Long time no post

Switching to a new computer and a new eMail has been nothing short of a time consuming disaster, not to say expensive.  I should start posting again this week.  See the previous post for why you must continually update your data to keep it accessible.

I do recommend an excellent review article on phase transitions in the cell [ Neuron vol. 109 pp.. 2663 – 2681 ’21 ] which tries to make sense of the chemistry behind it, particularly focusing on RNA.  Unfortunately it is likely behind a paywall.  I have written on the subject a while back, so here’s a link — https://luysii.wordpress.com/2020/12/20/neuroscience-can-no-longer-ignore-phase-separation/.  Now that people are looking for it, new examples are constantly being found.  It’s in chromatin. It’s at the synapse etc. etc.

Now a plea for help.  The hardest thing about shifting my database to Mathematica is finding a way to sort it.  This was no problem at all for Filemaker or Hypercard.  All you had to do was type sort and the programs did the rest.  Well no I have to do it.

Does anyone out there have any ideas what sort of internal data structures are available to keep 22K cards coherent and search them, while modifying them by continuing to read the literature.

No one will be able to access your data in 20 years

Hardware changes all the time requiring new software to use it even for the ‘same’ program.

 

Consider my history with HyperCard, a great Apple program I started using in 1987.  Apple didn’t support it after it moved away from Operating system 9 — new hardware managed memory differently.  So I was left with OS  X which still had a way to access OS 9 even though the processor was a 2.1 GigaHertz PowerPC.

Then newer hardware no longer accessed even the power PC, so as long my iMac G5 held out I was OK.  But hardware doesn’t last forever, so I tried to migrate my database to FileMaker Pro, another Apple product (although they tried to keep this quiet).

Filemaker documentation is simply horrible. Example: they don’t tell you what the reserved words are believe it or not.

So I’m currently trying to migrate my HyperCard database to Mathematica.  I had bought Mathematica 10 and the computer it runs on in 2015.  It was a macBook Pro with a 2.2 GigaHertz Intel Core i7.  But this year the battery started swelling (which Apple offered to replace for free), and worrying about exploding batteries in cars, I decided to move on.

So I bought the latest macBook Pro, which has 64 bit hardware instead of the 32 bit hardware of the old macBook Pro.  This means that Mathematica10 won’t work on the new computer so I must upgrade to Mathematica 12.

Well  what you get when you actually try to open a Mathematica notebook written in Mathematica 10 on the new machine is something like this.

(* Content-type: application/vnd.wolfram.mathematica *)

(*** Wolfram Notebook File ***)
(* http://www.wolfram.com/nb *)

(* CreatedBy=’Mathematica 10.0′ *)

(*CacheID: 234*)
(* Internal cache information:
NotebookFileLineBreakTest
NotebookFileLineBreakTest
NotebookDataPosition[ 158, 7]
NotebookDataLength[ 69720, 1756]
NotebookOptionsPosition[ 63597, 1546]
NotebookOutlinePosition[ 64410, 1576]
CellTagsIndexPosition[ 64240, 1569]
WindowFrame->Normal*)

(* Beginning of Notebook Content *)
Notebook[{
Cell[BoxData[
RowBox[{“(*”, ” “, “W645″, ” “, “*)”}]], “Input”,
CellChangeTimes->{{3.8400255875558558`*^9, 3.840025593274387*^9}}],

Cell[CellGroupData[{

Cell[BoxData[
RowBox[{“newList”, ” “, “=”, ” “,
RowBox[{“ReadList”, ” “, “[“, ” “,
RowBox[{
“\”\</Users/lewisrobinson/Desktop/ Cards 9461 to 9462\>\””, ” “, “,”,
” “, “string”}], ” “, “]”}]}]], “Input”,
CellChangeTimes->{{3.8400252429862013`*^9, 3.840025260918976*^9}, {
3.840025304055138*^9, 3.840025325036539*^9}}],

Hardly readable or usable is it?  Presumably the as yet unpurchased Mathematica 12 will be able to read this notebook and put it into recognizable form on the new machine.

Now let’s move 20 years into the future.  Further new hardware, further new software.  Will you be able to find a machine like my new computer

  Model Name: MacBook Pro
  Model Identifier: MacBookPro16,1
  Processor Name: 6-Core Intel Core i7
  Processor Speed: 2.6 GHz
  Number of Processors: 1
  Total Number of Cores: 6
  L2 Cache (per Core): 256 KB
  L3 Cache: 12 MB
  Hyper-Threading Technology: Enabled
  Memory: 16 GB
  System Firmware Version: 1554.100.64.0.0 (iBridge: 18.16.14556.0.0,0)
  Serial Number (system): C02G8AS4MD6M
  Hardware UUID: 28C836B3-C406-5215-AB85-A25653ADF226
  Provisioning UDID: 28C836B3-C406-5215-AB85-A25653ADF226
  Activation Lock Status: Disabled

 

In 2041 will you (or your grandson) be able to find a copy of Mathematica 12 to run it on, as the newer versions are unlikely to run on such an old computer (as just happened).

 

I seriously doubt it, cloud or no cloud.   So maintaining your data is a never ending process.

We’re not as protected as we thought we were

We all know that the only people hospitalized and dying of COVID-19 are lower forms of animal life such as the rednecked Trumpenproletariat from the deep South.  Here’s the New York Times of less than a month ago — https://www.nytimes.com/interactive/2021/08/10/us/covid-breakthrough-infections-vaccines.html

“Serious coronavirus infections among vaccinated people have been relatively rare since the start of the vaccination campaign, a New York Times analysis of data from 40 states and Washington, D.C., shows. Fully vaccinated people have made up as few as 0.1 percent of and as many as 5 percent of those hospitalized with the virus in those states, and as few as 0.2 percent and as many as 6 percent of those who have died.”

Nothing to worry about up here in Massachusetts where roughly 2/3 of the population have been vaccinated.  Well that’s what I thought until Friday 3 September — when I saw this from the Massachusetts department of public health — https://www.masslive.com/coronavirus/2021/09/massachusetts-reports-1703-covid-cases-as-percentage-of-breakthrough-hospitalizations-continues-to-drop.html

149 of 609 hospitalizations (24%) with COVID19 had been fully vaccinated.  That is far from the protection we had been led to believe.  It could have been worse.  If the vaccination was totally useless,  the fully vaccinated should have made up 66% of the cases.  So there was some protection, but nothing like the New York Times and others were talking about a few weeks ago.

So for the elderly, it’s back to restricted social contact and masks.

On a more personal note, I proved Richard Feynman right again.  He famously said ”

“The first principle is that you must not fool yourself — and you are the easiest person to fool.”

Well I certainly did.  I read the following article in the 27 August Science –https://www.science.org/content/article/grim-warning-israel-vaccination-blunts-does-not-defeat-delt

It contained the following statement. ” As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated.”

I even took notes on the article.  Yet somehow I chose to ignore it.  Why?  Too threatening?  Didn’t fit with what I’d been told?  Kahneman has shown just how irrational, those who call themselves rational turn out to be.  Mea Culpa.

Addendum  7 September — https://www.masslive.com/coronavirus/2021/09/breakthrough-covid-cases-in-massachusetts-up-to-about-40-while-unvaccinated-people-dominate-hospitalizations.html

“The state reported a total of 601 COVID hospitalizations Tuesday 7 September ’21. Data shows that 160 of the 601 hospitalizations are people who were fully vaccinated — about 26% of all COVID hospitalizations. ”

So the data of 3 September referred to earlier are to be believed and likely NOT a statistical fluke as they are essentially the same as today’s.

What controls should Cassava Sciences use for their open label trial?

MDs gradually woke up to the fallacy of using historical rather than concurrent controls particularly in studies of therapies to prevent heart attack and stroke, as the rates of both dropped significantly in the past 50 years, and survival from individual heart attacks and strokes also improved.

An open label trial is just that, no placebo, no controls.  Such trials are done in the exploratory phase of drug development to look for side effects and (hopefully) therapeutic effects.

Cassava Sciences has been attacked because their open label study of Simufilam had no controls.  Duh !

Here is a suggestion for the concurrent controls for the Cassava study:  the Biogen study leading to approval of aducanumab (Aduhelm).  It’s a little hard to find out exactly when it was done, but it certainly was within the past 10 years. Here is a link to an article on Alzheimer therapy from Science — https://science.sciencemag.org/content/sci/373/6555/624.full.pdf

Cassava’s work is nowhere to be found.  The article contains the following

“Although the marked decrease in amyloid deposits can be viewed as biological evidence of disease modification, this was accompanied by a decidedly mixed outcome on cognitive testing, with one aducanumab trial (EMERGE, NCT02484547) meeting its prespecified primary and secondary endpoints at the highest dose, whereas the other (ENGAGE, NCT02477800) did not achieve them.”

So use Biogen’s data on aducanumab as the placebo control (which I and the FDA advisory committee think it is).  There is a reason the entire committee resigned after the FDA approved the drug.

Cassava Sciences 9 month data is probably better than they realize

My own analysis of the Cassava Sciences 9 month data shows that it is probably even better than they realize.

Here is a link to what they released — keep it handy https://www.cassavasciences.com/static-files/13794384-53b3-452c-ae6c-7a09828ad389.

I was unable to listen to Lindsay Burn’s presentation at the Alzheimer Association International Conference in July as I wasn’t signed up.  I have been unable to find either a video or a transcript, so perhaps Lindsay did realize what I’m about to say.

Apparently today 25 August there was another bear attack on the company and its data.  I’ve not read it or even seen what the stock did.  In what follows I am assuming that everything they’ve said about their data is true and that their data is what they say it is.

So the other day I had a look at what Cassava released at the time of Lindsay’s talk.

First some background on their study.  It is a report on the first 50 patients who had received Simulfilam for 9 months.  It is very important to understand how they were measuring cognition.  It is something called ADAS-Cog11

Here it is and how it is scored and my source — https://www.verywellhealth.com/alzheimers-disease-assessment-scale-98625

The original version of the ADAS-Cog consists of 11 items, including:1

1. Word Recall Task: You are given three chances to recall as many words as possible from a list of 10 words that you were shown. This tests short-term memory.

2. Naming Objects and Fingers: Several real objects are shown to you, such as a flower, pencil and a comb, and you are asked to name them. You then have to state the name of each of the fingers on the hand, such as pinky, thumb, etc. This is similar to the Boston Naming Test in that it tests for naming ability, although the BNT uses pictures instead of real objects, to prompt a reply.

3. Following Commands: You are asked to follow a series of simple but sometimes multi-step directions, such as, “Make a fist” and “Place the pencil on top of the card.”

4. Constructional Praxis: This task involves showing you four different shapes, progressively more difficult such as overlapping rectangles, and then you will be asked to draw each one. Visuospatial abilities become impaired as dementia progresses and this task can help measure these skills.

5. Ideational Praxis: In this section, the test administrator asks you to pretend you have written a letter to yourself, fold it, place it in the envelope, seal the envelope, address it and demonstrate where to place the stamp. (While this task is still appropriate now, this could become less relevant as people write and send fewer letters through the mail.)

6. Orientation: Your orientation is measured by asking you what your first and last name are, the day of the week, date, month, year, season, time of day, and location. This will determine whether you are oriented x 1, 2, 3 or 4.

7. Word Recognition Task: In this section, you are asked to read and try to remember a list of twelve words. You are then presented with those words along with several other words and asked if each word is one that you saw earlier or not. This task is similar to the first task, with the exception that it measures your ability to recognize information, instead of recall it.

8. Remembering Test Directions: Your ability to remember directions without reminders or with a limited amount of reminders is assessed.

9. Spoken Language: The ability to use language to make yourself understood is evaluated throughout the duration of the test.

10. Comprehension: Your ability to understand the meaning of words and language over the course of the test is assessed by the test administrator.

11. Word-Finding Difficulty: Throughout the test, the test administrator assesses your word-finding ability throughout spontaneous conversation.

What the ADAS-Cog Assesses

The ADAS-Cog helps evaluate cognition and differentiates between normal cognitive functioning and impaired cognitive functioning. It is especially useful for determining the extent of cognitive decline and can help evaluate which stage of Alzheimer’s disease a person is in, based on his answers and score. The ADAS-Cog is often used in clinical trials because it can determine incremental improvements or declines in cognitive functioning.2

Scoring

The test administrator adds up points for the errors in each task of the ADAS-Cog for a total score ranging from 0 to 70. The greater the dysfunction, the greater the score. A score of 70 represents the most severe impairment and 0 represents the least impairment.

The average score of the 50 individuals entering was 17 with a standard deviation of 8, meaning that about 2/3 of the group entering had scores of 9 to 25 and that 96% had scores of 1 to 32 (but I doubt that anyone would have entered the study with a score of 1 — so I’m assuming that the lowest score on entry was 9 and the highest was 25).  Cassava Sciences has this data but I don’t know what it is.

Now follow the link to Individual Patient Changes in ADAS-Cog (N = 50) and you will see 50 dots, some red, some yellow, some green.

Look at the 5 individuals who fall between -10 and – 15 and think about what this means.  -10 means that an individual made 10 fewer errors at 9 months than on entry into the study.  Again, I have no idea what the scores of the 5 were on entry.

So assume the worst and that the 5 all had scores of 25 on entry.  The group still showed a 50% improvement from baseline as they look like they either made 12, 13, or 14 fewer errors.  If you assume that the 5 had the average impairment of 17 on entry, they were nearly normal after 9 months of treatment.  That doesn’t happen in Alzheimer’s and is a tremendous result.   Lindsay may have pointed this out in her talk, but I don’t know although I’ve tried to find out.

Is there another neurologic disease with responses like this.  Yes there is, and I’ve seen it.

I was one of the first neurologists in the USA to use L-DOPA for Parkinsonism.  All patients improved, and I actually saw one or two wheelchair bound Parkinsonians walk again (without going to Lourdes).  They were far from normal, but ever so much better.

However,  treated mildly impaired Parkinsonians became indistinguishable from normal, to the extent that I wondered if I’d misdiagnosed them.

12 to 14 fewer errors is a big deal, an average decrease of 3 errors, not so much, but still unprecedented in Alzheimer’s disease.   Whether this is clinically meaningful is hard to tell.  However, 12 month data on the 50 will be available in the fourth quarter of ’21, and if the group as a whole continues to improve over baseline it will be a very big deal as it will tell us a lot about Alzheimer’s.

Cassava Sciences has all sorts of data we’ve not seen (not that they are hiding it).  Each of the 50 has 4 data points (entry, 3, 6 and 9 months) and it would be interesting to see the actual scores rather than the changes between them in all 50.  Were the 5 patients with the 12 – 14 fewer errors more impaired (high ADAS-Cog11 score in entry) or less.

Was the marked improvement in the 5 slow and steady or sudden?   Ditto for the ones who deteriorated or who got much worse or who slightly improved.

Even if such dramatic improvement is confined to 10% of those receiving therapy it is worth a shot to give it to all.  Immune checkpoint blockade has dramatically helped some patients with cancer  (far from all), yet it is tried in many.

Disclaimer:  My wife and I have known Lindsay since she was a teenager and we were friendly with her parents.  However, everything in this post is on the basis of public information available to anyone (and of course my decades of experience as a clinical neurologist)

 

Biden is in early dementia — yet more evidence

This is the third post arguing that Biden is in early dementia.  Today’s post is  based on his performances on the 18th of August and today 20 August.  The previous 2 posts can be found below the ***

Addendum: 23 August.  Don’t take my word for it.  All the material in this post  is evidence — please look at the linked videos and quotations and decide for yourself.  Your conclusions may be different from mine, but at the least you will see the evidence on which mine are based.   If you disagree, I’d love to see a comment. 

On the 18th in an interview on ABC with George Stephanopoulos a transcript contains the following exchange

“STEPHANOPOULOS: I– I think a lot of– a lot of Americans, and a l– even a lot of veterans who served in Afghanistan agree with you on the big, strategic picture. They believe we had to get out. But I wonder how you respond to an Army Special Forces officer, Javier McKay (PH). He did seven tours. He was shot twice. He agrees with you. He says, “We have to cut our losses in Afghanistan.” But he adds, “I just wish we could’ve left with honor.”

BIDEN: Look, that’s like askin’ my deceased son Beau, who spent six months in Kosovo and a year in Iraq as a Navy captain and then major– I mean, as an Army major. And, you know, I’m sure h– he had regrets comin’ out of Afganista– I mean, out of Iraq.”

Doesn’t he know which branch of the service his son was in? Did he think his son was in Afghanistan?  My wife and I know where our 4 uncles served in world war two.

Unsurprisingly, ABC did not put this exchange on the air.  It was only found by reading the transcript.  Pravda could have done no better.

Today

“President Biden: (12:15) Look, let’s put this thing in perspective here. What interest do we have in Afghanistan at this point with Al Qaeda gone? ”

They aren’t gone according to Pentagon spokesman John Kirby.  At a briefing following Biden’s remarks Kirby said that there remains an al Qaeda presence in Afghanistan.

Wasn’t Biden told this?  If he was did he forget it?  Where is the shrink from Yale who wanted remove Trump using article 25 of the Constitution back in the day.

At least the questions he’s getting are no longer of the “what’s your favorite ice cream?” variety.

Here are two such questions.

Stephanie Ramos: (18:42)
Yeah. Thank you, Mr. President, two questions for you. The military has secured the airport, as you mentioned, but will you sign off on sending US troops into Kabul to evacuate Americans who haven’t been able to get to the airport safely?

President Biden: (18:56)
We have no indication that they haven’t been able to get in Kabul through the airport.

Given the incompetence of our intelligence this may actually be what Biden has been told.  Reports from Kabul say exactly the opposite.  It is also possible that Biden has been told what is going on there and simply forgot or is lying.

I have friends who have told me they’d rather have a demented Biden than an undemented Trump.  It looks like they’re getting their wish.

Here’s the previous post which contains older evidence.

*****

Biden is in early dementia — more evidence

In an earlier post (reproduced below the ***) I gave my reasons based on (presumably unedited) tapes of the President for concluding that President Biden is in the early stages of dementia.  I am a retired board certified neurologist and occasional board examiner with 34 years of clinical experience.

Here is further evidence.

In a town hall meeting put on by CNN 21 July President Biden became rather incoherent and confused when answering “When will children under 12 be able to get vaccinated.”

Here is the (presumably) unedited video of the meeting — https://www.cnn.com/2021/07/21/politics/full-president-joe-biden-cnn-town-hall-july-21/index.html.

The question was asked 6 minutes and 20 seconds into the recording.  The response starts to make not much sense at 7 minutes and at 7 minutes 21 seconds, he briefly becomes incoherent.  He continues on in this vein up to about 8 minutes.

This is what early dementia looks like.

Well that’s my opinion.  Look at the tape and make your own.

****  The earlier post

Biden is in early dementia — the evidence

As a neurologist I am often asked about Biden’s mental capacity.  My first post on the subject occurred after the first debate with Trump.  I thought he was intact — you can read about it here.

https://luysii.wordpress.com/wp-admin/post.php?post=5200&action=edit&calypsoify=1

Then I was asked to comment on the possibility that his previous operation for aneurysm could be causing trouble. I didn’t think this was likely as so much time had passed.  Interestingly, I knew the neurosurgeon as a Penn undergraduate when I was a neurology resident.  You can read the post at the end — Biden’s cerebral aneurysm.

That was written last December.

I changed my opinion after his press conference. of 14 June ’21 https://www.youtube.com/watch?v=PAWRHM4i3Dg
I strongly suggest you look at the segment at 15 minutes where his response makes little sense, and then he shuts down completely for 7 seconds, apparently quite confused. That’s my reading of the video. Form your own opinion.

Then on June 23rd I was sent another clip where he was confused

It is an 8 minute speech, and the clip can be found at 2 minutes, again showing an episode of confusion.

 

But first a story:

As a third year medical student on psychiatry rotation,  I interviewed a Bryn Mawr student who was on the psych ward (my wife was also an undergraduate at the time).  I well knew the intensity of the place, and how much pressure the girls (see the end of the post) put on themselves.  So I talked and talked and commiserated with her.  After a pleasant enough time the I concluded the interview and left.   The teaching psychiatrist asked me what I thought, and I told him how frigtening I found it given what I knew about Bryn Mawr. He asked me if I found out that she thought the television was talking to her.  Basically by yapping when she went off track, I kept her sane.

So I learned to shut up, and let people tell me what was wrong with them.  This is why Biden likely did well during the debates. The short time given to answer and the barrage of questions and interruptions kept him focused.

It really came home as I looked at the whole 8 minutes of the second clip trying to find the brief period of confusion.  Please look at the whole clip yourself and draw your own conclusions.  I see a pleasant,  rambling, slow thinking,  occasionally confused old man.

 

This is what early dementia looks like.

I was severely criticized by a follower after the first post.  Here it is,  “Issuing alarmist statements about his mental health is reprehensible. You are not his physician. Moreover, armchair diagnosis is frowned upon by the American Psychiatric Association.I’ve been following your blog for several years and also have been reading you comments on the “in the pipeline” blog. On the basis of that experience I had not expected to stoop that low.”

In my defense, I was defeated by the new WordPress editor which wouldn’t let me bring in the evidence shown here.  Apparently it was a (still extant) incompatibility of Safari with the editor.   I was still impressed enough by how confused Biden looked that I posted it anyway.

As the late Carl Sagan said “extraordinary claims require extraordinary evidence”. So here is the evidence (finally).  Apologies for the delay.

As children, our least favorite explanation was ‘because I say so’.

Essentially that’s part of what I’m offering here.  I was involved in clinical neurology from ’67 to ’00, and at a minimum saw at least 1 demented patient a week during that time.  That’s an underestimate, as I’d make rounds on other neurologists patients when covering weekends.  I doubt that anyone reading this has similar extensive experience.

So Biden just looks like all the early dementia patients I saw during that time.  Given my experience, I think that should carry some weight.

The fact that Biden appears sharp at times is typical of early stage dementia.  I’ve certainly seen it in family and friends, with such things being excused as ‘it must have been the heat’ or ‘they must not have been feeling well’.

Why is this important?  Khrushchev’s estimate of President Kennedy’s weakness lead to the Cuban Missile Crisis of 1962. Khrushchev’s son confirmed this when he spoke at the Kennedy Center at Harvard.   Kennedy was receiving narcotics for his back.  The side effects of what little medicines we had back then weren’t appreciated.  Example: thyroid and amphetamines were used to help people lose weight.

Biden does not appear mentally strong to Putin or Xi (or me).

  • Yes women undergraduates at Bryn Mawr and other members of the seven sisters called themselves girls (or at least were called that by males wishing to date them).  According my wife, who just corrected me,  Bryn Mawr undergraduates called themselves women, in contrast to a nearby educational institution which advertised “Are you a Harcum Girl?”  Similarly, 10 years later Native Americans in Montana called themselves Indians, not having the benefit of the linguistic and moral improvements to which we have currently ascended.

The post about Biden’s cerebral aneurysm surgery — https://luysii.wordpress.com/2020/12/08/bidens-cerebral-aneurysm/

 

Who lost Afghanistan ?

Who lost Afghanistan?  No one.  We were never winning, despite being told so.  It is not worth one more American life.  It is Vietnam all over again.

Here I speak with some authority, being an Air Force Officer and physician taking care of maimed US soldiers from Vietnam from ’68 – ’70 at Fitzsimons General Hospital in Denver.  The Army was short of neurologists, so I was assigned there for two years despite being an Air Force Officer and despite having only a year of residency under my belt.  Only fully trained neurologists were sent to Vietnam.

Vietnam is like Chile, a long strip of a country along a coast.  As a result, no wounded soldier was more than 20 minutes away by chopper from a fully equipped surgical field hospital, so the people surviving were far more gravely injured than those in world war II.

The tour of duty in Vietnam was 1 year, but the term of service for docs was two.  (Back then I asked one of my uncles what the term of service was in WWII — what do you think it was?   Answer — until the war was over). The doctors coming back after one year pretty much had their pick of the best places, and many wound up at Fitzsimons.  I talked (and worked with) a lot of them.  These were not career military with an axe to grind.  Not one of them thought we were winning.

They spoke of the corruption of our so-called allies, selling American military equipment to the Viet Cong, etc. etc.  The collapse when it came was swift, just as it is today in Afghanistan.

The only positive thing about Vietnam is that the country picked up a lot of smart Vietnamese.  One son went to Cornell with several children of Vietnamese boat people who came here with nothing.   Hopefully we’ll do the same with some of the Afghans.

We were never winning in Afghanistan despite the propaganda we’ve been fed.  The equally sudden collapse of our ‘allies’ in both countries is typical.

Although most conservative websites are unhappy, not all are.  The following is written by a vet who actually was over there

https://thefederalist.com/2021/08/13/u-s-leaders-have-been-lying-to-us-about-afghanistan-for-nearly-20-years/

This is from “The Federalist”  a conservative website.

 

Is the end of the pandemic at hand?

6 days ago I published my brother’s idea, that the pandemic may be nearing an end.  That post can be found below the ****

Here is some startling evidence that he might be right.  Today’s (12 August) Nature pp. 175 – 176, notes that new ‘cases’ in the UK defined as a positive test for the viral genome dropped in half from 17 July to 2 August 54,674 to 22,287. That could just be due to fewer people being tested (the total number tested isn’t given in the article).  More to the point, hospitalizations dropped from 836 25 July to 645 1 August.  It isn’t clear if all these numbers are daily or weekly.  Regardless, it is worth noting just how few cases are actually hospitalized ( 836/54674 = 1.5%)

These numbers are those persons deciding or required to be tested.  A random population survey is in order to see how many people now have antibodies to the virus.  Clearly SARS-Cov-2 can spread widely without making most people sick.

It is worth noting that the article doesn’t consider my brother’s idea as a possibility, so it likely originated with him.  If so, Bravo ! ! !

Addendum 19 August — from Nature vol. 596 p. 326 “In a nationwide survey of about 28,000 people (two-thirds of whom were unvaccinated and had therefore acquired immunity from infection) in June and July this year, researchers found that 68% had SARS-CoV-2 antibodies in their blood. This represented a huge increase from the 21% with antibodies, recorded in a similar survey in December 2020 to January 2021, before the second wave.”  This is exactly what my brother was talking about — vaccination by infection. It shows that most infections are survivable — with a population of 1.3 billion, the vast majority of those coming in contact with the pandemic virus are still here.

****

Sibling rivalry aside, my younger brother thinks that we’re currently in a mass vaccination situation with the pandemic virus.  He does not mean that people are willingly signing up for vaccinations. He says that the Delta virus is so infectious and spreading so quickly, and that most cases are asymptomatic that  the populace is being vaccinated by infection.  If so, those who will die because they weren’t vaccinated will die and those unvaccinated who have been infected but not sick will be immune, so that the populace will achieve herd immunity in a month or two and the pandemic will be over.Fantastic if true.

Cassava Sciences: What happened and what they should do next

The results of 9 months treatment with Sumafilam reported 29 July were exactly what I had hoped for;  namely continued improvement over baseline and over the 3 and 6 month interim results.  Yet the stock tanked that day, and has come back about 50% from the low.  It’s the old sick joke, the operation was a success but the patient was a failure.

I had a few guesses as to what happened in a post I wrote 30 July

” In the past few months, all companies with drugs for Alzheimer’s disease have been fluctuating in price together, and one of them (to remain nameless to protect the innocent) had the temerity to release a 25 day study today on their drug based on 14 patients.  The stock was down 60%.

 

So Cassava got tarred with this brush.

 

Another likely reason is that the rise in Cassava was fueled by very small investors.  If you watched the transactions on a day SAVA was soaring, the purchases were rarely over 200.  So many of them were likely buying because others were.  So they sold when others were.  Lemmings anyone?”

 

My guesses were totally wrong.  What actually happened was a very well timed and very well coordinated bear attack on the price of the stock.

 

As Lindsay Burns was presenting positive data the morning of July 29th, an article run by a guy with a political science degree attacked her data, using 3 neurologists, all developing other drugs for Alzheimer’s disease. At the same time some 200 Million  dollars worth of sell orders were placed (likely by several hedge funds).  The stock tanked.

 

Reality has subsequently intruded, as SAVA’s stock has rebounded 50% from the attack.

 

So what should Cassava do at this point?  Assume, as time passes, that patients continue improve or remain stable (as they already have for 9 months).  Within the next 3 months, and possibly sooner, SAVA will have  1 year results.  If patient cognition continues to show improvement (over 9 months, over baseline), game over.  No one taking care of an Alzheimer patient has ever seen them better off cognitively after a year has passed. .

 

The bears should not be forewarned as they have been. The 12 month results should released without warning, early in the week, so the bears don’t have the weekend to respond.  It would be an interesting short squeeze.