Just curious, anyone have a plan, or preps for global pandemic?

[TomBAvoider]

According to that report from the Italian physician cited above, many deaths were the result of the COVID-19 virus damaging lungs which subsequently resulted in opportunistic bilateral insterstitial pneumonia, that often proves fatal. If that is indeed so, then in the absence of a COVID-19 vaccine, it might be prudent or useful to get vaccinated against pneumonia - this is not a waste even in the worst case since pneumonia is a big killer in an of itself for older folk - something to keep in mind if you have friends or relatives past 65 years of age. YMMV.

[Shezian]

Why not have some chloroquine phosphate on hand,  so we can treat ourselves at home if we get the coronavirus?

 

[tea]

51 minutes ago, TomBAvoider said:

According to that report from the Italian physician cited above, many deaths were the result of the COVID-19 virus damaging lungs which subsequently resulted in opportunistic bilateral insterstitial pneumonia, that often proves fatal. If that is indeed so, then in the absence of a COVID-19 vaccine, it might be prudent or useful to get vaccinated against pneumonia - this is not a waste even in the worst case since pneumonia is a big killer in an of itself for older folk - something to keep in mind if you have friends or relatives past 65 years of age. YMMV.

Based on some very cursory reading, it looks like "the current pneumonia vaccine protects against Streptococcus pneumoniae bacteria that cause pneumonia...That vaccine will not protect against SARS Cov2 COVID2019 pneumonia.”

full article here: https://www.newsobserver.com/news/local/article240916181.html

[mccoy]

15 hours ago, Ron Put said:

In times of plague, people yearn for a strong "father" figure and populists invariably rise to the occasion. 

Just to place this whole thing into perspective:

Ron, I fully agree that panic is bad but the fact that SARS-COV-2 is not comparable to the flu is now pretty much widely accepted. Maybe those figures were shown at the beginning to reassure people and to avoid panic. But it is enough to listen to the main experts, some of'em apparently pretty reputable and reasonable.

What I grasped:

• The flu has a relatively low mortality ratio, whereas SARS2 (or Covid19) has at least a tenfold mortality; in the case of Italy, it would be 60 times as the flue, if we accept 0.1% flu MR and 6% SARS-COV2 MR as it is now in Italy, relative to confirmed cases.
• SARS-COV2 appears to be more contagious (higher attack ratio, far more spreadable).
• SARS-COV2 patients in the 10% of cases (in Italy) need intensive care, whereas flu has not such an effect, pneumonia is less serious because of the S2 receptors-mode of attack of SARS-COV-2 (low pulmonary tissue is the main target).
• The flu has a consolidated vaccination protocol, every year the most vulnerable part of the population can be protected. With SARS-COV2, there is no protection at all, excluding the immune system reaction.
• Last but not least, let's look at the effects: china stopped its precious economic development for a while, an unprecedented measure in the latest 20 years. Italian government locked down the whole country, an unprecedented measure in the lates 75 years, since world war 2. The only flu comparable as effects to SARS-COV2 is perhaps the 1918 Spanish flu.

Edited March 11, 2020 by mccoy

[mccoy]

6 hours ago, Shezian said:

Why not have some chloroquine phosphate on hand,  so we can treat ourselves at home if we get the coronavirus?

 

As far as I grasped from the podcast, the remedy is used in S Korea when the first symptoms of pneumonia show up, in elderly people. So it appears not to be a preventive remedy, for some reasons. I don't know if the suggested dosages (500 to 1000 mg/d) are comparable to malaria prevention or are larger.

Nevertheless, if IC sections get clogged up, having chloroquine at hand may be a good idea, just in case.

We know that the orthorexic-fitness-fixated population of this forum will exhibit serious symptoms of COVID19 with a very, very low degree of probability.

But we can use specific preventive measures, such as 10 mg zinc daily at wake-up, 25 micrograms D3 (10000 IU) per day, abundance of immunity-boosting food such as fresh fruit and vegetables, mushrooms, garlic, onions, all the xenhormetic superfoods we know such as ginger, turmeric and so on, fresh air, exercise. Edit: there is in this forum a specific thread on xenohormetic foods, foods contatining phytotoxins which express genes which boost the immune natural defenses.

Of course, I don't like gambling so I'll take all other hygienic measures anyway.

With all the above, I believe that SARS-COV2 will fly away and try and find some less hostile hosts.

 

Edited March 11, 2020 by mccoy

[Gordo]

Yes mccoy, it's a treatment, not recommended as a prophylactic.  If everyone tried taking chloroquine and zinc daily there is no way we'd have the supply required, there are also of course side effects and risks with any drug.

Just when there was a glimmer of hope that China had things under control, they reported 1336 new infections today.  Italy now  has over 10,000 confirmed infected, the United States has 1,050 confirmed infections.  The trend is obviously very bad right now, and spreading fast especially in Europe (Spain now has a big problem).  They were talking about Boeing on the radio this morning, drawing in on their entire credit line ($13.8 billion).  A liquidity crunch can lead to a solvency problem if this pandemic lasts more than a few months. 

Hopkins got some new URLs:

https://coronavirus.jhu.edu/map.html

Another site with detailed updates: 

https://corona.help/

Edited March 11, 2020 by Gordo

[mccoy]

By the way, at least so far, during national lockdown:

• Toilet paper is available in the supermarkets
• Amazon is delivering with the usual efficience.

[Todd Allen]

9 hours ago, mccoy said:

We know that the orthorexic-fitness-fixated population of this forum will exhibit serious symptoms of COVID19 with a very, very low degree of probability.

Unless rapamycin increases susceptibility to COVID19.

[Gordo]

The World Health Organization has officially declared COVID-19 a pandemic.
https://time.com/5791661/who-coronavirus-pandemic-declaration/

[Dean Pomerleau]

Sam Harris has a good podcast out today with a infectious disease pandemic expert from John's Hopkins. They talk about chloroquine at around 42 minutes (promising but only in vitro so far):

https://samharris.org/podcasts/191-early-thoughts-pandemic/

--Dean 

[Gordo]

2 minutes ago, Dean Pomerleau said:

(promising but only in vitro so far)

What do you mean by "only in vitro so far"?  They've done clinical trials in humans with enough success that the Chinese say it should be included as a recommended treatment: https://www.ncbi.nlm.nih.gov/m/pubmed/32074550/?i=1&from=/trending

 

[Dean Pomerleau]

4 minutes ago, Gordo said:

What do you mean by "only in vitro so far"?  They've done clinical trials in humans with enough success that the Chinese say it should be included as a recommended treatment: https://www.ncbi.nlm.nih.gov/m/pubmed/32074550/?i=1&from=/trending

He also says people are trying chloroquine for COVID-19 with some promise but calls it anecdotal evidence, not randomized control trials. 

Listen for yourself. 

--Dean 

[mccoy]

Italy's prime minister has just announced a further lockdown, where all commercial businesses will close up excluding food stores and pharmacies. Circulation of people is also very much restricted. The data today was just disastrous. I still cannot figure out (nor heard reasonable explanations in regard) the high fatality ratio in Italy which climbed up to 7%.

My sick curiosity now is if Amazon will deliver. I'm just going to order something I need since tomorrow the hardware store will be shut.

[Shezian]

14 hours ago, mccoy said:

As far as I grasped from the podcast, the remedy is used in S Korea when the first symptoms of pneumonia show up, in elderly people. So it appears not to be a preventive remedy, for some reasons. I don't know if the suggested dosages (500 to 1000 mg/d) are comparable to malaria prevention or are larger.

Nevertheless, if IC sections get clogged up, having chloroquine at hand may be a good idea, just in case.

We know that the orthorexic-fitness-fixated population of this forum will exhibit serious symptoms of COVID19 with a very, very low degree of probability.

But we can use specific preventive measures, such as 10 mg zinc daily at wake-up, 25 micrograms D3 (10000 IU) per day, abundance of immunity-boosting food such as fresh fruit and vegetables, mushrooms, garlic, onions, all the xenhormetic superfoods we know such as ginger, turmeric and so on, fresh air, exercise. Edit: there is in this forum a specific thread on xenohormetic foods, foods contatining phytotoxins which express genes which boost the immune natural defenses.

Of course, I don't like gambling so I'll take all other hygienic measures anyway.

With all the above, I believe that SARS-COV2 will fly away and try and find some less hostile hosts.

 

Sorry, did you say Zinc in the am? Also l take 15mg per day is that too much?

[mccoy]

19 minutes ago, Shezian said:

Sorry, did you say Zinc in the am? Also l take 15mg per day is that too much?

I'm taking 10 mg since Chris Masterjohn said it's probably not absorbed in doses higher than 7 mg, but 15 mg is not too much. You might split it in two and take it twice a day. It seems that polyphenols bind it significantly, so it's better taken with just a little water early in the morning then wait a while, for example 15 minutes, before drinking beverages or eating.

[BrianA]

Regarding getting the bacterial pneumonia vaccine, I did recommend to my parents to get it a couple weeks back. The reasoning is that even though it won't help directly against this viral type pneumonia directly, many cases of fatal pneumonia end in part due to secondary opportunistic infections. So that vaccine might perhaps help slightly with that. Maybe.

 

Secondary infections mentioned in fatal covid-19 case studies:

First study identifies risk factors associated with death in adults hospitalized with new coronavirus disease in Wuhan

https://www.sciencedaily.com/releases/2020/03/200309130109.htm

 

Some dual viral & bacterial infections noted in this study of mask effectiveness in health care workers:

Study shows superiority of N95 respirators in protecting health workers against bacterial respiratory infections.

http://www.isg.org.au/index.php/news-items/study-shows-superiority-of-n95-respirators-in-protecting-health-workers-against-bacterial-respiratory-infections./

Edited March 12, 2020 by BrianA

[BrianA]

Doctors in Italy reported to be experimenting with chloroquine treatment

 

 

[Sibiriak]

3 hours ago, BrianA said:

many cases of fatal pneumonia end in part due to secondary opportunistic infections.

True enough.  I've read (can't find the articles at the moment)  that being on a hospital respirator for a long time can lead to bacterial or fungal infections. See also:

There Is a ‘Tipping Point’ Before Coronavirus Kills

Quote

Secondary bacterial infections represent an especially pernicious threat because they can kill critical respiratory tract stem cells that enable tissue to rejuvenate. Without them, “you just can’t physically repair your lungs,” Taubenberger said. Damaged lungs can starve vital organs of oxygen, impairing the kidneys, liver, brain and heart.

 

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel  A Randomized Clinical Trial (2019)

Quote

In this pragmatic, cluster randomized trial that involved multiple outpatient sites at 7 health care delivery systems across a wide geographic area over 4 seasons of peak viral respiratory illness, there was no significant difference between the effectiveness of N95 respirators and medical masks in preventing laboratory-confirmed influenza among participants routinely exposed to respiratory illnesses in the workplace. In addition, there were no significant differences between N95 respirators and medical masks in the rates of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness among participants. A sensitivity analysis suggested that the primary analysis reported was fairly robust to the missing outcome data with quantitative outcomes varying by less than 5%. This supports the finding that neither N95 respirators nor medical masks were more effective in preventing laboratory-confirmed influenza or other viral respiratory infection or illness among participants when worn in a fashion consistent with current US clinical practice.

Respiratory viruses are primarily transmitted by large droplets. Because a fraction of respiratory viruses may be transmitted by aerosol, N95 respirators have been presumed to provide better protection than medical masks against viral respiratory infections in health care settings.² However, definitive evidence of greater clinical effectiveness of N95 respirators is lacking. A well-designed trial⁶ found the effectiveness of medical masks to be noninferior to N95 respirators, but the trial was stopped prematurely and was limited by small sample size.

Two additional studies^3,4   (and a pooled analysis¹²)concluded that N95 respirators may be more effective than medical masks; however, these studies were limited by uncertain clinical significance of end points.²⁴ The current study was undertaken because of remaining uncertainty based on previous studies, which made it challenging for infection control clinicians to effectively implement respiratory protection programs in health care settings.

 

And FWIW:
Treatment Strategies for Reducing Damages to Lungs In Patients with Coronavirus and Other Infections

 

Quote

Abstract

We conducted many model simulations to understand the causes of the damages of coronavirus to lung tissues and constructed a diagram showing viral development, immune response and damage accumulation curves. We found that main causes are (1) the phase lag between the viral reproduction process and a belayed immune response, (2) the direct viral damages and massive collateral damages which are mainly caused by belated immune responses, and (3) further tissue damages triggered by accumulated wastes in lungs.

 

We deduced from those causes that the key strategies for preventing lung damages include avoiding direct lung infection, altering host-virus interactions, promoting immune responses, diluting virus concentrations in lung tissues by promoting viral migration to the rest of the body, maintaining waste removal balance, protecting heart function and renal function, avoiding other infections, reducing allergic reactions and other inflammation, etc.

 

We finally discussed how to use dietary, medical, emotional, lifestyle, environmental, mechanical factors, etc. to alter disease outcomes. We show why true benefits of those factors cannot be determined by randomized controlled trials, and why the multiple-factor optimization approach can be highly effective by examining organ usable capacity in the cause of death. This treatment protocol using water, air, salt, sound, temperature, emotion, exercise, etc. can be the most powerful cures for viral and non-viral lung infections because they do not depend on molecular specificity and are freely available to anyone. [Full text available]

 

 

Edited March 12, 2020 by Sibiriak

[Matt]

10 mg/day of zinc is not going to hurt you. I don't have time to go through individual studies right now, but higher doses of 100 mg/day + of zinc have been tried for months with no issues. It takes a while before you start causing an imbalance.

When I was correcting a zinc deficiency a few years back, acne responded much better to 100 mg/day than 50 mg/day at first. I've maintained a lower dose of 50 mg every other day or 22 mg/day of zinc picolinate for 3 years now and have no issues. I've not been sick at all with any infection either since taking it. No viral infections at all for me even though my 7 nephews and nieces bring things back all the time to the house and the rest get sick.

I shared my story here: 

 

Regarding zinc toxicity:

High levels of intake by humans[edit]

Zinc has been used therapeutically at a dose of 150 mg/day for months and in some cases for years, and in one case at a dose of up to 2000 mg/day zinc for months.^{[7][8][9][10][11]} A decrease in copper levels and hematological changes have been reported; however, those changes were completely reversed with the cessation of zinc intake.^[9]

However, zinc has been used as zinc gluconate and zinc acetate lozenges for treating the common cold^[12] and therefore the safety of usage at about 100 mg/day level is a relevant question. Thus, given that doses of over 150 mg/day for months to years has caused no permanent harm in many cases, a one-week usage of about 100 mg/day of zinc in the form of lozenges would not be expected to cause serious or irreversible adverse health issues in most persons.

https://en.wikipedia.org/wiki/Zinc_toxicity

And a study regarding zinc absorption:

At the end of four weeks, hair, urine and erythrocyte zinc levels rose significantly during zinc picolinate administration. There was no significant change in any of these parameters from zinc gluconate, zinc citrate or placebo administration.

https://www.ncbi.nlm.nih.gov/pubmed/3630857

 

Edited March 12, 2020 by Matt

[Matt]

Just an anecdote on Facebook from a Doctor that I want to share: 

 

Coronavirus (COVID-19) update:

I haven't posted much other than memes lately, but as a primary care physician practicing in Tarzana, I wanted to give you my experience, and information that I know to be true. I won't mention hand washing or sanitizers, or things that everyone obviously knows, as there is plenty of information about this already.

I have two patients right now with CV, one hospitalized, and one not, and am close to a third patient. Essentially, 14 men went on a ski trip to Northern Italy. All have become ill, and all 14 have tested positive for CV. Of the 14, 4 needed to be hospitalized, and of the 4 patients, 3 are very ill as I write this. One had a significant pre-existing medical condition. The other 3 did not, and are relatively young. The news today out of Northern Italy is not good.

I have practiced for over 30 years, and have seen it all, or so I thought. Nothing has worried me like this. I recommend to all who read this that you avoid going to large group events such as sporting events, and concerts. I believe that all schools should be closed immediately and classes conducted online, which is relatively simple. I know that so far, children infected with CV have done relatively well, but they might come home and hug Grandpa, who won't do so well. Avoid contact with others as much as possible. CV in the United States is at a relatively early stage, but it won't last there for long. Make sure you have any medications you need, as well as supplies, but panicking hurts all of us.

My biggest hope is that I am totally wrong, and that you will all wonder in a few weeks what the hell I was talking about. But I have a pretty good track record, and I think you should take steps now to protect yourselves and your family. There is little cost to taking extra precaution right now, and the earlier, the better.

Feel free to share.
Sam Fink, M.D.
Fellow, American College of Physicians

[Gordo]

Do you guys think the serious "lockdown" type response (at least to hot spots)  is required to beat this virus?  So far I don't see anyone in the U.S. seriously talking about that.  There is still lots of travel going on.  I did notice parades and large sporting/concert type events being suspended, not sure if that will be enough.

Coronavirus: Why You Must Act NowPoliticians, Community Leaders and Business Leaders: What Should You Do and When?

[Todd Allen]

29 minutes ago, Gordo said:

Do you guys think the serious "lockdown" type response (at least to hot spots)  is required to beat this virus?

It looks like the virus is very wide spread as it has already been seen in at least half of the countries of the world.  Much of the rapid recent growth in cases is likely due to rapid increase in testing finding pockets of virus already well established in places previously unscreened.  At this point I don't believe any amount of quarantining and locking down can beat the virus although it might slow it down.  It could be worthwhile if it limits the degree to which medical facilities and other resources are overwhelmed by surges in new cases.  Perhaps with time strains of varying virulence will be identified.  Being able to constrain the worst while allowing benign ones to spread might lessen the carnage.  There could be other explanations but it looks to me as if the virus in Italy is of a nastier flavor than the virus in South Korea.  If so, it would be curious to see if South Korean covid-19 provides protection against Italian covid-19.

[Sibiriak]

56 minutes ago, Gordo said:

Do you guys think the serious "lockdown" type response (at least to hot spots)  is required to beat this virus?

They can't beat the virus,   but "lockdown" policies of one type or another are needed to buy time so that healthcare systems are not completely overwhelmed  before vaccines and treatments can be developed.

Edited March 12, 2020 by Sibiriak

[Sibiriak]

Quote

The Brazilian government has confirmed that president Jair Bolsonaro’s communications secretary Fabio Wajngarten has coronavirus just days after meeting Donald Trump at Mar-a-Lago. [...]  Wajngarten shared photos of himself with Trump and Mike Pence during the trip, as well as Bolsonaro. Bolsonaro and Trump dined on Saturday at Mar-a-Lago in Florida.

This could get interesting. Or not.

Meanwhile:

Quote

 ... at the Cobra [cabinet] meeting it was decided that the UK had moved from the “contain” phase into the delay phase.

Containment is not possible.

[mccoy]

1 hour ago, Sibiriak said:

They can't beat the virus,   but "lockdown" policies of one type or another are needed to buy time so that healthcare systems are not completely overwhelmed  before vaccines and treatments can be developed.

That's exactly the point, if the infection is allowed to fully peak, then there is no way hospital rooms and especially so IC units are going to be enough. Right now hospitals are overflowed in Italy.