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[Pilotpilot]

Protocol for most treatments in America.

Attached Files

•  EVMS_Critical_Care_COVID-19_Protocol.pdf   612.52KB   32 downloads

[Investment novice]

Great write up. The chloroquin was the jet fuel... But this is a company I'm demand for a number of business lines. It's only uphill from here.

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[Lionelza1]

Thanks for the thoughts guys... Personally for me, it's a health share and I doubt Mr Market has priced in the effects of covid-19.... No1 saw this comming

So for me.... I Tata MA chance and hope not to see my arse haha

[Pilotpilot]

So what is going on with Ascendis?? How does a share go from 60c to more than R1-62 in 2 trading days and now retract down to 90c/share five trading days later?

 

In short, Ascendis (ASC) came out with a statement on the 9th of April that they manufacture Chloroquine and that there has been a significant demand for it. They are also running at full capacity supplying test kits, medical devices (ie. Respirators), medicines, masks, glove, vitamins, all being crucial in the fight against Covid-19.

 

Their share price shot up from 60c to R1-44, gaining 140% in one day, and closing at R1-62 the day after (reaching highs of R2-29). The day before the announcement was also interesting. Their share price rose from 46c to 60c, gaining 30%. This in itself should have raised some eyebrows, and maybe indicating that the news was available to some larger investors. But let's not go there......enough said.

 

2 o' Clock the afternoon of the statement's release, I added ASC's data into my program and couldn't believe the result. R6-89 in a year's time!! Obviously I had made a mistake?.........but after checking it for the third time, the figure stayed at R6-89. It was giving a 375% y-y growth rate to a share!!? The best figure I have seen before this was Sasol at R23-00 and showing 220+% growth with a target price of R75-00.

 

I have learned to accept my program's calculations, and not ask how, but why is it giving these values. So I had to dig into the fundamentals to find reasons why the market is giving this high of a value to ASC?

 

Looking at the daily graph over a 5 year period, the events of the past 7 days does not even look that significant. It looks like a small sharp hill after a very big long downhill on your Strava elevation map. It's then that you realize that the R6-90 price tag does not look out of place in the bigger picture, after all, ASC has traded at R4-80 only 6 months ago and has been as high as R28-00 in the last 4 years.

 

So what happened since then? The main criticism about ASC has been the amount of debt they have, especially with regards to their market cap. In finding a valuation for ASC, the best way was to compare it to its peers. Aspen was chosen, as it is in the same sector, also with a global footprint and is competing with many of the same products that ASC supplies. So let's look at the debt.

 

Debt to Equity(or Debt to Market Cap) is not always the issue with most companies. For example, Sasol has lawsuits against them for a total value of about R180-00 per share and yet they traded at R22-00/share. Earnings are one of the main things lenders are concerned about when they lend money. They want to know that you can keep on repaying every month and still show a profit. A bank wants to know that your income, less expenses, can cover your payments........simple as that. So comparing ASC's total liabilities of R8.88B to Aspen's liabilities of R61.75B and their earnings of R1,01b and R5,4b respectively. We now see Debt to earnings ratios of 8,79 vs 11,43. So, in fact, ASC has less liabilities compared to their earnings than Aspen has.

 

Ascendis has sold 4 of their loss-making businesses over the past 2 years and as a result, has increased their earnings and it showed in the last financials.

 

So let's look at the growth figures for the last 6months' financials between ASC and APN.

 

Aspen - Revenue up 3% , EBITDA flat at 0%

 

Ascendis - Revenue up 12%, EBITDA up 6%

 

The division that showed the most growth was Remedica, which showed 30% growth compared to the previous period. They are based in Cypris and a large player in Europe and contribute about 55% of the group's earnings. With the Rand weakening by 30% vs the Euro over the past 4,5 months, these earnings have increased significantly. Taken into account that they are running at maximum production with Covid-19 over this period, and supplying some of the worst struck areas of Covid-19 (Great Britain, Italy, Spain etc.) with supplies, their earnings will contribute a lot to future earnings.

 

Ascendis has also impaired their intangible assets (Goodwill, Brands, Trademarks and Patents) by R4,7b, and thus cleaning their balance sheet. This has caused the Asset Value to decrease considerably. ASC 's Intangible assets now make up 47% of their total assets and APN's Intangible assets make up 55%.

 

In the healthcare sector, Aspen, Adcock Ingram, Medi Clinic and Netcare have PE ratios of between 9.04 and 10.9. So let's say we believe ASC to be 2/3 as good as Aspen and put them on a 6.6 PE, although they are showing better growth figures and have better revenue prospects. That would mean a share price of R4-00 per share currently. With the strengthening of Euro vs Rand (by 30%) and maximum production on most divisions, this price should be 20-40% higher on total earnings, which would mean a current share price of between R4-80 and R5-60. ASC has 70% of its assets in foreign countries and this would further contribute to its value.

 

Looking at Macroeconomic conditions, the healthcare stocks are defensive stocks and these are the first to recover at the end of a market cycle. Most of these shares have fallen out of favor over the past 4 years and have been in a bear trend since.

 

My quick valuation method is as follows. Company value = NAV + 3-6 years predicted earnings. For the NAV, I use Tangible assets + 1/2 the Intangible assets)- less Total Liabilities. For a premium defensive stock, it would be more towards the 6-year earnings, but in this case, I will use 4 years. Fair value for their NAV would be at around R0-80/share and 4 years' earnings at 6% growth would be (R1-26+R1-34+R1-40+R1-48) = R5-48 + R0-80 = R6-28 (Current valuation)

 

I can now understand why my program is projecting a R6-89 share price for ASC over the next year and an upper trading limit of R17-05.

 

Even if you take the Chloroquine, Test Kits, Respirators, Masks etc. out of the equation, this is still the Health Share with the best value and most upside potential at 90c/share.

 

Chloroquine and Covid-19 will surely be helping their cause, especially in Europe.

 

Stay safe

 

 

Attached Files

•  Aspen-Ascendis Statements.xlsx   28.96KB   9 downloads

[Investment novice]

Buy and look away, similar for other stocks. Except sasol... This bad boy going to find r15 soon

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[Spell Jammer]

And that's the problem, if market is forward looking surely this share shud run up based on those assumptions?

I'm already in so I hope your theory tops my thinking... And I'm thinking it's comming back to hhmm 50c

Anything is possible in these markets theoretically after yesterday. Who would ever think that oil could go negative. That means that other commodities like platinum and palladium could as well.

The risk has to be worth the reward for you. On this one if the management act decisively in the next week weeks/months, there should be a turnaround in my opinion.

[Lionelza1]

It shouldn't see 60. The range will likely be 80-100c until Sunwave and Farmalider are sold will reduce debt by a Billion. Remedica is now producing profit for them which strengthens their case to either sell at a higher price which will clear all of their debt or sell parts of it to keep European earning potential.

Once the sale of the first 2 starts, this share is definitely going to R3, no ifs or buts.

And that's the problem, if market is forward looking surely this share shud run up based on those assumptions?

I'm already in so I hope your theory tops my thinking... And I'm thinking it's comming back to hhmm 50c

[Investment novice]

Sent this below... The tide she going to turn.. The tsunami... Pullback and then the rush for the Share...we got the initial sense with the move from 40c to r2....... Dont say we did not pump...

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[Investment novice]

POST MORTEM RESULTS ARE GRADUALLY REVEALING THE PATHOPHYSIOLOGY OF COVID 19 DISEASES.

Based on observations in USA, Spain, Italy, France and UK, and from postmortem of lungs involvement in COVID 19 , all revealed pulmonary thrombosis which is not typical ARDS , but more alarming that it is patient hypoxemia that is not responding to PEEP but high oxygen flow.

Like methemoglobin, the COVID 19 virus structural protein, sticks to heme - displaces oxygen - which release iron-free ion , that leads to toxicity and causes inflammation of alveolar macrophages- that results in bilateral CT scan changes as it is a systemic response.


There is No benefit of invasive ventilation, but patients May require frequent blood transfusions or plasmapheresis.



The COVID 19 virus attacks beta chain, dissociates heme, removing iron and converting it to porphyrin. The virus can dissociate oxy-Hb, carboxy-Hb and
glycosylated Hb.

Lung inflammation results from the inability of both oxygen and CO2 exchange, leading to the ground glass on x rays, it mimics CO2 poisoning as an invisible enemy.



Chloroquine competes for the binding to porphyrin.

Favipiravir binds to the virus envelope protein with very high affinity, prevents entry into the cells as well as binding of the structural protein to porphyrin.



If free radicals scavengers and iron chelating agents are added to the protocol of management, it may lessen the inflammation process.



COVID 19, SARS2 is not 'pneumonia' nor ARDS. Invasive ventilation is not only the wrong solution, but emergency intubation can harm and result in more damage, not to mention complications from tracheal scarring and stiff lung during the duration of intubation.

Furthermore, a new treatment protocol needs to be established, so we stop treating patients for the wrong disease.

COVID-19 causes prolonged and progressive hypoxia by binding to the heme groups in the red blood cells.

People are desaturating due to failure of the blood to carry oxygen.

This will lead to multi-organ failure and high mortality.The lung damage seen on CT scans is due to the oxidative iron released from the haemolysed red blood cells which in turn overwhelm the natural defences against pulmonary oxidative stress and causes what is known as Cytokine storm.

There is always-bilateral ground-glass opacity in the lungs. Recurrent admission for post-hypoxic leukoencephalopathy fortifies our findings that COVID-19 patients are suffering from metabolic hypoxia due to blood capacity failure.



COVID-19 glycoproteins bond to the heme in RBC, and in doing so, the toxic oxidative iron ion is disassociated and released. The freely roaming iron in the blood without any physiological function will culminate into the following;



1) Without the iron ion, haemoglobin can no longer bind to oxygen. Once the haemoglobin is impaired, the red blood cell is essentially none functioning in carrying and delivering oxygen to any tissues.



RBC's Become useless and a burden on the patients as they circulate around with COVID-19 virus attached to its porphyrin. This lead to the destruction of the red blood cells and the patient's oxygen saturation levels drop significantly.



What is happening equates to carbon monoxide poisoning, in which carbon monoxide is bound to the haemoglobin with the failure of gas exchange.

Ventilations will not manage the root cause, which is blood organ failure.



COVID 19 patients, unlike CO poisoning in which eventually the CO can break off, the affected haemoglobin is permanently stripped of its ability to carry oxygen where the body compensates by secreting excess erythropoietin to stimulate the bone marrow to secrete new red blood cells. This is the reason we will find thrombocytosis and decreased blood oxygen saturation as one of the three primary indicators of COVID 19 severity score.



2) The freely floating iron ion are highly reactive and causes oxidative damage. This always happens physiologically and naturally to a limited extent in our bodies and such cleanup is a defence mechanism to keep the balance.



The Three primary Lung defences to maintain "iron homeostasis", 2 of them are in the alveoli.

The first of the two are macrophages that roam around and scavenge up the free radicals of the oxidative iron. The second is a lining on the epithelial surface which has a thin layer of fluid packed with high levels of antioxidant molecules such as ascorbic acid (Vitamin C) among others.



When too much iron is in circulation, it begins to overwhelm the lungs' counter measures begins, the process of pulmonary oxidative stress. This leads to damage and inflammation, which leads to the so-called Cytokine storm; this can be documented on high-resolution CT scans of

In COVID-19 patient lungs, It is a fact that it affects both lungs at the same time and Pneumonia rarely ever does that, but COVID-19 does every single time.



The liver is attempting to do its best to remove the iron and store it in its 'iron vault'. Only its getting overwhelmed too. It is starved for oxygen and fighting a losing battle from all the haemolysis haemoglobin and the freed iron ion. The liver will start releasing alanine aminotransferase (ALT) which is the second of 3 primary COVID 19 severity score indicators.



A patient must be managed on maximum oxygen flow through a hyperbaric chamber on 100% oxygen at double or multiple atmospheres of pressure, for 90 minutes twice per day for five days.



This is in order to give what has left of their functioning haemoglobin a chance to carry enough oxygen to the organs and keep them alive.



We do not have nearly enough of those hyperbaric chambers, and we might use all parked grounded aeroplanes as a ready-made functional hyperbaric chamber with the advantage of providing double atmospheric pressure with an aerosol of prostacyclin as pulmonary hypertension modulator.



Blood transfusion with packed fresh red blood cells to patients after plasmapheresis may ameliorate the cytokine storm.

The main point that patients will require ventilators if they present late with multi-organ system failure to tie them over this life or death scenario. However, intubation is futile unless the patient's immune system modulates the situation. We must address the root of the illness and avoid using traditional teachings to manage a failing system.



3) No longer armchair pseudo-physicians sit in their little ivory towers, proclaiming "Chloroquine use is stupid as malaria is bacteria, COVID-19 is a virus, anti-bacteria drug no work on the virus!". A drug does not need to act on the pathogen to be effective directly. Chloroquine lowers the blood pH and interferes with the replication of the virus.



We advise that if COVID-19 positive patients are conscious, alert, compliant, they must be kept on maximum oxygen and initiate hyperbaric oxygen as early as possible.



If we reach the inevitably to ventilate, it must be done at low pressure but with maximum oxygen flow. We must avoid tearing up the lungs with maximum PEEP as we are doing more harm to the patient because we are managing the wrong organ.



There is a small village in northern Italy where the majority of its population suffers from thalassemia. They had no deaths and no cross-community spread. Moreover, parts of Nepal which are 1km above sea level are COVID-19 free. All points that we are chasing the wrong organ; it is not the lungs; it is a blood problem.



We recommend the following :



1. Inhibit viral growth and replication by the adjuvant use of CHQ+ZPAK+ZINC or other retroviral therapies being studies. The less virus load we have, the less haemoglobin is losing its iron, the less severity and damage with the prevention of cytokine storm.
2. Hyperbaric medicine utilization in any shape or form for anyone with thrombocytosis and elevated ALT can prevent the rapid ascent to the abyss.
3. Plasmapheresis and Blood transfusions will give supportive symptomatic relief.
4. No international Travel until an effective vaccine is available.
5. Cessation of tobacco, vaping and alcohol products.

Stay safe and Self Isolate

Sincerely

Prof Sherif Sultan MD, FRCS, FACS, PhD
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[Spell Jammer]

Dropped below R1... Now there's kak, Andi's slow poison could be correct

It shouldn't see 60. The range will likely be 80-100c until Sunwave and Farmalider are sold will reduce debt by a Billion. Remedica is now producing profit for them which strengthens their case to either sell at a higher price which will clear all of their debt or sell parts of it to keep European earning potential.

 

Once the sale of the first 2 starts, this share is definitely going to R3, no ifs or buts.

[Lionelza1]

Dropped below R1... Now there's kak, Andi's slow poison could be correct

[Investment novice]

Profit taking and speculative buyers... Buy and look away... Hoping to get a lot more end month when salary comes in.
If you aware about pharma market you will know this is currently a hot potato and there is lots Goin on in the back ground. We shod be getting some news soon.


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[soutie]

There has been lots of social media craze about covid being fake news.
...... All course mortality rate which is market of all deaths following seasonality..... This single measure indicates that we are in big trouble... And that covid is real or something is killing people.. If there was any hidden agenda and lying this rate would be normalised.......
The worst thing trump media can do is calm people using lies...
Our President is fighting a war and is buying us time...

This company is full into the war and pumping.... Demand on the ground is up... Crazy and desperate.

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Why's it dropping +/- 6% per day then....?

[Investment novice]

There has been lots of social media craze about covid being fake news.
...... All course mortality rate which is market of all deaths following seasonality..... This single measure indicates that we are in big trouble... And that covid is real or something is killing people.. If there was any hidden agenda and lying this rate would be normalised.......
The worst thing trump media can do is calm people using lies...
Our President is fighting a war and is buying us time...

This company is full into the war and pumping.... Demand on the ground is up... Crazy and desperate.

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[Investment novice]

Please check this... Treatment approach will be staggered with a primary care protocol. Early admission and icu protocol.. Learning so much every day.
There is a blood transfusion and preparation, lab type stuff used for icu and serious ill. Very limited products. Asc has these also.
Not sure when to start jumping... This company sitting on assets right through treatment value chain....

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[Investment novice]

Thanks Andi. Will get more. Remedica will sell for 8 billion.

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[Pilotpilot]

Keith McLachlan gave his view on the valuation of ASC in Sep 2016.

 

http://smallcaps.co....tive-valuation/

 

I will post on the valuation as well, but this gives another perspective, at a time when ASC's share price was R28-00. 

 

[andi222]

think Andi just wants the market to come down so he can get more. Listen. I have never been so convinced of a company and product portfolio. I reduced my snh holding by 80 percent and placed all here.. It would have been 100% but kept 20% sentimental...
No matter what you think.. This is a life savior and I will jump on this ship even at R8, as the acquisition price may be r10.... Or even the delisting price. I bought at 1.60....did not care it drops to 20c even because my exit in two months is R10... In 4 weeks we going to be in our ears corona. And the Rand is going further south and this babe is a hedge as well as a money spinner..

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Hi IN, whatever we say here on the forum won't have a substantial impact on any medium to large cap company. That you can be assured of. 

I have learned to be patient in my years of investing and to realize profits and to look away. 

 

ASC has one substantial problem and thats its debt. As you have mentioned current debt lies at 5 billion with a company market cap of at around 600 Million. That's a ratio of basically 1 to 10. 

Its equity lies at 2 Billion rands- Now scrap the Intangible assets and Goodwill and you are at a negative 3 Billion rand. 

 

ASC cannot trade itself out of this situtation with or without Corona etc. They have to sell Remedica at a price that would help to repay basically all of its debt. 

If there is no news anytime soon there will be slow poisoning on the share price.

 

A good risk reward ration lies around 50 and 60 cents. And that's were I will be willing to enter again. 

As mentioned before this is just my own opinion. 

 

Going back in this threat you can read up on the pros I have mentioned of this company.

[Investment novice]

Some lekkah stuff coming through on media on drugs to treat rhuematoid arthritis and ecmo, and use of chloroquine...
Ascendis got feet in all of this...
Debt r5 billion.. Assets worth alot more. Market cap r600, what's the next logical steps........ Private equity takeover.

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[Investment novice]

Ouch???? They need quick money...they multiplying their liquidity over and over... What you see as eish is actually brilliant... Resizing... Perhaps they have a quick deal they posturing for with a brand that may not take this due to competition... Maybe they working in reverse.. To quicken a clearance...... Not all that we see meets the eye.. And the market moves slow... And now it's time for us to load as much as you can

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