Covid 9/9/20

Vaccine issue – https://www.cbsnews.com/news/covid-19-vaccine-trial-oxford-astrazeneca-pauses-participant-may-have-suffered-adverse-reaction/

“AstraZeneca pauses COVID-19 vaccine trial over possible adverse reaction in participant”

“AstraZeneca did not provide details on what symptoms the participant had experienced, or when the trial was expected to resume.”

“The Oxford/AstraZeneca vaccine is considered the leading candidate in the race to develop an effective COVID-19 vaccine. Oxford University has been conducting phase three trials in the U.K., Brazil and South Africa. In earlier phases, there was no evidence that the drug caused serious reactions.

Other vaccine candidates in phase three trials are being developed by Pfizer/BioNtech and Moderna. Russia skipped phase three testing of its potential vaccine. On Tuesday, the CEOs of nine drugmakers — AstraZeneca, BioNTech, GlaxoSmithKline, Johnson & Johnson, Merck, Moderna, Novavax, Pfizer and Sanofi — released a joint statement vowing not to release any vaccine unless proven safe by rigorous testing.”

What about the Chinese?

Another good reporting day for the US – lag from holiday? Only 445

Texas leads with 95

Once again it’s a border county in TX leading TX and the nation – Hidalgo County with 16 deaths

Houston ICU never got close to those dire predictions….

Covid 9/8/20

Glad to see more than NBA using the saliva test – https://abc7chicago.com/covid-19-illinois-covid-university-of-saliva-test-near-me/6413359/

“The University of Illinois says its rapid saliva-based COVID-19 test is "working" for its campus.

Last month, Governor JB Pritzker announced that state health officials would begin using the new groundbreaking test after it was approved for wider use by the FDA.”

“U of I researchers say it is faster, cheaper and requires significantly less raw materials than traditional testing. The new test can turn results within 3 to 6 hours, which scientists say is contributing to the drop in positivity rates.”

“The test is said to be only $10 a specimen, allowing tests to be done frequently, giving hope to researchers as Illinois cases continue to rise.”

Lots on the vaccine front – https://www.scmp.com/news/china/society/article/3100570/chinese-drug-firm-says-hundreds-thousands-have-been-given-covid

“Hundreds of thousands of Chinese have been given two experimental Covid-19 vaccines under an emergency scheme without a single case of infection, a top official with a state-owned vaccine developer has said.”

“Eight vaccines are currently undergoing phase three trials around the world, including four made by Chinese companies.”

“Three of the Chinese vaccines – including the two made by CNBG and one developed by Beijing based Sinovac – have been approved for emergency civilian use, while a fourth has been given the greenlight for use by the military.

Sinovac’s product is currently being tested in Brazil and Indonesia and the trial is expected to expand to more countries. The company has reportedly said that tens of thousands of people have already been given the vaccine under China’s emergency use scheme.

Meanwhile, the Chinese military has given the green light to the limited use of a candidate vaccine developed by CanSino and the Academy of Military Medical Sciences.”

“Zhou said they still showed high levels of antibodies, and added: “At present, based on the results of animal experiments, phased research results, and similar vaccines using similar technology, it is without question that immunity can last from one to three years.””

“CNBG has built two secure facilities in Beijing and Wuhan to produce the vaccines. He said the annual production capacity of more than 220 million doses will rise to between 800 million to one billion when work to extend the facilities is complete.”

https://weather.com/en-IN/india/coronavirus/news/2020-09-08-russia-covid-19-vaccine-produced-for-civilian-circulation

“the Russian Health Ministry said on Tuesday that the first batch of Sputnik V vaccine has been produced for civilian circulation.”

“Earlier this month, a study published in the peer-reviewed journal The Lancet said a Russian COVID-19 vaccine has shown no serious side effects and elicited an immune response in early human trials.

Russia last month registered the "Sputnik V", becoming the first country to approve a COVID-19 vaccine. On August 15, the Russian Health Ministry announced the launch of the vaccine production.

The Lancet study’s authors also held that large, long-term trials, including a placebo comparison, and further monitoring are needed to establish the long-term safety and effectiveness of the vaccine for preventing COVID-19 infection.

The Indian government said late last month that New Delhi and Moscow are in communication regarding the Sputnik V vaccine.”

Lets hope the Sputnik term bodes better than Sputnik 2 – https://www.wired.com/story/space-dogs-laika-documentary/

“Space Dogs uses archival footage to tell the story of the clever, docile, and doomed Moscow street dog Laika, the first mammal to go into orbit—and the first mammal to die there. In 1957, the Soviet Union sent Laika to space in the satellite Sputnik 2.”

Take your vitamin D or get outside more often – https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770157

“In this cohort study of 489 patients who had a vitamin D level measured in the year before COVID-19 testing, the relative risk of testing positive for COVID-19 was 1.77 times greater for patients with likely deficient vitamin D status compared with patients with likely sufficient vitamin D status, a difference that was statistically significant.”

Perhaps no more nasal test…but stool test – https://fortune.com/2020/09/07/covid-infection-gut-stool-respiratory-research-study/

“COVID-19 patients have active and prolonged gut viral infection, even in the absence of gastrointestinal symptoms, scientists in Hong Kong showed.

The coronavirus may continue to infect and replicate in the digestive tract after clearing in the airways, researchers at the Chinese University of Hong Kong said in a statement Monday. The findings, published in the medical journal GUT, have implications for identifying and treating cases, they said.

SARS-CoV-2 spreads mainly through respiratory droplets — spatters of virus-laden discharge from the mouth and nose, according to the World Health Organization. Since the first weeks of the pandemic, however, scientists in China have said infectious virus in the stool of patients may also play a role in transmission.”

Major revision in Ecuador – 3852 deaths increase 7953 confirmation DECREASE? – fatality rate approaching 10% – US only reported 267 deaths (labor day)

Bolivia also saw a big jump of death 1656

TX lead death at 43

Hidalgo lead TX county at 23 – but the leader in all US county death LA at 25

Covid 9/7/20

Death reporting is generally dumb down to high level numbers as the general public is perceived to not be able to handle all the details and numbers – also its hard to display and write about it. However if you do look at the detail it does clear some of the conspiracy concerns. Below is NY weekly deaths by the various categories. Lots to look at but the key is to look where the red line is relative to the other lines – if outside the range of the other lines – then 2020 is an outlier and there is something going on above the normal. This is not a normal year. You can see the spike in all categories – what is interesting but not talked about is the death from symptoms signs and abnormal – this divergence starts at the beginning of the year and still sustain itself above the rest of the year.

Even in TX we see the same unique issue with symptoms signs and abnormal but only starting slightly ahead of the covid bump – if they wanted to overreport covid one could easily put this into covid.

US death only 403 – but it’s a weekend report

TX leads at 78 deaths in the US

The leading county is Hidalgo TX – border county at 22

There are lots of strict rules in New Zealand – plus being naturally on an island and yet they cant still get the confirmation to 0. We need to accept the inevitable and adapt.

Covid 9/6/20

Everywhere you go now they have hand sanitizer out as if that proves the facility is covid safe. Probably one of the first things that sold out and was the first line of defense applied was hand sanitizing – clearly that did not work. Covid is spread not from fomites (objects) but primarily through the air via droplets and other airborne particles. Yet we still have this fascination of hand sanitizers. Before Covid the FDA/CDC were investigating the overuse of hand sanitizer. There are many studies siting the concerns and misuse of hand sanitizer – over and over there is no better way than washing your hands with soap and water. IF they are so concern about this why not put the portable hand washing systems seen at concerts and events around. For now we see plastic bottles of hand sanitizers all over the place.

2019 report basically saying ethanol based sanitizers ineffective in mucus – wash with soap and water!

https://msphere.asm.org/content/msph/4/5/e00474-19.full.pdf

“Both antiseptic hand rubbing (AHR) using ethanol-based disinfectants (EBDs) and antiseptic hand washing (AHW) are important means of infection control to prevent seasonal influenza A virus (IAV) outbreaks. However, previous reports suggest a reduced efficacy of ethanol disinfection against pathogens in mucus.”

“Our clinical study showed that EBD effectiveness against IAV in mucus was extremely reduced compared to IAV in saline. IAV in mucus remained active despite 120 s of AHR; however, IAV in saline was completely inactivated within 30 s. Due to the low rate of diffusion/convection because of the physical properties of mucus as a hydrogel, the time required for the ethanol concentration to reach an IAV inactivation level and thus for EBDs to completely inactivate IAV was approximately eight times longer in mucus than in saline. On the other hand, AHR inactivated IAV in mucus within 30 s when the mucus dried completely because the hydrogel characteristics were lost.”

2011 report noting that hand sanitizers are ineffective with norovirus and can actually cause more harm – wash with soap and water!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168661/

“Alcohol-based hand sanitizers may not be the panacea for hand hygiene they were once supposed, as mounting research indicates they may not be effective substitutes for soap and water, and in some cases may actually increase the risk for outbreaks of highly contagious viruses in health care settings.”

“It’s widely recognized that improper use of antibiotics contributes greatly to the development and spread of super bugs in health care settings, but the link between hand sanitizers and bacterial resistance is less clear.

A survey of 161 long-term care facilities in the United States presented at an American College of Preventative Medicine meeting in February revealed an association between the preferential use of alcohol-based hand sanitizers for routine hand hygiene with an increased risk for outbreaks of norovirus, the highly infectious virus that causes most cases of acute gastroenteritis.

Staff in facilities that experienced norovirus outbreaks were six times more likely to use hand sanitizers equally or more than soap and water for routine hand hygiene, according to the study (Am J Infect Control 2011;39:296–301). Of 45 facilities that reported preferential use of alcohol-based hand sanitizers, 53% experienced a confirmed outbreak of norovirus, compared with 18% of 17 facilities that used hand sanitizers less often than soap and water.”

2009 report – shows soap and water most effective/superior to alcohol hand rub

https://pubmed.ncbi.nlm.nih.gov/19115974/

“There was an immediate reduction in culture-detectable and PCR-detectable H1N1 after brief cutaneous air drying–14 of 20 health care workers had H1N1 detected by means of culture (mean reduction, 10(3-4) TCID(50)/0.1 mL), whereas 6 of 20 had no viable H1N1 recovered; all 20 health care workers had similar changes in PCR test results. Marked antiviral efficacy was noted for all 4 HH protocols, on the basis of culture results (14 of 14 had no culturable H1N1; (P< .002) and PCR results (P< .001; cycle threshold value range, 33.3-39.4), with SW statistically superior (P< .001) to all 3 alcohol-based hand rubs, although the actual difference was only 1-100 virus copies/microL. There was minimal reduction in H1N1 after 60 min without HH.

Conclusions: HH with SW or alcohol-based hand rub is highly effective in reducing influenza A virus on human hands, although SW is the most effective intervention. Appropriate HH may be an important public health initiative to reduce pandemic and avian influenza transmission.”

Conclusion wash you hand with soap and water – save your microbiome and effectively rid yourself of harmful viruses. Use of alcohol based sanitizers should be limited for use where there is no option to wash hands. Your use of alcohol sanitizers are not for the reduction of covid but from getting other illness as the primary transmission of covid is through the air. Just because a store has hand sanitizers laying around this will not create a safe environment for you in terms of covid infection.

India leads the death chart – US is under 1K deaths. Israel joins the total 1K death club (1006 deaths attributed to covid)

Texas leads the US at 150 deaths

Harris County TX actually leads the death count for all counties in the US at 27

Fatality rate in Harris County still sits at 2% and even with current jump in deaths still showing a downward trend on a 7 day moving average.

India has overtaken Brazil in deaths and confirmations largely due to the shear volume of people. Fatality rate is still relatively low at 1.7%

Covid 9/5/20

Media seems slow – https://www.bbc.com/news/amp/health-54000629?

This was already in NYTimes and we noted on 8/31/20 – https://covid19mathblog.com/2020/08/covid-8-31-20/

Do you want to test for the just the existence – or to test for whether someone is infectious?

“Most people are infectious only for about a week, but could test positive weeks afterwards.

Researchers say this could be leading to an over-estimate of the current scale of the pandemic.

But some experts say it is uncertain how a reliable test can be produced that doesn’t risk missing cases.

Prof Carl Heneghan, one of the study’s authors, said instead of giving a "yes/no" result based on whether any virus is detected, tests should have a cut-off point so that very small amounts of virus do not trigger a positive result.

He believes the detection of traces of old virus could partly explain why the number of cases is rising while hospital admissions remain stable.

The University of Oxford’s Centre for Evidence-Based Medicine reviewed the evidence from 25 studies where virus specimens from positive tests were put in a petri dish to see whether they would grow.

This method of "viral culturing" can indicate whether the positive test has picked up active virus which can reproduce and spread, or just dead virus fragments which won’t grow in the lab, or in a person.”

“A person shedding a large amount of active virus, and a person with leftover fragments from an infection that’s already been cleared, would receive the same – positive – test result.

But Prof Heneghan, the academic who spotted a quirk in how deaths were being recorded, which led Public Health England to reform its system, says evidence suggests coronavirus "infectivity appears to decline after about a week".

He added that while it would not be possible to check every test to see whether there was active virus, the likelihood of false positive results could be reduced if scientists could work out where the cut-off point should be.

This could prevent people being given a positive result based on an old infection.”

“Public Health England agreed viral cultures were a useful way of assessing the results of coronavirus tests and said it had recently undertaken analysis along these lines.

It said it was working with labs to reduce the risk of false positives, including looking at where the "cycle threshold", or cut-off point, should be set.

But it said there were many different test kits in use, with different thresholds and ways of being read, which made providing a range of cut-off points difficult.

But Prof Ben Neuman, at the University of Reading, said culturing virus from a patient sample was "not trivial".

"This review runs the risk of falsely correlating the difficulty of culturing Sars-CoV-2 from a patient sample, with likelihood that it will spread," he said.”

In the blog we talked about science of the PCR test and how it is not just a yes or no lab test.

First clinical trial of Vitamin D for treatment of Covid-19- positive results – https://www.sciencedirect.com/science/article/pii/S0960076020302764?via%3Dihub#bib0100

“The vitamin D endocrine system may have a variety of actions on cells and tissues involved in COVID-19 progression.

Administration of calcifediol or 25-hydroxyvitamin D to hospitalized COVID-19 patients significantly reduced their need for Intensive Care United admission.

Calcifediol seems to be able to reduce severity of the disease.”

“Our pilot study demonstrated that administration of a high dose of Calcifediol or 25-hydroxyvitamin D, a main metabolite of vitamin D endocrine system, significantly reduced the need for ICU treatment of patients requiring hospitalization due to proven COVID-19. Calcifediol seems to be able to reduce severity of the disease, but larger trials with groups properly matched will be required to show a definitive answer.”

Hmmm want Remedisvir for $3.6K or Calcifedol for under $10 – certainly remedisvir is not 360% better. Let the data point to the answer(s) and that’s what we have done in this blog. Vitamin D has been an early push as noted since early April –
“I have been telling my kids to take D and C as noted in the learnings of 1918 Flu – but here is another confirmation bias report – I also take it ?https://www.irishexaminer.com/breakingnews/ireland/trinity-college-study-says-vitamin-d-could-help-fight-against-covid-19-infections-991944.html

Far UVC solutions showing up as initially discussed on 8/27 – https://healthelighting.com/blogs/press-releases/the-moments-memory-care-community-is-first-in-minnesota-to-install-state-of-the-art-sanitization-solutions

India leads the way in death again at 1089 – US under 1K

California leads the US in death at 145

Leading county death is LA at 45. Not sure why more discussion on LA deaths not more prominent – perhaps being in TX? They routinely lead the county deaths. CA the state is not always the leader in total deaths but LA seems to lead all counties more often than not.

Here is the big 4 view you can see LA for sure leads in death give early surge and never really coming down since.

Another state view showing much improvement over the beginning surge in the NE

World view countries with 1000+ deaths – unfortunately the list has grown. Interesting to note Spain and Portugal….Portugal has a much lower death per capita than Spain even though more dense in Portugal.

Covid 9/4/20

Better late than never – as many doctors in NY were advocating to prescribe corticosteroids/steroid treatment – WHO finally concluded that is the right thing to do – https://jamanetwork.com/journals/jama/fullarticle/2770279

“Corticosteroids were associated with lower mortality among critically ill patients who were and were not receiving invasive mechanical ventilation at randomization, as well as in patients from the RECOVERY trial who required oxygen with or without noninvasive ventilation but were not receiving invasive mechanical ventilation at randomization. These results were consistent with the subgroup analysis suggesting that the association between corticosteroids and lower mortality was stronger in patients who were not receiving vasoactive medication at randomization than in those who were receiving vasoactive medication at randomization. The ORs for the association between corticosteroids and mortality appeared similar for older and younger individuals, men and women, and for longer and shorter durations of symptoms before randomization.”

“There was no suggestion of an increased risk of serious of adverse events.”

This is a very cost effective treatment of covid – no $1000+ treatment needed in many cases.

It would seem media is like a month slow to the science publication – discussion of Africa and covid rates – https://bgr.com/2020/09/03/coronavirus-spread-africa-outbreak-immunity-common-cold/

We discussed this back in 8/13 https://covid19mathblog.com/2020/08/covid-8-13-20/

An added point we needed to add from that discussion is the Darwinian impact. Africa likely has a greater younger mortality rate in general therefore those surviving to older age likely have a more stronger immune system than the general western society.

India leads the death chart at 1096

Leader in US death TX – but looks to be a major confirmation revision for MA -7636

Though TX leads in death the leading county is LA CA at 54

Big 4 reporting – Maricopa is showing an alarming high fatality rate of recent ~5%. Miami-Dade deaths are still not trending down yet.

Play the long game….note the only country that is not showing an increase in confirmation below….

Covid 9/3/20

The CDC revisions of death classifications DO NOT mean covid impact was minimized. Each of those deaths still was confirmed for covid just reclassifying direct death results. As noted yesterday deaths are above average. Covid confirmation in patients exist and the more than 1 comorbidity increases your chances of death was always known. The ONLY argument that minimizes the reclassification of deaths from CDC is that those people were going to die anyway and covid just accelerated it. Quite a morbid argument – but IF true then one should see at some point the deaths below the average line – this is yet to be seen.

Cant trust the latest data points as it seems to be revised upwards every update so it must be a partial data. The point is deaths are above average more so in NY (scale different for each state) – so far not showing a trend below normal perhaps later on – and this would prove the point most were going to die anyway – but how much faster did covid cause this to occur time will tell when that line is below the average of the past years.

As noted before to – age plays a very important part in deaths from covid.

Also in a separate database they also show breakout from deaths with confirmed patient and they are only attributing a quarter of deaths directly to covid.

Covid is not trivial but also not catastrophic and perhaps not worth shutting down the economy given the collateral damage. At the beginning we did not know this – but we do now. Stay healthy and the odds will be in your favor! Stay in places where the viral load is managed.

Collateral damage – https://www.itv.com/news/2020-09-01/male-suicide-rate-highest-in-twenty-years-new-data-shows

“The rate of male suicide in England and Wales last year reached its highest level for two decades, according to new figures.”

“Men aged 45 to 49 had the highest age-specific suicide rate at 25.5 deaths per 100,000.”

“NS warned that the suicide rate among women aged 10 to 24-year-old had also increased "significantly" since 2012 to its highest level, with 3.1 deaths per 100,000 females in that age group”

In essence the data indicates a sacrifice is being made from the younger generation for quarantine/lifestyle change to save the older generation with additional collateral damage for younger as suicide rates among older are much lower.

On a more cheery note vaccine development is going quite well – https://www.cnn.com/2020/09/02/health/novavax-vaccine-safe/index.html

“Early stage clinical trial results show the Covid-19 vaccine candidate made by Novavax is safe and elicits an immune response, according to a study published Wednesday in The New England Journal of Medicine. The results had previously been announced by the company in early August.”

“Five vaccines are in clinical trials in the US, and 33 around the world, according to the World Health Organization.”

There are already 9 vaccines in phase 3 – I believe the odds of passing phase 3 for vaccines is around 60% this means the odds of an improved vaccine is very high.

Brazil tops death chart second is the US at 1056

Texas leads the death at 165 – CA leads confirmation at 5664

Leading death county is LA at 49 which also leads the confirmation.

The big 4 counties are still declining in confirmation using a 7 day moving average.

All the major European countries are now on a uptrend in confirmations -as noted previously Spain back to April levels.

Covid 9/2/20

While the #1 supercomputer in the world processed that mask wearing was effective (no duh https://covid19mathblog.com/2020/08/covid-8-26-20/) – the #2 supercomputer analyzed the genes of the covid and came out with some interesting conclusions and is probably the most important paper released with some certainty – they provide a uniform theory that wraps up all the odd symptoms of covid – https://elemental.medium.com/a-supercomputer-analyzed-covid-19-and-an-interesting-new-theory-has-emerged-31cb8eba9d63

A lot of the article is important so it was hard to only put snippets in….FYI bradykinin is a peptide in the kinin system – the kinin system is a hormonal system regulating blood proteins for inflammation, blood pressure, coagulation, and pain.

“Dr. Daniel Jacobson, lead researcher and chief scientist for computational systems biology at Oak Ridge, a “eureka moment.” The computer had revealed a new theory about how Covid-19 impacts the body: the bradykinin hypothesis. The hypothesis provides a model that explains many aspects of Covid-19, including some of its most bizarre symptoms. It also suggests 10-plus potential treatments, many of which are already FDA approved. Jacobson’s group published their results in a paper in the journal eLife in early July.”

“According to the team’s findings, a Covid-19 infection generally begins when the virus enters the body through ACE2 receptors in the nose, (The receptors, which the virus is known to target, are abundant there.) The virus then proceeds through the body, entering cells in other places where ACE2 is also present: the intestines, kidneys, and heart. This likely accounts for at least some of the disease’s cardiac and GI symptoms.”

Hmmm perhaps wearing a mask not covering the nose not a good thing?

“data Summit analyzed shows that Covid-19 isn’t content to simply infect cells that already express lots of ACE2 receptors. Instead, it actively hijacks the body’s own systems, tricking it into upregulating ACE2 receptors in places where they’re usually expressed at low or medium levels, including the lungs.

In this sense, Covid-19 is like a burglar who slips in your unlocked second-floor window and starts to ransack your house. Once inside, though, they don’t just take your stuff — they also throw open all your doors and windows so their accomplices can rush in and help pillage more efficiently.”

“The renin–angiotensin system (RAS) controls many aspects of the circulatory system, including the body’s levels of a chemical called bradykinin, which normally helps to regulate blood pressure. According to the team’s analysis, when the virus tweaks the RAS, it causes the body’s mechanisms for regulating bradykinin to go haywire. Bradykinin receptors are resensitized, and the body also stops effectively breaking down bradykinin. (ACE normally degrades bradykinin, but when the virus downregulates it, it can’t do this as effectively.) The end result, the researchers say, is to release a bradykinin storm — a massive, runaway buildup of bradykinin in the body. According to the bradykinin hypothesis, it’s this storm that is ultimately responsible for many of Covid-19’s deadly effects. Jacobson’s team says in their paper that “the pathology of Covid-19 is likely the result of Bradykinin Storms rather than cytokine storms,””

“As bradykinin builds up in the body, it dramatically increases vascular permeability. In short, it makes your blood vessels leaky. This aligns with recent clinical data, which increasingly views Covid-19 primarily as a vascular disease, rather than a respiratory one. But Covid-19 still has a massive effect on the lungs. As blood vessels start to leak due to a bradykinin storm, the researchers say, the lungs can fill with fluid. Immune cells also leak out into the lungs, Jacobson’s team found, causing inflammation.”

“And Covid-19 has another especially insidious trick. Through another pathway, the team’s data shows, it increases production of hyaluronic acid (HLA) in the lungs. HLA is often used in soaps and lotions for its ability to absorb more than 1,000 times its weight in fluid. When it combines with fluid leaking into the lungs, the results are disastrous: It forms a hydrogel, which can fill the lungs in some patients. According to Jacobson, once this happens, “it’s like trying to breathe through Jell-O.”

This may explain why ventilators have proven less effective in treating advanced Covid-19 than doctors originally expected, based on experiences with other viruses. “It reaches a point where regardless of how much oxygen you pump in, it doesn’t matter, because the alveoli in the lungs are filled with this hydrogel,” Jacobson says. “The lungs become like a water balloon.” Patients can suffocate even while receiving full breathing support.”

“The bradykinin hypothesis also extends to many of Covid-19’s effects on the heart. About one in five hospitalized Covid-19 patients have damage to their hearts, even if they never had cardiac issues before. Some of this is likely due to the virus infecting the heart directly through its ACE2 receptors. But the RAS also controls aspects of cardiac contractions and blood pressure. According to the researchers, bradykinin storms could create arrhythmias and low blood pressure, which are often seen in Covid-19 patients.

The bradykinin hypothesis also accounts for Covid-19’s neurological effects, which are some of the most surprising and concerning elements of the disease. These symptoms (which include dizziness, seizures, delirium, and stroke) are present in as many as half of hospitalized Covid-19 patients. According to Jacobson and his team, MRI studies in France revealed that many Covid-19 patients have evidence of leaky blood vessels in their brains.

Bradykinin — especially at high doses — can also lead to a breakdown of the blood-brain barrier. Under normal circumstances, this barrier acts as a filter between your brain and the rest of your circulatory system. It lets in the nutrients and small molecules that the brain needs to function, while keeping out toxins and pathogens and keeping the brain’s internal environment tightly regulated.

If bradykinin storms cause the blood-brain barrier to break down, this could allow harmful cells and compounds into the brain, leading to inflammation, potential brain damage, and many of the neurological symptoms Covid-19 patients experience”

“the bradykinin hypothesis explains several other of Covid-19’s seemingly bizarre symptoms. Jacobson and his team speculate that leaky vasculature caused by bradykinin storms could be responsible for “Covid toes,” a condition involving swollen, bruised toes that some Covid-19 patients experience. Bradykinin can also mess with the thyroid gland, which could produce the thyroid symptoms recently observed in some patients.

The bradykinin hypothesis could also explain some of the broader demographic patterns of the disease’s spread. The researchers note that some aspects of the RAS system are sex-linked, with proteins for several receptors (such as one called TMSB4X) located on the X chromosome. This means that “women… would have twice the levels of this protein than men,” a result borne out by the researchers’ data. In their paper, Jacobson’s team concludes that this “could explain the lower incidence of Covid-19 induced mortality in women.” A genetic quirk of the RAS could be giving women extra protection against the disease.”

“As Jacobson and team point out, several drugs target aspects of the RAS and are already FDA approved to treat other conditions. They could arguably be applied to treating Covid-19 as well. Several, like danazol, stanozolol, and ecallantide, reduce bradykinin production and could potentially stop a deadly bradykinin storm. Others, like icatibant, reduce bradykinin signaling and could blunt its effects once it’s already in the body.

Interestingly, Jacobson’s team also suggests vitamin D as a potentially useful Covid-19 drug. The vitamin is involved in the RAS system and could prove helpful by reducing levels of another compound, known as REN. Again, this could stop potentially deadly bradykinin storms from forming. The researchers note that vitamin D has already been shown to help those with Covid-19. The vitamin is readily available over the counter, and around 20% of the population is deficient. If indeed the vitamin proves effective at reducing the severity of bradykinin storms, it could be an easy, relatively safe way to reduce the severity of the virus.

Other compounds could treat symptoms associated with bradykinin storms. Hymecromone, for example, could reduce hyaluronic acid levels, potentially stopping deadly hydrogels from forming in the lungs. And timbetasin could mimic the mechanism that the researchers believe protects women from more severe Covid-19 infections. All of these potential treatments are speculative, of course, and would need to be studied in a rigorous, controlled environment before their effectiveness could be determined and they could be used more broadly.”

US back over 1K but at least only barely 1066

Florida leads both death and confirmation for the US

Leading county for deaths and confirmation is Miami-Dade at 100 deaths 2149 confirmed

Miami-Dade 100 deaths caused the 7 day MA to spike for that county until yesterday death was trending down.

There is no doubt 2020 is a very bad year and that covid is not some hidden lie that covid is from other deaths– deaths are for sure there. Below are the weekly deaths for the major states compared to historical deaths. Note scale differences – NY for sure is an outlier. One could still argue that these deaths were inevitable within a year or 2 – IF so then we should have deaths under the curve of history – time will tell. Ignore the latest weekly data looks like a delayed reporting issue.

New Zealand still not going to 0 in terms of confirmation.

Covid 9/1/20

Another vaccine in China approved – https://www.pharmaceutical-technology.com/news/sinovac-vaccine-emergency-use/

“Sinovac Biotech has received emergency use approval for its potential Covid-19 vaccine CoronaVac under a programme in China to vaccinate high-risk groups”

“Currently, seven vaccine candidates against Covid-19 are in final trial stages globally, including four from China.”

Perhaps a vaccine winner might show up – but then can it scale not only in production but of people taking the vaccine.

Another day under 1K for the US

Leading the US is TX with 96 deaths – CA leads in confirmations at 6524

Tarrant county in TX leads the county death for the US at 58 – near Dallas TX.

Fatality rate is creeping up for Maricopa – the trailing 3 wk fatality rate now 4%. The other major counties are around 2% or less.

Spain confirmations back up to the levels seen in April – positive 2-4wk fatality rate under 1% vs. in April over 6%

Covid 8/31/20

The big story in covid should be https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html

One could conclude from the article that only 10-30% of those positive are actually infectious. Basically in a nutshell one needs to ask what do you want from a test for covid. Should the primary focus be to test if one is infectious to the general population? Test if one has Covid at any level? I would presume the first question should be the prime objective. What is exactly the PCR Test? Using what most kids are now using to learn – the internet – https://www.khanacademy.org/science/biology/biotech-dna-technology/dna-sequencing-pcr-electrophoresis/a/polymerase-chain-reaction-pcr

“Polymerase chain reaction (PCR) is a common laboratory technique used to make many copies (millions or billions!) of a particular region of DNA”

In the link it goes through a sample and actually gives you a question at the end.

However the creation of the gel visualization is more complexed than they even tried to discuss. False positives were actually the issue in the beginning not false negatives. Elon Musk tweeted they had 50% false positives in the beginning – https://twitter.com/elonmusk/status/1300077893352030209?s=19

“Some of the tests we initially tried at Tesla were ~50% false positive, including some from major medical device companies. Too many testing methods were approved too quickly. Wouldn’t blame the FDA, though. Public was demanding fast test approval.”

To really highlight the complexity of PCR and the art/science blend of it you need to delv into the details – discussed in this paper – https://academic.oup.com/ajcp/advance-article/doi/10.1093/ajcp/aqaa133/5873820

In this paper they focus on not getting false negatives – which in the grand scheme of things false negatives is much worse than false positives – so typically the test are already biased to that. Key variables to understand is CT (cycle threshold – testing process) and the LoD (limit of detection)

“sensitivity of a test is largely dependent on a combination of (1) LoD of the test and (2) the distribution of viral load in the population being tested.”

“The primary aim of the study was to establish the distribution of observed CT values for each target in symptomatic patients, and to determine the proportion of patients with CT values near the LoD as an indicator of the likelihood of false-negative results due to low viral load.”

Though PCR test are the gold standard for detection – they are not focused nor can they really be used to quantify viral load. The exact level of CT is not fixed – and would seem largely dependent on the biological context of the testing. There is interpretations being made from the labs – it is not as black and white as you may think it is.

This detection but not connection with viral load could possibly explain some of the volume of asymptomatic patients and those who observe zero symptoms through the life cycle of the virus until the test show negative readings.

Amazing death count for the US even for a weekend – only 305

Ohio had a -123 death count revision….Tx lead the way at 76

Leading county Kern Ca at 12

Even though countries like Italy and Spain are resurging in confirmations deaths are not moving. One COULD conclude the virus is weaker now….or #2 more testing is confirming the virus is prevalent and most are healthy enough to defeat it….or #3 the remaining population is stronger…or #4 better ways to treat it ….I go with the combination of #2 and #4