Covid-19 Diary : Thursday 28 January, 2021

 

I’ve seen a number of news items this week which form part of a common theme, which I’ll call “The Stitch in Time” theme.

You know the proverb “A stitch in time saves nine”.  It applies for medical problems the same as for many other things.  Sometimes, the need for urgent treatment and response is obvious – a person suffering a heart attack or stroke is in a grave situation where literally seconds count.  We know that if there’s concern about a cancer, the healthcare providers rush you through testing and diagnosis, and quickly get you started on treatments before the cancer becomes too large and advanced.

In general terms, many ailments can be treated at various phases.  Let’s consider several possible points where a medical intervention might be possible.

1.  A prophylactic treatment to prevent becoming infected.  This is something you’d do before being exposed to the infection.  Two examples of this are having a vaccine, or starting to take anti-malarial tablets prior to arriving in a malaria-infested region.

2.  A treatment after a suspected exposure to the disease, before it becomes a problem.  That’s a bit like a tetanus shot after being cut by a rusty nail, or a series of rabies shots if bitten by a possibly rabid animal.

3.  A treatment as soon as an infection/disease becomes apparent.  Maybe an example of that is taking an aspirin if you have a headache, or a course of antibiotics if you have a sore throat.

4.  Hospitalization and more complicated treatments if a disease becomes serious.

5.  Panic-mode in the ICU, trying anything and everything, in a desperate attempt to “salvage” a patient who is facing certain death if not treated.

The thing about this series of steps is that, in many cases, if you do nothing, a disease may progress all the way through all five steps, and might ultimately end up killing the patient.

The other thing about this series of steps is that at each point, the discomfort to the patient becomes more severe, and the cost of resolving the disease becomes more resource intensive and expensive.

Now let’s start applying this model to the Covid virus.

For step one, we are now deploying vaccines.  There are also some other drugs that have demonstrated prophylactic properties which have not been used but which have been available and known about for many months, including the period of time when vaccines where still a distant and uncertain hope.

For step two, there are a number of anti-viral drugs that can be used but which are not being used.  Some anti-viral drugs have weak rather than guaranteed anti-viral effects, and so work best when a person starts taking them as soon as possible.  The official CDC/FDA statement is to do nothing except stay at home and hope you get better all by yourself.

For step three, there are again a number of anti-viral drugs that can be used, and a number of other drugs that address secondary elements of a Covid infection which can also be used.  None of these are being usedThe official CDC/FDA statement is again to do nothing except stay at home and hope the infection doesn’t become more extreme.  New drugs are coming available, and sometimes getting emergency use approvals, but they are very expensive, and available only in limited quantities.

For step four and five, things start to become complicated and costly – it is a struggle to even stay for a single night in a hospital and not end up with a $10,000 bill, and your risk of dying has massively increased; survivors might have lasting or permanent damage to their lungs, heart, brain, and other organs.  The battle shifts from a focus on simply treating the virus to now needing to treat the problems the virus causes too.

So if you were in charge of planning a public health response to the Covid pandemic, and if you had to choose only one or two of these five levels to develop treatments for, which would you focus on?

We are spending billions of dollars on vaccines – and may need to continue spending more and more billions on new vaccines to counter new virus variants, and we’re spending who-only-knows how many billions of dollars on health care costs for people who require hospitalization.

But the government and its Operation Warp Speed hasn’t spent anything on responding to people in step 1 (other than vaccines, which we know will take a year or so to get everyone vaccinated, and which we know not everyone will choose to accept), and hasn’t spent anything at all in step 2 and 3 responses.  Why not?  These could be low-cost “stitch in time” type treatments that prevent people from getting variously any infection or a serious infection, relieving the stress on our hospitals, and massively cutting the cost of a course of treatment.

The good news is the government doesn’t need to spend anything to fund the development of new wonder drugs.  There are already low-cost drugs out there, that have been amply tested over decades to show their safety, and which have recently been the subject of dozens of trials and evaluations, and written up in peer-reviewed studies.  But the government refuses to acknowledge the existence of these drugs, or if it does acknowledge their presence, it lies – yes, lies – and claims they don’t work or are dangerous.  (Well, to be fair, it is either stunning ignorance or deliberate lies, and looking at the across-the-board incompetence demonstrated so far in our various responses to the virus, perhaps stunning ignorance is as likely as deliberate lying.)

For example, hydroxychloroquine, which appears to be a wonder-drug, but which is claimed to be either too dangerous or just not effective.

Dangerous?  How many people have died from HCQ compared to how many people have died from the vaccine, or from doing nothing?  A study last year rebutted the claim HCQ was dangerous, and used evidence and facts to show it was abundantly safe, as you’d expect of a drug that is in widespread use, all around the world, by tens, maybe hundreds of millions of people for other ailments at present.

Not effective?  This claim relates to using HCQ to treat late-stage patients with severe infections.  But everyone knows HCQ is not so good for such people, and the people who use this as an excuse for not considering HCQ are strangely ignoring its clearly demonstrated benefits for people in the very early stages of an infection.  Why are they ignoring this?

As for ivermectin, patients – and even their doctors too, now – are having to go to court to get hospitals to agree to allow the patients to be given ivermectin.  Ivermectin, the same as HCQ, is in use by tens/maybe hundreds of millions of people around the world, is remarkably safe, and seems to be even better than HCQ when it comes to combatting Covid.

How many of the 440,000 people who have died of Covid, so far, in the US, would still be alive today if there’d been a widespread program of dispensing either or both these drugs to people?  Probably more than half, possibly more than three-quarters, maybe even 90%.

If we take the most conservative of those numbers – 50%, that comes to 220,000 people who have needlessly died.  So far.  In the US, alone.  Death is not the only negative consequence that we should be concerned about, too.  Many more of the 26 million people in the US who have now had a Covid infection have suffered and will continue to suffer lasting damage to their lungs, heart, brain, and other organs.  How many million of those people are needlessly doomed to a lower quality of life for the balance of what may also be a shorter lifespan in total?

There is an abundance of facts to support the effectiveness of these two drugs, and of many other drugs too (I list over a dozen in my book).  Here are a couple of fact summaries :

Hydroxychloroquine (Links here and here)

Ivermectin (Links here and here)

The cost of these two drugs is about a dollar or so per dose.  A person might require two to eight doses during a course of treatment.  Doses are given in pill form – no need for IV transfusions or anything unpleasant and expensive.

Meanwhile, the FDA is continuing to review experimental new drugs about which nothing is known, and the only data in support of them comes from the big-pharma companies that have developed them.   Surely an existing drug, which has decades of use history to prove its safety, and dozens of independent trials to prove its value, would be more persuasive and compelling to authorize, especially if the drugs are inexpensive, easy to administer, and plentiful.

Why is the medical establishment so extremely opposed to these life-saving drugs?  There’s no downside to using them at all.  Heads, the patient recovers.  Tails, you’ve wasted a few dollars, and the patient is no worse.

Here are some examples of the medical establishment doing the exact wrong thing at present.  These examples have come in so far this week, there are plenty of others from previous weeks.  Tragically, there seem likely to be plenty more next week, and in subsequent weeks, too.

This is not a case of doctors knowing best.  It is a case of administrators not knowing what is right, correct, and proper.  Many doctors – those open-minded enough to actually review the facts – have come out in favor of HCQ, ivermectin, and other treatments, and are finding, every day in their clinics, that these drugs are saving the lives of their patients.

This is not me – a non-doctor – arguing against doctors.  It is a case of front-line doctors arguing against other doctors and administrators, with us as the meat in the sandwich and suffering the consequences.  Surely, we as patients should be allowed a voice in determining our treatments?  That is usually the case with other types of ailments, why, when it comes to this virus, are we ignored?  It isn’t as though the drugs are habit-forming or hallucinogens or illegal.  Both HCQ and ivermectin has been approved by the FDA, and – in theory – once a drug has been approved for a specific use, doctors may freely prescribe it for other uses too (what is termed “white labeling”).  Why the refusals to the ridiculous point of needing court orders to overrule?

Moving on to other topics…..

A question I couldn’t answer :  A reader asked me about a problem.  She has a daughter overseas who wants to return home to the US.  But the US – and many other countries too – now require a negative Covid-test before traveling.  The problem is her daughter had the Covid virus a while ago, and is now clear and free of it.  But the PCR test can continue to report a positive result for three months after a person has been infected and recovered!  (The question – what can her daughter do if the travel-test incorrectly shows positive?)

What makes this all the more frustrating is that sometimes the PCR test shows a person correctly as now being clear of the virus, but other times it gives a positive result.  Another reader mentions that in Thailand, if you get a positive test result, the military come and take you to a quarantine location.  He believes you have no chance of trying to “explain” the positive result, or of asking to get a second result in case the first result was wrong (as is thought to be the case more often than we’d hope for with the so-called “gold standard” PCR testing).

The false hope of vaccines :  Keep in mind you might still get infected by the virus after having been vaccinated.  The vaccines merely claim that you won’t become seriously unwell.  You still might get infected, and you still might be infectious in turn, and you still will test positive.

As long as countries continue to base their admission rules on PCR type testing, travel is and will continue to be a risky gamble.  The vaccines do not help you at all in terms of making travel easier.  This article, for example, says that New Zealand won’t open its doors to vaccinated travelers because of the concerns that vaccinated travelers might also be infected and infectious.

The bottom line?  You travel internationally at your own peril at present.  Indeed, since writing the above, here’s official confirmation, should you wish it.

To end these opening comments on a lighter and very different note, here’s an item headlined “Travel group, airlines oppose quarantine for U.S.-bound air passengers“.  Could we suggest a better and more accurate headline would be “Airlines and travel group put profits before safety”.

Current Numbers

In the US, Hawaii displaced Vermont and now is the state that has been least affected by the virus.  UT and RI swapped places at the other end of the case list.

Strangely, Hawaii and Vermont swapped places, but the opposite way, in the death list.  Vermont is now the state with the lowest death rate.

In the country lists, not a lot of changes, other than the UK shooting up two places in the death rate list.

US Best and Worst States

RankCases/MillionDeaths/Million
A week agoNowA week agoNow
1 BestVT (16,955)HI (18,039)HI (232)VT (276)
2HI (17,473)VT (18,467)VT (269)HI (287)
3MEMEAKAK
4ORORMEME
5WA (39,338)WA (40,881)OR (437)OR (458)
47TN (102,177)TN (105,076)MS (1,904)MS (1,998)
48RI (102,690)UT (106,815)RI (1,960)RI (2,024)
49UT (103,080)RI (107,380)MA (2,018)MA (2,082)
50SD (120,262)SD (121,849)NY (2,151)NY (2,221)
51 WorstND (126,460)ND (127,686)NJ (2,338)NJ (2,398)

 

Top Case Rates Minor Countries (cases per million)

RankOne Week AgoToday
1Andorra (121,279)Andorra (126,447)
2Gibraltar (115,214)Gibraltar (121,182)
3MontenegroMontenegro
4San MarinoSan Marino
5LuxembourgLuxembourg
6SloveniaSlovenia
7PanamaPanama
8LithuaniaIsrael (68,376)
9Israel (63,372)Lithuania (66,727)
10Lichtenstein (63,238)Lichtenstein (64,806)

 

Top Case Rates Major Countries (cases per million)

RankOne Week AgoToday
1Czech Republic (85,574)Czech Republic (89,983)
2USA (75,872)USA (79,303)
3Belgium (58,897)Portugal (67,330)
4Portugal (58,463)Belgium (60,218)
5Spain (54,754)Spain (59,710)
6NetherlandsNetherlands
7Sweden (53,575)Sweden (55,700)
8UK (52,047)UK (54,980)
9FranceFrance
10BrazilBrazil
11ArgentinaArgentina
12Italy (40,194)Italy (41,640)

 

Top Death Rate Major Countries (deaths per million)

RankOne Week AgoToday
1Belgium (1,771)Belgium (1,802)
2Czech Rep (1,397)UK (1,515)
3Italy (1,394)Czech Rep (1,487)
4UK (1,389)Italy (1,446)
5USA (1,266)USA (1,336)
6Peru (1,182)Spain (1,236)
7Spain (1,177)Peru (1,218)
8Mexico (1,113)Mexico (1,184)
9France (1,102)France (1,144)
10Sweden (1,078)Portugal (1,140)

 

The rest of this newsletter is for the very kind Travel Insider Supporters – it is their support that makes all of this possible, and it seems fair they get additional material in return.  If you’re not yet a Supporter, please consider becoming one, and get instant access to the rest of the Diary Entries – today and in the past, and much extra content on other parts of the website too.

If you’re a contributor, you should make sure you’re logged in to the website, and when you are, you’ll see the purple text and balance of the newsletter below on the website.  If you’re not logged in, or reading this via email, you need to log in on the website first.

Items below include an article suggesting that everything the government has done in response to the Covid pandemic has either not helped or actually actively hindered the response to the virus, more bad news about the virus and its symptoms, should we be wearing three masks, and, if wearing two or more masks, how should they be layered, Germany gives the AstraZeneca vaccine only a partial approval, an update on the status of other vaccines under development, the government adopts a more aggressive target for vaccination, the Czech Republic discovers that what goes around comes around (and doesn’t like it), the mystery of California’s ending its lockdown measures, and another example of “too little, too late, and ended too soon” which has haunted our response to the virus all the way until now.

SUPPORTER ONLY CONTENT

……….

END OF SUPPORTER ONLY CONTENT

One final item.  It sounds like an April Fool’s Day joke, but it is no laughing matter.  Some people have observed that the “stick a Q-tip high up in your nose” types of tests aren’t very comfortable.  Maybe they will be pleased to learn that China has now developed a new type of test that doesn’t require sticking anything up your nose at all.

Instead, they are now rolling out anal swab tests, with something a great deal larger than a Q-tip being inserted some distance into one’s rectum, rolled around, and then taken out, well coated with “material” for testing.  Details here.

 

Please stay happy and healthy; all going well, I’ll be back again on Sunday.

Please click here for a listing of all our Covid-19 articles.

 

4 thoughts on “Covid-19 Diary : Thursday 28 January, 2021”

  1. Even more than usual, your reports hit a respondent chord with me. Tuesday saw me add another hybrid component replacement to my 2004 Prius (206K miles), but of much higher value than getting strapped into the ‘new car warranty’ scam. What really hurts us both is the insurance value; we cannot afford even a slight fender-bender since insurers will offer only a ‘total loss’ discounted payout.

    Likewise, music streaming tops even good radio signals (avoiding obnoxious commercial coveting). Wondering if we both stream AllClassical.org out of Portland.

    Was there ever any question which Apple cares most about: a) customer satisfaction; b) environment; or c) entrapment to Apple $olutions in the gui$e of $erving loyal u$ers?

    Online reviews can be helpful, but I exclusively read/trust the lowest ratings; failure complaints aren’t fabricated.

    Pin the tail of many COVID tragedies on the greed of big pharm execs piling it higher & deeper. You said it best “The cost of these two drugs (HCQ & Ivermectin) is about a dollar or so per dose.” Do you know how general public (non-med) can acquire HCQ or Ivermectin as vaccine-alternative prophylactic attempts? Veterinarians maybe?

    The Travel Insider remains my favorite treat of Friday mornings!!

    1. Hi, David (good name, that)

      Thanks for a wide-ranging series of replies – almost as wide-ranging as the newsletter itself!

      I’d not thought about the insurance issue of having a car with an intrinsic value much higher than the very low book value. One time I had a total car write-off (the in-laws truly did total the car) and was stunned at how little the payout was, particularly because it was a well-cared for car that I liked very much. Putting $15k into my Landrover, then having the merest of scratches (which very quickly can exceed $5k in cost) and being told the car was being written off, and taken from me, in exchange for $5k, would be very disappointing (that’s a polite way of putting it).

      I listen to the UK Classic FM station, both the regular programming (light but pleasant and easy listening while driving) and their podcasts. I’m working my way through John Suchet’s excellent series of 52 one hour podcasts on Beethoven – he’s something of an expert on Beethoven, wrote a book on the topic a couple of years ago (and also the brother of David Suchet aka Poirot). They even have a high-quality option if one wants to treat oneself to more bandwidth.

      Of course I agree about Apple’s underlying commercial venality. The astonishing thing to me is how many people believe Apple and take their claims about caring at face value, while turning a blind eye to their Chinese sweatshop manufacturing, inflated pricing, monopolistic policies, etc etc.

      I try to distill some sense from both bad and good reviews. I’ve seen some extremely unfair bad reviews where the fault was clearly the reviewer’s, not the product’s. As well as the throwaway one-liner positive reviews that one wonders how Amazon ever lets get published.

      I never used to believe the stories of big pharma greed and the distortive effect it has on medical practices. But I’m becoming a believer.

      My book The Covid Survival Guide has an appendix with sources for things like HCQ and IVM. Because you’re a kind and generous supporter, I’ll write to you directly with details, too.

      Glad you continue enjoying your Friday morning reads. Knowing that helps me enjoy my Thursday writing!

  2. Of course you are spot on regarding the beneficial use of HCQ under prescribed conditions. Unfortunately, TDS killed any possibility of the media recognizing it and reporting fairly on it. Dozens of people have already died after taking the vaccine. I wonder who the media will figure out who is to blame.

    1. Hi Rich

      I’d naievely thought/hoped that the medical and scientific communities might have been immune from TDS (Trump Derangement Symptom). Apparently not.

      While that fairly clearly explains away the enormous amount of unreasoning and unsupported hate directed at HCQ, it doesn’t explain the total silence about ivermectin, a drug which actually appears to be even better than HCQ and which I believe Mr Trump never referred to. What’s the reason for that?

      David.

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David.