*Medium has taken this piece down, but it seems worth considering, as it*
*appears to bolster Dr. Kyle-Sidell's view of COVID-19.*

*Here's a recent interview with him:*
https://thinkingcriticalcare.com/2020/03/28/covid-clinical-discussion-w-cameron-kyle-sidell-nyc-ed-icu-doc-in-the-trenches-foamed/

*MCM*

*Covid-19 had us all fooled, but now we might have finally found its
secret.*

libertymavenstock
<https://medium.com/@agaiziunas?source=post_page-----91182386efcb---------------------->

Apr 5
<https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb?source=post_page-----91182386efcb---------------------->
· 8 min read

https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb



In the last 3–5 days, a mountain of anecdotal evidence has come out of NYC,
Italy, Spain, etc. about COVID-19 and characteristics of patients who get
seriously ill. It’s not only piling up but now leading to a general
field-level consensus backed up by a few previously little-known studies
that we’ve had it all wrong the whole time. Well, a few had some things
eerily correct (cough Trump cough), especially with Hydroxychloroquine with
Azithromycin, but we’ll get to that in a minute.

There is no ‘pneumonia’ nor ARDS. At least not the ARDS with established
treatment protocols and procedures we’re familiar with. Ventilators are not
only the wrong solution, but high pressure intubation can actually wind up
causing more damage than without, not to mention complications from
tracheal scarring and ulcers given the duration of intubation often
required… They may still have a use in the immediate future for patients
too far to bring back with this newfound knowledge, but moving forward a
new treatment protocol needs to be established so we stop treating patients
for the wrong disease.

The past 48 hours or so have seen a huge revelation: COVID-19 causes
prolonged and progressive hypoxia (starving your body of oxygen) by binding
to the heme groups in hemoglobin in your red blood cells. People are simply
desaturating (losing o2 in their blood), and that’s what eventually leads
to organ failures that kill them, not any form of ARDS or pneumonia. All
the damage to the lungs you see in CT scans are from the release of
oxidative iron from the hemes, this overwhelms the natural defenses against
pulmonary oxidative stress and causes that nice, always-bilateral ground
glass opacity in the lungs. Patients returning for re-hospitalization days
or weeks after recovery suffering from apparent delayed post-hypoxic
leukoencephalopathy strengthen the notion COVID-19 patients are suffering
from hypoxia despite no signs of respiratory ‘tire out’ or fatigue.

Here’s the breakdown of the whole process, including some ELI5-level cliff
notes. Much has been simplified just to keep it digestible and
layman-friendly.

Your red blood cells carry oxygen from your lungs to all your organs and
the rest of your body. Red blood cells can do this thanks to hemoglobin,
which is a protein consisting of four “hemes”. Hemes have a special kind of
iron ion, which is normally quite toxic in its free form, locked away in
its center with a porphyrin acting as it’s ‘container’. In this way, the
iron ion can be ‘caged’ and carried around safely by the hemoglobin, but
used to bind to oxygen when it gets to your lungs.

When the red blood cell gets to the alveoli, or the little sacs in your
lungs where all the gas exchange happens, that special little iron ion can
flip between FE2+ and FE3+ states with electron exchange and bond to some
oxygen, then it goes off on its little merry way to deliver o2 elsewhere.

Here’s where COVID-19 comes in. Its glycoproteins bond to the heme, and in
doing so that special and toxic oxidative iron ion is “disassociated”
(released). It’s basically let out of the cage and now freely roaming
around on its own. This is bad for two reasons:

*1)* Without the iron ion, hemoglobin can no longer bind to oxygen. Once
all the hemoglobin is impaired, the red blood cell is essentially turned
into a Freightliner truck cab with no trailer and no ability to store its
cargo.. it is useless and just running around with COVID-19 virus attached
to its porphyrin. All these useless trucks running around not delivering
oxygen is what starts to lead to desaturation, or watching the patient’s
spo2 levels drop. It is INCORRECT to assume traditional ARDS and in doing
so, you’re treating the WRONG DISEASE. Think of it a lot like carbon
monoxide poisoning, in which CO is bound to the hemoglobin, making it
unable to carry oxygen. In those cases, ventilators aren’t treating the
root cause; the patient’s lungs aren’t ‘tiring out’, they’re pumping just
fine. The red blood cells just can’t carry o2, end of story. Only in this
case, unlike CO poisoning in which eventually the CO can break off, the
affected hemoglobin is permanently stripped of its ability to carry o2
because it has lost its iron ion. The body compensates for this lack of o2
carrying capacity and deliveries by having your kidneys release hormones
like erythropoietin, which tell your bone marrow factories to ramp up
production on new red blood cells with freshly made and fully functioning
hemoglobin. This is the reason you find elevated hemoglobin and decreased
blood oxygen saturation as one of the 3 primary indicators of whether the
shit is about to hit the fan for a particular patient or not.

*2)* That little iron ion, along with millions of its friends released from
other hemes, are now floating through your blood freely. As I mentioned
before, this type of iron ion is highly reactive and causes oxidative
damage. It turns out that this happens to a limited extent naturally in our
bodies and we have cleanup & defense mechanisms to keep the balance. The
lungs, in particular, have 3 primary defenses to maintain “iron
homeostasis”, 2 of which are in the alveoli, those little sacs in your
lungs we talked about earlier. The first of the two are little macrophages
that roam around and scavenge up any free radicals like this oxidative
iron. The second is a lining on the walls (called the epithelial surface)
which has a thin layer of fluid packed with high levels of antioxidant
molecules.. things like abscorbic acid (AKA Vitamin C) among others. Well,
this is usually good enough for naturally occurring rogue iron ions but
with COVID-19 running rampant your body is now basically like a progressive
state letting out all the prisoners out of the prisons… it’s just too much
iron and it begins to overwhelm your lungs’ countermeasures, and thus
begins the process of pulmonary oxidative stress. This leads to damage and
inflammation, which leads to all that nasty stuff and damage you see in CT
scans of COVID-19 patient lungs. Ever noticed how it’s always bilateral?
(both lungs at the same time) Pneumonia rarely ever does that, but COVID-19
does… EVERY. SINGLE. TIME.

— — — — — — — — — — — — -

Once your body is now running out of control, with all your oxygen trucks
running around without any freight, and tons of this toxic form of iron
floating around in your bloodstream, other defenses kick in. While your
lungs are busy with all this oxidative stress they can’t handle, and your
organs are being starved of o2 without their constant stream of deliveries
from red blood cell’s hemoglobin, and your liver is attempting to do its
best to remove the iron and store it in its ‘iron vault’. Only its getting
overwhelmed too. It’s starved for oxygen and fighting a losing battle from
all your hemoglobin letting its iron free, and starts crying out “help, I’m
taking damage!” by releasing an enzyme called alanine aminotransferase
(ALT). BOOM, there is your second of 3 primary indicators of whether the
shit is about to hit the fan for a particular patient or not.

Eventually, if the patient’s immune system doesn’t fight off the virus in
time before their blood oxygen saturation drops too low, ventilator or no
ventilator, organs start shutting down. No fuel, no work. The only way to
even try to keep them going is max oxygen, even a hyperbaric chamber if one
is available on 100% oxygen at multiple atmospheres of pressure, just to
give what’s left of their functioning hemoglobin a chance to carry enough
o2 to the organs and keep them alive. Yeah we don’t have nearly enough of
those chambers, so some fresh red blood cells with normal hemoglobin in the
form of a transfusion will have to do.

The core point being, treating patients with the iron ions stripped from
their hemoglobin (rendering it abnormally nonfunctional) with ventilator
intubation is futile, unless you’re just hoping the patient’s immune system
will work its magic in time. The root of the illness needs to be addressed.

Best case scenario? Treatment regimen early, before symptoms progress too
far. Hydroxychloroquine (more on that in a minute, I promise) with
Azithromicin has shown fantastic, albeit critics keep mentioning
‘anecdotal’ to describe the mountain, promise and I’ll explain why it does
so well next. But forget straight-up plasma with antibodies, that might
work early but if the patient is too far gone they’ll need more. They’ll
need all the blood: antibodies and red blood cells. No help in sending over
a detachment of ammunition to a soldier already unconscious and bleeding
out on the battlefield, you need to send that ammo along with some
hemoglobin-stimulant-magic so that he can wake up and fire those shots at
the enemy.
The story with Hydroxychloroquine

All that hilariously misguided and counterproductive criticism the media
piled on chloroquine (purely for political reasons) as a viable treatment
will now go down as the biggest Fake News blunder to rule them all. The
media actively engaged their activism to fight ‘bad orange man’ at the cost
of thousands of lives. Shame on them.

How does chloroquine work? Same way as it does for malaria. You see,
malaria is this little parasite that enters the red blood cells and starts
eating hemoglobin as its food source. The reason chloroquine works for
malaria is the same reason it works for COVID-19 — while not fully
understood, it is suspected to bind to DNA and interfere with the ability
to work magic on hemoglobin. The same mechanism that stops malaria from
getting its hands on hemoglobin and gobbling it up seems to do the same to
COVID-19 (essentially little snippets of DNA in an envelope) from binding
to it. On top of that, Hydroxychloroquine (an advanced descendant of
regular old chloroquine) lowers the pH which can interfere with the
replication of the virus. Again, while the full details are not known, the
entire premise of this potentially ‘game changing’ treatment is to prevent
hemoglobin from being interfered with, whether due to malaria or COVID-19.

No longer can the media and armchair pseudo-physicians sit in their little
ivory towers, proclaiming “DUR so stoopid, malaria is bacteria, COVID-19 is
virus, anti-bacteria drug no work on virus!”. They never got the memo that
a drug doesn’t need to directly act on the pathogen to be effective.
Sometimes it’s enough just to stop it from doing what it does to
hemoglobin, regardless of the means it uses to do so.

Anyway, enough of the rant. What’s the end result here? First, the
ventilator emergency needs to be re-examined. If you’re putting a patient
on a ventilator because they’re going into a coma and need mechanical
breathing to stay alive, okay we get it. Give ’em time for their immune
systems to pull through. But if they’re conscious, alert, compliant — keep
them on O2. Max it if you have to. If you HAVE to inevitably ventilate, do
it at low pressure but max O2. Don’t tear up their lungs with max PEEP,
you’re doing more harm to the patient because you’re treating the wrong
disease.

Ideally, some form of treatment needs to happen to:

   1. Inhibit viral growth and replication. Here plays CHQ+ZPAK+ZINC or
   other retroviral therapies being studies. Less virus, less hemoglobin
   losing its iron, less severity and damage.
   2. Therapies used for anyone with abnormal hemoglobin or malfunctioning
   red blood cells. Blood transfusions. Whatever, I don’t know the full
   breadth and scope because I’m not a physician. But think along those lines,
   and treat the real disease. If you’re thinking about giving them plasma
   with antibodies, maybe if they’re already in bad shape think again and give
   them BLOOD with antibodies, or at least blood followed by plasma with
   antibodies.
   3. Now that we know more about how this virus works and affects our
   bodies, a whole range of options should open up.
   4. Don’t trust China. China is ASSHOE. (disclaimer: not talking about
   the people, just talking about the regime). They covered this up and have
   caused all kinds of death and carnage, both literal and economic. The
   ripples of this pandemic will be felt for decades.

Fini.

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