Dr Mike Hansen is a lung specialist who works in emergency medicine in the United States. He has been giving reports and updates on Covid 19 since the beginning of the pandemic. Here, he is very clear on Ivermectin dosage and risks, as well as analysing trials to date on its effectiveness. He also gives his opinion about the effectiveness of vaccines from his own experience treating thousands of hospitalised COVID-19 patients.
"Can the people with COVID suffer long term effects? Including long term effects that affect the brain? Yes. These are the so-called “long-haulers.” And it is not necessarily just people with COVID who have required the intensive care unit."
"Dexamethasone, a steroid medication, specifically a glucocorticoid. Yes, it can cause anxiety, irritation, psychosis, delirium, sleep disturbance. This is why when we do give steroids, we try to avoid giving them before sleep. When assessing someone’s mental status, or psychiatric state, its important to know what they are normally like at their baseline. Are they acting differently? That’s really what you’re looking for. Steroids are prescribed very frequently, and these side effects, are not necessarily rare, its not like we give steroids and necessarily expect them to have these side effects. It's very hard to put a number on how often these side effects occur because there are so many different medications that can cause these symptoms and so many other factors that can contribute towards mental status changes. So you will never get a concrete number on how often these mental side effects occur, but if I had to put a number, I would say less than 10%, at least based on my experience of giving thousands of patients steroids.
Well, let me start out by saying there are over 30 million documented COVID cases and 1 million deaths worldwide, and over 200,000 deaths in the US. The clinical spectrum of disease can range anywhere form no symptoms to mild symptoms, to pneumonia, to ARDS and shock with multiorgan failure, and death. Because COVID is a new disease, the possible long-term health consequences, are still not well-known. So these long-term effects of COVID, we can call this postacute COVID, defined as the presence of symptoms extending beyond 3 weeks from the initial onset of symptoms. And Chronic COVID is beyond 12 weeks.
But postacute COVID syndrome is not just seen in those who had a severe illness and were hospitalized. In a telephone survey conducted by the CDC among a random sample of 292 adults (≥18 years) who had a positive outpatient COVID test and were symptomatic, 35% said they did not return to their usual state of health 2 weeks or more after testing. And this occurred in all ages of adults.
The most commonly reported symptoms after acute COVID are fatigue and dyspnea. And this is exactly what I’ve been seeing with some of my patients with COVID. This persistence of fatigue, and feeling short of breath. Other symptoms include joint pain and chest pain. In addition to these symptoms, there are cases of patients with specific organ dysfunction, primarily involving the heart, lungs, and brain. This might be a result of the viral invasion, by hijacking those ACE2 receptors in our body, but it can also be related to the intense inflammation and cytokine storm, or a combination of these.
In a study of 55 patients with COVID, at 3 months after discharge, 35 had persistent symptoms and 39 had abnormal findings on chest x-ray or CT scan, meaning interstitial thickening and evidence of fibrosis, meaning scarring. In 2 different studies that were done, they looked at patients with COVID who were discharged from the hospital. At about three months after discharge, about 25-30% of patients had at least some impairment in lung function, as evidenced by pulmonary function tests.
Heart damage, aka myocardial injury, as defined by an increased troponin level in the blood, has been described in patients with severe acute COVID. Inflammation of the heart muscle, meaning myocarditis, in addition to heart arrhythmias, has also been described after SARS-CoV-2 infection. I dedicated an entire video to this topic, so you can check that out for more details. The virus that causes COVID, SARS-CoV-2, can infiltrate brain tissue when the virus gets in the blood. It can also get to the brain by invading the olfactory nerve, which is the nerve responsible for the smell. This is why the loss of smell is a common symptom. Besides the loss of smell and loss of taste, the most common long-term neurologic symptoms after COVID are headache and dizziness. Less common, but still possible, is stroke, brain inflammation, meaning encephalitis, and seizures. In previous pandemics with SARS, MERS, and influenza, some people who recovered from those illnesses had neuropsychiatric issues that lingered for months. So were talking about cognitive health here, like depression and anxiety. And the post-COVID is known to cause “brain fog” and mood swings, this has been reported up to 2 to 3 months after initial COVID" illness. [Source: Partial transcript accompanying the video above.]
Ivor Cummins is a health writer and biochemical engineer, who calls himself The Fat Emperor. He has drafted a letter for people to send to politicians and the press, querying the seriousness of COVID-19. He calls it the "Corona Basic Realities Letter," and writes, advocating 'herd immunity', as one of his 'indisputable facts', that: "Sweden, who were vilified for their approach, has had a very similar death rate to other countries." But Sweden actually has had a much higher death rate than its neighbours, although it did practice social distancing and other hygiene measures, whilst leaving businesses open etc.
The virus killed more than 5800 people in the relevant period, giving Sweden one of the world’s highest per capita mortality rates.
To compare those figures with other Scandinavian countries, Denmark has recorded 621 deaths, Finland has recorded 334 deaths, and Norway 262." [Sweden has about twice the population of the other Nordic countries, but the number of deaths is still very high in comparison.]
"The study, carried out by the country’s Public Health Agency, found that just 6.1 per cent of the country’s population had developed coronavirus antibodies by late May. This figure falls far short of Dr Tegnell’s prediction.
Cummins compares South American countries, Peru vs Brazil - lockdown vs none - claiming death rates are similar and assuming this proves lockdown does not help. But he should take into account other factors, such as dirty water, crowding, poor hygiene, undocumented workers, poor health system, which would make lockdowns and or treatment ineffective. See https://www.kunc.org/2020-08-31/peru-grapples-with-the-pandemic-despite-an-early-and-tough-lockdown.
Cummins criticises (Ferguson's epidemiological model> (an early influential British coronavirus epidemiological simulation that contributed - among others - to lockdown decisions), for Sweden vs 'actual' data. Strangely, Cummins does not appear to take into account the effect on the death rate of measures taken against the virus in Sweden, albeit lesser measures than in neighbouring countries (which had much lower death rates). This virus is so infective that, without any infection control measures, much higher contagion would be expected. This seems to be a common error in criticisms of quarantines and lockdowns. See this article for a thorough explanation of what the Ferguson model purported to do.
Ivor Cummings does not talk about Italy, which is an example of an entire country crippled by COVID-19, with a high severe illness and death rate that overwhelmed the hospital and funeral system. Three well-known factors operated there: The first was a mass infection that took place in a crowded football match; the second was that the government treated COVID-19 as if it were no more serious than the flu; the third was that Italy had such a high proportion of elderly people. The situation was made worse by the government failing to give financial support to its citizens, whilst ordering them into lockdown.
Victoria, Australia, is still experiencing in September 2020 what most of the world would see as a comparatively minor outbreak of COVID-19 in the community – certainly in contrast to Italy. The state initially locked down the most affected suburbs, but expanded lockdown quickly to the rest of the metropolis, and some affected regions. Contiguous states locked their borders against Victoria. Known new infections only reached 684 at their current peak, against a background of total known infections of 19,688 total, yet contagion reduced hospital and nursing-home staff, by quarantine and illness, to the extent that other states had to send in relief. What would have happened if there had been no lockdown? The virus would have spread to all other states and the hospitals would quickly have been overwhelmed. If, bizarrely, staff had continued to work in them without being tested themselves, without isolating if asymptomatic, patients presenting to hospitals with other illnesses would have run high risk of acquiring COVID-19 in addition to their presenting illnesses. Knowing this was a risk, even with quarantine, people avoided hospitals. Victoria is not out of the woods yet, and a small number of infections have escaped beyond the state, but the health system has coped to this point.
Cummins seems to be championing the idea of herd immunity, without thinking it through. Herd immunity needs definition. Many definitions disagree. The requirement, in herd immunity, for a much higher number of cases to establish, than usually allowed through strict quarantine, would mean potentially far more suffering. The virus would not go away, but would remain in the community to affect upcoming aging or otherwise vulnerable cohorts; thus a lurking endemic nasty. The capacity for COVID-19 to reinfect, and the ability of the virus to change rapidly, calls into question the very possibility of widespread immunity.
Not just deaths
Cummins should not just be looking at deaths, and neither should we. Deaths may actually be a poor indicator of the damage this virus may do. We should be looking at a continuum, as in: If the proportion of people who contract COVID-19, and who are over 80, die, what happens to those (of any age) who live? Given the ability of this disease (unlike flu) to cause clotting problems all over the body, affecting organs which affect other organs, we should be expecting that a proportion of survivors will have various rates of blood clots and organ damage. What proportion of these will clear, improve, or become chronic and dangerous? How long will how many survivors survive? Check out the following videos by doctors regarding clotting and organ-damage.
"More long-term damage caused by COVID-19 than expected | COVID-19 Special" (August 26, 2020)
The above video has many comments of interest, from people who have suffered lingering damage from the virus.
"An NYC Cardiologist Explains the Long Term Effects of COVID-19."
The cardiologist in the above video points out that, even if you are young and fit when you catch COVID-19, you still may not be able to do what you used to do, after you recover. He also says that people should present early for treatment because then treatment can be started to reduce the damage to organs, thus perhaps reducing the severity of chronic conditions that may linger and prevent full recovery. He also says that four years after the 1918 Great Flu epidemic, many survivors still had debilitating symptoms.
"Long-term health effects of COVID-19" (Lung specialist talks about pulmonary fibrosis, which may lead to need for lung transplants.)
Most important to factor in, among all these continuum possibilities, is the incredibly infectious nature of COVID-19, far more than the flu. Cummins does not appear to think much about this.
Ivor Cummins' letter suggests that recent rises (second waves) of corona virus are the result of countries conducting more tests, or the effects of seasonality. There seems to be little evidence of seasonality, however.
He speaks confidently of vaccines to help the susceptible, but there is no certainty of any effective vaccines arriving.
Ivor Cummins is a health writer and biochemical engineer, who calls himself The Fat Emperor. He has drafted
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