I'm questioning "sick enough." Perhaps the degree of sickness warranting hospitalization is lower for younger people. Should the care be used on the sickest people or on the ones most likely to benefit from care?
Anyway, it's important for people who are faced with the effort of social distancing to see that youth is not immunity. Though "20 to 54" is a big category. What about those under 40? Under 30?
Here's a closer look from the underlying CDC report (also on this table):
As of March 16, a total of 4,226 COVID-19 cases had been reported in the United States, with reports increasing to 500 or more cases per day beginning March 14 (Figure 1). Among 2,449 patients with known age, 6% were aged ≥85, 25% were aged 65–84 years, 18% each were aged 55–64 years and 45–54 years, and 29% were aged 20–44 years (Figure 2). Only 5% of cases occurred in persons aged 0–19 years.It's easy to know how old each person is, but the differences may have more to do with each person's health and strength, which correlates roughly to age. If so and if anyone is thinking that those who vulnerable to this disease should accept their fate and not expect so much sacrifice from the rest of us, they ought to realize that it's not just about old and young. It's about weak and strong.
Among 508 (12%) patients known to have been hospitalized, 9% were aged ≥85 years, 26% were aged 65–84 years, 17% were aged 55–64 years, 18% were 45–54 years, and 20% were aged 20–44 years. Less than 1% of hospitalizations were among persons aged ≤19 years (Figure 2). The percentage of persons hospitalized increased with age, from 2%–3% among persons aged ≤9 years, to ≥31% among adults aged ≥85 years. (Table).
Among 121 patients known to have been admitted to an ICU, 7% of cases were reported among adults ≥85 years, 46% among adults aged 65–84 years, 36% among adults aged 45–64 years, and 12% among adults aged 20–44 years (Figure 2). No ICU admissions were reported among persons aged ≤19 years. Percentages of ICU admissions were lowest among adults aged 20–44 years (2%–4%) and highest among adults aged 75–84 years (11%–31%) (Table).
Among 44 cases with known outcome, 15 (34%) deaths were reported among adults aged ≥85 years, 20 (46%) among adults aged 65–84 years, and nine (20%) among adults aged 20–64 years. Case-fatality percentages increased with increasing age, from no deaths reported among persons aged ≤19 years to highest percentages (10%–27%) among adults aged ≥85 years (Table) (Figure 2).
From the NYT article:
The report included no information about whether patients of any age had underlying risk factors, such as a chronic illness or a compromised immune system. So, it is impossible to determine whether the younger patients who were hospitalized were more susceptible to serious infection than most others in their age group....
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87 comments:
Yeah, this will make Achilles and Yancey believe this is a real problem now lol.
Virus conspiracy theorist are common here and you just roll over and accept it. Will you accept their ignorance if it puts you or Meade in the hospital?
The CDC is guilty of self serving. Their past decrees have been shown to be less than an accurate assessment of facts, known data. The CDC is NOT going to let this pandemic go to waste. A Big budget increase and at least one new directorate is on the wish list. The fiefdom will grow.
I wonder what a "virus conspiracy theorist" is.
It's so interesting that the symptoms vary so much. Some people show no or few symptoms, while others like this man suffer terribly. Obviously he was healthy if he runs five miles a day, and he is not elderly. I know a woman who has it, and she has a fever and a cough, but it's not that bad. I wonder why?
Browndog, someone who insists this is just Democrat media hype or peddles a conspiracy theory about this being around in China since late last summer.
Just go back a couple weeks and read Achilles or Yancey or the many others who still peddle insane theories here.
Just be patient, one will show up.
I am suspicious of anyone who labels something a "Conspiracy theory" or calls someone a "denier".
Lately, people who have tried to shame skeptical voices don't have a great track record. The UV Rape Case, the Hillary isn't sick, the Kavanaugh is a rapist, the Russian Conspiracy....all things people were shamed about doubting.
As long as they aren't putting anyone in real danger, you should be grateful for those who dare to question. It's what this nation is about. We'll see who is right and who is wrong on the other side.
The last thing Yancy is, is insane.
I think it's interesting there were the THC vaping deaths- lungs lungs lungs- and now Coronavirus- lungs lungs lungs. And I wonder if the TCH vape pens came from China? This is definitely the year of the lung deaths.
While it's definitely true that younger people are neither immune nor immortal, the NY Times headline is fairly misleading.
The numbers for ages 20-44 are still: <0.2% mortality, <2% admitted to the ICU, <20% hospitalized.
And if I'm reading the table correctly -- 0.1-0.2% mortality times 705 cases means there's been exactly one (1) death in the 20-44 age cohort, despite it being the single largest cohort of cases.
Does anyone know how to make graphs any more?
Just go back a couple weeks and read Achilles or Yancey or the many others who still peddle insane theories here.
I read them in real time. After several days I published a comment for all to see that I was inclined to agree with Achilles. Not a popular thing to do at the time.
A few days later I was firmly in his camp, and have yet to find anything Yancy says I disagree with.
I AM YOUR CONSPIRACY THEORIST.
MayBee said...
I think it's interesting there were the THC vaping deaths- lungs lungs lungs- and now Coronavirus- lungs lungs lungs. And I wonder if the TCH vape pens came from China? This is definitely the year of the lung deaths.
YES! i'm STILL waiting for a illness breakdown, for smokers/non smokers
The closest i've seen, is some talking head causally mentioned that CHINESE deaths were overwhelmingly male; on account of because
But i Still haven't seen any figures. Anybody?
Also, what has this crisis done to recreational marijuana sales?
MayBee said...
I think it's interesting there were the THC vaping deaths- lungs lungs lungs- and now Coronavirus- lungs lungs lungs. And I wonder if the TCH vape pens came from China? This is definitely the year of the lung deaths.
Makes sense because our politicians banned everything BUT THC vaping after several THC vaping deaths.
Don't touch our weed!
The table is a lot more useful in picturing the data than all the words describing it. One odd thing is that if you are >85, you are more likely to die than be admitted to the ICU.
Are they figuring it is hopeless or are the really old people dying so rapidly that there isn't time to move them to the ICU?
I agree completely with MayBee [nearly always, as a matter of fact, because she’s one of our most sensible commenters]. As soon as someone starts deriding someone else as a “_______” I stop listening. It’s obvious the fun for that person is in the name calling.
MayBee said...
I am suspicious of anyone who labels something a "Conspiracy theory" or calls someone a "denier"
The Debate is OVER!
Science has AGREED!
The Consensus of the Scientific Community!
Near-unanimous acceptance of the evidence!
MayBee, I am sure the Achilles types in Italy thought they weren't creating any harm either.
Until recently any time someone said something certain people didn't like they would just reply with "BENGHAZI!", implying a 'debunked' conspiracy theory to shut down debate.
Fear plays a prominent role in young Americans' lives. Anxiety over school shootings and crime, economic insecurity, etc. Is it surprising that they're hypochondriacs who demand drugs they don't need and fail to take the ones they do? Consider the following (medical) definition:
Hypochondriasis is an excessive and persistent fear or belief that one has a serious illness, despite medical reassurance and lack of diagnostic findings that would warrant the health concern. If a medical disorder is present, the distress and preoccupation exceed what the patient’s physician considers reasonable.
This definition fits these kids to a tee. But they are friggin' huge and unhealthy. Maybe they have good reasons to be paranoid that Covid 19 might affect the obese in a more deadly manner? I don't know. I do sort of wish they wish they'd go on diets and get some exercise. I mean, what the hell?
Finally, some actual data out of the CDC. I refer to Table 1 from the article linked. On the CDC website, under number of new cases, the CDC shows four straight days of zero new cases, which follows a declining number from the high point of 135 one day last week.
Table 1 shows new cases rising and the high point was about 1,000 on 3/15, Sunday. A very different picture!
I left out something. The CDC has done an awful, awful job.
So closing colleges and schools is more for the protection of the employees than the customers.
An interesting thing showed up on my Facebook feed yesterday, written by a friend of a friend in Hong Kong (both of them, the friend and the friend of a friend):
Guide to slow down the spread of new coronavirus
Basically, what day-to-day life in Hong Kong is like at the moment. Boils down to "treat all surfaces and objects as though they were smeared with dog poo".
If so and if anyone is thinking that those who vulnerable to this disease should accept their fate and not expect so much sacrifice from the rest of us, they ought to realize that it's not just about old and young. It's about weak and strong.
It’s called natural selection. If Mark, for example, has blown out his alveoli by tugging on his meth pipe, I don’t see why one-fifth of the US work force have to lose their jobs.
- Krumhorn
"and have yet to find anything Yancy says I disagree with."
I love Yancey, but he keeps pushing this unsupported theory that the virus has been around a long time, without explaining why it only recently began killing lots of people.
I have previously posted that "Nobody knows anything."
I'm retracting that statement.
What I know, for sure, is that, whether the Wuhan virus turns out to be the Spanish Flu x 1000, or our typical seasonal flu, or (most likely) something in between, this will happen with certainty:
Attempts will be made, with some degree of success, to use this crisis to extend government control over American citizens. We have the TSA, with its Security Theater, due to 9/11. Going forward, we will have, at a minimum, a streamlined mechanism to shut down the country and its economy with the flipping of a metaphorical switch by the President, or worse, some unelected bureaucrat at FEMA, whenever it becomes convenient for the right people.
I know this for sure.
Except this actually is more than the seasonal flu if you dig into medical literature. Here's a really good write up that pulls it all together - with, surprise, a possible way to blunt the potential serious fallout if you get Covid-19 aka SARS-CoV-2.
https://www.evolutamente.it/covid-19-pneumonia-inflammasomes-the-melatonin-connection/
Not to mention the seasonal flu does kill thousands every year so it's obvious we are crap at mitigating that spread, and it is much less contagious. Plus, the aftermath of recovery from flu doesn't usually come with the potential for serious, even debilitating lifelong lung damage.
I am, as I've said elsewhere, concerned with overwhelming our health services if it breaks big because of asymptomatic transmission that has been occurring even as we speak. And the overwhelm will in turn have ripple effects for those who may need treatment from serious illness or injury - say heart attack, stroke, car wreck, seasonal flu - other than this virus. Steps now are about flattening the curve peak by reducing transmission. About staggering the patient load. Other parts of the country are already feeling the impact of a growing, symptomatic cohort and seeing growing numbers of verified infected .
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Let's do a run through. Most recent reports I'm reading - although this is fluctuating constantly at this point - say a coronavirus can live on various surfaces for 24 hours up to several days. Your mail carrier is an asymptomatic carrier. He's delivering mail. Did he sneeze or cough into his hand just before he grabbed your mail bundle, shove it in your box, cough into his hand again before closing the box? Did you hear him and go outside immediately, open the box that he just touched, grab your mail, take it indoors and toss it on your table, where you sit down to finish eating your chips and sandwich while you sort through it? You may now be infected.
How many people, when gathered in a group, 50 or less or even 10 or less, stay 6 feet away? Take a tape measure and extend it 6 feet from your body. Yeah. Didn't think so. Why are you gathered to begin with? I encourage you to research about the viral load in the throat of a person just at the beginning of the illness. Might have a headache, feel a bit tired, but hey, who doesn't have headaches and feel tired these days. They can spread the virus simply by exhaling, no cough needed to warn you to stay away.
And let's not even talk about the thousands of 18-22 year olds who are flooding the beaches in Florida and South Texas for Spring Break. They are potential disease carrying vectors that will be flooding back into the states in short order.
This is about being creative in our efforts and abilities to keep the economy running in spite of the steps that are needed to, in effect, starve the virus for lack of hosts. People are not taking precautions and seem incapable of doing so without local, state, and federal authorities going draconian. I am not a fan, but there it is.
This is a potentially serious/very serious/deadly illness for thousands of people. And serious, and creative, responses are needed to beat this thing down while attempting to keep the economy afloat. It's a balancing act where over reaction may cripple the economy and under reaction may kill thousands. Not really wanting to add to the seasonal flu death statistics, cripple healthcare, and potentially still cripple, or hopefully only just stagger, the economy as it tries to absorb mass quantities of workers unable to work because they are now too ill.
Click here to go to an interesting read on rapid dissemination.
Going forward, we will have, at a minimum, a streamlined mechanism to shut down the country and its economy with the flipping of a metaphorical switch by the President, or worse, some unelected bureaucrat at FEMA, whenever it becomes convenient for the right people.
I know this for sure.
I couldn’t agree more! I have thought that this “social distancing” stuff could be more aptly called “social conditioning”. We are being trained to do as we’re told by the gub’ment which is mostly staffed by shiny-pants’d fellas named Mark
- Krumhorn
Sounds to me like "Mark" is into conspiracy theories.
The Panic continues
Karen, I clicked through.
Haven't read through the whole article, which appears well researched at first glance, but the Abstract states, "We estimate 86% of all infections were undocumented."
Leaving out the many important variables that go into the determination of that 86% factor, it means that the all-important denominator in all of our equations is off by a factor of >7. The containment ship has sailed. Rather than kill our economy as we are doing, why not assume that the vast majority of Americans will be exposed and concentrate our resources on those most at risk- old, immunocompromised.
We can't do what can't be done, but we can quarantine a small minority who will benefit from it.
From my previous "melatonin connection" link if you didn't want to wade through:
"SARS-CoV viroporin E proteins form protein-lipid channels in cell membranes that allow passage of calcium ions. These ion channel movements involving calcium are specific triggers in the activation of NLRP3 inflammasomes, resulting in the overproduction of pro-inflammatory IL-1β cytokines. Calcium transport through these E protein ion channels initiates the cascade of cytokine production that may eventually result in uncontrollable cytokine storms, and ARDS/ALI in bilateral interstitial pneumonia.
Ionic disturbances at the cell level is the reason why coronaviruses like SARS-CoV can have such immense impact on causing severe immunopathological consequences and disease progression that spiral out of control in infected..."
(Here's a tinfoil hat pro tip. 5g affects the body's voltage gated calcium channels. Microwave non ionizing radiation has this downstream biologic effect. And evening blue light from all the tech we constantly have in our faces totally jacks your circadian rhythm, and thus melatonin.)
The next good part:
"Selenium is a strong scavenger of free radicals. Selenium is believed to be effective against viruses such as Ebola, HIV and influenza A virus [47, 48]. However, selenium is also a powerful inhibitor of angiotensin-converting enzyme (ACE) [49]. Patients suffering from cardiovascular diseases, hypertension and diabetes are often prescribed drugs that inhibit ACE.
The use of selenium during COVID-19 infections therefore, can be problematic. ACE inhibitors actually INCREASE expression of ACE2, and SARS-CoV-2 infects host cells through binding with ACE2 receptors [50]. ACE2 receptors are found on lung epithelial cells, intestines, kidneys and blood vessels. Thus using ACE inhibitors either through medication or supplements risk elevating COVID-19 infection and developing severe or even fatal disease complications [51]."
"Melatonin, nitric oxide and ascorbic acid (vitamin C) are all inextricably intertwined and deeply involved with ACE2. Melatonin, nitric oxide and ascorbic acid can reduce COVID-19 virulence by inhibiting NLRP3 inflammasomes to stop the perpetuation of cytokine storms..."
Asians, especially Asian males, express more ACE2 receptors. Who knows with our general population. And how many people are on ACE inhibitors?
Make of this what you will.
Thanks, WTIC, appreciate the feedback on the details. I admit I don't have the math skills to follow up on things like that.
And I am not opposed to you concluding words at all. I shudder at what this is doing to the economy and the fallout from all of this.
Interesting article on Taiwan, and the WHO. Apparently the new boss is the same as the old boss!
https://thefederalist.com/2020/03/11/what-the-rest-of-the-world-can-learn-from-taiwans-success-containing-coronavirus/#.XnLdubUT2t4.twitter
Most of these reports are garbage. Interesting that the Professor put up the CDC and that Greenland Ice melt articles. Makes me question the data and how it’s extrapolated (not the data itself, facts are facts, but based on what’s presented and what’s left out it can be very misleading) and the conclusions drawn are often just hysterical click bait.
This is what I saw today on the news:
Claim: “It’s not just impacting old people”
Data Breakdown:
Age 0-20 low number cases and deaths
Age 20-64 bigger number of cases and deaths
Age 64-84 bigger still
Age 85 and up huge
Why break it down there? Average lifespan is less than 85 isn’t it?
Why such a huge group between 20-64? How many of those cases were 20-59 and how many were 60-64?
I’m guessing most were 60-64.
Where you draw the line matters and makes it valuable data or misleading data.
Sorry. Just show me the facts, let me ask questions and dig deeper, and then I can make my own determination of how hysterical to get.
"Should the care be used on the sickest people or on the ones most likely to benefit from care?"
The answer is obvious, and triage should start now.
Good column by Holman Jenkins in the WSJ yesterday, the first rational assessment of the clampdown. In normal medical decision-making, value of a QALY is 50 to 150K. Currently, even in worst-case scenarios, considering the limitless cost incurred, QALYs are valued at orders of magnitude more. That makes no sense and is not sustainable. Something will have to give, as it already has in Italy.
This is not an argument against distancing and low-cost efforts to "flatten the curve." But as Herb Stein's law says, what can't go on, won't.
80,000 people died from the flu last flu season.
Not to mention the seasonal flu does kill thousands every year so it's obvious we are crap at mitigating that spread, and it is much less contagious
I don’t believe that has been established. The CDC reports that the 2017-2018 flu season saw upwards 46 million people sick, 800,000 hospitalized and 61,000 deaths. And that was with vaccinations generally available. Dr Amesh Adalja of the Johns Hopkins Health Safety Center says that the R0 of the C19 is in the general range as the flu, but well under R3. Maybe it’s slightly more contagious but it’s in the same class, and it is transmitted in the same way.
This virus will always be with us. It cannot be contained, and it will be the fifth Coronavirus that we will annually encounter along with the 4 that causes colds. It will, ultimately have a mortality rate with upper bounds of .6% which is at least twice as high as flu. So unless there is an effective vaccine or anti-viral treatment, there will be croaking every year.
- Krumhorn
"I love Yancey, but he keeps pushing this unsupported theory that the virus has been around a long time, without explaining why it only recently began killing lots of people."
You pass the reading comprehension test.
It's amazing how many people are willing to go along with this theory here.
Meanwhile the personal insults pile up from Dr K and Krumhorn, because they're trolls when people don't kiss their ass.
"The use of selenium during COVID-19 infections therefore, can be problematic."
My personal takeaway is: don't eat Brazil nuts for awhile. How'd I do?
I don’t believe that has been established."
Can't establish it if you aren't testing for it. Even people exhibiting best case symptoms have been told over the course of the last couple of weeks, unless you are dying, don't come in. I know. My best friend, a teacher, likely has it and was told exactly that. But they don't want her coming in for a test. She is 45 and weathering it, but it's been rough.
I agree. It's here. If we've managed to flatten the curve by luck because a large cohort of people have had this and thought it was regular flu, or just a cold (and thus went on about their daily lives spreading it further), then we may have seen our peak. At this point we simply don't know. We haven't tested. How many dead from what seemed to be regular flu - no testing was done - may have been this? This really is about the ability to structurally handle a wave of very sick people who may need critical care. We're looking at dumping a lot more people into a system that already is dealing with those flu stats everyone likes to quote.
Except for the thousands of college age spring breakers who are going to set off potentially another wave, we're golden.
Some interesting numbers from S Korea's CDC (who did extensive testing) and the Princess cruise ship (a virtual incubator).
https://spinstrangenesscharm.wordpress.com/2020/03/18/covid-19-interesting-data-from-korea-and-from-the-diamond-princess/
I get a (free) daily email newsletter from David Leonhardt of the NYT. Well-written descriptions of the conventional wisdom in the Acela corridor. Today’s letter concerns the various motivations for hospitals to order more ventilators. He makes a valid point that these are expensive machines and that they will likely sit unused once this pandemic passes.
All true, and completely irrelevant.
The limiting factor in treatment of severe lung disease is not ventilators, or ICU beds. It’s people. Highly trained nurses, physicians, respiratory therapists, and (often forgotten) maintenance engineers who run the systems. A ventilated patient consumes tremendous amounts of manpower, already in short supply. There is not a lot of flexibility in the system either. You can’t take an orthopedic surgeon, a pediatric nurse, and a speech therapist and convert them into a team capable of competently running a ventilator without several months of retraining and experience.
Or, we could declare a moratorium on legal liability for health care workers who do their best but get bad results. That will happen when the Venn for lawyers and legislators has no overlap.
Getting back to my original point, there is a lot of stuff being put out there that is wrong. This is some stuff that is right. Most of the stuff that is right is irrelevant.
Nobody knows anything.
I love Yancey, but he keeps pushing this unsupported theory that the virus has been around a long time, without explaining why it only recently began killing lots of people.
My (life long Democrat) wife believes that she acquired the virus in February. She was sick as a dog for three weeks and could barely breath at one point. She is now recovered and back working out with her friends in the running club. Many of them believe that the virus passed through the Tucson area this January because their symptoms were quite similar and unusual.
That is an unsupported theory, but it seems reasonable to me. It could be that it is only recently "killing people" because deaths were not ascribed to the virus until recently. People are always dying. It is not clear to me that we have a spike in deaths in this art (or any part) of the country.
I wonder Mark, if your issues with Yancy have more to do with politics.
Well, we her aren't the only ones skeptical of the reaction to this: A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data
Key 'graph, IMO:
If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths. This sounds like a huge number, but it is buried within the noise of the estimate of deaths from “influenza-like illness.” If we had not known about a new virus out there, and had not checked individuals with PCR tests, the number of total deaths due to “influenza-like illness” would not seem unusual this year. At most, we might have casually noted that flu this season seems to be a bit worse than average.
"I don’t believe that has been established."
Can't know if you aren't testing. And we aren't.
I am hoping that a lot more people than we realize have had it and have recovered or are recovering. Lot of sick people with awful respiratory issues starting in about October last year, but really bad just before and just after New Year's. I know several, including my sister. Tested negative for flu. In another case, wouldn't even do a flu test just said it was an upper respiratory infection and gave her antibiotics. Told her unless she felt like she was dying to stay away. Self reporting I'm seeing on pages I follow where, in many cases, they are still clamoring on that this is all a get Trump hoax, are saying they think they already had it or know someone who they think does.
A nurse friend of my daughter had her spidey sense peaked, too, based on what she was seeing at the clinic where she works and started doing an informal query. She had over a hundred "yes!!" at my last count just from her friend cohort.
I'm hoping she's right about a peak in January/February and that the measures taken now might squash it entirely before it gets real for our medical system. If so, we just might be spared an Italy situation.
And then I probably get to get really irritated because I'll be hearing the cranks on the Left bleat on about how Trump overreacted and crashed the economy yada yada yada. And the idiots on the Right will claim it WAS all a hoax to get Trump and now the economy has been crashed yada yada yada. And we'll have 120 million or so right back at each others throats and will have learned nothing.
Thank you. Thank you for the quotation marks, Michael K.
Every time I see him comment, I cringe.
Just look at your own words and actions and ponder this. A little self reflection might be good for the soul.
I love Yancey, but he keeps pushing this unsupported theory that the virus has been around a long time, without explaining why it only recently began killing lots of people.
Actually, we don't know that it only "recently" began to be fatal. We only know that they are able to determine now cause of death.
It may very well be that some unknown "something" that was not regular flu went around during flu season, and it may very well be that many people who had that unknown something died. But they are long buried and no one is going to go dig them up to test them.
I do know from personal experience that people I know had a mysterious something that was worse than usual and lingered and in at least one case really floored the guy. What was it? Could it have been corona? We cannot exclude the possibility.
Even assuming the underlying data is accurate, that CDC report and the way they presented the data is suspicious. Why did they lump ages 20-44 together, a range of 25 years, when they used a range of ten years for all other age groups except children? Why not separate 20-34 from 35-44? Is it because the numbers for 20-34 are incredibly low, similar to those for children? Notice that the total number of cases for the 20-44 is only about 65% larger than for 45-54 despite that age range being two and a half times as large.
This report isn't about science or truth; it is about trying to scare young adults.
What I also know is that all this ad hominem berating and name-calling and insults and hostility -- which already were quite tedious and caustic -- are at the present time especially unhelpful and poisonous.
They have become part of the problem. And they are at risk of permanently destroying any and all social comity.
@Karen of Texas
“Make of this what you will.”
Makes sense that it’s a bad idea to increase ACE 2 receptors, since the virus uses them. So many older people are on Ace Inhibitors, so the increased mortality in this group makes sense beyond just the typical co-morbidities in that age group. I’ve also been hearing about the of anti-inflammatory use by critical Covid patients and there seems to be some thinking that the use of anti inflammatories should stop in the treatment of Covid patients. I read that anti-inflammatories were in higher use in Italy as compared to other European nations who used Tylenol more for fever and pain in the treatment of Covid patients.
I wonder if the use of Calcium channel blockers would be of benefit to disrupt the way the calcium ions travel, mitigating a cytokine storm.
Thanks for a fascinating comment and link. We are going to be learning so much about how this virus works, hopefully it will be sooner rather than later.
@Inga
I've read that as well, about anti-inflammatories being a bad idea with respect to treatment for this virus.
Another thought on Ace inhibitors, one of the side effects is angioedema. It can happen in the face, lips and airway which can be deadly quick and in the gut. There were people who were presenting to the ER with extreme gut pain and diarrhea, they did the typical work ups and the typical reasons for these symptoms was not found. They saw a pattern of people with these symptoms who were on Ace inhibitors and when taken off, within 4 days the symptoms ceased. They’ve since found that there is a subset of people who do not tolerate Ace inhibitors at all and cannot ever take them again. Another side effect of Ace inhibitor use is a dry nagging cough.
When ACE is inhibited, bradykinin increases. Bradykinin is associated with the increase of the inflammatory processes. I’m not sold on the anti inflammatory connection though, nothing yet from the WHO on that.
Thanks for the feedback, Inga. I am not a doctor or a nurse and cataloguing such feedback helps me to at least be aware so if this knocks at my door and goes bad, I at least have a clue. Trying to limit damage where and if possible.
"What I also know is that all this ad hominem berating and name-calling and insults and hostility -- which already were quite tedious and caustic -- are at the present time especially unhelpful and poisonous.
They have become part of the problem. And they are at risk of permanently destroying any and all social comity."
The problem is that both "sides" do it. And both are equally certain they are justified. In many cases don't realize they do it - or absolutely don't think that's what they are doing. We've become entrenched.
Just because I'm willing to support the president on this current path doesn't mean I blindly agree with or "follow" him down just any old path. Others "entrenched" force me to defend certain of his actions and paths. It's generally a bad idea to paint everyone in a group with a broad brush. Or, actually, to continually divide people into groups - where they can then be more easily otherized. Or the whole divide - conquer thing. It tends to rile them up.
Conservatives don't operate as a monolithic, unthinking block. Nor do Republicans. Liberals, progressives, Democrats?
People don't see individuals anymore, human beings with faults and failings, with past traumas and ugly experiences - histories you know nothing of that shaped that person into who they are. For better or worse, we all have back stories. Nobody cares anymore.
@Inga-
Coincidentally I was just reading a study that found the opposite about ACE2 receptor expression. The authors expected high expression in the most vulnerable populations but found the opposite.
https://www.preprints.org/manuscript/202003.0191/v1/download
They also speculated that Losartan might be protective, and this study also looked at that possibility.
Ugh, links not working (don’t seem to work with https URL, is there some way to change that?)
Anyway, hers the Losartan study:
https://www.cambridge.org/core/services/aop-cambridge-core/content/view/196AA8922246C70F26BC8F0B72C6533A/S0899823X2000080Xa.pdf/potential_protective_role_of_losartan_against_coronavirus_induced_lung_damage.pdf
Although I understand to some degree the idea that people are less alarmed by a disease claiming lives of the elderly, I feel people go too far when they dismiss this on those grounds.
Similarly, so far the reaction to young people dying has frequently been “they were probably smokers!”
I wonder, if it ends up being a genetic predisposition, will the reaction change?
"Though "20 to 54" is a big category."
Exactly, and the group that is most out and about with work, shopping, travel, etc. They should be even more of the cases.
“Ugh, links not working (don’t seem to work with https URL, is there some way to change that?)”
Thanks C Stanley, more interesting studies to read!
@CStanley - what Inga said.
Tom T. said...
"and have yet to find anything Yancy says I disagree with."
I love Yancey, but he keeps pushing this unsupported theory that the virus has been around a long time, without explaining why it only recently began killing lots of people.
3/19/20, 7:53 AM
I don't know what Yancey would say but the answer is obvious.
The number 4 killer in the USA is respiratory disease. Bronchitis, asthma, emphysema, etc.
Over 100,000 people die of this every year.
Someone comes into the hospital, they're already sick with one of these things (as seems to be the case with many who are already dying) and the chalk it up to a respiratory problem instead of the WuFlu.
Now they're testing so that won't happen.
“I wonder, if it ends up being a genetic predisposition, will the reaction change?”
https://www.thailandmedical.news/news/breaking-coronavirus-research-reveals-that-people-with-blood-type-a-have-higher-risk-of-contractingcovid-19-compared-to-blood-type-o-which-has-a-low
“Coronavirus Research : An interesting new non peer-reviewed study that was conducted by 19 Chinese Medical Researchers in collaboration with eight different medical research centers and universities have concluded that individuals with blood type A had a higher risk of contracting the SARS-CoV-2 coronavirus and developing the Covid-19 disease irrespective of gender or age.”
God dammit, Inga. Just when I want to view you with a mix of hatred and contempt, you publish a string of comments that are remarkably sensible. Nice analysis.
Thankfully I had an allergic reaction to lisinopril back in the day and am on a beta blocker instead.
Mark#1, even the professionals undertand that less than 1/7 of the people infected are getting tested, and this is them making a conservative estimate since most agree that the testing is finding less than 1/10 of the infected- and this has little to do with availability of testing itself- people with mild symptoms, even today, aren't likely to go get a test, they are just self-isolating now.
Now, as for Italy, I pointed out the other day that 50,000 per month die in Italy, the vast majority of them age 65+. In the last month, they have been able to assign the cause of death to 3000 as COVID-19, but what about the 50,000 who died in January? In December?
My question, that no one has answered is this- if we hadn't identified COVID-19 and been running tests for it, would we have noticed the illness and the deaths. I ask this because the number of deaths is still a small fraction of the people dying every day and everywhere.
This isn't a conspiracy theory, by the way- this is me pointing where the gaps in the data exist. Gaps that are always going to be there at this stage of viral epidemic of this kind.
I hope the data discussed above is correct- my 72 year old mother is on losartan once a day and she has O type blood. Unfortunately for me, I have A.
I forgive you Big Mike, What good would me hating you back do?
I’m also one of those who had a bad and I mean bad reaction to lisinopril. I had angioedema of the gut and am taking calcium channel blockers instead. People who have had angioedema from Ace inhibitors can never again take them, very dangerous. There is a genetic proponent to this reaction to Ace inhibitors, I’ve read.
@CStanley, the trouble with all three of the sartens, especially including Losarten, is that the drugs as manufactured in India and China are often contaminated with known carcinogens. With my cardiologist’s permission I dropped Losarten from my pill regimen. As I told him, who wants to have the strongest heart in the oncology ward?
eric,
"Someone comes into the hospital, they're already sick with one of these things (as seems to be the case with many who are already dying) and the chalk it up to a respiratory problem instead of the WuFlu."
Or they test positive for the WuFlu and assume that that is the cause of death, and not the other respiratory issue.
Yeah I get it Mike...my husband is on it and we’ve had those concerns too.
If the underlying theory is correct, hopefully there will be a domestically produced drug either among those currently available or on the horizon.
“Unfortunately for me, I have A.”
Me too, plus I can’t tolerate Ace inhibitors.
@Inga, my reaction wasn’t as serious as yours, just dry mouth, but it came up almost immediately so my doctor wasted no time changing the prescription to a beta blocker. But I am also blood type A which is bad news if I do get COVID-19.
Maybe you’ll outlive me. ;-)
"...25% were aged 65–84 years..."
I think 65 to 84 is a rather large spread as well. I'm 65 and have an 81-year-old neighbor. We don't have a lot in common health-wise. He took a fall about 4 1/2 years ago at age 76 and hit his head. He took a long time to recover, and with the additional passage of time, he is simply not anywhere near as vigorous as he was in his early 70's.
He does a lot of exercise, mostly shuffling around in a poor imitation of walking. He still seems to have his mental faculties. I didn't think he'd make it to 80, but now he is 81. I admire his fortitude. His wife is 71.
Someone wised me up and I see the Bloomberg tracker shows 2,500 new cases yesterday. So the surge is on. Why I imagined our Center for Disease Control would publish accurate figures on their website, I have no idea.
So, young Spring breakers, maybe not such a good idea?
Of course, it is the CDC.
And the UK is trying the "let the young catch it and recover" and create herd immunity to protect those more vulnerable who are supposed to be sheltering per a friend of my daughter's who lives in London.
So. The younger Millenial and older Gen Z cohort were yelling , "Woo, kill off the Boomers. They're responsible for all the messed up crap in the world." Maybe they're getting sacrificed and are clueless.
https://pulmotect.com/product/
Another possible treatment
A Plausible “Penny” Costing Effective Treatment for Corona Virus – Ozone
Btw, supposedly they were using ozone and IV-C in China from articles I read. But, it IS the internet. These modalities have also been successful in treating seasonal flu. Also, UVBI may be a viable treatment. But let's put all our eggs in the vaccine basket.
Virus conspiracy theorist are common here and you just roll over and accept it.
Being skeptical as to what's being peddled in the media doesn't make one a 'virus' conspiracy theorist.
In fact, it's a better approach than blindly accepting what's being spoonfed to you by the same media.
FWIW
DM, yesterday:
EXCLUSIVE: Chinese doctor claims he made a breakthrough in coronavirus pandemic with stem cell injections - having 100% success rate after treating nine mostly elderly patients
Dr. Dongcheng Wu, who runs a lab in Wuhan - the ground zero of the coronavirus pandemic, claims he has discovered a treatment for the deadly virus
The expert in stem cell therapy said he has successfully treated nine patients who were hospitalized with novel coronavirus pneumonia
The patients, mostly elderly and living in Wuhan, had developed serious breathing issues as well as overwhelming inflammation in their lungs
Stem cells, often dubbed the building blocks of life, are cells that have the ability to develop into different cell types and can also help repair damaged tissue
They are taken from adult tissue such as bone marrow or the umbilical cord
The stem cells were injected directly into all nine patients' veins and they all reportedly made a complete recovery within days of receiving the treatment
https://www.dailymail.co.uk/news/article-8116881/Doctor-claims-breakthrough-stem-cell-injections-treat-coronavirus.html
Out of curiosity, I did a search in Google Scholar for 'stem cell and CD8+' (a Treg-cell recently measured in the lungs of both severe and mild cases of COVID-19 in a Wuhan hospital).
The search yielded 21,100 hits.
The hospital report:
Characteristics of Peripheral Lymphocyte Subset Alteration in 2019-nCoV Pneumonia
After one-week treatment, 37 patients (67%) reached clinical response, and
had a significant increase of total lymphocytes, CD8+ T cells and B cells. In
multivariate analysis, post-treatment DECREASE of CD8+ T cells and B cells and
INCREASE of CD4+/CD8+ ratio were indicated as independent predictors for POOR CLINICAL EFFICACY.
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3539681
Raising the question: Will a black market develop for umbilical cords?
What I also know is that all this ad hominem berating and name-calling and insults and hostility -- which already were quite tedious and caustic -- are at the present time especially unhelpful and poisonous.
The first ad hominem berating in this thread was from a commenter named “Mark”. It was gratuitous, and not responsive to any previous post, including any post in this thread of the target. Would that have been you? Or are you an exception to the rule regarding poisonous comments? Many lefties believe that because they mean oh-so well and believe they have a monopoly on virtue.
- Krumhorn
Bloomberg reporting in Italy that over 99% of all deaths had preexisting condition or illness. Average age of person who died was 79.5. That's from Italian health officials and reported by Bloomberg, yesterday.
The first ad hominem berating in this thread was from a commenter named “Mark”. It was gratuitous, and not responsive to any previous post, including any post in this thread of the target. Would that have been you?
No, it would not have been me.
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