Coronavirus

[ERICOPOLY]

Your comment about Covid pushes people into death more than flu is only for the set of people..

 

Getting back to my comment, it is only with regards to the fact that most people who die of covid-19 illness have preexisting condition, and those conditions would have eventually killed them, but they were pushed to an early grave by covid-19 to a far greater degree than the common cold, so credit where credit is due.

 

 

 

I dont think it is appropriate to take asymptomatic to mild sympomatic patients who does not have signs of going into second stage (Oxygen drop, lung radiology results, etc) and count them into Covid deaths. 

 

As I said, if they are pushed into their grave to a far greater degree by covid-19 as compared to the common cold, then credit where credit is do.

 

EMPHASIS:  does the common cold have this effect?  If no, then credit covid-19 where credit is due.

 

[rolling]

Dear investor20,

While I liked your post about deaths and attribution to covid, I'd like to comment (not evidence based comments)

1- those 3 stages of covid make some sence, but I don't think you should apply rigid criteria over them, and especially, you should not rely on symptoms only to check disease severity in an already dead person.

A) In covid you have people with oxygen pressure that usually would put you in a comatous state and are talking on the phone.

B) many mildly symptomatic people have horrible looking CT scans (and some of those never get any other symptom). This means that if you get another problem simultaneusly you might die, while that other condition would never have killed you alone (the same could mostly be said on reverse, true)

C) covid is a systemic disease, mild lung lesion does not exclude enough systemic disease to send you ever the edge if you are already fragile.

 

With that said, in my country death are not counted as covid if you have another obvious main disease to die from. If however you shouldn't have died from the disease you had, then covid certainly should be the cause of death.

[Investor20]

Dear investor20,

While I liked your post about deaths and attribution to covid, I'd like to comment (not evidence based comments)

1- those 3 stages of covid make some sence, but I don't think you should apply rigid criteria over them, and especially, you should not rely on symptoms only to check disease severity in an already dead person.

A) In covid you have people with oxygen pressure that usually would put you in a comatous state and are talking on the phone.

B) many mildly symptomatic people have horrible looking CT scans (and some of those never get any other symptom). This means that if you get another problem simultaneusly you might die, while that other condition would never have killed you alone (the same could mostly be said on reverse, true)

C) covid is a systemic disease, mild lung lesion does not exclude enough systemic disease to send you ever the edge if you are already fragile.

 

With that said, in my country death are not counted as covid if you have another obvious main disease to die from. If however you shouldn't have died from the disease you had, then covid certainly should be the cause of death.

 

I agree with you if there are signs of oxygen drop or lung xray showing lung pnemonia, then it may be appropriate.  However,

 

https://blog.radiology.virginia.edu/covid-19-and-imaging/

"A significant percentage of patients with COVID-19 have normal chest CTs or x-rays. "

 

What is being proposed is that if a PCR test is positive for a dead person, that it self becomes automatically a Covid death. 

 

Even CDC does not take this position in an indirect manner.  After a positive test and quarantine, if one is healthy, CDC does not recommend a second test with PCR.  The reason is our immunity has broken up the virus and PCR is just catching broken pieces of virus. With such a test that cannot even differentiate between broken pieces of virus vs active replicating virus, and no other symptoms of Covid, declaring death for Covid by testing a dead person is too far for me. Please see below for reference.

 

"People who have been confirmed with mild to moderate COVID-19 can leave their isolation without receiving a negative test, according to recently revised guidance from the Centers for Disease Control and Prevention."

 

"The CDC also notes that virus fragments have been found in patients up to three months after the onset of the illness, although those pieces of virus have not been shown to be capable of transmitting the disease."

https://www.nbcnews.com/health/health-news/cdc-changes-covid-19-guidance-how-long-patients-need-be-n1234883

 

What they are proposing is a person gets asymptomatic Covid, the body clears it and something else happens, dies and they check the body and find PCR positive but it could be broken pieces of Virus and declare Covid dead.

[Cigarbutt]

@Investor20

Of course I agree with your self-evident truths but reading your assertions typically triggers the following slogan: with enough ‘ifs’, you could put Paris in a bottle. Looking past the fundamental aspect, one has to wonder: what is the driver behind all this?

 

1-Positive tests versus reality

-Just like with everything else, there are false positives and there are false negatives

-To suggest that a single positive test is the driver of conclusions does not add up to the real world

-It has become clear that most excess deaths (quite an objective measure) happened secondary to a direct effect of Covid as a significant contributing cause

Yes, you can find stuff that questions the above notions but the weight of the evidence has become very strong.

 

2-Hospital-acquired Covid

This has been studied (healthcare workers and patients). The conclusions are variable but the weight of evidence suggests strongly that the number of hospital-acquired cases is much lower than the 25% mentioned. A very interesting sub-aspect of this discussion is that most hospitals adapted (to various degrees) and adapting (basically through basic tools of distance, masks or other equipment, basic hygiene measures and basic protocols) meant significantly reducing in-hospital transmission. i have access to data from a nearby and major metropolitan hospital that became a designated center for Covid in a city that reported one of the highest community spread in the world and they have convincingly shown that the risk of in-hospital transmission can be effectively brought down to near zero (without using ivermectin, h-chloroquine or other various supplements). If you want evidence and more discussion, see below.

https://jamanetwork.com/journals/jama/fullarticle/2773128

https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/universal-masking-is-an-effective-strategy-to-flatten-the-severe-acute-respiratory-coronavirus-virus-2-sarscov2-healthcare-worker-epidemiologic-curve/9301E77612122039190A29CB7223F9C4

 

3-Aiming intervention at the root of the problem

The virus started somewhere around Wuhan and ended up, somehow and for an unusually high number of cases, at the morgue. Effective interventions have been defined along the chain of events and there’s more work to be done. The document you mention contains the word chloroquine 76 times. Consider the following:

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013587.pub2/full?cookiesEnabled

https://www.bmj.com/content/372/bmj.n526

Of course you can indicate that hydroxychloroquine has not been appropriately studied because people did not take the ‘miracle’ drug with various co-supplements etc etc etc or as a magic ‘cocktail’ etc etc etc but a lot of time and precious resources have been allocated to this question and results have been deeply disappointing.

 

The person who is chair of this WHO committee works in my province in critical care and he has helped to feed the thought process involving the evaluation of ‘alternative’ solutions. One of the conclusions is that alternative pathways need to be considered cost effectively. However, campaigns of disinformation and misinformation are like diseases and need to be eradicated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188430/

 

[wachtwoord]

Your comment about Covid pushes people into death more than flu is only for the set of people..

 

Getting back to my comment, it is only with regards to the fact that most people who die of covid-19 illness have preexisting condition, and those conditions would have eventually killed them, but they were pushed to an early grave by covid-19 to a far greater degree than the common cold, so credit where credit is due.

 

 

 

I dont think it is appropriate to take asymptomatic to mild sympomatic patients who does not have signs of going into second stage (Oxygen drop, lung radiology results, etc) and count them into Covid deaths. 

 

As I said, if they are pushed into their grave to a far greater degree by covid-19 as compared to the common cold, then credit where credit is do.

 

EMPHASIS:  does the common cold have this effect?  If no, then credit covid-19 where credit is due.

 

Following your argument to its logical conclusion you would say no-one ever dies from AIDS? As its always a secondary infection that kills after AIDS took down the immune system. It is common practice to refer to AIDS as the cause of death and not the flu.

 

Same with Corona. The "credit" is due with the lethal pre-existing condition not Corona.

 

Or do you believe the death of Franz Ferdinand caused a world war? ;)

[Investor20]

@Investor20

Of course I agree with your self-evident truths but reading your assertions typically triggers the following slogan: with enough ‘ifs’, you could put Paris in a bottle. Looking past the fundamental aspect, one has to wonder: what is the driver behind all this?

 

1-Positive tests versus reality

-Just like with everything else, there are false positives and there are false negatives

-To suggest that a single positive test is the driver of conclusions does not add up to the real world

-It has become clear that most excess deaths (quite an objective measure) happened secondary to a direct effect of Covid as a significant contributing cause

Yes, you can find stuff that questions the above notions but the weight of the evidence has become very strong.

 

2-Hospital-acquired Covid

This has been studied (healthcare workers and patients). The conclusions are variable but the weight of evidence suggests strongly that the number of hospital-acquired cases is much lower than the 25% mentioned. A very interesting sub-aspect of this discussion is that most hospitals adapted (to various degrees) and adapting (basically through basic tools of distance, masks or other equipment, basic hygiene measures and basic protocols) meant significantly reducing in-hospital transmission. i have access to data from a nearby and major metropolitan hospital that became a designated center for Covid in a city that reported one of the highest community spread in the world and they have convincingly shown that the risk of in-hospital transmission can be effectively brought down to near zero (without using ivermectin, h-chloroquine or other various supplements). If you want evidence and more discussion, see below.

https://jamanetwork.com/journals/jama/fullarticle/2773128

https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/universal-masking-is-an-effective-strategy-to-flatten-the-severe-acute-respiratory-coronavirus-virus-2-sarscov2-healthcare-worker-epidemiologic-curve/9301E77612122039190A29CB7223F9C4

 

3-Aiming intervention at the root of the problem

The virus started somewhere around Wuhan and ended up, somehow and for an unusually high number of cases, at the morgue. Effective interventions have been defined along the chain of events and there’s more work to be done. The document you mention contains the word chloroquine 76 times. Consider the following:

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013587.pub2/full?cookiesEnabled

https://www.bmj.com/content/372/bmj.n526

Of course you can indicate that hydroxychloroquine has not been appropriately studied because people did not take the ‘miracle’ drug with various co-supplements etc etc etc or as a magic ‘cocktail’ etc etc etc but a lot of time and precious resources have been allocated to this question and results have been deeply disappointing.

 

The person who is chair of this WHO committee works in my province in critical care and he has helped to feed the thought process involving the evaluation of ‘alternative’ solutions. One of the conclusions is that alternative pathways need to be considered cost effectively. However, campaigns of disinformation and misinformation are like diseases and need to be eradicated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188430/

 

Cost effectively....I agree.  It is cost effective to test Hydroxychloroquine in early treatment. Ivermectin too. How many studies did NIH or WHO conducted for early use (not in hospital)? I dont know of any.  Please share if I missed any.  All Ivermectin randomized clinical trials were done in India, Iraq, Iran, Argentina, etc. Obviously they are not that expensive to conduct.  Yet I dont know of one randomized control study of Ivermectin from US, WHO or Europe.

 

The main import of the article I posted is about different phases of Covid and different treatments that are appropriate. Its not about any one drug.

 

For example referring back to Figure 2, antivirals need to be given early.  Drugs that act against pneumonia and cytokine storm at that stage, etc...

 

This is the main difference from official standard.  For example Remdesivir is given in hospital stage, after virus replication according this paper.

 

Yes for Hydroxychloroquine there are no early RCT.  But there are RCTs for Ivermectin.  There is one also for Budenoside by Oxford.

 

The typical official line for Ivermectin or Budenoside is they want more data.  Yet, I dont know of any clinical studies planed by NIH, Oxford, WHO etc.  Its so unfortunate that despite these big budgeted organizations, we have to rely on clinical studies from hospitals in Baghdad or Dhaka.

 

I take my decision on the data I have.  If this data is not good enough, I would call upon NIH, Oxford, WHO to conduct the studies, not keep saying we need more data.  They have been saying that for a long time now.

 

And finally how many randomized clinical studies showed Remdesivir is effective.  Please share that Remdesivir data Cigarbutt.

 

WHO recommends against the use of remdesivir in COVID-19 patients (November 2020).

https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients

 

Is Remdesivir cost effective?

 

Note: Only for discussion.  Please consult your physician about any treatment.

[ERICOPOLY]

Same with Corona. The "credit" is due with the lethal pre-existing condition not Corona.

 

Read it again:

 

if they are pushed into their grave to a far greater degree by covid-19 as compared to the common cold, then credit where credit is do.

 

 

 

 

[ERICOPOLY]

Same with Corona. The "credit" is due with the lethal pre-existing condition not Corona.

 

 

Read it again:

 

if they are pushed into their grave to a far greater degree by covid-19 as compared to the common cold, then credit where credit is due.

 

[ERICOPOLY]

It is common practice to refer to AIDS as the cause of death and not the flu.

 

When AIDS wasn't understood and people were dying from common illnesses to a FAR GREATER degree than otherwise, I believe they went hunting around and eventually pinned it on AIDS.  Thanks for the example.

 

 

[Investor20]

Same with Corona. The "credit" is due with the lethal pre-existing condition not Corona.

 

Read it again:

 

if they are pushed into their grave to a far greater degree by covid-19 as compared to the common cold, then credit where credit is do.

 

"Dubbed long-term nonprogressors, they are able to maintain low viral loads – measured by the amount of HIV in a blood sample – and near normal T cell counts without medication."

https://www.fredhutch.org/en/news/center-news/2015/12/HIV-super-survivors.html

 

For HIV too there is a clinical effect, decreased T cell counts.  You dont pin it on HIV for people who have HIV but normal immunity. This percentage of asymptomatic people for HIV are much less than Covid, but the concept is the same.

[Liberty]

Yes, finally!

 

https://www.cbc.ca/news/politics/johnson-johnson-covid19-vaccine-approved-1.5937900

[Cigarbutt]

This may interest some and the topic has economic and potential investment implications.

 

Recently (two main references listed at the end), it has been suggested that the Coronavirus episode has subtracted a full year or more of expected life expectancy in 2020 (US data). The underlying assumptions for the raw inputs are open for debate but are quite reasonable. The method used however is highly questionable and the ‘message’ potentially misleading.

 

First, at the population level, even if the 1+ year loss in life expectancy is taken at face value, this is NOT an extinction-level type of event.

 

Second, the following discussion makes abstraction of individual consequences. At the individual level, death, especially if unexpected, is likely to be a tragedy. Whoever questions that should sign up to be a volunteer at an oncology clinic for a few days (BTW, this is a relatively easy thing to do if you are inclined and can be a great learning (humane) experience for adolescents). One thing that you may come away with going through this type of volunteer work is the amazing thirst for life that individuals typically have (even problematic, especially the way the issue is framed by those offering care). People are often ready to invest ($, suffering, debilitating side effects etc) in exchange for often questionable quality of life of limited duration.

 

Anyways, absent these very real individual considerations, the point of this post (respectfully submitted) is that the impact of this virus on the population (economic wise) has been (and will be) mostly inconsequential. It’s great if you can benefit from market swings related to the perceived impacts but i’d be really surprised if this topic is materially mentioned again in 2022 or after. In a conceptual way (assuming a few aspects), this is like if the entire population had decided to take a sabbatical and to dip into their savings (or incur more debt..).

 

Also, the 1+ year life expectancy loss is a misrepresentation of reality. The classic methodology uses a ‘periodic’ aspect which means that the method assumes that the excess deaths for the measured period will continue to apply in the future (hysteresis level of about 100%) which, clearly, does not apply anywhere close to 100% for the coronavirus episode. There are factors that will stay after the virus is gone or becomes endemic and the net effect is still unknown but the periodic effect on future periods is likely to become close to 0% over a relatively short period of time. This is why the impact on life expectancy from the deaths of despair is so much more significant. The US has decoupled from developing countries in terms of the evolution of life expectancy in the last 10 or 20 years. In some years, life expectancy in the US has even decreased(!). This is due to many reasons but the biggest one is the rising incidence of deaths due to drug overdoses (a phenomenon that has continued to increase in 2020). This phenomenon involves younger cohorts of potentially very productive individuals and has shown a much enduring (and growing) pattern.

 

Correcting for this methodological flaw means that the life expectancy loss in 2020 in relation to the pandemic is about 50 times less than the 1+ year reported.

 

https://www.cdc.gov/nchs/data/vsrr/VSRR10-508.pdf

https://www.pnas.org/content/118/5/e2014746118#T1

[Spekulatius]

^ Yes, I think This makes sense. We had excess death last year which lowered the life expectancy but only last year, going forward this should revert to its LT trend.

 

I do agree that on the long run, the drug related death are more important. In 2019 we had about 70k and about half of those were from opioids. Those 70k are mostly younger folks, so the impact is much larger than the COVID-19 death hitting mostly older folks.

 

Anyways, the epidemic will turn into an endemic by early summer in the US, so we are almost done here. On the drug abuse issue, I wondering legalization of marijuana might have a positive impact on mortality. My thinking is that people will use one drugs or another and marijuana is less likely lethal than opioids and alcohol, so crowding out these drugs with a healthier one could have a positive impact on mortality.

I recall seeing stats that the introduction of marijuana in a state has reduced alcohol consumption for example (I forgot about the source). There is now a natural experiment going on with some states in the US legalizing marijuana and others not yet. Do it should be possible to get some interesting data from consumption trends of various drugs upon introduction  marijuana.

 

Longer term,  I think alcoholic beverages may suffer from increased competition.

[Investor20]

This shows how bad the reporting about Ivermectin is:

 

https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19

Title: Why You Should Not Use Ivermectin to Treat or Prevent COVID-19

By FDA.

 

In the article:  "The FDA has not reviewed data to support use of ivermectin in COVID-19 patients to treat or to prevent COVID-19; however, some initial research is underway."

 

"The FDA has received multiple reports of patients who have required medical support and been hospitalized after self-medicating with ivermectin intended for horses."

 

Then other media take this article by FDA, such as by CNN:

 

https://www.cnn.com/2021/03/05/health/ivermectin-covid-19-fda-statement-wellness/index.html

FDA warns against using anti-parasitic drug for Covid-19 after reports of hospitalizations

 

But they forget to note that FDA states "The FDA has not reviewed data to support use of ivermectin in COVID-19 patients to treat or to prevent COVID-19"

 

Instead they point to one study that appeared recently in Jamanetwork out of over 20  RCT studies with Ivermectin:

 

CNN says (instead of saying FDA did not review the data)

"The announcement comes just a day after new research published in the medical journal JAMA that found ivermectin did not seem to "significantly improve" the time needed for symptoms to get better among patients with Covid-19. "

 

But what did JAMA article find?  They used volunteers with average age 37 of a small study, where you dont expect statistically significant severe disease.

 

In fact Jama article states:

https://jamanetwork.com/journals/jama/fullarticle/2777389

 

Few patients had clinical deterioration of 2 or more points in the ordinal 8-point scale, and there was no significant difference between the 2 treatment groups (2% in the ivermectin group and 3.5% in the placebo group;

 

There was no significant difference in the proportion of patients who required escalation of care in the 2 treatment groups (2% with ivermectin, 5% with placebo;

 

"One patient in the placebo group died during the study period." Table 2 shows zero died in Ivermectin group.

 

Table 2 also shows fever since randomization 8% with Ivermectin vs 10.6% Placebo.

 

That is the results showed a plausable signal for efficacy, except that it was conducted with average 37 years old in a small study that  even escalation of care between Ivermectin with 2% patients vs 5% with placebo, that is potential 60% reduction is not statistically significant.

 

Its so sad to read such reporting.

 

Note:  This is for discussion only.  Please consult your phsician for any treatment.  I agree with FDA that medication intended for horses should not be taken by humans.  Not a suggestion for any treatment.

[KCLarkin]

Investor20, I'm not sure the relevance to investing? Any therapeutics that are not yet in late stage trials will be of no use in the current pandemic. Vaccines will make this moot.

 

You do you. But this seems like a lot of work for an audience of one.

[Investor20]

Investor20, I'm not sure the relevance to investing? Any therapeutics that are not yet in late stage trials will be of no use in the current pandemic. Vaccines will make this moot.

 

You do you. But this seems like a lot of work for an audience of one.

 

One of the best things I ever heard from Warren Buffett is about 5 years back at Omaha.  Some one asked about the future gains vs past gains.  He said the importance of money is what you can buy.  He gave an example, of Rockfeller, who besides his great wealth would not have had a proper head ache medicine or an AC car, let alone a mobile phone.

 

Yes Ivermectin is off patent and is almost free and there is no money to be made by selling Ivermectin.  But that is besides the point.

 

Ivermectin was started being used in April in FLorida by a Covid center.  The first publication showing its efficacy came in June 2020. 

 

https://www.medrxiv.org/content/10.1101/2020.06.06.20124461v2

June 2020

After adjustment for between-group differences and mortality risks, the mortality difference remained significant for the entire cohort (OR 0.27, CI 0.09-0.85, p=.03;).  That is over 70% reduction in death.

 

The media said this is only propensity matched observational study.

 

Since then Unitaid funded meta-analysis of 18 RCTs published showing substantial reduction on death which I posted before.  The media said only 18 RCT studies.  Then CNN takes this one study which is underpowered to write an article "FDA warns against using anti-parasitic drug for Covid-19 after reports of hospitalizations".

 

Come on KCLarkin.  This does not bother you?

 

And vaccine is not 100% efficacious.  Its efficacy in transmitting is not clear.  The effect of strains is not clear.  In fact Biden and Fauci suggested that normal life may not come till 2022 even though most will be vaccinated by summer.

 

So my understanding is Ivermectin will play a role in future infections.  Vaccine does not treat infected people.

 

Note: For discussion only.  Not intended as a suggestion for any treatment.  Please consult a physician for any treatment.

[Spekulatius]

LOL:

https://www.cnbc.com/2021/03/05/detroit-mayor-rejects-initial-jj-vaccine-shipment-saying-pfizer-and-moderna-are-the-best.html

[ERICOPOLY]

You dont pin it on HIV for people who have HIV but normal immunity. This percentage of asymptomatic people for HIV are much less than Covid, but the concept is the same.

 

Did you understand the digital camera analogy?  A few bad pixels around the corners don't really matter.  Also, in the NPR article it was indicated that they were looking at the comments the family was making about symptoms, so these were not asymptomatic people.

[Investor20]

People not seem to understand the "advanced care" they get if they got infected.  Right now as per https://covidtracking.com/data

 

Still above 50,000 cases per day with about 50,000 current hospitalizations.  So what is the treatment for these 50,000 people covid positive per day that is offered so that they dont get to hospitalization stage?

 

See below by NHS (US is not that different):

 

https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-and-treatment/how-to-treat-symptoms-at-home/

 

How to look after yourself at home if you have coronavirus:

 

Treating a high temperature

 

If you have a high temperature, it can help to:

 

    get lots of rest

    drink plenty of fluids (water is best) to avoid dehydration – drink enough so your pee is light yellow and clear

    take paracetamol or ibuprofen if you feel uncomfortable

 

Treating a cough

 

If you have a cough, it's best to avoid lying on your back. Lie on your side or sit upright instead.

To help ease a cough, try having a teaspoon of honey. But do not give honey to babies under 12 months.

If this does not help, you could contact a pharmacist for advice about cough treatments.

 

Things to try if you're feeling breathless

 

If you're feeling breathless,

Try turning the heating down or opening a window. Do not use a fan as it may spread the virus.

 

You could also try:

    breathing slowly in through your nose and out through your mouth, with your lips together like you're gently blowing out a candle

    sitting upright in a chair

    relaxing your shoulders, so you're not hunched

    leaning forward slightly – support yourself by putting your hands on your knees or on something stable like a chair

 

Try not to panic if you're feeling breathless. This can make it worse.

 

KCLarkin, I am talking about treatment for these patients and hoping they dont get worse.  Right now, today its about 50,000 patients a day just in US and 400,000 new cases world wide (https://www.worldometers.info/coronavirus/).

 

Note: Not suggesting any treatment.  Consult a physician.  This is only for discussion.

[Investor20]

People not seem to understand the "advanced care" they get if they got infected.  Right now as per https://covidtracking.com/data

 

Still above 50,000 cases per day with about 50,000 current hospitalizations.  So what is the treatment for these 50,000 people covid positive per day that is offered so that they dont get to hospitalization stage?

 

See below by NHS (US is not that different):

 

https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-and-treatment/how-to-treat-symptoms-at-home/

 

How to look after yourself at home if you have coronavirus:

 

Treating a high temperature

 

If you have a high temperature, it can help to:

 

    get lots of rest

    drink plenty of fluids (water is best) to avoid dehydration – drink enough so your pee is light yellow and clear

    take paracetamol or ibuprofen if you feel uncomfortable

 

Treating a cough

 

If you have a cough, it's best to avoid lying on your back. Lie on your side or sit upright instead.

To help ease a cough, try having a teaspoon of honey. But do not give honey to babies under 12 months.

If this does not help, you could contact a pharmacist for advice about cough treatments.

 

Things to try if you're feeling breathless

 

If you're feeling breathless,

Try turning the heating down or opening a window. Do not use a fan as it may spread the virus.

 

You could also try:

    breathing slowly in through your nose and out through your mouth, with your lips together like you're gently blowing out a candle

    sitting upright in a chair

    relaxing your shoulders, so you're not hunched

    leaning forward slightly – support yourself by putting your hands on your knees or on something stable like a chair

 

Try not to panic if you're feeling breathless. This can make it worse.

 

KCLarkin, I am talking about treatment for these patients and hoping they dont get worse.  Right now, today its about 50,000 patients a day just in US and 400,000 new cases world wide (https://www.worldometers.info/coronavirus/).

 

Note: Not suggesting any treatment.  Consult a physician.  This is only for discussion.

 

"Try not to panic if you're feeling breathless. This can make it worse", NHS says.

 

NHS under the heading "Things to try if you're feeling breathless" offers the advice to try "breathing slowly in through your nose and out through your mouth"

 

There are so many medicines tested, many randomized clinical studies across the world with positive signal of working and the western world has found a problem with each of them.  332 studies listed in this link.

https://c19early.com/

 

Forget about medicines, just looking at Vitamin D,  this randomized open label, double-masked clinical trial study of Vitamin D metabolite (Calcifediol) was found to reduce ICU admission from 50% to 2%:

 

Of 50 patients treated with calcifediol, one required admission to the ICU (2%),

while of 26 untreated patients, 13 required admission (50 %) p value X2 Fischer test p < 0.001.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456194/    (Published online 2020 Aug 29, done in Spain)

 

That is a reduction from 50% to 2%, or 96% reduction.

 

Yet there is no follow up study.  Yet it does not show up in guidances.  Dont panic if you are not able to breath is still the advise and try to breath slowly.

 

https://vitamindwiki.com/Vitamin+D+has+eliminated+ICU+COVID-19+in+hospital+in+Dubai+since+June+-+Sept+26%2C+2020

Vitamin D has eliminated ICU COVID-19 in hospital in Dubai since June - Sept 26, 2020

 

How do people stand this?  I can try to understand someone wants more studies of Calcifediol.  But no studies that I know of since the publication in Aug 2020 that showed over 90% reduction in ICU admission.

 

Note: For discussion only.  Not for treatment.  Please consult your physician for any treatment.

[StubbleJumper]

The outrageous part of the calcifediol issue is that it basically boils down to the most mundane recommendation:  "Be good and goddamned sure that you are not vitamin D deficient when there is covid floating around your community.  If you are white and in the middle of the winter, think hard about whether you are getting adequate vitamin D from dietary sources because you'll be getting nothing from exposure to the sun.  If you have a darker complexion, even in the middle of summer, think hard about whether your body will be producing adequate vitamin D from exposure to the sun."

 

For $10 per year, anybody can go to WalMart and buy vitamin D supplements.  Heads you win, tails you don't lose.

 

 

SJ

[UNF2007]

Had a patient come through clinic, had both vaccine series (Moderna), and was covid negative before I operated on him, I know because we test the day before. 3 weeks later he is in the ED with fever/cough etc and comes up covid positive, despite the vaccine, young otherwise healthy guy. n=1 but I'm still being very careful, the new CDC guidance notwithstanding.

[Cigarbutt]

The outrageous part of the calcifediol issue is that it basically boils down to the most mundane recommendation:  "Be good and goddamned sure that you are not vitamin D deficient when there is covid floating around your community.  If you are white and in the middle of the winter, think hard about whether you are getting adequate vitamin D from dietary sources because you'll be getting nothing from exposure to the sun.  If you have a darker complexion, even in the middle of summer, think hard about whether your body will be producing adequate vitamin D from exposure to the sun."

For $10 per year, anybody can go to WalMart and buy vitamin D supplements.  Heads you win, tails you don't lose.

SJ

A potential win/not-lose aspect is that: "One pill every two weeks fights diabetes, cancers, heart failure, and 18 other diseases".  :)

Covid-19 was recently added to this list. Isn't there an analytical risk here?

Disclosure 1: over the years, i've had to periodically participate in committees which had to decide if the single payer should pay for certain propositions (there was typically a few participants whose main line of argument was: what is there to lose? a similar line of argument is used now to justify the 2T fiscal shot in the arm). Apologies: i tend to focus (too much?) on second and other higher order effects (the 'unseen' ones).

Disclosure 2: i'm in the process of being enrolled in a study (based on strong foundations) which will follow people at relatively high risk to be exposed and to contract covid over the next few months. One arm of the study will receive vitamin D supplementation and the other arm will get a placebo. (i may receive a placebo but will watch for the side effects; you must be aware that the placebo group will also report side effects?)

[Jurgis]

The outrageous part of the calcifediol issue is that it basically boils down to the most mundane recommendation:  "Be good and goddamned sure that you are not vitamin D deficient when there is covid floating around your community.  If you are white and in the middle of the winter, think hard about whether you are getting adequate vitamin D from dietary sources because you'll be getting nothing from exposure to the sun.  If you have a darker complexion, even in the middle of summer, think hard about whether your body will be producing adequate vitamin D from exposure to the sun."

For $10 per year, anybody can go to WalMart and buy vitamin D supplements.  Heads you win, tails you don't lose.

SJ

A potential win/not-lose aspect is that: "One pill every two weeks fights diabetes, cancers, heart failure, and 18 other diseases".  :)

Covid-19 was recently added to this list. Isn't there an analytical risk here?

Disclosure 1: over the years, i've had to periodically participate in committees which had to decide if the single payer should pay for certain propositions (there was typically a few participants whose main line of argument was: what is there to lose? a similar line of argument is used now to justify the 2T fiscal shot in the arm). Apologies: i tend to focus (too much?) on second and other higher order effects (the 'unseen' ones).

Disclosure 2: i'm in the process of being enrolled in a study (based on strong foundations) which will follow people at relatively high risk to be exposed and to contract covid over the next few months. One arm of the study will receive vitamin D supplementation and the other arm will get a placebo. (i may receive a placebo but will watch for the side effects; you must be aware that the placebo group will also report side effects?)

 

Should I tell you that high vitamin D can cause (? ) (is linked to?) kidney stone problems?

Now that I told you this, watch out for kidney stones in placebo group...  ::)

[StubbleJumper]

The outrageous part of the calcifediol issue is that it basically boils down to the most mundane recommendation:  "Be good and goddamned sure that you are not vitamin D deficient when there is covid floating around your community.  If you are white and in the middle of the winter, think hard about whether you are getting adequate vitamin D from dietary sources because you'll be getting nothing from exposure to the sun.  If you have a darker complexion, even in the middle of summer, think hard about whether your body will be producing adequate vitamin D from exposure to the sun."

For $10 per year, anybody can go to WalMart and buy vitamin D supplements.  Heads you win, tails you don't lose.

SJ

A potential win/not-lose aspect is that: "One pill every two weeks fights diabetes, cancers, heart failure, and 18 other diseases".  :)

Covid-19 was recently added to this list. Isn't there an analytical risk here?

Disclosure 1: over the years, i've had to periodically participate in committees which had to decide if the single payer should pay for certain propositions (there was typically a few participants whose main line of argument was: what is there to lose? a similar line of argument is used now to justify the 2T fiscal shot in the arm). Apologies: i tend to focus (too much?) on second and other higher order effects (the 'unseen' ones).

Disclosure 2: i'm in the process of being enrolled in a study (based on strong foundations) which will follow people at relatively high risk to be exposed and to contract covid over the next few months. One arm of the study will receive vitamin D supplementation and the other arm will get a placebo. (i may receive a placebo but will watch for the side effects; you must be aware that the placebo group will also report side effects?)

 

 

Yes, there is a big analytical risk here, but not a big practical risk.  The analytical risk is that you kind of need to twist yourself into a bit of a pretzel to make the logical jump from correlation to causation when considering vitamin D deficiency and adverse covid outcomes.  And for some (most?) of the conditions that are portrayed in that chart, the correlation is likely only that -- correlation.  On the other hand, there is approximately zero downside to taking 1000 IU of vitamin D during the period between the two equinoxes, which is my point of there being very little practical risk.  If you do go down that road of twisting yourself into a pretzel, at worst you are only out $10.

 

With respect to the study in which you are participating, why are they initiating a vitamin D supplementation study to coincide with the arrival of the spring equinox?  That is as silly as it gets when you are dealing with a city located on the 45th parallel with an overwhelmingly white population.  In three weeks, you'll be sitting in the sun in a sheltered area of your back yard, drinking a beer and wearing short-sleeves.  With the rapidly strengthening sun, your pasty-white skin will enable you to soak up more vitamin D in an hour of drinking beer in the sun than what your daily 1000 IU tablet could give you over a week.  The logical timing to conduct that study would have been from November 1 to February 28th, when the sun in Mtl is at its weakest and when nearly every square inch of our body is covered with insulating clothing.  Even pasty-white guys have trouble getting enough vitamin D during that period.

 

 

SJ