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Showing posts with label Covid-19. Show all posts
Showing posts with label Covid-19. Show all posts

Tuesday 27 April 2021

Holiday Injection … Done! Getting “Pfizered” for Greece

 


Some parts of the world are trying to get back to some sort of Covid normal, while others are in crisis.  Where we live 40% have been vaccinated and likely 50% have already had the virus.

Monty, aged 17 with ASD, is a big fan of swimming in the sea and where we live that means crossing borders.  Crossing borders is much easier if you have had a Covid-19 vaccine and it looks like for children the best option is the one from Pfizer-BioNTech.  BioNTech is the clever company set up by a Turkish husband and wife team in Germany. They licensed their vaccine to Pfizer for distribution outside of China, in China they have a deal with Fosun Pharma.

Last week Monty had the opportunity, at very short notice, to go and get the Pfizer inoculation. I collected him from school and took him to a clinic in the city centre, that he has never been to and which undoubtedly would have a long line of people queuing outside it.

Monty knows all about injections and syringes, courtesy of his dental marathon a couple of years ago. He even knows about antibodies from Biology classes. The most rational explanation I came up with while driving, for why he was going to see the “doctor” was that it was for his “holiday injection”.  Monty’s school assistant had some more scientific explanations, but the problem is then you are left wondering why you still need to wear a mask at school, after you have been “Pfizered”.


“Do you like swimming in the sea, on holiday?” …   “Yes” was reply.


“This year, because of Covid, you need to get a holiday injection in your arm.  It doesn’t hurt and we’ve all had ours.”


“After 2 holiday injections, you’re ready for summer holidays.”


Bad news became good news.  Holidays … nice!

 

Children traveling without a covid Vaccine

In many cases children can travel without a covid vaccine, but you may need a PCR test before the trip out and the trip back.  You might well develop covid whilst you are abroad and then you are stuck.

A classmate of Monty was traveling with his vaccinated parents and the border policeman was not sure whether to let him through, since he had no PCR test, or vaccine certificate.

The Pfizer vaccine does look the best choice for a healthy 17-year-old.  For them, safety is more important than efficacy, because they are at almost zero risk from the current variants of the virus.  This may very well change in the coming years.

  

Covid risk for those with autism

Whether you are at elevated risk from Covid depends on what kind of autism you have.  I think my son is at even lower risk than his peers; he very rarely gets sick and another reason is his steroid inhaler for asthma; this actually reduces the chance of mild covid becoming severe covid.  Steroids are now widely used in hospital treatment, but really should be started before you even think about going to hospital.

People with MS (multiple sclerosis) taking disease modifying therapy may be another group who are protected from severe Covid.  These therapies block the cytokine storm that takes you from mild covid to severe covid.  The studies are somewhat contradictory, so you can believe whichever you want.   

The expensive drug Remdesivir, was approved as a therapy even though it has no effect on mortality, which makes you seriously wonder about its benefit.  Not surprisingly, the cheap oral steroid drug, Dexamethasone, substantially reduces mortality.

What happened to hydroxychloroquine (HCQ) and Didier Raoult, the French Professor who promoted it?  He still thinks he is right, even though great efforts were made to prove him wrong, including using data later shown to have been faked.

A recently published study looking at 28,759 adults with mild COVID 19 in Iran actually supports Raoult:


https://www.sciencedirect.com/science/article/pii/S1567576921002721

Early administration of HCQ reduced the odds of hospitalization by 38%.

Early administration of HCQ reduced the odds of death by 73%.

Serious HCQ adverse drug reactions were not reported in any of the age groups with or without comorbidities.

 

Does hydroxychloroquine have an anti-viral benefit in Covid-19?  Only you can decide.  The scare stories about dangerous side effects were evidently grossly overstated, which makes you wonder what else was made up by the naysayers.

I think this shows that you can find data to support whichever side you favour.  This seems to happen quite often, when a medical issue becomes politicized.

My own Covid therapy was hydroxychloroquine as the antiviral, to which I would have added prednisone if necessary.  As a local doctor told me, you do not want to go to hospital with Covid.

Back to autism.

Some types of autism are associated with comorbidities elsewhere in your body.  These can include problems with your lungs, as in the case of Down syndrome. If you have Prader Willi syndrome, you will present with autism and obesity.  The obesity is the covid risk.

Intellectual disability is put forward as a Covid risk, which makes sense.  People with ID/MR are likely to live in group homes or institutions, where they may be exposed to the virus and they may not follow all the protective measures.  People taking psychiatric drugs are likely to be overweight, which is a bigger risk factor than age.  People with ID/MR are likely to get worse healthcare than typical people, even when there is no health crisis.  The study below seems very credible'. 

After old age, intellectual disability is greatest risk factor for death from COVID-19, study finds

The results showed that those with intellectual disabilities were 2.5 times more likely to contract COVID-19, were about 2.7 times more likely to be admitted to the hospital and 5.9 times more likely to die from the infection than the general population.


Nowadays most people diagnosed with autism do not have any intellectual disability, so it makes sense that in some countries they have made people with intellectual disability, rather than just autism, as a priority group for vaccination.  

On a practical level, an overstretched hospital is not going to be a good place for an adult with intellectual disability, with or without autism.  They should indeed be prioritized for vaccination

When it comes to autism parents there seem to be three groups: -

1.     Desperate to get the vaccine

2.     Desperate to avoid the vaccine

3.     Desperate to go on holiday

 

 

 

 

Monday 19 October 2020

Synchrony 2020 and Back to School with Covid

 


I am giving a presentation in November at an online autism conference called Synchrony 2020. It is organized by a group of parents of children with autism.  You can read all about it here: 

 

https://synchronysymposium.com/

 

If you want to attend this virtual conference there is a coupon code for readers of this blog: -

EPIPHANY

I am told the coupon code applies only to Early Bird and Regular Price, not to the Day Pass. 

Our doctor reader Agnieszka gave a presentation at this event last year.

This year Dr Ben-Ari is going to talk about Bumetanide and I am then talking about 8 years of using Bumetanide.

The proceeds go towards the Brain Foundation’s funding of autism research. 


The Brain Foundation

Our mission is to support translational research that will lead to the development of FDA-approved treatments and an improved standard of care for co-morbidities in individuals with autism spectrum disorder. 


I suppose my mission is to take the fast track, by repurposing existing approved drugs and skip the part requiring $30 million and 15 years to get FDA approval, specific to autism, for each drug.

As you would expect, most of the presenters are medical doctors or medical researchers. 

I did point out to the organizers that many of these people are not going to like what I do.  They spend decades researching autism and here comes Peter, not a doctor, developing therapies by repurposing existing drugs. 

There will be nothing controversial in my presentation, I am just talking about the effects of long-term Bumetanide therapy.

Doctors who have a child with autism do see things differently. I had a British pediatrician come up to me at an event and just about the first thing he said was “I want to do for my daughter, what you have done for your son”.  Good luck to him.

I did my bit to help the conference organisers by asking Dr Ben-Ari to present about Bumetanide.

Dr Ben-Ari does read this blog and I know he does not entirely approve of my methods.  If I did not have a child with autism, I would also not approve of my methods. Necessity is the mother of invention.

A classic example of medical dithering appeared in a recent meta-analysis of the research into the use of NAC in autism.

The review concludes that NAC is safe to use and does reduce some key symptoms of autism, but then adds the caveat “However, further evidence should be sought before a general recommendation.”

So, NAC is cheap, safe and effective, but don’t use it. 

Effectiveness of N-acetylcysteine in autism spectrum disorders: A meta-analysis of randomized controlled trials

Conclusion: We concluded that N-acetylcysteine is safe and tolerable, reduces hyperactivity and irritability and enhances social awareness in children with autism spectrum disorder. However, further evidence should be sought before a general recommendation. 


Incidentally, the FDA do not seem to like NAC being sold as a supplement in the US.  NAC is very popular and it is included in hundreds of OTC products, so banning it would not go unnoticed.  They are not concerned on safety grounds. Some drug producers seem to want it to be exclusively an expensive prescription drug. 

I think the Brain Foundation has noble goals and good luck to them.

I suspect Dr Ben-Ari’s what will be 15-year push to get Bumetanide adopted as an approved autism therapy will have the most transformative impact. Good luck to him too. 

 

Back to School with Covid 

After several months break, Monty started back at school on September 1st.  The only significant difference from before is that everyone is wearing a mask. School is 5 days a week from 8.30am to 3.30pm, as before.

Nobody likes wearing a mask, but it is just something you currently have to do.  Monty, like most people with autism, can cope just fine wearing a mask.  Some people need to practise, others do not.  Without a mask there would be no school.

Online learning at home actually worked very well, with lessons via Zoom.  We are not new to the idea of home schooling; Monty’s 1:1 assistants have been teaching him at home since he was 4 years old.  Our current assistant was happy to come during the lockdown period.

It is much more fun to actually go to school.

Monty, now aged 17, attends a mainstream international school that follows the English curriculum.  He has no IEP (Individual Education Plan), so he does the same work and has the same tests as everyone else. Because I held him back 2 years at the age of 9, his classmates are 15-year olds.

He is remarkably well included, particularly by the girls.  In kindergarten and junior school there often is a little girl who takes a special interest in the cute little boy with classic autism, but this can fade away as the girl heads to puberty and the cute little boy becomes adult-sized, with not so cute classic autism.

I heard an endearing anecdote from Monty’s Assistant.  Two of the girls in class have been reading on the internet about boarding/residential schools. They found a school they liked the look of in Holland and asked our Assistant “would Monty’s parents allow him to come with us?  Look, it says they have 24-hour provision for those with special needs”.  I doubt they will actually be changing schools, but it was nice they kept Monty in mind. 

As I mentioned in previous posts, it does help to have a younger Assistant, if you want to promote social interactions with teenage classmates. Our Assistant has a sister the same age as Monty’s peers.

I did ask our Assistant why she thinks people are so nice to Monty; there are other people at school who are ignored by their peers and are pretty miserable. “Oh, he’s so cute, he says funny things in class and acts differently, look how he sits nicely and he’s the only one that eats properly; he also knows what is on the lunch menu and people come and ask him”, was the first response.  There must be more to do with it than that.   

There is a girl with spots who everyone ignores, do they really ignore her because of her spots?

As regular readers may recall, there is an interesting therapy for Aspie girls with spots.  Spironolactone, which lowers male hormones, will reduce acne in girls, but will also affect ROR alpha which determines the expression of many autism genes. So, both acne and autism might improve. Then add a squirt of oxytocin, or an oxytocin inducing gut bacteria and watch what happens.

I did see an interesting paper about children with autism who are flourishing at home with remote learning during covid.  The paper is about high functioning children (HFA in the text below), but some children with Classic autism also prefer life at home.

 

Debate: Remote learning during COVID‐19 for children with high functioning autism spectrum disorder 

Over the past 6 months, many children with HFA have told us they enjoy learning from home for a variety of reasons. They do not need to worry about whom to sit with at lunch, or be annoyed by the frequent changing classes, or have to tolerate the aversiveness of the school bell ringing, or the smell of the cafeteria. They report feeling liberated by not having to try so hard to fit in with the neurotypical world while trying to thrive academically. The anxiety, demoralization, and depression that have plagued them when in school have dissipated. Ironically, then, COVID‐19 has allowed many children like Stephan, who are oftentimes silently suffering, to flourish at home in ways that they could not do while in the regular classroom setting. We speculate that by eliminating the demands of the elusive, ‘hidden curriculum’, such children now expend their emotional and cognitive resources on the formal curriculum, which has resulted in improved grades and improved mental health. The following example illustrates this point … 


I advocate teaching the "hidden curriculum" to pre-teen Aspies, so they do not have a miserable time in high school and later in life, perhaps becoming an autism self-advocate. I would also use the buddy system to pair them with a slightly older outgoing neurotypical girl.

It looks like many of the parents of children with severe autism are ones that really do not like remote learning during Covid.  In some cases, they do not try to engage in remote learning.  If they were already teaching their child pre-Covid, it would not have been so difficult.

In some countries public schooling provides a seamless service year-round picking up the child from home and bringing him/her home at the end of day, setting both parents free.  You then become totally dependent on this level of service.  We never had that kind of support, so had to create our own independent approach.



 



Thursday 16 April 2020

Life with Autism under Lockdown






I thought there should be at least one post about how life has changed during Covid-19.  Where we live, Monty’s life goes on pretty much as before, now we are back to home schooling - but that is nothing new for us.

School starts at 9am, there are 3 or 4 classes a day online from school and then activities and exercises till 3.30pm. 

We have PE, art and music like at school.  Piano practice continues most days.

Monty’s latest addition to his routine is reading 30 pages a day of a novel in the evening.  Now that he has started, he insists on doing it every day.  Having finished the (boring) books from school, he is going to start reading his brother’s collection of Biggles novels. They are about a fictional fighter pilot, the series starts in 1916 and continues for 50 years (the author got old, but Biggles did not).  We are going to set the scene with one of the old epic films about fighter aces from 1914-18.

The parks are closed and we have a curfew starting at 5pm weekdays and now across the entire weekend.  If you live in a small apartment, as many people do in the areas with the most strict lockdowns, life clearly will be difficult for people who do not understand why their movements have suddenly been restricted.

In many countries parents have asked for special treatment for those with autism, so that they can go outside more often. This has just been implemented where we live.

Parents are now going outside to walk their child with autism during the curfew and then neighbours are calling the police to report them.  In some countries you can get a special paper confirming your right as a disabled person to be taken outside, when everyone else has to stay at home.

In our case, Monty accepts that schools, parks, restaurant and cafes are all closed, but he expects that come September life will return to normal and his brother will go back to University.  Monty is lucky to live in a house with a garden, so he has plenty of space and lots of things to do.

Life with autism under control is not so demanding, even under lockdown.

When Monty was eight years old, we had nine months of autism out of control, which then results in a self-imposed lockdown.  That period ended just before Monty started his Polypill therapy in 2012.

I would not want to be in lockdown with an adult-sized person with untreated severe autism.


The Big Issue

Recently I was asked for some advice by Monty’s assistant; her friend works publishing a magazine homeless/disadvantaged people sell on the street.  One of their best “sellers” is a young man with mild autism.  He actually lives with his parents – he is not homeless.  He is struggling under the lockdown, because the magazine is not being published; he still turns up at the office to collect his copies to sell, even though there are none.

The young man became very anxious and so his parents gave him something to calm his nerves (which turned out to be Valium).

I was told that he had been given some pills, but in spite of these pills he got worse and started being aggressive, which is totally out of character.  This was all (falsely) attributed to the Corona virus changes to life.

As usual you do have to double check the facts.  Where we live a man with “mild autism” does not mean a person with Asperger’s, it means a person with Autistic Disorder (i.e. severe autism), but not such a bad case, so the young man can walk to work by himself and has some speech. 

I was asked what pills the parents could ask for, to calm him down. I explained that for anxiety people with autism often get prescribed benzodiazepines, but for aggression and self-injury they might get antipsychotics.  Neither are a good choice in most cases.

“And … there should not be any side effects.
The pills he currently takes are just something very mild”

So, what pills had he been given? It was a local brand name I did not know, so I looked it up and it was Valium/Diazepam, the benzodiazepine.

Adult with autism going crazy after Valium? that sounds familiar.

You don’t want Valium, you want 2mg of Bumetanide.

People who show a negative reaction to benzodiazepine drugs, usually prescribed to calm you down, are very likely to be bumetanide responders.

Benzodiazepine drugs increase the effect of the neurotransmitter GABA. In most people GABA is inhibitory, so increasing its effect will calm you down and ultimately sedate you.

In people with GABA working in reverse, it acts as excitatory.  This will reduce cognitive function and affect mood and behavior.  If you “turn up the volume” of GABA by taking a Benzodiazepine drug like Valium, you will make such people go crazy, with aggression and self-injury.

Hopefully the parents of the young man will get my message and stop giving Valium.  It would be nice to think they will also start to give Bumetanide, but that is their choice and I assume they most likely will not.  A diuretic for autism? How crazy is that.



How crazy is an anti-malarial for Covid-19?

How are the French doing with an antimalarial and an antibiotic for Covid-19, that I referred to in an earlier post? Say farewell to Covid-19 in just five days, it appeared.







By now the French have treated thousands of people with their new off-label therapy.  Also being developed in Marseille is Bumetanide as an off-label autism therapy by Neurochlore.  It looks like free thinking is flourishing on the Cote d'Azur.   

The data below is from the Marseille University Hospital Institute for Infectious Diseases (IHU Méditerranée Infection) and the wider hospital group in Marseille called APHM, which means Assistance Publique-Hôpitaux de Marseille.

The public hospitals in Marseille have treated 4,337 Covid-19 patients and 78 died (1.8%).

Within that group 2,671 were treated at the specialist IHU hospital with the antimalarial hydroxychloroquine (and some with azithromycin in addition) and of those that received at least 3 days of treatment 11 died (0.4%).

I think we can infer that 1,666 patients did not have hydroxychloroquine and 67 died (4%).

So if taken sick with Covid-19 in Marseille, tell the ambulance:

         "IHU Méditerranée Infection et vite !!"

If needed you can add:

        "Appuyez sur le champignon!"





As I suggested in my post on Covid-19, hydroxychloroquine looks a very good bet.  The supposedly fact-based media (CNN, BBC etc) continues to say there is no hard evidence to support the use of hydroxychloroquine.  How much evidence do you need?

To measure the success of hydroxychloroquine, you just count the bodies.

If this is such a struggle, what hope is there to ever prove a drug can work for such an ill-defined condition as autism?

Until you have been vaccinated against Covid-19, it appears that what you need is hydroxychloroquine + azithromycin and some potassium, to treat the hypokalemia caused by Covid-19. Ideally you would also have a home test for Covid-19, which are getting much cheaper, so you do not take the drugs unnecessarily.

Fortunately where we live hospitals are routinely giving hydroxychloroquine + azithromycin, but ideally you would start the antiviral therapy before getting ill enough to go to hospital.

Tom Hank’s wife was complaining recently in the media about the side effects (nausea, vertigo etc) of the chloroquine she was given in hospital in Australia for Covid-19.  I think that is a little ungrateful. Untreated Covid-19 can have a pretty terminal side effect.






Thursday 26 March 2020

Covid-19 – Friends, Survival of the Fittest, Focus on Reality and Forget about PC



Replacing the EU Flag with the Chinese Flag in Italy

In times of crisis people often find out who their friends really are.  In Northern Italy teams of doctors and equipment arrived from China, Russia and Cuba.  The citizens of a town in Italy have taken down the blue EU flag and replaced it with a red Chinese one.

Some Americans on social media think it is a "photoshop job".  Where we live Chinese doctors have also arrived, along with donated ventilators and other equipment.  The Chinese flag is fluttering on many video/digital billboards.

We should note that Italy sent aid to China, when Covid-19 first appeared. 
  
In most countries treatment guidelines have been published to determine how to treat patients and how to ration the limited available medical resources.  There is nothing new in rationing medical resources, it happens every day.

In terms of therapy, the note linked to below (in English), is very good.  It includes both chloroquine and hydroxychloroquine, mentioned in my initial post.  Note the dosage is tapered, as I suggested in my post.  In the case of hydroxychloroquine, you only need 12 tablets; so a standard pack can treat 5 adults.  Time for emergency production to start? Or we have to wait for the Chinese to do that for us?




Note that these drugs may have side effects, in particular QT prolongation of your heart beat.  This is a possible side effect of many drugs,  You would not want to combine multiple drugs that prolong QT. The QT interval is measured by ECG.






I am pretty sure I took chloroquine many years ago when travelling in a malaria infected area and never had an ECG.  It is clearly a case of balancing risks.  



Back to triage 

In the Napoleonic wars the French came up with the word triage and by the time of the World War One they had fine-tuned it. Those collecting the injured had to categorize patients into one of three groups:-

·         Those who are likely to live, regardless of what care they receive
·         Those who are unlikely to live, regardless of what care they receive
·         Those for whom immediate care might make a positive difference in outcome

In the current Covid-19 outbreak patients are first split into two groups: -

·        At-risk group, based on age and existing medical conditions 
·        Not in an at-risk group, based on age and existing medical conditions

Severity of the Disease

·        Mild to moderate, the case for most people (no pneumonia or oxygen required)
·        Severe, breathing difficulties requiring oxygen
·        Critical, ARDS (Acute Respiratory Distress Syndrome), Sepsis, Multi organ failure.  The people with critical severity require mechanical ventilation and intensive care

Frailty assessment

The clinical frailty scale (CFS) is used to give a rating from 1 (very fit) to 9 (terminally ill).  Each patient is given a CFS score when it is necessary to ration care.

People with a disability obviously do not want to get a black mark in the frailty assessment.

When overwhelmed with sick people, those working in hospital are not going to be able to devote time to people who are disruptive (aggression, self-injury etc) or those who need a family member at their bedside.

Another issue is where to put disabled people after treatment, so they do not block hospital beds needed for others.  In Italy hotels have been taken over to house people who are still infectious, but not seriously ill.

People who have intellectual disability (ID/MR) are not so easy to house, as this recent article highlights.

Developmentally Disabled New Yorkers Stuck in Hospital After COVID-19 Recovery
According to AABR ( Association for Advancement of Blind and Retarded), a non-profit with a New York State contract to house roughly 200 adults with developmental disabilities, their staff does not have enough necessary masks and gowns to safely retrieve 12 autistic and developmentally disabled residents who are ready for discharge after being treated for coronavirus.

Nine of those patients tested positive and six more hospitalized are awaiting test results. The 12 patients no longer require hospitalization, but are still considered contagious.  

“We have twelve individuals who have been hospitalized who are ready for discharge and isolation at home, but we don’t have a safe plan to bring them home,” said Libby Traynor, executive director of AABR, which used to be known as the Association for Advancement of Blind and Retarded, an 80-year-old organization that runs 22 group homes in the five boroughs.  Residents in six of those group homes have tested positive for COVID-19. 

Because of their intellectual disabilities, many of the AABR clients are unable to speak, let alone comprehend and follow safe social distancing and isolation rules, and the virus appears to be spreading rapidly within their facilities.

"It’s a pretty big ask to ask folks to take care of individuals, and they don’t have the protective equipment that they need,” Traynor said.


Survival of the Fittest

People affected by disabling conditions are worried that they might suffer from the rationing of hospital resources.  In times of crisis political correctness goes out of the window and it is back to survival of the fittest.  Younger healthier people get priority because they have more potential future years ahead of them and they recover faster and make space for the next patient.
  
Complaining that it is not fair is not going to help you.  Assigning ventilators by lottery, as some suggested, is just deluded. Fortunately, rationing life-saving treatment is nothing new and systems are in place to maximize the public good.



He, too, asked the Department of Health and Human Services to take action to stop rationing.
The letter, dated March 18, asked the department to "quickly issue a notice to physicians and hospitals specifying the applicability of non-discrimination requirements" of federal disability civil rights law.
Romano says he got a response from Roger Severino, who heads the HHS Office for Civil Rights and that he's now been talking to officials there about taking action.
"We're working very, very closely and very hard to make sure that we get some form of guidance out to the medical community as soon as possible," Romano says.
It's still unclear. If the federal government will respond. And if so: How forcefully.

If you are at high risk, self-isolate.  It is up to you if you want to self-treat, but it is wise to know what you are doing.



An Arizona man has died and his wife is in critical condition after they ingested chloroquine phosphate - an aquarium cleaning product similar to drugs that have been named by US President Donald Trump as a potential treatment for coronavirus infection.
The couple, in their 60s, experienced immediate distress after swallowing the drug, an additive used at aquariums to clean fish tanks, according to Banner Health Hospital in Phoenix.
Chloroquine phosphate shares the same active ingredient as malaria drugs that Trump has touted as possibly effective against Covid-19, the potentially life-threatening disease caused by the coronavirus.

According to the CDC’s at-risk list, people with Classic/ Kanner’s/ Severe autism are at elevated risk from Covid-19.  I have my doubts that young people in this group are at any elevated risk, if they are in good general heath.  Admitting a child with this level of autism to hospital for several days, alone, might cause problems (for the child and the hospital).


Missed Chemotherapy

Many medical procedures have been cancelled.

People are complaining that the delay disembarking from their cruise ship is affecting their chemotherapy. 

They might want to skip the article below from an oncologist.




In the above article the oncologist is brutally frank about the benefit of chemotherapy in most cases.

In effect, she is saying not to worry if you have to stop your chemotherapy.  The positive results in trials do not reflect the real world, where people have comorbidities etc. She says that “Patients are often astonished to hear that common therapies offer less than 5% benefit. The more lines of chemotherapy, the less the chance of success. Hand in hand with benefit goes harm.”

You do wonder why the bar is set so low for not very effective cancer therapy and yet so high for autism therapy. One pill is supposed to works for hundreds of different autism variants. All avenues are pursued to treat a person with cancer, but no avenues are pursued for someone with autism and intellectual disability. 

The same is actually true with dementia drugs, which are pretty much a placebo for the family members, rather than an effective therapy.


Conclusion

The currently recommended Chinese solution is mass testing to identify all those carrying the virus, most of whom have minor symptoms or no symptoms and then isolate them, so they cannot infect their family members and others.

My solution would be mass treatment of healthy people (no people with abnormal ECGs) with prophylactic doses of Chloroquine, to stop the virus spreading.  The drug is very cheap and it is much easier to make more of this drug than millions of ventilators. Once you take the drug the effect will last for weeks (the half-life is one month), so you could treat whole cities, one by one.  Many old people with arthritis take chloroquine or hydroxychloroquine every day, so I think the QT risk can be managed. 

Chinese doctors found that treating health workers with prophylactic doses of Chloroquine gave them protection from catching the virus from their patients.  15% of those with confirmed Covid-19 in Spain are health workers, so a little advice from China might be in order.   A trial in the UK is planned.

Chloroquine Prevention of Coronavirus Disease (COVID-19) in the Healthcare Setting (COPCOV)

Once hospitals get over-loaded, as they now are in Italy and parts of Spain, there are inevitably people who do not get fully treated.

If you are in the CDC’s at-risk group, it would seem smart to start treatment at home, when the symptoms start, and hopefully avoid the need for triage and “frailty” assessment a few days later.

Anti-viral therapy is most effective when taken early on and in later stages, not surprisingly, has little benefit.

Fish tank cleaner will kill you rather than the virus, but the pharmaceuticals proposed in the medical guidance note from Belgium are saving lives.