Coronavirus Central

Episode 36 starts a new week with more stories about the terrible symptoms of this disease as well as a report all may not be well in Wuhan.  Italy can't even count their dead and now Covid-19 is everywhere in Canada.  New York features as the center of this outbreak with 5% of global current cases and we see the struggle to keep going as one surgeon at NY Presbyterian Hospital reports that can't meet the coming demand.  Medical imports are lagging, chloroquine is running out, and the search for PPE is becoming critical as the CDC is telling nurses to wear bandanas if all else fails.  We look into the quarantine letters about essential businesses and see that as an effort to keep people out, but at what expense to the virus fighting effort as many people in Seattle choose to ignore stay at home orders.  As DC fights over a pork laden bill, we look at the debt balloon, the question of inflation, and listen to the Fed warn nearly 1/3 of people may lose their job and half our GDP may also be lost.  We look at three ways to deal with that:  Resetting the debt, sending in the military, or trying to limp through, admitting there is no perfect solution to a pandemic running roughshod.

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Links:Latest statistics: https://covid19info.live/Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/

Report of Lung Failure from Louisiana: https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients

Report Wuhan now denying virus tests as focus shifts to economy: https://news.rthk.hk/rthk/en/component/k2/1516240-20200323.htm

Italian doctor too busy to count the dead: https://www.oe24.at/coronavirus/Italienische-Aerzte-Sind-am-Ende-unserer-Kraefte/423073342

Coronavirus in every Canadian provinces as restrictions tighten: https://www.reuters.com/article/us-health-coronavirus-canada/canada-coronavirus-death-toll-jumps-officials-could-punish-those-ignoring-precautions-idUSKBN2190PX

Seattle residents of all stripes ignore shetler-in-place suggestion: https://mynorthwest.com/1779279/rantz-seattle-force-coronavirus-shelter-in-place/

NYC Epicenter of Pandemic: https://www.nytimes.com/2020/03/22/nyregion/Coronavirus-new-York-epicenter.htm

Some positive news starts Episode 35 as we report on a new blood test for Covid antibodies which might open up the opportunity for rapidly expanded onsite testing.  We also found a study from China which reports that Tocilizumab is a drug which helped patients in severe distress recover lymphocytes and improve blood oxygen saturation, a chance to reduce the ventilator shortage.  The government is working with social media to gain information even as suppression efforts continue, including more analysis of the leaked US Health and Human Services report where they anticipate supply shortages for the next 18 months or longer.  The Trump Administration appears to be contemplated a ban on domestic air travel, shutting down the stock market, and asking people to stay in place.  However, the existing bill before Congress slowly working forward is not adequate to meet the needs of many people to accomplish such a quarantine meaning absent much improved medical intervention, the spread will likely hasten.  Reports from California, Massachusetts, and Pennsylvania all show the acceleration of the coronavirus and slowing of the economy.  While government thinks small, people come up big as 3D printers help keep people safe and alive in both New York and Italy, showing the value of open source community based action.

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Links:Latest statistics: https://covid19info.live/Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/CDC US Case and Test Count: CDC Update

New blood test for antibodies: https://www.sciencemag.org/news/2020/03/new-blood-tests-antibodies-could-show-true-scale-coronavirus-pandemic

Chinese study about efficiacy of Tocilizumab for acute and severe cases: http://chinaxiv.org/abs/202003.00026

Additional information on Tocilizumab: https://en.wikipedia.org/wiki/Tocilizumab#Severe_acute_respiratory_syndrome_coronavirus_2019_(COVID-19)

Review: Immunological study of T-Cell exhaustion: https://www.medrxiv.org/content/10.1101/2020.02.18.20024364v1

The experiences of a family in Milan during the outbreak: https://slate.com/technology/2020/03/coronavirus-covid19-italy-hospital-deaths-us-warning.html

Balance between privacy and public health as social media tracking apps are considered: https://www.cnbc.com/2020/03/19/facebook-g

For Episode 34, we start with a reminder that younger people can and do get sick, die, and use valuable resources when they don't separate themselves from the Covid-19 outbreak.  London is moving toward lockdown as the United States sees a report leak that claims they see the crisis as being 18 months or longer, perhaps informed by the Imperial College study and the time to vaccine with multiple waves.  Amazon now has a warehouse worker sick and a personal anecdote about food scarcity serve as warning for potential shortages ahead.  We look first at nursing homes where people are getting sick from hospital visits or other sources, but also at prisons and the complex situation there.  To prevent virus spread, nonviolent offenders are being released before riots happen, but will they have access to resources, cause disruptions, and how will law enforcement react and will it continue showing up?  Big questions and few answers, but situations we need to watch.  JP Morgan sees our economy shrinking by 14% next quarter already, and oil is tumbling further - what will last and how you can prepare are what we look at in this challenging episode.

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Links:Latest statistics: https://covid19info.live/Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/CDC US Case and Test Count: CDC Update

CDC analysis elevates health risk for younger people: https://thehill.com/policy/healthcare/488325-cdc-data-show-coronavirus-poses-serious-risk-for-younger-people

37 year old healthy man dies from Covid in Spain: https://www.larazon.es/madrid/20200318/zxruj2ihinajzobf24fp36tlla.html

Lockdown thought to be imminent in London: https://www.thesun.co.uk/news/11206724/what-lockdown-mean-when-start-london/

Pandemic to last 18 months or longer according to leaked US report: https://arstechnica.com/tech-policy/2020/03/us-govt-expects-18-month-pandemic-with-widespread-supply-shortages/

Amazon warehouse worker tests positive for coronavirus: https://www.theatlantic.com/health/archive/2020/03/amazon-warehouse-employee-has-coronavirus/608341/

Florida believes 19 nursing homes have Covid cases: https://thehill.com/policy/healthcare/public-global-health/488328-19-long-term-care

For our thirty-third episode, we start by noting that Facebook is now blocking legitimate stories which they attribute to a "bug" as the WHO and partners invest more energy into controlling information than fighting the outbreak.  We share a new study that suggests children can still be at risk, though thankfully less than adults, as we also report from the Dutch that many young seemingly healthy people are in severe distress from Covid.  The hope is people will change their behaviors as New York is perched on the verge of a major shutdown that we see happening now in Switzerland.  We look at the problems of renters, unemployed, and those needing resources as a bipartisan consensus forms around debt suspension or forgiveness and the direct payment of income to all adult Americans to get through this crisis so people won't have to go out.  As that lurches forward, we see Texas getting prepared with better decisions about public events, but shortfalls in supply.  Louisiana is also coming under the gun post Mardi Gras, and while Florida has begun shutting down some bars and restaurants, partially, the Sunshine State continues to lag.  Lastly, a new drug for fighting flu in Japan is having some positive impacts so we talk about favipiravir (Avigan) as another tool in the arsenal.

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Links:Latest statistics: https://covid19info.live/Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/CDC US Case and Test Count: CDC Update

Facebook censors multiple news sources about coronavirus: https://www.forbes.com/sites/johnkoetsier/2020/03/17/facebook-deleting-coronavirus-posts-leading-to-charges-of-censorship/#329163525962

New study reports that children are at risk from Covid though less than adults: https://www.news.com.au/lifestyle/health/health-problems/new-data-shows-children-can-get-severely-ill-from-coronavirus-first-known-child-death/news-story/02fbdf91cd35eb08b3156dd3bd89dc38

Belgian doctor reports on severe lung trauma to healthy people in 20's and 30's: https://nypost.com/2020/03/17/coronavirus-doctor-says-lung-scans-for-young-patients-were-nothing-short-of-terrifying/

WSJ discusses intergenerational war about how seriously people take Covid: https://www.wsj.com/articles/a-generational-war-is-brewing-over-coronavirus-11584437401

NYC considering issuing shelter in plac

A deeper look into how these lockdowns will function and what purpose they serve is the focus of Episode 32.  After more harrowing evidence from Italy, we look deeply into why you don't want to treat Covid with ibuprofen for the early fever and a dive into the T-cells suggests that afflicted immune response is at the heart of case severity.  Revised modeling in the UK is leading to a shift from mitigation to containment, as reflect in France's mandatory shutdown.  We see the same in the US starting as San Francisco is the first area to begin lockdowns will likely only accelerate even as we must wonder will they prove enough given the many exemptions required to keep basic services functioning.  We address the strange irony that the food production, distribution, and delivery system will require people who are most at risk for the least compensation to contemplate serious risk to help others who are not exposed, and look at how Amazon will deal with this and the many tensions that create a massive vulnerability.  Lastly, we peek at the first efforts toward the first vaccine candidate - a goal far off in this distance but toward which progress is being attempted.

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Links:Latest statistics: https://covid19info.live/Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/CDC US Case and Test Count: CDC Update

Stories of those departed from Italy: https://www.theguardian.com/world/2020/mar/17/this-is-like-a-war-view-from-italys-coronavirus-frontline

WHO considers airborne precautions in reversal: https://www.cnbc.com/2020/03/16/who-considers-airborne-precautions-for-medical-staff-after-study-shows-coronavirus-can-survive-in-air.html

French recommend using tylenol over advil: https://www.sciencemediacentre.org/expert-reaction-to-reports-that-the-french-health-minister-recommended-use-of-paracetamol-for-fever-from-covid-19-rather-than-ibuprofen-or-cortisone/

T-Cell expresion in Covid-19 and how the immune system gets exhausted: https://www.medrxiv.org/content/10.1101/2020.02.18.20024364v1

Revised modeling from Imperial College about effectiveness of NPI measures to contain the pandemic: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowship

Episode 31 sees a new week beginning with the world shutting down to fight coronavirus by stopping the spread by any means possible.  Austria, France, and Spain join Italy in lockdown as Europe's outbreak accelerates wildly.  We cycle the Anglosphere to see New Zealand closing down fast, Australia treading water, the United States stumbling, and the UK preparing for the worst.  Ohio offers an example of aggressive proactive action for social distancing as other states and cities begin independently doing the same.  New numbers suggest a higher case fatality rate, in both the best case scenario, and the unfortunately more realistic situation we are moving toward which will sorely test each country's medical system but for a fortunate few.

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Links:Latest statistics: https://covid19info.live/Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/CDC US Case and Test Count: CDC Update

Coronavirus lockdowns across Europe and Australia's preparations: https://www.abc.net.au/news/2020-03-16/coronavirus-lockdowns-how-do-they-work/12057870

How Spain is managing both political tensions and the viral outbreak in lockdown: "https://www.nytimes.com/2020/03/15/world/europe/spain-coronavirus.html"

Italian doctor reports patients are lucidly approaching their death with desire to have last words with family; https://nypost.com/2020/03/13/italian-doctor-describes-coronavirus-patients-last-calls-to-loved-ones/

Lancet offers updated projections on CFR: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30195-X/fulltext

Two US ER doctors in critical condition with Coronavirus: https://www.nytimes.com/2020/03/15/us/coronavirus-physicians-emergency-rooms.html

UK predicts 8 million people to need hospital assistance: https://www.express.co.uk/news/uk/1255724/coronavirus-uk-latest-news-covid-19-coronavirus-europe-outbreak-boris-johnson-trump-US

Ohio shuts down bars and restaurants expecting multiple "Wuhans" nationally: https://www.dispatch.com/news/20200315/coronavirus-governor-orders-ohio-bars-restaurants-to-shut-down

Minnesota deregulates ambulances in anticipation of additional need:

For the thirtieth episode, we take stock of what we have to expect as the first heavy blast of the coronavirus outbreak is hitting the West beyond ravaged Italy.  A story from Hong Kong talks about lost lung capacity from survivors who at least, in the short term, seem likely not to be immediately reinfected based on best research.  The war against Covid is furious in Italy, and we share a personal narrative of what it was like seeing the world a person knew disappear in two weeks to the novel reality of the coronavirus contagion.  Modeling explains why we cannot simply flatten the curve, but must change how we live for a time - potentially quite a while - to overcome this by containing ourselves.  Against that backdrop, we see policy leaders from the President onward still reacting and taking minor steps against a problem more major than they seem able to comprehend.  The DOD is preparing to shut down travel for sixty days for military personnel and families.  We should probably be thinking no less as this weekend may be the last chance for travel and resupply for some time.  If not, then it only means the price we will all pay will be that much worse in terms of victims who ultimately will succumb to Covid-19.

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Links:Latest statistics: https://covid19info.live/Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/CDC US Case and Test Count: CDC Update

Hong Kong recovered patients have permanent lung damage in some cases: https://www.scmp.com/news/hong-kong/health-environment/article/3074988/coronavirus-some-recovered-patients-may-have

Patients testing as reinfected might be due to rush to release patients or inaccurate testing as opposed to reinfection: https://www.latimes.com/world-nation/story/2020-03-13/china-japan-korea-coronavirus-reinfection-test-positive

Coronavirus like a world war for Italian doctors with soaring death toll: https://nypost.com/2020/03/13/coronavirus-in-italy-is-like-a-world-war-as-death-toll-soars/

Italian shares real-life experience of how quickly Covid changed everything: https://www.reddit.com/r/China_Flu/comments/fhxap2/from_an_italian_to_the_rest_of_the_world_you_have/

Contain, not flatten, or death toll will spike https://medium.com/@joschabach/flattening-the-curve-is-a-deadly-delusion-eea324fe9727

President Trump holds pr

Episode 29 starts with a quick jaunt through the world of the Covid-19 pandemic looking at Iran having major trouble with mass graves potentially spotted as Italy is buckling.  We see the viral shedding lasts up to 37 days with a median of 20 days post infection as India offers another similar treatment protocol.  As the crisis deepens, tensions between the US and China are beginning to flare as China's export economy and America's dependence on Chinese drugs create a toxic relationship as politicians search for who to blame in the outbreak.  Amidst that backdrop, Boston looks to be going around the CDC and developing a more aggressive and proactive plan to keep their residents from experiencing the worst of it, which while probably not enough to protect everyone, does offer the promise of saving many lives by further sustaining the health care system.

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Links:Latest statistics: https://covid19info.live/Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/CDC US Case and Test Count: CDC Update

Coronavirus lives up to five weeks in patients after contagion: https://www.bloomberg.com/amp/news/articles/2020-03-12/coronavirus-can-live-in-patients-for-five-weeks-after-contagion

ECDC reports Covid will overwhelm European hospitals: http://www.cidrap.umn.edu/news-perspective/2020/03/ecdc-covid-19-not-containable-set-overwhelm-hospitals

Iranian burial mounds spotted from space suggesting higher than reported death toll: https://www.vox.com/2020/3/12/21176968/coronavirus-iran-outbreak-satellite-photos-burial-trench

Experience of a recovered Covid-19 patient from New Jersey: https://nypost.com/2020/03/12/new-jersey-patient-james-cai-recovering-from-coronavirus/amp/

India uses drug protocoal with HIV drugs with chloroquine to successfully treat patient: https://timesofindia.indiatimes.com/city/jaipur/city-docs-cure-corona-patient-with-hiv-drugs/articleshow/74584859.cms

American dependency on Chinese drugs and efforts to create domestic manufacturing: https://www.nytimes.com/2020/03/11/business/economy/coronavirus-china-trump-drugs.html

Chinese residents in Hubei spontaneously protest

Episode 28 goes for a deep dive into science and policy about the coronavirus outbreak.  We start with a new study which informs us Covid-19 can survive as an aerosol for up to three hours contradicting the earlier claim by the CDC that masks were unnecessary, a major problem as we are desperately lacking supplies despite efforts to ramp up production.  We present a study that argues for immune suppression capacity of Covid-19 with reduced white blood cell count, but which offers also a useful diagnostic to predict case discovery and prognosis.  Another study informs that people can have influenza and coronavirus simultaneously, leading to the testing errors, and perhaps increased risk.  We look closely at how chloroquine offers the best hope for immediate aid, especially early in the infection, as it serves to basically jam the lock of the ACE-2 receptor which Covid-19 has most commonly been using.  This treatment already pioneered in China and elsewhere is further amplified by using Zinc in conjunction to make the cell even less vulnerable to the virus in a method already being applied by Korea.  Solutions exist to mitigate the crisis, but the policy continues to lag in the United States.  While there is a welcome departure toward more serious consideration, the reality is both sides are still seeking to mitigate the crisis in a reactive mindset driven more by economics and ideology than understanding this is a war where a week's delay will mean fatal consequences for many people.  Get prepared, or you'll be like the feral monkeys now roaming in Thailand looking for food as the tourists suddenly disappeared.

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Links: Latest statistics: https://covid19info.live/ Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/ CDC US Case and Test Count: CDC Update Study: Covid lasts for three hours in air, one day on cardboard: https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v1

Global mask shortage worsening: https://www.bloomberg.com/news/articles/2020-03-10/the-global-mask-shortage-may-be-about-to-get-much-worse

White blood cell problems with Covid indicate suppresed immune response: https://www.medrxiv.org/content/10.1101/2020.03.01.20029074v1

Covid and Influenza at once: https://www.ncbi.nlm.nih.gov/pubmed/32160148How and Why Chloroquine Works: https://medium.com/@savesightmd/an-old-drug-for-the-new-virus-a6fd6a0843bcChloroquine works against Zika: https://www.biorxiv.org/content/10.1101/051268v1.full Chloroquine helps against Influenza A: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1481635/Chloroquine helps against Covid-19: https://www.ncbi.nlm.nih.gov/pubmed/32074550Details about Hydroxychlorine, the most common American variant of Chloroquine: https://www.drugs.com/hydroxychloroquine.htmlChloroq

For Episode 27, we broaden our horizons to check out what is happening in Spain, France, and Japan.  A quarantine much like New Rochelle, New York is in northern Spain as French people defy Covid-19 to have a Smurf convention in contravention of sound public health.  Japan finds small gatherings just as dangerous as large ones.  We look at Washington's ventilator problem and the potential for DC to soon be a hot spot.  All this, and a discussion of what issues you should be keeping your eyes upon as we bungle through this uncoordinated response throughout the West and most of the world.

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Links:Latest statistics: https://covid19info.live/Case sources: https://bnonews.com/Covid-19 news: http://covidreport.net/CDC US Case and Test Count: CDC Update

German Chancellor Angela Merkel expects 70% of the world to be infected by coronavirus: https://www.bbc.com/news/world-us-canada-51835856

Spain surpasses 2,000 cases in countrywide outbreak: https://www.express.co.uk/news/world/1252975/Coronavirus-spain-map-regions-in-spain-covid-19-coronavirus-latest

Quarantine in La Rioja, Spain now enforced: https://www.the-sun.com/news/507166/coronavirus-patients-in-spain-forced-to-stay-in-their-homes-by-terror-cops-in-hazmat-suits/

France also moves to 2,000 cases promising future mitigation strategy: https://www.connexionfrance.com/French-news/France-close-to-Covid-19-coronavirus-epidemic-as-cases-hit-1-784-and-Macron-says-only-the-beginning

Preparations in French hospitals: https://www.france24.com/en/20200310-war-footing-french-hospital-in-frontline-of-coronavirus-fight

3,500 people defy Coronavirus in France to gather as world's largest Smurf outing: https://news.avclub.com/defying-all-logic-and-reason-the-world-record-for-larg-1842216045

Japanese music clubs in smaller outings become new epicenter of cluster as case number spikes: https://www.reuters.com/article/us-health-coronavirus-japan-music/japans-live-music-clubs-emerge-as-new-coronavirus-transmission-sites-idUSKBN20X0WU

Japan deliberates