Life is not a Hollywood script

At present, I am not concerned about Jillian's claim that JJ would prevent this issue or do anything to alleviate such from occurring.  My concern, as it was posed as a question to me, is this a legitimate concern or threat?

Short answer,,, everything I have read indicates that yes it is a threat. 

There is circumstantial evidence that these five strokes (or at least many of them) may be causally related to COVID-19. First, they all were confirmed to have the disease. Also, they all had the same type of stroke – large vessel stroke caused by a blood clot (thrombus). That is at least consistent with a common underlying mechanism.
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With regard to large vessel stroke in COVID-19 patients, do we see the same cluster in other locations? What about other age groups – why would younger patients be affected but not older ones? Is it just that strokes are more common in older patients and therefore do not garner as much attention? An excess of five older strokes might be lost in the background.

As I initially wrote when this was brought to my attention. (My response was concerning a WaPo article. Same topic.)

From my understanding CV-19 is causing many issues that are unexpected. Clotting being one of them,,,and not just causing strokes, but heart attacks, pulmonary embolisms and deep vein thrombosis among other things.

Many researchers suspect strokes in covid-19 patients may be a direct consequence of blood problems that are producing clots all over some people’s bodies.

Clots that form on vessel walls fly upward. One that started in the calves might migrate to the lungs, causing a blockage called a pulmonary embolism that arrests breathing — a known cause of death in covid-19 patients. Clots in or near the heart might lead to a heart attack, another common cause of death. Anything above that would probably go to the brain, leading to a stroke.
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Chou said one question is whether the clotting is because of a direct attack on the blood vessels, or a “friendly-fire problem” caused by the patient’s immune response.

“In your body’s attempt to fight off the virus, does the immune response end up hurting your brain?” she asked. Chou is hoping to answer such questions through a review of strokes and other neurological complications in thousands of covid-19 patients treated at 68 medical centers in 17 countries.

In regard to our common interest, these are catastrophic events caused by clots in main branch arteries. Regretfully not something you recover from without damage,,, ie no watching Planet of the Apes as they occur. While the immune response may play a role it does not validate anything cabbagebitch states.

Now, before we go any further, I need to remind folks that I am but a layman.  While I believe I have a solid background is the sciences (except physics, I suck at physics), I must remind y'all that this is my attempt to make sense of the vast amount of information available.  I do my best to refer you to solid consensus science and opinion.

While I shouldn't have to state the obvious, I am going to anyway.  If you have legitimate concerns please speak with your medical doctor.  There are too many variables for a layman to consider.

With that said, I have done some follow-up reading I felt compelled to share.

Initial studies are still providing insight with research ongoing. 

Jillian has is 3 ½ years of trial and error messing with people's health in no guided fashion.  She has no substantiation for any claim she makes. And has now returned to a modified take on regrowing limbs.

Being of an older age, showing signs of sepsis, and having blood clotting issues when admitted to hospital are key risk factors associated with higher risk of death from the new coronavirus (COVID-19), according to a new observational study of 191 patients with confirmed COVID-19 from two hospitals in Wuhan, China, published in The Lancet.
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For the first time, the study describes the complete picture of the progression of the COVID-19. The median duration of fever was about 12 days in survivors, which was similar in non-survivors. But the cough may last for a long time -- 45% of survivors still had cough on discharge. In survivors, dyspnoea (shortness of breath) would cease after about 13 days, but would last until death in non-survivors. The study also illustrates the time of the occurrence of different complications such as sepsis, acute respiratory distress syndrome (ARDS), acute cardiac injury, acute kidney injury and the secondary infection.
[Original:: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30566-3.pdf]

But new studies are needed (and are being done) as secondary issues are coming to the fore. For example, Broadway actor Nick Cordero is recovering after having his right leg amputated following complications with coronavirus; a clotting issue.

Or, as The Telegraph notes, “Covid-19 may trigger post-viral fatigue syndrome in some patients, experts have warned, amid growing evidence that an infection could have significant long term health repercussions.”

“We’re at the very primitive stage in terms of understanding the long term effects of this pandemic,” said Dr Harvey Moldofsky, former professor of Psychiatry and Medicine at the University of Toronto’s Center for Sleep and Chronobiology. “But it’s clear that it doesn’t just attack the lungs, it’s everywhere.

“Based on my experience with Sars, I am deeply concerned that our definition of ‘recovered’ is far too narrow. It’s likely that some patients will experience chronic fatigue syndromes for months or even years after an initial infection,” Dr Moldofsky told The Telegraph.

This one terrifies me!  To borrow from SciBabe, “I miss a simpler time (mere weeks ago) when I thought this was a respiratory illness. And now it seems to be an everything illness.”

The Santa Clara woman whose death from COVID-19 is the earliest so far known in the United States suffered a massive heart attack caused by coronavirus infection, signs of which were found throughout her body, according to an autopsy report obtained exclusively by The Chronicle.

While I am not trying to fear monger, the take away point for me personally, we are dealing with something very new, very troubling, and very deadly.  Now is not the time to rely on bad science and woo-woo.

Jillian's claims that JJ will some how fight this virus is very misguided.  Although, it should be noted that since David Icke has been taken down from FB, her narrative surrounding CV-19 has mellowed almost to the point of nonexistence.  Her other crap information has not.

Now she claims her “mini-strokes” slash 6 day headache, was “BLOOD FINALLY [getting] to the DIFFERENT parts of my brain.”

Think about that for a moment!!

See also::  Revealed: How coronavirus attacks your veins, heart, brain and blood – as well as lungs

This is a clotting issue, as noted above, with stroke being a possible outcome.  A study, carried out by the Irish Centre for Vascular Biology, RCSI and St James's Hospital, Dublin states,

The authors found that abnormal blood clotting occurs in Irish patients with severe COVID-19 infection, causing micro-clots within the lungs. They also found that Irish patients with higher levels of blood clotting activity had a significantly worse prognosis and were more likely to require ICU admission.

"Our novel findings demonstrate that COVID-19 is associated with a unique type of blood clotting disorder that is primarily focussed within the lungs and which undoubtedly contributes to the high levels of mortality being seen in patients with COVID-19," said Professor James O'Donnell, Director of the Irish Centre for Vascular Biology, RCSI and Consultant Haematologist in the National Coagulation Centre in St James's Hospital, Dublin.

In addition to pneumonia affecting the small air sacs within the lungs, we are also finding hundreds of small blood clots throughout the lungs. This scenario is not seen with other types of lung infection, and explains why blood oxygen levels fall dramatically in severe COVID-19 infection.

"Understanding how these micro-clots are being formed within the lung is critical so that we can develop more effective treatments for our patients, particularly those in high risk groups.

Many hypotheses abound, each with their own strong points.  As WebMD notes,

One theory is that the body launches an immune attack called a cytokine storm to fight the virus that becomes self-directed, causing cells to kill themselves in an attempt to shut down the infection. Doctors believe that for some patients, the immune attack can end up doing the body more damage than the virus itself. This hyper-inflamed state is itself a well-known risk for blood clots. Cytokine storms can cause a condition called disseminated intravascular coagulation, or DIC, where patients both bleed uncontrollably and clot too much at the same time.

A second idea suggests “evidence of viral bodies of the new coronavirus invading endothelial cells. The endothelium is the lining of our blood vessels. It directs important functions of the vascular system like clotting and swelling.”

Study co-author Mandeep Mehra, MD, medical director of the Brigham and Women’s Heart and Vascular Center in Boston, says the findings suggest that the virus can directly infect the endothelium. He says that while COVID-19 can certainly cause breathing problems, he doesn’t think it’s just a lung disease.
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The bottom line, he says, is that clotting is a feature of the COVID-19 syndrome. When it becomes a big problem, the disease is advanced and very severe. For that reason, treating the resulting blood clots probably won’t work.

He believes something worth trying might be to give patients drugs to support the endothelium, like ACE inhibitors and statins, along with anti-inflammatory drugs to tackle the cytokine storm, early in the course of the disease, but more research is needed to know for sure.

Returning to SciBabe's thought, “now it seems to be an everything illness” as StatNews puts it,

As with so much else about the Covid-19 response, health experts are learning about the symptom on the fly. Blood clots are common in patients who are immobilized, but they seem to be smaller and cause far more severe damage in some Covid-19 patients. Doctors have said they see patients with blood clots forming not only in their lungs, but also in blood vessels. Autopsies have also revealed blood clots in kidneys and other organs, which some experts say suggests an overwhelming immune system response to the virus that inflicts harm on the body.
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“This is a real-time learning experience,” said Clyde Yancy, chief of cardiology at Northwestern University Feinberg School of Medicine.

With that in mind a few possible treatments that have been floating about the inter-web.  And FYI, I am going to do my best to avoid outright conspiracy shit.

Hydroxychloroquine (and azithromycin)
Thanks to a flawed study and the mouth of the orange man in charge, people that need these meds can not get them.

From Skeptical Raptor,

The study is tiny, nowhere near enough to consider any results statistically significant. There was no randomization. It was not double-blinded. The “controls” were not patients who were in the same medical center, who would, presumably, receive the same kinds of treatment. And let’s not forget that in all clinical trials, the control group is blinded to both the patient and the treating physician.

According to a thorough analysis of this study by Skepchick:

That means that you analyze everyone enrolled in the study, regardless of whether they complete the trial or not. This allows the effects of death, non-compliance, cessation of treatment because the side effects are intolerable, etc, to be included and for the impacts of a treatment to be fully considered beyond a narrow group. It gives you more of the drug’s true effect, not simply the effect in the best, most compliant patients.

In the H (hydroxychloroquine) group, participants who stopped taking the drug, died, or went to the ICU were not included. This is hugely problematic because the criteria were not applied uniformly and the outcome in the H group may be the result of only including very robust participants. Patients that are dead or in the ICU and not monitored may have higher viral loads that would not be reflected in the data if these participants are eliminated.

While there are reports of anecdotal successes, a newer unpublished study does not support the claims made.

No effective therapy for Covid-19 has yet been identified. Given the longer development, testing, and approval times for novel chemical entities, repurposing drugs already approved for other indications is a promising approach to rapidly identify an effective therapy. Hydroxychloroquine is at the forefront of drug repurposing candidates Although ongoing randomized, controlled studies are expected to provide more informative evidence about hydroxychloroquine in the coming months, the outcomes observed in ourstudy represent the best available data,,, Specifically, hydroxychloroquine use with or without co-administration of azithromycin did not improve mortality or reduce the need for mechanical ventilation in hospitalized patients. On the contrary, hydroxychloroquine use alone was associated with an increased risk of mortality compared to standard care alone.
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Data from ongoing, randomized controlled studies will prove informative when they emerge. Until then, the findings from this retrospective study suggest caution in using hydroxychloroquine in hospitalized Covid-19 patients, particularly when not combined with azithromycin.

See also:: Chloroquine for coronavirus, I mean the Trumpvirus – evidence is weak and Step Away From Your Z-Pack…

Bacillus Calmette-Guerin vaccine (Tuberculosis)
Borrowing heavily from Skeptical Raptor again.

Despite all of the evidence regarding some amazing clinical uses for the vaccine, how did we get to the point that some people are pushing the BCG vaccine for COVID-19?

This hypothesis was based on a rather simple observation. Dr. Gonzalo Otazu from New York Institute of Technology, College of Osteopathic Medicine stated that:

We found that there was a reduction in the number of deaths attributed to COVID-19 per million inhabitants in countries that have universal BCG vaccination (usually at birth) compared to the countries that never established such policy. The earlier the establishment of such policy, the stronger the reduction in mortality, consistent with a protection to the elderly population which is more severely affected by COVID-19.

Now, there’s a lot to criticize in that statement. I am always uncomfortable with population-level statistics that can be misused. Anti-vaccine activists love to make specious claims comparing the number of vaccines and some random effects between countries while ignoring hundreds of confounding variables.

But with a lot of desperation surrounding the coronavirus, observations like this can lead to interesting hypotheses, which is what we’ve got here. No one thinks that the BCG vaccine is a guaranteed slam dunk to either prevent or treat COVID-19, but this is the start.

As Raptor explains,

In other words, the BCG vaccine may induce certain parts of the immune system to produce more cytokines, which are important to signal the growth and maturation of numerous cells that are part of the immune system’s responses to pathogens.

It is well understood that a cytokine storm was probably responsible for the high mortality during the 1918 flu pandemic. A cytokine storm results from large numbers of white blood cells are activated and release inflammatory cytokines, which in turn activate yet more white blood cells. This can be dangerous.

However, the BCG vaccine does not cause a cytokine storm (or we would have noticed it during the last 100 years of its use).

Remdesivir
So initially remdesivir was brought to my attention via SciBabe who wrote,

It's not a miracle drug, it's not a treatment that cures 100% of cases. But it does seem to help reduce the length of severe cases and there are indications it can reduce the number of fatalities.

This won't stop you from contracting it, and our best defense is still social distancing. But this is a really good piece of news in managing critical cases.

Edit: as has been pointed out by a doc I respect in the comments, there is still mixed evidence on this in trials. So perhaps not "really good news," but potential news. Eventually. Who knows. *heavy sigh*

in response to this article, Remdesivir shows promising results for coronavirus, Fauci says.

Remdesivir is an experimental antiviral drug that's thought to work by blocking the virus from replicating itself in the body.

Low and behold, David Gorsk (MD, PhD, FACS a surgical oncologist at the Barbara Ann Karmanos Cancer Institute), a man whose input and analyses I highly respect, had this to say,

“Apparently Fauci’s and the FDA’s definition of “clear-cut evidence” has changed. I’m certainly unimpressed, as are most docs.”

With an added caution,

“Yes and it is not published yet. It was announced by press release. Press releases do not interest me.”

While I believe Dr Gorski is waiting on full publication to do a complete analysis, his preliminary thoughts are telling.  But bear in mind, my understanding of this discussion is muddled in a bit of confusion as a number of studies were bandied about in conversation.  TBH I not sure which study was being discussed at times.

Which brings me to Skeptical Raptor's take on the matter.

Too many times we get clickbait headlines about some new miracle drug or treatment that is based on preclinical data, usually in a press release. That’s why I won’t get excited until I see that phase 3 clinical trial data.

However, things are different today, at least with respect to the COVID-19 pandemic. The disease is deadly and highly infectious, and as of today, we don’t have a good treatment for the disease. Of course, there are quacks and scam artists who are pushing pseudo-medicine that doesn’t work.

Like Gorski,

Always wait for Phase 3 clinical trial results. Since I’m going to be skeptical about the FDA Emergency Use Authorization for remdesivir, and we really do need useful coronavirus treatments, just getting the data, compared to a placebo, may give us a good idea about the ability for this drug to improve outcomes.

The National Institutes of Health has released preliminary data that shows positive results. But it is only one study, though encouraging. 

However, a peer-reviewed study was just published in The Lancet that analyzed a small, double-blinded, randomized clinical trial in China – “In this study of adult patients admitted to hospital for severe COVID-19, remdesivir was not associated with statistically significant clinical benefits.” The study also had to be stopped early because of the high level of adverse events in the remdesivir group. OUCH.

So, we have conflicting results about the safety and effectiveness of remdesivir, although the preliminary NIH results are in a much larger study group than the ones from China.

SR concludes,

The NIH results, which are being touted across the internet, do show a reduction in the mortality rate from 11.6% in the placebo group to 8.0% in the drug group. That’s a 31% decrease. But it’s not a miracle cure that everyone wants, though I suppose a 31% better chance of surviving the disease is a miracle. However, these are very preliminary results, and there are other clinical trials with remdesivir that might show contradictory results.

As this essay has taken me a couple  few days to put together, it has come to my attention that remdesivir has been given emergency authorization by the FDA.

In a news release, the FDA said "While there is limited information known about the safety and effectiveness of using remdesivir to treat people in the hospital with COVID-19, the investigational drug was shown in a clinical trial to shorten the time to recovery in some patients."

The move allows for the drug to be given to adults and children hospitalized with severe COVID cases. The agency defined severe as patients with low blood oxygen levels, needing oxygen therapy, or breathing support such as a mechanical ventilator. 

As y'all can see this is not a cut-n-dry situation as some "skepdicks" and con-nutters will have you believe - it's not "like the flu."  It is ever changing as this virus manifests in ways we have never conceived possible.

While personally I am not currently concerned in regards to myself, I am for friends and family that may be more exposed than I.  I live in rural PA, we have had but 1 case and for the most part people are following guidelines.

Now that we have gone to yellow status, that may change.  I am a high risk candidate due to my diabetes as well as my prior strokes.  I would be lying if I said I am not concerned or will not be once flatlanders invade for hunting and fishing.  All I can do is stay informed and follow what science tells us. 

Unlike Jillian who believes those "weaker" than her should suffer or perish.  Life is not a Hollywood script.