30th April 2020 - Colonel Tom and Virus Theories

Thought for the day :"Well I wanted to make a joke about social distancing but this is as close as I could get"

LINK JOHNS HOPKINS
Office of National Statistics 

As the conspiracy theories start to permeate - I shall record this one for posterity - pulished on 27th April and purporting to be from Professor Montagnier, the man who discvered HIV and received the Nobel Prize in 2008...  I leave the links in ...  Snopes seem to support it as a legitimate article.

In a highly significant development, Professor Luc Montagnier, the French scientist who shared the 2008 Nobel Prize in Medicine for discovery of the human immunodeficiency virus (HIV), has added his voice to those who believe the new coronavirus was created in a laboratory. Interviewed on the CNews channel in France, Montagnier asserted that the virus had been designed by molecular biologists. Stating that it contains genetic elements of HIV, he insisted its characteristics could not have arisen naturally.

Asked by the CNews interviewer what the goal of these molecular biologists was, Montagnier said it wasn’t clear. “My job,” he said, “is to expose the facts.” While stressing that he didn’t know who had done it, or why, Montagnier suggested that possibly the goal had been to make an AIDS vaccine. Labeling the virus as “a professional job…a very meticulous job,” he described its genome as being a “clockwork of sequences.”

“There’s a part which is obviously the classic virus, and there’s another mainly coming from the bat, but that part has added sequences, particularly from HIV – the AIDS virus,” he said.

Growing evidence that the virus was ‘designed’

Montagnier also pointed out that he wasn’t the first scientist to assert that the coronavirus was created in a laboratory. Previously, on 31 January 2020, a research group from India had published a paper suggesting that aspects of the virus bore an “uncanny similarity” to HIV. Taken together, the researchers said their findings suggested the virus had an “unconventional evolution” and that further investigation was warranted. While the researchers subsequently retracted their paper, Montagnier said they had been “forced” to do so.

In February 2020, a separate research paper published by scientists from South China University of Technology suggested the virus “probably” came from a laboratory in Wuhan, the city where it was first identified. Significantly, one of the research facilities cited in this paper, the Wuhan National Biosafety Laboratory, is said to be the only lab in China that is designated for the study of highly dangerous pathogens such as Ebola and SARS. Prior to the opening of this laboratory in 2018, biosafety experts and scientists from the United States had expressed concerns that a virus could escape from it. As with the paper published by the Indian researchers, however, the Chinese scientists’ paper has similarly been withdrawn.

Involvement of the pharma industry

Professor Montagnier has long demonstrated that he is not afraid to challenge the prevailing views of the scientific establishment. Previously, in an interview recorded for the 2009 AIDS documentary ‘House of Numbers’, he had spoken out in favor of nutrition and antioxidants in the fight against HIV/AIDS. As the co-discoverer of HIV and a Nobel prize winner, Montagnier’s statements in this interview gave valuable support to Dr. Rath and other scientists who, for years beforehand, had been warning the world about the pharmaceutical business with the AIDS epidemic.

In a similar way, his assertion today that the coronavirus was designed by molecular biologists raises serious questions about the possible involvement of the pharmaceutical industry. As Montagnier infers, a manmade virus whose genome consists of a “clockwork of sequences” and includes elements of HIV could not have been assembled by amateurs. With estimates of the total global economic cost of the coronavirus varying from $4.1 trillion to $20 trillion or more, the ongoing questions about its origins are unlikely to disappear anytime soon.

In fairness - Wikipedia is up to the minute with references on Montagnier and a dispute by French Authorities..

Montagnier argued that the 2019–20 coronavirus pandemic was man-made in a laboratory and that might be the result of an attempt to create a vaccine for HIV/AIDS. His allegation came after the United States had launched a probe into whether the virus came from a laboratory. According to Montagnier, the "presence of elements of HIV and germ of malaria in the genome of coronavirus is highly suspect and the characteristics of the virus could not have arisen naturally."^[44]
However this was described as "a conspiracy vision that does not relate to the real science" by Jean-Francois Delfraissy, an immunologist and head of the scientific council that advises the French government on the COVID-19 pandemic.^[45]

We shall see..
(again I have left the references in place )

Apparently an antibody test has been certified and is ready to go into production - we shall see...

In other news - it is Captain Tom's 100th Birthday today having raised over £30 million for the NHS Charities - he received an Honorary Colonel rank from the Queen, and a fly by Spitfire and Hurricane...

Sad that we have to fund the NHS by charity...

Weather has gone into a cold snap - the heating came on last night!

Have been a little remiss the last couple of days and not gone into the Studio. Have to change that today.
I don't have any more ready to go.....

Also need to do some Birthday Cards - think I need to snap out of this Ground dog day scenario ...

Would have been heading to CP 1  - Curious Pastimes Event 1 - so here is are a few LARP Charactersfrom Switzerland - Equinox...

Cheers !

29th April 2020 - Fiddling with Numbers

Thought for the day :"Bards Guild or Thieves’ Guild ? Hmm Will have to weigh up the Prose and Cons"

LINK JOHNS HOPKINS
Office of National Statistics 

So, USA goes over the millions cases today, and over 58,000 deaths. 
However, percentages are still showing that we are not really doing any better, and the figures coming out now for Care Home deaths are saddening. I really do not like the images you see for the Care industry where we have so many old and weak who are now being cared for by teams of people in masks and gloves... It has to be - but what a sad way to end your existence. 

	Case	Population
World	6.95%	0.003%
USA	5.76%	0.018%
Spain	10.26%	0.051%
Italy	13.58%	0.045%
France	14.02%	0.035%
UK	13.39%	0.033%
Germany	3.95%	0.008%

Deaths shown as percentage of Cases reported and of population...

Still great discrepancies - but more useful than just the bold figures I think. If USA were running at the rate that is reported in the UK they would be on 107,000 deaths.  Of course they are ten days behind us and opening up the economy so watch this space.

May need to brush up my keyboards skills...

In other news - need to get back into the studio today to get the next few vids ready.

But we can come up to date today with a little tale of a small creature.. who became O So Famous..
Earwig O! Shut Down Serenade No 15...

Earwig O

And so - off we go again
Cheers !

28th April 2020 - Wet and Cold again

Thought for the day :"Burned 3000 calories – fell asleep while cooking cakes"

LINK JOHNS HOPKINS
Office of National Statistics (latest)

Another miserable day. But the garden will benefit from a drop of rain and it may keep some people home for a while.

Up relatively early and chasing Contact Lenses that should have been delivered. Automated chase system so we will see whether I get a reply.

We are now at the denial stage with regard to self medication - where He will take no responsibiltiy for suggestions that he made might have been linked to disinfectant firms all sending out directions repeating that they are not to be injested!! or to the thousands of help calls made to state bodies asking if they should follow the advice.  They walk among us ...

New Zealand opened today - having no cases left apparantly. We are a along way away at the moment with the Care Home figures looking very bad.

We seem to be on to No 14 in the Shut-down Serenades - will have to start recording again tomorrow .. To Althea - (From Prison apparently rather than in) Oh well...  

"Stone Walls do not a Prison Make nor Iron Bars a Cage" - seemed appropraite ...

Cheers!

27th April 2020 - Statistics, more Statistics and damn lies

Thought for the day :"Exercise can help decision making – Went for a run this morning and decided – never again"

LINK JOHNS HOPKINS
Office of National Statistics


Saw some Welsh reading yesterday ..

Another week and still the same ....

I skipped No 12 so we can go back for it now ...

English Country Garden

Two more in the bag - so can have a day off today ...
Managed to get rid of one barrel of Glycol today and clear behind the Greenhouse. It was covered in Brambles so managed to not injure myself too much as I cleared it. The first barrel was mainly water so flushed down the drains easily - will look at another one today. Need to start digging a hole for a drainage ditch...

Weather looks as though it is turning which at least may keep more people in their houses. 

Boris Back from Chequers today.
Total cases creeps to within a statistical error of 3 million. Deaths over 200,000. USA getting close to the million cases on their own and almost 55,000 deaths.  UK have almost 21,000 deaths.
I am not a great one for statistics but, though those fingures look horrifying, the US death toll is only 1.6% of the polulation of the USA. In the UK we are at 3.1%.
I don't see that statistic bandied around a lot.
Thought I would look at other countries to see ...
Spain -   4.9%
Italy - 4.4%
Germany - .07%

Well done Germany...

They say that a Statistician is someone who can draw a mathematically precise line from an unwarranted assumption to a foregone conclusion.

Well - back to the Grindstone..

Cheers !

26th April 2020 - Cider, Outsiders, and Sundays

Thought for the day :"Binge reading everything by Stephen King – Didn’t enjoy it"

LINK JOHNS HOPKINS
Office of National Statistics


Reading Laurie Lee's Cider With Rosie and found the following passage:

Mother's romantic memories may not have all been reliable, for their character frequently changed. But of the stories she told us, about herself and others, the one of the Blacksmith and the Toffee-Maker was true...

Once, she said, in the village of C---, there lived a lovelorn blacksmith. For years he had loved a local spinster, but he was shy, as most blacksmiths are. The spinster, who eked out a poor existence by boiling and selling toffee, was also lonely, in fact desperate for a husband, but too modest and proud to seek one. With the years the spinster's desperation grew, as did the blacksmith's speechless passion.

Then one day the spinster stole into the church and threw herself down on her knees. "Oh Lord" she prayed, "please be mindful of me, and send me a man to marry!"

Now the blacksmith by chance was up in the belfry, mending the old church clock. Every breathless word of the spinster's entreaties rose clearly to where he was. When he heard her praying, "Please send me a man!" he nearly fell off the roof with excitement. But he kept his head, tuned his voice to Jehovah's, and boomed "Will a blacksmith do?"

"Ern a man's better than nern, dear Lord!" cried the spinster gratefully.

At which the blacksmith ran home, changed into his best, and caught the spinster on her way out of church. He proposed, and they married, and lived forever contented, and used his forge for boiling their toffee.

Hmm - I wondered where Jake got the idea from ... Shut-Down Serenades No 13 ...
(I know - I skipped 12 - you can look it up if you want or wait until tomorrow)

The Blacksmith

In other news - on essential journeys..

 or even

But we always have to come back to the main stories..

And a musical interlude...

And to put the record straight

"So if I inject my friend with disinfectant

Could I be charged with bleach of the peace 😁

Or domestos violence"

And won't we look stupid next week 

A day in the studio yesterday, and three songs under the belt. Well two songs and a monologue really - they will be heading to the blog and all good social media outlets in due course.

Meanwhile - it is Sunday  -I know - I checked on the computer and so another week is about to start....

Cheers :

25th April 2020 - 28 Days Later

Thought for the day :"Giraffes can grow up to 15 feet - most however stop at four"

LINK JOHNS HOPKINS
Office of National Statistics

Saturday - and the lock-down is 1 month old ...
Susie has made four of her scrubs. Two went yesterday to a lass who was starting work but could not get any matching scrub from any of the hospitals so was delighted to get them..

They liked the quality, and so instead of deciding that she would call it a day after the ones that she is currently doing that we bought material for, the local volunteer co-ordinator is bringing her a bolt of material to make blues!!! Got to say I am proud of her.

Oh - and it is Green One!

Meanwhile - after the debacle with Trump and the Disinfectant, the machine is trying desperately to recover face and stop people trying to kill themselves. Dettol and Lysol have felt it necessary to come out and warn people that their productes are NOT for internal use.

Trump is saying that he was directling at a Hostile press as "sarcasm". I watched the broadcast as it was happening - he was musing to his medical advisors, not directing at the press at all.

Daily briefing last night and he refused to answer any questions at all. I think that he will soon deciode that this is no longer the best place for him to appear and we may get back to a factual briefing. An interestig comment from CNN suggested that the original briefings were by the Vice President and advisors, but heir popularity led Trump to decide that he should be getting the attention and publicity so he could use it as a platform for his re-election. Now it is getting sticky he will probably stop appearing there - makes sense. Bydon claims that Trump is looking for ways to stop the election in November . Watch this space for more claims by the Republicans that postal voting is corrupt.

In other news...  some unlikely films for the shut-down...

In other news - I was discussing the popularity of the press yesterday, and included a chart whosing thet the Press were now held in very little respect at all..

I think this is summed up with this little missive that I discovered...

Lets have dome music!

Shut Down Serenades No 11 - Me and Bobby McGee

Cheers !

24th April 2020 - Why don't we trust our Media?, Poems and Port

Thought for the day :"Without a doubt, the best Robin Williams role is Mrs. Fire."

LINK JOHNS HOPKINS
Office of National Statistics

Was a little late to bed last night.

I have a tendency to watch the midnight news on Sky and "the papers" though I haven't read a paper in many years with the possible exception of a freebie on the train or aeroplane. Lately I have flicked over onto CNN - the only US channel that we have available here and have been getting to know the main broadcasters for that time of night - which often coincides with the daily briefing from the White House. I see some differences in the broadcasting style - Interviewer will normally make a very long statement outlining everything that the interviewee is likely to say, while the interviewee waits patiently for the questioner to stop.. then the interviewee will thank him/her for allowing them onto the programme and confirm what was asked. And the interviewer will let them finish until the end! Even if it is quite a long statement!

Interesting questions like "Trump today has suggested injecting disinfectant to kill the virus" is not treated with hilarity or horror - but is discussed by the official "health advisor" as "the sort of thing that a patient may ask a doctor" and refuses to criticise the President for foolish and stupid statements. "Perhaps Ultra Violet light can be shone inside the body - you can look at that as a possibility". After a full interview it is left to the interviewer - in this case Anderson, to suggest that this is something that people should not be doing at home...
The news style is very gentle - and appears to be trying to be "informative" - talking with clearly either stupid people or those who are too scared of losing their position in government to talk candidly..... Let us watch Dr Birx - His medical advisor as he suggests some of his ideas...

As a result a glass or two of Port seemed the best thing to quell the exasperation and it was well after 2.30am when I got to bed last night  - so was a little slow on the rising this morning.

I learned a new word today - Ultracrepidarian.
Definition: one who is presumptuous and offers advice or opinions beyond one's sphere of knowledge. The meaning of this word comes from a story in antiquity, in which the famed Greek painter Apelles one day heard a cobbler criticizing the way he had rendered a foot in a painting.
(It is a verb and a noun...)

I woke to some suggestions regarding Trumps ideas...

In other slightly interesting information I saw a little snippet that pointed out that the Trump millions originally were the result of Life Insurance payment after the 1918 Flu pandemic...

Still, the style of press and media coverage across all channels does little to impress me. The coverage over Brexit (remember that?) and the need for 24 hour news led to the drivel that appeared where everyone piece of information was repeated and analysed - the Vox Pox (happily now they cannot walk down the street of Brummigan to ask what the "people" think) and this has now set the standard. We had months of daily "BREXIT CRISIS" and so the media now starts everything with "Virus Crisis" and finds new things to worry people about under the guise of "investigative journalism" and holding the Government, NHS, Local Authority, or Public to account, and throwing the worst possible view on any possible future. Don't get me wrong.. I do not suggest that we shoudl be doing a Trump "It will all go away" - but incessant criticism can only lead to depression.

I am not surprised by the poll from Sky

How our mighty media have fallen..
So more fool me for staying up late...  Must be pressure from the Shut Down !

In other news..

Pam Ayres? She's 73 and still going strong. This is her latest ode to coronavirus...

I'm normally a social girl
I love to meet my mates
But lately with the virus here
We can't go out the gates.

You see, we are the 'oldies' now
We need to stay inside
If they haven't seen us for a while
They'll think we've upped and died.

They'll never know the things we did
Before we got this old
There wasn't any Facebook
So not everything was told.

We may seem sweet old ladies
Who would never be uncouth
But we grew up in the 60s -
If you only knew the truth!

There was sex and drugs and rock 'n roll
The pill and miniskirts
We smoked, we drank, we partied
And were quite outrageous flirts.

Then we settled down, got married
And turned into someone's mum,
Somebody's wife, then nana,
Who on earth did we become?

We didn't mind the change of pace
Because our lives were full
But to bury us before we're dead
Is like a red rag to a bull!

So here you find me stuck inside
For four weeks, maybe more
I finally found myself again
Then I had to close the door!

It didn’t really bother me
I'd while away the hour
I'd bake for all the family
But I've got no flaming flour!

Now Netflix is just wonderful
I like a gutsy thriller
I'm swooning over Idris
Or some random sexy killer.

At least I've got a stash of booze
For when I'm being idle
There's wine and whiskey, even gin
If I'm feeling suicidal!

So let's all drink to lockdown
To recovery and health
And hope this awful virus
Doesn't decimate our wealth.

We'll all get through the crisis
And be back to join our mates
Just hoping I'm not far too wide
To fit through the flaming gates!

And so - another day in the Tavern Studio...

No 10 : An old favourite - Fiddler's Green - the fabled "heaven for Sailors"

Best get on and think about the history of Pembroke Consistory of the Scarlet Cord.

Cheers !

23rd April 2020 - Ramadan, St George, and Vote Him Away

Thought for the day :"I’ve lost my audiobook. I will never hear the end of it !!"

LINK JOHNS HOPKINS
Office of National Statistics

Happy Ramadan and Happy St George's Day ...

though there are images that I could have used...

Susie carrying on with the Scrubs - I am back at the computer - no real change really ...

Will have to go down to the tavern/studio to re-record the songs from yesterday ...

But this is No 9 - Sister Josephine..

Other than that - not much happening - Weather good once more...

Saw this reporting on Trump and enjoyed the captions.. Totally Factual of Course - He doesn't like the W H O (World Health Organisation)

and someone else doesn't like him much I think - 1.5 million views in a day ..

There are a number of good songs on this link - but I will just leave this one tonight ..

Don't often agree with Brendan O'Neil - but occasionally I get very exasperated with the media...

Cheers!

Follow @TwitterDev

22nd April 2020 - Trip to the Country - Essential of Course

Thought for the day :"I took the P out of a Pirate – made him very angry "

LINK JOHNS HOPKINS
Office of National Statistics

Jacksonville - The place to Live

still unconvinced that it is a spoof

Spent the morning writing up the history of Llanelli Scarlet Cord 24 TI and Aberystwyth Consistory 25 TI  for the Scarlet Cord social media site...

Susie finishing her first two scrubs. Green and Small. appropraie that we start with a Green One!

We are going to try to run the gauntlet up to Carmarthen with the rotovator up to the Communtiy Farm. See how far we get.
Got there and back without being stopped - had a lovely walk around the farm with proper social distancing - though I think Angel is more isolated than we are !!  Hilly Farm - dog enjoyed the run and is exhausted - me - I think I needed oxygen !!!

Paul the mechanic did not charge for the mending of the machine - he said he was happy to support the Community Farm so will be taking a dozen eggs for him as a thank you. Not much but a symbol.

(waiting for Susie at "The Range " as she tried to get some cotton for the scrubs - 20 minute wait - everyone well behaved)

Forgot to take his eggs - Naughty Iain - must take tomorrow

Went into the Tavern/Studio and did a lovely recording of Bobby McGee and English Country Garden - sadly did not check the camera - it was pointed at my Knees - and with all head and shoulder videos, I was in full Vollie up top and a pair of shorts below - mainly covered  by the long shirt and looking as though I was doing it without trousers - needless to say I shall be in the tavern/Studio again tomorrow
No - No pictures to see!!!.

So one from the vaults... Batchelor's Lament

Some admin for Vic and his new flat to come in Llanybydder - he is getting excited by the move -
doing Identity and fincancial information - am feelign so glad that we moved him when we did. I think by now he would have been in a care home in Barton and health risks in homes are worrying at the moment . Took him for a walk along the Harbour wall yesterday and he was delighted - did not think that he was allowed out - so I made a fuss of the cleaning arrangements with the disinfectant cloths and washing when we got back...

about it for a day
Should have been in Crete this evening - Ho Hum !!

Cheers !

21st April 2020 - Garden Leave - or Leave the Garden

Thought for the day :"Just so everyone is clear, I will be putting my glasses on."

LINK JOHNS HOPKINS
Office of National Statistics  (new)


One for Captain Tom ...

Captain Tom 

Shut-down Serenades No 7 - Obi Wan Kenobie

All a bit depressing really at the moment, went out to look at the sky train last night and froze but did not see anything worth looking at  ..
Mythodea - planned for Germany in August cancelled ...
Politics and Media starting to bicker like kids on lock down...
Governement fail to get PPE to staff while rumours are that we are exporing to other countries because no-one took companies up on their offers - no way of believeing anything at the moment.
Florida opens its beaches and people are rioting in Phoenix Arizona against the shut down.
Death rates in Care homes beginning to be counted and make depressing reading.

but the sun is shining today.

Susie managed to get a roll of material so has started on the Scrubs for local paramedics.

Washing Manchine arrived at Nancy's

Suppose I had better go back into the studio again later - though there is a large bramble with my name on it behind the Greenhouse... I may get outside and attack it for an hour.

Anything is possible when the World is your Lobster....

Cheers :

20th April 2020 - Medical Notes

Thought for the day :"Today I melted an ice cube with just the power of my mind – just by staring at it – though to be honest it took longer than I was expecting !"

LINK JOHNS HOPKINS
Office of National Statistics 

Tel Aviv - Social Distancing Demonstration

sciencemag.orgsciencemag.org

The infection begins

When an infected person expels virus-laden droplets and someone else inhales them, the novel coronavirus, called SARS-CoV-2, enters the nose and throat. It finds a welcome home in the lining of the nose, according to a preprint from scientists at the Wellcome Sanger Institute and elsewhere. They found that cells there are rich in a cell-surface receptor called angiotensin-converting enzyme 2 (ACE2). Throughout the body, the presence of ACE2, which normally helps regulate blood pressure, marks tissues vulnerable to infection, because the virus requires that receptor to enter a cell. Once inside, the virus hijacks the cell’s machinery, making myriad copies of itself and invading new cells.

As the virus multiplies, an infected person may shed copious amounts of it, especially during the first week or so. Symptoms may be absent at this point. Or the virus’ new victim may develop a fever, dry cough, sore throat, loss of smell and taste, or head and body aches.

If the immune system doesn’t beat back SARS-CoV-2 during this initial phase, the virus then marches down the windpipe to attack the lungs, where it can turn deadly. The thinner, distant branches of the lung’s respiratory tree end in tiny air sacs called alveoli, each lined by a single layer of cells that are also rich in ACE2 receptors.

Normally, oxygen crosses the alveoli into the capillaries, tiny blood vessels that lie beside the air sacs; the oxygen is then carried to the rest of the body. But as the immune system wars with the invader, the battle itself disrupts this healthy oxygen transfer. Front-line white blood cells release inflammatory molecules called chemokines, which in turn summon more immune cells that target and kill virus-infected cells, leaving a stew of fluid and dead cells—pus—behind. This is the underlying pathology of pneumonia, with its corresponding symptoms: coughing; fever; and rapid, shallow respiration. Some COVID-19 patients recover, sometimes with no more support than oxygen breathed in through nasal prongs.

But others deteriorate, often quite suddenly, developing a condition called acute respiratory distress syndrome (ARDS). Oxygen levels in their blood plummet and they struggle ever harder to breathe. On x-rays and computerized tomography scans, their lungs are riddled with white opacities where black space—air—should be. Commonly, these patients end up on ventilators. Many die. Autopsies show their alveoli became stuffed with fluid, white blood cells, mucus, and the detritus of destroyed lung cells (see graphic).

An invader’s impact

In serious cases, SARS-CoV-2 lands in the lungs and can do deep damage there. But the virus, or the body’s response to it, can injure many other organs. Scientists are just beginning to probe the scope and nature of that harm.

Some clinicians suspect the driving force in many gravely ill patients’ downhill trajectories is a disastrous overreaction of the immune system known as a “cytokine storm,” which other viral infections are known to trigger. Cytokines are chemical signaling molecules that guide a healthy immune response; but in a cytokine storm, levels of certain cytokines soar far beyond what’s needed, and immune cells start to attack healthy tissues. Blood vessels leak, blood pressure drops, clots form, and catastrophic organ failure can ensue.

Some studies have shown elevated levels of these inflammation-inducing cytokines in the blood of hospitalized COVID-19 patients. “The real morbidity and mortality of this disease is probably driven by this out of proportion inflammatory response to the virus,” says Jamie Garfield, a pulmonologist who cares for COVID-19 patients at Temple University Hospital.

But others aren’t convinced. “There seems to have been a quick move to associate COVID-19 with these hyperinflammatory states. I haven’t really seen convincing data that that is the case,” says Joseph Levitt, a pulmonary critical care physician at the Stanford University School of Medicine.

He’s also worried that efforts to dampen a cytokine response could backfire. Several drugs targeting specific cytokines are in clinical trials in COVID-19 patients. But Levitt fears those drugs may suppress the immune response that the body needs to fight off the virus. “There’s a real risk that we allow more viral replication,” Levitt says.

Meanwhile, other scientists are zeroing in on an entirely different organ system that they say is driving some patients’ rapid deterioration: the heart and blood vessels.

Striking the heart
In Brescia, Italy, a 53-year-old woman walked into the emergency room of her local hospital with all the classic symptoms of a heart attack, including telltale signs in her electrocardiogram and high levels of a blood marker suggesting damaged cardiac muscles. Further tests showed cardiac swelling and scarring, and a left ventricle—normally the powerhouse chamber of the heart—so weak that it could only pump one-third its normal amount of blood. But when doctors injected dye in the coronary arteries, looking for the blockage that signifies a heart attack, they found none. Another test revealed why: The woman had COVID-19.

How the virus attacks the heart and blood vessels is a mystery, but dozens of preprints and papers attest that such damage is common. A 25 March paper in JAMA Cardiology documented heart damage in nearly 20% of patients out of 416 hospitalized for COVID-19 in Wuhan, China. In another Wuhan study, 44% of 138 hospitalized patients had arrhythmias.

The disruption seems to extend to the blood itself. Among 184 COVID-19 patients in a Dutch ICU, 38% had blood that clotted abnormally, and almost one-third already had clots, according to a 10 April paper in Thrombosis Research. Blood clots can break apart and land in the lungs, blocking vital arteries—a condition known as pulmonary embolism, which has reportedly killed COVID-19 patients. Clots from arteries can also lodge in the brain, causing stroke. Many patients have “dramatically” high levels of D-dimer, a byproduct of blood clots, says Behnood Bikdeli, a cardiovascular medicine fellow at Columbia University Medical Center.

“The more we look, the more likely it becomes that blood clots are a major player in the disease severity and mortality from COVID-19,” Bikdeli says.

Infection may also lead to blood vessel constriction. Reports are emerging of ischemia in the fingers and toes—a reduction in blood flow that can lead to swollen, painful digits and tissue death.

In the lungs, blood vessel constriction might help explain anecdotal reports of a perplexing phenomenon seen in pneumonia caused by COVID-19: Some patients have extremely low blood-oxygen levels and yet are not gasping for breath. It’s possible that at some stages of disease, the virus alters the delicate balance of hormones that help regulate blood pressure and constricts blood vessels going to the lungs. So oxygen uptake is impeded by constricted blood vessels, rather than by clogged alveoli. “One theory is that the virus affects the vascular biology and that’s why we see these really low oxygen levels,” Levitt says.

If COVID-19 targets blood vessels, that could also help explain why patients with pre-existing damage to those vessels, for example from diabetes and high blood pressure, face higher risk of serious disease. Recent Centers for Disease Control and Prevention (CDC) data on hospitalized patients in 14 U.S. states found that about one-third had chronic lung disease—but nearly as many had diabetes, and fully half had pre-existing high blood pressure.

Mangalmurti says she has been “shocked by the fact that we don’t have a huge number of asthmatics” or patients with other respiratory diseases in HUP’s ICU. “It’s very striking to us that risk factors seem to be vascular: diabetes, obesity, age, hypertension.”

Scientists are struggling to understand exactly what causes the cardiovascular damage. The virus may directly attack the lining of the heart and blood vessels, which, like the nose and alveoli, are rich in ACE2 receptors. Or perhaps lack of oxygen, due to the chaos in the lungs, damages blood vessels. Or a cytokine storm could ravage the heart as it does other organs.

“We’re still at the beginning,” Krumholz says. “We really don’t understand who is vulnerable, why some people are affected so severely, why it comes on so rapidly … and why it is so hard [for some] to recover.”

Multiple battlefields
The worldwide fears of ventilator shortages for failing lungs have received plenty of attention. Not so a scramble for another type of equipment: dialysis machines. “If these folks are not dying of lung failure, they’re dying of renal failure,” says neurologist Jennifer Frontera of New York University’s Langone Medical Center, which has treated thousands of COVID-19 patients. Her hospital is developing a dialysis protocol with different machines to support additional patients. The need for dialysis may be because the kidneys, abundantly endowed with ACE2 receptors, present another viral target.

According to one preprint, 27% of 85 hospitalized patients in Wuhan had kidney failure. Another reported that 59% of nearly 200 hospitalized COVID-19 patients in and near Wuhan had protein and blood in their urine, suggesting kidney damage. Those with acute kidney injury (AKI), were more than five times as likely to die as COVID-19 patients without it, the same Chinese preprint reported.

Buffeting the brain
Another striking set of symptoms in COVID-19 patients centers on the brain and central nervous system. Frontera says neurologists are needed to assess 5% to 10% of coronavirus patients at her hospital. But she says that “is probably a gross underestimate” of the number whose brains are struggling, especially because many are sedated and on ventilators.

Frontera has seen patients with the brain inflammation encephalitis, with seizures, and with a “sympathetic storm,” an immune response that’s the brain’s version of a cytokine storm. Some people with COVID-19 briefly lose consciousness. Others have strokes. Many report losing their sense of smell. And Frontera and others wonder whether in some cases, infection depresses the brain stem reflex that senses oxygen starvation. This is another explanation for anecdotal observations that some patients aren’t gasping for air, despite dangerously low blood oxygen levels.

ACE2 receptors are present in the neural cortex and brain stem, says Robert Stevens, an intensive care physician at Johns Hopkins Medicine. But it’s not known under what circumstances the virus penetrates the brain and interacts with these receptors. That said, the coronavirus behind the 2003 severe acute respiratory syndrome (SARS) epidemic—a close cousin of today’s culprit—could infiltrate neurons and sometimes caused encephalitis. On 3 April, a case study in the International Journal of Infectious Diseases, from a team in Japan, reported traces of new coronavirus in the cerebrospinal fluid of a COVID-19 patient who developed meningitis and encephalitis, suggesting it, too, can penetrate the central nervous system.

But other factors could be damaging the brain. 

For example, a cytokine storm could cause brain swelling, and the blood’s exaggerated tendency to clot could trigger strokes. The challenge now is to shift from conjecture to confidence, at a time when staff are focused on saving lives, and even neurologic assessments like inducing the gag reflex or transporting patients for brain scans risk spreading the virus.

Last month, Sherry Chou, a neurologist at the University of Pittsburgh Medical Center, began to organize a worldwide consortium that now includes 50 centers to draw neurological data from care patients already receive. The early goals are simple: Identify the prevalence of neurologic complications in hospitalized patients and document how they fare. Longer term, Chou and her colleagues hope to gather scans, lab tests, and other data to better understand the virus’ impact on the nervous system, including the brain.

Chou speculates about a possible invasion route: through the nose, then upward and through the olfactory bulb—explaining reports of a loss of smell—which connects to the brain. “It’s a nice sounding theory,” she says. “We really have to go and prove that.”

Most neurological symptoms “are reported from colleague to colleague by word of mouth,” Chou adds. “I don’t think anybody, and certainly not me, can say we’re experts.”

Reaching the gut
In early March, a 71-year-old Michigan woman returned from a Nile River cruise with bloody diarrhea, vomiting, and abdominal pain. Initially doctors suspected she had a common stomach bug, such as Salmonella. But after she developed a cough, doctors took a nasal swab and found her positive for the novel coronavirus. A stool sample positive for viral RNA, as well as signs of colon injury seen in an endoscopy, pointed to a gastrointestinal (GI) infection with the coronavirus, according to a paper posted online on in The American Journal of Gastroenterology (AJG).

Her case adds to a growing body of evidence suggesting the new coronavirus, like its cousin SARS, can infect the lining of the lower digestive tract, where the crucial ACE2 receptors are abundant. Viral RNA has been found in as many as 53% of sampled patients’ stool samples. And in a paper in press at Gastroenterology, a Chinese team reported finding the virus’ protein shell in gastric, duodenal, and rectal cells in biopsies from a COVID-19 patient. “I think it probably does replicate in the gastrointestinal tract,” says Mary Estes, a virologist at Baylor College of Medicine.

Recent reports suggest up to half of patients, averaging about 20% across studies, experience diarrhea, says Brennan Spiegel of Cedars-Sinai Medical Center in Los Angeles, co–editor-in-chief of AJG. GI symptoms aren’t on CDC’s list of COVID-19 symptoms, which could cause some COVID-19 cases to go undetected, Spiegel and others say. “If you mainly have fever and diarrhea, you won’t be tested for COVID,” says Douglas Corley of Kaiser Permanente, Northern California, co-editor of Gastroenterology.

The presence of virus in the GI tract raises the unsettling possibility that it could be passed on through feces. But it’s not yet clear whether stool contains live, infectious virus, not just RNA and proteins. To date, “We have no evidence” that fecal transmission is important, says coronavirus expert Stanley Perlman of the University of Iowa. CDC says that based on experiences with SARS and with the virus that causes Middle East respiratory syndrome, another dangerous cousin of the new coronavirus, the risk from fecal transmission is probably low.

The intestines are not the end of the disease’s march through the body. For example, up to one-third of hospitalized patients develop conjunctivitis—pink, watery eyes—although it’s not clear that the virus directly invades the eye. Other reports suggest liver damage: More than half of COVID-19 patients hospitalized in two Chinese centers had elevated levels of enzymes indicating injury to the liver or bile ducts, according to two preprints. But several experts told Science that direct viral invasion isn’t likely the culprit. They say other events in a failing body, like drugs or an immune system in overdrive, are more likely driving the liver damage.

This map of the devastation that COVID-19 can inflict on the body is still just a sketch. It will take years of painstaking research to sharpen the picture of its reach, and the cascade of cardiovascular and immune effects it might set in motion. As science races ahead, from probing tissues under microscopes to testing drugs on patients, the hope is for treatments more wily than the virus that has stopped the world in its tracks.

sombre reading....

Florida:

So - another week starts ...

Captian Tom raises £25 million for walking around his house... there are many lovely protraits of him out there - but I saw this one and thought that it was a masterpiece..

and this piece of advice seemed very appropriate ..

Cheers !