COVID19 update, July 1, 2020: skipping phase 3 trial, China vaccinates entire army; Hong Kong loses autonomy; Israeli volunteer for “vaccine challenge trial”; how to recondition N95 masks

(1) I had somehow missed this bombshell: China skipped the Phase 3 clinical trial for its vaccine altogether and is now vaccinating its entire “People’s Liberation Army”, reports the Daily Telegraph. Dr. Campbell comments in his daily update. Epoch Times commentator Joshua Philipp (at 4:00 into the video) notes that, in parallel, it will be tested on 9,000 volunteers in Brazil: if these trials are successful, the vaccine will be manufactured in Sao Paulo and distributed free of charge. Free? Timeo DanaosSinos et dona ferentes. Keep watching for some insight on ChiCom influence operations in Brazil from, admittedly, a stridently anti-CCP commentator.

(2) While everybody was preoccupied with COVID19 and with the US riots, China’s sham parliament rubber-stamped the extension of China’s national security law to the Hong Kong Special Administrative Region, de facto (if not de jure) abrogating the “One Country, Two Systems” agreement. The UK is extending an offer of residence, with a path to citizenship, to the 3 million Hong Kongers with “British National Overseas” status.

(3) “Infect me”. The Times of Israel has an interview with Keren P., a US-born army veteran who just graduated as a mechanical engineer from the Technion. She is one of 61 Israelis who have volunteered to be “guinea pigs” in a vaccine challenge trial through the 1daysooner nonprofit. In a “challenge trial”, people are first vaccinated, then deliberately exposed to the pathogen under controlled circumstances.

(4) Following the sharp rise in new infections in Israel, the relevant Knesset committee has greenlighted the renewal of “track and trace” by Israel’s domestic security service, the Shin Bet.

(5) Can you recondition an N95 mask? An article in ACS Nano studies the question experimentally. https://pubs.acs.org/doi/10.1021/acsnano.0c03597

Quoting from the abstract:

We investigated multiple commonly used disinfection schemes on media with particle filtration efficiency of 95%. Heating was recently found to inactivate the virus in solution within 5 min at 70 °C and is among the most scalable, user-friendly methods for viral disinfection. We found that heat (≤85 °C) under various humidities (≤100% relative humidity, RH) was the most promising, nondestructive method for the preservation of filtration properties in meltblown fabrics as well as N95-grade respirators. At 85 °C, 30% RH, we were able to perform 50 cycles of heat treatment without significant changes in the filtration efficiency. At low humidity or dry conditions, temperatures up to 100 °C were not found to alter the filtration efficiency significantly within 20 cycles of treatment. Ultraviolet (UV) irradiation was a secondary choice, which was able to withstand 10 cycles of treatment and showed small degradation by 20 cycles. However, UV can potentially impact the material strength and subsequent sealing of respirators. Finally, treatments involving liquids and vapors require caution, as steam, alcohol, and household bleach all may lead to degradation of the filtration efficiency, leaving the user vulnerable to the viral aerosols.

ADDENDUM: CovidAGE risk calculator by Sanford Health (via Dr. Seheult)

COVID19 update, May Day edition: reduced contagion of and from children; reopening schools in Israel; miscellaneous updates

(1) De Standaard (in Dutch) reports on a study by the Dutch institute for public health about the infection risks from and to small children. I had intuitively expected that they would be mostly asymptomatic spreaders with a minority of mild overt cases (the few exceptions of young children who went into cytokine storm appear to be ‘man-bites-dog news’: newsworthy precisely because they are rare). Now the study[s main findings, mostly based on contact tracing, can be summarized as follows:

  • children are much less likely to be infected (symptomatically or asymptomatically) than adults if both are exposed to the same infection source
  • if they are infected, viral swabs of their throats show similar virus levels as in adults, but they cough less, and owing to smaller lung volumes, coughs can’t project as far

Needless to say, this has implications for whether it is safe to open schools (apparently, more so than previously assumed).

(2) Speaking of which, Israel is reopening Grades 1-3 of primary schools on Sunday, as well as preparation classes for the bagrut (high school leaving [and college placement] exam, like the French baccalauréat or the German Abitur) in the last two years of high school. (These exams play an important role in college admission and placement, together with the psichometri which is somewhat similar to the SAT.) Kindergartens will be opened on or before May 10 — originally they were to be opened on Sunday as well, but personnel requested more preparation time. Remaining elementary and high school grades will open June 1.

(3) Miscellaneous updates:

  • According to De Standaard’s breaking news ticker, Portugal intends to start reopening on Monday. It has been much less hard-hit than neighboring Spain despite similar demographics and climate: Sarah Hoyt (herself born and raised near Porto, and an alumna of Porto University) attributes much of the difference to the continued existence of a parallel private medical system in Portugal, while Spain’s was nationalized. Choice is always good for quality.
  • Shaarei Tzedek in Jerusalem, one of the largest hospitals in Israel (and the largest Orthodox hospital) is closing down its purpose-built corona ward as the last patient in it was discharged some days ago. The hospital had already gradually resumed normal operations as its COVID19 patient load declined.
  • Le Figaro (in French) reports that France will reopen by Départements [France’s administrative regions/provinces], not one-size-fits-all. Based on various criteria such as new infections, mortality, and hospital case load to capacity ratio, the ninety-odd Départements are classified as green (most permissive unlock), orange (more limited unlock), or red (most limited unlock).
  • And in what is probably the most exasperating thing I read on Victims of Communism Day, Die Welt’s reporter in Italy describes Italians looking on Germany as “the enemy” and China as “their friend”. Italians, remember timeo Danaos et dona ferentes. [I am wary of Greeks, even if bearing gifts.][*] As much as I can understand your resentment of the EU, becoming a client state of China will make even you nostalgic for the EU one day.

[*] There is a Hebrew idiom taken from 1 Kings 21:19 for one who unleashes a calamity, then sets himself up to benefit from the resulting devastation: ratzachta ve-gam yarashta? [Literally: hast thou murdered, and also inherited?]

UPDATE: a writer at City Journal calls for people to volunteer for “Hunan challenge trials” with the new Oxford University candidate vaccine, and put his money (or life) where his mouth is. In HCTs, willing subjects get the vaccine (or a placebo) then deliberately expose themselves to infection. This way it can be definitely ascertained whether a vaccine candidate has protective value. So far, over 8,000 others have signed on to a grassroots call for volunteers.

COVID19 update, April 14, 2020: vitamin D, zinc, testing; end of globalization as we know it?

(1) Roger Seheult MD in his latest update gives a clear discussion of RT-PCR (reverse transcriptase polymerase chain reaction) testing vs. antibody testing.

I spoke to an industry insider about why not more antibody testing yet? I was told that first-generation antibody testing kits achieved accuracies of around 30%, which are “worse than useless”. But accuracies are steadily improving, and we should soon be looking at something comparable in accuracy to a good RT-PCR.

In response to reader demand, Dr. Seheult also gives a link to a hydrotherapy regime that might be useful for prophylaxis and for treatment of mild cases — but only in addition to more conventional approaches: https://www.hydro4covid.com

(2) Nursing school instructor John Campbell, in his latest update, hammers a lot on the beneficial effect of vitamin D for the human immune system. In fact, he looks at the different mortality statistics for ethnic groups in NYC, and finds it fascinating that everybody comes up with socio-economic explanations while overlooking something obvious: at northern latitudes, vitamin D deficiency is quite common among dark-skinned people. (In fact, both the white and “yellow” skin types evolutionarily started as mutations that just happened to allow humans to thrive in less-sunny northern regions.)

He strongly recommends everybody who does not already enjoy abundant sunshine take vitamin D supplements to boost their immune systems — especially people with darker skin types.

On a related note, he looks at the surprisingly mild statistics of the epidemic in Australia, and notes that this militates in favor of seasonality — but again stresses the beneficial effect of vitamin D in the sunny Australian summer and early fall. (I note that South Africa too has so far dodged a major bullet.)

He also notes that homes for the elderly everywhere have appalling statistics — it takes only one or two cases to cause a major outbreak in one unless you really know what you are doing.

One more thing: out of 459 newly diagnosed cases in South Korea, 228 are imports from the USA. While he admits this will not be a representative sample of the US population (whoever still travels may be a businessman or some sort of expert), it does have implications for the Dunkelziffer/”dark case load” in the USA.

(3) Speaking of nutrition, a number of doctors advocate zinc supplements. [Full disclosure: I have been taking such since the beginning of the crisis.] This is emphatically not quack science: zinc is an essential nutrient, and in fact the most common transition metal in the body outside the bloodstream. (Iron in hemoglobin is the most common one if you include it.) Hundreds of physiological processes depend on zinc in the catalytic site of an enzyme, as a co-catalyst or modulator, or as a structural element. This includes the immune system too: I was struck between the similarity between some early COVID19 symptoms (such as loss of taste and smell) and those of zinc deficiency (presumably because Zn is mobilized in great amounts for the immune system). Here is an academic review article on the roles of zinc in the antiviral immune system.

Particularly people who live on vegetarian diets are at risk for Zn deficiency — those who primarily live on red meats or seafood least so.

(4) Urban geographer Joel Kotkin, in a must-read essay , explains how COVID19 (and whatever similar epidemics may lay in our future) will make dense urban centers less attractive to live in. He notes NYC accounts for nearly half of COVID19 mortality in the USA, greater Milan for half the cases in Italy and almost 3/5 of deaths,… “Simply put, pandemics are bad for dense urban areas, particularly those that are diverse and relatively free. This has been very much the case since antiquity. The more global and vital an urban system—Rome, Alexandria, Cairo, Venice, Florence, London, Paris—the more susceptible it is to the pandemics that seem to be occurring regularly over the past two decades. Cities no doubt will recover, particularly if real estate prices continue to fall, but the pandemics limit their upward trajectory and will continue to drive people elsewhere.”

On a related note, former director of the World Bank’s research department Branko Milanovic, https://www.standaard.be/cnt/dmf20200327_04904960 interviewed in De Standaard (in Dutch) argues that (my paraphrase) “We went for the extremes of globalization because technology enabled it. COVID19 showed such an economy is brittle.” He does see a return to some form of globalized economy the day after the crisis, but not again to this extreme extent.

It is noteworthy that such “the end of globalization as we know it” rhetoric is not the province of just the American populist “right”, but that one can hear similar voices around the globe and the political spectrum from the German establishment center-right to the left. I was (pleasantly) surprised to read a scathing article in The Guardian (!!) about the way some Chinese academic publications about the origins of the virus had to be airbrushed by CCP regime fiat. “Oceania is not at war with Eurasia.” [On a related note, Taiwan released an Email from December in which it warned the WHO about patients with a new, SARS-like lung disease.]

The American Interest looks at the long, hard road to decoupling from China. An article in De Standaard (in Dutch) entitled “[shoddy m]asks as a canary in the coalmine”, looks at the trend towards what it calls with an English neologism “reshoring” — bringing production back home to have better control over supply chain and especially quality. This process is said to have been going on for a while in Belgium, but is now being accelerated by COVID19.

Finally, feelgood story of the day: at age 107, a Dutch woman named Cornelia Ras is now the oldest person to survive a bout with COVID19 .

COVID19 update, April 12, 2020: Easter edition

Happy Easter to my Christian readers. Below are a few COVID19 updates.

(1) Dr. Seheult from MedCram, who is actually a pulmonologist himself, weighs in on the “to ventilator or not to ventilator” debate in Episode 53 of his COVID19 video series. He references a paper by an Italian team that distinguishes two “phenotypes” of clinical presentations in severe COVID19 patients: about 20-30% are “type H” who fit the classic criteria of ARDS and can benefit from intubation, while the remainder are “type L” who are best managed with noninvasive techniques.

Dr. Seheult also cites a “white paper” on COVID19 case management by a colleague. Most interesting for some of us, perhaps, are the prophylaxis recommendations:

  • Vitamin C 500 mg BID [=twice a day] and Quercetin 250-500 mg BID
  • Zinc 75-100 mg/day (acetate, gluconate or picolinate). Zinc lozenges are preferred. After 1-2months, reduce the dose to 30-50 mg/day. [Full disclosure: I started doing this two weeks ago. Especially people on vegetarian diets, who often have zinc insufficiencies, should take supplements. Zinc plays an essential role in hundreds of processes in the body, including the immune system. If you exclude iron in hemoglobin, zinc is actually the most common transition metal in the human body.]
  • Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 1-2 mg at night [this appears to be primarily to ensure adequate sleep, which affects immunity]
  • Vitamin D3 1000-4000 u/day (optimal dose unknown). Likely that those with baseline low 25-OH vitamin D levels and those living [north of the 40th Parallel] will benefit the most.

(2) An article in the Israeli business paper GLOBES looks at the “underworld” of medical equipment procurement. (H/t: Mrs. Arbel)

(3) Immunosuppressant drugs in COVID19? Erik Wingren brings this case in Washington State to my attention: https://komonews.com/news/coronavirus/experimental-drug-helped-critically-ill-emergency-room-doctor-recover-from-covid-19 The drug administered here is https://en.wikipedia.org/wiki/Tocilizumab, which was actually FDA-approved in 2017for the management of cytokine release syndrome, (“cytokine storm”) as a side effect of CAR-T cell immunotherapies. It is increasingly becoming clear that, while most younger patients weather the disease well if they are symptomatic at all, a small subgroup appears to be predisposed to cytokine storm — in plain English, a massive overreaction of the immune system that does more harm to the body than the disease itself. In such situations (only!), immunossuppressants may actually save lives. (Cytokine storm appears to have accounted for the majority of deaths in the 1918 “Spanish Flu” pandemic — which explains why young and otherwise healthy patients were often more at risk than ) For more on cytokine storm in influenza more broadly, see this paper and that paper.

(4) A fairly large-scale (440 patients) clinical trial is in progress at the Erasmus Hospital in Rotterdam, the Netherlands with plasma antibodies from healed patients. (This is technically known as “passive vaccination”.)

(5) No, it’s not just Trump: in an op-ed in the German center-right daily DIE WELT, entitled “Diese WHO gefährdet ons” (This WHO endangers us) a human rights activist blasts the WHO, its leadership, and its execrable behavior in the early part of the crisis. As she puts it, the current WHO chair knows he owes his job to Chinese support and has been a devoted piper playing the tune called by his meal ticket.

But what’s more, DIE WELT reports in its lead article that the German domestic intelligence & counterespionage service, the Verfassungsschütz (Constitution Protection ) registers intensive influence and recruitment operations of German civil servants and elected officials by the Chinese regime. The goal is to get them to parrot the Chinese propaganda line that the country is a leader in combating the outbreak and helping the whole world do so, and that the virus did not come from China. “Together, let’s write a fairy tale,” (Wir schreiben gemeinsam ein Märchen) Die Welt comments sarcastically

UPDATE 1: Denmark is reopening in stages starting Wednesday April 15. In the first step, kindergartens and primary schools will be reopened, as their charges are least at risk from the consequences of an infection. The country has seen hospital occupancy drop since the beginning of the month.

In Austria some shops reopen this Tuesday, followed by other stores, restaurants and hotels in May.
Children go back to Norway’s kindergartens on 20 April and junior schools a week later.
In Bulgaria farmers’ markets are reopening. In the Czech Republic, shops selling building materials and bikes are back in business and rules have been relaxed for open-air recreation areas.
Spain, which along with Italy has been hardest hit by Covid-19, aims to allow non-essential workers back to work from Monday and will hand out protective masks at stations.

Mao’s great leap to famine

Via Insty, a withering indictment by historian Frank Dikötter of the Chinese “Great Leap Forward” (into the abyss) at that [sarc]Christofascist Dominionist Teabagging Right-Wing Rethuglican rag[/sarc], the New York Times:

The worst catastrophe in China’s history, and one of the worst anywhere, was the Great Famine of 1958 to 1962, and to this day the ruling Communist Party has not fully acknowledged the degree to which it was a direct result of the forcible herding of villagers into communes under the “Great Leap Forward” that Mao Zedong launched in 1958.To this day, the party attempts to cover up the disaster, usually by blaming the weather. Yet detailed records of the horror exist in the party’s own national and local archives.

Access to these files would have been unimaginable even 10 years ago, but a quiet revolution has been taking place over the past few years as vast troves of documents have gradually been declassified. While the most sensitive information still remains locked up, researchers are being allowed for the first time to rummage through the dark night of the Maoist era.

From 2005 to 2009, I examined hundreds of documents all over China, traveling from subtropical Guangdong to arid Gansu Province near the deserts of Inner Mongolia.

The party records were usually housed on the local party committee premises, closely guarded by soldiers. Inside were acres of dusty, yellowing paper held together in folders that could contain anything from a single scrap of paper scribbled by a party secretary decades ago to neatly typewritten minutes of secret leadership meetings.

Historians have known for some time that the Great Leap Forward resulted in one of the world’s worst famines. Demographers have used official census figures to estimate that some 20 to 30 million people died.

But inside the archives is an abundance of evidence, from the minutes of emergency committees to secret police reports and public security investigations, that show these estimates to be woefully inadequate.

In the summer of 1962, for instance, the head of the Public Security Bureau in Sichuan sent a long handwritten list of casualties to the local boss, Li Jingquan, informing him that 10.6 million people had died in his province from 1958 to 1961. In many other cases, local party committees investigated the scale of death in the immediate aftermath of the famine, leaving detailed computations of the scale of the horror.

In all, the records I studied suggest that the Great Leap Forward was responsible for at least 45 million deaths.

Between 2 and 3 million of these victims were tortured to death or summarily executed, often for the slightest infraction. People accused of not working hard enough were hung and beaten; sometimes they were bound and thrown into ponds. Punishments for the least violations included mutilation and forcing people to eat excrement.

[graphic detail of unspeakably barbaric execution methods omitted]
Starvation was the punishment of first resort. As report after report shows, food was distributed by the spoonful according to merit and used to force people to obey the party. One inspector in Sichuan wrote that “commune members too sick to work are deprived of food. It hastens their death.”

As the catastrophe unfolded, people were forced to resort to previously unthinkable acts to survive. As the moral fabric of society unraveled, they abused one another, stole from one another and poisoned one another. Sometimes they resorted to cannibalism.

But this begs the same question as with that other “harvest of sorrow”, Stalin’s collectivization campaign in the Ukraine:  was this tragedy a bug or a feature of the program? Frank Dikötter argues the latter:

[…] The term “famine” tends to support the widespread view that the deaths were largely the result of half-baked and poorly executed economic programs. But the archives show that coercion, terror and violence were the foundation of the Great Leap Forward.Mao was sent many reports about what was happening in the countryside, some of them scribbled in longhand. He knew about the horror, but pushed for even greater extractions of food.

At a secret meeting in Shanghai on March 25, 1959, he ordered the party to procure up to one-third of all the available grain — much more than ever before. The minutes of the meeting reveal a chairman insensitive to human loss: “When there is not enough to eat people starve to death. It is better to let half of the people die so that the other half can eat their fill.”

Read the whole thing. ddd

To this day, there is little public information inside China about this dark past. Historians who are allowed to work in the party archives tend to publish their findings across the border in Hong Kong.

There is no museum, no monument, no remembrance day to honor the tens of millions of victims. Survivors, most of them in the countryside, are rarely given a voice, all too often taking their memories with them to their graves.

Insty adds:

Communists are as bad as Nazis, and their defenders and apologists are as bad as Nazis’ defenders, but far more common. When you meet them, show them no respect. They’re evil, stupid, and dishonest. They should [suffer]  the consequences of their behavior.

Amen. I somehow doubt that the victims care whether they were victims of a genocidal regime or “merely” another democidal one.