Home > Critical Thinking, Current Affairs, Dystopia, Musings, Philosophy sans Sophistry, Reason, Secular Religions, Skepticism > Assorted Observations about the COVID-19 aka SARS-2 Pandemic: 2

Assorted Observations about the COVID-19 aka SARS-2 Pandemic: 2

In the previous post of this series, I briefly touched on some things we still don’t fully understand about the disease caused by SARS-2 virus. Also, I am going to start calling it as the SARS-2 virus instead of COVID-19 since it displays high genetic similarity (sequence homology) to the original SARS virus. Most notably, the similarity extends to the main host protein used by both viruses to enter cells, main organs affected as well as pathological changes and diseases process caused by them. Therefore, SARS-2 is best understood as a significantly less lethal but more easily spread version of the original SARS virus. This is not to say that SARS-2 evolved from SARS- far more likely, both evolved from a common ancestor. With that out of the way, let us start by talking about ventilators or why they are of limited utility- at best.

1] During the past 2-3 weeks every politician and public figure has been incessantly talking about how we need tens of thousands more ventilators. To be fair, western countries which adopted the “neoliberal consensus” over past two-three decades ended up starving their healthcare systems to vary degrees. Hence a chronic shortage of ventilators have been a fact of life for many years especially during bad influenza seasons. While we could cerainly use more ventilators, ICU beds, more hospital beds and other medical resources in general- a large increase in those resources is unlikely to have a beneficial effect on the course of the SARS-2 pandemic. Here is why..

Based on a examination of multiple studies from countries such as Italy, Spain, UK and China- it appears that ventilators (at least as they are used right now) don’t help much with the survival of the most vulnerable group of patients. Let me put it this way, about 70-80% of people of people over 80 who end up on a ventilator due to this disease die. For those between 70-80, the number is closer to 50%, while the majority of those below 60 survive their stint on the ventilator. But why do these numbers matter. Well.. because the vast majority of those ill enough to require ventilators are over 60. To be clear, I am not claiming that nobody below 60 requires a ventilator. It is just that they are a small percentage of that age group of patients.

In other words, ventilators have poor efficacy in the age group who needs them the most. Unless significantly better protocols for medical intervention in very old and ill patients are developed, we should reconsider the wisdom of putting people above 80 with serious multiple comorbidities on ventilators- especially if there aren’t enough of them. People above 80. but without significant comorbidities. and in otherwise OK health have a better than 50% chance of survival as are those between 70-80. Any body below 70 who is not in poor health has a pretty good (better than 60%) chance of coming out alive. We should make resource allocations accordingly. I am not suggesting we go all soylent-green, but a realistic assessment of the chance of survival for each patient in the ICU with SARS-2 is necessary.

2] Talking about pre-existing conditions, it seems that the previously reported strong link of poor survival to hypertension is mostly an artifact. See.. most people above 75 have a slightly higher blood pressure than what is defined as “normal”. More relevantly, there is no evidence that blood pressures upto 150/95 are associated are bad for those over 75. Indeed, supposedly healthy systolic blood pressures below 130 have a link to slightly increased in those over 75. Having said that, there is now good evidence that the link between increased mortality from SARS-2 and cardiovascular disease and Type II diabetes is real. Infact, given that ACE2 receptors (which allow the virus to infect cells) are found on the endothelial lining of most blood vessels, it appears that the quality of baseline endothelial function is a significant factor in how ill a patient will end up.

Disturbed microvascular perfusion and tiny clots in lungs which disturb normal oxygenation of blood might also explain why so many patients in ICU due this virus have normal lung tissue compliance but really low oxygen saturation in their blood. All the cytokines released due to this infection in some patients (Il-1 and Il-6) don’t help microvascular function either. To make a long story short, very impaired microvascular perfusion and oxygen exchange in the lungs due to damaged and dead endothelial (and related) cells + severe inflammation and small clots is likely what puts most people in ICU. Clearly, we need a different and better treatment protocol for this disease than treating it as if was not different from the most common presentations of ARDS.

3] With those things out of the way, for now, let us talk about therapeutic options for SARS-2. As luck would have it, the vast majority (over 80%) who are symptomatic do not require anything more than bed-rest and anti-pyretics. This is especially the case for those below 60 years, who account for the majority of population- even in old and demographically stagnant western countries. Furthermore there is emerging evidence that the number of people who develop and recover from an asymptomatic form of this disease might be far higher than previously believed. But what about all those patients (15-20 %) who have symptoms which require some degree of medical intervention? Well.. this is where things start getting controversial.

But before we go there, let me say something else about potential treatments. It is my opinion that drugs that have to be injected or biological in nature (antibodies, recombinant proteins) are unsuitable for mass treatment of this disease because quickly scaling up facilities which make injectables or antibodies/ proteins etc is not easy. This does not mean that such drugs have no role in treating this disease. It is just that they would be most useful for people who are ill enough to be in an ICU. But as I mentioned in the earlier parts of this post, most older patients who end up in ICU end up dying- at least with current treatment protocols. The key, then, is to keep as many patients from deteriorating enough to need the ICU. In other words, we require effective orally available drugs to have a significant effect on the mortality rates due to SARS-2.

So what are the options? Well.. the most hyped drug, Remdesivir, does have activity in animal models of many viral diseases including Coronaviruses. However, it cannot be administered orally and hence will be used only in very ill patients- and that is a bad thing. See.. viral infections unlike their bacterial counterparts have to be treated early since peak viral levels are reached (and most of damage has been done) around the time people are sick enough to be require hospitalization. You can see why a drug which cannot be administered orally (and therefore used only in hospitalized patients) might provide very little therapeutic benefit in later stages of the disease. Now let us talk about Chloroquine (CQ) and Hydroxychloroquine (HCQ).

While Trump haters in media and bureaucracies are trying their best to discredit CQ and HCQ, the reality is that we have known that both drugs have decent activity against coronaviruses at concentrations achievable with normal anti-malaria or lupus dosages since 2003 (link 1, link 2, link 3, link 4). It doesn’t hurt that both drugs also have an immunomodulatory/anti-inflammatory effect. Multiple reports from China (mostly preprints) strongly suggest that normally used doses of both drugs are effective at treating SARS-2 in human beings. To be more specific, they are most effective at reducing the number of people who go on to develop severe disease if given within first 4-5 days of symptoms. No serious person is suggesting that they are miracle cures for patients ill enough to need intubation and ventilators. However, it also quite obvious that they speed up recovery from disease, reduce peak viral loads and significantly reduce the risk of complications when given early. It also helps that they can be given orally and synthesized very easily and on a large scale (by the metric ton).

Since we are already past a thousand words, I Will write about other potential drugs and therapeutic options such and convalescent plasma, monoclonal antibodies and vaccines in next post of this series.

What do you think? Comments?

  1. Jack Donovan
    April 9, 2020 at 10:29 pm

    Since my mouth is more lethal than my lesion infested asshole, well the new recruits at the wolves of vineland get to wreck my rectum. Social gatherings of 10 plus, but we are rebels…

    BTW, will you cucks stop leaving bad reviews of my masterpiece…

    So what if I like Richard Spencer, just because you don’t doesn’t mean you get to trash me, I am better than you because I am white, don’t forget it!

  2. P Ray
    April 10, 2020 at 1:28 am

    Even if they survive, their lung function is permanently degraded, and as I said earlier, these are the steps:

    1)In South Korea, “51 recovered coronavirus patients test positive again”

    Clickbait.. viral shedding after recovery (detected by PCR) is not the same as active infection.

    2)This is a virus, it stays with you for life.

    Given what we know about Coronaviruses.. NO. It is an acute infection.

    3)When enough people get it, and employers don’t hire people who had it previously, those people will lobby governments so that finding out who has it is a crime.

    4)Air New Zealand has already started hiding results. “Coronavirus: Air NZ employee says airline’s not releasing Covid-19 results”

    5)When the infected outnumber regular people, they will legislate for their own advantage

    6)Gonna be even more fun when the coronababies are born.

    Not likely, but idiotic reactions of people are always possible.

    I wonder how governments will react when women say “I don’t want to have sex with someone who had CoViD-19 before”

    The extra bit now is you will have a lot of old people asking for special consideration, while when they didn’t have the illness they were telling young people: “Youngsters nowadays don’t work hard but they expect everything, even when couldn’t walk I crawled to work” (like that Monty Python sketch “Four Yorkshiremen”).

    Another reason why CONservatives get hoisted by their own petard.

    • P Ray
      May 23, 2020 at 8:11 am

      Now they better work real hard on the vaccine … or they will wind up with a second bunch of children to lie to that “looks don’t matter” (the first bunch are the zika kids with mis-shapen heads):
      https://www.dailymail.co.uk/news/article-8350307/Pregnancy-warning-study-finds-Covid-injures-placenta-cuts-blood-unborn-babies.html
      Coronavirus threat to unborn babies: Infection ‘injures’ the placenta, cuts off blood to unborn babies and can lead to low birth weight, organ damage or even foetal death
      Lesions and blood clots were discovered in the vital organs in 15 women
      Issues with blood flow can lead to low birth weight and even foetal death
      But the 15 babies were delivered on due date and were a healthy weight
      16th woman miscarried, but researchers unsure if it was caused by virus

      Just like in a war, the people who galvanise public opinion against one continuing for very long, are the ones who are the maimed survivors.

  3. plus d'un cafard
    April 10, 2020 at 6:39 am

    AD, how are things in India? I laughed at the police forcing confinement breakers to do squats and pus-ups, but lately there are videos of large crowds getting rowdy.

    It is going to get very ugly pretty soon- largely because government cannot think in terms of reality. Too many people in that country are dependent on day-to-day jobs and there is no real social security net or even the willingness to implement one. It also helps that population is much younger than west and is less likely to suffer same percentage of casualties.

  4. Yusef
    April 10, 2020 at 10:47 am

    “While Trump haters in media and bureaucracies are trying their best to discredit CQ and HCQ, the reality is that we have known that both drugs have decent activity against coronaviruses at concentrations achievable with normal anti-malaria or lupus dosages since 2003”

    Some people believed this hoax was motivated by Trump haters desperate to remove him from office or thwart his reelection in November. I never thought that, but when I consider things like this, I really have to wonder. I mean, what’s their fucking problem? They disparage a treatment just because Trump is the one suggesting it? Who would do such a thing!

    • plus d'un cafard
      April 10, 2020 at 11:46 am

      Watch as the people who were rabidly against HCQ, with quinoline now a hate symbol, suddenly were always all for it, it just needed a little quick testing. It was never opposed, no sir. This is centralised religion at work.

    • GAY NIGGERS FROM OUTER SPACE
      April 11, 2020 at 12:10 am

      BIll Gates holds patents regarding coronavirus, and was warning about a coronavirus pandemic a few years ago, with the aim of forcing a vaccine with embedded microchips (https://id2020.org) onto the entire world population. He was one of the main people organizing “Event 201“.

      https://www.bitchute.com/video/IRJpP83MqNs/

      (This video has been “Removed for YouTube for violating community guidelines”.)

      They (Fake News Mass Media, Twitter Trump haters, etc) are getting paid to shill for Bill Gates’s PLANNED vaccine for this PLANNED pandemic.

      The sudden and unexpected emergence of a 100% cure for this engineered virus in the form of Hydroxychloroquinine+Azythromycin+Zinc completely thwarted Gates’ racketeering plans, which explains why they are all screeching in unison.

  5. Just An Observer
    April 10, 2020 at 1:47 pm

    > ventilators

    Important in themselves, also a proxy for the lack of preparation in almost every respect for a health crisis.

  6. Rum
    April 10, 2020 at 2:45 pm

    I roll my eyes every time I hear about these patients having “other conditions.” Heck, the way western healthcare systems work, no one over the age of 55 does not have at least 3 “diagnoses” attached to their name. In the USA, I bet 80% are labelled with hypertension by that age. You will find sleep apnea in every obese person you examine — as a diagnosis.
    Did I mention that you get paid by the diagnosis? Same thing in Italy.

    Agree.. the best correlation with mortality due to COVID-19 has to do with poor endothelial function (established cardiovascular disease, type 2 diabetes). Interestingly people who have received prior treatment for cancer are also especially susceptible to bad outcomes- specifically, chemotherapy for blood and lymphatic cancers + those with extensive surgery for removal of cancers.

    • doldrom
      April 10, 2020 at 8:40 pm

      I’m 64 and have zero diagnoses and no meds and gladly pass people on their racing bikes, although my left knee prevents running. Have visited a GP 2× the past 20 years or so, for bureaucratic purposes. And I’m not the only one. I suspect a lot of old people with 31 bottles of meds would survive fine without them, but most people think they would all die if the healthcare establishment wasn’t present. That’s the attitude that has led to this whole shit show, committing collective suicide to make sure we can better stagger ventilator availability for people with 1-2 years of life expectancy, give ‘m an extra 24 hours before sending them off.

  7. Yusef
    April 10, 2020 at 3:28 pm

    If the MSM would disseminate information like this, people would begin to realize there are very serious, very real threats to their well-being coming at them now from more than one direction:

    Coronavirus Presents Looming Food Crisis FAO Warns:

    https://allianceforscience.cornell.edu/blog/2020/04/coronavirus-presents-looming-food-crisis-fao-warns/

    I can’t be the only one who sees what a horrible world we now live in….And I do mean NOW.

  8. Jack Donovan
    April 10, 2020 at 10:58 pm

    Us gay nazi’s are like those white wimminz with their credit cards…

    Yes, I got Richard Spencer as my sugar momma, you don’t think he get’s to wreck my rectum for free, do ya?

    But now big daddy trump is spending debt like I putt tattoos on my sugar mommas credit cards…

    See Hayle !!!

    14 88 !!!

    Not Str8

    • doldrom
      April 12, 2020 at 10:22 am

      This video is more breathless BULLshit about how enormous is they debt.
      How can the average household have $100,000 of debt and only $8000 of savings? Except for the part owed to the Chinese, the average savings/assets and debts have to be equal. There is exactly as much wealth as there is debt. Every penny owed is owed to someone holding an IOU.
      So if we owed it to ourselves, we could cancel the liabilities and the assets against each other, netting out to zero. Our children don’t just inherit our debts, they also inherit our assets.
      The only problem is that the distribution of those assets and liabilities is increasingly lopsided. But that is a different problem entirely than how big the debts are. They are not owed to Martian space invaders who will wreak vengeance. Those debts are owed to banks, pension funds, and the wealthy.
      It has nothing to do with us running out money!
      Maybe you or I will run out of money, but “we” will not

      • Yusef
        April 12, 2020 at 5:05 pm

        “How can the average household have $100,000 of debt and only $8000 of savings?

        This is possible if the average household’s regular paycheck income covers living expenses, required payments on debt principle and interest.

        See, people have been playing the dangerous game of covering their ever-increasing monthly expenses with more and more debt. As long as what comes in each month is enough to cover, everything is okay. If there is an interruption, though, the game is soon over.

        “Those debts are owed to banks, pension funds, and the wealthy.”

        So? You think they’ll not being wreaking vengeance? Check out how they’ve historically behaved. I have no problem calling it “wreaking vengeance.” They don’t give a shit. Everyone can live in the streets and eat garbage and that’ll be fine, as far as they are concerned.

        Just a note: they didn’t militarize American police forces and place surveillance at every American street corner just for nothing.

      • Yusef
        April 12, 2020 at 5:10 pm

        “Maybe you or I will run out of money, but “we” will not.”

        Be careful of the royal WE, Doldrom.

        There is no “we.” There is us and them.

        They are ruthless and we’re more or less pussified.

      • doldrom
        April 12, 2020 at 7:40 pm

        @Yusef. The point of this documentary is to scare us with how great the debts are. I’m just pointing out some mathematical and accounting tautologies, true by definition. For every $ owed by a debtor there is a creditor to whom it is owed. Average (not median) means the total divided by the number of the population you are referring to. Barring external parties (or globally) the average person is owed just as much as they are owed. But for any single individual it could easily be very different, yes.
        Of course I know there is no genial “we”, but theoretically, we can cancel all the debts, we could kill the creditors, we could go bankrupt (which cancels all the debts: the iron law of mounting debt inequality is that that which cannot be paid will not be paid). Shock & awe at how vast the sums are is completely beside the point, it distracts from the real point: The real point is that there are few owners and many debtors, and the inequality such that the boat must capsize sooner or later.

      • Yusef
        April 13, 2020 at 7:19 am

        I appreciate your points.

        The boat has now capsized. The question is whether the owners remain the owners and the chains of the slaves become even more burdensome and confining.

        It looks to me as if it is nearly inevitable the owners remain in control. (Now that there has been some sort of regime change it may be more accurate to call the owners controllers instead.) It just cannot be a good sign the slaves scared this easily.

        I basically think this is a master-slave dialectic event. You either say it is better to die on your feet a man than to live, on your knees, a slave. The slaves have reaffirmed they like living on their knees just fine, thank you.

      • doldrom
        April 13, 2020 at 7:34 am

        Worse. The slaves themselves are calling for action. They are now afraid of their fellow slaves and even ratting them out if they go out to enjoy themselves. The more forcefully (unconstitutionally, fascist) governors act, the more popular. The population is completely confusing mitigation and containment, with the help of the people in charge (nobody is saying clearly that we are all going to be exposed sooner or later … the whole point was to stretch the sooner, forgetting that 98% of ICU demand comes from the at risk population groups like nursing homes).
        As for more Fed actions to save the economy (!?), it seems most people think that as long as the Fed makes sure we don’t run out of money everything will be fine. It is not getting through to them that you are not getting ahead if you get $1200 in exchange for 13,300 of extra debt load, and that they are making speculators and coddled cronies whole. When supply chains start to break down, there will be complicated misconstruals and more state violence “to keep order”.

  9. GAY NIGGERS FROM OUTER SPACE
    April 10, 2020 at 11:56 pm

    Robert F Kennedy Junior completely exposing Bill Gates in detail:

    View this post on Instagram

    LINK IN BIO. Vaccines, for Bill Gates, are a strategic philanthropy that feed his many vaccine-related businesses (including Microsoft’s ambition to control a global vac ID enterprise) and give him dictatorial control over global health policy—the spear tip of corporate neo-imperialism. Gates’ obsession with vaccines seems fueled by a messianic conviction that he is ordained to save the world with technology and a god-like willingness to experiment with the lives of lesser humans. Promising to eradicate Polio with $1.2 billion, Gates took control of India ‘s National Advisory Board (NAB) and mandated 50 polio vaccines (up from 5) to every child before age 5. Indian doctors blame the Gates campaign for a devastating vaccine-strain polio epidemic that paralyzed 496,000 children between 2000 and 2017. In 2017, the Indian Government dialed back Gates’ vaccine regimen and evicted Gates and his cronies from the NAB. Polio paralysis rates dropped precipitously. In 2017, the World Health Organization reluctantly admitted that the global polio explosion is predominantly vaccine strain, meaning it is coming from Gates’ Vaccine Program. The most frightening epidemics in Congo, the Philippines, and Afghanistan are all linked to Gates’ vaccines. By 2018, ¾ of global polio cases were from Gates’ vaccines. In 2014, the Gates Foundation funded tests of experimental HPV vaccines, developed by GSK and Merck, on 23,000 young girls in remote Indian provinces. Approximately 1,200 suffered severe side effects, including autoimmune and fertility disorders. Seven died. Indian government investigations charged that Gates funded researchers committed pervasive ethical violations: pressuring vulnerable village girls into the trial, bullying parents, forging consent forms, and refusing medical care to the injured girls. The case is now in the country’s Supreme Court. In 2010, the Gates Foundation funded a trial of a GSK’s experimental malaria vaccine, killing 151 African infants and causing serious adverse effects including paralysis, seizure, and febrile convulsions to 1,048 of the 5,049 children. …Continued on slides 2 + 3.

    A post shared by Robert F. Kennedy Jr. (@robertfkennedyjr) on

    • Yusef
      April 11, 2020 at 11:14 am

      The horrible thing is, unless something startling happens very soon, Gates is going to win. This freakish megalomaniac psychopath is going to get what he wanted. It’s Gates’ world– we just live here.

  10. MikeCaCa
    April 11, 2020 at 11:33 pm

    what is this horrid stuff yusef is leaving everywhere…

    yusuf, get a job son, my stocks went down and I don’t want to get out my books on Fortran and Cobalt so that I can fix New Jersey’s broken unemployment site…

    • Yusef
      April 12, 2020 at 9:23 am

      Good video.

      We get to see Jeffie and Mattie a couple times. Jeffie sure does resemble Dr. Evil these days. (Strange, again, to remember Dr. Evil in Austin Powers was headquartered in Seattle.) Is this whats-it-called predictive programming or Mike Meyers’ intuitive genius?

      You just can’t envy Jeffie or Mattie. Who would want to be like them? (Or Trumpie.) They are freaky, obviously unhappy and primarily empty. They’ve eaten the lives of millions of their fellows and this is what they are.

      I disagreed it is a choice between staying at home and collapsing the economy or going back to work and risking the deaths of millions of Americans. This is because I have felt, a little at first, then more and more as this has progressed, the pandemic was a planned-demic. It’s a hoax. The plutocrats and their spokesmen are forced into asserting the workers need to go back to work AND risk death, though, because to say there was no risk of death would be for them to admit it had been a hoax all along. (They just wanted the hoax to end now because if it continues too long their interests begin to be harmed.)

      It would be very, very interesting if workers used this as an opportunity for a mass strike. “We aren’t going back to work now and risk death. No, we aren’t available now under the same terms as before. You want us to go back to work? Then you meet our demands. We want a doubling of the minimum wage, health care, no more of this bull shit 35 hour work week so you don’t have to pay us benefits. You hear us?” I’ve feared further and much more frightening concessions will be extracted from Americans, but there is at least the possibility Americans can extract concessions from the plutocrats. (The plutocrats don’t deserve to be called Americans.)

      • MikeCaCa
        April 12, 2020 at 11:55 am

        Yusef, what a flippant response. And since you know I am old and reckless with my health, you did not ask how have I been doing in these dangerous times we now live. I have been doing fabulously with my solar powered home. I have also been spending my money on escorts as Advocates Diaboli recommends. Hey there, ‘lil girl, you furloughed? Make some money keeping MikeCaCa company. Then here’s the kicker, when it is time to pay, I bust out my thermometer. They might be 98.3 but it always reads 102.1. I kick ’em to the curb and say how dare you risk my health by exposing me to covid. I learned that one from Jeff Bezos BTW.

        Now vote for Joe Biden you pathetic little man.

        Us boomers rule you, you fool!

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