Covid-19, Your health and that of your community

Quote from Dr Richard

prevent hospitalization as Zelenko has demonstrated

Zelenko has demonstrated 4 hospitalisations and 1 death from 700 out-patients, prescribing HCQ+AZT+Zn

Let us assume that all these are infected with COVID.

From a normal demographic that would be outstanding success. You would expect 0.66% IFR, of which 50% might be asymptomatic and notpresent. Therefore of his patients we would expect 1.3% IFR, or 10 deaths.

BUT HE DOES NOT SERVE A NORMAL DEMOGRAPHIC. His patients are very very young.

Therefore the low hospitalisations he shows are expected, due to the way this virus works. No demonstrated prevention if that number would have happened anyway with no treatment.

In fact his demographic is so unlikely to develop serious symptoms that it is very difficult to conclude anything from his data, alas.

THH

Quote from Shane D.

[Quoting a letter in the New York Times] Ok, then while we are at it, where was the New York Times. Why was a paper this large was not able to hear from responsible sources, epidemiologists, someone, somewhere, that on March 1, the very few deaths from community transmission, would likely follow the course already observed in Italy?

This person has not checked the archives of the New York Times. They reported the facts and the reasons to be alarmed early on. For example:

Jan. 28, 2020

https://www.nytimes.com/2020/0…on/coronavirus-china.html

Opinion

We Made the Coronavirus Epidemic

It may have started with a bat in a cave, but human activity set it loose.

The latest scary new virus that has captured the world’s horrified attention, caused a lockdown of 56 million people in China, disrupted travel plans around the globe and sparked a run on medical masks from Wuhan, Hubei Province, to Bryan, Texas, is known provisionally as “nCoV-2019.” It’s a clunky moniker for a lurid threat.

Jan. 29, 2020

https://www.nytimes.com/2020/0…coronavirus-outbreak.html

Opinion

Is the World Ready for the Coronavirus?

Distrust in science and institutions could be a major problem if the outbreak worsens.

The coronavirus outbreak, which began in early December in the Chinese city of Wuhan, had as of Wednesday sickened more than 6,000 people across at least 15 countries and claimed more than 130 lives, all of them in China. Experts don’t yet know how contagious, or how deadly, this new virus is. But the growing crisis has inspired panic. Cities around the world are bracing for a potential wave of infections. Stock and oil prices are tumbling. And experts in just about every global industry are fretting over the many supply chains that could be disrupted — from prescription drugs and surgical masks to rare earth metals — if the outbreak grows into an even wider epidemic.

Agreed - in this case it looks like Zelenko was selecting younger patients who had a higher probability of recovering without hospital treatment, ICU or ventilator therapy. Why quote median age of 15 instead of average age? So that's 350 above 15 and 350 below (lots of children & babies actually showing COVI-19 symptoms, these are usually asymptomatic according to the media). Is this Zelenko really such a scoundrel to try and fiddle the figures and try and show this therapy is successful as apposed to doing nothing? - what would be his motivation? Copying that other scoundrel Prof. Didier Raoult (again only selecting patients likely to recover)? Before hard evidence comes in surely the evidence as observed by experts in the field and their professional advice should be objectively considered. From the same thread above:

I personally have seen 7 patients all of whom were getting worse by the day and all of them tested positive for COVID-19 and all but one developed pneumonia… Unfortunately their misguided DOCTORS did not want to give them Hydroxychloroquine, Azithromycin and Zinc, they kept telling them “just rest, drink plenty….” meanwhile all we’re getting worse. 3 needed up in the hospital including 2 in the ICU and one on a respirator.

When they got to the hospital they were given Hydroxychloroquine with azithromycin BUT unfortunately for 1 of them After 3 days in the hospital he ended up an a respirator, miraculously he recovered after 3 days on a respirator (the Doctor practically gave up), round the clock Tillim did the trick.

The other 4, we got them to Dr. Zelenko and other GOOD doctors who prescribe the medications and they started getting better .

One can always argue that it’s no proof, perhaps they would have (miraculously) gotten better anyhow.. Stupidest argument, because you can say it by any patient who gets better after taking medication (perhaps he would have gotten better)

Quote from Dr Richard

Agreed - in this case it looks like Zelenko was selecting younger patients who had a higher probability of recovering without hospital treatment, ICU or ventilator therapy. Why quote median age of 15 instead of average age? So that's 350 above 15 and 350 below (lots of children & babies actually showing COVI-19 symptoms, these are usually asymptomatic according to the media). Is this Zelenko really such a scoundrel to try and fiddle the figures and try and show this therapy is successful as apposed to doing nothing? - what would be his motivation? Copying that other scoundrel Prof. Didier Raoult (again only selecting patients likely to recover)? Before hard evidence comes in surely the evidence as observed by experts in the field and their professional advice should be objectively considered. From the same thread above:

I personally have seen 7 patients all of whom were getting worse by the day and all of them tested positive for COVID-19 and all but one developed pneumonia… Unfortunately their misguided DOCTORS did not want to give them Hydroxychloroquine, Azithromycin and Zinc, they kept telling them “just rest, drink plenty….” meanwhile all we’re getting worse. 3 needed up in the hospital including 2 in the ICU and one on a respirator.

When they got to the hospital they were given Hydroxychloroquine with azithromycin BUT unfortunately for 1 of them After 3 days in the hospital he ended up an a respirator, miraculously he recovered after 3 days on a respirator (the Doctor practically gave up), round the clock Tillim did the trick.

The other 4, we got them to Dr. Zelenko and other GOOD doctors who prescribe the medications and they started getting better .

One can always argue that it’s no proof, perhaps they would have (miraculously) gotten better anyhow.. Stupidest argument, because you can say it by any patient who gets better after taking medication (perhaps he would have gotten better)

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We don't know his patients were median age 15. we have no info directly on that. But we know the locality where he worked has median age 15 population (at least that is what I understand from the link). It may be there is a school etc, and his patients do not come from it, so his population is more typical. But since he has provided no information we can only go by local population demographics.

I'd dearly like to have more info on HCQ/AZT/Zn. I'm quite prepared for this to be in any form - but it needs enough data so that the claims are meaningful. the big red flag with Zelencko is that these claims emerge without any details (patient demographics, etc). The whole thing has become very political in the US so I don't necessarily blame him - he could just be reported by others in this unhelpful way.

Oh well, the first real US RCTs should have prelim results this month I'd think.

It's not just political in the US it is political worldwide unfortunately. Here we have a chemical compound with well known side effects due to blocking inwardly rectifying voltage dependent K channels in heart muscle, causing slowing of conduction velocity in signal transmission of pacemaker activity. The actual site of channel block is known to be on the cytoplasmic side of the channel where the chloroquine is concentrated intracellular up to 1000 times the external concentration. Other K channel blockers tend block sites within the channel, so cannot be used to displace it. The resulting lowering of cardiac contractility (also due to some effect on blocking Ca channels) slows the heart rate, lower conduction velocity shows up as an increase in ECG QT interval, hypotension (lowered blood pressure).

Some of these effects could be regarded as beneficial particularly to patients with hypertension, and in the older literature chloroquine was actually shown to be effective, like quinidine, in treating cardiac arrhythmias like atrial fibrillation. Simply by reducing excitability. Remember clinical medicine is an art not a science, and treatment trends change over the decades often for no reason other than vested interests usually of pharma. So in this context the present hysteria against is use is very surprising, a tried and tested medicine used for decades, freely available over the counter for many years without a prescription and regularly used by travellers abroad for malaria, also used for Lupus, for rheumatoid arthritus, for cancer, tested for anti HIV activity. Corona virus comes along and it's use suddenly becomes restricted by pharmacies, orders abroad cancelled, it is now stockpiled by medical professionals in the know, it's unprecedented. That's this pandemic's favourite word to date, unprecedented.

Quote from THHuxleynew

We don't know his patients were median age 15.

Usually you are immune against obvious nonsense. But please show me a western region with a median age of 15.... Even in india its much higher.

Numbers of cases in India are creeping up, 6,600 or so cases now but only 199 deaths. Papua New Guinea still has only 2, no deaths. Keep taking that mefloquine!

Quote from Wyttenbach

Usually you are immune against obvious nonsense. But please show me a western region with a median age of 15.... Even in india its much higher.

wyttenbach - this is now the 3rd time I've posted it: all you have to do is read what I post, you should know by now that when I make statements I have facts to back them up.

In the village, the population was spread out with 57.5% under the age of 18, 17.2% from 18 to 24, 16.5% from 25 to 44, 7.2% from 45 to 64, and 1.6% who were 65 years of age or older.

The median age was 15 years. For every 100 females, there were 116.3 males. For every 100 females age 18 and over, there were 118.0 males.

The village abides by strict Jewish customs and its welcome sign asks visitors to dress conservatively and to "maintain gender separation in all public areas".^[18]

from https://en.wikipedia.org/wiki/…el,_New_York#Demographics

So, basically, he was doctor to an Orthodox Jewish community with a lot of children, and therefore demographics guaranteeing extremely low incidence of serious COVID.

These details matter. A lot.

Now without a lot of research, you would not know this, because the anecdotal data reported in the media contained no information on the demographic profile of his patients. His comments make excellent propaganda.

When we look more closely we can see that in fact these results are what you might expect with no intervention - but there is too much uncertainty to make any conclusion. I'm not concluding from this evidence that HCQ+AZT+Zn does not work. Merely that this evidence provides no evidence one way or the other without a lot more data (the precise age profile of his patients to start with).

Quote from THHuxleynew

n the village, the population was spread out with 57.5% under the age of 18, 17.2% from 18 to 24, 16.5% from 25 to 44, 7.2% from 45 to 64, and 1.6% who were 65 years of age or older.

The median age was 15 years. For every 100 females, there were 116.3 males. For every 100 females age 18 and over, there were 118.0 males.

The village abides by strict Jewish customs and its welcome sign asks visitors to dress conservatively and to "maintain gender separation in all public areas".

This gives 25% for the group >18 that counts for 5% only in the mortality. Thus 175 people with 1/9 having it = 20 thereof 1/20 ... 1 death in "average" just luck to find it...

But this exactly shows (said before already) what will happen in the US: No testing is done at least 90% of medication spoiled for nothing but risk!

They should use this as a sample for miss guiding.

Quote from Dr Richard

Numbers of cases in India are creeping up, 6,600 or so cases now but only 199 deaths. Papua New Guinea still has only 2, no deaths. Keep taking that mefloquine!

India:

6600 cases vs 200 deaths => CFR (instantaneous, before all cases have resolved) of 3%. That is pretty typical while still on the upward part of the exponential - it varies with population demographics and with how many cases are actually counted. For example in the UK there are a lot of cases not counted because never tested at home.

If the issue is why so few cases, then note that india has done very little testing:

“India’s [coronavirus] strategy was conservative and limited to only those persons with a travel history or connected to such individuals. We have gone up from 5 per million one month back to about 30 now, said K Sujatha Rao, a former health secretary.

"Unless we test much more, we will never know the actual extent of the problem and understand whether our interventions are adequate or falling short,” said Rao, who is the author of But Do We Care: India's Health System.

“I hope that the lockdown and expanded testing and treatment will help contain and mitigate the epidemic. Since more cases are coming up, it is imperative to scale up testing to understand the actual spread of this infection,” he told Anadolu Agency.

India has reported a total of 136 deaths of coronavirus, with around 4,780 confirmed COVID-19 cases across the country as of Tuesday morning.

Gagandeep Kang, a clinical scientist who heads the Translational Health Science and Technology Institute in India, said “not enough tests are happening.”

“We need to expand PCR [polymerase chain reaction] testing as much as possible and also develop a rapid antigen test,” she told Anadolu Agency.

PCR tests are used to directly detect the presence of an antigen, rather than the presence of the body's immune response, or antibodies.

“We will see a synchronous development of localized outbreaks in different regions with size depending on how effective the lockdown was in that area. We are too big a country with too many people for uniform spread through our population. Preparedness depends on the scale of what happens where.”

The ICMR last week also issued an advisory to start rapid antibody-based blood tests for COVID-19 “in areas reporting clusters and in large migration gatherings or evacuee centers.”

ICMR Director-General Balram Bhargava wrote to India’s Health Secretary Preeti Sudan asking her to disseminate an advisory in states and union territories to start rapid antibody- based blood tests for COVID-19.

"Overall testing for COVID-19 using real time RT-PCR is increasing, and we will be approaching full capacity in the near future. At the same time, we are expecting delivery of rapid (blood-based) test kits for use in response to the COVID-19 situation," Bhargava said in his letter.

Ramanan Laxminarayan, director of the Washington-based Center for Disease Dynamics, Economics and Policy and a lecturer at Princeton University, told Anadolu Agency that while “India has been proactive in tackling the epidemic both by sealing borders and locking down the country, the biggest such exercise in the world,” testing has been slow.

“India has among the lowest rates of testing in the world but is picking up speed. Rapid antibody-based tests are now being introduced. There is still a long way to go and there is simply no way for any country to win against COVID-19 without extensive testing,” he said.

PNG:

do I need to look at this? Perhaps instead you could martial evidence for us to see whether the data from there is unusual in any way other than being an island that hoped to remain COVID-free and is completely unprepared for it?

https://www.theguardian.com/wo…er-first-coronavirus-case

No, PNG is an interesting case because like Italy it is part of the 'New Silk Road' trade agreement with China so like Italy has a very large number of Chinese business people travelling to and fro. China has about 40 separate businesses operating there gobbling up all their natural resources. This large Chinese contingent has been blamed for the massive outbreak in Northern Italy following the Chinese New Year. A similar outbreak has not occurred in PNG (2 cases). The only other malarial region China has close ties with the same trade agreement is Nairobi, Kenya with 186 cases and 7 deaths. Compared with Italy with 143626 cases and 18279 deaths. China has supplied PNG with free anti malaria drugs for many years including chloroquine and mefloquine. No travel restrictions, no quarantine measures social distancing or hand sanitizer. Draw your own conclusions.

Well Italy actually banned flights from China twelve days before the Chinese New Year. Probably just as well,

An Italian ban on flights to and from China has ruffled diplomatic ties with Beijing, less than a year after Rome had positioned itself for a privileged relationship by signing up to the Chinese Belt and Road infrastructure project.

Italy on Jan. 31 suspended flights to and from China, Hong Kong, Macau and Taiwan in a bid to prevent the spread of the deadly coronavirus. The ban, due to last until April 28, was the first by a European Union member. The Czech government later followed suit.

Clinical trial statrted in US:

NIH clinical trial of hydroxychloroquine, a potential therapy for ...

www.nih.gov › news-events › news-releases › nih-clinical-trial-hydro...
1 day ago - A clinical trial to evaluate the safety and effectiveness of hydroxychloroquine for the treatment of adults hospitalized with coronavirus disease ...

DR Colbert answers questions about CV

Good explanation of CV

Anyone who wants more indepth CV information.

Frontline workers stories.

Quote from Dr Richard

Clinical trial statrted in US:

NIH clinical trial of hydroxychloroquine, a potential therapy for ...

www.nih.gov › news-events › news-releases › nih-clinical-trial-hydro...
1 day ago - A clinical trial to evaluate the safety and effectiveness of hydroxychloroquine for the treatment of adults hospitalized with coronavirus disease ...

They are recruiting now, the primary outcome measure (COVID disease severity on day 15) will be available in April for all of the 510 patients. The study is randomised, stratified by location, and quadruple blind. Basically, they are being very very careful.

They have a lot of secondary outcomes - including patient state throughout the treatment - some of these should be available by the primary completion date.

Just under 3 weeks to wait assuming they do the preliminary results write-up quickly.

Some here will maybe be unhappy that this is just HCQ. But it makes sense. The data for HCQ+AZT being more effective is very minimal, and before looking at combinations it is best to look at individual effectiveness.

THH

Quote from sam12

This is how Our Canadian Medicare

started.Sure is nice not to get that

Big Bill.

https://canadiandimension.com/…iew/the-birth-of-medicare

Ahh Canada 🤗. Lol will have to spend some time there. Espior en Amérque du Nord.