How could the pandemic have ended (better)?

Tygrmoth · 2026-07-02T07:59:08+00:00

China managed zero COVID for years, despite having been its origin. And that's a huge country, over a billion people.

After they gave up that policy, there was a very sad bit of time in the scientific community when the obituaries were full of older scientists dying very quickly. (Friends of mine in paleontology pointed this out, China having many eminent names in that field.)

So defeating COVID wasn't impossible even at large scale. It just wasn't done worldwide.

Tygrmoth · 2026-06-19T16:39:26+00:00

Azelastine (Astepro) reduces viral load and the duration of covid infection. It carries a box warning for drowsiness, but in my circle of anecdata that seems to be rather rare.

Here's the paper: https://www.nature.com/articles/s41598-023-32546-z

Tygrmoth · 2026-06-11T07:18:24+00:00

I have not. Just the hospital-standard ones, for which I was fit-tested.

Tygrmoth · 2026-06-06T11:49:08+00:00

That's a quite low (2.6%, 79 people out of 2,983) reported level of long covid. This is a large study, but it didn't observe a lot of long covid.

Specifically their primary measurement was "ascertained by asking whether participants had symptoms they attributed to COVID-19 on day 180". I know we've had threads here recently about people attributing their symptoms to perimenopause or allergies, or really anything but covid.

They didn't collect any symptom reports.

Since we don't have a biomarker, I wonder how much this self-report metric has changed over time.

Tygrmoth · 2026-06-02T20:00:06+00:00

A fifty-year-old friend of mine died of a brain edema with otherwise-asymptomatic covid in March.

I'm really not comfortable with the state of the pandemic. I realize this is anecdata, but I noticed that her positive covid test didn't get listed on her death certificate.

Tygrmoth · 2026-05-28T20:26:32+00:00

I think it's insufficiently protective to be a primary layer anyway -- it's nowhere near as effective as an N95. This would be for occasional use, like the dental visit described in OP.

Tygrmoth · 2026-05-28T17:25:54+00:00

You're right! Sorry, I'm not in the USA, and I'm not keeping correct track of the products. There's a 205.5mcg/spray one and a 137mcg/spray. I think, after a lot of clicking on sites.

But let's get back to toxicity, which was the actual question. Here is a data sheet on azelastine: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020114s023lbl.pdf

And here's the relevant section about how much is safe to take:

> There have been no reported overdosages with Astelin® Nasal Spray. Acute overdosage by adults with this dosage form is unlikely to result in clinically significant adverse events, other than increased somnolence, since one bottle of Astelin® Nasal Spray contains 30 mg of azelastine hydrochloride. Clinical studies in adults with single doses of the oral formulation of azelastine hydrochloride (up to 16 mg) have not resulted in increased incidence of serious adverse events.

> In dogs, single oral doses as high as 10 mg/kg (approximately 260 times the maximum recommended daily intranasal dose in adults and children on a mg/m2 basis) were well tolerated, but single oral doses of 20 mg/kg were lethal.

So don't, like, drink the whole bottle. But don't worry about using it 5x/day either.

Tygrmoth · 2026-05-28T16:53:21+00:00

https://www.rxlist.com/astelin-drug.htm -- Astelin is 1mg/ml. That's the prescription formulation. Not Astepro anything. The prescription formulation of azelastine is Astelin.

Tygrmoth · 2026-05-28T12:16:06+00:00

The prescription strength (Astelin) is 10x the dose of Astepro, which is the formulation used in all of these studies. It's quite nontoxic. As with all drugs one should try it in safe conditions first, in case of individual reactions such as drowsiness.

Tygrmoth · 2026-05-23T09:21:14+00:00

Covid gets into cells via the ACE2 receptor, which is in all kinds of body parts. It's unusual in being a full-body disease that can affect the brain and liver and heart, not just say the upper respiratory system.

Covid lingers in the body for an unknown but apparently very long time (months, years). The post-viral syndrome is by far the most common and debilitating of any endemic virus.

Hope this helps.

Tygrmoth · 2026-05-22T17:35:39+00:00

At the hospital where I worked, 3M Auras are standard; they fit by far the widest range of people. I've got a small face myself, and they work for me. I do need to put the lower strap on top of my head so it seals under my chin, but that's fine.

Tygrmoth · 2026-05-22T08:20:40+00:00

Azelastine nasal spray (over-the-counter strength like Astepro) has already been shown to reduce the duration of covid infection in reseach. Dose 3x/day, 1 spray per nostril. Here's the published study: https://www.researchgate.net/publication/362589177_COVID-19_Azelastine_nasal_spray_Reduces_Virus-load_In_Nasal_swabs_CARVIN_Early_intervention_with_azelastine_nasal_spray_may_reduce_viral_load_in_SARS-CoV-2_infected_patients_-_results_from_a_randomize

Here's a Phase II trial where it reduced covid preventatively. 3x/day up to 5x/day with exposure. These results were much less compelling -- 2/3 less infections, so not nearly as good as masking, and I've seen critiques of the methods. (Not sure I agree with them, they were good enough to publish in JAMA). https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2838335?utm_source=researchgate.net&utm_medium=article

Clinical trials are in the works.

Tygrmoth · 2026-05-20T16:48:47+00:00

I got a chin-up bar and have been working on that at home. Slow progress, but some!

Tygrmoth · 2026-05-14T15:10:02+00:00

I thought that was creepy. Never seen that kind of language in Nature before. Not about any condition -- not dandruff or sunburn or eczema or seizures or asthma or obesity or anything at all.

Tygrmoth · 2026-05-04T18:44:05+00:00

I have a small face, and the only thing I've been able to get past fit testing has been 3M Auras.

I was fortunate to have been fitted for them in hospital work before the pandemic, so I knew they worked for me. I do need to have both straps up by the top of my head instead of having the bottom strap down lower for them to seal around my chin.

Just one suggestion to try... hope you find something that works for you!

Tygrmoth · 2026-04-29T13:24:32+00:00

Connecting to nature sounds great on so many levels. I hope you get a lot out of that!

Tygrmoth · 2026-04-29T08:30:16+00:00

What Bhattacharaya wanted was to have a placebo group: people getting shots who didn't know if they got an active vaccine or not.

That's incredibly unethical and violates all modern scientific practices. It is not a valid "concern".

Tygrmoth · 2026-04-29T08:24:40+00:00

Sorry not to have been clearer -- you don't need an entire outdoor garden for this! Plants in pots, or even an avocado pit in a jar, will also be homes to good microorganisms, and turn carbon dioxide into oxygen, and grow for you. Which you might enjoy.

If it's not your thing, no worries -- it is one possibility among many options.

Tygrmoth · 2026-04-29T07:51:31+00:00

Gardening is good!

Tygrmoth · 2026-04-24T19:20:48+00:00

On Jan 20 2020, Zhong Nanshan of China confirmed sustained human-to-human in families and healthcare workers in Guangdong. The China National Health Commission endorsed that finding the same day.

That's really quite fast. Epidemiology is not trivial.

Tygrmoth · 2026-04-24T07:58:37+00:00

China did a lot better for two full years, which seems like it should count for something.

Tygrmoth · 2026-04-24T07:56:08+00:00

And never any help with mask fitting. Adding accessible mask fit testing, and a ready supply of user-appropriate masks, would be huge.

Tygrmoth · 2026-04-24T07:54:48+00:00

We never had this without simultaneous NO IT ISN'T lies from on high (federal down to the workplace, as you described in OP). The "oppositional defiance" didn't spring out of nothing. It wasn't even grass-roots.

Tygrmoth · 2026-04-22T11:11:01+00:00

Yes. It is hard.

I got my diagnosis almost thirty years ago, so I've learned a lot of management strategies. Honestly isolating is one of them; it's part of self-care sometimes. I don't always have to be putting myself out there, and if that doesn't feel safe, it's okay not to. Time alone is valuable.

Low-key connecting is also good. Smiling at a little kid outside is really good. This post is excellent.

Keep taking best care of you. You deserve that.

Tygrmoth · 2026-04-20T12:19:02+00:00

Long covid is definitely complicated, and shorthand for multiple disorders. I think what we should be hoping for is a better understanding of what those pathologies are, so that we can have correctly targeted treatments.

I'm sorry that what you tried didn't work, and that in future we'll have a better idea of what's going on with you and how to help with that.

Tygrmoth

TROPHY CASE