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5 hours ago, 8FillTheHeart said:

The one mom who died, 55, mom of 3, no underlying conditions, good health, active lifestyle does not fit the mantra profile. Children are in critical condition.

I haven't read further in the thread so forgive me if this has been said, but there are some known genetic links to the cytokine storm.  I wonder if that will have something to do with this family.

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I think the other gap in understanding is in statistics.  Just because you have a higher mortality rate in a certain demographic doesn't mean that the other demographics are excused from getting the disease.  I think the NJ(?) cases still fit within the data we see from China and Italy. The young are just more likely to pull out of criticality because they have more "reserves" in their bodies.

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19 minutes ago, prairiewindmomma said:

I think there is a huge gap in understanding with regards to testing. People seem to have a hard time wrapping their minds around the fact that there are a lot more covid-19 cases out there than there are posted in test results.

 

Evidently it is normal, in healthcare, not to test if the result of the test isn't going to make a difference in how you treat the disease. That's part of the reason for restricting tests even with a few more tests available

(another is that evidently there is still a chemical -- a "reagant" -- in short supply. People in other countries are occasionally running short of it as well. So wanting to limit the use when the reason is for more than curiousity "Did I have that disease"

 

However, if many more people had been tested and even if some percentage of them had been found to have coronavirus, I'm not sure it would change the narrative of those saying "no worse than the flu" -- in some ways it would confirm because some high percentage don't even need to go to the hospital but can take care of themselves at home. To an extent, the problem with coronavirus (That we know about) is the numbers that end up in the hospital and need ventilators and other such equipment.

 

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Update from Israel:

529 cases, no deaths yet. Huge ramp-up in testing, with much more supposedly to come.  The Mossad brought 100,000 test kits back from heaven knows where overnight, but reports are that they are missing some crucial component, so not so helpful.

We remain in 'voluntary lockdown,' with frequent threats to make it official.  Not clear what that would look like, exactly. Here in Jerusalem the weather is terrible so nobody is out anyway.  It was dry this morning so I went out for a few errands.  The streets were quiet but not deserted, and stores are desperately trying to stay open.  It seems pretty obvious that this can't go on for long without absolutely bankrupting the country.

The security services have rolled out the cellphone tracking program.  People who have tested positive are notified by phone, and then anybody who was less than 2 meters from them for more than 10 minutes (as determined by cell tower data) is notified that they have to go into quarantine.  The legality of the program is being challenged in court.

The Knesset (legislature) is still shut in what appears to be a power play by the (Likud) speaker. There are reports that it may be reopened on Monday.  Or not.  And there may be a unity government after all.  Or not.  The optics are extremely not fabulous at a moment when the caretaker government is making expansive use of its emergency powers, that's for sure.  

The most interesting news of the day, IMO, was that one of the two Orthodox Chief Rabbis of Israel ruled that religiously observant Jews must keep their phones turned on and nearby on Shabbat in case the authorities need to notify them that they either have or have been exposed to coronavirus.  As I've mentioned before, the idea that saving a life trumps nearly all other religious requirements is an essential aspect of Jewish law, but still, this is a pretty remarkable ruling.  Observant Jews do not use any electronics at all on Shabbat, unless, well, it's a life-threatening emergency.

 

 

 

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There is still so much unknown.  Will there be a second wave in China?  Or Japan (both of which had very different responses to the virus since Japan has done contact tracing and quarantine of those people but not any widespread quarantines and restaurants etc. are still open.)  Will there be a second wave in Italy?  What will happen in England with their approach?  Why does it seem (at least from what I've read) that Africa has been mostly spared?  What will the results be of the US's attempts at "flattening the curve" - at least in certain regions?

Will the treatments available work on everyone?  Who will it  help and who won't be helped?  Will it help to lead to a vaccine if they identify the treatments that work and more importantly why they work?

Will the non-disposable but sterilizable masks that I saw up thread somewhere that are being made/tested in Israel lead to less medical waste overall?

Will there be positive (and not just dystopian) ramifications from this?  Some areas are already seeing less pollution from the "shelter in place" quarantines.  Will that lead to some positive work and family cultural changes?  Will the relationships forged even in my neighborhood (neighbors helping the elderly, the man across the street who has started a huge garden with hopes of being able to potentially feed our entire block etc., the new computer network directing us in our small city to ways to help out small businesses and restaurants) lead to permanent positive social changes? 

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33 minutes ago, prairiewindmomma said:

I think there is a huge gap in understanding with regards to testing. People seem to have a hard time wrapping their minds around the fact that there are a lot more covid-19 cases out there than there are posted in test results.

Yes, I think the more trustworthy statistics are hospitalizations and deaths.

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35 minutes ago, prairiewindmomma said:

I think there is a huge gap in understanding with regards to testing. People seem to have a hard time wrapping their minds around the fact that there are a lot more covid-19 cases out there than there are posted in test results.

Plus, who knows if someone in the stats who tested negative one time, won't get it later and then test positive? 

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Macaque monkeys could not be reinfected with COVID-19 one month after recovery from initial infection. 

https://www.livescience.com/monkeys-cannot-get-reinfected-with-coronavirus-study.html

Obvious limitations of the study are that it was tiny (four monkeys total) and the rechallenge with the virus was only one month after recovery. Also, poor monkeys!

But hey, I think we could all use a glimmer of hope right now. 

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2 minutes ago, prairiewindmomma said:

Hydroxychloroquine/Plaquenil has been in and out of shortage for the last decade or so.  2014, 2015, 2018..... The price of it tripled in 2015. I hope the supply issues are sorted out if it really is efficacious for covid-19.

I used to take this for my RA, but it didn't help me.  I had no side effects, though.  If I end up getting Covid-19 I would certainly ask for a prescription for it.

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1 hour ago, Arcadia said:

@Pen@J-rap@8FillTheHeart@square_25@Pawz4me@Arctic Mama
https://abc7news.com/health/live-trump-says-fda-to-approve-drugs-for-covid-19-treatment/6027491/

“CORONAVIRUS CRISIS: President Donald Trump said the FDA is approving two drugs -- the antimalarial hydroxychloroquine and antiviral drug Gilead's remdesivir -- for coronavirus treatment.”

Just to be accurate for the record. Trump actually said the FDA *has* approved hydroxychloroquine taking the process down from many months. I watched the clip. FDA says no they haven't approved it for that. Like many drugs, it will be used in ways it hasn't actually been approved for, so in that way, this isn't unusual. But my head is about to explode from the misinformation coming from places it shouldn't (not meaning you, Arcadia), and I'm trying to do my little part for accuracy.

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43 minutes ago, Jean in Newcastle said:

But it's also a mountainous region in Jordan (originally part of Ancient Israel?  Or at least mentioned in the Bible)

 

Balm of Gilead is a plant used for medicinal purposes.  And has come to symbolize a Universal cure according to Wikipedia.

 

 

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1 hour ago, prairiewindmomma said:

I think there is a huge gap in understanding with regards to testing. People seem to have a hard time wrapping their minds around the fact that there are a lot more covid-19 cases out there than there are posted in test results.

Yes.

Suppose a cabinet has a thousand drawers. Any given drawer on any given day can have either one spider or zero, and having a spider in one drawer makes it more likely that adjacent drawers will have other spiders move in within the next week--based on other people's cabinets, at least one adjacent drawer will. A spider leaves its drawer after 14 days, so if a drawer had a spider, it will never have one again after that time is up. You have no spider repellent but can pay a carpenter to remove drawers and put them in separate locations to prevent the spread. Of drawers that get a spider inhabiting them, one in twenty will be ruined within a month no matter what.

You are fairly confident that the cabinet had no spiders when you bought it a month ago.

You opened twenty of the drawers four days ago. You only saw two spiders, and also one ruined drawer. How many spiders are in the cabinet today? How many spiders have ever been in the cabinet? Should you give the carpenter money or leave it alone? What if the carpenter wants 10% of the cost of the cabinet? What if you want to wait until you get paid at the end of the month?

Still just two spiders is unlikely to be a good guess, but that's the one that goes on the news, leaving many with the inclination to wait. 😕

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Cross-posted with the Expat thread:

DD in Switzerland sent me this.  We're talking about what she should bring home, what she can stash there, and what to do with the three baroque harps currently sheltering in place in her room.

https://www.politico.com/news/2020/03/19/coronavirus-travel-advisory-level-four-137227

We'll cross the how to get her home bridge when they actually go to level 4.  I'm someone who truly believes in having a plan b, but this one is tough to plan.

 

 

 

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1 hour ago, Jean in Newcastle said:

Just musing (with no scientific basis for this really):  but if anti-malarial drugs can work on this, I wonder if the vaccine (if they can make one) will lead to a vaccine to treat malaria? 

 

No.  Malaria isn't a virus, it's a parasite.  It's like lyme in that if it gets past a certain point before you get treatment, it can recur months or even years later. I've heard stories about Vietnam Vets having a recurrence of it 20 years after Vietnam who haven't left the states in decades. I don't know how the drug treats malaria, but I know how it helps treat autoimmune diseases and CV19: it dampens the immune response and cytokine storm.  Ironic that all those people saying not to take advil because it does the same thing (in a lesser way) may be advising people to stop the only over the counter drug that might help.

On a related track though, I wonder if the gene for sickle cell that makes people more resistant to malaria also somehow stops a cytokine storm or somehow makes you less likely to have symptoms of CV19, and if that might be the reason there aren't outbreaks in Africa.

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Global Level 4 Health Advisory – Do Not Travel

 

Global Health Advisory
March 19, 2020

Level 4: Do Not Travel

The Department of State advises U.S. citizens to avoid all international travel due to the global impact of COVID-19.  In countries where commercial departure options remain available, U.S. citizens who live in the United States should arrange for immediate return to the United States, unless they are prepared to remain abroad for an indefinite period.  U.S. citizens who live abroad should avoid all international travel.  Many countries are experiencing COVID-19 outbreaks and implementing travel restrictions and mandatory quarantines, closing borders, and prohibiting non-citizens from entry with little advance notice.  Airlines have cancelled many international flights and several cruise operators have suspended operations or cancelled trips.  If you choose to travel internationally, your travel plans may be severely disrupted, and you may be forced to remain outside of the United States for an indefinite timeframe.

 

 

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52 minutes ago, Katy said:

 

No.  Malaria isn't a virus, it's a parasite.  It's like lyme in that if it gets past a certain point before you get treatment, it can recur months or even years later. I've heard stories about Vietnam Vets having a recurrence of it 20 years after Vietnam who haven't left the states in decades. I don't know how the drug treats malaria, but I know how it helps treat autoimmune diseases and CV19: it dampens the immune response and cytokine storm.  Ironic that all those people saying not to take advil because it does the same thing (in a lesser way) may be advising people to stop the only over the counter drug that might help.

On a related track though, I wonder if the gene for sickle cell that makes people more resistant to malaria also somehow stops a cytokine storm or somehow makes you less likely to have symptoms of CV19, and if that might be the reason there aren't outbreaks in Africa.

It seems to me, and I don’t know a ton about it, that it must have some other mechanism also with covid-19. The study from France said people were showing negative for the virus extremely early after being treated with chloroquine.

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My state just cancelled the required assessment testing for students for this year. Pennsylvania. We call them PSSA and Keystone exams here in PA.  (ETA, To clarify: For public schoolers, not for homeschoolers.)

https://www.wfmz.com/health/coronavirus/pssa-keystone-exams-cancelled-in-pa-amid-coronavirus-pandemic/article_68948616-6a1a-11ea-a383-4f59d458865b.html?utm_medium=social&utm_source=facebook&utm_campaign=user-share

Edited by Garga
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For those who need to order food for themselves or relatives

 https://www.nbcbayarea.com/news/coronavirus/list-companies-offering-deals-discount-freebies-coronavirus/2256595/

“&Pizza

Hospital workers are invited to stop by their local &Pizza for a free pizza! All you have to do is show your hospital ID. If you're too busy to leave work, &Pizza will deliver it. Just text 200-03 #HERO

Regular customers can also take advantage of free delivery with their orders.

Blaze Pizza

Blaze Pizza is offering free delivery across the country. All you have to do is order on their website or app and spend $10 or more. You can also score free delivery on Postmates until March 22 or on DoorDash until March 22.

Burger King

Beginning Monday, March 20, Burger King is giving away two free kids meals with any purchase made through its app for take-out or drive-thru orders. The offer is valid through April 6 and can be redeemed once daily. 

The fast-food chain also has free delivery via its mobile app for orders over $10.

Chipotle

Chipotle will deliver orders of $10 or more for free from March 15 through March 31 within its delivery areas and with participating stores only. The waiver is only applicable when you order at chipotle.com or on the Chipotle app.

Del Taco

Use code DELTACONOW for free delivery on Postmates until March 20. No minimum purchase. Delivery is also free on DoorDash for first-time customers. The company promises your order will be sealed to minimize any potential risk for customers.

El Pollo Loco

Along with offering sealed, tamper-proof delivery bags, the company is also offering free delivery on Grubhub at participating locations until April 7.

Just Salad

Just Salad is also offering free deliveries on salads ordered through its website and app. The offer runs through March 31.

KFC

KFC is making it easier to enjoy a bucket of fried chicken from the comfort of your own home by offering free delivery now through April 26. Order online on kfc.com

Moe's Southwest Grill

You can pick up your order yourself or have it delivered for free, now through April 10 for all orders over $10 placed online and in the app.

Popeyes

Popeyes is offering free delivery through its mobile app and website.

Sweetgreen

The fast-casual chain is thanking medical personnel and hospital workers by delivering free salads and bowls directly to them. If your health facility could use an Outpost, head to bit.ly/sgimpactoutpost, fill out a form and a member of the Sweetgreen Outpost team will be in touch.

Uber Eats

The food delivery service has waived delivery fees for more than 100,000 independent restaurants in the U.S. and Canada to support the restaurant industry "through an uncertain season," a press release read. Uber Eats will also provide 300,000 free meals through its app to first responders and health care professionals in the two North American countries.”

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1 hour ago, Katy said:

  Ironic that all those people saying not to take advil because it does the same thing (in a lesser way) may be advising people to stop the only over the counter drug that might help.

actually, the recommendation not to use Ibuprofen has been withdrawn by the WHO.

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For anyone curious, my granddaughter was diagnosed as basically having panic attacks. My dil is very anxious about it all (she is an AML survivor and ds has lupus and damaged lungs from PEs) I told her to put her kids on a media blackout and not talk in front of them. 

My 10 yr old has been anxious so we stopped all conversation in front of her 2 days ago. Just be careful to watch how these conversations are impacting your younger kids.

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4 minutes ago, 8FillTheHeart said:

For anyone curious, my granddaughter was diagnosed as basically having panic attacks. My dil is very anxious about it all (she is an AML survivor and ds has lupus and damaged lungs from PEs) I told her to put her kids on a media blackout and not talk in front of them. 

My 10 yr old has been anxious so we stopped all conversation in front of her 2 days ago. Just be careful to watch how these conversations are impacting your younger kids.

We've had to take similar measures.  We're not super anxious as adults, but overhearing the news was too much for a couple of our kids. 

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Along the anxiety line -- we have adults who are required to work in crowded situations (whether retail, construction, warehouse, or factory) with no precautions being taken. It came to my attention that some of them are actually very afraid, while they've continued to go to work anyway. They're washing hands and doing all they can, but obviously their entire workplace could easily be infected, AND they are afraid they will bring it home to those of us who are high risk. So because of that reality, and to honor courage in the face of fear, I placed a moratorium on the constant talk of the pandemic. I'm doing all the protocols to keep home as safe as possible, and I make sure everyone knows the current recommendations. Beyond that, I am giving these workers peace at home.

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11 minutes ago, CuriousMomof3 said:

 

I agree with this, although I'd say that teenagers probably need to be protected too.

Anxiety is super high in our household, because I have a kid with advanced heart/lung disease, and unless it's a conversation that we've planned for the sake of the kids (e.g. if we need to explain a new restriction, or ask a question they've raised), then we aren't talking about it in front oft the kids.  In our case that's tricky because DH and almost never alone together without a child in the room.  Yesterday, we got about 15 minutes alone time, which is the first we've had this week.  So, all our anxious conversations and decision making is happening over emails.  

I agree, but older kids have more self-determination. My 21 and 18 yr olds have been talking about it constantly. 14 yod is hanging out with them. No way to stop that.

Edited by 8FillTheHeart
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So in the past hour, this has happened:

My state (PA) cancelled their public school assessment testings.

My state said that all non-life-sustaining businesses must close. If they don't then "enforcement actions" begin on Sat at 12:01 a.m.

And the US is now on a Do Not Travel advisory.  

 

I can't keep up!!  I'm trying, though.

Edited by Garga
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5 minutes ago, pitterpatter said:

Out of curiosity, why is New York the only state doing bulk testing? Where did they get all their tests all of a sudden? It's seems like their positives go up a 1,000 every couple of hours. 

I think they started making their own tests.  The results going up were ones taken several days ago.  It's taking 1-5 days to get results.

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2 minutes ago, freesia said:

I think they started making their own tests.  The results going up were ones taken several days ago.  It's taking 1-5 days to get results.

 

9 minutes ago, pitterpatter said:

Out of curiosity, why is New York the only state doing bulk testing? Where did they get all their tests all of a sudden? It's seems like their positives go up a 1,000 every couple of hours. 


https://coronavirus.health.ny.gov/covid-19-testing#overview

“The FDA has approved New York State to authorize the state's 28 public and private labs to begin manual, semi-automated and automated testing for novel coronavirus, or COVID-19. 

The approval will allow the state to dramatically increase testing capacity to about 6,000 tests per day in the next week. The approval also extends to the Roche high-volume platform for testing.

Testing is free to all eligible New Yorkers as ordered by a health care provider or by calling the NYS COVID-19 hotline at 1-888-364-3065.

Your local health department is your community contact for COVID19 concerns.

The single most important thing we can do to combat and contain the novel coronavirus is test for it.

Governor Andrew Cuomo”

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I've lost track of this post and maybe someone has already posted about this, but ABC is reporting that Africa is seeing an "extremely rapid" rise in cases. I know somebody was asking why we weren't hearing about deaths in Africa and wondering if certain races might be more immune. On that line of thinking though, there's a family in NJ were 3 members have already died and 4 are in the hospital with 3 being in critical condition. They are an Italian-American family and it did make me wonder if genetics could have some impact on how people respond. It's an interesting thought, but I don't think anywhere in the world is being spared.

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6 minutes ago, Thatboyofmine said:

That’s pretty much us, too.  We have three working, so while I disinfect at home and ask them to not bring shoes in, wash hands, etc, there’s not really any point in trying to do everything perfectly or to keep bringing it up.  There’s nothing they can do about it, so....  in fact, ds’s job just laid more hours on him so he’s probably hit full time now.   Even in a pandemic, life keeps moving. 

Garga posted upthread that her state closed all non-life sustaining businesses. That may be the future. If it gets to that point, I hope they'll also move retail to pickup only, to protect workers.

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CNN link for today: https://www.cnn.com/world/live-news/coronavirus-outbreak-03-19-20-intl-hnk/h_82563a65844f021393cad5c9d0613a3d

The headlines that pop out to me are:

1. US preparing for 18 month long strain, with waves of illness. I'm seeing this reported across multiple newspapers, I think these all tie back to that Imperial College study.

2. Two army mobile hospitals have been activated. One is based out of WA state, the other out of KY.

3. US state department Level 4 warning

4. critical blood shortages

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9 hours ago, 8FillTheHeart said:

The one mom who died, 55, mom of 3, no underlying conditions, good health, active lifestyle does not fit the mantra profile. Children are in critical condition.

 

Cytokine storm appears to occur in people who have particular genetic mutations in about 10 or so proteins that influence the perforin gene. Most likely, the family has one or more of those mutations. All that is needed is one mutation.

https://www.uab.edu/reporter/know-more/publications/item/8909-here-s-a-playbook-for-stopping-deadly-cytokine-storm-syndrome

The US should be using the CytoSorb device to remove excess cytokines but, although it was invented in the US, it is not yet approved for use here in the US although it's been used since 2013 in the EU and is being used even in China and Italy now and soon Iran.

https://www.biospace.com/article/releases/cytosorbents-provides-update-on-cytosorb-and-covid-19-coronavirus-activities/

Quote

 

The underlying cause for these complications is often a cytokine storm that results in a massive, systemic inflammatory response, leading to the damage of vital organs such as the lungs, heart, and kidneys, and ultimately multiple organ failure and death in many cases.  Steroids are being used reflexively to try to control this inflammation, despite WHO recommendations against using steroids in COVID-19 infection, and evidence from other coronavirus infections (e.g. SARS and MERS) and influenza that its use can delay viral clearance and increase mortality. 

This is why CytoSorb represents a potentially promising option in helping to treat these patients, and get them out of the ICU faster, thereby relieving this bottleneck.  Although CytoSorb does not kill or remove the virus, it has been used in more than 80,000 treatments as an approved treatment of cytokine storm in the European Union and distributed in 58 countries around the world, where it has helped physicians control severe inflammation while helping to reverse shock, and improve respiratory and other organ function.  And again, these complications are often the real reason patients die of COVID-19 infection.

Over the past two weeks, multiple patients with at least respiratory failure, shock, or kidney failure, in multiple hospitals in Wuhan, China have been treated with CytoSorb.  Based on preliminary positive feedback on patient outcomes, we have responded to a request for additional devices and have now delivered a second shipment of CytoSorb devices to our partner in China, intended for new critically-ill COVID-19 patients. 

In addition, we have learned of the first initial treatments of CytoSorb on COVID-19 patients in intensive care units in Italy.  Though challenging to get feedback on how these patients have done, due to the overwhelming workload of the treating physicians, we hope to have more information soon.  Meanwhile, we have also received an additional order from Iran, another country where coronavirus infection has been rapidly spreading.

 

 

This is fantastic technology. Why aren't we using it? Do we have to let thousands or millions die first?

Btw, for ARDS vitamin C IV can be helpful. I talked to an MD yesterday who said they are "miraculous" for ARDS when he used them on patients. Parts of China are using IVC as their first line of treatment with pretty good results.

Vitamin C, thiamine and corticosteroids also have recently been used with good success for cytokine storm in both an adult trial and a pediatric trial (Lurie Children's Hospital in Chicago). I linked those studies within the past week in this thread.

Germany and Austria still use oxygen and ozone therapy which was used here in the US about 100 years ago. Once penicillin was discovered, we stopped using it even though it had a very good record and is extremely safe (breathing it in would not be, though). Some MDs still use it to treat all kinds of conditions. I spoke with a virologist and he thinks it would work very well on this corornavirus. It works by oxidizing the sulfhydryl groups. A DIV (direct intravenous) of oxygen/ozone would take 2-5" to administer and is very potent. My son, who has to work long hours, will be getting a saline ozone IV soon. He's also been getting IVC. Both can be used as preventives.

Edited by BeachGal
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https://www.repubblica.it/cronaca/2020/03/19/news/coronavirus_tamponi_da_brescia_a_stati_uniti-251735473/?refresh_ce

In Italian, but essentially the US bought a bunch of coronavirus tests in Italy (from the Brescia region) and then flew them to the US. I'll attach the google translate of the first few paragraphs.  Tampons is a mistranslation....tamponi = test swabs in English. My Italian is pretty rough though, so I'm not even going to try to translate it on my own. 

--------------------

The whole world says it's a war. And for the first time in history it seems to be everyone against everyone, without any alliances. Each nation thinks for itself, using every means to guarantee the winning weapons against the virus: tampons, masks, respirators. So the United States managed to buy half a million kits to detect the infection in Brescia. And they moved them to Memphis in a military plane.

America celebrated on Wednesday for the arrival of a load of tampons, just half a million pieces. An impressive supply: in our country since the beginning of the epidemic, just over 100 thousand have been made. But that supply landed in the USA came from the American base in Aviano, not far from Pordenone. Yes, in Italy there was a colossal reserve of diagnostic tests, available a few tens of kilometers from the epicenter of Covid-19: tools that our regions seek in every way to stem the spread of the disease but that they cannot find .

The announcement of the transatlantic expedition was made on Istagram, together with the photo of the hold of an Air Force C-17 Globemaster quadrireactor full of containers with kits. Then the post was removed. But the news found official confirmation in the words of the Pentagon spokesman, Jonathan Hoffman. "There are multiple elements to take the test - explained General Paul Friedrichs, of the central medical command - The first are the swabs that are used to collect the samples from people, then there is the liquid where to develop them. This is what we have brought from Italy. " The general said that the materials are produced in the US and abroad, without specifying where they were found. And he added: "This is a great example of how nations work together to ensure that global questions are answered."

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