March 27, 2020

Begin at the Beginning: The Malayan Pangolin Hypothesis

How do you begin at the beginning if you do not know where the beginning is? You speculate. You check various bits of data, cross reference them with other bits of data and then you come up with a hypothesis. After doing the research for this, I am convinced that COVID 19 is the result of our mismanagement of tropical forests. I also have a hunch that the tropical forests in question might be on Borneo (but a hunch is not a hypothesis)

Here is a quick refresher on the origins of RNA viruses that infect humans:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157708/

An important point: the ability to infect humans and the ability to be transmitted from human to human are two separate things, i.e. going from Level 2 to Level 3. There are whole lot more Level 2 than Level 3. And there is a stage beyond Level 3. It is not enough to simply be transmissible human to human. You have to have a perfect situation to transmit enough of the virus if you want to reach Level 4—and epidemic.

“Level 4 corresponds to the ability to transmit sufficiently well that the virus can invade human populations, causing epidemics and/or establishing itself as an endemic human pathogen. In epidemiological parlance this corresponds to the condition that R0 is greater than one within the human population, where R0 is the basic reproduction number, defined as the number of secondary cases generated by a single primary case introduced into a large population of naïve hosts. In contrast, Level 3 viruses have an R0 of less than one in humans, which implies that although self-limiting outbreaks are possible, the infection cannot “take off” and cause a major epidemic. Although R0 is partly determined by the transmissibility of the virus, it is also a function of the behaviour and demography of the human host population; for example, changes in living conditions, travel patterns, sexual behaviour (for sexually-transmitted viruses) can all greatly influence R0. This argument is reflected in the term “crowd diseases”, which implies that certain human viruses (and other pathogens) could only become established once critical host population densities had been reached [10]. Our best estimate is that there are 47 Level 4 RNA virus species in humans “

Since labs all across the world including China typically retain serum and tissue samples of people who have died of unknown causes, it ought to be possible to trace the current COVID 19 epidemic back to a source. Maybe it killed someone before the first known victim who shopped in the Wuhan Seafood Market where more than just seafood was sold

https://www.bloomberg.com/news/articles/2020-01-14/wuhan-doctors-tried-to-save-pneumonia-patient-with-life-support

Note that since there is a mild form of the infection, the victim did not necessarily catch it from a freshly butchered animal. It could have easily come from a human vendor of that animal.Or this could not have anything to do with the meat being sold in Wuhan Market. But, I have to start somewhere, I will assume that it does.

We have a newly identified disease-causing RNA virus, most likely it was a zoonosis before it got into our populations (since that where most RNA viruses come from). If someone died from it, the evidence is there, waiting to be uncovered in a lab.

If the first case did not die--say that person was basically healthy and brought a few sniffles home them to Wuhan China from who knows where---then things will get more difficult. How do you track down a virus that left no foot prints until it had passed from two to three to more people before leaving evidence of its passage (e.g. a fatality)?

Since this virus has already been well primed to infect humans, then it is likely that it already exists somewhere in the world as a well-controlled human (or, less likely simian) viral pathogen—much like the common cold is for most of us. People in that isolated part of the world get COVID 19 and get over it in childhood. But if you do not get your immunity at the right time, it can become deadly. (Has anyone seen how sick people get when they catch measles as adults, even young adults?) This implies that it exists in the wild—somewhere.

Bats are speculated to be the world’s biggest carrier of coronavirus. However, the disease is not thought to jump straight from bat to humans. Instead there is likely to be an intermediate host. It has been reported that COVID 19 resembles a virus found in the diseased lungs of a pair of Malayan pangolins. It is not a full match suggesting that the disease did not jump straight from the two dead pangolins to humans. Since pangolins are eaten and used for medicine in China, a logical step to look would be those who make a living hunting Malayan pangolin.

https://www.cell.com/pb-assets/journals/research/current-biology/CURBIO_CURRENT-BIOLOGY-D-20-00299-compressed.pdf

Or, if you go back to the first article, look for simians in the region where the region where the Malayan pangolins are naturally found since

“Although humans share their RNA viruses with many different mammalian taxa, those from other primates appear most likely to be capable of spreading through human populations”

We do no know that COVID 19 came from Malayan pangolin. But say it does. South Asian and South East Asian Pangolins are endangered. Their forest habits are being cut down. Humans poach them for food and medicine and their scales. According to this recent article, South Asian and Southeast Asian pangolins are now the most trafficked mammals around the world. Local bow and hunter hunters in some region have been squeezed out by poachers who have come in armed with rifles, driving on new roads through forests that have been newly leveled. A perfect storm if there is a well-controlled animal origin RNA virus to which the locals have adapted. So yeah, the timing is right.

https://www.jstor.org/stable/26393255?seq=1#metadata_info_tab_contents

More on how clearing tropical forest land is associated with increased rates of viral disease. Note the ten times higher viral diversity in coronaviruses in bats in tropical forest which have been highly disturbed.

https://pmac2018.com/uploads/poster/A11-ZAMBRANA-TORRELIO-5600.pdf

Different coronaviruses have been show capable of exchanging their RNA in vivo.

“RNA-RNA recombination between different strains of the murine coronavirus mouse hepatitis virus (MHV) occurs at a very high frequency in tissue culture. To demonstrate that RNA recombination may play a role in the evolution and pathogenesis of coronaviruses, we sought to determine whether MHV recombination could occur during replication in the animal host of the virus. By using two selectable markers, i.e., temperature sensitivity and monoclonal antibody neutralization, we isolated several recombinant viruses from the brains of mice infected with two different strains of MHV. The recombination frequency was very high, and recombination occurred at multiple sites on the viral RNA genome. This finding suggests that RNA-RNA recombination may play a significant role in natural evolution and neuropathogenesis of coronaviruses.”

Meaning cleared tropical forest which is also being targeted by poachers might have two things going for it if your goal is accelerated mutation and spread of a new coronavirus pathogen.
https://jvi.asm.org/content/62/5/1810.short

If the Malayan pangolin is the (original source) of COVID 19, then checking the indigenous populations of the areas where the pangolin live and have been hunted by locals might detect antibodies to the virus. Or turn up local remedies that have been used to limit its virulence. And checking for mysterious illness and death among those who poach pangolin and then carry them back to China might also be fruitful.

Oh, and about the simian intermediary hypothesis. The proboscis monkey is on the top ten list of most desirable poached wild animals in China—along with the pangolin. So be sure to check Borneo where both proboscis monkeys and pangolin live--and are threatened with extinction.

https://www.borneoecotours.com/blog/the-disappearing-wildlife-of-borneo/

But watch out. Heavy deforestation in Borneo is giving rise to a bunch of disease.

Mosquitoes are not the only carriers of pathogens from the wild to humans. Bats, primates, and even snails can carry disease, and transmission dynamics change for all of these species following forest clearing, often creating a much greater threat to people.

https://e360.yale.edu/features/how_forest_loss_is_leading_to_a_rise_in_human_disease_malaria_zika_climate_change

And being an island with some pretty unique animals (like the proboscus monkey) Borneo would have had a very long time of relative isolation in order to cook up an RNA virus that we, the rest of the world, are not prepared for.

Edit. The video tagged on YouTube is not the Wuhan Seafood Market as was posted below. I found several different videos online all claiming to be The Wuhan Market but which were actually filmed elsewhere. Films taken in Wuhan are very brief and show little detail so maybe filming was discouraged. But there are stories confirming that bats, pangolin and other animals were sold there.

March 26, 2020

Finally humor from COVID 19. Trump send "cease and desist letter" to his big fat mouth.

https://www.democraticunderground.com/?com=view_post&forum=1014&pid=2456680

This ad is nothing but Trump's unedited words about COVID 19. He should not be sending a cease and desist letter. He should be looking for that sock that the GOP used to keep around in order to plug up Rep. Dan Burton's mouth (when he got diarrhea of the mouth) in order to stop his own verbal diarrhea.

March 25, 2020

Trump's Declaration "Well by Easter" Spells Serfdom for Working Americans

Business owners are pissed. How dare city and state government tells them that they cannot run a titty bar or casino or Christian themed craft store (Hobby Lobby) during a pandemic! The nerve of them! It isn't as if the owners are at any risk. They can retreat to their summer homes in places like Nantucket to ride out COVID 19.

But their serfs are sitting at home, trying to stay alive and praying for extended unemployment benefits so they do not starve or lose their homes or cars. Ordinarily, hunger would drive many of these people back to work. However their kids have no school to attend--meaning no daycare, meaning that most minimum wage employees would see no net income if they had to pay for daycare in order to go back to work.

What happens if Trump declares "There is no emergency!"?

People will be forced back to work. They will not have the option of saying "No, I don't want to die!" Schools will be forced to reopen. Teachers will die. Malls will open. Salesclerks will die. (Trump) casinos will reopen. The maids who change your sheets (that we now know can harbor Covid 19 for up to 17 days!) will die. The stimulus money will not flow into workers hands, because there will be plenty of "safe" jobs for them---we know that they are "safe" because Dr. Trump says so.

The really insidious part of this--those who are 40 or older or who have underlying health problems will resist the call to return to their "safe" jobs. They will be declared AWOL and fired for cause--meaning no unemployment benefits. And then the employers will replace them with lots of workers in their older teens and early twenties--those who are least afraid of COVID 19. Meaning we will see a repeat of 2008 when employers used the recession as an excuse to enact "First hired first fired"--eliminate the job positions of those with seniority and chronic medical conditions so that the could replace them with a bunch of youngsters.

Here is an idea. If Trump decides to force all workers back to their jobs, the owners and CEOs and administrators should be placed on the front line, waiting tables, serving as airline stewards, teaching kindergarten classes. I want to see Trump changes sheets in one of his hotels.

March 25, 2020

Why Do Casinos Need a Bailout?

What essential function do they serve? There are better ways to encourage tourism than feeding an addiction like gambling.

https://www.nytimes.com/2020/03/25/world/coronavirus-news-maps.html?action=click&module=Spotlight&pgtype=Homepage

March 24, 2020

Interesting article about neurological effects of coronavirus

https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25728

I have a hypothesis that the sudden worsening that some patients experience at day 8 could be due to affects on the central nervous system triggering dysphasia—-difficulty swallowing which’s leads to aspiration which in turn can cause pneumonia and respiratory failure. Note the coronavirus can affect the medulla and strokes of this area can affect the ability to swallow safely.

What does this mean for those infected? Sleep with your head elevated to prevent aspiration at night, do not lie down immediately after you eat, eat small portions and consume a mechanical soft diet——yogurt, soup, while avoiding tough foods that could get stuck in the airway (like meat)

There is nothing dangerous about a diet designed to prevent aspiration and it could improve survival rates. Someone should do swallowing studies on people with Covid. They should also do demographic studies to see if the risk factors for aspiration—-neurological disease, frailty, obesity, smoking, alcohol abuse—-are also risk factors for Covid death.

March 24, 2020

Fox is worried --about the health of the big corporate bailout.

After weeks of poo-pooing Corona-virus as democratic hoax, seven days ago, Fox's TuckereCarlson suddenly changed his tune.

https://www.cnn.com/2020/03/17/media/fox-news-coronavirus-reliable-sources/index.html

Why? Could it be because the Senate was working to sell a huge "stimulus" package that would allow Trump to funnel half a trillion dollars to his friends in the casino industry, hotel industries as well as anyone else willing to kick back a portion of their "stimulus" to the RNC or directly into Trump's pocket? Maybe some of that money is earmarked for Fox.

March 21, 2020

Why The Hell Is So Much Science Research Pay for View Only?

Seriously. I am trying to do my part as a physician who also has a masters public health to search the medial literature for hints about how COVID kills and how we could stop the deaths. However, I keep stumbling across roadblocks in the form of "You have to pay us if you want to read this." One article even blacked out most of the abstract! Grrr! How do you know if you want to pay for it if you don't know even know what the study is about?

I know what I have to do. I am part of a huge healthcare organization so I just have to sign up for our system's online library, something I have been putting off because it is a hassle. But what about people who are retired?

March 21, 2020

(Since Barr and Mitch Will Protect Senate Insider Traders) The Solution Is....

Civil Suits.

Those who bought the dumped stocks should lawyer up and file civil suits. That will lead to a discovery phase and then when the entire federal government changes to Democratic next year, the prosecutors' job will be easier. This would be a very good place for Bloomberg to invest some of his billions that way the investors will not be limited to Pro bono attorneys.

March 16, 2020

Did Trump Shut Down Our Pandemic Response to Please Right to Life?

In particular, did the religious right take offense at efforts to prevent the spread of infectious killers because they feared that such efforts would causes countries to loosen restrictions against abortion and birth control? Did Trump shoot our country in both feet by crippling our ability to respond to global pandemics because abortion foes would rather see us all dead than have a meaningful debate on contraception?

Recall that the two biggest threats before Trump were Ebola and Zika. And Zika, in particular had the potential to become what rubella once was--a reason to make abortion a matter of choice not law due to the risk of birth defects in affected embryos.

(Before you report me for citing right wing sites, the whole point of this piece is to see if the Right objected to world pandemic public health planning in the years before Trump)

Here is an example:

https://www.nationalrighttolifenews.org/2016/02/standing-up-against-the-barrage-of-pro-abortion-propaganda-to-use-zika-virus-as-a-reason-to-tear-down-protective-abortion-laws/

Here is another example:



https://townhall.com/columnists/megantoombs/2016/06/28/zika-abortion-and-population-control-the-hype-and-the-real-danger-n2184219

Here is a 2016 public health planning document about how we should respond to Zika. Notice how often the plan calls for improvement in family planning services.

https://www.phe.gov/Preparedness/planning/Documents/zika-response-plan2016.pdf

Some in Congress delayed funding to fight Zika due to concerns that Planned Parenthood might benefit



https://www.npr.org/sections/health-shots/2016/09/28/495806979/congress-ends-spat-over-zika-funding-approves-1-1-billion

Trump is now claiming that he crippled our public health pandemic disease fighting readiness 1) to save money and 2) because it was part of Obama's legacy. But I think it was neither. I think that those who hate women and hate for women to have control over their own bodies persuaded him to do it because they would rather see us all dead than give a woman the right to choose. Meaning that Trump allowed politics to literally trump our health.

Right to Life (and the politicians who pander to you)---you are truly the agents of death and destruction.

March 15, 2020

How School Closings Will Affect the Economy

The tourism industry is being hit hard by coronavirus. So is the entertainment industry. However, the pain is about to get a lot worse. Even industries that will have to stay open--health care, police, grocery stores, drug stores, public safety, gas stations---because they are essential to our survival are about to take a big hit. That is because all across the nation, summer break is coming early--and working parents are not prepared.

Our local school is closing for two weeks--minimum. For those working parents with children aged 4 to 11 who rely upon school for day care so that they can work, this is going to be huge blow. An even bigger blow than not having paid sick leave. Most young adults will have only a mild bout of coronavirus and they may or may not choose to stay home. However, every working parent who suddenly has no day care will be unable to work. That means no paycheck whether or not they have paid sick leave at their job since jobs do not pay someone to stay home to take care of the kids.

Things we can expect to see happen

1) Lots of people with paid sick leave seeing their doctor (medical clinics will still be open) for work notes for bogus respiratory infections, flare ups of chronic back pain etc that will last exactly until their kid's school reopens. (Yes, this does happen. Every year at Spring Break I see a certain number of working parents who "get sick" for exactly one week). The medical system is already over strained but it will get worse as health care facilities become both understaffed (see 4 below) and demand for medical services will rise.

2) Grandparents and elderly relatives enlisted to do child care--meaning more exposure to infectious disease for our most vulnerable

3) Unlicensed daycare--lots of kids crowded together in squalid circumstances for those parents who have no paid sick leave defeating the purpose for closing schools (preventing spread of disease)

4) And most devastating of all, lots of absences of nurses, phlebotomist, janitorial staff, clerks, public safety workers--those who will not be furloughed from their jobs because their jobs are essential. This means that attempting to get health care, fill a prescription or stock the pantry will become even more challenging in the weeks to come. And even some discretionary industries (like nail salons, clothing retailers etc) will be hit as their workers are forced to call in for "No daycare"

If Trump and Pence were not such idiots, this would not have happened. Trump actually insisted upon bringing coronavirus to this country and also insisted that we would not test for it or have any public health policy in place to deal with it.

Some have called this "Trump's Katrina." This is much worse than Katrina.