What is being done to check whether rats in L.A. are spreading the disease? Research has shown Rat ACE2 is 20% effective as a Sars-Cov-2 receptor. Even if the rats are not infected they could be transmitting virus via contact of surfaces with fur and feet. If LA homes are infested with rats that are spreading diseases, how does that impact the effectiveness of shelter in place orders? Same question for New York City, Boston, Detroit, Chicago, New Orleans and other rat infested hot spots.
Wonderful. Thank you for taking the time to share. It is so hard to find evidence-based information updates.. it’s hard to find anything outside of major news networks (or I just don’t know where to look). Thank you!
So, this is just a hypothesis but I am thinking that this kind of thing is happening in adults but just tacking right on to the end of the disease period itself. It seems like there's a pattern of the first few days or maybe a week being not that bad for most people but then everyone starts showing up at the hospital after that because they take a turn for the worst. I got sick with this thing but it was really weird the first week because I was just barely noticeably sick. My temperature went all the way up to around 100 F, which is ridiculously high for me since I commonly run 97.6, so I knew I was sick. I took my temperature before bed so I fully expected to wake up feeling completely awful the next day but I really didn't. I had some pretty extreme fatigue, a headache, some gut pain and diarrhea, and the fever. Incidentally, I had a runny nose but I have no way to tell whether that was related to the illness or whether it was just because the orange blossoms had just started blooming and they do that to me every year. The fever went away on the third day so all I really had was what felt like a cold that couldn't quite become fully a cold but that had much more fatigue and then some joint pain by that point. For nine whole days, the illness was nothing more than a mostly mild nuisance. When I woke up on day ten, it was a whole different ball game. I was even more tired and I was starting to really feel like I couldn't breathe. Now I had never had pneumonia before, only asthma, and this was more of a feeling of getting air in and out of my lungs, but having it not make me feel like I had enough oxygen. I have a stethoscope so I listened to my lungs, which sounded much like a crumpled up bag being filled with air and uncrumpling right at the end of my inhale, but it didn't make much sound on the exhale so that was interesting, although disconcerting. I got winded doing basically anything but sitting still and even going some ten feet to the bathroom was hard to do. I did keep going to the bathroom a lot because I could feel a full bladder but I couldn't get any more than just a little pee to come out. Finally, I noticed myself in the mirror as I was washing my hands and realized that my entire body was ridiculously swollen! The pain I had in my joints shot up to levels so high that I didn't even care if I had to die so long as I could stop hurting. At that time, people were skeptical about taking ibuprofen with this disease but I decided that I didn't care what else it did so long as it took at least some of the pain, which it did a little bit. The inflammation was incredibly alarming to me because all these problems had sprung up in very little time while I was asleep and I was feeling progressively worse. I desperately didn't want to go to the hospital but I decided that I would if I got to the point of not being able to pee. I did everything I could think of to get the inflammation down and it took me three days to succeed at that. I kept doing everything I could to keep the inflammation down for probably another four or five days and then I thought I was better so I went back to normal. In another couple of days, I was on my way to that same hyper inflamed state I had been in before so I went back to all the anti-inflammatory measures I had been taking before. I went through several cycles of thinking I could let up on these measures only to find myself swelling up again. I went through about two months of that and now those problems are starting to wane so that I don't have to be as strict about dehydrating myself to avoid inflammation. I had conjunctivitis too and it was the most persistent case of it I have ever had, plus the last time I even had conjunctivitis I was pretty young. I also had the weird sunburn without the sun rash and it got worse with higher ambient temperatures, even if I was never in direct sunlight (although that would make it worse too). I also started getting weird bruises and there's no way I bumped myself on anything because I was literally still too short of breath to do anything at the time. The random bruises and persistent inflammation have been going away together I think. Anyway, sounds a bit like Kawasaki, no? The problem is that I'm 40 years old, which I don't think anyone in the world would consider a child. I also never had any break between the initial feeling of illness and this insane inflammation fiasco. Since I have basically had to sit and do nothing for some two months because I was short of breath and since I happen to owe a lot in student loans for having gone to school for biology, I have been sitting here learning from things like this podcast and all the other wonderful resources available to us right now. What has really struck me is that it seems like a person's own immune response is killing them, particularly the inflammation. The inflammation in the lungs has been most noticeable, but when you think about what happens if inflammation blocks you from being able to pee waste out, you can see how extreme inflammation throughout the whole body could spiral into multi system organ failure. It seems to me that the whole ball game with this disease is out-of-control inflammation in response to fighting off this virus and cleaning up after it. It seems to me that doctors are on the right track when it comes to blocking cytokines. I see a lot of talk about blocking IL-6 and some talk about IL-1, but what about TNF alpha? Anyway, this is mostly subjective, but at least it's coming from someone who has been trained to think about these things and understand the basic biology involved. A pandemic was never my idea of a good 40th birthday present but I must say that it's very interesting, although obviously really sad because so many people are dying.
From the Scientific Publications, it appears a SERIOUS intervention utilizing Vitamin D Supplementation is CRITICAL for those COVID-19 patients deficient in Vitamin D.
D levels can be diagnostic of the route the immune system takes, but rather than focus on testing, why not treating? NAC, IV ascorbic acid, IV d3 should be standard care, but for some reason isnt?
Thank you for this! This kind of evidence-based presentation is what I’ve been looking for. Appreciate your work. Thank you especially for your pediatric discussion here.
In China and other countries there has been reported use of Traditional Chinese Medicine aka Herbal Formulas have been somewhat successful on MERS, a coronavirus. Have studies included this opportunity in the USA?
Another excellent, even-handed presentation based on the best evidence available. Thank you Dr. Wachter and UCSF for this series. I share with it with the healthcare community in Cleveland Ohio every week. As a non-scientist, I especially appreciate seeing the international cooperation of scientists working towards both treatments and prevention. Your panelists reports are not just cold science. There are many moments where generosity and humanity of individuals and institutions shine through and bring hope. I am a grateful subscriber.
Didn't mentioned much about HCQ. What about the positive studies? What about the NYU study with Zinc included into the regimen? 44% improve mortality rate. What about the observational study done in Italy,65000 lupus & ra patients on HCQ,only 20 was infected. HCQ a prophylactic? A very high chance! Didn't mention about Vitamin D definciency and how it affects people of color.
In absence of HCQ, I am using Quercetin. Zinc, I have been going back and forth between sulfate and gluconate. I haven't made up my mind on the best choice, so I chose to drink the sulfate and use the gluconate for capsules following the same dosage as the EVMS prophalactic guideline, just split between the two
Given the number of hospitals in various towns ,cities , and states which are so underwhelmed they have doctors and nurses and other staff doing the most disgusting choreographed dances in the hallways and the parking lots.... WHY WAS THERE NO TRANSFER OF PATIENTS TO THESE VARIOUS FACILITIES ? Also, it's starting to sound like a great many of deaths were caused by medical negligence and error..... not all that unusual......the sludge that they put in those tubes when people need to be tube fed because they're unconscious? Have you ever read the ingredients? Completely the opposite of health promoting.... Highly inflammatory...... UTIs? I V infections?( Has anyone noticed over the years the prevalence of hospital-acquired infections in the United States , directly caused by laziness and arrogance of the people who work there ?) I'd imagine there have also been quite a few medication-induced fatalities. Hypothermia? ( I know all too well how goddamn cold hospitals can be.... To the great detriment of patients..... Can you imagine lying there, paralyzed and unconscious on a ventilator, with no one there to advocate for you.... Freezing? It's extremely difficult for the human body to fight infection when it is cold ) Perhaps this is why the governor of New York is putting in place legal protection for the hospitals and medical personnel? I know this virus is horrific, you can bet had a great many of these deaths could have been avoided.
There seems multiple outbreaks in Meat Plant in Canada we well. I wonder if there is any connection of SARS-CoV-2 virus stay on meat hence easy to transmit among workers who are handling and packing raw meat.
Andrew and Susan the problem is that ACE2 results in increased Angiotensin II and that influences the remainder of the Angiotensin System which includes DPPIV/CD26 which is complexed with Adenosine Deaminase 2 on cell membranes. DPPIV is a SARS & MERS receptor and likely high affinity for CoV2. Even without that, DPPIV will be downregulated because of high Ang II. That means that Substance P wrecks the lungs, Adenosine isn't metabolised so it interferes with G6PD (so no 2,3-Bisphosphoglycerate to help Heme release O2). There you have G6PD & Adenosine Deaminase Deficiency which are known causes of Severe Combined Immune Deficiency and Coagulopathy and Kawasaki and strokes. Also inflammation and vascular permeability. They are a dynamic duo but take them out and you have real problems. DPPIV/CD26 is also an Angiotensin Converting Enzyme and controls immune activity. It creates such a biological contradiction it is unsurprising that it is hard to figure out. In the absence of Adenosine deaminase, adenosine can convert to Inosine UNDER HYPOXIC CONDITIONS. Adenosine receptors also control surfactant in lungs. The Lividoid rash being observed is a symptom of Acquired Adenosine Deaminase Deficiency as is the coagulopathy. I have a video on my channel explaining my findings - please do get in touch.
The moderator is a gloom and doom, keep it closed Kathy. The presenters try to be positive only to be depressed by his political and Black Death attitude.
@Christian Molick Perhaps, but I found little compassion or empathy pushing the ID doctor to make a political statement. The question, and the badgering, were not enlightening and decidedly not clinical.
What is being done to check whether rats in L.A. are spreading the disease? Research has shown Rat ACE2 is 20% effective as a Sars-Cov-2 receptor. Even if the rats are not infected they could be transmitting virus via contact of surfaces with fur and feet. If LA homes are infested with rats that are spreading diseases, how does that impact the effectiveness of shelter in place orders? Same question for New York City, Boston, Detroit, Chicago, New Orleans and other rat infested hot spots.
Wonderful. Thank you for taking the time to share. It is so hard to find evidence-based information updates.. it’s hard to find anything outside of major news networks (or I just don’t know where to look). Thank you!
So, this is just a hypothesis but I am thinking that this kind of thing is happening in adults but just tacking right on to the end of the disease period itself. It seems like there's a pattern of the first few days or maybe a week being not that bad for most people but then everyone starts showing up at the hospital after that because they take a turn for the worst.
I got sick with this thing but it was really weird the first week because I was just barely noticeably sick. My temperature went all the way up to around 100 F, which is ridiculously high for me since I commonly run 97.6, so I knew I was sick. I took my temperature before bed so I fully expected to wake up feeling completely awful the next day but I really didn't. I had some pretty extreme fatigue, a headache, some gut pain and diarrhea, and the fever. Incidentally, I had a runny nose but I have no way to tell whether that was related to the illness or whether it was just because the orange blossoms had just started blooming and they do that to me every year. The fever went away on the third day so all I really had was what felt like a cold that couldn't quite become fully a cold but that had much more fatigue and then some joint pain by that point.
For nine whole days, the illness was nothing more than a mostly mild nuisance. When I woke up on day ten, it was a whole different ball game. I was even more tired and I was starting to really feel like I couldn't breathe. Now I had never had pneumonia before, only asthma, and this was more of a feeling of getting air in and out of my lungs, but having it not make me feel like I had enough oxygen. I have a stethoscope so I listened to my lungs, which sounded much like a crumpled up bag being filled with air and uncrumpling right at the end of my inhale, but it didn't make much sound on the exhale so that was interesting, although disconcerting. I got winded doing basically anything but sitting still and even going some ten feet to the bathroom was hard to do.
I did keep going to the bathroom a lot because I could feel a full bladder but I couldn't get any more than just a little pee to come out. Finally, I noticed myself in the mirror as I was washing my hands and realized that my entire body was ridiculously swollen! The pain I had in my joints shot up to levels so high that I didn't even care if I had to die so long as I could stop hurting. At that time, people were skeptical about taking ibuprofen with this disease but I decided that I didn't care what else it did so long as it took at least some of the pain, which it did a little bit. The inflammation was incredibly alarming to me because all these problems had sprung up in very little time while I was asleep and I was feeling progressively worse. I desperately didn't want to go to the hospital but I decided that I would if I got to the point of not being able to pee. I did everything I could think of to get the inflammation down and it took me three days to succeed at that.
I kept doing everything I could to keep the inflammation down for probably another four or five days and then I thought I was better so I went back to normal. In another couple of days, I was on my way to that same hyper inflamed state I had been in before so I went back to all the anti-inflammatory measures I had been taking before. I went through several cycles of thinking I could let up on these measures only to find myself swelling up again. I went through about two months of that and now those problems are starting to wane so that I don't have to be as strict about dehydrating myself to avoid inflammation.
I had conjunctivitis too and it was the most persistent case of it I have ever had, plus the last time I even had conjunctivitis I was pretty young. I also had the weird sunburn without the sun rash and it got worse with higher ambient temperatures, even if I was never in direct sunlight (although that would make it worse too). I also started getting weird bruises and there's no way I bumped myself on anything because I was literally still too short of breath to do anything at the time. The random bruises and persistent inflammation have been going away together I think.
Anyway, sounds a bit like Kawasaki, no? The problem is that I'm 40 years old, which I don't think anyone in the world would consider a child. I also never had any break between the initial feeling of illness and this insane inflammation fiasco. Since I have basically had to sit and do nothing for some two months because I was short of breath and since I happen to owe a lot in student loans for having gone to school for biology, I have been sitting here learning from things like this podcast and all the other wonderful resources available to us right now. What has really struck me is that it seems like a person's own immune response is killing them, particularly the inflammation. The inflammation in the lungs has been most noticeable, but when you think about what happens if inflammation blocks you from being able to pee waste out, you can see how extreme inflammation throughout the whole body could spiral into multi system organ failure. It seems to me that the whole ball game with this disease is out-of-control inflammation in response to fighting off this virus and cleaning up after it. It seems to me that doctors are on the right track when it comes to blocking cytokines. I see a lot of talk about blocking IL-6 and some talk about IL-1, but what about TNF alpha?
Anyway, this is mostly subjective, but at least it's coming from someone who has been trained to think about these things and understand the basic biology involved. A pandemic was never my idea of a good 40th birthday present but I must say that it's very interesting, although obviously really sad because so many people are dying.
is it becoming standard for those who test positive for covid to also check their vitamin d levels and then monitor their outcomes? if not, why not?
From the Scientific Publications, it appears a SERIOUS intervention utilizing Vitamin D Supplementation is CRITICAL for those COVID-19 patients deficient in Vitamin D.
There is no money in it.
D levels can be diagnostic of the route the immune system takes, but rather than focus on testing, why not treating? NAC, IV ascorbic acid, IV d3 should be standard care, but for some reason isnt?
Why is there no count on the like / dislike buttons?
Thank you for this! This kind of evidence-based presentation is what I’ve been looking for. Appreciate your work. Thank you especially for your pediatric discussion here.
Noticed no mention of Vitamin D deficiency
In China and other countries there has been reported use of Traditional Chinese Medicine aka Herbal Formulas have been somewhat successful on MERS, a coronavirus. Have studies included this opportunity in the USA?
Yes, but it's nothing but a dead end.
Are the PowerPoint packets available for distribution?
Another excellent, even-handed presentation based on the best evidence available. Thank you Dr. Wachter and UCSF for this series. I share with it with the healthcare community in Cleveland Ohio every week. As a non-scientist, I especially appreciate seeing the international cooperation of scientists working towards both treatments and prevention. Your panelists reports are not just cold science. There are many moments where generosity and humanity of individuals and institutions shine through and bring hope. I am a grateful subscriber.
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How much of lungs efficiency would be lost (because of scar tissue) even after recovering from COVID-19?
Please do elaborate.
Seems like the scar tissue in the lungs, approves majorly with the time.
VITAMIN D
Monoclonal, vitamins, vaccines, anything to get the world a chance...
any idea on how long it lasts on soft surfaces like clothing, seats or furniture like beds or couches?
Reducing droplet transmission protects us all, adding hygiene is even stronger, staying home if ill or running a temperature is critical!
Didn't mentioned much about HCQ. What about the positive studies? What about the NYU study with Zinc included into the regimen? 44% improve mortality rate. What about the observational study done in Italy,65000 lupus & ra patients on HCQ,only 20 was infected. HCQ a prophylactic? A very high chance!
Didn't mention about Vitamin D definciency and how it affects people of color.
In absence of HCQ, I am using Quercetin. Zinc, I have been going back and forth between sulfate and gluconate. I haven't made up my mind on the best choice, so I chose to drink the sulfate and use the gluconate for capsules following the same dosage as the EVMS prophalactic guideline, just split between the two
Very good talks 👍
Vitamin D, N-AC re von willebrand factor?? would love to get views from your team and contacts
Given the number of hospitals in various towns ,cities , and states which are so underwhelmed they have doctors and nurses and other staff doing the most disgusting choreographed dances in the hallways and the parking lots.... WHY WAS THERE NO TRANSFER OF PATIENTS TO THESE VARIOUS FACILITIES ? Also, it's starting to sound like a great many of deaths were caused by medical negligence and error..... not all that unusual......the sludge that they put in those tubes when people need to be tube fed because they're unconscious? Have you ever read the ingredients? Completely the opposite of health promoting.... Highly inflammatory...... UTIs? I V infections?( Has anyone noticed over the years the prevalence of hospital-acquired infections in the United States , directly caused by laziness and arrogance of the people who work there ?) I'd imagine there have also been quite a few medication-induced fatalities. Hypothermia? ( I know all too well how goddamn cold hospitals can be.... To the great detriment of patients..... Can you imagine lying there, paralyzed and unconscious on a ventilator, with no one there to advocate for you.... Freezing? It's extremely difficult for the human body to fight infection when it is cold ) Perhaps this is why the governor of New York is putting in place legal protection for the hospitals and medical personnel? I know this virus is horrific, you can bet had a great many of these deaths could have been avoided.
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There seems multiple outbreaks in Meat Plant in Canada we well. I wonder if there is any connection of SARS-CoV-2 virus stay on meat hence easy to transmit among workers who are handling and packing raw meat.
Disgust ing
Andrew and Susan the problem is that ACE2 results in increased Angiotensin II and that influences the remainder of the Angiotensin System which includes DPPIV/CD26 which is complexed with Adenosine Deaminase 2 on cell membranes. DPPIV is a SARS & MERS receptor and likely high affinity for CoV2. Even without that, DPPIV will be downregulated because of high Ang II. That means that Substance P wrecks the lungs, Adenosine isn't metabolised so it interferes with G6PD (so no 2,3-Bisphosphoglycerate to help Heme release O2). There you have G6PD & Adenosine Deaminase Deficiency which are known causes of Severe Combined Immune Deficiency and Coagulopathy and Kawasaki and strokes. Also inflammation and vascular permeability. They are a dynamic duo but take them out and you have real problems. DPPIV/CD26 is also an Angiotensin Converting Enzyme and controls immune activity. It creates such a biological contradiction it is unsurprising that it is hard to figure out. In the absence of Adenosine deaminase, adenosine can convert to Inosine UNDER HYPOXIC CONDITIONS. Adenosine receptors also control surfactant in lungs. The Lividoid rash being observed is a symptom of Acquired Adenosine Deaminase Deficiency as is the coagulopathy. I have a video on my channel explaining my findings - please do get in touch.
**The virus uses ACE2 to enter cells and in doing so it causes it to go inside the cell and no-longer deactivates Angiotensin II.
Great to have George back-so multi- talented his French is amazing!
Cool, cool cool cool.
Excellent presentation. Thank you, UCLA Alumni ...
Thanks
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Weren't there vaccines developed for SARS one and MERS? Were those RNA vaccines?
no they stopped funding the sars vaccine after the cases stopped. Sad mistake.
The SARS vaccine killed the test animals on viral exposure.
The moderator is a gloom and doom, keep it closed Kathy. The presenters try to be positive only to be depressed by his political and Black Death attitude.
I think he is being thorough and clinical and that comes across as cold when it is really driven by compassion and empathy.
@Christian Molick Perhaps, but I found little compassion or empathy pushing the ID doctor to make a political statement. The question, and the badgering, were not enlightening and decidedly not clinical.