The Democrats Go Full Götterdämmerung as Manchin Makes DOA of BBB Official; Omicron Undermines Scapegoating the Unvaxxed

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1. DJG, Reality Czar December 20, 2021 at 7:07 am

   “In other words, the “vax vax vax” policy appears to have included deliberate neglect of treatments as well as non-pharmaceutical interventions, not just the much demonized horse paste but even medically recognized monoclonal antibodies. After all, only the morally remiss unvaccinated could possibly need them, right?”

   An excellent summing-up paragraph, given the many dire facts in the article that have to be addressed.

   To translate into neoliberalese, the main language spoken by the U.S. elites:

   Monetizing everything, the elites have learned the value of nothing.
   1. Mikel December 20, 2021 at 8:23 am

      You bring up Ivermectin. Then think about this:

      “the respiratory symptoms that used to predominate are now replaced with intense nausea-inducing headaches at times leading to severe vomiting, intense fever, chills, and now I have been seeing a few patients with intense diarrhea. Interestingly, the muscle cramps and pain seem to all of a sudden be really bad…”

      Someone who has been taking Ivermectin or knows its use might want to talk me down, but with this description of the symptoms, doesn’t it sound like Ivermectin is tailor-made for the Omicron variant?
      Th symptoms that have intensified remind me of a parasite in the gut or food poisoning.
      1. Yves Smith Post authorDecember 20, 2021 at 8:52 am

         I hope GM comments but my first reaction is *sigh*.

         The parasite that Ivermectin is most used to treat is the worm that causes river blindness, which attacks the eye, not the gut.

         The reason that Ivermectin is believed to be effective v. Covid is its antiviral properties. As I have stated repeatedly, it’s in the advanced stages of several clinical outside the US as an HIV med and doing well in all of them.

         See here for more on its antiviral activity:

         https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539925/

         Data from Wuhan showed 40% of those who got Covid had digestive symptoms. They often assumed it was food poisoning and not Covid. That may be just as true in the US given how spotty our testing is.
         1. Mikel December 20, 2021 at 9:27 am

            I’m now just chilled to the bone by the idea of worm that attacks the eye and causes blindness.
            Can’t even think about Covid right now…
            1. Susan the other December 20, 2021 at 12:14 pm

               ….”Climate change is painless, it brings on many changes, but you can to learn to love it if you try.”
               1. coboarts December 20, 2021 at 5:00 pm

                  Now That’s a MASH up, Susan
         2. Mantid December 20, 2021 at 11:40 am

            Yes, good. And Ivermectin is an effective anti-inflammatory:
            https://openheart.bmj.com/content/openhrt/7/2/e001350.full.pdf
            ttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578741/
         3. Kris Alman December 20, 2021 at 2:11 pm

            As an endocrinologist, I’ve been very interested in the role of the ACE2 receptor in the pathology of Covid since it is the primary portal for the virus spike to enter the cell. A Trojan horse.

            When I was in fellowship training decades ago, the ACE2 receptor and angiotensin-(1-7) (Asp-Arg-Val-Tyr-Ile-His-Pro) were just babes in benchwork research.
            https://europepmc.org/article/med/1342241

            We have had a much better understanding of angiotensinogen, an inactive precursor peptide cleaved by renin to form angiotensin 1 and further processed by angiotensin converting enzyme 1 (ACE1) to angiotensin 2 in the Renin-Angiotensin System (RAS). ARBs (Angiotensin-II receptor blockers) and ACE inhibitors have been widely used to manage hypertension, congestive heart failure and kidney disease (including diabetic nephropathy).

            Covid-19 has created a surge of interest in these parallel pathways that intersect with our complex immune system and our body’s response to stress/inflammation (including the role of glucocorticoids and gender differences).

            Here’s a dense review with its abstract and one paragraph on diarrhea:
            Functional ACE2 deficiency leading to angiotensin imbalance in the pathophysiology of COVID-19
            Reviews in Endocrine and Metabolic Disorders (2021)
            https://link.springer.com/article/10.1007/s11154-021-09663-z

            Abstract
            SARS-CoV-2, the virus responsible for COVID-19, uses angiotensin converting enzyme 2 (ACE2) as its primary cell-surface receptor. ACE2 is a key enzyme in the counter-regulatory pathway of the broader renin-angiotensin system (RAS) that has been implicated in a broad array of human pathology. The RAS is composed of two competing pathways that work in opposition to each other: the “conventional” arm involving angiotensin converting enzyme (ACE) generating angiotensin-2 and the more recently identified ACE2 pathway that generates angiotensin (1–7). Following the original SARS pandemic, additional studies suggested that coronaviral binding to ACE2 resulted in downregulation of the membrane-bound enzyme. Given the similarities between the two viruses, many have posited a similar process with SARS-CoV-2. Proponents of this ACE2 deficiency model argue that downregulation of ACE2 limits its enzymatic function, thereby skewing the delicate balance between the two competing arms of the RAS. In this review we critically examine this model. The available data remain incomplete but are consistent with the possibility that the broad multisystem dysfunction of COVID-19 is due in large part to functional ACE2 deficiency leading to angiotensin imbalance with consequent immune dysregulation and endothelial cell dysfunction.

            Gastrointestinal system
            The small intestine hosts the body’s highest tissue concentration of both ACE and ACE2 [73]. High doses of exogenous AT2 administered enterally to rats impair jejunal sodium-water reabsorption – potentially explaining the increased risk of diarrhea in COVID-19 – while ACE inhibitors and angiotensin receptor blockers (ARBs) reduce intestinal inflammation in rodent models [73, 74]. The effects of ACE2 in the gut are less well recognized but it appears to act in a non-catalytic manner to regulate tryptophan transport and the expression of antimicrobial peptides [4, 7, 73]. It has been more broadly hypothesized that ACE2’s impact on cardiovascular and pulmonary physiology may also proceed in part through alteration of the gut microbiome [4, 7].

            Also see:
            The pivotal link between ACE2 deficiency and SARS-CoV-2 infection: One year later
            https://www.ejinme.com/article/S0953-6205(21)00307-1/fulltext
            It has been recently suggested that free-floating Spike proteins released by the destroyed cells previously targeted by vaccines may interact with ACE2 of other cells, thereby promoting ACE2 internalization and degradation [[80],[81]]. This mechanism may enhances the imbalance between Ang II overactivity and Ang1-7 deficiency through the loss of ACE2 receptor activity, which may contribute to trigger inflammation, thrombosis, and other adverse reactions [[82],[83]].
            Of note, spike proteins produced upon vaccination have the native-like mimicry of SARS-CoV-2 Spike protein’s receptor binding functionality and prefusion structure [[84]].

            All very concerning if vaccines and boosters are down-regulating ACE2 since…

            It appears that spike protein is also important for cell-to-cell transmission. In other words, viral-infected cell to viral-infected cell.

            This June 2021 pre-print, “SARS-CoV-2 Spreads through Cell-to-Cell Transmission”, shows evidence that the spike glycoprotein mediates the spread of SARS-CoV-2 in cell-to-cell transmission in the absence of ACE2 (angiotensin-converting enzyme 2) receptor expression in target cells.
            https://www.biorxiv.org/content/biorxiv/early/2021/06/01/2021.06.01.446579.full.pdf bioRxiv. 2021 Jun 1

            The authors (primarily from Ohio State University) point out that, “Cell-to-cell transmission is considered to be an effective means by which viruses evade host immunity, especially antibody-mediated responses.”

            Moreover, “(w)hile not statistically significant, some of the COVID-19 sera (2 out of 5) even enhanced cell-to-cell transmission of SARS-CoV-2 (Figure 6D), although the underlying mechanisms are currently not known.”

            These in vitro studies with a small number of samples were using older variants of concern (B.1.351, “Beta” first detected in South Africa and and B.1.1.7, aka British variant).

            One has to wonder why this NIH funded study has not been peer reviewed and published in any journal yet.

            These studies should be replicated with the omicron variant and with sera from vaccinated and delta-infected individuals to see if cell-to-cell transmission is further enhanced through down-regulation of ACE2 receptors.
         4. Oh December 20, 2021 at 4:52 pm

            It’s also used widely for the treatment of scabies, I believe.
      2. Kris Alman December 20, 2021 at 2:19 pm

         As an endocrinologist, I’ve been very interested in the role of the ACE2 receptor in the pathology of Covid since it is the primary portal for the virus spike to enter the cell. A Trojan horse.

         When I was in fellowship training decades ago, the ACE2 receptor and angiotensin-(1-7) (Asp-Arg-Val-Tyr-Ile-His-Pro) were just babes in benchwork research.
         https://europepmc.org/article/med/1342241

         We have had a much better understanding of angiotensinogen, an inactive precursor peptide cleaved by renin to form angiotensin 1 and further processed by angiotensin converting enzyme 1 (ACE1) to angiotensin 2 in the Renin-Angiotensin System (RAS). ARBs (Angiotensin-II receptor blockers) and ACE inhibitors have been widely used to manage hypertension, congestive heart failure and kidney disease (including diabetic nephropathy).

         Covid-19 has created a surge of interest in these parallel pathways that intersect with our complex immune system and our body’s response to stress/inflammation (including the role of glucocorticoids and gender differences).

         Here’s a dense review with its abstract and one paragraph on diarrhea:
         Functional ACE2 deficiency leading to angiotensin imbalance in the pathophysiology of COVID-19
         Reviews in Endocrine and Metabolic Disorders (2021)
         https://link.springer.com/article/10.1007/s11154-021-09663-z

         Abstract
         SARS-CoV-2, the virus responsible for COVID-19, uses angiotensin converting enzyme 2 (ACE2) as its primary cell-surface receptor. ACE2 is a key enzyme in the counter-regulatory pathway of the broader renin-angiotensin system (RAS) that has been implicated in a broad array of human pathology. The RAS is composed of two competing pathways that work in opposition to each other: the “conventional” arm involving angiotensin converting enzyme (ACE) generating angiotensin-2 and the more recently identified ACE2 pathway that generates angiotensin (1–7). Following the original SARS pandemic, additional studies suggested that coronaviral binding to ACE2 resulted in downregulation of the membrane-bound enzyme. Given the similarities between the two viruses, many have posited a similar process with SARS-CoV-2. Proponents of this ACE2 deficiency model argue that downregulation of ACE2 limits its enzymatic function, thereby skewing the delicate balance between the two competing arms of the RAS. In this review we critically examine this model. The available data remain incomplete but are consistent with the possibility that the broad multisystem dysfunction of COVID-19 is due in large part to functional ACE2 deficiency leading to angiotensin imbalance with consequent immune dysregulation and endothelial cell dysfunction.

         Gastrointestinal system
         The small intestine hosts the body’s highest tissue concentration of both ACE and ACE2 [73]. High doses of exogenous AT2 administered enterally to rats impair jejunal sodium-water reabsorption – potentially explaining the increased risk of diarrhea in COVID-19 – while ACE inhibitors and angiotensin receptor blockers (ARBs) reduce intestinal inflammation in rodent models [73, 74]. The effects of ACE2 in the gut are less well recognized but it appears to act in a non-catalytic manner to regulate tryptophan transport and the expression of antimicrobial peptides [4, 7, 73]. It has been more broadly hypothesized that ACE2’s impact on cardiovascular and pulmonary physiology may also proceed in part through alteration of the gut microbiome [4, 7].
      3. Kris Alman December 20, 2021 at 2:36 pm

         As an endocrinologist, I’ve been very interested in the role of the ACE2 receptor in the pathology of Covid since it is the primary portal for the virus spike to enter the cell. A Trojan horse.

         When I was in fellowship training in the early 1990s, the ACE2 receptor and angiotensin-(1-7) were just babes in benchwork research.

         We have had a much better understanding of angiotensinogen, an inactive precursor peptide cleaved by renin to form angiotensin 1 and further processed by angiotensin converting enzyme 1 (ACE1) to angiotensin 2 in the Renin-Angiotensin System (RAS). ARBs (Angiotensin-II receptor blockers) and ACE inhibitors have been widely used to manage hypertension, congestive heart failure and kidney disease (including diabetic nephropathy).

         Covid-19 has created a surge of interest in these parallel pathways that intersect with our complex immune system and our body’s response to stress/inflammation (including the role of glucocorticoids and gender differences).

         Here’s a dense review with its abstract and one paragraph on diarrhea:
         Functional ACE2 deficiency leading to angiotensin imbalance in the pathophysiology of COVID-19
         Reviews in Endocrine and Metabolic Disorders (2021)
         https://link.springer.com/article/10.1007/s11154-021-09663-z

         Abstract
         SARS-CoV-2, the virus responsible for COVID-19, uses angiotensin converting enzyme 2 (ACE2) as its primary cell-surface receptor. ACE2 is a key enzyme in the counter-regulatory pathway of the broader renin-angiotensin system (RAS) that has been implicated in a broad array of human pathology. The RAS is composed of two competing pathways that work in opposition to each other: the “conventional” arm involving angiotensin converting enzyme (ACE) generating angiotensin-2 and the more recently identified ACE2 pathway that generates angiotensin (1–7). Following the original SARS pandemic, additional studies suggested that coronaviral binding to ACE2 resulted in downregulation of the membrane-bound enzyme. Given the similarities between the two viruses, many have posited a similar process with SARS-CoV-2. Proponents of this ACE2 deficiency model argue that downregulation of ACE2 limits its enzymatic function, thereby skewing the delicate balance between the two competing arms of the RAS. In this review we critically examine this model. The available data remain incomplete but are consistent with the possibility that the broad multisystem dysfunction of COVID-19 is due in large part to functional ACE2 deficiency leading to angiotensin imbalance with consequent immune dysregulation and endothelial cell dysfunction.

         Gastrointestinal system
         The small intestine hosts the body’s highest tissue concentration of both ACE and ACE2 [73]. High doses of exogenous AT2 administered enterally to rats impair jejunal sodium-water reabsorption – potentially explaining the increased risk of diarrhea in COVID-19 – while ACE inhibitors and angiotensin receptor blockers (ARBs) reduce intestinal inflammation in rodent models [73, 74]. The effects of ACE2 in the gut are less well recognized but it appears to act in a non-catalytic manner to regulate tryptophan transport and the expression of antimicrobial peptides [4, 7, 73]. It has been more broadly hypothesized that ACE2’s impact on cardiovascular and pulmonary physiology may also proceed in part through alteration of the gut microbiome [4, 7]
2. The Historian December 20, 2021 at 7:25 am

   I can’t say I am surprised or even disappointed by Manchin’s latest utterances. Only idiots would have given control of what was in BBB to a person who was never going to vote for it, yet that is exactly what the progressives did. My disappointment happened months before this when the Progressive Caucus allowed Joe Manchin to dictate what was in the bill.

   To paraphrase Frank Herbert, ala Lambert: “Manchin had one weapon left and both (were the Progressives really that asleep?) knew it: treachery.”

   And in keeping with the musical terms, all the Sturm and Drang by the White House is meaningless – as it always has been. Could they really not see what Manchin was doing? Maybe not! – seeing as how everything that happens these days, including the emergence of new variants, surprises them.
   1. James E Keenan December 20, 2021 at 7:52 am

      “… the Progressive Caucus allowed Joe Manchin to dictate what was in the bill.”

      What is the evidence for this? You seem to imply that the Progressive Caucus was a majority within the House and/or the Senate — when they’re not.
      1. The Historian December 20, 2021 at 8:09 am

         You are forgetting one thing – how closely divided the Congress is. The Democrats only hold a slim majority in the House and a 1 vote majority (Harris) in the Senate, meaning, given the levels of exteme partisanship that exists today, to get bills passed, the Democrats needed every Democratic vote. The Progressive Caucus had enough votes to block any legislation they wanted. They didn’t have to compromise much nor give away their basic planks in the BBB bill nor cow down to Manchin. Sure, they would have taken a lot of heat and criticism, and no doubt there would have been a lot of unpleasantness, but if they had stood fast and refused to vote for the infrastructure bill without their original BBB bill, they could have shown Manchin and Sinema where the real power was. But they caved instead.
      2. Michael Ismoe December 20, 2021 at 8:16 am

         The bill passed with a three-vote majority. The Progressive (HAHA) Caucus in the House agreed to pass the bill and count on Joey B to “use his interpersonal relationships” with the senators to get the thing done. Jaypal’s strategy and it blew up in her face. She trusted the wrong people and it shows. Bad judgement does not get you into Democratic Party leadership – although by the end of the midterms there could be so few Democrats left in Congress that the whole speaker thing is moot for a decade or so.
         1. lordkoos December 20, 2021 at 4:16 pm

            “Bad judgement does not get you into Democratic Party leadership…”

            Are you sure about that?
         2. lance ringquist December 20, 2021 at 6:15 pm

            agreed. to actually trust a nafta democrat again after all of the betrayals since 1993, is just setting you up to be the public boob you deserve to be.

            you have no power unless you exercise it.
      3. Brooklin Bridge December 20, 2021 at 8:42 am

         Um, was Manchin a majority? One single lone vote? And yet he got what he wanted. The progressives could have played the same game, demanded that BBB stay intact or they would not allow either bill, and thus the corporate giveaway (infrastruc) that Manchin DID want, would fail. But the mean ol’ press said, “Boo” to the progs and they spluttered out like candles on Manchin’s victory cake.

         These progs drop trow faster than their shadows.
         1. The Historian December 20, 2021 at 8:48 am

            I think you said it better than I did!!
            1. Brooklin Bridge December 20, 2021 at 9:35 am

               Thanks Historian, I was too busy going (grrrr) to think of doing a refresh on my browser, so I didn’t see your comment until I posted mine.
               They work together, detail and rant.
         2. MK December 20, 2021 at 10:10 am

            Don’t forget – it still took 13 Rs in the house to get the infrastructure bill to pass.

            The Progressives never had the numbers to stop the infrastructure bill because there was always enough Rs to vote it through even if the progressive caucus had held together 100% and voted no.
            1. The Historian December 20, 2021 at 10:16 am

               According to Wikipedia, the Progressive Caucus has 95 members in the House. You think 95 Republicans would have crossed the partisan divide?

               https://en.wikipedia.org/wiki/Congressional_Progressive_Caucus
               1. Mk December 20, 2021 at 12:03 pm

                  To fund infrastructure bill – 100%
               2. Expat2uruguay December 20, 2021 at 12:53 pm

                  I think the composition of “the progressives” is closer to “the squad” than the progressive caucus. The progressive caucus is full of a lot of people who would otherwise never be called progressives
                  1. Jonathan King December 20, 2021 at 11:25 pm

                     Indeed. It’s an easy conflation for those who think Ilhan Omar and Hakeem Jeffries must be in cahoots.
            2. Brooklin Bridge December 20, 2021 at 10:53 am

               As I understood it, this was a game of chicken. The trick was for the progs to keep the two bills together as all or nothing and to hold Pelosi’s feet (and her promise) to the fire. In terms of embarrassment, if nothing else, It would have been almost impossible for Pelosi to gather enough Dem_wits to agree to separating the two bills without the prog’s duplicity, I mean agreement. And if the progs had held firm anyway, and still been steamrolled, they could now be making that painfully clear every step of the way. As it is, quite honestly, they are pretty much just slime; fast on their way to being exactly like the rest of the Dems, bought and paid for.
            3. tegnost December 20, 2021 at 5:56 pm

               because there was always enough Rs to vote it through even if the progressive caucus had held together 100% and voted no.
               and they would now have had their “I told you so…” moment.
               Instead the get nothing.
      4. Susan the other December 20, 2021 at 12:19 pm

         I’d like to get an instruction manual on how to indict Congress for crimes against humanity and crimes against the state; and lesser crimes like total legislative incompetence and bribe taking.
   2. Andrew December 20, 2021 at 10:18 am

      Odd that Manchin, as you say, “was never going to vote for it” in a 50/50 Senate, but somehow this is the fault of progressives.
      1. The Historian December 20, 2021 at 11:43 am

         We are never going to know what the Senate would have done if the two bills were tied together because we weren’t given the chance to find out, were we? And yes, I blame the Progressive Caucus for that!

         I saw this on Common Dreams:
         https://www.commondreams.org/news/2021/12/20/progressives-demand-floor-vote-spotlight-manchins-contempt-his-constituents

         The feckless Progressive Caucus is going to make sure the barn door is tightly locked…..after the horse has escaped! I wonder if they can even accomplish that! I wonder also if they really think ‘shaming’ Manchin by holding a vote on BBB in the Senate matters one whit.
      2. lance ringquist December 20, 2021 at 6:25 pm

         if you do not exercise your power. you have none. manchins daughter was a very big easy target.
         1. Yves Smith Post authorDecember 20, 2021 at 7:56 pm

            Yes, I’ve been saying that in code: “If Biden could have had Manchin’s vote by means he was willing to use, he would have had it months ago.” Pretty obvious that Biden hasn’t used all the means of inflicting pain to which he has access….or bribes either. He could sponsor some sort of coal transition program to pay off mine shuttering (as a personal bribe to Manchin) and sponsor other businesses in the state (if nothing else government call centers).
   3. Christopher Horne December 20, 2021 at 12:01 pm

      LOL. Soooo…… The Mystery Of The Ages is finally solved! Now we know who the Antichrist is.
3. Roger Blakely December 20, 2021 at 7:40 am

   My vote goes to Rochelle Walensky’s beauty and wardrobe team. She was cute as a Harvard public health professor. Now they have her looking fetching on the screen.
   1. Lena December 20, 2021 at 8:19 am

      And major kudos to her dentist$! She has such a lovely smile.
4. SomeGuyinAZ December 20, 2021 at 7:50 am

   I’d say “clowns to the left of me, jokers to the right, here we are stuck in the middle” would have made a fair musical interlude/summation, but I think it’s better to put this down to greedy malevolence rather than foolishness by our “leaders”.
   1. HomoSapiensWannaBe December 20, 2021 at 8:51 am

      Now renamed to “Jabbed in the Middle With You”.
      I miss Gerry Rafferty!
      1. lordkoos December 20, 2021 at 4:19 pm

         Me too — “Baker Street” was one of the best songs ever to hit the charts.
         1. lance ringquist December 20, 2021 at 6:51 pm

            he drank himself to death.
5. ScoFri December 20, 2021 at 7:53 am

   About Vaccine Effectiveness, can someone who knows more about this answer a question I have been asking but cannot seem to get answered?

   In the first vaccines to my understanding, they did not use the mRNA for the whole viral envelope, only the Spike Protein.

   Why did they not use the mRNA for the envelope and matrix protein as well? Is it possible they play a role in infection as well? It looks like it from this image:

   https://www.echelon-inc.com/wp-content/uploads/2020/04/SARS-CoV-2-graphic@2x.png

   The cynic in me thinks that this was part of Big Pharma’s plan…
   1. KLG December 20, 2021 at 9:18 am

      Short answer that GM could do better. The viral envelope is composed of a phospholipid/cholesterol membrane that is similar in composition to the plasma membrane (often mistakenly called the cell wall) of all of our cells. These phospholipids are generally not antigenic. Viral proteins such as spike are “swimming” in two dimensions in the correct orientation (outside out, inside in) in that viral envelope. Proteins from “the other” are antigenic. Spike is essential for viral binding to ACE2 and entry into in our cells, so that is why it was used: Prevent binding and stop infection, disease, and transmission. Only, it didn’t work very well. But that is no surprise. Vaccines against coronaviruses have had significant unicorn character since, well, forever. People who have recovered from COVID-19 typically do have antibodies to non-envelope viral proteins, but it is not clear the antibodies do much to fight disease.
      1. Susan the other December 20, 2021 at 12:32 pm

         Are you aware of any new studies on ace blockers for BP? I talked to one doc who told me there was an ongoing debate about their usefulness for covid and I surfed and found just one study that showed a small beneficial effect at prevention (sorry can’t cite – can barely read actually). And another thing from way back in 2019 – there was a lot of info early about covid being a “blood disease” as it was said to attack red blood cells and gobble up the hemoglobin molecule, leaving the rest of the cell detritus to clog up the alveoli, etc. This was followed some months later (I think a link here on NC) by studies involving mice wherein there were “resilient” mice, resilient to viruses that were deadly to other mice – and the reason for their good health seems to have been high levels of iron in their blood – enough for both the mouse and the virus, buying the mouse’s immune system enough time to survive without much harm. Anything on that one and covid? And do doctors recommend B-complex for anemia still – ages ago it was prescribed for me and it worked like a charm. It’s been a stand-by ever since, for just about every incipient little misery.
         1. Kris Alman December 20, 2021 at 3:13 pm

            I will try to tackle this one. The short answer is that it’s unclear because ACE inhibitors and ARB blockers affect the ACE1 receptor.

            As an endocrinologist, I’ve been very interested in the role of the ACE2 receptor in the pathology of Covid since it is the primary portal for the virus spike to enter the cell. A Trojan horse.

            When I was in fellowship training in the early 1990s, the ACE2 receptor and angiotensin-(1-7) (Asp-Arg-Val-Tyr-Ile-His-Pro) were just babes in benchwork research.

            We have had a much better understanding of angiotensinogen, an inactive precursor peptide cleaved by renin to form angiotensin I and further processed by angiotensin converting enzyme I (ACE1) to angiotensin II in the Renin-Angiotensin System (RAS). ARBs (Angiotensin- receptor blockers) and ACE 1 inhibitors have been widely used to manage hypertension, congestive heart failure and kidney disease (including diabetic nephropathy).

            Covid-19 has created a surge of interest in these parallel pathways that intersect with our complex immune system and our body’s response to stress/inflammation (including the role of glucocorticoids and gender differences).

            Here’s a dense review with its abstract:
            Functional ACE2 deficiency leading to angiotensin imbalance in the pathophysiology of COVID-19

            Reviews in Endocrine and Metabolic Disorders (2021)
            https://link.springer.com/article/10.1007/s11154-021-09663-z

            SARS-CoV-2, the virus responsible for COVID-19, uses angiotensin converting enzyme 2 (ACE2) as its primary cell-surface receptor. ACE2 is a key enzyme in the counter-regulatory pathway of the broader renin-angiotensin system (RAS) that has been implicated in a broad array of human pathology. The RAS is composed of two competing pathways that work in opposition to each other: the “conventional” arm involving angiotensin converting enzyme (ACE) generating angiotensin-2 and the more recently identified ACE2 pathway that generates angiotensin (1–7). Following the original SARS pandemic, additional studies suggested that coronaviral binding to ACE2 resulted in downregulation of the membrane-bound enzyme. Given the similarities between the two viruses, many have posited a similar process with SARS-CoV-2. Proponents of this ACE2 deficiency model argue that downregulation of ACE2 limits its enzymatic function, thereby skewing the delicate balance between the two competing arms of the RAS. In this review we critically examine this model. The available data remain incomplete but are consistent with the possibility that the broad multisystem dysfunction of COVID-19 is due in large part to functional ACE2 deficiency leading to angiotensin imbalance with consequent immune dysregulation and endothelial cell dysfunction.
         2. Kris Alman December 20, 2021 at 5:20 pm

            As an endocrinologist who trained in the early 1990s, I have had to learn about the two competing arms of the Renin Angiotensin System (RAS) pathways. Covid-19 enters the cell with its spike via the membrane-bound enzyme ACE2 (Angiotensin Converting Enzyme 2) receptor.

            This is not to be confused with ACE1 which is far better understood.

            Angiotensinogen is an inactive precursor peptide which is cleaved by renin to become Angiotensin I (AT1), which is further cleaved by ACE 1 to be Angiotensin 2 (AT2). These pathways are fundamental to prescribing ACE 1 inhibitors and ARBs (angiotensin receptor blockers) for high blood pressure, congestive heart failure and kidney disease (including that due to diabetic nephropathy).

            Angiotensin (1-7) is a bioactive component of the renin-angiotensin system that promotes vasodilatory, anti-inflammatory, and anti-fibrotic effects. It is formed from either AT I or AT II using membrane-bound enzyme ACE2.

            Activation of this arm is thought to oppose the activity of the conventional ACE/AT2 pathway. Depletion of ACE2 is associated with worse Covid outcomes with less inactivation of A2 and less generation of A(1-7), which may ultimately trigger inflammation, thrombosis, and other severe adverse reactions influencing the outcome of COVID-19. Patients with co-morbidities like diabetes and cardiovascular disease share a variable degree of ACE2 deficiency.

            The pivotal link between ACE2 deficiency and SARS-CoV-2 infection: One year later
            https://www.ejinme.com/article/S0953-6205(21)00307-1/fulltext
            “Thus, it is very likely that is not the ‘excess’, but the deficiency of ACE2 receptor activity that complicates the outcome of COVID-19.”
         3. Kris Alman December 22, 2021 at 2:54 pm

            egads! My comments weren’t coming through and then flooded in!

            Here’s an article worthy of your question. Note “might” re ACEIs or ARBs. That helps settle the question, right?:

            Hypertension and its management in COVID-19 patients: The assorted view
            https://www.sciencedirect.com/science/article/pii/S2772487521000234

            Conclusion
            This study concluded that hypertension increases COVID-19 severity due to underlying endothelial dysfunctions and coagulopathy. COVID-19 might augment the hypertensive complications due to down-regulation of ACE2. The use of ACEIs or ARBs might be beneficial in the management of hypertensive patients with COVID-19.
      2. Kris Alman December 20, 2021 at 3:23 pm

         Spike is essential for viral binding to ACE2 and entry into in our cells

         But in vitro studies suggest that ACE2 is not necessary for cell-to-cell transmission–meaning infected cell to infected cell. (Cell-free infection is virus into cell via spike/ACE2 receptor.
         https://www.biorxiv.org/content/biorxiv/early/2021/06/01/2021.06.01.446579.full.pdf

         The authors of this study point out, “results indicate that cell-to-cell transmission of SARS305 CoV-2 is mostly refractory to neutralization by neutralizing antibodies against spike relative to cell-free infection.”
         1. Kris Alman December 20, 2021 at 3:37 pm

            As for Susan the Other’s question, the short answer is that it’s unclear because ACE inhibitors and ARB blockers affect the ACE 1 (not 2) receptor.

            As an endocrinologist, I’ve been very interested in the role of the ACE2 receptor in the pathology of Covid since it is the primary portal for the virus spike to enter the cell. A Trojan horse.

            When I was in fellowship training in the early 1990s, the ACE2 receptor and angiotensin-(1-7) (Asp-Arg-Val-Tyr-Ile-His-Pro) were just babes in benchwork research.

            We have had a much better understanding of angiotensinogen, an inactive precursor peptide cleaved by renin to form angiotensin I and further processed by angiotensin converting enzyme I (ACE1) to angiotensin II in the Renin-Angiotensin System (RAS). ARBs (Angiotensin- receptor blockers) and ACE 1 inhibitors have been widely used to manage hypertension, congestive heart failure and kidney disease (including diabetic nephropathy).

            Covid-19 has created a surge of interest in these competing pathways that intersect with our complex immune system in our body’s response to stress/inflammation (including the role of glucocorticoids and gender differences).

            Functional ACE2 deficiency leading to angiotensin imbalance in the pathophysiology of COVID-19
            https://link.springer.com/article/10.1007/s11154-021-09663-z

            This dense review suggests that “coronaviral binding to ACE2 resulted in downregulation of the membrane-bound enzyme” and this “limits its enzymatic function, thereby skewing the delicate balance between the two competing arms of the RAS.” Further “available data remain incomplete but are consistent with the possibility that the broad multisystem dysfunction of COVID-19 is due in large part to functional ACE2 deficiency leading to angiotensin imbalance with consequent immune dysregulation and endothelial cell dysfunction.”

            I would further wonder if vaccines and boosters downregulate the ACE2 receptors.
         2. Kris Alman December 20, 2021 at 3:46 pm

            “One important feature of the virus cell-to-cell transmission is evasion of host immunity, particularly neutralizing antibody-mediated response.”

            These in vitro studies with a small number of serum samples from older variants of concern (B.1.351, “Beta” first detected in South Africa and B.1.1.7, aka British variant).

            One has to wonder how well Omicron transmits cell-to-cell without ACE2 receptor.
            1. Kris Alman December 20, 2021 at 3:52 pm

               Because downregulation of ACE2 receptor seems to be associated with bad outcomes.

               Downregulation of Membrane-bound Angiotensin Converting Enzyme 2 (ACE2) Receptor has a Pivotal Role in COVID-19 Immunopathology
               https://www.ingentaconnect.com/content/ben/cdt/2021/00000022/00000003/art00003

               Results: Several studies have indicated that the downregulation of membrane-bound ACE2 may exert a key role for the impairment of immune functions and for COVID-19 patients’ outcomes. The downregulation may occur by distinct mechanisms, particularly: (1) the shedding process induced by the SARS-CoV-2 fusion pathway, which reduces the amount of membrane-bound ACE2, stimulating more shedding by the high levels of Angiotensin II; (2) the endocytosis of ACE2 receptor with the virus itself and (3) by the interferon inhibition caused by SARS-CoV-2 effects on the immune system, which leads to a reduction of ACE2 receptor expression.

               Conclusion: Recent research provides evidence of a reduction of the components of the alternative RAS axis, including ACE2 and Angiotensin-(1-7). In contrast, increased levels of Angiotensin II can activate the AT1 receptor in several organs. Consequently, increased inflammation, thrombosis and angiogenesis occur in patients infected with SARS-COV-2. Attention should be paid to the interactions of the RAS and COVID-19, mainly in the context of novel vaccines and proposed medications.
            2. Kris Alman December 20, 2021 at 3:55 pm

               Because downregulation of ACE 2 receptor is associated with worse outcomes.
               https://www.ingentaconnect.com/content/ben/cdt/2021/00000022/00000003/art00003

               The downregulation may occur by distinct mechanisms, particularly: (1) the shedding process induced by the SARS-CoV-2 fusion pathway, which reduces the amount of membrane-bound ACE2, stimulating more shedding by the high levels of Angiotensin II; (2) the endocytosis of ACE2 receptor with the virus itself and (3) by the interferon inhibition caused by SARS-CoV-2 effects on the immune system, which leads to a reduction of ACE2 receptor expression.
            3. Kris Alman December 20, 2021 at 4:30 pm

               As an endocrinologist who trained in the early 1990s, I have had to learn about the two competing arms of the Renin Angiotensin System (RAS) pathways. Covid-19 enters the cell with its spike via the membrane-bound enzyme ACE2 (Angiotensin Converting Enzyme 2) receptor.

               This is not to be confused with ACE1 which is far better understood.

               Angiotensinogen is an inactive precursor peptide which is cleaved by renin to become Angiotensin I (AT1), which is further cleaved by ACE 1 to be Angiotensin 2 (AT2). These pathways are fundamental to prescribing ACE 1 inhibitors and ARBs (angiotensin receptor blockers) for high blood pressure, congestive heart failure and kidney disease (including that due to diabetic nephropathy).

               Angiotensin-(1-7) is a bioactive component of the renin-angiotensin system that promotes vasodilatory, anti-inflammatory, and anti-fibrotic effects. It is formed from either AT I or AT II using membrane-bound enzyme ACE2.

               Activation of this arm is thought to oppose the activity of the conventional ACE/AT2 pathway.

               Depletion of ACE2 receptors is associated with worse Covid outcomes.

               https://www.ejinme.com/article/S0953-6205(21)00307-1/fulltext
               “The interaction between ACE2 and SARS-CoV-2 Spike protein induces a substantial loss of ACE2 receptor activity from the external site of the cellular membrane. This phenomenon leads to less Ang II inactivation and less generation of Ang1-7 (imbalance between Ang II overactivity and Ang1-7 deficiency), which may ultimately trigger inflammation, thrombosis, and other severe adverse reactions influencing the outcome of COVID-19.

               The degree of ACE2 expression and the biological relevance of ACE2 deficiency may vary depending on the presence of specific characteristics and conditions (phenotypes of ACE2 deficiency). Important phenotypes including older age, hypertension, diabetes, cardiovascular disease and COPD share a variable degree of ACE2 deficiency and are associated with more severe forms of COVID-19.

               Thus, it is very likely that is not the ‘excess’, but the deficiency of ACE2 receptor activity that complicates the outcome of COVID-19.
               In the SARS-CoV-2 era, we may assume that ACE2 receptors are not dangerous Trojan horses, but useful defense weapons against the adverse mechanisms associated with the disease.”
         3. KLG December 20, 2021 at 10:14 pm

            I looked through that pre-print quickly. I defer to those well versed in the cell biology of coronavirus infection. It is not clear to me how the authors distinguished between cell-cell transmission and syncitium formation, the latter of which is well described for respiratory syncitial virus (RSV) and other similar viruses: Excess viral fusion protein is expressed on the plasma membrane of an infected cell and mediates fusion with an adjacent cell. At least one of the coauthors has worked on RSV. This is also still a preprint according to PubMed, and has not been published after peer review. That does NOT mean the work is incorrect in any way, however! Their experimental system is useful for the measurements they made, and I have used similar, broadly, in my research. But this system is not directly analogous to the environment in an infected animal. All I have time for tonight. Sorry.
      3. Kris Alman December 20, 2021 at 5:43 pm

         There’s more attention to the competing pathways of ACE1 and ACE2 in the renin-angiotensin system. ACE1 pathways are better understood in clinical medicine with ACE inhibitors and ARBs (angiotensin receptor blockers) used to treat cardiovascular disease, hypertension and kidney disease (including secondary to diabetes.

         It is very likely that is not the ‘excess’, but the deficiency of ACE2 receptor activity that complicates the outcome of COVID-19.

         Therapeutics like Vitamin D induce ACE2/Ang-(1-7)/MasR axis activity and inhibit the classic renin and the ACE/Ang II/AT1R axis, thereby increasing expression and concentration of ACE2.

         A brief review of interplay between vitamin D and angiotensin-converting enzyme 2: Implications for a potential treatment for COVID-19
         https://onlinelibrary.wiley.com/doi/full/10.1002/rmv.2119
6. Cocomaan December 20, 2021 at 7:58 am

   I’m wondering what the next spin is, because the democrats do have a pretty effective spin machine.

   Is it war with Ukraine? As an extension of Russia Russia Russia.

   Mandate boosters?

   I have no idea where they can turn but the Dems always intrigue me. What’s certain is that they will not do the right thing.
   1. Michael Ismoe December 20, 2021 at 8:21 am

      January 6th. They are making it the line-in-the-sand. If you do not believe that this was a combination of Shay’s Rebellion and the firing on Fort Sumpter than you are a Deplorable.

      It’s all they got. The problem is that the only people who care are Democrats but it’s good for fundraising and that’s all that matters. “This could be the last free election in America…”
      1. Cocomaan December 20, 2021 at 8:35 am

         Good one. I had thought about how we are coming on the one year anniversary now, so it will be a day of ritual pearl clutching.
      2. Screwball December 20, 2021 at 9:03 am

         I think you are correct. Blame/shame the unvaxxed, and go all in on Jan 6 heading into the midterms. Their base will eat it up.

         I hope they get a historical ass beating come November, and if it is worse than that – good. And they can STFU about Manchin and the whole blame game.

         We are/have been, in the middle of a pandemic. They shouldn’t have 2000 page bills that nobody knows what’s in them, and argue over for months. Create smaller bills that can actually pass, and quickly. You know, like create a bill for X million for mailed at home test kits, money for R&D on a sterilizing vax, a nose/sinus wash, or pill. But no – all they have is the one trick pony – vax, vax, vax.

         And it’s the Trump vaccine to boot. You can’t make this stuff up.

         Carlin was right – they don’t give a **** about you. Vote them all out.
         1. Pavel December 20, 2021 at 11:58 am

            They shouldn’t have 2000 page bills that nobody knows what’s in them, and argue over for months. Create smaller bills that can actually pass, and quickly. You know, like create a bill for X million for mailed at home test kits, money for R&D on a sterilizing vax, a nose/sinus wash, or pill. But no – all they have is the one trick pony – vax, vax, vax.

            Bingo!

            By all means get rid of these ginormous omnibus spending bills stuffed with lobbyist pork and loopholes for the elite.

            Small bills posted on the internet ahead of the vote, and force the critters to read every word aloud on the floor.

            Use GitHub to track the changes and who makes them.

            Is it true the CTC isn’t means-tested? That was one of Manchin’s objections, I believe. I agree with him there.

            Plus that obscene $80K SALT deduction!

            Throw them all out and start over with a randomly selected group of citizens. They couldn’t do any worse.
            1. Michael Ismoe December 20, 2021 at 12:36 pm

               The SALT deduction will pass before the midterms. It’s Chuck Schumer’s baby and that baby will get through in time for Schumer’s re-election or Long Island turns against him. And the Hamptons are on the other end of LI and must be defended.
               1. Pavel December 20, 2021 at 4:21 pm

                  Iron Dome for Israel, SALT for the rich liberal elites… we know where the Senate priorities lie.

                  Plus of course $780B for “defense”. (And BTW all those Dems who bleat about how climate change is an existential threat — how then can they vote for Pentagon spending when the US military is the world’s number one polluter?)

                  Bur fairly-priced insulin? That can wait.
                  1. tegnost December 20, 2021 at 5:51 pm

                     They had to wait to kill the BBB until they’d passed the defense bill?
         2. Grumpy Engineer December 20, 2021 at 12:08 pm

            “They shouldn’t have 2000 page bills that nobody knows what’s in them, and argue over for months. Create smaller bills that can actually pass, and quickly.”

            Oh, wow. It’s difficult to describe how strongly I agree with you here. I HATE the Democrats’ practice of writing enormous bills that are so opaque that even full-time political writers have difficulty summarizing them well. How in the world are ordinary citizens supposed to have meaningful opinions about the merits of such bills?

            Manchin has been accused of lying about his support regarding the BBB, but I doubt he’ll suffer a political price at home. Most Democrats in WV will be mad at him because they think he blocked good benefits, but most Republicans there will be happy because they think he blocked wasteful spending. And sadly, these emotions will be driven primarily by political loyalties rather than hard opinions about the bill itself. Why? Because it’s too large. “Nobody knows what’s in them.”

            Asking citizens to parse 2000 pages of legalese is asking too much. So the Democrats are effectively asking people to trust them. Except we don’t.
            1. Another Scott December 20, 2021 at 2:20 pm

               Isn’t the 2000 pages the point? Politicians get to include bad stuff without any consequences from their side of the isle because of all of the goodies that they included. Not to mention it allows more opportunities to reward their donors with line items that might otherwise be caught or publicized. And when the bill is inevitably killed, politicians at the end of the spectrum get to grandstand on Twitter and TV
               1. tegnost December 20, 2021 at 5:48 pm

                  Yes to this. There was a lot of pork in that monstrosity. One might assume that they have had time to actually read this bill…
                  I’m happy to see it go down in flames…
            2. lordkoos December 20, 2021 at 4:23 pm

               A majority of W Virginians did in fact support BBB.
            3. George December 20, 2021 at 8:39 pm

               What we have lost is our nation but go ahead and choose sides.
               “The taxes involved in the Build Back Better bill were just a small part of Trump’s $4.5 trillion 2018 tax cuts. The Build Back Better bill’s funding involved partially raising Trump’s corporate taxes. But even that was too much for the thousands of corporate lobbyists who descended on Washington in recent months; their single objective has been to ensure corporate interests in the Senate–within the Democrat party as well as the Republican–don’t pass the Build Back Better bill in any form, since paying for it involved to a significant extent clawing back some of Trump’s $4.5T tax cuts for corporations and investors. Their lobbying effort has proved quite successful.”

               Jack Ramus Build back better now DOA
   2. TroyIA December 20, 2021 at 12:49 pm

      The next spin will be that total cases aren’t important only severity. In practice we will be like the NFL. They had such a spike in cases they needed to postpone games so they changed their policy to only testing symptomatic unvaccinated players instead of everyone.

      Biden admin eyes a potentially stark shift in messaging around ending the pandemic

      A shift toward focusing on severity instead of case numbers
      Some of Biden’s advisers are encouraging the administration to begin discussing publicly how to live alongside a virus that shows no signs of disappearing, a potentially stark shift in messaging for a White House that once touted “freedom from the virus.”

      Steering public attention away from the total number of infections and toward serious cases only — as some Biden advisers have encouraged — could prove a challenge after nearly two years of intense focus on the pandemic’s every up and down. It is a part of a growing conundrum that Biden faces as the Covid-19 pandemic refuses to abate.

      “We’re getting to the point now where … it’s about severity,” said Xavier Becerra, the secretary of the Department of Health and Human Services, in a meeting with reporters this week. “It’s not about cases. It’s about severity.”

      Becerra said the issue recently arose during a meeting at the White House with Biden’s Covid response team. Other officials also said the issue of how to refocus the public away from total cases toward the severity of illness has been an ongoing subject of discussion within the administration.

      “There’s a degree of difficulty that now comes in trying to decide what means it’s severe and what you have to do to stay out of that threshold of severity,” Becerra said. “But I think that’s where we’re heading, is to try to be able to tell the public that.”
      1. Objective Ace December 20, 2021 at 3:47 pm

         > they changed their policy to only testing symptomatic unvaccinated players instead of everyone.

         The CDC set the example and was doing that 6 months prior
   3. fajensen December 20, 2021 at 3:59 pm

      … an extension of Russia Russia Russia.

      Sabotage the gas supply to Germany, Publicly blame the Russians for it, While leaving some breadcrumbs leading back to the UK and/or China, for additional shit & giggles, while giving the Nuclear Mob some desperately needed help?
7. Kengferno December 20, 2021 at 8:12 am

   Here’s some info on omicron symptoms from a super spreader event in London:
   https://twitter.com/chrischirp/status/1471119076244209669?s=21

   And here’s a chart from an Oslo Xmas party omicron event:
   https://twitter.com/ty4on/status/1472289436943667205?s=21
   Not sure where this chart came from however.
   Symptoms are:
   Cough 83%
   Runny nose 78%
   Fatigue/lethargy 74%
   Sore throat 72%
   Headache 68%
   Muscle pain 58%
   Fever 54%
   Sneezing 43%
   Reduced smell 12%
   Reduced appetite 33%

   People in the thread who’ve had covid lately agree with this list
   1. Yves Smith Post authorDecember 20, 2021 at 8:18 am

      Funny they don’t have the digestive symptoms the way IM Doc’s patients do.

      But it’s an average of 3 days from exposure to symptom onset with Omicron. So Dec 3 is only 4 days into their cases. I can’t imagine they’d all be done being sick by then.
      1. Lena December 20, 2021 at 8:31 am

         People I know who had Covid recently (all are “breakthrough cases”) have reported GI problems. Diarrhea, nausea and (less often) vomiting.
         1. redleg December 20, 2021 at 2:01 pm

            I can vouch for this based on my own experience plus a score of friends and family in the last few weeks (Delta)- lots of nausea but no vomiting.
            1. SB December 21, 2021 at 3:37 am

               Dr. Tom Yarema, who gives a weekly Zoom webinar, said this week that he’s seeing new symptoms in his COVID patients – less respiratory symptoms and a complex of viral GI disease. This was his Zoom 78, but Youtube has apparently taken it down so I don’t have a link.
      2. Mikel December 20, 2021 at 8:35 am

         Sounds like something an organization like The Who should be on top of: compiling and sharing lists of symptoms from country to country.

         Where they at? They still moonlighting as pharma salesmen?
         1. Mantid December 20, 2021 at 11:47 am

            They’ve called Gates and are on hold. Dial 1-8000-END-LIFE Phil Ochs is the music on hold: https://www.youtube.com/watch?v=ibYHlk-EafU
   2. pxx December 20, 2021 at 10:06 am

      Yep now in day 8 with a pretty gnarly, yet could-be-worse, set of symptoms. These are atypical for me. (male 40s good health): sore throat, impressive nasal mucus, headache for a day, and an intense wet cough. Appearing in that order. Everything but the cough and congestion cleared up by day 4, cough tapering off slowly, still not all the way gone. Girlfriend similar, minus sore throat, plus fatigue for a day or two, and faster to improve. Location has massive 2500-active-case outbreak for a college town. Girlfriend’s immediate relative contact traced as exposed but asymptomatic (and tested negative). I had negative result on home test, G/F and immediate family had negative result on both home tests and PCR, so we didn’t fully isolate, though stayed home for the most part.

      If this thing is registering false-negative on PCR, look out! That should be story number one…
      1. Pate December 20, 2021 at 12:57 pm

         “had negative result on home test, G/F and immediate family had negative result on both home tests and PCR”

         Was your illness ever confirmed Covid?
         1. pxx December 20, 2021 at 2:05 pm

            No, so likely in the category of a cold/whatever. But with how much confidence? Rearranging holiday plans, concern about older family etc. The Abbott home tests available here were already 85% accuracy per the fine print — with the 15% false-neg in large part as best I can tell from press reports — and that was tested against the original-recipe virus. The item in the article above questioning PCR vs Omicron raises huge concerns.
            1. Objective Ace December 20, 2021 at 4:19 pm

               >with the 15% false-neg in large part

               I don’t see how they could calculate this. It will depend on how much covid is in the area at a specific time.. To take it to the extreme if everyone has covid in the area it will have a 100 percent false negative rate
   3. p fitzsimon December 20, 2021 at 11:19 am

      Are their any symptoms that can tell you it’s not covid just a bad cold or flu?
      1. Michael Ismoe December 20, 2021 at 12:40 pm

         No offense but the symptoms of Runny nose, Fatigue/lethargy, Sore throat, Headache. Muscle pain,
         Fever and Sneezing sound like a normal day to us allergy sufferers. Could it be that I originated Covid?
         1. lordkoos December 20, 2021 at 4:57 pm

            I’ve had bad allergies to certain grasses and trees since I was 14 and I have never had headaches, sore throat, muscle pain or fever from it. I would not consider those to be typical allergy symptoms at all?
8. TMoney December 20, 2021 at 8:13 am

   Meanwhile inside the PMC Beltway cabal…..
   A: Young and Worried
   B: Older and Wiser

   A: “We get wiped out in the midterms ”
   B: “I know – awesome right ? ”
   A: “what ?? ???”
   B: “Relax, our fund raising numbers go through the roof when we are out of power – how else are you going to pay for your kids college ? ”
   A: “Oh…..”
   1. Michael Ismoe December 20, 2021 at 8:25 am

      The amazing part to me is that these very same people who are going to master strategize for the Dems and lose 75 House seats and 5 senate seats are going to be in high demand because 2024 is right around the corner. Falling upwards is a Democratic Party tradition. Look at the commander in chief. The Speaker. The Majority Leader.
9. michael December 20, 2021 at 8:17 am

   When I was a kid growing up in the 70’s, my dad told me about the yellow dog Democrats. Yellow dog Democrats would vote for a yellow dog running as a Democrat over any Republican. Has anyone here thought about what it would take to create yellow dog Republicans? I think threatening people with loss of their job so that they can’t feed, clothe, or provide shelter for themselves and their family would be an excellent place to start. I think that allowing crime to run rampant is a close second. I still remember the congressional Democrats kneeling to the altar of BLM as protestors rioted, destroyed and looted businesses, started fires with the express intent to hurt people, and attacked police and national guardsmen on duty to protect government buildings and police stations. Today, we have Democrat DA’s deliberately not prosecuting criminals. These criminals then go out and commit more crimes that they aren’t prosecuted for. This doesn’t even factor in the illegal immigrant invasion or the “whiteness bad” cults that seem to have taken over the schools, universities, and major multinational corporations. I know that a lot of the people upset by the above are already Republicans but how many are now former Democrats? How many yellow dog Republicans have these policies created? A small permanent shift of even 2 to 3% could make the Democratic party the minority party for years to come.
   1. marym December 20, 2021 at 9:00 am

      While it’s very generous of people all across the country who don’t live in or travel to troubled big cities run by Democrats, to be concerned about them, they should vote for or against candidates based on issues like jobs, healthcare, social services, local infrastructure, school budgets, natural disasters made worse by climate change, local pollution by corporate industries, the opioid epidemic, debt relief, etc. that have an impact on their own lives. Perhaps this would make corrupt and anti-working class politicians a minority in both parties.
      1. coboarts December 20, 2021 at 5:07 pm

         In the clown show to which I have referred before, the recent recall election of our next president, Gavin Newsom, those are exactly the types of issues that were demanded and nowhere found.
         1. Jeff December 21, 2021 at 2:55 am

            Newsom is an excellent representation of a California Democrat. He failed as the mayor of SF and was rewarded by the dim population to be governor.

            Ignore the crime, homelessness, bad schools, unaffordability and business hostile approach to governance. As I’ve said ad nauseam, California is a basket case, and it’s best personified by Newsom himself.

            Remember, he’s the guy helping PG&E fight off those entitled, pesky homeowners who lost their homes in the Wolsey fire and who are suing PG&E for restitution.
   2. Phil in KC December 20, 2021 at 9:37 am

      You only need to visit rural USA and you will find all the “yellow dog” Republicans you want. Some of my in-laws from the high plains view Satan more favorably than the Democratic Party. If you confine discussions to policy and philosophy only, a lot of these folks will express a preference for Democratic and even some progressive proposals. I mean, come one, who is FOR child poverty? Or more expensive treatments for diabetes? No one, but once the “D” label is applied, the idea becomes radioactive. The GOP has effectively branded the Democratic Party. Dems seem unable to get out of GOP framing.
      1. Synoia December 20, 2021 at 11:36 am

         Yellow dog republicans: See Orange County, CA
   3. LY December 20, 2021 at 10:04 am

      The yellow dog Republicans are the DAs refusing to prosecute criminals (polluters, wage theft, fraud, affluenza), those causing the illegal immigrant invasion (i.e. those employing them), etc. Of course, Islamaphobes, the “Lost Cause”, and slavery apologists are part of the base, so that’s not going to change.

      Biden and Obama get stick for illegal immigration as they deport record numbers, while Republicans get a utter free pass on hypocrisy (farm labor, Trump, Inc. with Costa Ricans and Poles). And heaven forbid BLM get the same treatment as the Bundy’s, KKK, frat boys celebrating a sports championship victory/loss, or Jan. 6th rioters.
      1. diptherio December 20, 2021 at 11:02 am

         I think Michael must have gotten lost on his way to the Fox News comments section.
         1. TMoney December 20, 2021 at 12:22 pm

            Not lost. He just accidentally found his way to a more enlightened comments section.

            Warning! Continual Exposure to NC may cause thinking.
         2. Jeff December 21, 2021 at 2:58 am

            Hmm, much of what he said about cities not prosecuting criminals is indeed happening in Los Angeles and SF.
   4. WobblyTelomeres December 20, 2021 at 2:31 pm

      Yellow dog Democrats (YDD) and yellow dog Republicans (YDR) are the exact same people. YDD were Democrats only because they refused to vote for the party of Lincoln, who freed the slaves. They slowly began turning into YDR following LBJ’s civil rights act, which became a stampede when told they didn’t have to be ashamed of their rascism, that they were patriots, builders, moral even.
      1. JBird4049 December 20, 2021 at 3:01 pm

         Dixiecrats in the South. Once President Richard “Tricky Dick” Nixon’s Southern Strategy got going, it gave an excuse for all those crypto-racists an excuse to go Republican.

         Don’t forget that the Democratic Party is what the conservative Republican Party used to be; the Republican Party today, if not insane, is very reactionary being the American version of the French Ultras, but perhaps worse; they look like they want to rule as the American version of the Latin American or Brazilian varieties of reactionary oligarchies. Especially, the Southern wing.
      2. Duke of Prunes December 20, 2021 at 4:31 pm

         Maybe I’m an optimist or incredibly naive (or, perhaps, a closet racist in denial of such), but I believe there’s often more to these things than racism. Then again, blaming everything on racism is neat and easy.
         1. Jeff December 21, 2021 at 3:01 am

            The racism trope is tired nonsense. The woke mob would accuse the sun of racism for not rising in the west and likely accused the Earth’s rotation as just another example of white privilege.

            Oh, and math is racist.
10. Gregory Etchason December 20, 2021 at 8:20 am

    Post Holiday is likely be an historic WTF moment. When many return to work and find 30% of co-workers out sick. The 2021 story won’t be body bags and refrigerated trailer morgues. But the economy will likely end up crtically ill.
    1. Posaunist December 20, 2021 at 2:25 pm

       I wouldn’t bet against body bags and trailer morgues.
       1. Gregory Etchason December 23, 2021 at 9:53 am

          I agree that Omicron may be just as lethal as Delta in the immunologically naive( no prior infection or vaccination). I would guess at least 100 million immunologically naive in the US right now. My sense the intact T cell immunity in everyone else is keeping Omicron out of the lungs. If so, an historic Red State die off is coming
11. IM Doc December 20, 2021 at 8:31 am

    .About the Gottlieb tweet.

    Is it just me misremembering, or was there a time this summer, when the National media were all aghast that deSantis was obtaining monoclonal for Florida outside of the federal process?

    It was a big right wing conspiracy theory there in our national media. Meanwhile, in academic medical departments everywhere, the Abs were recognized as a really good tool.

    It seems to me that part of this fiasco is also the complete and total failure of our media and their social media censors and fact checkers.

    We must not forget that as well when the blame is being assessed.
    1. Shonde December 20, 2021 at 8:56 am

       Also, I recently read that the Florida health department is promoting use of D, C and zinc whereas my northern state with supposedly an excellent health department (Minnesota) has not said a thing.

       Shouldn’t we have walk in D testing stations free of charge? Had my D tested in May and even while taking 5000 IU’s a day, it was still at the minimum of 40.
       1. endeavor December 20, 2021 at 9:42 am

          I’ve read repeatedly from trusted practitioners that Vit D needs magnesium and quercuitan to be really effective. Plus a heavier person needs a larger dose of D as it is fat soluble.
       2. Louis Fyne December 20, 2021 at 10:02 am

          Long-term supplements of zinc should be accompanied by copper (but I have no idea how upping copper and zinc affects covid).

          Mega-dosing of zinc is really meant for very brief periods, around the time one feels an infection developing.

          Tread carefully with zinc! get knowledgeable advice.

          Mega-dosing with zinc is not as fool-proof as mega-dosing with Vitamin C or D.

          just saying
          1. redleg December 20, 2021 at 2:14 pm

             The body needs both zinc and copper to maintain the big brass….
             Y’all get the idea.
       3. KLG December 20, 2021 at 10:08 am

          That is not the minimum. I recently had a complete metabolic panel done. Anything above “40” is good IIRC (the current Endocrine Society recommendation is 40-60 ng/mL for both children and adults, which accounts for vagaries in assays). It is not clear that excess helps, and it may hurt. Vitamin D3 is fat soluble and excess is not excreted as with water-soluble vitamins (such as B vitamins). Toxicity caused by too much vitamin D can be a thing: “Vitamin D, when ingested in large amounts, is one of the most likely of all vitamins to cause overt toxicity” (Advanced Nutrition and Human Metabolism, 6th edition, S.S. Gropper and J.L. Smith, 2013). The key is not to be deficient, while maintaining good health. Our bodies do homeostasis very well, and if enough of a vitamin is present, more is not necessarily good. This applies to all nutritional supplements. It is also good to remember that the “supplement business” is not regulated by the FDA, which among our alphabet agencies has not yet been tainted by the rampant stupidity associated with this pandemic AFAIK. You never really know what is in those pills…
          1. Amfortas the hippie December 20, 2021 at 12:10 pm

             yeah. i keep the Zinc and D on the shelf until there’s a syptom or relatively certain exposure.
             we’re all outside a lot….like, really a lot,lol…and eat like old time farmer people.
             so i know that our D is pretty decent, compared to other folks…and i expect the rest of the vitamin and mineral profiles to be good as well(picked the last vine ripened tomatoes last week….and wrapped 30# of green toms in newsprint and stuck them in a ventilated cooler in the living room, in a dark-ish corner…we’ll be eating lots of tomatoes through january, at least…plus peppers and green onions in the greenhouse)
             i push vitamin C on everyone…because, as you say, water soluble=can’t OD on it. and i’ve been taking B Complex forever(due to grandma’s advice, long ago), because why not? for the same reason….can’t OD.
             touch wood, but i very rarely get sick…even with all the time i’ve spent with wife in hospitals and such in the last 3 years.
             of course, i have always avoided crowds and close contact with people out in the world…so i’m sure that has an effect, as well—i’ve been “social distancing’ my whole derned life.
             (if only this method could do something about whole body arthritis, Fibro and Cedar Fever!)
          2. Yves Smith Post authorDecember 20, 2021 at 8:03 pm

             20 minutes of full body sun at the equator = 20,000 IU of Vitamin D. It’s very hard to get to toxic levels. No one is recommending 100,000 IU.
             1. Amfortas the hippie December 20, 2021 at 8:33 pm

                i’ll take your word for it.
                thanks.
                a tickle in my mind remembered something about too much D being bad, so i erred on the side of caution…and, like i said, we get lots and lots of sun around here(especially me).
                (and all that milks we drink has D added, too.)
                too much to keep up with, i suppose….i may have been thinking of zinc.
                box in my closet has all the preps for covid exposure.
                …and to their credit, local clinic recommended D, zinc and even melatonin when wife and boys had it last january.

                where i’m at, the general consensus is that the pandemic is over…even that it never happened/was a hoax(in spite of the local deaths and sickness).
                so omicron should be interesting.
                i haven’t seen a single at-home test on any shelf, anywhere, here.
                clinic only does them for folks with symptoms(and cancer patients)
                luckily, wife is taking january off(FMLA), since she’ll be tied up with the clinical trial for so much of the month anyway(and retiring in May)…and youngest, sophomore, feels like mask wearing in school is akin to letting his whiskers or hair grow out: an act of defiance.(local school is sticking to their role as hair police)
                (eldest works outside, and refuses vax(fwiw))
       4. Kris Alman December 20, 2021 at 5:47 pm

          There’s more attention to the competing pathways of ACE1 and ACE2 in the renin-angiotensin system. ACE1 pathways are better understood in clinical medicine with ACE inhibitors and ARBs (angiotensin receptor blockers) used to treat cardiovascular disease, hypertension and kidney disease (including secondary to diabetes.

          It is very likely that it is not the ‘excess’, but the deficiency of ACE2 receptor activity that complicates the outcome of COVID-19.

          Therapeutics like Vitamin D induce ACE2/Ang-(1-7)/MasR axis activity and inhibit the classic renin and the ACE/Ang II/AT1R axis, thereby increasing expression and concentration of ACE2.

          A brief review of interplay between vitamin D and angiotensin-converting enzyme 2: Implications for a potential treatment for COVID-19
          https://onlinelibrary.wiley.com/doi/full/10.1002/rmv.2119
    2. Eloined December 20, 2021 at 9:15 am

       Not only that, the narrative was that he was doing so as quid pro quo benefiting a campaign donor: https://apnews.com/article/joe-biden-business-health-coronavirus-pandemic-4d0d18b24e0dd41de2424e19b3ed994f. By the time of this story the treatment efficacy had to be acknowledged, but was presented as inferior to vaccines. (Apples to oranges?)
    3. The Rev Kev December 20, 2021 at 9:44 am

       Digging back, it seemed that DeSantis was setting up Monoclonal antibody treatment centers back in August-

       https://miami.cbslocal.com/2021/08/12/covid-florida-desantis-monoclonal-antibody-treatment-regeneron/
    4. coboarts December 20, 2021 at 5:18 pm

       Going out on a limb IM D, and, obviously only my delusional, conspiratorial predilections at work, plus several well documented counter-narrative sites that are beyond the gates kept (The Last American Vagabond & Corbett Report are the best), I might suggest that there is a long planned agenda to… well, one would have to go there… And, if so, and if there are enough remaining with the vigor, then the entire PMC class: Academics, Media, Corporates, Politicians will be tried and condemned for crimes against humanity – and all who acquiesced on the way.
12. Louis Fyne December 20, 2021 at 8:55 am

    —- And in that story, even though their war burns down the world, it also produces its renewal. Will that be the Democrats, or a wider conflagration?—

    Then throw in….for whatever reason, DC decides that the midst of a pandemic, and generation-high inflation, is precisely when the US should turn up the diplomatic heat on Russia and PRC—but of course, the Beltway turns up the diplomatic heat by using meaningless gestures that make no practical difference (diplomatic boycott to the ’22 Olympicis, sending light arms to Ukraine) but absolutely infuriates the other sides and tips the US’s intrasigent hand.

    For hating POTUS #45, the DC Dems are literally doing everything that they can to given him 300+ electoral college votes.

    The results of incompetence truly look no difference than the results of malice.
    1. NotTimothyGeithner December 20, 2021 at 9:06 am

       Failed domestic Presidents go shopping for foreign policy wins, so former Vice President Biden is looking for a win. Africa doesn’t get headlines, and he’s run out of small countries. Pervasive propaganda about Russia has likely been internalized. He might think they will fold and the Russians will make a deal, but Biden doest realize he’s not a new President but a continuation of now three mad men. He’s too aligned with Obama to be treated with in good faith.

       Again, former Vice President Biden is very stupid.
13. Tom Stone December 20, 2021 at 8:56 am

    Step back for a moment and consider how pervasive the incompetence is.
    This took talent of a kind. and an impressive amount of effort or there would,if only by accident,someone doing a good job.
    1. Mantid December 20, 2021 at 12:03 pm

       I agree. However, when all sorts of agencies, universities, politicians, medical publications, and even a large variety of countries are incompetent, perhaps they are really exhibiting competence. Their efforts, what they want to achieve, are successful.
       Why hasn’t Harvard Medical School, Emory Univ., USC Med. Ctr. come out with simple Covid avoidance measures? Well, who signs their pay check? Who offers them grants? Why did Andrew Hill, who was initially all in for Ivm (and other cheap treatments) and then did an about face in Jan. of 2021, receive a $40,000,000 check for his institution? Also, why are the people who suggest preventatives being fired (Dr.s Korey, Meric, etc.). Vaxifornia, uber alles!
       1. coboarts December 20, 2021 at 5:27 pm

          what’s this… synchronicity.. my comment above, under IM Doc, is not so different:
          coboarts
          December 20, 2021 at 5:18 pm
14. Wukchumni December 20, 2021 at 9:07 am

    48 double vaxed came down with Covid on a cruise ship in Miami yesterday, so its a matter of time before hospitals are overwhelmed, with the worst part being that those vaccinated were told they were in the clear, nothing much to worry about.

    So, we’ll have the non-vaxed and vaxed getting sick simultaneously, I knew we could bring this country back together somehow!
    1. The Rev Kev December 20, 2021 at 9:51 am

       Bonus points if some of the passengers aboard that cruise ship were also aboard the “Diamond Princess”-

       https://en.wikipedia.org/wiki/COVID-19_pandemic_on_Diamond_Princess
       1. ChrisFromGeorgia December 20, 2021 at 11:20 am

          What is the proverb, “as a dog returns to his own vomit, so a fool returns to his own folly?”
       2. Mantid December 20, 2021 at 12:04 pm

          Maybe we’re all on the Titanic?
15. Arizona Slim December 20, 2021 at 9:42 am

    Was chatting with three friends yesterday evening. Two of them are sisters and the third is the husband of one of the sisters.

    There were glum faces all around, and the truth soon emerged. Two of the three had to be vaxxed so they could keep their jobs.

    The wife of that couple said, in essence, that she knew that being vaccinated wouldn’t do her any good, but she had to do it. And she experienced some pretty scary side effects — hallucinations, trouble moving her legs, and tinnitus. Suffice it to say that she wants no part of any booster.

    Meanwhile, the husband sailed right through his vaxx experience.

    The other sister had you-know-what last year and does not want the vaccine. She may lose her job, but so be it. She saw what just happened to her sister and she’s frightened.
    1. Louis Fyne December 20, 2021 at 9:56 am

       not that it’s worth getting tinnitus, but there is some recourse through the vaccine claims process.

       https://www.hrsa.gov/cicp
       1. Arizona Slim December 20, 2021 at 10:10 am

          I can’t tell you how grateful I am for your comment, Louis. I sent this information on to my friends.

          The NC Commentariat is truly the BEST!
          1. cocomaan December 20, 2021 at 10:20 am

             Yeah this is interesting. At the very least, if you have side effects, document that you had them! Never know what may come of it.
             1. Anonymous 2 December 20, 2021 at 12:49 pm

                I had tinnitus after my first vaccine dose. The good news is that in many cases it seems to disappear gradually if, as in my case, it was probably an off-target inflammatory response.
    2. Pavel December 20, 2021 at 12:05 pm

       I have had constant tinnitus since my second vax (never had it previously). One result is that I can’t get to sleep until exhausted at five AM or so. Thankfully I am on work sabbatical.

       I can only hope it will resolve over time. I read of one chap who killed himself because it was so unbearable.

       No way I will get a booster.
       1. Anonymous 2 December 20, 2021 at 12:51 pm

          There is a tinnitus support group on Facebook. You might find it helpful to join. In my case it has got better with time – but it does take months (I am 10 months on, now much better).
          1. Pavel December 20, 2021 at 4:26 pm

             Hello…

             thanks for the encouraging words (which I had heard elsewhere). I have no wish to be on FB but I’ll do some research elsewhere!

             Mine is high-pitched and comes-and-goes (right now at full blast) and is worst of course at 3AM or 4AM and destroys my sleep. I might try some white noise recordings instead of the podcasts I listen to now — interesting and/or amusing but no good for my sleep!

             Thanks again.
             1. Amfortas the hippie December 20, 2021 at 8:39 pm

                i’ve had it off and on for a long time.
                music in my head helps…and whiteish noise…like a box fan…really helps me to sleep(exhaustion is my friend, as well,lol)
                i chalk mine up to loud amplifiers back in my guitar god days, as well as the likely constant inflammation from the arthritis.
                it’s worse in winter.
                wouldn’t wish it on…very many people….
             2. Oh December 21, 2021 at 8:49 am

                Smart of you not to join the snooper Facebook.
                Hope you the tinnitus goes away.
       2. Anon December 20, 2021 at 2:07 pm

          I am still suffering with GBS after getting my J&J vaccine in the Spring. It is unsafe for me to get a booster of any of the vaccines. At this point, I am essentially unvaccinated.
       3. johnnyme December 20, 2021 at 6:54 pm

          I’ve had bad tinnitus all my adult life. Something that generates soft white noise (like having a fan nearby) helps immensely with sleep.
16. Carolinian December 20, 2021 at 9:50 am

    Don’t forget hospitals being short handed because Biden forced them to fire their staff. Since Biden likes to play doctor someone should tell him about “first do no harm.”

    But of course it’s not just him as hospitals around the country insist on following the Fauci party line re ivermectin and other non vax treatments. We are living in a repressive environment where doctors are attacked if they challenge a failed consensus. The entire establishment seems more focused on protecting their position than in solving problems.

    Still, isn’t it possible that Omicron could turn out to be a ray of light if it changes Covid into a less deadly disease? The Spanish Flu did fade after a couple of years and early on some epidemiologists said this would happen with Covid. Perhaps now’s the time….
17. Hana M December 20, 2021 at 9:52 am

    Flu is making a comeback and sadly, but not unexpectedly, the current Northern Hemisphere flu does not match the virus that is currently circulating. An interesting thread:

    https://twitter.com/SCOTTeHENSLEY/status/1471539459711815687
    1. Judith December 20, 2021 at 12:04 pm

       Hi Hana, did you mean to say “Northern Hemisphere flu vaccine“?

       Thanks.
18. Tom Stone December 20, 2021 at 9:53 am

    A friend of mine and his wife held their annual Christmas party yesterday, 30 odd attendees.
    Inside because the weather is cold.
    No worries because everyone was vaxxed.
    He’s mostly apolitical, she’s a lifelong Dem and vice principal of a private High School.
    BA and Master’s degrees.
    Really nice people and I hope they are lucky.

    We are only weeks away from a tsunami of new cases, and an obviously corrupt and incompetent leadership guarantees a clusterfuck of historic proportions.
    When Governments lose legitimacy the only tools they have left are lies and violence.
19. Louis Fyne December 20, 2021 at 10:42 am

    Icing on top of the incompetence cake—-my hunch is that behind-the-scenes West Wing staffers called Manchin’s constituents something a bit more nasty than Deplorable.

    ****
    —On statewide WV radio, explaining his decision to buck BBB, Manchin says Biden staffers alienated him.

    “They drove some things, and they put some things out that were absolutely inexcusable. They know what it is, and that’s it,” he says on @HoppyKercheval’s MetroNews program.—

    https://twitter.com/stevenportnoy/status/1472951145362567170? (CBS News reporter)
    1. marym December 20, 2021 at 11:14 am

       If we’re proposing that Manchin decided to vote against things his constituents need and want – having already “negotiated” those things downward – because some elite Dem said something mean about his constituents, we would have to ask who else besides Democrats is showing contempt for those constituents in this scenario.
    2. Pat December 20, 2021 at 11:39 am

       I may despise Manchin, and though this story reeks of entitlement along the lines of “don’t they know who I am, I also have to give him some props. He has read the situation, played the key entities, “negotiated” hard and gotten everything he wanted while denying any wins for those key entities. He might not have made out so well with an LBJ or even a Reagan/Bush 1 administration (they would have used the tools Biden forgot he had) but this is possibly the best hardball play by a Democrat in over a decade. Too bad it was all about self serving greed.
       1. Anonymous Coward December 20, 2021 at 11:56 am

          You mean like strong-arming Joe with legal threats to his daughter? LBJ would have done it.
          1. NotTimothyGeithner December 20, 2021 at 12:31 pm

             Manchin is whining about WH staffers. I think Obama could squeeze Manchin. Manchin if he’s ever read a book would probably curl up into a fetal position and piss himself if he read on Caro’s LBJ books.
             1. Michael Ismoe December 20, 2021 at 12:49 pm

                So would Obama.
             2. Pat December 20, 2021 at 2:00 pm

                No drama Obama! Nah I don’t think so. Michelle would just appear on some talk show talking about going high. What I will give Obama in this is there never would have been the President Manchin meme as he would make sure Jaypal would never have been able to pin the failure on him, he would have arranged it to be all about the squad’s overstep and incompetence.
20. Matthew G. Saroff December 20, 2021 at 10:49 am

    This was why Pelosi should have held off passing the infraxtructure (glorified highway) bill before the BBB bill made it through the Senate.

    DINOs never keep their promises.
21. Hepativore December 20, 2021 at 10:59 am

    Of course when the Democratic wipeouts happen in 2022 and 2024, the Democrats will use this as a sign that they should move further right and become even more Republican-Lite.

    If Joe Biden really wanted Manchin to fall in line he could have threatened to have his daughter investigated for all of the various illegal financial misdeeds that the Manchin family has been involved in. The same thing goes for Sinema. Biden could have told her to either play ball or he could make a few calls to ensure that she loses those cushy lobbyist jobs she has lined up after her political career.

    This is why I do not think that Biden ever actually wanted to stop Manchin or Sinema in the fist place.
    1. NotTimothyGeithner December 20, 2021 at 12:29 pm

       After 2024. Manchin et all will be held in gallows set up your Trump and his supporters. He voted to convict Trump twice.
    2. Dr. John Carpenter December 20, 2021 at 12:45 pm

       Agreed with this 100%. And I would add, if one vote is all that’s standing in the way, howcome Biden didn’t go after a Republican? We heard so much about how he was beloved by them and was going to reach across the isle, etc. And yes, I know. Republicans evil. It would have been a long shot. But did he even try?
       This was supposed to be his signature accomplishment. He’s either the laziest man in politics or he really didn’t care if it passed.
    3. Duke of Prunes December 20, 2021 at 2:15 pm

       Perhaps Biden is hesitant to go after family because of his family? That lovable scamp Hunter has been out of the news for while…
       1. polar donkey December 20, 2021 at 7:27 pm

          For real. Biden threatens Manchin, Manchin flips to republican party and then 24/7 Senate investigation and hearings.
22. drb48 December 20, 2021 at 11:13 am

    In all, most monoclonal antibodies were completely ineffective against the Omicron variant. Some, such as sotrovimab, S2K146, and S2X324 retained neutralizing activity, but at a significant reduction. This points to the immune escape capabilities of Omicron via its distinctly mutated S protein and genome.

    Conclusion

    Many seem surprised at the ability of SARS-CoV-2 to mutate to increase resistance against convalescent sera, most vaccines, and most monoclonal antibodies. However, the surprise was unwarranted for those who realized that coronaviruses have evolved over many millions of years to reinfect hosts over time. Those previously infected with earlier strains of the virus, contrary to our assumptions earlier in the pandemic, are able to be reinfected with Omicron and strains to come.

    We previously predicted that SARS-CoV-2 would persist, continue to vary, and evade our natural and adaptive immune responses. We have also learned that SARS-CoV-2 has the potential to become far more lethal than it is today. We reiterate that the sister of this virus, SARS-CoV, and its cousin, MERS-CoV, ranged between 10% and 30% lethality. This is presumably due to slight variations in the structural, nonstructural, and accessory proteins. We must be ever alert now and for many years in the future of the possibility of such changes and their consequences.

    https://www.forbes.com/sites/williamhaseltine/2021/12/17/how-omicron-evades-natural-immunity-vaccination-and-monoclonal-antibody-treatments/?sh=808bb7f60e08
    1. MT_Wild December 20, 2021 at 11:42 am

       “The rise and fall of Omicron” is but Act III of the Shakesperean tragedy we are living through. The variant with a 10% CFR does not arrive untill midway through Act IV.
    2. Objective Ace December 20, 2021 at 4:39 pm

       >We reiterate that the sister of this virus, SARS-CoV, and its cousin, MERS-CoV, ranged between 10% and 30% lethality.

       The more this drama unfolds, I’ve been wondering if China–who are actually getting their public health response correct–may actually be kicking themselves down the road. Everyone in the west will have been exposed many times over the next 5 to 10 years. Will China be sitting there like the America’s were when Christopher Columbus landed and brought a bunch of viruses they had never encountered anything the likes of before
23. Russel Allinson December 20, 2021 at 11:24 am

    I am so sick of all the commentary about the impact of the BBB failure on the democrats and the president. How about the impact on children of the poor , low income families, the climate, and those who depend on Medicare? Failure of this bill leaves all the problems unresolved and worsening. That is the tragedy in a country of enormous wealth and criminal inequality
    1. Mark Sites December 20, 2021 at 12:27 pm

       And, of course, there will be no tax increases on the richest. That was the whole game for Manchin, and he delivered BIGLY to every one that matters to him.
    2. Amfortas the hippie December 20, 2021 at 12:38 pm

       Hear, hear!

       …but we’re by now rather acclimated to having no help, i suppose.
       i know i sure am…
       i’m not eligible for medicaid, for instance, because wife makes too much money teaching(!)…(she’s eligible, because it’s Cancer, which apparently puts her in a different, not-lazy category.)

       i allowed myself a tiny sliver of hope, up until the Progs caved on the highway bill.
       if i vote at all, going forward, it will be in the GOP primary so i can screw with them.
       and local things like the sheriff, that have an actual effect on me…and that, due to polity size, i can actually have an effect on.
       i vow to never vote for a democrat again.
       if i do deign to vote in the General, it will be only for greens.
       a pox on them all.
       1. coboarts December 20, 2021 at 5:40 pm

          What if those who care for the Earth and dwell in cities decide that each privately owned quarter of an acre, anywhere, should be taxed – a lot – to bring equity and justice to the land?
    3. Michael Ismoe December 20, 2021 at 12:56 pm

       It’s the children of the wealthy I’m most concerned about. Their parents were expecting a SALT increase and didn’t get it. The dues at the country club went up, the leases on the Lexuses are due and will they have to hire another maid so Courtney can get private Spanish lessons?

       Burn the whole thing down. I gladly sacrifice my voucher for a free hearing test that was carefully crafted to make one happy Medicare recipient (damn entitlement mentality).
24. Samuel Conner December 20, 2021 at 12:10 pm

    Stimulated by an alternative spelling, “Hybris”, in comments yesterday, I’m wondering if the “u” in “Hubris” is properly pronounced the same as the “u” in “nu”.

    —-

    If “yes”, I cannot resist the temptation to paraphrase Gandalf as he fell into the abyss at the bridge of Khazad-Dum:

    “Flu’, you fools!”
    1. coboarts December 20, 2021 at 5:47 pm

       I didn’t see personal fear as a driving theme in the “Lord of the Rings” story
    2. ddt December 21, 2021 at 10:17 am

       Ypsilon “υ” in Greek is an ee sound, like the word ‘Greek’. The capital is “Y”. So the word in the language, ύβρις, is pronounced eevrees (“h” is silent) with the accent on the first syllable. There endeth your Greek lesson for the day.
25. LAS December 20, 2021 at 12:15 pm

    From within the NYC DOHMH, we are being encouraged from City Hall and leadership to believe that Pfizer and Moderna shots stop Omicron, where other makers’ shots do not. They are relying on the fact that Moderna says its booster significantly raised the level of antibodies which could combat Omicron and the rest of the world does not have access to Pfizer/Moderna used in the USA. It is not clear to me how these claims can be reliable at so early a stage of Omicron. Nonetheless, these are the talking points by an outgoing DiBlasio administration and commissioner of health.
    1. urblintz December 20, 2021 at 12:54 pm

       Jesus in a jab, brother. Ya gotta believe!
26. Kris Alman December 20, 2021 at 2:11 pm

    As an endocrinologist, I’ve been very interested in the role of the ACE2 receptor in the pathology of Covid since it is the primary portal for the virus spike to enter the cell. A Trojan horse.

    When I was in fellowship training decades ago, the ACE2 receptor and angiotensin-(1-7) (Asp-Arg-Val-Tyr-Ile-His-Pro) were just babes in benchwork research.
    https://europepmc.org/article/med/1342241

    We have had a much better understanding of angiotensinogen, an inactive precursor peptide cleaved by renin to form angiotensin 1 and further processed by angiotensin converting enzyme 1 (ACE1) to angiotensin 2 in the Renin-Angiotensin System (RAS). ARBs (Angiotensin-II receptor blockers) and ACE inhibitors have been widely used to manage hypertension, congestive heart failure and kidney disease (including diabetic nephropathy).

    Covid-19 has created a surge of interest in these parallel pathways that intersect with our complex immune system and our body’s response to stress/inflammation (including the role of glucocorticoids and gender differences).

    Here’s a dense review with its abstract and one paragraph on diarrhea:
    Functional ACE2 deficiency leading to angiotensin imbalance in the pathophysiology of COVID-19
    Reviews in Endocrine and Metabolic Disorders (2021)
    https://link.springer.com/article/10.1007/s11154-021-09663-z

    Abstract
    SARS-CoV-2, the virus responsible for COVID-19, uses angiotensin converting enzyme 2 (ACE2) as its primary cell-surface receptor. ACE2 is a key enzyme in the counter-regulatory pathway of the broader renin-angiotensin system (RAS) that has been implicated in a broad array of human pathology. The RAS is composed of two competing pathways that work in opposition to each other: the “conventional” arm involving angiotensin converting enzyme (ACE) generating angiotensin-2 and the more recently identified ACE2 pathway that generates angiotensin (1–7). Following the original SARS pandemic, additional studies suggested that coronaviral binding to ACE2 resulted in downregulation of the membrane-bound enzyme. Given the similarities between the two viruses, many have posited a similar process with SARS-CoV-2. Proponents of this ACE2 deficiency model argue that downregulation of ACE2 limits its enzymatic function, thereby skewing the delicate balance between the two competing arms of the RAS. In this review we critically examine this model. The available data remain incomplete but are consistent with the possibility that the broad multisystem dysfunction of COVID-19 is due in large part to functional ACE2 deficiency leading to angiotensin imbalance with consequent immune dysregulation and endothelial cell dysfunction.

    Gastrointestinal system
    The small intestine hosts the body’s highest tissue concentration of both ACE and ACE2 [73]. High doses of exogenous AT2 administered enterally to rats impair jejunal sodium-water reabsorption – potentially explaining the increased risk of diarrhea in COVID-19 – while ACE inhibitors and angiotensin receptor blockers (ARBs) reduce intestinal inflammation in rodent models [73, 74]. The effects of ACE2 in the gut are less well recognized but it appears to act in a non-catalytic manner to regulate tryptophan transport and the expression of antimicrobial peptides [4, 7, 73]. It has been more broadly hypothesized that ACE2’s impact on cardiovascular and pulmonary physiology may also proceed in part through alteration of the gut microbiome [4, 7].

    Also see:
    The pivotal link between ACE2 deficiency and SARS-CoV-2 infection: One year later
    https://www.ejinme.com/article/S0953-6205(21)00307-1/fulltext
    It has been recently suggested that free-floating Spike proteins released by the destroyed cells previously targeted by vaccines may interact with ACE2 of other cells, thereby promoting ACE2 internalization and degradation [[80],[81]]. This mechanism may enhances the imbalance between Ang II overactivity and Ang1-7 deficiency through the loss of ACE2 receptor activity, which may contribute to trigger inflammation, thrombosis, and other adverse reactions [[82],[83]].
    Of note, spike proteins produced upon vaccination have the native-like mimicry of SARS-CoV-2 Spike protein’s receptor binding functionality and prefusion structure [[84]].

    All very concerning if vaccines and boosters are down-regulating ACE2 since…

    It appears that spike protein is also important for cell-to-cell transmission. In other words, viral-infected cell to viral-infected cell.

    This June 2021 pre-print, “SARS-CoV-2 Spreads through Cell-to-Cell Transmission”, shows evidence that the spike glycoprotein mediates the spread of SARS-CoV-2 in cell-to-cell transmission in the absence of ACE2 (angiotensin-converting enzyme 2) receptor expression in target cells.
    https://www.biorxiv.org/content/biorxiv/early/2021/06/01/2021.06.01.446579.full.pdf bioRxiv. 2021 Jun 1

    The authors (primarily from Ohio State University) point out that, “Cell-to-cell transmission is considered to be an effective means by which viruses evade host immunity, especially antibody-mediated responses.”

    Moreover, “(w)hile not statistically significant, some of the COVID-19 sera (2 out of 5) even enhanced cell-to-cell transmission of SARS-CoV-2 (Figure 6D), although the underlying mechanisms are currently not known.”

    These in vitro studies with a small number of samples were using older variants of concern (B.1.351, “Beta” first detected in South Africa and and B.1.1.7, aka British variant).

    One has to wonder why this NIH funded study has not been peer reviewed and published in any journal yet.

    These studies should be replicated with the omicron variant and with sera from vaccinated and delta-infected individuals to see if cell-to-cell transmission is further enhanced through down-regulation of ACE2 receptors.
27. skippy December 20, 2021 at 4:08 pm

    @Lambert …. per mention of Chicago School indoctrination.

    This is the most important factor above all others in assessing Manchin moves, corner stone to his entire world view[.]

    When I recently saw him quoted as saying the nations debt was his driving concern I stopped all other further introspection on what environmental conditions might be influencing his views/agenda – personal interests or otherwise. He is a vassal filled and no amount of wrangling will ever change his beliefs, probably thinks the private sector creates all the wealth for the nation of which the government relies upon to function – you know people like him and his.

    Its this perspective that mentally allows him the hall pass for letting the unwashed take the brunt of all the bad decisions pre and post GFC and now Covid. Might actually think he is fighting for some higher purpose, would explain his intractability in allowing any social good which might threaten his perspective.

    That’s not to say all the looters in the rest of the Dem or Rep parties would make BBB resemble 3rd world aid or Afghan school building.
    1. RalphR December 20, 2021 at 8:24 pm

       Should be @Yves, this is her post.
28. Kris Alman December 20, 2021 at 4:31 pm

    As an endocrinologist who trained in the early 1990s, I have had to learn about the two competing arms of the Renin Angiotensin System (RAS) pathways. Covid-19 enters the cell with its spike via the membrane-bound enzyme ACE2 (Angiotensin Converting Enzyme 2) receptor.

    This is not to be confused with ACE1 which is far better understood.

    Angiotensinogen is an inactive precursor peptide which is cleaved by renin to become Angiotensin I (AT1), which is further cleaved by ACE 1 to be Angiotensin 2 (AT2). These pathways are fundamental to prescribing ACE 1 inhibitors and ARBs (angiotensin receptor blockers) for high blood pressure, congestive heart failure and kidney disease (including that due to diabetic nephropathy).

    Angiotensin-(1-7) is a bioactive component of the renin-angiotensin system that promotes vasodilatory, anti-inflammatory, and anti-fibrotic effects. It is formed from either AT I or AT II using membrane-bound enzyme ACE2.

    Activation of this arm is thought to oppose the activity of the conventional ACE/AT2 pathway.

    Depletion of ACE2 receptors is associated with worse Covid outcomes.

    https://www.ejinme.com/article/S0953-6205(21)00307-1/fulltext
    “The interaction between ACE2 and SARS-CoV-2 Spike protein induces a substantial loss of ACE2 receptor activity from the external site of the cellular membrane. This phenomenon leads to less Ang II inactivation and less generation of Ang1-7 (imbalance between Ang II overactivity and Ang1-7 deficiency), which may ultimately trigger inflammation, thrombosis, and other severe adverse reactions influencing the outcome of COVID-19.

    The degree of ACE2 expression and the biological relevance of ACE2 deficiency may vary depending on the presence of specific characteristics and conditions (phenotypes of ACE2 deficiency). Important phenotypes including older age, hypertension, diabetes, cardiovascular disease and COPD share a variable degree of ACE2 deficiency and are associated with more severe forms of COVID-19.

    Thus, it is very likely that is not the ‘excess’, but the deficiency of ACE2 receptor activity that complicates the outcome of COVID-19.
    In the SARS-CoV-2 era, we may assume that ACE2 receptors are not dangerous Trojan horses, but useful defense weapons against the adverse mechanisms associated with the disease.”
29. RalphR December 20, 2021 at 8:23 pm

    Should be @Yves, this is her post.

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