COVID-19: Medical and Scientific Information

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TIDE-HSV

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Well, I presented two charts, showing countries which would seem to be comparable. Sweden is fifth our of twelve in one chart and 6th out of ten in the other.
What is the metric showing them to be the 8th worst in the world? I'm not doubting you, just not sure what metric you are looking at.
The lower chart comes from Johns Hopkins and the data were as of yesterday.
Belgium has locked down tighter than a drum (but is starting to reopen now), but their deaths/100,000 rate appears to be double Sweden's.
They may be the only honestly-reporting state. They're not just reporting confirmed cases; they report suspected cases in nursing homes, etc., if the symptoms are consistent...
 

Tidewater

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They may be the only honestly-reporting state. They're not just reporting confirmed cases; they report suspected cases in nursing homes, etc., if the symptoms are consistent...
Huge difference between the north and the south in that country. In the Dutch-speaking north, the roads are maintained, the private property is kept up.
The south, as my Canadian colleague says, "needs a coat of paint." The unofficial motto is "pas de souci."
 

TIDE-HSV

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Huge difference between the north and the south in that country. In the Dutch-speaking north, the roads are maintained, the private property is kept up.
The south, as my Canadian colleague says, "needs a coat of paint." The unofficial motto is "pas de souci."
It's always amazed me how it holds together. The Flemish have contempt for the Walloons and, pretty much, vice versa. However, they all seem to be loyal to idea of the whole country. At my daughter's restaurant in the French Alps, they get quite a few Belgians, or did before "confinement." (The limit for driving in France now is 100 km.) However, they get mostly Francophones. The Flemish tend to head towards Austria and Switzerland. So, they don't even vacation together. The restaurant is still on carryout only. This week, they got an American couple, very unusual. This couple lives half the year in Alexandria and half the year in Courchevel. The plague and travel restrictions caught them at their home in France, so they just elected to stay there. It's not that easy, really. Almost nothing is open in the shoulder seasons between the winter ski season and the summer season. You even have to drive quite a distance for a grocery store...
 

Tidewater

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It's always amazed me how it holds together. The Flemish have contempt for the Walloons and, pretty much, vice versa. However, they all seem to be loyal to idea of the whole country. At my daughter's restaurant in the French Alps, they get quite a few Belgians, or did before "confinement." (The limit for driving in France now is 100 km.) However, they get mostly Francophones. The Flemish tend to head towards Austria and Switzerland. So, they don't even vacation together. The restaurant is still on carryout only. This week, they got an American couple, very unusual. This couple lives half the year in Alexandria and half the year in Courchevel. The plague and travel restrictions caught them at their home in France, so they just elected to stay there. It's not that easy, really. Almost nothing is open in the shoulder seasons between the winter ski season and the summer season. You even have to drive quite a distance for a grocery store...
I just read that Belgians are opening their primary schools June 8.
 

Padreruf

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Here's the latest from Erin Bromage:

 

TIDE-HSV

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Another post I wondered where to place. My stepson's 50th birthday was yesterday. He's convinced he's had the virus and the symptoms seem probable. Yesterday, a number of his friends, who've either tested positive in the past or have been very ill threw him a beach party. I hope immunity is a real thing. I wouldn't have taken a chance on it...
 

UAH

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This from Sky News Australia with some insights into how the virus developed:

EXCLUSIVE: The coronavirus that has become a world-wide pandemic may have been created in a “cell-culture experiment” in a laboratory, according to prominent scientists who have conducted ground-breaking research into the origins of the virus. Flinders University Professor Nikolai Petrovsky has completed a scientific study, currently undergoing peer review, in conjunction with La Trobe University in Victoria, which found COVID-19 was uniquely adapted for transmission to humans, far more than any other animal, including bats. Professor Petrovsky, from the College of Medicine and Public Health at Flinders University who has spent the past 20 years developing vaccines against pandemic influenza, Ebola and animal SARS, said this highly unusual finding left open the possibility that the virus leaked from a laboratory. “The two possibilities which I think are both still open is that it was a chance transmission of a virus from an as yet unidentified animal to human. The other possibility is that it was an accidental release of the virus from a laboratory,” he said. “Certainly we can’t exclude the possibility that this came from a laboratory experiment rather than from an animal. They are both open possibilities.” Professor Petrovsky, who is the Chairman and Research Director of Vaxine Pty Ltd, said COVID-19 has genetic elements similar to bat coronaviruses as well as other coronaviruses. The way coronavirus enters human cells is by binding to a protein on the surface of lung-cells called ACE2. The study showed the virus bound more tightly to human-ACE2 than to any of the other animals they tested. “It was like it was designed to infect humans,” he said. “One of the possibilities is that an animal host was infected by two coronaviruses at the same time and COVID-19 is the progeny of that interaction between the two viruses. “The same process can happen in a petri-dish. If you have cells in culture and you have human cells in that culture which the viruses are infecting, then if there are two viruses in that dish, they can swap genetic information and you can accidentally or deliberately create a whole third new virus out of that system. “In other words COVID-19 could have been created from that recombination event in an animal host or it could have occurred in a cell-culture experiment.” Professor Petrovsky was originally modelling the virus in January to prepare a vaccine candidate. He then turned his attention to “explore what animal species might have been involved in the transmission to humans” to understand the origins of the virus - and had a “surprising” result when none were well-adapted. “We found that the COVID-19 virus was particularly well-adapted to bind to human cells and that was far superior to its ability to bind to the cells of any other animal species which is quite unusual because typically when a virus is well-adapted to an animal and then it by chance crosses to a human, typically, you would expect it to have lower-binding to human cells than to the original host animal. We found the opposite so that was a big surprise,” he said. Scientists worldwide have, to date, overwhelmingly said the virus was more likely originated in a wet-market and was not created in a laboratory. Even the United States Office of National Intelligence ruled out COVID-19 being created in a laboratory. Asked why scientists have had this view, Professor Petrovsky said scientists “try not to be political” and do not want their research impacted adversely by tighter laboratory controls. “We just try to base our findings on facts rather than taking particular political positions but sometimes obviously the alternatives may have unintended consequences,” he said. “For instance, if it was to turn out that this virus may have come about because of an accidental lab release that would have implications for how we do viral research in laboratories all around the world which could make doing research much harder. “So I think the inclination of virus researchers would be to presume that it came from an animal until proven otherwise because that would have less ramifications for how we are able to do research in the future. The alternative obviously has quite major implications for science and science on viruses, not just obviously political ramifications which we’re all well aware of.” Professor Petrovsky said an inquiry needs to start straight away, not when the pandemic is finished. “The idea of putting it off to the pandemic is over, it would be a mistake,” he said. “I’m certainly very much in favour of a scientific investigation. It’s only objective should be to get to the bottom of how did this pandemic happen and how do we prevent a future pandemic…. not to have a witch-hunt.”

 

UAH

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Of note, he is not a geneticist or immunologist from a quick search, but an endocrinologist. He does not specialize in bio weapons or anything of the sort. I am open to the possibility but he’s going to have to bring the proof.
I viewed the video and do not recall that he suggested it was created as a bio weapon. He discussed alternative means by which the virus mutated either within an animal or within a petri dish. I felt that the conversation was interesting from the standpoint of Covid attacking human ACE2 more strongly than any other animal species.
 

NationalTitles18

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The retracted Lancet study, published May 22, found Covid-19 patients treated with hydroxychloroquine and chloroquine were more likely to die or suffer dangerous side effects.

The second retracted study, published in The New England Journal of Medicine, had found that certain heart disease drugs, including ACE inhibitors, didn't worsen the risk of death for coronavirus patients. The authors included Desai of Surgisphere and Mehra and Patel, who were authors on study in The Lancet, as well as Drs. SreyRam Kuy and Timothy Henry.
 

4Q Basket Case

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Here's an update on the Oxford vaccine. I'm really rooting for this one because it's further down the process, which is in turn because they'd been working on a vaccine for a similar virus for some time.


Some good news, some not so encouraging:

- They were having trouble testing the vaccine because the rate of infection in the UK has fallen through the floor. So if a vaccinated person didn't get COVID, there was no way to tell if it was because the vaccine was effective, or if the person simply wasn't exposed out in the real world.

- Also, in earlier trials, the vaccine didn't actually prevent macaque monkeys from getting COVID....it prevented them from developing pneumonia, which is the core cause of most deaths from COVID.

- As I suspected might have to be the case (because of the low rate of infection in the UK), they're now testing in Brazil, which is a virus hotspot, in order to get real world exposure to vaccinated persons.

Details on backing and source of manufacture:


- The Oxford vaccine has financial support from a lot of places, including the US government. But the one I take heart in is the Gates Foundation. They're as apolitical as such things get, could support any effort, and have thrown a lot of money ($750M) behind this one.

Hard data expected by August. Meanwhile, producing hundreds of millions, perhaps billions, of doses of vaccine in the hope that it proves effective. If it does, we're ahead of the production game. If it doesn't, it's wasted. But under the circumstances, it's a gamble worth taking.

Fingers crossed.
 

NationalTitles18

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pneumonia, which is the core cause of most deaths from COVID.
This is a very common slight misunderstanding/misconception. I'm not trying to pick on you or to be nitpicky, but it's just much more complicated than that. It's important that people understand it since many don't and this sometimes contributes to a mistrust of everything from the true lethality of the disease to how it causes death and how deaths are counted (and thus the count of deaths) with some believing deaths are overcounted as a result of the misunderstanding.

I'll let Mandeep Mehra, a professor of medicine at Harvard Medical School, explain it:

“What this virus does is it starts as a viral infection and becomes a more global disturbance to the immune system and blood vessels — and what kills is exactly that,” Mehra said. “Our hypothesis is that covid-19 begins as a respiratory virus and kills as a cardiovascular virus.”
The article quoted can be found here.

More from this article:

In the initial days of the outbreak, most efforts focused on the lungs. SARS-CoV-2 infects both the upper and lower respiratory tracts, eventually working its way deep into the lungs, filling tiny air sacs with cells and fluid that choke off the flow of oxygen.

But many scientists have come to believe that much of the disease’s devastation comes from two intertwined causes.

The first is the harm the virus wreaks on blood vessels, leading to clots that can range from microscopic to sizable. Patients have suffered strokes and pulmonary emboli as clots break loose and travel to the brain and lungs. A study in the Lancet, a British medical journal, showed this may be because the virus directly targets the endothelial cells that line blood vessels.


The second is an exaggerated response from the body’s own immune system, a storm of killer “cytokines” that attack the body’s own cells along with the virus as it seeks to defend the body from an invader.

Research and therapies are focused on these phenomena. Blood thinners are being more widely used in some hospitals. A review of records for 2,733 patients, published Wednesday in the Journal of the American College of Cardiology, indicates they may help the most seriously ill.

“Things change in science all the time. Theories are made and thrown out. Hypotheses are tweaked. It doesn’t mean we don’t know what we are doing. It means we are learning,” said Deepak Bhatt, executive director of interventional cardiology at Brigham and Women’s Hospital in Boston.

Inflammation of those endothelial cells lining blood vessels may help explain why the virus harms so many parts of the body, said Mandeep Mehra, a professor of medicine at Harvard Medical School and one of the authors of the Lancet study on how covid-19 attacks blood vessels.


That means defeating covid-19 will require more than antiviral therapy, he said.

“What this virus does is it starts as a viral infection and becomes a more global disturbance to the immune system and blood vessels — and what kills is exactly that,” Mehra said. “Our hypothesis is that covid-19 begins as a respiratory virus and kills as a cardiovascular virus.”

The thinking of kidney specialists has evolved along similar lines. Initially, they attributed widespread and severe kidney disease to the damage caused by ventilators and certain medications given to intensive-care patients, said Daniel Batlle, a professor of medicine at Northwestern University Feinberg School of Medicine.

Then they noticed damage to the waste-filtering kidney cells of patients even before they needed intensive care. And studies out of Wuhan found the pathogen in the kidneys themselves, leading to speculation the virus is harming the organ.
The thinking on this is constantly evolving, with pneumonia, ARDS, Sepsis, Cytokine Storm, direct organ damage from the virus itself, blood clots, and others factors thought to cause or contribute to death from COVID-19.

So it's not that anyone is wrong for thinking pneumonia - or more accurately it's usually ARDS - causes death; it's just much more complicated.

I'd also like to include in this post another article, which shows that sepsis is present in 100% of those who died in one study. ARDS is present in 93% and respiratory failure in 98%, so these are definitely contributing to nearly every death, but they are not alone.


COVID-19 Deaths (n=54)COVID-19 Survivors (n=137)
Sepsis100% (54)42% (58)
Respiratory failure98% (53)36% (50)
Acute respiratory distress syndrome (ARDS)93% (50)7% (9)
Heart failure52% (28)12% (16)
Septic shock70% (38)0
Blood coagulation issues50% (27)7% (10)
Acute cardiac injury59% (32)0.7% (1)
Acute kidney injury50% (27)0.7% (1)
Secondary infection50% (27)0.7% (1)
Low protein blood levels37% (20)1.5% (2)
Acidosis (body fluids are too acid)30% (16)0.7% (1)

The main point is that the damage does not stop at the lungs - that is more the beginning point with many more systems affected.

This article is about sepsis in COID-19.

This one is related to clotting issues in COVID-19.

This article explains how COVID-19 affects multiple systems within the body from head to toe.
 

4Q Basket Case

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This is a very common slight misunderstanding/misconception. I'm not trying to pick on you or to be nitpicky, but it's just much more complicated than that. It's important that people understand it since many don't and this sometimes contributes to a mistrust of everything from the true lethality of the disease to how it causes death and how deaths are counted (and thus the count of deaths) with some believing deaths are overcounted as a result of the misunderstanding.

I'll let Mandeep Mehra, a professor of medicine at Harvard Medical School, explain it:



The article quoted can be found here.

More from this article:



The thinking on this is constantly evolving, with pneumonia, ARDS, Sepsis, Cytokine Storm, direct organ damage from the virus itself, blood clots, and others factors thought to cause or contribute to death from COVID-19.

So it's not that anyone is wrong for thinking pneumonia - or more accurately it's usually ARDS - causes death; it's just much more complicated.

I'd also like to include in this post another article, which shows that sepsis is present in 100% of those who died in one study. ARDS is present in 93% and respiratory failure in 98%, so these are definitely contributing to nearly every death, but they are not alone.


COVID-19 Deaths (n=54)COVID-19 Survivors (n=137)
Sepsis100% (54)42% (58)
Respiratory failure98% (53)36% (50)
Acute respiratory distress syndrome (ARDS)93% (50)7% (9)
Heart failure52% (28)12% (16)
Septic shock70% (38)0
Blood coagulation issues50% (27)7% (10)
Acute cardiac injury59% (32)0.7% (1)
Acute kidney injury50% (27)0.7% (1)
Secondary infection50% (27)0.7% (1)
Low protein blood levels37% (20)1.5% (2)
Acidosis (body fluids are too acid)30% (16)0.7% (1)
The main point is that the damage does not stop at the lungs - that is more the beginning point with many more systems affected.


This article is about sepsis in COID-19.

This one is related to clotting issues in COVID-19.

This article explains how COVID-19 affects multiple systems within the body from head to toe.
I wasn't going to get into the domino effect, but you obviously have more data than I do.

So a question: Of COVID deaths, how many didn't involve pneumonia as either the COD or the primary stressor that caused other system(s) to fail?
 
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