[pgsagar]

Ok, I may sound stupid here but if there is no cure for this pandemic, what are some of the patients recovering on? In my town, there were 21 cases. All were hospitalized, were treated and after 18 of them recovered after spending 12-15 days in hospital they were sent home. 3 are still in hospital. What are they recovering on? My town has made elaborate arrangements but so far only 21 cases in a city of 28 lakhs. Zero fatality. Hope it stays that way.

[carboy]

Originally Posted by pgsagar

Ok, I may sound stupid here but if there is no cure for this pandemic, what are some of the patients recovering on?

80% of the people infected have no symptoms. They don't even know they are infected. So there is nothing needed to recover. Some of the others recover just like they recover from common cough & cold without medication.

[Miyata]

Originally Posted by pgsagar

if there is no cure for this pandemic, what are some of the patients recovering on?

What are they recovering on - Lots of loving care, warm fluids (soup, tea/coffee, etc), plenty of rest, and small doses of fever meds - the usual stuff!

As carboy mentioned, majority of cases recover without much fuss at all. The infection is handled by the immune response and above mentioned things as moral support to that immune response!

A small fraction has their immune system going into overdrive and doing more harm than good...all downhill.

A smaller fraction has poor response from the immune system and lead downhill.

[pgsagar]

Carboy and Miyata, all 21 exhibited symptoms consistent with onset of covid-19. Then, they were subjected to testing and only after testing positive, they hospitalized. They must have been administered some kind of medication. I don't think they were treated on love, care and coffee for 15 days. I don't know anyone in these hospitals, else I would have enquired about that. And, Miyata, how does having a robust immune system become a liability? Am I missing here something?

[carboy]

Originally Posted by pgsagar

Carboy and Miyata, all 21 exhibited symptoms consistent with onset of covid-19.

Just like people exhibit symptoms of cold & flu but get ok after 10 days even without any treatment.

I didn't say these 21 people didn't exhibit symptoms. I said that there must lots of others in your place who are positive (but not tested) but don't exhibit symptoms. Several reports (from India & other places) say that for most people, the virus is harmless even after they get infected.

Originally Posted by pgsagar

Then, they were subjected to testing and only after testing positive, they hospitalized. They must have been administered some kind of medication.

Maybe, but many people with mild symptoms must be getting OK even without treatment. Just like in cold & flu.

This is my estimate - 100 people infected. 80 people don't even realize it & don't have any symptoms & the virus dies off on it's own in a couple of weeks. Many of these people would have tested positive if they would have been tested, but they aren't.
Remaining 20 people - 18 have flu like symptoms. They are tested & they test positive. They are either given some flu like treatment or may be HCQS or antivirals etc. They get OK in 2 weeks. The remaining 2 people die.

Originally Posted by pgsagar

And, Miyata, how does having a robust immune system become a liability? Am I missing here something?

I don't think he said that a robust immune system is a liability. What he said that those who die, they die because their immune system goes into overdrive after a particular stage. This is because their immune system produces a cytokene storm which kills them.

[Thad E Ginathom]

Whoever put the word cured at the top of a column made a simple but bad mistake. It has been made clear by previous posters that the symptoms may be anything from bad to mild, to horrible, to serious, to requiring hospitalisation, to requiring ICU breathing support. The vast majority will recover. Some even return to the land of the living from the ICU ward.

At the serious/ICU end of the spectrum, perhaps it is splitting hairs, because they might have died without the hospital treatment. They have still not been cured because there isn't a cure: their body has been successfully supported until it successfully got better.

To complicate things further, we have probably fallen into the assumption that the progression of the disease is linear. I've read one or two reports from family members of victims going from mild to dead very quickly.

So we should discard the word cure unless or until some specific antiviral is found. We either recover... or, errm, not :(. And because there is "no cure" doesn't mean everybody dies: most victims recover.

One of those times when those of us who like to split hairs over using the right word might have a very good reason to do so!

[carboy]

Originally Posted by Thad E Ginathom

the symptoms may be anything from bad to mild, to horrible, to serious, to requiring hospitalisation, to requiring ICU breathing support.

Don't forget no symptoms (not even mild). I have seen a few reports which say that 80% of infected people have no symptoms.

[kushagra452]

A potential vaccine under development at the University of Oxford will start human trials from Thursday. Excerpt from The Telegraph article (Link given below). Prof Sarah Gilbert is leading the study.

The Oxford University team's experimental product, called "ChAdOx1 nCoV-19", is a type of immunisation known as a recombinant viral vector vaccine and is just one of at least 70 potential Covid-19 candidate shots under development by biotech and research teams around the world.

“There's always an unknown. We can never be certain that these vaccines will work,” said Prof Gilbert. "But personally I think it has a very strong chance of working.”

https://www.telegraph.co.uk/global-h...virus-vaccine/

[naveenroy]

Originally Posted by Miyata

Yea, I actually find this prevalence for blind acceptance just because an "expert has said so" to be lot more prevalent in India than in the US.

Mistaken my friend. People are pretty much the same all over the world. Many of his fans have blindly accepted that that medicine is a cure.

Originally Posted by Miyata

On Georgia, was speaking to a friend there and apparently Brian Kemp's intel seems to be at odds with what's being presented by Johns Hopkins and other tracking portals/sites.

Kemp was the guy who said in a news conference that he didn't know that people could be asymptomatic.

Originally Posted by Miyata

However, he also appears to be doing things quite sensibly

This could provide a template for others to return to work while maintaining safe practices at work place. Hope things go good.

I don't think so. It is too soon to be opening up the state when we have high numbers - even in the county I am in. Oh well, politicians - he will wait to see if the numbers go up again and feign innocence and get away with it.

EDIT - it was done to make sure that people cannot file unemployment. I won't post info here but it is out there.

[Santoshbhat]

Originally Posted by carboy

Don't forget no symptoms (not even mild). I have seen a few reports which say that 80% of infected people have no symptoms.

I think what they mean is that they were asymptomatic at the the time of taking samples. Symptoms could still manifest after a few days from mild to severe.

Since the number of recovered cases in India is large enough now, we need to know

• How many recovered with none to mild symptoms?
• How many had severe symptoms and needed hospital support and to what extent in terms of saline/ monitoring of vitals/ ventilator support etc...?
• How many had to visit the ICU?

The purpose of the lockdown is to flatten the curve so that the number of cases don't come in all at once and we are able to spread it over a longer period so that we are able to provide hospital care to the patients who come in. If a large percentage of patients who recovered, needed ICU support or ventilator support then extending the lockdown could be justified. This assumes that the fatality rate would just go through the roof if people are unable to get hospital care. OTOH if a large number of people recovered with just mild symptoms/ fever, then maybe we can move swiftly towards coming out of the lockdown.

I feel we need to open up slowly. The number of new cases is fairly stable since the past few days. It is not going down to zero any time soon. The number of cases is going to rise once we lift the lockdown whether it is May 3 or June 3 or July 3. Every day of the lockdown comes with a huge price tag. It's like paying your credit card dues - Pay now or pay later. We know paying later comes at a huge price, so most of us pay before due date.

[Miyata]

Originally Posted by pgsagar

Miyata, how does having a robust immune system become a liability? Am I missing here something?

Robust immune system would be good. It would address the coronavirus (or any foreign matter) infection and take a back seat.

When it goes overdrive, the immune system does not rest after the virus threat is neutralized. It continues the attack leading to inflammation and subsequently sepsis with potential fatal results for the patient.

Aspects of the bio-chemical pathways are still being worked out is what I understand. But the knowledge of overdrive -> inflammation -> sepsis -> possible-death itself is very well understood. This is one of the mechanisms understood to be at play here.

[rdst_1]

Originally Posted by pgsagar

And, Miyata, how does having a robust immune system become a liability? Am I missing here something?

It is a RNA virus which uses reverse transcriptase to convert the RNA to DNA which integrates with human DNA and starts replicating, eventually the host cell dies and thousands of virions get ready to attack thousands more cells.
Now in response to this, our body produces cytokines ( there are many, but let's keep it simple by taking only interleukin for the time being)
If thousands of infected cells produce a lot of interleukin, this is cytokine storm.
This is causing the pulmonary damage, renal damage, multi organ failures etc. This is also what happens in sepsis.
The virus can also cause viral myocarditis, this is extremely dangerous and practically untreatable.

People who are even showing mild symptoms and testing positive are being hospitalized for the sake of safety. These people would have been fine just taking paracetamol at home, if not for the infectious nature of the disease.

Some of the mild cases, roughly 21% going by the worldometer stats, turn severe and die. Some of the severe cases recover when supported by ventilators and even ECMOs abroad. ECMOs are the holy grail and have very good recovery rates even in severe cases, according to a WHO doctor who we are in touch with at another forum.
When on ventilator support, doctors have been trying numerous medications all over the world, right from HCQ and Azithromycin to cocktails of HIV and Swine Flu medications. In a recent trial by Gilead Sciences, their anti viral drug Remdesivir showed exceptional results against CoVID - 19, and they have been providing the drug on compassionate basis, but it is still under trial. I posted a link yesterday or day before where you can track all the different vaccinations and medicine trials going around the world against CoVID 19, and the stages they are in.

[msdivy]

Originally Posted by Gansan

What explains the difference in Covid 19 numbers (both infections and mortality) between Spain and Portugal? I think they are almost a single country, more or less. I read Portugal has universal BCG and Spain doesn't.

I was trying to convey that there is no relation between corona & BCG. Iran has mandatory BCG but they have over 85,000 cases. Within our country where all have had BCG vaccination, the number differs across states in terms of total cases, deaths & recovery.

Response from WHO : https://www.who.int/news-room/commen...n-and-covid-19

Originally Posted by Miyata

With so much hoopla surrounding hydroxychloroquine, it appears to be emerging that there's "More deaths, no benefit from malaria drug"

The recovery mechanism from the corona is to rest the body and helping it to recover. Any bacterial infection during recovery is treated via medicine. The infection can vary from patient to patient. Malaria drug may help in some patients and if it helps then good.

[pgsagar]

Thanks Carboy, Miyata for clearing that up.

Rdst_1, you must be a doctor. I will re-read it to make it sink in my head. Thanks again.

[Thad E Ginathom]

Originally Posted by carboy

Don't forget no symptoms (not even mild). I have seen a few reports which say that 80% of infected people have no symptoms.

Yes. That's what I meant to say!

the symptoms may be anything from none to mild to...

Thanks for the important correction.