COVID-19 Pandemic: Transmissions, Deaths, Treatments, Vaccines, Interventions and More...

[RUinPinehurst]

You are incorrect grasshopper. If China does not place a figure head leader in charge and decides to otherwise place troops within North Korea’s borders that is a troubling thing . It not only re- enforces everything the Chinese are attempting to accomplish , a dominance of the pacific theatre but it threatens our current allies if South Korea and Japan. It also puts US troops in harms way.There is much old history here especially the mutual dislike of Japan. China would command a military force of overwhelming proportions. The Russians would not and are NOT happy with China as we post this. This will play out eventually. So , you would be ok with them possessing that capability ? I find it hard to believe how naive people with some supposed brains literally think this possible scenario would not impact their lives. There are many who have accepted this theory that world globalization will work. I hope China doesn’t push the issue it will not end well. Prediction still stands : Russia will get into conflict with China... will ask for US help and you know the rest will be ugly mess.

China has an enormous economic opportunity before it, as a natural expansion of its recent advances and resources. With that economic growth comes political growth and influence. It is INEVITABLE. They will contend with us and then likely overtake us as the dominant nation of power and influence. That does not diminish us in any other regards, though. But it will be in China's best interest now and moving forward to promote world and market stability. I'm sure the progression won't be perfect or without setbacks but they likely won't be self-inflicted. It'll be due to other regional conflicts (political or religious) or natural disasters including pandemics, asteroids, etc.

 

[LETSGORU91]

You obviously know a lot more about all this than I do, although I had an exchange with an MD friend by email and he thought this comment of mine was interesting...

You'll forgive me if I don't think I have much to add with regard to what to do medically for hypoxia, but the one thing I can comment on is the step-by-step process involved in transferring air from the lungs to the alveoli and then diffusing across to the blood and the red blood cells (gases are in both) rich in CO2/deficient in O2, which is supposed to be happening in parallel with that CO2 diffusing the other direction from the blood/red blood cells in the capillaries into the alveoli, so the CO2 can be exhaled.

From a mass balance perspective (that's what we chem E's do, lol) it tells me that somewhere the diffusion process seems most likely to be the issue, if "breathing" appears to be close to normal, i.e., the volume of air to and from the alveoli is close to normal, but the gases simply aren't being diffused/exchanged into and out of the blood in the capillaries properly for some reason. Diffusion is a pretty simple process, though, so unless the paper thin walls of the alveoli or the capillaries are affected in some way, perhaps the hemoglobin in the red blood cells is being impacted somehow, not allowing the oxygen to be properly captured by the hemoglobin (like what happens to some extent in carbon monoxide poisoning, where CO binds so tightly to hemoglobin that O2 is displaced and not delivered to the tissues).

The problem with that theory is the oximeter is presumably reading the O2 in solution in the blood at the fingertip (unless it'srreading total O2 in the blood and the hemoglobin somehow), not what's held by the hemoglobin for delivery to the tissues (and most of the O2 is supposedly sequestered by the hemoglobin vs. the much smaller amount in solution in the blood - so if the hemoglobin in the red blood cell isn't working "properly" to take up O2, then one would expect the O2 levels in the free blood to be high and they're not. That would argue for the first point, that somehow the O2 is not crossing into the blood very well at all in the alveoli, resulting in the hemoglobin taking what comes to the blood up, leaving very low levels of O2 in solution in the blood. No idea why the virus could cause gas diffusion issues though.

Is there any chance some pH imbalance caused by the virus/inflammation could be impacting the CO2 side of the equation, not allowing the dissolved carbonic acid to be transported from the blood fluid and and into the alveoli where it converts to CO2 and is expelled by breathing. If the O2 in the blood is low, does this mean the CO2/carbonic acid in the blood are high (if they're high, the competing ion effect might not allow O2 into the blood)?

His response was hmmmmm, respiratory acidosis? Any thoughts?

Your friend is correct, it is a respiratory acidosis. And more specifically it is usually a compensated respiratory acidosis as the renal system releases bicarb to help buffer the acidity of the blood. As for the rest of your friend's explanation, it's a Sunday morning and it makes my head spin.

So similar to CPAP, then. Not the "I snore really loud" kind, but the kind that was introduced to the rigs about 15 years ago We could connect them to the House O2 on the bus and they'd basically blow people up with oxygen.

Yes, I forgot to mention CPAP is also being utilized as well and similar to high flow O2. CPAP drives the air in and helps keep the alveoli open for better gas exchange. CPAP typically uses a mask system which many find to be uncomfortable/unbearable. But it sure beats being sedated, intubated and placed on a ventilator.

 

[ArminRU]

New England Journal of Medicine will be releasing a statement on Leronlimab tomorrow .

Fingers crossed, think the trial was a double blinded study too

 

[Akron Buck]

https://www.acc.org/latest-in-cardi...2/association-of-inpatient-use-of-angiotensin

sounds like many if the deaths due to hypertension may have been uncontrolled hypertension as those on ACEi/ARB had lower mortality. In Minnesota they are testing using losartan to fight the virus. https://med.umn.edu/news-events/uni...-clinical-trials-blood-pressure-drug-losartan

 

[RU#1fan]

New England Journal of Medicine will be releasing a statement on Leronlimab tomorrow .

Also some promising tests being done at Oxford .

https://www.bbc.com/news/amp/health-52394485

 

[goru7]

Fingers crossed, think the trial was a double blinded study too

Yes double blind study.

 

[goru7]

Also some promising tests being done at Oxford .

https://www.bbc.com/news/amp/health-52394485

The UK is about to use it extensively as it is being used I being either experientially or for compassionate use now.

 

[RU848789]

Your friend is correct, it is a respiratory acidosis. And more specifically it is usually a compensated respiratory acidosis as the renal system releases bicarb to help buffer the acidity of the blood. As for the rest of your friend's explanation, it's a Sunday morning and it makes my head spin.



Yes, I forgot to mention CPAP is also being utilized as well and similar to high flow O2. CPAP drives the air in and helps keep the alveoli open for better gas exchange. CPAP typically uses a mask system which many find to be uncomfortable/unbearable. But it sure beats being sedated, intubated and placed on a ventilator.

Thanks for the feedback, although the long "explanation" is mine not my friend's. I was simply trying to analyze the situation from a physicochemical/engineering perspective of mass balance/kinetics/solubility etc. At least I left out the math of all the rate equations, lol.

 

[bac2therac]

Numbers...would like to hear your thoughts on Japan, correct me if im wrong but I believed you or someone else praised them but I saw a report last night that its a total mess with testing and 90% of people are turned away from testing and many are not even practicing social distancing or wearing masks anymore.

this says they are only testing 300 people a day....that seems odd....its from cnn so the truth of this report is up in the air as it may be pushed with an agenda...they only have 360 days, they seem to be doing something right

 

[Proud NJ Sports Fan]

When is NJs peak?

New cases, new hospitalizations and other numbers are still extremely high

 

[RU848789]

https://www.acc.org/latest-in-cardi...2/association-of-inpatient-use-of-angiotensin

sounds like many if the deaths due to hypertension may have been uncontrolled hypertension as those on ACEi/ARB had lower mortality. In Minnesota they are testing using losartan to fight the virus. https://med.umn.edu/news-events/uni...-clinical-trials-blood-pressure-drug-losartan

Have had a few friends email me about the losartan angle. It's an angiotensin II receptor blocker for high blood pressure that I worked on for 4 years in the early 90s, bringing the synthetic process to make the active ingredient from the labs through several rounds of pilot-scale runs of the 5-chemical-step process and then to manufacturing at our Albany, GA (since closed) and Ballydine Ireland plants over a 6-month period.

Also featured my first patent, on a distillative crystallization process, featuring concomitant addition of anti-solvent in the presence of finely milled seed crystals in order to achieve a finely controlled set of particle size and physical properties for the active ingredient, which were key to the bioavailability of the drug in the tablet formulation. Would be cool if it helped. I do know it is one of the safest drugs ever brought to market, with a safety profile that was incredibly clean in phase III clinical trials.

 

[RU848789]

Numbers...would like to hear your thoughts on Japan, correct me if im wrong but I believed you or someone else praised them but I saw a report last night that its a total mess with testing and 90% of people are turned away from testing and many are not even practicing social distancing or wearing masks anymore.

this says they are only testing 300 people a day....that seems odd....its from cnn so the truth of this report is up in the air as it may be pushed with an agenda...they only have 360 days, they seem to be doing something right

View embedded media

Japan is about to see whether a mask culture, contact tracing and modest social distancing are enough to prevent exponential growth, with very low testing rates (although they're not quickly ramping up testing capability, but maybe too late). They're on the edge of a major outbreak, especially in some very densely populated cities. I called out their low testing rate relative to South Korea on 3/10, so not sure what you're referring to (I have included them recently in lists of countries that have done well and talk about the many elements that help with that, including testing, but didn't create an exhaustive list of which countries are practicing which elements), although I'm sure your gotcha search of my old posts is well underway.

https://www.sciencemag.org/news/2020/04/did-japan-miss-its-chance-keep-coronavirus-check

 

[Akron Buck]

Have had a few friends email me about the losartan angle. It's an angiotensin II receptor blocker for high blood pressure that I worked on for 4 years in the early 90s, bringing the synthetic process to make the active ingredient from the labs through several rounds of pilot-scale runs of the 5-chemical-step process and then to manufacturing at our Albany, GA (since closed) and Ballydine Ireland plants over a 6-month period.

Also featured my first patent, on a distillative crystallization process, featuring concomitant addition of anti-solvent in the presence of finely milled seed crystals in order to achieve a finely controlled set of particle size and physical properties for the active ingredient, which were key to the bioavailability of the drug in the tablet formulation. Would be cool if it helped. I do know it is one of the safest drugs ever brought to market, with a safety profile that was incredibly clean in phase III clinical trials.

I am considering having my doc swirch me from lisinopril to losartin

 

[bac2therac]

Japan is about to see whether a mask culture, contact tracing and modest social distancing are enough to prevent exponential growth, with very low testing rates (although they're not quickly ramping up testing capability, but maybe too late). They're on the edge of a major outbreak, especially in some very densely populated cities. I called out their low testing rate relative to South Korea on 3/10, so not sure what you're referring to (I have included them recently in lists of countries that have done well and talk about the many elements that help with that, including testing, but didn't create an exhaustive list of which countries are practicing which elements), although I'm sure your gotcha search of my old posts is well underway.

https://www.sciencemag.org/news/2020/04/did-japan-miss-its-chance-keep-coronavirus-check

But they seem to have low number of cases and death...what are they doing right

 

[rutgersguy1]

Have had a few friends email me about the losartan angle. It's an angiotensin II receptor blocker for high blood pressure that I worked on for 4 years in the early 90s, bringing the synthetic process to make the active ingredient from the labs through several rounds of pilot-scale runs of the 5-chemical-step process and then to manufacturing at our Albany, GA (since closed) and Ballydine Ireland plants over a 6-month period.

Also featured my first patent, on a distillative crystallization process, featuring concomitant addition of anti-solvent in the presence of finely milled seed crystals in order to achieve a finely controlled set of particle size and physical properties for the active ingredient, which were key to the bioavailability of the drug in the tablet formulation. Would be cool if it helped. I do know it is one of the safest drugs ever brought to market, with a safety profile that was incredibly clean in phase III clinical trials.

Haven’t a lot of blood pressure drugs been recalled recently, losartan being one, for trace amounts of carcinogenic substances in them? I think OTC Zantac as well. Although these issues have more to do with the manufacturing of the drugs than the drugs themselves.

 

[Akron Buck]

Haven’t a lot of blood pressure drugs been recalled recently, losartan being one, for trace amounts of carcinogenic substances in them? I think OTC Zantac as well. Although these issues have more to do with the manufacturing of the drugs than the drugs themselves.

yes a recall but like you said because of manufacturing issue not safety of the drug when made properly

 

[RU848789]

Haven’t a lot of blood pressure drugs been recalled recently, losartan being one, for trace amounts of carcinogenic substances in them? I think OTC Zantac as well. Although these issues have more to do with the manufacturing of the drugs than the drugs themselves.

Many of the "sartans" made in China/India, mostly, were found to have elevated levels of fairly mutagenic/carcinogenic nitrosamines, formed during the manufacturing process of active ingredients containing the classic tetrazole ring, and a bunch of recalls occurred. Much of this was due to manufacturing changes made without considering toxic by-products; Merck's version of losartan was shown to not contain elevated levels of these nitrosamines and we had no recalls, as the process is different. As an aside, the level of concern over extraordinarily low levels of mutagenic impurities has gone way overboard, IMO.

file:///C:/Users/Owner/Downloads/67041-200183-1-PB.pdf

 

[RU848789]

But they seem to have low number of cases and death...what are they doing right

They've had a mask culture for decades and we know that that is a significant element in preventing spread from infected people (even asymptomatic ones) to others and maybe that, combined with social distancing and tracing those infected, have been enough until now. Will be interesting to see if they can control this growing outbreak now without a lot more testing, although a big ramp up in testing is in the works.

It's absolutely clear that early/aggressive testing, contact tracing, isolating, wearing masks and social distancing are all tools in the pandemic toolbox, but it's not like anyone has been able to run "controlled" experiments to see which one or combos are most important and/or if one or more can be left out (Germany hasn't done much with masks, but has been huge on testing/tracing, for example) - and that may also vary with the outbreak dynamics. The story is also not over yet.

 

[retired711]

The Washington Post is suing the State Department for expedited handling of the Post's request under the Freedom of Infomation Act for the release of cables from U.S. diplomats in Beijing two years ago that raised questions about the safety of a lab in Wuhan that was studying bat viruses. For some reason, the story does not link properly.

 

[retired711]

Dr. Birx says (a) social distancing will have to be in place this summer; and (b) we need a technological breakthrough to do testing in the necessary volume. She also said (the science people here will understand this) that the testing should be of antigens (as opposed to antibodies, she seems to suggest, although maybe I'm just not understanding her). And she also said that she thought the WHO is being "very cautious" when it says there is no present evidence that having the virus produces immunity. All this on Meet the Press this morning. https://www.nytimes.com/2020/04/26/...action=click&module=Spotlight&pgtype=Homepage

 

[Akron Buck]

what is the difference between an antigen and an antibody?

 

[e5fdny]

what is the difference between an antigen and an antibody?

Antigens use the DH.

 

[RUJohnny]

When is NJs peak?

New cases, new hospitalizations and other numbers are still extremely high

Our peak was weeks ago. We had 75 reported deaths yesterday, off of a high in the 400s 7-10 days ago

 

[Proud NJ Sports Fan]

Our peak was weeks ago. We had 75 reported deaths yesterday, off of a high in the 400s 7-10 days ago

What was Friday's deaths number?

 

[Akron Buck]

trying to decide if I should switch to losartan for my BP med.

 

[RUJohnny]

What was Friday's deaths number?

200s I think.

 

[retired711]

200s I think.

I always suspect the weekend numbers to be understatements; state and local offices are not as active as during the week. Let's go through the week and see. Let's also see if the peak passes through Central and Southern New Jersey; being in South Jersey, I am naturally concerned about that.

 

[Ronnie_B]

200s I think.

Correct.

 

[charliem24]

trying to decide if I should switch to losartan for my BP med.

FWIW I Take losartan (mine was not recalled), 20 mg/day, works great for me, zero side effects.

 

[jreinsdorf]

If I am correct, you are a doctor either on the front line or in the medical field. You questioned in my mention in my earliest post that Leronlimab is showing promising early treatment results in a small sample size and fast tracked for 2 trials for treatment of Covid in mild/ moderate and a severe cases, and it has little to no side effects. You said every drug has side effects which is probably true but this one seems to have minimal serious side effects and is safe. It actually is a drug for AIDS and breast cancer and was already in Phase 3 and Phase 2 trials for those now, with no major side effects in early AIDS trials, and was used experientially for Covid. What is your medical opinion on this drug Leronlimab ?

TBH i cannot speak on behalf of the drug. Between myself, my brother and my wife we are around a broad spectrum of classifications but i have no experience with Leronlimab. I`d have to go back and reread my reply to you but if memory serves i may have taken issue with the claim of a drug having "no side effects" which is simply impossible. Every drug has unintended effects whether they be asymptomatic or obvious, mild or severe...that is the question. If i misquoted you then my bad. Hopefully, the drug knocks it out of the park in Covid rx.

 

[wisr01]

I am considering having my doc swirch me from lisinopril to losartin

Can I ask why? The study referenced above was of ACEI/ARB's and lisinopril is an ACEI. If your BP is under control why change it up? Are you having side effects? I take 10 mg of lisinopril and have no side effects.

 

[CERU00]

Not saying it's going to happen, but putting China in the DPRK doesn't really change anything.

I've been saying for years that our best political gambit (assuming a DPRK under Kim Jong Un's leadership) would have been to tell China to just go take it. It's a low-risk move for us and brings North Korea into a more stable environment.

There's not a great deal of concern about having a Chinese possession on the north side of the DMZ. None of the defensive strategy changes. Maybe you add a few more THAAD batteries, but that's about it.

Why not give them the South China Sea while we're at it..... It would sure make the region more stable, right?

 

[Akron Buck]

I take 20 mg and no side effect, just considering because researchers seem to think losartin is more effective versus the virus

 

[retired711]

Dr. Birx says (a) social distancing will have to be in place this summer; and (b) we need a technological breakthrough to do testing in the necessary volume. She also said (the science people here will understand this) that the testing should be of antigens (as opposed to antibodies, she seems to suggest, although maybe I'm just not understanding her). And she also said that she thought the WHO is being "very cautious" when it says there is no present evidence that having the virus produces immunity. All this on Meet the Press this morning. https://www.nytimes.com/2020/04/26/...action=click&module=Spotlight&pgtype=Homepage

BTW, I interpret the "very cautious" remark as a very tactful way of saying, "they'll be proven wrong."

 

[wisr01]

I take 20 mg and no side effect, just considering because researchers seem to think losartin is more effective versus the virus

I would not change for that reason.

 

[RU4Real]

Why not give them the South China Sea while we're at it..... It would sure make the region more stable, right?

The South China Sea is nowhere near North Korea. I'm going to assume you don't actually have a point.

 

[retired711]

The South China Sea is nowhere near North Korea. I'm going to assume you don't actually have a point.

He does, although you and I may disagree with him. His point is that anything that increases Chinese power is a bad thing. I disagree as to North Korea; even a Chinese satellite would be better than a regime that brandishes and tests nuclear weapons and is missiles. But his mileage may differ.

 

[LETSGORU91]

Thanks for the feedback, although the long "explanation" is mine not my friend's. I was simply trying to analyze the situation from a physicochemical/engineering perspective of mass balance/kinetics/solubility etc. At least I left out the math of all the rate equations, lol.

LOL!! I had 3 semesters of engineering school at RU and you were starting to give me flashbacks. I was thinking of Pascal, partial pressures, dynamics, Calc 3...I was close to a seizure.

 

[RU4Real]

He does, although you and I may disagree with him. His point is that anything that increases Chinese power is a bad thing. I disagree as to North Korea; even a Chinese satellite would be better than a regime that brandishes and tests nuclear weapons and is missiles. But his mileage may differ.

Which is a good point, IMO - since we are in agreement. :)

 

[LETSGORU91]

Have had a few friends email me about the losartan angle. It's an angiotensin II receptor blocker for high blood pressure that I worked on for 4 years in the early 90s, bringing the synthetic process to make the active ingredient from the labs through several rounds of pilot-scale runs of the 5-chemical-step process and then to manufacturing at our Albany, GA (since closed) and Ballydine Ireland plants over a 6-month period.

Also featured my first patent, on a distillative crystallization process, featuring concomitant addition of anti-solvent in the presence of finely milled seed crystals in order to achieve a finely controlled set of particle size and physical properties for the active ingredient, which were key to the bioavailability of the drug in the tablet formulation. Would be cool if it helped. I do know it is one of the safest drugs ever brought to market, with a safety profile that was incredibly clean in phase III clinical trials.

Very nice...it would be very apropros here if losartan was the miracle cure for Covid-19 and you helped develop it.

Haven’t a lot of blood pressure drugs been recalled recently, losartan being one, for trace amounts of carcinogenic substances in them? I think OTC Zantac as well. Although these issues have more to do with the manufacturing of the drugs than the drugs themselves.

Losartan was one with selective recalls, but I believe valsartan (Diovan) was a much broader recall. So much in fact, that Losartan 50 mg is now back ordered in many places due to the recall of Diovan.

I always suspect the weekend numbers to be understatements; state and local offices are not as active as during the week. Let's go through the week and see. Let's also see if the peak passes through Central and Southern New Jersey; being in South Jersey, I am naturally concerned about that.

Hopefully south Jersey will be spared. I did see one instance where there is an uptick in south Jersey cases. Plus Lakewood is there. I will take bets it is soon to become the south Jersey hotbed for Covid-19.

Can I ask why? The study referenced above was of ACEI/ARB's and lisinopril is an ACEI. If your BP is under control why change it up? Are you having side effects? I take 10 mg of lisinopril and have no side effects.

Or consider recommending to reduce salt intake, lose some weight (if applicable), minimize stress and exercise more. Then cut the lisinopril as those are four biggies to help reduce hypertension. If it's beneficial in the fight against Covid-19, continue to take it.