Comments by "Stephen Villano" (@spvillano) on "Dr. John Campbell" channel.

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  4. In the US, we're fortunate, as we fortify milk with vitamin A and D. I'd be quite guarded with megadosing vitamin D, fat soluble vitamins can get into all manner of trouble when one overdoses, compared to water soluble vitamins, which essentially get urinated out. I get that impression from doctor here as well. Blind dosing isn't a good idea, as doctor well knows. The US fortifies milk, most yogurts, breakfast candy, erm, cereals and margarine. Fairly commonly consumed, eggs (not a great source, but it adds up), various meats, Virtually extinct in the US diet, cod liver oil. Some orange juices are also fortified, but not all and orange juice is the number 1 consumed breakfast juice. Doctor, is there any definitive test(s) to diagnose a cytokine storm? Or is it a constellation of results that lead to the educated opinion that that is the only bloody thing going on? This was in my e-mail this evening from the county where I grew up and most of my family lives in. This week Delaware County reported a high number of positive COVID-19 cases and COVID-19 deaths. On Monday, April 13- 117 new cases and 1 death was reported. On Tuesday, April 14- 101 new cases and 5 deaths were reported. On Wednesday, April 15- 84 new cases and 15 deaths were reported. On Thursday, April 16- 120 new cases and 11 deaths were reported. On Friday, April 17- 226 new cases and 3 deaths were reported. This brings the total number of cases in Delaware County to 2281 and the total number of deaths to 74. When I hear deniers, I get angry that their parents would've poked them so hard and so often in their fontanelle.
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  11. Dr Fauci referred to it as modified quarantine. Odd term, to be sure, but he did explain it a bit as he'll largely be at home, with some office presence. I was unaware that hydroxychloroquine caused ionophores to be created that would admit zinc, but I vaguely recall other drugs that are known to do that for zinc. Still, I do (again, vaguely) recall zip1 transporting zinc from the interstitial space through the plasma membrane. Still, I'm aware of two high quality studies that show no effect for HCQ in patient outcomes and one that showed higher morbidity and mortality, the latter seemed to hint that cardiac conduction anomalies might have been exasperated. Yesterday, we learned that our youngest, who was working in hospital housekeeping on COVID floors took ill. She briefly placed us on hold, where her physician had called with her SARS-CoV-2 test results. Positive. She sounded horrible last evening, severe coughing, which seems to have abated today, sounds like she's moving air well, held longer sentences than last night, but retained a fever and now has purple toes. Fortunately, she's now staying with her sister, who is an RN. I've been hearing chatter that initial viral exposure levels may possibly play a role in initial disease severity. We'll have to see if any studies are being conducted and of course, await peer review. If there's one thing I've learned personally about peer review is, peers love little better than to savage shoddy work. That induced me to rapidly produce high quality work!
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  16. It's a lot worse than emotionally scarring, it's destabilizing of what few governments remain stable in the famine afflicted regions. That spreads outward, both due to refugee flight and genuine anger over their needs not being met, their loved ones dying and they'll strike out at whoever appears or is doing better than they are. With plenty of online fingers pointing exclusively to the west, ignoring Russia stealing most, if not all of Ukraine's grain stocks as we speak. As far as I'm concerned, send those pirate vessels to the bottom, switch them with US excess grain, paint over the vessel names and fly no flag. If something needs to be on the hull, put a banner up saying MV Grain Fairy. Pull it from what I'll use, I'll not be alone volunteering it and I can stand losing another 20 pounds. One fee for the grain - recipes. We've had enough food to not only feed the entire planet, we've had enough food for my entire 60+ years of life to literally make the entire planet morbidly obese. Oddly, those against feeding those who hunger claim ever so loudly to be fine, upstanding Christians, who as Gandhi said, are ever so unlike Christ. Now, a bit of homework for most. Look up "Scarcity economics", which is the actual economic system we live under. Add in lean practices, such as just in time delivery keeping stocks low, it's no wonder that the US has an infant formula shortage due to 30% supply halting for contamination issues at the main plant. Not stocking warehouses means, any interruption in the supply chain leads to shortages and in scarcity economics, increased profits at everyone's expense. And there will always be interruptions in the supply chains, an earthquake here, typhoon there, volcano blowing its top diverting traffic over there, pirates in the underwear...
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  27.  @peetsnort  actually, there are several comparisons to be made. Both had circulatory damage, both have cytokine storms wreaking havoc. This bugger just happens to trigger a touch more widely distributed of a cytokine storm, complete with cardiac and kidney damage, making it a fair bit higher in the fatality department. Now that we've got a handle on some effective treatments, the CFR should drop down by a lot. A couple of months back, I was hospitalized with respiratory distress with SPO2 bouncing around 83 - 85. CXR revealed atelectasis with infiltrates. So, while working up the differential, TX was initiated for presumptive COVID-19 pending further testing and DX. First up, dexamethasone, followed with heparin. Sputum and nasal membrane swabs were taken. Speaking with doctor, I simply asked, "Presumptive pending differential and testing proving otherwise, huh". Doctor, shocked simply confirmed my suspicion. What had made me ill, thankfully was not infectious, but a full blown thyroid storm with hypertension and decompensation resulting in the pulmonary issues. Never before had I ever thought that the words, "Thank God it's only a type of heart failure!" would leave my lips. Oversimplified, that's what happened with me, loosely resembling part of the symptom set of COVID-19 and I entirely agreed. Were I still treating military patients, that'd have been my approach while ordering testing and getting doctor on the radio, as well as scheduling MEDEVAC in a New York minute, then decontaminating my treatment and waiting area of my BAS.
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  28.  @peetsnort  one calculates not on total global population, but per capita so that apples to apples are compared. Currently, for hospitalized patients, the CFR for COVID-19 is higher than for 1918 influenza. That said, there are confounders present for both, as both have cases that never are hospitalized and that skews the numbers. One upside is, we've yet to have people expiring on city streets, whereas with the 1918 influenza pandemic, that was a regular occurrence. We also now have dexamethasone to tamp down cytokine storms and heparin to prevent clotting issues, where in 1918, we only had hopes and prayers. Downside, thus far, per capita, Coronavirus has a higher per capita CFR than the 1918 influenza pandemic. Upside, as I said, we now have treatments, although I really would have a much warmer and fuzzier feeling in regards to one antiviral with additional studies on the efficacy, as the studies I've reviewed are rather weak tea. That all said, at the beginning of any pandemic, all studies are weak tea or non-existent, we learn as we go along, as life isn't a Doctor Who episode where one has a time machine to violate physics with. ;) A couple of months ago, we were embracing dexamethasone and heparin for preventing cytokine storm and clotting cascade failure, resulting in DIC, which has proved quite effective in preventing worse sequelae advancing and some studies suggest cardiac, CNS, peripheral circulatory and nephritic damage is far more limited when such treatments and possibly one antiviral treatment is initiated. At the time, I was hospitalized with dyspnea, SPO2 on room air 83 - 85, swiftly improving to 95 - 99 SPO2 on 5 LPM nasal cannula. Admitted for that and a hypertensive crisis, atelectasis with infiltrates. Immediate TX, dexamethasone and heparin, doctor was surprised that I asked if that was presumptive to possible COVID-19, pending labs and differential and shocked, he concurred. That's been the gold standard initial treatment. I was dubious that it was COVID-19, due to any possible exposure was over 30 days previous, due to one burst of intracranial flatulence on my part and since, I've been my usual cautious self in regards to contamination. Additionally, I have a HX of Grave's disease and hypertensive crisis and had fallen complacent on monitoring my BP and pulse, as well as remaining afebrile, retrograde or common fever at all and no precursor symptoms of a respiratory infection. A few allergy attacks, but those aren't unusual with me upon return to the US after five years. Well, the usual battery of tests, including nasal membrane swab drilling for oil in my sinus, a sputum test and my FT3 and FT4 being ridiculously high, it was confirmed to be a decompensation after initiation of a thyroid storm. Honestly, I never before thought I'd ever utter, "Oh, than God it's only a form of CHF!". But, the protocol matched and the dexamethasone also would be effective for limiting damage from the circulatory inefficiencies present due to the hypertensive crisis that turned things into an acute decompensated state. It's also right at the edges of my understanding and capabilities from when I was treating military patients in the field and I'd be getting doctor on the radio, after scheduling a New York minute MEDEVAC (basically, I'd brook no delay, urgent means what I *@&!%!!! said), TX to stabilize and advance doctor's efforts before arrival. And I've actually performed cut downs to gain circulatory access in some cases. So, I'm rather adept at knowing my limits, I'm also quite adept at anticipating what doctor will call for at a SF military level. I've also responded to more than a few outbreaks of infectious diseases and raced to get in front of them. Where I excel is, I know when to call in an SME and that's always before I'm well and truly in trouble - it's far less damned work! Even today, now that I'm retired from the military, I have my network of SME's available by telephone, personal visit or e-mail, counting PhD epidemiologists, some personal friends who my wife and I have enjoyed many fine meals with. Still, there are comparisons. Cytokine storms, DIC seems to have been present with both due to probable peripheral circulatory system damage, high unmitigated R0 and the only real difference is COVID-19's unmitigated hospitalized CFR being twice the CFR for hospitalized 1918 influenza pandemic patient rates, adjusted for per capita, rather than total number of ill. For, comparing outside of a per capita rate adjustment isn't even an apple to apple comparison, it's apple to bowling ball.
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  29.  @peetsnort  there was no concern at that time about overdose, the patent was confiscated from a German company, something about enemies and a World War, you might've heard a little something about that. Aspirin does not cause a cytokine storm, try looking up the germ cytokine storm, then look up what cytokines are. That's medical knowledge, not hypochondria, which is a psychiatric condition involving a pathological fear of being ill. We don't hospitalize people for hypochondria, we do hospitalize them for major illnesses. Nobody had antibodies for smallpox until they contract the disease, the same for influenza, which is most commonly carried by birds, which the Native Americans were most certainly familiar with. Measles, mumps, varicella and smallpox were unknown to them. Peanut butter allergy has already been figured out, underexposure when young resulted in allergy when exposed when older, it was repeatedly written up in every pediatrics journal in the world. Not microdosing, but microexposures to promote tolerance to the allergen, which is a standard desensitization method that's been in use for decades. No, COVID-19 isn't some emotional overreaction, we don't put people on ECMO or ventilators for emotional illnesses, we put them on such invasive technologies when their respiratory system is so badly damaged that they'd die otherwise. Even then, a fair number still die, which most assuredly is not an emotional overreaction! It's been globally, even within Sweden, to be acknowledged that the Swedish approach was a dismal, abject failure that resulted in excessive deaths. Only one political leader in Sweden supports that failed view, well, that leader and Russia, who's always contrary to those not their friends. Again, we don't hospitalize people for a mental condition as minor as hypochondria, we do hospitalize people for life threatening illnesses. So, why do you go on at such length about things that you repeatedly prove with your own words, of which you know nothing whatsoever about? Are you proud of such alarming and excessive ignorance?
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