Sunday, March 22, 2020

Surviving the Coronavirus: Part 5

Chloroquine Edition

Yes, it's all over the news now. Apparently someone read Part 2 and/or Part 4 of this august series, acted on it/them, and now the world is saved.

Perhaps I overstate the matter in one or two tiny aspects, but there is certainly good news afoot.

150 million or so doses of chloroquine (or some variant thereof) are being promised by various manufacturers. China's protocol calls for 2 tablets per day for 10 days. The 150 million doses would be good for 7.5 million cases. South Korea's protocol calls for 1 tablet per day for 10 days. The 150 million doses would be good for 15 million cases.

I've come across a nice looking site out there called Spin, Strangeness, and Charm. It's not a site about sub-atomic physics, as most of you immediately presumed. It is instead about media and political spin, the strangeness of the world around us, with a sprinkling of charm to keep everything in perspective. It's running frequent updates regarding the coronavirus, the updates seem to be rational and well informed, and everything there is free, so good on the fine folks at Spin, Strangeness, and Charm.

In a very recent post, "COVID19 update: a brief look at three possible drugs," TFF at SSC embedded a video from the questionably-named medical site Personally, I don't like combining thoughts of medical treatment with the word cram. The fine folks at Medcram, though, were apparently using "cram" in the sense of "cramming for a test." The site's banner reads "Medical Videos and Lectures Explained Clearly." Their underline, unlike mine, is hand-drawn, bold, colorful, and eye-catching. But I digress.

The video was quite well done. 17 minutes or so long, as I recall. When I attempted to play it a second time, it wouldn't play. I received an error message. When I tried to play it a third time, I got an error message. When I tried to play it a fourth time (and I really did do that), I got an error message. My guess is that Part 2 and/or 4 of this august series indirectly but eventually led to so many Google hits for "chloroquine" that the Medcram server was overwhelmed.

Somehow, astoundingly, blessedly, the server serving this site has been able to withstand the traffic. But I digress.

As a public service, I'll try to summarize the Medcram video, since you can't watch it yourself. (I just tried to view it again. Same result. Perhaps I'm part of the problem.) Since I'm not a doctor, physician, epidemiologist, biomedical researcher, or involved in any fashion whatsoever in the medical field, I may get things a bit wrong here and there.

Hang on. Buckle up. Here we go.

A virus is a strange creature, not at all like a human, or even a human cell. Instead of multiplying through dividing, as do our cells, it replicates itself inside our cells only after creating something that scientists cleverly call replicase. Wikipedia, which I can still get to, describes replicase in simple, understandable fashion.
RNA-dependent RNA polymerase (RdRP, RDR) or RNA replicase is an enzyme that catalyzes the replication of RNA from an RNA template. This is in contrast to a typical DNA-dependent RNA polymerase, which catalyzes the transcription of RNA from a DNA template.
The coronavirus, and others of its evil ilk, have a loophole that we might be able to jump through. Coronavirus replicase hates zinc, because zinc kills coronavirus replicase. Good for us, bad for them. Don't go rushing to your store for zinc tablets, though, because our cell walls will not allow zinc to pass through without an appropriate escort. (The clever among you can now see where this is going.) Our cell walls, however, allow zinc to pass IF the zinc is escorted by Chloroquine!!!!!

If this works in practice as well as it works in the video, which is not working at the moment, then here's how you can survive the coronavirus. Have a medical profession administer chloroquine, or one of it's even better variants, make sure your cells are smart enough to allow the zinc to enter if escorted by chloroquine, watch the coronavirus already in your cells wither on the vine (my metaphor server is obviously down), get better.

But wait, there's more. The fine doctor in the fine video pointed out some very interesting comparisons between the outbreak in South Korea and the outbreak in Italy. Both countries have similar populations, 51 and 60 million respectively. Both countries have similar infections per million people. HOWEVER, the South Koreans have an order of magnitude fewer deaths AND more than an order of magnitude fewer instances of critical cases per infection.

Though the video doctor did not say so directly, it seems to me that the differential rates of critical cases per infection rules out the primary reason being differences in age distribution, testing, social distancing, wearing face masks, etc. There seems to be some difference in how the patients are treated after they have been infected. One difference is that the South Koreans have apparently been treating their patients with chloroquine while the Italians apparently have not.

The video doctor actually expressed cautious optimism that chloroquine will prove in practice to be an effective treatment. He did caution that we have been fooled before by early promising results, and that is all we have now for chloroquine. I already pointed out (in Part 4 of this august series) that the HIV drug that was once thought promising, and was being used in China, has since been shown in better controlled testing to have no effect.

As far as I am concerned, the best strategy for surviving the coronavirus, both as an individual and as a nation, is to flatten the hell out of the curve while quickly identifying and making widely available an effective cure. The chloroquine may be that effective cure. If not, we need to quickly move on to the next best candidate in the long list.

We need to save both our lives and our economy. To save us and it, we absolutely must quickly discover and widely distribute an effective cure. There is no other good option.

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