COVID=19 UPDATE for April 23rd

COVID=19 UPDATE for April 23rd:

1. We are eagerly watching for preliminary data from The University of WA’s clinical trial of Hydroxychloroquine (HCQ) + azithromycin. Unlike two other studies, including a study of Veterans Administration hospitals, the UW study will give a low dose to newly diagnosed individuals and their close contacts, looking for an effective way to reduce transmission of the virus. It is likely that high doses given to gravely ill patients is a bad idea due to common cardiac side effects that I discussed in my FaceBook Update on April 8th.
 
2. It may be that the main therapeutic action of HCQ is to escort zinc into the cells. This makes HCQ what is known as a zinc ionophore; but there are other zinc ionophors, including quercetin and epigallocatechin gallate (EGCG), derived from green tea. In fact, there are probably hundreds of polyphenols in a natural foods diet that enhance the transport of zinc into infected cells to limit the severity of this pandemic. [REF 1]
 
3. Regarding our recommendation to supplement with 30 to 50 mg/d of zinc (as gluconate or acetate). Warnings are appearing on the internet that this amount might cause a deficiency of copper, as the two elements compete for binding sites. Natalie and I want to point out that because copper deficiency is rare and zinc deficiency is common, this should not be a concern. Recommendations for 75 to 100 mg of zinc per day such as listed in the Eastern Virginia School of Medicine protocol, should only be done for 2 to 3 weeks.
 
4. The road ahead. Researchers around the world are trying to answer key questions that will help us overcome this incredible challenge.
* How many positive cases are there?
* How many people are asymptomatic?
* What accounts for the severity of symptoms?
* Which drugs work, and when should they be used?
* What are the protective / preventive factors: diet, supplementation, lifestyle, blood chemistry, immune profile?
 
In the meantime, Natalie and I fully support the comprehensive and insightful work of www.covidexitstrategy.org. This is a different virus. Aside from its lethality, we are learning that asymptomatic people not only can transmit the disease, but that this is the most common vector. Models from China showed 79% of transmission was via asymptomatics. And peak infectiousness appears to occur 2 days prior to symptoms. [REF 2]
 
A study out of Italy where an entire town was tested, showed that one asymptomatic spreader can spread Covid-19 to – not hundreds, but thousands. Since about 40% of those people have no symptoms, they are less likely to stay home or maintain social distancing. [REF 3]
 
Stay home protesters argue that factoring in asymptomatics means that COVID-19 is less deadly since the case fatality rates (CFR) is lower. But this feature actually makes it more deadly, not to the young healthy protestors, but to their elderly neighbors and family members with asthma, bronchitis or heart disease.
Onward!
 
References:
1. Food Chem. 2016 Apr 15;197(Pt A):916-23.
A simple liposome assay for the screening of zinc ionophore activity of polyphenols. Clergeaud G, Dabbagh-Bazarbachi H, Ortiz M1, Fernández-Larrea JB, O’Sullivan CK.
 
[2] Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2)
Ruiyun Li, Sen Pei2, et al. Science 16 Mar 2020:
DOI: 10.1126/science.abb3221
 
[3]. MedRxiv Suppression of COVID-19 outbreak in the municipality of Vo, Italy. Enrico Lavezzo, Elisa Franchin, et al.

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