in Editorial , 512 references
OK, enough of the bullshit (again)
We know at this point Covid-19 is a bi-phasic disease. That is, in most people it presents either asymptomatic or with mild to moderate flu-like symptoms. That's what the vast majority of people experience, including a very significant percentage of people at "high risk."
Indeed even the CDC is now admitting that ten times the number of people that have "tested positive" have actually had Covid-19. This, of course, means the death rate is 1/10th that reported. I pointed this out -- that the data we had was only supportable as valid if there was a monstrous number of people who were "silently" infected in March.
In some small percentage of the people infected they may or may not get that set of symptomology but irrespective of that they also get a far more-serious set. These are the people who wind up the ICU and die. We know what the co-morbidities are that greatly increase the risk of that happening -- in some cases by a factor of 10 or more. But there is no guarantee for anyone that they won't get the more-serious set of conditions.
The NIH explicitly recommends against screening for two markers (sequentially, if necessary) that we know, through clinical experience and have known since March, are markers for the more-serious form of the disease when someone originally presents to a medical facility. The cost of such a screening test is about $20.
Further, there are exactly zero circumstances under which a high reading on that first test is not indicative of a serious problem of some sort in the human body. D-dimer, the test in question, is a byproduct of blood clotting; if it is elevated there is abnormal clotting activity going on somewhere; it does not tell you where, but it does tell you what.
One potential cause of the first test being abnormal is cardiac clotting. That's very bad for obvious reasons, and ruling it out costs about an additional $10-12 to test troponin level, which is a cardiac enzyme indicating distress in the heart muscle. (If that one's positive, by the way, you're probably being admitted to the hospital, but not for Covid -- for a serious heart problem!)
The Marik Covid19 protocol, developed by the Eastern Virginia Medical School, focuses on exactly this issue.
Note that their protocol includes anticoagulants unless otherwise indicated against (e.g. people with clotting disorders, etc) right up front for all hospitalized patients. Specifically, Enoxaparin. Think about that one; you give people that to either forestall or treat hyper-coagulation problems.
They're not alone. Note that Reuters is referencing multiple medical centers in the US and elsewhere that are using both steroids and anticoagulants.
The NIH specifically recommends against looking for clotting disorders right up front and also recommends against steroids for patients with severe disease even though we now have had a result reported out where the risk of death was cut by more than a third of people in ICU with severe Covid-19 through the use of an inexpensive and readily-available IV steroid.
Has the NIH or CDC modified their protocol and recommendations in light of any of this? No.
In short the NIH is explicitly ignoring the fact that immune dysregulation resulting in clotting disorders are both well-documented in people who have severe Covid-19 courses of disease and specifically recommending against both checking inexpensively for the early manifestation of same and treatment of same EVEN UNDER SEVERE, ADVANCED CONDITIONS.
That's flat-out nuts.
Who, must I remind you, is in charge of a significant part of the NIH?
Who, may I remind you, has placed that man on a pedestal and has yet to do anything about it? Trump.
When did we know that severe cases of Covid-19 included elevated D-dimer levels and normal troponin and thus involved immune dysfunction and coagulation disorders? Abnormal D-dimer levels were reported on Pubmed in February and in at least one reported hospital in the earlier days (e.g. March) when testing was slow and unreliable due to the CDC fucking up their reagents they were using that pair of test results (abnormal D-dimer, normal troponin) as a surrogate Covid-19 indicator when people were admitted and later found, when the Covid tests came back, that it was nearly 100% accurate. In short when they couldn't get rapid Covid-19 test results back they were using this as a surrogate to identify people who needed to be treated for Covid-19 with nearly 100% accuracy.
Is the NIH intentionally not going where the science leads because that would drop the fatality rate dramatically? The hospitals that are doing so on their own have already driven the fatality rate down by more than half nationally in just the last month and by a factor of more than five since the pandemic began in the United States If we actually updated these standards and expected them to be followed nationally as we learned more would there be anything to be alarmed about with this disease any longer at all or would it be similar to ordinary seasonal flu? The answer, by the data, is obvious.
Now let's add a few more things.
Where are all the dead people with Lupus and RA in this disease? While there have been a few reported cases the key word here is few. Far fewer than expected based on the prevalence in the population. In fact, since both combined are about 1% of US population and about 1.5% of the adult population we would expect among the dead somewhere between 1,000 and 1,500 who were taking maintenance doses of HCQ at a minimum. Since both are autoimmune disorders and immune disorders are considered a high risk factor we should expect material over-representation among these populations. Well, are the deaths there or is their prevalence statistically smaller than expected? Why hasn't that been reported? You do realize that Medicare and Medicaid know exactly how many people have these disorders among the elderly, poor and disabled and exactly who is taking that drug among them, right? Where's the data and who is blocking its compilation and release?
Next, there is some anecdotal evidence that Ivermectin may work too. I note that Ivermectin is a one dose drug, as opposed to "take X per day" sort of thing and it is considered safe enough that even non-medical illiterate persons can safely dispense it in third world nations. It has arguably prevented more human suffering (specifically, putting a stop to serious parasitic infections that often debilitated and blinded people) than anything discovered in the last 50 years. In other words the odds of it hurting you are nearly zero (although no drug has actual zero risk) while the odds of it helping are unknown but suggested by association. Should that be tried, especially on initial presentation when viral replication is still going on? I think you should have that explained to you and get the choice, but again, since it interrupts viral reproduction whether it will do much if anything once the disease has progressed is uncertain at best. Note that you can buy enough Ivermectin to treat a horse for about $6; it's literally dirt cheap and thus nobody can make any material amount of money on it.
There are no "minor" clotting disorders folks. Have we looked at these "ground glass" opacities talked about on CT scans via dissection to figure out what they are? Of course not; you don't dissect a live person! What if they're not "fluid" build-up but are instead thrombus? That would functionally explain not only what we're seeing and why O2 sat falls but also would explain why intubation without dealing with that problem is likely to kill the patient. In short a lung that's got micro-clots all over the capillary bed is much less-compliant and thus much-more prone to barotrauma. In addition if the root cause is immune dysregulation intubation inevitably stimulates an immune response and as a result makes that worse. Couple the two together and the reason for failure becomes quite clear, doesn't it?
We're still not owning up to this "ventilator" madness officially, yet it has killed thousands -- probably tens of thousands. Coupled with the refusal to look at this as a bi-phasic disease, where most people get a flu-like case while others get a secondary case that involves immune dysregulation including clotting disorders is outrageous. It's not like we haven't seen viruses behave that way before either; polio does, and it's one of the most-notorious viral bugs ever The second form of attack by this virus appears to be able to be detected by a trivially-inexpensive test; why would anyone with a working brain ignore an indication of a severe metabolic compromise for which they can be treated? Both Trump and Cuomo, along with Fauci, Birx and many others, should be sitting in the dock facing manslaughter-for-profit charges writ large.
Perhaps some of those with an actual "MD" after their name can explain how intentionally ignoring testing for a known problem -- specifically, a clotting problem -- can be medically defended? Is in fact the only reason the NIH specifically recommends against this is to give cover when the doctors don't treat for said disorder and that winds up being a major part of -- if not the entire reason -- why the patient dies?