Perhaps we found another reason why the Yoga class didn’t get covid compared to the Zumba class in this study https://wwwnc.cdc.gov/eid/article/26/8/20-0633_article

I know perhaps this is some confirmation bias I am presenting since I try to do Yoga everyday – but it works for me. I really had no idea about the Nitric Oxide (NO) science behind it – so it is a really cool confirmation bias.

This article highlights BREATHING as a treatment – https://www.oregonlive.com/coronavirus/2020/06/the-science-behind-why-this-is-the-safest-way-to-breathe-to-avoid-coronavirus.html

“By Louis J. Ignarro, Distinguished Professor Emeritus of Molecular & Medical Pharmacology, UCLA School of Medicine

Inhale through your nose and exhale through your mouth. It’s not just something you do in yoga class – breathing this way actually provides a powerful medical benefit that can help the body fight viral infections

The reason is that your nasal cavities produce the molecule nitric oxide, which chemists abbreviate NO, that increases blood flow through the lungs and boosts oxygen levels in the blood.

Breathing in through the nose delivers NO directly into the lungs, where it helps fight coronavirus infection by blocking the replication of the coronavirus in the lungs. But many people who exercise or engage in yoga also receive the benefits of inhaling through the nose instead of the mouth. The higher oxygen saturation of the blood can make one feel more refreshed and provides greater endurance. I am one of three pharmacologists who won the Nobel Prize in 1998 for discovering how nitric oxide is produced in the body and how it works.”

“Nitric oxide is a widespread signaling molecule that triggers many different physiological effects. It is also used clinically as a gas to selectively dilate the pulmonary arteries in newborns with pulmonary hypertension. Unlike most signaling molecules, NO is a gas in its natural state.

NO is produced continuously by the 1 trillion cells that form the inner lining, or endothelium, of the 100,000 miles of arteries and veins in our bodies, especially the lungs. Endothelium-derived NO acts to relax the smooth muscle of the arteries to prevent high blood pressure and to promote blood flow to all organs. Another vital role of NO is to prevent blood clots in normal arteries.

In addition to relaxing vascular smooth muscle, NO also relaxes smooth muscle in the airways – trachea and bronchioles – making it easier to breathe. Another type of NO-mediated smooth muscle relaxation occurs in the erectile tissue (corpus cavernosum), which results in penile erection. In fact, NO is the principal mediator of penile erection and sexual arousal. This discovery led to the development and marketing of sildenafil, trade name Viagra, which works by enhancing the action of NO.

Other types of cells in the body, including circulating white blood cells and tissue macrophages, produce nitric oxide for antimicrobial purposes. The NO in these cells reacts with other molecules, also produced by the same cells, to form antimicrobial agents to destroy invading microorganisms including bacteria, parasites and viruses. As you can see, NO is quite an amazing molecule.”
“Inhaled NO dilates the constricted pulmonary arteries and increases blood flow in the lungs. As a result, the red blood cell hemoglobin can extract more lifesaving oxygen and move it into the general circulation. Inhaled NO has literally turned blue babies pink and allowed them to be cured and to go home with mom and dad. Before the advent of inhaled NO, most of these babies died.

Inhaled NO is currently in clinical trials for the treatment of patients with COVID-19. Researchers are hoping that three principal actions of NO may help fight covid: dilating the pulmonary arteries and increasing blood flow through the lungs, dilating the airways and increasing oxygen delivery to the lungs and blood, and directly killing and inhibiting the growth and spread of the coronavirus in the lungs.

In an in vitro study done in 2004 during the last SARS outbreak, experimental compounds that release NO increased the survival rate of nucleus-containing mammalian cells infected with SARS-CoV. This suggested that NO had a direct antiviral effect. In this study, NO significantly inhibited the replication cycle of SARS-CoV by blocking production of viral proteins and its genetic material, RNA.

In a small clinical study in 2004, inhaled NO was effective against SARS-CoV in severely ill patients with pneumonia.

The SARS CoV, which caused the 2003/2004 outbreak, shares most of its genome with SARS CoV-2, the virus responsible for COVID-19. This suggests that inhaled NO therapy may be effective for treating patients with COVID-19. Indeed, several clinical trials of inhaled NO in patients with moderate to severe COVID-19, who require ventilators, are currently ongoing in several institutions. The hope is that inhaled NO will prove to be an effective therapy and lessen the need for ventilators and beds in the ICU.

The sinuses in the nasal cavity, but not the mouth, continuously produce NO. The NO produced in the nasal cavity is chemically identical to the NO that is used clinically by inhalation. So by inhaling through the nose, you are delivering NO directly into your lungs, where it increases both airflow and blood flow and keeps microorganisms and virus particles in check.”

When we come back to work I expect everyone going to Yoga with me ?? Yoga is what you make of it and the breathing does help you through burn. Challenge yourself to a point and breath knowing once you get out of the pose all the pain will go away. Perhaps someone should market NO shots?

So in summary of all the reading and analysis so far Vitamin C & D, Zinc, Exercise a30-1hour a day, Eat whole preferably vegan, and do Yoga – and you will be good from Covid PLUS improve on many other facets of your life!

Brazil tops but the story has to be Spain with 1179 deaths with zero for weeks. Looks like it was an update? https://www.aa.com.tr/en/europe/spain-updates-covid-19-death-toll-to-28-315-/1883268

“The surge of deaths comes after the total death toll had been frozen for weeks at around 27,130. The death toll includes only those who tested positive for the disease before passing away.”

“The country will open its borders to the rest of the world on July 1, although officials have said restrictions could remain on countries suffering from uncontrolled outbreaks.”

Texas leads the confirmation – but California leads the death at 70.

The increase in confirmation is for TX driven by Harris County

Alarm bells for Harris county not just yet if you look at the confirmation, and deaths. Though we like to tease Trump on his use of words – Increase testing should lead to more confirmation – but it doesn’t always have to either – but if you expand how and where you test IN THEORY confirmations would likely rise. HOWEVER confirmations do NOT and we would not want them to lead to deaths. This would be a metric to watch to see if the system is getting overwhelmed. So far fatality rates in Harris County are actually dropping not rising.

You can see how Spain looks out of place from zero for many days to a big surge. Japan is also on an upswing alond with Phillipines

Vaccine news – highlighting the unique/old method China is doing vs. the rest of the world – https://www.inkstonenews.com/science/chinas-leaders-covid-19-vaccine-race-use-method-shunned-west/article/3089814

“It is the only country pouring resources into the use of inactivated viruses, a technique used in vaccines against numerous diseases in the past – including hepatitis A, influenza and polio – but largely shunned in new vaccine development.

The technology is simple and involves growing a virus strain in the laboratory and then using heat or chemicals to destroy its ability to replicate. Once injected as a vaccine, the immune system recognizes the antigens in the inactive virus and reacts by making antibodies.”

“Of the five vaccine candidates undergoing clinical trials in China, all but one involve inactivated viruses. There are a further 126 potential vaccines in preclinical evaluation around the world and, again, only five of these are based on the decades-old technique. Two are being developed by Chinese companies, with scientists in Japan, Kazakhstan and France working on the others.

Most Western scientists are turning to newer technologies, with many putting their energy into experimental nucleic acid vaccines based on genetically engineered virus DNA, despite there being – as yet – no licensed human vaccine using this technique.”

“One reason developed countries have shown little interest in trialing inactivated vaccines is that immunity can be of limited duration, with more doses required over time. Another problem, according to scientists, is the higher risk of adverse reaction – known as an enhanced disease response – because the entire virus strain is used, which may contain harmful antigens.”

“In separate reports, published in April and May respectively, researchers working on two inactivated vaccine candidates went to some length to address these concerns. The two teams – one a joint project between the Beijing Institute of Biological Products and state-owned Sinopharm, and the other from privately owned Sinovac Biotech – found no enhanced disease response in testing on rhesus macaques.”

““If inactivated vaccines are effective in field trials and there is no evidence of enhanced disease, I would not foresee obstacles for licensing for use,” said Peter Smith, professor of tropical epidemiology at the London School of Hygiene & Tropical Medicine and a WHO advisor on vaccine development.

“In the present situation, even a vaccine with short-term efficacy would be preferable to not having a vaccine.”

Petousis-Harris said it was important for scientists around the world to explore different options.”

Potentially great trend for the US – not sure many will take it well but there are a lot of externality cost to allow society to overindulge – https://www.politico.com/news/2020/06/18/men-cut-back-alcohol-federal-recommendation-328893

“Men should cut back their alcohol intake to one drink per day rather than two, according to an influential panel that is advising the government on new dietary guidelines due out this year.

And Americans should also further cut back on added sugars, said the panel of outside experts convened once every five years called the Dietary Guidelines Advisory Committee.”

““For those who drink alcohol, recommended limits for better health are up to 1 drink per day for both women and men,” the committee said in its draft report.

Consuming the current limit of two drinks per day for men is associated with a “modest but meaningful increase” in death rates due to all causes, compared with just one drink per day, the panel found. The recommended advice would be unchanged for women.

The conclusions — a notable departure from what the federal government has recommended since the 1980s — are seen as surprising to some who worried the Trump administration-appointed committee would be too industry-friendly.

Since it was convened late last year, the committee has been criticized for having too many connections to food and beverage companies and being hamstrung by the Trump administration. But the recommendations look pretty similar to those during the Obama administration, except they go further on alcohol and sugar.”

“The latest conclusions, which were unveiled Wednesday during a lengthy webinar that lasted more than eight hours, are still in draft form. The final scientific advisory report is expected to be publicly released in mid-July.”

“The last iteration of the guidelines, crafted during the Obama administration, recommended that consumers not get more than 10 percent of their calories from added sugars.

The latest panel recommends that the government go further. A limit of 6 percent of calories from added sugars is “more consistent with a dietary pattern that is nutritionally adequate while avoiding excess energy intake,” the committee concluded.”

“The expert panel did not touch on the issue of environmental sustainability, something that was a major controversy during the last round of the guidelines. In 2015, the advisory committee recommended that sustainability be part of the guidelines, something that the meat industry saw as a major threat.”

“The guidelines are aimed at preventing diet-related diseases, not combating them — which means the advice is not geared toward a majority of the U.S. population.”

““A Dietary Guidelines that does not address the two-thirds of Americans who are overweight or have obesity is, in our view, a nutrition policy that lacks relevance to much of the general public and reflects an insufficient review of the science,” the Academy of Nutrition and Dietetics said in a comment to the panel this week. The group represents more than 100,000 dietitians and other nutrition professionals in the health field.”

The last points are important to note these guidelines will help not get to an issue IF you are in an issue(obesity, diabetic, etc..) you have to do more. I will say evidence does show eating a whole diet will yield improvements. Meat does make the goal of staying whole easier – but it can be done without meat to.

Another tough day for Brazil. India big drop down not sure what the surge of reporting was about.

California is the leader in US deaths at 84.

St. Louis is showing up in the county death map but looks like it is due to backlog not a sudden surge – https://www.ksdk.com/article/news/health/coronavirus/coronavirus-missouri-increase-st-louis-area-decrease/63-f706f60f-f27f-458c-8f1d-768fc15e4dff

“Missouri health department spokeswoman Lisa Cox said in an email that the state “received a backlog of deaths from St. Louis County at once. That happened yesterday and again today. We haven’t recently seen a day with a big spike in deaths that all occurred in the past 24 hours."

Interesting dip in India, Sweden, Switzerland….not sure what is driving this perhaps backlogs?

Ok we found the issue in the jump in TX confirmation – https://www.dallasnews.com/news/politics/2020/06/17/texas-coronavirus-totals-jump-thanks-to-1500-previously-excluded-state-prison-infections/

Interesting timing to put these numbers in when opening up state – when in theory these confirmations is NOT a function of opening.

“On Tuesday, the Texas Department of State Health Services reported that the total number of coronavirus cases increased by more than 4,000. Of those, about 2,600 are new and the rest were previously excluded infections among inmates in two counties: 887 in Anderson County and 589 in Brazoria County. Department spokesman Chris Van Deusen told The Dallas Morning News the prison cases date back to March. “These weren’t cases that were diagnosed yesterday,” Van Deusen said Wednesday.”

Even if it was yesterday vs. months ago – any prison jump in confirmation have nothing to do with the opening up of society given they are not necessarily interacting with the public.

Reality check – another evidence to conclude this is an endemic not pandemic – HUGE implications if right – don’t read if you are already down – https://www.scmp.com/news/china/science/article/3089476/there-may-be-no-immunity-against-covid-19-new-wuhan-study

I tried to find the source study they point to but I could not find it on medRxiv.org

“Humans may never develop immunity against Covid-19, according to new research on antibodies by Chinese and American scientists.

Their conclusion was based on a study looking at whether hospital workers in Wuhan who were directly exposed to infected patients at the early stage of the outbreak had developed antibodies. The deadly new disease was first detected in the Chinese city late last year.

At least a quarter of the more than 23,000 samples tested could have been infected with the virus at some stage, according to the scientists. But only 4 per cent had developed antibodies as of April.

“People are unlikely to produce long-lasting protective antibodies against this virus,” the researchers concluded in a non-peer-reviewed paper posted on preprint website medRxiv.org on Tuesday. Many efforts to fight the pandemic are being done on the assumption that people who have had Covid-19 will produce antibodies that will protect them from reinfection. Those efforts include countries considering issuing “immune certificates”, the over 100 potential vaccines in development, and recovered patients being encouraged to give blood for experimental drugs and therapies. But the new research in Wuhan suggested not everyone infected was producing antibodies, or producing long-lasting ones. Antibodies are the molecules generated by the immune system to bind with the virus spike protein and stop it from infecting cells. Some, like immunoglobulin G, or IgG, can remain in the system for a long time – it has been found in severe acute respiratory (Sars) patients 12 years after they were infected.”

“They found that 4 per cent of the health care workers and 4.6 per cent of general hospital staff had the IgG antibody. Earlier research found that 2.5 per cent of hospital employees in Wuhan had contracted Covid-19 during the outbreak, but it has been estimated that the real proportion of infections among this group could be as high as 25 per cent. Some people have mild or no symptoms when they have the coronavirus that causes Covid-19, and may not even know they have it. And with human-to-human transmission not confirmed until late January, many doctors and nurses in Wuhan were not wearing extra protective gear to treat patients.

“They just got infected with Sars-CoV-2 and fought off the virus with their own immune systems,” according to Wang and his team..”

“Patients with confirmed infections, where the symptoms were usually more obvious, tended to produce more antibodies, according to the researchers. An earlier study found all confirmed cases they looked at had developed the IgG antibody two weeks after the disease onset.

Wang’s team also suggested that more than 10 per cent of the people in their study may have lost antibody protection within a month or so.

“Our findings have important implications for herd immunity, antibody-based therapeutics, public health strategies, and vaccine development,” they said.

Based on their research, they said antibody tests may not be enough to tell whether someone had been infected, and the presence of antibodies like IgG may not necessarily provide immunity later.

“The idea of an immune certificate for recovered Covid-19 patients is invalid,” Wang wrote.

“a separate study by a team at Tsinghua University in Beijing suggested that the more antibodies produced by Covid-19 patients, the worse the outcome – the patient with the strongest antibody response in their study died. They pointed to a phenomenon known as antibody-dependent enhancement, in which viruses “hitch a ride” on an antibody to infect cells they could not enter otherwise.

Wang said that was “a big concern to be closely monitored””

“Wu Yingsong, director of antibody engineering research at the Southern Medical University in Guangzhou, said the Wuhan study should be treated with caution. He noted that most antibody tests only checked for a couple of antibodies to save time and cost – and that could mean false results.

“There are still a lot of fundamental things about the coronavirus we don’t understand,” he said.”

The outcome to all this IF true – its time to be a healthy society. Spending so much money on immunization, drug development, etc… seems like a diversification to making society healthier could be better allocation. Mechanical solution to reduce viral load needs to be highlighted and done in environments with multiple people such as offices, shopping, apartments, etc…

Brazil still the top death country

TX leads confirmation in US but as noted confirmation data is suspect. IL leads death 87. Death data is probably much better to watch than confirmation as I have noted many times.

County level view IL and CA are the only hotspots in death

Big drop in India death – data issues?

The big news going around is a cheap drug that can improve survival – dexamethasone. Hate to be a downer here but there are some important points not really highlighted in many articles. First we discussed the use of steroids back 5/12 in the must watch testimony in the morning report https://covid19mathblog.com/2020/05/covid-5-12-20/ when Dr. Kory testified 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

He was using Methylprednisolone for treatment WHEN ADMITTED TO HOSPITAL. So IF you are at this point things are not looking too good for you. This solution is a late stage solution. This is not helping you not to get to this point. The other concern about this is the source of the paper where this comes from https://apnews.com/89d963958b042cc921e64ab3eff5a74d :

“The Oxford study is the same one that earlier this month showed the malaria drug hydroxychloroquine was not working against the coronavirus. The study enrolled more than 11,000 patients in England, Scotland, Wales and Northern Ireland who were given either standard care or that plus one of several treatments: dexamethasone; hydroxychloroquine; the HIV combo drug lopinavir-ritonavir; the antibiotic azithromycin; the anti-inflammatory drug tocilizumab; or plasma from people who have recovered from COVID-19 that contains antibodies to fight the virus. Research is continuing on the other treatments. The research is funded by government health agencies in the United Kingdom and private donors including the Bill and Melinda Gates Foundation. ”

It would seem they used dosage of HCQ 6X what most other places have used in their study. This is a noted concern and they have not released results or response to this inquiry.

It looks like Brazil is joining the India alliance to use HCQ vs. what the FDA and WHO would like – https://amp.cnn.com/cnn/2020/06/16/americas/brazil-hydroxychloroquine-recommendations-fda-intl/index.html?

Pretty sad when the Brazil Health Ministry is criticizing FDA methods.

“Research around the world subsequently cast doubt on its effectiveness, and the FDA ultimately determined that the drugs do not meet "the statutory criteria" for emergency use authorization

But Pinheiro on Tuesday dismissed the studies cited by the FDA, claiming that the "quality of their methodology is terrible."

She also said, without presenting any evidence, that coronavirus cases in Brazil had gone down since May 20, when the Health Ministry approved new guidelines allowing the use of chloroquine and hydroxychloroquine for all patients displaying mild, moderate and severe Covid-19 symptoms if both doctor and patient agree on the use of the drugs.”

Ok so here is some evidence – which a journalist in CNN could have done – IF what she says is true they started May 20th – then fatality rates should have dropped – which they did. Remember this drug treatment is NOT going to stop the spread- so death will rise as confirmation rise – what needs to happen IF the drug is doing what it needs to do the fatality rates should drop – and this happens to be the case. Now there was a slight trend a week before May 20th before the drop but the trajectory has maintained itself. Unlike Mexico where they are not using HCQ they have not observed any drop in fatality rate.

WSJ is catching up – the report pretty much summarizes our morning report using the same reports I highlighted to come to the conclusions and proposed guidelines– https://www.wsj.com/articles/how-exactly-do-you-catch-covid-19-there-is-a-growing-consensus-11592317650?

“Health agencies have so far identified respiratory-droplet contact as the major mode of Covid-19 transmission. These large fluid droplets can transfer virus from one person to another if they land on the eyes, nose or mouth. But they tend to fall to the ground or on other surfaces pretty quickly.

Some researchers say the new coronavirus can also be transmitted through aerosols, or minuscule droplets that float in the air longer than large droplets. These aerosols can be directly inhaled.”

“Sufficient ventilation in the places people visit and work is very important, said Yuguo Li, one of the authors and an engineering professor at the University of Hong Kong. Proper ventilation—such as forcing air toward the ceiling and pumping it outside, or bringing fresh air into a room—dilutes the amount of virus in a space, lowering the risk of infection.”

“Another factor is prolonged exposure. That’s generally defined as 15 minutes or more of unprotected contact with someone less than 6 feet away, said John Brooks, the Centers for Disease Control and Prevention’s chief medical officer for the Covid-19 response. But that is only a rule of thumb, he cautioned. It could take much less time with a sneeze in the face or other intimate contact where a lot of respiratory droplets are emitted, he said.”

“Being outside is generally safer, experts say, because viral particles dilute more quickly. But small and large droplets pose a risk even outdoors, when people are in close, prolonged contact, said Linsey Marr, a Virginia Tech environmental engineering professor who studies airborne transmission of viruses.

No one knows for sure how much virus it takes for someone to become infected, but recent studies offer some clues. In one small study published recently in the journal Nature, researchers were unable to culture live coronavirus if a patient’s throat swab or milliliter of sputum contained less than one million copies of viral RNA.”

“CDC guidelines for employers whose workers are returning include requiring masks, limiting use of public transit and elevators to reduce exposure, and prohibiting hugs, handshakes and fist-bumps. The agency also suggested replacing communal snacks, water coolers and coffee pots with prepacked, single-serve items, and erecting plastic partitions between desks closer than 6 feet apart”

“the bigger risks are close-range face-to-face interactions, and having lots of people in an enclosed space for long periods. High-touch surfaces like doorknobs are a risk, but the virus degrades quickly so other surfaces like cardboard boxes are less worrisome, he said. “Surfaces and cleaning are important, but we shouldn’t be spending half of our budget on it when they may be having only a smaller effect,” he said.”

“The places he worries about are the break rooms, locker rooms and security checkpoints, where people interact. Those are spaces where the company has instituted social-distancing measures by staggering the times they are open and how many people can be there at once. Only a few cafeterias are open, and those that are have socially distanced seating. In bathrooms, only half the stalls are available to cut down on the number of people.”

How one gets covid covered 5/15/20

https://covid19mathblog.com/2020/05/covid-5-15-20/

Suggested Guidelines 5/18/20

https://covid19mathblog.com/2020/05/covid-5-18-20/

Vaccine progressing in China – going to phase 3 – China got a head start I wouldn’t be surprise they get to a vaccine first.

– https://www.scmp.com/news/china/society/article/3089334/coronavirus-chinese-firm-says-its-vaccine-candidate-passes-phase

“Inside one of the new production facilities the China National Biotec Group (CNBG) has built for manufacturing a Covid-19 vaccines CNBG announced that one of the potential vaccine candidates had completed phase one and phase two clinical trials. Photo: The State-owned Assets Supervision and Administration CommissionInside one of the new production facilities the China National Biotec Group (CNBG) has built for manufacturing a Covid-19 vaccines CNBG announced that one of the potential vaccine candidates had completed phase one and phase two clinical trials. Photo: The State-owned Assets Supervision and Administration Commission

Inside one of the new production facilities the China National Biotec Group (CNBG) has built for manufacturing a Covid-19 vaccines CNBG announced that one of the potential vaccine candidates had completed phase one and phase two clinical trials. Photo: The State-owned Assets Supervision and Administration Commission

A potential Chinese Covid-19 vaccine, which has completed phase one and phase two human trials, is generally safe and can generate immune response in test subjects, the vaccine’s developer, China National Biotec Group, said on Tuesday.

The vaccine candidate, developed by a CNBG subsidiary, the Wuhan Institute of Biological Products, began human trials in Henan province in April. Volunteers 18 to 59 years old were inoculated with low, medium and high doses and were given a second shot two weeks, three weeks or four weeks later to study the safety and immunity response of the vaccine, CNBG said.”

“The programme inoculating volunteers with two doses four weeks apart induced neutralising antibodies – blocking pathogens from infecting human cells – in all its test subjects, the company said.

“This study is the world’s first clinical trial to obtain safety and effectiveness data of a two-dose inactivated Covid-19 vaccine … The research also involves the longest period, the most comprehensive data and the most satisfying clinical research results of Covid-19 vaccine clinical trial,” the group said. The company said that it was “actively advancing” the phase three clinical trial overseas and that it had reached “intention of cooperation” with companies and institutions in numerous countries. China is not considered suitable for the trial, which would involve at least thousands of volunteers, because the number of Covid-19 patients has dropped significantly there and it would be difficult to determine whether the vaccine could actually prevent a test subject from getting sick.””

“The company announced earlier that it has reached an agreement with Instituto Butantan in Brazil to prepare and conduct a phase three clinical study”

Not a good day for India 2003 deaths reported yesterday. Brazil 1282 US maintained below 1000 – 836

CA leads the way in US death at 86. The big story likely is TX big jump in confirmation at 3358.

TX confirmation seems to be wrong given Brazoria county confirmation jumped 613 in 1 day. That’s more than the total they have….Cant confirm with county data….

This caused the delay of this release….hopefully we see a fix in tomorrow data release. https://www.brazoriacountytx.gov/departments/health-department/brazoria-county-coronavirus-map

Or at least an explanation. I know the difference in one area is the counting of the correctional facilities.

Not good for India and Brazil and Mexico, Russia, UK, Sweden all surging in deaths

There goes some salmon demand – https://www.bloomberg.com/amp/news/articles/2020-06-15/salmon-shunned-in-china-after-link-to-beijing-virus-outbreak?

“ A fresh outbreak of coronavirus cases in Beijing is being blamed on imported salmon, prompting a nationwide boycott of the fish.

Salmon has been taken off the shelves in major supermarkets like Walmart Inc. and deleted from grocery delivery platforms across China, while top experts are warning people not to consume the omega-3 rich fish. Provinces and cities from Yunnan to Shanghai are testing the seafood at local wet markets for the virus.

The backlash came after the chairman of a major fruit and vegetable market called Xinfadi, the site of over 100 newly-detected infections in Beijing, said that the virus was traced to the chopping board used by a seller of imported salmon.

While it is unclear if the virus can be actually be transmitted through frozen food that’s later thawed, the furore has put a $700 million market for imported salmon at risk, dealing a blow to major exporters like Denmark, Norway and Australia.”

““We have yet to find out whether human beings transmitted the virus to salmon, or salmon contracted the virus first,” said Zeng Guang, a senior expert with the National Health Commission, in an interview with state media on Sunday. He warned Beijing residents not to eat raw salmon or purchase imported seafood for the time being.

Wu Zunyou, chief epidemiologist of China’s Center for Diseases Prevention and Control said on Sunday that the virus can survive on the surface of frozen food for up to three months and that the agency “highly suspects” contaminated goods as the source of the latest outbreak.”

“In a study published in April, researchers with the Food and Agriculture Organization of the United Nations concluded that the coronavirus is not known to infect aquatic food animals or contaminate their products.

The risk “should be negligible” with “proper food handling and sanitation,” although their surfaces might potentially become contaminated when handled by people who carry the virus, scientists including Melba G. Bondad-Reantaso wrote.”

American Cancer Society comes out with guidance to prevent cancer – https://www.popsci.com/story/health/diet-exercise-how-to-prevent-cancer/

Exercise More, Eat more whole foods and less processed stuff, don’t drink alcohol

“The ACS now recommends 150 to 300 minutes of moderate-intensity or 75 to 150 minutes of vigorous physical activity every week, which works out to either 2.5 to 5 hours or 1.25 to 2.5 hours a week. Broken down even further, that’s an average of about 20 to 45 minutes of moderate exercise a day, or 10 to 20 of vigorous activity.”

“ACS guidelines now suggest what it calls “a healthy eating pattern.” That means eating nutritious food, a variety of veggies, plenty of fruit, and lots of whole grains. It also means limiting or not eating red and processed meats, sugary drinks, and highly processed foods in general.”

“Alcohol consumption is the third-biggest modifiable risk factor for cancer after smoking and being overweight. At least seven types of cancers are directly linked to it, including oral cavity, colorectal, liver, and breast cancers. That’s because alcohol is a known carcinogen—it damages DNA, increases cellular division rates, and causes cellular (or oxidative) stress.”

“The ACS notes that if you do drink, your goal should be to limit yourself to no more than one drink a day for women, and two for men. That may be a lot lower than what you normally consume, but if you really want to reduce your cancer risk, this is one of the biggest impacts you can have.”

Overall reasonable request if you do not want to get cancer and also very likely improve on heart condition. I know many won’t want to follow this advice but look what we had to do as a society with covid death at 116k and rising. Media always noting more deaths than certain wars. Well Heart and Cancer deaths each year in US TOTAL 647K and 599K a year respectively https://www.cdc.gov/nchs/fastats/deaths.htm . These steps could save 10x Covid lives – plus all the hospitalization and medical cost. These guidelines would also reduce covid deaths. I am all for limited govt. but govt is needed to limit our vices and for sure our lifestyle is one of our biggest vices. Just like global warming concerns on externalities not being paid by fossil fuel usage, there are huge externalities from society choices to drink alcohol, be sedentary, and eat process foods. Following these guidelines you will see benefits in your lifetime unlike global warming issue which may not be seen until 50+ years from now.

Great update day with US in 4th place in deaths 395. India took the top spot at 705

Global snapshot – health/lifestyle/diet looks to be an obvious key metric in our death count. Along with population density.

NJ leading the death chart for the US at 49 followed by Georgia at 43

Riverside CA now showing an increase in deaths – latest headlines – https://www.desertsun.com/story/news/health/2020/06/15/more-than-50-covid-19-patients-riverside-county-have-recovered/3191760001/

“Coronavirus in Riverside County: 795 new cases since Friday; more than 50% of patients have recovered”

Careful on the county local reporting as headlines grab attention. Not sure how many headlines noted 0 days. Below is Harris county deaths in the second chart note 3 zero death days and now the 9 death day spike. 7 day moving average death still not really significantly moving up just yet.

India is not looking good. Columbia is also starting to spike. Brazil and Mexico perhaps has past the peak.

Sunday reporting are the lowest. No country reported deaths over 1000

Brazil at 612 US at 296

Death per capita still low. Calculating the amount confirmed is still subject to debate – as of right now the current fatality rate for the US sits around 5.5%. IF you get confirmed with covid you have a 5.5% chance of dying. However IF more people are actually confirmed (likely) than reported this is where the fatality rate could quickly drop. This is the reason CDC has dropped the fatality rates projected.

MA lead the way in US death at 48. Confirmation are growing as testing grows. As long as they are mild conditions than they should actually drop the fatality rates.

Though Alabama is not really showing up on our county map for concern there are press release indicating concerns – https://www.alreporter.com/2020/06/14/we-cant-handle-much-more-doctors-sound-alarm-as-covid-19-surges-in-alabama/

IF there were such a surge and the system couldn’t handle it – we should see an increase in fatality rates – which are not yet being observed.

Harris County TX fatality rate is dropping over time.

Most countries are declining other than Peru, Pakistan, India

CDC has issued public guidelines – https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/activities.html

Unfortunately they have not offered any updated business guidelines nor proposed mechanical solutions to limit risk giving an option for business to invest and get society more comfortable in venturing out. There are mechanical solutions to mitigate the spread that are not outrageously expensive (HVAC systems, UV light, metals selection, etc..). Mask and more mask is clearly an easy low hanging fruit and should be done as noted in several studies I have posted. Viral load is key – so time becomes an important element as noted in the CDC guideline. IF you plan to be somewhere under 10 minutes the risk mitigation can be much less than if you plan to be in an office environment or restaurant or entertainment venue for hours.

Some of the language is also suspect –

“Older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.”

Not sure on the grouping – why not say older adults who have underlying condition are at higher risk. I don’t think that’s a might – it is a fact you are at higher risk. Risk itself already has uncertainty so there is no need to confuse it with might. ALL the data shows elderly with multiple comorbidities have higher fatality rates hence higher risk. People with MORE than 1 comorbidity is also well documented to have higher risk.

If you are in India it would seem females are worse off than males – https://www.ndtv.com/india-news/coronavirus-women-may-have-higher-covid-19-death-risk-than-men-in-india-study-2245761

“While early evidence indicated that males have higher overall burden across the world, females have a higher relative-risk of COVID-19 mortality in India, the researchers said.”

“Citing the limitations of the study, the researchers said the analysis is based on crowdsourced data with "considerable gaps in reporting of age-sex specific information of all the COVID-19 infections and deaths."

The scientists said the number of confirmed cases in India depends upon the testing facility and capture of the data on age-sex specificities of COVID-19 cases, which they added "has been inadequate."”

Brazil continues to lead the daily death 892. US under 1K – but it is the weekend reporting. US leads in confirmation.

NJ leading the US in death at 132

County view shoes the usual suspects

Ecuador data looks revised so not as bad as yesterday reporting. Phillipines is seeing a big increase. Many are now showing declines including Brazil and Mexico. Spain is essentially zero now.

Bitter sweet – that’s the corona news today….

Arkansas getting some press with more infections but as noted previously food processing facilities are the ideal environment for spreading….sweet part at least for those infected the majority asymptomatic…. https://www.4029tv.com/article/247-test-positive-at-tyson-plant-on-berry-st-in-springdale/32842660

“Of the 199 infected workers tested by Tyson, only one was showing symptoms. The rest were asymptomatic and may not have been identified as carriers without the testing.”

Nigeria noting one can get reinfected with covid – developing antibody is not consistent – https://tribuneonlineng.com/you-can-get-reinfected-with-covid-19-if-expert/

“Professor Alonge, the coordinator of treatment at Oyo State Isolation centre, stated that the pattern of developing antibody to COVID-19 is so erratic and unpredictable.”

““In fact, the so called 14 days quarantine period is not magic. We have seen people who after 14 days are still shedding the virus, even at 28 days. So the bottom line now is to check the viral load and the CT value and the antibody they have mounted before you discharge them.

“Even when they are discharged, we ask them to stay at home and still wearing their masks because they may not be infectious to you, but you, in coat looking clean may be infectious to them, so there is a risk of reinfection when you get exposed.”

““We don’t know who had already contracted the virus and had developed antibodies. This virus you can wash away from your system if you have good immune system, it is when the damage comes and you have s subsisting medical condition that weakens the immune system that you succumb. More than 90 per cent actually recover full from what we are seeing and at Olodo Isolation centre, 100 per cent have recovered fully.”

Last part brings much relief to me as not many discuss the recovery and just note people are rid of covid – but that’s not any good if you have reduced lung capacity for the rest of your life. At least here he is noting a FULL recovery! Bitter sweet it would seem reinfection can happen but you can recover fully….and once again its all about the viral load – keep it low a healthy body can manage it.

““So my hypothesis has always been that good nutrition and coming out into the sun, say about one hour, is what is giving us some degree of protection in the tropical region rather than the fact that we have some inherent immunity.”

This has been my hypothesis for awhile to. The death per capita from Covid in Nigeria has been extremely low. Staying at home without going outside is likely very detrimental.

A success but with a bitter taste – https://www.foxnews.com/health/seattle-man-70-beats-coronavirus-then-gets-1-1m-hospital-bill-report-says

This man was very poignant to realize that a $1.1 million charge which he could never pay will burden someone else. Just because you don’t pay the bill doesn’t mean its not being transferred in some form to something/someone else.

“$408,912 – for 42 days in an intensive care unit (ICU) room that was special equipped as an isolation chamber because of the contagious nature of the virus.

$100,000 – for treatment as his heart, kidney and lungs all nearly failed during his stay.

$82,215 – for 29 days of ventilator use.”

““I feel guilty about surviving,” Flor told the Seattle paper. “There’s a sense of ‘Why me? Why did I deserve all this?’ Looking at the incredible cost of it all definitely adds to that survivor’s guilt.” Flor said much of the guilt stems from knowing that taxpayers and other insurance customers will contribute to the cost of keeping him alive.

“It was a million bucks to save my life, and of course I’d say that’s money well-spent,” he says. “But I also know I might be the only one saying that.””

Brazil still the leader with 909 new deaths…US 849

NY leading the death count for the US 178. However CA leading confirmation – hopefully with sunny CA most will be relatively asymptomatic.

CA confirmation lead is driven by LA

Brazil and Mexico tempering. India continues to rise. Ecuador curve is going parabolic.

Support of BCG and potentially using polio vaccine- which is the preferred option in this report – to assist in fighting off Covid – https://science.sciencemag.org/content/368/6496/1187

“an increasing body of evidence suggests that live attenuated vaccines can also induce broader protection against unrelated pathogens likely by inducing interferon and other innate immunity mechanisms that are yet to be identified. The stimulation of innate immunity by live attenuated vaccines in general, and oral poliovirus vaccine (OPV) in particular, could provide temporary protection against coronavirus disease 2019 (COVID-19).”

“Large-scale clinical studies of OPV for nonspecific prevention of diseases were carried out in the 1960s and 1970s. These involved more than 60,000 individuals and showed that OPV was effective against influenza virus infection, reducing morbidity 3.8-fold on average (2, 3). OPV vaccination also had a therapeutic effect on genital herpes simplex virus infections, accelerating healing. OPV not only demonstrated positive effects against viral infections but also had oncolytic properties, both by directly destroying tumor cells and by activating cellular immunity toward tumors (2). These observations were among the first examples of viral oncotherapy, which is being actively pursued.”

“More recent studies confirmed these broad protective effects of OPV. Data from a randomized controlled trial (RCT) of OPV in Guinea-Bissau, West Africa, showed that OPV given at birth reduced infant mortality by ∼32% (5). In addition, an analysis of the effect of annual and biannual national OPV immunization campaigns showed that they reduced all-cause mortality by 19%, with each subsequent campaign adding a further 13% reduction (6). This means that repeated immunization has an additive effect despite antibodies induced by the first vaccination. Depending on initial age, it was necessary to give OPV to between 68 and 230 children to prevent one death within the first 3 years of life (6). These observations were made in the complete absence of poliovirus circulation, emphasizing the nonspecific nature of the OPV-induced protection.”

“Attenuated bacterial vaccines such as Bacillus Calmette–Guérin (BCG) against tuberculosis, as well as experimental live attenuated vaccine against pertussis (whooping cough), were also shown to protect against heterologous infections (5, 11). In addition, live pertussis vaccine also prevented noninfectious inflammatory diseases (11). RCTs showed that BCG vaccine at birth was associated with more than a one-third reduction of neonatal mortality, because BCG vaccine protected against deaths from septicemia and pneumonia (5). In 2014, an expert panel at the World Health Organization reviewed the evidence for nonspecific effects of live vaccines and concluded that they reduced childhood mortality by more than would be expected through their effects on the diseases they prevent (12). It is important to note that non-live (inactivated) vaccines do not seem to have the same effects, suggesting that replicating attenuated pathogens induce a broader immune response.”

“Numerous studies have shown that BCG activates the innate immune system, resulting in enhanced responsiveness to subsequent triggers, so-called “trained innate immunity” (13). BCG given 4 weeks prior to a yellow fever vaccine significantly reduced virus load, confirming that it could modify the course of a viral challenge in vivo. The effects were mediated through epigenetic modifications in innate immune cells, leading to higher innate cytokine production (13). BCG can also induce emergency granulopoiesis within hours of administration, leading to a marked increase in the number of circulating neutrophils, providing protection from sepsis (14). The duration of the nonspecific protection induced by live vaccines is unknown but has been observed to last for many months to years after vaccination. For example, BCG given at school entry (5- to 6-year-olds) in Denmark was associated with a 42% reduction in the risk of dying from natural causes until the age of 45 years (“

“We propose the use of OPV to ameliorate or prevent COVID-19. Both poliovirus and coronavirus are positive-strand RNA viruses; therefore, it is likely that they may induce and be affected by common innate immunity mechanisms. There are multiple important advantages to using OPV: a strong safety record, the existence of more than one serotype that could be used sequentially to prolong protection (2, 3), low cost, ease of administration, and availability. Over 1 billion doses of OPV are produced and used annually in more than 140 countries. Although the supply of BCG is limited, a small fraction of OPV intended for the suspended polio eradication campaign would be sufficient for the clinical trials, and provided a positive outcome, production could likely be scaled up quickly.

Another advantage of OPV over BCG is safety. Up to 1% of BCG recipients require medical attention, owing to adverse reactions. The risk of complications due to OPV is extremely low. Vaccine-associated paralytic polio (VAPP) develops in 1 per 3 million vaccine doses given to unimmunized individuals and mostly occurs in immunocompromised children. Sequential use of IPV followed by OPV demonstrated that prior immunization eliminates the risk of VAPP. In populations with inadequate immunity, OPV was also shown to generate circulating vaccine-derived polioviruses (cVDPVs). However, in countries with sufficient vaccine coverage, the risk is minimal: Over 35 years of OPV use in the United States has resulted in no documented case of cVDPV. Therefore, if used properly, OPV is likely a safer choice than BCG.”

On the HCQ front it is not likely wonder drug but still trying to conclude it is worthless is not so easy – https://www.sciencemag.org/news/2020/06/three-big-studies-dim-hopes-hydroxychloroquine-can-treat-or-prevent-covid-19

“On 5 June, researchers in the United Kingdom announced the results from the largest trial yet, Recovery, in a press release. In a group of 1542 hospitalized patients treated with hydroxychloroquine, 25.7% had died after 28 days, compared with 23.5% in a group of 3132 patients who had only received standard care”

High death rates likely mean very late stages….

“Many researchers agree that a good case can be made for continuing to test whether hydroxychloroquine can prevent infection if given to people just in case they get exposed to the virus, for instance on the job at a hospital—a strategy called pre-exposure prophylaxis (PrEP). “You have a much better chance of preventing something with a weak drug than you have of curing a fully established infection,” says White, who runs one of the largest PrEP trials. He notes that doxycycline, an antibiotic, has long been used in malaria prophylaxis. “We would never treat anybody with it, it’s too weak. But it’s a very good prophylactic.”

Landray, however, is on the fence about continuing prophylaxis trials: “I suspect it’s one of these decisions where there isn’t a right or wrong.” It’s an important question, Bhadelia says, because an effective PrEP drug could have a major impact on the pandemic. Hydroxychloroquine, a cheap and widely available drug, is one of the few compounds that could fit the bill.

But the Lancet paper, despite its retraction, will make it more difficult to continue current trials, White laments. Published on 22 May, the study claimed, supposedly based on data from 96,000 patients around the world, that hydroxychloroquine and chloroquine, whether given alone or in combination with another drug, caused a steep increase in deaths. That led many regulatory agencies to ask scientists to halt their trials and make sure they were not harming their patients. Recovery and Solidarity were temporarily halted but resumed after a safety committee took a look at the data.”

Covid not likely going away – https://whyy.org/npr_story_post/nothing-like-sars-researchers-warn-the-coronavirus-will-not-fade-away-anytime-soon/

“. It’s likely the disease will be here with us year-round and for years to come, says Albert Ko, an epidemiologist at Yale and co-chair of the Reopen Connecticut Advisory Group.

“This virus may become just another endemic virus in our communities, and this virus may never go away,” said Michael Ryan, director of WHO’s health emergencies program on May 13.

To call a virus “endemic” means that it has a constant presence in a specific location, explains Ngozi Erondu, an epidemiologist and research fellow at Chatham House.”

“the novel coronavirus might not have the staying power of some of these other endemic viruses. For one thing, it doesn’t mutate as fast as flu. And it doesn’t usually appear to hide out in the body after the initial infection, WHO specialists say.”

“there are still many hurdles to clear for vaccine development, Erondu says. “We keep getting these very hopeful estimates,” she says, “[but] we probably won’t have a vaccine for another two years at the minimum.”

Peiris says it’s possible a vaccine may come sooner — “maybe by early next year” — but that timeline assumes that everything goes perfectly. “We have to realize that there has been no vaccine for coronaviruses in humans,” he says.”

Brazil once again leading the pack 1239 deaths.

Brazil death much like US is centered in a region – Sao Paul

Total US death continues under 1K – Il taken over the lead for US death at 90. Confirmation is lead by CA.

County view we see Harris county (large part of Houston, TX) is noted in Bloomberg and discussions about shutting down the city again – https://www.bloomberg.com/news/articles/2020-06-11/houston-may-reopen-virus-hospital-at-stadium-as-cases-expand

This seems quite an early discussion given the current numbers.

The 7 Day moving average confirmation is climbing but should be expected as you are testing more and I believe some of the antigen test are being included in the confirmation. The death rate is actually coming down. Overall fatality rate is a dream for many counties at less than 1%

India has surpassed Mexico in terms of 7 day moving average daily deaths. US is now below Russia.

WEAR a MASK – even if it’s a bandana – this is what I wear since I am in TX! The risk/reward (risk=inconvenience) …reward not getting sick or getting someone else sick….

Here is the paper being cited in many articles but not linked to for some reason – https://royalsocietypublishing.org/doi/10.1098/rspa.2020.0376

It is all about reducing viral load – you don’t have to go to zero to do well for your body.

“information on the size of the infectious dose for SARS-CoV-2 is lacking, but research on SARS-CoV (the 2003 virus) showed that between 43 and 280 individual virus particles had to enter the human body in order to start an infection [60]. Even home-made masks, washed in soapy water after each use, therefore, should reduce fomite build-up and droplet-mediated airborne transmission.”

“The natural mechanics of filtration are that larger droplets are captured more effectively. So, it can safely be assumed that droplets in the 1 µm plus range will be almost completely eliminated by such an informally made mask. This is very important because a 2 µm droplet has a thousand times the mass of a 200 nm droplet, and a 20 µm droplet has a million times the mass of a 200 nm droplet, the virus load being proportional to the mass. The larger the droplets, the more important it is to capture them, and even a home-made mask will do this very well. There are also experimental data, for instance, that show that home-made facemasks consisting of one facial tissue (inner layer on the face) and two kitchen paper towels as the outer layers achieved over 90% of the function of surgical mask in terms of filtration of 20–200 nm droplets [25]. These facemasks are also disposable, so would clearly provide a pragmatic solution to the problem, and there are many sites now on social media that provide clear instructions on facemask making and safe use.”

“Our analysis indicates that a high proportion of the population would need to wear facemasks to achieve reasonable impact of the intervention. In Hong Kong, 99% of survey respondents reported wearing facemasks when outside of their home”

“Lock-down periods alone do not prevent the occurrence of secondary and tertiary waves of the pandemic occurring and these may be larger than the initial wave”

“If lock-down periods are combined with 100% adoption of facemask use by the public, the initial disease progress peak is dramatically flattened and delayed and subsequent waves are prevented”

“In summary, our modelling analyses provide support for the immediate, universal adoption of facemasks by the public, similar to what has been done in Taiwan, for example, where production will soon reach 13 million facemasks daily, with well-developed plans for N95 respirator production in the pipeline [68]. Our analyses indicate that actions to facilitate this in the UK should include clear instructions on the fabrication and safe use of home-made masks, as well as accompanying governmental policies to increase swiftly the availability of medical standard surgical, or N95 respirators, to the public.”

More is done to find our who is at risk – https://www.reuters.com/article/us-health-coronavirus-southkorea-study/south-korean-doctors-find-risk-factors-for-severe-covid-19-cases-idUSKBN23I07R

“In a paper published by the Journal of Korean Medical Science on June 2, Ahn and other South Korean doctors wrote that diabetes, high body temperature, low oxygen saturation and pre-existing cardiac injury were shown to be the prognostic factors for severe COVID-19.”

“The coronavirus patients with at least three of the four prognostic factors developed severe conditions, Professor Ahn said.”

Adding on from our recent papers don’t be a balding male, type A blood, high cholesterol both internally and diet, diabetic, have a high body temp, existing cardiac issue….and you will be good.

Not a good day for Brazil and Mexico…US under 1K

CA leading death at 109. Confirmations are growing and will likely be tied to opening – but there is also a likely growth IF the amount infected is much larger than everyone thinks so confirmation perhaps not the best metric to watch.

Death/Confirmed perhaps indicate the better stat of public awareness for those who are suspect of fatality from Covid as opening up the economy will likely not be able to be avoided.

Right now most states are flat other than Georgia, NY

Jefferson County TX is sticking out in our county watch – looks like coming from prison – https://www.texastribune.org/2020/06/10/texas-reports-largest-single-day-increase-coronavirus-cases/

“Just over 21% of the new cases were reported in Jefferson County, which reported 537 new cases Tuesday, nearly doubling its previous total.

Asked about the cause of the increase, DSHS spokesperson Chris Van Deusen pointed to Jefferson County’s three state prison units.

Most of the new cases were "due to a change in how the local health department is reporting" cases from the prisons, he said.”

Brazil and Mexico continue to rise. Sweden also is showing a big ramp of recent.