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74
Game over
Thing is it was originaly thought to be a respiratory disease, but it was actually a vascular disease. The cells infected were not confined to the respiratory tracts. Sars-Cov-2 had/has the potential to infect any cell bearing ACE2 Receptors, which, it turns out, are pretty much ubiquitous. The Angiotensin system, it turns out, was not that well understood, in its function beyond blood pressure control. The etiology is still emerging; the AHA for instance has concluded that COVID-19 is a vascular and neurologic infection. I said to taskforce colleagues back in February 2020 that this is a disease which will take a generation to understand, which is pretty par for the course for any emerging infectious disease agent. The difference is, previous EIDs took repeated infection events to really understood, whereas COVID-19 has amassed a literal unprecedented amount of data, which will take a generation to understand. You only havr to take a look at something such as Pubmed to understand the attention Sars-Cov-2 drew in just 2-3 years, compared to 80 years of influenza and 40 years of HIV. But even comparing Influenza to HIV tells you a lot. The flu was first recognised ~2000 years ago, I think in Greece. The causative virus wasn't discovered until 1933. Fears of another Spanish Flu (considered even then one of the side effects of the end of WW1) spurred Australian researchers to get a functioning vaccine ready by 1945. Strain identification was possible by 1957, allowing strain-specific vaccine production, but always too late to anticipate the coming season. By the 80s, multi-target effective vaccines were available. Literally just before COVID-19, there was success in developing tests to identify risk biomarkers in individuals that put them at risk of the flu virus killing them. For most people, a proper dose of the flu (which most of us rarely experience), is a fairly debilitating illness, but recoverable. For some, its a killer. Its not simply if you are old, fat, a smoker, a drinker that puts you at high risk. Its all those factors and more, and many of those factors are resulting from expression of some biomarkers that put some of us, more at risk from illness than others, leading to a changing risk profile as you age. Eg, someone could smoke 40 a day until a 100, and get by with a slice of orange in the beer for the vitamins. Many others can't. One of the early victims to COVID-19 I recall was a 95 year old gent who was recovering from lung cancer, down to one lung. He spent 2 days in hospital, an outlier. 80+ years of intense flu research has lead to vaccines that mostly work, and has lead to personalised medicine that can prevent death. 40 years of HIV research has changed a terminal disease into a chronic disease. 4 years of COVID-19 research has uncovered profound levels of knowledge about a virus type. There has been 100+ research to cure the common cold, caused by other coronavirus variants, without a shred of advancement. The scientific endeavour that has lead to ignoramuses pronounce COVID-19 nothing to worry about, was simply amazing. I was part of that, and? proud of my colleagues, despite the stick we took. Sars-Cov-2 might recede into the background, but we are going to know a damn lot more about infection, about strokes, about vascular disease, about dementia etc as a result. The Polio pandemics of the 1920s resulted in a whole new area of medicine. You probably didn't know Intensive Care Medicine only occurred because of Polio. Bfore that, you had dying rooms. Now you can go to hospital with a sudden impactful illness, and people are going to help make you survive. The Danes came up with the concept. This intense desire to save mostly middle class older children lead to the iron lung. Can you actually imagine that? Kids in their early teens, being suddenly struck down by an infection that caused them to choke to death. Can you imagine the sheer genius of the doctor who explained to the engineer how lungs work, and the lateral thinking, at pace, to develop a machine to keep children alive. This brought time, this allowed ventilators to be designed, and ventilators to be engineered. Ventilators have served us well, saving millions of people. Roll on to 2020, when people thought COVID-19 was a respiratory disease, a disease causing Acute Respiratory Disease Syndrome, or ARDS. People with ARDS are put on ventilators. ARDS leads to loss of elasticity of the lungs; your lungs can no longer expand, you can't breath. Lung scarification results. You die. Ventilators can help. Ventilators can also cause scarring, so they can just extend your life, because eventually you might need a lung transplant. COVID-19 was different. The lungs remained elastic, but the lungs were filled with cell debris. This was the unusual "shards of ice" features seen on lung CTs. This lead to a medical technological bit of genius, like the iron lung, which I think saved millions. A CPAP is a breathing device, often used by people with sleep apnea. It allows oxygen to be delivered to the lungs, unlike a ventilator with really is about a machine helping your lungs work better. But you can't use a CPAP on a COVID-19 patient, because they are going to exhale virus laden breath. University College literally dragged up an old CPAP device from the basement; it was no longer in production. They went to F1 Mercedes over at Brackley. F1 engineers are superb; they are very used to diagnosing engineering problems very quickly, and coming up with high quality solutions very quickly (Mclaren also got involved elsewhere during COVID-19). UCL wanted Mercedes to basiically reverse engineer this old Philips device, and make it suitable for a patient infected with a fairly poorly characterised biological threat agent. At speed, Mercedes, working with the doctors, came up with something that was mass produced cheaply. Ironically, the UK government, like many others, thought it was the military who could sort this out. The UK ventilator challenge was managed by Babcock, who are behind many MOD challenges, loads of companies engaged, genius designs came out, but they did not talk to the doctors. The military spec ventilators that were offered, none of the doctors wanted them, because no doctor had been involved in the design, and how the hell do they know they were safe. What they wanted was lots more of what they were already using, not some novelty that Dyson or whoever scribbled on a bit of paper (Ford came closest, applying mass production principles to some Philips devices). So the Pandemic changed how intensive care is delivered, its improved the outcomes of intensive care. If you go into intensive care now, your chances of coming out have improved. -
9
Kamala Harris Expresses Openness to Exploring Reparations for Slavery
what are you on about ? it's everything. people will want to know where the money will come from. exactly where. we are not talking about a few dollars here tug. -
29
Trump Is Finished: Rogan Just Roasted Him
It's a prediction, which means it's a guess. HRC thought she won before she found out she lost. -
28
Thai police shut down 21 villas on Koh Samui, foreigners evicted
Good job the netizens are not up in arms because the scenery has been built over illegally, lucky the workers were not seen peeing on the shrubbery -
1
Whoscares? Scam alert app is here to call out the cons in Thailand
Put it down to education... use you common sense not another App -
29
Trump Is Finished: Rogan Just Roasted Him
and he could have just not posted something so silly. -
2
Thailand banks could be forced to share hacking costs
If a singular bank is responsible then it lays with them for compensation. -
109
Today I met the first farang returning home because of exchange rate
The Pound would have gained against USD as a result of the Fed rate cuts so it's difficult to see if anything budget related is already built in. https://www.xe.com/currencycharts/?from=USD&to=GBP -
9
Thailand Ex-Deputy PM Faces New Money Laundering Allegations
Unusual wealth would be a good start. -
9
Thailand Ex-Deputy PM Faces New Money Laundering Allegations
So he has nothing but allegations... best go find a good lawyer Prawit will be after you with the big guns. -
3
Land office - quick or drags on
If you have an appointment, your agent or someone probably already contacted the land department. That's good news. It should be finished at 4pm. Otherwise, it can sometimes take the full day. -
617
BREAKING NEWS Second Assassination Attempt-Secret Service get Trump to safety
I wouldn’t shed any tears nor would I rejoice I’d certainly feel a great sense of relief that my country escaped further harm by this man….and what’s with the bot innuendo?I assure you I’m just a regular American dude with a successful long term marriage to my Thai wife I’ve had suspicions of you being a bot though -
109
Today I met the first farang returning home because of exchange rate
But i think most of the bad news we know already, CGT, Inheritance tax etc. I would have thought the markets would have priced that in already.- 1
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1
NBTC Approves Cell Broadcast System for Disaster Alerts
Good... hopefully many will benefit from storm warnings and flash floods. -
26
Police/immigration asking Condo jurisdiction for TM 30
I live between my Bangkok home and my Pattaya condo. After getting a marriage visa in Bangkok for 10 years I decided to use my condo address in Pattaya and get a retirement visa by an agent. If I'm in Bangkok when my 90 days in due I try to do my 90 days report online. Many times it doesn't work, so I drive to Pattaya and let the agent do the report for me. Which raises another point, how can an agent do your 90 days report. It's supposed to be so that the Immigration are aware of where your living. I've lived in Thailand for 24 years and I soon discovered to just play the Immigration game and you'll never have any problems.
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