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April 29, 2020 - Today in the world of coronavirus news:

Few of those hospitalized with the coronavirus are smokers, and researchers are trying to understand why, according to VICE.

One hypothesis is that nicotine, which has anti-inflammatory properties, may interfere with the way that COVID-19 causes an overreaction of the immune system.

The hypothesis comes from Konstantinos Farsalinos, a cardiologist in Greece who focuses on tobacco-use reduction. Farsalinos noticed that few COVID-19 patients who were hospitalized in China were smokers, though about half of men in the country smoke.

Farsalinos and colleagues wrote a new paper available as a preprint and scheduled to be published in Internal and Emergency Medicine. They found that among 13 studies in China with nearly 6,000 hospitalized COVID-19 patients, the rate of smokers ranged from 1.4% to 12.6%. No studies recorded e-cigarette use.

“The results were remarkably consistent across all studies and were recently verified in the first case series of COVID-19 cases in the U.S.,” the authors wrote, calling for an “urgent investigation.”

Of course, Farsalinos doesn't recommend that people should begin smoking simply to attempt to avoid a severe case of COVID-19. Smoking is still a leading cause of preventable death across the globe.

“We all know that smoking is obviously bad for you,” Raymond Niaura of New York University told VICE. Niaura co-authored the paper with Farsalinos. “It follows logically that smokers would be way worse off. I would think that too. But I've been surprised: That's not the story we're necessarily seeing.”


https://www.webmd.com/lung/news/20200430/smokers-hospitalized-less-often-for-covid-19

Interesting, more conflicting findings.  I've mentioned before the cytokine explosion that appears to be common in severe cases among younger people.  Perhaps smoking weakens your immune system so that is less likely?

There is a glut of available appointments. Everyone coughs, every day. I don't know why CVS is asking those questions. The hospital where I went asked nothing. Anyone can go, any time.

I'm not sure I want to go to an AZ hospital right now.  

This is why initial findings should never be released to the public.  We go on 'maybe' and 'what if' rabbit holes.  Only compete studies with concrete findings should be widely spread.  Ugh.

There is a "system" involved here, there are referred journals where articles can take a year or more to be published, and other outlets often called "Something Letters" which publish unrefereed articles.  Scientists understand these are less reliable, but they can be important particularly in a public health or other crisis.  

Then the "media" step in with their vast knowledge and perspective and generally misconstrue and mischaracterize whatever was in "X Letters", to get clicks, or just out of sheer incompetence.

There were some very preliminary findings that HCQ could teat COVID.  The studies were in vitro, generally considered to be "maybe interesting" but hardly definitive, at best pointing to a need for more study.  That got "hyped" obviously and then there was a furor, one that quietly abated.

It was useful to have that finding available to scientists, it was not useful to have it hyped as any kind of real treatment.

I still am unsure why NY State is coming down.  Is it simply that folks can't go out much still?  If they reopen places does it mean it will go bad again?

Europe is largely reopening of course, are they going to go bad again?

So, to me, the idea of closing down was to "manage" the spread, not change area under the curve.  Opening up means allowing it to spread relatively unconstrained, so any state that significantly reopens is going to see a dramatic increase.  It's inevitable.

So, you can keep nearly everything closed and delay the inevitable, perhaps until a vaccine is available.  Or, you open and believe you can manage it with hospital capacity as needed and hope the seriousness of infections is smaller.

I'm not sure it makes sense to me for a governor to brag about how well they are doing relatively, especially in New York.

The Asian countries largely continue to do well.  I wonder if they wear masks a lot .....

perhaps many more folks in California are being tested?  Don't know....

Perhaps the death rate in the flyover is less?

perhaps more midwest farmers are red voters, perhaps they are just more inclined to not wear masks?

perhaps the majority of the cases in Iowa and Nebraska were isolated to nursing homes and meat packing plants and folks outside those places feel safe?
it's interesting

Interestingly, Iowa has a deaths/1M rate about 50% higher than California, while Nebraska has a rate about 10% lower than California. I do know that Iowa was hit hard in the meat packing plants. Not sure we have many of those in CA...

Either way, my point was that clearly flyover country isn't immune from COVID-19 being a big concern, whether people are taking it appropriately seriously or not. Those two states (Iowa/Nebraska) are #12 and #13 in cases/1M (counting DC as a state here). 

It's just as big of a concern everywhere.