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

[BrianA]

Looks like some good results for chloroquine in this small new French study. Even better results when combined with azithromycin.

 

First results from french open-label trial of Chloroquine for COVID19

https://www.reddit.com/r/medicine/comments/fkh526/first_results_from_french_openlabel_trial_of/

 

[BrianA]

Why Telling People They Don’t Need Masks Backfired

https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html

[BrianA]

All these lockdowns are definitely having a huge impact on the employment figures. The upcoming weekly unemployment claims numbers could exceed peaks seen in 2008. The question is how rapidly and how fully do these jobs come back after the lockdowns are at least temporarily lifted in April/May?

 

Ohio Unemployment Skyrockets By 600% After All Bars & Restaurants Shuttered

https://www.zerohedge.com/economics/ohio-unemployment-skyrockets-600-after-all-bars-restaurants-ordered-closed

 

Marist poll from March 13 - 14

http://maristpoll.marist.edu/wp-content/uploads/2020/03/NPR_PBS-NewsHour_Marist-Poll_USA-NOS-and-Tables_2003151338.pdf#page=23

 

this is the part like back in 2008 where they corral Congress into a room and freak them out so badly they cough up huge amounts of stimulus:

 

Mnuchin warns senators lack of action could result in 20% unemployment rate, source says

https://www.cnn.com/2020/03/17/politics/steven-mnuchin-unemployment-warning-coronavirus/index.html

 

[TomBAvoider]

This is so lame. I don't understand why it is that the various governments have not had emergency plans worked out for exactly the scenarios like COVID-19. It's not like there have been no warning signs, heck, there's even been books published predicting this situation with a SARS like wildly spreading viral pandemic originating in China:

Regardless, there should have been plans in place for a pandemic. Instead, it sounds like everybody is improvising and caught by surprise. It's like the old joke from Chicago, "this year, yet again, our road clearance crews were caught by surprise that it snows in winter". I mean we know for a fact that it's just a matter of time when something serious appears - we've even had a couple of false alarms, like the Swine Flu. 

Why are all these guys caught so flat-footed? Did they not realize what the potential impact could be on the economy? How come they didn't have plans on how to deal with the fallout? Instead, it seems like they're sleepwalking into an economic disaster.

I seriously think that the potential damage from the global economic collapse might be far greater than the pandemic itself and cost many lives in and of itself as a precipitating factor. 

Looks like cash might be king for awhile yet. Folks who have not experienced a real bear market - or have not studied them - may get hurt if they jump in too soon spurred on by bear market rallies, not understanding that those are just punctuation marks in a steady descent. Let's hope it doesn't come to that, but to avoid it, we need a very determined effort to get back to "normal" as soon as possible, preferably by this summer at the latest.

[Sibiriak]

New Japanese Drug

Quote

Medical authorities in China have said a drug used in Japan to treat new strains of influenza appeared to be effective in coronavirus patients, Japanese media said on Wednesday.  Zhang Xinmin, an official at China’s science and technology ministry, said favipiravir, developed by a subsidiary of Fujifilm, had produced encouraging outcomes in clinical trials in Wuhan and Shenzhen involving 340 patients.

“It has a high degree of safety and is clearly effective in treatment,” Zhang told reporters on Tuesday.

Patients who were given the medicine in Shenzhen turned negative for the virus after a median of four days after becoming positive, compared to a median of 11 days for those who were not treated with the drug, public broadcaster NHK said.  In addition, X-rays confirmed improvements in lung condition in about 91% of the patients who were treated with favipiravir, compared to 62% or those without the drug.  Fujifilm Toyama Chemical, which developed the drug – also known as Avigan – in 2014, has declined to comment on the claims.

Doctors in Japan are using the same drug in clinical studies on coronavirus patients with mild to moderate symptoms, hoping it will prevent the virus from multiplying in patients.  But a Japanese health ministry source suggested the drug was not as effective in people with more severe symptoms. “We’ve given Avigan to 70 to 80 people, but it doesn’t seem to work that well when the virus has already multiplied,” the source told the Mainichi Shimbun.

Edited March 18, 2020 by Sibiriak

[Iporuru]

On 3/17/2020 at 11:48 AM, Sibiriak said:

Thanks for the info!

I just received 100 3M FFP2 masks (30 rubles each!).  Much better fit than the looser soft surgical masks, and presumably better filtration.  I'm particular concerned about a family member who has asthma.  All is calm at the moment, but I'm expecting things to explode any day now.    Reports of one case discovered locally, but afaik no official confirmation.

Hi Sibiriak

Are the masks you bought available online?

[Sibiriak]

Yes,  Iporuru.  In Russia,  at the moment.

[Iporuru]

51 minutes ago, Sibiriak said:

Yes,  Iporuru.  In Russia,  at the moment.

Do you know if they ship outside Russia? Could you provide a link to that shop?

[Sibiriak]

Iporuru,  message sent.

Edited March 18, 2020 by Sibiriak

[Sibiriak]

Quote

Facebook announced it would ban users selling masks on its Marketplace or placing ads featuring masks, in an attempt to stop price gouging.

Great.  But there needs to be a way for sellers' stockpiles to get to the market at reasonable prices, or be requisitioned.

[mccoy]

Some Italian industries are converting to producing facial respirators and masks. A retired taylor of 85 years in a small town has gone back to work to provide hand-made masks to his fellow citizens.

Presently, the only FFP2 masks available on Amazon in Italy are priced 2.5 Euro each and will be available for delivery in 2 months!!

[Dean Pomerleau]

A pretty in-depth and technical interview of Anthony Fauci by the editor of JAMA. He is an impressive individual - nice to have him in charge (more or less):

 

[Saul]

22 hours ago, TomBAvoider said:

But of course, Republicans - for whom cutting taxes is a religion - instead CUT taxes during boom times, thus ensuring that the frothiness will be even greater and nothing is saved for the recession... and once there is a recession, Republicans of course find the cure to be - you guessed it - CUT taxes. Basically cut taxes regardless (for the upper income folks, of course!). 

We saw that at work when Clinton ran budget surplusses - as soon as he could, Bush who is an economic illiterate, cut taxes instead of saving the money. It all ended up with a massive financial crash.

I have a feeling that you're a Democrat.

☺️

  --  Saul

[Dean Pomerleau]

Saul,

Nice to hear from you. I hope you are well. You are in upstate New York as I recall. Can you share how you personally are responding to this Covid-19 situation, and how thing are in your area?

--Dean

[TomBAvoider]

Saul, no I'm not a Democrat - I regard Democrats (i.e. the politicians, not Demo voters) as corrupt corporate shills, although of course not as bad as Repubs (politicians, not Repub voters), who are beyond the pale. I'm officially registered as Independent :) here in CA. 

[Dean Pomerleau]

 Here is a good explainer video on how covid-19 replicates inside the cell and how chloroquine may interfere with this replication by shuttling zinc across the cellular membrane and into the cell where the zinc seems to stop the cell from replicating the convid-19 RNA.

 

 I also found this paper [1] that found not only quercetin (which we discussed earlier) but also EGCG (the main polyphenol in tea) seem effective at transporting zinc across cellular membranes in vitro.

Here is a graph from the paper showing how four hours of bathing cancer cells in quercetin (QCT100), EGCG (EGCG100) or clioquinol (CQ100 - an prescription antifungal drug) dramatically increased the concentration of a fluorescent-labeled zinc inside the cell relative to control when zinc in present in the extracellular medium:

It looks like EGCG was more effective than quercetin at increasing zinc inside the cell when present in the same concentrations.

Hopefully there will be randomized trials soon to show the effectiveness of chloroquine / hydroxychloroquine so that they will become standard treatment in the US. But even then, you'll likely only get a prescription for it if you've tested positive and your symptoms have progressed to the point of being severe enough to warrant treatment with a drug that will likely be in short supply if proven to be effective. 

It is still speculative that a) chloroquine works against covid-19 and it does so by increasing intracellular zinc and b) that quercetin or EGCG would similarly increase intracellular zinc in the lung cells that covid-19 invades. Nevertheless, it might be worth considering buying one or both of quercetin and EGCG supplements (along with zinc if you think you might be low) to have on hand in case you or a loved one comes down with the virus.

--Dean

-------------

1. J Agric Food Chem. 2014 Aug 13;62(32):8085-93. doi: 10.1021/jf5014633. Epub 2014 
Jul 31.

Zinc ionophore activity of quercetin and epigallocatechin-gallate: from Hepa 1-6 
cells to a liposome model.

Dabbagh-Bazarbachi H(1), Clergeaud G, Quesada IM, Ortiz M, O'Sullivan CK,
Fernández-Larrea JB.

Author information: 
(1)Nutrigenomics Research Group, Department of Biochemistry and Biotechnology,
and ‡Nanobiotechnology & Bioanalysis Group, Department of Chemical Engineering,
Universitat Rovira i Virgili , 43007 Tarragona, Spain.

Labile zinc, a tiny fraction of total intracellular zinc that is loosely bound to
proteins and easily interchangeable, modulates the activity of numerous signaling
and metabolic pathways. Dietary plant polyphenols such as the flavonoids
quercetin (QCT) and epigallocatechin-gallate act as antioxidants and as signaling
molecules. Remarkably, the activities of numerous enzymes that are targeted by
polyphenols are dependent on zinc. We have previously shown that these
polyphenols chelate zinc cations and hypothesized that these flavonoids might be 
also acting as zinc ionophores, transporting zinc cations through the plasma
membrane. To prove this hypothesis, herein, we have demonstrated the capacity of 
QCT and epigallocatechin-gallate to rapidly increase labile zinc in mouse
hepatocarcinoma Hepa 1-6 cells as well as, for the first time, in liposomes. In
order to confirm that the polyphenols transport zinc cations across the plasma
membrane independently of plasma membrane zinc transporters, QCT,
epigallocatechin-gallate, or clioquinol (CQ), alone and combined with zinc, were 
added to unilamellar dipalmitoylphosphocholine/cholesterol liposomes loaded with 
membrane-impermeant FluoZin-3. Only the combinations of the chelators with zinc
triggered a rapid increase of FluoZin-3 fluorescence within the liposomes, thus
demonstrating the ionophore action of QCT, epigallocatechin-gallate, and CQ on
lipid membrane systems. The ionophore activity of dietary polyphenols may
underlay the raising of labile zinc levels triggered in cells by polyphenols and 
thus many of their biological actions.

DOI: 10.1021/jf5014633 
PMID: 25050823  [Indexed for MEDLINE]

[Saul]

14 minutes ago, Dean Pomerleau said:

Nice to hear from you. I hope you are well. You are in upstate New York as I recall. Can you share how you personally are responding to this Covid-19 situation, and how thing are in your area?

Hi Dean!

I'm due North of you (you're in Pittsburgh).  I'm doing fine, teaching full time at the University of Rochester.  Spring break has been extended, to give instructors time to teach remotely -- we're using Zoom.  All undergrads are banned from campus -- they're learning on-line.

It's surreal.  When I go to buy food at the largest supermarket (the original Wegman's), all paper products are gone -- people are hoarding the weirdest things.  And Wegman's is having trouble getting certain vegetables -- apparently they're being hoarded in California (I guess).  The University and Wegman's are unusually nearly empty.

I  sometimes like using the phrase "Coronophobia".

😊

 AKA (all kidding aside), how should we respond to the pandemic?  Dr.  Fauci pointed out that he's a senior citizen -- but that the group that's most vulnerable to the plague are those with pre-existing conditions.  Therefore, he feels that he's not in the "most vulnerable" group.  I feel pretty much the same way.

The worst effect of the pandemic on me is that my gym has closed -- so I'm beginning to work out at home.  Fortunately, I bought a large, high resistance elliptical cross-trainer with hand motion for my wife many years ago; I started using it today.

IMO,  those of us on this List who are healthy, exercising, and on a healthy and restricted diet have little to worry about, regardless of age.

Hope all is well with you Dean.

  --  Saul

[Ron Put]

21 hours ago, BrianA said:

Starting to see more US efforts towards cloning the successes from Asia. Masks... not sure if they will become a widespread thing here or not. Currently still being discouraged by officials due to their completely bungled (at all levels, fed/state/private) preparation levels, now scrambling to try and hoover up all mask supplies. ...

This is a bit too alarmist and not entirely accurate....

I don't think that any reasonable observer would consider China's handling of the crisis a "success." As a dictatorship which has extensive control over its citizens' life-opportunities, they have the ability to force both healthcare workers and ordinary citizens to do things which are not palatable to liberal democracies and are of dubious value, at best. Masks may be useful to prevent those sick from spreading the virus through coughing or sneezing, but it's less clear what their utility is for those who are healthy. Korea is a much better model and has achieved a good balance, but it has done nothing which is especially unique for a developed country.

China is milking this for all it can, to show, mostly to the developed world, that it's political model is an alternative to the Western democracies.

Russia, which is is too poor and with an insufficiently developed economy for Putin's ambitions, is also using the pandemic to further weaken and destabilize its more prosperous neighbours to the West:

Russia deploying coronavirus disinformation to sow panic in West, EU document says

"BRUSSELS (Reuters) - Russian media have deployed a “significant disinformation campaign” against the West to worsen the impact of the coronavirus, generate panic and sow distrust, according to a European Union document seen by Reuters. ...

The EU document said the Russian campaign, pushing fake news online in English, Spanish, Italian, German and French, uses contradictory, confusing and malicious reports to make it harder for the EU to communicate its response to the pandemic.

“A significant disinformation campaign by Russian state media and pro-Kremlin outlets regarding COVID-19 is ongoing,” said the nine-page internal document, dated March 16, using the name of the disease that can be caused by the coronavirus.

“The overarching aim of Kremlin disinformation is to aggravate the public health crisis in Western countries...in line with the Kremlin’s broader strategy of attempting to subvert European societies,” the document produced by the EU’s foreign policy arm, the European External Action Service, said. ..."

Of course, much of the free mainstream media in the liberal democracies thrives on uncensored sensationalism, and politicians blame and accuse their opponents along party lines. Lots of disinformation driving the panic and toilet paper buying, sometimes even coming out of otherwise legitimate sources. Like the ibuprofen warning BrianA posted earlier, and which was questioned from the start:

Is Ibuprofen Really Risky for Coronavirus Patients?

The advice left many medical experts scratching their heads. The coronavirus is a new pathogen, and little is known about the disease it causes, called Covid-19, or how patients respond to common medications.

Dr. Véran’s warning followed a letter published in The Lancet this month. The letter’s authors proposed that certain drugs increase the number of so-called ACE2 receptors on the surfaces of cells.

The coronavirus uses these receptors to infect cells, the authors noted, and so in theory patients taking the drugs might be more vulnerable to the virus. One of the drugs was ibuprofen.

But there was no research to back up the contention. “No data,” said Dr. Michele Barry, director of the Center for Innovation in Global Health at Stanford University. There is no reason to think that infected patients should avoid temporary use of ibuprofen, she added.

“It’s all anecdote, and fake news off the anecdotes,” said Dr. Garret FitzGerald, chair of the department of pharmacology at the Perelman School of Medicine at the University of Pennsylvania. “That’s the world we are living in.”

Edited March 18, 2020 by Ron Put

[Sibiriak]

CDC analysis shows coronavirus poses serious risk for younger people

Quote

A new CDC analysis of more than 2,400 cases of COVID-19 that have occurred in the United States in the last month shows that at least 1 in 7 and perhaps as many as 1 in 5 people between the ages of 20 and 44 who contract the virus require hospitalization, a level exponentially higher than the hospitalization rates for influenza.

 

Quote

"Lots of young people are getting hospitalized, a lot more than we’re messaging, and, yes, maybe you don’t die, but living with a damaged lung or damaged organ is not a good outcome," said Prabhjot Singh, a physician and health systems expert at Mount Sinai Health System and the Icahn School of Medicine.

 

[Sibiriak]

3 hours ago, Ron Put said:

Of course, much of the free mainstream media in the liberal democracies thrives on uncensored sensationalism [...] Lots of disinformation driving the panic [...] Like the ibuprofen warning..

But in the case of ibuprofen, the media is simply reporting on a controversy:

Quote

The sensible thing at the moment would be to avoid ibuprofen in cases of people who have coronavirus amid some uncertainty about its impact, MPs have been told by the UK’s chief scientific adviser.Take something else such as paracetamol, added Sir Patrick Vallance.

Quote

NHS guidance states that people managing Covid-19 symptoms at home should take paracetamol or ibuprofen.

“I would advise against that,” said Prof Ian Jones, a virologist at the University of Reading. “There’s good scientific evidence for ibuprofen aggravating the condition or prolonging it. That recommendation needs to be updated.”

Paul Little, a professor of primary care research at the University of Southampton, said: “The general feeling is that the French advice is fairly sensible. There is now a sizeable literature from case control studies in several countries that prolonged illness or the complications of respiratory infections may be more common when non-steroidal anti-inflammatories [NSAIDs] are used.”

A trial by Little and his colleagues, published in the BMJ, found patients with respiratory infections such as coughs, colds and sore throats who were prescribed ibuprofen rather than paracetamol by their GP were more likely to subsequently suffer severe illness or complications. Several other studies have linked anti-inflammatory drugs to worsened pneumonia.

Little said this could be because inflammation is part of the body’s natural response to infection. “If you’re suppressing that natural response, you’re likely inhibiting your body’s ability to fight off infection,” he said.

The evidence in this area was “not 100% clear” and had not come directly from studies of patients with Covid-19, Little said. “I personally think that given there is plausible evidence for harm, the advice should be changed.

Counterpoint::

Quote

Public Health England said there was currently insufficient information on ibuprofen use and Covid-19 to advise people to stop using ibuprofen. “Currently there is no published scientific evidence that ibuprofen increases the risk of catching Covid-19 or makes the illness worse. There is also no conclusive evidence that taking ibuprofen is harmful for other respiratory infections,” it said in a statement

Media reporting on statements by  France's minister of health,  the UK's chief scienctific adviser,   and other scientists and doctors,  combined with  reporting on criticism of those statements,  hardly constitutes "uncensored sensationalism".   

Edited March 19, 2020 by Sibiriak

[Ron Put]

1 hour ago, Sibiriak said:

CDC analysis shows coronavirus poses serious risk for younger people

That headline is a nice bit of of sensationalism and it's based on 9 deaths among the 20-64 age group. The numbers seem to be consistent with the ratio in China, so I don't see the point of the headline.

"Among 44 cases with known outcome, 15 (34%) deaths were reported among adults aged ≥85 years, 20 (46%) among adults aged 65–84 years, and nine (20%) among adults aged 20–64 years." https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_e&deliveryName=USCDC_921-DM23064

With more than 60% of the American underclass in the "significantly overweight" category, it's very likely that there are enough among the under 50 crowd who have multiple risk factors. And they are and should be included in the "vilnerable" category.

[Sibiriak]

38 minutes ago, Ron Put said:

it's based on 9 deaths

 

It's not about deaths,

Quote

"Lots of young people are getting hospitalized, a lot more than we’re messaging, and, yes, maybe you don’t die, but living with a damaged lung or damaged organ is not a good outcome,"

but rather, hospitalization:

Quote

at least 1 in 7 and perhaps as many as 1 in 5 people between the ages of 20 and 44 who contract the virus require hospitalization

 

Quote

Ron Put:  it's very likely that there are enough the under 50 crowd who have multiple risk factors. And they are and should be included in the "vilnerable" category.

Yeah, likely true ( needs evidence/quantification, of course--not all hospitalized younger people may have multiple risk factors).  But that is the point-- younger people can be vulnerable too, and therefore, "coronavirus poses serious risk for younger people."

Edited March 19, 2020 by Sibiriak

[BrianA]

To me this seems to be a good replication of the South Korea approach. Test a huge amount, isolate the positive people (especially including the asymptomatic ones), but let everyone else keep working in the economy.

 

Scientists say mass tests in Italian town have halted Covid-19 there

 

https://www.theguardian.com/world/2020/mar/18/scientists-say-mass-tests-in-italian-town-have-halted-covid-19

Edited March 19, 2020 by BrianA

[Sibiriak]

Brian,  here's  an article on the same town with some additional data and charts:

Why Mass Testing Is Crucial: the US Should Study the Veneto Model to Fight Covid-19

Admittedly, I haven't studied this argument too closely,  but it's not immediately clear  how feasible such a lockdown/mass -testing strategy  would be in the U.S. at this moment,  even if it were desirable.

 

Edited March 19, 2020 by Sibiriak

[BrianA]

Thanks for that alternate link. Well, the US is already in many places going through a fairly significant lockdown, we're already experiencing increasing intensity of it. I think it will likely be enough to slow the new cases significantly by early April perhaps. The question then becomes, what's the best way to proceed by mid-April or May? These lockdowns currently buy you time to figure that out while avoiding the health care system getting hit too hard, but if you don't come up with a more effective response for the post-lockdown time, then from the models I've seen we would expect the virus to come back just as big as before by the Fall or early Winter.

 

So my thinking regarding the extensive testing is that while the US currently can't do it, it is ramping up towards being able to do it perhaps by mid-April or May. I'd like to see it by then implement an intensive testing regime (not just those with symptoms, but everyone who had contact with a positive case even if they are asymptomatic) with more technologically advanced case tracing and isolation adherence verification via phone app, in order to better keep things under control after that point and hopefully avoid a Fall/Winter massive resurgence.