The FDA has warnings that azithromycin “can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm.”
So instead, Alam replaced azithromycin with another decades-old antibiotic that doesn’t pose any known risks to the heart.
“Doxycycline is an anti-inflammatory with properties similar to azithromycin but without the safety concerns and without cardiac toxicity,” he said.
Now that's an interesting twist -- and it appears to be working.
This doctor reports 38 of the 47 patients he had, all of whom were very high risk, have stabilized with this regime. It didn't work for everyone but the fact remains that this looks very promising for people who would otherwise likely be hosed straight-up; these are persons who would be rather likely to be killed by a simple flu.
Is this statistically significant? Not standing alone -- but another word for "anecdote" is "clinical evidence", and when you have a group of people who are otherwise screwed and you can only improve the situation for someone who is likely to die then it certainly looks to me like a positive outcome -- especially when we're talking about people who can't use ZPAK due to their underlying health conditions.
Interestingly enough doxycycline is also an anti-malarial.....
The article in question mentions that the Henry Ford health system -- a very large hospital network in SE Michigan -- is using this combination as well and as a result we'll probably get some pretty good data soon.
Again, do not attempt to play doctor with this on your own -- this is a tetracycline antibiotic and some people are allergic to those medications, and it can cause tooth discoloration (permanent) in un-erupted teeth. This would be a problem in both children and pregnant women for obvious reasons. Additionally it can be very dangerous in people using warfarin and similar medications.
Why do we keep putting up with the lies?
One quarter of the deaths in NYC, the area with the highest death count from Coronavirus, lived in nursing homes. This over-represents them as a percentage of the population in the city by fifty times.
FIFTY.
Not percent, TIMES.
Statewide 20% of NY deaths are patients in either nursing homes or people in assisted living facilities. This over-represents the population by FORTY times.
Again, not percent. TIMES.
We don't have a general-population pandemic. Yes, we have people getting sick. Yes, people are dying. Yes, many of them are in the general population. But we know how to deal with a lot of this; HCQ/ZPAK/Zn appears to work. Not in everyone, and it should be given early, not late.
But it appears to work.
Further, we now have damn good evidence that fully half of all infections are asymptomatic. That is the person who gets it never gets sick. At all.
Why am I being told to shelter in place when half the time if I get this bug I don't even sneeze? By the way if I get it and don't even sneeze you want me to have it. Why? Because then when the poor bastard next to me DOES get sick I can't get it and thus his ability to give it to others is reduced. Get enough people like me and that poor sick bastard will run out of attempts to transmit it before he either dies or recovers.
Where is the authority in the Constitution to quarantine people who are not ill? Who are not currently infected? I will not get ill nor can I transmit the virus to someone else unless I have it. Since when can someone's Constitutional Rights be suspended indefinitely when they are neither carrying a virus or ill with it? There is no such authority. Period.
We keep being told that this virus kills people left and right, like it's SARS, smallpox or something similar. The simple truth is that it isn't. Not even close.
Yes, the virus is dangerous. Quite dangerous, if you have one of a list of serious illnesses, but we know what they are. Worse, we also know where some of the major spreading is going on too given this over-representation among nursing home and assisted living facilities -- its the workers in those places, and worse, many of them are very poorly paid and thus take second jobs doing at-home care, during which they can transmit it to those people -- all of whom are at high risk by definition.
NY has even ordered nursing homes to accept discharged Coronavirus patients -- which is like throwing a lit match in a barn full of dry hay. That's flat-out insane, to the point that one wonders if they want to drive up the death rates for political purposes to justify their "shelter in place" order. That order is quite-arguably mass voluntary manslaughter!
75% of nursing homes have been cited for failing to monitor and control infections in the last three years.
Think about that: 75%!
We don't have a coronavirus pandemic among the general population. Oh sure, it's bad -- don't get me wrong. It's a nasty bug, it can get anyone, and it is getting plenty of people. A few who are not seriously ill are being killed by it. Key words: A few.
But when you have a quarter of the people getting seriously ill and dying coming from a part of the population that is one half of one percent of the total you do not have a widespread community pandemic.
You have a specific problem with transmitting disease in that part of the community, and since exactly zero of those people are in control of that part of their own destiny it's not that individual's responsibility either -- it is the health care system under which they are living that is infecting and killing them.
But without a widespread community pandemic you also don't have legal, ethical or moral justification for locking down anything under force of law -- constitutional or not.
Cut off the vectors to the most at-risk -- individually through strong advisories to shelter in-place and for those in assisted living facilities and nursing homes solve the problem there. It is outrageous and unjust to the point of questioning whether an immediate revolution is in order if, in order to protect the poor infection control record and obvious transmission from the outside to one half of one percent of the population you instead issue executive orders that imprison everyone in their homes.
This country is not a police state. Well, it's not supposed to be anyway but you sure as hell are acting like it is and you're a dictator with the right to imprison and even kill people simply because you say so.
The truth is becoming more-evident by the day -- even in the mainstream media. It will not be long at all before the people decide they've had enough of this con job; while a huge percentage of the people in this country cannot do math if you think the people will sit still in their homes and have their jobs destroyed permanently because some underpaid workers are infecting one half of one percent of the population through misfeasance and malfeasance I suspect you have another think coming, and you might not like how it comes either.
We have another option and it's entirely congruent with what we're learning about infectious vectors with this disease. I wrote about it this morning.
OPEN THE ECONOMY NOW MR. PRESIDENT.
Not tomorrow, not next month, NOW.
Cramer just admitted on-air the fact I've pointed out for more than a month -- in NYC fewer than 20% are making it off ventilators.
Oh, and just because you make it off doesn't mean you live. How many survive to discharge? Well, it's less than or equal to that, right? Yep, since if you're dead we already know the outcome.
Remember, we're not out of ventilators. Everyone who needs one gets one at the present time.
The problem isn't that they aren't available -- it's that in nearly every case they don't save the patient.
This was my point since this alleged "debate" all started. The premise that if you exceed hospital capacity we have 2 million deaths and if we don't then 100,000 people (or however many is the fantasy-land trot-out of the day) die was always intellectually bankrupt and a bald-faced lie. It has been relentlessly promoted on a literal minute-by-minute basis to justify buying tens if not hundreds of thousands of $30,000 machines never mind that each one requires skilled people to operate it, which we do not have.
It has been repeated daily by people like Cuomo, Fauci, Birx and others and President Trump laps it up and regurgitates it without first asking for the survival rate on the vents.
Wuhan managed to save five percent of those who went on vents.
FIVE PERCENT.
I said at the time we can and likely will do better. But not a lot better. Nor should we have expected to do better; a study done in 2015 said that the base rate for ventilator survival was 50% to discharge and just 30% over the following year.
Folks, we're not talking about those who are ambulatory and survive without invasive procedures dying if the hospitals overload. They won't die anyway. They'll be ok. Whether it's nasty in their house or in the hospital doesn't matter as they'll be ok.
The people who wind up in ICU on a vent, in nearly all cases, die. Whether you die with a tube down your throat or you die because there is no tube available to shove down your throat doesn't matter; you're still dead.
It is only those who we put on mechanical ventilation and survive that we can change outcomes for. They're the only ones for whom a bed in the hospital makes the difference.
For everyone else the outcome does not change.
This means that if we "intervene" and destroy the economy and we have 100,000 people die, all of whom will require intensive care, obviously, and the failure rate with said vents is 80%, then if we did nothing we don't lose 2 million people, we lose 120,000.
Now granted, 20,000 excess deaths is 20,000 I'd rather not have happen.
But that's the difference between the two scenarios and both Birx and Fauci know it -- not 100,000 .vs. 2,200,000.
Is it worth destroying the economy, 30% of all small business restaurants and bars, millions of jobs and millions of lives -- literal millions folks, not 10,000 or 20,000 -- in this attempt? Is it worth the risk of a critical supply chain disruption that leads to mass civil unrest, riots and potential destruction of one or more American cities? Is it worth real martial law -- not a "lockdown"? Is it worth the destruction of our civil society, our willingness to be social with other people, the permanent impact on our economy and the inevitable depression, suicides and overdoses?
And finally, for those of you who think this is all about protecting Granny, listen up:
There are 2.8 million people in the last year of their life in the United States right now. Some of those people know it's their last year and some do not. By definition every single person who dies in the next 12 months is in the last year of their life right here, right now.
These constraints are, right here, right now, today, preventing those people from socializing and spending time with the people they love and would otherwise like to spend that time with.
In Trump's 15 days to "slow the spread" over 115,000 Americans died while having had robbed from them the small, simple pleasures of being with the people they love and want to be around by government diktat. If we continue this insanity until April 30th over 345,000 of those people in the last year of their life will have died and they will have been prohibited the social interactions they would otherwise choose.
Our government -- backed by the vast majority of our population and all the scolds on CNBC and elsewhere -- are consigning 345,000 people to die literally locked in a prison.
All of this because you're not content to take your own precautions and calibrate your own risk. You're not content to tell people honestly up front that if the health system overloads we will triage and those who are older and are felled by this virus will have to face Brother Grim and then let them make the choice for themselves as adults.
I have, I hope, many years of life left and so does my daughter. Neither of us needs to be working right now. This is an inconvenience. For those put out of work who will lose their jobs on a permanent basis, and then their homes, this isn't an inconvenience, it's a damned travesty predicated on half-truths and outright lies. Nonetheless, we will survive this.
But for over 345,000 people between the start of this insanity and the end of April it is not an inconvenience or even a travesty; they will die in a literal prison imposed by you, bereft of the social benefit, comfort and simple daily pleasures of life they would have otherwise enjoyed. How dare you imprison those who have committed no offense and will be dead before this is over. That is a literal atrocity and a crime against humanity.
You are screwing over 7,000 people a day out of their small individual social pleasures in the puerile and false belief you can "stop the virus." Even China, welding people in their houses literally, did not stop it.
Not one of those people gets a "do over" when you're proved wrong; they're all dead. You can't apologize later or make them whole. Ever. And every single day this bullshit goes on another 7,000 people die having been imprisoned in their last days by you.
This is not a few people here and there against whom you commit these crimes -- over 100,000 of those people are dead now and there's nothing you can do to address the harm you caused to them. You literally throw over 7,000 more bodies on that pile each and every day.
My mother died of colon cancer about a year and a half ago. The last months of her life were spent doing what she wanted to do in her own home. She had two bad weeks at the end; up until that point she was still enjoying being who she was, and doing what she wanted to do, interacting with whoever she pleased. About a month before her final decline my daughter and I drove to her home, picked her up and we all went to lunch in a restaurant. That was the last time she was able to enjoy the simple pleasure of being served by someone in a dining establishment. Today that simple pleasure and her choice to engage in it, were she alive, would be prohibited under force of law at your demand.
In the name of a possible 10,000 or 20,000 speculative deaths you have destroyed the enjoyment of over 300,000 American's lives in their last days.
Preventing all of the people in her situation, over 120,000 of them who have passed thus far and 337,000 if this goes to April 30th, from doing as they wish and spending their remaining days as they wish and with whom they wish makes every last one of you a monster.
Yeah...... damn that flag is going to get worn out... You know which flag it is, right?
A supervisor urged surgeons at Columbia University Irving Medical Center in Manhattan to volunteer for the front lines because half the intensive-care staff had already been sickened by coronavirus.
“ICU is EXPLODING,” she wrote in an email.
A doctor at Weill Cornell Medical Center in Manhattan described the unnerving experience of walking daily past an intubated, critically ill colleague in her 30s, wondering who would be next.
Another doctor at a major New York City hospital described it as “a petri dish,” where more than 200 workers had fallen sick.
Where do all these essential workers go when their shift is over?
Do they stay in the hospital and self-quarantine?
Nope. They go home.
So do their other colleagues, who are likely silently positive with mild or non-symptomatic cases.
Does the Sheriff threaten to arrest them if they leave their house? Nope.
Why not? They just had contact with dozens, even hundreds of known-positive people.
What was I saying the other day about why, despite the lockdowns, the R0 is not below 1.0 when the majority of our society has reduced their interaction with others by 90, 95 or even 99%?
Gee, I wonder why there are any community transmissions at all?
If you lock down an area and close all the bars, restaurants and other social places and R0 started as 3.0 it goes under 1.0 instantly and the case rate collapses. If that does not happen then that is not how it's being spread.
Period.
So the spread wouldn't be coming from all the folks in the hospital who are not being forced to stay in said hospital where the infection would be contained, right? Could you even do that without every single staff member quitting on the spot? Probably not. But even if sick they're considered essential and thus are not subject to actual quarantine orders or arrest for going out in public even if suspected or known positive, never mind that every single one of them had contact with dozens if not hundreds of known-positive persons in the same building.
Meanwhile the rest of us have guns shoved in our faces when the data says we're not the largest component of the vector.
The health care workers are.
The biggest impact of the lockdowns is destroying the ability to pay for hospitals, which is likely to kill more people from all manner of other causes. I remind you that between heart attacks and strokes there are roughly 1.5 million Americans hit a year and if we destroy the hospital systems by trashing both economic activity and taxation you're very likely to kill far more people who have those events than the virus ever could.
Today, Typhoid Mary is paraded around as a hero.
Psst - Heh Doc, wash your fucking hands. You want to know how Singapore stopped their health care workers from getting the virus with nearly 100% efficacy and thus removed this vector from the equation? It wasn't masks or being kitted up in tyvec (entirely impractical for a full shift) -- it was washing their hands before and after each and every contact with a potentially infected person or thing. Every time. As soon as they enforced that even if you were chatting with another staffer in a hall without a mask on the infection rate among their health care workers went to a statistical zero.
Oh, want to know when the community transmission rate will start to drop in a given area? When all the docs, nurses and other medical workers have been infected and either resolved or died. They then are immune and their spreading of the virus into the community stops. That, by the way, is why despite the lockdowns, there is no effect for a couple of weeks instead of one viral generation time after the lockdown occurs -- the spreading continues until you run out of vulnerable health care workers who can spread it into the community.
THEN it stops.
And yes, that's exactly the pattern we're seeing. Community spread from ordinary social interaction isn't the largest component of the total in the vectors of transmission. The health care system workers are, which is why the anomalous pattern that we keep seeing in every single nation and area, where there is one case here and there in a given area and then suddenly the case count explodes upward. One or a few of those cases are go sideways, wind up in the hospital and then the entire staff gets it and spreads it back out in an exponential blast into the community.
PS: This same pattern was visible in Wuhan.
The field hospital style model being built at the Javits center -- and many other places, including what used to be called Cobo Hall in Detroit -- has promise as a means of treating people.
But -- it is not being thought through anywhere near at a sufficient level of detail.
This is very much the TB Sanitarium model as a means of pandemic response, but it is missing one critical element: During those years when the Sanitariums were operating if you worked there you were someone who had TB and recovered -- and were thus immune.
And this leads back to what I was talking about yesterday: If you ignore one of what appears to be a major vector for this disease out of a sense of hero worship and then amplify it with field hospitals you will create an all-on disaster.
There is currently no mass-test available for antibodies. We need one -- an OTC, anyone can buy it cassette style test. We have them available for diabetics; they run them every day on multiple occasions. There are even "home" A1c tests; same deal and those are even more-correlated as there is a reagent required with those as well (not just blood as with the routine sugar-level checks.)
This is critical for two groups: At risk Americans and health care workers.
Simply put with an antibody test those who have had the virus and recovered, and thus have antibodies, can safely work in those wards. It then becomes a matter of routine decontamination before leaving (it may require a hot shower and soap, but that's reasonable) before departing for the day. Other than direct transport of infectious material once immune you're "safe" in the general public even if exposed to sick individuals.
This is the key group, because one hospital worker can infect dozens of others. Oh, I know, they'd neeeeevvvvveeerrr do that. Except the data is that they are doing it right now. It's either that or we've got a bunch of so-called "essential" folks doing the transmitting -- and we're fucked, because you cannot cut off the grocery stores and such.
For at-risk Americans however seropositive status isn't about getting other people sick -- it's about their personal life. Just because you're at high risk it doesn't mean you didn't have an asymptomatic infection. You might have. For example it's implausible that the older couple on Diamond Princess who were quarantined in their cabin resulted in one infected and one not unless the individual who didn't get the virus seroconverted and was thus immune.
Further, if you know you're seroconverted then giving the finger immediately to President Trump, your Mayor, your Governor and everyone else in terms of your personal activity is not only appropriate -- it's a matter of civil and personal rights. If you have seroconverted (that is, you were infected and are now immune) then there is absolutely no reason whatsoever to abide any restrictions or constraints -- not ethically, morally or legally.
Of course this is why nobody wants you to be able to go and buy one of these tests at the local store. If you learn your seroconversion status then it renders all this "community" nonsense flat-out false since anyone can choose otherwise with absolute safety both on a personal and public basis.
Second, the facts on the ground are that only 10-15% of those who wind up on vents can be saved. Everyone else dies anyway, so that's what we're talking about here. If the facts are that 100,000 people are going to die then they are; we're now talking about a delta of 10,000 people or less than 1/5th of a moderate flu season in exchange for half the small businesses and an intentional economic depression being taken.
It is fine to urge people to "socially distance." It is fine to urge the elderly to shelter in place. It's even ok to ban mass-gatherings; after all, if there was a shooting war on would you allow theaters to operate with their lit marquees as the bombers flew overhead -- would that not be literally painting a target on hundreds of Americans at once?
But when you force closed businesses you do something that was not done even during actual wars. Businesses had their production diverted (those who lived through WWII were unable to buy tires for their cars as they were requisitioned for jeeps in battle) but actually forcing businesses closed? No. People went out, or not, as they deemed worth it during those times. A bomber might come. An air raid could happen with little or no warning. People in Britain faced V2s that were launched from German territory on a daily basis.
Some people decided to wait out the war in a bunker, cowering in fear but others went to work, baked bread and went about their businesses. The Allies won the war because we did not destroy our economy cowering in the corner at the point of a federal or state government gun.
Every time you claim some firm or operation or job is not "essential" that is someone who you destroy. You do it on the claim that it will keep others from dying, but that's speculative. You do not know -- you have a model, and it might be right or it might be wrong. The facts are that even without an overloaded medical system in the US today the data is that roughly 9 out of 10 people who wind up on a vent with this virus die anyway. That's the maximum size of the group you can save; everyone else has their path through this virus determined; if they're going to be ok, then they will, and if they would die on a vent they will still die without a vent.
Nothing changes for all but that tiny group of people.
Further, even if the system overloads and triage is appropriate or even necessary those who decide to operate their factory or go about their day knowing that a bomber might appear or a V2 might fall on their head made the decision.
They acted as adults, which is their right in any free society.
We no longer live in a free society.
Maybe you think that's worth it, but how many people will commit suicide? How many people will decide to drug or drink themselves to death? How many old people who are cooped up in the last year of their life die anyway without the social interaction and enjoyment of their friends? Death comes to us all and why is it my right to tell you as an older person that you must live with no visitors for your last two months in a nursing home because everyone is barred from coming to see you? What if you would choose to take the risk and enjoy time with your family members?
WHAT GIVES YOU THE RIGHT TO FORCE A SENIOR INTO ISOLATION AGAINST THEIR WILL?
Is this a free nation or a National Gulag?
THAT is what nobody is taking into account.
And, of course, we have Sweden. A nation that has looked at the very same data and the same experts our government has and refused to lock down and has told their citizens that they are adults and are expected to act like one. If they turn out to be right and we are wrong then whether this is a nation and people that deserves any respect, down to a single person, depends on whether one of the people involved in these decisions retains their jobs, their homes, their pensions, their jobs, even their underwear.
It will not be long before we know whether this was justified -- or whether Sweden was right and we were wrong.