So , ‘Dr. ‘ Trudeau , Are We To Believe You Or The Science ?

Oh, Oh remember when it was all about the science ——from Newfoundland and Labrador to British Columbia to Nunavut!!!

FOLLOW THE SCIENCE!!!

What has happened to that now?

Trudeau and Dr. Tam , all vaccines are safe .

Science saying , vaccines are safe but some conditions for some vaccines .

Big difference !!!

Here we have a group of scientists doing a 120 page Report  advising the Government . 

People should remember who these people are and their mandate :

‘The National Advisory Committee on Immunization (NACI) is an External Advisory Body that provides the Public Health Agency of Canada (PHAC) with independent, ongoing and timely medical, scientific, and public health advice in response to questions from PHAC relating to immunization.

In addition to burden of disease and vaccine characteristics, PHAC has expanded the mandate of NACI to include the systematic consideration of programmatic factors in developing evidence- based recommendations to facilitate timely decision-making for publicly funded vaccine programs at provincial and territorial levels.

The additional factors to be systematically considered by NACI include: economics, ethics, equity, feasibility, and acceptability. Not all NACI Statements will require in-depth analyses of all programmatic factors. While systematic consideration of programmatic factors will be conducted using evidence-informed tools to identify distinct issues that could impact decision-making for recommendation development, only distinct issues identified as being specific to the vaccine or vaccine-preventable disease will be included.

This statement contains NACI’s independent advice and recommendations, which are based upon the best current available scientific knowledge. This document is being disseminated for information purposes. People administering the vaccine should also be aware of the contents of the relevant product monograph. Recommendations for use and other information set out herein may differ from that set out in the product monographs of the Canadian manufacturers of the vaccines. Manufacturer(s) have sought approval of the vaccines and provided evidence as to its safety and efficacy only when it is used in accordance with the product monographs. NACI members and liaison members conduct themselves within the context of PHAC’s Policy on Conflict of Interest, including yearly declaration of potential conflict of interest.’

This is not some two bit operation but serious scientists doing research and study and this, just one of their reports is 120 pages of scientific data and analysis .

Where is Trudeau’s 120 page scientific report?? 

This is  the Advisory Committee to his own Government Agency The Public Health Agency.  

That’s it!!! Yet he ignores it . 

Here are the Committee’s exact words 

 ‘NACI recommends that a complete series with a viral vector COVID-19 vaccine may be offered to individuals 30 years of age and older without contraindications, only if the individual prefers an earlier vaccine rather than wait for an mRNA vaccine AND all of the following conditions apply:

a) The benefit-risk analysis* determines that the benefit of earlier vaccination with the viral vector COVID-19 vaccine outweighs the risk of COVID-19 while waiting for an mRNA COVID-19 vaccine; AND

b) The benefits, relative risk* and consequences of VITT and COVID-19 for the individual are clearly outlined, factoring in the anticipated waiting time to receive an mRNA vaccine as well as other effective personal public health measures to mitigate risk of COVID-19, and the individual makes an informed decision based on an understanding about these risks and benefits; AND

c) There will be substantial delay to receive an mRNA vaccine.

Note: Provinces and territories should adapt the age limit based on their local epidemiology.’

So no AZ or Johnson and Johnson vaccine for people below age 30. That’s what the scientists are saying 

The Prime Minister and Dr. Tam should have acknowledged and incorporated the Committee’s recommendations into an amended Government statement. 

Because all the vaccines are emergency approvals with no medium and long term clinical trials , everyone is learning —-on the fly. 

Hence , this Committee Statement. 

Oh, No , the narrative must remain —for Trudeau ——all are safe —-

Follow the science ???????????

Risky times, I say. 

Canadian Vaccine Confusion.

Leave it  to Canada. 

We have today some legitimate confusion. 

The National Advisory Committee on Immunizations is saying in a 120 page report issued on May 3, 2021  that the Pfizer and Moderna vaccines are to be preferred over the Astra Zena and Johnson and Johnson vaccines .

Meanwhile the advice otherwise by Heath Canada and The Government is to get the first vaccine that comes along. 

Here is Canadian Press with their take

‘National Committee On Immunizations said Monday that Canadians who aren’t at high risk of COVID-19 may choose to wait until they can get a shot of either Pfizer-BioNTech or Moderna, because they don’t carry the remote risk of a new blood-clotting syndrome.

NACI said Canadians under 30 shouldn’t be offered AstraZeneca or Johnson & Johnson at all, because their risk of severe illness or death from COVID is outweighed by the potential risk of the syndrome known as vaccine-induced thrombotic thrombocytopenia, or VITT.

That directly contradicts long-standing advice from Health Canada to get the first vaccine you’re offered, and Trudeau said Tuesday that advice still stands.’

Of course Prime Minister Trudeau and Dr. Tam , Canada’s  Public Heath Officer are in damage control asserting that all vaccines are safe. 

I have been scanning the report —there being some interesting items contained there in on which I will do in a separate article and the fact that  Canadian Press quickly changed their headline .

So , as I and others have been reporting,  there are many unanswered questions and new information ‘on the fly’ given that 

  1. We are dealing with emergency vaccines whose clinical  trials will not be completed until next year or 2023
  2. The vaccines have not been FDA approved. 

Three Things in this Pandemic That Show Canadian Governments’ Incompetence.

A. Dr. Hoffe of Lytton, BC  has at least eight patients that have contracted some sort of neurological condition after all of them had take the MODERNA VACCINE. Dr. Hoffe has asked for these patients to be examined by a specialist . To this date no one has seen these patients . All Governments in Canada have invoked emergency legislation. One would think this situation fits under such an emergency especially since it concerns the pandemic , the very thing for which the emergencies have been invoked . 

Of course,  there is the Canada Health  Act which says in Section 3 

‘3 It is hereby declared that the primary objective of Canadian health care policy is to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.’

Then there is the matter of the Constitution , Charter of Rights and Freedoms section  7:

‘7 Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.’

I never thought I would see the day where a qualified family doctor requests that his sick patients be seen by a specialist and that to be denied , and in this case in the middle  of a Pandemic where one of the remedies for the pandemic , a vaccine, is under suspicion for possibly causing the patients’ illness. 

Who would have thought that a Canadian Government would act this way? 

B. A group of Ontario medical experts wrote the Ontario Government about its response to the pandemic asking for an open debate on at least seven questions:

  1. What are the actual dangers of SARS-CoV-2 by age group and steps taken to protect those in long-term care and the most vulnerable, age 60 and older with co-morbidities?
  2. What is the rationale for the current vaccine roll-out and alteration to the manufacturers’ recommended vaccination protocols?
  3. What controls are in place to limit the number of cycles used in performing PCR tests to 30 cycles to avoid undue false positives inflating the cases reported?
  4. Identification and review of supporting science and corresponding data that led the province to their conclusions that the approach in use was, and is, appropriate, and not worth revision as the crisis evolved over the past 12+ months.
  5. How effective are stringent population-wide restrictions (lockdowns, school closures, mask mandates, and stay at home orders) at controlling the pandemic and are they the best response given the collateral damage?
  6. Why have early multidrug treatment measures, proven to be highly effective and including but not limited to ivermectin, hydroxychloroquine, doxycycline, azithromycin and other compounds used routinely in other countries, not being employed to save lives in Ontario, an action that would virtually eliminate the perceived need for lockdowns, school closures, masking among other things.
  7. What are the priorities in the management of the pandemic and how can we shift the response from fear to confidence?

No answer to that April 19 letter has been forthcoming. 

Who would have thought that serious concerns by experts in the  operation of a response to a pandemic would be ignored by a Canadian Government? 

C. The Justice Centre for Constitutional Freedoms is defending a Pastor from Alberta Government measures that it says violates the Constitution. The Court has ruled that the case will be heard for four days beginning May 3 However, the Alberta Government does not have to prove then the constitutionality of its actions.

Note the Centre’s comments 

 ‘The trial will proceed for up to four days initially, but will then be adjourned because government lawyers are not yet prepared to present any medical or scientific evidence that might support the health orders under which Pastor Coates is charged. Pastor Coates’ Charter challenge to the constitutionality and legality of Dr. Deena Hinshaw’s lockdown restrictions will be heard by the Court at an unknown later date.’

Can you believe this?? 

The Centre’s says 

‘By May 3, the government will have had almost fourteen months to assemble proper medical and scientific evidence to justify lockdowns and the resulting violations of our fundamental Charter freedoms. Yet the government cannot or will not put that evidence before the courts. But, somehow, the Alberta government would have us believe that it has enough medical and scientific evidence to shut down hundreds of small businesses, pushing many of them into bankruptcy, and to cancel over 20,000 medically necessary surgeries, and to force Albertans into a third lockdown as of yesterday, with its resulting harms of unemployment, poverty and despair,”

Who would have thought that a Canadian Government would act this way, withholding scientific information that they already possess and that a Court would agree to this Government action?

These things are facts , happening right now in a so called democratic Canada . 

Oh——You Gotta Read This One —It’s Just Too Outrageous!!!

Melinda and Bill ——that merry couple who are saving the world ????

Can’t save themselves ———-and the wording —the political correctness , the stifling phraseology ———

Wait for it———

‘ we no longer believe we can grow together as a couple in this next phase of our lives.”

You don’t say————-

New York  Post has a great take on it all

Bill and Melinda Gates’ daughter comments on divorce: Family going through ‘challenging time’

By Tamar Lapin

May 3, 2021 | 7:07pm | Updated

Bill Gates and Melinda Gates are ending their marriage after 27 years.

Jennifer Gates, the 25-year-old daughter of Bill and Melinda Gates, said the family has been going through “a challenging stretch of time,” after her parents’ shock divorce announcement on Monday.

Jennifer Gates spoke out about her parents divorce on Instagram.

Instagram

“I’m still learning how to best support my own process and emotions as well as my family members at this time and am grateful for the space to do so,” Jennifer wrote on her Instagram story.

The tech heiress — whose Microsoft co-founder dad is worth an estimated $130 billion — is the eldest of the couple’s three children. She has a brother, Rory, 22, and 19-year-old sister Phoebe.

The siblings grew up in Seattle and attended their father’s alma matter, the private Lakeside High School.

Jennifer graduated from Stanford University in 2018 with a degree in human biology. She then took a year off to focus on her equestrian career before going to Mount Sinai’s Icahn School of Medicine in New York.

To support her equestrian passion, her billionaire philanthropist parents reportedly shelled out $37 million on a string of properties in horseriding hotspot Wellington, Florida.

As a show jumper, Jennifer competed against other celebrity spawn, including Steve Jobs’ daughter Eve, Michael Bloomberg’s daughter Georgina, Bruce Springsteen’s daughter Jessica, and Steven Spielberg’s daughter Destry.

In January, Jennifer announced that she was engaged to renowned Egyptian equestrian Nayel Nassar, also a Stanford grad.

‘I can’t wait to spend the rest of our lives learning, growing, laughing, and loving together,” she wrote on Instagram at the time.

Jennifer Gates spoke out about Bill and Melinda’s divorce on Instagram.

When she’s not riding or studying medicine, Jennifer spends time jet-setting around the world. Her Instagram account shows off past trips to locales including Germany, Australia and Costa Rica.

The Gateses on Monday announced they would be splitting after 27 years of marriage, saying that “we no longer believe we can grow together as a couple in this next phase of our lives.”

In her statement, Jennifer wrote that: “It’s been a challenging stretch of time for our whole family.”

‘I won’t personally comment further on anything around the separation, but please know that your kind words and support mean the world to me,” she said.

‘Thank you for understanding our desire for privacy while we navigate the next phases of our lives.”

The winners in all this ——?

Likely the lawyers who will salivate as they find their life’s income  in dividing up this massive fortune ———-

The losers ?  The planet ——I mean how can it survive without the fused devotion of these  two. 

Will the UN call an emergency meeting? 

PM and Health Minister Talk Vaccine Passports—What About Our Rights and Freedoms ?

Many Canadians according to an IPSO Poll support vaccine passports . 

The PM and the Minister of Health  are talking it up. Here’s a headline from CTV News —

‘Hajdu says Canada will come up with ‘certification’ to allow COVID-clear Canadians to travel again’ 

And the PM from CTV News 

‘Vaccine passports ‘to be expected’ but Canada not ready to set terms yet: Trudeau’

Meanwhile the US Federal Government through its President said they will not get involved with the issue.  From that CTV news report :

‘U.S. President Joe Biden’s administration has said that it will not be pushing for mandatory vaccination credentials or a federal vaccine database because of sensitive legal and political issues.’

I don’t think many realize how such efforts violate our basic rights. 

Here are three areas of our Charter that are affected:

Fundamental Freedoms

Fundamental freedoms

2 Everyone has the following fundamental freedoms:

  • (ya) freedom of conscience and religion;
  • (b) freedom of thought, belief, opinion and expression, including freedom of the press and other media of communication;
  • (c) freedom of peaceful assembly; and
  • (d) freedom of association.

Mobility Rights

Mobility of citizens

  • 6 (1) Every citizen of Canada has the right to enter, remain in and leave Canada.

Legal Rights

Life, liberty and security of person

7 Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

I have sent an e-mail to the Minister of Heath Ottawa opposing such a measure . Her e-mail is hcminister.ministersc@canada.ca. 

China Unleashes Financial Tech Crackdown.

Ethan Yang —American Institute of Economic Research 

– May 3, 2021

On April 30, 2021, Seeking Alpha wrote the following about an escalating regulatory onslaught in China:

‘Taking a page from the Ant Group playbook, China has imposed sweeping restrictions on the fast-growing financial divisions of 13 companies including Tencent (OTCPK:TCEHY), ByteDance (BDNCE), JD.com (NASDAQ:JD), Meituan (OTCPK:MPNGF) and Didi (DIDI). The requirements include stricter compliance when listing abroad, as well as curbs on information monopolies and the gathering of personal data. Companies must also restructure their financial units into holding companies and sever “improper links” between their existing payments services and financial products.” 

This move by Chinese state regulators seems to be riding on the momentum from actions taken against Chinese billionaire Jack Ma back in late 2020. 

Chinese security regulators took aggressive action against the innovative Chinese financial tech firm Ant Group by canceling their IPO following Ma’s criticism of the Chinese banking system. Ma subsequently disappeared from the public eye for months after being summoned to meet with state authorities. 

On February 23, 2021, CNN Business reported that there was reason to believe that the Chinese government would be drastically altering Ant Group in what could be seen as punishment for speaking ill of Chinese state banks when it writes,

“The reports suggest that the Alibaba-affiliated company may now have to follow rules similar to those required of traditional Chinese banks — a move that could force it to scale down its aspirations to be a dominant force in the tech world.”

On April 13, 2021, CNN Business gives an update when it confirms,

“Chinese regulators have ordered Ant Group, which owns the hugely popular Alipay app, to overhaul its operations and become a financial holding company supervised by the central bank. The announcement late on Monday came just days after Ma’s online shopping giant Alibaba was hit with a record $2.8 billion antitrust fine.”

The move seems to be the Chinese Communist Party’s way of making an example of Jack Ma and Ant Group by forcing the once-innovative fintech firm to become the equivalent of a state bank. Ma’s feud with the CCP began when he made critical remarks about China’s outdated state banking system during a conference, making the case for an innovative company like Ant Group.

Now the same fate has been dealt to the 13 Chinese tech giants, which would not only render them far less dynamic and innovative but also turn them into surveillance tools for the CCP to gather more data on consumers. 

CNN summarizes the demands of the CCP when it writes,

‘The regulators laid out seven demands, starting with the requirement that “all financial activities be included in financial supervision, and financial businesses must be licensed to operate.” The way tech firms run their financial units should become more “standardized,” the central bank added, and should in some cases require them to apply to set up financial holding companies.”

A Closer Look at the Fintech Onslaught

This development is interesting given China’s unique economic position as a highly authoritarian regime with a fast-growing economy. It was once thought by many Western observers that economic liberalization and growth in China would give way to liberal democratic reforms. That is because when living standards increase people start to ask more questions as they become more educated and less concerned with where their next meal comes from. 

Furthermore, highly advanced economies need dynamic and innovative companies that can compete on the global stage, which requires liberalization of regulations both economic and social. Liberalization gives way to foreign influences and cultural exchanges which further weakens the power of the CCP to maintain an iron grip on everything its citizens see and do. 

As demonstrated by Jack Ma and Ant Group, the development of highly advanced tech firms has created tension and questions about the antiquated state-owned banking system which gives way to questions about the capabilities of the CCP itself. All these factors pose a considerable problem for the Chinese government.

CNN Business reports on a development back in March 2021 that provides evidence that this could be the case when it writes that even the Chinese President was taking notice of the behavior of tech firms,

‘Xi stressed the need to regulate “platform” companies to maintain social stability during a meeting of China’s leaders on Monday, according to state-owned Xinhua News Agency. The phrase “platform company” in China typically refers to businesses that offer online services for customers.”

The Chinese president added that it was necessary to strengthen regulation of the internet sector, according to a summary of his remarks published by Xinhua. The state media outlet reported that “all financial activities must be included in financial regulations,” according to Xi.”

Much like anything, this move by the CCP isn’t as cut and dry as it may seem. 

There are genuine antitrust concerns associated with these large financial tech firms as they hold a considerable portion of the Chinese market share. The Wall Street Journal notes,

‘Baidu, Alibaba and Tencent—received about 67% of digital ad revenues in 2018, up from 61% in 2015, according to consulting firm TS Lombard.”

E-commerce giants like Alibaba also engage in monopolistic behavior such as forcing partner companies to exclusively sell on their platform. This issue is complicated by the fact that the Chinese government maintains a strong grip on all economic activity in the country, which likely hampers the ability of competitors to challenge these e-commerce giants. However, The Wall Street Journal also notes,

‘The antitrust push is conspicuously silent on some of the biggest rent-seekers of all: China’s large state-owned banks, which now stand to benefit from fintech firms’ clipped wings.”

In light of these facts, it seems that the actions of the Chinese government on the surface may be about policing anticompetitive behavior to increase innovation and competition, but there seems to be an even deeper motive for political control. This should come as no surprise as Reuters reported in September of 2020 that the CCP was demanding more private sector loyalty which includes political alignment. 

Of course, this strangling of the private sector will lead to slower economic growth, less innovation, and reduced investment which may play out in favor for the United States geopolitically. 

Such a development is actually not inconsistent with Chinese history. China has always been an authoritarian and closed country that has managed to make great leaps of progress before falling into disarray as has attempted to manage stagnation and foreign threats. One does not need to look further than the last Chinese imperial dynasty to see this timeline play out. History does not repeat itself but it certainly does rhyme. 

What Could This Mean?

In order to compete on the global stage, China needs innovative and creative companies but that also requires freedom both economic as well as social. 

Such freedom inevitably leads to people asking questions which the CCP can’t have. This fintech crackdown could be emblematic of China’s authoritarian growing pains and it remains to be seen if they will even be able to balance economic progress with political control. 

This move will certainly have consequences for short-term investment and economic growth in China. It’s even possible they might end up killing the goose that laid the golden egg. 

Perhaps this is how the free world breaks China’s authoritarian model, by forcing them to increasingly compete on the open market or risk sliding into irrelevance.

Canada has an eerie ‘police state’ feel lately.

By Andrea Widbug—-American Thinker Website

Canada lacks the miracle that is the United States Constitution.  Still, as befits a nation the once-free British founded, it is a country that has traditionally had a few of what we consider to be core English freedoms — freedom of speech, worship, assembly, etc.  Those concepts seem far away now, as Justin Trudeau and the various provincial and municipal governments use COVID as an excuse to crack down on those liberties.

I’ve written before about Canada’s draconian and expensive hotel rule for people returning by air from overseas travel.  It’s gotten so bad that people are flying into the U.S. and driving to their home country to avoid the hotel restriction.

That inconvenience, though, is small potatoes compared to what else is going on in a country that, as of April 30, has had an average of only 653 COVID deaths per million citizens.  By contrast, France had 1,530 deaths per million, Germany has had 997 deaths per million, England has had 1,903 deaths per million, and America has had 1,744 deaths per million.

In other words, as the vaccine ramps up, treatments improve, and we get better at protecting the at-risk elderly, Canada should be relaxing its restrictions — but that’s not what’s happening.  Two men, however, are fighting back.

One of those people is already familiar to American Thinker readers.  A month ago, American Thinker posted a video of Pastor Artur Pawlowski, who grew up in communist Poland, kicking the Canadian police out of his church.  They had come to stop a worship service that exceeded the 15% capacity limit Canada imposes on religious worship.  (As a thought experiment, ask yourself if the government would do the same to a mosque.)

Pawlowski insisted (a) that the police come back with a warrant before he would let them into his church and (b) that they communicate with him solely through his lawyer.  What happened, instead, was that, on Wednesday, the same officials returned directly to him, not his lawyer, with an extremely specific type of warrant — a secret warrant.

According to Rebel News, a conservative Canadian internet outlet, the government obtained the warrant in a secret hearing, despite knowing the identity of Pawlowski’s attorney.  The warrant fails to state the evidentiary grounds that justified its issuance.  Instead, it simply empowers the state to go into Pawlowski’s church during services (something that ordinarily is barred under applicable law) and to arrest anyone who resists.

Pawlowski is planning to go ahead with services today, and it’s likely the event will end in his arrest.  During a conversation with Jesse Kelly, Pawlowski explained that, having grown up behind the Iron Curtain, he knows what’s happening.  Moreover, he says that religious people “are a pack of lions” who will “never bow before hyenas.”

In other words, on matters of conscience, Pawlowski answers to a higher judge than the Canadian government.

Chris Sky is a different kind of conscientious objector in the face of Canada’s burgeoning tyranny.  Last September, Vice news reported with dripping disdain about Chris Saccoccia (Sky’s given name):

A wealthy man who has become one of Canada’s most well-known anti-maskers is attempting to open up a network of private schools for the children of his followers to ride out the pandemic.

Chris Saccoccia, the son of a wealthy developer, is a childless man who founded a group called Mothers Against Social Distancing, whose Facebook page boasts 4,500 followers. Saccoccia, who goes by Chris Sky online, has been hyping “Private-On-Demand Education Inc.” online for weeks to his thousands of, mostly middle-aged women, followers[.]

Could you get a nastier (and more sexist) diss than referring to a man’s followers as “mostly middle-aged women”?  It’s not true — a Canadian friend told me that, in April, her daughter, along with hundreds of other young people, was going to head for an anti-mask rally at a Vancouver beach.

And indeed, hundreds of young people did rally.  This video shows Sky speaking to a crowd at the Sunset Beach protest that my friend’s daughter attended.

The Canadian government has responded to Sky’s popular message by placing him on its no-fly list and arresting him, as happened just three days ago.

Americans need to take seriously what’s happening in Canada.  When Trump was president, we had a bulwark against this totalitarianism.  With Biden in the White House, there’s no saying how far the government will go to continue using COVID as a justification to strip Americans of their civil liberties.

Canada—The Same Old Story —Indecisive And Bureaucratic -Vaccine Company To Leave Canada.

A Calgary based company involved in Covid vaccine development is leaving Canada . Eric Sorenson  of Providence Therapeutics says the federal Government is just too unresponsive .

“I’m moving on, that’s where I’m at now. I’ve prostrated myself at the altar of government in Canada for a year and I’ve received nothing for it. I’m tired of begging and pleading,” Sorenson said.

How do you like that ——-others in the past have done likewise from farm machinery to energy companies. 

We have not learned to stop the bureaucracy , be nimble , and make decisions. 

There will never be An Operation Warp Speed in this country—can’t do it. 

Sorenson is quoted in a CBC article as saying 

“I can’t tell you how much this pains me. The reality is, I can do more good for the world outside of Canada than I can in.” 

There’s a so called experts committee , task force that funnels all requests to the Federal  Government. Sorenson said the task force did not think the company could scale up fast enough. What a joke from a Government where we have no vaccine—nano—nothing. Soreness said that if the Feds had approved his $150 million request it could have scaled up. 

Moderna was small , and Trumps’ s Operation Warp Speed gave the company $430 million. And where is Moderna today? 

Sorenson said if he was located in Quebec or Ontario he likely would have had a better chance to get large Federal Investment. The FDERAL GOVERNMENT HAS PUT $ 173 MILLION INTO A QUEBEC CITY COMPANY AND $430 MILLION INTO A A GIANT DRUG COMPANY IN ONTARIO. 

Sorenson said 

‘I handed the government of Canada the football on the one yard line and all they had to do was punch it across and they took it and ran in the other direction.’

The more things change —————-

The COVID Crisis in India: an Interview with Dr Dhananjay Bakhle

Posted on May 1, 2021

by covexit

Dr Dhananjay Bakhle

Dr Dhananjay Bakhle, a physician treating COVID patients but also leading medical research for a pharmaceutical company, has agreed to respond to our questions regarding the recent crisis in India. In March, we published the article “The Mystery Behind India’s Success in Flattening the Curve,” which he co-authored. While infections and mortality remained low, per capita, in the first wave, the recent rapid increase in cases and mortality has taken the country by surprise. In this interview, Dr Bakhle helps us understanding what is going on, and why some states appear to fare much better than others. He also offers practical suggestions / recommendations. (Note: the interview was done in writing, through email exchanges on April 23-29; some edits were done for readability purpos

1. There has been a dramatic increase in new cases starting mid-march, with 23,000 new daily confirmed cases on March 15, and 281,000 new daily confirmed cases on April 22, according to World in Data. What do you think of these numbers?

These numbers have been outstripped as of today. India has crossed 346,000 new cases in a single day. In last 3 days close to million cases and yesterday crossed the death toll of 2000 in a single day.

coronavirus-data-explorer-india-versus-world.jpg

This graph contrasts new cases in India, Europe, Africa, North and South America – note how India flattened the first wave last fall.

2. What is the geographic spread of these new infections? Which states are the most affected? Is it mostly an urban phenomenon?

There are 7 states which contain 67% of all active cases in India as of today. The adjoining graph shows the break-up. One would expect some correlation between the number of active cases & cases per million but it doesn’t correlate in 4 states. 

india_two_graphs.jpg

This led me to look at the population density against the cases per million to see which states are outliers. The graph shows these numbers on two different axes. It shows that Uttar Pradesh is doing something right whereas Chattisgarh, Maharashtra & Karnataka are not on track. 

Since the whole country is following all standard methods of prevention like masks, sanitization & social distancing, the differences are likely to be attributed to the differential treatments being received by the patients in these states.

3. Similarly, there is a huge increase in daily deaths, from less than 200 per day to now about 1800 per day. Can you comment?

This figure has crossed 2000 per day for the last 4 days.

Today, most leading doctors in India are themselves not promoting the Ministry of Health guidelines that includes the use of hydroxychloroquine, ivermectin and inhaled budesonide (see below).

Another change from the first wave is that people from the upper middle class and the elite have been more involved in this wave, while they had escaped the first wave when people from lower socio-economic strata were mostly involved. 

The people from the slums who got hit by the first wave were treated in the govt and municipal dispensaries, and got hydroxychloroquine and zinc regimen. This helped keeping the death rate very low.

This time the upper class are being treated by the elite doctors in their private clinics/nursing homes who don’t use HCQ but use more expensive drugs like favipiravir and remdesivir. This has led to a huge demand and supply gap for remdesivir that did not occur in the first wave. 

These people also get admitted as inpatients much earlier than their lower socio-economic counterparts. The demand for hospital beds this time far exceeds availability in most urban areas of India. 

Also noteworthy is that, when remdesivir is used, HCQ is stopped even if it was given by a family physician. 

The net result of this whole situation is a higher death rate in major cities like Mumbai where it crossed 2% CFR.

4. Today, are there states where early treatment is being given more pro-actively?

This is clearly the case looking at the example of Uttar Pradesh, which has double the population of Maharashtra but 2.5 times less the number of active cases as seen from the graph below: This is simply because UP is providing home treatment kits containing Ivermectin to each positive case. 

Goa is another state, though much smaller than any of the 7 states listed above, that is providing Ivermectin home treatment kits as shown in the picture below.

This has made it possible for both states to avoid lockdowns whereas Maharashtra is in full lockdown. Even as compared to Mumbai, its twin metropolis of Thane has a much wider use of Ivermectin and lower fatality rates. 

Another feature of the second wave is that number of affected districts are more clustered in urban areas as compared to the first wave. The number of districts comprising the top 50% of cases has dropped from over 40 at the time of the last peak, to less than 20 currently, indicating a much more concentrated pandemic.

This has left treatment in the hands of fewer frontline doctors as compared to the last wave and also a change in the type of doctors treating the disease, from crowded localities to more housing societies and more plush areas of the cities. This has reduced the use of drugs such as hydroxychloroquine and Ivermectin as stated before

5. If early treatment is being given, how can you explain this dramatic increase in mortality?

Firstly, treatment is not necessarily comprising of HCQ & Ivermectin as much as Favipiravir & Remdesivir in small private hospitals and nursing homes. 

Also some of the state government establishments have written off the use of HCQ like what Pune Municipal Corporation did by issuing a statement not to use HCQ. 

Note also that the Lancet Covid-19 commission India Task Force does not give particular attention to outpatient treatment as a means to reduce the pressure on hospitals and ICUs.

6. Can you comment on the vaccination campaign in India? 

There is a clear increase in the number of cases associated with the vaccination campaign, which has brought out all the elderly from a lockdown-like situation directly into hospitals, which became spreading centres. 

Several patients that me and my colleagues have treated in the second wave had been recently vaccinated. 

Vaccination can’t cope up with the much faster spread of this wave and thus the campaign has so far not been able to impact the case increases. The following graph shows the fully vaccinated people vs. cases/million to see if there is some correlation. 

image.png

From the graph, there appears to be some advantage to Gujrat and Rajasthan in keeping cases/million lower than Maharashtra where vaccinated people/million are low and the cases/million is the largest. 

Uttar Pradesh again beats this trend and despite lowest vaccinated people, its cases/million are also the lowest. I believe this may be an “Ivermectin effect.”

7. With the “double mutant” variant, is there evidence that early treatment with Ivermectin, doxycycline, etc. is still effective? 

Since Ivermectin and HCQ are hos mediated drugs they work irrespective of the mutant strains. HCQ works on the ACE2 receptors and endosomes which normally work in acidic environment to facilitate endocytosis. Whereas, Ivermectin is the positive allosteric modulator of 7 alfa-nicotinic receptors that is attacked by SARS-CoV2. 

Doxycycline is a known inhibitor of IL-6, TNF-alfa and MMP enzymes which play a pathological role in Covid-19. These mechanisms are independent of viral strains and hence have been found to remain effective in the second wave also. 

Some doctors in a twin city of Mumbai called Thane have been using Ivermectin in double dose (12 mg twice daily) for 5 days, relatively free from side effects. 

The typical treatment that I have been using in the second wave has been primarily Ivermectin 12 mg once daily for 5 days along with elemental Zinc 50 mg once daily for 7 days. In patients with fever I add Doxycycline 100 mg twice daily for 5 days. Vit D3 either 60,000 units weekly or 4000 Units daily for at least 10 days. 

If the fever doesn’t settle by 5-6 days I start dexamethasone 4 mg for 3 days and then wean off. Dexamethasone has been doing wonders for the second peak of fever which is generally due to inflammation rather than viremia and appears sometimes after the first peak is resolved after Ivermectin/Doxycycline combination. 

For patients with cough, I prefer to add Budesonide inhalation by dry powder inhalation in a dose of 400 micrograms twice daily to be increased upto 800 mcg twice daily if required. I recently treated a patient of Asthma with Covid whose cough and breathlessness was not resolving with repeated inhalations with Albuterol to whom Budesonide resolved it completely in a dose of 600 mcg twice daily. 

Many young patients who show higher blood markers of inflammation like CRP, IL-6 and D-dimer have responded very well to HCQ and Zinc combination with or without Doxycycline.

If such a treatment is given to all patients, no hospital admission is necessary. This dramatically reduces the burden on hospital resources, including oxygen. The issue is that early home treatment is not being promoted by the medical task forces or in the media.

8. On social media, the most common requests are for oxygen and remdesivir. How do you explain the continued use of remdesivir while the SOLIDARITY trial and the WHO concluded it is not effective for COVID-19?

Remdesivir is touted as a life saving drug by most elite medical doctors and the media. I haven’t heard of any doctor giving the real data, which don’t show any mortality benefits. A sort of hype of unavailability of the drug created a huge demand with all patients wanting it.

Since the Indian government had restricted the use of Remdesivir to only those patients who require oxygen support, the demand for the drug may have even led to more usage of oxygen in all these patients whether required or not. This may have led to an artificial shortage of oxygen. 

Of course the mammoth new cases exploding every day also put additional pressure on the oxygen capacity of the hospitals.

9. From the data, or from your contacts with medical doctors on the frontline, are there indications that some outpatient treatments are working particularly well in India, at least in some states?

Yes, many doctors at district level in states such as Uttar Pradesh, Gujrat & Goa are treating patients with the early home treatments mentioned above. The ministry of health guideline continues to suggest HCQ and Ivermectin.

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Source: Government of India

It is very important to know that health is a state and not a central government responsibility. Hence, there are bound to be differences among states. 

While the giant second wave in India is associated with the double mutant, its management in different states shows variance. States like Uttar Pradesh have stuck to Ivermectin and show low numbers despite high population density. Maharashtra, where the use of these drugs declined, shows on the other hand very high numbers.

If our assessment of how India tamed the first wave is correct, the 2nd wave will also be brought under control by the frontline doctors at district levels who use early home treatments. We hope to see that happening soon just like the first wave faded away just a few months back.

10. Concretely, what are the solutions, from a public health policy perspective, for India to again flatten the curve?

We need to replicate the policies of the largest state in India – Uttar Pradesh – to provide early treatment kits to people in states like Maharashtra. 

India should remove the taboo around the use of hydroxychloroquine simply because there has not been a single death reported in the world due to HCQ while 2000 people are dying every day. 

While Ivermectin is a great drug for early treatment, it may not work as well as HCQ, from the experience of many of us in the second wave. The kit should also include Zinc supplement in the dose of 50 mg elemental Zinc along with Doxycycline. 

A pulse Oxymeter and a chart to indicate how to measure and record the readings should likewise be provided.  It goes without mentioning that a good thermometer should be provided like being done by the Goa government. 

There should be clear criteria provided about who should seek hospital admission. When the patient gets into hospital, the early outpatient treatment should be continued and not stopped, as is being done today. 

This will ensure that many patients will then complete at least 5 days of either HCQ or Ivermectin-based treatment, which stabilizes the immune response, thereby reducing the chances of cytokine release syndrome. 

All governmental media contact points should promote the early home treatment and the government should promote telemedicine initiatives as acceptable for CSR expenditure for corporates who will then come forward and initiate them. 

The telephone services can run a tune before each call is picked up to say that there is effective home treatment and primary care doctors should be contacted in case of symptoms. 

Early home treatment is no competition for vaccines and hence both have to co-exist, which can play a major role in reducing stretch on the hospital resources in the country. However, a lopsided massive emphasis on vaccinations has led to the current situation without a plan B for this new wave. 

If such a plan B for early home treatment were to be implemented, it can supplement the governmental ambitious plans for vaccinating the entire huge population of India in the next few months in a calculated and planned manner rather than struggling to cope with both at the same time.

The Sheer Stupidity and Incompetence Of It All —The National TV Press and The Lack of Prevention.

You know you try again to watch the TV News, hoping on hope that they can get something right, be accurate , some context etc.

No, just not possible. 

Take this morning. I sat down with coffee in hand and tuned into the CTV National  All News station and then the CBC National All News station. 

CTV

The were carrying the apparent new surge of Wuhan virus cases in Alberta. Cases , cases , cases—-not sick people , cases. People who tested positive using that faulty PCR test . 

Why not qualify the story with the test problem ?  Like , case numbers validity a problem. Why not give the cases , then how many of these needed hospitalization. Why not the age groups , the pandemic geographic break down. 

Feeding the narrative of 14 months the story turned to the outdoor  patios that were open showing video of people actually enjoying themselves and hinting they should be closed and some vague reference to groups and worship. 

Not one word about urging people about prevention—-the obvious vitamin D link that numerous studies have shown can help prevent serious sickness, other early treatments —-ivermectin and hydroxychloroquine. Of course, many are not available in this country . People have to turn to the US to get such treatments. Why not comment on that!!!

CBC

No better, of course. 

Here we had a story about  the homeless in Toronto . A local activist was being interviewed describing the dire situation regarding the virus infection. No numbers mind you ——-

Well, I would have thought that that Mayor would have had them all in hotels by now. If anyone has listened to him over the last months every stone  was being turned , every dollar being spent especially on the unfortunate. These ‘lily white ‘ intention led, action sparse,’ leaders are just so disgusting!

The activist did admit that the homeless were given priority for the vaccine but apparently only 30% or 40% took advantage. Now these were not hard numbers quoting any survey etc——oh, no, just thrown out there——I mean don’t we need better valid numbers —-and why the low numbers?? 

There was no mention by this public heath activist about sanitation, about early intervention ———diet —and nutrition like vitamin D . How expensive would it be ( given the billions going to our bottom line every day) to distribute vitamin D pills to all the homeless , its use known to cut down on sickness and hospitalizations. Studies show that 60% to 90 % of Canadians are deficient in vitamin D. Not a bad idea for the whole population. 

It’s all about the final solution , the ‘experimental ‘ vaccines , none of which are FDA approved —-no long term effects known—-clinical trials on two to continue until well into 2022 and one 2023 and two of which see the time specified for the two doses being administered violated  without scientific justification. 

Should we not have a more comprehensive approach , using all tools available? 

It ‘s as if all these wonderful terms like PREVENTION that led to hundreds of millions being spent on ‘Public Health ‘ have become no longer valid ———

Many lives have been lost because public health was discarded , and many could now be saved by wise prevention methods and early treatment at home. 

Common sense has become a UFO—-Government coercion and selected use of information the new —mantra.

We ignore Hayek at our peril —-‘while it is true that inventions have given us tremendous power, it is absurd to suggest that we must use this power to destroy our most precious inheritance : LIBERTY . ( Page 97 ‘Road To Serfdom.’)