triplehorn

You'd think I'm red hatter, huh. Across 3 states, of the multiple docs I know who are prescribing this for their patients, or who have a prescription on hand for themselves in the event they do catch Covid, not a single one is a Trumper. This is about medically informed pragmatism. If I lived in Texas where docs can freely prescribe this regimen off label for covid, and if I were of an age and had a medical history that put me at relatively higher risk of complicated illness, I would seek it to have it on hand in the event I got infected or request it if I got sick. Personally, even if there are outstanding questions needing clarification about best use for covid, it's not a hard choice at all because it all starts with safety. The safety scare in the US has to be the biggest charade affecting the practice of medicine I've ever witnessed. It's really saddening to observe in real time.

Where'd you see she's not practicing? link would be great. She's describing her own experience treating patients. That website you linked indicates she's active and practicing on the ER frontlines today. Looking at this without political bias, I can't find anything I disagree with in that interview about basically all the areas she speaks about, especially re safety. On masks, I wouldn't characterize what she said in the interview as anti-mask because she doesn't discourage use, but she clearly doesn't see that as the answer alone.

JFC, what.

Your first criticism of the study should be There's a LOT of positive studies out: https://c19study.com/ - site is updated with new studies regularly as they become available. Negative studies are listed as well. Really helpful conversation about safety, why a drug is OTC or not, off-label prescribing and what it means, and how the invisible hand of business and politics on health care decisions between physicians and patients in this pandemic are making matters much worse. People are being denied a treatment that many studies show works, that over 2 dozen nations are widely employing with apparent major benefit, all when health side effects are negligible. This ER doc gets it:

Watching that second video, with the hands in the air and cadence of the chant, you might as well be at Portland Thorns soccer match. Same local citizens.

Anyone familiar with the lifespan of protests in Portland knows it probably doesn't count as a protest until it's been 60 consecutive days. The Occupy Wall Street protests that started around the country in 2011 died down in Portland after a couple months, but there was an operational OWS protest camp downtown for what had to be 6-9 months. at least. There's obvious losses and costs incurred with this, as was the case across the country, but state and local officials best know its constituents and how to de-escalate it even if it takes a longer period of time than pretty much anywhere in the US. Everything was dying down and street level windows were getting un-boarded before Trump's goon squad arrived. Portland proper is very tolerant and that generalizes to the local population. Portland is too tolerant of the homeless situation for my liking (which is way more organized than most people would ever imagine). It has a quantifiable negative economic impact on businesses located near it. People are wary and complain but it doesn't result in mass escalation. Point being I haven't perceived any widespread panic or fear from the local population with this current protest. The situation blows, but it's not unfamiliar and hardly out of hand by Portland standards.

Today, my first ever 20mi. trail run is in the books. Continuous uphill 10mi and 3000ft vert, 10mi 3000ft descent. Did it in 2:35 up and 2:32 down. Last week had no real exercise so I ran a 7mi 600ft vert trail run yesterday to warm up. Turns out I've got some acute ileotibial-band pain flaring on the upper outside of my knee. After initially getting it a week ago coming off the summit of my second trail run ever, I noticed it yesterday on the 7mi again as soon as I started a descent. But it was completely gone 2 hours after the run. So decided to try the 20 mile today. It got my attention again barely 2 miles into the start today and it slowed me a lot all told. Everything else was great. Without the knee, I could have kept going. I'm open to some runner wisdom here on how to minimize this ITB flare. I know I could do a far better job at routine purposeful stretching. pic of an elbow in the PCT trail at the top of a canyon today: couple other pics:

Just found out 3 extended family relatives tested positive in Canyon (small town outside of Amarillo), 2 in 20’s and one 60y/o. Self quarantine? Nope. The two young ones already went to hang with other family in Aledo. With that kind of continued mobile indifference, no place will be spared.

Lancet study that got folded into the WaPo article a few days ago and referenced via hyperlink. The hyperlinked article elaborated on the findings of the study without any updates on the retraction, only vague references to controversy over the data, but extensive detail written on findings that are now unsubstantiated. The fact you are asking about 'which study' kind of underscores how many people read these articles with the result being a misinformed understanding. Why is it happening? follow the damn money.

I have a hunch this is the WH task force being led by the business front of Gilead, not the other way around. Based on what we know about the drug's efficacy and side effects, that news quote sure looks like reverse psychology applied in full effect. With billions for the pharma taking in the US amidst an accelerating viral inferno, remdesivir is being elevated almost entirely by PR manipulation and an incompletely informed if not willingly compliant press.

Right now, I am spontaneously coming full circle back to running, which I really haven't thought about advancing since before college. For years, I've been all ski mountaineering and vertical conditioning hikes to have enough gas to reach the top and make it safely back down. Been keeping up with it this spring (fresh air ftw) and did 5k ft of vertical twice in 3 days and a 13mi 7k ft vert climb up Mt Adams. Climbing Adams a couple weeks ago, a friend noticed I was wearing some Hoka ATRs as approach shoes before reaching snow level for skis and he talked up trail running. Never really took that path before. In the last two weeks I just started running when I could, or fast walking on steeper sections of trails, just always pushing the rate. Two running hikes in the last two weeks and it's like a running switch got flipped on in my brain. I did a 15.5 mi out and back with a 4300 ft climb Friday with about 40-50% running. I felt wrecked for the rest of the day but felt amazing the next day and still feeling the wave. Now I'm doing a deep dive into the light. Light trail running shoes, light running packs, light collapsable running poles, packable water filters on collapsable bottles. Today I'm locked in to mapping and prepping for a 20mi rounder with 3500 ft vert later this week on a section of the Pacific Crest Trail that sidles along a side of Mt Hood. PCT is well maintained with no technical sections, so should mean lots of track to run. Seems totally alien to think I'll be trying to run most of 20 miles up a mountain in a few days. Will see how it goes and figure out how to advance from it. Salt tabs are also the last thing I expected to be thinking about.

Here, they're dividing our neighborhood middle school into 2 cohorts - a Mon/Tu group and Th/Fri for in-school classwork. The other 3 days are online. The goal is to physically spread out the kids with half as many there per day while maintaining the social/face to face teaching/school experience. They'll scrub the school down each weekend and every Wed to keep the two cohorts separate from an infection control standpoint. The first two weeks of school will be 100% online, and it's clear that reverting to100% online is the fall back if it blows up. They also readily acknowledge it could blow up before school starts and just go 100% online. The initial 2 week 100% online sets initial expectations and we'll see where we are in September.

I read the WaPo article above stemming from the positive findings in the Henry Ford study and the WaPo article ("three major randomized trials" that have found *** is not effective in treating or preventing covid-19) that is embedded with a link in the article. I generally have a positive regard for WaPo, but the reporting here is garbage in that it lacks critical medical nuance needed to understand essential distinctions in research to date, and additionally STILL incorporates a fake study into the media reporting sausage to shape perception. jfc. It's also striking how medical reporting on this in the US is confined to the relative vacuum of US studies. Internationally, there's over 50 to date with positive findings. The 14 negative studies mentioned in the 50+ study link have something in common - late intervention/already severe cases. That's instructive. And anytime you have big pharma giving any oxygen whatsoever to the drug that will not be named, that tells you all you need to know about whether or not they see it as a viable and legitimate threat to their bottom line. Like this Gilead press release from 3 days ago . (You have to get half way through it to spot the talking point against _***). Not to mention re-splicing data into a 14 day window to capture the favorable spin for their own product. ignorance and greed stirred with politics is the fucking deadly cocktail people need to be aware of.

So with the commuted sentence (not actual pardon) Stone still carries the conviction, just no prison time. Why a commuted sentence instead of pardon? It means he can’t be compelled to testify. Same arrangement Scooter Libby got. in Libby’s case, he still paid a fine and got disbarred. Felony conviction won’t stop Stone from going right back into his groove.

toasted marshmallow impersonates a beargrass blossom

I really don't get your negative response to the interview. I didn't read it as him being an expert and a guiding light. It's what he reveals about forces affecting pragmatism and influencing process. Nothing earthshaking that we haven't known before, just more confirmation it's happening with negative consequences during a deadly pandemic causing death and disability. The lack of coherent national communication and apolitical decision making in the US (no CR) has created a void that naturally is being filled by those intent on maximizing profit and/or sowing confusion. The US historically has been a primary leader in medical problem solving and response, but right now there's quite a role reversal happening. Private US physicians are reaching out across borders to learn if they can help their patients avoid hospitalization and they are clearly taking action. However as it relates to access to timely outpatient care for covid19, should they want it, a giant swath of Americans infected with covid19 are left on the outside looking in. Here, forget about early treatment options, the first 3 months in the US was about where the hell you could even get fucking tested. The stated philosophy: "First, we must do everything within our power to address this disease earlier in the process. That is why the development of anti-viral medications targeting COVID-19 are so important. Ivermectin happens to have an incredible inhibiting effect on COVID-19 and we were pragmatic. Dominican Republic is blessed with beauty everywhere, incredible people and a great potential for business but it is still a relatively poor country. We don’t have the time to wait. We must treat as many people as possible and reduce the number of severe to critical cases." This is the key advantage to having safe and inexpensive generic medications available for off-label use (Iver is ~$0.12 per dose). Due to established safety with minimal or known potential side effects, you can give them without knowing what the exact future course of illness holds for each person. It can be limited to use in people with risk factors like age and medical co-morbidities, but ultimately it's an individual choice to gamble against briefly taking a safe med or becoming one of the unfortunate ones to experience disability or death. When observed through the lens of US media coverage, what he says about Ivermectin in the context of comparing to Remdesivir is also revealing wrt the lack of coverage of what is known and being done with off-label medications, repeating and amplifying unsubstantiated negative stories, and the unwarranted boosting of remdesivir. The study that led to Gilead's billion dollar windfall in the US did not even find a significant mortality reducing effect, only that length of hospital stay was reduced by 4 days in people who survived. With Ivermectin, they are observing an early illness reducing effect from 21 days to 10 days duration which has a direct impact on overall virus transmission in a population. The transmission reducing effect would also be true for infected young healthy people who are potential super-spreaders. Re several comments about Ivermectin used for heart worms in dogs and horses etc., realize it was first prescribed for people, not animals, to treat infectious disease, and has continued to be used in people on a very large scale. But that's also the case in like 99% of medications used in vet medicine for surgery, endocrine problems, infectious disease, and so on. A total red herring.

Really a great interview on the use of Ivermectin in the DR: President of Dominican Republic’s Largest Private Health Group Discusses the Success of Ivermectin as a Treatment for Early Stage COVID-19 Interesting bit re currents in US medical practice and the weighty thumb of big pharma: Treat early early early When time and money are lacking for RCTs, on the indispensable life saving value of Observational Studies in the context of an established safety profile: cont.

In all seriousness, it's used in people to treat threadworm infections and has a long safety track record. It appears effective vs covid19 at the same doses used to treat parasites in humans. Also has oral availability which means you can take it early, before you're parked in the hospital with ground glass opacities in the lungs. With Remdesivir, it's only available in IV form, which means the US will be paying over $3k per case to reduce length hospital stay by up to 4 days in people parked in the hospital with glass lungs. Double score for Gilead.

Emerging results of Favipiravir and Ivermectin, for one. And the drug that will not be named is being distributed in Brazil via telemedicine consults and pre-packaged polypharm med kits to essentially collapse hospitalizations/deaths despite soaring national case numbers. Kudos to the business face of Gilead though. They scored.

Alternatively, ponder that for a variety of reasons we in the US may have just paid Gilead too much for a drug the rest of the world doesn't exactly want or need.

Adams south climb. that's Hood with Jefferson over the shoulder

Last Friday I climbed well over a vertical mile and a quarter. Probably would have passed out and rolled down backwards wearing a mask. At the barest minimum, do not want to get my lungs fucked up by this bug.

quoting myself here as a follow-up. This is a an excerpt from an email I received today from the Oregon Health Authority. Note they are using a 4 week window to assess severity and end result incidence of death: If decreased severity equals decreased incidence of chronic pulmonary fibrosis in younger non-hospitalized and otherwise healthy people, that would be very, very welcome.

While this is no reason to let our guard down at all, testing viral genomics of covid-19 turned up evidence of ORF7a deletion in a sample in Arizona in May and now the same deletion in Thailand. An analogous ORF7a deletion is what was observed with SARS coronavirus in 2003 and was associated with slowing of the pandemic. SARS and MERS subsided on their own (without vaccines). The genomes of RNA viruses are less stable than DNA viruses, and decreased virulence through mutation is one mechanism thought to promote greater viral transmission, which in this case could mean less incapacitating and lethal in order to live and move about to promote spread. It's not conclusive of a definitive shift by any means, but spotting the ORF7a deletion in different parts of the world speaks to real time evidence of viral changes that can have substantial effects on the natural course of this bug based on past experience with SARS.