Category: medicin

It is more dangerous to live in a state with a Democrat Governor than it is with a Republican Governor, at least in regard to COVID-19

Taking a snapshot of the COVID-19 cases as of Apr 23 I was curious to see if there were any differences in infection and death rates between states that has a Democrat Governor and those states that has a Republican Governor. And indeed there is, there are nearly three times as many cases (2.89) in states with a Democrat Governor as there are in states with a Republican governor, and the death rate is 62% higher, a more telling statistic.

There could be many reasons for this discrepancy, but here is some food for thought: The indoor environment is where most viruses spread, elevators, staircases, central ventilation, mass transportation just to name a few. This is typical of the urban environment. Living in rural areas on the other hand, much more time is spent outdoors, in sunshine, which kills the virus nearly immediately and fresh air is very good for basic health. Therefore to issue a nationwide ban to stay inside was the wrong thing to do. Cleanliness, social distancing and get outside as much as possible would have been much better. Go out, plant your garden, take your boat out for a weekend spin or visit your cottage in the woods. If you don’t have a cottage just take a walk in the woods and listen to the sounds of spring, but don’t put canned music in your ears. If you don’t have any woods nearby, use any area not crowded.  That is one way to eliminate cabin fever.

Here are the statistics, state by state.

Democratic governor      Cases                  Deaths

New York                             268,581                 20861

New Jersey                         100,025                 5428

California                             39620                    1531

Pennsylvania                     37053                    1685

Illinois                                   36934                    1688

Michigan                              35291                    2997

Louisiana                             25739                    1599

Connecticut                        23100                    1639

Washington                        12753                    711

Virginia                                 11594                    410

Colorado                              11262                    552

North Carolina                   7854                       281

Rhode Island                      6256                       189

Wisconsin                            5052                       257

Nevada                                4208                       189

Kentucky                             3481                       191

District of Columbia        3361                       139

Delaware                             3308                       92

Minnesota                          2942                       200

Kansas                                  2734                       113

New Mexico                       2379                       78

Oregon                                 2127                       83

Maine                                   937                         44

Hawaii                                   596                         12

Montana                             442                         14

Total:                            647,099                   40,983  Death rate 6.33%

 

 

Republican governor     Cases                    Deaths

Massachusetts                  46023                    2360

Florida                                  29648                    987

Texas                                    22393                    576

Georgia                                21883                    881

Maryland                             15737                    748

Ohio                                      14694                    656

Indiana                                 13039                    706

Tennessee                          8266                       170

Missouri                               6384                       243

Alabama                              5832                       201

Arizona                                 5769                       249

Mississippi                          5153                       201

South Carolina                   4917                       150

Iowa                                      3924                       96

Utah                                      3612                       35

Oklahoma                           3017                       179

Arkansas                              2599                       45

Nebraska                             2124                       47

South Dakota                     1956                       9

Idaho                                    1836                       54

New Hampshire                1670                       51

West Virginia                      981                         31

Vermont                              825                         43

North Dakota                     709                         15

Wyoming                             453                         7

Alaska                                   337                         9

Total:                           223,781                       8,749      Death rate 3.91%

Why models fail when developed with political as well as pure scientific motives

The corona virus has given us all an education on why models fail. Everybody in any form of management have to make forecasts, plan for the future as they stare an uncertain future in the face. It is time to remember the old saying in the Army: “No plan ever survived contact with the enemy”. And so it is, the corona virus is the unseen enemy that will affect our future, and our plans will have to change on an almost daily basis as it initially worked by doubling every 3 days. No disease since smallpox or measles in the American Indian population has been that infectious. So it was time to panic when it broke out in the Wuhan city in China. The city was sealed off except for international flying which was allowed to continue. The SO2 over the city was strong from all the cremation ovens going full blast. Over 40000 cremations was paid for by the Chinese government if the descendant agreed to ask no further questions, so they were never counted. How many more cremations? Who knows, but the size of the SO2 clouds, which by the way was only over Wuhan and Chongqing indicates it could have been ten times as many. But back to the models. These rumors prompted Trump to close all air travel to all non U.S citizens that had recently been in China. The official line was that there was no human to human transmission. As the death toll mounted in Italy with a 10+ percent death rate among the infected, the models indicated that U.S would have 2.2 million deaths. The models have since been adjusted more than once a week, but has now stabilized at 60000 deaths or fewer. While this is good news, why did the models fail us so badly?

The answer is obvious. Models are only as good as the input data and the assumptive relationships. In this case the big unknown was the denominator, how many will have it and yet show no symptoms? They may even be carriers.

We now have some of the answers. The death rate will be between 0.2 and 0.3% and will affect the normal risk categories, the old, diabetes, asthma, smoking, marijuana use, other drugs, overweight, and a compromised or overactive immune system. Properly handled, early diagnosis, and protecting the most at risk will reduce the death rate even lower.

It is time to get back to work.

The other models hat has failed us badly are the climate models, but the time scale is decades, not days. The U.N. Intergovernmental Panel on Climate Change has given out projections five times, beginning in 1990 on what happens to global temperatures if the amount of the greenhouse gas CO2 released in the air is increased, held steady or decreased. The result is always alarming with predictions a high as a temperature increase of up to 8,5C globally by the year 2100. Every new assessment show a decreasing number with the IPCC5 prediction being that temperature increase will be 2.2 C or thereabout if all reductions proposed will be made. IPCC6 will show a larger increase, mostly because of the rapid increase of CO2 emissions by China, India and other developing countries (Yes China is considered a developing country by U.N.)

There is one major problem with all these models. The trends shown by the models do not match with reality. The increased CO2 already occurred since industrialization would show a substantial hot spot in the tropical troposphere. There is no such hot spot. What do IPCC do with that troublesome fact? They ignore it, because it is mostly politically, not scientifically driven. Yes the scientists are sincere and contribute their parts, but the conclusions are politically driven. Is climate change a hoax? Not at all, it is changing, and long term we will have another ice age, but until then the increasing CO2 will stop the oncoming ice age, and even increase it  by as much as 7C in the arctic and antarctic, but only in the winter. In the summer there is no increase in temperature!

Why is that? To get the answer we must study molecular absorption spectroscopy and explain a couple of facts for the 97% of all scientists who have not studied molecular spectroscopy. IPCC and most scientists claim that the greenhouse effect is dependent on the gases that are in the atmosphere, and their combined effect is additive according to a logarithmic formula. This is true up to a certain point, but it is not possible to absorb more than 100% of all the energy available in a certain frequency band! For example: If water vapor absorbs 50% of all incoming energy in a certain band, and CO2 absorbs another 90% of the energy in the same band, the result is that 95% is absorbed, (90% + 50% * (100% – 90%)),  not 140%, (90% + 50%).

Even in Barrow, Alaska water vapor is the dominant greenhouse gas. Only at the South Pole (And North Pole) does CO2 dominate (in the long winter).

All Climate models take this into account, and that is why they all predict that the major temperature increase will occur in the polar regions with melting icecaps and other dire consequences. But they also predict a uniform temperature rise from the increased forcing from CO2 and the additional water vapor resulting from the increased temperature.

This is wrong on two accounts. First, CO2 and H2O gas are nor orthogonal, that means they both absorb in the same frequency bands. There is three bands where CO2 absorb much more than H2O in the far infrared band, but other than that H2O is the main absorbent. If H2O is 80 times as common as CO2 as it is around the equator, water vapor is still the dominant absorbent.

And one more thing. Water vapor is a condensing gas, and it matters greatly whether it is in the atmosphere as a gas or in the form of a cloud. Clouds warm by night and cool by day and the cooling by day is much more than the warming by night, so it also matters greatly when clouds appear. People living in rural America know this instinctively even if they have not done the calculations. They look up and discern the sky and thank God for the clouds when they appear in the summer. In the winter that may mean even more snow. Clouds are the major temperature regulators of the earth. On the other hand people living in urban heat islands go from their air conditioned offices to their parked cars heated up in the sun so much that they get blisters when they touch the steering wheel. They are experiencing the worst of climate change, don’t look up and don’t thank God for the blisters.

We have immense environmental problems. CO2 is not one of them. There is a great need for a green new deal, but that involves cleaning up the earth, not destroying it even further. All of this takes a lot of energy. There is only one solution to this dilemma, renewables alone will not even begin to solve it, only Liquid Fluoride Thorium nuclear reactors, and in the future fusion power will have a chance to carry us through the next ice age, which will come when we have used up all available fossil fuels. We must save the bulk of it for our great grand-kids.

 

 

Does lockdown work to flatten the curve? Look at Sweden versus Great Britain.

Conventional wisdom told us in the Coronavirus pandemic that the only way to stop the hospitals from being overrun and the healthcare system collapsing was to enforce “social separation” between people and shut down the ecnomy, allowing only “essential workers” to go to work. Initially Italy, Spain and France had their hospitals overrun with people and their death rate from COVID19 is over 10%. This made all European countries enforce draconian rules to protect what was left. All countries except Sweden that is. They let people go to work, encouraged working from home, limited gatherings to less than 50 people and practiced “social separation” at restaurants, but kept them open. United Kingdom locked down their country on March 23. How much worse did Sweden fare? They both have about the same number of tests per capita, about 1/2%.

They both seem to have the same rate of increase, and are leveling off

The death rate, a lagging indicator also seem to come down for both countries.

There is one country, Norway, which is similar to Sweden that is doing much better. They took the approach of early testing and contact tracing, and their death rate per person is one quarter of Sweden’s. But the early outbreak occurred in the ski areas and traveling hubs, a younger and fit segment of the population.

Belgium on the other hand has a death rate of over three times as many as Sweden, a country having about the same population as Sweden, and they tested nearly twice as many people! The big difference there was that nearly half of all deaths so far has occurred in nursing homes.

The conclusion: Go back to work, start up the economy again, test and protect the most vulnerable. Most people will get it anyway, and most of them will not even know they had it, and for most of the rest it will be about the same as the regular flu. Give Hydroxychloroquine and Z-pack and Zinc for 5 days to all that want it, including all in the risk zone. It  must be under a physician’s supervision, not because of the Hydroxyxhloroquine, that has never killed anyone when taken in approved doses, but the Z-pack can make heart arrhythmia more severe.

 

Clinical trials take too long. With the COVID-19 virus acting on a time scale of 3 days, not 3 years, allow unlimited trials now!

The medicine suppliers have to go through a lot to get a new drug approved. There are the double blind tests that can take years to verify, and some of the people in the protocol are given placebos that only produce the side-effects, not the potential cure. Some of these people may die as a result, but that the cost of getting a drug approved. The cost can be upwards of 10 million dollars, so as a reward the Medical supplier company gets awarded a patent for the new medicine. This can take many years to develop, and a patent is valid for only 20 years, so a patent extension of up to 5 years is almost routinely granted. After the patent is expired it becomes a generic drug. And another thing, there has to be at least 170000 people suffering from the disease to make it worthwhile.

There is another way. Over 10 years ago my wife got a case of wet macular degeneration in one eye, but it was not the normal type, more like a blood-filled polyp lodging itself under the retina and causing warped vision to say the least.

There was an approved medication at 2000 dollars an injection, the insurance company paid for it, so she tried it, and it did absolutely nothing. But the eye doctor said, he worked with the Amish community, and they are uninsured and cannot afford more than generic drugs. He had had good results for a few to inject Avastin, an approved drug for colon and rectal cancer among other things, and in the amount needed for injection in one eye the cost was only 70 dollars. The trade-off was obvious; 2000 dollars for a drug that the insurance company paid for, but didn’t work versus a 70 dollar medicine that might work, so she let herself be included in the study. And it worked! And the doctor paid for the cost of the medicine himself, he wanted the study to succeed. He was not alone, a few other doctors worked together to find the cure. A few years later the insurance company accepted the treatment, and my wife’s polyp eventually disappeared.

The point of the story? To rely only on approved medications when confronted with cases out of the ordinary, medical science is advancing not only by medical companies seeking new and profitable drugs, or by University research, but by your regular doctor, in consultation with his peers, as they seek to find the best cure for the individual patient.

The Government is always to slow to react. In the case of COVID-19, it works on a time-scale of 3 days, so the best treatment must be administered immediately, not wait for normal approval procedures. So is the case with Hydroxychloroquine, it is approved and generic, no one will make a case study, the side effects are minimal for Lupus or rheumatic patients, of which there are tens of thousands patients and no one has died from it when applied in approved doses, so administer it to anyone that accepts to be in the study now!

 

 

 

 

The Corona-virus death rate is over-estimated, but by how much? Iceland gives a possible answer.

I have been fascinated with the spread of the coronavirus and the speed of which it has spread to all parts of the world. The question is how bad will it be, how many will die, and what can be done about it. Thanks to the ability to test who are having it, and who will get it, and how many have already died from it, and how many are still in critical care we can now estimate how bad it can be in countries with a good healthcare system, the Nordic Countries will serve as an example.

Let us begin with Sweden. They took a passive approach at first, the healthcare system will take care of the cases as they have always handled the flue. The problem is, that left to itself the coronavirus cases double every 3 days until the whole population is infected except for those with natural immunity. A few days ago even Sweden clamped down and is now implementing separation. Here are the current numbers for Sweden, normalized per million inhabitants

Cases 704, serious or critical 60, deaths 47, testing 0.36%

Denmark took a similar approach, and here are the

Cases 808, serious or critical 48, deaths 32, testing 0.92%

We can see testing makes a difference, cases go up, deaths go down

Finland is very similar, but cases started later:

Cases 393, serious or critical 35, deaths 5, testing 0.6%

Norway took a different approach, they applied early testing, and tracing and testing their contacts. Here are these results:

Cases 1082, serious or critical 16, deaths 14, testing 2.5%.

Going west there is the Faeroe Islands with little more than 50000 inhabitants:

Cases 3745, serious or critical 20, deaths 0, testing 10.2%.

Wow! No deaths at all! But the sample was small.

Of particular interest is Iceland. It is a unique country. Not only do they have excellent health care, they have the DNA genome of nearly every Icelander. They did a very aggressive testing, and here are the results so far:

Cases 4577, serious or critical 4, deaths 18, testing 8.2%.

It turns out that about half of those who tested positive had no symptoms, but were probably carriers. This leads us to the conclusion that testing is important, social separation only works if everyone participates, and if the country has an excellent health care system the total cases will be 5,6% of which 2.8% show no symptoms, critical or serious cases are 0.25%, and deaths are 0.3% of the whole population.

In a country like United States this means that we will have about 80000 deaths total if we test like Norway or Iceland from now on, and about 210000 deaths if we continue with only mitigation and no contact tracing, and let the disease work itself through the whole population.

The lesson from Spain, Italy and Franceis; if the hospitals get overloaded it could be far worse.

The generic drug Hydroxychloroquine combined with one more generic drug could lower those numbers substantially if taken voluntarily by a majority of early diagnosed patients, and even if taken later in the course of the disease. Of course there will always be some that would rather die than taking something that has been recommended by President Trump, but we are a free country, and there should be enough ventilators for them.

Enough people are taking the medicine cocktail now on a right to try basis to give us the answer in about two weeks if we can go back to work and back to normal life, but with changed social separation. The regular flu and pneumonia deaths are way down already.

 

The worst pandemic the world has ever seen can be stopped quickly, and this is how.

The pandemic has spread to the whole world, only Tajikistan and North Korea  have yet to report any cases, but territories like Falkland Islands and Saint Pierre Miquelon have reported in, a total of 208 countries and territories as of now. Antarctica is so far spared, but nobody lives there anyhow, only a few thousand people on temporary assignments.

This means the COVID-19 virus is so contagious that it will affect us all, and with a 3 day doubling rate it will not take long until everybody is or has been infected, except for those with protection or immunity.

One possible such protection is the use of Hydroxychloroquine, or just plain Chloroquine Phosphate. These are common drugs to protect against malaria, and in countries where malaria is prevalent there seems to be much fewer cases than in countries without malaria threats. These drugs are safe for most people, but must be taken under advise and prescription from a physician.

Early last week, Dr. Birx in the daily coronavirus briefing promised to look into if there was any correlation between people already taking Hydroxychloroquine for relief from Lupus of Rheumatism and their incidence of contracting COVID-19. She was going to utilize the large, anonymous part of the Medicare and Medicaid database that lists everybody that receives these benefits. It is already used to study interactions between medicines and outcomes, a most valuable resource, but as always they normally take their jolly time to verify and certify the results. She wanted the results by last Friday to keep up with the enemy, the virus. If there is a statistically valid difference between Lupus or Rheumatic patients and the population in general we have our answer! (China have their answer, but they are not telling, presumably to maximize the damage in the rest of the world.) If the result is conclusive, here is the answer,

Step 1. Give the Hydroxychloroquine medication to all patients testing positive for COVID-19.

Step 2. Give the medication to all health care workers coming in contact with COVID-19 patients.

Step 3. Give this medication to all potentially coming in contact with COVID-19 positive people such as police, first responders, the military and so on.

Step 4. Give this medication to all who have been in contact with people having tested positive for COVID-19

Step 5. Make taking this medication a condition for international travel and travel to and from national hot spots.

Step 6. Offer this medication to the rest of the world.

The medicine can be manufactured by the tons if speedy approval is issued by the FDA from sources other than China! This is why President Trump invoked the Defense Production Act!

If we can ramp up this action plan speedily, we should be back to normal life within a month, except most of us will have to take one more medication, (but it is cheap). When the vaccine is approved and available this requirement will go away

 

 

 

How to bend the corona-virus curve: Treat patients with Hydroxychloroquine

The recent chart on the corona-virus infection is really scary:

It is better to plot the Corona-virus cases on a logarithmic scale. It is less scary, but more serious. It shows the same thing. the virus cases double every 3 days. This is never seen before in pandemics history. Even worse, CDC is set up to develop and approve new medications with a time-frame of months, or even years, not 3 days.

Like they say in the military, even the best laid plans never survive contact with the enemy. That is why the Presidential task force wss forced to act with unprecedented speed and approve drugs that have not been subjected to double-blind clinical trials, which sometimes take years to validate. No, here speed is of essence, and President Trump is a man of immediate action, reacting on instinct rather than established scientific studies. Somebody showed him this study:

He got so excited he shared it in one of the daily briefings. The result was predictable. Three Democratic governors forbade its use in their state. They have since then all modified their stance and allow it under strict control of a licensed Physician or Licensed Practitioner, but Governor Cuomo was still insisting it could only be done in a hospital, not as an outpatient.

Then yesterday more information got out, so he tweeted this:

Donald J. Trump

@realDonaldTrump
I agree with this. Watch!
@WashTimes
·
Hydroxychloroquine rated ‘most effective therapy’ by doctors for coronavirus: Global survey bit.ly/2xKne7I
11:17 AM · Apr 4, 2020
The survey was large and international. 37% overall surveyed suggested that Hydroxychloroquine was the most effective treatment. It is interesting that the U.S. doctors had the lowest recommendation rating for this drug of all the nations surveyed.
There are some possible side effects when using the drug as with every medicine you take. That is why it should be taken after consulting a physician, but for over 95% it is perfectly safe. What are the side-effects? For people with arrhythmia it can worsen the condition, as with vision problems, but otherwise they are few severe side-effects.
Doctors in areas of mitigation should offer the drug to anyone who is a candidate for it, but we live in a free country, so you cannot force the drug on anyone that would rather die than use a remedy that has been strongly advocated by President Trump.
In the other areas, not in mitigation the drug should be offered to anyone testing positive for COVID-19 and their contacts! This is what China did after they had cremated the evidence in Wuhan and Chongqing, and the new infection rate went to nearly zero, only affecting foreigners visiting China, or so their recent statistics show.

Chinese COVID-19 deaths vastly under-reported, air pollution data shows.

There are many satellites in the air, monitoring air quality around the world. They were put up to monitor Climate Change. One picture can tell a lot, this picture measured the level of SO2 on February 8 of this year:

The map looks pretty good, except for two yellow spots, one over Wuhan, China and one over Chongqing, China. The one over Wuhan had a SO2 concentration of up to 1700 µg/m3 , corresponding to 0.65 ppm and the one over Chongqing  750 µg/m3 corresponding to 0.286 ppm, tolerable, except for sensitive people. There are no such clouds in any other area of the world, including the rest of China.

These two SO2 clouds can only have come from one source, cremations. A person contains about 0,3% Sulfur, and a 120 lb person generates about 3/4 lb of SO2 gas when cremated. SO2 is a gas heavier than air, so it stays close to ground until it is dispersed. The cloud over Wuhan is large, about 100 km in diameter with an average concentration of 200 µg/m3 up to a height of 3 m, a wild guess. The number cremated during that time snapshot could be about 13500 in Wuhan alone. Add to that about a quarter as many in Chongqing making the total about 17000 cremations going on simultaneously. A cremation takes about 3 hours, add about 2 hours for preparation and collection of the remaining ashes, so let us assume they did 4 cremations in a 24 hour period. That will bring us to about 70000 cremations in a 24 hour period. It is reasonable to assume that nearly all these cremations was from COVID-19 victims, since a normal rate of cremation for a city of Wuhan’s size, (11,000,000), a death rate in China of 7 per 1000 people would be about 210 cremations per day.

The clouds tell the story.

 

China and rare earth metals. Can China be trusted? Consider COVID-19 and pharmaceutical supplies.

In early May, 2019, President Xi and Vice Premier Liu He, China’s top trade negotiator, visited a rare earth metals mine in Jiangxi province. This has led to the rumor that China is seriously considering restricting rare earth exports to the US. China may also take other countermeasures in the future. The trade negotiations between U.S. and China got a lot more serious. It extended far beyond tariffs and intellectual property, it began to involve strategic materials.

The first thing we must realize is that rare earth metals are not all that rare. They are a thousand times or more abundant than gold or platinum in the earth crust and easy to mine, but a little more difficult to refine. Thorium and Uranium will  also be mined at the same time as the rare earth metals since they appear together in the ore.

Related image

U.S. used to be the major supplier of rare earth metals, which was fine up to around 1984. Then the U.S. regulators determined that Uranium and Thorium contained in the ore made the ore radioactive, so the regulatory agencies decided to make rare earth metal ore subject to nuclear regulations with all what that meant for record keeping and control. This made mining of rare earth metals in the U.S. unprofitable so in 2001 the last domestic mine closed down. China had no such scruples, such as human and environmental concerns, so they took over the rare earth metals mining and in 2010 controlled over 95% of the world supply, which was according to their long term plan of controlling the world by 2025.

Rare Earth Element Production

The U.S. used to have a strategic reserve of rare earth metals, but that was sold off in 1998 as being no longer cost effective or necessary. Two years later the one U.S. rare earth metals mine that used to supply nearly the whole world, the Mountain Pass Mine in California closed down, together with its refining capacity. From that day all rare earth metals were imported. In 2010 it started up again together with the refining capacity but went bankrupt in 2015, closed down the refining but continued selling ore to China. They just announced they will start up refining again late 2020. Meanwhile China is slapping on a 25% import tariff on imported ore starting July 1. Rare earth metals may be in short supply for a while.

So, why is this important? Just take a look at all the uses for rare earth metals. The most sought after pays all the cost of mining and refining, and the rest are readily available at nominal cost.

The Chinese almost got away with it, and that is but one reason the trade negotiations are so complicated and hard fought, but necessary. Donald Trump fights for reciprocity and fair competition.

For example, according to a 2013 report from the Congressional Research Service, each F–35 Lightning II aircraft requires 920 pounds of rare–earth materials. Who is making the most critical parts to this airplane? You guessed it – China, from our drawings and according to our specifications.

But it is getting worse. the COVId-19 virus hit China bad, probably in November or so, nobody knows and China won’t tell. Then they told us there was a small outbreak, but it is not contagious from person to person. Then on January 10 the first case of the Wuhan virus hit the U.S.A. Late January President Trump halted entry into the U.S. from foreigners having been in China recently. At one of the daily COVID-19 briefings President Trump got excited about a potential treatment. He had been shown the result of a french study. Here it is:

To make matters a little more complicated, China has stopped export of one of the ingredients in making this medicine, and they are the only source, until we have started up production of our own. We have to do it in days, not weeks.

It turns out that China had been, and is treating their COVID-19 patients with this medicine, both as a preventive, and as a cure for months, but they never told the world until now.

Why did China stop this medical export? There are at least two possibilities, either they are lying through their teeth about the COVID-19 cases and they need it for their own consumption but didn’t tell us, or, which is even worse, they do want to maximize the damage in the rest of the world.

This is the real China. The people are wonderful, but their government is evil.