Covid-19 Heroes

At 7:00 pm everyday in many cities in Europe, people go out on their balconies and clap in honor to the medical professionals and others who are manning the frontlines.  Many have lost long time colleagues.   I decided to name three heroes out of so many who we all are depending on to help us through this crisis.

Dr. Li Wenliang is both a hero and a victim of Covid-19.  From Wikipedia:

“Li Wenliang (Chinese: 李文亮; pinyin: Lǐ Wénliàng; 12 October 1986 – 7 February 2020) was a Chinese ophthalmologist who worked at Wuhan Central Hospital. Li warned his colleagues on 30 December 2019 about a possible outbreak of an illness that resembled severe acute respiratory syndrome (SARS), later identified as COVID-19. He became a whistleblower when his warnings were later shared publicly. On 3 January 2020, Wuhan police summoned and admonished him for “making false comments on the Internet”. Li returned to work and later contracted the virus from an infected patient (who had been originally treated for glaucoma). He died from the disease on 7 February 2020, at age 33. A subsequent Chinese official inquiry exonerated him and the Communist Party of China formally offered a “solemn apology” to his family and revoked its admonishment of him.”

What made an opthamologist (eye doctor) get involved in a virus epidemic?    He could have felt his job was over once he treated the eye problem, but he didn’t,  He knew he had to share what he had learned.   It was that simple.  He was a brave doctor and undoubtedly saved lives by  informing other doctors via social media.

Since Dr. Li’s  death,   Li Wenliang’s Weibo wall (similar to Facebook)  has been filled with personal messages.   “They speak to him like they know him, calling him brother, uncle, doctor, hero, comrade, martyr, friend.” The Chinese write to him on his wall as if he is still alive and with them.  (see links below).

 

 

Another hero is Dr.  Ai Fen,  Director of Emergency Services at the Wuhan General Hospital.    She used social media also to spread the word that a virus identified as the SARS virus was infecting patients.  She says she is not a whistleblower, but she supplied the whistle.

On 30 December, after seeing several patients with flu-like symptoms and resistant to usual treatment methods, Ai received the lab results of one case, which contained the word: “Sars coronavirus.” Ai, reading the report several times, says she broke out into a cold sweat.  She circled the words Sars, took a photo and sent it to a former medical school classmate, now a doctor at another hospital in Wuhan. By that evening, the photo had spread throughout medical circles in Wuhan, where it was also shared by Li Wenliang, becoming the first piece of evidence of the outbreak.

That night Ai said she received a message from her hospital saying information about this mysterious disease should not be arbitrarily released in order to avoid causing panic. Two days later, she told the magazine, she was summoned by the head of the hospital’s disciplinary inspection committee and reprimanded for “spreading rumours” and “harming stability”.

Fortunately, she did not contract the Covid-19 virus.   I believe long after the Covid-19 virus is over,  people in China will remember these doctors and others, who help sound the alarm when authorities were resisting the truth about Covid-19 virus.  The government of China is repressive, but they can’t control both the human spirit and the will of medical professionals to share what they know over the internet.

 

 

 

 

The third hero is Captain Brett Crozier.   The following is from Wikipedia.  “Crozier was captain of Theodore Roosevelt, then deployed in the Pacific, on March 24, 2020, when three members of the crew tested positive for COVID-19. The next day, eight sailors were infected, and within a few days it was “dozens.”   (Note:  The  exponential  growth of Covid-19 had  already occurred  before  March  24  as  it  takes  time  for  symptoms  to  appear).

The sailors became ill after more than two weeks at sea. The initial cases were airlifted to a military hospital. Theodore Roosevelt was ordered to Guam, where she docked on March 27, and all 4,865 aboard were ordered to be tested for the virus. About 100 affected sailors were offloaded, and the rest of the crew remained on board. Crozier wanted to have most of the crew immediately taken ashore, saying it was impossible to prevent the spread of the virus in the close quarters of the ship. However, his superior, Rear Admiral Stuart P. Baker, believed that to be impractical and too drastic.

On March 30, Crozier emailed a four-page memorandum to 10 Navy officers. Three were admirals in his chain of command, including his immediate commander Rear Admiral Baker, Admiral John Aquilino, the commander of the Pacific Fleet and Vice Admiral DeWolfe Miller III, commander of naval air forces in the Pacific. Crozier copied the message to seven other captains, five of whom were on board the Roosevelt and two who were executive assistants to the admirals. Crozier did not email Vice Admiral William R. Merz, who was higher than Baker in Crozier’s chain of command. In the memorandum, Crozier pleaded for authorization to have most of the crew evacuated and quarantined ashore, citing the impossibility of following CDC recommendations on social distancing and quarantine procedures on the Theodore Roosevelt, a ship more crowded than the cruise ship Diamond Princess infected earlier.  On March 31, the letter was leaked to the San Francisco Chronicle, which published it.  On April 1, the Navy ordered the aircraft carrier evacuated, with a skeleton crew to remain aboard to maintain the nuclear reactor, the fire-fighting equipment, and the galley.

On April 2, Crozier was relieved of command by acting Secretary of the Navy Thomas Modly…At a Pentagon news conference on April 3, Modly said that Crozier had “raised alarm bells unnecessarily” and showed “extremely poor judgment.” Modly mischaracterized the distribution list of the memorandum, inaccurately claiming that Crozier had copied 20 to 30 other people; Crozier in fact sent the memo to 10 officers.”

Captain Crozier is on shore leave, and his case is still under review.  My opinion is simple – he saved lives the best way he could.  There are 678 seamen who tested positive, and I am certain they would like to see Captain Crozier re-instated.

Under normal circumstances, the actions of Dr. Li Wenliang, Dr. Ai Fen and Captain Brett Crozier might seem a bit extreme.  But there was nothing normal about the circumstances, and their actions in acting against convention or authorities were absolutely justified.

The president blasted Crozier’s decision to write a letter to Navy leaders pleading for help as men on his ship fell sick with the coronavirus. “I thought it was terrible what he did. To write a letter? This isn’t a class on literature,” Trump said. Later, he said he might get involved in the decision to dismiss Captain Crozier.

Stay tuned and safe,

Dave Lord

Links:

Wikipedia:  Dr. Li Wen Liang

The Guardian: Chinese inquiry exonerates coronavirus whistleblower doctor

The Guardian: Hero who told the truth’: Chinese rage over coronavirus death of whistleblower doctor

Wikipedia:  Dr. Ai Fen

Wikipedia: 2020 coronavirus pandemic on the USS Theodore Roosevelt

Daily Beast: Trump: ‘I Agree 100%’ With Navy Decision to Fire Captain Brett Crozier

Politico: Navy delays decision on reinstating fired captain who warned of coronavirus

 

 

 

 

 

 

 

 

 

Covid-19 infection mechanisms

Scientists are exchanging information around the globe.  I’ve heard anecdotal accounts of how patients  have seemed to be improving, and then suddenly have a turn for the worse.  The link below has a pretty good explanation for this.   The immune  system, according to the article below, designed to defend the body against invaders, can kick into overdrive and act  in a harmful manner (cytokine storm).  Children with a less developed immune system might not have this immune reaction hence they have more mild symptoms.  Thank God!

I think I’ll stop here, as it is better explained in the article below.

Stay tuned and safe,

Dave

Link:

https://www.bloomberg.com/news/articles/2020-04-16/your-risk-of-getting-sick-from-covid-19-may-lie-in-your-genes?sref=MKhnhvyR

The Pullout of the World Health Organization is a Terrible Decision

Covid-19 is frightening and the human toll of Covid-19 already  is staggering: 134,000 people around the world succumb to the disease.  They died alone generally unable to breath. How high the death toll goes is uncertain.   Almost every country in the world lost lives to this virus.

What could be worse?  Every medical professional standing next to Trump knows the answer.  The CDC knows the answer.    Tuberculosis,   AIDS and malaria, really in that order.   Tuberculosis accounts for 1.2 to 1.4 million deaths in 2018.  It is present in urban areas of developing countries.   The 2018 estimate of HIV related deaths is 770,000.  For Malaria, in 2018, it is 405,000 deaths.  Malaria is deadly to children under 5 years old, as 262,000 children died of malaria (67% of the total).  In Africa, they say that average life expectancy is meaningless  as the big trick in life is getting past age 5.  Incredibly sad.

So, infectious diseases are ravaging the lives of the youngest and oldest in our society.  If one survives to age 5, the next challenge will be getting past 60.  Particularly bad in parts of the world where health services are just not available.

The World Health Organization allies with other countries to fight against infectious diseases, and public health issues regardless of politics.  It recognizes that the African countries, like Nigeria, where malaria is rampant, already was in a health crisis before the arrival of Covid-19.      World Health Organization is uniting efforts to find cures and vaccines for these infectious diseases.

And the World Health Organization is making progress, particularly against tuberculosis which is generally curable and preventable.  There are new challenges with drug resistant strains.

The current preventative measures, such as social distancing, closing schools and businesses and blocking international travel are only temporary measures.   And trying to isolate the US from the rest of the world is impossible without extreme economic consequences.

We absolutely need foundations like the Bill and Melinda Gates Foundation and the World Health Organizations working with health organizations in making our planet healthier.  We need cures and vaccines developed  through scientific cooperation.  Trump’s defunding WHO,  I hope, will  last only until November 2020, when we have a new president.   The  WHO isn’t perfect, but he is using it as a  distraction and scapegoat to the US problems with mess created when the CDC test kit debacle.  See NYT article.

We are “stronger together” and we need to restore our real leadership in the world.  It is time to increase global awareness- not isolate ourselves from the rest of the world.

Covid-19 is not a US problem.  It is a global problem.

A healthier planet = a healthier US.

Stay tuned and stay safe,

Dave

Links:

New York Times Opinion

Wikipedia: Tuberculosis 

World Health Organization

WHO:  Malaria

 

 

 

End of Covid-19

The disease won’t be gone until it is eradicated everywhere.  I could say this 100 times, and to some, it really won’t sink in.

Zero new cases in New York, Madrid, Moscow, New Delhi and Baghdad. It means the day the persons with symptoms are immediately tested, and isolated. If a vaccine is developed, it has to be applied globally.    That’s why we have the World Health Organization,  Doctors without Borders and many more international organizations.   The IMF, G-7 or G-20 will also be critical on how to transition from lockdown to more relaxed rules.

I’m so tired of hearing that it is the fault of China and/or the WHO, that we have it here.   After flights from China were canceled, flights were continuing from the real hot spots, namely Italy and Spain.  US travelers in Europe and China were, whenever possible, cutting short their trips to get away from the virus hotspots and were obvious disease vectors.   There will be plenty of time later for everyone to determine what we could or should have done to prevent the spread of Covid-19.  But it’s in 151 countries now, and it is a worldwide crisis.

Stay tuned,

Dave

 

Covid-19 increases and decreases

It’s terrible to see Covid-19 exponentially increasing in many countries.  An exponential curve means the number of infected to double in a specific number of days.  If doubling occurs every 2 days we go 1 – 2 – 4 – 8 in 8 days. We’ve seen worse with Covid-19 go from 100 to 1000 in a span of 8 days.   The hope is with all precautionary actions, including frequent hand washing and social distancing, the rate of increase (acceleration)  will be less than exponential and will transition to linear.  The disease is at a stable point for health officials when more people are leaving the hospital than entering it.   The disease is in decline phase only when there is a negative trend in new cases. The fact that the disease is less than exponential in many countries, is good news, but the rate of growth is still very high and still at crisis levels.

For the data to be accurate and to prevent a premature lifting of measures, there must be testing available on demand to anyone.   I have high hopes that the US and all countries will increase their testing.  I fear a second wave, as some scientists have warned.

Stay tuned and safe.

Dave

Coronavirus Origins

Coronavirus came from an animal, most likely a bat in China.  It is positively of animal origin,  based on a number of papers from distinguished scientific organizations, such as Scripps Institute. Apparently the scientists can tell the difference.

It was not made in the US in some secret lab.  Nor was it made in China in one of their secret labs.

If you hear Tucker Carlson on Fox News, spreading this idiotic conspiracy nonsense, just turn the channel.

Links:

Scripps Institute

USA Today 

 

Go Abbott, Elon, and Gilead

Some strong positives in the war against Covid-19:

Abbott

Abbott came out with their 5 to 13 minute toaster size molecular  point-of-care Covid-19 test.  It received emergency approval from FDA.   In layman terms, the virus is opened using reagents, then the released genetic material is replicated so even extremely small amounts can be detected.   Abbott is said to be ramping up production.  I would love to see this toaster at the drive-thru testing facilities.

Gov. Phil Murphy announced at his daily COVID-19 briefing on Tuesday afternoon that Bergen County, New Jersey will be the site for a new rapid test from Abbott Laboratories.

Elon Musk

How did Musk get 1225 ventilators so quickly, when the federal government couldn’t:  “China had an oversupply, so we bought 1255 FDA-approved ResMed, Philips & Medtronic ventilators on Friday night & airshipped them to LA,” Musk said on Twitter.   I’m sure patients and hospitals couldn’t give a damn about where these ventilators were sourced.

Gilead

Gilead is conducting limited clinical trials on their drug, remdesivir, in China.  Per their  Gilead website:  “The limited preclinical data on remdesivir in MERS and SARS indicate that remdesivir may have potential activity against COVID-19.   Remdesivir is an experimental medicine that does not have established safety or efficacy for the treatment of any condition. ”  It is being referred to in the media as the Ebola drug.  It is hope to slow or block the virus replication once in a healthy cell.    Gilead hopes to have results of clinical studies by the end of April.

Stay tuned and stay healthy,

Dave

Links:

Gilead story 

The other stories are very easy to find with a Google search.

Covid-19 – Testing delays cost lives

The numbers are becoming real familiar and really frightening. These are people not statistics.  I trust the professionals and their advice. All of it.

When someone is tested positive, it means that that person has been ill and potentially transmitting the disease, for days before the onset of symptoms.   This is the time lag, is the sum of the days in which the infected person had no symptoms, days with minor symptoms, days until the  patient can see a doctor and confirm that the symptoms are sufficiently  similar to Covid-19 (frequently a requirement for a test),  days until a test was performed, and days until the results were known and treatment begun.

Days + Days + Days + Days + Days = total time lag.   Surviving Covid-19 depends on early detection.   The last 3 lags occur from  the point of “flu like symptoms”  to  confirmed positives, and have to be shortened.   When I heard that in Miami, it takes 5 to 7 days from when a person is swabbed to a confirmed positive or negative, I was shocked, because this rules out early intervention.  These antiviral drugs are not working for late stage patients.  They may slow down the disease progression but not prevent death.    Testing areas in Miami and everywhere else are overrun.  Home swabbing has run into some real obstacles.   All this delay costs lives.

This also means that the new positives data, which show an exponential curve  are based on  old data.   The first light at the end of the tunnel is a decline in new positives.  Get ready for false lights, because a solid trend in the decline must be established.  Where some communities might be turning the corner, others will still be solidly on the all frightening exponential curve.  Early lifting of containment efforts can easily destroy the progress made.

Stay tuned,

Dave

 

 

Covid-19 Drive Thru testing in South Florida

The link below provides basic information on drive through testing in Miami, Broward and the Keys.

Drive Thru Testing in Miami

C.B. Smith Park site was closed after enormous lines.  A hotline for scheduling appointments has been activated.

https://wsvn.com/news/local/broward/officials-launch-pre-screening-hotline-to-expedite-drive-thru-covid-19-testing-at-cb-smith-park/

It is  truly heart wrenching to know so many are in need of tests, and the delays in getting results can be a week or more.   There are faster ways to process the swabs,  but it takes time to get the equipment.

Start up home swabbing companies have stopped sending kits.   There are concerns of false negatives from home swabbing.

Things look bad.

Dave

Coronavirus drive thru testing

I am very focused on the drive thru testing.  How is it working?  Who qualifies and who doesn’t? How long does it takes to get the results?

I am focused on four counties in South Florida, with a combined population of 6.4 million people.   I will dispense with any political commentary.

A lot is going wrong.  Some things are going right.  Those working in the hospitals, clinics, and testing centers, thank you so much.

I just want facts.

Stay tuned,

Dave

 

Drive thru’s testing Covid-19

As a public service, I will attempt to list the names, addresses and phone numbers of any drive through Covid-19 facility, which is accepting new patients, which has recently opened in 4 Florida counties: Broward, Palm Beach, Miami-Dade  and Monroe Counties.    I will start with Miami, Florida where I have better access to information.  It is likely to be a daunting task, because drive thru’s open, get mobbed and then close.   They set up telephone numbers to screen out people.

Anyone who wants to get tested, may not qualify.    Community Health of South Florida says it will begin testing patients Wednesday at its Doris Ison Health Center, 10300 SW 216th St, in Miami, FL.  Their phone number is 305-252-4820.   This is the only drive-thru testing facility in Miami-Dade County.   A link from WSVN is provided below.   Testing will be done from 9:00 am to 12:00 noon.   Do not call just to find out how testing is going, wait times or who qualifies or not.  

Testing will be done only for regular clients who have called ahead to make sure they meet certain criteria.  To be eligible for the test, patients must have recently traveled to any of the affected countries or have been in contact with someone who has the novel coronavirus. They must also be experiencing symptoms such as fever, cough or shortness of breath. The nonprofit is asking those with severe symptoms to visit a hospital ER instead.

I assume this “regular clients” qualifier means a lot of people will not qualify.

Stay tuned,

Dave

Local News Link:

https://wsvn.com/news/local/community-health-of-south-florida-begins-drive-thru-covid-19-testing-in-swmd/

Coronavirus vaccine

Experts estimate it will take 12 to 18 months for a vaccine to be developed and deployed. There may be setbacks or unexpected successes, changing this estimate.   Please disregard any political noise on this issue.    Any vaccine will need animal testing trials.

I found the following link very interesting as why it takes so long:

From ferrets to mice and marmosets, labs scramble to find right animals for coronavirus studies

Here are the opening lines:

One lab is digging into its freezer to thaw out the archived sperm of SARS-susceptible mice. Another is anesthetizing ferrets so they don’t sneeze when the new coronavirus is squirted into their nostrils. Yet others are racing to infect macaques, marmosets, and African green monkeys.

One of the main points is that coronaviruses are not new to scientists. The SAR’s virus is a coronavirus.  But Covid-19 is a different one, coming with new complications.   Apparently,  the good guys in our body’s defense (the immune system) might end up making things worse as it can result in “a violent inflammatory response to a viral intruder.”  Scientists refer to this as the host immune response.  The critters used in experiments need a response as similar as possible to the ones in humans.

Science is supposed to build on prior knowledge, but can only do so if the past viruses are similar in their attack and host response.  In novel coronavirus, it looks like nature has thrown a curve ball.  For SARS –  the golden Syrian hamster “an excellent model” according to the above article.

Now we get to the crazy part.  Testing may be most effective using genetically altered mice.  “Give the rodents [mice]  human receptors, either inserting the molecules locally in the respiratory tract or breeding mice that have virus-susceptibility wired into the entire body’s DNA.”

These  special mice used for testing will likely come from two sources:  Jackson Laboratories in Bar Harbor, Maine (see link below) and University of North Carolina.    The best line of the article is:

Now, researchers are rushing to figure out which creatures work best, a task that could take months. “We’re at the ‘Uh oh, it’s complicated’ stage,” said Lisa Gralinski, a microbiologist and assistant professor of epidemiology who studies coronaviruses at the University of North Carolina at Chapel Hill.

It’s absolutely complicated and really all the stuff about receptors and the virus sneaking inside a cell is beyond my high school level of biology.  But I immensely appreciate the author’s help in breaking down these concepts.

I also know of Jackson Labs, one of the great non-profit organizations.  It recently celebrated its 90th anniversary.  They will likely not be discovering the right vaccine, but they will be providing one critical element – the transgenic mice to research groups around the world.

My impression is we’ve got excellent research organizations and laboratories who are working around the clock on coronavirus.  There is an immense knowledge sharing worldwide.

Unfortunately bottom line is testing  of the many possible vaccines is challenging.  Finding the right test animals and creating a sufficient stock is one of the challenges.

Stay tuned,

Dave

Links:

Jackson Labs – Coronavirus

Notice from Jackson Labs:  We are now accepting pre-orders for the K18-hACE2 transgenic mouse model for coronavirus research.

An air-locked lab at UNC is leading research on cures for the coronavirus

Coronavirus, the flu shot, etc.

I got my shot in September of last year.  It was given free at CVS.  I’ve read enough on legitimate websites to convince me to get the shot.  Every year a lot of people will get the flu and some will show up at hospitals and doctor offices wanting to be tested for Covid-19.   I don’t want to be in that group if I can help it.   The flu shot doesn’t help your resistance to Covid-19.   Fewer folks with the flu this year means more effective Covid-19 testing.

I will also not buy a mask.  The surgeon general says it doesn’t help keep you from getting Covid-19.  Sure, doctors, nurses and dentist use them.    But they are in intimate contact with a lot of ill people.

I will travel outside the US.  Travel to me is one of life’s pleasures.  Fortunately, cruises have never been a part of my plan.

Stay tuned,

Dave