Personal Update / Sweden Update / Miracle Cures Showcase
Today, I've decided to devote most of my newsletter to showcasing miracle cures. This past week has been interesting with the two or more videos from the "America's Frontline Doctors," all of which appear to be banned, such that I had to go to a super-secret website to find the first one (and it's even a recording of the recording -- I felt like I had to take a shower after watching it).
But first, a couple of housekeeping items.
Personal Update
Good news and bad on my part ... I just got back my antibody test results. Finally being healthy enough, I went to give blood at the Red Cross, which is giving free antibody tests for another couple more weeks. It only took two days for the results to get back. And the result ...
NEGATIVE
I suppose there's a small chance that I caught C19 a long time ago, suffered long-term effects for months, and then lost my immunity just in time for this antibody test. However, the chances are minuscule after two negative "active" virus tests and one negative antibody test. In hindsight, a simple lingering bronchitis infection (triggered by allergies or a regular cold) could have explained all my symptoms.
So ... I'm still susceptible. Dang.
Sweden Update
Two weeks ago, I promised to come back and look at Sweden's Case numbers, and I totally forgot. Well, let's take care of that now. I previously showed how Sweden was reporting their deaths by death-date instead of report-date (like the rest of the world is), and how it makes their deaths look better than they are, and I wondered if they were doing the same with the Case numbers.
Turns out ... they are not. Measured on 7/16, I recorded 74,691 total cases on 7/9 and 77,129 on 7/16, showing an implied 2,438 cases for that week.
Measured on 7/23, I saw 74,686 on 7/9 and 77,128 on 7/16, for a total of 2,442. As you can see, the numbers did not change much.
And measured on 7/30, I saw 74,681 on 7/9 and 77,122 on 7/16, for a total of 2,441.
So, it appears that cases are still being reported on a report-date basis.
Further, looking at implied death reports for Sweden over the past four weeks, I've seen weekly counts of: 112; 90; 95; 63. So, either way we look at it, it appears that Sweden is indeed ramping down in both cases and deaths. I'll touch on this further next week when I discuss a risk-factor based assessment approach to understanding why some countries are doing better than others.
Miracle Cures Showcase
Okay ... finally the moment we've all been waiting for. What about all these miracle COVID cures we keep hearing about? I can tell you here and now, that if anyone tells you, "We got a cure, and no one will listen to us, and we could save the world, and all those studies are fake science," don't believe them. Because I know that tens of thousands of doctors, scientists, and epidemiologists all over the world have been fighting this. They've been trying countless different methods, and they're taking notes, and sharing results with each other. And these miracle cures? They're trying them, too ... and well ... in practice all over the world, not a single drug has proven to be a "silver bullet" that destroys COVID. Because, think about it ... if someone did find that silver bullet, they'd tell others, and then COVID really would disappear ... especially if the cure is cheap. It turns out that most of these wonder cures actually do show some use, but nowhere near the 100% cure rate being claimed.
To help you understand what's going on, I need to describe one of my favorite scams -- it demonstrates the math behind coincidences and why we need controlled studies.
This scam starts with letters mailed to 128 people. Start with a baseball game: the Braves vs. the Cubs. In half of the letters (64), write that the Braves are going to win, and in the other half write that the Cubs are going to win.
The Braves win, so next week, send 64 letters to all who received the Braves letters earlier. This time let's pick: Brewers vs. the Pirates. And again, in half the letters (32) say the Brewers win, and in the other half, the Pirates win.
After the Pirates win, we get to send 32 more letters: 16 saying Cardinals, and 16 saying Dodgers.
After the Dodgers win, there now exist 16 people who think that we've correctly predicted 3 games in a row: Braves / Pirates / Dodgers. So, this time say, "I gave you 3 winners in a row. Give me $100, and I'll tell you who wins in the Phillies vs. Marlins game in two weeks."
Then you probably see what comes next. If 10 give us $100, we're suddenly $1000 richer. And then we send this letter to 5 winners: "Okay ... that's 4 games in a row, so give me $250 for the next bet." ... and so on. If we play it just right, there's going to be 1 person out of the original 128 who will think we're psychic and give us $1000... no one could get that many games in a row ... right? So, how exactly did we achieve it? Think about this for a moment.
Now let's get back to that "American's Frontline Doctors" video, which I believe is a MAJOR SETBACK (yes -- I'm screaming that part) for what we've been accomplishing the last couple of weeks. When Trump Jr. and his dad decided to retweet the video (several times), I'm sure it has caused many right-wing supporters to stop wearing masks again.
In the video, they report 100% cure rates. They give passionate testimony ... especially Dr. Stella Immanuel, who's kind of famous now -- claiming she's treated 350 COVID patients and they've all gotten better. Not even one of them has died.
But get this ... it appears that all of these doctors work at clinics, family practices, and urgent cares. So, if anyone gets really sick from COVID, these are not the doctors who would care for them. So, let's take a closer look at Dr. Immanuel's 350 patients.
First, ask yourself, who exactly would go to her clinic? To help you answer, here is a video showcasing her practice from the clinic's Facebook page. It kind of reminds me of something out of "Better Call Saul," but I should be nice. It seems to be one of many first-defense clinics, which handles only the small stuff. So, I would entirely expect the vast majority of patients to survive anyway. Think of your family practitioner. And look at all the patients you see in the lobby and the halls ... do any of them look like they're going to die? It's totally different when you go into a hospital.
So, my questions on the 350 patients:
- How many of the 350 actually tested positive? (I thought I was positive for 2 months, but it evidently turned out to be something else.)
- How many of them had only mild symptoms that really didn't need treatment? (Remember, the really bad ones go straight to the hospital.)
- Has she followed up on all 350 patients to see if they subsequently got really sick and went to the hospital without letting her know? (Give it a week and we may start hearing stories of "My wife went to see her and later she went to the hospital and died." I give it a 60% chance of this happening in the next 7 days.) Ask yourself ... last time you went to the hospital, did you call a clinic to let them know what you were doing?
- Was it really the miracle cure, or was it some other treatment that really helped some patients get better? For example, Dr. Immanuel describes a man with COVID and pneumonia -- she treated it, and he got better, but was it because of the miracle cure or the antibiotics she prescribed for the pneumonia?
- How many other similar practitioners have a "100% cure rate" even though they didn't prescribe the miracle cure?
Even if all 350 patients did indeed survive, it could still be that she hit the lottery, like I described in the scam above. But for every lucky doctor like this, there are hundreds of other doctors who haven't been lucky. This is why we need controlled studies that can be replicated in other environments.
I'm not saying Dr. Immanuel is a terrible doctor, but she is clearly a terrible scientist / epidemiologist based on her claims that scientific studies are "fake science." But that's okay ... doctors should stick with doctoring, and scientists / epidemiologists should be the ones guiding us through this epidemic ... this is called specialization, and in practice it works pretty well.
And as for these doctors claiming to be "frontline doctors" in the trenches ... I see this as a slap in the face of those who are truly putting themselves in harm's way ... doctors and nurses who are manning the hospital beds -- the ones who are working countless hours many days a week, who are reportedly getting very exhausted and very distraught from the deaths they see.
BTW, as much as I hate the existence of these videos, I sincerely believe it is much more dangerous to censor them and remove all access. #1) It makes it much more difficult to research and debunk (I had to sign up with achive.org to find the video and a transcript). And #2) It really buys into the conspiracy theory angle ... "See, it's a coverup," which as I described before really helps conspiracists entrench into their beliefs. I think censoring these videos gave them a lot more publicity, and ended up doing a lot more damage.
BTW, as much as I hate the existence of these videos, I sincerely believe it is much more dangerous to censor them and remove all access. #1) It makes it much more difficult to research and debunk (I had to sign up with achive.org to find the video and a transcript). And #2) It really buys into the conspiracy theory angle ... "See, it's a coverup," which as I described before really helps conspiracists entrench into their beliefs. I think censoring these videos gave them a lot more publicity, and ended up doing a lot more damage.
But enough about these doctors ... let's take a look at all these miracle cures and see how they're doing. None of these are outright bad, and they have their uses, but so far, nothing by itself has proved to be a miracle cure.
Hydroxychloroquine (HCQ): We'll start with the most popular miracle cure. I believe this one has gotten a lot of traction because Trump supported it and then complained about hospitals not using it.
HCQ used to be really good at treating malaria, but little by little, malaria is becoming more resistant to it. In fact, as Dr. Immanuel explains above, HCQ is her speciality for when she treated malaria in Nigeria. It would make sense that she, an HCQ expert, would be all over this as a cure for COVID19.
HCQ is also used to treat lupus and some types of arthritis. Major side effects include heart and vision problems.
At first, HCQ looked to be promising in fighting COVID19. A doctor in France published his results of using HCQ along with azithromycin (Z-Pak). Other studies used it with zinc, while others used all three. Some studies showed improvement, while others didn't.
In April, the FDA opened up HCQ for emergency use ... the idea being, "it doesn't hurt to try it ... we've got nothing else." And hospitals used it, despite the many reports from ultra-conservative outlets that it was not being used. As one of my frontline friends reported, it is good in treating cytokine storm.
Studies seem to say that if HCQ is effective, it's best used near the beginning of the sickness, and seems to have practically no benefit at all in the later stages.
Dr. Immanuel above reports that HCQ has been failing because doctors haven't been using it correctly -- that it has to be used early and in combination with zinc and azithromycin. But her claim (that doctors haven't been doing it) can't be further from the truth ... tens of thousands of doctors and scientists have tried all kinds of combinations of HCQ and other drugs. The idea of using it with zinc has been around for years. Some doctors had already done "as prescribed" since March, but not with as much success. When used in practice, doctors have reported disappointing results ... it helps, but not that much.
As of the end of June, the FDA has retracted the emergency use for COVID, citing that the benefits just don't outweigh the potential for side effects (heart and vision problems).
Budesonide (BUD): A Dr. Bartlett (also from Texas) has become famous for touting an asthma inhaler medicine as a cure for COVID19. On the surface it makes sense. The medicine opens up the lungs, and as a corticosteroid, may help fight against the virus.
Unlike HCQ, it has fewer long-lasting side-effects, so it's safer to use.
Dr. Bartlett claims that one of his clinics had 200 patients that tested positive and a 100% survival rate thanks to the BUD treatment. Sound familiar? Though, unlike Dr. Immanuel, this doctor is willing to share his results here. But just like before, the same problems arise: is he really following all 200 patients, and wouldn't most of them be mild cases anyway?
But ... oh, check out this report. One of his patients ended up in the hospital anyway ... it didn't work for him.
This study from May seems to say BUD neither helps nor harms COVID19 patients -- maybe it doesn't work so well in later stages of the disease. It also appears that the UK and Australian researchers are currently conducting studies in using BUD as an early treatment (as Dr. Bartlett prescribes).
As far as science is concerned, it's still premature to call this a silver bullet, but at least it's considerably safe to use. We'll have to watch this treatment more closely. I do not believe any restrictions are in place ... with the main concern (if any) being that if too many people use it, it could possibly result in a BUD shortage. Right now, I don't see any evidence that hospitals are using this treatment.
Dexamethasone (DEX): This is another corticosteroid with many uses and safer side effects if used for a short time. Long time use (like most corticosteroids) can have adverse effects and dependency issues, and is not good for pregnant women. Like the two other drugs above, this one is really cheap.
UK researchers discovered that DEX is very helpful in the latest stages of the disease. The WHO seems to be very supportive of this treatment, continues to encourage studies, and is looking to increase worldwide production. Hospitals in the US are already using this treatment, as advised by the NIH, but mostly for use in the later stages.
It still seems too early to get results from the hospitals as to the success of this treatment, but consider this: As part of the HCQ conspiracy theories floating about, one of the claims is that hospitals are preferring to use expensive treatments like Remdesivir, so as to help out their friends in Big Pharma. But this rising popularity in using cheaper drugs like DEX seems to spit on this idea.
In either case, I would not consider this a miracle cure, as it only seems to save the lives of one-third of severe cases. It's very impressive, but still allows for many deaths. Out of the three we've looked at so far, this seems to be the most promising. We need something better!
Remdesivir (REM): Now comes probably the most expensive drug for COVID19. This one costs about $2,500 for a 5-day supply. It's also in very short supply, so in the US it's reserved for only the most severe patients.
Side effects seem to include respiratory failure, blood disorders, and other fun ailments.
Its effectiveness is still under question. In April and May, it was thought that its benefits outweighed the risks. One study in May seemed to indicate it sped up hospitalization recoveries by four days. However, while REM seems to speed up recovery, DEX seems to be possibly better at saving lives.
I can't seem to find good data on whether hospitals prefer DEX or REM, but DEX is definitely much more affordable and available. Note that in both cases, these drugs aren't typically used until the end stages ... so if you are to benefit, you still have to go through a lot of pain to get that far. (So still sounding like sucky miracle cures.)
Antibody-Infused Blood Transfusions (also called convalescent plasma): This is another idea that's been floating around for months, though I have yet to see much traction. Though, I'm pleased to hear that it's been tried already 50,000 times. The idea is that the antibodies in plasma donated by people who have already recovered from COVID19 can help other people fight the disease more quickly.
Yesterday, as the article in the link above tells, President Trump is encouraging more people to donate plasma for this effort. Studies so far are inconclusive, but surely it's got to help to some degree. It'll be interesting to see if the press mocks Trump and if this method becomes a panacea. But you know what ... I don't think so, because HCQ really only became a panacea because of its poor performance. Also considering this is a Washington Post article actually showing Trump in a positive light, there may still be hope for the press.
T Cells: A friend of mine shared this very interesting article on T Cells, which are another form of immunity our bodies employ. Unlike antibodies that form to attack specific viruses and can die out quickly, T Cells can remember the protein surfaces of viruses for a much longer time. And it's possible that many of us already have a whole bunch of T Cells already primed to fight from earlier exposure to cold coronaviruses with similar protein surfaces.
It's very possible that a successful vaccine or even a cure can arise from T Cells instead of from antibodies. If any of these become a miracle cure, I'd say this one has the most promising prospects, but we still have a long ways to go to even understand what's going on.
Vaccine: we still have no vaccine, but US officials keep saying we may have one by the end of the year. There also seem to be different vaccines in the making. It'll be interesting to see what comes of it all. Which ones will be safe? Which ones will have microchips (just kidding!)? Which ones will be effective, and for how long?
Up to now, we still have no miracle cure, but we do have a whole slate of drugs to choose from. HCQ appears to be the least effective ... period. DEX is the most immediately promising cheap drug for late-stage life saving. BUD may ultimately prove to be effective in the very early stages. Plasma transfusions may start to show effectiveness. REM is very expensive and is starting to look not that great. T Cells may ultimately provide us with a miracle cure (not just for COVID19, but other viruses as well -- yeah, this is just me thinking this up -- I see some potential).
But wait ... there is one more miracle cure that has actually proven to work in many countries, especially in the highly successful countries of South Korea, Japan, New Zealand, and several others ... a cure so effective that it has practically eradicated most of the virus inside of their borders.
And this cure is called ...
DON'T CATCH IT.
Hydroxychloroquine (HCQ): We'll start with the most popular miracle cure. I believe this one has gotten a lot of traction because Trump supported it and then complained about hospitals not using it.
HCQ used to be really good at treating malaria, but little by little, malaria is becoming more resistant to it. In fact, as Dr. Immanuel explains above, HCQ is her speciality for when she treated malaria in Nigeria. It would make sense that she, an HCQ expert, would be all over this as a cure for COVID19.
HCQ is also used to treat lupus and some types of arthritis. Major side effects include heart and vision problems.
At first, HCQ looked to be promising in fighting COVID19. A doctor in France published his results of using HCQ along with azithromycin (Z-Pak). Other studies used it with zinc, while others used all three. Some studies showed improvement, while others didn't.
In April, the FDA opened up HCQ for emergency use ... the idea being, "it doesn't hurt to try it ... we've got nothing else." And hospitals used it, despite the many reports from ultra-conservative outlets that it was not being used. As one of my frontline friends reported, it is good in treating cytokine storm.
Studies seem to say that if HCQ is effective, it's best used near the beginning of the sickness, and seems to have practically no benefit at all in the later stages.
Dr. Immanuel above reports that HCQ has been failing because doctors haven't been using it correctly -- that it has to be used early and in combination with zinc and azithromycin. But her claim (that doctors haven't been doing it) can't be further from the truth ... tens of thousands of doctors and scientists have tried all kinds of combinations of HCQ and other drugs. The idea of using it with zinc has been around for years. Some doctors had already done "as prescribed" since March, but not with as much success. When used in practice, doctors have reported disappointing results ... it helps, but not that much.
As of the end of June, the FDA has retracted the emergency use for COVID, citing that the benefits just don't outweigh the potential for side effects (heart and vision problems).
Budesonide (BUD): A Dr. Bartlett (also from Texas) has become famous for touting an asthma inhaler medicine as a cure for COVID19. On the surface it makes sense. The medicine opens up the lungs, and as a corticosteroid, may help fight against the virus.
Unlike HCQ, it has fewer long-lasting side-effects, so it's safer to use.
Dr. Bartlett claims that one of his clinics had 200 patients that tested positive and a 100% survival rate thanks to the BUD treatment. Sound familiar? Though, unlike Dr. Immanuel, this doctor is willing to share his results here. But just like before, the same problems arise: is he really following all 200 patients, and wouldn't most of them be mild cases anyway?
But ... oh, check out this report. One of his patients ended up in the hospital anyway ... it didn't work for him.
This study from May seems to say BUD neither helps nor harms COVID19 patients -- maybe it doesn't work so well in later stages of the disease. It also appears that the UK and Australian researchers are currently conducting studies in using BUD as an early treatment (as Dr. Bartlett prescribes).
As far as science is concerned, it's still premature to call this a silver bullet, but at least it's considerably safe to use. We'll have to watch this treatment more closely. I do not believe any restrictions are in place ... with the main concern (if any) being that if too many people use it, it could possibly result in a BUD shortage. Right now, I don't see any evidence that hospitals are using this treatment.
Dexamethasone (DEX): This is another corticosteroid with many uses and safer side effects if used for a short time. Long time use (like most corticosteroids) can have adverse effects and dependency issues, and is not good for pregnant women. Like the two other drugs above, this one is really cheap.
UK researchers discovered that DEX is very helpful in the latest stages of the disease. The WHO seems to be very supportive of this treatment, continues to encourage studies, and is looking to increase worldwide production. Hospitals in the US are already using this treatment, as advised by the NIH, but mostly for use in the later stages.
It still seems too early to get results from the hospitals as to the success of this treatment, but consider this: As part of the HCQ conspiracy theories floating about, one of the claims is that hospitals are preferring to use expensive treatments like Remdesivir, so as to help out their friends in Big Pharma. But this rising popularity in using cheaper drugs like DEX seems to spit on this idea.
In either case, I would not consider this a miracle cure, as it only seems to save the lives of one-third of severe cases. It's very impressive, but still allows for many deaths. Out of the three we've looked at so far, this seems to be the most promising. We need something better!
Remdesivir (REM): Now comes probably the most expensive drug for COVID19. This one costs about $2,500 for a 5-day supply. It's also in very short supply, so in the US it's reserved for only the most severe patients.
Side effects seem to include respiratory failure, blood disorders, and other fun ailments.
Its effectiveness is still under question. In April and May, it was thought that its benefits outweighed the risks. One study in May seemed to indicate it sped up hospitalization recoveries by four days. However, while REM seems to speed up recovery, DEX seems to be possibly better at saving lives.
I can't seem to find good data on whether hospitals prefer DEX or REM, but DEX is definitely much more affordable and available. Note that in both cases, these drugs aren't typically used until the end stages ... so if you are to benefit, you still have to go through a lot of pain to get that far. (So still sounding like sucky miracle cures.)
Antibody-Infused Blood Transfusions (also called convalescent plasma): This is another idea that's been floating around for months, though I have yet to see much traction. Though, I'm pleased to hear that it's been tried already 50,000 times. The idea is that the antibodies in plasma donated by people who have already recovered from COVID19 can help other people fight the disease more quickly.
Yesterday, as the article in the link above tells, President Trump is encouraging more people to donate plasma for this effort. Studies so far are inconclusive, but surely it's got to help to some degree. It'll be interesting to see if the press mocks Trump and if this method becomes a panacea. But you know what ... I don't think so, because HCQ really only became a panacea because of its poor performance. Also considering this is a Washington Post article actually showing Trump in a positive light, there may still be hope for the press.
T Cells: A friend of mine shared this very interesting article on T Cells, which are another form of immunity our bodies employ. Unlike antibodies that form to attack specific viruses and can die out quickly, T Cells can remember the protein surfaces of viruses for a much longer time. And it's possible that many of us already have a whole bunch of T Cells already primed to fight from earlier exposure to cold coronaviruses with similar protein surfaces.
It's very possible that a successful vaccine or even a cure can arise from T Cells instead of from antibodies. If any of these become a miracle cure, I'd say this one has the most promising prospects, but we still have a long ways to go to even understand what's going on.
Vaccine: we still have no vaccine, but US officials keep saying we may have one by the end of the year. There also seem to be different vaccines in the making. It'll be interesting to see what comes of it all. Which ones will be safe? Which ones will have microchips (just kidding!)? Which ones will be effective, and for how long?
Up to now, we still have no miracle cure, but we do have a whole slate of drugs to choose from. HCQ appears to be the least effective ... period. DEX is the most immediately promising cheap drug for late-stage life saving. BUD may ultimately prove to be effective in the very early stages. Plasma transfusions may start to show effectiveness. REM is very expensive and is starting to look not that great. T Cells may ultimately provide us with a miracle cure (not just for COVID19, but other viruses as well -- yeah, this is just me thinking this up -- I see some potential).
But wait ... there is one more miracle cure that has actually proven to work in many countries, especially in the highly successful countries of South Korea, Japan, New Zealand, and several others ... a cure so effective that it has practically eradicated most of the virus inside of their borders.
And this cure is called ...
DON'T CATCH IT.
That's right ... with the trifecta of Masks, Effective Contact Tracing, and Testing, we can effectively destroy this virus ... even without the need of further lockdowns, and without the need of waiting further for other miracle cures.
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