People are not dumb, but they can demonstrate idiocy in their behaviour*

*This quote finds its origin in one of the Evost Synthesis weekends, expressed by my friend Jean-Paul H?ppner somewhere beginning of this century...as an observation.

And this 'idiocy' is contagious...it can spread and even lead to mass-hysteria, as has amply been demonstrated lately...

When I see people sitting alone in a car with their masks on I always would like to ask them if they also wear a condom when they are alone in bed too?

People are not dumb, but they can demonstrate idiocy in their behaviour...

Like when trying desperately to force nonlinear Nature phenomena into a linear mathematic model. And from there create precise predictions or expectations...not leaving any room for doubt...

This whole "Corona episode" has put the finger right on the sore spot several times, and poked it hard, repeatedly...

For the keen observer, one of the obvious sore spots is the apparent systematic 'compartmentalisation' in thought, knowledge and practical applications.

Books as well, as courses are 'compartmentalised' in chapters or subjects, for of two main practical reasons: Space related (structure) and Time related (an average teaching day is usually 8 hours and three pauses).

Reality is the whole as one, there are no different loose chapters nor sections...

What probably shocked me most was the extremely high "navel staring" compartmentalisation of thought and in writing, as well as the vehement opinions expressed during this crisis. Afterthought: probably exacerbated by the widely distributed and shared fear-mongering...see https://www.dhirubhai.net/pulse/answer-worried-messages-i-get-max-girardin/

A few random examples, we zoom in to:

• ....stimulating the immune system.... SAY WHAT?
• ....the embolisms damaging the heart, the kidneys and the brain often lethally by organ or systemic failure as "unexpected complication"... SAY WHAT?
• ...the whole unsavoury bickering about the hydroxychloroquine and macrolides used succesfully by many M.D.'s in the early phase of the infection... SAY WHAT?
• ...with as summum the recent Lancet publication: www.thelancet.com Published online May 22, 2020  "Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis" ... a nice example of bad science...
• ...the distasteful masks and PPE overkill discourse, swinging out in a yes-no argument, without any argumentation...

"...without any argumentation..." Even in the 17th century, rogues and outlaws like pirates or buccaneers had a concept of "parley" ... making the actual modern buffoon display saddening. (In Flemish and Dutch we have a word for that "Paljassen" gedrag.)

Each of these bullet points actually merits almost a separate answer in a babble, but being a natural lazy cantankerous old bastard, and furthermore increasing or aggravating the "compartmentalisation disease" goes against my intent here...

Thus I choose to slide into one of my classical "streams of consciousness", cycling randomly through my stunned and baffled shockedness...

Let us see where it carries us...

Immune response, coagulation activation, coagulation self and inflammatory response are just a part of all the processes that are all typical for one tissue: the inner tissue, for our students "the green stuff", for people who have at least a 'simili' of histologic knowledge: the connective tissue and the muscle tissue as a whole, for embryology thinkers the mesoderm.

These topics and their processes are usually discussed in different chapters in most physiology textbooks. BUT it is not while they are compartmentalised in different chapters, that does not mean that in reality they are also subdivided. In reality the whole is one. Meaning that the inner tissue in the organism as a whole reacts, and with all that is triggered from the local interactions.

And please don't forget that what we perceive as global order are merely the consequences of many local interactions...

Maybe this adapted image from https://aptahem.com/en/portfolio/ makes it clearer:

What I like about this picture and thus why I used it: the cogwheels can't be actioned separately, if one is activated enough to get in motion, the others go along in the motion...It is one system, and stays that way.

What I don't like about this picture: there are many symbolic cogwheels missing, the connective or inner tissue is the most reactive of the whole organism, and reacts with many more than just the 4 represented...

So was it really unexpected? Or did our, 'habit of', very selective 'compartmentalised' thinking trick and fail us again?

All too often we can read or hear the ever-returning loop of simplistic and childish reasoning: “stimulating the immune system”. Whatever may be meant, it is too stupid for words.

However, we have to keep in mind, that most likely, this slogan is a transformation of a complicated story, into a strongly simplified meme. A meme which is virulently spread and replicated without reasoning.

Each class and subtype of viruses, as compartimented in Cartesian science, has its own oddities. Therefore, they are never completely comparable. I totally agree with that.

So, we can't compare the "Spanish Flu" pandemic from about a century ago with this corona pandemic. Certainly not, when looking at the difference in mortality...

It is definitively not corona who would win that contest. If it were one.

But there is at least one area where they are quite comparable. And that is: it is not the virus that kills the infected host, but the 'overkill' reaction of his connective tissues responses with all other consequences it encompasses.

So the expression: "stimulating the immune system" even more sounds as a raging madness in most cases? Or did I miss something in the reasoning?

Picture credit: https://getlighthouse.com/blog/crisis-leadership-questions/

Nowadays, a lot is shoved in the backpack of the 'cytokine storm', which also by the way includes most of the cytokines and interleukins. And this is for a good reason, because they are the communicators of the local responses, organized by the connective tissues. (including the blood and it's vessels, the bones and marrow and so on). They are the communicators or feedbacks for the local interactions, their intensity and amount... But

Is this really the case and is it the cause?

I don't think so. As usually in biology it is always more complex and multifactorial that any description is a compartmentalization model again...

Let us look at the principles provided and demonstrated by nature.

If a hailstorm releases bigger hail balls, branches, dead leaves and dirt than a brook can carry away, it will clog or block the brook's flow and provoke a local congestive phenomenon in its bed and surroundings... At least for a while.

If we take Richard Douglas's living picture of the WW1 trenches, that I love, we get something like this... (Look at the book the cat is so eagerly reading)

Picture credit: https://www.peoplescollection.wales/items/2694

The last picture is an aerial view of WW1 trenches as still visible today.

For those who did not read "The art of Military Strategy", the crooked zigzag lines are the narrow fighting trenches (our capillaries) the straight and, at some places wider trenches are the communication and logistic trenches (veins, lymphatics and arteries: they serve to get the wounded and dead, and also the debris out so as not to clog up everything, and also to communicate and bring provisions and replacement troops)

If the communication and logistic trenches get clogged up the fighting trenches will be a mess quickly becoming totally ineffective. Don't forget that the trenches are embedded in the middle of the battlefield (the connective tissue- green stuff - mesoderm )

For the comparison Richard just send me this picture he adapted:

In yellow the battlefield orientation, in blue the marshlands of the battlefield, on the right picture the road would be the mucus membrane, and in red the attackers or enemy, infecting direction... and here stops the general image comparison...because the first yellow line should be following directly behind the thin line of the mucosa membrane in the left tissues picture.

This is not so different when the concentration of communicators increases dramatically in a localized area of the connective tissue, it will have all the effects of a "cytokine storm" and the similar consequences...as nicely compartimentalised in this image.

Picture credit https://www.nature.com/articles/cmi201574

First thing to realize, is that the big white part of this drawing is not an imaginary void, but the connective tissue or green stuff or inner tissue. It is the playfield of most local interactions and the home of the circulatory system (the battlefield or brook surroundings or bed of the preceding living pictures).

The second thing to realize, is that we get basically into the 'classic inner tissue response equation' stance. This equation position is made up between the amount of inflammatory-immune communicators massed on one side, caused by the amount of cell death, against the speed and amount of drainage or circulation in the local connective tissue on the other side.

Now this equation defines the concentrations and thus harshness or "stormyness" of the inner tissue's responses; but it is never a standstill rather a process of many moving parts that are continuously shifting proportion wise.

The shifting happens between these extremes:

• High concentration equals heavy responses, lots of tissue and cell death, results in increased spiralling reactions accelerating in the storm build up...
• Lower concentration equals modulated responses, this is usually as long as the drainage and following arterial circulation can counter the dramatic build up. (Washout phenomenon)

Picture credit https://stemcellorthopedic.com/covid19_the_paper/

Everybody in the medical and paramedical professions 'normally' has learned that most of our body area's have collateral circulation, except: the heart, the brain and the kidneys. In these topographic regions or organs the circulation is terminal... Meaning there are no "bypass" trenches to help 'if all hell brakes loose'. Whenever and if the trenches get clogged up then " that was that", the area is dead or dying fast... Thus reason on the level of increasing drainage interstitial, venous and lymphatic...for that dimension. A clarifying picture of the battlefield, even in "normal conditions it is already a marsh or wetlands:

Picture credit https://www.the-scientist.com/news-opinion/new-discoveries-in-human-anatomy--67055

Reorient each picture: the top above the mucosa is the airspace in the alveoli, or the lumen in the digestive tract. The marsh or wetlands below is the basal membrane and the start of the inner tissue.

Now, think about ventilation during hypoxia (not enough exchange between the air & alveoli surface, top of the last picture): the inflammation and clogging up is probably happening. The marshland is flooded and as consequence, mechanically the collagen fibers are tensed to the max (remember how hard a congestion or an inflamed red zit feels)? These fibers and bundles are connected -anchored to the mucosa cells of the alveoli (by Laminins or C.A.M. 's). Now when you start active ventilation by the ventilation machine, you push in air volume actively, which will start expanding -stretching the alveoli. This action stretching these thin mesothelial cells which are held back by the congestive swollen marshland battlefield...

What is very likely going to happen?

Ripping apart of the mucosa membranes?

More cell death and more inflammation?

Heavier connective tissue response, more clogging?

Scarification and definitive loss of active exchange surface for the lungs? Reason!

It can easily become a rat race that spirals in the wrong direction, and starts to send blood clots around the whole organism, right?

If massive amounts of muscle tissue are dying off, the released myoglobin is indirectly toxic for the kidneys, next to the terminal circulation clots...

Third thing to realize, as viruses are not alive, they are not equipped to reproduce themselves. They are completely dependent for that on the cell machinery in which they inject their genetic material (infected cells).

So we need to add to the former classic connective tissue equation a few crucial points like: the amount of viruses entering our airways or gastrointestinal tract.

As well as the amount of those who manage to infect the cells here and thus get reproduced. (it is only in action movies that a single combatant enters the trenches and wins all, in reality you need at least a few sections or platoons if not a whole company to have that effect)

Let 's now look at this issue, defense line by defense line:

The viruses must approach the battlefield area "en masse" or they don't stand a chance (the same with bacteria by the way, this is called the 'infectious load' and is different for every particle or organism, in the obnoxious Salmonella for example the infectious load is minimum 10.000.000)...

This is why social distancing, PPE and masks and open air terrain as opposed to closeness, proximity, poorly ventilated spaces, etc... are absolutely game changers...understand this is not a black and white story, but a multifactorial series of shades of gray. A process with many moving parts or possibly changing parameters, of which each single one can make the stance shift in a new position.

The ones that reach the organism, still have to breach the next defense lines and still in massive amounts to stand a chance...

The next defense line is our mucous lining and its flora, as seen easily on the next picture

This pertains to the respiratory as well as to the digestive tract. Now when and if they can breach this defense line or when they are able to infect and use some cells to replicate and increase their numbers dramatically (exponentially), the battlefield is moving into our inner tissue or connective tissue and its fluids or marshland.

This is the line where the Hydroxychloroquine, and second generation Macrolides (Broad spectrum antibiotics) may play a crucial role in that space-time when the close combat battle is really starting in the trenches...

Picture credit https://www.nature.com/articles/cmi201574

The second generation Macrolides and Hydroxychloroquines are not targeted to be antivirals but have that as a side effect...How do they do that, at least partly.

As far as is known these medications interfere with several things but the main actions in this question are probably:

• The quinine dramatically acidifies the cells lysosomes and by that consequently messes up most of their proteinaceous enzymatic action and production: being among others most cytokines and also the viral reproduction in the cells, and thus reducing the 'stormyness' of the inflammation response too.
• The second generation of Macrolides like 'Azithromycin', which is as example in the figure messes up the ribosomal & Messenger-RNA interface in most cells, blocking the protein formation: hence killing the flora (possible virus reproducing factories) and strongly modulating or even stopping the neutrophils and granulocytes cytokines production. Hence making their overkill reactions almost impossible...

Now reason from facts please...

I am not a big fan of medication, but these guy's are really effective for high risk patients... but only at and in a particular space-time: the acute onset of the close combat assault.

Taking the medications too soon (as preventive medication) or at a late stage of the battle does not really make any sense...except negatively maybe...

Therefore I personally find that the article in the Lancet: "Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis" www.thelancet.com Published online May 22, 2020 https://doi.org/10.1016/S0140-6736(20)31180-6 , is another example of really bad compartmentalised so-called science...

It is logic that if the medication combination are taken too soon or too late they are not very effective ...

As a 'living picture': You have a huge battlefield with the "enemy" charging in line towards the first of your organisms trench lines. Then you start a set of airstrikes and artillery barrages (preventive) far behind the enemy line or...

You are doing the same on your own troops far behind the lines ...

This air strike and artillery barrage strategy only works if you do it exactly when the enemy are almost at your first trench line and only then....

In the article they mixed everything without any space-time timing; this does not seem to be the right tactics, to say the least! - organized and published stupidity...

 Maybe worse, I really have some serious doubts about the ventilations that were used, it sounds counterintuitive at first sight...but

Actively pumping air at high volume into the thin walled lung alveoli, which have a hugely congested hard - battlefield pushing in their backs simultaneously...

These are mesothelial cells, they are thinner than bible paper.

The chances that you just rip them apart are pretty big....

Did nobody think of perfusing via the peritoneal space?

In severe hypoxia it should work and cause less permanent pulmonary damage at least theoretically.

In a self-declared WAR situation, you should put your reason to use, and go for the solutions which have the least chance of damage to your own troops and infrastructure and which have most chance to win the battles and the war...

I invented nothing new...all this is on the internet and in the 'science journals' ... If I forget to mention or reference something, I am deeply sorry...

Is this really important?

Naaaeeeeh in Belgium we have an extra-mortality that barely goes above a bad flu year like in 2017, in the UK it is about 4 times, 60.000 so what does those numbers tell us?

(Look it up in Euromomo: European Mortality Monitoring)

Everything is relative...

Just the observation point in Space and Time you take... (Dimension zoom in or out)

Death is always a sad thing, especially for those who remain behind...

The numbers are relative, an interpretational thing depending on the stance taken...

Love and Peace and Health to all... also an interpretation thing

XXX the Hippo

Walter McKone responded critically to this babble here follows his response, my short answer in bold:

Hi Max,

response below. Use it all. It was a pleasure.

Regards

Walter

People are not dumb, but they can demonstrate idiocy in their be behaviour.

Initially there is a failure to explain, to the idiocy in question, what is meant by “whole as one.” This immediately makes me suspicious that the author has no foundation on which to make such a statement and therefore can not enlighten us. This is me ranting and raving in a babble , a sting to make people think or reconsider, not a Biblical nor Holism exegesis and final truth.

Using Cartesian “cog-wheel” animation to demonstrate what is meant is a typical example of a unifying of individual parts interacting “outside of each other.” Another example of Cartesian separateness masquerading as the “whole as one.” I consider it as a 'zooming in and out' on a topic not an image of reality or what I mean as the whole is one.

Bringing together “compartmentalized parts” interacting is “the sum of the parts” a mathematical form of Cartesian Mathesis Universalis (universal mathematics) prior to the symbolism of numbers. This is similar to Ludwig von Bertalanffy’s General Theory of Everything from the Vienna Circle and positivism. I sincerely think it is not the Alpha and Omega of Holism, on the contrary; but a few cherrypicks on which we zoom in or out, and that may disturb enough to stimulate thinking and maybe let individuals extract shortly of the actual blurry mold for a moment.

“Each class and subtype of viruses has its own oddities…” again this is reductionism and compartmentalization. You cannot ask for “whole as one” and continue to use the same method of Cartesian analysis or synthesis. I don't set myself above the method of Cartesian analysis or synthesis, just zoom in and out and use their language... using another method or language is pulling the plug of any discussion, in this babble context

Could reduce it to "the whole is one" done... and then very probably not have any sting effect for most? Moreover I would not have get rid of my emotion like now...

While I agree that, “it is not the virus that kills but the overkill reaction of our connective tissues responses with all the consequences it encompasses,” the plural “tissues” is used indicating compartmentalization, one outside of the other: Cartesian res extensa. The whole is, but when talking about a specific zoom in or out ... my limited language capability needs this, sorry Walter.

I am unable to continue to critique this article as the basic assumption that we should consider the “whole as one” has not been addressed, the basis on which this article is founded. This leaves us with an article this is disintegrating, like trying to hold water in your hand by making a fist. A unity in multiplicity, a one as the many, a Cartesian paradigm, and a counterfeit holism.

Dear Hippo,

Please try again. Your intent I understand. Your method is the same “idiocy” with which you criticize others. The eternal discussion between us, my brother: some think we can change thought from within, others think the only way is to change all paradigms in the same moment, and some, as I try to make things first visible in order to get the people to reason...

Kind Regards You too, Brother, you too.

Walter Llewellyn McKone, DO

www.waltermckone.com