dump. Current trajectory of Covid-19.  I'll update the curve fit as often as I'm able to. Coronavirus Could be Chimera of Two Different Viruses, Genome Analysis Suggests. In December 2019, 27 of the first 41 people hospitalised (66 percent) passed through a market located in the heart of Wuhan city in Hubei province. But, according to a study conducted at Wuhan Hospital, the very first human case identified…… [read more]

Why Hydroxychloroquine Works

BY Herschel Smith
6 hours, 48 minutes ago

This article, written at Medium but taken down and thus only on archive, comes to us via reader JJ.

Your red blood cells carry oxygen from your lungs to all your organs and the rest of your body. Red blood cells can do this thanks to hemoglobin, which is a protein consisting of four “hemes”. Hemes have a special kind of iron ion, which is normally quite toxic in its free form, locked away in its center with a porphyrin acting as it’s ‘container’. In this way, the iron ion can be ‘caged’ and carried around safely by the hemoglobin, but used to bind to oxygen when it gets to your lungs.

When the red blood cell gets to the alveoli, or the little sacs in your lungs where all the gas exchange happens, that special little iron ion can flip between FE2+ and FE3+ states with electron exchange and bond to some oxygen, then it goes off on its little merry way to deliver o2 elsewhere.

Here’s where COVID-19 comes in. Its glycoproteins bond to the heme, and in doing so that special and toxic oxidative iron ion is “disassociated” (released). It’s basically let out of the cage and now freely roaming around on its own. This is bad for two reasons:

Editorial comment: This is not exactly like, but similar to carboxyhemoglobin, where carbon dioxide binds to your hemoglobin, staying there unless you’re put inside a hyperbaric chamber, and thus preventing oxygen, O2, from binding to your hemoglobin.

1) Without the iron ion, hemoglobin can no longer bind to oxygen. Once all the hemoglobin is impaired, the red blood cell is essentially turned into a Freightliner truck cab with no trailer and no ability to store its cargo.. it is useless and just running around with COVID-19 virus attached to its porphyrin. All these useless trucks running around not delivering oxygen is what starts to lead to desaturation, or watching the patient’s spo2 levels drop. It is INCORRECT to assume traditional ARDS and in doing so, you’re treating the WRONG DISEASE. Think of it a lot like carbon monoxide poisoning, in which CO is bound to the hemoglobin, making it unable to carry oxygen. In those cases, ventilators aren’t treating the root cause; the patient’s lungs aren’t ‘tiring out’, they’re pumping just fine. The red blood cells just can’t carry o2, end of story. Only in this case, unlike CO poisoning in which eventually the CO can break off, the affected hemoglobin is permanently stripped of its ability to carry o2 because it has lost its iron ion. The body compensates for this lack of o2 carrying capacity and deliveries by having your kidneys release hormones like erythropoietin, which tell your bone marrow factories to ramp up production on new red blood cells with freshly made and fully functioning hemoglobin. This is the reason you find elevated hemoglobin and decreased blood oxygen saturation as one of the 3 primary indicators of whether the shit is about to hit the fan for a particular patient or not.

2) That little iron ion, along with millions of its friends released from other hemes, are now floating through your blood freely. As I mentioned before, this type of iron ion is highly reactive and causes oxidative damage. It turns out that this happens to a limited extent naturally in our bodies and we have cleanup & defense mechanisms to keep the balance. The lungs, in particular, have 3 primary defenses to maintain “iron homeostasis”, 2 of which are in the alveoli, those little sacs in your lungs we talked about earlier. The first of the two are little macrophages that roam around and scavenge up any free radicals like this oxidative iron. The second is a lining on the walls (called the epithelial surface) which has a thin layer of fluid packed with high levels of antioxidant molecules.. things like abscorbic acid (AKA Vitamin C) among others. Well, this is usually good enough for naturally occurring rogue iron ions but with COVID-19 running rampant your body is now basically like a progressive state letting out all the prisoners out of the prisons… it’s just too much iron and it begins to overwhelm your lungs’ countermeasures, and thus begins the process of pulmonary oxidative stress. This leads to damage and inflammation, which leads to all that nasty stuff and damage you see in CT scans of COVID-19 patient lungs. Ever noticed how it’s always bilateral? (both lungs at the same time) Pneumonia rarely ever does that, but COVID-19 does… EVERY. SINGLE. TIME.

Once your body is now running out of control, with all your oxygen trucks running around without any freight, and tons of this toxic form of iron floating around in your bloodstream, other defenses kick in. While your lungs are busy with all this oxidative stress they can’t handle, and your organs are being starved of o2 without their constant stream of deliveries from red blood cell’s hemoglobin, and your liver is attempting to do its best to remove the iron and store it in its ‘iron vault’. Only its getting overwhelmed too. It’s starved for oxygen and fighting a losing battle from all your hemoglobin letting its iron free, and starts crying out “help, I’m taking damage!” by releasing an enzyme called alanine aminotransferase (ALT). BOOM, there is your second of 3 primary indicators of whether the shit is about to hit the fan for a particular patient or not.

Eventually, if the patient’s immune system doesn’t fight off the virus in time before their blood oxygen saturation drops too low, ventilator or no ventilator, organs start shutting down. No fuel, no work. The only way to even try to keep them going is max oxygen, even a hyperbaric chamber if one is available on 100% oxygen at multiple atmospheres of pressure, just to give what’s left of their functioning hemoglobin a chance to carry enough o2 to the organs and keep them alive. Yeah we don’t have nearly enough of those chambers, so some fresh red blood cells with normal hemoglobin in the form of a transfusion will have to do.

The core point being, treating patients with the iron ions stripped from their hemoglobin (rendering it abnormally nonfunctional) with ventilator intubation is futile, unless you’re just hoping the patient’s immune system will work its magic in time. The root of the illness needs to be addressed.

Best case scenario? Treatment regimen early, before symptoms progress too far. Hydroxychloroquine (more on that in a minute, I promise) with Azithromicin has shown fantastic, albeit critics keep mentioning ‘anecdotal’ to describe the mountain, promise and I’ll explain why it does so well next. But forget straight-up plasma with antibodies, that might work early but if the patient is too far gone they’ll need more. They’ll need all the blood: antibodies and red blood cells. No help in sending over a detachment of ammunition to a soldier already unconscious and bleeding out on the battlefield, you need to send that ammo along with some hemoglobin-stimulant-magic so that he can wake up and fire those shots at the enemy.

All that hilariously misguided and counterproductive criticism the media piled on chloroquine (purely for political reasons) as a viable treatment will now go down as the biggest Fake News blunder to rule them all. The media actively engaged their activism to fight ‘bad orange man’ at the cost of thousands of lives. Shame on them.

How does chloroquine work? Same way as it does for malaria. You see, malaria is this little parasite that enters the red blood cells and starts eating hemoglobin as its food source. The reason chloroquine works for malaria is the same reason it works for COVID-19 — while not fully understood, it is suspected to bind to DNA and interfere with the ability to work magic on hemoglobin. The same mechanism that stops malaria from getting its hands on hemoglobin and gobbling it up seems to do the same to COVID-19 (essentially little snippets of DNA in an envelope) from binding to it. On top of that, Hydroxychloroquine (an advanced descendant of regular old chloroquine) lowers the pH which can interfere with the replication of the virus. Again, while the full details are not known, the entire premise of this potentially ‘game changing’ treatment is to prevent hemoglobin from being interfered with, whether due to malaria or COVID-19.

But don’t tell Dr. Zack Moore that he traffics in fake news with his counsel to North Carolina hospitals that they shouldn’t use hydroxychloroquine (yes, I have such a document).  I guess he cares too much about politics to be concerned about saving lives.

Another Win For Hydroxychloroquine

BY Herschel Smith
1 day, 7 hours ago

Via Insty, this story buries important details.

It wasn’t until she was given hydroxychloroquine, a drug used to treat Malaria, that things started looking up.

“After I started taking the Malaria medicine, I started to feel a lot better,” she said. “Like, the next day.”

The reason this information is buried is the same reason that people like Dr. Zack Moore of North Carolina recommends against the use of hydroxychloroquine.  Trump haters would rather see people perish that prescribe live-saving medications because Trump might get the credit.

Honestly.  They think like this.  That’s how juvenile they are.

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The Effectiveness Of Hydroxychloroquine: A Note To Dr. Zack Moore

BY Herschel Smith
2 days, 7 hours ago

First up, a newly elected congress woman in Detroit.

LANSING – A Democratic state representative from Detroit is crediting hydroxychloroquine — and Republican President Donald Trump who touted the drug — for saving her in her battle with the coronavirus.

State Rep. Karen Whitsett, who learned Monday she has tested positive for COVID-19, said she started taking hydroxychloroquine on March 31, prescribed by her doctor, after both she and her husband sought treatment for a range of symptoms on March 18.

“It was less than two hours” before she started to feel relief, said Whitsett, who had experienced shortness of breath, swollen lymph nodes, and what felt like a sinus infection. She is still experiencing headaches, she said.

Whitsett said she was familiar with “the wonders” of hydroxychloroquine from an earlier bout with Lyme disease, but does not believe she would have thought to ask for it, or her doctor would have prescribed it, had Trump not been touting it as a possible treatment for COVID-19.

But that same thing, i.e., Trump touting it as a possible therapeutic, has caused the status quo, the ensconced bureaucracy, and doctors who live by state decrees, to pan it as needful or effective.  Queue many more doctors who think it works, via Katie Pavlich.

First, in Los Angeles:

Dr. Anthony Cardillo said he has seen very promising results when prescribing hydroxychloroquine in combination with zinc for the most severely-ill COVID-19 patients.

“Every patient I’ve prescribed it to has been very, very ill and within 8 to 12 hours, they were basically symptom-free,” Cardillo told Eyewitness News. “So clinically I am seeing a resolution.”

Cardillo is the CEO of Mend Urgent Care, which has locations in Sherman Oaks, Van Nuys and Burbank.

He said he has found it only works if combined with zinc. The drug, he said, opens a channel for the zinc to enter the cell and block virus replication.

“We have to be cautious and mindful that we don’t prescribe it for patients who have COVID who are well,” Cardillo said. “It should be reserved for people who are really sick, in the hospital or at home very sick, who need that medication. Otherwise we’re going to blow through our supply for patients that take it regularly for other disease processes.”

New York:

Dr. Mohammud Alam, an infectious disease specialist affiliated with Plainview Hospital, said 81 percent of infected covid patients he treated at three Long Island nursing homes recovered from the contagion.

“In this crisis, I realized I had to do something,” Alam said. ”I realized if this was my dad, what would I do? And I would do anything I could to help.”

Alam said he decided he could not apply the touted combination of the antimalarial hydroxychloroquine and antibiotic azithromycin because the side effects could be potentially fatal for his high-risk patients, many of whom had underlying heart issues.

So instead, Alam replaced azithromycin with another decades-old antibiotic that doesn’t pose any known risks to the heart.

New Jersey:

Dr. Stephen Smith, founder of The Smith Center for Infectious Diseases and Urban Health, said on “The Ingraham Angle” on Wednesday night that he is optimistic about the use of antimalarial medications and antibiotics to treat COVID-19 patients, calling it “a game-changer.”

Smith, who is treating 72 COVID-19 patients, said that he has been treating “everybody with hydroxychloroquine and azithromycin [an antibiotic]. We’ve been doing so for a while.”

He pointed out that not a single COVID-19 patient of his that has been on the hydroxychloroquine and azithromycin regimen for five days or more has had to be intubated.

Around the world:

An international poll of thousands of doctors rated the Trump-touted anti-malaria drug hydroxychloroquine the best treatment for the novel coronavirus.

Of the 6,227 physicians surveyed in 30 countries, 37 percent rated hydroxychloroquine the “most effective therapy” for combating the potentially deadly illness, according to the results released Thursday.

The survey, conducted by the global health care polling company Sermo, also found that 23 percent of medical professionals had prescribed the drug in the US — far less than other countries.

“Outside the US, hydroxychloroquine was equally used for diagnosed patients with mild to severe symptoms whereas in the US it was most commonly used for high risk diagnosed patients,” the survey found.

The medicine was most widely used in Spain, where 72 percent of physicians said they had prescribed it.

The doctors who reflexively revert to bureaucracy for the determination of right and wrong, and who, because of hatred for Mr. Trump, have panned it and recommended against it because they lack fifty billion controlled studies approved by the FDA, have blood on their hands in the face of this mounting evidence.

Look, I have my issues with Trump too, from bump stock bans to red flag laws.  But reflexive reversion to opposing anything he says because a doctor doesn’t happen to like him, in a time of pandemic, is the most unethical and uncaring thing I can possibly think of.

It borders on negligent homicide.  If you’re a doctor, I’m speaking to you.

I’ll also point out that the epidemiologist in my own state of North Carolina, Dr. Zack Moore, opposes it, and I have sent him two notes now on this very subject, to be ignored both times.

I’ll have my say before this is all over with, and he’ll hear me loud and clear.

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We’re Not Violating Constitutional Rights Because We’re Just Following Orders

BY Herschel Smith
2 days, 8 hours ago

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The FDA Death Toll And Use Of Off-Label Medications

BY Herschel Smith
3 days, 8 hours ago

Mises Institute.

The Food and Drug Administration helped turn the coronavirus from a deadly peril into a national catastrophe. Long after foreign nations had been ravaged and many cases had been detected in America, the FDA continued blocking private testing. The FDA continued forcing the nation’s most innovative firms to submit to its command-and-control approach notwithstanding the pandemic. South Korean is in a far better situation dealing with coronavirus, because its government did not preemptively cripple private testing.

One of the clearest lessons from the current pandemic is that nothing has changed at one of the nation’s most powerful regulatory agencies. The FDA is repeating the same mistakes and showing the same arrogance that I chronicled decades ago in articles for the Wall Street Journal, the American Spectator, and other publications.

Dr. David Kessler, who became FDA commissioner in 1990, quickly sought to intimidate the companies that his agency regulates. A laudatory Washington Post article concluded, “What he cannot accomplish with ordinary regulation, Kessler hopes to accomplish with fear.” Kenneth Feather of the FDA’s drug advertising surveillance branch boasted: “We want to say to these companies that you don’t know when or how we’ll strike. We want to eliminate predictability.”

Dr. Kessler’s heavy-handed tactics battered the American medical device industry—one of the nation’s export superstars. An American Electronics Association survey found that “40% [of medical device companies] reduced the number of U.S. employees because of FDA delays, 29% increased their investment in foreign operations, and 22% moved U.S. jobs overseas.” The survey also found that “57% of the firms said the FDA had applied guidance instructions retroactively to some of their submissions,” as Biomedical Market Newsletter reported.

The FDA’s stonewalling of new medical devices was sometimes politically motivated. A 1994 report by the Medical Device Manufacturers Association noted, “It is not unusual for [FDA] reviewers to express the position that excessive requests [for additional information] are made because of a concern or fear about how a particular member or members of Congress will react” to the approval of a new device. Sacrificing lives was a small price to pay for bureaucrats to avoid bothersome interrogatories from Capitol Hill.

[ … ]

Dr. Kessler did not spare the First Amendment in his grab for power, and cancer patients and other seriously ill people suffered as a result. Doctors, hospitals, and researchers often discover after FDA approval that a drug to treat one disease is also effective at treating other diseases. Drug companies have routinely publicized this news, alerting physicians to other possible ways to save lives. American Medical Association vice president Roy Schwarz estimated that “off-label” uses of drugs account for up to 60 percent of all drugs prescribed.

But in 1991 Dr. Kessler prohibited pharmaceutical companies from informing doctors of new uses for approved drugs. He announced that the FDA would enforce the ban with seizures, injunctions, and prosecutions. Though the agency never finalized its proposed regulations, it warned companies that they would face its wrath if they violated the draft proposals. Dr. Kessler, in a speech before the Drug Information Association, said: “I would urge all members of the pharmaceutical industry to take a long and hard look at their promotional practices. I do not expect companies to wait until this guidance becomes final to put their advertising and promotional houses in order.” The question of off-label treatments is becoming a key issue again as doctors search for effective treatments for the COVID-19 coronavirus.

And thus because of a bureaucrat-laden impediment to medical science, the response to Covid-19 has been slow, cumbersome, lumbering, and deadly.

An example of this might be found in a recent article on another treatment for the virus.  Before we get to that, I recalled a few days ago before seeing this next article that a doctor friend of mine who volunteered in Haiti, found that he had nothing to treat the children who had scabies.  He had to let them suffer because he was sent without medications for that.  If he had been sent with it, he could have used Ivermectin to treat Scabies in humans.

I also recalled that I had treated my dog, Heidi, with Ivermectin once for a parasite, and was warned by the Vet that it was “off-label.”  In this case, off-label meant that it was for livestock, not dogs, but that it has worked for dogs for such a long time that Vets had no problem prescribing it.

As I live and breath, I actually had a fleeting thought and wondered a few days ago whether Ivermectin might be effective at treating Coronavirus.  I figured, “You’re not a medical doctor, never even bring this up because people will think you’ve fallen off your rocker.”

Then this.

An anti-parasitic drug available throughout the world has been found to kill COVID-19 in the lab within 48 hours.

A Monash University-led study has shown a single dose of the drug Ivermectin could stop the SARS-CoV-2 virus growing in cell culture.

“We found that even a single dose could essentially remove all viral RNA (effectively removed all genetic material of the virus) by 48 hours and that even at 24 hours there was a really significant reduction in it,” Monash Biomedicine Discovery Institute’s Dr Kylie Wagstaff said on Friday.

While it’s not known how Ivermectin works on the virus, the drug likely stops the virus dampening the host cells’ ability to clear it.

The next step is for scientists to determine the correct human dosage, to make sure the level used in vitro is safe for humans.

“In times when we’re having a global pandemic and there isn’t an approved treatment, if we had a compound that was already available around the world then that might help people sooner,” Dr Wagstaff said.

“Realistically it’s going to be a while before a vaccine is broadly available.”

Before Ivermectin can be used to combat coronavirus, funding is needed to get it to pre-clinical testing and clinical trials.

Ivermectin is an FDA-approved anti-parasitic drug also shown to be effective in vitro against viruses including HIV, dengue and influenza.

But if we’re waiting for FDA approval, we could be waiting for a very long time.  The bureaucrats get their say.

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Did COVID-19 Originate In A Chinese Lab?

BY Herschel Smith
1 week ago

PJM.

So where did the virus-carrying bats come from? The paper says this, quote: “We screened the area around the market and identified two laboratories conducting research on bat coronavirus.” Within a few hundred yards of the wet market was something called the Wuhan Center for Disease Control and Prevention. According to public reports, the center used Intermediate Horseshoe Bats for research. About seven miles away was another facility, called the Wuhan Institute of Virology. The virology institute also conducted research on Intermediate Horseshoe Bats.

South China University scientists concluded that the Coronavirus pandemic likely came from one of these two labs. They noted that a scientist at the Wuhan Center for Disease Control and Prevention had been exposed to the blood and urine of bats. They also suggested that infected tissue samples from research animals may have wound up in the Wuhan wet market. They ended their paper this way. Quote: “The killer coronavirus probably originated from a laboratory in Wuhan. Safety levels may need to be reinforced in high risk, bio-hazardous laboratories. Regulations may be taken to relocate these laboratories far away from city center and other densely populated places.” End quote.

That’s what I have believed from the beginning, it is what I believe today, and it’s what I will always believe unless someone presents clear and convincing evidence that persuades me to relinquish my belief.

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Updated Covid-19 Graph

BY Herschel Smith
1 week, 1 day ago

I’ve updated my Covid-19 graph.  I’ve started tracking active cases as well as confirmed cases.  Active cases are in red.  It’s as close to perfect as I can get it, and the fit hasn’t changed since my last post of the curve.

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Masks Work: So Why Don’t We Have Any?

BY Herschel Smith
1 week, 1 day ago

Via Instapundit, masks work.

Masks reduce the spread of infectious disease by catching microbes expelled by the wearer and protecting the wearer from microbes in their environment. When we cough, sneeze, talk, or simply breathe we emit a plume of air and droplets, which are largely composed of saliva, mucus, salts, and—if we are infected—potentially dangerous microbes. The smallest of these droplets, sometimes called aerosols, may hover or drift through the air for hours, potentially exposing anyone who enters that airspace. Larger droplets may travel only a few feet—or up to 26 feet if propelled by a sneeze—before falling to the ground or onto another surface, such as someone’s skin or clothes.

So why don’t we have any?

Last week, a Trump administration official working to secure much-needed protective gear for doctors and nurses in the United States had a startling encounter with counterparts in Thailand.

The official asked the Thais for help—only to be informed by the puzzled voices on the other side of the line that a U.S. shipment of the same supplies, the second of two so far, was already on its way to Bangkok.

Trump aides were alarmed when they learned of the exchange, and immediately put the shipment on hold while they ordered a review of U.S. aid procedures. Crossed wires would only confuse our allies, they worried, or worse—offend them. And Americans confronting a surging death toll and shortages of medical equipment back home would likely be outraged.

[ … ]

The administration has also placed a moratorium on overseas shipments of USAID’s stockpiles of protective gear and is asking that the equipment be sent to the U.S. instead, other officials said.

“It’s a good thing that we’re taking a holistic look at where and when we’re sending PPE as we’re looking to fulfill needs here at home,” said Pence spokeswoman Katie Miller.

President Donald Trump seems attuned to the political hazards. During Monday’s task force briefing, he emphasized that the U.S. was sending only “things that we don’t need” to other countries. “We’re going to be sending approximately $100 million worth of things – of surgical and medical and hospital things to Italy,” he announced.

[ … ]

“They’re really trying to walk a fine line between making sure Americans get everything they need and then starting to provide assistance elsewhere, and the vice president’s oversight is slowing down the decision-making process,” one person close to USAID said.

As usual for Politico, the article eventually turns into a tiring and monotonous blast piece against the administration.  But that fine line being discussed is, to me, unnecessary.  It shouldn’t exist.  PPEs should be directed towards America first.  Only when America has enough should we even consider shipping PPEs overseas.  What to the pols is a fine line should be a big bold border.

I think I mentioned that I know a health care provider who showed up for work wearing an N95 mask, only to be told by hospital administration that personal PPEs weren’t allowed.  “Fine,” this health care provider said, “Then give me one.”  “Oh, we don’t have any.”

And why is there such a thing as a sewing group who has to sew cloth masks for health care providers?  Cotton is cellulose, and N95 masks, like HEPA filters in nuclear power plants, work by interception of particles with electrostatic charge.  That’s why they can’t be decontaminated with alcohol.  They lose their charge.

So who’s running this show anyway?

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Promise In The War Against Covid-19

BY Herschel Smith
1 week, 2 days ago

We’ve previously seen the work by French doctors using hydroxychloroquine as a therapeutic for Coronavirus.  Those studies have been supplemented by another 80 patients.

For an Israeli doctor in Italy, “the hospital where he works has also seen positive results from the antiviral drug Remdesivir.”  He adds, “One technique he said had yielded dramatic results was to have patients lie on their stomach instead of on their back while on a ventilator. “Suddenly the oxygen level in the blood jumped by hundreds of percents,” he said.

But there is also copious data from doctors in New York concerning this new treatment protocol.

Last Wednesday, we published the success story from Dr. Vladimir Zelenko, a board-certified family practitioner in New York, after he successfully treated 350 coronavirus patients with 100 percent success using a cocktail of drugs: hydroxychloroquine, in combination with azithromycin (Z-Pak), an antibiotic to treat secondary infections, and zinc sulfate.  Dr. Zelenko said he saw the symptom of shortness of breath resolved within four to six hours after treatment.

Now, Dr. Zelenko provides updates on the treatment after he successfully treated 699 COVID-19 patients in New York. In an exclusive interview with former New York Mayor, Rudy Giuliani, Dr. Vladmir Zelenko shares the results of his latest study, which showed that out of his 699 patients treated, zero patients died, zero patients intubated, and four hospitalizations.

Dr. Zelenko said the whole treatment costs only $20 over a period of 5 days with 100% success. He defines success as “Not to die.” Dr. Zelenko first posted his Facebook video message last week calling on President Trump to “advise the country that they should be taking this medication.”

There are many other success stories about hydroxychloroquine across the country. Last week, Dr. William Grace, an oncologist at Lenox Hill Hospital in New York City, said they’ve not had a single death in their hospital because of  hydroxychloroquine. “Thanks to hydroxychloroquine, we have not had a death in our hospital,’ Dr. Grace said.

Also, in a study conducted by the National Institute of Health (NIH) also confirmed some of Dr. Dr. Zelenko’s findings. The study by NIH showed that Zinc supplementation decreases the morbidity of lower respiratory tract infection in pediatric patients in the developing world. A second study also conducted by NIH titled: “In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2),” also showed hydroxychloroquine to be more potent in killing the virus off in vitro (in the test tube and not in the body).

He has participated in an instructive video to explain his position.  There is hope with these protocol, but it’s clear from the data and information that the intent isn’t to wait until the patient isn’t responsive to other treatment.

Contrary to that, I’ve mentioned that I am personally aware of one local hospital that takes the position that only a pulmonologist can prescribe these drugs, and then, only as “rescue adjunctive therapy” after ARDS has already begun to occur.  In other words, he must wait until it’s too late to invoke this protocol.

Who knows why?  Perhaps this is because doctors are slow to accept these protocol, perhaps it’s because they are loath to accept treatment protocol that hasn’t been taught to them in medical school or accepted by the FDA.  But for whatever reason, this shows that America still isn’t prepared for this pandemic, and won’t be until doctors are willing to think outside their boxes and listen to others who have gone before them.

Politics may be standing in the way of the health and safety of the public.

UPDATE:

FDA Authorizes Use.

The Food and Drug Administration on Sunday issued an emergency use authorization for hydroxychloroquine and chloroquine, decades-old malaria drugs championed by President Donald Trump for coronavirus treatment despite scant evidence.

“Scientists in America and around the world have identified multiple potential therapeutics for COVID19, including chloroquine and hydroxychloroquine,” HHS Secretary Alex Azar tweeted on Sunday night, praising Trump and the EUA.

Career scientists have been skeptical of the effort, noting the lack of data on the drugs’ efficacy for coronavirus care and worried that it would siphon medication away from patients who need it for other conditions, calling instead for the agency to pursue its usual clinical trials.

What else would you expect from Politico.  “Despite scant evidence.”

Career scientists want to control what is administered to whom, when, under what conditions, and to ensure they get the credit for it.

I’m beginning to smell a rat.  My daughter observes to me that the potential side effects are nausea.  It isn’t like the drug can kill people when administered under the direction of a health care provider.

Do you think that perhaps some of this is political, and possibly a turf war, with American lives hanging in the balance?

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The Current Trajectory Of Confirmed Covid-19 Cases In America

BY Herschel Smith
1 week, 3 days ago

In my ongoing coverage and analysis of Covid-19 in America (updated almost daily), I included a much earlier graph with a curve fit, at the time, exponential and with a very high correlation coefficient.  The graph from 3/23 looked like this.

The doubling time was computed as:

ln(2) / 0.2988 = 2.32 days

The graph has been unsettled lately, until last night and today.  I have received requests to update the curve.  I said I would have to jettison the exponential curve fit and go with a polynomial (see original post), and today I did that.  The exponential model was massively over-predicting cases going forward and the correlation coefficient had begun to degrade.  The revised curve is below.

There is a remarkable difference.  The doubling time depends on where you are on the graph.  It’s a third-order polynomial.  Currently, the doubling time is 4.1 days, versus the value of 2.32 days computed not too many days ago.  The correlation coefficient is very high, and the curve is stable and well-behaved.

Here I am not weighing in on or performing analysis of the reasons for this.  There could be many, or only one, or some combination of causes.  Some readers may posit “social distancing,” others may point out that the testing rate has change because slightly symptomatic patients are not being tested, others may postulate that herd immunity may be playing a factor (i.e., it’s possible that many millions of Americans have already been exposed to and infected with the virus and had little to no problem with it), and still others may postulate that PPEs, hygiene protocol and the reluctance to go to hospitals may be playing a role (my own daughter, a surgical NP and first assist who also has to spend copious time in the ER) observes that numbers of patients entering hospital care is down.

Again, I am making no claim whatsoever as to reasons for this.  I am only mathematically modeling this phenomenon, and I can conclusively say that there is a remarkable difference between doubling time and trajectory today and a week ago.

UPDATE:

Per request, this is a picture of the previous exponential fit versus the polynomial fit.  It’s QAD (quick and dirty), with no bells and whistles.

With more time I could write Macros to make this much better with various data analytics options, but I’m not paid to do this analysis.

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