Seeking Understanding,
Larry Romanoff has good analysis again.
I make no claim to being a virologist, but this is beginning to look damned peculiar. A natural virus hasn’t the ability to simultaneously infect 85 different countries on all continents of the world, with outbreaks in multiple locations in each country – and to do it without the vehicle of a seafood market full of bats and bananas.More peculiar is that these countries were by no means all infected with the same variety of the virus, which means the simultaneous infections in these 85 countries were not from the same source. Even more peculiar is that most countries, at least the major ones, reported simultaneous outbreaks in multiple locations, and to date while some nations have been able to identify one or more of their ‘patients zero’, I am aware of no country that was able to definitively identify all their several ‘patients zero’. Considering the above information in light of the known basic facts of virus transmission, intuition suggests at least the possibility of there having been many people carrying a pail of live viruses.
It is interesting to note that high fatality rates are entirely within Italy, Iran, and China. For approximate figures, China’s fatality rate is between 3% and 4%, that of Iran at about 7% and Italy the highest at around 9%. Even more interesting is that if these countries did pass their strain of the virus to other nations, those strains abandoned their lethality when they left home. Of the 34 countries supposedly infected by Italy, for example, all exhibit very low mortality, the same being true of Chinese or Iranian infections. The natural conclusion is that these viruses prefer their ‘home populations’ and pose at best a minor threat to others.
Oh, this is funny, but it is a lead to follow. I was telling Jenny just now that I can't figure out who would benefit from releasing waves of mild-by-military-standards weaponized virus upon the world.
"This is evil genius stuff", I said...
Then I remember that a friend from Switzerland, high end audio uber-geek, had sent a TED talk by Bill Gates from 2015, explaining how the Ebola epidemic shows we are not prepared for the next viral pandemic. The picture Bill flashes after he walks in with the drum of survival rations for his childhood bomb shelter is CORONAVIRUS. He does not say that.
Bill goes on about the wonders of NATO and having doctors in teams ready to go to poor African countries so women can give birth safely and children can get vaccines.
Nice guy in Mr Rodgers sweater giving talk that predicts our current scenario rather neatly. https://www.youtube.com/watch?v=6Af6b_wyiwI
Bill resigned as CEO of Microsoft in January.
I wondered why...
Hey, I just looked up Microsoft headquarters. It's in Redmond Washington, which is to Kirkland, as Ft Worth is to Dallas, a confluent urban center.
Kirkland is where all hell broke loose with coronavirus, right after Bill quite as CEO.
A lot of CEOs resigned in January, I hear. I wonder where Bill is now.
Bill got Event 201 up and running in October, just as it appears novel coronavirus was entering human hosts. http://www.
I'm going to say that following-Bill-Gates'-money might be our best lead on this Malthusian biowarfare global pandemic.
We know Bill believes secret sterilizationwith tetanus vaccines is the save for human overpopulation.
Bill Gates may actually be trying to HELP the world by spreading a pandemic virus that kills 1-5%, and mostly the weaker ones. It may have other tweaks to increase and decrease mortality.
From this 2015 TED talk, Bill seems like he was already working with NATO. He talked them up pretty well.
With Bill running the main project, other military/spook participants would be able to pitch some curve balls, more deadly viral strains, after Bill's humanitarian effort was already underway, and understood by global elites as a helpful thing.
Here is Bill on Saturday saying the entire US has to shut-down right away for 6-10 weeks.
"Anything less will not work".
"State by state and county by county will not work", says Bill.
(How can you be so sure, Bill? It worked in China.)
Is the Corona Virus a new 9/11, a new deep event? We cannot yet be sure, as of this writing. Perhaps the current strategy of suspending basic liberties will work to effectively eliminate all threats posed by the virus. Governments will then restore the civil liberties currently being suspended and all will fairly quickly return to the way things were before. Perhaps the economy will confidently weather the fallout from the ‘lockdowns’ and everything will return to business as usual.
And perhaps a sober ‘lessons learned’ review will lead to public health officials developing reasonable and balanced plans, such as developing sufficient capacity for rapid testing and tracing, which can be deployed the next time a sufficiently dangerous virus starts to spread thus avoiding terrifying publics and implementing draconian measures that inflict significant damage to the social and economic fabric of society.
Or perhaps not. It may be that, as British journalist Peter Hitchens has been warning, the loss of liberty and basic rights will continue indefinitely as governments greedily hold on to their increased powers of control over their citizenry.
Thanks for this, Tom:
Today’s America is confronting an existential crisis similar to that which both Lincoln and Franklin Roosevelt battled in their time. Just as the proto-deep state of 1865 ran Lincoln’s assassination from Montreal Canada, and took over the White House minutes after FDR’s untimely death in 1945, today’s deep state has attempted in vain to overthrow President Trump while successfully undermining the political viability of other “outsiders” like Bernie Sanders and Tulsi Gabbard.The difference is that today’s crisis combines elements of all previous crises of 1861-1865, 1929-1933 and 1938-1945: the very real new threat of chaos and civil war within, NATO-led wars with China and Russia without and economic collapse across the entire trans-Atlantic bubble economy. The other difference is located in the current presidency’s inability to FOCUS with a clear mind on principled solutions to this multi-faceted crisis while instead finding itself trapped within contradictory impulses.
While FDR and Lincoln understood that VALUE was located the physically productive forces of labor which sustained and improved the lives of people and gave the constitution’s pre-amble a real living character, today’s American leadership has displayed a far greater ignorance to this basic fact of life.
Thanks for sending this, Tyler. The website format is edgy, but this is serious content:.
"I am an ER MD in New Orleans. Class of 98. Every one of my colleagues have now seen several hundred Covid 19 patients and this is what I think I know." Clinical course is predictable.
2-11 days after exposure (day 5 on average) flu like symptoms start. Common are fever, headache, dry cough, myalgias(back pain), nausea without vomiting, abdominal discomfort with some diarrhea, loss of smell, anorexia, fatigue.
Day 5 of symptoms- increased SOB, and bilateral viral pneumonia from direct viral damage to lung parenchyma.
Day 10- Cytokine storm leading to acute ARDS and multiorgan failure. You can literally watch it happen in a matter of hours.
81% mild symptoms, 14% severe symptoms requiring hospitalization, 5% critical.
Patient presentation is varied. Patients are coming in hypoxic (even 75%) without dyspnea. I have seen Covid patients present with encephalopathy, renal failure from dehydration, DKA. I have seen the bilateral interstitial pneumonia on the xray of the asymptomatic shoulder dislocation or on the CT's of the (respiratory) asymptomatic polytrauma patient. Essentially if they are in my ER, they have it. Seen three positive flu swabs in 2 weeks and all three had Covid 19 as well. Somehow this b***h has told all other disease processes to get out of town...
Day 10- Cytokine storm leading to acute ARDS and multiorgan failure. You can literally watch it happen in a matter of hours.
81% mild symptoms, 14% severe symptoms requiring hospitalization, 5% critical.
Patient presentation is varied. Patients are coming in hypoxic (even 75%) without dyspnea. I have seen Covid patients present with encephalopathy, renal failure from dehydration, DKA. I have seen the bilateral interstitial pneumonia on the xray of the asymptomatic shoulder dislocation or on the CT's of the (respiratory) asymptomatic polytrauma patient. Essentially if they are in my ER, they have it. Seen three positive flu swabs in 2 weeks and all three had Covid 19 as well. Somehow this b***h has told all other disease processes to get out of town...
Basically, if you have a bilateral pneumonia with normal to low WBC, lymphopenia, normal procalcitonin, elevated CRP and ferritin- you have covid-19 and do not need a nasal swab to tell you that.
A ratio of absolute neutrophil count to absolute lymphocyte count greater than 3.5 may be the highest predictor of poor outcome. the UK is automatically intubating these patients for expected outcomes regardless of their clinical presentation.
An elevated Interleukin-6 (IL6) is an indicator of their cytokine storm. If this is elevated watch these patients closely with both eyes...
An elevated Interleukin-6 (IL6) is an indicator of their cytokine storm. If this is elevated watch these patients closely with both eyes...
Disposition
I had never discharged multifocal pneumonia before. Now I personally do it 12-15 times a shift. 2 weeks ago we were admitting anyone who needed supplemental oxygen. Now we are discharging with oxygen if the patient is comfortable and oxygenating above 92% on nasal cannula. We have contracted with a company that sends a paramedic to their home twice daily to check on them and record a pulse ox. We know many of these patients will bounce back but if it saves a bed for a day we have accomplished something. Obviously we are fearful some won't make it back...
I had never discharged multifocal pneumonia before. Now I personally do it 12-15 times a shift. 2 weeks ago we were admitting anyone who needed supplemental oxygen. Now we are discharging with oxygen if the patient is comfortable and oxygenating above 92% on nasal cannula. We have contracted with a company that sends a paramedic to their home twice daily to check on them and record a pulse ox. We know many of these patients will bounce back but if it saves a bed for a day we have accomplished something. Obviously we are fearful some won't make it back...
Treatment: Supportive
Worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%. Our hospital has had 5 deaths and one patient who was extubated. Extubation happens on day 10 per the Chinese and day 11 per Seattle.
Plaquenil which has weak ACE2 blockade doesn't appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell...
Worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%. Our hospital has had 5 deaths and one patient who was extubated. Extubation happens on day 10 per the Chinese and day 11 per Seattle.
Plaquenil which has weak ACE2 blockade doesn't appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell...
We are also using Azithromycin, but are intermittently running out of IV...
Proning vented patients significantly helps oxygenation. Even self proning the ones on nasal cannula helps.
[That means people breathe better face down. Got a massage table?] ...
One of my colleagues who is a 31 yo old female who graduated residency last may with no health problems and normal BMI is out with the symptoms and an SaO2 of 92%. She will be the first of many.
I PPE best I have. I do wear a MaxAir PAPR the entire shift. I do not take it off to eat or drink during the shift. I undress in the garage and go straight to the shower. My wife and kids fled to her parents outside Hattiesburg. The stress and exposure at work coupled with the isolation at home is trying. But everyone is going through something right now. Everyone is scared; patients and employees. But we are the leaders of that emergency room. Be nice to your nurses and staff. Show by example how to tackle this crisis head on. Good luck to us all."
I PPE best I have. I do wear a MaxAir PAPR the entire shift. I do not take it off to eat or drink during the shift. I undress in the garage and go straight to the shower. My wife and kids fled to her parents outside Hattiesburg. The stress and exposure at work coupled with the isolation at home is trying. But everyone is going through something right now. Everyone is scared; patients and employees. But we are the leaders of that emergency room. Be nice to your nurses and staff. Show by example how to tackle this crisis head on. Good luck to us all."
Awaiting The Onslaught
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