First up, a study has been released by the IHU that looks at 3,737 patients treated there using HCQ-AZ (primary) and other treatments. The results are quite interesting, and it is worth noting that the death rate of those treated was 0.9% (35 deaths), and only 6.2% had a poor clinical outcome. You really should read the study since it gets into the underlying conditions and other factors that went into the poor outcomes. Their conclusion notes that early testing, diagnosis, and treatment are key to successful outcomes (more than 93 %).
It is a shame that HCQ has been politicized the way it has in the U.S., and it is worth noting that studies overseas that do honest reviews of HCQ-AZ (plus zinc) show very different outcomes than the limited, and somewhat questionable, studies done here. As such, it worth noting that only 4.5% of the patients treated at/through the IHU has problems with the treatment and most of those were mild (GI). Really, go read the whole thing.
Next up, how many really died of COVID-19? It’s less, possibly far less, than the 121,809 claimed by the CDC. Why? Read this and the linked article. As I noted when discontinuing the daily updates, the numbers being fed the public are worthless, and will remain so until corrected. Even if that number could stand, which it can’t, new data from the CDC saying that the number of cases may be 10 times what is reported. Which means that it is even less deadly, and/or debilitating, than reported. Now, take a look at the number of people who die from the regular flu in a given year. Go on, look it up as you might not believe it if I just tell you. For this we have gutted our economy and freedoms?
Finally, the elephant in the room that the MSM, CDC, and the usual suspects do not and will not talk about. The surges and spikes that are happening? Guess where they probably came from. Yet another signal failure of our so-called elites.
I want to thank two people for their tireless and even bulldog work on the science of COVID-19. First is Glenn Reynolds, the Instapundit. While his co-bloggers have done good work, Glenn has been tenacious on the science and has earned multiple hat tips here and on social media from me. Second, I want to thank Dr. Didier Raoult at the IHU for his efforts to get not only his own data out, but who has tirelessly shared studies and information from multiple other studies. His sharing, and informed commentary, has been everything our own experts have failed to do.
The panic is off and running. Want to avoid getting it? Wash your hands, often and well. Consider sterilizing the things you use often as well, such as your keyboard, cell phone, tooth brush, etc. A single molecule/virus is unlikely to infect you: the key is to reduce the load of any microbe below that load needed for infection.
This virus has not acted normally, and now we have a better understanding of why. A friend kindly provided me with links to three studies that have shed new light on how COVID-19 infects people, and it is both fascinating and interesting. Fascinating from a biomolecular viewpoint and interesting in terms of some of the questions this news raises.
This paper outlines how the virus shares an ACE2 receptor with SARS. ACE2 expression explains some of the oddity of who it infects and why it has been more deadly in China. Short version is that ACE2 expression is small (to non-existent) in healthy lungs; but, as we grow older it starts to crop up. When you live with heavy air pollution (such as China) and if you are a heavy cigarette smoker, your lungs are damaged, increasing the expression. This paper gets into the smoking aspect.
The real kicker, however, is that COVID-19 has a mutated gene similar to Ebola and SARS that gives it up to 1,000 times the ability of SARS to bind with human cells. There is a lot of detail to be found in this article at the South China Morning Post.
The good news out of all of the above is that ACE2 inhibitors and a number of HIV drugs may work on COVID-19, or at least slow it down. It opens up several fronts on fighting the disease while effective and efficient vaccines are developed. How and why it developed the similar mutation to Ebola and HIV is a very interesting question. Another question is how much damage the virus does to the lungs, and if it is permanent as this article suggests.
Meantime, the fight is on continuing to throttle the rate of infection spread here in the U.S. So far, that strategy is working despite the CDC (hat tip to Insty) and others. The testing issue is major, as is CDC staffers hanging up on doctors who disagree with them and incidents like this that are far more frequent than is being reported (again, hat tip to Insty). The goal is to slow it down so that warmer weather will slow it further. Why?
As I noted in a previous post, unchecked it will overload the system, just as it has done in China and elsewhere. This report from Business Insider notes that hospitals have been warned to prepare for 4.8 million hospitalizations in a worst-case scenario. By the way, if you are looking for reasonably good and accurate coverage, keep the BI coronavirus search going, and also stay up with the South China Morning Post coronavirus coverage. Also, Instapundit runs frequent updates and collections of stories that are a good resource.
Failure to do things properly is partly the blame with what has happened in Washington State and elsewhere. Improper responses have caused dozens of first responders and health care professionals to have to be quarantined, taking them out of the fight for the time being. I say yet again, if you are a first responder or medical professional, go to the highest level of protocol that your agency will allow. You won’t do anyone any good in quarantine.
Slowing the spread prevents overloading the system. If you suspect you have COVID-19 or have been exposed, do like the person in Indianapolis discussed yesterday: call your state health department and work with them so that you can be dealt with in a way that minimizes the chance of spreading the virus to those helping you and to the general public.
The continued kicker is that based on anecdotal evidence, there seem to be a higher number of “superspreaders” who also appear to be spreading while asymptomatic. The latest (again from BI) is in NYC and there are 20 cases linked to him.
Again (and again), the best defense is to wash your hands frequently and well, and to use hand sanitizer when you can’t wash or between washings. Want to do more? Avoid unnecessary travel and avoid large gatherings (esp. since many cases have come from conferences and such, including CPAC). Work form home, telecommute, and use virtual meetings for as much as possible. Do not shake hands. If someone is visibly sick and/or not following good protocols (hand washing, covering mouth and nose when sneezing/coughing, etc.) avoid them by about ten feet if possible. If you are 70 plus and/or have health issues, stay home as much as possible. If you have to go out, follow the above stringently. Been at a crowded event? Wash, bathe, and wash your clothes. You don’t need to kill every germ, just enough to stay below the load level.
Again (and again), COVID-19 is NOT Capt. Tripps. So, stop the panic and freakout. It is worse than the flu to certain populations, surprisingly mild in some ways outside of those populations, and right now the mortality numbers here in the U.S. are well below that of flu, which kills between 12,000-61,000 people in the U.S. each year. And, note that thanks to the early travel restrictions, the U.S. has the lowest per capita infection rate of any country with more than 100 cases by a significant margin. So, again, please stop the panic. You can safely ignore most of the media coverage, especially if it focuses on the political angle. So far, such reporting (and the politics) have almost 180 degrees from reality.
Your response to this, ultimately, is as important — if not more important — than the government response. You have the power to protect yourself. You have the power to avoid spreading it. You have the ability to think, plan, and prepare if a general quarantine is put in place for your area.
Think.
Yes, it’s hard and the media is stoking the panic for all it’s worth. All the more reason to stop, think, learn, and do what is right for you and for your fellow citizens.
So, wash those hands, cover your nose and mouth when sneezing or coughing, and don’t go running into an area crowded with already compromised people if you think you have it (i.e. a doc-in-the-box, ER, etc.). Think, then act. Use an online screening process, call your state health department, or similar step and then do what they tell you to do.
Final quick note: bureaucracies are not fast and responsive, particularly when they have mission bloat. That said, for all that some elements of the CDC (and WHO and others) are fucking up by the numbers, there are good people in all them who are having to fight their own administrations (not The Administration) to try to get things done. My hat is off to them, and if there is any way I can help them I’m glad to do it. I have a fond but faint hope that one good to come out of this is that some long-overdue reforms of the CDC and FDA may finally happen. It’s time to have the experts in charge again, not political administrators. Both need to be lean, mean, and flexible — something they are far from being now.
As always:
Use the interactive graphic to keep track of things. Is COVID19 an epidemic? Yes. Is it a Pandemic? Not according to WHO, but most everyone else is saying yes, it is. Is there need for panic? No. Should you be paying attention? Yes. Hell yes. Should you be preparing? Yes, better late than never.
Want to avoid catching COVID19 here in the U.S.? Wash your flippin hands frequently, wash them thoroughly every time you use the bathroom, then follow with hand sanitizer after every washing, use hand sanitizer liberally when you can’t wash on a regular basis. Cover your mouth and nose when you sneeze, and stay away from those who don’t. Also, keep your bugger hooks out of/away from your eyes, nose, and mouth. Do NOT shake hands with anyone, and avoid touching or being touched by strangers. Or your strange friends.
Avoid travel if at all possible. Right now, there is no way I’m going to a trade show, major convention, etc. If you can telecommute, get that set up now. If you have to travel, use lots of hand sanitizer and go to full flu protocols. If you have to use a public restroom, take full precautions including using paper towels and such to handle faucets, doors,etc. Believe it or not, this was highly recommended before now, and major grocery chains have long told employees to use those practices to avoid getting or spreading colds, flu, etc. Not many actually do it, but…
If you own a business, make sure your employees know the above protocols. Have someone who refuses to wash their hands or otherwise follow the protocols? Talk to them, write them up, and if necessary fire them as they now pose a risk of infection to you and your customers. Extreme? Yes, but while the CDC and others are working to slow it down, odds are it is already here and could hit hard and fast. Prepare for the worst and hope for the best.
I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.
Again, I have to start by saying there is no need to panic (yet) if you are in the United States. Running around in a mask and/or exposure suits is not helpful or smart, nor is making a “joke” and saying you have it: both types of things just point out that you are a dumbass.
Is there reason to worry? Yes. Now that even the WHO is reported as saying that there are likely more than 100,000 cases (mostly in China), it provides some validation to this study, this study, and this study.
As I’ve said before, the Chinese government has lied from the start about the disease and how bad it is. Read this article about what is coming out of China, and this article by Rod Dreher. The last also brings up two things that you do need to know about, along with some heartbreaking information from inside China.
The first is that the medical gear/drug shortage in China is not just a Chinese problem. It is also a problem here, in that there are already shortages here. It is going to get worse before it gets better. A number of people have argued for some time that it was not a good idea to become so heavily dependent on China for medicines and medical gear [not to mention electronics (including efforts to make us dependent upon them for military electronics) along with other finished products and raw goods]. Using regulation and other tactics to push things overseas was seen as a positive foreign policy in regards China and trying to control it. I would call it what I think of that policy, but am trying to some degree to keep this PG-13. Is this all going to have an impact on the US, Chinese, and global economies? Yep.
The second thing was a twitter link that Rod added to the article. I pulled up the source site for the graphic, and found it interesting to look at China and compare it to the interactive graphic from Johns Hopkins I’ve been linking to on a regular basis. I’m still playing with the data a bit, but I do find the correlation between high sulfur dioxide levels coming out of the cities with known high contagion rates interesting. Yes, it does appear to suggest that crematoriums are working overtime. And possibly in areas where there are no official cases…
If the models are correct, and if even the current official reports from China are correct, it appears that 2019-nCoV is more contagious than originally thought (hoped). The death rate, based on official figures, is approaching five percent however. If the unofficial reports coming out of China are correct, it is potentially much higher.
I wish the travel restrictions had been implemented much sooner. Then, you might not be reading about new cases in England and elsewhere, and the efforts to locate and test everyone those tourists contacted/interacted with during their trip. If the current restrictions and quarantines had been implemented even a week sooner, it would have taken thousands of potential transmission opportunities off the board. This article from Scientific American looks at some possibilities that are not good.
For all that I trust the WHO about as much as I do the Chinese government, they have daily situation updates that are a resource as you monitor what is going on.
So, should you panic? No. Should you be concerned? Yes. What is going on worries me, which on my personal defcon levels is a step above concerned. What am I doing? I’m watching, reading, and researching. Yes, I have started beefing up some of my normal levels of preparedness. If nothing happens, what I’ve gotten will get eaten, used, etc. in the normal course of life. More on preparedness later.
There is a difference between being alert and in a panic, a distinction that is lost (or deliberately ignored) by those of our “betters” sniffing in disdain and saying the current nCoV outbreak is nothing to worry about and it will fizzle out like SARS. Such people are, for the most part, educated idiots without much of a clue. The rest of us do not, yet, have a true clue but we know that and acknowledge it.
Yesterday, there was briefly some hope that this would be like SARS: deadly, contagious (particularly in non-first-world areas), and brief. This hope was very short lived. Note that the chart(s) are part of the link I provided yesterday to keep up on things.
Here’s a good post on part of the poor response to the outbreak by all levels of the Chinese government. Here’s another take by a medical professional.
In the “closing the barn door” department, we have this, this, this, and this. In the department of “Duh” we have this. I think SF activating it’s EOC is both prudent and interesting. This is a neat fact: an AI system issued an alert for the virus a week before WHO, CDC, et. al. For the record, I think we should have shut down air/sea with China already, and that the evacuation of Americans in Wuhan directly to CONUS without quarantine offshore is a mistake.
That’s all I have time for this morning, hope to get back into some of the background, and some discussion on practical preparedness in the days ahead. Stay safe.
I had originally planned to write about the bigotry of Stephen King and some other authors along with a miserable trope in USA channel movies, but that will have to be later this week. Instead, I need to cover a more important subject.
There is a lot being written about the coronavirus that is raging across China, and headed world-wide. A coronavirus is any of a family of single-stranded RNA viruses that has a lipid envelope with club-shaped projections. Some of the family don’t really have a negative affect on humans; but, some strains do. While a suspect for some cases of gastroenteritis, the ones that do effect humans do so through the respiratory system. The common cold is a coronavirus.
Unfortunately, Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) are both of the coronavirus family. The strain currently spreading from Wuhan (2019-nCoV) is a new strain and is similar to SARS.
Also understand that the Chinese government has lied about this disease from the start, and there is no reason for them to stop. They are severely censoring information as fast and as hard as they can. They are taking the virus seriously, but the question is will their efforts be effective. As a bit of background (hope to add more later), when the Chinese government was admitting to 50 cases, outside experts pegged it at 1,700. That was on the 18th, and there are reports suggesting that while there are roughly 3,000 confirmed cases, that the actual infection rate is in excess of 90,000 people.
What can and should you do? Well, I think having 3-7 days of food and water is a good start for anything. I try to keep that and a bit more (so I have a month’s supply of coffee, don’t judge my addictions) on hand at all times. For other reasons, I’ve been upping some of my preparations. If you don’t have a 3-7 day supply of food, water, medicines, supplements, and basic supplies, it is good to get and maintain them for general preparedness purposes.
If this does turn into a true global pandemic similar to the 1918 Spanish Flu (or worse), then you are talking a different level of preparedness. For that you will need 4-6 weeks worth of water, food, and supplies.
I will discuss practical preparedness, as well as preparedness for a pandemic more in the days ahead.
