An employer from years ago used to always say to me, “People are where they are in life because of the choices they have made.” This may be true, but it’s not the whole truth, and it certainly doesn’t come from a place of empathy.
Life is like a boardgame: some percentage luck and some percentage agency. These percentages are not static.
It was luck when I stumbled upon the work of Damon Vrabel nine years ago. It was agency when I read his work and it lead to Peak Prosperity.
It was agency when I read Prosper!, and it was agency when I decided to afford a portion of my budget to emergency preparedness.
It was agency when I tried to be Paul Revere on these topics, and it was agency when the majority of people ignored the warnings.
Empathy is good. Empathize with folks who experience bad luck, not apathy. When you empathize with people who relish in apathy, you become an enabler. That’s called codependency.
IMO, Les has hit it:
“As bad as it sounds, this [not invoking forced isolation] looks like the least terrible of really terrible options.”
I think Chris is absolutely right to be furious about the utter chaos and lack of rational public decisions in all this, especially in the US where health care is so problematic for so many. The delays, the lies, the double-talk, the bail-outs at the top and the happy-talk but no real relief for everyone else has been epic piracy.
I’m not up to all the statistical math - I’m assuming that, allowing for the largely imaginary nature of the numbers, that the exercises help us evaluate possible outcomes. Maybe. If the numbers aren’t too far off and if nothing else pops up out of left field. Or even center field, like no vaccine that actually works and no herd immunity past a few months and no crippling long-term post-viral effects.
Granny is right - the poor (and that includes everyone from the already homeless before this began to those whose lives were hard-working but in balance but are now up against total loss) in many cases have few or no options. Tragically few even with “opening up” now, because the customer base will have shrunk enormously, the supply lines are shattered. The virus turned an already visible but slow-moving train wreck into a nuclear explosion.
There are no simple answers to the whole problem, however straightforward some of the targeted sections of it are (masks, distancing, gardens). In Canada, ongoing efforts to house the homeless, get more cash to more people, support essential services, still free medical care is mitigating some of it. But the fact is, we’re in for heart-breaking, life-breaking, possibly violent times. Not for the first time in history, but certainly the first time in living memory. I’m not well-equipped for anger, but I grew up with it around me and know how bloody wasteful it is, how much emotional wreckage has to be cleaned up afterward, but people seem to need to go through it.
Solution? There isn’t one. I guess there will have to be many. and we don’t know what they are yet. Those of us who can will grow food - kitchen gardens saved a huge number during the collapse of the Soviet Union, and that may be a big factor this time too. Every country will approach it differently, and we’re all lab rats.
One of the things I appreciate about PP is that a retreat into intellect can be a haven, when circumstances and the emotions are taking us apart. These discussions cover a lot of ground, and the feeling that we are at least facing the realities and discussing them openly is far better than not knowing what is going on.
IMO and all that - no-one’s likely to shoot me for being a Pollyanna, anyway.
https://www.youtube.com/watch?time_continue=34&v=HrJBppuSEmk&feature=emb_logo
The virus has started to wane - seasonal.
Heuristically speaking, I’m a bit disappointed. Flu virus is generally seasonal; colds not so much. Heat, humidity, UV light, vitamin D; possibly all; seem to knock down the flu. For about the last 6 weeks central FL weather has been sunny, generally warm (Maybe not so much humidity, so for FL it’s been comfortable) Covid case rates are still going up with no detectable inflection in rate. So, disappointed.
Evidence would also suggest the lock down is working as overall infection rates seem to be decreasing. We’re getting to the “see we overacted” claim where you need to make the counter claim, that’s because we reacted. So as we protest to get back to work, people need to realize that the economy is not going to reset where it was, so a bit of caution should heed. No V recovery here, at best WwwW. It’s cliche but house of cards is appropriate. Takes a long time and care to build but once it falls you don’t get to simply get the house back by re-inserting the middle card. Small businesses probably already failed, supply chains broke. Heck, even oil is broken. New era.
Hello French connexion,
I am not quite sure what the treatment is here. I do know that you contact the health authorities and they ask about symptoms to decide if you are able to stay home or need treatment. In any case, if you need hospitalization, they send an ambulance (I guess this is the same most places) to take you there. I wanted to reply even though I don’t think this was much help.
https://mcclintock.house.gov/newsroom/columns/the-unseen-death-toll-of-covid-19-measures
The accumulating death toll from Covid-19 can be seen minute-by-minute on cable news channels. But there’s another death toll few seem to care much about: the number of poverty-related deaths being set in motion by deliberately plunging millions of Americans into poverty and despair.
In the first three weeks since governors began shutting down commerce in their states, 17 million Americans filed for unemployment, and according to one survey, one quarter of Americans have lost their jobs or watched their paychecks cut. Goldman Sachs predicts that the economy will shrink 34 percent in the second quarter, with unemployment leaping to 15 percent.
Until the Covid-19 economic shut-down, the poverty rate in the United States had dropped to its lowest in 17 years. What does that mean for public health? A 2011 Columbia University study funded by the National Institutes of Health estimated that 4.5 percent of all deaths in the United States are related to poverty. Over the last four years, 2.47 million Americans had been lifted out of that condition, meaning 7,700 fewer poverty-related deaths each year.
It’s a good bet these gains have been completely wiped out, and it’s anyone’s guess how many tens of millions of Americans will have been pushed below the poverty line as governments destroy their livelihoods. It’s also a good bet the resulting deaths won’t get the same attention.
And that doesn’t count an unknown number of Americans whose medical appointments have been postponed indefinitely while hospitals keep beds open for Covid-19 patients. How many of the 1.8 million new cancers each year in the United States will go undetected for months because routine screenings and appointments have been postponed? How many heart, kidney, liver, and pulmonary illnesses will fester while people’s lives are on hold? How many suicides or domestic homicides will occur as families watch their livelihoods evaporate before their eyes? How many drug and alcohol deaths can we expect as Americans stew in their homes under police-enforced indefinite home detention orders? How many new cases of obesity-related diabetes and heart disease will emerge as Americans are banished from outdoor recreation and instead spend their idle days within a few steps of the refrigerator?
I have participated in many discussions among top policymakers in Congress and the Administration over the last few weeks. Such considerations are rarely raised and always ignored. Instead, policymakers fixate on epidemiological models that have already been dramatically disproven by actual data.
On March 30, Drs. Deborah Birx and Anthony Fauci gave their best-case projection that between 100,000 and 200,000 Americans will perish of Covid-19 “if we do things almost perfectly.” As appalling as their prediction seems, it is a far cry from the 200,000 to 1.7 million deaths the CDC projected in the United States just a few weeks before. And even their down-sized predictions look increasingly exaggerated as we see actual data.
Sometimes the experts are just wrong. In 2014, the CDC projected up to 1.4 million infections from African Ebola. There were 28,000.
Life is precious and every death is a tragedy. Yet last year, 38,800 Americansdied in automobile accidents and no one has suggested saving all those lives by forbidding people from driving – though surely we could.
In 1957, the Asian flu pandemic killed 116,000 Americans, the equivalent of 220,000 in today’s population. The Eisenhower generation didn’t strip grocery shelves of toilet paper, confine the entire population to their homes or lay waste to the economy. They coped and got through. Today we remember Sputnik – but not the Asian flu.
It’s fair to ask how many of those lives might have been saved then by the extreme measures taken today. The fact that the Covid-19 mortality curves show little difference between the governments that have ravaged their economies and those that haven’t, suggests not many.
The medical experts who are advising us are doing their jobs – to warn us of possible dangers and what actions we can take to mitigate and manage them. The job of policymakers is to weigh those recommendations against the costs and benefits they impose. Medicine’s highest maxim offers good advice to policymakers: Primum non nocere -- first, do no harm.
This version corrects a miscalculation in the original release on the number of poverty related deaths in a population of 2.47 million. The correct calculation is 7,700, not 111,000.
I re-read AKGranny’s and Chris’ posts. The subject line to Granny’s post read, “Yeah, Granny’s a pain in the ass, I know. But I represent the poor. And here is my question, so what?” I recall from a prior PP kerfuffle that a PP member literally posted, in her defense, that Granny was a “pain in the ass” and then noted his appreciation for her perspectives. (I’d find the post but the PP site search function doesn’t work properly.)
Granny does provide an alternative perspective and voice for those that may not be well-represented among the PP tribe. Does she singularly represent all the poor (however defined)? Of course not. Does any PP member speak or represent the views of any particular ideology or subgroup? Of course not. In the future to avoid such criticisms, I would suggest Granny insert a qualifier such as “many” or “some” to make clear the otherwise obvious fact that she does not unilaterally represent the universal poor.
Granny acknowledged Chris’ expert analysis and conclusions reached of the flawed study. IMO, she then posed a valid question: “so what?”, or essentially, how does exposure of yet another lie in a sea lies impact or change the harsh reality of those lower socio-economic class that are at greater risk of exposure and harm due to the pandemic and financial collapse?
Chris responded that he wasn’t taking her comments personally, chalking them up to her tendency towards “wounded projection” and to take “offense where none exists”. I saw only one personal comment from Granny directed to Chris, which was that she wasn’t part of his “group think guys.”
Chris stated, "…you have a wound around being poor, down-trodden. I get that. I think we all get that. My very serious questions to you are, “how does holding tightly to that mindset serve you?” and “What do you get from casting yourself into and living into the role of victim?”
It is perplexing to me that Chris would default to virtual armchair psychoanalysis, and co-opt all PP members in his assessment of Granny’s supposed victim mindset and role. If genuinely concerned about Granny’s mental state, perhaps a personal message to Granny might be more appropriate and effective.
As founder and enormously respected principal of PP, Chris’ views carry substantial weight among the PP tribe. Such a public labeling by Chris, with others piling-on, must feel like a punch in the gut to anyone on the receiving end. Please don’t include me in the “We all get that” assessment of Granny’s presumed psychological state. This assessment has the effect of dismissing or neutralizing any arguments Granny makes, attributing them to playing the victim/“wound projection.”
Coming from Chris, this concerns me. Recently Chris also took issue with another long-term PP member who asserted a different perspective than Chris on another topic. Chris’ response to this alternative view included a suggestion for that member to depart the PP tribe via a “mouse click” away.
In his response to Granny, Chris proceeded to detail his humble beginnings and hard-earned success; as well as his view that “People can be poor and happy.” I don’t think Granny or anyone else has asserted any disagreement with that. Then he provided an anecdote about how a The Office binge-watching “already too fat already” woman got angry at a suggestion of how better to use her time, as an example of a self-imprisoned mindset. Moral of the story, “You are the master of your own ship. No one else.”
Not withstanding the binge-watching fat angry sister/cookie analogy; well, yes and no. That ship sails, thrives or perishes based on some important and dynamic internal and external influences, only some of which can be mitigated by the captain of the ship (e.g., body and condition of the water and weather; condition and capabilities of the ship; number, knowledge and skills of crew (if any)). [Yep, we can debate that endlessly…]
Then, more defensiveness and dismissiveness from Chris, “The lesser point is that your words are totally ineffective on me because I have no ability or any interest in taking on your pain as something that I have any control over or responsibility for. I’m old enough and wise enough to know that there’s nothing I can do to ease your inner pain. So, no thanks, you can keep that monkey.”
Say what???
I think the point that Granny is trying to make, that may be lost on some here, is that there is a critical mass of people with very limited, systemically-imposed options, that are disproportionately impacted by this pandemic/economic collapse. This multi-faceted crisis has laid bare these disparities and many are suffering and are angry. I did not interpret Granny’s admittedly sarcastic depiction of the comfortably quarantined secure with their portfolios and electric tea kettles as a personal attack on Chris. I read this as a contrast or juxtaposition of just how different daily life is for those with few options in the face of very stark, even dangerous alternatives.
While people with “cabin fever” are out putting others in danger with their protests to resume their right to go to the hairdresser or gym, those that work (or have been furloughed/laid off) at these or other high-exposure places have few viable alternatives but to place themselves at risk in these front-line occupations or circle the drain to further demise and despair.
How we as a society, country, community, household and personally got to this dire state of affairs is and will be the subject of conjecture, study and debate here on the PP site and elsewhere. Meanwhile, those largely left out of the discussion but fully engaged in the daily grind of survival are asking “so what” does all that mean to their ability to put food on the table and a roof over their heads. I think that is a valid question.
I appreciate Granny’s persistence in raising these and other uncomfortable questions. Whether or not one appreciates her “tone”, IMO Granny provides a valuable service in trying to alert others to the smoldering anger and potential for civil unrest brewing below the surface of this “controlled demolition”.
https://www.politico.com/news/2020/04/21/malaria-drug-virginia-coronavirus-study-198590
Comments appreciated.
Sparky1,
I agree with you.
“How we as a society, country, community, household and personally got to this dire state of affairs is and will be the subject of conjecture, study and debate here on the PP site and elsewhere. Meanwhile, those largely left out of the discussion but fully engaged in the daily grind of survival are asking “so what” does all that mean to their ability to put food on the table and a roof over their heads. I think that is a valid question.
I appreciate Granny’s persistence in raising these and other uncomfortable questions. Whether or not one appreciates her “tone”, IMO Granny provides a valuable service in trying to alert others to the smoldering anger and potential for civil unrest brewing below the surface of this “controlled demolition”.”
For several months, off and on Kunstler in his bi-weekly blogs would say he doesn’t like Trump, but Trump had tapped into that seething and smoldering anger and fury which had been building because of jobs being offshored, the growing wealth inequality, the pathetic health care system we have which is unaffordable for millions, etc. which helped him get elected back in 2016, which horrified the Deep State… So, this is another HUGE (to put it mildly, the collapse of oil futures, wow…) chapter in the demolition of our economy and the global economy, supply chains, future expectations and hopes…
It reminds me of the beginning of the first book of his “World Made by Hand” series. A pandemic, economies collapsed, jobs and businesses disappeared, modes of transportation and supply chains collapsed… Landfills became an important source of physical resources.
Linda
Some experts wonder if extreme social confinement is the right way to deal with a respiratory infection pandemic.
It is if one plans to solve the pandemic with a vaccine. But if one counts on herd immunity without having to vaccinate 7,5 billion people, absolute social distancing just stretches the crisis according to this expert and may cause more harm.
https://www.youtube.com/watch?v=lGC5sGdz4kg
Further: ok, there are very bad cases of Covid19 and the virus may target more organs than the lungs, etc. but in Belgium the number of deaths between age 25 and 44 is 18. Zero deaths before age 25. At this stage you would wonder if confining these cohorts has any sense at all. Even between 45 and 64 “only” 273 died. (no data on co-morbidities in these casualties).
The underlying reasons for deaths are numerous and I wonder more and more how much of the deaths are “from” covid instead of “with” covid. Here are some other reasons or crucial factors: underlying diseases in unhealthy western (american) populations (obesity, diabetes, hearth diseases), undesired effects of the prescription drugs taken for the underlying conditions (often undermining kidneys, liver), resistance to antibiotics (needed to combat the opportunistic bacterial infections), intubation (ventilators) that may cause more harm than good, novel drugs with harsh side effects (denounced by french professor Raoult, e.g. remdesivir), understaffed/under-equipped medical systems after years of savings and just in time commercial organisation of hospitals, high smoking rates (Italy) and high level of heart diseases, high age (everage age of deaths in Italy is 81 many with underlying diseases), people who wait too long before consulting their MD because of poor or no health insurance or fear of being expelled, psychologic distress due to panic and/or isolation, maybe even CO poisoning from staying indoors all the time, knocking out hemoglobine
It would be great to have a critical look too at the RT-PCR that seems to be unreliable according to some and not gold standard for testing and on which the whole sars-cov-2 thing is based.
https://www.globalresearch.ca/the-ebola-test-let-the-tests-inventor-speak/5406779
One of the authors together with the German dr. Fauci (Christian Drosten) of this German evaluation and protocol of the RT-PCR (among the first to come up with it) https://www.who.int/docs/default-source/coronaviruse/wuhan-virus-assay-v1991527e5122341d99287a1b17c111902.pdf?sfvrsn=d381fc88_2
is also the founder of TIB Molbiol Syntheselabor GmbH, the Berlin biotech company, who “sensed an opportunity” in the early days of january. https://www.bloomberg.com/news/articles/2020-03-12/a-berlin-biotech-company-got-a-head-start-on-coronavirus-tests
First I believe we are in an A scenario. Where very few people have had covid and antibodies. ( and even if a year down the road they wont do you much good.) So, I think we go back to work, just give the disease some respect. Meaning, we still do a lot of cleaning and hygiene. Wear masks, distance where possible, except unless protected. ( We have to change our way of life ) We still do TSA crap at the airport, the 911 threat is 20 years old. why not stop that? that only killed 3000 total AND look at the burden of that. Just need to understand, and educate people how the disease spreads… I am sure we can do it CZ style. and not US style. But I am pretty sure they will open up the US the way it was. it will be another catastrophe . The US is clearly at the bottom of the world managing this… with exclusion to Italy. But perhaps worse , as time will tell. And after we do open back up and we will, it will be another blunder of epoch proportions. You cant convince monkeys to use logic.
…and actually comes roaring back to life in short order, I expect the number of deaths due to poverty, riots, and food insufficiencies to dwarf the deaths from COVID-19.
But I don’t think the economy will be allowed free rein soon enough…and even when it’s declared “open” I don’t think it’ll come roaring back. Complex systems are fragile – and the economy is already well along the process of shaking itself to pieces. Witness the oil markets this week. There’s a dangerous contagion for you.
You ever seen that youtube video of the engineering students (or mechanically-minded redneck tinkers?) who deliberately unbalance a washing machine and set it to spin mode? What happens in that video could be a good analogue for the current state of the modern JIT economy.
We may get a 1-2 punch: a reopen, then the second viral wave (worse than the first?), and then the second lockdown, which finishes off what remained of the functioning economy.
I think there will come a second period of time where we’re all locked down in our houses, but it will be because the streets have become a violent and dangerous place to be. Prepare accordingly…
It’s a beautiful day once again. Spending it with my awesome 3-year-old. Gonna do some chores, then watch a few cartoons, then lunch and a nap. Yesterday he was introduced to the hilarious wonders of the self-retracting tape measure (courtesy of his uncle). We’re also working on potty training. That transition was nearly complete until the Current Weirdness arose. He has regressed quite a bit, sadly.
Still no love from PPP, EIDL, or the stimulus payment. Unemployment disqualified me from eligibility because, as I saw posted online “We don’t know what to do with the self-employed.” Us formerly self-employed are eligible under the new rules, but the computer system is so old (programmed in COBOL, for FS!) nobody around knows how to modify the system. (Why not just mark whatever box you have to, ie just lie to the software so as to process my claim?). They’re actually posting asks on FaceBook for COBOL programmers to come out of retirement, if there’s any left alive (who can still remember how to code it)…
I have money put away and won’t be in trouble for a while. But my surmise is that about half of America is running out of money at this moment. When that happens, and hunger and desperation begin to stalk the streets in earnest? Watch out.
VIVA anyway – Sager
I don’t think the only reason for the lock-down is to wait 18 months for a vaccine. If we were using this time (however long it takes) to ramp up testing, as well as knock down the number of cases, we could get back to a “new normal”.
Why aren’t we using the Defense Production Act to get reagents and swabs made, here in the USA (and everything else that is currently limiting our ability to test)? Why is there so much hand waving and arguing about whether testing is “available” or we have “capacity” enough? It seems clear to me (and especially clear to those on the front lines) that we are not able to do the amount of testing that we need.
If we “open” the economy absent the ability to test, test, test (as well as to do contact tracing, and to administer a reliable treatment), then many rational people (myself included) will opt out, and the economy won’t come roaring back. (And we will just stay in a WWW cycle.)
We need the Three Ts: Testing, Tracing, and Treatment.
The current effort to “flatten the curve” is meant to allow space to get all of those things into place. BUT it seems clear that the Feds are not even serious about working on the first of these three, testing. Instead, it’s every State for itself, and best of luck to ya!
Truthman, no one is using zinc.
Look, weird yet active chemicals do a lot of things in many complicated ways. We know that hydroxycholoroquine has a special romantic thing with zinc and does some very antiviral things with it. Yet an almost infinite plethora of reactions are possible with any drug you can imagine and you do anything with statistics, such as ignore and go around the most important factors in a relationship.
The real reaction (subject) of this study is a political reaction. A very special doctor is treating patients with this drug, along with zinc and the other drug. He is politically incorrect because Trump likes him. Political reactions ensue. Eyeballs swivel and fingers leap into action onto keyboards. Chit chat crapping ensues. Money changes hands. Feelings are enhanced and vindicated.
Anyway, without more information, that is my analysis of this “study.”
That was one of my first thoughts. When they saw their high level brothers and sisters being hit by the virus (ministers, parliamentaries, royals, etc) and the fact that the age cohort most struck by the virus was mostly theirs (+50) they must have been real scared. I wonder if it had been the same if the virus had only hit kids between 0 and 15. The fact that 17.000 kids die everyday in the world is not causing so much concern. https://www.philstar.com/world/2014/09/17/1370112/un-17000-children-die-every-day
The paper for the Vets HCQ study is posted on MedRxiv;
https://connect.medrxiv.org/relate/content/181
http://medrxiv.org/cgi/content/short/2020.04.16.20065920
This is just another case of a study showing that there are few benefits to HCQ when given in the later stages of disease progression. The patient population was already hospitalized, and already proven positive. Here is a section from the paper;
Baseline demographic and comorbidity characteristics were comparable across the three treatment groups. However, hydroxychloroquine, with or without azithromycin, was more likely to be prescribed to patients with more severe disease, as assessed by baseline ventilatory status and metabolic and hematologic parameters. Thus, as expected, increased mortality was observed in patients treated with hydroxychloroquine, both with and without azithromycin. Nevertheless, the increased risk of overall mortality in the hydroxychloroquine-only group persisted after adjusting for the propensity of being treated with the drug.So this is where I call bullshit on the paper. We already know that the benefits of treatment are heavily front loaded for this treatment. They say that they, "adjusted" for the fact that in this study the HCQ group was even sicker than the non-HCQ cohort.. but did they really? Is this even possible. This treatment regimen works when it's administered early, before someone is hospitalized, as with the TX nursing home population treated by Dr. Robin Armstrong. Hopefully there will emerge other treatments that can save someone about to die on a ventilator.. but I don't think this is it. Edit: As Mots says, no Zinc also.
yet another study of idiots. What is odd - even the chinese early on said this was effective but not if used late. By the time you are sick enough to be hospitalized , I agree this wont help you. You need this when you first get sick , if you are in a risk group. It has been shown to work when used with “ZINC” and if you give it with out zinc and you are deficient ( as a lot are ) … it does nothing … So early and with zinc… Even I , would not use this once admitted to the hospital and without zinc… So , more idiots want to save lives of dead people… instead of live people.
I cannot seem to make sense of this. Are all the responders tested and collected by the same staff as others? if its done by somone on your team, it could be a collection issue. Or perhaps the tests are just unusually lowly sensitive and only picking up people with large viral load ( weak , infirm, nursing care .) Id bet its a test sensitivity issue. I do not believe you guys are walking around contacting people with this with minimal PPE and not getting it. Of course , the biggest thing is to not touch your face. But if you are going in where people are overtly ill, coughing etc, with no PPE - and not getting it , perhaps you all had it, But it is worthy of questioning. It definitely seems like it does not have a problem spreading. So, what you are saying , is you are visiting people sick with this , but not getting it , without PPE… It is hard to believe. only thing that may be going on is something in the weather , where you are, that is making it not easy for virus to live outside the body very long. This would also go to , what you said about fresh air and outside… Well yes, if its very sunny there, a half our in the sun will nuke it off clothing , skin, gear etc… so, perhaps… its a combination of good climate, normal hygiene, and fresh air, and getting this with a low inoculation… again we have spoke about severity of illness and amount of inoculum. So, I am going there for now.
A story of a Richmond doctor has been posted here a couple of times. He became very sick and just prior to going on a ventilator was given an IL-6 blocker, the Roche drug Actemra. Miraculous cure. Fever and dyspnea gone in just a few hours. Sent home the next day.
This was the first formal statement of Stages of COVID-19
Stage I Known as the early infection phase, this stage usually lasts about five days after contracting the virus. The patient can be asymptomatic or have a somewhat elevated fever and mild symptoms such as aches, pains and a cough. Stage II Known as the pulmonary phase, this stage usually takes place in days six through 10. The patient can have shortness of breath or have hypoxemia, which is low oxygen in the blood. X-rays and CT scans of the chest can reveal abnormalities in the lungs. During this stage, the body’s typical immune response diminishes, and the dangerous inflammatory response increases. The stage is broken into parts A and B to designate if the body is more in the viral stage or the inflammatory stage. Stage III Known as the hyperinflammation phase, this stage usually begins after Day 10 and can result in the patient suffering acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome, shock, cardiac failure, renal damage or other problems. Cytokine storms can be found in both lungs.The HCQ/Zn/Azith is a Stage 1 treatment. Actemra, the IL-6 blocker, is a Stage 3 treatment. The VA study was RETROSPECTIVE and NOT RANDOMIZED. How was it decided who got which drug? By location? The doctor's preference? The sickest? Those with COPD? -------------- And yes, you can design a study to produce a desired outcome. For example, giving a drug active in Stage 1 to patients in Stage 3 and "showing it doesn't work." This is the reason that the Cochrane Collaboration will not include in their meta-analyses any studies funded by a pharmaceutical company.