CORONAVIRUS

[Rod1883]

Peter

It will be interesting to see if you get a response. I think I might buy another pack or two of D3 before this advice is heeded by the wider health profession and Supply and demand forces up the price.

Just a small point - I tried to look at the reference #5, but the link seems broken.

Rod

[iain]

Peter I'm not suggesting otherwise, I just think that in an Open Forum, extolling the virtues of D3 as being the great saviour for many conditions is perhaps a little misleading. Of course it impacts in many diseases, however there are many other causative factors. I m just trying to give a little balance to the subject.

I wish you luck with your open letter and hope that some decent research results from it.

Iain

[Deggers]

5 hours ago, john.r.davies said:

Quote, Guardian article "It's a racial justice issue" 8/4/2020:

Further to that, John  -  this discussion from CNN.  7/4/2020 :

"CNN political commentator Van Jones explains how the novel coronavirus pandemic has the potential to hit the African-American community especially hard."

 

Deggers

[Peter Cobbold]

2 hours ago, Rod1883 said:

Peter

It will be interesting to see if you get a response. I think I might buy another pack or two of D3 before this advice is heeded by the wider health profession and Supply and demand forces up the price.

Just a small point - I tried to look at the reference #5, but the link seems broken.

Rod

Rod,   Good idea, get a years supply.  We also are putting out a petition to HMG. To supply everyone would need 2 tons D3 per year !

Tks for the broken link, I've emailed the team

Peter

[Peter Cobbold]

2 hours ago, iain said:

Peter I'm not suggesting otherwise, I just think that in an Open Forum, extolling the virtues of D3 as being the great saviour for many conditions is perhaps a little misleading. Of course it impacts in many diseases, however there are many other causative factors. I m just trying to give a little balance to the subject.

I wish you luck with your open letter and hope that some decent research results from it.

Iain

Iain, The research is done and dusted. The physiological level of serum 25(OH)D3 is defined, and we know the amount of D3 needed tp get there. And ther is extensive knowledge of the ability of D3 to promote innate and adaptve immune pathways. Plus we know physiologicla D3 reduce flu infections 5-fold.  Waiting is killing people. Peter

[Peter Cobbold]

Dutch data from blood transfusion donors indicates 3% of their population has had SARS-CoV-2.

So 97% have not.

It is going tp take a looooong time to reach herd immunity.

No point in freeing the clutch on the 6, it wont be going anywhere this year.

Peter

Edited April 16, 2020 by Peter Cobbold

[foster461]

On cnn this evening there was a professor from Cambridge that says they have a vaccine similar to the one they developed for Ebola that will shorten the trial duration as it is very similar to other vaccines that they have developed and tested. They are going to start a large 1000 person phase 2 (efficacy) trial very soon. All good but what I dont understand is how you speed up the phase 2 trial. You give 500 people the vaccine and 500 people a placebo. Then what ?, you just wait and see who gets infected ?. I assume they dont deliberately expose the trial participants to the infection but what if nobody that got the vaccine is exposed to the virus since they are all likely doing the social distancing, face mask thing. How does the efficacy period ensure that an equal number from each arm of the trial has exposure to the virus ?

[Peter Cobbold]

Video, 200,000 views in 2 days, the message is spreading:

 

[Peter Cobbold]

6 hours ago, foster461 said:

On cnn this evening there was a professor from Cambridge that says they have a vaccine similar to the one they developed for Ebola that will shorten the trial duration as it is very similar to other vaccines that they have developed and tested. They are going to start a large 1000 person phase 2 (efficacy) trial very soon. All good but what I dont understand is how you speed up the phase 2 trial. You give 500 people the vaccine and 500 people a placebo. Then what ?, you just wait and see who gets infected ?. I assume they dont deliberately expose the trial participants to the infection but what if nobody that got the vaccine is exposed to the virus since they are all likely doing the social distancing, face mask thing. How does the efficacy period ensure that an equal number from each arm of the trial has exposure to the virus ?

and how  many of the partcipants will be elderly? where delibarate infection might well be dangerous.

Risk for a 20 year old deliberateyl infected with a controlled dose would be low, maybe acceptable.

Iain will know how trials are designed.

Peter

Peter

[iain]

12 minutes ago, Peter Cobbold said:

and how  many of the partcipants will be elderly? where delibarate infection might well be dangerous.

Risk for a 20 year old deliberateyl infected with a controlled dose would be low, maybe acceptable.

Iain will know how trials are designed.

Peter

Peter

Phase 11 would normally be Double Blind Placebo Controlled primarily to prove safety...in this instance I'm not sure DB would be used. Probably Single blinded, i.e Investigator knows who's had the active vaccine the subject doesn't.

I guess they will recruit young healthy volunteers with no co-morbidity to prove its safe in the first instance. Hopefully with a wide range of ethnic groups. Then move on from there.

 

[john.r.davies]

Would a Phase 2 include testing for antibodies - efficacy?

[AndyR100]

24 minutes ago, john.r.davies said:

Would a Phase 2 include testing for antibodies - efficacy?

P2 concentrates on side-effects (including adverse events), effectiveness in humans with the condition being studied and associated metabolism/excretion of the compound.

........ Andy 

[foster461]

1 hour ago, john.r.davies said:

Would a Phase 2 include testing for antibodies - efficacy?

Perhaps that answers my question.. they don't wait for chance and they dont deliberately expose people they just test for antibodies and assume immunity ?

[foster461]

Putting aside the voodoo advice videos, cnn for the last couple of days has been airing reports from NY doctors that have been successful in keeping people off ventilators by putting patients on O2 and turning them on their stomachs. Immediate improvement in blood 02 levels.

 

[Geko]

2 hours ago, foster461 said:

Putting aside the voodoo advice videos, cnn for the last couple of days has been airing reports from NY doctors that have been successful in keeping people off ventilators by putting patients on O2 and turning them on their stomachs. Immediate improvement in blood 02 levels.

 

The goal is to optimise the lung surface for breathing. Standing is the best position, sideways the default position (lateral safety position)

[Waldi]

Putting patients in the IC on their stomach is done here too (I have no medical back ground but got this from Dutch (reliable) tele.

Waldi

[john.r.davies]

"Proning", positioning a patient face down  has been used in ICUs for patients with severe pneumonia for many years.      When inflamed, the  lower parts of the swollen lungs don't drain their normal fluid so well.   This is cell fluid, not lung secretions, and in patients still able to sit up is seen in the dependant parts of the lung, nearest the diaphragm.    ICU patients can't sit up, and are nursed supine, lying on their backs as we do in bed.    Good nursing will 'turn' them, side to side, to spare the skin they are lying on, but the same swelling occurs in the now dependant lung parts, all along the back.    Proning, for several hours at a time, allows those lung parts to drain  and regain some function.   

But you may imagine, while 'turning' a patient needs two nurses, proning them can require six.  Moreover, in the prone position more of the patient's weight presses on their heart and main blood vessels, and in their critically endangered state can precipitate collapse, and death.    Proning is not a trivial procedure.        

Also, we know that lying still in bed makes ill people less likely to improve and survive.     ANY activity, 'mobilisation', improves survival, so advice to lie on your face from time to time for as long as is comfortable is sensible, if you are able to do it for yourself.    As for oxygen, it is standard procedure for ANY illness that involves the heart or lungs, because it is simple and cheap to do, with little risk, unless you are an unreconstructed chain smoker.       So much so, that in the present crisis, several hospitals have found that their Oxygen storage and pipeline systems are failing under the demand.   Another victim of an under-resourced, deprived NHS that can't even keep its buildings and infrastructure in good repair.

Edited April 18, 2020 by john.r.davies

[Waldi]

Dutch Radboud university hospital did a small trial ((10 patients) with an existing medicine for high blood pressure, Valsartan, which blocks Angiotensine-II. It is believed this may affect saturation of the long cells (sorry, do not know proper English terminology).  First results of this small group give reason to start an expanded trial with 300 patients (and another 300 placebo) in around 15 Dutch hospitals. Aim is to reduce long (capacity) related problems and hopefully improve recovery rate/time.

Thought this would be interesting for the more knowledgeable people on here. 

Waldi

[john.r.davies]

At the same time, Waldi, it is known that the Covid virus attacks cells by attaching to the ACE2 receptor on cell walls (Angiotensin-Converting Enzyme 2).       Valsartan is one of a class of drugs known as "Angiotensin receptor blockers" , a group among the ACE inhibitor drugs for blood pressure.   Treatment with these for high blood pressure leads to a proliferation of the receptors, especially on lung blood vessels, and it has been suggested that this provides the virus with more and easier access to lung cells, in people on such treatment.     Tghus tending to make them sicker and with worse lung function than others.

I would be interested to know the reasoning of the Radboud group, and their results.  Can you point me to a source, please?

I have a more than academic interest - I take an ACE inhibitor for my blood pressure!     But it would be unwise to just stop, as there can be a severe and dangerous rebound of hypertension on doing so.

John

 

[foster461]

John, I also take an ACE inhibitor and had the same concerns. I found this helpful.

 

[john.r.davies]

Thank you, foster!    An excellent mini-lecture, took me right back to the style some of my best tutors!

And it answered my question to Waldi - the team at Radboud are invetigating that left hand limb, low AT-II and blocked ACE2s.

I didn't know of the statement from theHypertension Council of the ESC, and Dr.Seheult's explanation makes it clear.     But it does depend on "we have no evidence in humans", so we will see.    

As I said before, I'll sit tight, ACE inhibitors  are otherwise excellent treatment for me, and the alternatives are less attractive!

John

[Peter Cobbold]

1 hour ago, foster461 said:

John, I also take an ACE inhibitor and had the same concerns. I found this helpful.

 

Stan,  He has completely missed the role of D3 in depressing renin activity.

D3 depression of renin gene expression has long been known:

eg https://www.jbc.org/content/282/41/29821.full.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999581/

D3 will depress renin and drive the pathway to low Angll and keep ACE-2 blocked, and viral entry reduced

The Indian doctor is on the right track.

Peter

and monitoring BP at home is easy enough.

BTW sunlight on skin not only makes D3 it has an additional efect of liberating nitric oxide and lowering BP.

 

Edited April 19, 2020 by Peter Cobbold

[james christie]

Just found this on another forum

james

[Waldi]

Hi John, 
sorry for the slow response, I was following Peters recommendation above and was outside, raising D3 levels and lowering my bp. 

I could not find an English-language link to the announcement of the Valsartan trial in the Radbout UMC, so here is a link to their site-announcement in Dutch:

https://www.radboudumc.nl/nieuws/2020/kunnen-hoge-bloeddruk-medicijnen-ernstige-complicaties-door-corona-voorkomen

If you want I can make a google-translation for you, please PM me in that case with your e-adress.

Meanwhile, I notice that trials are also made in the US with Losartan, which is also an ACE- blocker but then ACE-1.
I have no idea what the difference between ACE type 1 and 2 is, but this is what I did read, and you will probably know.
I googled for Losartan because... I have an interest in that, so to speak;)

Cheers,

Waldi

[john.r.davies]

Thank you, Waldi, no need.    Not that I can read Dutch, I'm English, damn yer eyes!    We really are the worst linguists on earth!   And Google Translate is wonderful!

The abstract reads:"Cardiologists from Radboud university medical center have started a large study into the treatment of corona patients with a medicine for high blood pressure. The results should show whether the commonly prescribed drug Valsartan can prevent serious accumulation of fluid in the lungs in the corona virus disease COVID-19. That would ensure that many patients do not have to go to intensive care. The Dutch Heart Foundation supports the research."

And answers the question, "Why Valsartan? The drug Valsartan lowers blood pressure by blocking the protein Angiotensin II. This protein increases blood pressure in blood vessels, allowing fluid to leak to surrounding tissue. Normally, this protein is broken down by another protein, ACE2. Because the coronavirus uses ACE2 to invade cells, corona patients have less of this protein. As a result, less Angiotensin-II is broken down and fluid can leak through the blood vessels into the lungs under pressure. It has not been scientifically proven that antihypertensive drugs such as Valsartan can counteract fluid build-up in the lungs. This research must prove or disprove this"

Which very much agrees with Dr.Seheult's explanation.    

Thnak you, again,

John