MUST WATCH AND MUST READ STATEMENTS – https://www.hsgac.senate.gov/covid-19-how-new-information-should-drive-policy
In (italics) are my comments – others are notes from the testimony and audio
Pierre Kory, M.D., M.P.A.
Critical Care Service Chief
Associate Professor of Medicine
University of Wisconsin School of Medicine and Public Health
https://www.hsgac.senate.gov/imo/media/doc/Testimony-Kory-2020-05-06-REVISED.pdf
“We are at war”…supportive care not right approach-
Even though his protocol is named MATH+….this is purely coincidence of our public site covid19mathblog.com
MATH+
steroid therapy (methyprednisolone therapy – Methylprednisolone was granted FDA approval on 24 October 1957) is the right approach – anti-inflammatory
Vitamin C
Blood thinner
Avoid incubation – disease makes it worse
Push back from CDC….people are not coming to hospital early enough…fear is causing patients coming in late now….
David L. Katz, M.D., M.P.H.
President
True Health Initiative
https://www.hsgac.senate.gov/imo/media/doc/Testimony-Katz-2020-05-06.pdf
98-99% cases are mild
Different diseases for different populations
The national policy objective should be total harm minimization (1-3) and establishment of a safe “all clear” for all population groups
Closed the barn door when all the horses were out…
Supporter of herd immunity
DON’T NEED MILLIONS OF TEST (but you got to test smart – just like polling)
Hopeful widespread
We can do better than Sweden
GET HEALTHY – use risk calculators to get people to care about longterm health issues! Making lemon from lemonade!
Tom Inglesby, M.D.
Director, Center for Health Security
Bloomberg School of Public Health
John Hopkins University
https://www.hsgac.senate.gov/imo/media/doc/Testimony-Inglesby-2020-05-06.pdf
A Kaiser Family Foundation report concluded that 37.6% of adults 18 and older in the U.S. (92.6
million people) have a higher risk of developing serious illness if they become infected with
coronavirus, due to their older age (65 and older) or health condition.
(there are ways to substantially reduce this number in a two week time period – a two week change in diet with exercise can be done)
Against Herd immunity
Some have proposed allowing the disease to spread until the point where the country has
achieved “herd immunity”. Epidemiologic estimates are that it will require on the order of 70%
of the population to be infected to achieve herd immunity. 70% of the US population is about
people 233 million people. Most studies that have been done calculate the infected fatality
rate to be in the .5 to 1% range. For example, this Lancet analysis concluded that there was an
infected fatality rate of .66% in China. If .5% of 233 million people were to die from this illness
in the US, that would be 1,165,000 deaths.
Q&A Failure to help nursing home is tragic.
Avik Roy
President
Foundation for Research on Equal Opportunity
https://www.hsgac.senate.gov/imo/media/doc/Testimony-Roy-2020-05-06.pdf
… conventional wisdom now claim
that we must continue lockdowns for as long as we can’t test the entire population for
COVID-19, and have an effective treatment, and develop herd immunity, and produce a vaccine. All of this, we are assured, can take place in the next 12 to 18 months.
But what if it takes us 12 to 18 years to develop a vaccine? We have never developed a
coronavirus vaccine before. The best scientists in the world have been trying to develop a
vaccine for HIV for nearly 40 years, and we still don’t have one. Effective non-vaccine
treatments may arrive sooner, but when? And is it realistic to stick 6-inch swabs up the
nostrils of millions of Americans, every day, until that happens?
Treating UTAH OK like NY is not reasonable.
Businesses can deep-clean their surfaces and
provide hand sanitizer and masks to their workers and customers. People can wash their
hands regularly, and minimize close contact with strangers. This is, in fact, what East Asian
countries did after the original SARS outbreak in 2003, and it enabled them to gradually
return to normal life, despite the absence of a vaccine or effective treatments.
John P.A. Ioannidis, M.D.
C.F. Rehnborg Professor in Disease Prevention
School of Medicine
Stanford University
https://www.hsgac.senate.gov/imo/media/doc/Testimony-Ioannidis-2020-05-06.pdf
Highly dependent on age – children and middle age adults similar to flu
Typically very benign but has potential to be devastating in particular situation.
we need to defend hospitals and nursing homes with strict infection control and hygienic measures; universal and periodic testing of all personnel; and quarantine for infected and exposed personnel
we should reassure most citizens – those of younger ages without serious preexisting conditions – that they are at very low risk.
unrealistic to expect COVID-19 deaths to stop accruing before reopening. Deaths may happen 3 weeks after infection, and modern medical technology can maintain some people on mechanical support even for months.
The pace of re-opening may differ across locations, depending on their evolving levels of infection, hospital capacity, and population vulnerability structure. While treatment advances and vaccine efforts may be successful eventually, lockdown measures cannot be prolonged until we find treatments and vaccines that save many lives, since such breakthroughs may take a long time (or may even never happen). For example, remdesivir has shown promising results in shortening duration of disease, but no conclusive evidence yet for saving lives.
In Q &A with Romney (did a very good job balancing questions concern)– discuss gradient of risk relative to flu and covid-19 and also talk about specificity of working areas. (very good response to explain S. Korea and Taiwan success)
Scott W. Atlas, M.D.
David and Joan Traitel Senior Fellow
Hoover Institution
Stanford University
https://www.hsgac.senate.gov/imo/media/doc/Testimony-Atlas-2020-05-06.pdf
Transplants from living donors are down 85 percent from the same period last year. Missed biopsies of now undiscovered cancers number thousands per week. That doesn’t include the latest reports of skipping two‐thirds to three‐fourths of cancer screenings, most childhood vaccinations, and treatment for new strokes and known cancer.
In the Covid‐19 epicenter New York City, higher immunity is likely, although undoubtedly muted by the extreme isolation policies, as more than 20 percent of those tested had antibodies. A similar finding was reported in Boston. That fact has been incorrectly portrayed as an urgent problem requiring mass isolation. On the contrary, infected people are the immediately available vehicle for establishing widespread immunity. By transmitting the virus to others in lower‐risk groups who then generate antibodies, pathways toward the most vulnerable people are blocked, ultimately eradicating the threat
In Detroit’s Oakland County, 75 percent of deaths were in those over 70; 91 percent were in people over 60, similar to what was noted in New York. And younger, healthier people have virtually zero risk of death and little risk of serious disease – as I have noted before, under one percent of New York City’s hospitalizations have been patients under 18 years of age, and less than one percent of deaths at any age are in the absence of underlying conditions.
If under 18 and in good health, you have nearly no risk of serious illness from Covid‐19. Exceptions exist, as they do with virtually every other clinically encountered infection, but that should not outweigh the overwhelming evidence to the contrary. Again, standards for consciously protecting elderly and other at‐risk family members or friends, including teachers in higher‐risk groups, should still be employed.
There is no scientific reason to insist that people remain indoors.
implement prioritized testing for three groups: nursing home workers, health care workers and first responders, and patients in hospitals with respiratory symptoms or fever. Widespread testing for the whole population is not a predicate for reopening as above. And contact tracing is not as valuable after a disease is already widespread, even though it would be an important part of the overall preparation for potential future outbreaks.
I am proponent of Guidelines to the public and business owners – perhaps a rating scale of “cleanliness/hygiene” for businesses. Those that invest in a fresh air HVAC UVC should get X points, those that offer hand sanitizer and mask wearing get Y points, those that keep the density of people below # per sq ft get Z points, those using approved chemicals for cleaning and clean 2 times a day get W points, those that have temp scanners before entry get T points — let people weigh their risk to visit certain places – let business owners get something for their investment to make their places safer!
Nursing home stats – https://freopp.org/the-covid-19-nursing-home-crisis-by-the-numbers-3a47433c3f70
“39 percent of U.S. COVID-19 deaths have occurred in nursing homes and residential care facilities.”
Another paper – need to go outside and/or take vitamin D- https://link.springer.com/article/10.1007/s40520-020-01570-8
“In conclusion, we found significant crude relationships between vitamin D levels and the number COVID-19 cases and especially the mortality caused by this infection. The most vulnerable group of population for COVID-19, the aging population, is also the one that has the most deficit Vitamin D levels.
Vitamin D has already been shown to protect against acute respiratory infections and it was shown to be safe. It should be advisable to perform dedicated studies about vitamin D levels in COVID-19 patients with different degrees of disease severity.”
Unfortunately the data source today is having problems so we cannot show the latest update. However the above is a lot to go through. I highly recommend it – critical thinking is needed.