Geography Matters

_{Barry Arrington

April 27, 2020

Intelligent Design}

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In response to my last post (The Data Are in: A Nationwide Lockdown Was Never Necessary) Bob O’H got red in the face, stamped his feet, and apparently insisted that a nationwide lockdown was necessary. Was it? Here is an analysis performed by a friend:

To put US COVID19 cases into perspective, it helps to separate the terrible outbreak in the five-state region of New York, New Jersey, Connecticut, Rhode Island and Massachusetts from the other 45 states. (Stats as of April 25.)

Total Population
NY-NJ-CT-RI-MA – 39.8 million
Rest of US – 288 million

COVID Cases – Total (per million people)
NY-NJ-CT-RI-MA – 490,675 (12,312)
Rest of US – 496,657 (1,722)

COVID Deaths – Total (per million people)
NY-NJ-CT-RI-MA – 33,262 (835)
Rest of US – 22,153 (77)

HT: Mark Hillman

Those who insist that regional differences make no difference are now in the “willfully obtuse” category.

Comments

Wow. Your false accusation is duly noted. There are plenty of papers that demonstrate zinc prevents viruses from replicating. There are others that demonstrate quercetin is an ionophore. The list isn't something they threw together willy-nilly. And the only reason it won't end the pandemic is because people won't follow it. And if you look at the alternative, riding it out hoping your immune system kills it before it kills you, take some Tylenol and rest, I don't really understand the resistance. But do tell of your vast experience about how scientific evidence works. And how somehow you know better than the existing science.ET_{April 28, 2020
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I'm not sure I've ever read someone who understands less about how scientific evidence works. As I say, I don't think this is likely to be the panacea that ends the pandemic.orthomyxo_{April 28, 2020
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The science says it. That is what has you confused- it's science. And that is why the list exists- the science.ET_{April 28, 2020
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and disinfectant will kill the virus on a surface, Doesn't make for a treatment though. I think we should probably wait until there is any evidence that taking these supplements protects from the virus before we declare it safe to reopenorthomyxo_{April 28, 2020
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Wow, the science says it will work. Quercetin is an ionophore. That plus the zinc will stop the virus from replicating. Vitamin D boosts the immune system.ET_{April 28, 2020
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OK... the article you linked to say there is no evidence that this works. So I'm not sure it's going to be the answer to ending lockdowns.orthomyxo_{April 28, 2020
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Ortho- read the following: EVMS CRITICAL CARE COVID-19 MANAGEMENT PROTOCOL. It provides a list of OTC supplements to be used to fight this virus.ET_{April 28, 2020
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It's always possible to make a post hoc justification to save you favoured hypothesis. If the handful of doctors who have become famous from this think that have a protocol that works they should publish it. Others can then run the trials and we'll see if it works.orthomyxo_{April 28, 2020
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PS: It's not being "wedded: to an idea, it is a cluster of direct data amounting to thousands of cases backed by in vitro at plausible concentrations, known ability to get into the body with manageable side effects, and the apples vs oranges pattern of discordant results. Especially on seeing the gold standard fallacy. 0.38^100 = ____kairosfocus_{April 28, 2020
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Ortho, WHEN are they administering the cocktail -- early or late -- and is it a cocktail? From Raoult, they worked with cardiac specialists [it's a big complex] to manage for complications. Given an earlier Guardian article I am not confident in their reporting or in apples vs apples. See Ms Lin on S Korea. KF PS: Ms Lin, HT Jerry:
Hydroxychloroquine used by Korea for Covid-19 while US is divided Apr 27, 2020, 9:52 PM South Korea recommended the anti-malarial drug HCQ to treat Covid-19 while political interference in the US over the drug has alarmed medical experts [ . . . ] Medical treatments have traditionally been a private decision between patients and doctors, but now it seems politicians are usurping their right to choose. According to Dr Jeffrey Singer, a general surgeon and Cato Institute fellow, this threatens the integrity of the medical profession and indirectly imperils patients, by denying them emergency options when no other alternatives are available. Moreover, the politicization of treatment options would not help Americans, given the fact countries such as Belgium, France and South Korea have used HCQ to treat Covid-19 with a good degree of success. South Korea was one of the first countries to be hit by the virus after China, reporting its first case on January 20 and peaking by late February, before suddenly tapering off in early March and “flattening the curve.” It also has a comparatively low mortality rate through a combination of testing, tracing, containment and HCQ . . . . Hydroxychloroquine (HCQ), a well-known anti-malarial drug that has been around for decades, is now a political football between the Trump administration and Democrats during an election year in the United States. US President Donald Trump has repeatedly touted the drug and received significant pushback from the media and the Democratic Party, with the governors of Nevada, Michigan and New York even going so far as to issue executive orders restricting how doctors can use HCQ to treat patients suffering from Covid-19. Medical treatments have traditionally been a private decision between patients and doctors, but now it seems politicians are usurping their right to choose. According to Dr Jeffrey Singer, a general surgeon and Cato Institute fellow, this threatens the integrity of the medical profession and indirectly imperils patients, by denying them emergency options when no other alternatives are available. Moreover, the politicization of treatment options would not help Americans, given the fact countries such as Belgium, France and South Korea have used HCQ to treat Covid-19 with a good degree of success. South Korea was one of the first countries to be hit by the virus after China, reporting its first case on January 20 and peaking by late February, before suddenly tapering off in early March and “flattening the curve.” It also has a comparatively low mortality rate through a combination of testing, tracing, containment and HCQ. Last month, the Korea Centers for Disease Control and Prevention, the Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, Korean Society of Pediatric Infectious Diseases and a tuberculosis association recommended the use of Kaletra, an anti-HIV medication, in combination with HCQ, to treat Covid-19. This was bolstered by a French study that showed HCQ had an antiviral effect against Covid-19 in confirmed cases. Used in conjunction with the azithromycin Z-Pak, most patients cleared the virus in three to six days rather than the 20 days observed in China, drastically narrowing the period during which a patient can spread the virus to others. As such, Dr Jeff Colyer, chairman of the US National Advisory Commission on Rural Health, and Dr Daniel Hinthorn, director of the Division of Infectious Disease at the University of Kansas Medical Center, in a Wall Street Journal article recommended that the US could adopt this approach and use the treatment cocktail early rather than wait until a patient is on a ventilator in an intensive care unit. To be clear, these scientists and doctors now recommend HCQ as a treatment, not a preventive measure, for Covid-19. They argue that a positive effect of using HCQ early is the reduction of virus transmission to other people given the shorter number of days the patients remain contagious, thereby flattening the curve sooner.
Remember, SK has beaten this wave.kairosfocus_{April 28, 2020
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KF, I really don't understand why you are all wedded to the idea HCQ is effective (in some combo). It would be great if it were true, but the evidence just isn't there. If you follow drug development at all you know that drugs with plausible modes of action and promising in vitro (or mammalian model) results fail in human trials more often than they succeed. At the moment the evidence for HCQ alone is disappointing. Studies will continue, including those with cocktails, but at the moment the evidence just isn't very good. (It should also be pointed out the drugs combined with HCQ often have the potential for serious side effects)orthomyxo_{April 28, 2020
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ET, I'm sorry, but that's the weirdest claim I've heard during this whole pandemic! Any evidence for this?orthomyxo_{April 28, 2020
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Jerry, The guardian has a running list of HCQ studies: https://www.theguardian.com/world/2020/apr/22/hydroxychloroquine-coronavirus-scientific-studies-research. One RCT suggests a modest effect. We will see, but taking the results as a whole doesn't look good for HCQ.orthomyxo_{April 28, 2020
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Barry: "Jim Thibodeau (aka Kevin) is no longer with us. We try to give commenters latitude, but there is a limit to the amount of bigotry and hate we will allow be be spewed into our combox. Jim passed it some time ago." Could you give the rest of us a little guidance here? Where exactly did Jim Thibodeau express bigotry or hatred? I hope you're not saying that accurately calling Jack Chick an anti-Semite is bigotry because he obviously was. Just look at the pictures. He was anti-Catholic too. Again, just look at the comic strips. And liberals ... wow! I didn't see him express any hate, either. Perhaps if you'd outline where you think he showed bigotry or hatred, it would help everybody.MatSpirit_{April 28, 2020
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We can fight covid 19 with OTC supplements. People can choose to take them or not. But now that we can fight covid 19 with OTC supplements the lockdown is no longer needed.ET_{April 28, 2020
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We don’t have a cure at present
Of course we do. What disappointing studies? I’m not aware of any. It could be less than we hope but so far no negative reports. Don’t bring up the VA survey which is irrelevant. There are several reports of successful interventions. Zelenko has a large practice which include himself with his other doctor plus 4 nurse practitioners and 1500 patients. Then there Is Raoult and Brazil. Then there is Singer and his group of over 60 doctors. Then there is Todaro and his analysis and plan based on results from multiple doctors.jerry_{April 28, 2020
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Ortho, the fact that you single out one component of a cocktail and fail to distinguish early intervention from trying to retrieve a situation where serious damage has set in, leading to heightened odds of death, is telling. Zelenko in particular has been very explicit about such issues. In effect you are setting up and knocking over a strawman caricature. Please, stop. There is a baseline that shows chemical effectiveness in plausible in-tissue concentrations, there are candidate mechanisms [several of which may be working in parallel], there is a near business as usual flu with complications baseline and there are thousands of cases showing that early intervention with a cocktail makes something like a 90% reduction in deaths. Attempted dismissals strongly tend to attack strawman caricatures and we have seen designs proposed that have to be regarded as deck-stacking: synergistic action of drug cocktails is a longstanding established fact so to segregate components to look for effects on which one would only then consider a cocktail, is frankly criminal negligence. And more. KFkairosfocus_{April 28, 2020
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Jerry, When "Instead insanity rules" then, we look for a business as usual framework backed by dominant factions and locking in an adverse trend in the teeth of signs that something is seriously wrong. Of course, power factions are generally able to insulate themselves from the worst pain, exporting such to the disregarded or despised other. There is likely to be stereotyping and scapegoating of strawman caricature targets for fear, resentment, hostility. Resemblance to current political gamesmanship and media antics in the USA is not coincidental. The reason insanity rules is that warped views are shaping policy and warped power systems . . . and the media are a power system . . . are locking in an agenda that serves dominant factions and their perceived interests. But now, we have an incipient crisis triggered by the advent of a pandemic viral disease. If it was a bacterial, there would be antibiotics and it would have been locked down. But as there are no established broad spectrum antivirals, highly contagious novel viral diseases can spin utterly out of control. That's why once this virus broke out in China and spread, we were looking at a large number of deaths. We are forced to resort to quarantine and lock down measures, even while such create economic and social chaos, also giving the power hungry a taste of near totalitarian control. (Remember, never let a crisis go to waste?) At this point, there is a dismal choice, power clash to decide onward paths for our civilisation. Deaths by at least dozens to hundreds of thousands are inevitable globally, from the plague. They were locked in from the moment it broke out. This, regardless of containment measures. However, some containment can reduce it from where it could go unchecked. The Spanish Flu and beyond it the Black Death show what is possible. On the other hand, severe containment measures cannot be sustained. Otherwise, economic breakdown and even more deaths and chaos lurk. With war a likely consequence. So, there is a dismal choice tightrope, and there are a lot of people who see such a crisis as an opportunity for a totalitarian power grab that allows them to remake the world to suit their agendas. The sound answer is to try initial containment to break exponential growth then to transition to a sustainable new norm until long term measures stop the pestilence. Those will take years. Meanwhile, there are factions that have to be reined in. And it looks like face masks are a new fashion statement. With Wuhan space suits not far behind. KFkairosfocus_{April 28, 2020
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We don't have a cure at present. I assume you are referring to hydroxychloroquine, but there are now quite a few disappointing studies for this drug. It's seems safe at any impact from this will be small. Re: your other comments, I don't think anyone is advocating many many months in "lockdown"waiting for a treatment. Rather, the goal is to get some control over the epidemic now then lift measures to allow more of the economy to function while keeping the epedemic in hand. In that case physical distancing might in place all year, but full lockdowns won't.orthomyxo_{April 28, 2020
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There are a few ways.
I was well aware of reason 1 and discussed it with my wife just after making my post. It is discussed on MedCram several times. It is the only valid reason but as we are finding out has extraordinary negative outcomes as RHamptom roams the site with his optimism Also we are learning that hospitals are not treating the disease. They are ameliorating patients’ symptoms in the hope their immune system can win the battle. At the same time spreading the virus to health care workers. The other two seem to be bogus. Vaccines sound good but are a long way off and we already have a cure. But we have Bob O’H roaming the site with a phony need for purity. It’s like a city being strafed in war and demanding that the guns must go through a thorough testing before we can shoot back. Herd immunity may be the only way out but it has to be quick. Lockdowns will extend it too far into the future that there may be little left when it arrives. Already major food suppliers are talking about shutting down. The irony is that hospitals all over the country are laying off people as they are not treating people. Instead insanity rules.jerry_{April 28, 2020
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Ortho, I agree with your first point, was about to suggest that. On the second, this disease's main waves will likely come through in about 1 - 2 years. That sort of timeline is about the same as the estimates for a fast development cycle for a vaccine. Similarly, the approvals process for treatments will likely drag out beyond the main waves. Unsustainable lockdowns will not create herd immunity, they postpone the bulk of the disease while opening up loss of life from economic breakdown. There is a dismal choice issue on the table. KFkairosfocus_{April 27, 2020
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Jerry,
The rationale for the lockdown is not to save lives. If you think it is, tell me how that is going to happen.
There are a few ways. As your own post says, and uncontrolled epidemic could overwhelm health systems and lead to a higher death rate among the infected and kill people who can't be treated for routine illness. Second, the longer the epidemic can be kept smouldering rather than raging the longer you have to develop effective treatments or a vaccine. Current treatment trials are a mixed bag, but there are a lot of pre-existing treatments to test and more will be developed. Finally, limiting transmission means fewer infections are required for "herd immunity" to be reached and fewer people will be infected after than milestone as a result of "overshoot" (though, note, this is premised on the idea some for of physical distancing says well after the peak in deaths, which might not be politically manageable).orthomyxo_{April 27, 2020
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RHampton is back with doom and gloom. The strokes are explained by the virus attacking the ACE2 receptors on blood cells. This causes a cascade of other effects causing coagulation and clotting. Could most of these Navy personnel been spared any harmful affects of the disease if they took the treatment?jerry_{April 27, 2020
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The Tri-County Health Department said that the Aurora, CO Walmart was cleaned and disinfected over the weekend and has good social distancing measures, an enhanced system of keeping track of the number of customers in the store, one-way aisles and a strong worker illness screening and reporting process. The department closed the store Thursday following complaints from employees and shoppers about a lack of social distancing. It said that a 69-year-old man who worked for a private security company at the store had died along with a 72-year-old store employee and her 63-year-old husband, who did not work at the site. There are 11 other coronavirus cases linked to the outbreak at the store, the department said.rhampton7_{April 27, 2020
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Roughly half the crew members on the USS Kidd have been tested for the virus, and some have been evacuated, the Navy said. "As of today, 45% of USS Kidd (DDG 100) crewmembers have been tested for COVID-19, with 47 total positive results, according to Navy Live, the service branch's official blog: "Two Sailors have been medically evacuated to the United States. 15 Sailors have been transferred to USS Makin Island (LHD 8) for monitoring due to persistent symptoms. None are in the ICU or on ventilators. Sailors aboard Kidd are wearing PPE and N95 masks."rhampton7_{April 27, 2020
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Doctors at hospitals in New York City and Philadelphia say they have 'never seen so many' young people suffer large vessel occlusions, the deadliest type of stroke. A study in 15 medical centres over three weeks found 40 per cent of LVO admissions were in COVID-19 patients under 50 - the average age for the severe stroke is 74. Separate research, not yet peer-reviewed, looked at 214 COVID-19 patients treated at three hospitals in Wuhan, China. It found 36 per cent had neurological symptoms like impaired consciousness or blood clots in the brain. Once thought to be disease that primarily attacks the lungs, doctors are now starting to believe many coronavirus deaths are caused by blood clots.rhampton7_{April 27, 2020
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The rationale for the lockdown is not to save lives. If you think it is, tell me how that is going to happen. The lockdown has a its main purpose not to spike the rate of infection and rapidly increase demands on the hospital system. It is meant to spread out the infections and deaths over time. Thus, approximately the same number will get the virus and the same number will die but just over a longer period of time. The term used is flattening the curve. But that does not mean less deaths. Just the same number of deaths over a longer period of time. One possible answer is that we may develop a vaccine and when that happens we can come out of our shells. But that is several months off at best. The other possible answer is that there will be a cure for the virus. Anyone here have any suggestions for that? Many here have a candidate but there is always the resistance of several to this idea. But they propose no alternative other than a destruction of the economy and probably more dead to that than to the virus. That is what those who oppose using a potential cure have in mind when they argue against using the proposed treatments.jerry_{April 27, 2020
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Ortho, if treatments are affordable and out patient based -- IF -- that is big. Africa is not going to be able to surge ICU's and US$ 40k+ ventilators etc. Soap-water works but is a problem for highly frequent hand and surface cleansing. Also, they mess up certain things that [re-]sanitise with alcohol just fine. KFkairosfocus_{April 27, 2020
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KF,
I think the only reasonable way forward is through reasonably effective treatments and social distancing measures that reduce rate of transmission.
For countries that can't reasonably eliminate or suppress the epidemic (due to lack of infrastructure or letting the disease escape) that's quite possibly true. Not sure alcohol is so important, soap does the trick just fine (though is admittedly less portable).orthomyxo_{April 27, 2020
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Missouri Governor Mike Parson says testing plant workers for the coronavirus is critical to keeping the food supply chain open for the state and the nation. Parson stays testing IS available for plants that choose to test their workers. Community COVID-19 testing is taking place in two counties in Missouri where there’s a higher incidence of the illness: in Saline County where ConAgra and Cargill plants are located and in Moniteau County, where Burger’s Smokehouse has closed because of coronavirus cases. The Smithfield processing plant in the Martin City area of Kansas City has shut down because of coronavirus cases.rhampton7_{April 27, 2020
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