Coronavirus: What We Can Say Publicly & What We Can't

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I thought reposting this to be next to the ACEII post might be helpful.
ARBs won’t help
There seems to be alot of confusion/confounding here of ACE and ACE2. It is easy to confuse for sure, science does a crappy job naming things (they all sound so alike but they are different!) which creates these misunderstandings. Maybe this can help.
ACE is a gene called Angiotensin I Converting Enzyme. This gene encodes an enzyme involved in catalyzing the conversion of angiotensin I into a physiologically active peptide angiotensin II. Angiotensin II is a potent vasopressor and aldosterone-stimulating peptide that controls blood pressure and fluid-electrolyte balance. This enzyme plays a key role in the renin-angiotensin system. Many studies have associated the presence or absence of a 287 bp Alu repeat element in this gene with the levels of circulating enzyme or cardiovascular pathophysiologies. This mutation is commonly referred to as the ACE insertion/deletion or, more simply ACE I/D. The relative frequency of this mutation in various ethnic populations worldwide has been of interest to scientists (As are the population frequencies of many other mutations in hundreds of genes) as they have bearing on diseases, medications, etc. ACE is NOT related to 2019 novel CoV or SARS at all.
ACE inhibitors produce vasodilation by inhibiting the formation of angiotensin II. (Which is NOT ACE2) This molecule is a potent vasoconstrictor formed by the proteolytic action of renin (released by the kidneys) acting on circulating angiotensinogen to form angiotensin I.
ACE inhibitors end with -pril: benazepril (Lotensin, Lotensin Hct); captopril (Capoten); enalapril (Vasotec); fosinopril (Monopril); lisinopril (Prinivil, Zestril). These medications have nothing to do with Coronaviruses.
Much has been made about the non-peer reviewed study that ACE2 is the putative (considered to be based on available evidence)receptor for the spike protein of novel CoV (and likely this seems true) but even more has been said here by commenters that Asian males are more susceptible because they hav higher expression of ACE2 in lung cells.
https://www.biorxiv.org/content/10.1101/2020.01.26.919985v1
I want to say that study was done on EIGHT samples from a tissue bank of lung tissue from healthy donors. ONE of those samples came from a Asian male and in this tissue sample ACE2 expression was found to be much higher than in other samples, and ACE2 was also being expressed in more cell types. The authors SPECULATE that this observation may underlie the virulence for novel CoV in Asians.
First: this sample size is ridiculously small, it is NOT established fact. It is a very interesting observation that needs to be replicated by another research group in a much larger cohort. I am not a statistician, but there are guidelines for sample size needed in order to obtain results that can be statistically significant. That sample size of EIGHT was insufficiently powered. You can read more here: https://www.statisticsdonewrong.com/power.html
So, if someone looked at tissue samples from 1000 people, 250 each: Africans, Caucasians, Asians and Latinos of roughly half male/female you might get a better idea of the actual ACE2 expression pattern as it varies by ethnicity. BTW: I am not a statistician, so 1000 might not be sufficiently powered (or may be overpowered) …but you get the idea.
Also, when you read the comments associated with this study, several people (way smarter than me, who work in this area of science) point out some problems with the methodologies used in the research. I cannot comment on this, as I am not a subject matter expert in this area, but I am very clear this happens alot……it is only people who work in these highly specialized niche areas of research who can understand these subtleties.
But what about ACE2? https://www.genecards.org/cgi-bin/carddisp.pl?gene=ACE2&keywords=ACE2
First, it is not ACE, it is also not angiotensin II.
ACE2 (Angiotensin I Converting Enzyme 2) is a gene that encodes an enzyme which converts angiotensin I to angiotensin 1-9, a peptide of unknown function, and angiotensin II to angiotensin 1-7, a vasodilator (PubMed:10969042, PubMed:10924499, PubMed:11815627). Also able to hydrolyze apelin-13 and dynorphin-13 with high efficiency (PubMed:11815627). By cleavage of angiotensin II, may be an important regulator of heart function (PubMed:10969042, PubMed:10924499). By cleavage of angiotensin II, may also have a protective role in acute lung injury (By similarity). Plays an important role in amino acid transport by acting as binding partner of amino acid transporter SL6A19 in intestine, regulating trafficking, expression on the cell surface, and its catalytic activity (PubMed:18424768, PubMed:19185582). ACE2_HUMAN,Q9BYF1
ACE2 also acts as a receptor for SARS coronavirus/SARS-CoV. ACE2_HUMAN,Q9BYF1
What apparently makes novel CoV so serious for some is this surface expression of ACE2 protein on lung alveolar epithelial cells. ACE2 is poorly expressed in the upper respiratory tract: nose, sinus tissue, throat, but gets expressed in the lung. Hence, many people develop a fever and shortness of breathe, pneumonia and never really get a “cold” prior: sneezing, sore throat.
In short high/upregulated ACE is bad: think high blood pressure. Hence ACE inhibitors to block it.
ACE2 is good. An upregulated ACE2 (not angiotensin II) is actually regarded beneficial in cardiovascular and kidney disease. Perhaps having alot of ACE2 expressed in lung tissue ends up being bad for CoV infection though…and the result of that infection is the down regulation/inhibition of ACE2’s positive effects.
Stephen Buhner mentions in his book, page 55: “SARS viruses attach to ACE-2 on the surface of lung, lymph, and spleen epithelial cells. (Licorice, Chinese skullcap, luteolin, horse chestnut, Polygonum spp., Rheum officinale, and plants high in pro- cyanidins and lectins such as elder and cinnamon block attachment to varying degrees.)”. Unfortunately the research supporting this statement tends to be highly technical in-vitro experiments with purified constituents, not real life/in vivo clinical trials involving 2019 novel coronavirus. But hey, it is something to look at seriously. Herbs are powerful used correctly.
And what about using ARBs? These drugs end in -sartan. Azilsartan (Edarbi); candesartan (Atacand), valsartan (Diovan); losartan (Cozaar); olmesartan (Benicar).
ARB stands for AT1R blockers and they represent a major class of antihypertensive medications.
Angiotensin-II (not ACE2) activates two major types of receptors, angiotensin II type one (AT1R) and type two (AT2R) receptors. While AT1R is widely expressed and mediates most inflammatory Ang-II effects (bad), AT2R, is less expressed and has opposite effects, promoting vasodilation and anti-inflammatory effects [1] . Physiologically, AT2R actions are usually masked by the more abundant AT1R. It has been suggested that ARBs can mediate their action through increasing angiotensin II (Ang II) availability to bind to the beneficial angiotensin type 2 receptor (AT2R), thus leading to unopposed AT2R stimulation.
So long story short, ARBs do not block the gene or the enzyme ACE2. They block the receptor for Angiotensin 2 (AT1R: which is produced by ACE, not ACE2).
I know, it is crazy to sort out. But trust me, ACE inhibitors and ARBs have nothing to do with fighting coronavirus infection. What is needed are antiviral meds or herbs that work on multiple levels:

  1. Block the receptor on ACE2 so the spike protein of novel CoA cannot attach
  2. Stop the endocytosis of the virus into the cell
  3. Stop/slow viral replication with in the cell.
  4. Activation of host defense systems
  5. Many other strategies: https://www.ncbi.nlm.nih.gov/pubmed/25108320
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I agree, neither of us are home in this territory.
But nobody gives home who are and even if they do, they are doomed from the sitting.
Take a look at Chris banned from Wikipedia.
So we amateurs are doing our best and to be fair, we get the word out, we challenge the narrative and we do score points.
I have also said that high temperatures would mess with corona, based on the research of SARS, and low and behold, Trump just tweeted the same thing after his conversation with China’s frontman.

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I watched the WHO conference on NCoV today and they said that every time a new infection shows up on these ships, they have to extend the quarantine period 14 days from the date of the last diagnosed infection…that could go on for quite a while. Months if they get unlucky. So sad…
This is the link, it is rather lengthy, hard to hear and surprisingly frustrating to listen to. Lots of concerns about supply chain and availability of PPE to healthcare workers.
https://www.youtube.com/watch?v=OTEMh0T2ZmQ

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Lightning 17, wondering where you are getting your info on China. I have several in-laws, former colleagues, and friends living in China and none of them are “nailed into” as you put it or confined to their homes. There are temperature checks that go on entering buildings but those are in the cities. Hubei and Wuhan are significantly more “nailed down” then the rest of the country from what I have seen. Most of the Chinese and expats I have spoken with seem calmer and less panicked then a lot of people on here. Most of social media these days seems like an echo chamber of whatever platform one is on. I am curious about how this will turn out. I lived in Beijing at the end of SARS and that looked like it was heading towards a major pandemic and then suddenly cratered. Also lived in Beijing when H1N1 was ravaging through North America - lots of deaths from that but without the Xenophobia and prejudice about North Americans like we are seeing towards China. (12,469 Deaths in the United States from 2009. H1N1.). Corona isn’t anywhere near that yet even worldwide!

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I just heard an interesting argument by pulmonologist Dr. Roger Seheult, which suggested that perhaps the reason that Chinese men seem to be more susceptible to the Coronavirus is that nearly 50% of males in China are smokers, whereas only 2% of females in China are smokers. He presented some evidence that showed that smoking is known to increase the amount of ACE2, especially in the lower lung tissue, which can facilitate the Coronavirus progressing into sever pneumonia.

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That 2020.01.26.919985 report that indicates Asians have up to 5x ACE-2 expression that keeps circulating around here only has an 8 patient sample. Garbage.
Here is a report – likewise has not yet been peer-reviewed – that has a 225 nCoV patient sample size (across 4 datasets). It concludes there is no racial or gender bias in the ACE-2 expression, only tobacco smoking. Smoking is prevalent in China! So is severe smog, which I speculate might have an effect on the SCR and CFR too.
https://www.preprints.org/manuscript/202002.0051/v1
If you haven’t had enough reason to quit smoking yet, well here’s a really good reason to stop asap, IMO!
 

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Don’t know if any of us will need to face this choice. But probably good to have considered it ahead of time.
What if authorities say you must stay in this building (or where ever) for the public good? Being locked down inside the quarantine boundary makes infection risk go way up. But, it is beneficial for those OUTSIDE the boundary.
You don’t have to answer publicly (as the internet is forever), but just consider the issue.

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Im not seeing some of the newer CM videos on PP, but can view from the link referenced above on youtube.
Anyone else?
 

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“Quadratic fit
I have a possible explanation. Remember we are not modeling the infections, but the detected infections. The map is not the terrain. It may be spreading exponentially but detected quadratically. The quadratic equation is a limited growth model, and detecting nCov may be limited by the amount of test kits available, the number of doctors, beds, etc. I would say a quadratic fit for infections is an indication of an overwhelmed (limited) healthcare system.”
Thank you for this, Cheapseats. You make a useful distinction. I wonder, though, would you expect the data to fit any curve to very tightly? Wouldn’t you expect more deviation?

90

“Videos not on PP?
Im not seeing some of the newer CM videos on PP, but can view from the link referenced above on youtube.
Anyone else?”
Me too. The latest I can see on PP is “What We Can Say…” and “How We’re Personally Preparing…”

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Jim Cramer Says Investors Shouldn't Shrug Off Coronavirus Worries

Cramer told members on the AAP call that when he was in Miami for the Super Bowl he asked "some of the wealthiest people in the world” what they thought about the coronavirus. Former hedge fund manager and current owner of the NFL’s Carolina Panthers franchise, David Tepper, was one of a few who expressed concerns about the virus. “We were getting more and more reports about how China was hiding how many were really sick and how many were really dying, and the Wuhan diaspora was just settling in to where it could infect untold souls,” Cramer said. https://www.thestreet.com/investing/jim-cramer-has-coronavirus-concerns
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I am pretty bent how some people who have authority positions trash people without warrant. As they did with Chris and wikipedia… Its really a shame that such people ( the wrong people ) are controlling the masses . Its true censorship. Never the less, I have to keep reminding myself that the people in control are not the intellects and empathetic and compassionate people. they are usually narcissists and psychopaths. how they manage to acquire these positions in a democratic system is amazing. The truth is when the average intellect is less than 100. and most people here and chris have an IQ more than a standard deviation higher than the average medical student ( 140 or above, less than 1% of the population ) what chance can we expect to rationalize with the monkeys… that are easily manipulated by the unethical tactics of politicians and big corporations etc.

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Vitame D, the most virulant, pun included, virus confronter.
Kannibalisme is about omega 3. Apart from the sea, and algi derived sweet water creatures like forel, we naked people, we need the sea, river or domesticated animals to convert ALA, like in clover, into DPA or EPA.
 

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Bleep,
There have been numerous video posts showing people being locked into their domiciles. I’m sure if you search you can find them. Also available are (presumably sick) Chinese people actively resisting transportation along with messages from citizens.
China is a huge place and I did not mean to state that all Chinese citizens in all areas are being nailed into their homes. If you took it that way, my apologies.
Nowhere in my message is any bigotry. I have visited China more than a dozen times , have done business with Chinese companies for years and my post said the folks are hardy and pragmatic. I have many friends in China. I’ve often referred to Chinese as the Americans of Asia as there are many similarities in the culture when you strip away some of the trimmings.
It would also be accurate to say there is equally a great deal of ethnic bigotry in China to non-Han peoples and to non-Han culture, so bigotry and Xenophobia run both directions. The Chinese Muslims in re-education camps come to mind. I think it would behoove all of us to minimize with the “Racist” this and “Racist” that claims. Some of the political correctness will be our undoing. For example, not releasing the ethnicity of infected people so we can understand and educate ourselves to transmission and treatment of the disease. The lack of accurate info coming from China has been incredibly irresponsible and has lost the world months of preparation.

95

http://www.medscape.com/viewarticle/924807
Chris, I am a triage RN and the corporate party line is this is a concern not a crisis… And the US Healthcare system can more than handle growing cases here…Eye roll

96

Where is there evidence that the nCoV spread and/or severity will be reduced due to warmer weather? If Trump “knows” then perhaps he should share this information.
Trump tweeted–and yet it wasn’t enough to pump the ““markets”” and allay fears of a global cascading economic slide due to nCoV. Expect more Presidential tweets, Central Banks intervention, and “promising” or “better than expected” reports to goose the ““markets”” today. Its Friday, after all, so expect that the PPT (Plague Protection Team) will be hard at work about late afternoon today and by 2 a.m. Sunday.
Both Trump and Xi know “The Rules for Rulers” (Source) and the potential opportunity and crisis the nCoV pandemic presents: Opportunity to consolidate power and redistribute “treasure” to their “keys” that keep them in power. Crisis that they will lose control of the narrative, their “mandate” and, most importantly, their ability to control the distribution of the “treasure” (e.g., through ““markets””, economic productivity, supply chains).
Yeah, I think rulers like Trump, Xi, and others, and their “keys” such as WHO, CCP, CDC, Central Banks, the 1% “know” and have known for quite a while the potential for the nCoV pandemic disaster to provide unprecedented opportunities to seize even more power and treasure and to redistribute them to a more concentrated circle of loyal or strategically useful “keys” (while eliminating those “disloyal” or “un-useful” keys or blocks). That is IF they can keep the masses from revolting (with the help, of course, of competing, opportunistic alternative emerging rulers). Hence, the need to keep the masses in the dark as long as possible: “No one knows until everyone knows.” (Which is why Chris has been targeted for informing the public “early” with messages that run contrary to the official narrative.)
When the extent and impact of the crisis (i.e., nCoV pandemic) become “known”–too great to hide, becoming common knowledge–then the rulers need to have convenient scapegoats ready to lambaste and punish to appease and distract the frightened, angry masses.
I think we’re at a tipping point where the extent and potential impact of the nCoV pandemic are becoming “known”. President Xi and the CCP are already actively blaming and punishing the Wuhan provincial government and others while consolidating even more power and redistributing resources to loyalists. Other countries, including the US, are a bit behind in the process, still of trying to keep their citizens in the dark while using this time to align power and resources to maintain control of their “treasures”.
IMO, warmer springtime weather will not bring nCoV relief, but rather, a dramatic increase in sick and dying people, even more draconian government interventions, and social and economic dislocations.

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Nordicjack are you suggesting that we, middle and poor are un-intelligent monkeys??? Low IQ who are … “are easily manipulated by the unethical tactics of politicians and big corporations etc.”
Most poor people I know are hard working and and just too dam busy trying to survive to give a lot of time and effort to politics. How about you smart dudes do more to make a difference? Did I miss understand you? After all I don’t have a college degree or have any idea what my IQ is, though Davefairtex suggested once it might not be exceedingly low or something to that effect?
Cranky Granny

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ACE II genotype frequency in different populations/countries
Generally, the minimum number of samples for people is 100. However, sometimes a sample of one can provide valuable data and provide a ballpark figure. Few people are outliers, so the probability that the one person is an extreme example is unlikely.
 

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IMO, warmer springtime weather will not “bring nCoV relief, but rather, a dramatic increase in sick and dying people, even more draconian government interventions, and social and economic dislocations.“
Plus maybe wildfire, floods, earthquakes, famine and pestilence. Kinda sounds like the four horseman. Family and community will become a saving grace!
AKGrannyWGrit

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https://www.spiegel.de/international/a-vaccine-would-come-too-late-for-this-a-e5862b8e-e144-4356-939b-2871ff3b87b0
Bio of author: https://wellcome.ac.uk/about-us/executive-leadership-team