Friday, August 28, 2020

Covid-19: What Lessons Can We Learn from the Golden Hamsters and Utah Minks?


German Chancellor Angela Merkel has repeatedly warned that there is no clear end in sight for Covid-19 until a vaccine is developed:

Chambers, M. & Sheahan, M. (2020, August 28). Merkel says pandemic to worsen, vaccine key for return to normality. Reuters.https://www.reuters.com/article/us-germany-merkel-virus/merkel-says-pandemic-to-worsen-vaccine-key-for-return-to-normality-idUSKBN25O191

BERLIN (Reuters) - German Chancellor Angela Merkel warned on Friday that the coronavirus pandemic would worsen in coming months, and that life would not return to normal until a vaccine against it had been developed.



So far Covid has not been exceptionally lethal, although up to 10% of people need hospital care of some form. But what if you are weakened by it irreparably and then you get it again?

The answers to these questions may be in the infected minks.

Europe mink farms contracted Covid-19, especially in Spain and the Netherlands, causing farmers to kill entire colonies.https://www.npr.org/sections/goatsandsoda/2020/06/25/882095588/dutch-minks-contract-covid-19-and-appear-to-infect-humans


Now mink farms in Utah are infected. An unusual mortality event reported to state authorities, led to testing of the animals, many of which tested positive. But the colonies aren't being destroyed as they were in Europe. https://www.sciencemag.org/news/2020/08/covid-19-hits-us-mink-farms-after-ripping-through-europe

It will be interesting to see what happens to them. The Hong Kong whistleblower, who has been ignored (domestically) by all but conservative US media, Li-Meng Yan was studying Covid in a colony of golden hamsters https://www.nature.com/articles/s41586-020-2342-5

She warned that humanity was at risk.

So, I hope for resilience after infection and immunity against re-infection, but I think we need to be prepared for other possibilities, as well. What lessons can we learn from the minks and hamsters?


Monday, August 24, 2020

Covid-19 Reinfection or Reactivation?

 


Work by researchers in Hong Kong finds that reinfection may be possible in rare cases. (2020, August 24). The New York Times. https://www.nytimes.com/2020/08/24/world/covid-19-coronavirus.html#link-4b468050


REACTIVATION OR RE-INFECTION

• Galanti M, Shaman J. (2020) Direct Observation of Repeated Infections With Endemic Coronaviruses [published online ahead of print, 2020 Jul 7]. J Infect Dis. 2020;jiaa392. doi:10.1093/infdis/jiaa392

• Huang, J. et al., (2020). Recurrence of SARS-CoV-2 PCR positivity in COVID-19 patients: a single center experience and potential implications. medRxiv 2020.05.06.20089573; doi: https://doi.org/10.1101/2020.05.06.20089573 This article is a preprint and has not been peer-reviewed

• Roe, K. (2020). Explanation for COVID‐19 infection neurological damage and reactivations. Transbound Emerg Dis. doi:10.1111/tbed.13594

· Kirkcaldy RD, King BA, Brooks JT. (2020). COVID-19 and Postinfection Immunity: Limited Evidence, Many Remaining Questions. JAMA. Published online May 11, 2020. doi:10.1001/jama.2020.7869

· Long, Q., Tang, X., Shi, Q. et al. (2020). Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nat Med. https://doi.org/10.1038/s41591-020-0965-6

RECOVERY? SEQUELAE & POST-VIRAL SYNDROME - Myalgic Encephalomyelitis (ME)-like illness

• Davido, B., Seang, S., Tubiana, R., & de Truchis, P. (2020). Post-COVID-19 chronic symptoms: a post-infectious entity? Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases, S1198-743X(20)30436-5.

• Perrin, R., Riste, L., Hann, M., Walther, A., Mukherjee, A., & Heald, A. (2020). Into the looking glass: Post-viral syndrome post COVID-19. Medical Hypotheses, 144, 110055. https://doi.org/10.1016/j.mehy.2020.110055 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320866/pdf/main.pdf

• Carfì A, Bernabei R, Landi F, (2020). Persistent Symptoms in Patients After Acute COVID-19. JAMA. Published online July 09, 2020. doi:10.1001/jama.2020.12603

• Geddes L. (2020). The enduring grip of covid-19. New Scientist (1971), 246(3288), 34–38. https://doi.org/10.1016/S0262-4079(20)31141-6

LASTING IMMUNOLOGICAL IMPACTS

· Zheng, M., Gao, Y., Wang, G. et al. (2020). Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cell Mol Immunol 17, 533–535. https://doi.org/10.1038/s41423-020-0402-2

· Terpos E, Ntanasis-Stathopoulos I, Elalamy I, (2020). Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-847. doi:10.1002/ajh.25829

o COVID-19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis. Lymphopenia may be considered as a cardinal laboratory finding, with prognostic potential.

HEART DAMAGE


• Puntmann VO, Carerj ML, Wieters I, et al. (2020). Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. Published online July 27, 2020. doi:10.1001/jamacardio.2020.3557

• Zachary D Demertzis, Carina Dagher, Kelly M Malette, Raef A Fadel, Patrick B Bradley, Indira Brar, Bobak T Rabbani, Geehan Suleyman (2020). Cardiac sequelae of novel coronavirus disease 2019 (COVID-19): a clinical case series. European Heart Journal - Case Reports, , ytaa179, https://doi.org/10.1093/ehjcr/ytaa179

• Lindner D, Fitzek A, Bräuninger H, et al. (2020). Association of Cardiac Infection With SARS-CoV-2 in Confirmed COVID-19 Autopsy Cases. JAMA Cardiol. Published online July 27, 2020. doi:10.1001/jamacardio.2020.3551

NEUROLOGY

· Wu, Y., Xu, X., Chen, Z., Duan, J., Hashimoto, K., Yang, L., Liu, C., & Yang, C. (2020). Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain, behavior, and immunity, 87, 18–22. https://doi.org/10.1016/j.bbi.2020.03.031

oViral infections have detrimental impacts on neurological functions, and even to cause severe neurological damage. Very recently, coronaviruses (CoV), especially severe acute respiratory syndrome CoV 2 (SARS-CoV-2), exhibit neurotropic properties and may also cause neurological diseases. It is reported that CoV can be found in the brain or cerebrospinal fluid. The pathobiology of these neuroinvasive viruses is still incompletely known, and it is therefore important to explore the impact of CoV infections on the nervous system. Here, we review the research into neurological complications in CoV infections and the possible mechanisms of damage to the nervous system.

· Koralnik, I.J. & Tyler, K.L. (2020), COVID ‐19: A Global Threat to the Nervous System. Ann Neurol, 88: 1-11. doi:10.1002/ana.25807

o …we now understand that coronavirus disease 2019 (COVID‐19) also involves multiple other organs, including the central and peripheral nervous system. The number of recognized neurologic manifestations of SARS‐CoV‐2 infection is rapidly accumulating. These may result from a variety of mechanisms, including virus‐induced hyperinflammatory and hypercoagulable states, direct virus infection of the central nervous system (CNS), and postinfectious immune mediated processes. Example of COVID‐19 CNS disease include encephalopathy, encephalitis, acute disseminated encephalomyelitis, meningitis, ischemic and hemorrhagic stroke, venous sinus thrombosis, and endothelialitis. In the peripheral nervous system, COVID‐19 is associated with dysfunction of smell and taste, muscle injury, the Guillain‐Barre syndrome, and its variants. Due to its worldwide distribution and multifactorial pathogenic mechanisms, COVID‐19 poses a global threat to the entire nervous system. COVID‐19. ANN NEUROL 2020;88:1–11 ANN NEUROL 2020;88:1–11

Friday, August 21, 2020

Covid-19 Recovery?

Tenforde MW, Kim SS, Lindsell CJ, et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020. MMWR Morb Mortal Wkly Rep 2020;69:993-998. DOI: http://dx.doi.org/10.15585/mmwr.mm6930e1external icon.
https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6930e1-H.pdf

Return to Usual State of Health 

  • Among the 270 of 274 interviewees with available data on return to usual health,† 175 (65%) reported that they had returned to their usual state of health a median of 7 days (IQR = 5–12 days) from the date of testing (Table 1).
     
  • Ninety-five (35%) reported that they had not returned to their usual state of health at the time of interview.
     
  • The proportion who had not returned to their usual state of health differed across age groups:
    26% of interviewees aged 18–34 years, 32% aged 35–49 years,
     
  • 47% aged ≥50 years reported not having returned to their usual state of health (p = 0.010) within 14–21 days after receiving a positive test result.
     

•Presence of chronic conditions also affected return to health rates; among 180 persons with no or one chronic medical condition, 39 with two chronic medical conditions, and 44 with three or more chronic medical conditions, 28%, 46%, and 57%, respectively, reported not having returned to their usual state of health (p = 0.003) within 14–21 days after having a positive test result.

*Among respondents aged 18–34 years with no chronic medical condition, 19% (nine of 48) reported not having returned to their usual state of health

 

 

Monday, August 17, 2020

Covid-19 and Lasting Heart Damage


This is a must read introductory article explaining the impacts of Covid-19 on your heart, even if you have no immediate symptoms of illness:
Research reveals heart complications in COVID-19 patients https://www.cidrap.umn.edu/news-perspective/2020/07/research-reveals-heart-complications-covid-19-patients

The most important research study cited is this one here:
Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. Published online July 27, 2020. doi:10.1001/jamacardio.2020.3557

CONCLUSIONS AND RELEVANCE In this study of a cohort of German patients recently recovered from COVID-19 infection, CMR revealed cardiac involvement in 78 patients (78%) and ongoingmyocardial inflammation in 60 patients (60%), independent of preexisting conditions, severity and overall course of the acute illness, and time from the original diagnosis. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.

Covid-19 is not merely a respiratory disease with no lasting impact.

It is a circulatory disease capable of causing lasting damage to your heart, lungs, and central nervous and immunological systems.

It produces a post-viral syndrome that has been clinically well-documented. It may destroy mitochondria.

People are either re-infected or never clear the virus, resulting in the resurgence of troubling symptoms, as illustrated here: Philippine minister tests positive for virus for second time.

We need to re-think the flu metaphor fast.

 



Wednesday, August 12, 2020

Covid-19: The Random Death Sentence


Covid-19 is a random death sentence. Approximately 20 percent of people who develop symptoms will require medical care, with between 5 and 10 percent of people requiring intensive care.

But the real question is "recovery"? What does recovery from Covid-19 look like?

Increasingly, it is becoming apparent that SARS-CoV-2, the virus that causes Covid-19, infiltrates many organs in the body SILENTLY causing potentially life-threatening damage, even among asymptomatic individuals.

In late January some whistleblowers described Covid-19 as akin to "airborne aids." Covid-19 doesn't replicate like HIV but it may down-regulate T cells effectively enough to avoid detection in colonized cells.

One of the most concerning impacts of Covid-19 is lasting heart damage. Athletes may be at risk for sudden cardiac events:

Charean Williams (2020, August 10). Report: Heart condition possibly linked to COVID fueling Power 5 concerns. ProFootball Talk on NBC Sports. https://www.yahoo.com/sports/report-heart-condition-possibly-linked-222452145.html

The Big Ten announced a conference-only schedule last week. Only a few days later came word the conference was moving toward a cancellation of football for 2020.
 
So what changed?
 
ESPN reports that doctors have diagnosed at least five Big Ten athletes — as well as athletes in other conferences — with a rare heart condition that could have a link to COVID-19.
 
Myocarditis, inflammation of the heart muscle, is usually caused by a viral infection. Left undiagnosed and untreated, it can cause heart damage and cardiac arrest. 

Covid-19 is a random death sentence. We must adopt a precautionary approach in our institutions - especially our schools and universities - or many hapless people will die after winning the covid-19 lottery.

 

RESOURCES

Perrin, R., Riste, L., Hann, M., Walther, A., Mukherjee, A., & Heald, A. (2020). Into the looking glass: Post-viral syndrome post COVID-19. Medical Hypotheses, 144, 110055. https://doi.org/10.1016/j.mehy.2020.110055 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320866/pdf/main.pdf

Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-847. doi:10.1002/ajh.25829

Abstract: COVID-19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis.

Lymphopenia may be considered as a cardinal laboratory finding, with prognostic potential. Neutrophil/lymphocyte ratio and peak platelet/lymphocyte ratio may also have prognostic value in determining severe cases.

During the disease course, longitudinal evaluation of lymphocyte count dynamics and inflammatory indices, including LDH, CRP and IL-6 may help to identify cases with dismal prognosis and prompt intervention in order to improve outcomes. Biomarkers, such high serum procalcitonin and ferritin have also emerged as poor prognostic factors. Furthermore, blood hypercoagulability is common among hospitalized COVID-19 patients.... 
So, COVID-19 infected patients, whether hospitalized or ambulatory, are at high risk for venous thromboembolism, and an early and prolonged pharmacological thromboprophylaxis with low molecular weight heparin is highly recommended. Last but not least, the need for assuring blood donations during the pandemic is also highlighted.

 

Monday, August 10, 2020

Plutonium from Fukushima


Particulate plutonium was released from the Fukushima Daiichi nuclear disaster in 2011:

EitaroKuriharaa et al. (2020, November). Particulate plutonium released from the Fukushima Daiichi meltdowns. Science of The Total Environment, 743(15). November 2020, 140539
https://doi.org/10.1016/j.scitotenv.2020.140539

Traces of Pu have been detected in material released from the Fukushima Daiichi Nuclear Power Plant (FDNPP) in March of 2011; however, to date the physical and chemical form of the Pu have remained unknown. Here we report the discovery of particulate Pu associated with cesium-rich microparticles (CsMPs) that formed in and were released from the reactors during the FDNPP meltdowns. 

The Cs-pollucite-based CsMP contained discrete U(IV)O2 nanoparticles, <~10 nm, one of which is enriched in Pu adjacent to fragments of Zr-cladding. The isotope ratios, 235U/238U, 240Pu/239Pu, and 242Pu/239Pu, of the CsMPs were determined to be ~0.0193, ~0.347, and ~0.065, respectively, which are consistent with the calculated isotopic ratios of irradiated-fuel fragments. 

Thus, considering the regional distribution of CsMPs, the long-distance dispersion of Pu from FNDPP is attributed to the transport by CsMPs that have incorporated nanoscale fuel fragments prior to their dispersion up to 230 km away from the Fukushima Daiichi reactor site.

The effects of plutonium on populations have been well studied. They are terrible:

But plutonium from Fukushima is not new news.

There was evidence early on that plutonium had been dispersed in the unit 3 explosion. For example, here is a news report from 2012.

Amina Khan (of the Los Angeles Times). (March 8, 2012). Plutonium near Fukushima plant poses little risk, study says Published: Thursday, March 8, 2012 http://www.heraldnet.com/article/20120308/NEWS02/703089849 

The levels of radioactive plutonium around Japan's Fukushima Daiichi nuclear power plant aren't much higher than the amount of plutonium remaining in the environment from Cold War-era nuclear weapons tests, and it probably poses little threat to humans, a new study indicates. 
The paper, published Thursday in the journal Scientific Reports, provides the first definitive evidence of plutonium from the accident entering the environment, the authors say. It examines the area within a roughly 20-mile radius of the plant and details the concentration of plutonium isotopes deposited there after explosions ripped open multiple reactors. 
At the three sites examined, the levels for certain isotope ratios were about double those attributed to residual fallout from above-ground nuclear tests conducted by the U.S. and former Soviet Union at the dawn of the Cold War.... 
Robert Alvarez, who has served as a senior policy adviser in the U.S. Energy Department, said he would have been surprised if researchers had not found evidence of plutonium contamination near the plant. "They were irradiating plutonium in Unit 3, which experienced the biggest explosion," he said. In fact, the explosion was so massive that investigators found fuel rod fragments a mile away, leading to speculation that a supercritical fission event may have also occurred, Alvarez said.
The article is referring to a study by Zheng et al. Here is my synopsis of the study's findings:

A study released in Scientific Reports published by Nature titled ‘Isotopic evidence of plutonium release into the environment from the Fukushima DNPP accident’ by Zheng et al found that a wide array of highly volatile fission products were released, including 129mTe, 131I, 134Cs, 136Cs and 137Cs, which were all found to be ‘widely distributed in Fukushima and its adjacent prefectures in eastern Japan.’[i]

The study also found evidence of actinides, particularly Pu isotopes, on the ground northwest and south of the Fukushima DNPP in the 20–30 km zones. The study called for long-term investigation of Pu and 241Am dose estimates because of findings of ‘high activity ratio of 241Pu/239+240Pu (> 100) from the Fukushima DNPP accident.’

The study concluded that in comparison to Chernobyl, the Fukushima accident ‘had a slightly higher 241Pu/239Pu atom ratio, but lower ratio of 240Pu/239Pu.’ Unit 3 was seen as the likely source for the high Pu detections.

[i] J. Zheng, K. Tagami, Y. Watanabe, S. Uchida, T. Aono, N. Ishii, S. Yoshida, Y. Kubota, S. Fuma and S. Ihara (8 March 2012 ) ‘Isotopic Evidence of Plutonium Release into the Environment from the Fukushima DNPP Accident,’ Scientific Reports, 2, http://www.nature.com/srep/2012/120308/srep00304/full/srep00304.html.

 

Saturday, August 8, 2020

Remembering Hiroshima and Nagasaki: When We All Became Human Subjects for Radiological Experimentation

 

Atomic scientists’ success during World War II in harnessing the power released by nuclear disintegration was heralded as a major scientific advancement. Indeed, the December 22, 1945 issue of Science News Letters proudly declared “Atomic Power Leads” as the year’s most significant scientific advancement given its “world shaking consequences.”[i]

The Japanese cities of Hiroshima and Nagasaki experienced those world shaking consequences first hand with the deployments of the “Little Boy” uranium weapon on Hiroshima on August 6, 1945 and the “Fat Man” plutonium-based bomb over Nagasaki on August 9. 

However, the article in Science News Letters emphasized the medical benefits of newly discovered radiological isotopes over the destructive power of radiological fallout. This tendency to emphasize purported benefits of all things nuclear by scientific and government authorities was a strategy to sell the world on the benefits of nuclear power.

The Radiation Effects Research Foundation in Hiroshima was established in 1950 to study the effects of exposure on atomic bomb survivors. Fourteen studies have been published from the data collected from a cohort of approximately 120,000 subjects, including residents of Hiroshima and Nagasaki who were in the cities during the bombing and residents who were outside of their home cities at the time of the bombing.[ii] 

In the foundation’s report published in 2012, the data support the linear, no-threshold model of the effects of ionizing radiation. The report finds no threshold below which radiation doses are harmless.

Moreover, their research has linked diseases beyond cancer – including circulatory, respiratory, and digestive disease – to fallout exposure. Health effects are documented at exposure levels of 20 millisieverts and a “statistically significant upward curvature” of effects for low doses in the 0-2 Gray range is documented.[iii] 

This upward curvature raises questions about the effects of low doses. Could there be an adverse dose-response at the low end?[iv] This question permeates the scientific literature on the biological effects of radiation.

Research on the atomic bomb survivors has been the foundation of post-World War II government understandings of dose-effects, excess relative risk from radiation exposure (ERR) and radiation protection regulations. However, although the atomic bomb survivors represent the largest available cohort on excessive radiation exposure, there have been three main criticisms of using research on atomic bomb victims to extrapolate to the health effects of lower-dose exposure to radiation.

First, the research findings on atomic bomb survivors who were exposed to high doses have been used to extrapolate the effects of low doses. This strategy essentially homogenizes the effects of dose, irrespective of the intensity of that dose. Criticisms of this practice of extrapolation have been launched by those who argue that the effects of low level radiation are not the same as the effects of acute exposure to higher-level radiation.

Second, some critics have noted that the population of survivors from the blast may not be representative of the larger population impacted by the disaster and therefore survivors may have biological predispositions that enabled them greater survivorship capacities.

Third, some critics claim the study of survivors was severely biased because many people in Japan hid symptoms of fallout exposure for fear of social exclusion and economic marginalization.[v] Finally, critics argue that fallout effect from the atomic bombs dropped on Hiroshima and Nagasaki cannot be extrapolated to encompass all forms of radiological contamination because they were detonated at relatively high altitudes and produced minimal fallout.[vi]

Research on the effects of ionizing radiation was not limited to atomic bomb survivors in the immediate poste WW period. For example, in 1946 and between 1950 and 1953, the AEC working, with the National Institutes of Health and the Quaker Oats Company, funded research carried out by MIT scientists that entailed feeding radioactive iron or calcium to children deemed “mentally retarded” who were institutionalized at the at the Walter E. Fernald School. 

Although the researchers anticipated no health benefits for the children, parents were led to believe the children might benefit from the experiment.[vii] Cancer patients also served as human subjects for research on radiation, particularly at the M.D. Anderson Cancer Center in Houston Texas.[viii] Although these secret studies remained classified, public concern was growing about the atmospheric fallout of nuclear weapons.

Indeed, the entirety of atmospheric testing ranging from Trinity in New Mexico in 1945 through the 1980s constituted an unprecedented medical experiment upon entire populations by governments. The U.S., the Soviet Union, and the U.K., conducted atmospheric testing until 1963 when the limited test ban treaty was signed. France and China persisted in atmospheric tests through the 1980s. In sum, 504 nuclear devices are known to have been detonated above ground.[ix] The U.S. conducted 1,030 tests total, atmospheric and below ground. The human and biosphere costs are incalculable and few governments in the world have incentives for attempting to calculate them.



[i]           Atomic Power Leads. The Science News-Letter, Vol. 48, No. 25 (Dec. 22, 1945), pp. 389-396 Published by: Society for Science & the Public Stable URL: http://www.jstor.org/stable/4548515 .Accessed: 11/06/2012 15:07Your use, 389.

[ii]             Kotaro Ozasa, Yukiko Shimizu, Akihiko Suyama, Fumiyoshi Kasagi, Midori Soda, Eric J. Grant, Ritsu Sakata, Hiromi Sugiyama and Kazunori Kodama. Studies of the Mortality of Atomic Bomb Survivors, Report 14, 1950–2003: An Overview of Cancer and Noncancer Diseases. Radiation Research 177, 229–243 (2012),  p. 229

[iii]          Ozasa, p. 234.

[iv]          Goddard’s Journal has produced a review of the data published by the Radiation Effects Research Foundation. Available http://www.youtube.com/user/GoddardsJournal. 

[v]           Shuntaro Hida, a Japanese doctor who survived the atomic bomb, has advocated on behalf of atomic bomb victims who hid their symptoms. In a lecture given in Japan on December 12, 2012 Hida describes uncounted deaths and inexplicable symptoms: "The term 'internal radiation exposure' didn't exist at the time. . . .  Because these people entered the city and were exposed to radiation, we called it ' city-entering radiation exposure.' We had no theory on why they were dying, though." Hida states that some victims died while others lived with various ailments. In 1950 he opened a clinic to treat many of these victims. He explains that they came at night to avoid stigmatization: "Atom bomb survivors were at one time unable to take out life insurance policies. Countless survivors have been discriminated against in marriage, studies, employment, and other important life events," Hida writes in his book, "Naibu hibaku no kyoi" (The Threat of Internal Radiation Exposure). "This is inherited by the second (children's) generation, and the third generation . . . ."  From 1979 to 2009 he served as the chair of the Japan Confederation of A- and H-Bomb Sufferers Organizations' central consultation center. Bomb survivor doctor continues to speak up about significance of internal exposure. Mainichi. 2012, January 23: http://mdn.mainichi.jp/mdnnews/news/20120123p2a00m0na013000c.html

[vi]          Steven L. Simon, André Bouville, and Charles Land Fallout From Nuclear Weapons Tests and Cancer Risks. American Scientist, 94, 48-57. 2006, p. 50.

[vii]            Walker p. 17.

 [viii]           Goliszek p. 127.

 [ix]            Steven L. Simon, André Bouville and Charles Land. Fallout from Nuclear Weapons Tests and Cancer Risk. American Scientist 94, p. 48.

 

Friday, August 7, 2020

Is Arizona's Covid-19 Infection Rate Actually Decreasing?


Hospitalization rates are, in my opinion, a better indicator than positive tests and the good news is that AZ hospitals are seeing less of a surge, for now at least.

However, I believe that community spread is widely ongoing in Maricopa County based on the anecdotal evidence I've seen and my knowledge of the virus.

Test results in AZ can take 2-3 weeks. Fewer and fewer people whom I know are interested in being tested because of these slow results and also because of overall Covid-19 fatigue.

Unfortunately, the press to open schools will probably reverse the downward trajectory in the hospitalization rate. I'm praying for an influenza-free fall:

Steinbach, Alison (2020, August 6). COVID-19 tests in Arizona dropped dramatically in July. Here's why that's an issue. The Arizona Republic. https://www.azcentral.com/story/news/local/arizona-health/2020/08/06/covid-19-testing-dropped-dramatically-july-here-is-why-matters/3304724001/

Why are test numbers dropping?

The peak for diagnostic testing statewide was in late June and early July. During those several weeks, an average of more than 107,000 tests were conducted each week, according to the state health department's COVID-19 data dashboard.

But during the week of July 12, that dropped to about 93,200 diagnostic tests conducted, falling further to about 66,200 tests the week of July 19 and about 51,400 tests the week of July 26.

Over the course of just three weeks in July, weekly diagnostic tests conducted dropped by well over half. Arizona is now back to testing at the level it was two months ago.

Dr. Cara Christ, the state health director, said "a number of reasons" could explain the decreased demand for tests.

"It may be that people are feeling fine, so they’re not looking for the tests because it’s circulating less in the community," Christ told The Arizona Republic. "It could be that they’re hearing about the long wait times — that's why it’s so critical for us to fix that."

Wait times have improved significantly in the last week, but for weeks prior, many test results were taking up to two weeks or longer to come back, meaning frustration for individuals and no use for public health interventions. Because of the long waits, people may have just decided to skip getting tested....


Thursday, August 6, 2020

Covid-19 Human Tragedy


The official US job loss is growing and yet it fails to capture the true scale of economic dislocation, with  jobless claims now exceeding 54 million over the past four months, wiping out the 20 million jobs added over the last decade by a near three-to-one margin.

The Nation reported that a "Wave of Evictions" is coming.

The global impacts are even worse with food insecurity rising alarmingly worldwide.

Global supply chains are vulnerable.

Global conflict will surely rise in the context of food insecurity and rising disease impacts.

The time is now to act decisively and on an unprecedented scale to ensure that people's basic needs for housing and food are met globally or we will face an unprecedented decade of upheaval.

New leadership needed NOW!


Monday, August 3, 2020

Covid-19 Significantly and Adversely Impacts Blood Cells



Covid-19 is a SYSTEMIC INFECTION that compromises our red and white blood cells.

Efforts to reassure us all that we won't contract Covid-19 over and over again as antibodies fade have invoked the mighty T cell as our salvation. I am cheering them on!

However, consider this: Covid-19 produces lymphopenia, that is it compromises B lymphocytes, T lymphocytes, and NK (natural killer) cells:
Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-847. doi:10.1002/ajh.25829
Abstract

COVID-19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis.

Lymphopenia may be considered as a cardinal laboratory finding, with prognostic potential. Neutrophil/lymphocyte ratio and peak platelet/lymphocyte ratio may also have prognostic value in determining severe cases.

During the disease course, longitudinal evaluation of lymphocyte count dynamics and inflammatory indices, including LDH, CRP and IL-6 may help to identify cases with dismal prognosis and prompt intervention in order to improve outcomes. Biomarkers, such high serum procalcitonin and ferritin have also emerged as poor prognostic factors. Furthermore, blood hypercoagulability is common among hospitalized COVID-19 patients.... 
So, COVID-19 infected patients, whether hospitalized or ambulatory, are at high risk for venous thromboembolism, and an early and prolonged pharmacological thromboprophylaxis with low molecular weight heparin is highly recommended. Last but not least, the need for assuring blood donations during the pandemic is also highlighted.

Other diseases that are characterized by lymphopenia are HIV and Lupus.