We’re some 6 months into the Wuflu pan
demic and science and medical research has taught us a lot about the virus and the disease it causes, but scientific research doesn’t move in a linear direction and findings get retracted, invalidated and so on. Hence, unless you are a reader of my friend Nitay Arbel’s “Spin, Strangeness and Charm” blog, Derek Lowe’s “In the Pipeline” and other similar sites, you may be confused about what is known and unknown, what is valid science, what is fake news, and so on. This post attempts to summarize what we know as of now mid-July 2020. It starts with a few bullet points and below them I’ll add some commentary. I’m deliberately not linking directly to places that back up my specific claims because you as a reader will do better to use your favorite search engine and check yourself.
The facts as we know them
- If you are young you are unlikely become infected and if you are infected somehow you are unlikely to develop serious symptoms. This seems to be due to T-cell response which is stronger in the young and the effect gradually fades with age, but definitely applies to the under 40s if not the under 50s. If you had a BCG vaccination that is likely to help you because the BCG vaccine stimulates the T cells. Interestingly the original SARS virus and some other coronaviruses (presumably some of the ones that cause the common cold) seem to prime the immune system to detect and fight off the Wuhan variant coronavirus.
- If you are older a bunch of other things mean that people in good general health with a healthy immune system will also develop, at worst, mild symptoms. In addition to the obvious indicators of a weak immune system, low levels of vitamin D and Cysteine are highly correlated with a developing serious symptoms from the wuflu. Therfore taking Vitamin D and NAC (Cysteine) supplements seems like a no brainer.
- Obesity and related chronic health conditions (high blood pressure, diabetes …) are also significant indicators that severe symptoms are likely if infected.
- If you are in a long term care (LTC) facility the chances are high that you have many of the co-morbidiites that indicate a poor reaction to the virus. Hence the scandals of various governments forcing LTC homes to take known infected patients. Outside of the LTC environment these are far less common, but some (e.g. vitamin D) deficiency are widespread
- If you do in fact have mild symptoms, taking Hydroxychloroquine plus zinc (sulphate) and/or azithromycin will almost certainly help a lot. At the doses required for this, HOCQ is well understood, safe and unlikely to produce adverse side-effects. There are a few other effective treatments such as remdesivir, though due to cost that tends to be used if things start getting worse.
- One leading indicator that things are getting bad is lower blood oxygen saturation levels (pO2) so testing for that frequently is a good thing if you test positive for Wuflu.
- If things get bad then the key is not so much fighting the virus as fighting the immune-system over-reaction – the cytokine storm. All sorts of anti-inflamatories seem to have an effect here from steroids to a new drug Itolizumab. There are other promising treatments too such as the already-approved drug Fenofibrate (Tricor). This is totally different to what is needed for people with mild symptoms and explains why trials of HOCQ (and some other treatments such as antivirals) were reported to not work. The key here is that once your lungs become seriously inflamed you need to treat that inflammation rather than the virus itself.
- The virus spreads in much the same way as other cold and flu viruses do. So personal hygiene (washing hands, not touching face…) and avoiding prolonged close contact in crowded enclosed places are the keys. The sun kills it, as do UV rays, alcohol and time in general, but cleaning surfaces that are touched by others is important to reduce indirect transmission. Regarding airborne transmission, masks of all sorts limit the velocity of droplets expelled by singing, speaking, coughs and sneezes and therefore help stop infected people spreading the virus, but that’s all they do. Only really good masks (e.g. n95 properly worn etc.) help to stop uninfected people inhaling the virus. Hence if you are sure you are not infectious wearing a cloth mask is just virtue signalling.
- Evidence suggests that a significant fraction of the population in places like New York have been exposed to the virus and not developed any symptoms that were distinguishable from those of a cold (if that). Note that the reported statistics are confusing and vary from place to place. Some places have failed to count negative tests results. Some have overcounted positive test results (e.g. not checking whether they are for the same person). Some places have undercounted deaths. Some places have overcounted deaths (e.g. the UK where anyone who dies who was once diagnosed as a Wuflu victim counts as a wuflu death). All in all it looks like more people have been exposed to the virus than is represented in the test statistics and fewer people have died of the virus rather than dying after having been infected.
- Evidence also suggests that the virus is mutating, however the T-cell response seems to mean that people who have been infected with one variant will not become re-infected (or at least not symptomatically), whether or not they still produce the antibodies.
How to protect yourself
Based on the science to date this is how to protect yourself:
- Take vitamin D and NAC supplements. Also look at diet and lifestyle changes that reduce carbs and increase physical activity
- Wash your hands.
- Spend time outdoors. In particular try meeting other people outdoors in daylight rather than indoors. Outdoors reduces transmission risk because of UV from the sun, it helps you get more vitamin D and if you do some activities while outdoors it will help with general fitness and thus reducing blood-pressure etc.
- Exposure is a matter of numbers. Avoid crowded theatres, live music venues, and indoor places where you are intimately sharing the air with complete strangers for a significant period of time.
That’s it. If you have children they can go to school – children don’t seem to either catch the virus or spread it. If you or someone in your household has some of the risk factors (obesity etc.) be more scrupulous about hygiene and avoid crowds. If you have contact with a long term care facility be absolutely fastidious about hygiene and wear something more protective than a cloth mask when you visit the facility. That is pretty much it. And the same advice also applies to pretty much any infectious disease, or indeed in terms of the diet and exercise recommendations, life in general.
Most importantly, unless you have some of the risk factors, your chances of becoming seriously ill, let alone dying from the Wuflu are very very low. If you do test positive, try and get a course of HOCQ plus zinc. It won’t do you any harm and is highly likely to help. Also check your O2 levels. If your health professionals don’t do it, get an oximeter yourself (amazon has many and they don’t cost much).
All in all the message should be
DON’T PANIC OR COWER IN FEAR!
In particular don’t be concerned about the “second wave” because the second wave is proving to be remarkably light on deaths all round the world
Death rates, Care homes and the Rest of Us
As touched on above, the Wuflu is absolutely deadly in a care home environment because people in care homes typically have weakened immune systems and often other conditions that correlate with poor wuflu outcomes – including the most basic: being old. This means that if an LTC resident catches the disease he is highly likely to either die of it or have it so harm his overall health that some other cause kills him prematurely. However LTC facilities are not representative of the wider society, in fact they are very different. In particular LTC residents have an extremely low future life expectancy compared to the average person. Once you enter an LTC your expected stay is going to be between 6 and 18 months and, especially if you are post retirement age, your most likely exit is to the funeral home. What this means is that those LTC residents who die from the wuflu have probably only seen their death hastened by a few months.
This is completely different to the rest of us. Most of us do not suffer from any of the factors that make us vulnerable to the Wuflu and we are (obviously) in far better general health even if we do suffer from one or two of the risk factors. Once you take out the deaths of people in LTC facilities and the very old in general (anyone over 80) then death rates are really low.Almost certainly the easiest and most cost-effective way to avoid a resurgence in serious cases in the general population would be to test people for Vitamin D levels and prescribe supplements for those with low levels. Which leads us to
The Dark Skin Factor
If you read the news you’ll see that people with darker skin seem to be more susceptible to developing serious symptoms and/or dying from the wuflu. If you look at the points above you can see why this might be – and that the reasons are unrelated to racism etc. The first problem is that, particularly away from the equator, dark skinned people are endemically low in vitamin D, which means they will tend to have a weaker immune system. Likewise the obesity/diabetes rates seem to be higher in some darker skinned groups compared to the average and, again, we know that these pre-existing chronic conditions are risk factors for the wuflu . Thus those two factors alone mean that darker skinned people have higher susceptibility. Worse, the infection method is via the ACE receptors and, here again, there’s a genetic factor that increases vulnerability and which correlates with darker skin. Given all these factors there’s absolutely no need to look at racism in society in general or in the provision of healthcare in particular to explain the differences in wuflu susceptibility.