COVID19/4 Keep calm and wash your hands

[Ran]

2 minutes ago, Filippa Eilhart said:

I tried to link the lancet article but it doesn’t seem to work. Here’s the article in die Welt that links to it. 

https://www.welt.de/wissenschaft/article206555049/Ibuprofen-und-Corona-Ist-das-Schmerzmittel-gefaehrlich-fuer-Infizierte.html

Ah, I heard about this a week ago -- someone pointed out that ACE2 receptors seemed to be an issue that led to increased mortality, with the person noting that smokers have more of them than non-smokers. I didn't realize ibuprofren might have an effect.

Will buy some paracematol-based pills when I've a chance.

[Zorral]

5 minutes ago, Rippounet said:

Nope, the study is French and was ordered in 2018 after a few cases received a lot of media attention. Haven't found a reference to The Lancet anywhere, the study was officially performed by the national agency of medicine (ANSM).

There's an article in English here: https://www.tellerreport.com/news/2019-12-17---aspirin--paracetamol-and-ibuprofen-relegated-behind-the-counter-of-pharmacies---france-24-.Bkel0-v8Ar.html

Refutation after refutation -- the solution is to switch to a tiny part of THC to a large part CBD.

~~~~~~

There's a supermarket in Belfast, They Say on Twitter, which is limiting its opening hour of shopping to elderly only. Which, you know, after cleaning the store, and then opening, is intelligent, community thinking.

The one thing we here won't be doing, I think, is run out of food.  The trick will be, maybe, getting it.  Right now the supermarkets here are filled with untouched section after section of fresh produce, vegetables and fruits, and nobody's buying the stuff.  Buy it and eat it now -- save your non-perishables until later, if you need them.

 

[Fragile Bird]

Gov. Cuomo is telling CNN that the entire state has 600 ICU beds and 60 are already filled. They will not be able to cope with what he expects to be a huge number of cases and he wants the Army Corps of Engineers to start to modify available space into hospital beds right now because it’s going to take time.

[Filippa Eilhart]

8 minutes ago, Ran said:

Ah, I heard about this a week ago -- someone pointed out that ACE2 receptors seemed to be an issue that led to increased mortality, with the person noting that smokers have more of them than non-smokers. I didn't realize ibuprofren might have an effect.

Will buy some paracematol-based pills when I've a chance.

to clarify, the Welt article states the lancet study is merely a hypothesis, the sample was too small to reach any conclusions and also ibuprofen is not a ACE inhibitor.

 

from google translate  

“So the ibuprofen hypothesis is very shaky. It is not enough to draw a clear conclusion. It was not tested at the cell level whether ibuprofen - via whatever mechanism - leads to the fact that the virus can penetrate the cells more easily.”

 

[Ormond]

5 hours ago, Fragile Bird said:

Just heard a new poll says 60% of Americans think the worst has not yet come. It begs the question, what do the other 40% think? Are they just tuned out, or do they think it’s fake news?

And just recently we were discussing the fact that many people live from pay cheque to pay cheque. How are these people going to pay rent and utilities, credit card bills, car payments, mortgage payments etc etc if everything gets shut down? Will landlords evict tenants? You know some will.

Well, as with any poll I'd suspect around 5% claimed "don't know" and another 2% or so simply didn't understand the question.  I suspect the other 33% do think it's all some media hype conspiracy, either to "get Trump" or just to raise ratings.

[Ormond]

5 hours ago, Fragile Bird said:

 

Sorry, have no idea why that double posted.

[Ser Scot A Ellison]

21 minutes ago, Filippa Eilhart said:

to clarify, the Welt article states the lancet study is merely a hypothesis, the sample was too small to reach any conclusions and also ibuprofen is not a ACE inhibitor.

 

from google translate  

“So the ibuprofen hypothesis is very shaky. It is not enough to draw a clear conclusion. It was not tested at the cell level whether ibuprofen - via whatever mechanism - leads to the fact that the virus can penetrate the cells more easily.”

 

Y’all will take my OTC Ibuprofen from my cold dead fingers.  It is my headache medicine of choice because it works well.

[Ran]

22 minutes ago, Filippa Eilhart said:

ibuprofen is not a ACE inhibitor.

It is not an ACE inhibitor, but it does increase expression of ACE2, which is hypothesized to be a vector for the virus.

I don't know what evidence the French ministry used to make their own statement -- have they responded to queries?

[Filippa Eilhart]

not that I know of.

[Tywin Manderly]

Today the Dutch Government ordered the closure of all schools and hospitality establishments, except for hotels. 

[DMC]

So now ISIS is taking the pandemic more seriously than Trump and the GOP:

Quote

In the latest edition of the terrorist group’s al-Naba newsletter, the editors who normally urge followers to carry out attacks on the West instead ask them to "stay away from the land of the epidemic" for the time being.

In a full-page infographic on the back cover, a list of pro-tips instructs militants on how to stop the pandemic's spread. ISIS members are advised to "put trust in God and seek refuge in Him from illnesses," but to also "cover the mouth when yawning and sneezing," and to wash their hands frequently.

Those who believe they might have contracted coronavirus are told to stay away from areas under ISIS control in order to preserve the health of others and fulfil the holy "obligation of taking up the causes of protection from illnesses and avoiding them."

 

[James Arryn]

4 hours ago, Ser Scot A Ellison said:

I watch the Johns Hopkins tracker fairly closely and the total worldwide is about to jump over the total in China.

I lost my job back in February and had been driving Uber till I found a new one.  I’m scheduled to start work 3/30.  I emailed to confirm that is still the case on Friday and haven’t heard back.

Sorry to hear that, Scot. Keep us posted, wilya? Are you considering going solo?

 

edit: ninja’d by solo. Solo, glad to see you back. 
 

 

[Buckwheat]

57 minutes ago, Filippa Eilhart said:

from google translate  

Aren't you a professional translator? Shame!

So anyway, all public transport here is cancelled starting at midnight. This is getting more and more serious.

An interesting phenomenon showed up relevant to the discussion about real estate and rents in this time. I am sure most people here don't understand Slovene, but here is a good post by an initiative which raises awareness about high rent prices and difficulties in finding a place to live affordably. They noticed a number of recent (in the last few days) ads for fairly luxurious flats in the centre of the capital, which are only being rented out for a month or two - most say they are looking for tenants until the end of April or end of May. It is assumed that those are the apartments that are regularly rented out to tourists over AirBnb, but because of all the covid-related cancellations, they have now freed up for the next couple of months, so the owners are trying to still find somebody to stay there for a month or two.

[DireWolfSpirit]

Illinois governor orders bars and restaurants to close

https://cnn.it/2QhC63Q

[A Horse Named Stranger]

28 minutes ago, Buckwheat said:

An interesting phenomenon showed up relevant to the discussion about real estate and rents in this time. I am sure most people here don't understand Slovene, but here is a good post by an initiative which raises awareness about high rent prices and difficulties in finding a place to live affordably. They noticed a number of recent (in the last few days) ads for fairly luxurious flats in the centre of the capital, which are only being rented out for a month or two - most say they are looking for tenants until the end of April or end of May. It is assumed that those are the apartments that are regularly rented out to tourists over AirBnb, but because of all the covid-related cancellations, they have now freed up for the next couple of months, so the owners are trying to still find somebody to stay there for a month or two.

UNfortunately those AirBnB landlords won't go broke over a few months. And also if hell exists, there's a special place in hell, who use that platform for their trips to metropolitan areas and help to drive rents there. But since hell doesn't exist, I really hope for the day that entire neighbourhoods drive out AirBnB tourists with pitch forks and torches. But that has very little to do with ConVid and is just a vague hope.

[Castellan]

This will not contribute to confidence but I feel I should post this terrifying article in case anybody is not aware of what we are all facing. 

https://www.independent.co.uk/voices/coronavirus-uk-doctor-nhs-hospital-symptoms-italy-china-a9397736.html?utm_source=taboola&utm_medium=Feed

 

[Darth Richard II]

Well two cases confirmed in my town. Fun.

[Lollygag]

On the Advil issue:

https://www.cleveland.com/news/2020/03/french-warn-against-anti-inflammatory-drugs-to-treat-coronavirus-cleveland-doctor-wants-more-data.html

Quote

Edwards said she is aware generally of what the French are saying and believes it’s probably based on a single study and therefore she is reluctant to accept any blanket statement. Also, the study would be looking at data from a lab setting and that the results in real life could be different. If more data comes out she might change her mind, she said.

Edwards said if a patient is already on heavy-duty anti-inflammatory drugs for, say, rheumatoid arthritis, taking them to control inflammation brought on by the coronavirus may be a problem. She said as a pediatrician she often advises that children alternate between acetaminophen and ibuprofen. That could work for adults, too, she said although they would have to make sure it doesn’t cause complications with any underlying conditions or other medicines they are taking.

Adults with coronavirus can also chose to take no anti-inflammatory drugs, she said, because inflammation is how the body fights a virus. You don’t have to necessarily lower your temperature if it’s 100 or 101 degrees, she said, because a high temperature fights infection.

 

 

Some of the worst cases seem to involve cytokine storms. I'm seeing it passed around that elderberry should be avoided because it creates this immune response. So for certain patients, the best treatment may be specific immune-suppression (!)

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30305-6/fulltext

https://trendflare.com/site/elderberry-warning-for-covid19-coronavirus/

https://www.oregonlive.com/coronavirus/2020/03/the-coronavirus-turns-deadly-when-it-leads-to-cytokine-storm-identifying-this-immune-response-is-key-to-patients-survival-report.html

https://www.webmd.com/diet/anti-inflammatory-diet-road-to-good-health#2

Quote

Lancet:

All three coronaviruses induce excessive and aberrant non-effective host immune responses that are associated with severe lung pathology, leading to death. Similar to patients with SARS-CoV and MERS-CoV, some patients with 2019-nCoV develop acute respiratory distress syndrome (ARDS) with characteristic pulmonary ground glass changes on imaging. In most moribund patients, 2019-nCoV infection is also associated with a cytokine storm, which is characterised by increased plasma concentrations of interleukins 2, 7, and 10, granulocyte-colony stimulating factor, interferon-γ-inducible protein 10, monocyte chemoattractant protein 1, macrophage inflammatory protein 1 alpha, and tumour necrosis factor α. In those who survive intensive care, these aberrant and excessive immune responses lead to long-term lung damage and fibrosis, causing functional disability and reduced quality of life.

Specific drugs to treat 2019-nCoV will take several years to develop and evaluate. In the meantime, a range of existing host-directed therapies that have proven to be safe could potentially be repurposed to treat 2019-nCoV infection. Several marketed drugs with excellent safety profiles such as metformin, glitazones, fibrates, sartans, and atorvastin, as well as nutrient supplements and biologics could reduce immunopathology, boost immune responses, and prevent or curb ARDS. Zinc and other metal-containing formulations appear to have anti-viral activity, are safe, cheap, and readily available. These formulations could be used as adjuncts to monotherapy or as combinational therapies with cyclosporine, lopinavir–ritonavir, interferon beta‑1b, ribavirin, remdesivir, monoclonal antibodies, and anti-viral peptides targeting 2019-nCoV. Tocilizumab, a monoclonal antibody that targets the interleukin 6 receptor, has a good safety profile. Monoclonal and polyclonal antibodies to 2019-nCoV could be developed for post-exposure prophylaxis.

Quote

Oregonian:

For one thing, a new study indicates that Covid-19 triggers in some people something called a cytokine storm, where one’s own immune system goes berserk. This “virus-activated” immune response can be deadly, causing severe respiratory distress and the subsequent shutdown of multiple organs.

Indeed, how one’s immune system reacts appears to be central to Covid-19′s severity.

“The virus matters, but the host response matters at least as much, and probably more,” University of Iowa virologist Stanley Perlman told The Scientist magazine last month.

For some people whose immune systems are compromised by age or for often-subtle genetic or environmental reasons, the normal immune response doesn’t retreat when it should. It goes into overdrive, leading to “a flood of immune cells into the lung.” This has a rapid cascading effect in the body.

Key to the patient’s survival is their doctors quickly recognizing this is happening. Dr. Randy Q. Cron and Dr. W. Winn Chatham, in a report for Vox, wrote that --

All Covid-19 patients sick enough for hospitalization should be given a cheap, quick, and readily available serum ferritin blood test. Indeed, elevated serum ferritin values have recently been reported in Chinese hospitalized patients with Covid-19. This is a good first screening tool for the possibility of a cytokine storm syndrome in sick patients with high fevers.

...

In China, coronavirus patients exhibiting signs of cytokine-storm syndrome reportedly are being treated with the anti-inflammation drug Actemra (tocilizumab). Actemra is used in the U.S. for rheumatoid arthritis.

So with the anti-inflammatory thing, I'm researching anti-inflammatory diets and found this and I'm not sure what to make of it.

Quote

Webmd:

Sweets, cakes and cookies, and soda: They're not dense in nutrients, and they're easy to overeat, which can lead to weight gain, high blood sugar, and high cholesterol (all related to inflammation). Sugar causes the body to release inflammatory messengers called cytokines. Soda and other sweet drinks are main culprits. Anti-inflammatory diet experts often say you should cut out all added sugars, including agave and honey.

[Fragile Bird]

I got a phone call this afternoon, on a Sunday no less, cancelling my manicure/pedicure appointment in two weeks. The place I go to is in a wealthier neighbourhood (I like my aesthetician) and the clientele are older. Like me. I was surprised but pleased. I told them so, and they were grateful I was ok with their salon shutting down.

i now know the province of Ontario is finally taking things seriously. All the casinos are being shut down. About bloody time. I guess they finally noticed they were empty.

[Aemon Stark]

3 hours ago, Fragile Bird said:

Gov. Cuomo is telling CNN that the entire state has 600 ICU beds and 60 are already filled. They will not be able to cope with what he expects to be a huge number of cases and he wants the Army Corps of Engineers to start to modify available space into hospital beds right now because it’s going to take time.

Only 600?? We supposedly have 98 in NL, though I suspect that overcalls some beds that aren't truly fully capable ICU beds. Either way, that's for half a million people. 

1 hour ago, Lollygag said:

On the Advil issue:

https://www.cleveland.com/news/2020/03/french-warn-against-anti-inflammatory-drugs-to-treat-coronavirus-cleveland-doctor-wants-more-data.html

Some of the worst cases seem to involve cytokine storms. I'm seeing it passed around that elderberry should be avoided because it creates this immune response. So for certain patients, the best treatment may be specific immune-suppression (!)

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30305-6/fulltext

https://trendflare.com/site/elderberry-warning-for-covid19-coronavirus/

https://www.oregonlive.com/coronavirus/2020/03/the-coronavirus-turns-deadly-when-it-leads-to-cytokine-storm-identifying-this-immune-response-is-key-to-patients-survival-report.html

https://www.webmd.com/diet/anti-inflammatory-diet-road-to-good-health#2

So with the anti-inflammatory thing, I'm researching anti-inflammatory diets and found this and I'm not sure what to make of it.

A lot of issues in sepsis amount to this kind of immune "overreaction" - which is why people going on about how "strong" their immune system betray a complete lack of knowledge of how this works. We're not very good at finding effective immune-modulators in sepsis or ARDS or viral pneumonias generally. But antivirals might help - except which ones? Chloroquine, which is an old anti-malarial, might be good. We won't really know for a while. Anti-inflammatory diets are more faddish than anything else for this sort of thing.