The White House is living in a dreamland that everything is under control but you don’t have to follow that lead. Instead, give more power to the mayors, especially of the larger cities, to encourage mask-wearing and social distancing.#covid #virus #lockdown #politics #guardian #stayathome
In the absence of competent federal leadership, governors need to take control themselves and impose more stringent guidelines. There’s a risk here: if more draconian measures should be needed I have very little confidence that people will comply with what many will see as a big reversal in their conditions.
Que dit notre comité scientifique ? Eh bien, finalement, il est probable (voire un peu plus que probable) que le virus SARS-Cov2 (dit Covid-19) ait bel et bien été manufacturé dans le laboratoire P4 de Wuhan et qu’il s’en soit échappé. Naturellement, quand notre comité scientifique nous a avisé de ses dernières trouvailles, nous lui avons posé des questions et tâché de vérifier ses soupçons. C’est ce que raconte cette enquête, pas à pas, de façon à ce que vous puissiez à votre tour vérifier nos vérifications et vous faire votre propre opinion. Allez, au boulot.Texte de Pièces et Main d’œuvre (en PDF, et disponible en version papier).
Traquer le complotisme plutôt que la vérité.
L’amour du savoir censé animer les scientifiques s’arrête où commencent leurs intérêts personnels.
WHY IS SMOKING THOUGHT TO PROTECT AGAINST THE CORONAVIRUS?
Scientists discover adults who are hooked on cigarettes are 50% less likely to test positive for the illness
By Vanessa Chalmers Health Reporter For Mailonline
Published: 16:43 BST, 2 June 2020 | Updated: 18:09 BST, 2 June 2020
Smokers are less likely to test positive for the coronavirus, according to research that offers yet more evidence that the habit may be protective.
Since the crisis spiralled out of control, researchers have seen unusually low rates of smokers with Covid-19 in hospitals - suggesting they rarely get severely ill.
Now, for what is believed to be the first time, experts in Israel have found adults who smoke cigarettes are less likely to pick up the virus in the first place.
Researchers analysed data from 3million people, including 115,000 swabbed for the virus. They discovered a 'genuine' protective effect of smoking.
Ten per cent of patients who tested positive for Covid-19 were smokers, compared to 19 per cent in the general population, according to the study.
Experts believe nicotine, the chemical that makes tobacco addictive, competes with the virus to binds with cells in the body, therefore blocking it from entering.
Scientists claim nicotine offers a legitimate avenue for both preventing and treating Covid-19, as the global race to find a cure to halt the pandemic continues.
Studies show nicotine may stop a dangerous immune system over-reaction called a cytokine storm - a phenomenon found to be killing many Covid-19 patients.
The Israeli study, yet to be scrutinised by fellow scientists, comes after UK scientists last week rubbished the theory that smoking protects against the coronavirus.
Israeli researchers found 9.8 per cent of patients who had tested positive for SARS-CoV-2 were smokers compared to 18.5 per cent of people who had tested negative and 19 per cent in the general population. The findings were similar for past smokers but not as strong
The latest study pooled data from more than three million people who were part of Clalit Health Services, the largest health provider in Israel.
CHS collected data on the age, gender, ethnicity, pre-existing medical conditions and smoking status of all the participants.
Some 114,500 people in the data had been given a test for Covid-19, of which 4,537 had received a positive result.
The researchers, led by Dr Ariel Israel, matched each Covid-19 patient to five people who had tested negative who were of the same age, gender and ethnicity.
They found the rate of current smokers among the coronavirus patients was significantly less than in the matched participants - 9.8 per cent compared to 18.5 per cent of people who tested negative, and 19.4 per cent in the general CHS cohort.
Current smoking was found to reduce the risk of testing positive by almost half (54 per cent), statistical analysis showed.
And 11.7 per cent of those who tested positive were past smokers, compared with 13.3 per cent in matched controls and 13.9 per cent in the total CHS population.
Those who had previously smoked had a slightly lower (19 per cent) risk of catching the coronavirus, the results suggested.
Using hospital records, the team also found there was 'no evidence' that those who had the coronavirus were any more at risk of severe disease needing mechanical ventilation, or dying.
The results appeared to stay true even when the researchers took into account underlying health conditions, which are known to play a role in disease severity.
The team wrote: 'The risk of infection by COVID-19 appears to be reduced by half among current smokers.
'This intriguing finding may reveal unique infection mechanisms present for COVID-19 which may be targeted to combat the disease and reduce its infection rate.'
Dr Israel and colleagues said their findings are unique to the coronavirus - normally smoking would increase the risk of an infection.
This is because they touch their mouth more often and one of they routes of transmission is by touching a contaminated surface and then the nose and mouth. Studies have also shown the potent chemicals in smoke can also damage the airways.
The team wrote: 'The magnitude of association observed for current smoking, with odds of infection reduced by about a half in smokers, suggests a genuine protective effect of smoking on the risk of Covid-19.'
Those who have come across similar patterns propose nicotine is the key component for protecting smokers.
It is broadly understood that SARS-CoV-2 - the virus that causes the disease - enters the body by binding to receptors in the body called ACE-2, which are found along the respiratory tract.
Nicotine has been found to reduce the expression of ACE-2, which would suggest smokers have less entry points for the virus.
The evidence for this theory is murky, however, because there is also some evidence that nicotine actually boosts ACE-2 expression.
Another theory is that the virus first enters via the the nicotinic acetylcholine receptor (nAChR), which is present around the nose and mouth.
This would explain why the virus causes a loss of taste and smell and in some cases, headaches, dizziness and intense fatigue.
Researchers from Paris wrote in a paper published on Qeios that nicotine would compete with the virus to bind to nAChR, and therefore may prevent the virus from latching on.
The World Health Organization (WHO) said on May 26 there is a lack of knowledge about whether smoking alters the risk of catching the coronavirus or being hospitalised.
There are currently no peer-reviewed papers on the matter published in medical journals, meaning none have been looked over and critiqued by other scientists.
The recent Israeli research, among many other papers that have found few smokers on Covid-19 wards, has been published on the pre-print site MedRxiv or similar.
Researchers across the world have discovered very low numbers of smokers among hospitalised Covid-19 patients, suggesting they are somewhat protected against severe symptoms of the disease, at least.
For example, University College London academics looked at 28 papers and found the proportions of smokers among hospital patients were 'lower than expected'.
One of the studies showed that in the UK the proportion of smokers among Covid-19 patients was just five per cent, a third of the national rate of 14.4 per cent.
Another found in France the rate was four times lower. In China, a study noted 3.8 per cent of patients were smokers - despite more than half of the population regularly smoking cigarettes.
Similarly a review of 13 Chinese studies, published on Qeios in April, found only 6.5 per cent of 5,300 hospitalised patients.
Another study, by America's Centers for Disease Control of over 7,000 people who tested positive for coronavirus, found that just 1.3 per cent of them were smokers - against the 14 per cent of all Americans that the CDC says smoke.
The study also claimed smokers stood no greater chance of ending up in hospital or an ICU.
The data up until this point has been full of holes - which could skew findings - because doctors are not always able to find out if someone severely sick is a smoker, either because they are too busy or the patient is so unwell they cannot speak.
Low smoking rates may be explained by differences in smoking rates between age groups, with middle-aged people more likely to have the habit, but elderly people more likely to be hospitalised with COVID-19.
They found the rate of current smokers among the coronavirus patients was significantly less than in the matched participants - 9.8 per cent compared to 18.5 per cent of people who tested negative, and 19.4 per cent in the general CHS cohort
University of College London reviewed 28 studies and found smoking rates were lower than expected among COVID-19 patients. The graph shows the smoking rate of each country against the percentage of smokers among COVID-19 patients. The lowest figure has been chosen for each country to show the stark comparison discovered by some studies
Swathes of studies have shown a low prevalence of smokers in hospitals with COVID-19.MORE:
When smokers do get diagnosed with the virus, however, they appear to be more likely to get so sick that they need ventilation, two studies in the review showed.
If the findings are proven, scientists say it's likely that it is not cigarettes - filled with thousands of harmful chemicals - that would offer a potential protection, but the nicotine that is beneficial.
A theory flouted by scientists is that nicotine reduces ACE-2 receptors, which are proteins in the body the virus binds to in order to infect cells.
The coronavirus enters cells inside the body via the structures, which coat the surface of some cells, including in the airways and lungs.
If nicotine does lowers ACE-2 expression, it makes it harder for viral particles to gain entry into cells and therefore cause an infection.
On the other hand, other studies show that nicotine enhances the action of the ACE-2 receptor, which in theory, puts smokers at a higher risk of contracting the coronavirus.
Other scientists say low levels of ACE-2 expression as a result of nicotine may prevent worse damage from viral infection, and there is no evidence that says higher quantities of ACE-2 receptors increases the risk of SARS-CoV-2 infection in the first place.
Dr Konstantinos Farsalinos, from the University of West Attica, Greece, who queried whether nicotine could be a cure for COVID-19 in a paper published on May 9, said: 'Up-regulation of ACE2, though seemingly paradoxical, may in fact protect patients from severe disease and lung injury.'
A 2008 study in mice found that getting rid of ACE-2 made the animals more likely to suffer severe breathing difficulties when infected with the SARS virus, which is almost identical to COVID-19.
Other scientists have turned their head towards nicotine's ability to prevent inflammation, where evidence is more robust.
Nicotine has been shown inhibit the production of pro-inflammatory cytokines, such as TNF, IL-1 and IL-6, which are involved in promoting an inflammatory response.
A 'cytokine storm' is a phenomenon in which an abundance of cytokines are released in response to infection.
Doctors have previously said that it's often the body's response to the virus, rather than the virus itself, that plays a major role in how sick a person gets.
A cytokine storm can lead to respiratory failure and the attack of healthy tissues, causing multi-organ failure.
Therefore, the cytokine storm is being looked at as a target for COVID-19 treatment.
'Nicotine has effects on the immune system that could be beneficial in reducing the intensity of the cytokine storm,' Dr Farsalinos wrote in Internal and Emergency Medicine.
'The potential benefits of nicotine.... could explain, at least in part, the increased severity or adverse outcome among smokers hospitalized for COVID-19 since these patients inevitably experience abrupt cessation of nicotine intake during hospitalization.
'This may be feasible through repurposing already approved pharmaceutical nicotine products such as nicotine patches.'
Dr Nicola Gaibazzi, who recently published findings on MedRxiv of 'very low' numbers of smokers in Italian COVID-19 patients, speculates smoke exposure may bolster the immune system.
He said exposure to cigarette smoke reduces the body's immune system over time, measured by lower inflammatory markers.
Therefore, when smokers are infected with a virus like SARS-CoV-2, their immune system is more 'tolerant' and does not overreact.
On the other hand, non-smokers may be more prone to having the sudden and deadly cytokine storm when they are infected with the virus.
Scientists have stressed that the evidence supporting nicotine as a medicine does not mean everyone should take up smoking.