Coronavirus – Thu 19 Mar 2020 – press conference lies and racism, homemade masks, Peter Watts, drugs

I can’t watch Trump’s press conferences. The frustration with their worthlessness is amplified by the danger we’re all in. Today was the first day that the only trusted voice, Dr. Fauci, was not present. People noticed. Why we shouldn’t listen:

  • For the past two days (more?) Trump switched to calling coronavirus “Chinese virus” to trap any thinking person into focusing on his racism instead of his ineptness. That’s story has not become the main story, so I hope that the importance of focusing on the problem has weakened that particular distraction technique.
Corona Chinese

As Media Matters documented earlier this week, Rion reported on “information” she had received about the virus’s origins from conspiracy theorist Greg Rubini, who has said COVID-19 was “genetically engineered as a Bio-Weapon at the Univ. of North Carolina BSL-3 Lab.”

Rubini believes that the virus was produced as part of a “deep state” conspiracy to destroy the economy ahead of Trump’s reelection, and he even implicated the Trump administration’s Dr. Anthony Fauci in the plot.

California governor projects “56% of state’s population will be infected” in the next 8 weeks

Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic?

The study is paywalled, this image is from @CMichaelGibson

I’m not sure how it took me until yesterday to start associating our current pandemic with the biological catastrophe described in the later books of Peter Watts Rifters series (free online here). In that, a primordial microbe that exists dormant on the ocean floor (dubbed ßehemoth) gets carried to the surface and results in a fast-transmitting, slow-symptomatic disease that gradually eliminates a person’s ability to process proteins (I’m not remembering the exact science, that sounds half-right) so that they effectively starve to death. Society crumbles in slow motion. Remembering this story, and its bleak cruelty, unnerves me during our current situation.

Revenge of the Pangolins(Or, The Epidemiology of Understatement)

There are, so far, at least two strains of COVID-19, the younger and more virulent “L-Type” being responsible for most of the symptomatic cases. But L is already waning—probably because of active control measures— leaving the more benign “S-Type” to outcompete it in the wild

Watts, a pessimist’s pessimist, feels that COVID-19 is not even close to what we should expect in the future, and so has an oddly optimistic take on what’s happening. China’s carbon emissions have dropped 25%. Canceled conferences may push organizations to primarily virtual gatherings and eliminate the associated air travel, along with development of better remote groupware tools. The US healthcare industry might finally get a boost (not holding my breath).

It’s 8:30 PM and the US is up to 13,680 (Johns Hopkins) / 13,859 (Worldometer) so we’ve doubled in 2 days, making my graph from yesterday already 3 days behind. I’ll redo it in a couple of days.

Updated the next day

As the coronavirus spreads, a drug that once raised the world’s hopes is given a second shot (16 Mar 2020) – Article from Stat (very respected journal, esp. for this COVID-19 pandemic) on remdesivir.

Vaccines being tested:

  • Favipiravir – Antiviral, useful against influenza, West Nile, yellow fever.
  • Hydroxychloroquine (HCQ) Hydroxychloroquine sulphate (brand name: Plaquenil) – Useful against malaria.
  • Remdesivir – Antiviral, useful against Ebola, Marburg, MERS, and SARS.

China has had successful tests against COVID-19 using all three.

Related diseases and viruses:

What are these (types of germs)?

  • Virus – Smaller than bacteria. Can only survive and replicate in a host’s cells. Bacteria, since they are cells, can be infected with a virus. Influenza, AIDS, MERS/SARS/COVID-19.
  • Bacteria – Single-celled microorganisms with no nucleus. Staphylococcus (pneumonia, meningitis), Lyme disease (spread by ticks), chlamydia.
  • Protozoa – Single-celled organisms that can be free-living or parasitic. Feeds on organic tissue and microorganisms. Ex.: Malaria, taxoplasmosis, cryptosporidiosis.

(Fun fact: In college, when water from Lake Allatoona was spreading cryptosporidiosis, I won 2nd place in an art dept. contest to illustrate the cause. My entry was a National Enquirer cover showing Egyptian pyramids and aliens living at the bottom of the lake.)

Updated 28 Mar 2020

Hydroxychloroquine (HCQ)

Here’s a date-ordered summary aggregation of the research I’ve done so far on HCQ studies. The articles that references these had some of the additional information noted. Some articles reference “the French study” or “the Hong Kong” study and the referent is unclear. I’ve attempted to specify correctly.

DatePaperPatients/DoseResult Notes
26 Feb 2014 (published)Angiostrongylus cantonensis eosinophilic meningitis: a clinical study of 42 consecutive cases in French Polynesia.

French
42 patients but only 36 were included in the results,
No randomization,
Poor control group selection
Three statisticians reviewed the data (see Statistical review of Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial.) and concluded that the way it was designed makes the results look better than they are.
11 May 2018Paradoxical Effect of Chloroquine Treatment in Enhancing Chikungunya Virus Infection from MDPI
29 Feb 2020A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19) from Zhejiang University Journals

Chinese, Fudan University in Shanghai
30 patients,
Randomization between HCQ and control groups.
Jun Chen (one of the authors): “HCQ has never been effective in any viral diseases, despite its in vitro antiviral activity” [ref]
9 Mar 2020In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Chinese, Shanghai
30 patients
17 Mar 2020 (published)Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. (abstract)

Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: an observational study (PDF)

French, Philippe Gautret in Marseille, France
80 patients,
Mild symptoms,
85% had no fever
22 Mar 2020

31 Mar (published)
Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial from medRxiv

Chinese, Renmin Hospital of Wuhan University
62 patients divided into test and controlBody temperature and cough went down faster (24 hours earlier) in the treatment group,
No details on the initial severity of the disease
30 Mar 2020No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection from Médecine et Maladies Infectieuses

French, Hôpital Saint-Louis in Paris, France, Jean-Michel Molina
11 patients,
8 with underlying health conditions,
10 quite ill and feverish
5/6 days and 8 still had COVID-19,
1 died, 2 ICU, 1 removed because of serious complications
11 Apr 2020 (published)Chloroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study)
Brazil
81 patientsHalted after 10 days because of heart arrhythmias and 11 dead.

from Small Chloroquine Study Halted Over Risk of Fatal Heart Complications (NYT)
23 Jul 2020Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19Large-scale test. Conclusion:
“the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status”

What if hydroxychloroquine doesn’t work? What if it does? Right now, we don’t know from Stat 27 Mar 2020. Stat is the source of reporting on COVID-19 research. Some important facts:

Angiostrongylus cantonensis eosinophilic meningitis: a clinical study of 42 consecutive cases in French Polynesia. (published 26 Feb 2014) – French study of 42 patients. Three statisticians reviewed the data (see Statistical review of Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial.) and concluded that the way it was designed makes the results look better than they are.

  • Only 36 of the 42 were included in the study.
  • There was no randomization.
  • The control group was poorly chosen.

In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (published 9 Mar 2020) – Shanghai study of 30 patients. Had randomization between HCQ and control groups.

Both our study and theirs had many limitations,” Chen wrote. “But personally, I would say that hydroxychloroquine was not a ‘magic’ drug, if there is any antiviral effect. And in fact, hydroxychloroquine has never been effective in any viral diseases, despite its in vitro [in a petri dish] antiviral activity.

from Jun Chen, one of the authors of the Shanghai study

The Trumpian French Doctor Behind the Chloroquine Hype from Slate, 30 Mar 2020

The doctor who has all of the Internet-degreed Scientists declaring victory on Twitter is Didier Raoult. An although he has many legit awards, some of his scholarly techniques can be seriously questionned:

[Raoult] publishes more papers in a month than most productive researchers publish in a career. Raoult’s method, according to one critic, is to task a young researcher at IHU with an experiment, then co-sign the piece before it is submitted to publication.

Also see his controversial (spelled “idiotic”) critiques of climate change.

W/r/t HCQ, he performed a study in Mar 2020 of 24 individuals who had tested positive for COVID-19. After six days of HCQ, 3/4 were cured. And although this is a different study from the 2014 French study referenced several paragraphs above, apparently the same mistakes were made, weakening considerably any findings:

Critics argue that not only were there too few subjects in the chloroquine study, but that some of them dropped out during the trial, potentially skewing the results.

Sound familiar? Raoult also went to YouTube instead of any journal or peer review. Maybe to expedite the knowledge transfer to allow other researchers to confirm? However, that could easily be accomplished by sending it to research institutions rather than the aforementioned Respected Internet Scientists.

The damage to serious understanding of a potentially useful drug has been done in order to get his name in the spotlight.

There’s a separate Chinese study I see referenced online titled Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial from 22 Mar 2020 treating 62 patients. This is distinct from the 9 Mar 2020 one referenced above (In Vitro Antiviral Activity…), and in fact it may have a circumspect reference to that or other “in vitro” studies. This may have more solid research, but with no control group it’s uncertain.

Updated 7 Apr 2020

Small Trial Suggests Antimalarial Drugs Not Effective For Treating Coronavirus from ScienceAlert, 6 Apr 2020

This article is by a medical chemist who specializes in antivirals and coronaviruses. The studies that are referenced (added to table above):

Detailing the currently thin, and thinning, evidence:

However, a study just published in a French medical journal provides new evidence that hydroxychloroquine does not appear to help the immune system clear the coronavirus from the body.

There are already other clinical studies that showed it is not effective against COVID-19 as well as several other viruses.

Several of the studies show it only effective for patients with mild symptoms. One study showed most of the benefits are for the flu.

Updated 13 Apr 2020

Anti-malarial drug touted by Trump was subject of CIA warning to employees from The Washington Post, 13 Apr 2020