Fauci in New England Journal of Medicine - March 2020

Submitted by entrepreneur on Mon, 05/04/2020 - 1:20pm

Posted for informational purposes without comment

Covid-19 — Navigating the Uncharted
Anthony S. Fauci, M.D., H. Clifford Lane, M.D., and Robert R. Redfield, M.D.

"... This suggests that the overall clinical consequences
of Covid-19 may ultimately be more akin to
those of a severe seasonal influenza (which has
a case fatality rate of approximately 0.1%) or a
pandemic influenza (similar to those in 1957
and 1968) rather than a disease similar to SARS
or MERS, which have had case fatality rates of
9 to 10% and 36%, respectively. ..."

https://www.nejm.org/doi/pdf/10.1056/NEJMe2002387?articleTools=true

If this has already been posted I apologize.

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COVID-19 Fauci Trump

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Submitted by vtcc73 on Mon, 05/04/2020 - 2:18pm

Interesting from a historical perspective.

The editorial was published on 28 February.

The reports, trials, and information used as a basis for the editorial were from as early as 2016 (a clinical trial paper) with most publishing dates clustered from 4 January to 25 February according to the citations with dates. The data on which these were written is unknown. I doubt it's unreasonable to think the data was from first report to the world about a possible outbreak in China through mid to late February. That's ages ago in a pandemic.

The publishing date of the editorial was 67 days ago if I added correctly or 66 if not. Our knowledge of the characteristics of the virus responsible for the pandemic has changed. I wonder if Dr. Fauci and the co-authors would stand by the characterizations of the virus reported in the editorial?

I'm not making accusations. I see this as nothing more than a spot situation report based on horribly thin information and little usable evidence. I'm also sure they knew it at the time and that was their intention. It's actually quite good and indicates that at least some in the administration weren't totally asleep or in willful denial.

—

"Ah, but I was so much older then, I'm younger than that now..."

Submitted by UntimelyRippd on Mon, 05/04/2020 - 2:58pm

Unfortunately, Fauci's speculations from 9+ weeks ago

[EDITED, I had dated the subject from the date of the journal, but the editorial itself was published online 4 weeks earlier] were not borne out in the event. (Note, significantly, his qualifications of "may" and "may".)

As I have stated, more than once here, and now one more time:

There are 8,000,000 people in NYC.
At least 20,000 have died of Covid-19 -- more likely 25-30K.
This represents 0.25% of the entire population of NYC, two and a half times the infection fatality rate Fauci cited for seasonal influenza.
On the order of 200K have tested positive. If 90% (is that "several" times enough to meet the vague maybes of Fauci's remarks?) of infections went either undetected or unreported (because of mildness), the implication would be that:
A. TWO MILLION citizens of NYC have been infected -- 1/4 of the population.
B. The lethality rate (I'm becoming wary of the term "case fatality rate", which different people seem to be applying in different ways), or "infection fatality rate", or whatever you want to call it, would be 1%, ten times the 0.1% figure Fauci cites for seasonal influenza, and 50% higher than the 0.67% that has been estimated for the 1957-59 worldwide rate, but 4 times higher than the best-guess US IFR for that pandemic (~40,000,000 infections, ~100,000 deaths, or 0.25%). BTW, that was no economic picnic. The Dow fell 15% in late 1957.

In other words, even assuming the almost incomprehensible figure of 25% city-wide infection within a span of only 8 weeks, the at least 20,000 dead imply an infection-fatality rate 4 times higher than the worst seen in any influenza pandemic since 1918. A more reasonable (though still improbable) guess of only 1 million infected in NYC gives an IFR of at least 2%. Suggesting that if we were to lift the social-distancing restrictions and see infection rates comparable to 1957-59, we'd have 80,000,000 infections and 1.6 million deaths. Which, by the way, is a lot of dead people. By the way. But of course, not as bad, relatively speaking, as the 1918 pandemic. So, nothing to worry about. Because not as bad. As the worst pandemic western civilization has seen since, i don't know, probably the black death. Also, not as bad as epidemic smallpox. Maybe not even as bad as epidemic typhus. And not as bad as epidemic malaria. So. Not so bad. Really. Carry on. Business as usual. Not that anybody around here was all that chuffed with business as usual.

—

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

Submitted by vtcc73 on Mon, 05/04/2020 - 4:09pm

Points well taken.

@UntimelyRippd I tend to give him/them the benefit of the doubt but not his boss. Like I said in my comment I see this as a spot report intended for wide distribution and nothing definitive. So little was actually known or is now known with any certainty. Fauci is a small fish in the cockroach nest that is this administration who has a very difficult and narrow path to tread. He has a duty to get out the best information and to make the best recommendations but is doing so in the face of powerful, hostile opposition by complete morons. (I think it is criminal the way the politicians have acted.) Toss in the uncertainty accompanying the managing of a pandemic from a previously unknown pathogen and he deserves plenty of latitude. He seems to be working in good faith which is about all anyone in his unenviable position could be expected to be able to do.

[EDITED, I had dated the subject from the date of the journal, but the editorial itself was published online 4 weeks earlier] were not borne out in the event. (Note, significantly, his qualifications of "may" and "may".)

As I have stated, more than once here, and now one more time:

There are 8,000,000 people in NYC.
At least 20,000 have died of Covid-19 -- more likely 25-30K.
This represents 0.25% of the entire population of NYC, two and a half times the infection fatality rate Fauci cited for seasonal influenza.
On the order of 200K have tested positive. If 90% (is that "several" times enough to meet the vague maybes of Fauci's remarks?) of infections went either undetected or unreported (because of mildness), the implication would be that:
A. TWO MILLION citizens of NYC have been infected -- 1/4 of the population.
B. The lethality rate (I'm becoming wary of the term "case fatality rate", which different people seem to be applying in different ways), or "infection fatality rate", or whatever you want to call it, would be 1%, ten times the 0.1% figure Fauci cites for seasonal influenza, and 50% higher than the 0.67% that has been estimated for the 1957-59 worldwide rate, but 4 times higher than the best-guess US IFR for that pandemic (~40,000,000 infections, ~100,000 deaths, or 0.25%). BTW, that was no economic picnic. The Dow fell 15% in late 1957.

In other words, even assuming the almost incomprehensible figure of 25% city-wide infection within a span of only 8 weeks, the at least 20,000 dead imply an infection-fatality rate 4 times higher than the worst seen in any influenza pandemic since 1918. A more reasonable (though still improbable) guess of only 1 million infected in NYC gives an IFR of at least 2%. Suggesting that if we were to lift the social-distancing restrictions and see infection rates comparable to 1957-59, we'd have 80,000,000 infections and 1.6 million deaths. Which, by the way, is a lot of dead people. By the way. But of course, not as bad, relatively speaking, as the 1918 pandemic. So, nothing to worry about. Because not as bad. As the worst pandemic western civilization has seen since, i don't know, probably the black death. Also, not as bad as epidemic smallpox. Maybe not even as bad as epidemic typhus. And not as bad as epidemic malaria. So. Not so bad. Really. Carry on. Business as usual. Not that anybody around here was all that chuffed with business as usual.

—

"Ah, but I was so much older then, I'm younger than that now..."

Submitted by Blue Republic on Tue, 05/05/2020 - 1:04am

You might want to have a listen

@vtcc73

to Dr. Judy Mikovits who is familiar with Fauci and his work from the early-mid 1980's and beyond before you decide to give him too much, or any, benefit of the doubt...

Submitted by CB on Tue, 05/05/2020 - 10:47am

I wouldn't give too much credence

@Blue Republic
to Valuetainment. The following video is typical on how they manipulate their audience. They are highly skilled in the art of disinformation, information pollution, false analogy, half truths and appeals to emotion. Don't forget that these people are marketeers, they have something they want to sell you. Another giveaway is they are not scientists or experts with a lengthy background in the fields they profess to be knowledgeable in.

[video:https://www.youtube.com/watch?v=c47KVyz0Gsg]
In that emotional video, Danielle DiMartino "proves" the Chinese deliberately allowed the coronavirus to go unchecked because they had signed the phase one trade deal with China on Dec 15, 2020 and they needed this virus to trigger their "out clause".

Transcript from above video:

... weeks later the trade truce was signed with an out clause. A very clever out clause that the Chinese made sure was in there that said if there was any kind of act of God pandemic then they didn't have to make good on what they had committed to buy from the United States. Within days they announced the first coronavirus. So did the Chinese know damn well that this thing was running around the world for six weeks before they shut down Wuhan? Yes they did. Is that criminal? Yes it is. Does it deserve to go in front of a world Tribune? Oh yes it does.

The "very clever out clause" she is talking about is a standard clause contained in the majority of legal agreements - especially financial ones. Given her background, she must be aware of this. It works for the benefit of both parties. In any event, there is another clause in the contract that states either party can terminate the agreement simply by giving written notice. China wouldn't need an "Act of God" clause to get out of the agreement.

https://d3i6fh83elv35t.cloudfront.net/static/2020/01/Economic_And_Trade_...
...
Article 7.6: Miscellaneous
...
2.In the event that a natural disaster or other unforeseeable event outside the control of the Parties delays a Party from timely complying with its obligations under this Agreement, the Parties shall consult with each other
...
Article 8.3: Entry into Force and Termination
...
2. Either Party may terminate this Agreement by providing written notice of termination to the other Party. The termination shall take effect 60 days after the date on which a Party has provided that written notice to the other Party, or on such other date as the Parties may decide.
...

One important factor is China actually needs this trade deal, especially for pork and poultry, both of which have been hit hard by viruses in China. Take note that many of these very same shyster web sites will soon be touting that America should not have sold all this food to China because this has caused a "food shortage" in the US.

The part that China doesn't need is this trade deal is it also opens the door for US GMO's - a long wished for win by American GMO ag corporations. This will give the green light for American farmers to plant GMO crops this spring to the delight of the GMO seed providers. BTW, Chinese people are very much against GMO's in their food.

Fait accompli:

'These are acts of WAR!' Economist claims China covered up its early coronavirus outbreak and preempted global crisis by inserting a 'pandemic clause' in trade deal with United States

Danielle DiMartino Booth said Beijing officials were aware of the outbreak in Wuhan in November

She said Chinese officials had countless lives on their hands for under-reporting

The economist points to a 'pandemic clause' in the January US-China trade deal

It came as Wuhan revised its official death toll to add nearly 1,300 fatalities

See how easy it was to spread FUD?

Submitted by Blue Republic on Thu, 05/07/2020 - 4:19am

See how easy it is to suppress

@CB

dissent?

Youtube Mikovits takedown 2.png

Although it did get over a million views and 43K likes before the thought police got to it.

#2.1.1 to Valuetainment. The following video is typical on how they manipulate their audience. They are highly skilled in the art of disinformation, information pollution, false analogy, half truths and appeals to emotion. Don't forget that these people are marketeers, they have something they want to sell you. Another giveaway is they are not scientists or experts with a lengthy background in the fields they profess to be knowledgeable in. [video:https://www.youtube.com/watch?v=c47KVyz0Gsg] In that emotional video, Danielle DiMartino "proves" the Chinese deliberately allowed the coronavirus to go unchecked because they had signed the phase one trade deal with China on Dec 15, 2020 and they needed this virus to trigger their "out clause". Transcript from above video: ... weeks later the trade truce was signed with an out clause. A very clever out clause that the Chinese made sure was in there that said if there was any kind of act of God pandemic then they didn't have to make good on what they had committed to buy from the United States. Within days they announced the first coronavirus. So did the Chinese know damn well that this thing was running around the world for six weeks before they shut down Wuhan? Yes they did. Is that criminal? Yes it is. Does it deserve to go in front of a world Tribune? Oh yes it does. The "very clever out clause" she is talking about is a standard clause contained in the majority of legal agreements - especially financial ones. Given her background, she must be aware of this. It works for the benefit of both parties. In any event, there is another clause in the contract that states either party can terminate the agreement simply by giving written notice. China wouldn't need an "Act of God" clause to get out of the agreement. https://d3i6fh83elv35t.cloudfront.net/static/2020/01/Economic_And_Trade_... ... Article 7.6: Miscellaneous ... 2.In the event that a natural disaster or other unforeseeable event outside the control of the Parties delays a Party from timely complying with its obligations under this Agreement, the Parties shall consult with each other ... Article 8.3: Entry into Force and Termination ... 2. Either Party may terminate this Agreement by providing written notice of termination to the other Party. The termination shall take effect 60 days after the date on which a Party has provided that written notice to the other Party, or on such other date as the Parties may decide. ... One important factor is China actually needs this trade deal, especially for pork and poultry, both of which have been hit hard by viruses in China. Take note that many of these very same shyster web sites will soon be touting that America should not have sold all this food to China because this has caused a "food shortage" in the US. The part that China doesn't need is this trade deal is it also opens the door for US GMO's - a long wished for win by American GMO ag corporations. This will give the green light for American farmers to plant GMO crops this spring to the delight of the GMO seed providers. BTW, Chinese people are very much against GMO's in their food. Fait accompli: 'These are acts of WAR!' Economist claims China covered up its early coronavirus outbreak and preempted global crisis by inserting a 'pandemic clause' in trade deal with United States Danielle DiMartino Booth said Beijing officials were aware of the outbreak in Wuhan in November She said Chinese officials had countless lives on their hands for under-reporting The economist points to a 'pandemic clause' in the January US-China trade deal It came as Wuhan revised its official death toll to add nearly 1,300 fatalities See how easy it was to spread FUD?

Submitted by vtcc73 on Tue, 05/05/2020 - 11:15am

Our two best friends in the US

@Blue Republic are internists. The older and our longest friend's specialty is ID (Infectious Disease). Both are strongly in favor of single payer/MFA and a long list of reforms necessary in the medical profession they say are necessary to move it back to be patient focused. The younger one is too close to the mainstream Dems and his wife went full Russia, Russia, Russia! but an awful lot of people my age did too. They're not ready to accept that the world has changed like it has. Trump winning was just too much cognitive dissonance in one dose. They know a lot of somethings don't make sense but can't look at their part in it. Regardless, both are the finest people and physicians I've known.

When each independently say they've loosely followed Fauci's work at NIH for a long time and think he's been very effective I accept their professional judgment. He's certainly the lone sane voice associated with the White House.

Neither cares about Fauci's politics, that's who they are, or if he's ruffled feathers professionally during his career. Administering in an institution as large as NIH is going to create opponents and enemies. The point I want to make here is that they both can separate a person's personal life, politics being a big one, from their professional and social life. Only when their politics, ethics, and humanity, lack of, show up in public and their professional life is it a public matter. Think about it a few moments. We will never come together as a people if we continue to hold grudges and stay at each other's throats. We've demonized each other so much that it's hard to see those with whom we disagree as decent and mostly just like us. That has to change. Has. To. Change. The alternative is for the toxicity to worsen which goes nowhere good for any of us.

—

"Ah, but I was so much older then, I'm younger than that now..."

Submitted by Blue Republic on Thu, 05/07/2020 - 4:00am

Not contending Fauci

@vtcc73

has been ineffective - the question is for whom?

Youtube is being effective, too - they have removed Dr. Mikovits ' interview for "violating their terms of service" - who is that protecting?

"Only when their politics, ethics, and humanity, lack of, show up in public and their professional life is it a public matter."

As far as I'm concerned in Fauci's case, his (Hillary-loving) politics, ethics and humanity are all questionable at best. He has sought to undermine Trump, to promote an extended lockdown whose efficacy is unproven and costs understated and to discourage cheap, effective life-saving treatments (HCQ/AZT/Zinc) in favor of promoting expensive, unproven ones like Remdisvir - even though he was enthusiastic about chloroquine for treating coronavirus in 2005.

Fauci's record is fair game for examination and if it invites criticism then so be it - that by itself is not demonizing someone. If the record reveals demonic tendencies that's not the fault of those who expose it.

I find Dr. Shiva a whole lot more credible - I *think* this interview is still up on Youtube...

Submitted by Pluto's Republic on Thu, 05/07/2020 - 5:55am

I completely agree

@Blue Republic

...with your views on this matter. I have been moving in the same direction. Thanks for posting them here. I especially share your view of Fauci. He is indeed a nefarious character, with the vibe of a psychopath. Deep State operatives like Fauci are very good at gaslighting the American People. Even when the People are exposed to factual information, their views do not transform. They will continue to cling to the gaslit reality and Fauci's subversive narrative.

Dr Shiva in the video above is certainly a refreshing change. His ideology may not mesh with my own, but his clarity of mind is a welcome change.

—

____________________

The political system is what it is because the People are who they are. — Plato

Submitted by ScienceTeacher on Mon, 05/04/2020 - 6:20pm

Great summary -- yet again.

@UntimelyRippd
We agree. The epidemic is real. Here are some data from the CDC.

national 020-05-04 Provisional Death Counts for Coronavirus Disease (COVID-19).png

NOTE: Number of deaths reported in this table are the total number of deaths received and coded as of the date of analysis and do not represent all deaths that occurred in that period.

Table 2. Deaths involving coronavirus disease 2019 (COVID-19), pneumonia, and influenza reported to NCHS by jurisdiction of occurrence, United States. Week ending 2/1/2020 to 5/2/2020.*

state 2020-05-04 Provisional Death Counts for (COVID-19).png

*Data during this period are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction, age, and cause of death.

1Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1.

2Percent of expected deaths is the number of deaths for all causes for this week in 2020 compared to the average number across the same week in 2017–2019.

3Pneumonia death counts exclude pneumonia deaths involving influenza.

4Influenza death counts include deaths with pneumonia or COVID-19 also listed as a cause of death.

5United States death count includes the 50 states, plus the District of Columbia and New York City.

6Excludes New York City.

New York City has had 215% of the expected number of deaths since the beginning of February.

[EDITED, I had dated the subject from the date of the journal, but the editorial itself was published online 4 weeks earlier] were not borne out in the event. (Note, significantly, his qualifications of "may" and "may".)

As I have stated, more than once here, and now one more time:

There are 8,000,000 people in NYC.
At least 20,000 have died of Covid-19 -- more likely 25-30K.
This represents 0.25% of the entire population of NYC, two and a half times the infection fatality rate Fauci cited for seasonal influenza.
On the order of 200K have tested positive. If 90% (is that "several" times enough to meet the vague maybes of Fauci's remarks?) of infections went either undetected or unreported (because of mildness), the implication would be that:
A. TWO MILLION citizens of NYC have been infected -- 1/4 of the population.
B. The lethality rate (I'm becoming wary of the term "case fatality rate", which different people seem to be applying in different ways), or "infection fatality rate", or whatever you want to call it, would be 1%, ten times the 0.1% figure Fauci cites for seasonal influenza, and 50% higher than the 0.67% that has been estimated for the 1957-59 worldwide rate, but 4 times higher than the best-guess US IFR for that pandemic (~40,000,000 infections, ~100,000 deaths, or 0.25%). BTW, that was no economic picnic. The Dow fell 15% in late 1957.

In other words, even assuming the almost incomprehensible figure of 25% city-wide infection within a span of only 8 weeks, the at least 20,000 dead imply an infection-fatality rate 4 times higher than the worst seen in any influenza pandemic since 1918. A more reasonable (though still improbable) guess of only 1 million infected in NYC gives an IFR of at least 2%. Suggesting that if we were to lift the social-distancing restrictions and see infection rates comparable to 1957-59, we'd have 80,000,000 infections and 1.6 million deaths. Which, by the way, is a lot of dead people. By the way. But of course, not as bad, relatively speaking, as the 1918 pandemic. So, nothing to worry about. Because not as bad. As the worst pandemic western civilization has seen since, i don't know, probably the black death. Also, not as bad as epidemic smallpox. Maybe not even as bad as epidemic typhus. And not as bad as epidemic malaria. So. Not so bad. Really. Carry on. Business as usual. Not that anybody around here was all that chuffed with business as usual.

Submitted by Blue Republic on Tue, 05/05/2020 - 12:42am

Nothing wrong with your math

@UntimelyRippd

as far as I can see. Your assumptions, maybe not so much.

Regarding the number of NYC deaths, I'd recommend a look at Project Veritas' latest documentary investigating just that issue. While there may well be some undercounting, Veritas' investigation, based on discussions with funeral homes strongly suggests that in some cases there COVID-19 is being assigned as cause of death incorrectly or without any direct investigation by medical examiners.

Given questions about the true NY death toll and allowing that experience in treatment should lead to improved outcomes, trying to extrapolate from NY to predict outcomes for the country as a whole may be a little or wildly off...

Especially if we were to adopt the approach of this Brazilian effort:

This study aims to assess whether empirical prescription of
hydroxychloroquine and azithromycin for patients with suspected COVID-19 is
associated with less need for hospitalization Methods: A telemedicine team
evaluated suspected COVID-19 outpatients with flu-like symptoms, if no
contraindications were detected, treatment with hydroxychloroquine and
azithromycin was prescribed after consent from subjects. Patients were monitored
daily by telemedicine appointments. Results: Of the 636 symptomatic outpatients,
412 started treatment with hydroxychloroquine and azithromycin and 224 refused
medications (control group). Need for hospitalization was 1.9% in the treatment
group and 5.4% in the control group (2.8 times greater) and number needed to treat
was 28 (NNT = 28). In those who started treatment before versus after the seventh
day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively.
Conclusion: Empirical treatment with hydroxychloroquine associated with
azithromycin for suspected cases of COVID-19 infection reduces the need for
hospitalization

(Note: quote from the study ends there. For some reason, even though the following follows the block quote when typed in, it shows up as included in the quote(?))

Average age was about 62. The study population was 60% female and had lower rates of obesity and diabetes than might be typical for Americans so MMV, but it still suggests that a simple and cheap outpatient regime applied *early* could prevent prevent numerous hospitalizations.

Sorry, could not embed Veritas' video - available on their site though, here: projectveritas.com

[EDITED, I had dated the subject from the date of the journal, but the editorial itself was published online 4 weeks earlier] were not borne out in the event. (Note, significantly, his qualifications of "may" and "may".)

As I have stated, more than once here, and now one more time:

There are 8,000,000 people in NYC.
At least 20,000 have died of Covid-19 -- more likely 25-30K.
This represents 0.25% of the entire population of NYC, two and a half times the infection fatality rate Fauci cited for seasonal influenza.
On the order of 200K have tested positive. If 90% (is that "several" times enough to meet the vague maybes of Fauci's remarks?) of infections went either undetected or unreported (because of mildness), the implication would be that:
A. TWO MILLION citizens of NYC have been infected -- 1/4 of the population.
B. The lethality rate (I'm becoming wary of the term "case fatality rate", which different people seem to be applying in different ways), or "infection fatality rate", or whatever you want to call it, would be 1%, ten times the 0.1% figure Fauci cites for seasonal influenza, and 50% higher than the 0.67% that has been estimated for the 1957-59 worldwide rate, but 4 times higher than the best-guess US IFR for that pandemic (~40,000,000 infections, ~100,000 deaths, or 0.25%). BTW, that was no economic picnic. The Dow fell 15% in late 1957.

In other words, even assuming the almost incomprehensible figure of 25% city-wide infection within a span of only 8 weeks, the at least 20,000 dead imply an infection-fatality rate 4 times higher than the worst seen in any influenza pandemic since 1918. A more reasonable (though still improbable) guess of only 1 million infected in NYC gives an IFR of at least 2%. Suggesting that if we were to lift the social-distancing restrictions and see infection rates comparable to 1957-59, we'd have 80,000,000 infections and 1.6 million deaths. Which, by the way, is a lot of dead people. By the way. But of course, not as bad, relatively speaking, as the 1918 pandemic. So, nothing to worry about. Because not as bad. As the worst pandemic western civilization has seen since, i don't know, probably the black death. Also, not as bad as epidemic smallpox. Maybe not even as bad as epidemic typhus. And not as bad as epidemic malaria. So. Not so bad. Really. Carry on. Business as usual. Not that anybody around here was all that chuffed with business as usual.

Submitted by CB on Tue, 05/05/2020 - 11:12am

This wasn't a random double blind study.

@Blue Republic
Why did 224 refuse the drug treatment? Did they also refuse other treatments? Were all the test subjects treated the very same way except for taking the drugs being tested for? Did all the outpatients self quarantine to an equal extent? Did some who refused medication feel that they are "invincible" or don't trust doctors and would be more likely to break their self isolation?

Unfortunately, the test subjects had not been tested positive for COVID19 so they may have just had a regular flu or even common cold.

https://static.poder360.com.br/2020/04/2020.04.15-journal-manuscript-fin...

Study population

Patients enrolled in the study were residents of the city of Sao Paulo, Brazil, after the pandemic was officially declared in this city. Positive epidemiology for COVID-19 was defined as living in a city with more than 100 confirmed cases of COVID-19.

Consecutive outpatients with persistent flu-like symptoms (suspected COVID-19 infection), persisting for a period equal to or greater than 2 days, were first evaluated by the tele medicine team or by the emergency department medical doctor. All physicians had access to medical records of all subjects, such as clinical history, laboratory parameters, images exams and electrocardiograms.

#2 as far as I can see. Your assumptions, maybe not so much. Regarding the number of NYC deaths, I'd recommend a look at Project Veritas' latest documentary investigating just that issue. While there may well be some undercounting, Veritas' investigation, based on discussions with funeral homes strongly suggests that in some cases there COVID-19 is being assigned as cause of death incorrectly or without any direct investigation by medical examiners. Given questions about the true NY death toll and allowing that experience in treatment should lead to improved outcomes, trying to extrapolate from NY to predict outcomes for the country as a whole may be a little or wildly off... Especially if we were to adopt the approach of this Brazilian effort: This study aims to assess whether empirical prescription of hydroxychloroquine and azithromycin for patients with suspected COVID-19 is associated with less need for hospitalization Methods: A telemedicine team evaluated suspected COVID-19 outpatients with flu-like symptoms, if no contraindications were detected, treatment with hydroxychloroquine and azithromycin was prescribed after consent from subjects. Patients were monitored daily by telemedicine appointments. Results: Of the 636 symptomatic outpatients, 412 started treatment with hydroxychloroquine and azithromycin and 224 refused medications (control group). Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group (2.8 times greater) and number needed to treat was 28 (NNT = 28). In those who started treatment before versus after the seventh day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively. Conclusion: Empirical treatment with hydroxychloroquine associated with azithromycin for suspected cases of COVID-19 infection reduces the need for hospitalization (Note: quote from the study ends there. For some reason, even though the following follows the block quote when typed in, it shows up as included in the quote(?)) Average age was about 62. The study population was 60% female and had lower rates of obesity and diabetes than might be typical for Americans so MMV, but it still suggests that a simple and cheap outpatient regime applied *early* could prevent prevent numerous hospitalizations. Sorry, could not embed Veritas' video - available on their site though, here: projectveritas.com

Submitted by Blue Republic on Wed, 05/06/2020 - 7:24am

More to the point...

@CB

Note below: they say that WRT what they defined as baseline clinical characteristics the treatment and control groups were similar except for the treatment group having a higher incidence of diabetes and previous history of stroke - meaning the treatment group was more at risk to some degree. Additionally, they had a higher prevalence of symptoms including breathing difficulties.

But, despite the control group being lower risk and less sick than the treatment group, it was the control group that required hospitalization at a rate 2.8 times higher than the treatment group.

So, if the goal is to keep hospitals from being overwhelmed and (presumably) having people recover without ever needing hospitalization at all - then why should this not be considered a significant and positive result?

The baseline clinical characteristics were similar
between groups except by a higher rate of diabetes and previous stroke in the
treatment group (Table 1). The treatment group also had higher prevalence of flu-like
12
symptoms than the control group, such as fever, cough, dyspnea, diarrhea, myalgia,
coryza, and headache. Dyspnea at baseline was more prevalent in the treatment
group compared to controls (22.1% versus 16%, p

The study results also showed a marked difference in treatment effectiveness based on how early after the onset of symptoms treatment was begun:

When the treatment group was stratified concerning the day of the symptom
on which the drugs were started, we observed that patients treated before versus
after day 7 of symptoms required less hospitalization (1.17% and 3.2%, respectively

BIG difference, no? Which very much tends to validate their approach of initiating treatment early on an empirical basis without waiting for confirmatory testing.

limited supply of tests for detection of COVID-19 and time for
diagnosis can pose a serious obstacle for treating patients at the beginning of
infection. On the other hand, empirical treatment has been routinely performed in
medicine, especially for serious infections when antibiotic therapy must be chosen
empirically, despite the lack of knowledge of the etiologic pathogen (33). The
strategy of empirical treatment prescription is based on the principle of risk
assessment versus benefits for each individual case and the therapeutic safety
profile must be considered. Use of hydroxychloroquine and azithromycin for treating
patients with suspected COVID-19 fulfill the principles of empirical treatment and
may be a reasonable approach to refrain the disease.

Looks *quite* reasonable to me, too - am I missing something?

FWIW - the telemedicine approach would appear to enhance quarantine since it reduces the need for symptomatic people to go out to seek treatment - and presumably reduces risk for medical providers as well.

Submitted by CB on Wed, 05/06/2020 - 1:33pm

I still contend that there are too many

@Blue Republic
unknowns between the control group and the treatment group to be a significantly valid study of this drug treatment.

Brazil has now put a partial halt on these studies. Doing these tests outside of a hospital setting (telemedicine) was probably not a good decision due to possible complications.

Heart woes spur partial stop of malaria drug study for virus
April 13, 2020

Scientists in Brazil have stopped part of a study of a malaria drug touted as a possible coronavirus treatment after heart rhythm problems developed in one-quarter of people given the higher of two doses being tested.
...

The NIH does not recommend the use of these drugs for the treatment of COVID-19 except in clinical trials where the patient can be continually monitored for adverse affects.

The telemedicine aspect would be very valuable in Brazil where medical treatment/care is unavailable to millions of the poor in remote locations. This would require expensive HS internet plus diagnostic equipment to be sent to these locations which the country cannot afford. The quality of the health system has been exacerbated as 8,500 Cuban doctors, who mostly work in those areas, lost their license to practice and were forced to leave.

China has taken advantage of 5G telemetry by setting up diagnostic equipment such as CT scanners in remote to make diagnoses. This was put in effect very early in the pandemic - late January. China also rapidly increased the production of CT and X-Ray machines as well as ventilators at this time.

ZTE 5G gear lets China’s experts remotely diagnose Wuhan coronavirus
January 27, 2020

As a dangerous coronavirus continues to spread outwards from the eastern city of Wuhan, China, experts from other parts of the country are now being called in — literally, using 5G cellular technology — to support growing diagnostic and treatment efforts. Chinese telecom equipment provider ZTE announced today that it has launched a remote 5G diagnosis and treatment system between West China Hospital and the Chengdu Public Health Clinic Center of Sichuan University, resulting in the first 5G remote diagnosis of coronavirus pneumonia. The company will expand the service to Wuhan as the public health crisis continues.
...
Prior to the coronavirus outbreak, 5G’s potential for remote medical services was largely theoretical, as carriers and practitioners spoke of the future prospect of performing remote surgeries or offering diagnoses to patients in far-flung areas. The use of 5G communications to enhance practitioner safety in circumstances such as this, where a virus’ transmission characteristics and other vectors remain unclear, is fairly new but represents a highly practical test of the high-bandwidth wireless technology.
...

#2.3.1 Note below: they say that WRT what they defined as baseline clinical characteristics the treatment and control groups were similar except for the treatment group having a higher incidence of diabetes and previous history of stroke - meaning the treatment group was more at risk to some degree. Additionally, they had a higher prevalence of symptoms including breathing difficulties. But, despite the control group being lower risk and less sick than the treatment group, it was the control group that required hospitalization at a rate 2.8 times higher than the treatment group. So, if the goal is to keep hospitals from being overwhelmed and (presumably) having people recover without ever needing hospitalization at all - then why should this not be considered a significant and positive result? The baseline clinical characteristics were similar between groups except by a higher rate of diabetes and previous stroke in the treatment group (Table 1). The treatment group also had higher prevalence of flu-like 12 symptoms than the control group, such as fever, cough, dyspnea, diarrhea, myalgia, coryza, and headache. Dyspnea at baseline was more prevalent in the treatment group compared to controls (22.1% versus 16%, p The study results also showed a marked difference in treatment effectiveness based on how early after the onset of symptoms treatment was begun: When the treatment group was stratified concerning the day of the symptom on which the drugs were started, we observed that patients treated before versus after day 7 of symptoms required less hospitalization (1.17% and 3.2%, respectively BIG difference, no? Which very much tends to validate their approach of initiating treatment early on an empirical basis without waiting for confirmatory testing. limited supply of tests for detection of COVID-19 and time for diagnosis can pose a serious obstacle for treating patients at the beginning of infection. On the other hand, empirical treatment has been routinely performed in medicine, especially for serious infections when antibiotic therapy must be chosen empirically, despite the lack of knowledge of the etiologic pathogen (33). The strategy of empirical treatment prescription is based on the principle of risk assessment versus benefits for each individual case and the therapeutic safety profile must be considered. Use of hydroxychloroquine and azithromycin for treating patients with suspected COVID-19 fulfill the principles of empirical treatment and may be a reasonable approach to refrain the disease. Looks *quite* reasonable to me, too - am I missing something? FWIW - the telemedicine approach would appear to enhance quarantine since it reduces the need for symptomatic people to go out to seek treatment - and presumably reduces risk for medical providers as well.

Submitted by Blue Republic on Thu, 05/07/2020 - 3:23am

If you are that obsessed

@CB

with safety and the need for rigorous testing then how about applying the same to 5G, not to mention to that of existing wireless technologies?

#2.3.1.1 unknowns between the control group and the treatment group to be a significantly valid study of this drug treatment. Brazil has now put a partial halt on these studies. Doing these tests outside of a hospital setting (telemedicine) was probably not a good decision due to possible complications. Heart woes spur partial stop of malaria drug study for virus April 13, 2020 Scientists in Brazil have stopped part of a study of a malaria drug touted as a possible coronavirus treatment after heart rhythm problems developed in one-quarter of people given the higher of two doses being tested. ... The NIH does not recommend the use of these drugs for the treatment of COVID-19 except in clinical trials where the patient can be continually monitored for adverse affects. The telemedicine aspect would be very valuable in Brazil where medical treatment/care is unavailable to millions of the poor in remote locations. This would require expensive HS internet plus diagnostic equipment to be sent to these locations which the country cannot afford. The quality of the health system has been exacerbated as 8,500 Cuban doctors, who mostly work in those areas, lost their license to practice and were forced to leave. China has taken advantage of 5G telemetry by setting up diagnostic equipment such as CT scanners in remote to make diagnoses. This was put in effect very early in the pandemic - late January. China also rapidly increased the production of CT and X-Ray machines as well as ventilators at this time. ZTE 5G gear lets China’s experts remotely diagnose Wuhan coronavirus January 27, 2020 As a dangerous coronavirus continues to spread outwards from the eastern city of Wuhan, China, experts from other parts of the country are now being called in — literally, using 5G cellular technology — to support growing diagnostic and treatment efforts. Chinese telecom equipment provider ZTE announced today that it has launched a remote 5G diagnosis and treatment system between West China Hospital and the Chengdu Public Health Clinic Center of Sichuan University, resulting in the first 5G remote diagnosis of coronavirus pneumonia. The company will expand the service to Wuhan as the public health crisis continues. ... Prior to the coronavirus outbreak, 5G’s potential for remote medical services was largely theoretical, as carriers and practitioners spoke of the future prospect of performing remote surgeries or offering diagnoses to patients in far-flung areas. The use of 5G communications to enhance practitioner safety in circumstances such as this, where a virus’ transmission characteristics and other vectors remain unclear, is fairly new but represents a highly practical test of the high-bandwidth wireless technology. ...

Submitted by Granma on Mon, 05/04/2020 - 4:21pm

Flu lethality rate is a guess

There is an article in Scientific American by Dr Jeremy Faust, an ER doctor. He realized he had only ever seen 1 flu death in his career. He asked other Drs around the country how many they had seen. The answers were 1 or 2 to none. So he looked in to where those seasonal flu death numbers came from.
They are estimated guesses from algorithms. The actual seasonal flu deaths are far less.
I’ll get a link and see if I can manage to post it here.
https://blogs.scientificamerican.com/observations/comparing-covid-19-dea...
edit to add link

Submitted by UntimelyRippd on Mon, 05/04/2020 - 6:49pm

I appreciate Faust's essay, and your bringing it to our

@Granma
attention.

However -- and remember, I believe Covid-19 is far, far worse than seasonal flu, and substantially worse than any pandemic flu since 1918 -- I believe he's overstating his case.

As far as I can tell, the CDC's estimates are based on several data sources. I presume they include an analysis of:
A. the way that aggregate deaths in the US spike during the winter
B. increases in deaths attributed to "respiratory illness" during the winter
C. correlations between those increases and the incidents of influenza reported to the CDC during those times ("flu season").

NYC, for example sees an invariable bump of "extra" deaths during the peak of flu season, well beyond diagnosed flu deaths that are reported to the CDC. It would takes hours and hours for me to try to track down how many of those are reported as "respiratory illness," so I'm afraid I ain't gonna, but just as with Covid-19, there's a certain burden on the doubter to tell us what exactly is killing those people, if it isn't the flu. (Note that excess deaths in NYC are now running at least 25k above expectation since Mar 11th, but the "official" NYC numbers appear to be well below that).

OTOH, a more realistic summary of seasonal influenza is that there's really no such thing as a typical year, but rarely does the CDC's after-the-fact estimate exceed ~30k, and a whole lot of those are, just as with Covid-19, nursing home patients or others who die without ever coming anywhere near an ER. Keeping that in mind, and understanding that:
A. Influenza and influenza deaths are NOT evenly distributed across the land;
B. There are somewhere between 10 and 15K Emergency Departments and Acute Care Clinics in the US;
... the reality is that the "average" such institution will only see 2 or 3 flu deaths per year -- but in reality, most will see none, and larger units and those in hotspots will see several -- but still, only a handful per month, at most; and not all of those will be diagnosed as a flu death.

In fact, this is one of the more curious things Faust says:

Based on the CDC numbers though, I should have seen many, many more. In 2018, over 46,000 Americans died from opioid overdoses. Over 36,500 died in traffic accidents. Nearly 40,000 died from gun violence. I see those deaths all the time. Was I alone in noticing this discrepancy?

I don't know where he practices, or what he considers "all the time", but assuming that in these particularly gnarly circumstances, most of those who don't die on the scene end up in ERs rather than Acute Care Clinics, you'd still only expect a half a dozen of each per ER per year. If this guy's ER sees one death per month by opioid overdose, they're in a hotspot; and if he sees more than one death per month, they're in a crisis zone, because he don't work 24/7, implying that his ER sees 30-40 deaths by overdose per year. If that were the case for every ER in the country, there'd be at least 150k such deaths, not 46k.

Indeed, this is specifically one of the things that really ticks me off about the whole, "Hey, there's nobody at all in our Acute Care Clinics," or "Hey, our ER only gets three Covid-19 cases per week," shtick: Even in the context of a pandemic killing 10s of thousands, most ERs or ACCs would see few or no cases in a typical week, and only a handful of deaths over the course of the pandemic. Other ERs, however, would see multiple deaths per day.

In summary: Yes, it's interesting that he has seen almost no official flu deaths that he can recall. On the other hand, we don't know:
A. What fraction of flu deaths occur in ERs
B. What fraction of flu deaths occur elsewhere in a hospital (presumably, most of them)
C. What fraction of flu deaths occur without the patient ever visiting a hospital.
D. The protocols by which a death in the ER would be assigned to the flu

The bottom line is, even granting an average of 30k per year, I wouldn't expect the average ER physician to encounter a whole lot of seasonal flu deaths, even over a span of a decade.

—

Submitted by Granma on Mon, 05/04/2020 - 7:29pm

Hmm yes.

@UntimelyRippd he may be overstating. He seems to have lost patience with people saying Covid is no worse than seasonal flu and wanted to counter that.

#3 attention. However -- and remember, I believe Covid-19 is far, far worse than seasonal flu, and substantially worse than any pandemic flu since 1918 -- I believe he's overstating his case. As far as I can tell, the CDC's estimates are based on several data sources. I presume they include an analysis of: A. the way that aggregate deaths in the US spike during the winter B. increases in deaths attributed to "respiratory illness" during the winter C. correlations between those increases and the incidents of influenza reported to the CDC during those times ("flu season"). NYC, for example sees an invariable bump of "extra" deaths during the peak of flu season, well beyond diagnosed flu deaths that are reported to the CDC. It would takes hours and hours for me to try to track down how many of those are reported as "respiratory illness," so I'm afraid I ain't gonna, but just as with Covid-19, there's a certain burden on the doubter to tell us what exactly is killing those people, if it isn't the flu. (Note that excess deaths in NYC are now running at least 25k above expectation since Mar 11th, but the "official" NYC numbers appear to be well below that). OTOH, a more realistic summary of seasonal influenza is that there's really no such thing as a typical year, but rarely does the CDC's after-the-fact estimate exceed ~30k, and a whole lot of those are, just as with Covid-19, nursing home patients or others who die without ever coming anywhere near an ER. Keeping that in mind, and understanding that: A. Influenza and influenza deaths are NOT evenly distributed across the land; B. There are somewhere between 10 and 15K Emergency Departments and Acute Care Clinics in the US; ... the reality is that the "average" such institution will only see 2 or 3 flu deaths per year -- but in reality, most will see none, and larger units and those in hotspots will see several -- but still, only a handful per month, at most; and not all of those will be diagnosed as a flu death. In fact, this is one of the more curious things Faust says: Based on the CDC numbers though, I should have seen many, many more. In 2018, over 46,000 Americans died from opioid overdoses. Over 36,500 died in traffic accidents. Nearly 40,000 died from gun violence. I see those deaths all the time. Was I alone in noticing this discrepancy? I don't know where he practices, or what he considers "all the time", but assuming that in these particularly gnarly circumstances, most of those who don't die on the scene end up in ERs rather than Acute Care Clinics, you'd still only expect a half a dozen of each per ER per year. If this guy's ER sees one death per month by opioid overdose, they're in a hotspot; and if he sees more than one death per month, they're in a crisis zone, because he don't work 24/7, implying that his ER sees 30-40 deaths by overdose per year. If that were the case for every ER in the country, there'd be at least 150k such deaths, not 46k. Indeed, this is specifically one of the things that really ticks me off about the whole, "Hey, there's nobody at all in our Acute Care Clinics," or "Hey, our ER only gets three Covid-19 cases per week," shtick: Even in the context of a pandemic killing 10s of thousands, most ERs or ACCs would see few or no cases in a typical week, and only a handful of deaths over the course of the pandemic. Other ERs, however, would see multiple deaths per day. In summary: Yes, it's interesting that he has seen almost no official flu deaths that he can recall. On the other hand, we don't know: A. What fraction of flu deaths occur in ERs B. What fraction of flu deaths occur elsewhere in a hospital (presumably, most of them) C. What fraction of flu deaths occur without the patient ever visiting a hospital. D. The protocols by which a death in the ER would be assigned to the flu The bottom line is, even granting an average of 30k per year, I wouldn't expect the average ER physician to encounter a whole lot of seasonal flu deaths, even over a span of a decade.

Submitted by UntimelyRippd on Mon, 05/04/2020 - 7:45pm

and i can certainly relate to that.

@Granma

—

Submitted by edg on Mon, 05/04/2020 - 7:56pm

Regarding Opioids

@UntimelyRippd

Great analysis, ScienceTeacher. Here's a study I found regarding opioid overdose cases in emergency rooms:

"Among approximately 91 million ED visits captured in NSSP ... from July 2016 through September 2017, a total of 142,557 ED visits (15.7 per 10,000 visits) from 52 jurisdictions in 45 states were suspected opioid-involved overdoses." Link

Dr. Faust is engaging in pure speculation. With just 15.7 per 10,000 visits involving opioids at all and only a subset of those actually resulting in death, the chance of any particular ER doctor seeing more than one or two opioid deaths is minuscule.

I would think the same is true for flu deaths and gun deaths.

#3 attention. However -- and remember, I believe Covid-19 is far, far worse than seasonal flu, and substantially worse than any pandemic flu since 1918 -- I believe he's overstating his case. As far as I can tell, the CDC's estimates are based on several data sources. I presume they include an analysis of: A. the way that aggregate deaths in the US spike during the winter B. increases in deaths attributed to "respiratory illness" during the winter C. correlations between those increases and the incidents of influenza reported to the CDC during those times ("flu season"). NYC, for example sees an invariable bump of "extra" deaths during the peak of flu season, well beyond diagnosed flu deaths that are reported to the CDC. It would takes hours and hours for me to try to track down how many of those are reported as "respiratory illness," so I'm afraid I ain't gonna, but just as with Covid-19, there's a certain burden on the doubter to tell us what exactly is killing those people, if it isn't the flu. (Note that excess deaths in NYC are now running at least 25k above expectation since Mar 11th, but the "official" NYC numbers appear to be well below that). OTOH, a more realistic summary of seasonal influenza is that there's really no such thing as a typical year, but rarely does the CDC's after-the-fact estimate exceed ~30k, and a whole lot of those are, just as with Covid-19, nursing home patients or others who die without ever coming anywhere near an ER. Keeping that in mind, and understanding that: A. Influenza and influenza deaths are NOT evenly distributed across the land; B. There are somewhere between 10 and 15K Emergency Departments and Acute Care Clinics in the US; ... the reality is that the "average" such institution will only see 2 or 3 flu deaths per year -- but in reality, most will see none, and larger units and those in hotspots will see several -- but still, only a handful per month, at most; and not all of those will be diagnosed as a flu death. In fact, this is one of the more curious things Faust says: Based on the CDC numbers though, I should have seen many, many more. In 2018, over 46,000 Americans died from opioid overdoses. Over 36,500 died in traffic accidents. Nearly 40,000 died from gun violence. I see those deaths all the time. Was I alone in noticing this discrepancy? I don't know where he practices, or what he considers "all the time", but assuming that in these particularly gnarly circumstances, most of those who don't die on the scene end up in ERs rather than Acute Care Clinics, you'd still only expect a half a dozen of each per ER per year. If this guy's ER sees one death per month by opioid overdose, they're in a hotspot; and if he sees more than one death per month, they're in a crisis zone, because he don't work 24/7, implying that his ER sees 30-40 deaths by overdose per year. If that were the case for every ER in the country, there'd be at least 150k such deaths, not 46k. Indeed, this is specifically one of the things that really ticks me off about the whole, "Hey, there's nobody at all in our Acute Care Clinics," or "Hey, our ER only gets three Covid-19 cases per week," shtick: Even in the context of a pandemic killing 10s of thousands, most ERs or ACCs would see few or no cases in a typical week, and only a handful of deaths over the course of the pandemic. Other ERs, however, would see multiple deaths per day. In summary: Yes, it's interesting that he has seen almost no official flu deaths that he can recall. On the other hand, we don't know: A. What fraction of flu deaths occur in ERs B. What fraction of flu deaths occur elsewhere in a hospital (presumably, most of them) C. What fraction of flu deaths occur without the patient ever visiting a hospital. D. The protocols by which a death in the ER would be assigned to the flu The bottom line is, even granting an average of 30k per year, I wouldn't expect the average ER physician to encounter a whole lot of seasonal flu deaths, even over a span of a decade.

Submitted by ScienceTeacher on Mon, 05/04/2020 - 5:37pm

We have better information now.

This is a very interesting article mostly because of the status of the authors.

Case fatality rates of 2-3% were reported in earlier articles, but the number of people with few or no symptoms was not known. Asymptomatic carriers were identified in China, but they did not know how common they were. People with mild symptoms were also identified in China by contact tracing and they were isolated. A current case fatality rate of 1% is reasonable.

SARS and MERS are the other two coronaviruses known to cause serious infections in humans. A case fatality rate of 1% is obviously much less than a CFR of 10% for SARS or 35% for MERS.

Increased understanding the the disease is likely to help reduce fatalities. Overcrowded hospitals with overworked staff who are severely stressed by insufficient PPE are likely to have higher fatalities. Some of the many clinical trials in progress are likely to find some effective therapeutic agents that will help. People who get the virus six months from now are likely to have better outcomes since there will be a better understanding about the best way to help them recover. I truly hope drugs and treatments can eventually bring the CFR down to 0.1%, but that is not the case at present.

Both SARS and the virus that causes Covid-19 get into the cells of our bodies by sticking to a protein on the surface of the cell being attacked. This protein is called ACE-2. ACE-2 is found in many types of cells including lung cells, cells in the cardiovascular system and cells in the digestive system. The virus for Covid-19 causes clotting problems that can lead to long-term health problems even if the person survives. The virus also interferes with the immune system.

Children may have very mild cases and some of them may have different types of symptoms than adults. Complications for some children had not been identified when this article was written.

Obviously there were people at the White House who were aware of the issues in February.

Submitted by edg on Mon, 05/04/2020 - 8:11pm

The "Nobody Cared" Myth

It's amazing and scary how fast myths are created and spread. Common knowledge has it that the US government totally ignored coronavirus during the important months of January and February when it could have been stopped in its tracks. The truth, while less palatable to Democrats, is that steps were already being taken. However, breathless news reports about Kobe Bryant's helicopter crash and Trump's impeachment drowned out early reporting on coronavirus.

USA Today, January 24, 2020

Drugmakers are hustling to make a vaccine to counter the rapidly spreading respiratory virus that has sickened at least 1,975 people in China and five in the United States.

The National Institutes of Health has partnered with a Boston-area company, Moderna, on a vaccine targeting the novel coronavirus. A Pennsylvania biotechnology company, Inovio, also secured a $9 million grant from Norway-based Coalition for Epidemic Preparedness Innovations to develop a vaccine. The company already is developing a vaccine for Middle East respiratory syndrome, or MERS, another type of coronavirus.

Officials with the National Institute of Allergy and Infectious Diseases say they can quickly develop a vaccine because Chinese scientists rapidly sequenced the virus’s genome.

“The agency has the funding and technology,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “Barring any bureaucratic or regulatory holdups, which I don’t think will happen, we can almost certainly get into phase one in three months.”

The first U.S. case, a Washington state man in his 30s, was diagnosed Tuesday. A second case, a woman in her 60s, was reported Friday in Chicago. Three more cases were confirmed Saturday and Sunday in California.

The federal Centers for Disease Control and Prevention is coordinating efforts to limit the virus's spread, limiting flights from the region to five U.S. airports and screening 2,000 returning travelers as of Friday. At least 63 potential cases are under investigation in 22 states, and 11 had been confirmed negative, officials said.

Source: Drugmakers are rushing to create and test a coronavirus vaccine. Here's how they're doing it

Submitted by ScienceTeacher on Mon, 05/04/2020 - 9:48pm

People in the sciences were worried

@edg
and quite a few tried to do something to stop this virus. MERS and SARS scared a lot of people and nobody who understood the possible consequences wanted the new virus to rampage through the population.

The problem was that politicians in the US and some European countries did not get the testing in place and did not make a serious effort at contact tracing.

Politicians have not required care homes and for-profit hospitals to stock enough personal protective equipment. Nursing homes often are careless about infection control and they have not been forced to decrease their profits to improve safety. National stockpiles of PPE were raided during the Obama administration and the masks, gowns, etc. were not replaced. Provisions for prisons and the homeless have not been organized.

The worst thing was the lack of coordination of the shut down. Shutting down properly for a month could have made the number of infected people plummet. People usually show symptoms about a week after exposure. That is also the period when they are most likely to infect others. By the second week of a really effective shutdown most infected people would have been identified and isolated. At the end of the month only a few people would still be infected. They could be isolated and all their contacts traced. This would not require nearly as much testing as our current situation. This is working in Korea and New Zealand.

A lot of people are doing what they can, including the volunteers who started sewing masks. Our individual efforts cannot replace organized, effective leadership although it would be worse without all the people who have been doing what they can.

It's amazing and scary how fast myths are created and spread. Common knowledge has it that the US government totally ignored coronavirus during the important months of January and February when it could have been stopped in its tracks. The truth, while less palatable to Democrats, is that steps were already being taken. However, breathless news reports about Kobe Bryant's helicopter crash and Trump's impeachment drowned out early reporting on coronavirus.

USA Today, January 24, 2020

Drugmakers are hustling to make a vaccine to counter the rapidly spreading respiratory virus that has sickened at least 1,975 people in China and five in the United States.

The National Institutes of Health has partnered with a Boston-area company, Moderna, on a vaccine targeting the novel coronavirus. A Pennsylvania biotechnology company, Inovio, also secured a $9 million grant from Norway-based Coalition for Epidemic Preparedness Innovations to develop a vaccine. The company already is developing a vaccine for Middle East respiratory syndrome, or MERS, another type of coronavirus.

Officials with the National Institute of Allergy and Infectious Diseases say they can quickly develop a vaccine because Chinese scientists rapidly sequenced the virus’s genome.

“The agency has the funding and technology,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “Barring any bureaucratic or regulatory holdups, which I don’t think will happen, we can almost certainly get into phase one in three months.”

The first U.S. case, a Washington state man in his 30s, was diagnosed Tuesday. A second case, a woman in her 60s, was reported Friday in Chicago. Three more cases were confirmed Saturday and Sunday in California.

The federal Centers for Disease Control and Prevention is coordinating efforts to limit the virus's spread, limiting flights from the region to five U.S. airports and screening 2,000 returning travelers as of Friday. At least 63 potential cases are under investigation in 22 states, and 11 had been confirmed negative, officials said.

Source: Drugmakers are rushing to create and test a coronavirus vaccine. Here's how they're doing it

Submitted by edg on Tue, 05/05/2020 - 12:33pm

I have a different opinion on a few things in your comment.

@ScienceTeacher

You say politicians didn't get the testing in place. That is inaccurate. CDC had responsibility for testing and through a combination of arrogance ("we can make our own, superior test") and malfeasance (contamination in the lab making the test kits), it totally failed. FDA bureaucratic hurdles also played a part.

Second, the problem with PPE goes way beyond the political level. The corporations that run hospitals and nursing homes want just-in-time delivery of minimal supplies in order to maximize profits. The companies that used to manufacture PPE in the US moved production to China, leaving us at China's mercy. Hoarding and profiteering also played a role.

Third, while Korea handled their outbreak well, it's not a fair comparison to the US. The US has 99 times as much land area as Korea and more than 6 times the population. Korea also has a far more homogeneous populace and easily controlled borders. OTOH, the Korean government refused to ban travel and allowed 70,000 travelers a day from China into the country.

Most importantly, the US was destined to fail at shutting down. The restrictions on travel from China instituted in January brought out full-throated cries of racism. Travel restrictions on Europe were too little, too late, and were bashed by Democrats. Worst of all, half a million people were allowed into the US even with travel restrictions in place.

I have yet to see a credible depiction of how an earlier or more comprehensive lockdown of the US could have been achieved considering our federalism, our overweening sense of exceptionalism, and the constant war between our political parties. The "Resistance" fought the Trump administration on every step it tried to take.

Submitted by ScienceTeacher on Tue, 05/05/2020 - 4:21pm

Definitions may be causing part of our disagreement.

@edg
The heads of government agencies like the CDC and FDA are generally political appointees. It is nice if they know one end of a test tube from the other, but their role is administrative and political. They need to make sure there are enough competent people further down the food chain working on the critical problems and that they have the resources they need. This would require checking on the progress of key projects. The politicians in charge of the CDC made the decision to create the test in-house and did not make sure a working test was available in a timely way. The politicians in charge of the FDA could have cut through a lot of beaurocratic red tape if they had chosen to do so. There is more than enough technical skill in this country to create and manufacture the tests that were needed in January and February.

I was disappointed by the Obama administration but am sure that Obama would have taken the time to assign someone to find the plans that had already been written for a response to an epidemic and be sure that personnel and materials were available. On the other hand the Obama administration had an obligation to replenish the masks and other materials they took from the federal stockpile and they failed to do so.

Nursing homes and hospitals are regulated. Politicians pass the regulations and rules for oversight. They could easily have required these organizations to stock a reasonable levels of PPE. Infections are a major cause of death in nursing homes. Politicians could make sure laws require better training and compliance with rules about infection control. Right now quite a few politicians are planning on giving for-profit health care providers legal immunity for failing to properly care for patients.

Shutting down this country in an orderly way would have been difficult, but there was not even a vestige of an effort to try. I blame both parties for playing politics instead of working together. There will be even less excuse for doing a poor job organizing the next shutdown.

Submitted by edg on Tue, 05/05/2020 - 7:11pm

Still disagree a bit.

@ScienceTeacher

You wrote:

The politicians in charge of the CDC made the decision to create the test in-house and did not make sure a working test was available in a timely way.

It has been longstanding CDC policy for decades to create tests in-house. Think about it -- would a Republican appointee decree creating tests in-house instead of outsourcing to their buddies in private industry?

The problem was the contaminated lab reagent that delivered false positives. It took multi-week back and forth to detect, diagnose, and correct the problem, initially by allowing 2 reagent tests instead of 3. This was then compounded by worldwide shortages of reagents.

FDA made things worse:

March 12, 2020

The directive, issued by the U.S. Food and Drug Administration, requires that the Centers for Disease Control and Prevention, a sister agency, retest every positive coronavirus test run by a public health lab to confirm its accuracy. The result, experts say, is wasting limited resources at a time when thousands of Americans are waiting in line to get tested for COVID-19.

The duplicative effort is the latest obstacle that is slowing the federal response to COVID-19, which has infected more than 1,300 people and resulted in 38 deaths in the United States. Progress was already delayed because the CDC decided to make its own test rather than adopting the design endorsed by the World Health Organization. The test then didn’t work properly and had to be fixed. The problems were further compounded by delays in certifying tests by private laboratories as well as a shortage of supplies and raw materials used for testing.

#5.1.1 The heads of government agencies like the CDC and FDA are generally political appointees. It is nice if they know one end of a test tube from the other, but their role is administrative and political. They need to make sure there are enough competent people further down the food chain working on the critical problems and that they have the resources they need. This would require checking on the progress of key projects. The politicians in charge of the CDC made the decision to create the test in-house and did not make sure a working test was available in a timely way. The politicians in charge of the FDA could have cut through a lot of beaurocratic red tape if they had chosen to do so. There is more than enough technical skill in this country to create and manufacture the tests that were needed in January and February. I was disappointed by the Obama administration but am sure that Obama would have taken the time to assign someone to find the plans that had already been written for a response to an epidemic and be sure that personnel and materials were available. On the other hand the Obama administration had an obligation to replenish the masks and other materials they took from the federal stockpile and they failed to do so. Nursing homes and hospitals are regulated. Politicians pass the regulations and rules for oversight. They could easily have required these organizations to stock a reasonable levels of PPE. Infections are a major cause of death in nursing homes. Politicians could make sure laws require better training and compliance with rules about infection control. Right now quite a few politicians are planning on giving for-profit health care providers legal immunity for failing to properly care for patients. Shutting down this country in an orderly way would have been difficult, but there was not even a vestige of an effort to try. I blame both parties for playing politics instead of working together. There will be even less excuse for doing a poor job organizing the next shutdown.

Submitted by vtcc73 on Tue, 05/05/2020 - 11:26am

Don't you think that the "Nobody cared"

@edg is actually just oversimplified? A lot of people in the public health, ID, the US military, and US intelligence services cared and were scared spitless. Those who didn't care were elected and politically appointed officials - the decision makers who hold actual power to do something.

I think I've posted this before: Timeline of the Coronavirus Pandemic and the US Response

It's amazing and scary how fast myths are created and spread. Common knowledge has it that the US government totally ignored coronavirus during the important months of January and February when it could have been stopped in its tracks. The truth, while less palatable to Democrats, is that steps were already being taken. However, breathless news reports about Kobe Bryant's helicopter crash and Trump's impeachment drowned out early reporting on coronavirus.

USA Today, January 24, 2020

Drugmakers are hustling to make a vaccine to counter the rapidly spreading respiratory virus that has sickened at least 1,975 people in China and five in the United States.

The National Institutes of Health has partnered with a Boston-area company, Moderna, on a vaccine targeting the novel coronavirus. A Pennsylvania biotechnology company, Inovio, also secured a $9 million grant from Norway-based Coalition for Epidemic Preparedness Innovations to develop a vaccine. The company already is developing a vaccine for Middle East respiratory syndrome, or MERS, another type of coronavirus.

Officials with the National Institute of Allergy and Infectious Diseases say they can quickly develop a vaccine because Chinese scientists rapidly sequenced the virus’s genome.

“The agency has the funding and technology,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “Barring any bureaucratic or regulatory holdups, which I don’t think will happen, we can almost certainly get into phase one in three months.”

The first U.S. case, a Washington state man in his 30s, was diagnosed Tuesday. A second case, a woman in her 60s, was reported Friday in Chicago. Three more cases were confirmed Saturday and Sunday in California.

The federal Centers for Disease Control and Prevention is coordinating efforts to limit the virus's spread, limiting flights from the region to five U.S. airports and screening 2,000 returning travelers as of Friday. At least 63 potential cases are under investigation in 22 states, and 11 had been confirmed negative, officials said.

Source: Drugmakers are rushing to create and test a coronavirus vaccine. Here's how they're doing it

—

"Ah, but I was so much older then, I'm younger than that now..."

Submitted by edg on Tue, 05/05/2020 - 11:57am

That's not true.

@vtcc73

Elected officials don't perform the day-to-day operations of the government. That's done by the permanent staff at federal agencies. It doesn't matter one iota what Trump says or doesn't say other than giving the MSM a new meme to bash him with. The real work gets done by those who actually do something, the career professionals.

Submitted by vtcc73 on Tue, 05/05/2020 - 1:25pm

Only if what the agency leaders recommend

@edg actually gets accepted up the chain, funded, and acted on. The record of this pandemic and what lead up to it instead is one of political leaders ignoring the agency requests, cancelling programs, cutting funds, and actively telling the public the exact opposite when the event the pros expected occurred. The administration set the agenda, requests budgeting, and administers the programs that come out of what congress approves. Are you trying to say that the failures in this pandemic is the responsibility of the underlings who do the day-to-day management? No wonder trump can say he takes no responsibility and people let him off the hook. You know better than that. Or am I misunderstanding your point?

—

"Ah, but I was so much older then, I'm younger than that now..."

Submitted by edg on Tue, 05/05/2020 - 3:18pm

My point...

@vtcc73

You're giving far to much credit to Trump. He's not a dictator. Have you worked for a federal agency? I did, as a contractor when I lived just outside DC. Once you get below the top level political appointees, career federal employees and contractors run the agencies and do the work.

The biggest screw-up thus far was the CDC totally botching testing. A contaminated CDC lab in Atlanta tainted one of the reagents used for the test and set testing back more than 6 critical weeks. This has been well documented in the media. That screw-up was caused by CDC staff and exacerbated by FDA staff.

You claimed that merging the duplicative pandemic offices into a single organization would have made a difference. How so? Would separate offices have prevented the CDC lab contamination that was the root of the testing issue? I think not. Would a separate office have eliminated the CDC arrogance and hubris that led them to refuse the WHO test kit? I sincerely doubt that.

Submitted by vtcc73 on Tue, 05/05/2020 - 4:30pm

Excuse me?

@edg @edg @edg I'm giving too much credit to trump? Please tell me exactly where I said anything about any of those other items. You are confusing me with someone else.

I challenged your claim that "Nobody Cared" is a meme dreamed up by the MSM which you then turned around and pointed out that agencies with expertise and authority for this kind of event had reacted. Exactly, they did react in the manner that hamstrung agencies react - inefficiently, ineffectively, and too slowly. All the while the senior leaders in the trump administration did everything possible to minimize and deny the threat. They certainly didn't care about anything except their own interests. They had lots of perfectly good reasons why bad news like this shouldn't be allowed to be aired.

The "Nobody cared" as a general statement about the federal government is an oversimplification like I said. Those with a voice and who had power to act didn't care about how the developing situation affected the average citizen but only how it affected their interests. Those in the federal government charged with daily ops in the relevant agencies did what they could. They made mistakes and they were sometimes wrong. Anyone in their positions know that is characteristic of the job. It's impossible to be right and act correctly when the actual knowledge you need to do the job is minimal and is often highly inaccurate.

I don't know where or how our wires got crossed. I generally agree with what you've written. I don't agree that "nobody cared" is accurate except to a very specific part of government or that it was a made up characterization originating in the MSM. I know I certainly didn't need to hear news organizations, that I never watch or listen to, tell me this was a massive flustercluck in the making. The daily denials and inaction were more than enough for almost everyone I know.

—

"Ah, but I was so much older then, I'm younger than that now..."

Submitted by Pluto's Republic on Tue, 05/05/2020 - 6:05pm

I'm working on a detailed timeline

@vtcc73

...of the response failures by specific US Government officials that pertain to current Coronavirus epidemic. Some of it is quite shocking, the neglect, the hostile cruelty toward peoples lives.

Below is a link to one of the source papers I'm working with. Thought it might interest you both. It lists the ignorance and incompetence and neglect that negatively impacted the current epidemic.

https://www.justsecurity.org/69650/timeline-of-the-coronavirus-pandemic-...

The failures began three years ago on on January 13, 2017.
They continue through April 30, 2020.

Much of it is connected to capitalist thinking. There is an urge throughout to strip national healthcare out of the government, leaving the states to reinvent the wheel with no national health care exchange or coordination. The Deep State authorities want the Federal government to handle wars, trade, finance, and foreign affairs with the current national tax revenues. The states can deal with the rest and raise taxes to pay for it. States should probably be regionalizing anyway, combining resources, and forming 7 to 13 discrete and sustainable countries. The US is going to break apart sooner or later.

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____________________

The political system is what it is because the People are who they are. — Plato

Submitted by edg on Tue, 05/05/2020 - 6:40pm

The Dawn of History

@Pluto's Republic

It would be nice if history began Jan 13, 2017. But it didn't.

Inside America’s 2-Decade Failure to Prepare for Coronavirus

Top officials from three administrations describe how crucial lessons were learned and lost, programs launched and canceled, and budgets funded and defunded.

Speaking to POLITICO this month, the Bush Administration's Secretary of HHS Michael Leavitt, who was ridiculed on Jay Leno's "Tonight Show", described a trap that health and national security officials know too well: Prepare too early and you’re called Chicken Little. Act too late — and millions may die.

"In advance of a pandemic, anything you say sounds alarmist,” Leavitt explained. “After a pandemic starts, everything you’ve done is inadequate."

After each major health crisis of the last two decades, American health and political leaders have launched preparedness programs and issued blunt warnings to their successors — only to watch as those programs were defunded, staff was allowed to depart and Washington forgot the stark lessons it had just learned.

Source: Politico, 4/11/2020

Submitted by edg on Tue, 05/05/2020 - 7:02pm

Helpful additions to your timeline

@Pluto's Republic

Here's a partial timeline I put together of coronavirus events from Jan 24, 2020 to March 13, 2020. I'm sure your timeline already has all of them, but just in case you missed any...

Jan 21 - first confirmed US coronavirus case
Jan 24 - NIH partners with Moderna to create vaccine
Jan 24 - CDC limits flights from China and screens returning travelers
Jan 27 - Coronavirus task force begins daily meetings
Jan 31 - China travel restrictions implemented
Jan 31 - Trump declares Public Health Emergency, thus kicking federal response into high gear
Feb 24 - Trump requests $2.5 billion in spending to fight coronavirus
Feb 29 - first US coronavirus death
Mar 6 - Congress approves Trump spending request + additional funding
Mar 11 - Europe travel restrictions implemented
Mar 13 - Trump issues personal distancing and other CV guidelines
Mar 13 - Trump declares National Emergency (NE), boosting federal response to warp speed
Mar 13 - NE declaration frees additional $50 billion in coronavirus spending

Submitted by edg on Tue, 05/05/2020 - 6:14pm

Time to pull the plug.

@vtcc73

You're getting worked up over I don't know what. So thanks for participating and I look forward to future discussions.

Submitted by Deja on Mon, 05/04/2020 - 10:05pm

Let's talk about cleavage & insertion - "furin cleavage site"

Was listening to a video on the virus, as I was about to cook myself supper, and he started talking about:

furin cleavage site
placed in SARS in 2006 (and since)
insertion
RRSRR

I stopped the video to post it (I'm half way through, but hungry; so, I'm posting and running.) I hope people watch it. Some might actually like it.

This guy likes numbers, data and doesn't claim a political "side". He also has a PhD in something related to medical data, but I don't remember what it is. Epidemiology? Not sure.

[video:https://youtu.be/uZUJhKUbd0k]

Submitted by Pluto's Republic on Thu, 05/07/2020 - 8:28am

I think this is Important and credible

@Deja

...and ultimately useful information. Knowing how the virus came into existence will help expose the lies and deceptions going forward. There's some evil dealing going on. Just look at the blatant wealth transfers the Duopoly is passing off as a stimulus. Folks should be skeptical of all medical information, especially if the corporate media is touting it. A lot of it is unscientific and wrong. A lot of if it is political. The science is not that difficult to learn the principles of how viruses work. Understanding the virus can help people ask the important questions. Is it even possible to create a vaccine for a Franken-virus like Covid-19? What would the future look like if we cannot find a medical solution that will prevent continuous infection and the culling of those with poor health. Intentional or not, the virus is a smart and targeted depopulation device.

The video is a richly detailed scientific explanation of the strange characteristics of the virus. It's not for everyone wants to spend 40 plus minutes on that. If you want to hear the message and truths that are exposed here, I suggest starting it at 38:20 to watch the ending.

This is my summary: The video reveals that the Covid-19 Coronavirus was created in a lab. The video explains why the virus could not have mutated naturally. It discusses a few of the world's prominent scientists in this field, scientists from China, the US, and Europe. These scientists are writing and releasing a flurry of journal papers and news releases — and all of them plant the same misleading conclusion. Their papers proclaim that Covid-19 evolved naturally in the wild. The video explains the illogical and faulty assumption the scientists use to reach their incorrect conclusion. The faulty assumption is one that any trained virologist would immediately spot. Thus, these acclaimed scientists are deliberately flooding medical journals and newspapers with specific misinformation.

So, why would they do that? It appears that these scientists are trying to cover up a truth. A dangerous truth. Concurrently, the tech giants like Facebook and Twitter are proactively deleting online discussions and messages that address this deliberate misinformation. It's a very big cover-up. There is something the "authorities" are desperate to hide from the people.

(My research: I don't know how the virus came to be, but I know Covid-19 was not born in China. It was moved to China by Anthony Fauci. Congress has been paying China millions of dollars to keep it there. Fauci is not who people think he is. There are labs in the US that may have samples of the virus. Wide-spread testing for the virus in the US (which is obviously being suppressed and will never happen) may show that the virus was active in the US as early as August 2019. The inconclusive Vaping mystery disease, which abruptly disappeared when Covid-19 showed up, may be a missing link.)

—

____________________

The political system is what it is because the People are who they are. — Plato

Submitted by Deja on Sun, 05/17/2020 - 2:03pm

Thanks, Pluto's Republic

@Pluto's Republic
You broke it down quite well, and most people don't want to spend 40 minutes listening to data garble, but he makes it understandable even to little ole backwoods me.

I completely agree with your last paragraph. Fauci is not to be trusted at all, and neither is the WHO. My CT brain wonders if there is executable code in the virus, but that's too crazy, right?

#6

...and ultimately useful information. Knowing how the virus came into existence will help expose the lies and deceptions going forward. There's some evil dealing going on. Just look at the blatant wealth transfers the Duopoly is passing off as a stimulus. Folks should be skeptical of all medical information, especially if the corporate media is touting it. A lot of it is unscientific and wrong. A lot of if it is political. The science is not that difficult to learn the principles of how viruses work. Understanding the virus can help people ask the important questions. Is it even possible to create a vaccine for a Franken-virus like Covid-19? What would the future look like if we cannot find a medical solution that will prevent continuous infection and the culling of those with poor health. Intentional or not, the virus is a smart and targeted depopulation device.

The video is a richly detailed scientific explanation of the strange characteristics of the virus. It's not for everyone wants to spend 40 plus minutes on that. If you want to hear the message and truths that are exposed here, I suggest starting it at 38:20 to watch the ending.

This is my summary: The video reveals that the Covid-19 Coronavirus was created in a lab. The video explains why the virus could not have mutated naturally. It discusses a few of the world's prominent scientists in this field, scientists from China, the US, and Europe. These scientists are writing and releasing a flurry of journal papers and news releases — and all of them plant the same misleading conclusion. Their papers proclaim that Covid-19 evolved naturally in the wild. The video explains the illogical and faulty assumption the scientists use to reach their incorrect conclusion. The faulty assumption is one that any trained virologist would immediately spot. Thus, these acclaimed scientists are deliberately flooding medical journals and newspapers with specific misinformation.

So, why would they do that? It appears that these scientists are trying to cover up a truth. A dangerous truth. Concurrently, the tech giants like Facebook and Twitter are proactively deleting online discussions and messages that address this deliberate misinformation. It's a very big cover-up. There is something the "authorities" are desperate to hide from the people.

(My research: I don't know how the virus came to be, but I know Covid-19 was not born in China. It was moved to China by Anthony Fauci. Congress has been paying China millions of dollars to keep it there. Fauci is not who people think he is. There are labs in the US that may have samples of the virus. Wide-spread testing for the virus in the US (which is obviously being suppressed and will never happen) may show that the virus was active in the US as early as August 2019. The inconclusive Vaping mystery disease, which abruptly disappeared when Covid-19 showed up, may be a missing link.)