2 May 2020 – Saturday – #48

Things are getting back to normal in the US!

No one who visits Florida or lives there part time is dying of Covid-19. Is it a coincidence they stopped dying just as the summer beach season approaches? I think it’s a Republican miracle.

Those meatpacking plants with thousands of Covid-19 cases? Remember the ones that were threatening the US food supply chain? Well, must have been fake news. The CDC has decided that Covid-19 measures aren’t really needed at meatpacking plants. If workers have a high fever, no need to send them home. The US can churn out Big Macs all summer long because those workers don’t vote Republican.

Best news of all is the 300 million vaccine shots that will be available right after the election. Not clear where those shots are coming from, but the president says so. He was right about hydroxychloroquine and about UV up your you-know-what, so he must be right about a December vaccine, too. You’ll get your shot right after you vote, Republicans to the front of the line, please. Not sure why you even need a Covid-19 vaccine since everything is back to normal, but better safe the sorry, I suppose.

Thank God the Republicans are in charge and things are back to normal in the US.

Meanwhile, on the rest of planet earth …

In Spain, we can go outside for exercise! Adults over 14 have to stay within a kilometer of home. There’s a morning exercise shift from 6a – 10a. I’ll be watching my neighbors while I take my coffee on the terrace. I’ve never been able to get my hair done by that hour, and there’s a lot more of it now than two months ago. I’m all in on the evening exercise shift from 8p – 11p. I’m not sure if adult beverages are allowed, though. Couldn’t find that in the rules.

For my Spanish friends heading outside, here’s a quick refresher from Dr. Craig Spencer on what we know works to stop the spread of Covid-19. The whole thread is worth a look.

The precaution that’s been added to the initial Covid-19 protection lists is, of course, masks. At first we weren’t supposed to wear them. Now we are. Personally, I’m a big fan of social distancing and operating in open air environments. I just took a nice walk around Gracia for jug wine and coffee and, oh, wow, ran into Nicole and her daughter. How did that happen? Pretty sure I had zero chance of infection being outside or in open air shops the whole time.

I’m not such a big fan of masks. Like bicycle helmets, I worry that they create a false sense of security, especially when they are used incorrectly (and I often see them used incorrectly). But don’t mind me. Here’s what an expert says about masks.

Okay, back to the US for this update on Covid-19 testing. On 6 March, Trump claimed anyone who wanted a test could get one. Since no one could get a test, it didn’t really matter who paid. Two months after Trump’s pronouncement, Medicare and Medicaid are stepping up to pay, a sign that maybe the tests every American wants, but few have been able to get, are finally coming. For the second time ever, yesterday the US performed more that 300k Covid-19 tests in a single day. That’s short of the 1-1/2 million daily tests that I think the US needs, but it’s double the rate in early April.

Brad reminded me that we’re not doing our Covid-19 research very well. We should have learned from our mistakes during the recent Ebola outbreaks. What we learned is that it’s always best to test a new drug with a control group. We humans, though, can’t stand the thought of someone dying when there’s even the hint of a possibility of a cure, so we compassionately give everyone the new drug. And we believe we’re helping everyone with this new drug until the day we find out we’re not.

We haven’t learned from the Ebola outbreaks. The research problem of skipping control groups continued with hydroxychloroquine. The president claimed it worked wonders. A poorly designed Paris “study” without a control group said it had an amazing 98% success rate. A rural New York doctor claimed he cured hundreds of Covid-19 patients with hydroxychloroquine. It’s cheap. Let’s try it on everyone.

Then two studies came out, a French study with a control group and a retrospective Veterans Administration study comparing outcomes of patients based on hydroxychloroquine treatment. Both studies came to the same conclusion, namely that hycroxychloroquine has no benefit to Covid-19 patients and Covid-19 patients using hydroxychloroquine had a higher incidence of heart problems.

Good science takes time, but we want answers today. We want to believe the Republican back-to-normal play book. We’re human.

Here’s a couple things scientists are working on, things that take time, but have huge payoffs.

UCSF researchers have found some weird candidates for Covid-19 treatment. You may remember I wrote how UCSF swung into action in early March. This UCSF work is going quickly, but it will still take months to find out if their line of research pans out. They are looking for drugs to gum up the way Covid-19 interacts with human proteins.

Scientists first created a detailed map of how the coronavirus manipulates human proteins to infect cells and replicate like mad. They then used the map to find existing drugs and experimental compounds that act on those key proteins. Finally, in the lab, they tested 47 of those drug candidates against the virus, to see if the drugs interfered with infection.

San Francisco Chronicle, “UCSF team has discovered drugs that block coronavirus, paving way for ‘a better drug sooner,'” 30 April 2020

The immediate payoff from the UCSF approach is a list of five existing drugs that may treat Covid-19. One is hydroxychloroquine, which already hasn’t passed muster (see above). The others are a schizophrenia drug (Haldol), a cough suppressant (cloperastine), an antihistamine (clemastine), and a hormone (progesterone). Wait, progesterone? The silly little boy in me worries that I’ll go into the hospital for Covid-19 and come out with boobs. The adult in me worries that the president will tout one of these before there is proper testing.

Longer term, UCSF also is modifying existing drugs to block the way Covid-19 uses human proteins. “One compound, known as PB28, was 20 times more potent than hydroxychloroquine against the virus in one test. It also did not bind as strongly to proteins that affect the heart, suggesting that it may be less toxic.”

As discussed last Monday, scientists understand that Covid-19 uses ACE2 and TMPRSS2 enzymes to gain entrance to human cells. The first report I read said that there were three human sites that generated both ACE2 and TMPRSS2, but researchers are finding cells in other parts of the body that express these enzymes. It’s clear that Covid-19 attacks the nasal passage and lungs. It’s not clear yet whether Covid-19 attacks any of the cells producing ACE2 and TMPRSS2 in other parts of the body, or whether Covid-19 provokes an immune system response that attacks areas of the body besides the nasal passage and lungs.

I have young friends tell me that they hope they are exposed to Covid-19 so they build a immunity. For most of them, the results would be okay. But when I read how little we know about what organs Covid-19 attacks and how, I realize Covid-19 exposure comes with an enormous, if rare, risk of organ damage or death.

I’m going to end today with this fun Quarantine Queen video. It seems like the Republicans are trying to paper over Covid-19, make it all go away. There are parts of the US electorate, though, that might be on to this Republican ploy that things are getting back to normal. Ask any minority who’s been screwed over by Republican AIDS or healthcare policies. If you want to know what’s going on, pay attention to these minorities because they’ve learned the hard way on the Republican play book on viruses and health.

Quarantine Queen. Mask, Gloves, Soap, Scrubs.
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