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Friday, August 14, 2020

First The Good News

 Potential Beneficiaries,


I saw a couple sick with typical coronavirus symptoms Tuesday morning, and risk factors, especially for the sicker husband, who was more obese and had badly uncontrolled diabetes. He also had lower blood oxygen, but it was below normal for the wife, also. Both had diarrhea, fevers, sweats, chills, body aches, headaches, fatigue and got short of breath easily. Most of the usual stuff, and worsening, not improving. Test reporting times were getting much better than the 15 days we lived with in July (though not everybody "lived"), but I had no certainty that we would get results this week. He had been sick 10 days, and she had been sick for a week. 
 I have been sick for months, sick that I can't diagnose and treat people, get them better, keep them out of the ICU and the morgue... I have had so many instances of people being hospitalized for severe illness after I tested them for mild to moderate illness, before we got results.
 We talked. I said "you have typical symptoms of coronavirus". "There are treatments." They were familiar with hydroxychloroquine, and not worried. I don't  think it's a scary thing in the Spanish speaking world. I also discussed ivermectin, both in concert with zinc, and either azithromycin or doxycycline. I explained that coronavirus can cause heart attacks and strokes by itself, but the HCQ can cause some heart problems, that the ivermectin combination has a bit less side effects, and might even work a little better, that Its use has increased in India, because of very good results, not politics. They both wanted treatment with "whatever I thought was better". 
 I am tremendously grateful to be able to do this work, and to rightly earn people's trust by doing the best I can.
I went and counted out zinc tablets, 3 times per day for 7 days, and put them in a white paper bag and labeled it for use. My personal gift. I prescribed 200 micrograms per kilogram of ivermectin each, 6 pills for her; 7 pills for him. I prescribed about $5 each of doxycycline, to take twice per day for 10 days, I faxed and gave printed/signed prescriptions also. They got it and took it.
 Thursday morning before I got in to work the afternoon clinic, the reports came in, both positive. One of our Spanish speaking nurses called to inform them, and ask how they were doing.
 Both "got better right away since starting the medicine Dr. Day gave them". 
No more fever or body aches, and no diarrhea. Less tired; doing a little more.
He still had a cough, and requested cough medicine, but felt much better otherwise.
 It's better to be lucky, than to be good, but sometimes, you can be both.
I broke the rules. I treated without a test result. It seemed to work like a charm. 
Of course we'll need 6 months of randomized placebo-controlled clinical trials, before we'll really know...
Or maybe we'll just be dead before we get those conclusive results.

Ivermectin was studied in monkey cell cultures earlier this year, at higher concentrations than what can be achieved with real doses in real people. It shut down viral release from infected cells, and seemed to stop viral replication.
​  ​Supernatant and cell pellets were harvested at days 0–3 and analysed by RT-PCR for the replication of SARS-CoV-2 RNA (Fig. 1A/B). At 24 h, there was a 93% reduction in viral RNA present in the supernatant (indicative of released virions) of samples treated with ivermectin compared to the vehicle DMSO. Similarly a 99.8% reduction in cell-associated viral RNA (indicative of unreleased and unpackaged virions) was observed with ivermectin treatment. By 48 h this effect increased to an ~5000-fold reduction of viral RNA in ivermectin-treated compared to control samples, indicating that ivermectin treatment resulted in the effective loss of essentially all viral material by 48 h.  

​It's not real until Americans say it's real:​
 Associate Professor Tong is aware of other trials looking into ivermectin as a potential COVID-19 treatment in South America and elsewhere.
He says there even are reports that some countries are using the drug ‘more broadly’ as a treatment for COVID-19.
However, Associate Professor Tong says there is currently insufficient evidence to show ivermectin can be used as therapy for COVID-19 and that randomised controlled trials are needed to investigate this area.
‘And until we get that level of evidence, these agents should only be used in the context of a clinical trial,’
he said.

​There's this, but it's not conclusive. (You can't just take parasite medicine like you had worms, and doxycycline like you had a bacterial infection. This is serious. Don't Try!)
A Combination of Ivermectin and Doxycycline Possibly Blocks the Viral Entry and Modulate the Innate Immune Response in COVID-19 Patients  

This bold and innovative Australian doctor is using it, but where's his data? Can Professor Tong please see it?
Thomas Borody MB,BS, BSc (Med), MD PhD, DSc, FRACP, FACP, FACG, AGAF, touts FDA and TGA approved Ivermectin, which he reports to use regularly in his hospital as it evidences positive results for COVID-19 and should be used immediately to fight the pandemic. The developer of the world’s first cure for peptic ulcers, which saved millions of lives worldwide, employed the same methodology to come up with the Ivermectin triple therapy. 

What the world needs is a cheap home test like a pregnancy test that everybody can use a few times a week (and then just disappear for a few weeks when it shows positive, 'cause there's no cure, and we're waiting on a vaccine, but NOT a Russian vaccine. They are rushing things too much.) Good 5 minute video advocating production of cheap, quick tests.

Saliva Test For COVID-19 With "Less Than 1 Second" Results Enters Trial Phase In Israel

Those dirty Russians say the west is making a propaganda war against their vaccine, before they are even finished testing it on Russians.

Four Reasons Civilization Won't Decline: It Will Collapse
I like this one best:
Unlike past civilizations, the economy of industrial society is capitalist.  Production for profit is its prime directive and driving force.  The unprecedented surplus energy supplied by fossil fuels has generated exceptional growth and enormous profits over the past two centuries.  But in the coming decades, these historic windfalls of abundant energy, constant growth, and rising profits will vanish.
​ ​However, unless it is abolished, capitalism will not disappear when boom turns to bust.  Instead, energy-starved, growth-less capitalism will turn catabolic.  Catabolism​ ​refers to the condition whereby a living thing devours itself.  As profitable sources of production dry up, capitalism will be compelled to turn a profit by consuming the social assets it once created.  By cannibalizing itself, the profit motive will exacerbate industrial society’s dramatic decline.
​ ​Catabolic capitalism will profit from scarcity, crisis, disaster, and conflict.  Warfare, resource hoarding, ecological disaster, and pandemic diseases will become the big profit makers.

Chris Smaje at Small Farm Future is musing about how to diagnose and treat our current mass psychosis:
​  ​Maybe we’ll get somewhere different if we think about illness at the collective level. The constant refrain of cultural critics down the ages is that present society has lapsed into a sick, decadent or fallen state. And the pushback is often something along the lines of Markovits – that this is an anti-human, or misanthropic or elitist position that maligns the ordinary struggles of everyday people. This kind of trick is often pulled by ‘eco-modernists’ and other peddlers of business-as-usual porn – that theirs is the pro-human position, while any wider cultural critique is mere nihilism or misanthropy. However, the point of cultural critique isn’t to wallow in nihilism, but to diagnose the source of the malaise in order to improve the human condition. So, for me, to talk of humanity’s deep illness isn’t necessarily anti-human.​...
 But I think we need to stop looking at ourselves in the mirror of the past and liking what we see so much, instead addressing the dramatically dangerous trade-offs that our modern hive intelligence poses for us in the here and now. More importantly, I think we need to address the possibility that a world of human autonomy outside the hive might suit us better.

​It seems that nobody ever bought the $700,000 worth of ammonium nitrate, or at least ever paid for it, before it was impounded in Beirut for unsafe shipping. Nobody ever appeared to own it or lose money on it. Where did the money injection originate, which created the biggest fertilizer bomb ever?

While the whole rest of the world, except "Israel" tries to at least make sounds about helping crushed and penniless Lebanon, the US is going to increase economic sanctions to bring the heaviest possible pressure of suffering to bear, at this opportune moment. Really. Yes.

Public Health Guy 

4 comments:

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  2. Truly appreciate your wonderful blog. Thank you for all the time you put into it.
    Two questions: how is Jenny? Have we missed a post? It doesn't seem you have spoken of her lately.
    We think that you are totally onto something with your Rx suggestions, but how do we find a doctor who will agree? We do not live in your state. And add to that, we are with the Kaiser system, so they have a particular protocol to which their doctors agree. Any response would be highly appreciated. Thank you.

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    1. Hi Anomymous.
      Jenny is now one month out from her complex surgery, and is doing about as well as a human can do. She still has significant limits, some of which are now structural, but she has had some of the hoped-for improvements also. Very heartening!
      This is moving so fast that I don't know how you can find a physician to prescribe Ivermectin, doxycycline and zinc. You should probably just get some zinc. 50 mg zinc gluconate tablets are a good choice. I was able to get some from Rite-Aid, but it took 5 weeks to arrive.

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