triplehorn

India's Council of Medical Research (ICMR) all aboard the Darjeeling prophylaxis express based off of 3 of their own studies: ICMR finds it’s effective in preventing coronavirus, expands its use ICMR's official notice: Revised advisory on the use of Hydroxychloroquine (HCQ) as prophylaxis for SARS-CoV-2 infection (in supersession of previous advisory dated 23rd March, 2020)

The delineation is subject inclusion based on need for hospitalization. Show me a study where early treatment, pre-hospitalization, had no benefit. The study mentioned above this morning involves hospitalized patients, ie advanced illness. This is basic stuff. There are myriad examples in medicine where timing of an intervention has everything to do with whether or not treatment produces the desired outcome. If you give it too late, little or no benefit. Even your average Joe understands this. Only I'm not politicizing this issue. Trump doesn't understand the first thing about any distinction in timing. He's fucked this up beyond recognition.

What are you talking about? Please, say more. I'm persuadable.

This was a full two months ago, you know, back when the US had 400 deaths total: Dr. Pier Luigi Bartoletti, Deputy National Secretary of the Italian Federation of General Practitioners

“The new analysis — by Mandeep Mehra, a Harvard Medical School professor and physician at Brigham and Women’s Hospital, and colleagues at other institutions — included patients with a positive laboratory test for covid-19 who were hospitalized between Dec. 20, 2019, and April 14, 2020, at 671 medical centers worldwide. The mean age was 54 years, and 53 percent were men. Those who were on mechanical ventilators or who received remdesivir, an antiviral drug made by Gilead Sciences that has shown promise in decreasing recovery times, were excluded.” ——> goddammit. hospitalized patients AGAIN. These are patients who largely have advanced illness by which point the window of benefits for quinine derivatives has passed. So this study just reinforces what we already knew.

There could be any number of explanations, but the simple one is that there's still an awful lot of potential burn time:

Seeing posts above, it just underscores how important it is to have - at the highest levels - careful and clear communication from competent authorities who understand these matters. People are rightfully scared about their health and safety. But chaotic messaging leads to both missed opportunities for good and misinformed judgement leading to harm.

An accessible and fairly extensive summary of global research findings (French news source) for Covid treatment interventions to date: Treatment of Professor Raoult: update on current knowledge, study by study If your pc doesn't translate it, try this: The Link

South Korea stats studying long term care facilities vs. Ron DeSantis' numbers. messenger blamer, ftw.

Not sure why you quoted me, but your message is true regarding danger with ingestion by kids. Definitely keep out of the hands of children.

The US was late to the dance to do something. Asleep at the wheel. Full stop. If you put any stock in the work and reporting from medical scientists in other nations to date, it's not backwards. I'm looking at the protocols and actions of multiple other nations and their associated evidence based findings resulting in them incorporating early and late application of HCQ into their national protocols. here's another:

In other words, their findings are that it's effective against death, not the virus. Technically, the term 'COVID' relates to the resulting disease, not the virus proper. If we can reduce the extent to which the disease process is associated with a death outcome, by whatever path, that's winning. Giving HCQ in higher doses, if needed, for early intervention or prophylaxis is probably a lot safer than higher doses once you have complicated advanced disease process unfolding. At the complicated stage, cumulative and systemic metabolic imbalances can make electrophysiologic events like arrhythmia with HCQ or HCQ/AZ more unpredictable and dangerous. Isolated one-time seizures out of the blue also happen under similar adverse electrophysiologic circumstances. So you try to avoid things that nudge an imbalance further in the wrong direction. HCQ in stable people with early Cov infection (without significant disease progression) probably have the same risk as the millions of people who have taken it for lupus. RA. and malaria for decades. Ongoing NY/WA study: Study will test if hydroxychloroquine can prevent COVID-19 - results expected by summer Another: University of Minnesota COVID-19 Pre-Exposure Prophylaxis Clinical Trial

Like I said just above, I'm taking a general advocacy stance until it's demonstrated to be of no benefit in early intervention or prophylaxis. Here's one that published 5 days ago: Low dose of hydroxychloroquine reduces fatality of critically ill patients with COVID-19 notable table: They made these observations as well: "Furthermore, we analyzed the effects of different IL-6 levels on death risk in response to HCQ treatment and found that when the IL-6 levels were higher than 60 pg mL–1, patients were more severe. For patients with IL-6 levels higher than 60 pg mL–1, HCQ treatment decreased IL-6 level from 100.0 (62.6–189.4) pg mL–1 to 28.4 (10.9–59.3) pg mL–1 after 5 days’ treatment, and reached 9.8 (5.5–24.6) pg mL–1 after 10 days’ treatment. In contrast, in the NHCQ-treated patients, IL-6 levels were elevated from 87.5 (72.9–240.3) pg mL–1 to 92.4 (34.1–199.3) pg mL–1 after 5 days, and reached 110.4 (31.6–235.6) pg mL–1 after 10 days." ---> IL-6 is an immune response associated cytokine associated with complications like vasculitis affecting heart and lung function and collateral damage to other tissues. This likely plays a role when Cov patients acutely deteriorate.

It's also a CYA explanation to leave yourself an out for stockpiling it, should they need it. Again the takeaway is that they're studying its applicability and getting real time feedback as they simultaneously are opting to stockpile it. The thrust of the article isn't about covering for sufferers of lupus and RA. Given the controversy, it's a smart position to take. Look, no need to overthink this. If something were so dangerous, for anyone for any condition, it wouldn't be getting stockpiled for any reason. Replicated gold standard RCT studies are lacking today but there are a lot of other experimental designs and ways to assess what you've got now, and I'm struggling to find any country bailing on HCQ for Cov. It's the opposite outside of the US. I'm assuming a general advocacy stance for now and will ditch any consideration of HCQ for use in early intervention or prophylaxis should the science support abandoning it. So far it hasn't.

I understand. I thought through that before posting. It's a news article for public consumption. Their trials are ongoing meaning they get to see what's happening and make moves pre-completion, pre-publication. To put it another way, if they saw zilch, or worse something like more deaths associated with the HCQ/AZ arms, I don't think they'd be moving to bolster their national stockpile right now. There would be no anticipated global shortage if adding HCQ was a harbinger of death with cov. The plug would be getting pulled. And it is the most fucked up position to be in wrt to Trump in this discussion. It feels gross.

Or maybe Trump curbsided Modi. Almost half of the 10,000 policemen of Mumbai went for HCQ when offered to take it prophylactically. Not 'Murican and not doctors, but that's thousands right? Partial credit for the cretin, I say.

Daily dose of HCQ news: UK is stocking up on HCQ and AZ while their clinical trials are ongoing. Wonder what they're seeing. UK bulk buys hydroxychloroquine as potential Covid-19 treatment

Don't look at me. Look at what's happening basically everywhere else outside of the US. The UK scientists might be seeing something in the interim results of their ongoing studies. They've just moved to stock up on HCQ and AZ.

Looks like he was on the job for just a few weeks following his predecessor getting axed. It also appears this is about more than quinine derivatives. Brazil's entire pandemic response is a disaster of its own kind. Psychologically deformed leaders crossed with a natural science and math problem that undercuts their concocted version of reality will turn into a catastrophe every damn time.

More than anything, it's ripe for miscommunication and grates the hell of me having these autocrats (Trump included) driving the messaging around nuanced and touchy medical/science matters when the public should be addressed by the national health officials for their respective nations. I guess we'll learn more tomorrow about Bolso's protocol.

No offense, but you badly mis-comprehended what you read. The South Korean study on which the article is founded studied 285 subjects. It's stated in the second sentence of the article. The n=7 study you're stuck on is referenced in passing in the middle of the article. Those 7 people were tested 9-17 years later for presence of antibodies after having SARS infections. So they found 7 people to participate who had SARS infection 1-2 decades earlier. Not shocked. And what are these sunshine pumping articles with "incredibly low sample size" you are referencing? You're using plural, but point to just one you're talking about so I can respond in kind. And to be clear, I am advocating for specific studies to examine the potential benefit of very early intervention of HCQ to inhibit Covid from taking hold. There are trials underway, but even the just announced NIH study may only glancingly touch early intervention, instead incorporating mild cases, not necessarily very early stage infection. While I don't support mass use of HCQ without better evidence, the discourse has been badly perverted in the US and may create too big an obstacle to overcome in the event studies demonstrate benefit with defined parameters for a safe and effective application. I do think individual states and health care providers with informed consent from patients should be able to apply it now for off label use. I would not give it to complicated illness, signs of acute vasculitis, or those with cardiovascular disease. Best case is it saves lives and reduces transmission. Ideal worst case is that it is applied safely by a knowledgable provider even if no measurable benefit is observed. If diagnosed with Covid, I would be a consenting patient to receive it with zinc today, ASAP, but that's only my personal choice. Edit: I didn't read the above posts already catching your error.

Covid Patients Testing Positive After Recovery Aren’t Infectious, Study Shows

House impeachment investigation ongoing: House Democrats tell Supreme Court they need Mueller grand jury materials to decide on new articles of impeachment "The Democratic-led House of Representatives on Monday told the Supreme Court that the House needs secret Mueller grand jury materials to determine if there is new evidence of impeachable offenses involving President Donald Trump." "'The Committee's impeachment investigation related to obstruction of justice pertaining to the Russia investigation is ongoing,' Douglas Letter, the House general counsel, said in a court filing Monday. 'If this material reveals new evidence supporting the conclusion that President Trump committed impeachable offenses,' Letter said, 'the Committee will proceed accordingly -- including, if necessary, by considering whether to recommend new articles of impeachment.'"

"The mean duration from symptom onset to randomisation was 16.6 (SD 10.5; range 3-41) days" Over 2 weeks mean duration from symptom onset to randomization ? That ship has sailed.