SARS-COV-2: Learning the Lessons from our Experiences, A Critical and Personal Review

Authors

  • Graham Ewing Mimex Montague Healthcare Limited, Unityed Kingdom

DOI:

https://doi.org/10.24203/ajpnms.v8i4.6258

Keywords:

SARS-COV-2

Abstract

The aims and objectives of this paper is to question established scientific thinking and medical protocols surrounding SARS-COV-2, stimulate debate, and consider alternative and more effective ways of screening and treating the severely affected patients which improve therapeutic outcomes and thereby reduce the complexity and cost of treating infected SARS-COV-2 patients.

 

The paper argues that national quarantine or lockdown strategies among countries (as a preventive approach) exhibit many shortcomings and are based on a set of erroneous assumptions which enables the independently minded to consider alternative diagnostic and/or therapeutic strategies e.g. to quarantine only the ‘at-risk’ groups; which could be significant in the future.

 

It raises for discussion a number of pertinent points e.g. (i) that the virus affects different patient groups in different ways; (ii) that the most severely affected who are at risk of death is currently the vast minority of the population, in particular those who are diabetic, obese and immunosuppressed; (iii) that chasing the virus using ‘test and trace’ methods should be augmented by advanced, remote screening methods to determine those in the most ‘at-risk’ groups who should be quarantined; and (iv) reviews the fundamental limitations of seeking only drug-based solutions instead of considering and focussing upon scientifically sustainable solutions based upon an understanding of the fundamental chemistry of biology.

References

Long, Q., Tang, X., Shi, Q. et al. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nat.Med. (2020). https://doi.org/10.1038/s41591-020-0965-6

https://tu-dresden.de/med/mf/die-fakultaet/newsuebersicht/immunisierungsgrad-geringer-als-erwartet-schulen-haben-sich-nicht-zu-hotspots-entwickelt.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases

Covid-19: Why Germany’s case fatality rate seems so low. British Medical Journal 2020;369:m1395

Computer code for Prof Lockdown's model which predicted 500,000 would die from Covid-19 and inspired Britain's 'Stay Home' plan is a 'mess which would get you fired in private industry' say data experts. By Vanessa Chalmers Health Reporter For Mailonline and Luke May09:24 17 May 2020, updated 16:49 17 May 2020

https://abcnews.go.com/International/satellite-data-suggests-coronavirus-hit-china-earlier-researchers/story?id=71123270

Mouton CA, Hanson R, Grissom AR, Godges JP. COVID-19 Air Traffic Visualization. COVID-19 Cases in China Were Likely 37 Times Higher Than Reported in January 2020. RR-A248-3. https://doi.org/10.7249/RRA248-3

Daniel P, Oram AM, Topol EJ. 45% symptomatic: Prevalence of Asymptomatic SARS-CoV-2 Infection. A Narrative Review. Annals of Internal Medicine 2020. https://doi.org/10.7326/M20-3012.

Hubert B. COVID-19: The T Cell Story. Posted on Linkedin 5th June 2020.

Nikolich-Zugich J. Ageing and life-long maintenance of T-cell subsets in the face of latent persistent infections. Nat. Rev. Immunol. 2008;8:512–522.

Gui J, Mustachio LM, Su D-M, Craig RW. Thymus Size and Age-related Thymic Involution: Early Programming, Sexual Dimorphism, Progenitors and Stroma. Aging Dis. 2012 Jun; 3(3): 280–290.

Jang JG, Hur J, Choi EY, Hong KS, Lee W, Ahn JH. Prognostic Factors for Severe Coronavirus Disease 2019 in Daegu, Korea. Journal of Korean Medical Science 2020;35(23):e209 doi.org/10.3346/jkms.2020.35.e209.

Tan T, Khoo B, Mills EG et al. Association between high serum total cortisol concentrations and mortality from COVID-19. The Lancet Diabetes & Endocrinology published 18th June 2020; https://doi.org/10.1016/ S2213-8587(20)30216-3.

https://www.hsj.co.uk/patient-safety/almost-half-of-healthcare-workers-had-covid-19-at-some-hospitals/7028090.article.

UK government study reported in the Financial Times on 14th May 2020. https://www.ft.com/content/ba968964-0ee6-4ca3-b98e-9779180f3649.

Schuit M, Ratnesar-Shumate S, Yolitz J et al. Airborne SARS-CoV-2 is Rapidly Inactivated by Simulated Sunlight. The Journal of Infectious Diseases 2020;jiaa334. https://doi.org/10.1093/infdis/jiaa334.

McDevitt JJ, Rudnick SN, Radonovich LJ. Aerosol susceptibility of influenza virus to UV-C light. Appl. Environ. Microbiol. 2012;78(6):1666-1669. doi:10.1128/AEM.06960-11.

Aldridge RW, Lewer D, Katikireddi SV et al. Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data [version 1; peer review: 3 approved with reservations]. Wellcome Open Res 2020, 5:88 https://doi.org/10.12688/wellcomeopenres.15922.1

Merzon E, Twoworski D, Gorohovski A, et al. Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study. The Febs Journal; First published: 23 July 2020; https://doi.org/10.1111/febs.15495.

Ewing GW, Parvez SH, Grakov IG. Further Observations on Visual Perception: the influence of pathologies upon the absorption of light and emission of bioluminescence. The Open Systems Biology Journal 2011;4:1-7.

Chakhtoura M, Rahme M, Chamoun N, El-Hajj Fuleihan G. Vitamin D in the Middle East and North Africa. Bone Rep. 2018;8:135-146. Published 2018 Mar 17. doi:10.1016/j.bonr.2018.03.004

Selvaran S, Gunaseelan V, Anandabaskar N, et al. Systematic Review on Vitamin D Level in Apparently Healthy Indian Population and Analysis of Its Associated Factors. Indian J. Endocrinol. Metab. 2017 Sep-Oct; 21(5): 765–775.

Nair R, Maseeh A. Vitamin D: The "sunshine" vitamin. J. Pharmacol. Pharmacother. 2012;3(2):118-126. doi:10.4103/0976-500X.95506.

Prietl B, Treiber G, Pieber TR, Amrein K. Vitamin D and Immune Function. Nutrients 2013;5(7):2502-2521.

Ewing GW. Issues which Influence the Etiology of CoVid-19 infection: a Proposed Treatment Protocol based upon optimising the autonomic and immune response. Health Education & Public Health 2020;3(3):290-295. doi: 10.31488 /heph.142

Sugimoto J et al. Magnesium Decreases Inflammatory Cytokine Production: A Novel Innate Immunomodulatory Mechanism. J.Immunol. 2012; 188(12): 10.4049/jimmunol.1101765.

Bernstein H, Sugimoto J, Suzuki-Kasisaka H, Romani A. American Journal of Obstetrics and Gynaecology 2011;206(1): doi.org/10.1016/j.ajog.2011.10.841

Tam M, Gomez S, Gonzalez-Gross M, Marcos A. Possible Roles of Magnesium on the Immune System. Eur. J. Clin. Nutr. 2003 Oct;57(10):1193-7 doi: 10.1038/sj.ejcn.1601689.

Schmitz C, Perraud A-L. Chapter 26 - Magnesium and the Immune Response. Molecular, Genetic, and Nutritional Aspects of Major and Trace Minerals 2017: 319-331.

Mannon E, Sun J, Wilson K, et al. A basic solution to activate the cholinergic anti-inflammatory pathway via the mesothelium? Pharmacological Research 2019; 141:236-248.

Clinical management of persons admitted to hospital with suspected COVID-19 infection. Publications approval reference: 001559. Specialty guides for patient management during the coronavirus pandemic. https://www.england.nhs.uk/coronavirus/secondary-care/management-confirmed-coronavirus-covid-19/clinical-medical-management/

Tan CW et al. A Cohort Study to Evaluate the Effect of Combination Vitamin D, Magnesium and Vitamin B12 on Progression to Severe Outcome in Older CoVid-19 Patients. MedRxiv preprint. https://doi.org/10.1101/2020.06.01.20112334. https://www.medrxiv.org/content/10.1101/2020.06.01.20112334v1

Dondorp AM, Schulz MJ. Early Lessons on the Importance of Lung Imaging in Novel Coronavirus Disease (COVID-19). The American Society of Tropical Medicine and Hygiene 2020;102:917-918 https://doi.org/10.4269/ajtmh.20-0225

https://www.recoverytrial.net/

Kwon E, Ahn C. Low Hemoglobin Concentration Is Associated with Several Diabetic Profiles. Korean J Intern Med. 2012; 27(3): 273-274.

Kowalewski M, Fina D, Słomka A, et al. COVID-19 and ECMO: the interplay between coagulation and inflammation—a narrative review. Crit Care 2020;24:205. doi.org/10.1186/s13054-020-02925-3

Beyrouti R, Adams ME, Benjamin L et al. Characteristics of ischaemic stroke associated with COVID-19. J. Neurol. Neurosurg. Psychiatry 2020. doi:10.1136/jnnp-2020-323586.

Gregg D, Goldschmidt-Clermont PJ. Platelets and Cardiovascular Disease. Circulation 2003;108(13):e88–e90.

Gorter KAM, Stehouwer MC, Van Putte BP. Acidosis induced by carbon dioxide insufflation decreases heparin potency: a risk factor for thrombus formation. Blood 2007;110 (11): 3930. https://doi.org/10.1182/blood.V110.11.3930.3930

Gissel M, Brummel-Ziedins KE, Butenas S, Pusateri AE, Mann KG, Orfeo T. Effects of an acidic environment on coagulation dynamics. J. Thromb. Haemost. 2016; 14: 2001–10.

https://www.diabetes.co.uk/news/2020/june/study-shows-covid-19-impacts-blood-glucose-levels-among-those-with-type-1-diabetes.html

https://www.diabetes.co.uk/news/2020/june/covid-19-found-to-trigger-diabetes-in-healthy-people.html

Ewing GW. The Regulation of pH is a Physiological System. Increased Acidity alters Protein Conformation and Cell Morphology and is a Significant Factor in the onset of Diabetes and other common pathologies. The Open Systems Biology Journal 2012;5:1-12.

Ewing GW. Is Metformin a Drug or a Buffer and Why is this Significant? Further evidence that the brain Regulates the Autonomic Nervous System, in particular prevailing levels of Intercellular pH. Endocrinology, Diabetes and Metabolism Journal 2018;2(4):1-9.

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Published

2020-08-29

How to Cite

Ewing, G. (2020). SARS-COV-2: Learning the Lessons from our Experiences, A Critical and Personal Review. Asian Journal of Pharmacy, Nursing and Medical Sciences, 8(4). https://doi.org/10.24203/ajpnms.v8i4.6258

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