Welcome to another MedCram COVID-19 update as we get closer 1.5 million infections were confirmed worldwide and nearly eighty-four A death is one thing that I found interesting is the number of cases In this country is the highest in the world and the total tests that were performed The world is also the highest in the United States at this point and that it did The condition you know a lot of people was not asking when this happens To finish when you will reach the peak and I think one of the best sites for it In our update yesterday we discussed kovat health data 19 points for our G who Looks at the expectations that were updated and used in the model it was developed in University of Washington projection model is updated somewhat often Some countries are missing especially Canada is not on this A model for some reason but as we’ve talked about before with potential benefits Hydrotherapy and Finland wanted so take a look because they have it Modeling for those countries in the North and so on if we look at them An example we can see here is that in Norway the whole family is under The threshold required for the ICU family actually exceeds the threshold for that There may be a problem with the ICU family in Norway then of course Invasive fans in terms of mortality per day in a country of about five a Half a million people look at deaths today at around 10 It rises up to 25 based on this or if the model is expected The worst scenario is up to 70 deaths a day if we go to Sweden we can see Once again it appears that all the beds go beyond a bed as they are available ICU beds look great To go beyond the beds we have available to know what happens in this case Where deaths per day are expected to be within 19 days, for example And we can see where we are now expecting More than a hundred and possibly even a hundred and twenty deaths per day to Up to 450 until it goes back down here before june this of course Based on the assumptions of isolation now let’s go to Finland all the family below Their ability to look after them may have a little bit of a crisis There are in terms of intensive care beds then down here in terms of deaths per day may be It peaked here at the end of April at about 6 or 7 deaths per day but it could be Up to 26 to 27 deaths per day, which will be about 16 days in terms of The United States for those who are wondering it seems as though the peak Around April 12, April 13 can reach 5,000 deaths a day But we have to see where we are going with this and hopefully before Jun we’ll see the numbers go down enough if we keep the isolation going to be It is interesting to see by then if we still do isolation and what Effects of lifting isolation will be ok let’s talk about ivermectin Ivermectin hydroxychloroquine is like a FDA approved drug It does have some other infection purpose but it does May be helpful with 19 kovat Uses ivermectin for parasites Other viruses such as West Nile Virus have been investigated Flu but researchers now view this fork Ovid 19 to obtain A better understanding of how this actually works for ivermectin We return to our cellular cell biology of course The nucleus we have DNA here in the nucleus and we have protein here This nuclear membrane allows the RNA messenger to exit in The cytoplasm and allows it to translate into a good protein, the problem is that When the virus also comes in, its copy of the RNA, of course The ribosomes cannot tell the difference and start translating the messenger RNA from virus to viral proteins and these Proteins can have problems that may have unintended consequences Proteins can come and go through these proteins that allow viralization Proteins to go to the nucleus where it can cause problems and it can happen It reduces immunity, especially against this virus and some scientists We think this is what is actually happening with the corona virus there A specific goal for this move in or import intelligently This protein is important and there are several different versions of this There is an alpha task and there is also a beta task even otherwise This is known as imp alpha and imp beta one and what ivermectin does Ivermectin shuts down this ability to transport viral proteins into proteins This condition in the nucleus which reduces the ability of the virus to It causes cell damage so this article was published on April 3 2020 It includes that data and version to show you here a link The description below is a pre-release proof and magazine Article summary Although many clinical trials are under way To test possible treatments worldwide in response to its Kova 19 outbreak To a large extent, I have limited control and containment ivermectin is certified by FDA previously shown In vitro broad-spectrum antiviral activity is an inhibitor of the cause The co2 SARS virus with one addition to the vero h slam cells is of type The cells they use here in the test tube two hours after infection with SARS The cuff is able to affect 5,000 times the decrease in viral RNA in 48 hours This is a very short time and therefore a large amount of Ivermectin Further investigation calls for potential benefits in humans and this Of course it is heavy because this drug is already used in Humans have been considered safe enough to use in humans after that Give the ivermectin cells that looked at day zero, one, and three to see What is the relative viral load of RNA in percentage terms and you can see here Over two days one three four five orders of magnitude drop Only 48 hour period so this is inside the cells the amount of virus is inside The supernatant refers to an extracellular solution and here you are We can see over two days we have one two three four nearly five orders The lower amount in the relative amount of viral RNA here is looking for RNA-dependent RNA polymerase genes we talked about a number of weeks ago A gene encoded by RNA in this virus is also known A duplicate of the genes causing reproduction.

Here we can see that Ivermectin is in Fully specific concentrations removes this genome and here we see Ivermectin inhibitor drug This is mpa and Impa one beta of tolerance Corona virus proteins go from the nucleus that we see when they go In the hypothetical nucleus is that there is an improved infection and Reducing the anti-virus response when ivermectin binds to alpha and beta one It prevents it from binding to and importing the corona virus virus Through this nuclear membrane so that you have an unimproved infection There is a strong anti-virus response that occurs so this research is Interesting because it does not address a matter of immunity that we have Discussed during the past two weeks and also related to my Personally in the hospital with patients arriving at the emergency room Just to make up for the next 12 to 24 hours and die than he tells me about Some of these cases are the only way you’ll be able to get involved In those precious hours and days by netting this mechanism that we are See here to reduce immunity reduce the ability to synthesize the immune system The response is important so I got a lot of comments recently about Theme Does the virus cause the inability of the hemoglobin molecule to It binds oxygen and looks as though many of these concerns have been raised in this An article from the Chemistry Archive, which is again another repository of nonprinting prints Peer review articles do not mean that this is generally bad but it just realizes These articles are not peer-reviewed, and this is a coffa 19 attacks on a single beta chain, hemoglobin and capture porphyrins It prevents the metabolism of the heme that they looked at a different structure they looked at Various structures to see what they were keeping and they made three-dimensional modeling Try to find out where this virus can bind elsewhere in the human body Accordingly, it appears that he is attacking the beta series of hemoglobin as well Episode of porphyrin so you have to be able to understand that before you really can Evaluate what is going on in this article so here we have the alveoli The capillary where blood gas exchange occurs and this is where the oxygen is located What you breathe in the alveoli is of course the air sac where oxygen comes In the capillary is spread into the bloodstream so oxygen is present here It will passively pass through this alveolar membrane in the blood Stream so here we have plasma the next day the thing that happens is that this oxygen It will dissolve in the plasma and the way we measure it Something called partial pressure of the oxygen that the plasma does not carry An enormous amount of oxygen is diffuse and does not dissolve in Plasma but enlarging the amount of oxygen that can be dissolved in Plasma is a very small way for us members to really benefit from it The main way organs get enough oxygen with these red blood cells Full of hemoglobin of course each has a human globe molecule it is tetramer means four and can carry four molecules of oxygen and that’s really it It is where the lion’s share of oxygen is now carried in these hemoglobin bags A lubricant is also wet with it.

Here comes the term hemoglobin Of iron as well and usually its iron state plus two versus Her iron status is a plus, which is what allows oxygen to bond with it Red blood cells carry a lion a share if you want oxygen and what The extent to which this hemoglobin is satiated determines a molecule in the red blood cell Determined by something called the hemoglobin binding curve but you do To understand that hemoglobin curve simply binding function Partial oxygen pressure here so here we have saturation on the y axis Partial pressure of oxygen on x instead of a straight line going up A linear line because of the cooperative in the hemoglobin molecule we actually are She has something that looks more like this as you actually pao2 go up Be better and more bound by fine oxygen so why does everything go through That is why this even matters if Kofat 19 affects some It indicates the ability of hemoglobin to bind to the oxygen it prevents The oxygen stripping hemoglobin stripping I keep hearing this stripping The human lupine oxygen strips the problem that we must have Our saturation is because this is a function of pao2 On the other hand we should not have oxygen passing Initially to the plasma and so there are two things we can measure we can Measure saturation which is spo2 this is the thing that we measure by This finger is saturation on the watch and we can also measure pao2 This is the partial pressure of oxygen clearly dissolves if we have The problem here is in red blood cells that should not necessarily cause a problem Here in the membrane and see that we might have Partial oxygen partial pressure but we will have low saturation On the other hand if this RDS really is an issue where there is inflammation and is inside Really rather than having a nice thin wall we have a thick foggy wall where It is very difficult for oxygen to diffuse and then what we will see is very low po2 As a result, we will see a decrease in saturation as shown when I took care of Kovat’s 19:00 patients that’s exactly what I see I see patients with low po2 and a low saturation are not patients with low saturation Saturation and normal PA2 even if we get back to the conclusions of this An article talks about molecular docking technology wherever they are Looking at the three-dimensional structure of some of these proteins that are Able to determine based on genetics that they are evaluating Viral proteins attack the heme part of the hemoglobin molecule It causes the dissociation of iron from porphyrin and then this will cause less Hemoglobin to transport oxygen and carbon dioxide if this is the case in my country Conditions of clinical opinion modest appearances I expect initially The partial pressure of oxygen is the dissolved oxygen in the plasma Not affected but only potential saturation or even the amount of oxygen Delivery to the peripheral tissue that will cause an increase in milk Acidosis I do not see at least in the patients that I see Lactic acid is often high then the authors go here to say this The inability to carry oxygen and release carbon dioxide causes the lungs Very severe inflammation says here due to the inability to The exchange of carbon dioxide and oxygen often results in the end Ground glass like lung images are now very interesting to say because it is More class explanation is that Inflammatory reaction to the virus by those epithelial cells that cause it Opacity of ground glass, not the inability to exchange carbon dioxide And oxygen frequently so that’s what we are and found in terms of hemoglobin I issue I think the biggest issue we are going to address is the next update is The issue of the ventilation strategy was great in the news D conditions.

Gavin Unni in Italy usually published these patients Viral pneumonia has low compliance and this is what we usually see in RTS There is some data coming from Italy that talks about higher compliance and Patients with only the hypoxia you know may not have seen enough patients With kovat 19 or not seen enough patients with kovin 19 but sick Which I see clinically in the hospital are behaving like RDS Sick of course does not mean that there are no those who are not There may be many patients who act like this Differently we don’t know if we’re going to get a good handle on this anytime Soon, we’ll have something more to come in the next update And talk about the various clinical presentations where you found this article The New York Times is a very interesting show that some coronavirus patients It actually comes with confusion signs and symptoms of stroke and even Seizures in other words they are presenting like encephalitis here The patient in early March in Florida had lost the patient’s ability to speak Convulsive movements appeared in his legs and appeared to have a seizure and when Suspected treatment in 19 results came back positive here another patient on Her late fifties were confused with 19 kovat complaining of a headache that she could tell Doctors named it but little became less responsive over time Brain scans showed abnormal swelling and inflammation in several areas Smaller regions where there are some cells actually died and this is known as It is rare for encephalopathy, necrosis of influenza complications and others Viral infections but I think because there are so many people going down With this viral infection we started to see some of these more rare cases In general then I finally want to talk about this article that was on The The Washington Post, titled New Zealand, is not just a flattening curve that it is crushing This is New Zealand Prime Minister and she talks about what Continuing in New Zealand they have decided to do four weeks of isolation They were so strict about it that they even restricted beach swimming Hunting in the jungle as it is considered unnecessary activities Despite the fact that they are doing more testing of the number of new cases They shrink dramatically there and they get a break on Coronavirus and I have to admit when I look at their cause on the world I am Very impressed that they have tested more than 46,000 people the total number of cases In the country only 1200 and the total deaths is only one in four Critical condition in the entire country but there was a collective feeling The purpose of the police phone line was overshadowed by non-emergency With people calling to the table as we say here reporting others think they are Violation of the response rules was noticeable A center-right non-political politician has clearly made the decision not to do so Criticizing the government’s response, and in fact, for its help These efforts appear to be paying off after it peaked at 89 on April 2 The number of new cases decreased to 67 on Monday and 54 on Tuesday broad Most cases can be linked to international travel contact Tracking is relatively easy and that person who died was an elderly woman With health problems in course, one wonders how long they can last New Zealand of course is a small island nation and keep virus in you bay We must make sure that anyone entering the country is quarantined For at least two weeks or if not, you have to wait for the entire epidemic That ends where that leaves the United States of America So this line really goes to us collectively as a nation we will develop Links to this and other sites that we discussed in the description below Thanks for joining us, please subscribe to this channel if you haven’t already We will see you next time

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