Day 173: NO Means Nitric Oxide

The most notable development on the international front is Bolsonaro's third positive coronavirus test, taken yesterday and reported today.

California is still a day or two away from New York's #1 spot, though nothing can ever take away Governor Cuomo's title of Most Likely To Kill Your Grandma. In fact, California remains remarkably inefficient at killing people, with only 200 deaths per million, and will probably never achieve New York's high of 1,676 deaths per million. (The US average is about 440.) Of course the New York Times pats itself and the rest of the Northeast on the back for having already killed our low-hanging fruit our amazing pandemic control. Yelp, of all places, is unimpressed by the grandma slaughter's lockdown's effects on the economy, though; they report 132,500 business closures at the moment, 55% of them permanent.

On the science front, a future article in the official journal of the International Nitric Oxide Society already available online posits (you guessed it) nitric oxide (NO) as a prophylactic against COVID-19. While the paper references some previous in vitro and inhalation experiments with NO against the previous SARS epidemic, they go into far more reviewing detail about the efficacy of smoking as a COVID prophylactic, and why NO might be the reason. PlagueBlog readers may recall that nicotine has also been proposed as the smokers' secret weapon, and the authors also mention carbon dioxide as a potential mechanism, though their hearts are clearly in the NO theory.

We hypothesize, in view of our knowledge of NO and positive experience with NO inhalation in the SARS epidemic, that the intermittent bursts of high NO concentration in cigarette smoke may be a likely mechanism in protecting against the virus. To copy the intermittent high NO concentration by breathing in NO from a gas tank is problematic, since NO₂ will build up during dilution with air to potentially toxic concentrations. Pulsed short bursts of high NO concentration will require a delivery system for inhaled NO that is independent on supply from a gas tank. Such a tankless system does exist, and has been approved by the US FDA.

In a rare moment of honesty for the scientific literature (which may have something to do with the majority of the paper's authors hailing from Sweden), the authors address the ongoing misinterpretation of the clear evidence in favor of smoking:

The reluctance may be due to a general opposition to smoking and fear of using tobacco to prevent the ongoing pandemic.

As the panicked masses would put it, smoking is better than dying.

Also on the science front is an interesting preprint out of Ireland, in which the region reporting experienced a significant drop (73%) in premature births (with no corresponding increase in stillbirths). The authors enumerate quite a few potential factors brought on by the lockdown, most of which were already known to be associated with premature birth, but have no specific data on those points. If PlagueBlog had to guess, we would go with the reduction in maternal work stress and physical workload as the most pervasively changed by the pandemic, rather than with more external, seasonal, and variable factors like air pollution, exposure to infection, and partner support.

Massachusetts cases are up a quarter of a percentage point again today. The cities and towns report is out; here's the data, set up the same as last week. (The PlagueBlog punch-card girls computers may grind out a few more details tomorrow.)

(Pop out.)