Things a rural doctor has in his iPhone during Alberta’s COVID-19 pandemic

Doctors were early adopters of Palm Pilots. My in-laws gave me one as a graduation president from medical school more than twenty years ago.

The ability to carry large texts around in your pocket was revolutionary–it saved many medical students from carrying the telegraphic handbooks with which my lab coats were always too stuffed. (Hard on the shoulders! Plus they tend to spill everything out of your stupid little short medical student coat, which makes you look even dumber than you actually feel, which is saying something.)

We’ve come a long way since then. Like most people, I now carry a supercomputer everywhere in my pocket. Sometimes I use it to watch funny videos.

But, I also use it as an “auxiliary brain” for medicine. It’s particularly useful for stuff that I will rarely use, but if I need it, I need it right now.

One of those things wasn’t in my iPhone until the COVID-19 pandemic. But it is now.

It’s an article that appeared in the Canadian Medical Association Journal. It begins like this: “All physicians should be prepared to manage dyspnea, especially during the coronavirus pandemic.”

What’s dyspnea?

It’s feeling short of breath–of being starved for oxygen, like you’re smothering or drowning. It is a terrible way to die. Even with all the oxygen we can blow at you, it isn’t enough. Each breath is torture.

Usually, my patients with dyspnea get quickly transferred to Lethbridge for an ICU. I might intubate them (sedate them and put a tube into their breathing passage) to help.

Right now, that’s what my patients with COVID get. (All of them that I have had to transfer to Lethbridge thus far have been unvaccinated.)

If the health care system becomes overwhelmed, and if we have to triage care (as described here), then that won’t happen. I even wonder if I might be sent patients from Lethbridge for whom there is no space in the ICU. The Lethbridge docs might decide that I can at least “palliate,” and so unclog their hospital slightly.

They help me so often with my patients, it would be nice in a way to return the favour.

What’s palliate?

To “palliate” means to treat symptoms for comfort until the patient dies. It is “keeping you comfortable.”

We can treat dyspnea.

We’ll give you things like morphine or fentanyl, and maybe drugs like Valium or Ativan if needed. Don’t worry, I don’t even need to look up the doses in my iPhone.

If things get bad enough, we’d put you into a medical coma. Not to save you–it won’t–but to spare you suffering. You’ll be unconscious as you drown to death.

Medical coma doses–those I would have to look up. But I’ve got my supercomputer to help. Won’t take long.

We won’t let you suffer. Your family might suffer–it’s hard to watch someone die of dyspnea. But, if you’re dying of COVID and the health care system is in the kind of crisis where a rural family doc is your top care provider, your family probably won’t be allowed at the bedside anyway. So they won’t have to hear you suffer, except as you say good-bye via Facetime before we sedate you.

I’m not trying to be dramatic. I hope it doesn’t come to this.

But this is the outcome we in health care have feared all along, and what we’ve tried so hard to prevent. And right now it is hard to see how this won’t happen to someone in Alberta in the next few weeks, maybe many someones.

Last thoughts

If it does come to this, the last thing you see will probably be the nurses’ and my gowned and masked faces (plus goggles or face shield and sweaty gloves). We drilled how to get in and out of all the gear safely at the beginning of the pandemic, since we knew we’d have to look after people while being vulnerable ourselves.

A nurse’s gloved hand will probably hold yours as we administer the meds. You won’t have to ask, and I won’t have to order it–it’s just what they do.

When I’ve done my part and moved on to the next patient, the nurses will watch you closely to make sure you don’t come out of sedation and suffer some more. I won’t have to order that either.

But, after you’re asleep and comfortable, we’ll probably think of all the people who told us COVID was a hoax, that vaccines don’t work, and masking was too inconvenient.

I might even think about all the people who’ve screamed at my clinic staff or the nurses I work with when asked screening questions. I hope not. Such people don’t bear thinking about.

We’ll be wearing masks. And yeah, they aren’t as comfortable as we’d like.

But we’ll be far more uncomfortable about everything else that’s going on. So we probably won’t notice the masks much.

You, at least, will be comfortable. We promise.


Most important 6 minutes you can see today on COVID-19

There was a recent interview on CBC with Dr. James Talbott.

He was the Chief Medical Officer of Health for the Government of Alberta from 2012 to 2015.

He is currently Co-chair of the Edmonton Zone’s Strategic COVID-19 Pandemic Committee.

His past jobs include:

  • Director, Prov Lab of Public Health for N. AB, Chair;
  • National Foodborne, Waterborne & Enteric Disease Committee;
  • Medical Officer of Health for Edmonton, Alberta Health Services
  • Chief Medical Officer of Health for Nunavut;
  • Founding member SIREVA and ARTSSN surveillance networks.

Given that he works for a University and his committee is a medical one–not a government one–he is free from political pressure.

If you’d like to see the “triage” document he refers to, here it is.

I have been asked if the triage means that those who are unvaccinated would go “to the back of the line.” Decisions are not made based on foolish decisions by the patient. Decisions are based on who has the best chance of survival and quality of life. Being unvaccinated lowers the risk of survival despite intensive care, so that would be factored into the decision.

There is more detail here, and a FAQ here.

The fact that I am reviewing it and that it is being circulated among physicians tells you where we are at.

Get vaccinated. Wear masks. Be smart.

You’re not just “choosing for yourself.” You’re choosing for all of us.

Those holding back are also choosing for me to potentially make choices I should never have to make.

How did things get so bad?

How did Alberta’s COVID situation become so bad?

Easily — by utterly ignoring what we know about this virus, wishful thinking for political reasons, and cherry-picking what they would believe.

In June, the province did what no other jurisdiction in the western world had done–they declared the pandemic “over” and told us we could just treat it as “endemic” (i.e., a disease that is always present at low but not dangerous levels in the population–colds are “endemic,” for example).

Why did they do this?

Jason Kenney seemed determined to have the Calgary Stampede go on, and to remove the unpopular public health restrictions. (If you think the fact that his plan allowed for everything to go back to “normal” on the precise dates needed for the Stampede to happen just by happy coincidence, I have beach front property in Calgary to sell you).

But didn’t they do modelling?

Yes. Sort of. Not really. Let me explain.

Models are mathematical simulations about possible outcomes in diseases. They obviously have limitations, but they can be useful tools.

A model is only as good as its assumptions. To make a model, you’re trying to simplify reality. So, you try to focus on the things that matter, and ignore the things that don’t. All models will ignore something.

Doctors have been demanding that the province release the models and data they used ever since the announcement. The province dragged its feet on this. (If that doesn’t make you suspicious, I will add a beautiful condo on the beach-front property I’ve already sold you).

They finally released the model. We can now look at what assumptions were made. This is from a Twitter feed that highlights some assumptions made by the model:

What are the problems?

When you make a model, you should not assume things that you know to be false.

Here’s some assumptions, and why they are clearly false.

  • Assumes “homogeneity” of vaccines — this means that it assumes that all areas of the province that interact have the same rate of vaccination. But we know this is false. Edmonton, for example, has about 85%. County of Warner, where I live, still has less than 50% of the population. FALSE, and known to be false from the beginning.
  • Case detection stays the same — government announced that they would stop contact tracing and testing in the same way. FALSE, and known to be false.
  • Assumes infected patients will not infect anyone else — this assumes that everyone who tests positive will self-isolate, and thus not infect people further. C’mon, this is idiotic. If you aren’t testing, people may not know if they are infectious. The province cancelled the requirement to quarantine even if you KNEW you were positive. FALSE, and government took active steps to MAKE it more likely to be false
  • Assumed no waning in protection from vaccinations — we’re still in early days, and this may not be a a reasonable assumption in all cases. Not necessarily false, but a dangerous assumption when combined with the other issues.

Finally, the model did not include the possibility of major gatherings without public health measures. What kind of gatherings? Oh, you know, things like 1st of July celebrations and the Calgary Stampede (which was 500,000 people this year).

Alberta used the UK as a model for how things would “improve” if they opened. Why the UK? Well, because they were the only country in western Europe which had the results that Kenney’s government wanted. It was an out-lier. (And it now isn’t doing very well again.)

So, they cherry-picked the one example from Europe that supported what they wanted to do, ignored all the others, and then patted themselves on the back for a job well-done. (As another modelling group–cited below–noted, “Alberta has not seen this trend, and neither has the United States.” So, the North American experience was not the same, and there were good reasons for this–levels of testing–that made it foolish to act as if the UK would apply to Alberta. And, this was known immediately, not after-the-fact.)

So, big surprise, given that almost all of these assumptions were clearly false, the model didn’t work so great.

Didn’t anyone realize this was a a problem?

Of course they did. Most medical groups in the country were screaming about it (here’s the Alberta Medical Association; here’s the Alberta Pediatrics section). We had other people doing models without these crazy assumptions, and they did not encourage happy warm thoughts.

British Columbia has a modelling group for COVID-19. Unlike in Alberta, that modelling group is independent–they are scientists who do the modelling who don’t answer to the premier. It’s amazing how not fearing for your job can make you be more honest. (If you don’t believe this, I will throw in a Porsche for sale when you act now on my beach property offer.)

You can see their modelling work here. It is eerily accurate. They explained precisely why Alberta’s modelling was wrong, and why it would go wrong. And they were right.

They also used multiple models, and came up with the same answers. That tells you you’re on to something.

The BC group wrote:

It is important to remember, as noted above, that these figures are projections in a scenario with no change in policy or behaviours. The projected peak in hospital occupancy is several times higher than previous peaks, and those led to substantial changes in both individual behaviour and public health policy. We do not expect to observe these projected incidence or hospital volumes, because we think policy would change to protect hospital capacity, and individuals will change their behaviour in response to such high case numbers. What is clear from these analyses is that there are substantial evidence-based reasons to believe that greater utilization of non-pharmaceutical interventions – such as social distancing, masking and air filtration will be required to protect the Alberta health care system, and the health of Albertans, while vaccination coverage is expanded

Thus far, they are wrong in one thing–a substantial worsening has not resulted in the Alberta government deciding that “policy would change to protect hospital capacity.” Apparently even they can’t factor in Jason Kenney, Tyler Shandro’s, and the United Conservative Party’s utter stupidity.

Ah well. No model is perfect.

But, their advice is still valid: “greater utilization of …. social distancing, masking and air filtration will be required.”

Required, maybe. But whether it will be done remains to be seen.

So, how did government respond?

In a word? With mockery. Doctors and scientists (along with the media reporting their concerns) were accused of stirring up fear, and of refusing to admit the pandemic was over.

Here’s Premier Kenney:

And here’s Matt Wolf, who is paid $194,253 per year of taxpayer money to be Kenney’s “issue manager.” His job seems to be mainly mocking Kenney’s enemies on Twitter:

But, since they’ve seen the error of their ways, I’m sure Kenney, Wolf, Shandro, and the rest will admit their mistake, apologize to those they attacked, and take steps to correct their errors, right?

Right . . . . ?

Yes, I’m sure they will.

I’ll show you a video of them doing so as soon as you sign for the deal on that beachfront property I’m selling.

With luck, it comes with towel-boy Matt Wolf, and his salary will go to paying for a few more nurses’ shifts.

ICU status in Alberta – worse than you think

The condition of Alberta ICUs is dire. We are currently at around 140% — that is, we have 140 people for every 100 beds usually available. This has certainly never happened in my memory of the last 20 years.

Government makes this look better than it is by talking about “surge” capacity. These are supposedly “extra” ICU beds.

Here’s the graph

The blue line is number of patients who need ICU care. Red line is typical ICU numbers.

The extra “ICU surge” is in yellow. As of the evening of 13 September, we had 202 people (above the “record 186 COVID-19” line).

For those telling you that “this is no worse than the flu,” you can also see the grey line at the very bottom, which shows the worse flu season levels ever.

The “extra” beds

What you need to realize is that the “extra beds” aren’t quite the same as regular beds. Normally ICUs have one ICU nurse per patient. There are reports from health care workers of:

  • 4 patients being cared for by 1 ICU nurse, assisted by nurses “recruited” from other areas, such as administration and public health
  • patients being “doubled bunked” — two beds in one room looked after by 1 ICU nurse
  • And so forth.

Duh, just open more beds!

People and government talk rather casually about “expanding ICU beds” and “opening more beds.”

This is naive. Beds and equipment are important but they are not much use without staff. We need ICU nurses (and physicians). ICU nurses are retiring or transferring elsewhere due to burn-out and the government’s on-going disrespect. Anyone who wants to be working ICU nursing is already doing it. There is not some untapped pool of nurses waiting to do this job.

AHS is compelling nurses who have never worked in the ICU to work there. I’m sure they’ll do their best, and they deserve credit for “stepping up”–but they don’t deserve to be put in that situation, and from what I’ve seen I think those nurses would be the first to admit that the level of care isn’t going to be what it should be.

It ain’t over yet

Even if we could stop all infections right now from spreading, the next few weeks are locked in stone. They are already rolling, and we can’t change that. It will get worse before it gets better.

Many are warning about a health system failure. I’m afraid that is not an unlikely possibility.

Health care workers will continue to do their best. But the public needs to help us. And we can only do so much with limited resources. Eventually the need may be too great.

The longer government waits, either (a) the higher the cost in disability, illness, and death; or (b) the more severe measures we’ll have to take–e.g., I really don’t want to see the economy or schools shuttered again; or (c) both of the above.

Who cares? I’m young and won’t need an ICU even if I catch COVID

Let’s hope not. But if you’re in a car accident, and you need an ICU, you may be in dire trouble if the ICU beds are all full of COVID patients.

Wishful thinking is not–despite what Premier Jason Kenney seems to think–a good public health strategy.

What to do?

Call your MLA. Demand that provincial leadership act and that they hold daily briefings to keep the public informed and to allow the press to question them and hold them to account. (It’s no surprise that Kenney, Health Minister Tyler Shandro, and Medical Officer of Health Deena Hinshaw have been conspicuous in their absence in front of the press for the last 6 weeks.)

Get vaccinated. Mask and encourage the schools to require masking.

We know what works. But we need to be united in doing it.

Current state of health system in Alberta

The government of Alberta and Alberta Health Services are not being forthright with Albertans.

The current state of the health care system is very serious, verging on catastrophic.

This is a letter sent yesterday by the Edmonton Zone Medical Staff Association to the premier and company.

ICU is actually above levels of any previous point in the pandemic at this point.

Remember that anything we started doing now won’t be felt in the system for at least 3-4 weeks, since what is happening now will take time to work its way through the system.

What can you do?

  1. Vaccinate — Alberta has the lowest vaccine rate in Canada (neck and neck with Saskatchewan). Our local County of Warner has less than 50% of the population vaccinated. At present, all the COVID patients in the Lethbridge ICU are unvaccinated.
  2. Wear a mask.
  3. Urge school board to implement in-class masking in schools if not already in place. This is especially important for those under age 12 who can not yet be vaccinated.
  4. Contact your MLA and demand that they take action, and that they tell Albertans the truth.

This isn’t going to just affect people that aren’t vaccinated. “Elective” surgeries are cancelled. That doesn’t just mean “surgeries that would be nice to do.” It means “surgeries that if you don’t have right now, you’re not going to immediately die.”

This includes things like biopsies for cancer, cancer debulking surgeries, etc.

What does “failure” of the system mean? It means that at some point, people who need care to preserve life or limb won’t be able to get it at the level they should have it. We will have to start deciding who gets treated, and who doesn’t.

And if things get really desperate, you might have a family doctor running your intensive care . . . .

COVID-19 Vaccine Questions

In my medical clinic, several people have asked me about the COVID-19 vaccine. I appreciate their trust in helping them make health decisions.

One concern that has been raised is the speed at which the vaccine was developed. Does this mean corners have been cut? Is it enough time to know that the vaccine is safe? These are good questions.

I think we can have high confidence that it is safe. Here are a few points to consider when you think about the speed at which the vaccines were developed.

We didn’t start from scratch

With typical vaccine development, you’d probably need an average of 4 years to go from beginning to human testing. COVID-19 was done within about 9 months.

It’s important to realize that the 9 months wasn’t the start date. We owe a lot to people who have toiled for years or decades to have this technology ready when we needed it.

SARS–A Dry Run?

Some of us may remember SARS (Severe Acute Respiratory Syndrome) virus. This outbreak of a new coronavirus started in February 2003.

It was a lot like COVID-19 turned out to be. In fact, the official name for the COVID virus is SARS-CoV-2 (SARS Coronavirus #2). It shares about 80% of its genetic code with COVID-19.

Happily, a great deal of work had been done on a SARS vaccine (though fortunately SARS was less contagious than COVID, and so was controlled with local lock-downs and public health measures like contact tracing).

A lot of the nations that got hit hard by SARS did much better this time around–they had put public health measures in place to respond if something similar happened. In retrospect, it’s probably a good thing we had SARS to prepare us for COVID (even though many nations, including the US and Canada, did not learn the lessons they should have).

mRNA vaccine platform is not new

You can think of the mRNA vaccine approach as a “gun”–and the gun has been worked on for almost two decades. This is the first human vaccine built with it, but there’s been a lot of work on other viruses, and a lot of animal testing.

Part of the goal with the mRNA approach was to build a “gun” that you could use every time. You would then only have to craft “a bullet” (the mRNA of the specific virus you were after) in the event of an outbreak. So, as soon as the Chinese scientists published the RNA sequence of COVID-19, within hours work on the mRNA could begin.

This means that a great deal of safety work has already been done on the “gun”–it’s had far more than 9 months of use, refinement, and testing.

mRNA vaccines are faster to make

One of the appealing things about mRNA vaccines is that you can make them faster. One goal was to have the gun ready, and then store the genetic code of various possible infections. If there was an outbreak, you could just turn it on and go.

Vaccines up until now have used biologic synthesis. That means that making whatever it was you put in the vaccine involved growing things in a lab. You needed to culture a weakened organism (like the Salk polio vaccine).

Or, like the flu vaccine, you’d have to grow the proteins you were going to use in tissue culture. This takes time, and then you have to extract and purify the protein for use.

This is not quick (which explains why with the flu vaccine, we have traditionally had to simply “guess” what strain is likely to circulate, and then start making the vaccine ahead of time. Sometimes they guess right, and sometimes not so well–which explains how the flu vaccine varies in its effectiveness.)

But, mRNA vaccines aren’t like this–aside from the pre-built gun, you just have to make a string of mRNA. That can be done with chemical synthesisno living organisms, no growing in cell culture, just industrial chemistry. Put stuff in a vat or test tube, and let ‘er rip. And that is something that industry is very good at, and fairly quick.

In short, comparing mRNA vaccine turn-around times to other vaccines just isn’t fair–its two completely different processes and time frames. Which is a good thing!

Targeting the spike protein

One trick with viruses–especially RNA viruses–is that they mutate. Everyone knows how the flu changes every year. So for a vaccine to work, you need a “steady target” that doesn’t change from year to year. We’re lucky with COVID in that it has a “spike protein”–this is the protein that fits like a key into a lock. In this case, the lock is the ACE2 receptor, which is how the virus gets into your cells.

There can be mutations in that protein (and there have been–the three new strains from US, UK, and Brazil that are more infectious all have mutations in their spike protein). But–and this is very important–the shape of the protein can’t change too much, because it still has to fit like a key in the lock.

You might be able to file off a key a bit to get a better fit in the lock. That’s like the new mutations. But you can’t shave of large bits of the key and still work the lock.

The vaccine targets the spike protein because it is a relatively stable shape. It can mutate, but large mutations in shape will almost certainly die out quickly because they can’t get into cells to reproduce. In evolutionary terms, they are selected against. So that single target doesn’t change enough to make the vaccine not work.

A single protein is less likely to cause a reaction

Targeting the spike protein has other advantages. It is a single target for your immune system. In the old days, the killed pertussis vaccine used to have at least 3,000 proteins on it (see my article here, especially the end bit, for more on this). That’s still a drop in the bucket compared to what your immune system handles in a day, but it gives more chance for a “cross reaction” to happen between a protein on the bacteria, and a protein on a human cell.

If you look at all the vaccines given to children in the US as of 2013, there are only 315 protein exposures (“epitopes,” in technical language). That’s incredibly low.

But the mRNA vaccine for COVID is even better. It’s one. So there’s an even lower risk of a reaction to it.

How about how long we’ve watched for problems?

The clinical trials for COVID-19 were not terribly long–less than a year. How can we know that there won’t be longer-term problems?

One can never be certain about such things. But, remember, the “gun” isn’t new. And that gun with a variety of bullets has been used in a lot of animal studies. And experience has shown that any reactions or problems are likely to be seen in the first few months.

We could wait years to be certain–but that means COVID kills more people and causes way more financial damage to the economy. That’s a very high price to pay for something we have no evidence happens, and considerable evidence that it doesn’t.

What about drug company bias?

Maybe the drug companies are going to be over-optimistic?

I don’t worry about this–the Pfizer study, for example, had over 40,000 people. That’s huge. And the study was blinded–neither the patients nor Pfizer knew who was getting the vaccine and who got the placebo.

Pfizer never had access to that data. There was an independent panel who decided when to release the data. So Pfizer couldn’t cook it even if they wanted to.

That independent committee is, if anything, going to be biased against releasing something prematurely. They don’t want the professional or personal costs of being “the guys who let the bad vaccine get through.” So they will tend, if only out of self-interest, to be conservative.

That gives me considerable reassurance, because even the worse aspects of human nature (e.g., seeing what you want to see, lying) will act as a check and balance on releasing a bad vaccine. (It’s sort of like the US Constitution in that sense–balancing potential bad behaviour by another group with separate interests.)

Really, it’s the best way to do this kind of science.

And besides, there’s no way Pfizer will make enough from the vaccine for it to run the risk of releasing something that doesn’t work or causes bad problems. They don’t want their name to be mud.

Two vaccines

Thus far, we have two mRNA vaccines–Moderna and Pfizer. They were developed separately.

And yet both got results within about 1% of each other: 94-95% protection.

That’s a nice bit of reassurance–there wasn’t something weird or fluky about the data. Nobody is likely to have cooked it. You have two different groups, using a similar but not identical approach. And they score within 1% of each other.

That suggests to me that this is a real effect–you can trust it when you have independent confirmation like that.

Investment helps

Contrary to popular belief, vaccines are not a huge money-maker for drug companies. Relatively speaking, fairly little money up until now was invested in this kind of tech. It’s been more basic research.

A pandemic, however, is a good way to convince private companies, individuals, and governments to open up their wallets. More money invested can gain you speed, which is what happened here. (There’s an old engineering joke: it can be fast, cheap, or good–pick two. In this case, we’ve picked good and fast, at the price of cheap.)


As should be obvious, I’m quite confident in the vaccine. I’ve been fortunate to get my first dose (Moderna, because that was all they had) already. I had a sore arm about 24 hours later, but otherwise, nothing.

So, I have put my money where my mouth is.

Nothing in medicine is ever 100% risk free. But that’s true of doing nothing as well.

Doing nothing has risks. It has upsides, and downsides. I think the benefits to me and society of getting control of the pandemic with a well-tested system (in animals and now humans) are far bigger than the small risk I run of a problem. If we do nothing, we’ll have more death and more financial catastrophe for many people. I don’t want to contribute to that, even though I myself am at very low risk of death were I to catch COVID-19.

In medicine, we call that “a no-brainer.”

Personal postscript

Most who read this know that I’m a religious person as well as someone who works in medicine. I’m very grateful for the rapid progress that was made on this front. Many things were in place that allowed us to make great progress faster than we maybe had a right to. As a society, we have been foolish in ignoring warnings about risks for pandemics, and our elected representatives and the attendant bureaucracies have not covered themselves in glory.

So, I see the vaccine as very much a “godsend.” It is, I am convinced, an answer to many prayers. I hope we’re grateful, and I hope we’ll use it properly and well. It would be a shame if the speed at which we got there ironically made us less grateful, more suspicious, and less willing to use the wonderful tool that has dropped in our laps. (Though the work of many for decades was needed to have it “so quickly”! God is much better at preparing ahead of time than we are.)

And hopefully we’ll be more ready next time–because you can bet there will be a next time. I suspect this isn’t the last time we’ll be profoundly grateful for this type of vaccine tech that can be deployed so rapidly. That’s the part that excites me the most, even more than an end to COVID.

How effective a COVID-19 vaccine do we need?

In medicine, as in life, nothing is perfect.

This is true of vaccines. No vaccine is 100% effective. Yet, vaccines have produced massive declines in many serious illnesses, and succeeded in eradicating two such illnesses (smallpox in humans and rinderpest in cattle).

Herd immunity

Since COVID-19 has come along, everyone is talking about herd immunity. This is a straightforward idea. Let’s say I’ve never had smallpox. I’ve never been vaccinated against it. But, if you put me in a group of people who are immune to smallpox, I’ll never catch smallpox. Why? Because they can’t catch it to spread it to me.

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Hydroxychloroquine and why it doesn’t help COVID-19 in humans

New study may well explain why hydroxychloroquine doesn’t work in humans.

Unlike the tissue cultures, human lung cells don’t have the proper enzymes, so virus enters by different receptors that hydroxychloroquine can’t affect.

Remember, the 2005 study that everyone claims is a conspiracy was done in Vero E6 cells. These are green monkey KIDNEY cells, not lungs.