As we continue to navigate through the many headlines on COVID-19, it is becoming increasingly difficult to see the SIGNAL from the noise. There have been key developments and findings on COVID-19 which have not been broadly presented through the mass media.
The Good: Therapeutic Options for Different Stages of COVID-19
Based on the latest publications on Hydroxychloroquine[i] (and related combinations), Ivermectin,[ii] and Dexamethasone,[iii] we have feasible therapeutic options to treat COVID-19 at its different stages. The topline results from these studies are summarized below along with the disease progression and related clinical manifestations.
ARDS: Acute Respiratory Distress Syndrom, DIC: Disseminated Intravascular Coagulation
All three drugs are highly available and affordable, and on the WHO’s list of Essential Medicines. They all have high safety profiles. Their topline results represent best-in-class reduction in mortality rates within each stage of COVID-19 at the current juncture. There are numerous ongoing trials that could provide better options for each stage in the future. From a mechanistic perspective, the results are aligned with their respective therapeutic benefits given below.
- Hydroxychloroquine (and related combinations) has demonstrated inhibition against the viral replication process of the COVID-19 virus. When given at the onset of disease, hydroxychloroquine limits the extent of viral infection.
- Ivermectin has demonstrated inhibition against the transport of viral proteins from the cytoplasm of the cell to it nucleus. This transportation impairs the immune response needed to fight off the COVID-19 virus. In the “moderate” stage of COVID-19 where oxygen support is needed, Ivermectin enhances our immune response against the virus.
- Dexamethasone has demonstrated anti-inflammatory benefits. In the “severe” stage of COVID-19 where ventilation is required, excessive inflammatory response arises from a combination of cytokine storm, pulmonary hypertension, and possibly infection from ventilation procedure itself. Dexamethasone mitigates against the excessive inflammation.
The Bad: Case Counting as the Scoreboard
The mass media continues to push the narrative that the number of new coronavirus cases is ultimately the measure of success against COVID-19. From a scientific perspective, this is a quixotical quest—a chasing after the wind on the grandest level. From the mouths of scientific “experts” themselves, the COVID-19 virus is highly transmissible.
CDC director Dr. Robert Redfield commented, “Our best estimate right now is that for every case that’s reported, there actually are 10 other infections.” That estimate near end of June puts the total number of COVID-19 cases to at least 23 million. COVID-19 spreads like the common cold and the flu, and worst yet, a significant portion of the infected population do not have any symptoms. As reference, there are up to 45 million cases of influenza and up to 1 billion cases of common cold for any given year. Any reasonable person understands you cannot stop the spread of COVID-19. With more testing, there will come more new cases. The ultimate scorecard is the number of deaths and the number of new deaths is still steadily declining across America.
7 per. Mov. Avg. = 7 day Mov. Avg.
The Ugly: Children and School Re-opening
The hottest COVID-19 topic now, especially for parents, is the status of school re-opening in the fall. Both the American Academy of Pediatrics[iv] and the United Kingdom’s Royal College of Paediatrics and Child Health[v] wrote open letters in support of school re-opening with students “physically present.” The common reasons cited are: 1) COVID-19 presents negligible risks to children and 2) COVID-19 does not transmit readily from children to others. On the adverse effects of remote learning, the common disadvantages include: 1) less effective learning from virtual schooling, 2) dependency on school meals by lower-income children, and 3) lower detection of children abuse.
European countries (Denmark, Austria, Germany, Netherlands, Finland, Belgium, etc.) re-opened their schools starting in April and the results so far suggest school re-opening is safe.[vi] Sweden never closed their schools. There is a substantial amount of data supporting the re-opening of schools in the fall yet we are still progressing through this debate state-by-state, with nervous parents holding their breath.
Washington DC insiders will tell you everything in an election year is about the election. As we witness firsthand through 6 months of COVID-19 responses already, efforts to save lives, to sustain economic prosperity, and now to maintain children and family well-being (through school and its various extra-curricular activities) have become a partisan issue. This is the UGLIEST FINDING we see!
[i] https://doi.org/10.1016/j.ijid.2020.06.099
[ii] https://www.medrxiv.org/content/10.1101/2020.06.06.20124461v2
[iii] https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1
[iv] https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/
[v] https://www.rcpch.ac.uk/sites/default/files/2020-06/open_letter_re_schools_reopening_2020-06-17.pdf
[vi] https://www.sciencemag.org/news/2020/07/school-openings-across-globe-suggest-ways-keep-coronavirus-bay-despite-outbreaks