I assume by “works” you mean in relation to COVID19?

Sars-Cov2 is a respiratory disease. I guess it maybe present in blood, but it doesn’t seem like removing it from blood would help with the respiratory issues it causes.

I can’t see how you would easily get UV light into the lungs. But maybe there’s a way... seems a bit far fetched.

My understanding of the article was that it doesn't need to be a blood-borne disease. The authors point out several times that, while most people would assume this works by directly killing germs (i.e. like sterilizing water with UV), this is not the mechanism. The exact mechanism is still unclear (which is one of the reasons it was never as widely adopted), but it seems more likely to be boosting the immune system.

So there would be no need to shine UV light directly into the lungs.

To expand on the unknown method of action. It could for example be removing other pathogens from the blood that lets the immune system focus on covid-19. Alternatively, random cellular damage could clause a useful immune response. Etc etc.

Medicine has often found treatments that works without any real understanding of why.

Isn't this true of Pasteur and his initial application of vaccines?

While he identified the mechanism of inoculation, my understanding is he theorized that it was due to the attenuated pathogen outcompeting the virulent one for nutrients rather than due to stimulation of the immune system.

I think I got that from a lecture by a science historian once. This idea seems to be glossed in the Wikipedia article on Pasteur here:

https://en.wikipedia.org/wiki/Louis_Pasteur#Anthrax

Do I have that right?

>While he identified the mechanism of inoculation, my understanding is he theorized that it was due to the attenuated pathogen outcompeting the virulent one for nutrients rather than due to stimulation of the immune system.

How could it outcompete the actual virus if the actual virus isn't there yet at the time of vaccination?

Good point. Maybe the theory was the attenuated pathogen would consume available nutrients thereby depriving the real pathogen when it arrived?

Interesting, but if it boosts the immune system in the wrong way a side effect could possibly be a cytokine storm.

There are some indications that COVID-19 can already triggers cytokine storms by itself and that's what's killing some patients that seem to get better then crash.

Vitamin D?

Created in the skin, not blood.

Interesting, the vitamin letters were arbitrarily assigned but I wonder if we could back-cronym D to dermis

This virus has many skills.

It does directly infects kidney cells, and kidney failure is one common cause of death.

I think the current understanding is that the primary way that it kills is through circulatory system effects, blood clots that cause difficulty getting oxygen from the lungs, as well as strokes and heart attacks and other organ failures.

That's not an understanding, it's an observation and a very preliminary hypothesis for one of the major immediate causes of death. Huge difference.

Because of all the additional attention, it would be unsurprising for doctors to seemingly discover all kinds of previously unexamined phenomenon which have always been present, or to confuse increases in certain phenomenon as peculiar rather than simply reflecting the fact that you have a ton of patients with the same type of illness. For example, in one of the articles about blood clots a doctor is quoted as saying something to the effect of, "we're used to seeing these types of blood clots in the ICU, but only in 1 or 2 patients at a time, never in this number". For the sake of argument, maybe that's just because they've never had an entire ICU full of patients in viral-induced acute respiratory distress, that such blood clots happen to be more prevalent in such cases, and if you examined all such ICU patients over time (COVID, flu, w'ever), you'd see a similar pattern. (Because it's usually the elderly who die from respiratory infections, not alot of attention is paid to mechanisms of death. "Pneumonia" is something of a catch-all term, especially with an older cohort.) Maybe it's typical of anything that can incite such immune reactions--the article hinted that the mechanism may be related to how Ebola works, except with opposite outcomes (clots instead of bleeding out), which suggests the mechanism might be more a reflection of the severity of the distress than anything peculiar to the infectious agent, per se. Maybe younger cohorts are more likely to clot, but before COVID-19 they rarely died or had such severe symptoms, so nobody quantified prevalence. And if so, treating the clots might not significantly reduce fatality rates; or maybe it would, not just for COVID-19 but any similar viral ailment.

It could be part of the intubation process, if the patient is already that bad. Just theorizing.

The problem is the lungs are an incredible network of tunnels. If you spread out the surface area of your lungs, they would cover a tennis court (something I heard a long time ago, likely not exactly correct but generally right).

You could get UV light to the large bronchi but you couldn't get UV light into all the million little aveoli.

According to https://en.wikipedia.org/wiki/Lung, Estimates of the total surface area of lungs vary from 50 to 75 square metres (540 to 810 sq ft);[28][29] roughly the same area as one side of a tennis court. They then offer two references for this.

So you're off by a factor of 2 but are basically correct.

In the documentary movie Blade II, they show how UV light can go around corners if you make your light grenade strong enough.

UV light can go through the corners, and walls, if you make it strong enough. It could easily get into the smallest of aveoli. You may not have much of a lung left after that, though.

How about the patient breaths dilute Argon, and then excite it with a magnetic field so it lights up and create UV from inside the lungs? I think Argon is non toxic, and I think we’re only aiming for weak UV exposure.

And also, if you are intubating the person, they are probably pretty close to death. And then on top of that you paralyze them (with a medication, temporarily). So you are stopping their breathing. You have a few seconds in these people to get their lungs connected to mechanical ventilation. From what I've seen, if you don't, the outcomes are very bad.

This may be somewhat different from the typical intubation case, for example prior to surgery. Where its a generally more healthy person who has not been hypoxic for hours or days and is not at the last of their reserves...

Claims about the surface area of fractals are almost always true if generally interpreted. If you went down to the atomic scale you could probably calculate that the surface area of your lungs would cover the Earth. :)

The fractal structure of the lung ends with relatively smooth tissue after a finite amount of branching. So the usual arguments about fractals notwithstanding, there actually is a finite area to discuss that makes sense.

Sure, but if you look closer you will see that all of the cells have holes for stuff to go in and out, and the proteins sticking up from the surface have shapes, and so on. That's why I said "the atomic scale" not "the microscopic scale."

Any claim about surface area that relies on the examination at the atomic scale is no longer due to the fractal nature of the lung's branches. Such claims would be equality true (or false) of non-fractal organs.

On the atomic scale surfaces are not continuous so they don’t really have a surface area. You can’t infinitely zoom in like you can in a real fractal.

That assumes the fractal nature continues at all scales, which won't hold here I suspect (i.e. it's not enough for the structure to exist on those scales, the scaling properties have to continue for the geometry to be "fractal")

You wouldn't have lung tissue at that point. You'd have atoms that came from lung tissue.

If you blast a bright enough light it has the potential to penetrate extremely deeply. It would be a balancing act of maximizing luminosity while minimizing human tissue damage.

Are the internal structures of the lung all opaque to UVA light?

> Sars-Cov2 is a respiratory disease. I guess it maybe present in blood, but it doesn’t seem like removing it from blood would help with the respiratory issues it causes.

Biological systems are almost unimaginably complex. Unintuitive effects are not uncommon.

Isn't the respiratory issue caused by issues in the blood?

Totally agree, which is why I led with "which I will do for the point of this conversation, not that I believe it".

How does the virus get to the lungs? Directly via inhalation or via the blood stream?

Directly via inhalation, or by physical introduction of the virus from the hands onto a mucosal membrane (eyes, nose, mouth)

Presumably it depends on the virus, but tissues of the respiratory tract, from the nose/mouth all the way down to the lungs, have many of the same receptors. Typically a cold or flu virus infects the surface tissues in your nasal passages and then replicates its way down into your lungs, assuming it cares to reach that far.

At least, that's how someone who researched rhinoviruses once explained it to me many years ago, but probably using more accurate terminology.

Also, AFAIU, these viruses have also evolved other exploits. It's no coincidence that cold viruses induce sneezing and other sinus irritations; the viral fragments themselves have evolved to trigger this behavior, which is why it can happen after a live infection is gone--your tissues are still shedding viral fragments.

That appears to be the case. That's why you ought not touch your face or your nose, and why wearing a mask is recommended.

I also don't think this approach would be helpful, but regarding these points.

1. Photopheresis units already exist but would require some modification for whole blood irradiation rather than wbc only.

2. There are (a limited number of) nurses

3. Catheters are routinely placed

4. Most photopheresis units don't have 1:1 staff, but for ICU patients the situation may be different

Re: staffing - I agree that there is a difference between plasmapheresis (which is reasonable to monitor a few people at once) and ICU care (which, at least at my institution, we generally rely on 1:1 staffing for devices that circulate blood outside of the body).

Re: catheters - agreed that they are routinely placed, but they're morbid and we don't do it unless necessary. Generally we use a different type of catheter for recirculation vs a standard central line, so this probably can't be piggy-backed on what is already going to be placed in the ICU.

I wonder if a simpler model could be done. When donating plasma your blood is cycled through some machine that removes the plasma and then your red blood cells are pumped back into your body. It's about the same as donating blood as far as pain/invasiveness. While it would take some doing, it seems pumping your blood around a UV light source has GOT to be simpler than removing the plasma. Yes, you still have to make the machine, but intuitively it doesn't seem super complicated.

Make the machine? Take an ordinary plasma donation machine, insert a UV irradiation gizmo into the blood path somewhere. Obviously not ideal but it could be built much faster.

That should work as long as you can reasonably disable the plasma collection bit. If you're sick you probably want to keep that.

More like dialysis I think?

They suggest treating only 5-7% of the blood, which is 250 - 350 ml. It's still going to be an elaborate procedure, but a lot less so than hemodialysis, which moves much larger volumes of blood. You wouldn't even need a large-bore catheter, and keeping the blood pressure stable would be far less of a concern, so you probably don't have to do it 1:1.

Couldn't you treat the blood within the body? Find a high flow, easily accessibly blood vessel and inject a thin fiber optic cable connected to a uv laser?

Nadal cavity. Already exists...

"Michael Hamblin is a Principal Investigator at the Wellman Center for Photomedicine at Massachusetts General Hospital" - http://wellman.massgeneral.org/faculty-hamblin-pi.htm

I mean, to be clear, this is not a treatment for covid. No-one is suggesting that.

That is maybe technically true, but completely misses the context. The only reason this link from 2018 was submitted today and the only reason it's voted up to the top of the front page of HN is because the president of the United States went on camera yesterday claiming that injecting bleach and disinfectants and using UV light was a promising path to a covid treatment.

So now we have to argue about whether or not a 70-year-old quack treatment from soviet Russia is effective against this current pandemic instead of building consensus on test deployment or lockdown exit protocols. It's the same thing that happened with chloroquines last month. It's tiresome, and harmful.

Oh, yeah, I mean, that's definitely why this is here, but it's extremely doubtful that it's what Trump was promoting; he was probably just confused about sterilisation vs treatment of humans, and grasping at straws.

I'm not sure "the president is just dumb" is much of an improvement over "the president is actively malicious."

Oh, I mean, I'm pretty sure he's both, but Occam's Razor says that this particular bit of nonsense is coming from the dumb side.

Sufficiently advanced incompetence is indistinguishable from malice.

He didn't say using light or disinfectants were "promising". Please don't make me defend Trump, because I hate him, but I hate misinformation more. He suggested it might be possible, but clearly he was off script and had no idea what he was talking about and just making conversation, something that a president should not do. He shouldn't have said anything, but he didn't say it was "promising".

"So, supposing we hit the body with a tremendous — whether it’s ultraviolet or just very powerful light — and I think you said that that hasn’t been checked, but you’re going to test it. And then I said, supposing you brought the light inside the body, which you can do either through the skin or in some other way, and I think you said you’re going to test that too. It sounds interesting.

BRYAN: We’ll get to the right folks who could.

TRUMP: Right. And then I see the disinfectant, where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning. Because you see it gets in the lungs and it does a tremendous number on the lungs. So it would be interesting to check that. So, that, you’re going to have to use medical doctors with. But it sounds — it sounds interesting to me.

So we’ll see. But the whole concept of the light, the way it kills it in one minute, that’s — that’s pretty powerful."

Technically, you are correct, he didn't say the word "promising". Given that promising has latinate origins, rather than germanic, it's likely not in his vocabulary.

Still hydroxychloroquine ended up killing a bunch of vets, and at least one person credible enough to ingest it directly without medical advice or a prescription.

I applaud your goals of precision, but, stochastic terrorism is real, and the point of communication, especially in such dire circumstances, shouldd not only to be understood, but to make it impossible to be misunderstood.

Clarity and unambiguous language from leaders is literally essential public health.

>and I think you said you’re going to test that too. It sounds interesting.

That's a pretty far cry from telling people to inject bleach, which is the narrative some outlets are trying to spin right now.

It's entirely too close for the leader of the free world.

It's also remarkably stupid. Like astoundingly dumb.

To quote Craig Manzin: 'One of the hallmarks of the dangerously stupid is the consistent belief they’ve found great solutions that experts somehow missed.'

The Manzin quote isn't appropriate. The experts themselves have stated they're still investigating the virus and potential solutions. Trump wasn't suggesting they experts missed something.

It is entirely appropriate. One person died from ingesting hydroxychloroquine[1]. Perscriptions for hydroxychloroquine increased 46X. [2] It turns out that taking it killed more people than the control group. [3].

The Maryland Emergency Management Agency received over 100 calls about injecting disinfectant as a potential cure. [4]

You know, it's possible to explore highly experimental therapies for a novel disease without naming them explicitly at the presidential press briefing during a pandemic. Doing so is INCREDIBLY irresponsible, as evidenced above.

[1] https://www.cbsnews.com/news/coronavirus-news-arizona-man-di...

[2] https://www.nytimes.com/2020/04/25/us/coronavirus-trump-chlo...

[3] https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2

[4] https://abcnews.go.com/Health/coronavirus-updates-china-repo...

I'm seeing this a lot, but it's pretty clear that's exactly what he was saying, just confusingly. Here's a transcript (I couldn't find a more official link, but it definitely matches the video): https://www.rev.com/blog/transcripts/donald-trump-coronaviru...

Bill Bryan stands up and reports that they've tested a bunch of disinfectant processes in vitro and on surfaces, including bleach. Then Trump immediately begins riffing on that, before the guy sits down, and says, verbatim:

> [...] And then I see the disinfectant, where it knocks it out in one minute. And is there a way we can do something like that by injection inside or almost a cleaning because you see it gets in the lungs and it does a tremendous number on the lungs, so it’d be interesting to check that so that you’re going to have to use medical doctors with, but it sounds interesting to me.

Now, no one is going to call that a clear statement. But in context it seems really obvious to me that he's talking about injecting exactly the list of disinfectants that he's referring to.

I think "promising" sounds like a very apt paraphrase of what he said. I did indeed watch the press conference, and I didn't present it as a literal quote. Do we need to dig in and tear out the quote word by word now before we're even allowed to refute it? Is that really a good use of our collective time?

That was, after all, exactly my point.

>Do we need to dig in and tear out the quote word by word now before we're even allowed to refute it?

Are you actually a new account? Because if so, be warned - that is exactly how HN works a lot of the time.

I'm not. I have a longstanding account, but had a... somewhat suspicious event on other social media that I think might have been inspired by comments here. My account has never been very private and there's a lot of potentially harvestable information there. So I'm experimenting with keeping my comments in more controversial topics isolated.

I'm curious, how much does the Internet Research Agency pay these days?

Then be more accurate with your words and not irresponsibly spreading misinformation.

FWIW: 'Promising' is a pretty accurate paraphrase of “I think that’s a great thing to look at", which is what the NY Times quotes him as saying.

I'll assume no negative intent and that English is not your first language, because there's a big difference between calling something "promising" versus "interesting to look at".

I am a native English speaker and would agree that "interesting to look at" is perhaps a little weaker than "promising." Maybe 20% weaker, as if there's a scale.

However, the transcript from the NY Times and BBC--not to mention my comment above--also has him saying "a great idea to look at" in the same response, which I do think is equivalent to 'promising'.

This is an inevitable consequence of telling others to be careful with their words.

How, exactly? In context, a treatment being "interesting to look at" is interesting because you think it might work. Isn't that what "promising" means in the same context? You seem to be hiding behind the presidents imprecision here. I genuinely don't understand how someone could look at the video of that press conference and think the president was not celebrating the idea of possibly finding a cure by injecting disinfectants into people's bodies.

Perhaps you could demand that first of the president of the united states, and then perhaps, secondarily of some random poster on hacker news?

You're the one being irresponsible here, in mounting any kind of defense of what Trump said. It was total crazy talk. Tell the truth.

> Do we need to dig in and tear out the quote word by word now before we're even allowed to refute it?

Yes, this is a forum consisting largely of founder-engineers and words mean things. Not all bugs are spiders, not all disinfectants are bleach. Claiming the president suggested we inject bleach is disinformation, and it weakens the credibility of the rest of your argument.

... Wait, what non-bleach disinfectant would it be appropriate for him to recommend injecting?

Does the president bear any responsibility whatsoever for his own words, or should we treat them as oracular emanations of the divine, to be explored for meaning like the entrails of a sacrificial beast or the residues at the bottom of a coffee cup?

What you are saying is disinformation. Nobody has suggested injecting bleach. Bleach is a disinfectant, not all disinfectants(i.e agents that disinfectant) are bleach. It was poorly worded enough without you spinning it, the spin only strengthens his base of people who don't trust the media because of sophistry like this.

Is there some other disinfectant that we could be injecting that would not be of roughly equal harm?

Because I don't think injecting hydrogen peroxide, benzalkonium chloride, or isopropyl alcohol is going to have an effect that's any better.

Quibbling over whether or not they meant bleach or some other disinfectant isn't really the point. The point is the President was lending credence to the idea that injecting disinfectant into the human bloodstream might be a good thing to do. Which is absurd, regardless of whether or not he specifically meant bleach, and bleach is a perfectly reasonable stand in.

He asked a question of experts. That's not the same as "lending credence" to a particular response to the question.

OK, I went back and checked the transcript. It's true that the president didn't say the word "bleach". It's not true that "nobody" did. Trump was riffing off of a report that had just been given by Bill Bryan, listing out some anticeptic testing in an in vitro context.

Bleach was, in fact, the first disinfectant in his list. Then Trump stands up and says we should investigate injecting those into the body.

I really don't think this it's applying a whole lot of spin to argue that Trump was saying we should inject the stuff the guy he was referring to had listed.

At least one person was suggesting it https://www.nytimes.com/2020/04/24/health/sunlight-coronavir...

It’s extremely doubtful that this obscure anti-bacterial technique is what he was talking about; he was probably just confused by reporting on UV room sterilisation, which is a real, effective, practice, but not suitable for humans unless you’re not fussy about whether they survive.

> “Supposing we hit the body with a tremendous — whether it’s ultraviolet or just very powerful light,” Mr. Trump said. “And I think you said that hasn’t been checked, but we’re going to test it?” he added, turning to Mr. Bryan, who had returned to his seat. “And then I said, supposing you brought the light inside the body, either through the skin or some other way.”

FTA. He was very explicitly talking about doing it inside human bodies.

Which this proposed therapy _doesn't do_ (it works by taking blood out, irradiating, putting back in).

Sure, but that's really the same thing, if you don't think about it.

Yes:"The Healight technology employs proprietary methods of administering intermittent ultraviolet (UV) A light via a novel endotracheal medical device."

https://apnews.com/b44f4531071e6204023f7b8e16f59d4b

And it ostensibly has the same mechanism of action this, which the FDA already approved recently for compassionate use:

https://www.fiercebiotech.com/medtech/fda-expands-access-to-...

I'm not fan of Trump, but the attacks on him over this and hydroxychloroquine are ridiculous.

> I'm not fan of Trump, but the attacks on him over this and hydroxychloroquine are ridiculous.

Even without going into the absurdity of any of his specific claims, he should not be standing at a podium spitballing and speculating about potential treatments that he may or may not have heard about. Kind of the opposite of what is required from a leader during a crisis, and the impacts of doing so can actually be pretty devastating.

> impacts of doing so can actually be pretty devastating.

Source on this? I have heard about the couple that ate the aquarium chemicals, a bit of a stretch unless I missed the part where Trump mentioned aquarium chemicals

You need a source to acknowledge that a President's words have impact and that speaking ignorantly and off the cuff on medical topics can lead to misunderstanding and dangerous decision making by the general public?

There's a reason why Reckitt Benckiser Group quickly issued a statement after Trump's claims, imploring people not to consume "through injection, ingestion or any other route" any of their products.

https://www.rb.com/media/news/2020/april/improper-use-of-dis...

Yeah, and, in my opinion, the reason why Reckitt Benckiser Group quickly issued a statement after Trump's claims is as much the media as Trump himself. The media had an opportunity to educate people on "proprietary methods of administering intermittent ultraviolet (UV) A light via a novel endotracheal medical device" to which Trump is referring and instead ran stories about Lysol. Would we even be talking about Lysol if they had led with Healight? I won't claim to know the answer to this question because I don't but it is worth considering that the answer is "no".

Edit: just to combat the obvious response, would we even be talking about Lysol if Trump had not made those comments? Obviously, no. Two wrongs don't make a right

Having watched the unedited press conference, there's zero evidence that he was talking about the Healight. If he were, they have had nearly 24 hours to clarify that he was referring to that. It's not the media's role to search out and bolster rational explanations for the President's seemingly irrational claims.

The Healight also offers no explanation for his "injecting disinfectant" claims, which were separate from the UV light claims. The term "disinfectant" among the public is most commonly used to indicate household disinfectant chemicals. So when the President muses about "injecting disinfectant", why would it be the media's role to then go and hunt for explanations that actually make sense from a medical perspective?

I would say that there is "little evidence" that he was talking about Healight because his sentences are barely coherent but it does appear to be that he is referring to "injecting" UV light to "disinfect" the lungs which is what Healight is doing when you get past the exact words that I quoted.

Yes, I believe it is the media's responsibility to be more intelligent than the President in this case, which honestly shouldn't be very hard. Time and time again they are lowering themselves to Trump's level presumably to soak up that sweet sweet ad revenue

You acknowledge that the President speaks in "barely coherent" sentences. And that he's not very intelligent.

That's the real problem, here. That's the real story.

If we view the media's role as nothing more than taking Trump's drivel and turning it into teachable moments or trying to find a positive spin on it, not only does it basically position the media as a PR arm of whomever the current administration is, by doing so it fails in its duty to inform the public about what is actually going on in the White House, and what the President is actually saying.

A key role of the fourth estate is to hold the President to account. That is incompatible with your view that they need to be a booster of the President in the name of "intelligence" or elevation of the dialogue.

Edit: I will also add that I see now that Trump is claiming that his talk yesterday of UV light and injecting disinfectants was "sarcasm".

I don't think you understand my argument. That's fine, I haven't been articulating it very well, let me give it another shot.

> That's the real problem, here. That's the real story.

Is it? Is Donald Trump's incorrect use of the word disinfectant the most important thing happening in the world right now?

> If we view the media's role as nothing more than taking Trump's drivel and turning it into teachable moments or trying to find a positive spin on it, not only does it basically position the media as a PR arm of whomever the current administration is, by doing so it fails in its duty to inform the public about what is actually going on in the White House, and what the President is actually saying.

I have a few points here:

1. I don't think that the media needs to put a "positive spin". As I mentioned, the preferable response in my opinion is something along the lines of "Trump is wrong, but here is whats right" and then quickly move on. Instead, they put a negative spin on things, connecting Trump's words to Lysol because it better matched their incentives, which went viral and made this the biggest news story of the week. I'm sure some Trump supporter is going to inject Lysol because that's now what Trump said even though its not really what he said

2. The media IS in many ways a PR arm of whomever the current administration is. The government has a lot of control over what the media says as do many other powerful/wealthy individuals/organizations in this country. Source: https://en.wikipedia.org/wiki/Manufacturing_Consent

3. By criticizing Trump so often, the media leads many to believe that #2 is not the truth. But, the vast majority of criticism of the current administration is trivial in nature. Trump incorrectly using the word "disinfectant" is not the most important thing happening in the country this week. Not even close.

4. As a result of #3, the Trump administration has basically free rein to do any of the real evil things that the US government does on a regular basis without fear of scrutiny. The media is too busy talking about "disinfectant" to talk about any real issues. And the general public (edit: Democrats) trusts that the media is holding the Trump administration to a high standard as a result of #3. In terms of "real evil things", I think the media should be investigating the current bailouts and injection of liquidity in financial markets. But, the persons/organizations getting rich off that (at the tax payers expense), are the same powerful persons/organizations that have control over the media (again, see Chomsky).

All in all, I see the focus on this disinfectant as one of a long series of smoke screens to give the appearance of keeping the White House in check. In reality, they are just polluting our brains with all this talk about Lysol. Instead, they should have just said, maybe Trump is talking about this UV light therapy, and then moved on to something more important, instead of creating this whole hullabaloo about Lysol that really is not important in the grand scheme of things.

This is not a new pattern - this has been happening since Trump took office. The media uproar about what dumb things Trump said each week isn't real scrutiny.

Another way to look at it is that Trump intentionally says stupid things often to keep the media pre-occupied with that and distracted from the real things his administration is doing. In other words, he is "controlling the news cycle". I think this is a valid interpretation of the events although I don't give Trump that much credit and I think we should be looking closer at the media because they're going to be relevant much longer than Trump will. But, if this strikes a chord with you at all, consider this question: perhaps the media should not be taking the bait? The sarcasm comment aligns better with this theory. He got what he wanted and can now backtrack on his statements

PS. I realize that the argument in this comment is far from my argument in previous comments. It took some time for more to develop my thoughts. I'll be more careful next time. I would apologize for wasting time but I think I already paid the price in terms of downvotes

PPS. Summarizing my argument one last time before I put a lid on this: it seems to me that this whole disinfectant debacle is a big waste of time and the media could be doing better by educating people on treatment options to keep them optimistic or investigating real bad shit that the Trump administration is doing to make this country a better place. Thanks for your time, I definitely learned a lot from this argument and appreciate your participation even if we don't see eye to eye on this issue.

From the HN guidelines:

"Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith."

The statement we are supposed to find the strongest plausible interpretation of is this one

So, supposing we hit the body with a tremendous - whether it's ultraviolet or just very powerful light and I think you said that hasn't been checked but you're going to test it. And then I said, supposing you brought the light inside of the body, which you can do either through the skin or in some other way. And I think you said you're going to test that too. Sounds interesting. And then I see the disinfectant where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning? Because you see it gets in the lungs and it does a tremendous number on the lungs, so it'd be interesting to check that'

I don't think anybody can plausibly claim this incoherent stream of verbiage is an attempt to raise ultraviolet irradiation of blood as a possibility, particularly not in the context of a discussion which instead focused on how sunlight weakens the virus and isopryl alcohol kills it within one minute. And especially not now the person who made that statement has walked it back and said it was 'sarcastic'

HN guidelines don't require HNers to abandon their critical faculties.

It's hard to defend Trump's words on this topic. He's not a medical expert and doesn't sound like one.

But, in my opinion, it would benefit people more if the media tried to educate instead of "hurr durr he wants you to inject Lysol". Sadly I am optimistic in thinking the media exists to educate rather than accumulate ad views...

We need to be pursuing all treatment options right now, even if the gut feeling is that they won't work. We're in a situation that we have never been in before (i.e. pandemic with modern medicine), it is not far-fetched to believe the solution is something that we never expected to work.

edit: downvoters, feel free to respond..

Perhaps you can elaborate on what you see as "the consequences" to help me understand your point of view? Personally, I didn't think that he was suggesting to inject Lysol until I read that in the main stream media. And when I looked into it myself, I found Healight, and I think this is something the media could have pointed me instead of their knee-jerk Lysol reaction

The point is, you had to go looking because it was so confusing. And sounded to many people like dangerous nonsense. Its illustrates the point.

A responsible leader would leave the technical communications to competent department heads. Which this joker has mostly fired.

I explicitly agreed with your point a few posts ago:

> It's hard to defend Trump's words on this topic. He's not a medical expert and doesn't sound like one.

My point is, the media is fighting stupidity with stupidity with this whole Lysol thing. They could have used this as an opportunity to say, we know Trump sounds dumb, but let us teach you about what he is actually referring to

Sorry I'm a different guy. Should have kept out of it I suppose.

But yeah, its a game now, pointing out how (nearly) everything the guy says is dumb. Its not a game we should be playing; he should be sticking to broad goals and comforting the public. Like, you know, a leader. Instead of a regular schmuck way out of his depth who likes to hear himself talk.

No worries! I agree with mostly everything you have written. I just wish that the media used these opportunities to educate people on what Trump was actually talking about instead of getting obsessed with the specific words (namely "disinfectant" and "inject") that he used to describe it

> you about what he is actually referring to

Where is your evidence that supports that this is what he was referring to?

President Trump doesn't purport to be an expert. Indeed, it was a question he directed to the medical experts who were present.

It seems that given effectiveness of UV treatment on surfaces, he extrapolated its potential to use within the body. Just because he landed on a solution that on paper sounds like an anti-bacterial cure from the 40s and 50s doesn't mean that is the same treatment he was suggesting.

I think rsynnott is saying it's pure coincidence that what he suggested sounds like UBI and it's likely that UBI is a term Trump has never heard before.

Don't forget, he also suggested injecting disinfectant.

Well, maybe the president of the United States is...

Hence the need to find around something that when appropriately distorted by biased media will make some of Trump's statements (exposing Covid-19 patients to UV) appear more legit to the uninformed, so that the whole "inject disinfectants" thing can be conveniently buried.

The paper is old, let's see how many news sources will magically remember about it to turn it into a PR stunt.

Well, not no-one.

Given that one only needs to recirculate 5-7% of the blood and expose it to UV C, could we not shrink this age-old device into something portable? I don't know anything about phlebotomy or the implications of liquid pressure in the body, but it seems like if you can administer a syringe you can draw blood, UV it, and put it back in as well.

The clotting cascade will not be friendly to that approach.

Thank you, that makes sense!

Is there a reason everyone presumes in-situ/ closed-loop treatment is required, other than that is what the paper discussed? It seems like an artificial constraint, or maybe just the convenient method to use for research.

Why not: Remove whole blood, treat whole blood (possibly in bulk with other patients' bags of blood), replace whole blood.

It would address most of what you list, and otherwise simplify things, especially if only a small % of blood needs to be treated.

This sounds like ECMO or less invasive ECMO.

No- that's the opposite direction I was trying to describe. Not a closed loop system. Draw, treat, replace.

Whole blood drawn into a bag as if you were donating, then treated separately (maybe even sent to a lab), and then transfused back into the patient.

The closed loop systems are what create a lot of the complication and expense. ECMO (or similar) definitely doesn't simplify anything.

How feasible is it to just....take out all the blood, treat it, and return it?

Wouldn't there be some residual blood with a virus or whatever you want to stop?

Would that actually be easier to do?

The blood is typically not where the virus or bacteria are concentrated.

Also, "treating" the blood would also destroy red and white blood cells which we need to survive. ...not to mention the 10^6 other proteins, antibodies, and many unknown structures in the blood. ...things we'd be breaking that we don't even know what they do yet.

It's not about sterilizing the blood.

Being outdoors in sunlight would realize UV blood irradiation through skin capillaries?

If you have dark skin, certainly not. The whole point of having dark skin is so the UV doesn't make its way into your flesh, where it can wreak havoc.

Don’t forget the infection risk.

Proponents: "Don't worry, that secondary bacterial bloodstream infection due to vascular access will also be cured by this machine"

Just insert some tide pods in the machine.

This kind of care is only available for very wealthy people.

Which explains why the current administration sees it as a viable treatment.

Hmm, what about just treat people by exposing them to sunlight daily? Am I missing something?

Studies from the 1918 influenza outbreak show that patients treated partially outside had better outcomes

https://medium.com/@ra.hobday/coronavirus-and-the-sun-a-less...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504358/

Yes. When you remove the blood from the body and expose it to UV, you're exposing the pathogens in the blood directly to UV. When the blood is still inside the body, UV can't reach it, it's blocked by the skin. Also, that causes sunburns.

Yeah the blood irradiation approach avoids skin cancer risk by skipping straight to blood cancer!

Efficiency!

Blood is on the inside, and skin isn't transparent to UV.