Remdesivir - an opening to a proven treatment but not a magic bullet

Echo report published in the journal Nature by Heidi Ledford:

Also reported in USAToday:

https://www.usatoday.com/story/news/health/2020/04/30/remdesivir-what-we-know-potential-coronavirus-treatment/3054644001/

Dr. Fauci said a U.S. federal trial use of remdesivir with patiets who are ill with coronavirus showed 'proof of concept'.

As of now, remdesivir is given in combination with other prescribed pharmaceutical agents and is administered intravenously to very ill patients who are diagnosed with coronavirus infection.

An experimental drug — and one of the world’s best hopes against COVID-19 — could shorten the time to recovery from coronavirus infection, according to the largest and most rigorous clinical trial of the compound.

The experimental drug, called remdesivir, interferes with replication of some viruses, including the SARS-CoV-2 virus responsible for the current pandemic. 

On 29 April, Anthony Fauci, director of the US National Institute of Allergy and Infectious Disease (NIAID), announced that a clinical trial of more than a thousand people showed that people taking remdesivir recovered in 11 days on average, compared to 15 days for those on a placebo.

“Although a 31% improvement doesn’t seem like a knockout 100%, it is a very important proof of concept,” Fauci said. “What it has proven is that a drug can block this virus.”

Deaths were also lower in trial participants who received the drug, he said, but that trend was not statistically significant. The shortened recovery time, however, was significant, and was enough of a benefit that investigators decided to stop the trial early for ethical reasons, he said, to ensure that those participants who were receiving placebo could now access the drug. Fauci added that remdesivir would become a standard treatment for COVID-19.

The news comes after weeks of data leaks and on a day of mixed results from clinical trials of the drug. In a trial run by the drug’s maker, Gilead Sciences of Foster City, California, more than half of 400 participants with severe COVID-19 recovered from their illness within two weeks of receiving treatment. But the study lacked a placebo controlled arm, making the results difficult to interpret. Another smaller trial run in China found no benefits from remdesivir when compared with a placebo. But the trial was stopped early due to the difficulty in enroling participants as the outbreak subsided in China. Nevertheless, onlookers are hopeful that the large NIAID trial provides the first glimmer of hope in a race to find a drug that works against the coronavirus, which has infected more than 3 million people worldwide.

“There is a lot of focus on remdesivir because it’s potentially the best shot we have,” says virologist Stephen Griffin at the University of Leeds in the UK.
Small trials

The fast-flowing, conflicting information on remdesivir has left people reeling over the past weeks. 

In the rush to find therapies to combat COVID-19, small, clinical trials without control groups have been common. “I’m just very annoyed by all of these non-controlled studies,” says Geoffrey Porges, an analyst for the investment bank SVB Leerink in New York City. “It’s reassuring that 50–60% of patients are discharged from the hospital, but this is a disease that mostly gets better anyway.”

With so much uncertainty, the remdesivir-watchers were waiting anxiously for final results from the NIAID trial, which were not expected until the end of May. In lieu of a vaccine, which could still be more than a year away, effective therapies are critical to reducing deaths and limiting economic damage from the pandemic. Yet, despite the flood of small clinical trials, no therapy has been convincingly shown to boost survival in people with COVID-19.

The NIAID results put a new sheen on remdesivir. “It may not be the wonder drug that everyone’s looking for, but if you can stop some patients from becoming critically ill, that’s good enough,” says Griffin.

Fauci said the finding reminded him of the discovery in the 1980s that the drug AZT helped to combat HIV infection. The first randomized, controlled clinical only showed a modest improvement, he said, but researchers continued to build on that success, eventually developing highly effective therapies. For now, he said, remdesivir would become a standard treatment for COVID-19.

Remdesivir works by gumming up an enzyme that some viruses, including SARS-CoV-2, use to replicate. In February, researchers showed that the drug reduces viral infection in human cells grown in a laboratory.

Gilead began to ramp up production of remdesivir well before the NIAID results. By the end of March, the company had produced enough to treat 30,000 patients. By streamlining its manufacturing process and finding new sources of raw materials, Gilead announced that it hoped to produce enough remdesivir to treat more than a million people by the end of the year.

That calculation was based on the assumption that people would take the drug for 10 days, but the results announced from Gilead’s trial today suggest that a 5-day course of treatment could work just as well. If so, that would effectively double the number of people who could be treated, says Porges.
Many drugs needed

In the long term, clinicians will likely want a bevy (a large group) of anti-viral drugs — with different ways of disabling the virus — in their arsenal, says Timothy Sheahan, a virologist at the University of North Carolina in Chapel Hill, who has teamed up with Gilead researchers to study remdesivir. “There is always the potential for antiviral resistance,” he says. “And to hedge against that potential, it’s good to have not only a first-line, but also a second-, third-, fourth-, fifth-line antiviral.”

Researchers are furiously testing a wide range of therapies, but early results, while not yet definitive, have not been encouraging. The malaria drugs chloroquine and hydroxychloroquine, both of which also have anti-inflammatory effects, drew so much attention from physicians and the public that some countries have depleted their supplies of the drugs. Yet studies in humans have failed to show a consistent benefit, and some have highlighted the risks posed by side effects of the drugs on the heart.

Early interest in a mix of two HIV drugs called lopinavir and ritonavir flagged when a clinical trial in nearly 200 people did not find any benefit of the mix for those with severe COVID-19. Another promising therapeutic hypothesis — that inhibiting the action of an immune system regulator called IL-6 could reduce the severe inflammation seen in some people with severe COVID-19 — has met with mixed results thus far.

Still, a host of other therapies are being tested in people, and many researchers are hunting for new drugs at the bench. Sheahan and his colleagues have found a compound that is active against SARS-CoV-2 and other coronaviruses, including a remdesivir-resistant variant of a coronavirus, when tested in laboratory-grown human cells.

But much more testing would need to be done before the compound could be tried in people. “What we’re doing now will hopefully have an impact on the current pandemic,” he says. “But maybe more importantly, it could position us to better respond more quickly in the future.”

Message to Donald Trump was sobering- "You're Fired!"

Associated Press report by Zeke Miller and Jonathan Lemire

WASHINGTON (AP) — Donald Trump erupted at his top political advisers last week when they presented him with worrisome polling data that showed his support eroding in a series of battleground states as his response to the coronavirus comes under criticism.

As the virus takes its deadly toll and much of the nation’s economy remains shuttered, new surveys by the Republican National Committee and Trump’s campaign pointed to a harrowing picture for the president as he faces reelection.

While Trump saw some of the best approval ratings of his presidency during the early weeks of the crisis, aides highlighted the growing political cost of the crisis and the unforced errors by Trump in his freewheeling press briefings.

Trump reacted with defiance, incredulous that he could be losing to someone he viewed as a weak candidate.

“I am not f—-ing losing to Joe Biden,” he repeated in a series of heated conference calls with his top campaign officials, according to five people with knowledge of the conversations. They spoke on condition of anonymity because they were not authorized to speak publicly about private discussions.

The message to the president was sobering: Trump was trailing the former Democratic vice president in many key battleground states, he was told, and would have lost the Electoral College if the election had been held earlier this month.

On the line from the White House, Trump snapped at the state of his polling during a series of calls with campaign manager Brad Parscale, who called in from Florida; RNC chair Ronna McDaniel, on the line from her home in Michigan; senior adviser Jared Kushner; and other aides.

Echoing a number of White House aides and outside advisers, the political team urged Trump to curtail his daily coronavirus briefings, arguing that the combative sessions were costing him in the polls, particularly among seniors. Trump initially pushed back, pointing to high television ratings. But, at least temporarily, he agreed to scale back the briefings after drawing sharp criticism for raising the idea that Americans might get virus protection by injecting disinfectants.

Trump aides encouraged the president to stay out of medical issues and direct his focus toward more familiar and politically important ground: the economy.

Even as Trump preaches (fake!) optimism, the president has expressed frustration and even powerlessness as the dire economic statistics pile up. It’s been a whiplash-inducing moment for the president, who just two months ago planned to run for reelection on the strength of an economy that was experiencing unprecedented employment levels. Now, as the records mount in the opposite direction, Trump is feeling the pressure.

“We built the greatest economy in the world,” Trump has said publicly. “I’ll do it a second time.”

Trump’s political team warned that the president’s path to reelection depends on how quickly he can bring about a recovery.

“I think you’ll see by June a lot of the country should be back to normal, and the hope is that by July the country’s really rocking again,” Kushner told “Fox & Friends” on Wednesday morning. But other aides, business leaders and economists predict a far longer road toward recovery.

Representatives for the Republican National Committee and the Trump campaign did not comment on the polling or last week’s phone calls. In a tweet just after midnight Wednesday, Trump denied that he had recently shouted at his campaign manager and said that “he is doing a great job.” 

According to people familiar with the incident, Trump vented much of his frustration at Parscale, who served as the bearer of bad news.

Trump has long distrusted negative poll numbers — telling aides for years that his gut was right about the 2016 race, when he insisted that he was ahead in the Midwest and Florida. At the same time, Parscale and other Trump aides are talking up the sophistication of their data and voter outreach capabilities this time.

The president and some aides have had simmering frustrations with Parscale for a while, believing the campaign manager — a close Kushner ally — has enriched himself from his association with Trump and sought personal publicity. Trump had previously been angered when Parscale was the subject of magazine profiles. This latest episode flared before the campaign manager was featured in a New York Times Magazine profile this week.

Aides have grown particularly worried about Michigan — which some advisers have all but written off -- as well as Florida, Wisconsin and Arizona.

Trump announced Wednesday that he will visit Arizona next week — his first trip outside Washington in a month — as he looks to declare that much of the nation is ready to begin reopening after the virus.

The president has mocked Biden, his presumptive general election rival, for being “stuck in his basement” in his Delaware home during the pandemic.

Trump said Wednesday that he hopes to soon visit Ohio, a battleground state that Trump carried handily in 2016 but that aides see as growing slightly competitive in recent weeks.

Aides acknowledged that the president’s signature rallies would not be returning anytime soon. Some have privately offered doubts that he would be able to hold any in his familiar format of jam-packed arenas before Election Day, Nov. 3.

Jonathan Lemire reported from New York.

Do not drink bleach. Full Stop! A medical opinion

Health officials: Man drank toxic cleaning product after Donald Trump’s stupid comments on disinfectants

https://whdh.com/news/health-officials-man-drank-toxic-cleaning-product-after-trumps-comments-on-disinfectants/

Stupid Donald Trump, "wondered aloud if couldisinfectants could be injected into people, the Kansas Poison Control Center has reported a 40 percent increase in cases involving cleaning solutions, the Wichita Eagle reported."

Alcohol and bleach are surface disinfectants. They don't disinfect inside the body. They only cause harm, without any benefit at all.

Physician "Dr. Bernard"reported in MedPage Today:

CB is a 35-year-old man presenting to the emergency room unconscious. His mom tells the admitting nurse that she found him on the floor with an empty bottle of rubbing alcohol in his hand. CB had read on the Internet that alcohol disinfects the SARS-CoV-2 virus. Afraid that he had been infected after touching his face at the grocery store, CB found a bottle of 91% rubbing alcohol and started drinking it.

Immediately after drinking the entire bottle, CB felt confident. He wasn't going to be infected this time. Someone on the Internet said it'll burn a little on the way down, but in his mind the benefits of disinfecting himself outweighed that burn. As the minutes passed, CB started feeling dizzy. The floor started spinning. He collapsed. His mom heard the noise and found him unconscious on the floor. She called for 911 as he's brought to the emergency room where we are now.

Rubbing alcohol's real name is isopropyl alcohol. Iso- meaning equal, propan-, which is a prefix, denoting the quantity of 3 and referring to the number of carbons, and alcohol meaning a chemical moiety of 1 oxygen bound to 1 hydrogen.

Long chains of carbon are oil. Oil doesn't mix with water at all, but alcohol groups interact with water because water is also made of hydrogen and oxygen. Both the name isopropyl alcohol and its structure not only tells us everything that we need to know about what's happening to CB, but it also tells us why drinking disinfectant isn't going to cure anyone of the virus.

How do alcohols disinfect? Well, they disturb proteins. On the surface of the SARS-2 virus are crown-shaped spikes. The word corona means crown, crown virus. These spikes are how SARS-2 virus infects people, and they're made of protein. If alcohols interfere with proteins and SARS-2 infects people using a protein, then rubbing alcohol should disinfect SARS-2 virus.

Seventy percent rubbing alcohol is a better disinfectant on surfaces than 91%. More doesn't appear to be better here. If 70% is alcohol, then the other 30% is water. Extra water helps to target these proteins. But while 70% isopropanol disinfects viruses on surfaces, it's not going to disinfect viruses inside the body, and here's why.

Anything that you swallow goes into your stomach and then absorbs into your liver. The liver breaks things down into forms that the body can handle. This is called metabolism. Humans evolved a very specific way of metabolizing alcohols. In the liver, there's something called alcohol dehydrogenase, de- meaning the removal of hydrogen, and -ase describing an enzyme, which is a protein that does chemical reactions (-ase is like lactase, which is an enzyme that breaks down milk sugar).

The body has no use for rubbing alcohol. It wants to get rid of it. 

To do that, it needs to make it easier to react with, in the hopes that a final product easily dissolves in water and can be collected by the kidneys to be urinated out. When alcohol dehydrogenase processes isopropanol it becomes acetone, which is the chemical name for nail polish remover.

Okay. If someone is exposed to SARS-2 virus and they get infected, it ends up in both of their lungs. We've already established that drinking rubbing alcohol is going to pass it into the liver where it's broken down to acetone. Acetone is a disinfectant too, so why wouldn't it end up in the lungs to fight the virus?

Well, this brings us to a concept called distribution. Once something is broken down by the liver, it enters the circulation. Human body has a large volume of water and blood, so that acetone is going to get diluted in that huge volume. Drinking a bottle of 91% rubbing alcohol will overload alcohol dehydrogenase in the liver. The acetone floating around will cause temporary brain problems, but it won't be concentrated enough to hit any virus in the lungs. Okay, so that's rubbing alcohol.

How about 60% liquor, like vodka or rum? Well, the alcohol that humans drink for fun is different. It's named ethanol. Ethan- means two. The CDC says that 120 proof, or 60% alcohol, can disinfect SARS-2 virus. But that disinfection happens outside the body, not inside.

Ethanol's broken down by alcohol dehydrogenase in the liver. Anything with an alcohol group gets processed by this enzyme. The result is acetaldehyde. This is what causes someone to become red when they drink and it also causes hangovers.

Acetaldehyde isn't a disinfectant and the body wants to get rid of it, so acetaldehyde is broken down again into acetate, which is a very weak vinegar and also not a disinfectant. Vinegar can be a disinfectant, but when it's weakened like this it isn't.

Drinking 60% liquor won't cure anyone of COVID-19 if SARS-2 virus is already in the body. Inhaling it won't cure the disease either. It would bypass the liver. It would bring a first pass of alcohol right to the brain. We don't have good data on this. But at 60%, that's going to negatively impact your brain, provided it doesn't damage the mucous membranes and lungs in the first place.

Alcohol inhalation misuse can cause acute respiratory distress syndrome, which is what happens in severe COVID-19 disease. The only analogy I have for inhaling really concentrated ethanol in hopes of disinfecting SARS-2 virus in your lungs is that it's like lopping off your leg to clip a toenail. No benefit at all and all risk, so don't do it.

The final, alcohol. There were news reports of people in Iran drinking industrial-strength alcohol, a prominent one being methanol, methan- being the prefix meaning one. In the body, alcohol dehydrogenase turns methanol into formaldehyde. This chemical was used to embalm mummies.

Formaldehyde is a disinfectant, but it's also a poison. Instead of weak vinegar, formaldehyde gets broken down a second time to become methanoic acid, which causes blindness. The acid part spills into the blood, causing acidemia, acid presence in blood. In high enough amounts in blood, acids can cause the heart to stop beating, meaning that no alcohols are good enough for curing COVID-19 inside humans. They should be good enough to disinfect surfaces outside the body in the right concentrations, which brings us back to CB.

Acetone -- nail polish remover -- causes mild nervous system effects. The body can't break it down any further because of the balance part from the word iso-. The chemistry says that these bonds are too hard to break in humans, so it's a matter of time for CB's body to work to eliminate it in his urine.

With supportive care, he came out of his coma and was sent home a day later. It's good that he ended up being okay, but it's not good that the hospital had to use those resources during this pandemic. There are other patients who come in critically ill, and then there's CB because he drank rubbing alcohol. Don't be like CB.

How about another disinfectant? AC is a 40-year-old man presenting to the emergency room with drooling and vomiting. He tried to speak, but he couldn't. An exam of his mouth and throat found swelling, redness, and ulcers inside. In the emergency room, doctors immediately stick a tube with a camera down his throat. Swelling and inflammation were so bad that they couldn't find his vocal cords.

A longer tube was stuck down his throat to look at his stomach. Burns and dead tissue were found in the inner lining of his esophagus, confirming that AC is suffering from caustic burn injury because he accidentally swallowed industrial-strength bleach, thinking that it would cure him of the virus.

He later claimed that he thought it was dilute and watered down before drinking it, which is plausible, and here's why. Bleach is a really good disinfectant. Household bleach is sodium hypochlorite. If you take away the hypo-, sodium chlorite is industrial-strength bleach.

This brings us to a concept called equilibrium. Household bleach is around 6% sodium hypochlorite. The rest is mostly water. In this mixture, water interacts with the sodium and the hypochlorite. If we break it down, bleach is multiple chemicals living together in a balanced state called equilibrium.

These chemicals are sodium hydroxide, which is a base. A base is something that takes hydrogens. This is opposite to an acid, which is something that gives hydrogens, and this balance is complete because bleach produces hypochlorous acid in solution. These quickly kill bacteria and viruses, but they're not the only thing that bleach kills.

Human cells are enclosed by a layer of molecules that have long chains of fats. Sodium hydroxide from the bleach doesn't just take a hydrogen from these fats, it strips off long chains of it. Doing this actually ends up making soap. Immediately on contact, bleach rips open cells, spilling their contents out, but it's not done here.

Proteins live on the surface of cells, meaning that they're freed once that fat layer is stripped off. Sodium hydroxide and hypochlorous acid from bleach neutralize these proteins, all of this immediately consuming the bleach solution. By the time it gets to the stomach it's not really bleach anymore.

It's a mix of soap, salt, and dead liquefied tissue. This is why it doesn't cure COVID-19. It consumes itself on the way down because it reacts with everything that it touches. It never gets to the lungs, but if someone somehow did inhale it, it would strip off all the cells of the windpipe and the lungs, causing burns there too. Again, lopping off your leg to clip a toenail.

AC developed narrowing in his esophagus because scar tissue grew over time. He had to undergo multiple procedures where a balloon was put in his esophagus and inflated to keep it open, and he was maintained on a liquid diet because there were permanent scars.

Alcohol and bleach are surface disinfectants. They don't disinfect inside the body. They only cause harm, without any benefit at all.

How about other things? Some people say eating garlic is going to help fight SARS-2 virus. Well, it's probably not going to. Garlic has some antimicrobial properties and this could be because of a chemical named allicin. There could be more chemicals, and that's fine. When you see something like this in a chemical, you can assume that it's going to interact with sulfur in the body. Where's sulfur? It's in proteins, just like the SARS-2 virus spike. But inside the body, it's going to get broken down when you eat it.

You might say that garlic can boost the immune system. Okay, suppose that's real, and maybe it is. How are you going to measure that? And there's no role in treating a critically ill patient today with that. "I don't need to wash my hands because I ate garlic today." No, stop.

The only documented case of garlic doing anything for COVID-19 is a report from China in Zhejiang province, where a woman ate 3 lbs. of garlic. This is what happened to her throat. She couldn't speak because it was inflamed. That's it

Don't get me wrong, I like my garlic. But if I have fever and I'm starting to become short of breath right now in March 2020, I'm not going to be eating more garlic hoping that it all goes away and neither should you.

There's also more talk about ginger. Look, SARS-2 virus broke out in China. Chinese people today still practice traditional Chinese medicine, mixed with variations on Western standards of care. If ginger worked, they would have used it and SARS-2 virus wouldn't have spread like this. But it did spread like this.

Finally, essential oils. These have kind of become the butt of jokes -- and I know people probably want me to rag on them -- but they do actually have compounds that have demonstrated some antimicrobial activity, but the game changes once these things are inside the body. That's the overarching theme for everything involving disinfecting this virus. The scientific phrase for this is in vivo, from Latin meaning "inside life."

These things are broken down into things that don't disinfect, and if they do, they're not in the right amounts to disinfect. They end up causing more harm than good in the body. For essential oils, the reality is that the manufacturers of these oils have a wide variability in how much of the active chemicals are in their formulation. One manufacturer might have more of one thing than the other. One may have less than the other. It's not reliable and it's not enough to cure COVID-19 disease, and it could do harm in falsely elevating your confidence that it has eliminated a virus when it actually hasn't.

Anything that you swallow goes into your stomach and then absorbs into your liver. The liver breaks things down into forms that the body can handle. This is called metabolism. Humans evolved a very specific way of metabolizing alcohols. In the liver, there's something called alcohol dehydrogenase, de- meaning the removal of hydrogen, and -ase describing an enzyme, which is a protein that does chemical reactions (-ase is like lactase, which is an enzyme that breaks down milk sugar).

The body has no use for rubbing alcohol. It wants to get rid of it. To do that, it needs to make it easier to react with, in the hopes that a final product easily dissolves in water and can be collected by the kidneys to be urinated out. When alcohol dehydrogenase processes isopropanol it becomes acetone, which is the chemical name for nail polish remover.

Okay. If someone is exposed to SARS-2 virus and they get infected, it ends up in both of their lungs. We've already established that drinking rubbing alcohol is going to pass it into the liver where it's broken down to acetone. Acetone is a disinfectant too, so why wouldn't it end up in the lungs to fight the virus?

Well, this brings us to a concept called distribution. Once something is broken down by the liver, it enters the circulation. Human body has a large volume of water and blood, so that acetone is going to get diluted in that huge volume. Drinking a bottle of 91% rubbing alcohol will overload alcohol dehydrogenase in the liver. The acetone floating around will cause temporary brain problems, but it won't be concentrated enough to hit any virus in the lungs. Okay, so that's rubbing alcohol.

How about 60% liquor, like vodka or rum? Well, the alcohol that humans drink for fun is different. It's named ethanol. Ethan- means two. The CDC says that 120 proof, or 60% alcohol, can disinfect SARS-2 virus. But that disinfection happens outside the body, not inside.

Ethanol's broken down by alcohol dehydrogenase in the liver. Anything with an alcohol group gets processed by this enzyme. The result is acetaldehyde. This is what causes someone to become red when they drink and it also causes hangovers.

Acetaldehyde isn't a disinfectant and the body wants to get rid of it, so acetaldehyde is broken down again into acetate, which is a very weak vinegar and also not a disinfectant. Vinegar can be a disinfectant, but when it's weakened like this it isn't.

Drinking 60% liquor won't cure anyone of COVID-19 if SARS-2 virus is already in the body. Inhaling it won't cure the disease either. It would bypass the liver. It would bring a first pass of alcohol right to the brain. We don't have good data on this. But at 60%, that's going to negatively impact your brain, provided it doesn't damage the mucous membranes and lungs in the first place.

Alcohol inhalation misuse can cause acute respiratory distress syndrome, which is what happens in severe COVID-19 disease. The only analogy I have for inhaling really concentrated ethanol in hopes of disinfecting SARS-2 virus in your lungs is that it's like lopping off your leg to clip a toenail. No benefit at all and all risk, so don't do it.

The final, alcohol. There were news reports of people in Iran drinking industrial-strength alcohol, a prominent one being methanol, methan- being the prefix meaning one. In the body, alcohol dehydrogenase turns methanol into formaldehyde. This chemical was used to embalm mummies.

Formaldehyde is a disinfectant, but it's also a poison. Instead of weak vinegar, formaldehyde gets broken down a second time to become methanoic acid, which causes blindness. The acid part spills into the blood, causing acidemia, acid presence in blood. In high enough amounts in blood, acids can cause the heart to stop beating, meaning that no alcohols are good enough for curing COVID-19 inside humans. They should be good enough to disinfect surfaces outside the body in the right concentrations, which brings us back to CB.

Acetone -- nail polish remover -- causes mild nervous system effects. The body can't break it down any further because of the balance part from the word iso-. The chemistry says that these bonds are too hard to break in humans, so it's a matter of time for CB's body to work to eliminate it in his urine.

With supportive care, he came out of his coma and was sent home a day later. It's good that he ended up being okay, but it's not good that the hospital had to use those resources during this pandemic. There are other patients who come in critically ill, and then there's CB because he drank rubbing alcohol. Don't be like CB.Human cells are enclosed by a layer of molecules that have long chains of fats. Sodium hydroxide from the bleach doesn't just take a hydrogen from these fats, it strips off long chains of it. Doing this actually ends up making soap. Immediately on contact, bleach rips open cells, spilling their contents out, but it's not done here.

Proteins live on the surface of cells, meaning that they're freed once that fat layer is stripped off. Sodium hydroxide and hypochlorous acid from bleach neutralize these proteins, all of this immediately consuming the bleach solution. By the time it gets to the stomach it's not really bleach anymore.

It's a mix of soap, salt, and dead liquefied tissue. This is why it doesn't cure COVID-19. It consumes itself on the way down because it reacts with everything that it touches. It never gets to the lungs, but if someone somehow did inhale it, it would strip off all the cells of the windpipe and the lungs, causing burns there too. Again, lopping off your leg to clip a toenail.

AC developed narrowing in his esophagus because scar tissue grew over time. He had to undergo multiple procedures where a balloon was put in his esophagus and inflated to keep it open, and he was maintained on a liquid diet because there were permanent scars.

Alcohol and bleach are surface disinfectants. They don't disinfect inside the body. They only cause harm, without any benefit at all.

How about other things? Some people say eating garlic is going to help fight SARS-2 virus. Well, it's probably not going to. Garlic has some antimicrobial properties and this could be because of a chemical named allicin. There could be more chemicals, and that's fine. When you see something like this in a chemical, you can assume that it's going to interact with sulfur in the body. Where's sulfur? It's in proteins, just like the SARS-2 virus spike. But inside the body, it's going to get broken down when you eat it.

You might say that garlic can boost the immune system. Okay, suppose that's real, and maybe it is. How are you going to measure that? And there's no role in treating a critically ill patient today with that. "I don't need to wash my hands because I ate garlic today." No, stop.

The only documented case of garlic doing anything for COVID-19 is a report from China in Zhejiang province, where a woman ate 3 lbs. of garlic. This is what happened to her throat. She couldn't speak because it was inflamed. That's it

Don't get me wrong, I like my garlic. But if I have fever and I'm starting to become short of breath right now in March 2020, I'm not going to be eating more garlic hoping that it all goes away and neither should you.

There's also more talk about ginger. Look, SARS-2 virus broke out in China. Chinese people today still practice traditional Chinese medicine, mixed with variations on Western standards of care. If ginger worked, they would have used it and SARS-2 virus wouldn't have spread like this. But it did spread like this.

Finally, essential oils. These have kind of become the butt of jokes -- and I know people probably want me to rag on them -- but they do actually have compounds that have demonstrated some antimicrobial activity, but the game changes once these things are inside the body. That's the overarching theme for everything involving disinfecting this virus. The scientific phrase for this is in vivo, from Latin meaning "inside life."

These things are broken down into things that don't disinfect, and if they do, they're not in the right amounts to disinfect. They end up causing more harm than good in the body. For essential oils, the reality is that the manufacturers of these oils have a wide variability in how much of the active chemicals are in their formulation. One manufacturer might have more of one thing than the other. One may have less than the other. It's not reliable and it's not enough to cure COVID-19 disease, and it could do harm in falsely elevating your confidence that it has eliminated a virus when it actually hasn't.

Vitamin C*. There isn't great evidence for it on cold and flu, which are different illnesses than COVID-19. If you're going to take it, follow the directions on the label. Don't double it up. The general consensus is this. Lots of things can kill SARS-2 virus outside of the body. They don't kill the virus inside the body because the game changes in vivo. At best, they don't mess with COVID-19 disease like garlic and ginger, and at worst, they cause somebody to go blind, and someone's heart to stop beating like methanol. At worst, it liquefies and strips off the inner lining of your throat and stomach, like bleach. (Dr. Bernard received push back about this use of Vitamin C opinion.  See link to see the responses.)

Or at worst, it does nothing and gives someone self-confidence that they're clear of the infection, when they're actually not. Then they go out and spread it around the community because they think they're virus-free. Don't be that person.

Wash your hands after you come back home. Wash them after you touch anything that came from outside of your house. When you wash, keep the soap on your hands for 20 seconds while rubbing them together thoroughly. It's even better if you wash them a second time again for another 20 seconds right after, and then dry your hands with a clean towel.

That's all benefit for prevention with little risk. But if you do feel fever and cough and body aches, then get that checked out. Don't pretend nothing is wrong if you feel sick. It doesn't matter what age you are. This is very important. #alert_notanxious. Check out Heme Review. Take care of yourself and be well.

"Dr. Bernard" is a licensed physician and clinical adjunct professor at the University of Illinois.

*https://www.clinicaltrials.gov/ct2/show/NCT04323514
...and this one from China:
https://clinicaltrials.gov/ct2/show/NCT04264533

Quislings - Donald Trump's collaborators

"Trump's slaves...," David Driesen

Quisling is a term originating in Norway, used in Scandinavian languages and in English for a person who collaborates with an enemy occupying force – or more generally as a synonym for traitor.

Vidkun Quisling (left) with Nazi leaders including Heinrich Himmer (2nd from l), 1941

Echo opinion published in the History News Network by David Driesen, Professor at Syracuse University College of Law.

Trump has made it absolutely clear to every federal official that he will fire anybody who follows the law when it conflicts with his personal will. He fired FBI Director James Comey for investigating national security adviser Michael Flynn’s illegal conduct. Trump viciously forced out acting FBI Director Andrew McCabe, who authorized investigation of presidential obstruction of justice, days before he would become eligible for a pension and then his administration tried (unsuccessfully) to get a grand jury to indict him criminally. He dismissed Attorney General Jeffrey Sessions, who obeyed ethics rules requiring his recusal from investigation of Russian interference with the 2016 election. He secured the resignation of Homeland Security Director Kirstjen Nielsen, who wanted the administration to obey the laws protecting immigrants with bona fide asylum claims from deportation. 
With horrible imagry, Trump humiliated Lt. Col. Alexander Vindman by having him escorted off the White House grounds like a criminal, because he obeyed a lawful congressional subpoena requiring him to testify about President Trump’s conduct with respect to Ukraine. 

Trump cast out Inspector General Michael Atkinson for obeying the law requiring him to share whistleblower complaints with Congress.

Trump has made obeying the oath that every federal official swears to protect and defend the Constitution a firing offense. The Constitution specifically requires all federal officeholders to swear allegiance to the Constitution, a break from the monarchial practice of swearing featly to the supreme leader. The Oath Clause provides a foundation for the Framers’ project of creating a constitutional rule of law. Trump’s practice dismantles the rule of law at the heart of our constitutional democracy.

Trump seeks a government of quislings, people who view themselves as Trump’s slaves, not noble servants of the Constitution. Trump has triggered an exodus of competent officials who take their obligations to our constitutional democracy seriously.

The Founding Fathers and many of their most respected successors warned that giving the President unfettered control of the executive branch of government would lead to a quisling government and the death of freedom. Alexander Hamilton in the Federalist Papers said that the Constitution was designed to prevent appointees “personally allied to” the President or “possessing the necessary insignificance and pliancy to render them obsequious instruments of his pleasure” from gaining office. Senator Daniel Webster maintained that conferring an absolute removal power on the President would turn public officers into “sycophants . . . and man-worshippers.” Supreme Court Justice Joseph Story explained the “old Federalist position” that “unlimited power of removal” may become an “instrument of the worst oppression and most vindictive vengeance.” And Justice Brandeis saw the Founders’ decision to reject “uncontrollable” presidential removal as a part of the separation of powers designed “to save the people from autocracy.”

Trump’s attack on the rule of law emulates that of autocrats he admires in Hungary, Turkey, and elsewhere who have destroyed democracies. Once an autocrat establishes quisling government, the autocrat’s minions destroy freedom. In autocracies, the government investigates and prosecutes regime opponents, while giving a free pass to corrupt government supporters. Trump has repeatedly asked the Justice Department to persecute his political opponents and suggested that it not investigate Republicans suspected of corruption. Autocrats use law not to achieve the laws’ objectives, but to subdue opposition and bolster their supporters. If Trump remains in office, America will likely lose its freedom through these forces.

Some of Trump’s dismissals are illegal. They violate civil service laws put in place in the 19th Century when a practice of making offices contingent on political support for the President had debilitated the federal government. But Trump will pay no price for violating these laws, because the Supreme Court declined to allow damage actions against President Nixon when he allegedly forced out a whistleblower in a 5-4 decision. In cases where

Trump has formal authority to dismiss an official, he has abused that authority by violating our constitutional customs safeguarding prosecutorial independence and the freedom to obey the law.

As Trump dismantles constitutional government, Trump’s Department of Justice (DOJ) has asked the Supreme Court to hasten its demise. In that case, DOJ declined to defend a statute protecting the head of the Consumer Financial Protection Board from arbitrary dismissal, instead asking the Court to give Trump the power to fire all important federal officials for political reasons. The DOJ’s decision not to defend a statute that both courts of appeal reviewing this case found justified by existing precedent suggests that Trump has made remarkable progress in substituting autocratic rule for the rule of law. We can only hope that the Justices have the wisdom to reject these pleas, which a more independent DOJ probably would not have made.

Echo opinion- Donald Trump and his incompetent regime are callous, malevolent and deeply cruel

Donald Trump is a malignant narcissist....echo reported in Salon by Chauncey Devega

As of Friday April 24, the coronavirus pandemic has killed at least 50,000 people in the United States. That number is likely to be an undercount, and it's possible we will never have a true reckoning.

At almost every juncture, Donald Trump has made decisions about the coronavirus pandemic that have led to more death. His behavior is that of a person who has no care or concern for the health, safety and welfare of the American people. Nothing could epitomize that more perfectly than his grotesque suggestion this week that "injecting" disinfectants or household cleaning products might kill the coronavirus. This would seem comical, and entirely unbelievable, if it had not actually happened.

In 2016 the Obama administration told Trump and his advisers of the high likelihood that a pandemic would strike the nation and advised the incoming administration to take appropriate steps to reduce its impact. Obama officials also left their Trump counterparts a step-by-step guide on how to respond to a pandemic. Trump and his inner circle ignored that guidance.

Last November, the U.S. military warned Donald Trump that the country was likely to be afflicted with a devastating pandemic originating in China.

In January 2020, the Trump administration was told by its own experts that the coronavirus would spread beyond China and become a global pandemic. Again, Trump chose inaction.

Trump has deprived Democratic-led regions of the country from receiving needed medical supplies. He also waited months to begin using the Defense Appropriation Act to compel American companies to produce more ventilators, masks and other emergency equipment.

Late last year, Americans working with the World Health Organization began to warn Trump and his administration about the coronavirus pandemic. These doctors and other medical professionals were ignored.

In these examples and many others, Trump and his inner circle ignored or purged experts and other truth-tellers, and lied about, misrepresented, deflected or denied the dire threat to the American people posed by the coronavirus pandemic.

Considered in total, Trump and his regime have shown themselves to be incompetent, callous, malevolent and deeply cruel in their response to the coronavirus crisis (as well as to a plethora of other issues).

But to merely document the Trump regime's deadly failures in response to the coronavirus pandemic is to ignore the most important question: What were Trump and his advisers' underlying motivations?

This forensic question must be answered if we are ever to have a full accounting of the coronavirus, and see justice done for the sick, the dead and the dying as well as the damage done to the broader American community.

Media critic (and former Salon writer) Eric Boehlert summarizes the importance of determining Donald Trump's motives this way:

The media's preferred storyline suggests that Trump is simply incompetent, but that's too simplistic. It just doesn't add up, because Trump has made the wrong decision every single time in terms of how crises like this are supposed to be dealt with. (i.e. Be consistent, transparent, factual, and credible.) It's increasingly not believable for the press to suggest Trump has been distracted or inept during this crisis, in part because of the level of White House uselessness has become so staggering.

Maybe Trump's vengeful. Maybe he wants to wreck the economy to create investment opportunities? He's under the thumb of a foreign entity? He wants to cause panic and cancel the November elections? He's a fatalist? Who knows. And honestly, the specific "why" isn't what matters now. What matters is asking the difficult questions and pondering what the Trump presidency is truly about, no matter what lurks in the shadows….

Now the press needs to shift some of its focus and ask the truly alarming questions about Trump and his motives. Because we still don't know why he essentially ordered the federal government to stand down for the virus invasion.

Psychologist and psychotherapist John Gartner, contributor to the bestselling book "The Dangerous Case of Donald Trump" and co-founder of the Duty to WARN PAC, has an answer: Donald Trump is a malignant narcissist. Our president's mental pathologies inexorably compel him to hurt and kill large numbers of people — including his own supporters.

Dr. Gartner taught for many years at the Johns Hopkins University Medical School, and has private therapeutic practices in Baltimore and New York, specializing in the treatment of borderline personality disorders. In our most recent conversation, he explains that sadism and violence are central to Trump's malignant narcissism and his decision-making about the coronavirus pandemic. Gartner also warns that Donald Trump is an abuser locked into a deeply dysfunctional relationship with the American people and that, like other sadists, Trump enjoys causing harm and suffering.

Ultimately, Gartner concludes that Donald Trump is engaging in "democidal behavior" and cautions that the tens of thousands of dead (so far) from the coronavirus pandemic are not simply collateral damage from Trump's policies, but rather the logical outcome of Trump's apparent mental pathologies and the poor decisions that flow from them.

This conversation has been edited for clarity and length.

Failed Donald Trump response to coronavirus is incompetence!

Opinion echo published in the Reno Gazette Journal, by William McCurdy II, the Nevada State Democratic Party chair.

Avoid close contact with people who are sick (Nevada alert)!

As Nevadans struggle through worst public health crises of our lifetime, we’re also bearing the brunt of a man-made disaster. 

In fact, the consequences of an unprepared, erratic Trumpzi president are already being felt in hospitals across the state — and they will continue to be tallied in a rising death toll and surging damage to our economy. 

(Maine Writer says:  #Trump_genocide!)

Nevada is a majority-minority state made up of a vibrant African American community, a nearly one-third Latinx population and one of the fastest-growing Asian American Pacific Islander populations in the country. Nationwide, Brown and Black Americans have been disproportionately affected by the effects of this virus, meaning Nevada’s diverse communities are the ones bearing the brunt of the economic crisis and facing an increased mortality rate.

Yet despite warnings from his own advisers, pleas from state leaders and a devastating reality on the ground, Donald Trump has failed to mobilize quickly the resources Nevadans desperately need from the federal government. Instead, his chaotic response is leaving us to fend for ourselves.

Months ago, as U.S. intelligence agencies warned of a looming pandemic, Trump assured us that the situation was “very well under control.” As cases mounted and other countries sprang into action, he continued wasting precious time downplaying the crisis.

Then, as the pandemic reached Nevada, Gov. Steve Sisolak requested urgently needed personal protective equipment. Weeks later, the administration had delivered just a quarter of what was needed.

When SEIU Local 1107 surveyed the 9,000 health care workers; it represents at 11 hospitals across Nevada, 72% said they didn’t have enough equipment and cleaning materials to do their jobs safely.

We’ve heard the same story across the country. As doctors and nurses strain to keep up in overcrowded facilities, communities are desperate for gloves, masks, gowns and other basic supplies.

The administration’s response? You’re on your own.

“We’re not a shipping clerk,” Trump told reporters last month.

His son-in-law, Jared Kushner, echoed that chilling disinterest in distributing the administration’s emergency supplies: “It’s supposed to be our stockpile.”

That cold-blooded approach to public health isn’t just hurting those on the front lines. A severe lack of testing kits is leaving most of us in the dark about our personal status as well as the caseload in our communities.

Yet, after repeated requests for more tests, the administration told Gov. Sisolak that Nevada was stuck on an “indefinite backlog” with no timeline for delivery.

In the midst of a fight that has enveloped every aspect of our lives, Trump is sending us into battle unarmed and with one arm tied behind our back. That failure has forced Nevada to take matters into our own hands.

Under the governor’s decisive leadership, the state has raised funds, collected equipment and made strides toward developing our own testing systems.

There’s no question that Nevadans have made extraordinary progress in a short amount of time. These are major achievements that will save lives. But we can’t fully face this challenge on our own.

As the economy craters and record-breaking numbers of Americans suddenly find themselves out of work, an every-state-for-itself frenzy will only wreak further devastation.

In our greatest moments of crisis, Americans have always looked for national leadership to rally us together as a country. Instead, this White House would rather we face this pandemic divided and scrambling to survive.

This isn’t the time for petty, teritorial politics. An overwhelming disaster demands national cooperation and solidarity. 

Even as we keep our distance from each other, it’s never been more important for us to stand together. 

That’s doubly true for those in positions of power.

Coronavirus response requires a solidarity revolution: Food for body and soul

Quotes by Dorothy Day

• "The greatest challenge of the day is: how to bring about a revolution of the heart, a revolution which has to start with each one of us?"

• "Food for the body is not enough. There must be food for the soul."

Published in The Tablet, a British Jesuit journal, by Christopher White, National Correspondent 
Georgetown Panel: COVID-19 Crisis Shows Need for Solidarity, Community

NEW YORK — Addressing the world two weeks ago at the height of the global pandemic, Pope Francis paid tribute to the “forgotten people” – the grocery clerks, service industry workers, cleaners, and caregivers, the people that are frequently overlooked, yet are now keeping the world functioning.

Earlier this week, a virtual Georgetown University discussion examined how those individuals – and the tens of millions of people experiencing economic devastation from the pandemic – might best be supported by both the Church and the country in the pandemic’s aftermath.

The panel, “Life and Dignity, Justice and Solidarity: Moral Principles for Responding to the COVID-19 Economic Crisis,” was convened on Monday, by the university’s Initiative for Catholic Social Thought and Public Life and brought together a mix of policy experts, academics, and a community activist, with the aim of charting a path forward.

E.J. Dionne, who teaches at Georgetown and is a columnist for the Washington Post, kicked off the discussion by noting that while the government is rightfully calling for physical social distancing, he said that now, more than ever, is the time for social connection in order to ensure strong societal bonds to both get through the pandemic and to be united in the eventual rebuilding that will need to occur.

Similarly, New York Times columnist David Brooks highlighted the Catholic principle of solidarity as “an active virtue” that demands the participation of every single individual member of society. While Brooks is not a Catholic, he said that Catholic social teaching is the “most coherent philosophy that opposes a philosophy of rampant individualism” and should be relied on especially now.

The pandemic “exposes the fragmentation in our society,” Brooks continued, and saying that we can’t go back to way things were before.

Michael Strain of the American Enterprise Institute rebutted arguments made by some of his fellow conservatives in recent weeks that the cure to the pandemic “cannot be worse than the problem,” by arguing that the economy is meant to be in service of the common good.

While the decision to shutter many businesses in order to encourage social distancing is causing economic hardship, Strain said that economic loss must be tolerated in order to save human lives. Further, he said that there is good historical evidence for workers to be confident that this is not the end of the story and the economy will rebound.

Maru Bautista who works with the Center for Family Life in Brooklyn, New York promoting immigrant-led worker cooperatives said that she hopes that the crisis will lead to a reordering of our current system, including a greater opening to the possibility of Medicare for all to expand access to healthcare.

“We need to have the courage to see new possibilities that can create a different landscape for everybody,” she told the online audience.

Although most of the panelists cautiously praised the recent stimulus bill passed by Congress as a good and necessary first step at providing economic relief, they all agreed it would not be enough to provide long-term support.

Brooks said that he would have liked for a larger percentage of the money to go toward small businesses through the form of forgivable payroll loans rather than forcing businesses to layoff employees so that they can receive unemployment benefits. Bautista said that many immigrants will still have trouble accessing the funding programs, particularly highlighting that food stamps is a critical issue to many people in her community.

Dionne concurred, telling attendees that in Congress it’s hard to pass anything that helps non-citizen immigrants, but noting that if the nation is serious about wanting the economy to take off – and if it is concerned about justice – that must be remedied.

As the panel wrapped up, the discussion moved from economic concerns to communal ones, with Strain noting that even prior to the pandemic, loneliness and isolation was one the rise in America and he feared that this would only exacerbate the problem. He said that we should be particularly concerned about mental health issues, as well as that of heightened domestic abuse, in light of the pandemic.

Brooks said that the individualism that has defined the American system for the past sixty years has “had a good run,” but that he hopes that the nation is now at a turning point toward a great reliance on community.

John Carr, the director of Georgetown’s Initiative, concluded the program, which started at the beginning of Holy Week, but painfully acknowledging that “we’re doing passion and death pretty well, but I hope we can get to resurrection.”

“This is a time to go back to fundamentals,” said Carr, “as sisters and brothers made in the image of God.”
Tags: Catholic Church, Catholic Faith, Coronavirus Pandemic, Georgetown University

Save our Post Office: An integral part of our Nation

Maine Writer - Of course, I appeciate and support this point of view, an opinion published in the Iowa newspaper The Gazette, but in my further opinion, I intend to stand in line for as long as it takes to vote all Republicans out of office!  Remove every one of them!

Mail-in voting should be a pandemic priority- Congress must protect the Post Office from a being the victim of Donald Trump's political polarization!  He intends to prevent Americans from voting.

Echo opinion from Jan Patterson

The most important thing Americans do for our democracy is vote. That’s the basis for everything from our local officials to the President of these United States. 

But, we shouldn’t have to take a chance, or possibly expose the election officials, to the virus by voting in this pandemic.

Many states already vote exclusively by mail. All of the states should follow their example. Counties already have the process in place to vote by absentee ballot. By including all voters we can save countless lives, and isn’t that the goal in a pandemic? The life you save could be yours. Even the president voted by absentee ballot last time.

Fraud is often given as a criticism by opponents, but proof is never found to back up the claims. The Mueller Report did spotlight deficiencies that need to be addressed to protect against foreign or domestic hacking. These problems should be addressed by increasing election security, but bills designed to do this are sitting in the Senate majority leader’s desk. 

Cyber security should concern everybody.

Our Post Office is an integral part of our Nation, and would play an even bigger part if we all vote by mail. We should all support the work they do. It keeps America going.

Call the auditor’s office, ask for an absentee ballot, for health, weather, or other reasons.

Call our Senators and urge them to support the National Disaster and Emergency Ballot Act. 

No one should die because they cast a vote. (Protect voting rights!)

Jan Patterson  in Marion, Iowa

Christians who defy public health directives are putting others in danger

Christian Groups That Resist Public-Health Guidelines Are Forgetting a Key Part of the Religion's History

Published in TIME and the History News Network by Matthew Gabriele

(Maine Writer- I believe it's a tenet among some Pentecostals groups and cults like Seven Day Adventists that the end of times is to be desired, because those who believe their particular doomsday creed will be raised, while the those left behind will be cast into hades.)

Because of its long history, Christianity has a tendency to produce contradicting reactions to any number of situations—and the ongoing COVID-19 pandemic is no exception. 

On one hand, some religious leaders have shown that they believe a Christian response to the global emergency involves steps such as making allowances for their congregants to practice their faith with socially distant private worship or drive-through confession; in March, Pope Francis hailed “the creativity of priests” in responding to this crisis. Meanwhile, others have made it clear that they see their Christian faith as a reason not to follow public-health guidelines.

Lawsuits across the country filed by Christian churches seek exemptions from state-level stay-at-home orders, and some churches simply said they wouldn’t obey those orders and would hold services anyway this Easter, leading in some cases to arrests. 

One Virginia evangelical pastor who preached in March that he would continue to hold services in a crowded church, died on April 11 due to the coronavirus. In perhaps the most notable example, Liberty University made headlines as one of the few U.S. colleges that welcomed students back to campus after their Spring Break. Though the school later reversed course and went entirely to online instruction, university president Jerry Falwell, Jr., has downplayed the threat of the virus to young people, echoing earlier statements he’d made about the virus being a conspiracy to hurt President Trump. Now, as COVID-19 deaths in the area near the school grow, the school faces a class-action lawsuit initiated by a student.

The reasons behind these acts of defiance are, of course, varied. Some said that social distancing violates the Constitution, while others claimed their religion gave them immunity from virus, while still others acknowledged the threat but said that the gatherings were essential because “true” Christians welcomed death. 

Some of these ideas might suggest a link between these acts of defiance and the early Church, and certainly we can see similar themes — a sense of persecution by the state, spiritual protection against the evils of the world for the select few, welcoming (what they perceive as) potential martyrdom. 

In fact, the perception of such a link has been demonstrated over the past decade or so by scholars such as Elizabeth Castelli and Candida Moss, among others, and the defenses mustered by churches now support that linkage; for example, one Louisiana church that defied gathering-size limits relies on a theology that specifically touts its connection to the early church.

But there seems to be something missing from how Christian groups defying public-health guidelines are thinking about the ancient past. In fact, scholars of ancient Christianity might point out that the religion’s origins offer a very different lesson—one that would be useful for the world to remember at this moment of crisis.

The growth of the earliest local cult practices among the first followers of Jesus into a pan-Mediterranean religion is a development that has interested scholars for generations. Indeed, that rise and spread was by no means linear. It moved in fits and starts, with Jesus followers (people we today think of as “Christians”) at first clustering in and around urban centers across the Roman world, remaining a very small percentage of the overall population. The real explosion only came after the Emperor Constantine’s conversion in 312 CE and his Edict of Milan the following year, allowing the formal practice of Christianity across the empire.

But though the Emperor played a large role in that story, scholars have found another consistent element that, both before and after Constantine’s conversion, made the religion grow. This element was embodied by the Latin word caritas. In English, we often translate that word as “charity” but it also, and perhaps more meaningfully, meant “love.” The term is found throughout the Christian Bible, perhaps most famously in 1 Corinthians 13, that staple of so many wedding readings today (“Love is patient, love is kind,” etc.), in which every instance we translate as “love” is actually caritas in Latin. This love, this charity, in the ancient and early medieval world, was about care for others.

This mattered because the ancient Mediterranean world was a world of disease. For example, the Antonine Plague (perhaps smallpox) ravaged populations from the Tigris to the Rhine during the late second century CE, while the Plague of Cyprian (measles?) killed thousands in those same regions towards the end of the third century CE. Generally, polytheistic philanthropy was focused on endowments and monuments, with little care for suffering bodies. Christianity offered something different with caritas. Scholars have shown that a large part of Christianity’s attraction in the Roman world was that it cared for the welfare of the people who were suffering.

Although initially a closed community, wary of contemporary social antagonism and the threat of imperial violence, these early Christians offered people a sense of equality and a social network that would “love” them with donations of food or money, that would often take them in if they were ill. 

It’s striking how much time in early hagiographies (lives of the saints) was spent on healing miracles. These in part are literary convention, emulations of these same miracles in the Gospels, but they also reflect the very real concerns of contemporaries.

The Life of Martin of Tours, written in the fourth century CE, says at one point that “the gift of accomplishing cures was so largely possessed by Martin, that scarcely any sick person came to him for assistance without being at once restored to health.” In a world where affliction was everywhere, where the pandemic was always, a response of caritas was revolutionary.

The line between then and now is never direct. There is no “rainbow connection” that we can use to move between epochs, skipping over the historical change that’s occurred across the last 1,700 years. But history echoes. In the later Middle Ages, in stone on cathedrals across Europe, virtues and vices were paired. Charity was depicted as the antidote to avarice. Caritas was portrayed as a woman giving what she had to help someone in need. Avarice was shown as hoarding, being concerned only for yourself and not for the public good.

The early hagiographies, the images etched into those cathedrals, still hold lessons for us today. The Christian groups in 2020 that are resisting stay-at-home orders are actually far divorced from the historical models they might seek to emulate. Actions that put others at risk are actions that create rather than ameliorate future suffering. They’re far removed from the early Christian ideal of caritas—an ideal that should hold just as much power today as it did all those centuries ago.

Historians’ perspectives on how the past informs the present

Matthew Gabriele is a professor of medieval studies and chair of the Department of Religion & Culture at Virginia Tech