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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by alexandra_k on June 20, 2020, at 20:15:27
there was some PhD student at Otago who was given a project involving whether giving people Ketamine would help them feel better about communal sleeping on Marae.
There is a psychiatry professor, there, who is keen to prescribe chlorpromazine more widely as an anti-anxiolyitc.
I think it is ingenious...
He's sort of tag-teaming the research at another University whereby people with (drug induced) parkinson's donate their brains to his brain bank. Or maybe the brains get shipped to Harvard for a display over there... I don't know how much they pay for brains. To know how lucrative that might be...
Now they want to make LSD.
Or import LSD.
I'm not sure. I suppose to make LSD.
Because O'Leary didn't do ALLLLLLLLLLLLL the experiments that we might want to do with LSD.
Something about 'sub-theraputic doses may be theraputic'. Yes. Analytically. Okay, that's slightly facecious.
You are going to get students making LSD in the laboratory because...
It's a responsible thing to be doing.
Because it's likely (on balance of evidence) to result in more goods than harms to New Zealand society. The risks and pros and cons have all been weighted...
And it's thoguht to be a good idea to get New ZEalanders manufacaturing LSD.
Well okay, then.
ffs.
Posted by alexandra_k on June 22, 2020, at 12:05:35
In reply to illicit drugs, posted by alexandra_k on June 20, 2020, at 20:15:27
how much time is reasonable...
to give the district health boards of new zealand...
for them to stock up on supplies.
to stock up on hand sanitiser.
to fit test ppe.to purchase reasonable supplies.
to train the staff in infection management.
it can't be about the money because Jacinda Arden modelled a solution: a 20 per cent pay cut for everyone over $100,000 per year.
that money could have been used to purchase the medical supplies.
if they found themselves in the position of the money being forced into their bank account they could have used it to purchase supplies themselves, on their own bat. to keep those supplies safe for future distribution.
how much time is reasonable -- before our first wave?
Posted by sigismund on June 24, 2020, at 22:39:51
In reply to how much time?, posted by alexandra_k on June 22, 2020, at 12:05:35
do we have left?
Posted by alexandra_k on June 26, 2020, at 16:13:16
In reply to Re: how much time?, posted by sigismund on June 24, 2020, at 22:39:51
Hmm...
It's hard to say.
1 million New Zealanders live overseas.
half a million in Australia and the rest all over.
Many of them are coming 'home' now...
Bringing CoronaVirus with them into a Country that has only had a few minor clusters and no outbreak. No first wave.
We were trying to do 'quarantine' but we don't know what that means. We were trying to do 'managed isolation'. We like to take a plane-load that has been incubating the virus amongst passengers (no PPE required on our flights) and split them up on landing.
Send a few to Auckland, Rotorua, Wellington, Christchurch. Then they can mingle with the people there who are all the way up to day 13 of their 'quarantine' or 'managed isolation' or whatever it is.
If someone develops symptoms we like to then transport them to a particular hotel. Not sure how. Not sure if we fly them back from Wellington or Rotorua or...
It's like we are doing our best to get community transmission up off the ground.
I think we are.
I think our politicians might be starting to have a bit of a panic that we are going to be left out... Other borders will open and ours will have to stay closed because our people haven't been exposed at all and we haven't had a first wave, yet.
People haven't caught on to that...
It isn't that we stomped it out. It is that we haven't had our first wave yet.
The District Health Boards have had plenty of time to order hand sanitiser and PPE and to get it properly fit tested for the workforce.
Nasal swabs appears to be a problem. The rate limiting bottle-neck on testing.
We are testing less.
I bet when you go to get tested you have a 20 minute argument with some nurse about how you don't need to be tested. It's probably only a virus (no wait we don't say that anymore). It would be unsustainable to test everyone for anything everytime they got sick. Just go home. Stay home. Don't let us see you in public. Just curl up and die in your home for all we care.
The District Health Board members earn how much???
For doing what????
It would cost $100,000 per year to keep them in jail, apparently.
Instead of paying them we could imprison them for their crimes. Hire someone competent to do their job. And have change.
I don't understand.
Posted by alexandra_k on June 26, 2020, at 20:06:23
In reply to Re: how much time?, posted by alexandra_k on June 26, 2020, at 16:13:16
It's the cheapest thing, you see. And that's the bottom line. How to cut costs, how to make money. That's the entire point and the entire purpose of it all.
And things would be so very very very much more efficient if we simply cut these administrators loose. Things are looking good on the retraining front. They could to back to school. Things are looking good on the welfare front. They could take their redundancy pay-out and join the welfare cue.
Ohhhhhhhhhhhhhhhhhhhh. But it turns out that the point of the health system wasn't to be cost cutting and money making... It was to redistribute funds me-wards. That was (thought by them) to be the point of it all.
It wasn't about saving money. It was about giving it to them.
How much longer?
Posted by alexandra_k on June 26, 2020, at 20:16:23
In reply to Re: how much time?, posted by sigismund on June 24, 2020, at 22:39:51
Apparently ours have recently been 'updated'. Or... We have some now. Something like that.
Not sure why -- but it's the Minister of Education's job to say a little thing to the media about that.
Oh yeah, it's because of all the allegations of sexual harrassment that students make about staff in our Universities only for the Universities to go 'rubbish rubbish pooh pooh go away' and not follow up on the complaints / not acknowledge the complaints at all.
I phoned the fraud hotline to inform them of this bad habit the Universities have gotten into with double-billing. That is to say the supervisor says 'keep working and hand over more money or you will never qualify to complete your Degree' when external examiners don't say that the student is required to keep working for an extended enrolment period.
They laughed at me. Said that I phoned the wrong number. Said this was the fraud hotline that was only for allegations of mis-spending.
The State Services Commission. That's who it is, apparently. The people who ensure only corrupt incompetents are hired for watch-dog positions.
Apparently there is something now about the woman who was hired as senior executive of the childrens and young persons thing. You know the one. The one that takes babies and infants and toddlers from the parents labels them 'vulnerable' and gives them to a succession of abusers in state care to ensure they grow up to become prostitutes (to look after our tourists and politicians no doubt) and gangbangers (to look after our tourists and politicians no doubt). You know. Hook them up with the party pills and whatever whatever whatever their sick little hearts desire. Someone to beat on. Whatever.
Apparently she's just charming to work with (not).
I don't know. I don't know what to make of it.
I know that when you don't provide a living wage, really, to people who look after children and the like then either they are really kind good hearted people doing it for the love of children... Or they are sick hearted psychopaths. The latter tend to drive out the former.
And there we are.
Posted by sigismund on June 27, 2020, at 0:43:25
In reply to Re: how much time?, posted by alexandra_k on June 26, 2020, at 16:13:16
I had a swab test done. It touches a sensitive area but the nurse was so adept that there was no discomfort. I can see how it could be painful if not done well.
Posted by alexandra_k on June 27, 2020, at 2:44:17
In reply to Re: how much time?, posted by sigismund on June 27, 2020, at 0:43:25
Yeah. They need to collect actual cells (hence, a bit of a scrape) from the warmest (most hidden and sensitive area) of your oropharynx. Not very pleasant, yeah. But if they don't get a good scrape of that warmest place they might not find the virus even if it's there. Like cervical smears, apparently. Not very pleasant.
Posted by alexandra_k on June 27, 2020, at 3:01:12
In reply to Re: how much time?, posted by alexandra_k on June 27, 2020, at 2:44:17
Good luck with your test result.
I'm not sure whether I should wish you to be positive or negative.
Positive with few to no visible symptoms and lifelong immunity.
Be well.
(((you))))
Posted by sigismund on June 28, 2020, at 1:56:36
In reply to Re: how much time?, posted by alexandra_k on June 27, 2020, at 3:01:12
I was negative, so no such luck :)
We keep learning more about the virus and antibodies. I've read that some sewage analysis (sounds very odd, can this be right?) from northern Italy suggested there was virus there in November. And something suggesting the same from elsewhere.
Posted by alexandra_k on June 30, 2020, at 8:41:39
In reply to Re: how much time? » alexandra_k, posted by sigismund on June 28, 2020, at 1:56:36
> I was negative, so no such luck :)
Ah, well.
He lives, another day :)
> We keep learning more about the virus and antibodies. I've read that some sewage analysis (sounds very odd, can this be right?) from northern Italy suggested there was virus there in November. And something suggesting the same from elsewhere.
Weeeeeeeeeeeeeel...
I learned that a way of remembering which viruses tended to cause gastro-intestinal symptoms was that unencapsulated viruses tended to cause gastro-intestinal symptoms. Apparently this is because un-encapsulated viruses are more resilient to stomach acid than encapsulated viruses. Apparently stomach acid messes up their coating and chops up their DNA/RNA.
So... I was surprised to learn that CoronaVirus (an encapsulated virus) was possibly transmitted via fecal-oral route... Since I thought it would have gotten chopped up by stomach acid...
Buuuuuuuut theeeeeeeeeen....
I learned that it was interesting about CoronaVirus... Because it couldn't get to location in the GI tract with intact DNA without bypassing the stomach. So... The virus is inhaled and then it targets the cells in the respiratory tract...
I think there was something about it affecting the airways (conducting zone) and also the lobes (terminal zone). But I forget... Which cells in particular it targets in the lungs... Something about ACEII receptors that usually are activated by... I forget...
Anyway...
Then they found that people were having renal (kidney) problems...
And stuff about auto-immune...
One thing that can happen is that antibodies form complexes with antigens (virus particles or whatever) and then get stuck in filtration memberanes. Like... The filtration membrane of the lungs. Or the filtration membrane of the kidneys. So the kidney problems seemed to be about that... The body making antibodies... Maybe the antibodies are a bit too broad... Not only binding to CoronaVirus particles but to particles of something else in the body, too. So an auto-immune kind of a thing...
But then they started finding it in sewerage, yeah. So then the idea that the virus was targeting some of the cells in the GI tract (downstream from the stomach). So getting there by way of travelling around in the blood, or something.
Which suggests a blood test...
I don't know. I haven't been keeping up more recently.
Last I heard was that it can be a cause of Kawasaki Disease in Kids... Or... They reckon they found a 'new' disease in Kids that looked a lot like Kawasaki Disease (don't know if aspirin is effective so it's a new case where you may prescribe children aspirin??)
And then the thing about the cytokine storm. So CoronaVirus may cause cytokine storm. So now medications that help reduce cytokine storm (e.g., corticosteroids) are thought to be CoronaVirus Medications.
The sewerage thing surprised me, a lot.
I don't know how they are finding viral load of encapsulated virus in stool. That is weird to me / news to me.
___
Every now and then I learn something in molecular biology / genetics / biochemistry that kind of blows my mind. Like... A really really really important piece of the picture or puzzle or something...
I have a lot of questions in those kinds of things... But there's a lot of concepts that I don't have / get yet so I'm not really in the place to even ask questions about what I don't know yet. I mean... I don't know enough to know what I don't know sort of a problem...
But some of the things in the vicinity...
There was this guy doing really good work (I thought) in Ancient DNA. Sort of evolutionary stuff with really really old biological samples. Neanderthal DNA etc. Anyway point is that he said he was used to trying to extract samples that were degraded pretty badly. That often they only could take a very very small piece of bone or whatever from a fossle and they were trying to sequence the genome and there was deterioration from environmental stuff...
And then there is stuff about samples becoming contaminated. So.. SOmething about people sequencing their turkey sandwich...
And then stuff about how we often don't have the whole genome... Just smaller sample bits. So then looking at fingerprints or sample bits and trying to tell whether they are... Human. Neanderthal. Bacteria. Virus. Fungus. Turkey Sandwich...
And then thinking about whats-his-name. First person to have his genome sequenced. Oops.. First person to sequence the genome. Likely his. Anyway, Venter? Craig?? ANyway... Taking samples the ocean and how many differnet things there were... MIcroorganisms. And they have DNA...
So in a sample of soil... A tiny sample of soil around a grave site... So many microorganisms with their DNA...
I just mean... I don't know what they mean when they say they are finding CoronaVirus (the present one) in this or that or the other sample...
I think they might be sequencing turkey sandwiches??
When you work in a laboratory that sequences human DNA usually... ANd you sequence things asking whether they are human... YOu likely find human from laboratory contamination.
I don't know... Viruses are small. So very very very much smaller than the human samples I'm used to thinking of / about. It could be that they have sequenced it in it's entirety. All of the proteins and all of the enzymes that it has. Every coding portion. Likely they have... Yeah. I think so...
I don't know.
I think it was because they started saying you should put the lid down on your toilet before flushing because flushing could aerosolize coronavirus particles in the water..
I didn't think that was plausible.
But maybe it is.
Posted by alexandra_k on June 30, 2020, at 10:19:17
In reply to Re: how much time? » sigismund, posted by alexandra_k on June 30, 2020, at 8:41:39
It was weird that it tends to affect guys more, too, since they thought the reason for SOME people having a severe reaction was auto-immune -- but auto-immune disorders typically affect females not males.
But I don't remember why that was.
That's why the ACE thing was interesting...
Heart medications... But they reckoned it wasn't to do with that...
Not sure.
Posted by alexandra_k on June 30, 2020, at 18:46:45
In reply to Re: how much time?, posted by alexandra_k on June 30, 2020, at 10:19:17
You can lose up to 70 per cent of your lung capacity, they reckon, before the average common person will go to their doctor and say they are having trouble breathing.
Because onset is gradual, I suppose. People confuse normal aging / normal getting unfit from lack of activity / degenerative disease.
That means that there are a lot of people out there who think they are relatively healthy and it isn't until something hits their lungs and disrupts the filtration there and they realise they had nothing in reserve.
So... It could be about that. Why some people are more affected. Some of them, anyway.
Not all of them, of course.
There seem to be a variety of reasons / possible complications of CoronaVirus that result in it's course sometimes being very very very severe or lethal.
Bats are the natural resorvoir, they think.
SO now, of course the laboratory scientists will want to go out and collect bats and try and infect them and so on. The people at Otago have managed to find some bats and they want to study them now, all of a sudden. Sure. Course they do.
Dromedary Camels.
But I don't think that you will find it in the water-supply. It isn't like e-coli. That waves it's little flagella / flagellum (depending on whether you believe the text or the drawing)... Grrrrrrrrrrrrrrrrr THATS A F*CK*NG MEANING ERROR JUST SAYING WHERE'S MY F*CK*NG GIFT CARD??? (I jest. Sorta...)
Posted by alexandra_k on July 1, 2020, at 3:19:13
In reply to Re: how much time?, posted by alexandra_k on June 30, 2020, at 18:46:45
I keep thinking of the GI bacteria that kills the cells in the intestines so that the intestinal cells can't do their usual job of absorbing / re-sorbing food and water and vitamins...
How in developing nations kids die of dehydration because anything you put in one end basically falls out the other.
How putting a little sugar and salt into water will provide enough supportive therapy for the few days that it takes for the dead cells to basically be replaced by healthy new cells. Or paying $10 per 500ml, or whatever for 'medical grade' poweraid... Or whatever...
And I guess I was thinking of CoronaVirus like that. Affecting whatever kinds of cells there was in the lungs, like that, so the tiny little molecules of oxygen and carbon dioxide couldn't diffuse across the filtration membrane...
Only I'm not sure if that seems plausible... My view of it. So... I don't know...
I wondered how long the 'supportive treatment' of ventillation would be needed for... Lung cells replace... Replace... Hur...
Renal patients the cells in the proximal convoluted tubule... Like the GI tract... Supportive dialysis for a few days before they are replaced by healthy new cells...
But lung cells...
They don't say that in the book. So maybe they don't know.
Maybe they will say in the next book. This years book. Next years book. Maybe the type one pneumocytes or the type 2 pheumocytes or whatever will have a classification as to what kind of cell they are... How quickly they replace...
There were accounts (I feared) of people saying they were trying to rip their breathing tubes out...
People on ventillators waking up, in other words, and fighting fighting fighting fighting fighting to be allowed to breathe independently...
So now there are accounts (I feared) of psychosis as a symptom / consequence of Coronavirus infection.
Because, you know. People like Barry Taylor will decide if a CoronaVirus test is right for you, and in Ventillation is right for you, and how many weeks you need to be ventillated...
Course he will.
Posted by alexandra_k on July 1, 2020, at 3:22:40
In reply to Re: how much time?, posted by alexandra_k on July 1, 2020, at 3:19:13
Right before he decides if organ donation is right for you...
While the Ombudsman proclaims that people don't have rights in New ZEalandNo, Dear Ombudsman people do in fact have rights in New Zealand -- it is you, Dear Ombudsman who keeps denying the obvious in repeatedly and persistently delivering your verdict / 'wishful thinking' that they do not).
Posted by alexandra_k on July 1, 2020, at 18:06:05
In reply to Re: how much time?, posted by alexandra_k on July 1, 2020, at 3:22:40
The trouble is that everyone who wants money for their research, right now, tries to connect their research to CoronaVirus.
Don't get me wrong -- sometimes breakthroughs come from a bit of lateral thinking... But not very often. Many of the connections are dubious, at best.
Don't get me wrong -- there is much that we don't know about the world and people are learning about interesting things that may prove really useful down the track.
And many of the public health upgrades (seems to me) are in similar vein.
For example, it was physicists working in fluid dynamics who showed how ''in theory'' CoronaVirus particles (let's say) could aerosolise from flushing the toilet with the lid up. That's to say that a thing of it's weight / size / shape (or something like that) could be thrown up into the air and inhaled by a person in a closed space.
Only there wouldn't be infectious CoronaVirus particles in the toilet, most likely. Because anything pooped out would have been inactivated (and also chopped up and also unencapsulated now with only fragments of CoronaVirus genome)...
But that's not to say that there is any shortage of OTHER viruses that do have fecal-oral transmission... I mean... It's probably a good idea to drop the lid on the toilet seat. But likely not anything to do with CoronaVirus...
I remember learning that people generally... Bodies are very robust, usually. People are harder to kill than you might suppose. The body has all these homeostatic mechamisms and feedback loops and the like... Much of the time treatment or therapy is merely or only 'supportive'. That's to say to monitor vital stats. To intervene if progress is 'worse, worse, worse, worse, worse, dangerous' and otherwise... Wait it out. The body will fix itself. Mostly. All you gotta do is try not to 'help' by making things worse.
So... There are a bunch of 'complications' or upsets to vital stats (e.g., blood pressure too high, oxygen saturation too low sorts of things) that require intervention until the body takes back over control of things...
And so most / many of the 'treatments' are about monitoring the trajectory of those stats and providing 'support' for things that are getting worse rather than better... Hoping that you don't throw things off course the other way. E.g., if the person is micro-clotting you might give them aspirin and maybe fancier more expensvie things to prevent the clots and you hope they don't start to bleed into the brain because you were too agressive in your bood thinning...
If they aren't getting enough oxygen then there could be lasting neurological (brain) damage. So you want to give them oxygen... If you start mechanically ventillating them (forcing their lungs to expand) then... Well... You might be rather too agressive on teh delicate filtration surface and cause lifelong lung damage...
Balancing pros and cons... Helps and harms...
For the good of the patient. Of course.
Posted by alexandra_k on July 2, 2020, at 2:01:15
In reply to Re: how much time?, posted by alexandra_k on July 1, 2020, at 18:06:05
the 'arguments' about how anatomy 'should be' vs the realities of how it was 'when you get to look and see...'
but, uh, who gets to look and see?
not me, not me, not me not me not me.
and it applies, too, to the microscopic.
people 'try' and draw what they see.
and people 'try' and explain what they've seen.
and they are different ways people representing what makes sense...
but sometimes they are artists... and, well, anyway, people don't understand how 'interpretive' perception is, sometimes.
i'm kinda interested in movement.
i muchly despair i'm not much good at physics (maths prohibits... but also i need to do a 'stop, no compute' thing with their concepts, sometimes... it's a tricky tricky thing...)
anyway...
i was kinda interested in how a flagella works. the singular one. flagella, flagellum, i forget. anyway...
e-coli has one (according to the text).
and probably it's a propeller -- right? it pushes it forwards. so it's stuck on it's *rs*, in other words. stuck on the back of it.
but in the drawings it has one stuck on the back of it... and another one stuck on the front of it.
so then, uh, how does it work?
is it like a worm (with layers of circular and longitudinal muscle that allow it to contract and expand it's way forwards like a catterpiller, most visually)...
sort of kipping it's way up the pull-up bar???
with a flagella (or flaggellum) on the front of it, and a flagella (or flagellum) on the back of it?
does that seem likely???
probably it has just the one.
on the back.
i woulda thunk.
in the pathology pictures you see masses of them and you can't tell which flagella (or flagellum) belongs with this one or that one or the next one.
they don't show just the one of e-coli on the slides, that i've seen....
so i don't know.
but the picture of the singular on the periphery of the mass would be authorative. clearly.
This is the end of the thread.
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