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Brian I'm not sure I can agree that this short article proves the claim that I think you're making. The main paper on which you're basing it seems to be the Rose paper which states:

"Hospital-wide antibiotic use was significantly lower during March–October 2020 compared with March–October 2019"

There are other factors to consider

(1) massively reduced community prescribing of respiratory antibiotics (macrolides and cephalosporins) which you can ascertain from openprescribing.net. Prescribing late after an admission for pneumonia, during the phase or organising pneumonia, is a terrible pathway for preventing death from pneumonia

(2) you state that antibiotics - and reinforce this with a leading question - did not reduce deaths from COVID but the Zelenko, Kory and Tyson protocols and cohorts had death rates 10-20x lower than other community rates - using antibiotics.

(3) Crytogenic organising pneumonia is treated by steroids after treatment with antibiotics and exclusion of known causes of pneumonia. There has been to date no differentiation proven between COP and covid "pneumonia". If you don't have a known cause of the pneumonia (which was the case because "COVID" was an unknown entity), assuming there is no bacterial (or atypical bacterial) cause of that pneumonia - when this is one of only two valid treatment pathways (the other being steroids) is dangerous.

(4) It is unlikely that this syndrome was caused by a synthetic virus alone, and quite possible that there was a vector involved such as mycoplasma or coxiella. Without excluding these vectors it is narrow minded to purposefully withhold antibiotics.

Thanks

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All good points

0 and 4 - This post was written as a sub-section so it's a bit compressed in presentation. Besides Rose et al. there's the two papers in footnote 3 including Hughes et al. https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(20)30369-4/fulltext in which 77%+ of first-wave hospitalized London patients were screened and "true clinical pathogens were identified in 21 (3.2%) of 643 patients," 16 of which were non-respiratory.

1 - Agree that preventing pneumonia is more important, in this case of course the question is what cause of pneumonia was not being prevented. I'm a bit skeptical on whether antibiotics are operating as a damn on seasonal pneumonia deaths, and certainly wouldn't expect a spike in March/Spring if the elderly were suddenly left to "fend off bacteria on their own." Beyond that, it goes without saying that the situation in the UK in spring 2020 is very suspicious and the lack of PCR at the time leaves little way to make bold claims.

2 - I think any successful treatment protocol by definition involves attention and avoiding harm. Since most hospitals seem to have done neither, this is probably a bigger difference than antibiotics (which were supplied in abundance). A corollary here is HCQ which was actually used quite a lot in US hospitals in early 2020 but didn't make much difference, too little too late.

3 - Exactly why I am waging the case that this assumption doesn't seem to have been made in 2020-mid2021.

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The problem with the HCQ + AZ + Zn protocol successes (Zelenko, Tyson, Kory) was that it is impossible to separate the main effective ingredient - not that that matters. The other hidden ingredient in these protocols was the fact that doctors actually bothered to treat the patients, and the patients were usually well enough to attend the doctor.

However when you practise clinical medicine you do realise how frail elderly are and how necessary it is to implement antibiotics early after a virus. If you don't, they will just die. If they get to hospital and then you start antibiotics the death rates are higher than if you start them outside hospital.

https://pubmed.ncbi.nlm.nih.gov/18508820/

and

https://pubmed.ncbi.nlm.nih.gov/24707906/ showing that community treatment with antibiotics was associated with an increased risk of legionella but decresed risk of strep pneumonia, suggesting that hospitalisation with strep pneumonia was reduced (this was a case-control study, where patients who resolved on antibiotics weren't included!)

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Right, I would take the lower rates of strep to suggest that the resolvers were being kept out of the hospital to begin with. However, the low rates of death in both groups (4.8, 5.6%) as well as the other study from the 90s (7.7%) suggest that "dropping the ball" with pre-treatment isn't highly fatal (whether because some hospitalizations were actually for unrelated diseases or other reasons).

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Ah yes but the denominator is not known. So let's say you had 1000 people in the early cohort and 100 people in the late cohort - but 90% of the early cohort were resolved with early treatment. Then you would have 100 in each arm arriving at hospital (the only people the hospital people know about). 5% died in each arm.

Then that means that your early treatment arm had a 0.5% mortality, and your late treatment arm had a 5% mortality.

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I agree. But where I see the problem is that 5 to 8% can't account for the mortality rate in diagnosed / coded Covid-19. And we know that the late treatment for the same did include antibiotics. So even if you could somehow get the same absolute numbers by vectoring RNA with bacteria and being selective about hospitalization, the mortality rate in the hospital shouldn't be that high, i.e. you'd have to somehow give literally every elderly person bacterial pneumonia to get the same absolute death counts on the back end. You need something unresponsive to late antibiotic treatment.

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I think you're assuming that the death rate on transfer to hospital was 100% but it wasn't. Usually you find that if there are two divergent opinions the truth lies somewhere in between... It doesn't have to be dichotomous

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Coming down with Delta in Sept 21 I sent a message to my pretty tired primary care doc through the portal. I reported positive test and coughing up yellow stuff. She called that evening in urging me to go to the ER. I asked her if she'd prescribe azithromycin, one course. She did that. I yessed her the phone about going to the ER and then stayed home, took the Zpak and after a day yellow crud gone. I'm guessing the bacterial infection set in fast? But the Zpak took care of it, fast.

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38% of Covid patients weren't given antibiotics on admission, but 77% ended up getting antibiotics during their stay (23% didn't). So one could look at this and say not enough got antibiotics, and others say too many got them because there were only 8% with bacterial infections

Regardless, was the usage beneficial? Without a control group we can't say. It seems likely those who had the fewest symptoms got less antibiotics so there is healthy user bias here.

Then one can ask if the use of antibiotics were optimum. Did they use the right antibiotics. Azithromycin inhibits protein translation in ribosome of both virus and cytokine proteins, and is believed to reduce inflammation as well. . Some clinicians swear by it yet less than 1/2 of the patients getting antibiotics got Azithromycin.

There seems yo be an agenda by NIH to get Doctors to use less antibiotics so many studies seem designed to show this given most funding comes from these agencies.

With COVID its unlikely anyone one drug is a miracle drug, but in combination in appropriate dose, early use, etc it seems COVID is a treatable disease in all but the most vulnerable (very old, very sick people).

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You have done some of the most down-in-the-weeds work — and made it ACCESSIBLE to those of us moderately conversant in science-speak — that I have ever found. Thank you. Well deserved subscription tendered.

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Thank you!

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This mouse has shown many older people died because they did not receive antimicrobials - looks like the care / nursing homes did differently to hospitals?

I've flagged it for future reading / analysis, so cannot add more, but thought given the topic of this post it may prove of some value? https://twitter.com/TheJikky/status/1604543666135367680 - along the lines of what Heather Candy mentions in a comment below.

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Right, Jikky / Arkmedic is the source of the withheld-antibiotic myth / fad in skeptic space these last two months. Ok, some recommendations - but where are any numbers regarding actual practice? It's still really not easy to sort the latter out. I'd love a crystal ball that reveals exactly how patients have been iatrogenically murdered for the last 3 years, but the reality is more like a dodgeball ball.

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The lack of data all along has been ... one of the biggest wtf misdemeanors in this.

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Regarding your comment on the other post which went away, I did a review here https://unglossed.substack.com/p/pfizer-did-not-know-what-the-covid and a follow up after it turned out Pfizer simultaneously had published the same images. In the follow up, Latypova and Gutschi left comments which got me to thinking that the whole thing was regulatory "chaff" - it would have added to a ton of back and forth communication to employ an automated blot platform in regulatory submissions, and so my guess is that Pfizer employed the platform precisely for that reason, the same way corporate legal teams just bury the other side in busy-work https://unglossed.substack.com/p/updates-to-pfizer-didnt-know-what/comment/11982967

I am never up to date on twitter stuff, so twitter tips are never prima facie superfluous

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I wondered if you would have received a virtual copy, and nearly left deletion explanation in its stead. Thanks for the reply.

I appreciate the effort that goes into his mouseness-es tweets / investigations, etc, but it gets hyperbolic quickly and feels ADD-like in its frenetic frenzy?

I saw disagreement, (and then saw one disagreer was dodgy af already) so decided it might be a red herring. And we all know how they can fart and trick people into thinking there's a nuclear sub around...

Thanks for the link to your post too, I'll have a read.

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I saw a chart a few days ago for the UK and it showed prescribing of antibiotics and there was a definite dip for a few months then it climbed up again. I can't remember who wrote about it but the information is published by prescribing authority.

On the pneumonia question there were videos a while ago now where people attended hearings and spoke about what they were seeing/had seen in in hospitals in the US. One person in particular was totally distraught about what he witnessed. He was a very experienced nurse who had looked after 'pulmonary patients' for many years. He had had to leave the hospital because he couldn't bear to watch what was happening and, if my memory is correct, he was prevented from doing anything to help.

It was one of the most moving things that I have seen in the past three years. He explained how patients have to be helped to sit up to prevent pneumonia and not doing this their chances of survival are dramatically reduced. Patients were being left in rooms on their backs, not being moved into upright positions. It led to them dying when they should not have. It was quite early on, maybe even 2020 when I saw it, it could have been taken down by now.

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Hmmm, the acellular Pertussis vaccine seems like it might be in the same class as the Covid-19 vaccines in that it seems to suppress symptoms among those who have had it. Mentioned in this podcast towards the end:

https://www.unz.com/audio/kbarrett_zoey-otoole-of-childrens-health-defense-on-turtles-all-the-way-down/

So, is that possibly another example of IgG class switching to tolerance antibodies.

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DTAP is generically about inducing the immune system to front-load antibodies against bacterial toxins, so you aren't targeting the bacteria but their by-products. This protects you but renders you (an immunized baby) into an "asymptomatic carrier" of bacteria that natural/cellular immunity would be a bit more hostile to ("bro, spilling toxins on the game room carpet? not cool bro"), so you turn vaccinated people into vectors for anti-unvaccinated people bioweapons.

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To what extent did telling people to stay home help to depress serum D3 levels further?

I suspect perhaps it didn't have much impact because most old people don't get out a lot anyway.

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I think some of questions circulating about antibiotic use relates to non hospital patients, yes, but the other group is senior citizens - those in nursing homes. There were issues is the UK (as there were before Covid - look up Liverpool pathway), but also in Canada, where I live. In early Covid days, everything was about "spare the hospitals", so seniors home residents were *not* sent to hospital when they had Covid symptoms, and *were* palliated (ie given morphine, midazolam, etc.) to death. It was easily done in nursing homes here, as DNR status is discussed on admission to nursing homes & the vast majority of patients are DNR. *But* that never should mean don't try to treat something treatable. There was a gov't inquiry in my province about the deaths in nursing homes, either late in 2020 or some time in 2021) (It would take a bit of effort for me to find. I seem to be quite good at finding & downloading studies on-line, but not so great at organizing them so I can find them again 😬) BTW, I am a now retired (late 2021) registered nurse in Ontario, Canada.

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The US / CDC presentation suggests no deficit of antibiotic use in nursing homes; overall prescriptions decrease but not disproportionately to the resident population. And antibiotics spike with 2020/21 virus waves. So the depression, if there is one, is probably more driven by delays in surgery, which are always a driver of antibiotic prescriptions in the elderly (due to excessive UTI screening).

I should have put that in this post, but since I wrote this as a subsection of "Tolerance and severe disease" before deciding at the last moment to make it a standalone post, I took a narrow approach to the data. Anyway the nursing home charts are 1/4 down in https://emergency.cdc.gov/coca/ppt/2021/111821_slide.pdf

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Yes the mouse on twitter posted the following regarding UK's midazolam prescription spike:

https://twitter.com/Jikkyleaks/status/1623140333390561281

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Thanks for the shoutout!

I think much of the discussion on secondary bacterial infection misses out on the microbiome, which is a recent field. There was even an article I cited published around 2016 about the microbiome where the authors were discussing the consensus was that the lungs were sterile. It'd be interesting to see how much reworking of different ideas will come about due to the microbiome.

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Lungs are sterile - in 2016?! By this point the ancient myth that the bladder / urine are sterile was even crumbling

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Throwing together some pictures on Syncytia deliberately caused by US Bioweapons maniacs.

https://geoffpain.substack.com/p/pneumonia-caused-by-wuhan-covid19

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The first detected case of Covid19 who arrived in Melbourne, Victoria, Australia from Wuhan was given Antibiotics that were judged to have no effect on his condition.

https://geoffpain.substack.com/p/first-detected-covid19-case-arrived

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Wasn't Azithromycin given to Covid Patients? I thought it was, along with Dexamethasone? It's an antibiotic, but apparently it reduces inflammation in some manner. Am I incorrect?

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Yes, appears to have been prescribed a lot in the CDC slides.

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How effective are antibiotics if the patient is continuously exposed to the infecting bacteria?

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Well, what seems to happen is that hospitals are these hyper-sterile places without a lot of standard bacterial flora and high risk of AMR bacteria. So giving patients antibiotics like candy presumably doesn't do anything but amplify that same dynamic.

Presumably, nosocomial infections with AMR bugs would have shown up in the figures in footnote 3, i.e. just 8% or so.

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From the study.

“The precise nature of the secondary—and tertiary—invaders is largely a matter of accident, dependent on the occurrence of particular bacteria in the respiratory tract of individuals at the time of infection…”

What is being done differently from normal practice during covid that may cause a constant resupply of this bacteria?

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Sorry for late reply - that quote is from Jordan's 1918 flu review, from 1927

The 8% (almost certainly more in other contexts) of identified "coinfections" in

Rawson, et al. probably just reflect background rates among asymptomatic people, so my interpretation is that it isn't revealing a big problem with nosocomial infections among inpatients coded for "Covid-19."

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Interesting that it comes from that source. Somewhere in my education; basic industrial hygiene as it pertained to air supply and filtration systems, liquid oxygen generation for use by navy pilots or certification for respirator use I learned that a large number of deaths from the Spanish flu were due to bacterial infection of the lungs. The source for these infections was often the masks they made patients, and many others, wear. This fact and those learned by other post pandemic studies finding masks were ineffective against the spread of that disease is why we have not worn masks outside specific uses and setting in the century after the passing of that pandemic. Masks have long been known to be veritable germ incubators.

Hospitals can be as sterile as humanly possible but the patient wearing a mask is self contaminating the air they breath. Healthy surgical teams must change their masks periodically during lengthy operations for this very reason.

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I am definitely suspicious of a role of masks and hospitalization as opposed to open air rest in promoting secondary infections. One of the limits in interpreting the 1918 death patterns from today is imagining that most deaths were in well-nourished young adults. It seems more a problem of derelict young adults, of which there would have been many in that era. From Mare Island (Bay Area naval hospital):

"hese cases represent a small percentage of the total illness of the community, since many of those not seriously attacked went to their homes and did not report to the emergency hospital; and our allotment was principally composed of neglected patients who did not do well with home treatment together with a small proportion of men who had no home or were taken so suddenly and severely ill that they were unable to get to home. The general status of the large majority of patients, with a resultant failure of accepted care and treatment, was most discouraging. The average patient was of the lower type as regards mentality, morality, and personal hygiene, and in the main was physically deficient. A large proportion of the patients had been ill and without even simple care from two to eight days before admission."

https://www.deepdyve.com/lp/american-medical-association/transfusion-in-the-desperate-pneumonias-complicating-influenza-DaUq3ZeWdh

Then you also have the outlandish death rates in India. Which seem suggestive of some indirect disruptions to agriculture and food distribution as much as anything else, but certainly not suggestive of an iatrogenic roll (despite the fact that India did in fact have a lot of smallpox vaccine production and promotion at the time).

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There are limits to everything and they must be taken into account. Time permitting, no fires to put out first or the like, the first step to trouble shooting in the “plant” (propulsion, power, O2/N2 generation, etc.) is to determine what was done differently and rule that out as the cause. “Differently” in this context includes what changes to the plant were just made or being made. Was a bell being answered, sorry, that means was the throttle man changing the speed of the main engine, or what evolution was being carried out. It could also mean a new device or piece of equipment is being tried out. It could also mean a mistake was made. But the first question is, “What did we do differently?”

There are plenty of things we are doing differently in the treatment of covid that in my opinion must be ruled out before anything else is considered. Prior to covid, masking protocol in hospital called for “one mask per patient”. This means not each patient gets a single mask, rather that medical staff change their masks between patients, but only are worn with certain patients and for certain tasks, otherwise not worn outside the OR. Within the sterile OR environment, masks are changed periodically if the operation exceeds the time limit for the single mask. This is something that is being done differently but is not being investigated to learn how this change may be affecting outcomes.

So it is with the use of a single + result of a single test to determine if a patient has a disease. This is another change that in my option must also be investigated for its role in the outcomes we are seeing. Sending sick patients to nursing homes and the deviation in ventilator use protocols are two that are at least getting, or have gotten some attention. There are other changes.

In short, all pandemic response protocols were thrown out the window early on by every government on the planet. I am inclined to believe that these changes are the collective cause of all this, not the disease itself. It is what we have done differently. The fact that bringing this up on most any other forum invites verbal abuse leads me to believe that there are those who know this to be true but do not want any inquiry in that direction.

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I've seen the accusations of no antibiotics being given (it seems to be an accusation made especially in England). We gave antibiotics at my hospital in the USA. Maybe the issue was less antibiotics generally being given outpatient before severity warranted inpatient treatment.

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I can't quite recall, but it does appear that antibiotic use declined outpatient possibly because they didn't want people misusing it? IT does appear that antibiotic use was dependent upon a hospital's protocol and done more as a prophylactic. Other hospitals appear to have taken a more discerning point in their use of antibiotics.

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Absolutely - the damage is already done by the time you get to the hospital. Granted, you can still ameliorate inflammation again just like with any injury, but it seems like in practice no patients got the attention / calibration that would even make a difference as far as steroids, best I can make out.

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My hospital in the southern US did not give antibiotics. I was on the Covid wing (not ICU). All they did was take my vitals and check O2. More in my earlier post.

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I am in the south too. None of my family recieved antibiotics. We recieved absolutely nothing. We were all sent home. Even my twin boys. And when I finally (months later) got a cardiologist tonsee them, one had Pericarditis and the other had myocarditis.

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I am very sorry to hear that. As mentioned in my post last week, most of the published stuff on treatment is still for 2020, so there's little way to guess if things got worse especially in the South in 2021 but it seems like it. The CDC presentation stops in August 2021 and doesn't show an uptick even though that should be the beginning of the Delta wave, so maybe that reflects turning away from antibiotics and making deaths higher than 2020. Plus, doubling down on remdesivir, vents, all seems to have taken place in summer 2021. It was a whole package of mistreatment

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Thank you. My daughter and I had covid in March and again in October 2020. The twins had covid in 2020 and recovered completely. It wasn't until April 2022 that the twins had their hearts affected by covid. They'd had covid in Jan and and April 2022.

There was no difference in treatment from 2020 to 2022 in Texas. You got a diagnosis of anxiety, depression, or psychosis, told that absolutely nothing is physically wrong with you, and are then sent directly home....no matter what your blood tests or ekgs say.

I have filed for disability for the twins. The cardiologist said their outcome would have been much better if they'd been treated for what were obvious and serious cardiac issues. The twin with myocarditis also got a 2nd degree AV block from covid.

I've never in my life seen doctors so adamantly deny reality and treatment to patients in need. I do understand that they've been threatened and some have even admitted this. But it's still shocking to experience.

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It amazes me how murderous is the treatment you're describing. I asked for azithromycin and got it. A five day course early on (I did use ivm with it) seemed to be critical when I got Delta in fall 21. It's cheap, with few side effects. What the hell is wrong with doctors?

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Doctors are just part of the machine now. So much for their oaths to do no harm.

Had I known about ivermectin in 2020, and if I had the covid treatment knowledge I have now, my daughter and I would not be suffering from long covid.

The doctors didn't even need to treat us, just make us aware.

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One data point: I was hospitalized Jan 2022 (unjabb'd senior) with Covid, fever, CT-scan diagnosed ground glass opacity bilateral pneumonia, cough, vertigo, SVT, elevated D-dimer, etc. The only treatments I received over 5 days were: blood thinner injection (stomach) and - wait for it - MUCINEX. Fortunately my SpO2 was 93 the whole time so I was not given O2.

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Syncytia > Pneumonia > Death

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Ah, I was about to say I don't see any posts regarding syncytia on your substack and now your new post is up.

I am not sure what role fusion would have to pneumonia vs. standard viral invasion other than it contributes to immune evasion, thus maybe making viral invasion worse, but also potentially leading to persistent infections with lower immune response do to exhaustion and tolerance, thus less pathology, as might also be a feature of RSV.

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As cells merge, the surface area decreases. Oxygen, water and nutrient flow will be adversely affected. Links with multicellular Cancer could be interesting.

My former boss Prof Roger Dawkins got me to look at some slides of Cancer under the microscope as my Biology training had not included Histology.

He waited patiently beside me as I ramped up the microscope magnification to see the characteristic multinucleated malignant cells and the penny dropped.

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