Coronavirus - Relevant Context and Perspectives
Maintained and reviewed by a small team with medical training
• May 5, 2020
Note: this is no substitute for medical advice from your physician or health authority
Contact info@theinsidebid.com for content additions or discussions
UPDATE
May 25
We’ve been tracking this disease for a couple of months with a contrarian perspective based on data.
When we checked today the CDC site shows their best model
Fatality rate of
0.05% in ages 0-49 [211.6million]
0.2% in ages 50-64 [63.1 million]
1.3% in ages 65+ [52.4 million - some in the 80s/90s]
All in [weighted] fatality rate is thus 0.27% but with the
Overcounting of Covid deaths and undercounting of
Asympotomatic cases we are now moving towards
Stanford’s 0.1% number.
This is as serious as a new flu. Major progress can be made
w/ hydroxycholorquine (early on) and Ivermetcin (later on)
UPDATE
May 25
Overview
Highlights:
Biggest risks
Most Important Stat - Fatality
Flu [all viruses] have always been deadly
How deadly?
# deaths
# people with disease
Undercounting?
Overcounting?
#Deaths - Systemic overcounting
# deaths
# people with disease
Terminally ill patient was given a COVID test:“It’s bizarre that you would do that on a hospice patient, but they would get a COVID test positive. That person wouldn’t die of their terminal disease. They died of COVID – that’s the issue, that our hands are tied…. We can’t disclose this technically to anyone, or you are breaking federal law.” Utah ICU Nurse
Dr. Scott Jensen, Senator - “The determination of cause of death is a big deal.” (watch 4mins)
Dr. Anne Bukacek - 30 years experience in filling out Death Certificates (watch 3mins)
Financial Incentives
Hospitals will receive on average $13,000 in Medicare payments per COVID patient and $39,000 if ventilator used. Abuse here is known: Medicare paid 85 times more claims for noninvasive pressure support ventilators in 2015 than in 2009.Some states, such as Minnesota, Nebraska and Montana, are reportedly receiving more than $300,000 per COVID case. (link)
#Deaths - Systemic overcounting
# deaths
# people with disease
Illinois’s State Health Director (May 11, 2020)
“If you are in hospice and have a few weeks to live….even if you died of a clear alternate cause you are still treated as a Covid death.”
#Deaths - Systemic overcounting
# deaths
# people with disease
From Funeral Directors in NYC
“They’re assuming they all have it.”
“The sister refused to believe , they did the autopsy. Boom. No covid19”
Stanford Research shows undercounting
Only way to know # people with disease is population testing. Full stop.
# deaths
# people with disease
445: April 17, 2020 results from first population antibody testing [Santa Clara County
4% have antibodies to this disease - on the low end 50x more people
have it [more cases than those tested] have it in population [2 million]
Note: the prevalence range was 2.5%-4.2%
850: "about as deadly as flu...[or slightly worse]
�1333: "on the order of the flu, a little bit worse" - "we are presenting a conservative estimate [0.1-0.2% mortality]"
1633: "I dont want to look back and second-guess [need to look forward]”
29:57 What would you say to Governor or President?
Dr. Jay Bhattacharya, Stanford (watch 4mins) need for testing March 27, 2020
Dr. Jay Bhattacharya, Stanford testing results April 17, 2020
MERCY �TITLE
MERCY�MAIN POINT and
SUB POINT
Stanford Research shows undercounting
Only way to know # people with disease is population testing. Full stop.
445: April 17, 2020 results from first population antibody testing [Santa Clara County
4% have antibodies to this disease - on the low end 50x more people
have it [more cases than those tested] have it in population [2 million]
Note: the prevalence range was 2.5%-4.2%
850: "about as deadly as flu...[or slightly worse]
�1333: "on the order of the flu, a little bit worse" - "we are presenting a conservative estimate [0.1-0.2% mortality]"
1633: "I dont want to look back and second-guess [need to look forward]”
29:57 What would you say to Governor or President?
Dr. Jay Bhattacharya, Stanford (watch 4mins) need for testing March 27, 2020
Dr. Jay Bhattacharya, Stanford testing results April 17, 2020
MERCY �TITLE
MERCY�MAIN POINT and
SUB POINT
Dr. Jay Bhattacharya, Stanford (watch 4mins) need for testing March 27, 2020
Dr. Jay Bhattacharya, Stanford testing results April 17, 2020
Show transcript
# People with Disease - �Undercounting
# deaths
# people with disease
New York study 19.9% of New York City has tested positive
(link)
13,000 confirmed deaths
8,323,338 population * 19.9%
�
18,610 confirmed deaths
19,440,469 population * 12.3%
�
0.78% infectious fatality rate
In New York City
0.78% infectious fatality rate
In New York State
# People with Disease - �Undercounting
# deaths
# people with disease
4.1% of LA county’s adult population has an antibody to the virus. From here, they estimate that approximately 2.8% to 5.6% of the county’s adult population has an antibody to the virus, which means that up to approximately 442,000 adults in the county have been infected. This means that the number of those infected is potentially up to 28 to 55 times higher than the 7994 cases that have been reported to the county at the time of the study. (link)
# People with Disease - �Undercounting
# deaths
# people with disease
German study shows coronavirus might not be fatal as previously thought
German study shows 15% have had the disease (antibodies present) in hard hit community. (link)
“If you stop super spreading events, and hygiene and contain social distancing these are enough to contain the virus and at least in Germany our healthcare system will not be overwhelmed.
�As it is being passed from person to person it is losing virulence. For political decisions - I am a virologist - that is something I cannot comment on.”
..I think there are many more in New York infected because I don’t think the case fatality differs among countries.”
Professor Hendrick Streeck, University of Bonn.
So how bad is it?
Infection fatality rate
Treatments
Hydroxycholorquine 1 2 3 4 5
Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitra Jia Liu, Ruiyuan Cao, Nature Cell Discovery (2020) (link)
“Therefore, of the two potential drugs, Remdesivir CQ appears to be the drug of choice for large-scale use due to its availability, proven safety record, and a relatively low cost. In light of the preliminary clinical data, CQ has been added to the list of trial drugs in the Guidelines for the Diagnosis and Treatment of COVID-19 (sixth edition) published by National Health Commission of the People’s Republic of China…. In conclusion, our results show that HCQ can efficiently inhibit SARS-CoV-2 infection in vitro….”
Hydroxychloqouine worked on SARS in-vitro
Treatment with HCQ 20% better �
callout
Main message
Scientific study reference
Quote from study
graph
Index of slides
Hydroxychloroquine - Evidence (In-Vitro/In-Silico)
Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitra Jia Liu, Ruiyuan Cao, Nature Cell Discovery (2020) (link)
“Therefore, of the two potential drugs, Remdesivir CQ appears to be the drug of choice for large-scale use due to its availability, proven safety record, and a relatively low cost. In light of the preliminary clinical data, CQ has been added to the list of trial drugs in the Guidelines for the Diagnosis and Treatment of COVID-19 (sixth edition) published by National Health Commission of the People’s Republic of China…. In conclusion, our results show that HCQ can efficiently inhibit SARS-CoV-2 infection in vitro….”
Structural and molecular modelling studies reveal a new mechanism of action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection, Fantini et al. Université, Marseille, FR International Journal of Antimicrobial Agents (April 3, 2020) (link)
“Using..molecular modelling approaches, this study showed that chloroquine (CLQ)..binds sialic acids and gangliosides with high affinity. This study showed that, in the presence of CLQ [or its more active derivative, hydroxychloroquine (CLQ-OH)], the viral S protein is no longer able to bind gangliosides. The identification of this new mechanism of action of CLQ and CLQ-OH supports the use of these repositioned drugs to cure patients infected with SARS-CoV-2.”
Hydroxychloroquine - Evidence (China)
Hydroxychloroquine application is associated with a decreased mortality in critically ill patients with COVID-19. Bo Yu, Cheng | Wuhan, China | April 27, 2020 (link)
“All 568 patients received comparable basic treatments including antiviral drugs and antibiotics, and 48 of them additionally received oral hydroxychloroquine (HCQ) treatment (200 mg twice a day for 7-10 days). RESULTS: The median age of 568 critically ill patients is 68 (57, 76) years old with 37.0% being female. Mortalities are 18.8% (9/48) in HCQ group and 45.8% (238/520) in NHCQ group (p<0.001). The time of hospital stay before patient death is 15 (10-21) days and 8 (4 - 14) days for the HCQ and NHCQ groups, respectively (p<0.05). The level of inflammatory cytokine IL-6 was significantly lowered from 22.2 (8.3-118.9) pg/mL at the beginning of the treatment to 5.2 (3.0-23.4) pg/ml (p<0.05) at the end of the treatment in the HCQ group but there is no change in the NHCQ group. CONCLUSIONS AND RELEVANCE: Hydroxychloroquine treatment is significantly associated with a decreased mortality in critically ill patients with COVID-19 through attenuation of inflammatory cytokine storm. Therefore, hydroxychloroquine should be prescribed for treatment of critically ill COVID-19 patients to save lives.”
Hydroxychloroquine - Evidence (Algeria)
Observer Algerie Newspaper (link)
The Director General of the National Institute of Public Health of Algeria reports that they are treating Covid-19 with chloroquine and it has proven effective. According to one infectious disease specialist, "near-total effectiveness."”
Dr. Mohamed Yousfi, head of the infectious diseases department at Boufarik hospital ( Blida ), said figures to support that the treatment is effective. He said that half of the patients admitted since March 23, 2020 at this facility, had left the hospital, completely cured after being treated with either chloroquine or antivirals in other cases [cardiovascular diseases]. The doctor reveals that "90% of the cases responded very well to this treatment protocol recommended by the Ministry of Health, Population and Hospital Reform".
It specifies that 69.4% of the 5,000 patients treated, from March 24 to date, have been subjected to chloroquine treatment for a maximum period of 10 days.
Hydroxychloroquine - Evidence (Brazil)
Empirical treatment with hydroxychloroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine Rodrigo Barbosa Esper M.D., Ph.D., Rafael Souza da Silva M.D., Fernando Teiichi Costa Oikawa M.D., Ph.D., Marcelo Machado Castro M.D., Alvaro Razuk-Filho M.D., Ph.D., Pedro Benedito Batista Junior M.D., Sergio Wilhelm Lotze M.D., Cleber Nunes da Rocha M.D., Roberto de Sá Cunha Filho M.D., Saulo Emanuel Barbosa de Oliveira M.D, Philipe Leitão Ribeiro, M.D., Valéria Cristina Vigar Martins M.D., Fernando Silva Braga Bueno M.D., Priscila Ligeiro Gonçalves Esper M.D., Eduardo Fagundes Parrillo M.D. April 15, 2020 (link)
“Results: Of the 636 symptomatic outpatients, 412 started treatment with hydroxychloroquine and azithromycin and 224 refused medications (control group). Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group (2.8 times greater) and number needed to treat was 28 (NNT = 28). In those who started treatment before versus after the seventh day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively. Conclusion: Empirical treatment with hydroxychloroquine associated with azithromycin for suspected cases of COVID-19 infection reduces the need for hospitalization (p< 0.001).”
Hydroxychloroquine - Evidence (Italy)
Italian article in Il Tempo (April 28, 2020) (link) and International Journal of Antimicrobial Chemotherapy (link)
“Primaries and general practitioners contacted during this research, many admitted - under a whisper - to use the drug as a "prophylaxis", that is, to prevent infection. Healthcare professionals who are in close contact with contagious patients take the drug in advance, precisely to decrease the probability of contracting the infection. For now, in support of this "prophylaxis" effect, there is a recent publication, involving 211 people. It was published on the International Journal of Antimicrobial Agents , the official body of the International Society of Antimicrobial Chemotherapy. Of 211 people exposed to Covid positive 19 and undergoing hydroxychloroquine prophylaxis, none were infected.”
Hydroxychloroquine - Evidence (US)
Research published in the National Institutes of Health Virology journal - Fauci knew since 2005 -
“We report, however, that chloroquine has strong antiviral effects on SARS-CoV infection…”
“Chloroquine, a relatively safe, effective and cheap drug used for treating many human diseases including malaria, amoebiosis and human immunodeficiency virus is effective in inhibiting the infection and spread of SARS CoV in cell culture. The fact that the drug has significant inhibitory antiviral effect when the susceptible cells were treated either prior to or after infection suggests a possible prophylactic and therapeutic use.
Hydroxychloroquine - Evidence (US)
Rethinking the role of hydroxychloroquine in the treatment of COVID-19 (link)
“..specifically, the impact of HCQ on cytokine production and suppression of antigen presentation may have immunologic consequences that hamper innate and adaptive antiviral immune responses for patients with COVID‐19.”
“..Given these facts and the growing uncertainty... they should only be used with caution and in the context of carefully thought out clinical trials”
The facts listed a) no high quality data (disagree), b) that we don’t understand the unknown harms and biochemistry (moot, widely used drug, if it works clnically on Covid we use it; We don’t understand aspirin in all of its impacts; we have decades of use now) and c) they don’t work like anti-virals (agreed, we knew that, so?)”
This meta-review study suggest clinicians stop the use of this drug outside of more RCTs. We think that is dangerous - to put it mildly.
Meyerowitz writes off a lot of studies. In our opinion he seeks to find the weakness in each study, but fails to mention the positives in each that point to a trend. Most importantly, they don’t cover the recent 3 papers (China, Brazil, Italy) listed in this deck.
Point by point rebuttal
Available (email us)
Hydroxychloroquine and Azithromycin - Incoming (recentnotprocessed)
Hydroxychloroquine - Evidence (Senegal)
Senegal
Hydroxychloroquine - (US ) Clinical Experience
Dr. Stephen Smith (April 10, 2020) founder of The Smith Center for Infectious Diseases and Urban Health
Dr. Ramin Oskoui, CEO Foxhall Cardiology
“[Fauci] hasn’ t seen anyone with Covid, my team has treated over 115 patients...it has nothing to do with politics. This drug works.
“We need a solution that is safe, effective, cheap and scalable. Vaccines are not that. It will be lucrative to the makers.
We need to think about herd immunity, hyroxycholorquine...and we need to start this drug earlier not going into the ICU deathly ill.
Dr. Stephen Smith (April 28, 2020)
“I can’t believe anyone took VA study
Seriously. I’ve never seen an efficacy
Study without dosages...It is a sham,
It is a shame on UVA.
It is an embarrassment.” link
Hydroxychloroquine - (US ) Clinical Experience
Dr. Zelenko is a physician who practices medicine in Orange county, NY, and has cared for the 35,000 population Kiryas Yoel Jewish community for 16 years.
“It is absolutely essential treatment begins at first sign of symptoms..”
“..many New York Hospitals are waiting until disease has progressed to ARDS...this is senseless..”
“..I don’t know why the media is misrepresenting the facts..”
“As of April 26th I have treated 1600 patients,with 405 with my treatment protocol (HCQ, Azithromycin, Zinc)...nearly 100% recovery.”
“I have been in daily contact with Mark Meadows; and Israel, Ukraine, Russia, French, Brazilian governments.”
Hydroxychloroquine - (US ) Clinical Experience
Dr. Anthony Cardiollo (April 7, 2020) ER Specialist and CEO of Mend Urgent Care
“We are finding with our patients it only works in conjunction with zinc.
Should be reserved for people who are sick.
Every patient I’ve prescribed has been very very ill, and within 8-12hrs they were resolved.
�Taking it alone it is not having efficacy. “
Hydroxychloroquine - (US ) Clinical Experience
Dr. Bruce Fong and Lawyer on Fox
Laura Ingram: “Are people dying?”
“People are dying. People are dying. If this is not used in a therapeutic use window which is a sensitive time period, each and every case is different. It depends on who you are. You know, 90% of the population, maybe 80-85% is going to be fine. But it’s that 15% of the high risk that is going to die [wt/ HCQ]… I believe this is about money. I believe this is about panic and creating a whole swath of problems for America.” “
Hydroxychloroquine - (US ) Clinical Experience
Dr.Lozano - Texas (May 14, 2020)
“Yesterday I wrote 5 prescriptions, and sent them to a pharmacy I’ve been using for 20 years. They told me they won’t fill another prescription for me. I had to squirm all over Dallas to get these filled.
..
I have severe patients in the office. Temperatures of 102.9 and WBC of 17,000, +ve Covid. Their physicians are refusing to treat due to fear of the licensing board. This is shameful...every patient I have treated has had resolution in 24hrs.”
Hydroxychloroquine - LOW RISK PRE COVID
Hydroxychloroquine - HIGH RISK POST COVID
Hydroxychloroquine - HYPE POST-COVID
HYPE
Reality
Hydroxychloroquine - HYPE POST-COVID
HYPE
Reality
Fake
News Medi
a?
Hydroxychloroquine
Early Evidence it may work in conjunction with Zinc
Studies not using zinc could be misleading (most studies in US don’t use it and give drug late to mostly intubated patients!). Zinc is co-factor for antiviral activity. Need RCT.
Dangers of drug overhyped
Efficacy is what matters, and cardiac considerations are normal screen and monitor especially with other QT-prolonging drugs.
WHO is making risk statements counter to their own data
Recent Covid statements on risk of hydroxychloroquine are unquantified. Pre-Covid 2017 study by WHO said “despite hundreds of millions of doses of antimarials...no reports of sudden unexplained death.”
Media makes it hard to discern fiction from fact
Extremely dangerous mis/disnformation is impacting physicians and costing lives.
According to the Sermo Real Time Covid-19 Barometer 20 (https://www.sermo.com/ ,consulted 20 April), for over 20,000 physicians across 30 countries, 21 chloroquine derivatives are the first medication used to treat COVID-19 patients in ICUs (67%), the 22 second medication in other hospital settings (66%), and the third in outpatient settings (40%). While many countries recommend it for treating COVID-19, certain Western countries do not…
(link)
Ivermectin - New Study
“Ivermectin (150mcg/Kg) administered once compared with COVID-19 patients receiving medical therapy without ivermectin”�
The cohort (including 704 ivermectin treated and 704 controls) was derived from 169 hospitals across 3 continents with COVID-19 illness. The patients were matched for age, sex, race or ethnicity, comorbidities and a illness severity score (qSOFA). Of those requiring mechanical ventilation fewer patients died in the ivermectin group (7.3% versus 21.3%) and overall death rates were lower with ivermectin (1.4% versus 8.5%; HR 0.20 CI 95% 0.11-0.37, p<0.0001)
There is no substitute to a properly conducted randomized clinical trial. However, as the tempo of COVID-19 rages and aggressively so, we believe that even this preliminary information is important to communicate so that clinicians can consider this therapy for appropriate testing in this setting.
Ivermectin - Pharmacology
Safety
Mechanism of Action:
Ivermectin reduces SARS-CoV2 viral RNA replication by
Ivermectin - (International) Clinical Experience
Dr. Tarek Alam - Bangladesh (June 8, 2020)
Dr. Alam, head of medicine at private Bangladesh Medical College Hospital, and his team used the combination of two drugs (ivermectin and doxycycline) on 60 COVID-19 patients.
Dr. Alam said the combination shows “astounding results” and “are recovering within four days and 50 percent reduction of symptoms in 3 days”.
His results have made his team a “hundred percent hopeful” and are preparing a paper for an international journal to get international recognition of their breakthrough discovery. Link
Nikkei Asian Review - Japan (May 8,2020)
Japan's leading newspaper "Nikkei Asian Review" reported ivermectin was gaining attention and Kitasato University, where ivermectin was originally isolated, is in discussions for a clinical trial with Merck's Japanese arm. Link
TrialSite News - Japan (May 13,2020)
TrialSite News reports that Egypt's Tanta University and Iraq's University of Baghdad have already commenced studies using ivermectin targeting SARS-CoV-2. They are anticipating challenges on the production of the drug and "any supply chain bottlenecks could disrupt plans." Link
Ivermectin - (US) Clinical Experience
Dr. Peter H Hibberd - Florida (May 22, 2020) Emergency Medical Physician
Dr. Hibberd explains “The drug (Ivermectin) is salvaging people from their death bed” but understands more trials are needed before the FDA approves ivermectin’s use as a COVID-19 medication. Link
Dr. Jean-Jaques Rajter - Florida (May 22, 2020)
Dr. Rajiter and his team from Broward Health Medical Center in Fort Lauderdale, Florida submitted findings of 250 coronavirus patients involved in the Broward trial to an institutional review board. Their results showed “statistically significant improvement in mortality”. Link
Ivermectin - Experimental Trial
Caly, et al (June 2020) link
The collaboration between Monash University in Australia and the Victorian Infectious Diseases Reference Lab created the first peer-reviewed paper on ivermectin’s activity against SARS-CoV-2.
The in vitro study infected Vero-hSLAM cells with the causative virus and gave a single addition of ivermectin.
Results showed a “93% reduction in viral RNA” by 24 hours. By 48 hours, there was ~5000-fold reduction of viral RNA “indicating that ivermectin treatment result in effective loss of essentially all viral material”.
Ivermectin - Retrospective Cohort Study
Rajter, et al. (June 2020) link
*Undergoing peer-review
Collaboration between Broward Health Medical Center, Drexel University College of Medicine, and Florida International University.
The study looked at 280 patients with confirmed SARS-CoV-2 infection, of which 173 were treated with ivermectin. The primary outcomes was all-cause in hospital mortality.
“Overall mortality was significantly lower in the ivermectin group than in the usual care group (15% vs 25.2%, for ivermectin and usual care respectively, p= 0.03)”
Ivermectin - News
Ivermectin - Current Clinical Trials
May 5th 2020
Avifavir (Favipiravir)- Experimental Trial
Avifavir (Favipiravir)- Clinical Experience
Kiril Dmitriev (June 9th, 2020)
CEO of the Russian Direct Investment Fund discuss the development of Avifavir, the first favipiravir-based drug in the world to be registered against coronavirus.
"Medium time of elimination of the virus using just this one drug versus standard therapy goes from 9 days to 4 days. 65% of patients eliminate the virus completely on the 4th day, which is double the number in the standard group. Even the temperature returns back to normal 3 days for patients just taking the drug versus 6 days taking standard therapy.”
60,000 courses of the drug will be delivered to Russian hospitals in June.
Dexamethasone
Vitamin D- Current and Future Studies
Dr. JoAnn Manson (June 2020)
Dr. Manson, a Harvard Medical School professor and chief or preventive medicine at Brigham and Women’s Hospital is conducting a nationwide randomized trial to test if taking vitamin D will decrease COVID-19 severity.
For now, Dr. Manson recommends people take simple steps to avoid vitamin D deficiency.“More is not necessarily better. The goal is to avoid a deficiency. It’s not to get mega doses.”
Martineau, et al 2017 link
Meta-analysis from 11,321 participants and 25 RCT’s found that vitamin D supplementation at low doses protected against acute respiratory infections. The effect was greater among those classified as vitamin D deficient.
Daneshkhah, et al (May 2020) link
*not peer reviewed yet
Researchers at Northwestern University and Boston Medical Center found an inverse correlation between high C-reactive protein and vitamin D in COVID-19 patients. This suggests that vitamin D may suppress cytokine storm in COVID-19 patients.
Meltzer, et al. ( May 2020) link
*not peer reviewed yet
Researchers at University of Chicago reviewed records of over 4,300 patients who tested for COVID-19. After controlling for cofactors, they found that those who were vitamin D deficient before the pandemic were more likely to test positive for COVID-19.
Vitamin D- Current and Future Studies
Laird, et al. ( April 2020) link
Literature search of vitamin D status in European countries affected by COVID-19 found that countries with low concentrations of 25(OH)D and high rates of vitamin D deficiency had the highest infection a death rates in Europe.
Anticoagulation Therapy- Thromboprophylaxis
American College of Chest Physicians - June 2,2020
Lancet - June 2020
Properties of Heparin in COVID-19 treatment
Wiley Online Library - April 23,2020 link
Treatment protocol - May 5th
Other Treatments - Clinical Experience
Dr. Ban Truong is a physician with a PhD in Nutrition, and who is quadruple board certified in Emergency Medicine, Obesity Medicine, Anti-Aging and Regenerative Medicine, and as a Physician Nutrition Specialist. Has practiced in several large, urban emergency departments throughout the country. He owns and operates several brick-and-mortar clinics that range from primary care to urgent care. He also owns and operates a telemedicine clinic.
“I had a lot of pushback from pharmacies. I can't imagine this medication (HCQ) is not available. It is generic. I have been told FEMA can ramp this up quickly. We talk about social distancing why aren't we talking about treating people.”
...“90% of physicians and nurses have never used these
medications and supplements before. Improve your knowledge.”
Other treatments
AMA has created a pharmacologic summary
Valuable overview (link)
Ventilators
Ventillators may be harmful
A new disease?
“We may need to look at this as an entirely new disease. Then, perhaps all of the great RCT studies on Acute Respiratory Distress Syndrome in the 2010’s don’t apply because none of those patients had COVID19…”
“This is more like high-altitude mountain sickness than ARDS..we may have the wrong paradigm”
Dr. Cameron Kyle-Sidell
Ventillators may be harmful
Gattinoni - World leading ARDS researcher
Identifies novel subgroup in Covid (Type L). ARDS strategies (typical ventillator) would harm these patients.
Physicians are trying different things
Oxygen first strategy with lowest pressures possible, Intubation as last resort, Prone patient position
This is not medical advice but highlights the ongoing revolution of care
Various physicians discussing Covid wrt ARDS
Comorbidites
The vast number of serious cases is in people with comorbidities
NYC 94%, Italy 96.4%, Germany 99%
The majority of patients who die have 2+ comorbidities. It is killing very vulnerable people who’s life expectancy was low.
For example, coronary artery disease and hypertension. Healthy functioning immune systems respond well to covid.
Evidence is from the case fatality rate worldwide (ref: Covidgraph). For example, for cases from 18-45 in age it is about 0.4-0.7% around the world. Since the number actually infected in the population is 50x+ greater - that infection fatality rate is 0.008%-0.014%. Meaning one in 12,500 to one in ~7,500 people may die.
Let’s keep some perspective, 1 in 300 hospital visits suffer a medical error. For every, 100 hospitalized patients, 10 will get a hospital acquired infection. (WHO reference)
Vaccines
DJKF
Vaccine Issue - Politics and Power
Gates Foundation
AAPS (Physicans) Censureship Lawsuit
“AAPS is not ‘anti-vaccine,’ but rather supports informed consent, based on an understanding of the full range of medical, legal, and economic considerations relevant to vaccination and any other medical intervention, which inevitably involves risks as well as benefits,” noted Dr. Orient.
“Who appointed Congressman Adam Schiff as Censor-in-Chief? No one did, and he should not be misusing his position to censor speech on the internet,” said AAPS General Council Andrew Schlafly.” (January 19, 2020)
Bold business plan
Gates is on record as saying that this pandemic ends when every person on the planet is vaccinated.
Sidebar: In the United States vaccines are not regulated by the FDA. They are under the CDC. They are not a drug and don’t need to be proven; they are biologics - they were intended for war. In 1986, Congress made it impossible to sue a vaccine company for damages this stands today. In 1989, the vaccine schedule was boosted by CDC. It is a profit center and mega-business. The only business in the world that has no liability and no need to test drug efficacy (i.e . outcomes w/ drug are better than without). If you are concerned about humanity look at the test subjects of vaccines who are usually in India and China; there is a reason.. (hint: in Western trials they step from 10 to 100 people, for a reason (safety), and thousands $/head for participating--a good reason to use people abroad e.g. Uyghurs).
Social Engineering?
There are no words for this.
Translation. Newsweek (CIA connected) is stating that Dr. Fauci was doing “gain of function” work. That means making a virus more virulent, making, for example, a virus jump to a human. Making a more lethal virus. 200 scientists called for the work to be halted and Dr. Fauci’s response: “it can help us identify novel drug targets.” Or vaccines. This isn’t about Fauci - he is being setup as a fall guy in case things go south...
(link)
Luc Montagnier - Nobel Prize Winner Discovered HIV Virus
The Coronavirus Is Man Made According to Luc Montagnier the Man Who Discovered HIV (link)
“With my colleague, bio-mathematician Jean-Claude Perez, we carefully analyzed the description of the genome of this RNA virus,”...”in order to insert an HIV sequence into this genome, molecular tools are needed, and that can only be done in a laboratory.”
In these laboratories, Chinese scientists “have been working for more than ten years on corona viruses transmitted by animals, especially bats,” reports Professor Montagnier, who regularly reviews published reports….(link)
But at the moment “we are in such a climate, there are so many dead that nobody wants to carry this very heavy burden”, he admits.
Dr. Fauci’s Ex-Employee Speaks
Dr. Judy Mikovits PH.D - Molecular Biologist
Fauci was her ex-boss. They stole her work (and that of her direct superior). They filed patents and own the work now. “Everyone else was paid off, and paid off millions of dollars even today by Fauci’s organization NIAID.”
They imprisoned her, put a gag order on her for 5 years, saying that if she talked “they would find more evidence.” She is talking now nonetheless. She is an American hero.
Conclusions:
Next Steps
Contact with insights or edits: info@theinsidebid.com
Are RT-PCR tests a valid diagnostic test of disease? No.
Dr. David Rasnick, Founder of Viral Forensics Lab and Bio-Chemist and Protease Developer (link)
““It’s like fingerprints. With PCR you’re only looking at a small number of nucleotide. You’re looking at a tiny segment of gene, like a fingerprint. When you have regular human fingerprints, they have to have points of confirmation. There are parts that are common to almost all fingerprints, and it’s those generic parts in a Corona virus that the PCR test picks up. They can have partial loops but if you only took a few little samples of fingerprints you are going to come up with a lot of segments of RNA that we are not sure have anything to do with corona virus. They will still show up in PCR. You can get down to the levels where its biologically irrelevant and then amplify it a trillion-fold.”
PCR for diagnosis is a big problem,” he continues. “When you have to amplify it these huge numbers of time, it’s going to generate massive amounts of false positives.”
David Crowe, Researcher and host of “The Infectious Myth” Podcast
““PCR is really a manufacturing technique,” Crowe explained. “You start with one molecule. You start with a small amount of DNA and on each cycle the amount doubles, which doesn’t sound like that much, but if you, if you double 30 times, you get approximately a billion times more material than you started with. So as a manufacturing technique, it’s great…
“In one paper,” Crowe says, “I found 37 cycles. If you didn’t get enough fluorescence by 37 cycles, you are considered negative. In another, paper, the cutoff was 36. Thirty-seven to 40 were considered “indeterminate.” And if you got in that range, then you did more testing. I’ve only seen two papers that described what the limit was. So, it’s quite possible that different hospitals, different States, Canada versus the US, Italy versus France are all using different cutoff sensitivity standards of the Covid test. So, if you cut off at 20, everybody would be negative. If you cut off a 50, you might have everybody positive.”
David, in his quiet Canadian way, dropped a bombshell in his next statement: “I think if a country said, “You know, we need to end this epidemic,” They could quietly send around a memo saying: “We shouldn’t be having the cutoff at 37. If we put it at 32, the number of positive tests drops dramatically. If it’s still not enough, well, you know, 30 or 28 or something like that. So, you can control the sensitivity.”
Overzealous modeling?
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