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welcome to another med cram kovat 19
update we are looking at a total of
almost 200,000 cases that are confirmed
worldwide total deaths
7900 48 total recovered 81 thousand if
we look at Italy we have 30 1506 cases
and 2500 deaths if we compare that to
for instance South Korea which has done
extensive testing and has despite that
only about 1/4 of the cases and only 84
deaths
interesting numbers the United States
has 6,000 362 confirmed with a hundred
and eight deaths and 17 total that have
recovered ok so there was an interesting
paper that was published in science that
I will show you later and also put a
link in the description below basically
what it shows is that at a single point
where this virus started and we expanded
out there was a point where the travel
ban went into effect in China and that
was on January 23rd and what they did is
they used Bayesian statistics to try to
figure out how many people went
undiagnosed and which people were
diagnosed in terms of before and after
the travel ban using Bayesian statistics
they found that 86% of kovat patients
prior to January 23rd went undiagnosed
so in other words here is the proportion
of patients here at 86% by the time we
get to January 23rd in our timeline
going across the bottom these people
here did not get tested for Cova 19 so
they didn't know that they had it and
the authors note that those who don't
get diagnosed often had mild limited or
no symptoms at all so in other words if
these people had severe symptoms they
probably would have gone to the hospital
and they probably would have gotten
tested but they didn't get tested and so
many of them were walking around with
mild or no symptoms going to work going
to school going to restaurants etc and
further
more the author's mathematical model
predicts that these undocumented cases
were the source of approximately 79
percent of all reported cases in China
had these people known that they had
kovat 19 and not spread it let's say
that they were in isolation because they
knew they had the virus according to the
model the number of cases in China would
have dropped by 79 percent and the
number of cases in Wuhan would have
dropped by 66 percent so let's show you
this article so this is the article that
was published in science which is about
as good as you get in terms of peer
reviewed journals so you can go ahead
and look at the graphs in the link in
the description below but I wanted to
point out some things in their
conclusion our findings also indicate
that a radical increase in the
identification and isolation of
currently undocumented infections would
be needed to fully control SARS cub 2
and just think about that the two things
here that they're looking at
identification and that can only come
from increased testing and isolation
that's what we have to do as citizens
and that's the key is understanding that
a very large majority of the patients
who had been infected at the time of the
travel ban didn't know that they had
been infected with a corona virus and
because of the fact that they didn't
isolate themselves they were
unfortunately unwittingly able to infect
far more people and this is interesting
their model predicts that the
undocumented infections were less
contagious
55% as contagious as documented
infections but since there were a lot
more of this undocumented infection
group this group of people contributed
most to the spread of Kovan 19 in China
the 2009 h1n1 pandemic influenza virus
also caused many mild cases quickly
spread globally and eventually became
endemic presently there are four endemic
corona virus strains currently
circulating in human populations and
they're listed there
if the novel coronavirus follows the
pattern of 2009 h1n1 pandemic influenza
it will also spread globally and become
a fifth endemic coronavirus within the
human population these findings explain
the rapid geographic spread of SARS cuff
to and indicate containment of the virus
will be particularly challenging and
that's what we're finding out at this
point so what I get out of this article
is basically the best way to flatten the
curve is to isolate otherwise you might
be having a similar situation to what is
going on in Italy at this time so I want
to revisit the entire zinc and
chloroquine hydroxychloroquine issue
because that seems to be picking up
rapid speed here in the last couple of
days so the first thing is of course
here's this very busy picture enough to
say that when the corona virus infects
the cell it's going to dump in to your
cell a messenger RNA that's going to be
translated using ribosomes those
ribosomes the first thing they're going
to do is translate that RNA molecule
into a protein called RNA dependent RNA
polymerase or replicase and it is this
enzyme that it's been shown that is
inhibited by high intracellular
concentrations of zinc well as it turns
out chloroquine is a zinc ionna for as
is hydroxychloroquine zinc ionna for is
just basically a protein or a gate that
allows zinc to come into the cells we
don't know if that is the actual way
that it is working in this case but it
does seem to lead credence to the
mechanism of action that zinc does
inhibit replicates and that
hydroxychloroquine and chloroquine
increased the intracellular
concentrations of zinc for more on
hydroxychloroquine and chloroquine and
dosing and mechanism and recent articles
please go to update 35 which will give
you a lot of the background information
what I wanted to show you today was some
recent reports but not actual
publications as yet
there was an article that was published
in today's edition of a French
publication called the connection French
researcher post successful kovat 19 drug
trial I don't know if this has been
peer-reviewed or even published in a
journal but it is a newspaper article
that talks about a renowned research
professor in Marseille France by the
name of professor reveled and there is a
video in French on YouTube which I will
put the link to and this is what is
reported there is a medication of course
chloroquine and hydroxychloroquine which
is marketed as Plaquenil
and what they say here is that they took
24 patients who were among the first
patients to become infected in
south-east france and the patients were
given 600 micrograms per day for ten
days they were closely monitored and
what they found was this they were able
to ascertain that patients who had not
received Plaquenil which is the drug
were still contagious after six days but
of those that had received Plaquenil
after six days only 25% were still
contagious caution here because we don't
actually have the peer-reviewed data
this was only 24 patients but this is an
interesting finding as it may represent
the first glimpse into some of the
trials that will be coming out in the
next few months I'm sure the professor
was very excited to get this word out
here is a similar news on another French
news site coronavirus hydroxychloroquine
would be effective according to
Professor Raoul and we don't have the
actual paper published as yet but this
is the highlights from the press
conference that again we'll link to in
the description it says here that the
professor presented the first results of
the clinical tests with
hydroxychloroquine and the results are
even more promising with
hydroxychloroquine and ASA through
Meissen an antibiotic effective against
viruses now as it's from Ison for those
who don't know is an antibiotic it's the
active ingredient in what you may know
as a z-pack so that you might get if you
went to the urgent care or your primary
care doctor
the emergency room and had an infection
that's interesting that as Iranian might
have an effect against viruses it's an
interesting point and one that has to be
looked into to see why that was the case
there are some indications that as the
throw Meissen may have anti-inflammatory
properties one of the other concerns
that I would have personally is the fact
that hydroxychloroquine may have QT
prolongation issues and we know that
those are issues also that are present
with asa through Meissen QT prolongation
is a consequence of a number of
medications which can lead to fatal
cardiac arrhythmias if not monitored
correctly and apparently the government
was impressed enough to extend this test
to other hospitals to test its
effectiveness on a much larger scale and
if we go back to the table of countries
here we know that South Korea has used
this medication early with extensive
testing and we can see here that the
mortality or the number of deaths
divided by the number of confirmed cases
is quite small in fact it's about 1% and
makes one wonder if chloroquine is part
of that calculus well that's it for
today further updates we'll talk about
this idea of reinfection and immunity
thanks for joining us
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