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Election Day Countdown: 4 Days

After the phone call I just got, I have zero patience for language policing today. If you can’t stomach f-bombs, hit the the exit now.

I am goddamned sick of this tangerine-tainted blowhard and his constant incitement to violence. I am FURIOUS at his malignancy — his trash-talking about anyone who is competent and capable while he systematically fails this country.

I am just so fucking fed up with having to worry about COVID because that slack-assed corrupt sponge can’t be bothered to turn over the job of stemming the pandemic to competent people and instead finds every opportunity to siphon money off every thing he touches.

Wow, Rayne, you seem triggered…

You’re goddamned right I’m triggered. My younger kid just called and told me their boss tested positive for COVID. They’ve been in contact with their boss several times this week indoors at a retail entertainment venue, though part of those times the boss or my kid was wearing a mask.

And my spouse was in contact with the same boss at least three times in the last week, indoors, not wearing a mask all the time.

One of my BFFs was also in contact several times with the same COVID-positive person, indoors, with and without a mask.

All three — kid, spouse, friend — will have to get tested. If any of them test positive, I have to get tested, and then I have to make a bunch of phone calls to people with whom we’ve been in contact.

I’ve had three different companies here in my house doing repairs this week — two teams didn’t wear masks, one did.

My spouse met our other kid up north last weekend to go bow hunting, staying overnight with my elderly in-laws, one of whom is being treated for cancer. I dread telling my older kid about the potential exposure because they were just tested 10 days ago due to a workplace exposure; the test administrator injured my kid with the swab. Kid has a little PTSD after that episode and is reluctant to get tested any time soon.

Our financial advisor met my spouse after a multi-state road trip earlier this week — they’re on their way back across the same states. This advisor is a self-employed small business owner, has kids at home who are in a K-12 public school.

My kid’s COVID-positive boss is a small business owner — a first-time business owner who hasn’t yet finished their second full year running this operation. The business may have to shut down for two weeks depending on the rules covering their type of business.

Meanwhile, the utterly useless apricot-brained fuckwit is campaigning yet again in my state after causing a small spike in COVID cases when he campaigned here in September, spouting this kind of trash in front of his unmasked mouth-breathing base:

God damn it.

My kid’s boss, somebody we’ve known for years, one of my spouse’s friends, is now part of today’s COVID statistics.

For all I know my kid’s boss may have a second wave infection from the September campaign rally. Nobody is making money here off that wave of infection. Nobody will make money off the second wave.

Unless you’re an executive or stockholder of Regeneron up to this week’s problems with phase 2/3 trials of COVID therapy drug remdesivir, that is. What a pity for Trump’s Briarcliff member, Regeneron CEO Leonard Schleifer.

How the hell is this country supposed to return to normal if it never makes a sustained effort to stop COVID’s spread?

How is the economy supposed to turn around when the one person who could apply the powers of the executive branch to effectively end the pandemic, persists in undermining the states’ efforts, incites seditious acts against states, and actively spreads COVID by holding rallies which are not socially distanced or mask-mandatory?

How is this country supposed to simply muddle through without leadership to a safe and effective vaccine which may be one to two years away?

Vote that fucking hacktastic moron out of office in four days if you haven’t already cast a vote.

Help others vote that stupid orange fuckweasel out of the White House if you have already voted.

Do it for the 228,701 Americans who have died from COVID, and all the families who have to put up with this unending COVID circus.

Three Things: Racist Redirects as GOP Clings to Its Brand

[Check the byline, thanks!/~Rayne]

No news on the family front with regard to COVID-19 — at least with my family. No news is good news here.

I feel so very sorry for the New Jersey family which lost three of its family members * to COVID-19 this week. It was a blessing to the matriarch she didn’t know she lost her two oldest children; the heartbreak on top of the virus would have been torture beyond human ken.

None of this had to happen, either. Not a lick of it.

And it’s really only just beginning.

~ 3 ~

Let’s get this out of the way: Donald Trump is a racist jerk. He can’t read anything but inch-high print prepared for his ease; he had to go out of his way to make absolutely certain that he referred to COVID-19 as “Chinese.”

This is wholly intentional, deliberate as hell.

The fact COVID-19 emerged from China to become pandemic was sheer dumb luck. Spare us the racist bullshit talking down about eating unfamiliar animals and wet markets.

For Christ’s sake people here in the U.S. eat road kill and celebrate those animals with a festival.

They eat organ meats, blood sausages from across their many ethnic heritages, and they do odd-looking things with products made of proteins extracted from cartilage.

Americans and all the cultures from which they emerged have their own relationships with animals which have spawned biological crises over millennia. Just read Jared Diamond’s Guns, Germs and Steel.

It was simply a crap shoot this pandemic originated in China and not from a hantavirus in the American Southwest, or a flavivirus from South America or Africa. Chances are good we may yet see another emergent threat like a virulent Zika as the climate continues to warm.

Americans don’t have room to criticize. Their president being a racist moron to China about a crappy draw of luck is just plain stupid.

So is his and his party’s escalation of tension with the other largest economy in the world which both owns a lot of our debt. It’s incredibly shortsighted to bash the country which has been incredibly generous with research data based on their harrowing national experience with COVID-19.

I can’t begin to imagine how bad off the U.S. and other countries fighting COVID-19 would be if China hadn’t shared genomic and epidemiological data with the world.

We would not only be as far behind as we are because this administration felt winning re-election was more important than doing its job. We would have had to do much of the genomic and epidemiological research ourselves, on the fly, while our country’s health was in meltdown.

One need only look at how little research material has been published by other countries during this epidemic for comparison. They, too, have relied on China’s research.

Or look at how we continue to rely on China to do human testing – likely cutting corners on human experimentation ethics – just so Americans can obtain the benefit of a successful drug therapy while an American company reaps benefits.

No one of Asian ethnicity and heritage should have to put up with the hate unleashed by that slack-assed racist in the White House and the team of inept and bigoted enablers who are propping him up.

We may have legitimate concerns with China about supply chain integrity and intellectual property theft, but it’s on the U.S. that this is an issue to begin with. Outsourcing so much of what should be critical infrastructure is our own fault.

And failing to act in a responsible timely manner to a pandemic threat is solely that of the racist scumbag at the podium.

~ 2 ~

Speaking of failing to respond to pandemic threat…

If Senator Richard Burr knew by February 13 — when he sold $1.6 million worth of stock — that COVID-19 posed a potential national emergency, who else did and did nothing?

By “did nothing” I mean the way Burr lied to our faces and said, “the United States today is better prepared than ever before to face emerging public health threats, like the coronavirus,” a day before he voted to acquit Trump and six days before he sold his stock.

Think back to the earliest time you heard about the viral illness in China. Do remember when you first heard or read about it?

I do. I had just read about two high-profile deaths from pneumonia in middle and late December. A Chinese actress died, noted in Chinese media. She wasn’t known well to the U.S. so no mention here had been made. Only days later, right around Christmas, a young ESPN anchor also died of an odd pneumonia. This time there was news in the U.S. about his passing.

A week later on New Year’s Eve there was a report in English-language Chinese media about an odd cluster of pneumonia-like illness in Wuhan, China. My awareness of pneumonia had been heightened by the two high-profile deaths so close together.

If I could see a cluster of pneumonia in China by New Year’s Day, you know somebody within the U.S. intelligence community saw it even earlier.

We know now that the Senate Intelligence Committee chair had been briefed, based on a recording made of a meeting Burr had with large-ticket donors. Who else holding elected or appointed office were also briefed by intelligence and then refused to do the right thing to protect the American public?

Now you know why there’s been a full court press from the White House through the GOP congressional caucus to the right-wing media and punditry pushing racist invective against China about the pandemic.

It’s to distract and redirect the public’s attention away from the GOP’s wholesale betrayal of the American public and its allies while COVID-19 ramped up into a pandemic.

By the middle of summer thousands, perhaps tens of thousands of American lives will be lost because Richard Burr and others as yet unnamed helped Donald Trump fuck us over for their own venal aims.

Trump and the GOP had absolutely no intention of doing anything about COVID-19, which explains why Trump has only mentioned but still not used the Defense Production Act to ensure health care workers have adequate personal protection equipment. Crafters across the country are sewing homemade masks of irregular specifications right now to make up the shortfall while health care workers scavenge hardware supplies for mashed-up PPE.

Can’t help wonder how much PPE that $1.6 million would buy.

Or how much the profits from Sen. Kelly Loeffler’s stock sale would buy, or Sen. James Inhofe’s or Sen. Ron Johnson’s stock sale profits. (Sen. Dianne Feinstein’s household also recently liquidated stock but her press secretary said it was in a blind trust with the rest of her assets.)

Loeffler’s financial moves are egregious not only because of profit taking on inside information not shared with the public and then lying directly to the public on camera about the country’s condition. She then acquired stock in a business specializing in remote work, and her spouse is the chairman and CEO of the New York Stock Exchange. There’s absolutely NO excuse for not having her assets in a blind trust to avoid the appearance of a conflict of interest, particularly because of her spouse’s role. But I guess when you’re worth half a billion dollars you just don’t give a shit about annoying little details like ethics.

~ 1 ~

In previous posts I’ve discussed the different drugs being studied as potential therapies for COVID-19. This is an extremely important point which must be emphasized: all drugs, whether antivirals or monoclonal antibodies or anti-inflammatory meds are subjects of study. Some are being used off-label as last ditch efforts.

By off-label I mean they are NOT approved by the Food and Drug Administration as safe and effective for treatment of COVID-19 infections.

We are relying on off-label medications applied by doctors in desperate conditions in China and Italy on patients who are in dire shape to tell us about their effectiveness. We are literally relying on human experimentation without a consistent ethical framework

Yesterday’s presser with Trump was a disaster not only because of his racist bullshit aimed at China, but because he fucked up and discussed off-label drug therapies. He should have left that all together to the Center for Disease Control and the Food and Drug Administration.

His half-assed, poorly-framed remarks about an anti-malarial drug set off a run on black market chloroquine in Nigeria. The drug had been removed from the Nigerian market more than a decade ago because of the risks it poses to patients. It’s quite likely people will die because of misplaced trust in Trump’s words about this drug.

Two antivirals, lopinavir and ritonavir, used as a cocktail in a study in China failed to perform as needed against COVID-19. A study announcing these unfortunate results was published just Wednesday in  the New England Journal of Medicine. (Yet another example of Chinese researchers providing a benefit to the U.S. and the world, I’ll point out. Can only wonder what happened to the subjects of the test.)

And another antiviral discussed here before, remdesivir, is still under study, and still poses an unexamined conflict of interest for at least one person in the Trump administration.

The media did not catch how bad Trump’s remarks on drugs were — that hack Chris Cillizza offers an example, failing to mention the gross and dangerous errors about these medications in his list of fail.

Trump’s words and deeds, likely the output of his inept team including his son-in-law Jared Kushner and his pet Nazi Stephen Miller, are going to kill more people here and abroad on top of COVID-19. Given Miller’s history with this administration, this may be the desired result.

~ 0 ~

* I started writing this post Thursday mid-day. Before I finished it a fourth family member died.

Meanwhile, in neighboring New York, Gov. Cuomo doesn’t want a “shelter in place” order because it sounds too much like nuclear war and might scare people.

New York City is a COVID-19 hot spot rapidly become an American Wuhan cell. More people are likely to die there of COVID-19 than died during 9/11, and we changed our society dramatically out of fear of another such event. New Yorkers and the rest of the U.S. whose banking is centered in NYC need more than Cuomo’s personal concerns about a turn of phrase.

But as I said earlier, none of this had to happen, either. Not a lick of it. It makes the ongoing daily failures even more ridiculous because most are unforced errors. Much of the daily fail could be so easily stopped if Trump just shut up and left handling COVID-19 to ethical professionals.

This is an open thread.

Three Things: Even More Family Fun with COVID-19

[Check the byline, thanks!/~Rayne]

I figured it would be the oldsters in the family who would be my first worry. The grandparents still go to church, play bridge and golf, volunteer; they’re living typical retirees’ lives. They haven’t stopped mingling socially until this week.

But no. Last week I had to worry about my younger kid at college first. Fortunately they only had strep.

Last night the older adult child called, complaining of a migraine, dry cough, wheezing, and a tight chest. They’d already called the doctor about their symptoms; the doctor wouldn’t order a test because older adult child didn’t have a temperature.

All the other symptoms of COVID-19 except for a temperature. With so few tests available in Michigan, unless my kid checked ALL the boxes, there’s no way they’d be tested.

We’re pretty sure it’s not flu because the symptoms were slow onset rather than fast and adult child had a flu shot this year.

The kicker is that someone at work tested positive for COVID-19. It just hadn’t been announced across the business, likely because the business still needed to finish its plan for handling this situation.

Because my adult child couldn’t get a test, their spouse can’t say they’ve been exposed to COVID-19 and is likely now at work, probably spreading this around if indeed my adult child has COVID-19.

I won’t see my older kid or their spouse for a least a month now since we don’t yet know for certain if they have COVID-19 let alone how long exposed persons may be contagious. I dare not take the chance to see them because of my autoimmune disorder — not just because I might come down with COVID-19, but because hospitals may not be able to offer me an adequate level of care if there are no hospital beds or ventilators if one was needed.

When I saw this bullshit tweet this morning I almost levitated.

All the stress of our not knowing individual infection status and potentially exposing even more Michiganders is due to Trump, who instead directs his animosity toward an effective governor who isn’t getting the support she needs from the federal government.

My family and many others in Michigan and across the country are going through this Kafkaesque circus of uncertainty because the grossly-incompetent-when-not-corrupt Trump administration chose not to do the right thing and roll out testing back in January-February so that community acquired infections could be pinpointed earlier.

The one piece missing in this equation: why is it some people can get tested and others can’t? What arbitrary ju-ju allows Oklahoma to offer up a sizable percentage of its available tests for the Utah Jazz basketball players? Why are some political figures able to summon a test when others can’t?

Is this an additional layer of fuckery, not only the limitations on the number of tests available but an invisible prioritization of who can be tested? Does one’s political party affiliation make a difference, or the color of their state when it comes to getting a test for COVID-19 on a timely basis?

~ 3 ~

The UK did an about-face in its approach toward COVID-19. Boris Johnson backed off the idiocy of allowing the virus to simply run amok through the population to kill its most vulnerable citizens as well as those with the misfortune of being severly to critically ill while UK hospitals are overwhelmed by COVID-19 case load.

However, in spite of the noise made over the Imperial College’s latest assessment of COVID-19’s impact on the UK, nothing is being done. Leadership may have made some noises of surprise over the published mortality numbers but there have been no orders to lock down the country the way France has this past week, or Italy before that.

Instead, Johnson urged Britons to avoid pubs, restaurants and theaters.

He asked that the public only use the NHS “where we really need to.”

Britons were asked to avoid non-essential travel.

In short, a guidance was issued which appears wholly optional. It has no teeth.

Most importantly, Johnson did not order the country’s schools shut down, though young people are believed to be vectors for the virus. Murdoch’s tabloid-y outlet The Sun reports Johnson “hints” at shutting down schools in a few days, though a petition gathered more than 650,000 signatures asking for Johnson to do so immediately.

These numbers were pointedly ignored, though there was moaning at the number of deaths projected by Imperial College’s report — an estimated 250,000 souls. Johnson’s actions to date do little to mitigate let alone suppress COVID-19’S contagion, choices Imperial College explained as approaches to minimizing deaths.

The number of deaths even if Johnson implemented a more aggressive suppression regime in Great Britain* is staggering…

(*Great Britain versus United Kingdom may explain why the numbers shown are lower than a thumbnail analysis based on 67M UK residents x 40% infection rate x 2% case fatality rate.)

\Johnson’s action to date fails to respond adequately to the swamping of UK’s health care system, particularly its intensive care systems.

This past weekend the country continued to go to pubs and concerts, looking much like the revelers partying at the Masque while the Red Death roamed outside the walls of the palace.

Being on an island will not protect them, nor will having expressed a desire to leave the EU.

We won’t be able to help them, either; Trump has done little more than Johnson has for the U.S., relying instead on the states to do the heavy lifting of saving American lives.

If we survive this next year, those of us who are most at risk will owe our lives to the efforts of governors like Gretchen Whitmer, who must not only make the impossible happen with limited resources, but with an ignorant, mean asshat president whining about them at the same time.

~ 2 ~

One of our community members Surfer2099 has been digging away at pharma company Gilead Sciences; the company makes an antiviral drug, remdesivir, which has been used off-label to treat COVID-19 patients. As noted before in previous posts, the medication was shipped to China for tests without normal approval of the FDA.

Bloomberg reported yesterday that China wants to patent remdesivir (link to story at Reddit). It looks like China wants the patent in exchange for having allowed Gilead to test its drug on COVID-19 patients, bypassing the FDA’s test protocols in the U.S.

Surfer2099 noted that Gilead coincidentally launched a merger and acquisition the first week of March. How does such a move fit into the negotiations with China?

Don’t look away from this as remdesivir appears to have widening support in the treatment of COVID-19. If it’s the only drug approved by drug agencies including the FDA, there’s considerable money to be made with tens of millions of COVID-19 patients anticipated over the next 1-2 years.

~ 1 ~

Fortunately there was a little good news yesterday. A COVID-19 vaccine was injected into the first human volunteer in a Phase 1 trial. If successful, the vaccine will not be available for the public for at least a year and likely longer.

NIH Clinical Trial of Investigational Vaccine for COVID-19 Begins

The realistic time frame from this first injection to a public vaccine is at least 12 to 20 months under the best conditions, i.e., no reactions, no other hiccups like supply problems, no interference from outside entities like the Trump administration.

That’s how long we need to practice social distancing — at least 12 to 20 months. Settle in and develop a routine for the long haul.

~ 0 ~

This is an open thread. How are your friends and family doing with the changes we’ve had to make to our lifestyles?

Three Things: Good (Family) News, Bad (COVID-19) News

[NB: Check the byline, thanks! / ~Rayne]

It’s absurd that I’m happy my college student child tested positive for strep throat. Whew, what a freaking relief that they only had a bacterial infection which has killed humans throughout history! Thanks to science we have effective antibiotics to treat this kind of infection, one of which is already working away and making said student feel better. …

Literally just heard from my student that Michigan State University now has one confirmed case associated with its campus. I can’t find a published report yet, more details later; so much for the brief respite provided by streptococcus.

Brace yourself for the bad news which so far is the nature of COVID-19.

~ 3 ~

Drugs. Let’s get into them.

Beleaguered Italy is using the rheumatoid arthritis medication tocilizumab off-label to treat patients in ICU. It may become their protocol for treatment of patients who develop acute respiratory distress syndrome (ARDS).

COVID-19 apparently spawns a “cytokine storm” the same way the 1918 Spanish flu virus did. Health care professionals say COVID-19 kills via fulminating viral cardiomyopathy, (inflamed heart tissue), not hypoxia (suffocation due to lung failure).

The onset of inflammation can be sudden with the cytokine action but at a later stage in the infection, which is different from the 1918 bug. The Spanish flu affected mostly younger people whose immune systems over-responded to the virus, where COVID-19 affects older people whose bodies may already have inflammatory responses at work because of cardio vascular disease or diabetes.

(We don’t know yet why some young people without preexisting conditions have become very ill and in some cases have died. Some may be related to smoking, others could be related to an undiagnosed condition. More study will be necessary; in the mean time, young people should protect both themselves and the older and sicker people who could catch COVID-19 from them.)

China tried tocilizumab on roughly 20 patients and found this monoclonal antibody halted the storm, acting on interleukin 6. There’s a preprint unreviewed study online but I can’t open it now or would include it. An immunologist in Italy came to similar conclusion about the use of this med and consulted with Chinese docs. See this story in an Italian news outlet (open in Chrome and translate).

There are other meds being tested in China — antivirals remdesivir (mentioned in a previous post), favipiravir, lopinavir/ritonavir, umifenovir — but there I haven’t seen any information about their application treating COVID-19 cases as detailed as there is for tocilizumab.

Pharma manufacturer Roche has agreed to provide to Italy the tocilizumab which should not only help reduce burden on hospitals’ intensive care units but build a body of data about the drug’s success in short order. China has also approved the drug’s use on certain COVID-19 patients.

I want to emphasize here this is NOT a cure for COVID-19. It’s a treatment for patients whose heart and lungs are in distress, requiring intensive care and a ventilator. What this drug may do for many of these patients is prevent them from needing ICU and ventilation, while their bodies continue to fight off the virus.

~ 2 ~

And more drugs — this time, antivirals.

A number of existing drugs have been revisited for repurposing against COVID-19 instead of their original intended purpose. Antiviral remdesivir and antimalarial chloroquine are among them.

Chinese researchers posted a paper about in vitro results, not peer reviewed (at least I didn’t see that it was).

There’s a paper about chloroquine alone; in vitro studies suggest it may work against COVID-19. Chinese researchers have a number of in vivo studies in progress, but no data has been released.

Chloroquine by itself as an effective therapy would be a miracle in that it’s an old drug now off patent and available as a generic, super cheap to produce. Can’t imagine Big Pharma would like this. But we won’t even face this conflict if we don’t get data from in vivo studies.

What I haven’t seen yet is adequate research related to the ACE2 receptor to which the COVID-19 binds itself to attack the body. There’s a study under way about a decoy protein drug called APN01, but I haven’t seen any details yet. A discussion about the ACE2 receptor can be found at this link.

I’d like to see more work done in related to ACE2 receptor mechanism. I’m worried we’ll end up too focused on antiviral remdesivir because there may be some political hijinks behind this drug.

Gilead Sciences, the drug’s manufacturer, shipped a bunch of this drug to China without federal approval, for tests which I assume mean human experimentation on actual COVID-19 patients.

About the same time this happened two weeks ago Gilead launched a merger/acquisition of Forty-Seven Inc, a clinical-stage immuno-oncology firm. It looks fishy yet likely to go unexamined because of the mounting desperation to have a drug therapy in hand before the anticipated explosion of cases arrives at hospital doors. In short, it’d be too easy to extort the U.S. into using this drug.

What really takes the cake is that a former Gilead lobbyist, Joe Grogan, is now the director of White House Domestic Policy Council. Grogan has already undermined Trump’s drug pricing initiative to the benefit of pharmaceutical companies. How do we know Grogan isn’t still representing Gilead’s interests, perhaps encouraging the government to turn a blind eye to corner-cutting on remdesivir?

~ 1 ~

Now it’s time for some more blunt talk with the family members.

I have a health care power of attorney or a health care directive prepared, signed, witnessed, copies distributed with one copy in my fire safe. If the worst should happen and the doctors need direction if I become incapacitated, my patient advocate is authorized to order what I want done. I have more than one advocate in a chain in case the primary advocate can’t act on my behalf.

I also have a will prepared, signed, witnessed, etc. If I’m picked off this month my kids will be disappointed that I haven’t yet finished Swedish Death Cleaning in the basement, but such is life and death. (Sorry, kids. You’re stuck dealing with all of the grandmas’ china sets and fragile antique lamps. Heh.)

I put the question to you now: are you ready? Have you done the legal legwork to help your loved ones whether family and/or friends if you’re incapacitated or *knock-on-wood* die?

Get it done if you haven’t. Stop putting it off because there’s no more time for lollygagging. We’d all like to deny we could get very sick, lose control of our lives, even die, but nature has a way of having the very last word if you don’t provide one.

Need a resource for that health care directive? See the folks at AARP — they have links to free resources for each state.

Just as important is establishing a plan for what friends/family should do if they can’t reach you. Trusted friends/family members should have current phone numbers, addresses, alternate key locations, emergency contacts, so on. They should also know who the patient advocates are and how to obtain access to the relevant documents if advocates don’t already have them.

This doesn’t have to be heavy; some of this effort we should have been doing all along as part of your disaster preparedness planning. Think about the families and friends affected by hurricanes Katrina and Maria, and imagine COVID-19 as a kind of hurricane which won’t flood your house but could certainly upend your life. You’d be prepared for a hurricane. Be ready for this one.

~ 0 ~

Treat this as an open thread. Tell us what’s in your basement or closets you need to unload because no one in your family wants it.