Here Comes the Sun

Bad news has been unrelenting, so it seems, for some while. I think we may now finally be seeing some rays of sunshine.

Remdesavir seems to be somewhat helpful. A now concluded study showed a 31% faster recovery. It showed no change in death rate, but that may be because the study was ended early. Once it proved effective, the moral obligation was to offer it to all patients involved.

Contrary to many reports, it looks as though hydroxychloraquine is not dead. As noted yesterday in this space, a Ph.D. has compared total cases against active cases, state by state, and seems to show a difference for states in which hydroxychloroquine is more widely available. This suggests that it too shortens the course of the illness.

If hydroxychloraquine has not shown the same clear effect in clinical trials, it may be because the drug, being in limited supply, is generally given even in trials only to patients in very poor condition, already in hospital. And this may not be the stage of the illness for which it is effective.

Dr. Didier-Raoult, the French virologist who has strongly advocated hydroxychloroquine therapy, says viruses usually just burn themselves out; we do not understand why. He believes, accordingly, that Dr. Fauci in the US is probably wrong to think there will be a second wave of COVID-19 in the fall. I had said this before: SARS, Swine Flu, MERS, Ebola, seemed to burn themselves out. With any luck, COVID-19 will too. An Israeli mathematician thinks he recognizes a pattern of seven or eight weeks of virulence, after first community spread, beyond which it subsides. If the Chinese government figures are anything near accurate, this would seem to fit their evidence.

Plasma treatment also seems effective. The problem here seems only that quantities are inevitably limited.

After all the fears of lack of respirators, it seems the US has a great surplus. This surely had been our greatest fear: people being taken off respirators to die, or dying in the corridor because there were no respirators left. Moreover, it seems now as though less aggressive techniques may be more effective.

The news that the virus is sensitive to heat, temperature, light, and UV light, seems promising in two ways. For one thing, it suggests some relatively non-invasive new treatments. For example, just pumping warmer air into the lungs might make a difference.

For another, it makes it likely the virus will die back naturally for summer.

We had been worried that re-infection was possible; this would be devastating. Then vaccines would not work; herd immunity would not work. Sooner or later, we might simply all die of coronavirus. But it seems now confirmed that this does not happen. Prior results were testing failures.

Testing seems to have rapidly gotten better, and the US at least is concentrating on turning out test kits. Testing is almost a solution by itself. Until now, we have been quarantining upside down: locking everyone in. With efficient testing, we can quarantine right side up: locking in only the infected, and perhaps the most vulnerable, while business goes on for the rest of us.

There is an obvious and unexplained difference between the course of the virus in Korea, Japan, Taiwan, or Hong Kong, compared to Iran, Europe and America. The former, although they got the virus sooner, have lower rates of spread, and lower death rates.

The obvious explanation is that these are cultures that commonly use face masks in the street.

There is a second consideration: why do some able-bodied people of equivalent age suffer far more serious symptoms than others? There may be a genetic component; but there is a good chance it has to do with how strong the original exposure was: how many virus cells spread and bred before the body was able to muster its immune response.

Aside from reducing the spread, face masks combined with social distancing may more or less ensure that initial dosing is relatively mild. Almost, in a good number of cases, like a vaccination.

An Indonesian study shows vitamin D also matters. Those with low levels of vitamin D are more likely to catch the virus, and more likely to have a bad result.

Dr. John Campbell suggests that this may be behind the odd fact that meat packers seem to have become centres of spread, in the US and Canada. Why meat packers?

And why meat packers here, and not in Europe?

Campbell says that recent Somali immigrants tend to take these factory jobs. Aside from living communally, they are dark-skinned. Darker skin generates less vitamin D. They work inside. Sunlight generates vitamin D.

So the virus might claim fewer victims if we checked vitamin D levels, and took supplements.

Add all this together, and it seems as though we might have a program, even in the absence of anything more.