It seems we have had a lot of useless and often unedifying bickering here of late, while this grave crisis grows ever more serious and far dwarfs any other crisis any of us have seen in our lifetimes.
I will get straight to the pint with Jerry. I have nothing against Chinese people, but I consider the Chinese leadership to be criminals who have to be brought to account.
They deliberately hid and tried to suppress this outbreak by violent repressive means of that there is no doubt. I miss trust anything they have to say at this point.
They should have cleaned up their vile wet markets years ago, as they had been advised by many. Although making them illegal they offered no enforcement. It is still open to conjecture whether that was truly the source or something more sinister. I will have more to say about that later.
Since that time they have run a
concerted disinformation campaign.
Also this.
Inadvertently or not, and probably not they have hindered efforts to bring the pandemic under control.
The UK have received 3.5 million test kits from China all of them dud. The UK have cancelled their remaining 17.5 million and are demanding a refund.
The Dutch also received dud test kits, and unfortunately unlike the UK did not validate them, which has caused them to loose control of their targeted approach.
The governor of Minnesota stated today in his news conference that a large quantity of PPE ordered from China has been impounded without explanation by the Chinese military. Now according to the Chinese their epidemic is over. So either they are lying about that and actually they still have a problem, or they are deliberately hindering our response to the pandemic. Minnesota by the way is doing an excellent job of flattening the curve.
The thing that worries me is that it is clear this virus is becoming more dangerous over time, with increasing mortality and causing cardiac and neurological problems now. This needs control as fast as possible.
Henry Ford Hospital in Detroit reported this case.
I have spent the last few days intensively covering the literature in case I am called on to function in a Telemedicine role. My wife has renewed her nursing license and doing 27 hour pharmacy course on line to get her nurse practitioner license back. It seems that older vulnerable physicians like me who go back to the front lines just add to the problem.
I took part in a North Dakota webinar on all this this evening. Due to the stupidity of the governor of ND, they have more cases than Minnesota!
They are seeing a lot of cases in Bismark and Fargo. The accounts from Fargo ICU physician Karla Johnson were extremely interesting. She is very experienced and said she had never encountered a disease with anything like these features before. It seems the virus seems to attack the elastic structure of the lung actually increasing lung compliance. She said she had never seen this before and nor have I. I have never seen a pulmonary problem putting a patient on a ventilator not decrease lung compliance. It also produces marked impairment of oxygen transfer. In addition some patients are developing classic ARDS. It is vital to distinguish the two. In addition they report neurological problems causing swallowing and especially speech problems. Others in the US are reporting this also. Damage to the heart has been noted world wide. The first case in Bismark a 37 year old from the oil fields who was on the ventilator went into atrial fibrillation and has markedly reduced cardiac contractility even at the time of discharge. It is unknown if he will have permanent cardiac damage. It seems in both Fargo and Bismark, about half the cases that come to the ER end up on the ventilator. Interestingly one Bismark case has developed Guillan Barre syndrome with paralysis. One thing I did take note of that in ND most of their ventilated patients were in their thirties for some reason.
In my view there has been far too much loose talk of this being a mild illness and not a very serious devastating one. This has no resemblance to seasonal flu what so ever. Herbu, if you still harbor any of your notions to the contrary dump them now!
The social restrictions have to follow the science as it unfolds. There is no quick end to this. I agree with our Minnesota governor that there is a significant risk of a further peak in the fall.
A study today from Belgium and Holland has shown that people who are working hard or exercising can spread a cloud of virus far and wide. So jogging is not safe unless you are a long way from anyone else.
It seems that military intelligence in the US and UK have had wind of this since November.
According to limited information released by the UK government the top secret biological and chemical warfare unit Porton Down on Salisbury plain have had this virus for sometime and have this as top priority for four to five months. It is a very high security and top secret unit formed in WW I. It is surrounded by an absolute ring of steel and probably the most secret and secure unit in the UK, or in the world for that matter. It is on Salisbury Plain. I have been passed it a number of times. An how they say they have the most reliable PCR test for detection of this virus and a highly accurate ELISA antibody test. They now have population studies under way. The government also state they have a
vaccine ready to undergo human trials in a month. They seem to have a high degree of confidence that this vaccine could be produced in quantity by sometime this fall. They are being assisted also by researchers from Oxford University which is not that far from Porton Down. The principle function of the Porton Down unit is thought to be defense from biological and chemical agents of warfare. There is an outside chance that this could be just such an event.
Here is an article by Robert Kuznia. He is a Pulitzer prize winning journalist. He grew up in Grand Forks and was one of a tight circle of friends of my son Andrew. This extremely bright and talented circle of friends who used to love to congregate at our house usually over fine food with the most stimulating of conversations. I have remained in contact with all of them, who have all risen to the tops of their chosen professions. Their math master who I knew told me that they were by far the brightest class he had ever had.
I sure hope that Porton Down deliver an ace in the hole! They are very experienced. In the recent Russian secret service poisoning cases Porton Down was not only able to quickly identify the agent as Novichok, but pinpoint the exact location in Russia were it had been produced.
My major concern is that this virus is going to increase in virulence and produce an even wider constellation of serious effects on more systems and functions. The ND physicians noted a significant number of patients presenting with intractable vomiting and resulting dehydration.
I am very afraid that this will not end until we have an effective vaccine produced in quantity. So this will likely not end soon. It will terminate with herd immunity of over 70% either by vaccine or case incidence. If by the latter we have to hope that immunity is long lived. If not we are in very, very serious trouble.
I have looked a little into the economic fall out. There seems to be a view that if these lock down have to go on longer than three months or have to be imposed recurrently, the impact will be severe. There seems to be enough resilience to tolerate three months of it. Unfortunately I fear it will go on longer than that. Singapore has got into serous trouble releasing too soon and too quickly.
For now the medical aspects will continue to dominate, and will what ever any politician tries to do or proposes. Right now community isolation is our only weapon and properly and intensively used it is highly effective and life saving.
In closing I personally am going to go out of my way to avoid purchasing any Chinese produced goods. Going forward I think we have to force regime change in China by whatever means. They are a clear and present danger.
