Saturday, July 4, 2020

The Failure of Pandemic Propaganda



I want my old life back.  I miss going to restaurants.  I am frustrated that my wife cannot get a flight back home.  I want to fly to places I haven’t seen.  I want this pandemic to be over as quickly as possible.  


The propaganda about the virus and its spread has been abysmal.  On one side are the epidemiologists.  They know how epidemics work in great detail.  The answers are, to them, blindingly obvious.  Their explanations, however, have largely gone over the heads of the citizenry.  


Unless they have personally seen someone struggle to survive the infection, the average person has only a muddled conception of what we face.   They naturally want to solve the problem.  There is a large gap, however, between what the experts know and what the public comprehends. 


The performance of government leaders worldwide has been mostly bad.  This is especially true in the United States and Brazil where the top leadership has turned incompetence into an Olympic sport, with the US taking the gold and Brazil the silver. 


The pandemic will end eventually.  How long that will take is within our control.  The experts have not given the public the building blocks of knowledge necessary to understand how we could stop the pandemic relatively quickly if we shared the same intent and pursued it relentlessly. 


The fundamental fact of the pandemic is that the virus uses our bodies to reproduce.  Understanding that we humans are making billions of copies of the virus every day, is essential.  Once we accept that we are the ones making the virus, the answer to the problem becomes just as blindingly obvious to us as it is to the experts.  


We need to stop making viruses.  It really is that simple.  In fact, that could be the slogan:  Stop making viruses!


There are two ways to stop making viruses.  The first is to not become infected.  People who are not infected do not make viruses. 


If that fails, the second method is not to infect anyone else.  If the virus’s victim does not pass it on to anyone else, all the viruses that victim makes will eventually break down into their constituent chemicals and be incapable of ever infecting anyone.  


So the simple injunctions are:  


  1. Don’t be a virus factory and 

  2. Don’t be a virus-spreader.


These are extremely simple ideas that everyone can easily understand.  Any suggested behavioral change has to be connected to one or the other.  Don’t make or spread viruses.  That is a very easy rule to internalize. 


Even at that, it needs to be repeated endlessly like “loose lips, sink ships” and other wartime slogans until it is deeply embedded in people’s understanding of how the world works. 


Perhaps the biggest error in messaging has been making men feel they are sissies if they try not to become a virus factory.   The tough guy mode of masculinity requires that males show their virility by flaunting risky behaviors.   The refusal to wear facemasks is an example of this. 


There is an alternative mode of masculinity that can help rather than aggravate the problem.  The better message would assume toughness and suggest that Mr. Virility could be so tough, he might be a virus factory and not even know it.  He should, therefore, always act as if he were a virus factory and a potential virus spreader to protect others from his super virile self.


Another failure in messaging concerns exponentiality.  It has been explained some but hasn’t been adequately emphasized on the growth side.  These things have to be repeated hundreds and thousands of times to get through to enough people to have any effect.  


What hasn’t been explained at all is that the same thing can happen on the way down.  On the way up if every person infects two other people, the number of cases keeps doubling and gets to very big numbers very quickly.  The same thing can happen, however, on the way down.  If only half of infected people infect someone else, the number of cases will keep getting cut in half so that 16 infections fall to 8 which then fall to 4 and then to 2 and the chain transmission stops if that last individual can avoid infecting anyone else.  


Only with intense repetition and lots of ways of saying the same thing can this get through to people.  But that kind of organized effort is certainly possible.


The last error in messaging is not showing a light at the end of the tunnel.  The way this is being presented now is not as a fight we can win by breaking the chain of infection and stamping out the last embers.  People are left with the idea that the only solution is a vaccine that could be years away.  


That is false.  If people can be sufficiently motivated to try hard not to become infected or to spread the infection to someone else,  this nightmare could end very quickly.  


The failure is one of imagination and determination.  The intent has to be to win by refusing to be slaves to this bit of chemistry we cannot even see.  People will get behind that idea if a highly focused effort is made to help them understand it.


Friday, May 29, 2020

Physician Group with Covid-19 Protocol





Their protocol includes:

  1. IV Methylprednisolone
  2. Vitamin C
  3. Heparin
  4. Thiamine, zinc, and Vitamin D
  5. Oxygen (when necessary)
They start it immediately.

Thursday, May 28, 2020

Fed corporate bond-buying

Buying corporate debt issues including BBB rated issues is new.

Sunday, May 24, 2020

Blood Abnormalities



"We’ve also seen really interesting derangements in the lab work. We’re seeing thrombocytosis, we’re seeing super high levels of platelet counts. And, we’re also on the other side of things — very low levels of hemoglobin and anemia — there’s no one clear clinical picture. Very high levels of ferretin. Very sky high D-dimer counts, like in the 20,000s and 30,000s… You know, I think again it’s really interesting to think about what is the pathophysiology that’s causing these derangements in lab values, and how does that translate out to clinical correlation?"

Saturday, May 23, 2020

Coronavirus Today


Overview 
Coronavirus Today is an original news publisher of research-based information related to various coronaviruses, such as SARS, MERS and the novel SARS-CoV-2.
Coronavirus Today.com is an affiliate of the Precision Vax, LLC media network, which includes brands such as Precision Vaccinations, Vax-Before-Travel, and Zika News. This trusted news network was founded in 2016, and is owned and led by Karen McClorey Hackett.

Sunday, May 17, 2020

A Path Out of this Mess




The Harvard plan lays out a way to stop the spread of the virus and get back to normal.  It requires massive testing and contact tracing.  

That massive testing would provide the foundational data needed to move to sewage monitoring to assess the level of infection within the region served by the sewage system. 



Monday, May 4, 2020

The Fed is buying junk

The US Federal Reserve is now 

Buying Junk-rated Debt

Years of near-zero interest rates led CEOs to gorge on cheap debt.  What did they do with the money?  There needs to be a rigorous study to know the details.  But some of it went to finance share buybacks to juice CEO pay.  

Now that debt is distressed, the Fed is stepping in to buy it up rather than let the bond-issuers default on it.  Just to be clear, the central bank is using fiat money to buy these junk-rated corporate issues so that bond-holders can trade this nearly worthless paper for spendable dollars.  Once again the financial industry pulls the levers and turns the dials of government to socialize losses.  Late empire corruption is in the air. 


Friday, May 1, 2020

The Amazing Tools we have Compared to 1918

Poop may tell us when the coronavirus lockdown will end

 


In 1918 humans had not yet learned of the existence of DNA and RNA.  This sewage-sampling method will be an efficient way to approximate numbers of people infected if we can work out how concentrations of viral DNA in sewage correlate to the number of people who have the disease and are shedding virus.  The figures derived so far again suggest that the infection fatality rate may be lower than it appears because so many people who have it don't have symptoms.  

Wednesday, April 29, 2020

Low Interest Rates Versus Helicopter Money


This NYT piece catalogues the implosion of corporate debt that CEO's could not resist because the Federal Reserve kept interest rates so low.  Had stimulus been in the form of simply giving people at the bottom money to spend, we would not have this junk debt hangover.  


Air Travel and Aerosols




For my wife to get back she will have to do 10 hours in the air between Moscow and DC plus a connecting flight to get to Moscow.  Probably 15 hours total including time on the ground.  I was thinking she might be able to come in July.  But the more I think about it, the risk is probably too high.  

Aerosols


This is not really surprising.  The very efficient spread on ships suggested that the infection was spreading through ventilation systems.  In hospitals, air handing is an important issue with concentrations of infected patients shedding virus particles through their exhalations and fluids.  

The hospital standard is 6 air changes per hour (ACH), meaning that all of the air in a patient's room must be replaced six times an hour.  This standard appears to have been adopted in 2001 when it was increased from 4 to 6 ACH.  This 2014 engineering article suggests that the standard is a consensus guess rather than a research-based conclusion.  

Especially if Covid-19 patients are concentrated on a single floor, which is necessary to reduce the risk to other hospital patients and staff, the concentration of particles is almost certainly quite high.   This NYT opinion piece raised the issue of dose-response and the question of whether the severity of the illness increases with the amount of virus particles inhaled.  





Sunday, April 26, 2020

Epidemic of Political Malpractice

An Epidemic of Political Malpractice

Eventually, someone is going to write a history of the 2020 pandemic.  The central theme will be that it was as much a political as a medical problem.  It will be a story of how people with political power made choices in their personal self-interest that facilitated the spread of the infection and greatly amplified its effects.   

It began with the local communist party officials in Wuhan.  This New York Times piece describes how, after the close call with SARS, a sophisticated reporting system was put in place to identify similar outbreaks and reduce the opportunity for political interference.  To the world's great loss, that system fell victim to the instinct to suppress bad news it was designed to overcome. 




It continues today with politicians who try to gain or maintain political power by opposing the only available tools of control when there is no cure and no vaccine.  Reducing the opportunity for people to infect each other is the only method we've got.  It is very disruptive.  No one likes it.  So it is easy to gain a following by criticizing it.  

The virus cannot reproduce on its own.  It requires the machinery of the human body to make copies of itself.  So human beings are the factories that make the virus.  

Humans not only make copies of the virus, they also help it to propagate.  The copies populate bodily fluids and ride them out into the world.  Some of them will make their way into another human host who is added to the virus-making productive capacity.  

The process of infection is so efficient that the growth in virus-producing capacity is geometric.  It can cause the number of virus factories to double every few days.  The power of doubling is humbling because the numbers get very big, very fast.  Half a million becomes 4 million in just three cycles.  

The opponents of the bitter medicine prescribed by epidemiology can legitimately argue that the economic consequences of lock-downs will produce bad health effects of their own.  It is undeniable that people having less money and losing health insurance will limit access to healthcare and lead to a different set of problems.   The question comes down to which set of problems is worse.  

Despite the human cost, perhaps it would be best for everyone if the "let 'er rip" approach were tested in a few places so we would have evidence of which path costs more in human suffering.  It appears likely that the US may provide some experiments of this type as officials in red states avoid adopting measures or dial back measures that are in place.  The citizens of those states will be the nation's guinea pigs, some willing and others not.  

Saturday, April 25, 2020

Thrombotic Stroke

The platelet activation by free hemoglobin was attractive as a building block for an argument that cell-free hemoglobin was behind the Covid toes and livedo reticularis that some people with Covid-19 seem to get.  The thought was that vasoconstriction caused the former and blood clots caused the latter.  That idea seems to be grinding to a halt. 

But something is going on with blood clots.  



What I can't Find

I have been unable to find anything that says whether Covid-19 patients have normal levels of nitric oxide (NO).  I have, in contrast, found multiple references to inhaled NO therapies being trialed.  

I have been looking for something to support or refute the idea that the coronavirus depresses NO levels by causing hemoglobin to leak out of red blood cells and into the blood plasma.  It was the idea that low NO levels might be causing the Covid toes phenomenon that started me down this path.  

It's not a direct refutation, but I found the reason why there is no blood test for NO.  

So if NO in the blood is always zapped within milliseconds by cell-free hemoglobin, it's hard to see how a little more spilled hemoglobin could alter the normal picture if NO is "scavenged" out of the blood in milliseconds in healthy people.  

In passing, I found this odd thread of research that says humming increases the level of NO in the nose and sinuses.   Who would have ever guessed that.   But the original research seems to have been replicated.  

So at this point, it seems there is a lot of interest in NO supplementation as a therapy.  As to the secondary question of how it helps, the answer seems to be the inhibitory effect on viral replication.  I cannot find any answer to my question about whether NO supplementation brings other bodily processes that are regulated by NO back to their normal range.  

Nitric Oxide and Coronavirus

The next search for "nitric oxide and coronavirus" led me to this paper that was published in the Journal of Virology in 2005.  It is useful to remember that the world dodged a bullet in 2003-2004 when the first SARS outbreak.  That was a classic case of a close call that was wasted.  

The Wikipedia article about it is well worth reading. 

Close calls are extremely valuable.  They alert us to a problem without our having to suffer the dire consequences the problem could cause if not corrected.  There should be a scientific discipline dedicated to the study of close calls.  Every organization should have a close call policy that requires the near-miss to be studied in detail, the causes identified, corrective measures implemented, and periodic testing done to confirm the measures have succeeded.  

Of course, we do not do this.  People hide close calls because they don't want to be criticized for whatever failing was responsible for them.  The 2003-04 SARS story foretold, in detail, what we have experienced with Covid-19.  The current narrative closely tracks what happened back then.  

It started in November, in China.  "Early in the epidemic, the Chinese Government discouraged its press from reporting on SARS, delayed reporting to WHO, and initially did not provide information to Chinese outside Guangdong province, where the disease is believed to have originated. Also, a WHO team that traveled to Beijing was not allowed to visit Guangdong province for several weeks."  [Wikipedia]  


Sound familiar?  The virus appears to have begun with bats and from spread to civets offered for sale in a Chinese wild animal market.  Bats, Civets and the Emergence of SARS  PubMed abstract only    A Chinese paper published in 2017 reinforced this conclusion.

Here is the link to the 2005 paper.  It concludes that nitric oxide (NO) impeded the SARS virus from replicating.   

Nitric Oxide Inhibits the Replication Cycle of Severe Acute Respiratory Syndrome Coronavirus.

I found a 2009 paper that cites it and proposes two mechanisms for how NO gets in the way of replication.  The chemistry is way above my head.  

Dual effect of nitric oxide on SARS-CoV replication.

This 2018 paper features chemistry that is even farther out of reach for me.  I think my weakness is in spatial reasoning, which seems useful in understanding organic chemistry. 

Post-translational modifications of coronavirus proteins: roles and function

Hemoglobin and Nitric Oxide (NO)


Continuing down the chain of associations, I tried searching on "hemoglobin and nitric oxide" and it turns out that hemoglobin, which is normally locked up inside the red blood cells aka erythrocites, can cause mischief when it escapes into the blood plasma. Once it is loose, free hemoglobin "scavenges" nitric oxide (NO), which is a very important regulatory chemical.  This reduces the available NO, messes with the regulation, and can lead to "vasoconstriction, decreased blood flow, platelet activation, increased endothelin-1 expression (ET-1), and end-organ injury...." 

As noted in a previous post, vasoconstriction is what reduces the blood flow to your toes in the cold. Platelet activation as used in this technical article, can be loosely translated as clotting. So maybe the Massachusetts investigators are on to something, but perhaps not for the reasons the reporter suggested.  It looks more likely that inhaling NO could be helpful by restoring this chemical to its normal level by replacing what was deactivated by the renegade hemoglobin.  It is not spelled out but it seems clear the authors of this technical article use the word scavenge to mean that some sort of chemical reaction happens between the free hemoglobin and NO that takes the NO out of circulation.  

Covid Toes to Nitric Oxide


The toes story talked about two symptoms.  One symptom was problems with the feet that resembled frostbite and the other was a condition called livedo reticularis.  The frostbite angle led me to search on "vasoconstriction and coronavirus."  

Vasoconstriction and vasodilation are two opposite states that our blood vessels assume, depending on the conditions.  If you break these words down, the meaning is easy to guess if you don't know them already.  Our blood vessels can either constrict or dilate.  

The more constricted the vessel is, the smaller the volume of blood that can flow through it.  Conversely, the more dilated the vessel is, the larger the volume the vessel can move.  When we are out in the cold, the vessels in our fingers and toes constrict to preserve heat.  On a hot day, they dilate so that our fingers and toes can radiate some of that heat back out into the air.  

I had never heard of livedo reticularis.  When you look it up, you see it is caused by blood clots.  So now we know that Covid-19 seems to be associated with both vasoconstriction and blood clots.  

My search turned up this story about Massachusetts General Hospital testing inhaled nitric oxide (NO) to see if it protects their staff from Covid-19.  Nitric oxide is a very interesting and important chemical the human body depends on for many different functions. 



As the coronavirus story has unfolded, I have found scattered references to hemoglobin, including comments by a medical resident with direct experience treating Covid19 patients who speculated that it was somehow important to the disease process. 

I started watching for stories with a blood angle.  This one started me off on a chain of connections that seem to be hints about what could be going on at the molecular level.  

COVID Toes