在更毒的新冠病毒侵襲台灣之前：分析屏東Delta之傳播異象
李瑞全
有關屏東由秘魯回台祖孫二人染了傳染力最凶的Delta病毒，奋而引發一群聚的感染，不但指揮中心非常緊張，屏東更宣布進入類第４級警戒，急速匡列近二千人進行篩檢。以近月的疫情來看，我們的篩檢與防疫的空間與防線如此狼狽，因此產生不少未被偵查到的感染源出現，也因此，一直不能完全匡列和隔離陽性受感染的病人（居家隔離實是讓家人成為第一線受感染者，而且防堵不住）。如果這種新病毒進入台灣，而以台灣已接種的第一劑疫苗人數比例如此低，後果之嚴重，可想而知。但這次傳播的情況卻不象傳聞的那麼快速和發病率不高，甚致被匡列篩檢的被感染成為陽性的人居然也極低！其中實有一些可能與這對祖孫的感染情況和用藥有關。因為，據聞南美地區，包括秘魯，感染 Delta病毒的很多，盛傳他們都是用美國幾位頂尖新冠防疫和治病的醫學專家所推薦的一種安全的治療寄生虫的藥物，名為Ivermectin（伊維菌素）來治療和預防新冠病毒。因為這種藥很便宜，而且療效可以達到八到九成以上。（參見附文）這個藥物是日本醫學家大村智（Ōmura Satoshi）與Merck 藥廠的寄生虫專家威廉·塞西爾·坎貝爾（William Cecil Campbell）在17年前共同發現，兩人在2015年同獲諾爾醫學獎。此藥的副作用極低，已被列為WHO基本藥物名單之內，訂價極低（約0・12美元），Merck每年都免費捐贈百萬劑給非洲等落後國家。此藥在2020年5月被澳州一群醫學組發現可以在2日內殺死新冠病毒。而在許多國家，包括美國，治療效力達到八至九成，它對高齡重症病人更非常有效，這些已近死亡的高齡病人服食一、二劑即可脫離氧氣呼吸機，康復回家。這對祖孫可能已在秘魯感染，在回來前吃了這種藥，因而病毒近於被消滅而清，但毒性和數量已減低，而其他接觸的家人或鄰居一時都沒有發病，只有接載他們的計程車司機出現病狀，而追踪到他們的鄰居和他們兩人。但此病毒似乎不如在英美等地的高度而快速的傳染發病方式！我不知道中心的疫調人員有沒有詳細追問他們的用藥，或不以為吃這種藥有療效而不予紀錄。但運用這個藥治療好末期新冠病人實有很多案例和醫學報告的支持。這推薦這個藥物是美國最早第一線有名的治療新冠病毒的一群專家專家聯盟（FLCCC），他們是設計現行標準治療新冠肺炎程式和用藥的標準之一的第一線專家，做了與Ivermectin（伊維菌素）用藥的學術研究報告超過27項研究，16個隨機測試，最少有33 篇研究報告等大量數據，基本上都證明Ivermectin（伊維菌素）是有效的，且防疫功能高達90%，且幾乎沒有任何不良的副用。他們在美國的發言人是團隊中最年輕耶魯大學的醫學副教授Pierre
Kory，且在去年12月8日曾在美國國會的專責聆證會做了正式的報告，但當時國會的民主和共和黨委員都不出席，紐約時報且預先出了評論，認為這是非科學的言論，推銷莫名其妙的藥物等，且污衊為與川普有關，等等，其後更被各大媒體和主要的網踏大頭所共同封禁，一律視為假消息，不準發放。縱使第一線的醫師和醫學專家的相關言論，都一律被馬上刪除。一般相信這與跨國大製藥企業和電際通路商的打壓有關。但去年在美國芝加歌一大醫院發生一宗案例。一對兄妺為受感染也快死的80多歲高齡的母親要求使用這種藥物，但被醫院和醫師拒絕，他們告上法院，法官快速開庭和判決要醫院提供此藥，而病人吃了第一劑後即馬上有好轉，兩天之內就不再用氧氣機，肺部恢服功能，雖然中間也有反覆情況（受過如此嚴重病毒催殘的老人，自然可以有各種不明狀況出現)，但幾天之後病情即穩定，可以出院回家！當然，由於這種是於所謂原定藥用之外的使用（off-label use），這個藥用於治療新冠肺炎仍然有許多醫學上的認證，但對於現行用了昂貴又不能治好病情的臨終病人，應可以准許病人使用這個藥物來救命。這個藥物如果真成為醫用藥物，對於跨國藥企的和受資助的科學研究者的研究，打擊自然極大，也因此，此中實有很嚴重的陰謀論在內。但在救人為先的天條之下，醫師與醫院不應拒絕讓病人最後使用Ivermectin（伊維菌素）作最後一試！
對於更多更嚴重的病毒變種不幾出現的情況，而各國又躍躍在開放旅遊，而台灣在接種疫苗的比例偏低，我們實要加強快速而嚴格的篩檢和預備更充份的隔離疫所，不宜讓確診者在社區出沒。在匡列之內而又未確知是陰性的人，必須要守嚴格的居家隔離的要求。準確的快篩可以有效地減低隔離的天數。我個人支持以下的幾點防疫措施：
1.
加快篩檢的速度，應在一天之內得到結果。
2.
嚴格進行全面篩檢入境人士和採取少14日的隔離，除非己有疫苗護照和入境前三天的CPR的陰性證明
3.
所有與確診病人有接觸的人士的被匡列者都必須隔離和進行快速的CPR檢查。
4.
在治療用藥上應可以開放讓病人採用Ivermectin（伊維菌素）。
附錄：(註釋中有一研究報告列出用藥的份量和天數)
Top Yale
Doctor/Researcher: ‘Ivermectin works,’ including for long-haul COVID
Mary Beth PfeifferMarch 22, 2021
Note that views expressed in this opinion article are the writer’s
personal views and not necessarily those of TrialSite.
A Yale
University professor and renowned cancer researcher has pored over the COVID-19
literature and treated several dozen patients. He can remain silent no longer.
Dr.
Alessandro Santin, a practicing oncologist and scientist who runs a large
laboratory at Yale, believes firmly that ivermectin could vastly cut suffering
from COVID-19. Santin joins a growing group of doctors committed to using the
safe, generic drug both as an early home treatment to prevent hospitalization
and alongside inpatient treatments like steroids and oxygen.
“The
bottom line is that ivermectin works. I’ve seen that in my patients as well as
treating my own family in Italy,” Santin said in an interview, referring to his
father, 88, who recently suffered a serious bout of COVID. “We must find a way
to administer it on a large scale to a lot of people.”
Santin’s
statements carry the prestige of a leadership position at Yale School of
Medicine and the gravitas of a top uterine cancer researcher, who has authored more
than 250 science journal articles and pioneered treatment, used worldwide, for
the most aggressive form of uterine cancer. At Yale, he is an OB/GYN professor,
team leader in gynecologic oncology at the Smilow Comprehensive Cancer Center,
and co-chief of gynecologic oncology.
Improvement
Across the Board
When COVID
came along, Santin began reading about how best he might help his cancer
patients, 10 to 20 percent of whom were coming in infected with COVID. He began
using ivermectin after the National Institutes of Health changed its advisory
in January to allow the drug’s use outside of COVID trials.
Santin’s
endorsement is not only important but broad. He said he has seen ivermectin
work at every stage of COVID — preventing it, eliminating early infection,
quelling the destructive cytokine storm in late infection, and helping about a
dozen patients so far who suffered months after COVID. One of them is an
athlete and mother of two, 39, who had been disabled by post-COVID chest pain,
shortness of breath and fatigue; she confirmed in an email to me her joy at being
able to walk up a hill again and breathing better within 72 hours of her first
dose.
“When you
have people that can’t breathe for five, six, eight, nine months and they tried
multiple drugs and supplements with no success, and you give them ivermectin,”
Dr. Santin said of long-haul patients, “and you see that they start immediately
feeling better, this is not placebo. This is real.”
The
majority of patients improved within one to three days, he said, particularly
those with breathing problems, debilitating fatigue and chest pain. Two draft studies
from Peru have reported improvement with ivermectin in long-haul patients;
several physicians, like Santin, have also had anecdotal success.
Beyond his
outpatients, Santin has treated family members and friends infected with COVID
in both his home community in Connecticut and in his native Italy via
telemedicine. There, he prescribed ivermectin to more than 15 families, in
which parents, children or others had became infected; the goal was both to
treat early and prevent severe COVID, as studies have shown ivermectin does.
“I have
not a single one that right now had to go to the hospital to receive oxygen,”
he said. “I have no doubt ivermectin saved my 88-year-old father’s life.” His
father survived COVID despite high blood pressure, cardiac disease that led
previously to seven stents and open heart surgery, and lung problems. “If I can
save you,” he said referring to his father, “I can tell you, I save anybody.”
Santin
said he has also consulted on inpatient care with a colleague at a hospital in
his native Brescia, one of the cities hardest hit by COVID in Italy.
Two
Italian newspapers first reported Dr. Santin’s experience with ivermectin,
on March 5 and March 18. In
the first article, he told the newspaper il Fatto Quotidiano, “Ivermectin can
really be the game-changer against COVID-19.” He reported seeing cancer
patients “radically improve their shortness of breath and oxygenation” within
24 to 48 hours of their first dose.
In a
subsequent article in Affaritaliani newspaper, he described his surprise after
first reading the body of 40 positive ivermectin studies and then using the
drug on patients. “I did not expect that a drug approved over 35 years ago with
other indications [namely to treat parasitic worms and scabies] could really be
so effective and well tolerated in COVID patients,” he said.
In both
articles and in my interview, Santin pointed to the crucial advocacy of Dr.
Pierre Kory, an ICU specialist and perhaps the nation’s strongest voice for
ivermectin as president of Frontline COVID-19 Critical Care Alliance.
Doctors: Read the
Research
Kory said
Santin’s experience is typical of doctors who take time to scour the new
ivermectin research. “I’m
just so encouraged that other thoughtful clinicians are able to assess, to
investigate, to look at the evidence and make a judgment on the risk-benefit
analysis,” he said of Santin.
Both
physicians faulted doctors who don’t read emerging science and instead follow
rigid hospital protocols; these notably leave out ivermectin, even though the
drug has now been given the same neutral NIH recommendation as monoclonal
antibodies and convalescent plasma.
As a
result, newly diagnosed COVID patients are typically told, as they have been
for a year: Go home, take acetaminophen perhaps, and go to the hospital when
breathing gets tough. In other words, get sicker before you get care.
But even
hospital care has huge gaps. “When you are an inpatient with severe COVID right
now, “ Santin said, “you give them a steroid, you give them heparin and
remdesivir. That’s it. If they improve, great. If they get worse, you
unfortunately keep on watching them die.”
“I was
very disappointed, and I’m still very disappointed, about the treatment
protocols that we currently are providing to patients,” he said. This is why,
he told me, he has decided to speak out.
Kory and
Santin differ in one respect. Kory believes long-haul syndrome is driven
largely by inflammation; Santin sees a significant role for persistent
infection, namely live lingering viruses.
In the
scheme of things, this is a small issue. The key to halting COVID is to use the
drug, both doctors agree. Instead, mainstream medicine, the press and public
health officials in the U.S. and Europe ignore it, while India, Bangladesh,
Peru, the Czech Republic, and other countries reap its benefits.
Put Focus On
Therapies
The
Western approach to long-haul COVID is a case in point. Studies at many
university centers are focused in general not on treatment therapies but on
defining the long-haul syndrome. As a result, Kory said, patients with
cognitive issues, pain, breathing and heart problems are referred to
specialists with few tools to help them. This may be understandable given
that long-haul research is scant and raw.
But for
doctors like Santin and Kory, existing safety data and clinical research gives
ample reason to try ivermectin at every stage, including in the 10 percent who
have what the FLCCC calls “persistent, vexing, and even disabling symptoms
after recovery.”
Fred
Wagshul, a pulmonologist in Dayton, Ohio, tried ivermectin for five to seven
days in what he called “true long-haulers.” Most reported significant
improvement in days. Similarly, Peruvian researcher, Gustavo Aguirre-Chang,
reported on 33 long-haul patients who were given ivermectin one to three months
after resolution; 88 percent got better with two daily doses.
The Story of Sam
Dann
Sam Dann
is the poster boy for what COVID can do to a muscular, active 41-year-old and
regular jogger. Like many other patients, he was sent home after a positive
test last July with the advice to “drink Gatorade and take Tylenol.”
Over the
next months, “I went through an absolute living hell,” he told me, that was
worse than three tours in Iraq.
After the
initial bout of infection, he experienced crippling fatigue, anxiety,
sleeplessness and nightmares, uncontrollable tremors, a racing heartbeat, and
an inability to think straight or recall basic information. He could not work.
Some six
months into his grueling odyssey, Dann went to Dr. Bruce Boros, a Key West,
Florida, cardiologist and urgent care center owner who, after treating about
200 patients with ivermectin, is now offering it prophylactically. There, Dann
got a 10-day prescription for ivermectin.
The
vertigo went away almost immediately. The tremors calmed. The nights were
difficult but gradually improved. The pain went from 8, on a scale of 10, to 1
to 3. “I still get weird feelings here and there,” he told me, “but I’m nowhere
where I used to be.”
Despite
stories like this, every day in the United States and elsewhere, we are minting
new long-haul patients just like Sam Dann. Said Dann, “There are a lot of dead
people because they refused to acknowledge this drug’s usage.”
Santin’s
advice to doctors who unquestioningly follow COVID protocols is this:
“Use your
brain. If your patient is dying, change something, try to do something more.”
Of
ivermectin, he said, “It’s safe, it’s cheap and it works.”
***Mart
Beth Pfeiffer is an investigative journalist and regular contributor to Trial
Site News. Her website can be found here. Twitter: @marybethpf.
Follow
the TSN Ivermectin Channel
Dr. Alessandro Santin
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Categories: News, Opinion Editorial
Tagged: COVID-19, Doctor, Ivermectin, Long COVID, Long Haulers, Researcher, Yale
Mary Beth
Pfeiffer, author of Lyme: The First Epidemic of Climate Change, has been an
award-winning investigative journalist for three decades. A reporter who has
specialized in social justice, environmental and health issues, she is also
author of Crazy in America: The Hidden Tragedy of Our Criminalized Mentally
Ill. The book is a critically acclaimed look at treatment of the mentally ill
in prisons and jails in the United States. Pfeiffer is married to Dr. Robert
Miraldi, whom she met when both were reporters at the Staten Island Advance.
Miraldi, a Fulbright scholar and journalism professor, is author of Seymour
Hersh: Scoop Artist. They have two children, four grandchildren and a Shih Tzu
named Bushwick.
Responses
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a comment.
1.
Find below how the U.S FDA describe an EUA:
The key text to think of is : “and that there are no adequate, approved, and
available alternatives”. So it is logical to assume that EUA beneficiaries will
work to assure that alternatives are held back:
Q. What is an Emergency Use
Authorization (EUA)?
A: Under section 564 of the Federal Food, Drug & Cosmetic Act, the FDA may,
pursuant to a declaration by the HHS Secretary based on one of four types of
determinations, authorize an unapproved product or unapproved uses of an
approved product for emergency use. In issuing an EUA, the FDA must determine,
among other things, that the product may be effective in diagnosing, treating,
or preventing a serious or life-threatening disease or condition caused by a
chemical, biological, radiological, or nuclear agent; that the known and
potential benefits, when used to treat, diagnose or prevent such disease or
condition, outweigh the known and potential risks for the product; and that
there are no adequate, approved, and available alternatives. Emergency use authorization
is NOT the same as FDA
approval or licensure.
2.
One plausible explanation why
Ivermectin is not yet widely adopted is legal regulations of the novel
vaccines. Emergency Use Authorization (EUA) requires that NO OTHER ESTABLISHED
treatment may exist for vaccine use to be granted. All the major vaccine
suppliers operate under such EUA for the product. The European Union now
operate under another construct named “Advance Purchase Agreement” https://ec.europa.eu/info/live-work-travel-eu/coronavirus-response/public-health/eu-vaccines-strategy_en
but conditions for how to treat alternative treatments seem to remain the same.
Should a drug such as Ivermectin be made widely available this would render the
EUA’s and similar agreements invalid and vaccine suppliers lose revenue.
Those revenues are in the billions of dollar worldwide so EUA shutdowns would
be dramatic if they occurred. So everything to gain for them by fighting/muting
alternative treatments.
Which really are “tragically long overdue” to complement the treatment
offerings.
3.
tetech2March 24, 2021
The link within the article isn’t
working but it’s only a page long so I’ll paste it here about the dosage for
long haulers.
PERSISTENT OR POST-ACUTE COVID-19: IVERMECTIN TREATMENT
FOR PATIENTS WITH PERSISTENT SYMPTOMS
Gustavo Aguirre Chang; Eduardo Castillo Saavedra; Manuel Yui Cerca; Aurora
Trujillo Figueredo; José A. Córdova Masías. Reseach Gate. July 12, 2020.
English translation copy edited by Madeline Oh
SUMMARY:
INTRODUCTION: It is estimated that between 10 to 45% of people who get sick of
COVID-19 will present symptoms after the acute stage of the disease and that
these will
persist for weeks, developing what is called Persistent or Post-Acute Symptoms
of
COVID-19. There is no consensus or publication on a specific and effective
treatment for
these cases. Therefore, an proper diagnosis and treatment for these patients is
not
currently not been being carried out, and there is a lack of knowledge as to
the etiology
that causes it.
MATERIAL AND METHODS: In the present study, 33 patients with the clinical
diagnosis
of Persistent or Post-Acute Symptoms of COVID-19 who were between 4 to 12 weeks
from the date of symptom onset and who had 1 to 3 months of symptoms were
enrolled.
Patients whose main symptoms were muscular system, such as fatigue due to
muscle
weakness, diminished muscle strength and myalgia (muscle pain) were excluded
from
the study.
The following protocol was followed: Ivermectin was administered at a dose of
0.2 mg
per kilogram of body weight per day was given for 2 days. If patients still had
symptoms
after the 2 doses, 2 more days of treatment with Ivermectin was given at the
same dose.
For cases with moderate symptoms, a dose of 0.4 mg per kilogram of body weight
was
prescribed for 2 days, then continued with 0.2 mg per kilogram of body weight
for 2 more
days. If a patient continued to have symptoms after the 3rd day of treatment,
more
Ivermectin doses were indicated and should continue while clinical improvement
was
observed and until there was no longer a clinical improvement response with
treatment.
RESULTS: 33 adult patients with Persistent or Post-Acute Symptoms of COVID-19
were
treated with Ivermectin. In 94% of the 33 patients treated with Ivermectin
clinical
improvement was observed to some degree (partial or total) after the 2 doses of
Ivermectin. Complete clinical improvement was observed (total, without
symptoms) in
87.9% of patients after the 2 doses of Ivermectin. In the 12.1% of patients
whom did not
have resolution of the symptoms with the first 2 doses, additional doses of
treatment with
Ivermectin was provided per protocol, with final clinical resolution of
symptoms seen in
94% of cases.
CONCLUSION: The result of the present study demonstrates that clinical
improvement
is seen in a high percentage of patients with Persistent or Post-Acute Symptoms
of
COVID-19 who had been treated with Ivermectin.
Given the high number of patients with Persistent Symptoms of COVID-19 and who
have
not been receiving effective treatment, we recommend conducting further
clinical studies
on the use of Ivermectin and other drugs to reduce the viral load for these
cases.
Key Words: Long hauler, Long COVID, COVID Long term, Persistent Symptoms, Long
Term
COVID, Persistent COVID-19, Post-acute COVID-19, Prolonged COVID-19, Subacute
COVID-19, Chronic COVID-19, Post-COVID Syndrome, Post-Viral Fatigue,
Ivermectin.
4.
Neville SealyMarch 24, 2021
FACT… Ivermectin works!
By these Covid19 options Fruit you will truly know them. If it soars
like an Eagle, looks like an Eagle & acts like an Eagle calling it a group
d bound Turkey no mater how qualified you are, is laughable!
5.
timdolan25March 23, 2021
This is real journalism. The story
of Dr Santin is an example that I wish more doctors and hospitals would follow:
when the current treatment protocols are not working and many people are dying
you cast about for the drugs that can be repurposed and prescribe them and find
what works!
6.
Angemerli TeodoroMarch 23, 2021
Thank you so much! My husband had
severe Covid and was hospitalized for 22 days. He didn’t need to be intubated,
but he used high flow oxygen and Bipap. It has been 60 days since he left the
hospital, but he still has shortness of breath when he does a flight of stairs,
or when he runs. I would like to know about the dosage of Ivermectin in this
post-Covid treatment. We are from Brazil.
7.
Andrew PearceMarch 23, 2021
Sara, I think the "after
resolution" refers to the absence of the actual virus. Long haul patients
get that descriptor because they have recovered from the virus (or so we think)
yet suffer long lasting complications. That IVM can drastically mitigate those
complications implies that they either still had the virus in them somewhere,
or that other unknown pathogens were still at work, but IVM stopped them as
well.
In another TSN article today, a reader hypothesizes that many many people have
amoebic parasites and don’t know it. These are extremely hard to test for and
actually quite common. Outside of the tropics, regular treatment for parasites
is almost unknown. Whatever else it may do, IVM starts as an anti-parasitic.
https://trialsitenews.com/ivermectin-discussion-goes-into-mainstream-media-in-france-but-stops-there/
8.
John HainautMarch 23, 2021
Thank you for this.
This article articulates 2 issues that seem to require some additional
research.
1) On disease progression: The FLCCC has presented a model of disease
progression that shows viral replication lasting on the order of 14 or so days.
According Dr. Paul Marik, physicians often continue to treat patients with the
antiviral remdesivir at a point where (even if it were effective against
SARS-COV 2), it couldn’t possibly help because all that is left is "dead
virus". Is anyone researching the virus lifecycle well enough to determine
if that is true? Is it testable? If so, why is it not being tested? Do we even
have an assay test to see if "live virus" still exists in long
haulers (not a PCR test)?
2) On hospital protocols. "doctors who don’t read emerging science and
instead follow rigid hospital protocols". In short, it’s a crap shoot to
get a doctor who isn’t just punching the clock.
9.
Sara SakumaMarch 22, 2021
"Most reported significant
improvement in days. Similarly, Peruvian researcher, Gustavo Aguirre-Chang,
reported on 33 long-haul patients who were given ivermectin one to three months
after resolution; 88 percent got better with two daily doses." Thanks!
Great news! I was a little confused about the above sentence. What is the
‘after resolution’ time? I thought they still had Covid while taking the
ivermectin twice a day.
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