Covid-19 News

    WHO chief singles out Taiwan for attacks.. not Trump..


    "“Three months ago, this attack came from Taiwan. We need to be honest. I will be straight today. From Taiwan,” he said. “And Taiwan, the Foreign Ministry also, they know the campaign. They didn’t disassociate themselves. They even started criticizing me in the middle of all that insult and slur, but I didn’t care.”


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    However Taiwan has the most successful response to coronavirus.. so far


    and was the first country to warn the WHO of an impending pandemic on December 31..


    the word 'patsy' comes to mind...patsy WHO?


    “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in #Wuhan, #China,” the WHO tweeted on January 14.

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    In this video you'll discover the nootropic benefits of Zinc. Including why we use Zinc as a nootropic, recommended dosage, side effects and clinical research.

    Zinc is an essential trace element absolutely required for optimal brain health and cognition.

    Zinc is required for memory formation. When more zinc is available in neurons, neurotransmitters move more efficiently and stay in play longer.

    Zinc helps boost BDNF which is needed for long-term potentiation and the formation of memory. A deficiency in this mineral results in poor memory.

    Zinc is integral to the activity of at least 100 enzymes. And zinc helps lower oxidative stress which protects brain cells and cerebral blood flow.
    Zinc is needed for protein synthesis to make neurotransmitters. And is involved in DNA repair, synthesis and cell division.

    Zinc deficiency is common even in our Western society because we often don’t get enough from food. If you’re vegan or vegetarian, you are particularly susceptible.

    Zinc levels are low in those with depression. And the lower the zinc level, the more severe the depression.

    Recommended zinc dosage is 30 mg daily, balanced with 2 mg of copper.

    • Official Post

    https://www.theguardian.com/wo…uary-despite-trump-claims


    The technical guidance notes published by the WHO on the 10 and 11 of January were issued when suspected infections in China comprised a few dozen cases.

    The notes lay out detailed clinical criteria for dealing with suspected cases as well as warning of the risk of ease of transmission both by airborne droplets and contact with contaminated surfaces, suggesting isolation procedures.

    As well as being posted online, the guidance was sent to the organisation’s regional emergency directors and country heads to be circulated to senior health officials.

    One note, published on 11 January, advised clinicians and health officials to be alert to the emergence of clusters of cases as well as any “evidence of amplified or sustained human-to-human transmission” despite the Chinese, at that stage, not reporting sustained local transmission.

    While the document advised medical personnel to look out for suspected patients who might have travelled to China’s Hubei province, or health workers who had contact with the then new virus, it also recommended that doctors look out for “unusual or unexpected clinical course, especially sudden deterioration despite appropriate treatment” regardless of those factors.

    Well looks like we can rule out inherited resistance as a reason for the low incidence of COVID-19 cases and deaths in Sub-saharan Africa (excluding S Africa). Such resistance was originally suspected by Chinese medics when one Camarroon man made a spectacular recovery. In US probably equally susceptible but racist suppression, poverty, overcrowding is probably the cause of higher number of fatalities. Same is true of Hispanic minority. Is it that simple? Sub Saharan Africans + Chloroquine = few cases, resistance/ American Africans - Chloroquine = massive deaths, no resistance. Similar age demographics in the two groups, but maybe less testing in Africa. The same or similar exposure to Chinese carriiers (super-spreaders) especially documented in Nigeria and Kenya. And yet the WHO is still not approving its use. Still no evidence?

    Coronavirus is disproportionately killing African Americans

    Early data from the US coronavirus pandemic exposes how systemic racism and inequality put minority groups at risk.

    by Violet Law9 hours ago

    People wait in line to receive testing during the global outbreak of the coronavirus disease (COVID-19) outside Roseland Community Hospital in Chicago, Illinois [Joshua Lott/Reuters] People wait in line to receive testing during the global outbreak of the coronavirus disease (COVID-19) outside Roseland Community Hospital in Chicago, Illinois [Joshua Lott/Reuters]

    MORE ON CORONAVIRUS PANDEMIC

    Chicago, Illinois - The early data emerging from the coronavirus pandemic in the United States has laid bare the disparities many public-health specialists are all too familiar with: Racial minorities are disproportionately affected by health crises such as this one. And in the case of COVID-19, more of them have died.

    Quote from Dr Richard

    And yet the WHO is still not approving its use

    The more experts are involved the slower the decision.. however many of the trials have just started..

    data is accumulating..

    If CQ was even an 80% magic bullet then the data would have justified approval by now


    However there are the Chinese (CHO?) consensus recommendations for trialling CQ... March 12


    https://www.ncbi.nlm.nih.gov/pubmed/32164085.


    Whether or not the WHO approves.. physicians are using their own judgement and experience with patients

    in their hospital and contacts milieu

    Quote from RobertBryant

    trialling CQ... March 12

    The CHO March 3 recommendations are for trials...

    there is no gold standard doubleblind randomised trial evidence. that takes a long time..


    2.4 Antiviral therapy: Hospitals can try Alpha-interferon (5 million U or equivalent dose

    each time for adults, adding 2ml of sterilized water, atomization inhalation twice daily),
    lopinavir/ritonavir (200 mg/50mg per pill for adults, two pills each time, twice daily, no
    longer than 10 days),

    Ribavirin (suggested to be used jointly with interferon or
    lopinavir/ritonavir, 500 mg each time for adults, twice or three times of intravenous
    injection daily, no longer than 10 days),

      chloroquine phosphate (500 mg bid for 7 days for
    adults aged 18-65 with body weight over 50 kg; 500 mg bid for Days 1&2 and 500 mg qd 9
    for Days 3-7 for adults with body weight below 50 kg),

    Arbidol (200 mg tid for adults, no longer than 10 days)

    . Be aware of the adverse reactions, contraindications (for example,
    chloroquine cannot be used for patients with heart diseases) and interactions of the

    abovementioned drugs.


    https://www.chinadaily.com.cn/…atment.of.COVID-19.V7.pdf

    This is a link to a BBC article about some of the trials that are ongoing.

    Research at Bradford Royal Infirmary


    The patients can agree to be in the trials; they are told the may be getting a placebo;

    The other four possibilities are:

    • Hydroxychloroquine, the antimalarial drug that President Trump said he had a good feeling about - which then led to a spate of overdoses and acute shortages
    • Kaletra, a combination of antiretroviral drugs used in treating HIV
    • Dexamethasone, a steroid, which is an old favourite in medicine when we don't quite know what's going on
    • Interferon, a cytokine, which may help fight the infection


    The patients only get the drugs while they are in the hospital, once they leave hospital the drugs stop.


    I bet some might want to comment on the word "spate".

    More on Zelenko


    I seem to be on the edge here posting both negative and positive stuff!


    https://docs.google.com/document/d/1SesxgaPnpT6OfCYuaFSwXzDK4cDKMbivoALprcVFj48/edit


    March 23rd correspondence, with more detailed info on patient criteria than before (but this is early, criteria may have changed).


    There is still no accurate information from this. This letter implies however that he is not treating everyone:


    1. Any patient with shortness of breath regardless of age is treated.

    2. Any patient in the high-risk category even with just mild symptoms is treated.

    3. Young, healthy and low risk patients even with symptoms are not treated (unless their circumstances change and they fall into category 1 or 2).


    That makes the results more interesting, if this protocol is followed and the quoted figures are for those treated in this way, rather than for all patients seen. However, we do not know that the stated results are for all patients so treated, at least I don't think we do.


    It is a pity because this protocol is not a stupid idea for a set of high infection likelihood patients as here, and it would therefore be good to have precise information from this intervention. No such information has yet been forthcoming: perhaps Zelenko will be persuaded to write this up with care? But, as he says, he is just a family doctor and probably neither interested in doing that nor used to it which means his experience stays anecdotal and of little interest to others except for political reasons.


    It does seem that his politics favour Trump - but I don't see that as relevant to evaluating this study, unless you think him likely to be deceiving people for political reasons. I don't, though there may be some over-optimism. Unfortunately I also don't think he has much understanding of statistics and therefore can't evaluate his own (bold, but not stupid) regime. I say bold because the possibility of side effects from the HCQ is real, though relatively low risk, and according to this he is not screening for heart conditions etc that would make these more likely. He could be doing more harm than good.

    'Spate' means 20 or less cases worldwide, only one idiot fatal (fish tank cleaner). Have to discount one of two intentional suicides too some taking as much as 60 mg/Kg but surviving with hospital treatment. Zelenko's treatment protocol would suggest that our dirty rotten scoundrel pro Trump activist doc (liberal media reporting) is doing more good than harm. His protocol also suggests his hydroxchloroquine/azithromycin supplies may be limited so is only treating those patients in definite need of it.:)

    Quote from ZenoOfElea

    The patients can agree to be in the trials; they are told the may be getting a placebo;


    The other four possibilities are:


    Hydroxychloroquine, the antimalarial drug that President Trump said he had a good feeling about - which then led to a spate of overdoses and acute shortages
    Kaletra, a combination of antiretroviral drugs used in treating HIV
    Dexamethasone, a steroid, which is an old favourite in medicine when we don't quite know what's going on
    Interferon, a cytokine, which may help fight the infection


    Such studies are very dangerous (in fact this one is nonsensical) as obviously the doctors did not inform themselves what a therapy is versus just giving a single drug.


    Hydroxychloroquine: Without Zinc (some pills may contain some of it) and without Azitromycin, that also is an antiviral,in this case, does not make much sense except in very early stages of a soft infection.

    Kaletra: Has been used in Switzerland since day one and did show some effect among the severe patients: Now its no longer used as it was of no real help.

    Dexamethasone: Immunsuppresive what might be dangerous if you have other infections.

    Interferon: Is always given in combination see Avigan protocol.

    Some more news:


    German and Austria statistics probe shows 3x more infected than verified. This would be bad in regard to mortality. ( we did assume 5x so far as best case and 2.5x as minimum ..)


    According to Taiwanese Chinese news my wive reads daily: Strong outbreak in China mainland Canton area. In North of China they build new hospitals to isolate patients. It looks like China is cheating the world again.


    Also Japan figures are now going through the roof as they lost cases tracking a week ago.

    All fun locals were still open until yesterday. Now they close batchinko, bars, karaoke!!, etc... Abe is even the bigger idiot than Boris & Donald.

    If true, this is NOT going to be over soon.

    If everyone can get reinfected, the only path around this seems to be a vaccine.

    “7:30 pm: South Korea reports recovered patients testing positive again”

    Quote from Roseland67

    “7:30 pm: South Korea reports recovered patients testing positive again”


    Recovered does not mean virus free!!! The virus can infect e.g. the guts what will take much longer to get rid of them. I would not rate such messages to have any impact if such are not based on e.g. at least 500 tested recovered patients.


    We also know form early antibody tests that the immune reaction (antibody titer) is strongly varying e.g. with age class etc... Thus in reality we almost know nothing as being given to hold !

    Mass Drug Administrations have been employed on China before, from Wikipedia:

    MDA is included in the malaria-control policy of the People’s Republic of China. Following the first malaria-control phase from 1955 to 1962, which was mostly focused on malaria surveys, mass administrations were added to vector control measures and improved case management in 10 of China’s 33 provinces.[35] The drugs used in the administrations, mostly chloroquine and piperaquine, were provided free of charge by the central government. The economic reforms instituted by Deng Xiaoping, which ultimately put an end to the provision of free health care through the central government and the emergence of resistance against the most widely used antimalarials modified the use of mass drug administrations after 1980. MDAs are now targeted at high-risk populations, specifically non-immune migratory workers who receive repeated courses during the high transmission season. According to government guidelines, piperaquine, chloroquine, or sulfadoxine combined with primaquine can be used for mass administrations.[36] The artemisinin derivatives are not used in mass drug administrations and are reserved for treatment failures. Malaria burden and control measures are shown in Table 1. Between 1990 and 2000 the malaria prevalence dropped from 10.6 to 1.9 / 100,000, the number of reported malaria cases dropped from 117,359 to 24,088 while the number of reported deaths attributable to malaria remained stable.[37] These data, reported to the national government, depend on reporting from health care providers and like all data depending on passive surveillance tend to underestimate the true disease burden. However, there is no reason to think that the level of underreporting has changed over the last decade. Therefore, the proportional reduction in malaria disease burden is likely to be true. Malaria-control measures, including MDA, as well as major ecologic changes during the second half of the last century are likely to have been responsible for the more than 100-fold reduction in malaria burden in China since the initial surveys in 1955.[38] The widespread use of antimalarials has been followed by the emergence of drug resistance especially in regions with high drug use. By 1995 more than 95% of P.falciparum strains isolated in the South of Yunnan province were found to be resistant to chloroquine, and piperaquine while in the remainder of Yunnan and Hainan province the resistance rates were 85%and 38% respectively.[39]


    And here we have, guess WHO?, The World Health Organization advocating adding our extremely toxic poisonous chloroquine to the table salt:

    Indirect MDA[edit]

    A different approach to MDA consists of adding an antimalarial to an essential foodstuff, usually salt. Chloroquinized salt for malaria suppression was introduced by Pinotti in 1952 and gave promising results in a number of field trials and malaria-control programmes in Brazil.[40][41][42]

    In 1959, the WHO conducted a trial in West New Guinea (later known as Irian Jaya).[43] Salt crystals were mixed with pyrimethamine so as to provide a 0.07% pyrimethamine salt. As there were no shops in the catchment area, each family unit received fortnightly a quantity of salt from the local teacher or another member of the village community. Within three and a half months of the onset of the campaign, clinically significant levels of pyrimethamine resistance were reported. It was then decided to mix the remaining stock of pyrimethaminized salt with chloroquine powder. The chloroquine base content was 0.04% or 140 mg per adult per week based on a 5g per day salt consumption. The emergence of chloroquine resistance was investigated, but this was not detected. The distribution of medicated salts otherwise had no effect and it was concluded that ‘Pinotti’s method holds no prospect of malaria eradication…’. The explanation for this finding given by the author is that ‘the salt consumption by children was too small to reduce significantly the parasite reservoir of the younger age groups’.

    Between 1961 and 1965, the use of chloroquinized salt was made compulsory over an area of 109,000km2 in Guyana, covering a population of 48,500 individuals.[44] The chloroquinized salt was prepared at a state salt plant so as to provide a 0.43% chloroquine concentration. The salt was sold in two pound plastic bags. The state held the monopoly for the salt. The only alternative source was salt smuggled from Brazil. Although the chloroquinized salt was used, its popularity was limited by the occurrence of a photo-allergic dermatitis popularly called ‘salt itch’ noted in all treatment areas. Chloroquine resistance was first observed in 1962 in the area with the lowest relative uptake of chloroquinized salt. In the course of the following months, a complete replacement of the susceptible strains with resistant P. falciparum strains was observed. Following the reintroduction of DDT spraying, the prevalence of P. falciparum declined.

    In Southeast Asia, the medicated salt project at Pailin, on the Kampuchea-Thai border, demonstrated how drug resistance can develop when a large population of P. falciparum undergoing high transmission rates is exposed to intense drug pressure.[45] The project was launched in 1960 and covered a population of approximately 20,000. Sea salt was mixed with pyrimethamine at a concentration of 0.05%. Between 1960 and 1961, 77 tons of medicated salt were distributed in the area. After widespread pyrimethamine resistance was reported, pyrimethamine was replaced by chloroquine. From 1961 to 1962, 75 tons of chloroquine were distributed. In two indicator districts, the parasite rates decreased from 40% to 7% and from 27% to 14%.[46] Chloroquine resistant P.falciparum isolates were first detected in Pailin in 1962 which appeared to be widespread by 1966. However no survey was undertaken to document the prevalence in the area. The factors leading to the emergence and spread of drug resistance appear to have been the continuous introduction of non-immune migrants, attracted by the promise of quick wealth from mining of precious stones, and prolonged drug pressure resulting from individual drug consumption and mass drug administration. Unrelated to MDAs the emergence of artemisinin resistant P.falciparum strains was reported in Pailin in 2008, this may have been related to overuse of artemisinin derivateves including counterfeit drugs but was not related to programmatic MDAs.[47][48][49]

    Further malaria-control projects have used MDA, but have never been published, or have been published as technical reports.[50][51


    Suggests that as far as chloroquine prescribing the WHO has a somewhat chequered history which might underly its reticence in approving it.

    https://www.medscape.com/viewarticle/928373


    (login needed but registration is free or you can get password-free login from an instant e-mailed link)


    COVID-19 Practical Tips: US Docs Share Clinical Strategies

    Tricia Ward


    April 08, 2020


    Hydroxychloroquine and IL-6 Inhibitors

    The standard protocol at NYU Langone is azithromycin and hydroxychloroquine/zinc. Horwitz didn't use hydroxychloroquine in patients who were recovering given the low anticipated benefit, and she was also hesitant to use it in patients with coronary disease or at risk for arrhythmia (they tracked corrected QT interval).

    Chopra added that they saw gastrointestinal adverse drug reactions and liver function test abnormalities from hydroxychloroquine, without any clear evidence of benefit.

    A controversial study from France  supporting use of hydroxychloroquine and azithromycin has been criticized by statisticians and others for overstating the benefits of these drugs in COVID-19.

    For the patients showing acute decline, Horwitz administered intravenous tocilizumab, an interleukin-6 (IL-6) inhibitor used to treat rheumatoid arthritis, off label. Chopra found that IL-6 blockers seemed to work when given early, but he warned that by the time the patient needed intubation, it was too late.


    There is preliminary data from China  and Naples, Italy, suggesting that tocilizumab reduced fever and need for supplemental oxygen in patients with severe or critical COVID-19 infection.

    The drug is being studied in the TOCIVID19 trial. Chopra told Medscape that they continue to use tocilizumab, but because of national shortages, they try another IL-6 inhibitor, sarilumab, whenever possible.

    Both hospitals are now participating in a clinical trial of sarilumab, and NYU Langone will also be a clinical site for trials of a third IL-6 inhibitor, clazakizumab, and the antiviral remdesivir.

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