Necessity is the mother of invention. My heart goes to all those in our community and those around the world that have loss and suffering to the virus and also to our amazing frontline medical caregivers as well the many workers providing essential goods and services making great sacrifice to save lives. This virus is a war on all of us. And in war we must arise to the occasion. In peacetime you can operate a system in a certain mode but in wartime you must innovate and adapt to overcome your enemy. Leading up to world war 2 The French were prepared to fight a long drawn out trench war with Germany as they had in world war 1. But the Germans didn’t want to fight that war and came up with a new strategy utilizing the so called blitzkreig with great success.
Now is the time for us to innovate. Now is the time to experiment and trial against a new enemy as you know the outcomes if you do not potentially a long drawn out trench war with great casualties overwhelming our medical,system. We have amazing and brilliant doctors around the country and the world that need to be allowed to engage the virus enemy with a multi pronged therapeutic approach to determine expeditiously the best possible medical outcomes. In this battle we need to let the doctors at the level of care innovate and practice their art while minimizing as best possible the hinderance that has become our medical system.
In war there is short term and medium term tactical battles (goals) and then there are the longer term strategic battle (goals) that must be achieved for the war to be won. We need to isolate and slow the spread of the virus flattening the curve giving time and also greatly increasing our testing . Our short term goal is to use currently available approved drugs and treatments that reduce the severity of the virus and respiratory distress syndrome shortening hospital stay time improving the overall outcomes. There are many possible drugs to choose from. I think that we will likely need to come up with a multi drug treatment to treat this virus or symptoms as is the case of HIV treatment (Kaletra) utilizing two drugs to effectively eliminate the hiv virus. Reports from France using chloroquine and azithromycin reporting better outcome against the virus.( this is anecdotal needing more evidence and mixing these two drugs may have cardiac risk) The medium term goal should involve developing a prophylactic treatment possibly involving the convalescent plasma particularly for those at highest risk and medical caregivers. The long term goal is creating a safe effective vaccine that will eliminate the threat of this virus as we have done with smallpox and polio.
The virus enters into the cell via the ace 2 recpt. This is an important receptor and the mechanism for the virus pathology is likely due to some effects related to this angiotensin and the ace 2 receptor system. See attached video. These effects on the angiotensin system make it quite possibly a good place to attack the virus and also a good place to possibly treat the resulting respiratory distress syndrome.
V is for victory over the virus.