Tracking Covid-19 Apr 3 . . . are we peaking (for this wave)?

_{kairosfocus

April 3, 2020

Defending our Civilization, Medicine, News Highlights, rhetoric, Sci-Tech watch}

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As we continue to track, let some graphs tell a story, first up is Euro-CDC:

That looks like a peaking, certainly it is not exponential surging in new cases. World in Data, on a 3-day, rolling avg will smoothen, highlighting key countries (including the USA):

That looks like a flattening, trending to turning over on the driving impulse. Let’s see doubling times, which will track comparable exponential growth:

Those were in the 2 – 3 day band previously.

Now, the by country log-lin deaths, with the same 2,3,5 day doubling time rays since five cases as previous:

Likewise, per country log-lin cumulative cases, with the same usual 2,3, 5 and 10 day doubling time from 100 cases rays:

We see a consistent message: while things are bad, we seem to be going peak for at least this wave.

Qualified good news, we are beginning to win this campaign, though we continue to pay a terrible price. Thank God. END

Comments

BobRyan, I know we had an exchange on this before:
If there’s a reduction in cases in the cities throughout the United States, it won’t be due to social distancing.
but isn't it true that we simply can't make such a determination? We are not running a carefully designed experiment which would allow us to rule out distancing as a cause of such a reduction in cases. By the way, are you practicing social distancing yourself?daveS_{April 8, 2020
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BA77, 149: Yet more proposals on mechanisms, many of which may well be acting in parallel. Which is good, it is plausibly harder to get viral resistance to several diverse effects that attack it. KFkairosfocus_{April 8, 2020
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If there's a reduction in cases in the cities throughout the United States, it won't be due to social distancing. Gangs and homeless are not following any protocols. Places like Los Angeles and San Francisco have large populations of both. The inner-cities have cramped living quarters, which make it impossible to have distance. We should see increases if COVID-19 is not acting in conjunction with influenza. If there is a lowering number of people being admitted due to COVID-19 symptoms, that means social distancing had no impact at all. Drug deals and prostitution have not stopped. The homeless are still packed together. Drive by shootings are always done with at least two people, at least one to shoot and one to drive. The Constitution has been violated and it would be nice if we were a country of equality under the law. There is no pause button for the Constitution. They never put in a provision of suspension of rights due to smallpox. People are being arrested for exercising their right to worship freely. People cannot peacefully assemble to protest. With nothing but doom on the horizon, including the idea of not knowing if they will have a job a month down the road, the suicides will continue at a higher rate. They already expect a doubling of those who are going to kill themselves. Who is going to answer for those lives that will be lost?BobRyan_{April 7, 2020
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found these 2 things to back up what was claimed in post 149:
Cameron Kyle-Sidell, an ER doctor in Brooklyn, makes the same assertion. Patient’s lung muscles work, but the patients have no oxygen in their blood (hypoxemia). He concludes there may need to be changes to ventilator protocols and stop treating Covid-19 as typical ARDS. https://medium.com/@andrewt3000/covid-19-and-hypoxemia-697bc8a19bae and Second thing they do is ventilate dozens in the average hospital; they use extracorporeal membrane oxygenation [removing blood from a person’s body and oxygenating their red blood cells] when ventilation doesn’t work. This is sophisticated health care. They have a survival rate for this disease I would not extrapolate to the rest of the world. What you’ve seen in Italy and Iran is that a lot of people are dying. This suggests the Chinese are really good at keeping people alive with this disease, and just because it’s 1 percent in the general population outside of Wuhan doesn’t mean it [will be the same in other countries]. https://www.vox.com/2020/3/2/21161067/coronavirus-covid19-china
bornagain77_{April 7, 2020
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My supply of quercetin arrived today. Already had the zinc. (quercetin is a natural ionophore) :cool:ET_{April 7, 2020
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Covid-19 - what is really going on in the body and some thoughts how to best treat it.
Covid-19 had us all fooled, but now we might have finally found its secret. Quote: "The past 48 hours or so have seen a huge revelation: COVID-19 causes prolonged and progressive hypoxia (starving your body of oxygen) by binding to the heme groups in hemoglobin in your red blood cells. People are simply desaturating (losing o2 in their blood), and that’s what eventually leads to organ failures that kill them, not any form of ARDS or pneumonia. All the damage to the lungs you see in CT scans are from the release of oxidative iron from the hemes, this overwhelms the natural defenses against pulmonary oxidative stress and causes that nice, always-bilateral ground glass opacity in the lungs. Patients returning for re-hospitalization days or weeks after recovery suffering from apparent delayed post-hypoxic leukoencephalopathy strengthen the notion COVID-19 patients are suffering from hypoxia despite no signs of respiratory ‘tire out’ or fatigue." Here’s the breakdown of the whole process, including some ELI5-level cliff notes. Much has been simplified just to keep it digestible and layman-friendly. Your red blood cells carry oxygen from your lungs to all your organs and the rest of your body. Red blood cells can do this thanks to hemoglobin, which is a protein consisting of four “hemes”. Hemes have a special kind of iron ion, which is normally quite toxic in its free form, locked away in its center with a porphyrin acting as it’s ‘container’. In this way, the iron ion can be ‘caged’ and carried around safely by the hemoglobin, but used to bind to oxygen when it gets to your lungs. When the red blood cell gets to the alveoli, or the little sacs in your lungs where all the gas exchange happens, that special little iron ion can flip between FE2+ and FE3+ states with electron exchange and bond to some oxygen, then it goes off on its little merry way to deliver o2 elsewhere. Here’s where COVID-19 comes in. Its glycoproteins bond to the heme, and in doing so that special and toxic oxidative iron ion is “disassociated” (released). It’s basically let out of the cage and now freely roaming around on its own. This is bad for two reasons: 1) Without the iron ion, hemoglobin can no longer bind to oxygen. Once all the hemoglobin is impaired, the red blood cell is essentially turned into a Freightliner truck cab with no trailer and no ability to store its cargo.. it is useless and just running around with COVID-19 virus attached to its porphyrin. All these useless trucks running around not delivering oxygen is what starts to lead to desaturation, or watching the patient’s spo2 levels drop. It is INCORRECT to assume traditional ARDS and in doing so, you’re treating the WRONG DISEASE. Think of it a lot like carbon monoxide poisoning, in which CO is bound to the hemoglobin, making it unable to carry oxygen. In those cases, ventilators aren’t treating the root cause; the patient’s lungs aren’t ‘tiring out’, they’re pumping just fine. The red blood cells just can’t carry o2, end of story. Only in this case, unlike CO poisoning in which eventually the CO can break off, the affected hemoglobin is permanently stripped of its ability to carry o2 because it has lost its iron ion. The body compensates for this lack of o2 carrying capacity and deliveries by having your kidneys release hormones like erythropoietin, which tell your bone marrow factories to ramp up production on new red blood cells with freshly made and fully functioning hemoglobin. This is the reason you find elevated hemoglobin and decreased blood oxygen saturation as one of the 3 primary indicators of whether the shit is about to hit the fan for a particular patient or not. 2) That little iron ion, along with millions of its friends released from other hemes, are now floating through your blood freely. As I mentioned before, this type of iron ion is highly reactive and causes oxidative damage. It turns out that this happens to a limited extent naturally in our bodies and we have cleanup & defense mechanisms to keep the balance. The lungs, in particular, have 3 primary defenses to maintain “iron homeostasis”, 2 of which are in the alveoli, those little sacs in your lungs we talked about earlier. The first of the two are little macrophages that roam around and scavenge up any free radicals like this oxidative iron. The second is a lining on the walls (called the epithelial surface) which has a thin layer of fluid packed with high levels of antioxidant molecules.. things like abscorbic acid (AKA Vitamin C) among others. Well, this is usually good enough for naturally occurring rogue iron ions but with COVID-19 running rampant your body is now basically like a progressive state letting out all the prisoners out of the prisons… it’s just too much iron and it begins to overwhelm your lungs’ countermeasures, and thus begins the process of pulmonary oxidative stress. This leads to damage and inflammation, which leads to all that nasty stuff and damage you see in CT scans of COVID-19 patient lungs. Ever noticed how it’s always bilateral? (both lungs at the same time) Pneumonia rarely ever does that, but COVID-19 does… EVERY. SINGLE. TIME. — — — — — — — — — — — — - Once your body is now running out of control, with all your oxygen trucks running around without any freight, and tons of this toxic form of iron floating around in your bloodstream, other defenses kick in. While your lungs are busy with all this oxidative stress they can’t handle, and your organs are being starved of o2 without their constant stream of deliveries from red blood cell’s hemoglobin, and your liver is attempting to do its best to remove the iron and store it in its ‘iron vault’. Only its getting overwhelmed too. It’s starved for oxygen and fighting a losing battle from all your hemoglobin letting its iron free, and starts crying out “help, I’m taking damage!” by releasing an enzyme called alanine aminotransferase (ALT). BOOM, there is your second of 3 primary indicators of whether the shit is about to hit the fan for a particular patient or not. Eventually, if the patient’s immune system doesn’t fight off the virus in time before their blood oxygen saturation drops too low, ventilator or no ventilator, organs start shutting down. No fuel, no work. The only way to even try to keep them going is max oxygen, even a hyperbaric chamber if one is available on 100% oxygen at multiple atmospheres of pressure, just to give what’s left of their functioning hemoglobin a chance to carry enough o2 to the organs and keep them alive. Yeah we don’t have nearly enough of those chambers, so some fresh red blood cells with normal hemoglobin in the form of a transfusion will have to do. The core point being, treating patients with the iron ions stripped from their hemoglobin (rendering it abnormally nonfunctional) with ventilator intubation is futile, unless you’re just hoping the patient’s immune system will work its magic in time. The root of the illness needs to be addressed. Best case scenario? Treatment regimen early, before symptoms progress too far. Hydroxychloroquine (more on that in a minute, I promise) with Azithromicin has shown fantastic, albeit critics keep mentioning ‘anecdotal’ to describe the mountain, promise and I’ll explain why it does so well next. But forget straight-up plasma with antibodies, that might work early but if the patient is too far gone they’ll need more. They’ll need all the blood: antibodies and red blood cells. No help in sending over a detachment of ammunition to a soldier already unconscious and bleeding out on the battlefield, you need to send that ammo along with some hemoglobin-stimulant-magic so that he can wake up and fire those shots at the enemy. The story with Hydroxychloroquine All that hilariously misguided and counterproductive criticism the media piled on chloroquine (purely for political reasons) as a viable treatment will now go down as the biggest Fake News blunder to rule them all. The media actively engaged their activism to fight ‘bad orange man’ at the cost of thousands of lives. Shame on them. How does chloroquine work? Same way as it does for malaria. You see, malaria is this little parasite that enters the red blood cells and starts eating hemoglobin as its food source. The reason chloroquine works for malaria is the same reason it works for COVID-19 — while not fully understood, it is suspected to bind to DNA and interfere with the ability to work magic on hemoglobin. The same mechanism that stops malaria from getting its hands on hemoglobin and gobbling it up seems to do the same to COVID-19 (essentially little snippets of DNA in an envelope) from binding to it. On top of that, Hydroxychloroquine (an advanced descendant of regular old chloroquine) lowers the pH which can interfere with the replication of the virus. Again, while the full details are not known, the entire premise of this potentially ‘game changing’ treatment is to prevent hemoglobin from being interfered with, whether due to malaria or COVID-19. No longer can the media and armchair pseudo-physicians sit in their little ivory towers, proclaiming “DUR so stoopid, malaria is bacteria, COVID-19 is virus, anti-bacteria drug no work on virus!”. They never got the memo that a drug doesn’t need to directly act on the pathogen to be effective. Sometimes it’s enough just to stop it from doing what it does to hemoglobin, regardless of the means it uses to do so. Anyway, enough of the rant. What’s the end result here? First, the ventilator emergency needs to be re-examined. If you’re putting a patient on a ventilator because they’re going into a coma and need mechanical breathing to stay alive, okay we get it. Give ’em time for their immune systems to pull through. But if they’re conscious, alert, compliant — keep them on O2. Max it if you have to. If you HAVE to inevitably ventilate, do it at low pressure but max O2. Don’t tear up their lungs with max PEEP, you’re doing more harm to the patient because you’re treating the wrong disease. Ideally, some form of treatment needs to happen to: Inhibit viral growth and replication. Here plays CHQ+ZPAK+ZINC or other retroviral therapies being studies. Less virus, less hemoglobin losing its iron, less severity and damage. Therapies used for anyone with abnormal hemoglobin or malfunctioning red blood cells. Blood transfusions. Whatever, I don’t know the full breadth and scope because I’m not a physician. But think along those lines, and treat the real disease. If you’re thinking about giving them plasma with antibodies, maybe if they’re already in bad shape think again and give them BLOOD with antibodies, or at least blood followed by plasma with antibodies. Now that we know more about how this virus works and affects our bodies, a whole range of options should open up. Don’t trust China. China is ASSHOE. (disclaimer: not talking about the people, just talking about the regime). They covered this up and have caused all kinds of death and carnage, both literal and economic. The ripples of this pandemic will be felt for decades. http://web.archive.org/web/20200405061401/https://medium.com/
bornagain77_{April 7, 2020
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And UBI.Jim Thibodeau_{April 7, 2020
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Jack Dorsey of twitter contributing ~25% of his net worth (USD 1 billion) to combat the virus, then to girls' education and other things later.daveS_{April 7, 2020
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F/N: I cross-post from the current Zelenko thread, as notable: >>F/N: Dr Mehmet Oz on with Lou Dobbs: Didier Raoult has initial results on his first 1,000 patients, 7 deaths, 20 to ICU, observes "a case series of 1,000 patients is not anecdotal." He notes that NY Gov Cuomo's ruling locked down his outpatient study, parallel to Raoult. A transcript of a key part:
Dr. Oz: Well the trial that I was helping with at my institution was shut down when the governor banned the use of hydroxychloroquine for prescription use for outpatients. And I was trying to see if it could prevent, well there was a prevention trial that was approved, but I was trying to see if it could actually treat early disease and replicate what has been done in China and in France. Unfortunately, those trials have been held back. I don’t know of a trial in New York State. I have been searching for the one that has been spoken about… I spoke this morning to the famous French Infectious Disease specialist Didier Raoult, he’s the one who’s actually been pioneering the hydroxychloroquine with azithromycin, it’s not published yet, but he shared the results of his first thousand patients who have been on that protocol. Seven people died. They were all older and frail individuals. That is lower than what you would expect from people who have been admitted to the hospital. And he’s had 20 got to the ICU, again lower than I would expect… Well, I’m upset because I wanted to do the trial. Also I wanted it to be legal in my state for a doctor to talk to a patient about the COVID-19 and treat them as they saw appropriate.
Something very wrong is going on at governance and policymaking level. He is also calling for someone with Lupus on HCQ with CV19 to come forward, in concert with a support group. So far, he has not had anyone. He also reports the colleague who heads the Lupus Society and others in that world of practice see fears over side effects as punched up, i/l/o their collective experience. This holds for heart effects and he says eye effects show up after five years of chronic use. Another straw in the wind.>> KFkairosfocus_{April 7, 2020
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Intelligently designed anti-bodies to fight COVID-19. Looks very promising. Still not a vaccine but it will definitely help sick people whenever it is released.ET_{April 7, 2020
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How does Chloroquine and Remdesivir work against the new coronavirus? It's a blog post so follow-up research is warranted.ET_{April 7, 2020
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@Ed George
I am still trying to figure out how chloroquine works. I know that for lupus and arthritis it acts as an immune system suppressant. If that is the case, why are imonocompromised people so at risk? Or are they?
Study Biology then. It is really fascinating. And logic. Logic is fascinating and very useful too.Truthfreedom_{April 7, 2020
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EG I think HQ is an anti inflammatory drug and helps with the lungs and is used along with a Z pack. There is so much we don’t know. Vividvividbleau_{April 7, 2020
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I am still trying to figure out how chloroquine works. I know that for lupus and arthritis it acts as an immune system suppressant. If that is the case, why are imonocompromised people so at risk? Or are they?Ed George_{April 7, 2020
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KF The idea that all these people who had jobs are going to magically get them back is a pipe dream. It’s going to take a long time for people to be comfortable in crowded spaces, many jobs that existed before don’t exist now. Case in point my office lease is up ,for regulatory purposes I need an office, so my plan is to lease the smallest office I can, work from home, and cut my overhead by 5k a month, great for me but not so great for the building owner. Commercial real estate is going to get savaged and all the jobs that are related to it. That’s just one example multiply that by 1000. Why didn’t I do this before because clients expect me to have a nice office but they don’t expect that now. Vividvividbleau_{April 7, 2020
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Vivid, the economics is always an issue. Once a pandemic broke loose, a lot of wealth was going to be destroyed. The issue is, which is least worst in an age of pandemics. KF PS India is making a very clear statement. BTW the US used uo 1/2 its existing stockpile of Pennicilin to treat the first successful case in 1942. But then mobilisation kicked in and that was the wonder drug of the war era. Never mind its limitations and the issue of penecillin shock.kairosfocus_{April 7, 2020
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KF “AKA, triggering another deep recession only a few years after the world is starting to climb out of one, cannot be sound policy. KF” Right now everyone’s attention is on the virus but one day soon we are all going to turn our attention to the economy and say “OMG what have we done”!! Vividvividbleau_{April 7, 2020
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JT, my conclusion pivots on the number of the mild or asymptomatic forming the base of the pyramid/ iceberg; estimates I have seen range up to 50 - 80 percent. That's significant. While testing is important for treatment, I think the notion that we can get a census of all cases or even all symptomatic cases is ill advised. We need to remember, sampling, including randomised and stratified random with adjustment to demographics. That's much like, tracking polls. In that context, I would calibrate tests against an antibody based population sample, to build up a statistical model. This has the advantage, that we can then look at the demographics and trends. My fundamental model is of course a market growth, logistic curve related approach, with the growth rate [proxy, new cases per day as estimated] giving a picture on the driving impulse. The second rate actually allows us to spot turning points. And, I love log-lin time series plots as we can see above. What these tell us is that we are capturing enough of the signal to make sense as informed by SIR related models; it is better to be roughly right than exactly wrong -- and for strategic decisions, rough trend indicators are often good enough, as long as we have some good models . . . which BTW is also so for price indices, price level estimating baskets, GDP numbers, I-O analysis tables for the economy and more. As noted in the OP, the big message is that we are at turning point globally on the driving impulse [it is peaking], though of course the US is still not yet at peak, projected in 1 1/2 weeks. That overall message is that there is light at the end of the tunnel. The morrow, more tracking thoughts, including on onward waves and sustainable strategies in the face of a pandemic threatening to be with us for years to come. AKA, triggering another deep recession only a few years after the world is starting to climb out of one, cannot be sound policy. We are looking at strategic change and linked governance, policymaking and creating critical mass at kairos. (And yes, that is directly connected to my handle.) KFkairosfocus_{April 7, 2020
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EG “KF, it might be of interest to you that India has stopped the shipment of drugs, including chloroquine, outside the country.” That did not last long. Vividvividbleau_{April 7, 2020
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DaveS “Their distancing measures worked at first, then people apparently became overconfident, and the numbers of deaths rose sharply.“ I don’t see how we don’t get a second and likely a third wave if a prophylactic is not found, all the people that are distancing will make up those waves. To shut down the economy until a vaccine is approved is just not a viable solution. Not that you have advocated that, just saying. Vividvividbleau_{April 7, 2020
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It "looks" like the distancing measures are working and the number of deaths are a bit less than projected perhaps? I say this because I was listening to a radio show recently about the 1918 pandemic. Their distancing measures worked at first, then people apparently became overconfident, and the numbers of deaths rose sharply.daveS_{April 7, 2020
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PS: On de egg-spurt gamez (and, I confess freely, I are wut pazzez fer wun, in my small korner . . .) https://www.powerlineblog.com/archives/2020/04/experts-pseudo-experts-and-other-progressive-conceits.php Hayward of Pl, gives food for thought:
The downloads folder on my computer is jammed full right now with endless charts depicting data and analysis of both the COVID-19 pandemic and the economic shocks rolling across the world, and naturally they can tell a widely varying story depending on the data quality and, most crucial of all, the assumptions that go into any model that generates projections about the future—even the near future. Experts and models disagree! Who’d a thunk it? More importantly, what is a responsible president or prime minister to do? President Trump is naturally taking fire for not following “the experts,” even though it is a simple matter to point out that “the experts” (including even the sainted Dr. Fauci) were downplaying the risks of the Coronavirus as late as the end of January, when liberals, the media, and some “health experts” howled at the moon when Trump imposed the travel ban on China. All the while, the “experts” at the CDC were botching the rollout of a reliable COVID-19 test. More broadly, though, it is worth lingering for a moment on the fetish for expertise . . . . While it is perfectly sensible to seek improvements in technical expertise and its integration into decision making by our political leaders, this misses the main point. For a century now, progressives have represented expertise as a distinct claim to rightful rule, akin to the classical claims on behalf of democracy and aristocracy. You can see this at work right now in the deep thinkers who are saying that Joe Biden ought to pick Bill Gates as his running mate, or that Dr. Fauci should be made president by acclamation. The progressive conceit of expertise lies at the heart of a lot of the progressive contempt for the non-credentialled “deplorables” of “flyover country” who, progressives think, don’t deserve self-government. Whenever a progressive says we should “follow the evidence” because we must have “evidence-based policy-making,” you should reach for your wallet (for starters). Because today we all too often have the opposite: policy-based evidence-making.
Food for thought. My longstanding rule: arguments gain persuasive power through pathos, ethos, logos. Particularly, no authority, expert or presenter is better than his or her facts, logic and assumptions. AKA, figgers don't lie but liars and fools can figger their way into trouble. Caveat emptor.kairosfocus_{April 7, 2020
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I read yesterday that as of Sunday night America had tested fewer than 900,000 people. Lord only knows how many real cases there are.Jim Thibodeau_{April 7, 2020
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DS, the local events are actually international, given the significance for volcanology and disaster management. And as you know, the associated logic, epistemology, ethics, decision theory and statistics are all general matters. As is the macroeconomics. And yes, when we accept a speed limit with a given degree of risk, we are implicitly pricing a value on lives; through what we tolerate. That extends directly to the regulatory burden on drugs testing in general and in the face of emergency. There is a priceable value for the priorities that did not push testing of HCQ etc post SARS1 (etc). We are now paying the price for those implicit decisions. In that mix, we find ambulance chasing litigation and deep ideological polarisation, agit prop and lawfare cultivated by some as a road to power. KFkairosfocus_{April 7, 2020
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PS: Funny thing, UK papers seem the best documentation just now! They allowed me to spot the area and while I was by the Clinic, I realised it had to be higher up the hill. The house is at an angle to the road. The man I recognised drives the green pickup.kairosfocus_{April 7, 2020
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F/N: Back home from Doc and Supermarket. Just passed by and wished condolences from the road. The house is on the main road in Sweeneys, in the St Johns area around the corner from Aravin's.The car was in the driveway. This is a video of the road and the house: https://www.mirror.co.uk/3am/celebrity-news/black-rippers-death-shrouded-mystery-21826146 According to ZJB (as I heard in Aravin's) an autopsy has been called for a sudden death. KFkairosfocus_{April 7, 2020
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Neither marijuana nor being an activist is a plausible cause of death. :roll:ET_{April 7, 2020
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Kairosfocus: ZJB has confirmed the passing. Cause is not plausibly COVID-19. He was a big marijuana smoker/activist so another cause was going to be more likely anyway. Loved your bit of detective work!! Thanks!JVL_{April 7, 2020
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@121 Kairosfocus:
All of that goes back to the point that the day of blind trust in ex cathedra announcement of experts is over. So is the day of pretence of “consensus” of experts [maintained by the no true Sassenach fallacy, doubtless].
True. And the Internet has been playing a key role here. That thing, information , is fascinating, ain't it? :)Truthfreedom_{April 7, 2020
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KF,
DS, are you aware that the FDA Fauci works with has given two successive tiers of approvals?
Yes, Bob O'H mentioned this recently here, and I read it earlier in some blog posts. And I think I can understand why you would take this position, given local events. For my part, I simply do not have the expertise needed to evaluate the situation. I have made too many probability/stat errors to trust my intuition (for example, the first time I saw the classic false positive exercise).daveS_{April 7, 2020
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