[The VFM Addict]

The Middle East spread continues.    Italy appears not to have gained control.   More EU states post first cases and Switzerland’s neutrality in this war appears not to be respected by this virus.   See here for live stats.   What a lovely day not.   Mankind is losing this one and being battered by this ninja virus that infects others even before running up the flag of its presence by causing symptoms. Nothing to worry about though because the WHO haven’t declared it a pandemic❗

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[The VFM Addict]

You can always trust an Aussie to tell it like it is.

Aus plus the trigger on its pandemic plan.   It is also being totally upfront with its population.    If only ours were also.

This is an absolute MUST READ.   But be warned it is not for the feint hearted.

Extract –

Considering the mortality rate of COVID-19 is 2 to 3 per cent, “if 50 per cent of Australians became infected, that is 492,000 to 738,000 people dying, over 3 million people needing a hospital bed and over 1 million people needing an ICU bed,” Professor MacIntyre said.

Yep, that’s what I call straight talking.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

There is an interesting omission from the live stats and that is Indonesia. Interesting but puzzling to have zero cases given there are roughly 3+ million ethnic Chinese in the country. However given the genocide of the Chinese that took place in the 60s, my guess is that the local Chinese are concealing any infections that were incurred during the New Year holiday. We should expect a huge jump in infections and deaths as the disease moves into the native Indonesian population.

[The VFM Addict]

£1.50p that might save your life this year – Don’t fail to spend it.

If you suffer Covid-19 severely the primary threat to life is inflammation of the lower respiratory tract which results in severe respiratory distress such that your lungs become incapable of supplying oxygen to your blood.    Inflammation of other organs can also occur causing sepsis.

Inflammation is one of our body’s key defense mechanisms against infection.  It seeks to contain an infection to stop spread and it also aids the flood of immune systems cells into the site to fight the infection.   However, quite often in matters respiratory it does more harm than good.   The ‘brown’ preventer inhalers, used in asthma and conditions such as COPD contain a steroid specifically to limit inflammation.   Because quite literally if it gets out of hand you drown in your own defence, so to speak.

Zinc plays a vital role in our immune systems.  It is vital to the activation of our immune cells to fight infections but – and this is important here – it also plays a vital role in ensuring that the body’s inflammation is not overly disproportionate to the threat such that it does far more harm than good.    This BBC piece explains this all and since its publication numerous studies, such as this, have repeatedly confirmed the rationale.

One cannot know if one is Zinc deficient without blood tests and GPs rarely test for it.   If one is zinc deficient it will be more likely that your body will either act insufficiently against this virus or overreact to it doing far more harm than good.    It is impossible to dangerously overdose with zinc at normal supplement doses.  Therefore taking a supplement from now on during this pandemic can do no harm and could significantly increase you chances of survival if you are to any degree zinc deficient.   Supplementation of 10mg to 20mg a day is optimal.    Sainsbury’s sell 15mg tablets at £1.50p for 60, enough for two months at one a day, and I’ve not found it cheaper anywhere else.

I consider Zinc supplementation a truly vital component of one’s preparation for getting through this.   It can do no harm but might be critical to your survival.    For the record – There is far more sound scientific evidence of the value of Zinc to ensuring an optimal immune system response than there is for Vitamin C.    Although I would still recommend Vitamin C supplements for other reasons during a period when fresh fruit may very well be unavailable.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[The VFM Addict]

Posting this picture out of enormous respect.   The following picture is of Chinese medics who have  died of Covid-19 while fighting it.    These to me are true heros.   They knew and saw first hand what this virus does to people.  Yet they remained engulfed by what must have been and they knew were clouds of this virus.   No different from running forward in the face of concentrated fire during a battle.     They have my total respect.  Sadly I have no doubts many medics in the UK will join their ranks this year.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

The Harvard Magazine has some interesting information on SARS-Covid-19. (some is understandably dated). Unfortunately the facts it contains are spread all over the place. I have therefore extracted and edited the article to hopefully make its findings a little more coherent. I have pulled together the information into a few major sections. (Any comments I have added are in parentheses).

SARS-CoV-2 is a close cousin to SARS, and uses the same human receptor, ACE2,  reports Farzan, who is now co-chair of the department of immunology and microbiology at Scripps Research. The ACE2 receptor is expressed almost exclusively in the lungs, gastrointestinal tract, and the kidneys, which explains why the disease is so effectively transmitted via both the respiratory and fecal-oral routes.

(It spreads extremely rapidly, and the virus is carried in aerosoled droplets from the nose and mouth, but it is also expressed in faeces and urine (ACE2 route). It appears to be capable of transmission on dried particles and as a result vertical transmission in apartment blocks has been seen. This is the probable explanation for the Chinese spraying the streets and doorways).

Lipsitch notes a further concern: the fact that the incubation-period distribution and the serial-interval distribution are almost identical. That’s a mathematical way of saying that people can start transmitting the virus even when they are asymptomatic, pre-symptomatic, or just beginning to exhibit symptoms. That makes tracing and quarantining contacts of infected individuals—a classic, frontline public-health measure—nearly impossible. (The corollary to this is that Public Health is then forced to use zone quarantine measures and has to allow the disease to burn out in those zones – sacrifice the few to save the many)

On the positive side it appears to have an R0 lower than SARS. (I personally question this finding as it fails to comprehend asymptomatic infections that appear to be running at > 10-15%).

(SARS-Covid-19 kills but most recover.)
The inflammatory response (causing severe infection in 20% of cases) can kill people in the respiratory phase of the disease. The inflammation in the lungs is basically a cytokine storm,” an overwhelming and destructive immune response “that’s the result of innate signalling. (That is why Zinc may be important to control this)

[The VFM Addict]

Ed, having read my post concerning £1.50p zinc above now walk with me a ways.

The human body cannot store zinc hence we need regular intake of it right before and at time of infection and before it develops a stronghold.    Changes in intestinal tract absorbability and permeability due, to viral, protozoal or bacteria pathogens can make both poor and additionally may also encourage fecal loss of zinc; all resulting in zinc deficiency.     Errrmmm……..    This virus specifically attacks the gut as well as the lungs doesn’t it?   Could it be that the reason that some younger apparently healthy individuals die of Covid-19 be that the virus depletes their zinc due to its attack on the gut and then that zinc deficiency allows the inflammation in the lungs (and elsewhere) to run away with itself because the attenuation of it which relies on zinc is no longer occurring adequately.

I’m firing this rationale off to several Chest Consultants, one a Professor, who I knew and they know me from my days in pharmaceuticals.    Checking the zinc levels of Covid-19 sufferers who are approaching critical would rapidly prove or disprove this hypothesis.   If they are indeed zinc deficient then IV Zinc may significantly, perhaps even dramatically, improve outcomes.

I’ve never before spoken Zinc in depth with medics.  But if my experience of talking Magnesium with them is anything to go by then other than the body’s main electrolytes most medics have sod all knowledge of the importance of most cations and almost never consider them when facing problems that might in part be caused by their deficiency.

It is all out of the box thinking but it is underpinned by good science and it might be the case that such has as yet never even been considered.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

All I can do is speculate and run some thought experiments in response:

The ACE2 receptor pretty much dictates where the virus will enter the body and where it will subsequently replicate. Although correlation does not equal causation, the elderly are the ones worst affected by the virus and also tend to be those who have very low zinc levels. Assuming that in this case correlation=causation then one has to speculate WHY the elderly have especially low zinc levels.

My guess would be that we are not absorbing it from the (mainly animal) constituents that contain zinc. The metabolism of zinc, like most gut related things, appears ill-defined. This article says that eukaryotes are the main regulators – unfortunately that is a term that means both everything and nothing, but my guess would be that gut bacteria are the main movers and shakers in getting zinc to these transporting system. If that hypothesis is correct then these are easily disrupted by bad diet and drugs (both illegal and prescription). Young people on medication/drug users and those with especially poor diets e.g. chip butties could then be expected to be in a covid-19 risk category despite being young, while elderly people on PPIs etc would be similarly high risk.

I don’t think my comments carry your theory any further forward as medical science is still in the dark ages when it comes to the roles of different gut bacteria. It may be worth asking your professor if the younger people who died had a ‘disrupted’ digestive system as that could provide another small step in a zinc logic train.

[Ed P]

An after thought that I could not add as an edit.

Re bad diet: an American friend of mine has a lot of contact with some US medical research institutions points out that sugars are preferentially absorbed in the gut and that this disrupts the mix of bacteria and tends to squeeze out the lacto-bacillus types and favours the sulfur  emitting anaerobic types. Perhaps zinc is high-jacked to form non-bio-available zinc sulphide.

[Ed P]

I wish I had longer to add edits!

A simple test for zinc sulfide (sorry about the previous ‘old skool’ spelling) is phosphorescence. Shine a UV light on a stool sample and see if it shows green!

[Les.]

These last few messages are interesting. Bare with me. In Dec 2001, I fell off the ‘bike at about 10mph (not the 60+ everybody expected) and broke my L. hip. A flexible pin was poked up the neck of femur and I wandered around with two crutches, then 2 sticks, then 1 stick finally discarding all aids after 9  months. ( telescopic stick helped when I got back on the bike in the July 2002. Later my dentist suggested I should consider glucosamine, in case my bones were weak, and somebody else suggested buying from HEALTHSPAN. I did take their glucosamine, but have since concluded it did nothing and stopped it. However, they did send out a questionaire which they followed up with individual recommendations, though by then I had already settled on my supplement diet. Summing up, currently it is a magnesium tablet (following advice here or in forerunner forum), zinc and a “hair and nails” supplement. After the bone density scan when you were all voting for or against Brexit, my GP added a Calcium tablet which includes Vit “D”. Add in my prescribed BP stuff (Amlodipene and Ramipril) and that is me done.

OK, now back in time. Easter 1991, back in UK, I had a STINKING cold, not my first. January 2000, I had a similar one. Other “normal” colds from time to time.

About 3 years ago, a bad cold started at 9:00am on a Saturday, so I stayed home instead of usual ‘bike ride. COMPLETELY cleared before bedtime!: this was my first cold for about 10 years!  About 12 months later, another lasted less than 24 hours, and a year later, whilst visiting UK, yet another and that lasted a full 30 hours. Not the former one week, dragging on with bad “snot” for another week or more.

Does this all tie in with my zinc supplementation from about 2005?

I will not be stopping this one!

From Healthspan, their zinc, 15mg PLUS 80mg Vit “C” is £10:45 for 360 tablets, or £8:45 if you place a standing order.

Les. Addendum, sorry Edp, I HATE sulfide. I was brought up on sulphur, and dammned if I am going to change to suit the Yanks!

[Ed P]

Not the Yanks I’m afraid but an International Standard (IUPAC) that also took the second ‘i’ out of aluminum  – so stuff you Boris we still have to conform to regulations made by others, but at least we have a say in this one, even if we get voted down!🤗

Seriously Les, if you are on calcium tablets, even with vitamin D I would recommend that you should also be taking Vitamin K2 (MK-7) isomer, it helps ensure that the calcium gets into the bones rather than your blood stream. link. Imo the MK-7 isomer is superior to MK4 as this is the form found in Japanese fermented foods and the Japanese have a significantly lower rate of cardiac problems. Incidentally this isomer is also found in the dairy products from the Island of Jersey (probably due to their cows only being grass fed). The Channel Islands have significantly less cardiac problems than mainland UK but the rest of their diet is very similar.

Those interested in looking at the health benefits of Vitamin K2 may be interested in downloading this pdf, and then look up the heart disease data in WHO for the corresponding countries  that it references. My cardiologist told me that K2 MK7 is on the NICE list but only given to those with very high cholesterol that does not respond to other treatments. (a cost issue)

Taking K2 is probably more important for women taking calcium supplements because of bone density issues as it has been proven that taking calcium supplements increases the chances of women having a heart attack. link

[Ed P]

The US is trialling the use of remdesivir to treat SARS-Covid-19, while the Chinese are suggesting that it be used together with chloroquin. For plebs like us, remdesivir is out of reach for emergency home medication.

[Ed P]

In the only sensible move I have seen from Mushroom Matt, the Government has banned the export of chloroquine. (without of course publicly naming it, as he has to keep us as much in the dark as possible!)

[The VFM Addict]

The USA trial design you linked is relatively sound but I always baulk at randomised placebo controlled trials in potentially life or death situations; despite them being the gold standard for providing robust clinical evidence.

To me there is a void of impeccable ethics in – “Ah yes more patients in the placebo group died while more in the active treatment survived.  We have our proof”.    The folks who were randomised into the placebo group also have the proof but they’ll never known that !!!     Of course trials are often cut short early if a statistically significant pattern appears to be developing to the effect that the active treatment delivers clear benefits; stopped on the basis that it is then unethical to continue to withhold a known effective treatment from the placebo group.   But the way I have always seen it is one has already jeopardised those in the placebo group by that point.   I’ve argued that one more times than I care to remember over dinner with medics.   To be fair most medics do agree with me regarding the abstract ethics.    Alas acquiring proof of ethicacy is perhaps the one situation where no-one can come up with an alternative and therefore the core medic’s obligation to make the care of one’s patient one’s first concern has to be sacrificed for the greater good.

Returning specifically to this study – I note that the protocol re eligibility criteria is, in brief, there must be robust evidence of or highly suggestive of, lung involvement.  The piece you sited does not state whether microbiological investigation must also have established that such proven or perceived respiratory degradation is not due to or is unlikely to be due to, a primary or secondary bacterial pneumonia.   I suspect this is within the full eligibility criteria however because failing to exclude such in the protocol could undermine the study’s findings totally.

Note though that the study is a study of the fire-fighting potency of the anti-viral because it clearly requires that there is already believed to be significant evidence of lung involvement rather than merely the subjective evidence of the patient reporting that they are experiencing breathlessness.   Indeed, I see nothing in the protocol that suggests that low or falling blood oxygen saturation (assessed by pulsoximeter) is even considered to be sufficient for eligibility.    Basically the eligibility criteria requires evidence that the virus has already established a significant beachhead in the lungs.    I personally prefer to subscribe to the old maxim that prevention is better than cure.    Surely far better to intervene before the virus has established a significant respiratory beachhead.

Chloroquine, an inexpensive compound that we already have significant experience and knowledge of, including safety and tolerable doses, might just be the ideal universal early intervention.    It is as you know used in malaria not merely as a treatment but also a prophylactic and its safety is such that it does not even need prescription.    Perhaps if used universally upon confirmation of the presence of the virus plus lower than average pulsoximeter sats and/or reports by the patient of perceived breathlessness, then fewer patients would ever progress to marked lung involvement.   In respect of bacterial chest infections no doctor waits for microbiological verification or for significant verified lung involvement before initiating antibiotics.   They initiate an antibiotic right away to seek to prevent the bacteria from proliferating.   Surely it makes sense to do similarly with this virus?   If the patient has tested positive for the virus and has low sats (an instant assessment by pulsoximeter) them immediately attempt to seek to assist the patient’s immune system to cope with the virus by initiating Choloroquine to reduce the chances that it will ever develops to the point of major lung involvement.

My own personal trigger plan for initiating Avloclor is quite simple and follows the above rationale.   Monitor my oxygen sats with our pulsoximeter; this I have already started.     If I at any point from here on in I suffer a fever and my sats are to even the slightest degree beginning to noticeably and progressively fall then the trigger is pulled.   Why not?   It is no different from taking Chloroquine in readiness for an overseas trip.   The objective here being to impede the virus to such an extent as to increase my own immune system’s ability to cope with it.    I’d rather not wait until the virus has established itself fully in my lungs before initiating and then having to fire fight a fully established blaze.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[The VFM Addict]

For the first time since this all began the UK is waking up to pretty much universal front page coverage of Covid-19 in the main stream press.    I believe today will probably be the day that the majority of the UK at last take this seriously and begin to prepare.    Panic buying will certainly begin to some degree today and only accelerate day on day.   With it the ability to prepare in fully considered fashion and at one’s leisure will begin to end and the window within which to do so close increasingly (indeed exponentially) rapidly.    Panic buying will certainly be in full swing this weekend and major shortages on shop shelves starting to become the norm.    Masks and hand santizer gels have over the last couple of weeks become increasingly hard to find and heaven knows where one will be able to find them after this weekend.

Anyone desiring to increase their chances of getting through what’s coming – and – who desires to ensure they can endure long periods of lock down without major hardship must act with genuine urgency – Pretty Damn Quick.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

I should perhaps have said that Mushroom Matt banned the UNREGULATED export of chloroquine. I believe the objective was to avoid round-tripping the drug and thereby saving the NHS money.

[Dave Rice]

It’s not Ebola. This just reminds me of the swine flu “pandemic”. Much panic at the start then when people realise that no-ones dropping dead in the street and far more are dying of the flu, it will all peter out.

The whole isolation thing is a nonsense, it’s not isolation. It seems to me like it’s a method of guaranteeing that anyone in the same establishment as you has a much better of chance of catching it. The whole self isolation isn’t thought out in any way.

Panic buying will only take place if people are whipped up into a frenzy by the media or comments like yours. What’s more likely to happen is that people will just start ignoring it, especially the self employed. It’s one thing telling those that will receive sick pay that they must lock themselves away (plus all the others in the household it now seems) and another telling those that have to work or starve.

[The VFM Addict]

Dave –

The fatality rate of this is 2.3% while the fatality rate with normal flu is 0.1% in a very bad year and a tenth of that in a good year.    For the record the fatality rate with Swine Flu was 0.4% that is to say it was/is four times more dangerous than normal flu but only approx. 1/6th as dangerous as this virus.

18% of those who are infected with this virus suffer a severe infection requiring hospital care which is astronomical compared to how many people with normal flu require such.   Do almost one in five suffers with normal flu require a hospital bed?   Nowhere near that number do yet such alone nearly breaks the NHS each year.

3% of those infected with this virus go critical and require an ICU bed typically needing time on a ventilator.   Two out of those 3 still die.    The ones that recover on average take 3 weeks to do so before hospital discharge; consuming a hospital bed all that time.

You can’t easily avoid being infected without PPE because those infected are infectious even before they have symptoms.   So not only do you not know they have it typically they themselves do not yet know.

Do you think for one moment China would have effectively shut down its economy for so long due to normal flu?

There is a truth – Any action one takes before or in preparation for a serious pandemic is typically accused of being alarmist.   But wait until after it strikes and any action you take is almost invariably vastly inadequate.

Imperial College London say approx. 60% of the UK population are likely to become infected.   That’s 60% of 67 million = over 40 million.   18% of those will require hospital care = 7.2 million.   3% will require an ICU bed.  That’s 1.3 million ICU beds.

Forget what I’m saying just go look at the facts yourself.    Considering this to be just bad flu or even like Swine Flu and ignoring, responding to or preparing for it only as being such will significantly reduce your chances or getting through what is definitely coming.

The UK government has sought to play this down for numerous reasons and you appear to have bought Boris’s and Matt’s spin, hook, line and sinker.    I have been looking at the facts (so has Ed); the published clinical papers; what the world’s leading centres on contagious diseases are saying, etc.

I have here merely tried here to ensure that Forumites are as fully informed as possible of what we are facing and as far as possible can take steps to mitigate its impact.    It is up to each Forumite, yourself included, to make his/her own decisions.    I genuinely hope the decisions you reach are based on the sound evidence rather than the spin of HMG.   The NHS simply cannot be prepared to deal with this one.  It is too big and even a tiny fraction of 1% of it will overwhelm the NHS. Therefore we must do all we can ourselves.    I very much hope and pray that you and all Forumites are still around by the end of this.   But our typical age and co-morbidities incline to the conclusion that this is most unlikely especially if one adopts an Ostrich Strategy and fails to prepare.  I genuinely pray to God that you today reject such a strategy and instead very rapidly prepare.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Richard]

Dave, I am with you, excess panic does nothing to protect anyone. Yes, a scenario did predict figures as high as 60%, but it was also identified as the proposer’s worst case. It showed what could happen if the public showed the levels of sloppiness that would drive such an event. Such predictions are not intended to be a build to plan, but a wake up call to do rather more in the self, family and friends protection direction of travel. We know that those with health issues are most at risk and that included some on here. Those already in institutional situations are clearly at heightened risks as events worldwide have already shown. So precautionary action need to focus on them to prevent them becoming a locus of trouble. Everybody needs to focus on personal hygiene, a really unpopular fact of life. In some ways catching a bug could come to be looked upon as an elective event. Avoid prolonged proximity to anyone who could be a carrier. Yes sanitise your hands as often as you can, yes wipe down surfaces that could or will harbour infectious agents. Perhaps maintain safe separation from others in general. While I suspect that face masks are nearly useless in most regards, I can see one way that might give protection, if they are changed whenever needed. Most people touch their face very often and more so when they are worried. So touch a dodgy surface and with about 120 seconds that contact will be transferred to their face, the wait time might even be less. A mask could reduce such contact and transfer events. Otherwise, not sharing eating utensils and better management of what are supposed to be quarantine situations is desirable. Apparently, the management of the ‘locked down’ hotels is somewhat woeful with long food queues sharing serving utensils, chatting while effectively  pressed together, etc.

VFM, I see you are subscribing to the idea what we must all take personal responsibility, those with health issues must be especially mindful of their role in personal protection.

It is absurd to propose bankrupting each other by suggesting the purchase of equipment that could never be delivered in time and for which no trained staff or space would be available in a 60% event.

[Author]

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