This site presents selected references on cvirus research and evolving societal responses. It cites conflicting scenarios and hypotheses from competing mainstream and fringe sources, for questioning and study by specialists. Please review with a critical and discerning perspective as new information subsets and theories come to light.

WARNING: IN CASE OF AN EMERGENCY, DIAL YOUR LOCAL EMERGENCY TELEPHONE NUMBER. FOR MEDICAL ADVICE, CONSULT LOCAL HEALTHCARE PROFESSIONALS. Content on this website is only provided for informational purposes and is not a substitute for advice provided by a doctor or qualified healthcare professional. Patients should not use the information on this website for diagnosing a health condition, problem or disease. Patients should always consult with a doctor or other healthcare professional for medical advice or information about diagnosis and treatment.

Updated on May 19, 2020

Care Protocols

2020-04-20, Dr. Paul Marik, Eastern Virginia Medical School, COVID-19 Critical Care Protocol

It is essential to recognize that it is not the virus that is killing the patient, rather it is the patient’s overactive immune system. The flames of the “cytokine fire” are out of control and need to be extinguished. Providing supportive care (with ventilators that themselves stoke the fire) and waiting for the cytokine fire to burn itself out simply does not work… this approach has FAILED and has led to the death of tens of thousands of patients …

Our treatment protocol targeting these key pathologies has achieved near uniform success, if begun within 6 hours of a COVID19 patient presenting with shortness of breath or needing ≥ 4L/min of oxygen. If such early initiation of treatment could be systematically achieved, the need for mechanical ventilators and ICU beds will decrease dramatically…

It is likely that there will not be a single “magic bullet” to cure COVID-19. Rather, we should be using multiple drugs/interventions that have synergistic and overlapping biological effects that are safe, cheap and “readily” available. The impact of COVID-19 on middle- and low-income countries will be enormous; these countries will not be able to afford expensive designer molecules.

ICU Protocols: Stanford · Frontline COVID-19 Guide

2020-04-28, Dr. Joshua Farkas, Internet Book of Critical Care: COVID-19

2020-04-29, Dr. Ruth Ann Crystal, Coronavirus Tech Handbook for Doctors

2020-04-01, MD+CALC, COVID-19 Resource Center

2020-05-12, Dr. Salim R. Rezaie, REBEL EM (Rational Evidence Based Evaluation of Literature in Emergency Medicine)

This new outbreak has been producing lots of hysteria and false truths being spread, however the data surrounding the biology, epidemiology, and clinical characteristics are growing daily, making this a moving target. REBEL COVID-19 will serve as a summary of what is currently known, how to screen, when to test, and how to prevent spread, and any new data/information on COVID-19.

Patient Discussion

2020-03-20, Rop Gonggrijp & Vera Wilde, Covid At Home

We have to confront the possibility that some of the people who would normally be cared for under medical supervision might need to be cared for at home. We hope some of the information here will give you some confidence in dealing with this disease, which in and by itself will reduce the load on doctors and nurses.

2020-05-05, Dr. Su Fairchild, Dietary Supplements & Surviving Coronavirus

2020-03-28, James Kai, experience as NYC patient with advocacy lessons learned from Chinese doctors · NYT audio interview

(video) Dr. Roger Seheult, Medcram, Coronavirus: Updates, Spread, Symptoms & Treatment

(discussion) Reddit, COVID19positive

Virus Strains

2020-04-19, New Yorker, What Viral Evolution Can Teach Us About the Coronavirus Pandemic

The coronavirus tree has grown explosively, its tips splitting and branching as the virus continues to spread … Seattle’s outbreak is fuelled by several distinct branches, evidence that the virus has taken multiple paths from Wuhan to Washington State. Most cases … from … New York City … belong to a single branch whose closest relatives are in Europe, not China, suggesting that the virus crossed the Atlantic rather than the Pacific Ocean to arrive on the East Coast.

Primer.ai, News headlines and papers on Genomic & Genome Sequences

(preprint) 2020-04-17, Drexel University, Genetic tracing ‘barcode’ is rapidly revealing COVID–19’s journey and evolution

There are at least six to 10 slightly different versions of the virus infecting people in America, some of which are either the same as, or have subsequently evolved from, strains directly from Asia, while others are the same as those found in Europe.

(preprint) 2020-04-20, Zhejiang University, Patient-derived mutations impact pathogenicity of SARS-CoV-2: paper, article

… first hard evidence that mutation could affect how severely the virus caused disease or damage in its host … The deadliest mutations … had also been found in most patients across Europe, while the milder strains were the predominant varieties found in parts of the United States, such as Washington state … the most aggressive strains could generate 270 times as much viral load as the weakest type. These strains also killed the cells the fastest.

(commentary) 2020-04-21, Derek Lowe, Watching For Mutations in the Coronavirus

A single patient may have several mutational strains going at the same time as the virus replicates, and there’s been a report of a person who turned out to be infected simultaneously by two strains with different geographic origins.

(preprint) 2020-04-16, Oregon H&S University, Human leukocyte antigen susceptibility map for SARS-CoV2

To the best of our knowledge, this is the first study to evaluate per-allele viral proteome presentation across a wide range of HLA alleles using MHC-peptide binding affinity predictors … this is the first study to report global distributions of HLA types and haplotypes with potential epidemiological ramifications in the setting of the current pandemic …. We recommend integrating HLA testing into clinical trials … potentially to tailor future vaccination strategies to genotypically at-risk populations.

Risk Factors

2020-04-17, Science, How does coronavirus kill?

A snapshot of the fast-evolving understanding of how the virus attacks cells around the body, especially in the roughly 5% of patients who become critically ill. Despite the more than 1000 papers now spilling into journals and onto preprint servers every week, a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen. Without larger, prospective controlled studies that are only now being launched, scientists must pull information from small studies and case reports, often published at warp speed and not yet peer reviewed.

Glucose and Diabetes

2020-04-22, Adam Brufsky, Blood sugar levels may influence vulnerability to coronavirus, and controlling them through conventional means might be protective

People with SARS - which is related to the new coronavirus – seem to get high blood sugar temporarily when they get infected as well … a high blood sugar test called hemoglobin A1c – which can be used even in those without diabetes or prediabetes – could be used as a marker for patients at risk for COVID-19 disease … Hydroxychloroquine may work by blocking processes in the cell that add sugars to proteins. This the opposite of what high blood sugar seems to do. This would theoretically impede the virus from interacting with its receptor and modulate the inflammatory response to the virus.

2020-04-15, U of Pittsburgh, Hyperglycemia, Hydroxychloroquine, and the COVID‐19 Epidemic

Binding of ACE2 by SARS‐CoV‐2 in COVID‐19 also suggests that prolonged uncontrolled hyperglycemia, and not just a history of diabetes mellitus, may be important in the pathogenesis of the disease. It is tempting to consider that the same mechanism acts in COVID‐19 as in SARS, where an overactive macrophage M1 inflammatory response, as neutralizing antibodies to the SARS‐CoV‐ 2 spike protein form at day 7‐10, results in acute respiratory distress syndrome (ARDS) in susceptible patients.

2020-04-15, Wuhan University, Metabolic Mechanism of Cytokine Storms

The results show that “there is a connection [between] influenza virus infection, enhanced glucose metabolism and cytokine storm, all linked through O-GlcNAcylation of IFR-5,” … cytokine storms are also a common cause of death in COVID-19, and patients with metabolic disorders including diabetes seem to be more at risk of such severe complications … because inhibiting these factors prevented both cytokine production and viral replication, drugs against these molecules may suppress inflammation “without compromising host immunity and viral control”

(fringe investigative journalist, 60 days prior) 2020-01-25, Yoichi Shimatsu, Outbreak Analysis Part 2

Coronovirus gains energy from sugar (and starch) in your bloodstream, meaning ice-cream lovers and fruit snackers worldwide will be more vulnerable to invasive infection … avoid cookies, cakes, milkshakes, blueberries and bubble tea … This advice is not some joke, sugar deprivation is the key to survival in this contagion.

Kidney Damage

2020-04-18, NY Times, Dire need for Kidney Dialysis

Kidney specialists now estimate that 20 percent to 40 percent of I.C.U. patients with the coronavirus suffered kidney failure and needed emergency dialysis … One problem with peritoneal dialysis in the context of Covid is that it requires putting a catheter in a patient’s abdomen. That makes it difficult to use in those with failing lungs who need proning, a technique in which patients are rolled onto their stomach to help them take in oxygen. Some hospitals, including Montefiore, are placing the catheter toward the patient’s side to help with the problem.

Oxygen

2020-04-20, NY Times, The Infection That’s Silently Killing Coronavirus Patients

Patients did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal … Covid pneumonia initially causes a form of oxygen deprivation we call “silent hypoxia” … detecting … early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter … Patient positioning maneuvers (having patients lie on their stomach and sides) open up the lower and posterior lungs most affected in Covid pneumonia. Oxygenation and positioning helped patients breathe easier and seemed to prevent progression of the disease in many cases.

Blood Clots

2020-04-11, U of Bologna, Reason for coronavirus lethality is heart problem, not lungs

It is venous microthrombosis, not pneumonia that determines fatality.” said the doctor. He says that ventilation is of no use in such a situation but anti-inflammatory drugs.

2020-04-19, Business Insider, Blood clots are the latest life-threatening complication of the coronavirus

Dutch researchers looked at 184 patients in the intensive care unit with coronavirus. About a third of them had a complication associated with a clot, such as clots in the lungs, clots in the legs, stroke, heart attack, or other clots cutting off blood to other parts of the body … In early autopsy data from Northwell, there appear to be major clotting events like a massive heart attack or lung clots in 40% of patients who have died after leaving the hospital.

2020-05-06, UMC Hamburg-Eppendorf, Autopsy Findings and Venous Thromboembolism in Patients With COVID-19

The high incidence of thromboembolic events suggests an important role of COVID-19–induced coagulopathy. Further studies are needed to investigate the molecular mechanism and overall clinical incidence of COVID-19–related death, as well as possible therapeutic interventions to reduce it.

Non-Actionable Factors

Increased Severity

Reduced Severity

  • Smoking

Research

NIH LitCovid

A curated literature hub for tracking up-to-date scientific information about the 2019 novel Coronavirus. It is the most comprehensive resource on the subject.

Genome Sequencing Data, NextStrain (intro lecture, slides)

An open-source project to harness the scientific and public health potential of pathogen genome data. We provide a continually-updated view of publicly available data alongside powerful analytic and visualization tools for use by the community. Our goal is to aid epidemiological understanding and improve outbreak response.

Synthego, Everything You Need to Know about CRISPR-Cas9

CRISPR has enabled a simple and affordable way to manipulate and edit DNA, completely changing the face of genome engineering … Once scientists learned how the CRISPR system worked in bacteria, they figured out how to reprogram it to allow efficient editing in any species. This revolutionary breakthrough has completely changed the way science is performed, and it will soon change many aspects of our everyday lives.

Scientific Paper Analytics, Primer.ai

Quickly understand the scientific progress in the fight against COVID-19. Using the most advanced NLP algorithms, read summaries and discover trends in the latest research papers and the conversations around them.

Virus Similarity

M.tuberculosis

2020-03-10, Shenyang Chest Hospital, Active or latent tuberculosis increases susceptibility to COVID-19 and disease severity

Patients with active or latent TB were more susceptible to SARS-CoV-2, and COVID-19 symptom development and progression were more rapid and severe. Tuberculosis status should be assessed carefully at patient admission and management and therapeutic strategies adjusted accordingly to prevent rapid development of severe COVID-19 complications.

2012-07, Sharon Levy, The Evolution of Tuberculosis

TB killed more people in 2009 than in any previous year in history. Antibiotic-resistant strains of the disease are rapidly evolving. The World Health Organization estimates that a third of the people on Earth are infected with TB. Three million people die from the disease each year … The germ would coexist with its host for decades, only flaring into active disease when the person was weakened by hunger or old age … Because they were able to feed themselves, the Dakota remained healthy while neighboring tribes were ravaged by TB.

Primer.ai, News headlines and papers on BCG Vaccination Policy & Countries

(preprint) 2020-03-24, New York IT, 100-year-old BCG vaccine for TB

National differences in COVID-19 impact could be partially explained by the different national policies [with] respect to Bacillus Calmette-Guerin (BCG) childhood vaccination … countries without universal policies of BCG vaccination (Italy, Nederland, USA) have been more severely affected compared to countries with universal and long-standing BCG policies. Countries that have a late start of universal BCG policy (Iran, 1984) had high mortality, consistent with the idea that BCG protects the vaccinated elderly population. We also found that BCG vaccination also reduced the number of reported COVID-19 cases in a country.

2020-04-12, Madhukar Pai, McGill University, BCG Against Coronavirus: Less Hype And More Evidence, Please

As a TB researcher, I would be thrilled if BCG worked against COVID-19. But, these ecological studies have serious limitations … the good news is that rigorous trials are getting underway, to settle the issue, one way or another.

(fringe investigative journalist), Yoichi Shimatsu, TB vaccine may reduce initial symptoms but weaken immune system response to secondary infection   (related paper)

[2020-04-14, part 18] A strand of M. tb was spliced into the SARS-COV parent virus. This explains the partial efficacy of the antibodies from early childhood vaccines … The TB hijacks antibodies from the phagophage defenses of white blood corpuscles and then subverts them into an antigen, which attacks the phagophage, rendering the human immune system ineffective. The counterattack by “turncoat” antigens enables unhindered replication in host cells, which basically causes death from coronavirus infection of the organs.

[2020-02-20, part 9] M. tb interference prevents coordination between the lysosome (producer of white corpuscles) and its partner phagosome, which releases protein capsules to capture pathogens … Neutralization of the tandem phagosome and lysosome enables the attacking COVID-19 to generate swarms of new virions undisturbed, attach components to complete virus production, and dispatch the swarm to seek out other organs for infection that weaken the host patient.

HIV1

2020-02-27, Nankai University, Coronavirus far more likely than SARS to bond to human cells due to HIV-like mutation

Coronavirus has an HIV-like mutation that means its ability to bind with human cells could be up to 1,000 times as strong as the SARS virus, according to new research by scientists in China and Europe … The mutation could not be found in SARS, MERS or Bat-CoVRaTG13, a bat coronavirus that was considered the original source of the new coronavirus with 96 per cent similarity in genes … This could be “the reason why SARS-CoV-2 is more infectious than other coronaviruses”.

2020-04-16, Dr. Luc Montagnier, 2008 Nobel Prize winner, HIV sequence in Coronavirus?

… in order to insert an HIV sequence into this genome, molecular tools are needed, and that can only be done in a laboratory.

2016-08-08, Monash University, Gain-of-Function Research: Ethical Analysis

Gain-of-function (GOF) research involves experimentation that aims or is expected to (and/or, perhaps, actually does) increase the transmissibility and/or virulence of pathogens … Rather than drawing a sharp bright line between GOFR studies that are ethically acceptable and those that are ethically unacceptable, this framework is designed to indicate where any given study would fall on an ethical spectrum.

2011-09, UW Madison, Human Immunodeficiency Virus Rev-Binding Protein Is Essential for Influenza A Virus Replication and Promotes Genome Trafficking in Late-Stage Infection

We investigated the role of the cellular human immunodeficiency virus (HIV) Rev-binding protein (HRB) … Our results identify HRB as a second endosomal factor with a crucial role in influenza virus genome trafficking, suggest cooperation between unique endosomal compartments in the late steps of the influenza virus life cycle, and provide a common link between the cytoplasmic trafficking mechanisms of influenza virus and HIV … this is the first study to implicate a common cytoplasmic trafficking strategy for the genomes of these two viruses. Since influenza virus, unlike HIV, does not use the endosomal sorting complex required for transport (ESCRT) for new virion production (5, 34, 41), it will be interesting to delineate the point of divergence between the influenza virus and HIV genome trafficking mechanisms.

(withdrawn by gov) 2020-01-30, India IT, Uncanny similarity of unique inserts in the 2019-nCoV spike protein to HIV-1 gp120 and Gag

We found 4 insertions in the spike glycoprotein (S) which are unique to the 2019-nCoV and are not present in other coronaviruses. Importantly, amino acid residues in all the 4 inserts have identity or similarity to those in the HIV-1 gp120 or HIV-1 Gag. Interestingly, despite the inserts being discontinuous on the primary amino acid sequence, 3D-modelling of the 2019-nCoV suggests that they converge to constitute the receptor binding site. The finding of 4 unique inserts in the 2019-nCoV, all of which have identity/similarity to amino acid residues in key structural proteins of HIV-1 is unlikely to be fortuitous in nature.

(fringe investigative journalist) 2020-02-20, Yoichi Shimatsu

[Part 9] Since the HIV function of COVID-19 targets the blood capillaries around the sperm tubes in the testicles, why not try ion channel blockers? … A China-sourced medical paper based on autopsy reports (which the censors pulled offline) indicate damage to the testes and kidneys (in mature men).

[Part 10] This assault on the organs is due to an S (Switch) protein in coronavirus sequences, comprised mostly of proteases that target the T cells for capture, especially in immunodeficient patients. The heavily modified COVID-19 looks scary but it’s slow to respond and therefore vulnerable to a counterstrike aimed at the Switch protein. The basic strategy is to damage the “parasites”, those S proteins exploiting the T cells vulnerability and also propagating inside the T cells by re-engineering the T-cell genomics. Targeting the COV S protein will therefore stop COVID-19 in its tracks.

2020-02-04, U of Texas, HIV-1 did not contribute to the 2019-nCov genome

Our results demonstrated no evidence that the sequences of these four inserts are HIV-1 specific … How the three bat CoV viruses obtain those inserts remains unknown … Because the host cells for bat CoV viruses and HIV-1 are different, the chance for both to exchange genetic materials are negligible … extensive studies of more CoV viruses in wild and domestic animals are warranted.

2020-04-09, Washington Post, Among the most vulnerable to coronavirus: The tens of millions who carry HIV and tuberculosis

HIV and tuberculosis are present almost everywhere around the globe. Tuberculosis has spread in recurring pandemics for hundreds of years, killing at its peak in the 19th century an estimated quarter of Europe’s population. More than 1 million still die of tuberculosis each year. HIV reached pandemic stage in the 1980s and has killed at least 32 million people. Around 40 million people currently live with HIV.

H1N1 (1918 Spanish Flu)

2005-10-05, Nature, The 1918 flu virus is resurrected

It is thought to have killed 50 million people, and yet scientists have brought it back to life. In this issue of Nature, scientists publish an analysis of the full genome sequence of the 1918 human influenza virus … Some scientists have already hailed the work as giving unprecedented insight into the virus. Working out how it arose and why it was so deadly could help experts to spot the next pandemic strain and to design appropriate drugs and vaccines in time, they say. But others have raised concerns that the dangers of resurrecting the virus are just too great. One biosecurity expert told Nature that the risk that the recreated strain might escape is so high, it is almost a certainty.

Wikipedia, Influenza A virus subtype H1N1

The 1918 flu caused an unusual number of deaths, possibly due to it causing a cytokine storm in the body … The Spanish flu virus infected lung cells, leading to overstimulation of the immune system via release of cytokines into the lung tissue. This leads to extensive leukocyte migration towards the lungs, causing destruction of lung tissue and secretion of liquid into the organ. This makes it difficult for the patient to breathe.

2007-01-18, Nature, 1918 Flu Virus Limited The Immune System   (paper)

A Frankenstein version of the “Spanish flu” virus, assembled from parts in the laboratory … is possible because in 2005 American researchers successfully completed the laborious work of copying the 1918 virus’s genetic blueprint, or genome, using fragments of tissue from three victims of the pandemic. That permits scientists to synthesize the microbe using a process called “reverse genetics” … animals infected with the 1918 virus produced less interferon, a type of cytokine that suppresses virus growth by limiting the microbe’s ability to infect new cells. The virus continued to replicate and spread, reaching in one case 5,000 times the levels seen in the tissue of the monkeys infected with the modern virus … The virus is really a bad actor,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.

2019, CDC, The Deadliest Flu: The Complete Story of the Discovery and Reconstruction of the 1918 Pandemic Virus

For decades, the 1918 virus was lost to history … A small ocean-side village in Alaska called Brevig Mission would become … crucial to the 1918 virus’ eventual discovery … The grave was frozen in permafrost and left untouched until 1951. That year, Johan Hultin, a 25-year-old Swedish microbiologist and Ph.D. student at the University of Iowa, set out on an expedition to Brevig Mission in the hopes of finding the 1918 virus … It wouldn’t be until 46 years later, in 1997, that Hultin would have another opportunity to pursue the 1918 virus.

Therapeutic Candidates

2020-04-13, U of Texas, Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review

The COVID-19 pandemic represents the greatest global public health crisis of this generation and, potentially, since the pandemic influenza outbreak of 1918. The speed and volume of clinical trials launched to investigate potential therapies for COVID-19 highlight both the need and capability to produce high-quality evidence even in the middle of a pandemic. No therapies have been shown effective to date.

2020-05-06, ASHP, Assessment of Evidence for COVID-19-Related Treatments

2020-04-09, U of Liverpool, COVID-19 Drug Interactions

The Liverpool Drug Interaction Group (based at the University of Liverpool, UK), in collaboration with the University Hospital of Basel (Switzerland) and Radboud UMC (Netherlands), have produced various materials in PDF format to aid the use of experimental agents in the treatment of COVID-19.

US N.I.H. COVID-19 Treatment Guidelines

At present, no drug has been proven to be safe and effective for treating COVID-19. There are no Food and Drug Administration (FDA)-approved drugs specifically to treat patients with COVID-19… treatment decisions ultimately reside with the patient and their health care provider.

Convalescent Plasma

2020-04-30, Rita Rubin, Testing an Old Therapy Against a New Disease: Convalescent Plasma for COVID-19

Taken from healthy people … who have recovered from the infectious disease of interest, antibody-rich convalescent plasma is thought to give recipients’ immune systems a running start … donors must be symptom-free for at least 28 days, or, alternatively, for at least 14 days if they get a negative PCR test for SARS-CoV-2, indicating that they are no longer infectious … convalescent plasma seems more effective if it’s given earlier in the course of the disease.

For now—and possibly the next 18 to 24 months … convalescent plasma, despite supply issues and questions about efficacy and who is most likely to benefit from treatment, remains the only off-the-shelf therapy for COVID-19.

Hydroxychloroquine and Zinc

2020-04-07, Dr. Vladimir Zelenko, Letter to Pres. Trump

It is essential to start treatment against Covid-19 immediately upon clinical diagnosis of the infection and not to wait for confirmatory testing. There is a very narrow window of opportunity to eliminate the virus before pulmonary complications begin. Delaying treatment is the essence of the problem. My treatment regime is listed below and please know that as of today it has saved 383 patients without complications or negative side effects.

2020-05-18, Wall Street Journal, President Trump Says He Is Taking Hydroxychloroquine as Preventive

… we concluded the potential benefit from treatment outweighed the relative risks,” said Dr. Conley, who is a Navy commander. A White House official said Dr. Conley prescribed the drug to Mr. Trump and that he took it in response to a potential exposure … Mr. Trump said he also took one dose of the antibiotic azithromycin and is regularly taking zinc.

2020-05-18, Prof. Dolores Cahill, Niall Boylan Interview

In March, 20,000 doctors in 30 countries, when asked what treatment they were using based on their clinical judgement, said that HCQ was the most effective … <audio seek> … you only need one tablet of HCQ, plus zinc, and you can engage fully in the world, and it will stay in your body for three weeks … India gave the Zelenko HCQ protocol to all frontline workers and not one healthcare worker died … HCQ 200mg starts working within three hours.

2020-04-21, Dr. James Todaro, A compilation of evidence on hydroxychloroquine and azithromycin in treatment of COVID-19

I’ve been asked by physicians to compile and summarize the available evidence in support and opposition of hydroxychloroquine and azithromycin in treatment and prophylaxis of COVID-19. Given the nature of this rapidly spreading pandemic, some of this evidence is anecdotal or expert opinion.

2020-05-02, Dr. Wolfgang Wodarg, Covid-19: a case for medical detectives

glucose-6-dehydrogenase deficiency, or “G6PD deficiency” … common among ethnic groups living in areas with malaria. The modified G6PD gene … makes its carriers resistant to malaria pathogens … One of the substances that is called very dangerous in all forms of this enzyme deficiency is the anti-malarial drug hydroxychloroquine (HCQ) … This connection applies not only to Africa, but also to large parts of Asia, South and Central America, Arabia and the Mediterranean region … A PCR test result leading to the prophylactic prescription of HCQ is sufficient to cause severe disease in up to one third of the people from high-risk populations treated in this way.

(case report) 2020-04-23, Geneva University, Treatment with HCQ caused severe haemolysis crisis in patient with G6PD deficiency

We report here the first case of severe haemolytic crisis in a patient with G6PD deficiency, initiated by severe COVID‐19 infection and hydroxychloroquine use … G6PD deficiency is the most common red cell enzymatic deficiency … especially in sub‐Saharan Africa or in countries with a high proportion of African descendants

2020-03-29, Ibrahima Gueye, Hypomagnesemia, G6PD deficiency and COVID 19 serious cases

The three most frequent variants are the A— type in black people, the Mediterranean type with more severe clinical features, and the Canton type in Asians.

(non-doctor) 2020-03-20, @Barton_options

HCQ/Zithromax combo requires careful dosing with the help of a well-informed physician. It is well established that HCQ/Zithromax both increase QT interval, and can be very dangerous for people with existing long QT interval … HCQ suppresses B-cell activity, even at low doses. Meaning lower antibody production, and slower viral clearance … HCQ has such a long half life in human body (weeks) that it might even increase the severity of COVID19 reinfection in a recovered patient, since IgG production can be suppressed. Overall, HCQ/CQ is complicated and requires meticulous care that overwhelmed doctors may not have … see Drugs that prolong QT

(response to contested paper) 2020-04-22, Dr. Didier Raoult

Control group was treated with azithromycin. Nearly dying patients with lymphopenia were treated with hydroxychloroquine.

(response to contested paper) 2020-04-22, Dr. Didier Raoult, Combination of hydroxychloroquine plus azithromycin as potential treatment for COVID 19 patients: pharmacology, safety profile, drug interactions and management of toxicity

Ongoing clinical trials are challenging the efficacy of this combination, many clinicians claim the authorization to— or have already begun to use it to— treat COVID-19 patients worldwide. The aim of this article is to share pharmacology considerations contributing to the rationale of this combination, and to provide safety information in order to prevent toxicity and drug-drug interactions, based on available evidence.

… our cohort of 1061 COVID-19 patients, treated at least three days with the hydroxychloroquine-azithromycin combination … good clinical outcomes with virological cure obtained for 91.7% of the patients, and with prolonged viral carriage at completion of the treatment for 4.4% of them. Poor clinical outcomes were described for 4.3% of the patients, including five death (0.5%). These observations suggest that the combination is safe and may avoid worsening, virus persistence and subsequent contagiosity.

Ivermectin

2020-04-13, NBC Miami, Local Doctor Tries New Coronavirus Drug Treatment

Dr. Rajter started adding Ivermectin to the cocktail of drugs currently used to treat COVID-19: hydroxychloraquine, azithromycin, and zinc sulfate … More studies need to be conducted,” Dr. Cepelowicz-Rajter said. “We haven’t had any ill effects from it and it’s readily available, we have some patients who are pretty advanced, not yet intubated, and even those, in 12 hours, they showed a significant improvement.”

2020-04-06, Monash University, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro

Ivermectin, an FDA-approved anti-parasitic previously shown to have broad-spectrum anti-viral activity in vitro, is an inhibitor of the causative virus (SARS-CoV-2), with a single addition to Vero-hSLAM cells 2h post infection with SARS-CoV-2 able to effect ~5000-fold reduction in viral RNA at 48h. Ivermectin therefore warrants further investigation for possible benefits in humans.

2020-04-13, Dr. JJ Raiter, Ivermectin Updates

I have used Ivermectin now on multiple carefully selected patients with a 100% response rate within 48 hours. Avoided intubation at all cost even if requiring 100% FiO2. All of them have improved. The earliest patients in the series are now on 2LPM nasal cannula and afebrile. No side effects noted … Dosing is 0.2 mg/kg PO single dose … protocols were approved across the 4 hospitals in my hospital system without restrictions.

Auranofin

2020-04-16, Atlanta Magazine, GSU uncovers promising treatment for COVID-19

Auranofin is a compound that contains gold and has been used since 1985 to treat rheumatoid arthritis (although it has been largely replaced by newer drugs). In tests in his high-level biosafety lab, Kumar and his colleagues found auranofin reduced the amount of coronavirus in infected cells by 95 percent just 48 hours after they were treated with one dose. The drug also dramatically lowered the release of cytokines, proteins that send signals to the body’s immune system, summoning a response to an infection.

2009-05, Johnson & Johnson, Gold and nano-gold in medicine: Overview, toxicology and perspectives

Gold has been used for the treatment of RA for several years. The cause of RA is still unknown and autoimmunity plays a pivotal role in its chronicity and progression … Auranofin (AF) is the name of an effective gold compound which has been used for the treatment of rheumatoid arthritis. The exact mechanism of action is still unknown, but it probably acts via immunological mechanisms and the alteration of lysosomal enzyme activity.

2020-04-14, Georgia State University, FDA-approved gold drug Auranofin inhibits novel coronavirus (SARS-COV-2) replication and attenuates inflammation in human cells

Treatment of cells with auranofin resulted in a 95% reduction in the viral RNA at 48 hours after infection. Auranofin treatment dramatically reduced the expression of SARS-COV-2-induced cytokines in human cells. These data indicate that auranofin could be a useful drug to limit SARS-CoV-2 infection and associated lung injury due to its anti-viral, anti- inflammatory and anti-ROS properties. Auranofin has a well-known toxicity profile and is considered safe for human use.

2020-04, CSHL/Northwell, Neutrophil extracellular traps (NETs): Are overactive immune cells causing COVID-19 related deaths?

11 medical research groups around the world have formed a consortium called the NETwork to investigate the potential role of NETs in the most severe cases … NETs are also found to occur in patients with cancer or sepsis (the occurrence of infection in the bloodstream and seeding to multiple organs), conditions which are also associated with the presence of these microthrombi or small blood clots … Autoimmune diseases like RA could be the result of exposure of histone complexes outside the cell, stimulating antibody production. They also play a role in abnormal clot formation and are linked to the occurrence of stroke.

(fringe investigative journalist) 2020-03-20, Yoichi Shimatsu, nano-gold therapeutic

At the micro-scale of 10 nanometers up to 40 nm, ions of gold have strong bonding capability along with powerful electrical properties. Inside your bloodstream, charged ions of gold-salt can organize bits of proteins into structures called ligands, especially when augmented with a target-detecting monoclonal antibody. The ligand can attract and take control over message-conveying proteins called cytokines. The exchange of signals with the cytokines enables the gold ligands to hunt down specific pathogens … in the battle against hepatitis, the ligand organizes teams of cytokines to rally antibodies against that infectious virus.

Gold ligands, in brief, are the magic bullet against the m.tuberculosis and HIV strands in COVID-19, along with the vulnerable Spike proteins jutting out of its membrane. Once the ligand reaches a cluster of viruses, the gold nano-particle captures the RNA strands of viruses, pinning these to its surface with polyvalent or multiple bonds. This counterattack is launched during the virus replication process when exposing its single-strand RNA or, alternatively, as a double-strand during transcription (producing a copy of itself). The capture process is completed with “passivation” though addition of ethylene glycol and alkyl-thiol molecules, which “root” the viruses preventing their escape. For 2-dimensional visual representation purposes, the gold orb resembles an axle while the RNA strands stick out like spokes of a wheel.

Vitamin D

(preprint) 2020-04-08, Northwestern University, The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients

Vit D … may boost the innate immune system and suppress the adaptive immune system, thus lowering cytokine levels … may help avoid potential complications in elderly and African-American patients as these individuals are more likely to experience a severe Vit D deficiency … Further research is needed to account for other factors through direct measurement of Vit D levels.

2020-05-12, Nature, Perspective: improving vitamin D status in the management of COVID-19

Considering the range of beneficial effects ascribed to vitamin D, it is safety and ease of administration, as well as direct effects of vitamin D on immune cell proliferation and activity, pulmonary ACE2 expression and reducing surface tension, evaluation of vitamin D supplementation as an adjuvant therapeutic intervention could be of substantial clinical and economic significance.

In summary, given the high prevalence of vitamin D deficiency and in order to rapidly, safely, and significantly raise serum concentrations, high-dose vitamin D intervention with potential benefit in decreasing risk of COVID-19 severity and mortality is suggested, which is a safe and noninvasive treatment.

2020-04-19, FoundMyFitness, Vitamin D may reduce susceptibility to COVID-19-associated lung injury

Philippines: for each standard deviation increase in serum vitamin D people were 7.94 times more likely to have a mild rather than severe COVID-19 outcome and were 19.61 times more likely to have a mild rather than critical outcome … New Orleans: 84.6% of COVID-19 patients had vitamin D deficiency compared to 4% of patients not in ICU … Indonesia: 98.9% of patients with vitamin D deficiency died - 88% of patients with vitamin D insufficiency died - 4% of patients with sufficient vitamin D died.

Since vitamin D insufficiency is widespread (and perhaps exacerbated in quarantine conditions, due to limited sunlight exposure), supplemental vitamin D might be a viable means to increase vitamin D to sufficient levels. Maintaining a healthy vitamin D status, an imminently solvable but often ignored problem, may turn out to be an important factor in protecting against susceptibility to lung injury in COVID-19.

Testing and Data Accuracy

2020-04-18, Nature, Will antibody tests for the coronavirus really change everything?

Many tests available now are not accurate enough at identifying people who have had the disease, a property called test sensitivity, and those who haven’t been infected, known as test specificity. A high-quality test should achieve 99% or more sensitivity and specificity … But some commercial antibody tests have recorded specificities as low as 40% early in the infection … . It took several years to develop antibody tests for HIV with more than 99% specificity.

2020-04-23, David Crowe, Risk of False Positives: Flaws in Coronavirus Pandemic Theory

33 RT-PCR tests for COVID-19 approved under US FDA Emergency Use Authorizations … look for a variety of different segments (‘genes’) of the presumed COVID-19 genome, that only amounts to about 1% or less of the total genome, which is about 30,000 bases … Some tests look for only one, so it must be present for a positive. But tests that look for two segments are split between those that require both to be present and those that require either one for a positive. Some tests look for three segments but only require any two to be present, while one test insisted on all three. Tests that allow a segment to be undetected raise the question of how it can be said that a virus was detected when an important part of it was missing.

2020-04, Andreesen Horowitz, How Do We Test for Coronavirus?

The FDA has issued EUA for two rapid qRT-PCR tests, the first is called Xpert Xpress SARS-CoV-2 from Cepheid and the second is called ID Now COVID-19 from Abbott.

2020-04-17, Dr. Shahriar Zehtabchi, Risk of False Negatives: Evidence Bites

What Is The True Accuracy of The Swab (RNA-PCR) Test? The Reverse Transcriptase-Polymerase Chain Reaction test is flawed. When the test finds SARS-CoV-2 it is overwhelmingly correct, but it often misses the virus that is present … an approach that employs CT scanning (emulating the Chinese technique) may be required to control the US epidemic in the long run.

(preprint) 2020-03-26, Sun Yat-sen University, Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19.

In addition to the emphasis on RT‐PCR testing, clinical indicators such as computed tomography images should also be used not only for diagnosis and treatment but also for isolation, recovery/discharge, and transferring … urgent needs for the standard of procedures of sampling from different anatomic sites, sample transportation, optimization of RT‐PCR, serology diagnosis/screening for SARS‐CoV‐2 infection, and distinct diagnosis from other respiratory diseases such as influenza infections.

2020-04-22, IEEE Spectrum, Portable Ultrasound Proves a Potent Weapon in the Fight Against COVID-19

Ultrasound is playing an indispensable role in the diagnosis, treatment and efficacy evaluation of severe acute pneumonia … hospitals are relying not on their biggest, most sophisticated systems—stationary or cart-based machines that can cost between US $50,000 and $100,000—but rather on handheld, pocketable systems that cost a tenth as much or less.

1994-07, Celia Farber, Interview with Kary Mullis, inventor of PCR

Mullis’s invention of the polymerase chain reaction (PCR) won him the Nobel Prize in Chemistry in 1993. PCR is a remarkably simple yet revolutionary method of selectively multiplying and mass-producing specific DNA segments.

2020-04-23, CovidTracking.com, US State Grading System

Many states will see their grades drop significantly in the new system. This does not reflect a drop in the quality of their reporting, but the addition of more—and more exacting—requirements. States that experience grade drops may be meeting basic requirements for reporting testing data, but not reporting demographic data, or breaking down hospitalization numbers. When this data becomes available, we will update the assigned grade accordingly.

Economics and Incentives

2020-04-23, David Crowe, Flaws in Coronavirus Pandemic Theory

It is generally believed that any surplus deaths seen since February could only have been caused by COVID-19, but there are actually several ways in which our panic could have caused death … coronavirus positive patients who die are generally older and sicker than the general population. This means that they are less able to withstand aggressive treatment … Both intubation and drug treatments have side effects that can be fatal … The use of powerful drugs because doctors are convinced that they have a particularly potent virus on their hands, especially in older people, with pre-existing health conditions, is likely to lead to many deaths.

2019-05-03, Budapest University, Two-Sided Information Asymmetry in the Healthcare Industry

Physicians are still regarded as omnipotent white magicians by most of the Central European people because of asymmetric information between them … if there is two-sided information asymmetry between the transacting parties at different levels (i.e. the low level of trust between the transacting parties), then the incentivization system between the service providers and the buyers, (i.e., the hospital or the government agencies) turns out to be a perverse one … it punishes the efficient doctor or medical unit, while it extends rewards to the inefficient one. An adverse effect of these changes was that a large number of health care professionals became fed up with their deteriorating working conditions. These employees left the health care sector.

2020-04-21, Swiss Propaganda Research, Facts about Covid-19

Fully referenced facts about Covid-19, provided by experts in the field, to help our readers make a realistic risk assessment … the old and proven propaganda rule applies again: the less is known, the more is speculated.
“The only means to fight the plague is honesty.” —Albert Camus, The Plague (1947)

2020-05-02, Dr. Matt Strauss, Queens University, The underground doctors’ movement questioning the use of ventilators

Every clear-eyed critical care doctor will admit that we sometimes ventilate people more out of wishful-thinking, desperation, or fear of lawsuit, than scientifically-based hope for recovery … Patients who would have been intubated one month ago are now staying in the emergency room or the medical ward with high-flow supplemental oxygen … This is completely uncharted territory for modern medicine. I cannot think of a time when entrenched practice had changed in such a short period, on such a fundamental question as when to use life support, without authoritative academic papers being published on the subject.

2020-05-07, Nature, Autopsy slowdown hinders quest to determine how coronavirus kills

The need arose to understand how the disease affects the various organs,” Gianatti says. “And the most effective way was performing autopsy” … Strained health-care systems, lockdowns and safety requirements have hampered efforts to collect tissue from patients that is crucial to research.

Contagion

Are there innate limits on coronavirus diffusion?

(not peer reviewed) 2020-04-15, Tel-Aviv University, Virus Follows Fixed Pattern

“Is the coronavirus expansion exponential? The answer by the numbers is simple: no. Expansion begins exponentially but fades quickly after about eight weeks,” Professor Yitzhak Ben Israel concluded. The reason why coronavirus follows a fixed pattern is yet unknown. “I have no explanation,” he told Mako, “There are kinds of speculation: maybe it’s climate-related, maybe the virus has its own life cycle.”

(preprint), 2020-04-27, University of Strathclyde, Glasgow, Individual variation in susceptibility of exposure to SARS-CoV-2 lowers the herd immunity threshold

As SARS-CoV-2 spreads, the susceptible subpopulation is depleted, causing the incidence of new cases to decline. Variation in individual susceptibility or exposure to infection exacerbates this effect. Individuals that are more susceptible or more exposed tend to be infected earlier, depleting the susceptible subpopulation of those who are at higher risk of infection. This selective depletion of susceptibles intensifies the deceleration in incidence. Eventually, susceptible numbers become low enough to prevent epidemic growth or, in other words, the herd immunity threshold (HIT) is reached.

(news article) 2020-04-19, Prof. Ian Frazer (HPV vaccine co-inventor), No vaccine for coronavirus a possibility

2003 SARS … had diluted potency as it went from host to host. “As it passed from animal to the first human and then through the second human, as it passed through every human it got a little less good at infecting people,” he said. “The virus attenuated itself; it got less powerful. It may well be the same with this virus. It’s not very effective in making us sick. It may become less effective. We are now mapping it as it goes and changes are occurring in its genetic make-up, small changes. Changes to it in China led to the virus becoming less virulent or sick-making.”

(disclaimed by France) 2020-04-16, Dr. Luc Montagnier (2008 Nobel Prize winner), HIV sequence in Coronavirus?

… the altered elements of this virus are eliminated as it spreads: “Nature does not accept any molecular tinkering, it will eliminate these unnatural changes and even if nothing is done, things will get better, but unfortunately after many deaths.”

(fringe investigative journalist) 2020-04-14, Yoichi Shimatsu, Outbreak Analysis Part 18

There are a lot of steps involved that can easily go wrong, resulting in incompatible or faulty RNA variants, which cannot carry the conversion process over to the next stage. That’s what accounts for the presence of HIV and m.TB inserts in the bio-engineered SARS coronavirus of the Hong Kong 2002-03 outbreak, those added components enabling “brute force” short-cuts, which is not possible with a naturally mutated variant. Indeed, exponential replication cannot last for long with these added-on structures, and so the COVID-19 pandemic will soon crash to a halt.

(preprint) 2020-05-01, Arizona State University, New mutation indicates that coronavirus might be weakening   (paper)

A mutation in the novel coronavirus mirrors a change that occurred in the genetically similar SARS virus in 2003 — indicating that the bug might be weakening … a single sample was missing a significant chunk of its genome. Eighty-one of the letters were permanently deleted … it mirrors a large deletion that arose in the 2003 SARS outbreak … Where the deletion occurs in the genome is pretty meaningful because it’s a known immune protein which means it counteracts the host’s antiviral response.

Immunity and Antibodies

2020-04-18, Business Insider, Coronavirus antibodies can’t guarantee long-term immunity

The World Health Organization warned that coronavirus antibodies can’t guarantee long-term COVID-19 immunity for recovered patients or former asymptomatic carriers … hospital workers had noticed a concerning trend of repeat patients who often require more intensive care than they did during their initial treatment.

2020-04-17, WSJ, South Korea Recovered Patients Test Positive Again

More than 160 South Koreans have tested positive a second time for the coronavirus, a development that suggests the disease may have a longer shelf life than expected.

2020-05-19, Forbes, South Korea Says Patients Who Retested Positive After Recovering Were No Longer Infectious

KCDC announced that it had studied 400 recovered Covid-19 patients, 285 of whom retested positive for the virus after they recovered; the KCDC then traced the close contacts of those individuals and found zero new cases of infection among 790 close contacts … The recovered patients retested positive because the test, known as a diagnostic polymerase chain reaction (PCR) test, falsely identified dead viral matter as active Covid-19 infection …

2020-04-18, Shanghai PHCC, Missing COVID-19 antibodies suggest mystery immune response

Many of the [mild disease] participants had high levels of [SARS-COV-2-specific] neutralizing antibodies (NAbs) … However, 30% did not have high levels of these antibodies, suggesting that other antibodies and immune factors contributed to their recovery … For ten patients, NAbs were not detectable at all, indicating that other immune system factors such as cytokines or T cells may have contributed to recovery.

(fringe investigative journalist) 2020-04-14, Yoichi Shimatsu, TB vaccine may reduce initial symptoms but weaken immune system response to secondary infection

… weak initial infection and a quick “recovery” due to the vax-promoted antibody attack that resists the CoV’s TB segment, but then succumbs to a “second infection”. It’s actually a relapse due to the viral infection’s comeback against fewer antibodies remaining after the initial bout. This situation is much worsened by the fact that the TB segment had already converted antibodies into antigens in such huge numbers to trigger alarms in the phagophages from the white blood corpuscles, which then erroneously assume that all such antibodies are attackers.

Virus Shedding

2020-05-10, OC Register, Sweden’s controversial approach to the coronavirus pandemic

Wearing masks in public is not mandatory … there are two main reasons why Sweden has not required citizens to wear masks … the science behind it is murky — everyone just points to one “very theoretical” study in Hong Kong. In his opinion, there are no studies that clearly show masks are effective when worn in public. Secondly … the Swedish government does not want sick people to go out in public. He is concerned sick people might be more inclined to go out if masks are encouraged.

2020-04-03, University of Hong Kong, Respiratory virus shedding in exhaled breath and efficacy of face masks

… Among the samples collected without a face mask, we found that the majority of participants with influenza virus and coronavirus infection did not shed detectable virus in respiratory droplets or aerosols … For those who did shed virus in respiratory droplets and aerosols, viral load in both tended to be low. Given the high collection efficiency of the G-II and given that each exhaled breath collection was conducted for 30 minutes, this might imply that prolonged close contact would be required for transmission to occur …

2020-04, OCLA, Masks Don’t Work: a review of science relevant to COVID-19 social policy

RCT studies … show that masks and respirators do not work to prevent respiratory influenza-like illnesses, or respiratory illnesses believed to be transmitted by droplets and aerosol particles … It would be a paradox if masks and respirators worked … The main transmission path is long-residence-time aerosol particles (< 2.5 μm), which are too fine to be blocked, and the minimum-infective-dose is smaller than one aerosol particle. The present paper about masks illustrates the degree to which governments, the mainstream media, and institutional propagandists can decide to operate in a science vacuum, or select only incomplete science that serves their interests.

2020-04-25, Detlev Kruger, Charité Berlin, Interview

… the wearing of “mouth-nose protection” discovered by politics is actionism. It should be clear that you cannot protect yourself because you continue to breathe the ambient air unfiltered. There is only a certain effect here if you are infected yourself and are therefore a virus eliminator. The “mouth-nose protection” pretends a security that does not exist and it is more of a “spinner” for various pathogens when it becomes dirty.

Otherwise, we’ve been living with respiratory infections all our lives. We all know how to protect ourselves from this: do not sneeze and cough, do not share the same air with infected people in a poorly ventilated room, wash your hands - all the basic hygiene rules that should have already passed into flesh and blood.

Airborne Transmission

News & Papers: Primer.aiNIH LitCovid

2018-04-01, Columbia University, UV Sterilization: Far-UVC light kills airborne flu viruses without danger to humans

Far-UVC at 222 nm inactivates more than 95% of airborne aerosolized H1N1 influenza viruses at a low dose of 2 mJ/cm2. Because light at wavelengths from 207 to 222 nm are completely absorbed by the dead outer layer of skin and by the outer tear layer of the eye, these wavelengths are safe for humans … continuous very low-dose-rate far-UVC light could be integrated into overhead lamps for hospitals, schools, airports, and so on—potentially drastically reducing influenza. As a bonus, far-UVC light could prevent the spread of airborne microbial diseases such as tuberculosis.

What is the origin of “Social Distancing”?

2020-05-15, Jeffrey A. Tucker, AIER, The 2006 Origins of the Lockdown Idea

So far as anyone can tell, the intellectual machinery that made this mess was invented 14 years ago, and not by epidemiologists but by computer-simulation modelers. It was adopted not by experienced doctors – they warned ferociously against it – but by politicians … Thus did some of the most highly trained and experienced experts on epidemics warn with biting rhetoric against everything that the advocates of lockdown proposed … the idea was born of a high-school science experiment using agent-based modelling techniques having nothing at all to do with real life, real science, or real medicine.

Infection Surveillance & Contact Tracing

(editorial) 2020-04-29, Nature, Show evidence that apps for COVID-19 contact-tracing are secure and effective

Researchers and policymakers have worked hard over many decades to ensure that medicines, vaccines and health-care products conform to agreed standards of safety and efficacy. These often need to be global standards. COVID-19 smartphone apps are a health-care intervention, too, and will potentially affect hundreds of millions of lives. But they are being rolled out without pilot studies or risk assessments being published. It’s not that digital contact tracing shouldn’t be done, but it should not be a substitute for human contact-tracing teams; nor should it be seen as a replacement for necessary COVID-19 testing.

(editorial) 2020-05-03, Charles Hoskinson, A Quick Question

These five entities, Costco, Amazon, Walmart, Target, Kroger, and so forth, having millions of people going to work every day, interacting with millions of people every day, and yet, somehow, we don’t have massive coffins outside of these stores … Why are we not taking a statistically significant subset of these people on a regular basis – every two weeks, four weeks – and testing them to see if they’ve been infected or are already infected — they have antibodies? … Isn’t the goal to reopen the country, and we’re trying to understand what’s going to happen when we reopen?

2020-04-23, David Crowe, Flaws in Coronavirus Pandemic Theory

It is impossible, in most cases, to prove that someone did have contact with another COVID-19 case … In the best case it will be possible to show that someone was in the vicinity of someone who tested positive earlier, but that does not constitute proof that they were exposed to the virus, let alone that it was that person who infected them.

2020-04-12, Ross Anderson, Cambridge University, Contact Tracing in the Real World

I suspect the tracing apps are really just do-something-itis … Our effort should go into expanding testing … must not give policymakers the false hope that techno-magic might let them avoid the hard decisions.

2020-04-19, Jaap-Henk Hoepman, University of Groningen, Google Apple Contact Tracing (GACT): a wolf in sheep’s clothes

Decentralised contact tracing is preferred over centralised solutions because it better protects our privacy. Unfortunately embedding it in the operating system, as proposed by Google and Apple, does not make centralised solutions impossible … We have to trust Apple and Google to diligently perform this strict vetting of apps, to resist any coercion by governments, and to withstand the temptation of commercial exploitation of the data under their control. Remember: the data is collected by the operating system, whether we have an app installed or not. This is an awful amount of trust…

Statistics

(editorial) 2020-04-22, Madhukar Pai, McGill University, A Skeptic’s Guide to Ecologic Studies During A Pandemic

If you torture the data long enough, you can come up with an infinite number of correlations linking all sorts of factors with the ongoing coronavirus pandemic.

Ecologic studies are simple and so can be very appealing to people who aren’t well versed in epidemiology because they tell simple stories that are easy to understand. For example, “countries where people always wear masks in public have smaller COVID-19 outbreaks than those where people do not” is a simple narrative that gives people hope that there is an intervention that we can control at a time when so many things feel out of control and hard to understand.

The public needs to remember that science is a process not a set of facts and any one study alone cannot provide us with the true answer … ignorance is always dangerous, but we often are forced to make decisions under conditions of ignorance. The best thing is to be attentive to our blind-spots, and think hard about potential alternate explanations, and the potential consequences if we are mistaken.

We Hold These Truths …


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Updated on May 19, 2020