Nel's New Day

March 23, 2020

Real Information about Covid-19

Filed under: Health Care — trp2011 @ 2:46 PM
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People tired of hearing nothing about covid-19 except washing hands, keeping six feet from other people, and lying from Dictator Donald Trump (DDT) might want to read the following information.

People at Risk and Why

From experts (aka not DDT): Rachel Graham, an assistant professor in the department of epidemiology at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill; Nathan Grubaugh, an assistant professor of epidemiology of microbial diseases at the Yale School of Public Health; and John Swartzberg, a clinical professor emeritus specializing in infectious diseases and vaccinology at UC Berkeley’s School of Public Health.

Symptoms of covid-19 can be from a body’s response to the virus, not only the virus. Coughing gets pathogens out of airways. Inflammation in lung tissue fights off the virus but can cause tissue damage and make breathing difficult. Bodies heal after the tissue destroys the virus. Some healthy people are predisposed to getting sick, perhaps from genetic factors or lack of activity. Older people may have “immunosenescence,” a gradually declining immune system that over-responds to pathogens from a respiratory infection. [Photo: Viral particles, colored yellow, emerge from the cell surface, colored blue and pink.]

People with minor symptoms such as slight cough, headache, or low-grade fever may get better—or much worse. People in the first phase, called a “slow burn, may also get better before have rapid development of severe symptoms—serious fatigue, chest pains, and extreme shortness of breath. That’s the time to call a doctor. One doctor said most of his critically ill patients have a combination of obesity, high blood pressure, and type 2 diabetes.

The elderly are not the only people at risk. Originally, covid-19 affected the elderly more than other ages, but younger people ages 20 to 54 comprise 38 percent of hospitalizations. Twenty percent of those aged 22 to 44. Hospital workers are at higher risk for severe disease than would be expected for their age. Newer studies show that babies are also affected, and males are dying at twice the rate as females. Although children have been known to die, most of them have milder reactions, which means that they can be passing on the disease. New York Governor Andrew Cuomo said that 53 percent of the 17,000 confirmed cases are under 50 years old

Increased or prolonged exposure to the virus may lead to more severe disease. Perhaps that’s the reason for the higher rate of illness among healthcare workers. Researchers find that an animal develops a worse disease based on the level of exposure.

A source giving differences among allergies, colds, flu, strep throat, and covid-19.

Vaccine Research

Researchers developing vaccines are looking for answers to the unknown, such as if people become immunity from having covid-19 and, if so, how long it will last. Their hope comes from two rhesus macaques (Macaca mulatta) did not seem to become re-infected after they recovered from SARS-CoV-2 infection. As for length of time, immunity to colds doesn’t seem to last long whereas SARS and MERS antibodies may stay in an infected body for up to 15 years. No one knows if these antibodies protect from infection. Nine companies are working on vaccines.

Trials are already beginning. This week saw the beginning of Phase 1 trial on the safety of Moderna, a vaccine developed by a Cambridge (MA) company, designed to train the immune system to make antibodies blocking the spike protein used by the virus to enter human cells. Instead of waiting for trials on animal testing for safety and effectiveness, Moderna is tested on humans at the same time. Another vaccine being developed by Inovio Pharmaceuticals in Plymouth Meeting (PA) is following the same practice with its first human trial planned in April. Inovio’s tests on mice and guinea pigs have produced both antibodies and T cells against the virus.

Vaccines usually have a higher bar for safety than drugs for sick people. Researchers’ main safety concern for SARS-CoV-2 vaccines was “disease enhancement,” giving a more severe form of the disease to vaccinated people who get infected than unvaccinated people.

Treatment Research

Remdesivir: Gilead Sciences, known for Hep-C and HIV therapies, is testing a treatment in Wuhan (China) for pneumonia in people with the virus. The company’s Phase 2 trial for 394 hospitalized patients will conclude April 1, 2023, and enrollment of patients for Phase 3 begins this month with results in May. Only patients experiencing severe symptoms are eligible for the trial. Remdesivir blocks the activity of new covid-19 in cells, and it’s effective against the other coronaviruses MERS and SARS. https://www.theverge.com/2020/2/26/21154220/coronavirus-experimental-treatment-remdesivir-trials-us-china-ebola    The drug remdesivir was studied in 2014 for an Ebola treatment.

Chloroquine and hydroxychloroquine: DDT has hyped these two drugs for a solution, but chloroquine requires high dosages for any success which results in serious toxicities. Non-human primates with chikungunya did worse with chloroquine. The drugs work by decreasing the acidity in endosomes, compartments inside cells that they use to ingest outside material and that some viruses can co-opt to enter a cell. The main entryway for SARS-Cov-2 is different by using its spike protein to attach to a receptor on the surface of human cells. The French study treating 20 covid-19 patients with hydroxychloroquine reduced viral load in nasal swabs, but it wasn’t a random text and didn’t report clinical outcomes such as deaths. Side effects from hydroxychloroquine might do more harm than good because it can damage the heart and heart conditions make people at higher risk for the virus. [Photo: the spikes on the surface of the virus gives the coronavirus its name, meaning crown.]

Ritonavir/lopinavir: Sold under Kaletra, this combination drug was approved for lopinavir to inhibit the protease of HIV and ritonavir keeps its companion drug working longer. The first trial with covid-19 showed no difference between patients given the drug and the control group.

Ritonavir/lopinavir + interferon beta: Adding the molecule to regulate inflammation, interferon beta, to the combination drug, could be risk because of worse tissue damage late in the disease. Saudi Arabia is testing this group of drugs in MERS patients.

Favipiravir: This influenza drug, as well as others, may be added to trials.

Public health non-profit the Milken Institute has developed a covid-19 treatment and vaccine tracker, updated daily, that gives the type of treatment or vaccine studied or developed, source of the researcher, their stage, source of fund, timetable, and FDA approval status. (None has yet been yet approved for treating covid-19 yet.) The table, currently listing almost 60 treatments and 43 developing vaccines, also gives credible media sources, journals, and the World Health Organization.  

The government is ignoring an excellent chance to track the increase of illness across the United States by ignoring the possibilities of the Kinsa thermometer. By now, hundreds of thousands of “smart” thermometers across the nation connect to the internet and reflect clusters of illnesses with fever. A 2018 study by the University of Iowa found that the Kinsa Health company could anticipate flu outbreaks three weeks before they happen, and Clorox used Kinsa results to target ads. Now the company’s owner says the predictions are 12 weeks out. Except for California, the Kinsa map of fever below generally follows the track of covid-19 across the United States.

The most dangerous virus to the United States, however, may be the man who starts the White House covid-19 briefings. Former White House Communications Director Anthony Scaramucci, who defended DDT even after “The Mooch” was fired, now calls his former boss “the virus” and described DDT as “very insane”:

“At the end of the day what he has done is, he’s effected and replicated through the executive branch and he’s destroyed the crisis management elements of the executive branch that we need right now, not only here in the United States, but globally.”

Scaramucci said that DDT needs to be put under “verbal communication quarantine to help out the nation.”

As of 3:00 pm (PST) on March 23, the world has 374,725 confirmed cases, 37,295 since 9:00 pm yesterday, and 16,350 deaths, 1,712 since 9:00 pm yesterday. These numbers include 195 countries and territories.

The United States has 42,443 confirmed cases—50 percent of those in China and 75 percent in Italy, with 8,897 since 9:00 pm yesterday. The total number of deaths, 517, includes 98 since 9:00 pm yesterday. These numbers include all 50 states and DC. U.S. territories: Guam, 29 cases and 1 death; Puerto Rico, 31 cases, and 1 death; and Virgin Islands, 29 cases.

February 29, 2020

Covid-19 Not a ‘Hoax’

The spread of the coronavirus covid-19 around the globe overshadowed other major events such as primaries in 14 states on Tuesday—including California and Texas—and signing of a peace agreement between the U.S. and the Taliban. Earlier this week, Dictator Donald Trump (DDT) spent days in India schmoozing with autocratic leader Prime Minister Narendra Modi while violent protests against restrictions on Muslim citizenship in the country killed people and the stock markets began serious declines, the worst week since the recession in 2008.

DDT found himself caught in the middle of the covid-19 crisis with his attempts to minimize its spread in the U.S. while the experts explain how easily it is spread and the possibility of death. His followers claim the virus is a “hoax” to bring down DDT was followed by  acting chief-in-staff Mick Mulvaney telling the lie to his conservative CPAC audience. Last night at his campaign rally, DDT repeated the falsehood that “the Democrats are politicizing” the virus, which is “their new hoax,” but today he had to face questions about his statements during a press conference. His political solution for problems with the virus is to instigate more tax cuts and against lower the interest rate

[Left: DDT’s vision of covid-19.] The first death from covid-19 in King County (WA) was close to the northern border with Canada, and DDT’s solution is to close the southern border to Mexico. Canada has five times the number of virus cases as Mexico. Secretary of State Mike Pompeo refused to answer questions about minimizing the danger when he testified before the House Foreign Relations Committee for a brief two hours before he ran off to attend the CPAC. 

The World Health Organization (WHO) upgraded covid-19’s global risk to the top level of “very high.” Over 60 countries have reported cases, and people in Iran’s healthcare system reported that statistics for illnesses and deaths are much higher than the government indicates—thousands of people attacked by covid-19. At least 86,000 people in the world have been infected, and about 3,000 have died.

Surprising HHS Secretary Alex Azar, DDT made VP Mike Pence the point person for the health crisis. DDT said that an outbreak was not inevitable although the CDC’s director of immunization and respiratory diseases stated that “it’s not a question of if, but rather a question of when and how many people in this country will have severe illness.” During Pence’s first day solving the covid-19 crisis he attended the CPAC, met with Fox’s Sean Hannity and farther-right Sinclair’s Eric Bolling, and put DDT’s economic adviser Larry Kudlow on his “team.” This week, Kudlow claimed that covid-19 was already contained in the U.S.; back in 2007/08, he said that there was no chance of a recession, a message that he’s again repeating. Pence fundraised in Florida the next day.

Pence did take time to meet with his task force to tell them that all statements and public appearances about the virus will go through him. Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, had said “we are dealing with a serious virus” which may have a higher mortality rate than influenza and “has adapted extremely well to human species.” He said he was told not to say anything else without clearance bu today claimed that he had not been “muzzled.” Pence also appointed Dr. Deborah L. Birx, the director of the United States effort to combat H.I.V. and AIDS, as the coronavirus response coordinator, but DDT said, “Mike will report back to me.” In a confusion of leadership, Azar claimed to be the chairman of the task force, making him the third leader. DDT failed to follow the “clearance” policy by announcing false statistics, reassurances, and accusations at his campaign rally.

The Food and Drug Administration took action in speeding up hospitals’ abilities to test for covid-19 by allowing labs to develop and use coronavirus diagnostic tests before the agency reviews them. The lack of testing in the U.S. has been a disaster: fewer than 500 people were tested at the same time that China tested 320,000 people. The shortage of tests was so severe that a woman in California waited for five days to get CDC permission for testing because she didn’t fit restrictive federal criteria such as travel to China.

The DOD canceled a military exercise with South Korea, restricted access to Army public areas in Italy, ordered ships visiting Pacific region countries to stay at sea for 14 days, and stopped all non-essential travel in the Persian Gulf region.  

Today, DDT bragged about the quick response and preparedness to stop covid-19 from spreading in the U.S. Yet a whistleblower faces retaliation for reporting how the government didn’t provide proper training and protective gear for people required to work with quarantined people. Employees for HHS Administration for Children and Families were ordered to help quarantined people flown in from overseas, some of them having contracted the virus. DDT had already overridden CDC’s recommendation to not return them back to the U.S.

When the group was taken to two Air Force bases in California, staff members were not provided safety-protocol training until five days into their assignment. Exposed staff members went around and off the bases; at least one person stayed at a nearby hotel and left California on a commercial flight. When the whistleblower expressed concerns relayed to her from staff members, she was reassigned. None of the workers was monitored after they worked with the sick returnees. One of the bases, Travis Air Force Base, is ten miles away from Vacaville where a woman contracted covid-19 without travel or known contact with someone testing positive for covid-19.  

At today’s press conference, Pence tried to downplay his part in the Indiana healthcare crisis while he was governor. He cut public health spending and delayed needle exchanges because of his belief that it leads to drug abuse. It doesn’t. After the state’s worst outbreak of HIV, he had to back off and allow needle exchanges—for 30 days until Indiana changed the law. Pence also doesn’t believe in a connection between tobacco use and cancer; he wrote, “Smoking doesn’t kill.” He also said, “Condoms are a very, very poor protection against sexually transmitted diseases.” Pence’s decisions are based on his evangelical Christian beliefs.

Although DDT announced the first covid-19 death in the U.S. as a “wonderful woman,” the death was that of a man in his 50s. The other two new presumptive cases in the state, meaning not yet verified by testing, include a health care worker and a resident at a long-term care facility in Kirkland (WA). The facility now has 52 people suspected of covid-19, and Gov. Jay Inslee has declared a state of emergency in Washington.

At least 28 million people in the U.S. are uninsured, and millions more are underinsured with high deductibles. Many employers don’t provide sick leave, and wages can be so low that people can’t stay home if they are sick. Children go to school because parents cannot afford child care. Some of DDT’s promised $2.5 billion for the healthcare crisis comes from other domestic funding, including that for low-income people such as the home-heating program, and $535 million from the program to avoid Ebola, an epidemic that can come to the U.S.

Development of a vaccine to block covid-19’s rapid spread could take a year or longer. While testifying before the House this week, Azar refused to guarantee that a vaccine or treatment developed with taxpayer money would be affordable. He told Rep. Jan Schakowsky (D-IL) that “we can’t control that price because we need the private sector to invest.” Schakowsky protested that “he’s giving Big Pharma a blank check to monopolize them instead.” While CEO of Elly Lilly, Azar doubled the price of insulin. Under the Affordable Care Act, however, the vaccine would be free for all insured people, like all federally-recommended vaccines. 

Polling among Democrats, independents, and undecideds shows them more anxious about paying for healthcare than for housing, food, and transportation. Two-thirds worry about paying unexpected medical bills, almost 50 percent are concerned about affording insurance deductibles, and 45 percent worried about paying for necessary prescription drugs. Another 40 percent worry about affording insurance premiums. The poll was taken from February 13-18, before anxiety was ramped up by the incidence of covid-19 in the U.S. and the administration’s mixed messages.

February 25, 2020

Coronavirus Hits the Economy

The latest victim to fall to the coronavirus in the United States was the economy: in the past two days, the Dow Jones stock market dropped almost 2,000 points, the worst two-day point drop on record. The three biggest indexes—Dow, S&P 500, and Nasdaq—each averaged three-percent drops for both yesterday and today. Goldman Sachs, citing the dangerous virus, cut its growth forecast for the U.S. economy to 1.2 percent for the first quarter, well below the 2.3 percent rate in 2019 and nowhere near the 4 to 6 percent that Dictator Donald Trump (DDT) promised when he pushed through his massive tax cuts for the wealthy and big business.

DDT largely ignored the coronavirus until the drastic drop in stock markets. That’s when he considered a request from Congress for first $1 billion and then $2.5 billion to ameliorate the disease–and raise the Dow. Asha George, director of the Bipartisan Commission on Biodefense, said an immediate package of $3 billion is necessary for funding vaccines and antidotes, stockpiling medical supplies, manufacturing medications, creating and sending diagnostic kits to doctors and hospitals, and planning and guidance. She said that agencies already need the $200 million taken from other programs to fight the disease. HHS has already transferred over $130 million from some of its accounts into combatting the virus, including an emergency infectious disease rapid-response fund. DDT wants to move $535 million from an Ebola preparedness account, a disease killing tens of thousands of people, making people vulnerable to that disease.

DDT attacked Democrats for wanting more money, but they aren’t alone. When HHS Secretary Alex Azar asked Congress for the $2.5 billion, some Republicans agreed that it might not be enough. “If you lowball something like this, you’ll deal with it later,” Sen. Richard Shelby (R-AL) told Azar. Sen. Roy Blunt (R-MO) said that senators will “decide the final numbers.”

DHS acting deputy secretary, Ken Cuccinelli, demonstrated DDT’s low level of competence in appointments when Cuccinelli frantically tweeted for help in in finding a map showing the coronavirus spread. When he couldn’t locate the Johns Hopkins Center for Systems Science and Engineering department’s map showing the latest COVID-19 numbers and locations, he tweeted that it “seems like bad timing to stop helping the world.” Curiosity had caused the site to be overwhelmed, but meanwhile Cuccinelli had publicized his ignorance to the world. The article about his experiences is well worth reading just because of Twitter responses.

Acting DHS secretary Chad Wolf did almost as badly as Cuccinelli during a Senate hearing when he couldn’t accurately state the number of coronavirus cases in the U.S., didn’t know how many cases came into the US. from cruise ships, couldn’t explain how the virus is transmitted, and was unaware of mortality rates for both coronavirus and influenza. According to the The Centers for Disease Control and Prevention, flu deaths are about 1 in 1,000 people in the U.S. compared to 1 in 50 deaths from coronavirus. Wolf doesn’t know whether the U.S. has enough respirators and masks. His ignorance was made obvious by questioning from Louisiana’s GOP Sen. John Neely Kennedy. Sen. John Neely Kennedy (R-La.).

On her MSNBC news program, Rachel Maddow pointed out how DDT has weakened the U.S. fight against the coronavirus health crisis: In 2018, DDT “fired the government’s entire pandemic response chain of command back in 2018 and never replaced them with anyone,” according to Pulitzer Prize winning science journalist Laurie Garrett. He fired the point person on all global health security matters on the National Security Council and didn’t bother to find someone else for the job. President Obama had one person in charge of the Ebola crisis, but DDT has left the coronavirus response to different agencies with difficulty in cooperation. The National Security Council’s entire global health security unit was shut down, and John Bolton pushed out a similar team from the DHS. Many of the CDC global health section were cut along with a reduction of countries where CDC worked from 49 to only 10. DDT is eroding the U.S. Public Health Service Commissioned Corps and wants to cut it by 40 percent. In addition, DDT’s cuts to the National Institutes of Health and CDC hurt the possibility for research into the disease.  

DDT has come up with two solutions for the growing pandemic: it will be over in April with warmer weather, and the U.S. is “very close to a vaccine.” The severity of some viruses lessens in spring and summer, but CDC is concerned that the coronavirus may not be one of them. Under optimum conditions, a vaccine for coronavirus might be available between 12 and 18 months. The White House tried to cover for DDT in his mistake with the claim that DDT referred to the Ebola virus in talking about being close to a vaccine.

The CDC opposed putting people with coronavirus on the same plane as those who tested negative to fly them from Japan for quarantine, but DDT’s administration ignored the recommendation. DDT said there wouldn’t be any problem in mixing presumably healthy people with sick ones. Director of the University of Minnesota’s Center for Infectious Disease Research and Policy Michael Osterholm called that decision “one of the cruelest human experiments I’ve seen in my entire career.” The administration, however, is protecting DDT. Acting chief of staff Mick Mulvaney was told not to go to India with DDT because Mulvaney had a cold.

DDT, supported by his National Economic Council Director Larry Kudlow, is endangering public health in the U.S. by encouraging people to buy “these dips” in order to make DDT look good before his election while minimizing the danger of a disease that has already killed thousands of people. DDT’s claim that the virus is “under control” has no proof. A public health crisis needs trusted information, something that people will never get from DDT.

Rush Limbaugh, the most recent recipient of DDT’s Medal of Freedom, complained about how “the coronavirus is being weaponized as yet another element to bring down Donald Trump.” Limbaugh has his own alternative fact about coronavirus that he shared with millions of conservatives and says that he’s “dead right on this.” He falsely claims that “coronavirus is the common cold.”

With no evidence for his conspiracy theory, Sen. Tom Cotton (R-AR) maintains that China deliberately created the coronavirus that is killing its citizens and destroying its commerce. Experts debunked Cotton’s theory, but he continues to talk about the proximity of a lab to a market, falsely considered the virus’ starting point. His justification for his myth is “China’s duplicity and dishonesty” and persists in identifying the false “hypothesis” of an engineered virus. According to the highly reputable medical journal Lancet, scientists from several countries outside China conclude that this virus, like many other recently emerging viruses in humans, originated in wildlife

The CDC sent out faulty coronavirus testing kits to U.S. labs, but officials aren’t saying how many of the 200 kits are in that category. These kits, each testing 700-800 specimens, were intended to provide results faster than shipping samples to CDC in Atlanta. Over 30 kits intended for other countries weren’t shipped because of the flaw. One ingredient in the test caused the problem. Mislabeled samples in San Diego allowed a woman with coronavirus to be discharged from a hospital. Tests cannot also identify infected people still in the incubation period.

A few facts about Covid-19, the new strain of coronavirus:

  • Symptoms: Coughs, fever, and breathing difficulties that can lead to pneumonia. Some people who test positive have no symptoms.
  • Cure: Recovery depends on a person’s immune system because antibiotics have no influence on the virus.
  • Transmission: Person to person within six feet through air, coughs, and sneezing.
  • Extent: 80,000 people in 31 countries, the worst being China. China has 2,663 deaths among 77,658 cases. Over 12,000 people in China have recovered. Italy, Japan, and South Korea have hundreds of cases, and deaths have occurred in Hong Kong, Taiwan, France, Iran and the Philippines.
  • Mortality rate: 2 percent in the epicenter of the outbreak.
  • Other coronaviruses: Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers).

Market Watch posits that the drop in stocks is more than the effect of the Covid-19 on the world economy. The uncertainty of the virus consequences may be equaled by the uncertainty of the 2020 election outcome. Economists have been waiting almost a year to see when over-valued stocks would “correct” as DDT kept using the high stock markets as an indicator of economic growth. Recession in the U.S. has been a concern for at least a year, and the virus concern may kick these worries into overdrive.

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