Covid-19 and the Elderly

Covid-19 and the Future

Millions of words have been written about Covid-19 by journalists, writers, wellness enthusiasts, bloggers and others – vast tracts, often at odds with each other and sometimes contradictory too. My point is that not enough is being made of the disproportionate number of deaths associated with Covid-19 and the elderly. It is just unconscionable. Everyone by now knows how vulnerable they are and more has to be done for them.

 

Yet we should all take time to thank the medical profession for their commitment. So many have perished across the world during the pandemic and we all – the billions of inhabitants of the earth, unite in saying, “Thank you very much!”

 

The title Covid-19 and the elderly, is partly in response to my own advanced years. A bag of bones as my one daughter calls me – but this is pure banter or as my American friends might say, “Just kidding”.

 

The elderly are definitely a group on the edge of a precipice, especially if they suffer from other conditions like diabetes, high-blood pressure, and dementia to name just a few. It is therefore imperative that they take certain fundamental precautions. Please refer to the statistics below. My old father – a veteran of WWII, liked to use the noun ‘stinker’ to express his discontentment – Covid-19 would definitely have warranted a big stinker!

 

Covid-19 and the Future

Stop-Press Stop-Press

September 15, 2020. Direct from today’s New York Times: ” Russia and China have already started vaccinating under emergency use measures, and the countries are making international deals to sell their experimental vaccines”.

September 03, 2020. Direct from the Wall Street Journal: “Poor countries lag behind in the vaccine race. Developing nations are at risk of being left far short of Covid-19 vaccine supplies as richer nations secure billions of doses. The U.S., China, European Union, Japan, the U.K. and India are expected to tie up nearly all of the immediate global vaccine manufacturing capacity”.

August 30, 2020. I have purposely withheld comment mostly because of the blatant politicisation of the process to obtain a vaccine. I refer to Russia, of course, that approved a vaccine that was still in clinical trials and after it had been tested on about a 100 people. If you have read this essay before you will know that phase III of the clinical trials usually involves thousands! The Russian vaccine, called Sputnik V is way short of this point and could endanger millions of lives in the short term if it became widely used.

What I have read is that Moderna started phase 3 on July 27, 2020. There is talk that a vaccine could be produced for the new year.

 

July 02, 2020. I see in today’s Wall Street Journal an announcement that Moderna Inc, a Boston area company – regarded by many as a front runner for the first vaccine, expects to start vaccine trials later this month.

 

Covid-19. US - the difference between April 4 and July 1
New York Times – Compare April 4 & July 1

July 01, 2020. Note the massive surge of cases across the US from April 4 on the left to July 1 on the right. Note too, how the hot-spot over NY has virtually vanished but not another hotspot over Southwest Georgia. It is very worrying to see the growth in numbers in the southeast of the country.

 

June 16, 2020. This information comes from the Guardian of London. Professor Peter Horby, of the department of emerging infectious diseases in the Nuffield department of medicine, at the University of Oxford, and one of the chief researchers in a trial involving Dexamethasone, a cheap drug available worldwide. He said, ““It is the only drug so far shown to reduce mortality and it reduces it significantly.” He added, “It is a major breakthrough, I think.”Dexametasone was given to the frailest patients – those on a ventilator and one in eight lived.

 

June 7, 2020. The information came in only hours after I had published this post. Covid-19 is a rapidly-moving topic, so a Stop-Press section has become inescapable.

 

Word has been received that Imperial College in the UK has formed a partnership with the investment firm Morningside Ventures of Hong Kong to manufacture a vaccine that would sell at cost and without a profit. It  would be offered to low and middle-income countries. Until now the race for the vaccine has been predominated by big labs that are very much profit conscious. Clinical trial will commence shortly and if all progresses successfully, the vaccine will be ready early next year.

 

Maximus your Mentor

Covid-19 and the Elderly
Maximus von Marwick

I am not a medical man but I do have a science degree and a deep interest in cosmology and philosophy – might this assist me you may ask? Well, I am also an old jolly jack – ie a sailor, to those not familiar with the term. This surely, must demonstrate a wide field of interests – perhaps in a kind of romantic way, don’t you think?

 

In fact, a friend, after reading my website, commented with the greatest sincerity, “Maximus, you are a veritable renaissance man!” Knowing him well and aware of his humor, I immediately struck him a heavy blow to the chest! My main areas of expertise are CBD oil and health. If you have the time and inclination, please visit my homepage at ‘The Ultimate Guide to CBD Oil’. This invitation has, I should stress, no covert allusion that CBD oil could be linked in any possible way with Covid-19. For a general idea of my website, please click on Homepage.

 

 

Q&A Session

I have often found that a well-judged and considered Q&A session is a superlative way to distribute information. The Q&A will tend to be somewhat arbitrary and will cover a miscellany of different aspects of Covid-19. The initial statistical information, on sneezing, coughing, dangerous environments like churches, meat-packing plants, gyms etc have been gleaned from an excellent article by Professor Erin Bromage of the University of Massachusetts, Dartmouth called ‘Covid-19: The Risks – Know Them – Avoid Them’.

  • Should I wear a mask? I personally believe that everyone should be masked while indoors in public. Out of doors you can remove your mask if you are not near someone else. This is very sensible advice when you come across the sneeze – see below.
  • What about all the instances of Covid-19 infection and deaths of the elderly in nursing homes, world-wide? The over-sixty-fives are often poor and suffering ill-health and without family. Maintaining a proper distance is virtually impossible and where money is tight, the staff in the home will be poorly trained and corners routinely cut. In many instances, no one ever visits these lost souls, many suffer dementia, and without family oversight – who cares what happens to them?
  • What kind of places/buildings should I try to avoid? Common-sense plays an important role here. Any hall or room that is perhaps poorly ventilated, perhaps because it is cold, and is filled with heavy-breathers would be ideal for the dissemination of the virus. Meat-packing plants must score an A+ in this regard and of course choir practice, call-centers and gyms. Additionally, I would be very wary of restaurants, unless I were seated outside.
  • Should I be wary of a cough or a sneeze near me? Indeed, you should. In fact, consider your bad luck if you entered a smallish room soon after an unmasked and infected person sneezed a mighty sneeze. One sneeze is like an intercontinental ballistic missile when it comes to the number of droplets released – about 30,000 that travel at up to 200 mph to as high as 600 mph! They can easily cross an average-sized room. A cough is not as potent but still very dangerous – 3,000 droplets at 50 mph. Cough droplets are bigger than the sneeze missiles but they too can cross a room.
  • So how many viral particles will you find in each sneeze? The humongous sneeze referred to above could contain as many as 200 x 10⁶ (two hundred million) viral particles. So, if you were in that smallish room mentioned above and the inconsiderate sneezer let fly, I think that I would hold my breath and bail as airmen say.
  • Do you think that Covid-19 started in a Chinese lab? I can, with the greatest confidence, say that it definitely did not. SE Asia is regarded as a coronavirus hotspot because of the substantial numbers of horseshoe bats living in the region that actually carry these viruses. Many scientists (including those from the west who have been working there for more than a decade) know this, but apparently politicians do not, most obviously because they cannot decipher genetic code. There exists a very real fear that another coronavirus is just waiting in SE Asia to cause another pandemic.

 

 

What are the Statistics?

  • United States: Please click on ‘CDC Covid Data Tracker’. Here you will find the very latest information on confirmed Covid-19 cases and deaths for each state. In addition, this is an extremely helpful site for anyone wanting to learn about the virus.
  • The Elderly, United States – 65+years old. CovidView.

Here again I have relied upon the CDC for the figures. For those with an interest in statistics, this is an excellent site. This time I can report that 58% of the deaths were in the age-group, 75+. In the group 65-74 years, the death rate was 21%. In the group 18-44, the deaths were a mere 3%.

 

What is truly an eye-opener for me has been the proportion of elderly people perishing in this pandemic. Near the end of my essay I shall make a prediction about the future of ‘us oldies’ that may shake you to the core.

 

It would have been helpful if WHO could supply figures for the world-wide deaths of those >65 years old. But as a group, we are expendable I fear. Just look at the numbers dying like flies in nursing homes – and in the West too, I might add. Asians and Africans tend to be culturally more able to provide a support system for their older folk. Although, I have noticed that China, probably because the young adults are so industrious, that there has been a significant increase in care homes for the aged.

 

 

Where did the virus come from?

Covid-19 and the Elderly
          Pangolin

To many of us in the West, the answer to the question is, ‘pangolins in Wuhan’s Wet market for sure!’

 

But back to the source of Corona-19. Professor Turner of Monash University in Melbourne is convinced that it originated in horseshoe bats (as are many scientists working in that field). But how it jumped to humans is not clear. Pangolins do have the characteristic to act as a port-of-call from say a bat to a human, but then so do quite a few other mammals – goats and sheep, buffaloes and cattle, birds like pigeons and even one of human’s closest companions, the cat.

 

Wet markets had already been implicated in other corona viruses, especially the last one, SARS. We know that someone, plus others, were infected in late 2019 with Covid-19 by an animal(s) from the market in Wuhan. The almost unseemly haste shown by the Chinese authorities in cleaning up the market, before the outside world or even their own scientists could have a look, demonstrates a potentially high level of guilt by them. So provisionally, I am sticking with Wuhan.

 

 

How is a New Vaccine Developed?

There are currently seven front-runners in the race to develop a vaccine. Two of them are ahead in that they are now classed as being in Phase II and they are: Can-Sino Biologies from China and Modena from the US. Five other vaccines are in Phases I-II. See below for an explanation of the phases and how long each phase might take. Clearly such is the urgency to find a vaccine, everything is now topsy-turvy and speed is paramount.

 

This broadly is the time-span it would normally take to develop a vaccine:

  • Exploratory stage. Here the laboratory will search for feasible route to treat the disease. This could take from 2 to 4 years.
  • Pre-clinical stage. Here lab tests are made on animals like monkeys and mice so the researchers can gauge if the there is a potential for success or not. Obviously many will fail. This stage could take up to 2 years. However, if all runs smoothly and, most importantly, the FDA approves, then they move to stage 3.
  • Clinical stage. This is an important phase because humans are used for testing. Phase I usually takes up to 2 years and normally less than 100 people will be used. Phase II will take up to say another 2 years, utilizing about 300 to 400 people. Then comes the big one – Phase III. This could engage thousands and last 4 years.
  • Regulatory review stage. Here the FDA and CDC go over the results with a fine-tooth comb and if all meets their approval, the project is signed off by them.
  • Production. The FDA continues their oversight of the manufacture of the vaccine. At this stage – the final hurdle, so to speak, also produces big problems – comprehensive testing is required and there are barriers to special technologies required for completion. I am told that many vaccines and pharmaceuticals do not succeed in making it.

 

So under normal circumstances if the clinical stage took a total of 8 years to complete, the researchers would be well-pleased with their efforts. It can of course take double that time and of course, a big percentage fall by the wayside. Evidence is clear that the traditional route and timing for vaccine development has been rerouted, consolidated and squeezed so that the vaccine can be developed in the shortest period possible.

 

The next heading will be how long?’ No wonder many researchers must have stretched their eyes wide when some political people said that a vaccine would be ready by the year’s end.

 

Can we Expect a Vaccine soon?

The Chinese released the Covid-19 genome sequence on the 10th January 2020.

 

Because Covid-19 is a pandemic every politician and his dog, has gotten involved. Consequently, this has meant that many persons with little knowledge of medical research are now very influential and the actual researchers and scientists less so. It is fairly common knowledge that even after a scientific break-through has occurred, there will follow a number of obstacles. These will certainly be political and nationalistic, bureaucratic, legal, administrative and then finally, manufacturing and marketing and distribution.

 

So I looked around on the internet. We all know that many big international organizations, think-tanks and such-like, chockablock with academics who are professors and fellows and directors of this and that, will recoil from the idea of giving their opinion – making a call. Of course, it could impact their careers if they say made an egregious error. Even the estimable Dr Fauci has said that by the end of 2021, he ‘hopes the US will have produced a couple of million doses’.

 

But then I read in the New Yorker on the 22 May that the US company, Moderna (in association with Johnson and Johnson) who are the co-leaders in the race and have completed phase II, could be ready by the fall to be in a position to obtain consent to go into production.

 

 

President Trump Announces – ‘2 Million Doses Ready to Go!’

Then on June 5, President Trump made his announcement. All he is waiting for, he says, is for the scientists to give him the go-ahead. When this will happen is anybody’s guess. If you look back at the phases of testing – none of the vaccines have reached stage III and normally that could take a while more. Even Dr Fauci’s estimate might seem, for some scientists, at times to be optimistic.

 

 

Remember the old proverb – Don’t Count your Chickens…

Dr Fauci has also said that he is concerned about the ‘durability’ of the vaccine when is comes available. This is because of the very nature of the corona virus. As an example just think of ordinary ‘flu. It kills older people especially, and it has the ability to change – for further information, please read ‘Types of Influenza Virus’. But, every year people are offered a ‘flu-jab’ precisely because it lacks durability.

 

But that does not mean that only one of the vaccines will succeed, but it might not be the first – so important at this stage. Also, covid-19 is a complex beast, so the first past the post may not offer complete or even the best immunity.

 

Another reason, and one that is unlikely to be bandied about, is something the businessmen and money men involved will surely be aware of by now – Covid-19 kills the elderly. Note the statistics in the US: 58% die in 75+ age group; 21% in the 65-74 years group and a tiny 3% in the 18-44 group (figures from CDC). It’s not rocket science – why wreck the economies of the world for a bunch of oldies? That sounds awful doesn’t it? But look again at the strategies of different countries: Brazil is a case in point where the President is generally scornful of Covid-19 diagnostics, care and vaccines. Perhaps he too is implying: why wreck my economy for a bunch of oldies?’

 

 

The Global Vaccine Summit

On the 4th of June, the UK hosted the Global Vaccine Summit. It was of course virtual and I had believed that it would resolve some problems that the discovery and production of the first vaccine might bring. Instead, it appeared its purpose was to raise money – and a tidy sum was raised too, $8.8 billion.

 

Boris Johnson was the host and many heads of state appeared on the screen. Many solutions need to be found, most importantly how will the big nations ensure that fairness prevails and the poorer countries will be able to afford the cost of the vaccine and of course, be able to obtain doses within a reasonable time period.

 

We know how important vaccines have been to global health although the anti-vaxxers with their often, bizarre rationalizations and interruptions have dented the progress of measles immunizations for one.

 

So, by the end of 2021 – or even earlier, if we develop a vaccine for Covid-19. What then? Will all the nations operate collectively and work as WHO would like us? Or would nationalism predominate and the rich countries buy up all the doses? Note, I have asked three questions in a row – all challenging.

 

The rational answers to my three questions are pretty obvious and simple. What makes them challenging is politics and even though many of the attendees of the Summit are, hopefully, very smart, they are politicians and worry about their jobs and power and prestige. So, I’m not going to mess around here – I shall just tip big bucks winning the day.

 

But, perhaps not. Perhaps the ambitions that were expressed at the Global Vaccine Summit will inspire everyone. But remember, I’ve already pointed out that we are dealing with politicians. They would have already started their maneuvering, they will want a to fashion a solution that is a win, win – with no apparent down-side. That will make them look good. And now we have the announcement from the UK that a vaccine produced at the Imperial College will be sold at cost to the poorer countries. This is excellent news!

 

 

Conclusion

But I fear that I shall be ending on a melancholy note – what about the elderly? Anyone even mildly thoughtful must have considered what will become of Earth in the future? Global warming and the Population Explosion are two menacing dangers – my opinion is that our politicians lack the temperament to do much, so everything and everyone will cook and starve unless they have the technology to survive. That alone will precipitate mortality numbers that will make all the Covid-19 deaths look like child’s play.

 

Covid 19 - Age Bias
Covid-19 – Age Bias from the Wall Street Journal

So, my thoughts return unerringly to an earlier suggestion of mine when I said that I suspected that some compassionless leaders, knowing that Covid 19 is essentially a disease affecting the 65+ generation, perhaps will incite them to begin reducing their social support thereby allowing many older folk to die.

 

Hopefully, these thoughts will be greeted with derision by all my readers and I shall be consigned to the corner with a dunces cap on my head. I hope so. But I then I thought, lets have a treat. Let’s be entertained and energized by a man whose reputation for courage, and support of the impoverished and persecuted is well-documented. I refer to the great Johnny Cash. God bless him.

 

Johnny Cash – You’ll Never Walk Alone

FDA Disclosure

Please note that the statements above are not intended to diagnose, treat, or cure Covid-19. Readers should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.

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