Perhaps I should give Japan a silver star before a gold star given the limited testing per capita (0.13%) we have from the country (S. Korea 1.2% US 1.75%). It is very suspicious how low deaths and confirmations are. Is the strategy is if you don’t see it – it isn’t there?

Japan is not in many of my plots because I had to put limit on how many lines I show on the chart. Previously I had 500 deaths as the limit. Japan is still hasn’t even crossed that for such a large population and dense area – really amazing if it is right.

Then I get articles such as – https://www.japantimes.co.jp/news/2020/04/29/national/japans-health-care-system-teeters-brink-coronavirus-takes-toll-hospitals/#.XqrEx2lOkwA

https://www.japantimes.co.jp/news/2020/04/28/business/corporate-business/mcdonalds-dining-coronavirus/#.XqrE22lOkwA

NY would only dream of being close to Japan deaths and confirmations….mind you this is a whole country vs. a state (death 413 vs. 23477) so it amazes me that they are in severe panic as noted in the articles above – or are the numbers wrong and/or articles all hype? They have seen a recent jump in confirmation and death but barely touching the scale of NY. Deaths are not even really accelerating for the last week (brown line below).

I like this article as it highlights what is missing in all the hype of how Covid-19 is spreading and being tested in various environment – do we really care if Covid-19 is tested and exist in extremely low levels that would never infect us? VIRAL LOAD is important.

https://www.alternet.org/2020/04/new-study-reveals-the-best-conditions-for-spreading-coronavirus/

“Kasten said one reason a study like this fails to get to the bottom of the mystery around coronavirus and aerosol transmission is because they still do not know exactly how many viral particles are needed to infect a person. Indeed, figuring out such a thing might not be ethical, at least on human subjects.

“Unless people want to volunteer for experiments where increasingly large amounts of virus are shoved up their nose until they become infected, the exact precise number isn’t known and won’t be except through animal studies,” Kasten explained. “Instead it is estimated from the other ‘baddy’ human coronaviruses, and then assumed to be lower, since this one is much more transmissible.”

For instance, a similar virus also in the coronavirus family, the MERS (Middle East Respiratory Syndrome) coronavirus, is known to require somewhere between 1,000 and 10,0000 viral particles in order to infect a person. Since SARS-CoV-2 is more transmissible, Willem van Schaik, a professor of microbiology at the University of Birmingham, estimates that the number of particles needed to become infected is in the high hundreds or low thousands.

Likewise, it is unknown if aerosols are even “hardy” enough to generate an infection.”

“This is all to say that just because aerosols are being detected doesn’t mean they can infect you.”

“Interestingly, there are more studies that suggest transmission is more likely to happen indoors, not outdoors. A study in Japan concluded that “the odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment.”

Closing state park and beaches – when really its not the areas that are the issue – it’s the closeness of people you are concerned about – well make that the rule – or is it just so unruly to be able to police? IF you live on the beach can you go on the beach? Wasn’t there a move in CA to restrict beach access before covid?

Sunlight & ventilation are both great elements to be which a beach offers. People limit people going into the stores – could you not do that at beach entrances?

WHO praises Sweden – skeptical NY Post – https://nypost.com/2020/04/29/who-lauds-sweden-as-model-for-resisting-coronavirus-lockdown/amp/

Once again too soon to know but they could be very right IF the second hump is inevitable and the virus is a lot more prevalent than anyone believes and no obvious cure or vaccine in sight – which as of right now the data sure is pointing to that.

I was not aware of the stark differences of approach by NZ and Australia – https://www.insider.com/new-zealands-economy-could-be-twice-as-bad-as-australias-2020-4?

“The two countries took some similar measures to combat the coronavirus including closing their borders to foreigners and enforcing quarantines for people returning home. But the rest of their approaches differed.

In New Zealand, for its month-long "Alert Level 4" lockdown, people could not interact with anyone outside of their households. Supermarkets and pharmacies were the only places still operating. Takeaways have only begun to be delivered earlier in the week as the lockdown was eased to "Alert Level 3."

In Australia, bars and restaurants stayed open the entire time to provide takeaways. Australia kept its construction and mining industries running. People could get haircuts, meet friends for coffees, or use babysitters, according to The Guardian.”

New Zealand’s stricter lockdown meant most people could not trade, Auckland-based economist Shamubeel Eaqub told The Guardian, which caused a much wider impact. His firm Sense Partners estimated during "Alert Level 4" lockdown electronic spending was half what it normally is.

The data shows Australia the likely winner in terms of balancing economy and approach. Population density here is likely misleading. Best to aggregate city population density – given Australia vast deserts.

Took a long time to confirm obesity is a big indicator – I have been noticing this in the data for at least the last month – https://www.webmd.com/lung/news/20200429/obesity-new-risk-factors-for-young-covid-patients

“Patients with a BMI of 30-34 were twice as likely to get admitted to the hospital or to be admitted to acute care.

Patients with a BMI of 35 or higher were twice as likely to be admitted to the hospital and three times as likely to end up in the intensive care unit.”

The economic dire situation could have been reduced with better food system and self-discipline. As I noted before Thomas Paine said “…while government is there only to keep man from indulging his vices.” Clearly one of our vices is food selection – not sure why not better oversight of feeding poison to the public. My guess it’s the $$$$. Stop addicting foods reduce earnings….

A silver lining to this issue is a revamping of the food selection for the public and perhaps a personal incentive by the public to be healthier. This will be a lot more impactful than forcing people to stay inside and wear mask (still pro mask – just ordering the effectiveness and overall value to society).

Speaking of money – Remdesivir back on the offensive – https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext?

The results certainly are not 1000X better – its good news but is it really that effective. The first few words certainly doesn’t build a lot of confidence – but that’s just me…could we say the same thing about many other things? “Although not statistically significant, patients receiving remdesivir had a numerically faster time to clinical improvement than those receiving placebo among patients with symptom duration of 10 days or less (hazard ratio 1·52 [0·95–2·43]). Adverse events were reported in 102 (66%) of 155 remdesivir recipients versus 50 (64%) of 78 placebo recipients. Remdesivir was stopped early because of adverse events in 18 (12%) patients versus four (5%) patients who stopped placebo early.”

Fake/scare news confirmed –

https://newsinfo.inquirer.net/1266758/tests-in-recovered-patients-in-s-korea-found-false-positives-not-reinfections-experts-say

“Tests in recovered patients in S. Korea found false positives, not reinfections, experts say”

On the fake/scare news front – the man made famous per trump and HCQ – who was a “smart” engineer that took fish cleaner per president statement – https://freebeacon.com/coronavirus/police-investigating-death-of-arizona-man-from-chloroquine-phosphate/amp/?

Will any of these media companies get in trouble for racing for a story?

Fake/scare news accountability – read the headline here 4/13/20 – https://www.washingtonpost.com/national/south-dakotas-governor-resisted-ordering-people-to-stay-home-now-it-has-one-of-the-nations-largest-coronavirus-hot-spots/2020/04/13/5cff90fe-7daf-11ea-a3ee-13e1ae0a3571_story.html#click=https://t.co/kBdZHmhDqF

“South Dakota’s governor resisted ordering people to stay home. Now it has one of the nation’s largest coronavirus hot spots.”

Tables below as of yesterday….Well I guess I don’t know what Largest or Hot or even Spot – means….SD best death per pop death per confirmed – they have tested more than MI and TX on per capita….Confirmed per pop is 2nd highest but population is the lowest by multiples….Right now being confirmed is not a bad thing if you are going for some immunity – it’s the death number we need to be concerned about.

Highest death county in state

Awful reporting…what a waste of time….

Daily update crazy change for UK 4421 new deaths – surpassing US by almost 2X 2612

NY continues to decline in terms of positive/tested even though confirmation is rising!

Not the best chart update today. PA surging back up. NY plateau vs declining. South Carolina spiking. FL,GA,TX OR NV uptick.

As noted above something is going on in UK death counts. Now highest death/confirmed rate in the major country category 15.7%. almost 2X NY.

Lots of discussion with a surge in Asia – relatively speaking I don’t see the surge in the data. Surge relative to their low numbers certainly plausible – but not in the scale to the rest of world from the data we have. Note UK is showing what a surge looks like.

Well the interview with the two doctors was interesting if you got to watch. I wouldn’t necessarily trust their math or their comparisons but I appreciated their perspective. Censorship of different opinions whether you believe them or not is very dangerous – it stops one from feeling safe to critically think and questions ones own beliefs. We are already naturally inclined for confirmation bias – proven to be true. To troll or not to troll – if you don’t follow people that go against your belief you will be trapped in confirmation bias. Questioning and understanding different perspectives allows one to have a discussion. Because of the interview – they made me think and research immune systems and I do feel concerned the kids of Covid-19 might be missing out on key microbial as we race to clean.

Of the several immune papers I reviewed I will highlight the following – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3515894/

This paper establishes the need for early immune response vs. later in age is important.

This paper cleans up the hygiene hypothesis with semantics to make it more palatable to all – its not about hygiene directly but the lack of microbial activity which could come from excess hygiene but perhaps other societal trend which reduces microbial activity e.g. C-section vs. Vaginal delivery – https://www.pnas.org/content/114/7/1433

This paper is recent – Jan 2019 – which demonstrate in mice the role of microbial products causing allergic airway disease – https://www.sciencedaily.com/releases/2019/01/190109110115.htm

All this reminds me of the story in the New Earth by Eckart Tolle – “Is that so” the point of the story is to not judge an outcome – at least very quickly. We reduce infectious disease – GREAT – but later we see growth in immune disorders. We have a child who always gets sick – how awful – but then as an adult hardly gets sick.

So I found this site that predicts the path of covid by country – https://ddi.sutd.edu.sg/

Notice something consistent in all countries….1 hump

I sent a question in and asked them to try to emulate 1918 would their model produce a second hump….waiting for the response….not that the past exactly repeats but how can you say the model works without backtesting to something? Maybe it maps well with Sars and ebola? Would be nice to know that….

Another ship stat – https://news.usni.org/2020/04/28/uss-kidd-arrives-in-san-diego-to-treat-covid-19-outbreak-first-cases-emerged-more-than-a-month-after-hawaii-port-visit

~20% infected

~30% confirmed/tested

“The first sailor began to show symptoms of the virus on April 22, more than 30 days after the ship’s last port visit in Hawaii, according to a status update provided to Congress and reviewed by USNI News.”

Here is a quick and easy prevention suggestion – https://www.hulldailymail.co.uk/news/uk-world-news/brushing-teeth-right-time-helps-4087439

Fresh breath for everyone before you leave the house ?

Japan to offer anti-flu avigan (favipiravir) – https://english.kyodonews.net/news/2020/04/01f746e01617-japan-to-offer-anti-flu-avigan-to-38-countries-as-early-as-this-week.html

“A scientific study in China concluded in March that the drug had been effective for patients, especially those with mild symptoms. Beijing has said it will officially adopt the drug as part of its treatment guidelines for COVID-19 patients.”

2017 study on favipiravir – https://www.ncbi.nlm.nih.gov/pubmed/28769016

I like the old studies as they are not Covid tainted.

“Favipiravir is effective against a wide range of types and subtypes of influenza viruses, including strains resistant to existing anti-influenza drugs. Of note is that favipiravir shows anti-viral activities against other RNA viruses such as arenaviruses, bunyaviruses and filoviruses, all of which are known to cause fatal hemorrhagic fever. These unique anti-viral profiles will make favipiravir a potentially promising drug for specifically untreatable RNA viral infections.”

April 2020 – https://www.jwatch.org/na51293/2020/04/09/favipiravir-potential-antiviral-covid-19

“With regard to COVID-19, lay media have reported on a non-placebo, open-label trial in Shenzhen, China, of oral favipiravir (1600 mg twice daily for 1 day, then 600 mg twice daily) plus inhaled interferon compared with a historical cohort of patients receiving lopinavir/ritonavir for 14 days (Med News Today; 2020 Mar 27). Those receiving favipiravir and interferon had median shedding of virus of 4 days, compared with 11 days in the lopinavir/ritonavir group. Radiographic improvement was seen in 91% of favipiravir-interferon treated subjects compared with 62% of those on lopinavir/ritonavir. The results of this study have not been published in a peer-reviewed journal to date. A prospective, multicenter, open-label, randomized trial in China comparing favipiravir with umifenovir (Arbidol), a membrane-fusion inhibitor active against influenza viruses, was recently reported (MedRxiv 2020 Mar 27; [e-pub]). It demonstrated a higher clinical recovery rate at day 7 in those on favipiravir among moderately ill patients but not among mildly or severely ill patients.”

Speaking of Japan – they do deserve the gold star along with S. Korea. The most common compared countries I put in the bar chart below. Using US is quite unfair so I just looked at NY and Washington state to compare to other countries.

The amount of deaths in NY is amazingly high compared to COUNTRY totals. The demographics difference is very hard to explain NY outlier. Italy is based on 3X the population of NY. All three are much older than NY.

Italy, Japan, and S. Korea all have very high pop density relative to NY. BMI is the only thing that sticks out for NY relative to those 3. In terms of the largess of economic impact, once again it would seem forcing a better diet on the US could be cost effective and would assist in other areas beyond covid.

The other countries shown a lot can be probably attributed to smaller pop density. Interesting to see New Zealand BMI so high but they have youth and low pop density.

US is back over 2K death daily change. Other countries are still low.

NY continues to trend down in positive/tested – below 35% now.

NJ is leading the way in daily death change in US

New Jersey back up trending on 7 day moving avg. daily death. PA continues big slide down.

UK observed a step function in confirm/tested – they must have changed their reporting or testing methods.

Brazil and Ecuador deaths are rapidly climbing

Office discussion perhaps answered – https://blogs.scientificamerican.com/observations/comparing-covid-19-deaths-to-flu-deaths-is-like-comparing-apples-to-oranges/

“flu deaths per year; they are estimates that the CDC produces by multiplying the number of flu death counts reported by various coefficients produced through complicated algorithms. These coefficients are based on assumptions of how many cases, hospitalizations, and deaths they believe went unreported. In the last six flu seasons, the CDC’s reported number of actual confirmed flu deaths—that is, counting flu deaths the way we are currently counting deaths from the coronavirus—has ranged from 3,448 to 15,620, which far lower than the numbers commonly repeated by public officials and even public health experts…….there are little data to support the CDC’s assumption that the number of people who die of flu each year is on average six times greater than the number of flu deaths that are actually confirmed…..While in the past it was justifiable to err on the side of substantially overestimating flu deaths, in order to encourage vaccination and good hygiene, at this point the CDC’s reporting about flu deaths is dangerously misleading the public and even public officials about the comparison between these two viruses. If we incorrectly conclude that COVID-19 is “just another flu,” we may retreat from strategies that appear to be working in minimizing the speed of spread of the virus”

Good points but nonetheless EVEN if it was not right the comparison to 60K is a comparison to 60K – which in the grand scheme of things is small. Certainly the perspective to flu needs to be adjusted.

This is a good segway to these 2 doctors express their concern of lockdown – https://youtu.be/xfLVxx_lBLU https://www.youtube.com/watch?v=zb6j7o1pLBw.

So sorry I just checked Youtube censored Part1 – better watch part 2 before it gets censored – still available now 8 AM. First video was very interesting – I hope someone can do a wayback machine on it…Doesn’t make sense why it got censored.  Update 1:34PM found another link to interview – https://www.youtube.com/watch?v=Bkvkd10tJug 

Here is a much longer (+1hr) video of the two doctors in Kern CA. Didn’t listen to the whole thing but appears to be the same interview…

In general they bring up good points – but just like everything I discuss here lets apply some critical thinking – they are in Kern County. Lets look at Kern County. For perspective I put NY County, King County (WA), Wayne County (MI) – 2nd highest death county in the nation, and Harris County TX for perspective. Kern county certainly seems like a utopia with the smallest population density – limited deaths, lots of sunshine, lowest BMI, lowest median age, hardly any mass transit….

The alarming report from them is the fact their healthy population has a 4-6% confirmed cases. This from their direct testing data ~300/5000 test – they have done 50% of the testing in the county. They did note the mass transit issue.

I am not sold on their comparison with Sweden vs. Norway – that’s not a very good comparison. Nonetheless a good point they addressed in Part 1 – was that quarantine could weaken our immune systems and the second wave will be painful if that was the case.

Not that this brings confidence for me but the Doctor did note the issues I had with HCQ study making the rounds – Foxnews report highlighting my concern on HCQ “study” – https://www.foxnews.com/media/dr-stephen-smith-study-hydroxychloroquine-coronavirus-treatment

“”I’ve no idea why [University of Virginia School of Medicine opthamology professor Dr. Jayakrishna Ambati] delved into this study, which isn’t a study. It’s a sham,” Smith said. “I can’t believe anyone took this seriously. There’s not one dosage listed, cumulative or daily, of hydroxychloriquine or anthromicin. And people call this a study.””

“”Not one person in that paper saw one COVID patient. Only three are MDs [and] all [those] are ophthalmology trained,” Smith said of the research. “It’s a sham. It’s a shame on UVA. I sent an email to the dean of the medical school at UVA. I have not heard back from them. It is an embarrassment that UVA allows this thing to be called a study.””

Another good day relatively speaking – US death change 1378 – no other country close to 1000

NJ sliding downwards now in terms of confirmation.

Death peaks likely for many states – still on the border is MA,MI, IL, WA, CA, AZ,MO

Mexico is ramping up testing and you will likely see large confirmations.

Good news continues for France, UK, Spain, Italy, Germany – all sloping down in daily death.

Jan 23 2020

March 2nd 2020

Those dates represent the day the first confirmed case of Covid-19 that was reported in WA and NY respectively. I find the New Yorker report blasting NY and praising WA interesting. Clearly the death score NY “wins” vs. WA – but is it as simple as that. https://www.newyorker.com/magazine/2020/05/04/seattles-leaders-let-scientists-take-the-lead-new-yorks-did-not

State level facts:

Everyone talks about how important testing is – well NY surpassed WA in terms of testing by multiples by day 20 of the first confirmed case – and now 2X Washington.

New York downward curve occurred day 42 vs. Washington day 78…certainly with Washington having the first confirmed case should have given NY an advantage to prepare and be more proactive than Washington.

Lets see if we can understand why NY vs WA is quite an unfair comparison. The two most reported death county in each state New York vs. King.

NY county is almost 74 times more dense than King. NY more likely to use mass transit by almost 6X. Is it fair to think we can compare NY county vs. King County on death metrics.

Hopefully this will help with mass transit – https://mobile.reuters.com/article/amp/idUSKCN2290S5?

“Researchers at a Hong Kong university say they have developed an antiviral coating which could provide 90 days of "significant" protection against bacteria and viruses such as the one causing COVID-19.

The coating, called MAP-1, took 10 years to develop and can be sprayed on surfaces that are frequently used by the public, such as elevator buttons and handrails, researchers at the Hong Kong University of Science and Technology (HKUST) say.

"These places are frequently touched, and, at the same time, serve as a very effective medium for transmission of diseases," said HKUST Adjunct Professor Joseph Kwan, one of the chief researchers in the team that developed the product.”

US death change only 1126 – but it’s the weekend…

Rhode Island has surpassed 5% of per capita testing. NY over 4%

FYI – NYC deaths include – “Probable deaths: People who did not have a positive COVID-19 laboratory test, but their death certificate lists as the cause of death "COVID-19" or an equivalent.” https://www1.nyc.gov/site/doh/covid/covid-19-data.page

Hopefully NY recent uptrend of Daily Death Change is just a temporary blip.

India has a far ways to go for testing…tested only 0.05% of per capita.

Ireland hopefully ready to turn down after plateau for the past few points. Brazil India and Mexico still a concern.

Statement from WHO on “immunity passport” spreading in major media publications – I think poorly written – or perfectly written to achieve a certain agenda – https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19

“There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.” So many things wrong but factually right with this statement.

Yes no evidence PEOPLE because those that have become sick and recovered are not stepping in line to try it again nor is that legal. HOWEVER we are harvesting the antibodies from people who have recovered so there is some rationale to extrapolate that IF one had it – the odds are very rare to get it again at least within a year and the antibodies you have are useful. In fact to reduce fear they could have mentioned the statistics with the common flu in terms of getting it twice in one year – I couldn’t find the number but they all say it is rare.

In addition the statement did not show or mentioned the results from macaques – which state Reinfection could not occur in SARS-CoV-2 infected rhesus macaques

https://www.biorxiv.org/content/10.1101/2020.03.13.990226v1.full.pdf

As noted in other discussion the limited claims showing human reinfection was so small the odds of it being a faulty test was much higher. No way could you say 100% no chance of reinfection but probably much greater than a coin flip – I would probably bet closer to the odds of getting the common flu twice in one year.

Clearly don’t drink bleach or any disinfectant – I feel more empathy for those people who are so desperate that they would even attempt to do that. No matter if someone told you to do something as soon as you are about to do it – it has to be daunting. Bleach does not smell good. There are warnings on the containers. Clearly they have to be overwhelmed by fear and/or are at the end of the road and more hopefully just fake news. If not fake – as a society we should use this as a signal to understand the underlying result of mass media and perhaps economic/health strife. This is no time to be using the outcome of these people as political agenda. Without critical thinking and continuing reading of the media this will cause depression and fear. The machine is out of hand – click bait beats journalism now.

The UV blood dosing is actually a real thing. Paper back in Sep 2018 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122858/

“Ultraviolet blood irradiation (UBI) was extensively used in the 1940s and 1950s to treat many diseases including septicemia, pneumonia, tuberculosis, arthritis, asthma and even poliomyelitis. The early studies were carried out by several physicians in USA and published in the American Journal of Surgery. However with the development of antibiotics, UBI use declined and it has now been called “the cure that time forgot”. Later studies were mostly performed by Russian workers and in other Eastern countries and the modern view in Western countries is that UBI remains highly controversial.”

Remember blaming HCQ on money – well who would get rich if this actually worked – when antibiotics were being developed/patented and sold – plus the antibiotics were doing wonders at that time.

“In 1904, the Danish physician Niels Finsen was awarded the Nobel Prize in Physiology or Medicine for his work on UV treatment of various skin conditions. He had a success rate of 98% in thousands of cases, mostly the form of cutaneous tuberculosis known as lupus vulgaris”

“Knott and co-workers then carried out a series of experiments using UV irradiation of blood extracted from dogs that had been intravenously infected with Staphylococcus aureus bacteria and hemolytic Streptococcus species, and then the treated blood was reinfused into the dogs. They found that it was unnecessary to deliver a sufficient exposure of UV light to the blood to directory kill all the bacteria in the circulation. It was also found unnecessary to expose the total blood volume in the dogs. The optimum amount of blood to be irradiated was determined to be only 5–7% of the estimated blood volume or approximately 3.5 mL per kg of body weight. Exceeding these limits led to loss of the benefits of the therapy. All the dogs that were treated with the optimized dose of UV to the blood, recovered from an overwhelming infection (while many dogs in the control group died). None of the dogs that were treated and survived, showed any long-term ill effects after 4 months of observation”

“The first treatment on a human took place in 1928 when a patient was determined to be in a moribund state after a septic abortion complicated by hemolytic streptococcus septicemia. UBI therapy was commenced as a last resort, and the patient responded well to the treatment and made a full recovery [7]. She proceeded to give birth to two children.”

“UBI affects various functions of red blood cells and various different leukocytes as has been proven in various in vitro studies. A common model is stimulator cells in mixed leukocyte cultures; another is helper cells in mitogen- stimulated cultures. UV also reversed cytokine production and blocked cytokine release.” Note last statement – remember written in 2018 before covid – note the recent papers on cytokine storms.

“…The mechanisms of action must lie in some other action of UV on the various components of blood. Although the entire body of evidence on the mechanisms of action of UBI is very complex, as can be seen from the foregoing material, we can attempt to draw some general conclusions. Firstly UBI is clearly an example of the well-known phenomenon called “hormesis” or “biphasic dose response’. This phenomenon has been well reviewed by Edward Calabrese from U Mass Amherst [73, 74]. The basic concept states that any toxic chemical substance or drug, or any physical insult (such as ionizing radiation, hyperthermia, or oxidative stress) can be beneficial, protective or even therapeutic, provided the dose is low enough.”

“In the case of neutrophils, monocytes, macrophages, and dendritic cells, UBI can activate phagocytosis, increase the secretion of NO and reactive nitrogen species, and convert the DC phenotype from an immunogenic one into a tolerogenic one, thus perhaps lessening the effects of a “cytokine storm” as is often found in sepsis. In the case of lymphocytes, the effects of UBI are to inhibit (or in fact kill) various classes of lymphocytes. This is not perhaps very surprising, considering the well-established cell-death pathways and apoptotic signaling found in lymphocytes. However it is not impossible, that the killing of circulating lymphocytes could reduce systemic inflammation, which would again be beneficial in cases of sepsis.”

“Sepsis is an uncontrolled response to infection involving massive cytokine release, widespread inflammation, which leads to blood clots and leaky vessels. Multi-organ failure can follow. Every year, severe sepsis strikes more than a million Americans. It is estimated that between 28–50% percent of these people die. Patients with sepsis are usually treated in hospital intensive care units with broad-spectrum antibiotics, oxygen and intravenous fluids to maintain normal blood oxygen levels and blood pressure. Despite decades of research, no drugs that specifically target the aggressive immune response that characterizes sepsis have been developed.”

Ok so those making fun of UV blood dosage – I think its not unreasonable to hope that this is real. Whether any drug manufacturer could make any money from this approach – probably not.

One thing to unfortunately support the next wave is coming – is the understanding that weather does have a physical impact on the virus. As many of you know already the Covid virus is an envelope virus – meaning it has an outer shell covering the RNA. This shell adapts due to weather. It is very well described in this report – https://www.sciencedaily.com/releases/2008/03/080330203401.htm

““Like an M&M in your mouth, the protective covering melts when it enters the respiratory tract,” Dr. Zimmerberg said. “It’s only in this liquid phase that the virus is capable of entering a cell to infect it.”

In spring and summer, however, the temperatures are too high to allow the viral membrane to enter its gel state. Dr. Zimmerberg said that at these temperatures, the individual flu viruses would dry out and weaken, and this would help to account for the ending of flu season.

The finding opens up new possibilities for research, Dr. Zimmerberg said. Strategies to disrupt the virus and prevent it from spreading could involve seeking ways to disrupt the virus’s lipid membrane.

In cold temperatures, the hard lipid shell can be resistant to certain detergents, so one strategy could involve testing for more effective detergents and hand-washing protocols to hinder the spread of the virus.

Similarly, Dr. Zimmerberg added that flu researchers might wish to study whether, in areas affected by a severe form of the flu, people might better protect themselves against getting sick by remaining indoors at warmer temperatures than usual.”

Last statement certainly is true – the behavior in winter likely more inside less sun more central air recirculation etc….- but the physical change of the virus is a real phenomenon and makes sense in terms of evolutionary survival.

US added almost 2K to the death. Russia is now second place in terms of confirmed cases. Weekend data is generally suspect.

Looks like they went back in time and fixed the NY confirmation issue – still a big jump yesterday 10533. Positive is the positive/finish test in NY continue to fall.

NY continues its slide down in daily death – looks like PA, OR, RI might be turning down. AZ is rising since they had plateaued.

On a global view Russia does stick out on the amount confirmed and those dead.

I see a lot of bipolar news coverage on Sweden – either they show a plot of Sweden on top with all the countries below them – or they show Sweden exceeding all the countries on top of them. Here they are fairly neutral. For humanity sake for future epidemics we do need a country to try a different approach or else we will never know. I am not sure wishing them well or ill helps anything – lets see it play out. Technically they should have higher positves/tested – hopefully they will show avg or below death/confirmation if their approach would be valid. The answer will not be known until after this winter.

Belgium on the slide down. Spain just had a little uptick. Brazil and Romania are concerning.

Must read – at least in terms of very well written and its Gates – https://www.gatesnotes.com/Health/Pandemic-Innovation?WT.mc_id=20200423090000_Pandemic-Innovation_BG-FB_&WT.tsrc=BGFB

Certainly some scary issues for third world places – “If you live in an urban slum and do informal work to earn enough to feed your family every day, you won’t find it easy to avoid contact with other people. Also, the health systems in these countries have far less capacity, so even providing oxygen treatment to everyone who needs it will be difficult.

Tragically, it is possible that the total deaths in developing countries will be far higher than in developed countries.”

He acknowledges there are SOME seasonal aspects given – “Almost all respiratory viruses (a group that includes COVID-19) are seasonal… we already know the virus is not as seasonal as influenza is.”

He leads with the Gilead drug – “For the novel coronavirus, the leading drug candidate in this category is Remdesivir from Gilead, which is in trials now. It was created for Ebola. If it proves to have benefits, then the manufacturing will have to be scaled up dramatically.”

His notes on HCQ – “Another class of drugs works by changing how the human body reacts to the virus. Hydroxychloroquine is in this group. The foundation is funding a trial that will give an indication of whether it works on COVID-19 by the end of May. It appears the benefits will be modest at best.”

I am thankful he did not mention the VA study that was released and noted in over 6+ reports I have read since last night. For clarity that was not a clinical study – but a MATH study matching past historical data to create various groups. Think about this you pull from a set of data not knowing any conversations with patients and you want a group that took NO drugs – what do you think the chances that group was doing relatively better than the rest of the group? There were no list of symptoms for each patient in the table they presented. A little journalistic dig would find this hole and not perpetuate that study.

Sad fact –“the typical development time for a vaccine against a new disease is over five years. This is broken down into: a) making the candidate vaccine; b) testing it in animals; c) safety testing in small numbers of people (this is known as phase 1); d) safety and efficacy testing in medium numbers (phase 2); e) safety and efficacy testing in large numbers (phase 3); and f) final regulatory approval and building manufacturing while registering the vaccine in every country.”

“I am often asked when large-scale vaccination will start. Like America’s top public health officials, I say that it is likely to be 18 months, even though it could be as short as nine months or closer to two years. A key piece will be the length of the phase 3 trial, which is where the full safety and efficacy are determined.”

He agrees with me but did not market it to get approval by regulators – we need “SMART” testing – not just testing!– “…South Korea, did a great job of ramping up the testing capacity. But the number of tests alone doesn’t show whether they are being used effectively. You also have to make sure you are prioritizing the testing on the right people. For example, health care workers should be able to get an immediate indication of whether they are infected so they know whether to keep working. People without symptoms should not be tested until we have enough tests for everyone with symptoms. Additionally, the results from the test should come back in less than 24 hours so you quickly know whether to continue isolating yourself and quarantining the people who live with you. In the United States, it was taking over seven days in some locations to get test results, which reduces their value dramatically. This kind of delay is unacceptable.”

“You want to have so much testing going on that you see hot spots and are able to intervene by changing policy before the numbers get large. You don’t want to wait until the hospitals start to fill up and the number of deaths goes up.”

Go talk to S. Korea and lets do this….

“China and South Korea, required patients to turn over information about where they have been in the last 14 days by looking at GPS information on their phone or their spending records. It is unlikely that Western countries will require this. There are applications you can download that will help you remember where you have been; if you ever test positive, then you can voluntarily review the history or choose to share it with whoever interviews you about your contacts.”

I know for a fact the data is there to do this in the US. IF this not worthy of homeland work I don’t know what is….Also can obtain this data from all those “free” apps.

Agree there is no going back to normal for awhile as there will always be a group that will be permanently effected by this and will change their behavior for a very long time. “Some people will be naturally reluctant to go out even once the government says it is okay. Others will take the opposite view—they will assume that the government is being overly cautious and start bucking the rules.”

Remember the big attack on Santa Clara study showing the virus is 4X more than reported number – and then the LA county study – KY county study – no we have Miami Dade county study also showing similar result – https://www.miamidade.gov/releases/2020-04-24-sample-testing-results.asp

“Using statistical methods that account for the limitations of the test (sensitivity and specificity), we are 95% certain that the true amount of infection lies between 4.4% and 7.9% of the population, or between 123,000 and 221,000 residents. These results are similar but not identical to other recent, non-randomized testing programs that have been conducted throughout the United States.”

The cat is out of the bag. Test more only to test what is out there not necessarily spreading is one potential outcome. In terms of public panic we shouldn’t be over alarmed the confirmation continues to rise. The focus probably should be on deaths. Can we keep those who are vulnerable safe?

Another study from Washington nursing shows even more alarming figures – https://www.nejm.org/doi/full/10.1056/NEJMoa2008457?query=featured_coronavirus

“More than half of residents with positive test results were asymptomatic at the time of testing and most likely contributed to transmission. Infection-control strategies focused solely on symptomatic residents were not sufficient to prevent transmission after SARS-CoV-2 introduction into this facility.”

“57 of 89 residents (64%) tested positive for SARS-CoV-2. Among 76 residents who participated in point-prevalence surveys, 48 (63%) tested positive. Of these 48 residents, 27 (56%) were asymptomatic at the time of testing; 24 subsequently developed symptoms (median time to onset, 4 days). Samples from these 24 presymptomatic residents had a median rRT-PCR cycle threshold value of 23.1, and viable virus was recovered from 17 residents. As of April 3, of the 57 residents with SARS-CoV-2 infection, 11 had been hospitalized (3 in the intensive care unit) and 15 had died (mortality, 26%).

They did note some caution not to extrapolate this data to the general population which I suspect the media might not translate given it lessens the fear – “because this analysis was conducted among residents of a skilled nursing facility, it is not known whether the findings apply to the general population, including younger persons, those without underlying medical conditions, or similarly aged populations in the general community or in other long-term care settings.”

They politely said that the facility could have been run much better “We estimated that the doubling time in this facility was 3.4 days, which is faster than that of the surrounding community, 5.5 days. The accelerated doubling time was likely to have been due to inadequately controlled intrafacility transmission, which sequencing and spatiotemporal data suggest was the primary driver of new infections”

Nursing facilities for sure should follow the recommendation – “Our data suggest that symptom-based strategies for identifying residents with SARS-CoV-2 are insufficient for preventing transmission in skilled nursing facilities. Once SARS-CoV-2 has been introduced, additional strategies should be implemented to prevent further transmission, including use of recommended personal protective equipment, when available, during all resident care activities regardless of symptoms.5 Consideration should be given to test-based strategies for identifying residents and staff with SARS-CoV-2 infection for the purpose of excluding infected staff and cohorting residents, either in designated units within a facility or in a separate facility designated for residents with Covid-19.”

Last topic before delving into the numbers and tying the concept the virus is prevalent – what is interesting is to go back in time and note that history doesn’t necessarily repeat itself but many times show similarity. Below is the graph of the 1918 flu in several places. Note the humps – 3. Note the timeline – summer to winter lull.

If our focus was to flatten the curve AND we have somewhat resemblance of the above – we flatten the easy curve. I have been a skeptic of Sweden approach https://www.bbc.com/news/world-europe-52395866?

But they could be right as they could be playing the LONG game and the rest of us are focus on the SHORT game. In terms of business strategy this is about seeing the bigger picture and not dealing with the day to day issues. One of the best focused on the LONG game is Elon Musk – https://twitter.com/thirdrowtesla/status/1253548213144965120

Amazing how he traversed all the naysayers and revolutionized something that was not possible by almost ALL – but it’s the focus on the LONG game.

Could Sweden approach look poorly in the beginning but only be the right approach when viewed on a long enough timeline. Fill up the hospital now keep it at a constant rate so the 2nd and 3rd hump are manageable?

Resource planning requires a LONG game approach knowing you could look like a fool for a decade only to be right the next 2-4 decades as you are dealing with 40-60 year assets. With this historical context I can appreciate their approach. I still think the “SMART”quarantine is the right approach given the risk/reward. Could I be wrong and that we “sacrifice” too many in the beginning WHEN it seemed it could be prevented easily for the next few months IF we just isolate —- OR if we can appreciate a historical movement that could cause an extreme spike this winter because we weren’t able to find a cure/vaccine and that the quarantine had wholes and people were able to keep it hosted and it came back this winter. I guess this no different when a commander makes a bet to attack and sacrifice his men for the greater good. I am not in that position but God help those who have to make that decision. This decision of how we quarantine could be the big war time decision.

If Sweden could apply SMART quarantine they should see a drop a drop in mortality rate. It is unfortunate they are under 1% per capita tested so their mortality rate is tough to understand. IF Europe countries had county data then the 1% could be right as it could be focused on the hot spots which could perhaps be over 2% in that county. As a country level they are still showing similar numbers from Spain, Italy, UK, France.

SMART quarantine is a compromise approach where we take the data we know on what causes covid-19 patients to be hospitalized go to ICU then eventually death. Play the probability game and find those issues – and test for those given the testing for those are easy and well known (Diabetes, Heart Issues, Obesity, Immune issues). Quarantine that subset. Slowly phase in by age group not in those categories. Just like any flu – if you show symptoms stay home – this reduces viral load. Managing the viral load in areas is the key. Take advantage of the virus ability to spread – but spread in small quantity which then allows many to build defenses in managed level.

Obviously continue to wash hands wear mask etc… all these things reduce viral load and help you body not have other agents to deal with so when you do get the virus your body is ready for it. A more controversial but the data shows during this period we should revamp the food availability and reduce process food – reduce inflammation food from the system. We need our strength to fight this virus.

US numbers came back down under 2000 new deaths. The rest of the world new deaths has been quite tamed. UK 776

NY confirmation bounced back likely fixing the 0 reported yesterday. NY positive/tested still coming down. At some point I can get an estimate of death similar to the Italy exercise done.

Sad this is a nice chart given the historical charts – NJ and MA 2nd and 3rd

Ecuador is in the early stage of testing – hence big spike in confirmation/tested

Good news NY big drop and NJ seems to be stabilizing. France, Italy, Spain, Belgium, Austria, UK, all trending down. Brazil, IL,MA, even Sweden are somewhat concerning. Ireland looks to just have spiked up so that’s a country to watch.

Today is data day – too much fluff in the press. We got the data to get into the county level for the US – its whole different beast at that level!

Not a good day per update – US jumped 3329 deaths….majority in NY 1560. US death nearly 50K

NY also saw a dramatic drop in confirmation to 168 – likely data error. Now NJ leader of confirmed cases at 4111

Diving down into states – we see over 50% of US death in NY and NJ. In fact NY,NJ, CT, and MA which comingle with each other via mass transit total represent 60.87% of death – in terms of confirmed cases they represent 49.79% of all confirmed case. It would really be hard pressed to think population density and mass transit are not correlated.

At the same time to think what would work for these states should necessarily applicable in the other states given the difference of lifestyle.

As an overall state the population density of RI and NJ are very similar but the difference in confirmation and deaths per capita is a stark difference to what is going on. Below is just a partial statistics we have for each state each county – yes it is the age of information we have a lot more demo data.

You are almost 2X likely to have Covid in NJ then RI and likewise 2X more likely to die if you have Covid in NJ than RI. AND IT IS NOT BECAUSE OF LACK OF TESTING – RI actually has more testing than NJ 4.2% per capita tested. Delving into the county data – we don’t have individual testing data by county. RI also did not bucket their deaths by county – total is 189.

Big difference on a county level NJ has a county that is almost 7X more dense than RI most dense county. Also note the public transportation rate is 4X higher on state level and particularly much higher for the highest dense location. When people bring up race – are they trying to attribute the race genetics or the race likelihood to do certain things or both? There is a race difference here of 4X in the state data – but the county level there are some unique difference which one could not necessarily state being black genetics would make you more likely to get it or die vs. perhaps better to state black race are more likely to commute and live in dense areas. Both Mercer and Union are high level of black race but look at the two highest death county Bergen and Essexx where the black percent is much lower. Bergen also one of the lowest poverty rates in the region. RI same concern – is it because black race more likely to live in place with high density and mass transport vs. just race. In this case, confirmation is much higher in Providence which also commutes 2X more.

Just for comparison and to gain perspective below is Harris County TX. Harris county is much more likely to be more similar to RI than NJ in terms density and public transport. IF race/poverty/lack of insurance is a concern Harris County should see much higher numbers. The positive is the median age is much lower and solar radiation is much better. However if you don’t go outside to socialize or work then it would not help. IF Harris county emulated Rhode Island expect at LEAST 10X from current levels on both confirmed and deaths for Harris County. Rhode Island has plateaued but not turned yet so likely to be higher hence at least.

On the other side of the country LA County which is similar to Harris county – ex the political voting – if Harris County emulated this area then only about 260 more deaths but unfortunately LA county has not turned yet so the end game is not clear – not even plateaued.

Global view – alarming rise in Mexico for confirmed/tested. New York looks to be setting a trend of downward confirm/tested – this is really good sign.

NY,Spain,Italy, and France is continuing to move down in daily deaths. Brazil, Mexico and MA still distinctively rising…

I have over 20 articles/studies reviewed – but today I will sit on them and if they percolate up I will mentioned them this weekend.

Ugh – https://amp.theguardian.com/world/2020/apr/22/rick-bright-trump-hydroxychloroquine-coronavirus?

Smells really bad “the Trump administration has“politicised the work of Barda, and has pressured me and other conscientious scientists to fund companies with political connections and efforts that lack scientific merit. “Rushing blindly towards unproven drugs can be disastrous and result in countless more deaths. Science, in service to the health and safety of the American people, must always trump politics.””

For context I didn’t vote for Trump – don’t personally endorse – nor by the way didn’t vote for Hillary – but yes I still voted – it was a vote of no confidence in the system. If you don’t start to vote like that you will get the same thing over and over…

Anyway lets use our critical thinking for this – a drug which is manufactured by 12 different companies and sells for less than $1 a dose used worldwide for treatment of malaria for decades….and there is money to be had to fund companies to push this drug? Vs lets say a drug that cost $1000 a dose – which by the way is not taken worldwide by millions of people for decades yet.

I whole heartedly agree that HCQ is not some panacea drug to be used in ALL cases. However there are studies showing that there is merit when applied early and with zinc and vitamin C. And in terms of a risk/reward – knowing that people take it all over the world for common issue of malaria AND any incremental improvement to avoid death from covid with very low monetary cost seems like a decent trade to me. And perhaps Trump was overly optimistic and rush to jump on it and hence be his typical self – one needs to adapt to this – but seriously a move like this (press release – statement etc.._) sounds like it could do the very thing he is purported to try to no do -countless deaths! Media blitz and partisan debate could potentially close down all these HCQ trials across the world to spite Trump. This would be tragic. Perhaps my logic is messed up but I don’t see it – money usually is a good path to see the truth but money is very limited with HCQ.

The study which continues to be noted among the trump hatters and this article – seem to not have the same merit of investigated journalism/inquiry in terms of the basis of the study that it was initially premised upon which is to question the results – then you need to question the results of the results – have some humility to question everything – even yourself.. See 4/22/20 write up.

On non US partisan but not in the name of partisan news ….the UK is moving forward with a vaccine – with or without Gates help is my question – https://news.sky.com/story/coronavirus-human-trials-of-a-uk-covid-19-vaccine-get-under-way-11977363

Once again who will line up – what is the risk/reward – I suspect no anti-vacc folks – “Scientists at the University of Oxford say a COVID-19 jab they are developing has an 80% chance of success.”

They did add some reward beyond the 80% chance – “An urgent appeal has been issued for volunteers to take part – with those who do so being offered up to £625. People coming forward must be aged 18 to 55 and in good health.”

Risk is somewhat mitigated with the word “harmless” –

“The Oxford vaccine, called ChAdOx1 nCoV-19, is made from a harmless chimpanzee virus that has been genetically engineered to carry part of the coronavirus. The technique has already been shown to generate strong immune responses in other diseases.”

Not a favorites source for info – but it’s a good reminder to understand the symptom of strokes "FAST": F for face drooping, A for arm weakness, S for speech difficulty and T for time to call 911. – https://amp.cnn.com/cnn/2020/04/22/health/strokes-coronavirus-young-adults/index.html?

Journalism – “seven-fold increase in incidence of sudden stroke in young patients during the past two weeks.” It’s a scary statement – denominator is fewer than 2 people a month – perhaps stress could play a part of this – I suspect this is the most stressful time – or we going to blame it all on Covid?

Well a concern for the people dying due to the economy coming from the UN – https://news.un.org/en/story/2020/04/1062272

“"While dealing with a Covid-19 pandemic, we are also on the brink of a hunger pandemic," David Beasley told the UN’s security council. "There is also a real danger that more people could potentially die from the economic impact of Covid-19 than from the virus itself."
Will there be anything available for the super vulnerable as worldwide bailouts now over $8 Trillion.

Santa Clara back in the news – https://www.mercurynews.com/2020/04/22/santa-clara-county-death-data-shows-20-increase-in-march-suggesting-more-coronavirus-victims-than-previously-known/amp/?

This time they are using some rather simple math death vs. death and showing a 20% increase March on March.

“He said COVID-19 fatalities appear to have accounted for about 41% of the increase in the total number of deaths.”

“Experts said the county death tolls deserve more study but suggest the coronavirus death toll is understated, either because not enough people have been tested or fear of the virus is scaring sick people away from hospitals.”

Vitamin D run is going to make its run now – https://www.bbc.com/news/amp/health-52371688?

Good thing under $1 dose

“Time to make that change” MJ – https://www.foodnavigator.com/Article/2020/04/22/Coronavirus-and-obesity-Doctors-take-aim-at-food-industry-over-poor-diets

Article also notes/pushes for govt regulation as history has proven we cant help ourselves in our food choices – history is history – and if you think of certain food as addictive well then consider them drugs and perhaps regulation is a necessary. As Thomas Paine said “while government is there only to keep man from indulging his vices.”

Stanford guys again agitating the system – https://www.spiked-online.com/2020/04/22/there-is-no-empirical-evidence-for-these-lockdowns/amp/?

As noted before I am not a Sweden buyer just yet – testing levels are still low relatively speaking. Population density not matching for the state comparison he uses. I think its too hard to compare unsimilar population density responses. IF NJ would have opened up policy then this would be much more comparable to NY. Arkansas, Iowa, Nebraska, North Dakota, South Dakota, Utah and Wyoming just not states with a significant population density. His concern about Asian states comparison is culture – I think one could make an argument those states culture could be just as different as Asian culture from major metropolitan areas. However I do agree “It should not be taboo to discuss these facts.”

US confirmation and death continue to lead the way. Database changes again military and VA hospital state disappeared – grrrr!

First time NJ higher than NY

Georgia is showing a spike in confirmation.

Maryland looks to be on a steep ramp for Deaths. Many states are still not on a clear trend up or down – e.g. MA, PA, MI

Changed the global view now that we have tested over time. Confirmed/tested allows one to see if testing is changing and anticipate a decline. Amazingly the number is quite flat and not erratic supporting the concept of being able poll vs. test everyone in terms of understanding overall trend. As an individual person trying to understand if I have it I would want to be tested – but this is not what is meant by saying one doesn’t need to test everyone. Testing without changing testing method seem to produce consistent results not just in states but worldwide. Italy changed the trend but still quite linearly since day 53 and continues to decline – which is good news. See the math exercise for Italy below.

Italy and Spain continues the trend down. France latest shows a big drop. Austria is showing a U.

We can actually make a guess at Italy total death toll now with this trend of confirmed/tested. Eventually confirmation is expected to stop (go to zero) in 30 more days. We cant do this for Spain given the upward trend on confirmation/test.

Testing is growing at the following rate

I cut the data down for death/confirmation as the ramp has really flattened so past history was too steep – also R^2 tighten now

So this would produce a total death for Italy at 420K. Death per capita 0.7%.

The math also says the total amount per capita needed to test is 4% – currently 2.5%.

Hopefully this MATH exercise is on the high side of reality.

Interestingly the two big stories I kept seeing over and over was the failure of HCQ and then front page Remdesivris good news….coincident? perhaps?

Anyway lets use the power of our mind (critical thinking) to understand the reality from the reported – lets all be our own journalist we all have the capability to do this – some of us just need to unlock it – quarantine is a perfect time – Here is the source paper – https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf

Lets first understand what they did – “ We performed a retrospective analysis of data from patients hospitalized with confirmed SARSCoV-2 infection in all United States Veterans Health Administration medical centers until April 11, 2020. Patients were categorized based on their exposure to hydroxychloroquine alone (HC)

or with azithromycin (HC+AZ) as treatments in addition to standard supportive management for Covid-19.”

Okay so no controlled experiment – the author had no control to how or when the dosage was given – did they gather notes and talked to doctors that prescribed it to understand the context of why they were giving the drug – based on paper that was not discussed. However they did do a good job of balancing the covariates. They present a table and it seemed very well balanced.

They did conclude what most press articles are noting “In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19.”

Lots to read in the paper but I kept coming back to HCQ dosage and timing. Also I feel left out based on several papers I posted before about HCQ – zinc vitamin C combination missing. Clearly HCQ is not a solution for all. Many papers note effectiveness is before inflammation and the issue for heart concerns.

A big concern was all these patients median age older than 65 and perhaps the decision to try HCQ was because things were getting so bad that they decided to throw a hail mary to HCQ whereas those that did not take HCQ never reached that point. The only way to know that is to be there and/or talk or review notes with the doctor on hand. There was no discussion on that in this paper. It would seem this was just a statistical matching paper from a large dataset. Could they have done the same approach to Remdesivirs? Would this approach typically produce the same result due to the concerns I have?

Also noted that I would think it shouldnt present a big influence but just as with campaign contributions its not super clean but the authors did get funding before from Gilead Sciences “SSS has received research grants from Boehringer Ingelheim, Gilead Sciences, Portola Pharmaceuticals, and United Therapeutics, all unrelated to

this work. The other authors declare no competing interests.” – but maybe everyone does this so I am not addressing it as a main point but its always important to understand.

So then I see on the front of my news feed – https://www.usnews.com/news/health-news/articles/2020-04-21/more-good-news-on-remdesivirs-power-to-treat-covid-19?src=usn_tw

No link to any paper just regurgitation of optimism. This is awesome if it will work but at $1000 a dose and 10 day treatment this better return 1000X return on efficacy than HCQ, Vitamin C, AZ, Zinc – combo.

Lots of issues being brought up with Santa Clara and LA county testing methods – well outside CA – in KY with a population density of only 89pop/mi^2 – they are showing similar results – this one around 3.8% – https://fox4kc.com/tracking-coronavirus/johnson-county-reveals-3-8-test-positive-in-random-coronavirus-testing/amp/

Also the prison results from Ohio are showing this thing spreads but doesn’t kill at least not immediately – https://www.npr.org/sections/coronavirus-live-updates/2020/04/20/838943211/73-of-inmates-at-an-ohio-prison-test-positive-for-coronavirus

Anti-Vac beware of the following discussion: Briefly discussed the BCG (bacille Calmette-Guerin, is a vaccine for tuberculosis (TB) disease) vaccination before – this person (Jun Santo ) went in depth on it – https://www.jsatonotes.com/2020/03/if-i-were-north-americaneuropeanaustral.html?m=1 . Lots of chatter with why East Europe doing so much better and many trace back to BCG vaccinations. My initial concern was perhaps testing was behind in Eastern European countries but that’s not the case Estonia, Latvia, Lithuana above 2% – Slovakia almost 1%.

Risk/Reward – get the BCG vaccination I am thinking (I already have it). He also concludes the same thing – little to no downside but a significant upside – “If I were North American/European/Australian, I would take BCG vaccination now.”

This is great news for countries such as India – lets hope this is real.

Well the weekend lull perhaps is real big jump in new US deaths today 2751 – big jump in confirmation to for the US 39460. Some can be accounted for adding US military and Veteran Hospitals into the dataset (~10500 for confirmation,~380 death)

Looks like LA is slowing down their testing now over 3%. NY positive/tested continues drop now under 39%. NJ still staying at 50^. MN looks to be alarming. MA big jump in confirmation 3122

Lots of press on KY – but really they are right in the pack – yes they have had a surge but so did MN, NC, PA, CT,CO. Remember CO was supposed to be past peak per the Washington model. MI looks to heading down. Even TX has hope to be on a downward move.

India Confirmed case now over 20K – but still limited deaths being reported.

Spain has a little uptick daily death. Sweden still rising and Germany hasn’t turned yet. Another positive note for the US – we have turned much quicker than the European countries.

Another study noting infected likely outpacing confirmed cases. This one was done in LA County and roughly same results – 4.1%. They both have similar population density LA County slightly higher at 2474 population/mi^2 vs Santa Clara 1448 population/mi^2 – for perspective NY County 71,380 pop/mi^2.

https://www.latimes.com/california/story/2020-04-20/coronavirus-serology-testing-la-county?

The impact is two fold. The first discussed is the mortality rate as a function of confirmed drops drastically. Hence I have been reporting the crude fatality rate (population denominator) as suggested by many experts to use. From article: “The mortality rate is based on the number of confirmed infections; the higher the number of infections, the lower the fatality rate. Both studies estimated a mortality rate of 0.1% to 0.2%, which is closer to the death rate associated with the seasonal flu.” Now just because its close to the seasonal flu doesn’t mean you jump off a cliff and join the right wing conspirator – the population that is confirmed will likely be much higher than seasonal flu given the contagious nature. Also I suspect the death rate among those hospitalized is much greater than the common flu. In addition this is sunny not as dense CA vs. NYC.

““If this mortality were to continue for the whole year — we hope it doesn’t, but if it did — COVID would be the leading cause of death in Los Angeles County,” Simon said.”

Nonetheless it is not the worse case scenario – which is a good thing – some people really seem to want the worse case.

The other factor not discussed is the sheer volume of people infected and what it means to quarantine. This would mean that NYC is likely over 5% – assuming 5% confirmed – mortality rate is ~2% vs. ~7% now. The positive nature of myself can spin this to be a positive. The cat being out of the bag means we can probably realize that many people will not have much to any symptoms. Many with symptoms can do fine without hospitalization. We need to focus and understand who gets hospitalized. We can with much more certainty test for those issues. Once that is identified we know who for sure needs to be quarantined. With that subset being smaller we should be able to pay them and those that take care of them a monthly stipend (UBI like) to stay quarantined. The rest can restore our economy. Those getting sick should stay home as viral load minimization is key as discussed in many findings. This is what I mean by “SMART”quarantine. We can do better we don’t have to be trading life and yet sustain our very nature of our democracy and freedom. We can do both – its not as binary as it is portrayed in the media. The media loves to biforcate the issue. Each camp gets a captive audience. I believe testing should be SMART deployed – move testing to hot spots – Follow S. Korea approach. Mass quarantine can be implemented in hot spots but phased back using a “SMART” quarantine approach.

Another positive from this – the ability for the second phase – the winter time flu season – will not as be rough vs. if we all stay quarantine. This is how I would make lemonade with lemon news as such.

On lighter news – can we go long on divorce lawyers – https://www.bloomberg.com/news/articles/2020-03-31/divorces-spike-in-china-after-coronavirus-quarantines

“Shanghai divorce lawyer Steve Li at Gentle & Trust Law Firm says his caseload has increased 25% since the city’s lockdown eased in mid-March. Infidelity used to be the No. 1 reason clients showed up at his office door, he says, adding that “people have time to have love affairs when they’re not at home.” Like Christmas in the West, China’s multiday Lunar New Year holiday can strain familial bonds. When the virus hit in late January, on the eve of the festivities, couples in many cities had to endure an additional two months trapped under the same roof, sometimes with extended family. For many it was too much.”

“A study of people in Hong Kong in the wake of the 2002-03 SARS epidemic found that “one year after the outbreak, SARS survivors still had elevated stress levels and worrying levels of psychological distress,” including depression and anxiety; divorce in Hong Kong’s general population in 2004 was 21% higher than 2002 levels. SARS infected nearly 1,800 people in Hong Kong and killed 299 after originating over the border in China, which reported a total of more than 5,300 cases and 336 deaths. China has so far reported more than 80,000 Covid-19 cases and more than 3,300 deaths.”

Don’t quarantine in the house the whole time – it’s not healthy – I force my teenagers outside at least 10-15 min. It is too easy to live in the virtual world – but you won’t get the sunlight your body needs – https://www.sciencedirect.com/science/article/pii/S0022202X15368974

Exercise and eat healthy IF you really want to help this situation – seriously use your commute time for commitment to be healthy – go juice! https://www.rebootwithjoe.com/mean-green-juice/ I wish juicers would sell out ….

Still crossing the fingers the weekend data drop is real…so far so good on the death front…

Not only death changes following but also confirmed cases – even on 7 day moving avg. NJ is precariously wanting to turn down but it looks to be heading up. NY is in a clear downward movement for confirmed cases. The positive/tested has dropped to 39% now. Every state has tested over 0.5% of the population now.

NY is no longer an outlier in daily death differences. However CT and NJ has not peaked.

Using the absolute numbers for US one would think we are the big losers in all this. However that’s just not true. The US certainly is not the best but not the worst when considering a per capita view and even a population density view for NYC. Our testing volumes are reasonable but could be better (1.2% per capita – Spain and Italy over 2% but they are 2 months ahead in terms of confirmation. NY has surpassed Italy and Spain in under month to what took them 2+ months. Confirmation to population (contagion of disease) 0.24% with over 1.2% tested per capita not horrendous (Belgium 0.34% tested 1.4%) not great (S. Korea 0.02% tested 1.1%). US Deaths per population (healthcare system efficacy) 0.01% as compared to Belgium (0.05%) S. Korea (.0005%). Cup is half full? Yes we can and should do better.

NY, UK, Spain, Italy, Belgium, Iran, Switzerland, France, optimistically have peaked in daily death change 7 day Moving Avg. Germany, NJ, Brazil, MA, CT, PA, GA, Sweden, Canada, Mexico, upward trend still. FL is on a plateau right now – we will see if the opening of the beaches does something.