triplehorn

My buddy on the Cali coast down in HB just received IgG/IgM antibody kits for his practice. Said it's wild west trying to get them - not shipping to individual docs yet. Ordered 160 and had to pick them up himself. I don't now. Hope they're legit.

Yeah. He's an actively licensed MD in NY w board cert. Some stories popping up now This doc is getting some socmed attention, but docs have been applying the SK/China protocols off label for weeks. It appears this Hasidic doc just happens to have a robust primary care practice in a major covid hotspot. So he's getting the actual volume of clinical cases in real time to make initial observations.

cross-posting this tweet (read the inset images of the report from the NY doc): Where this is headed: treating with HCHQ/Azith as early as possible MIGHT offer definitive advantages to limit complications and death from covid. The dilemma is that 1) still need blinded controlled studies to confirm 2) Our national per capita testing capacity and results turnaround time (avg. 4-7 days) is horrible and nullifies any advantage the meds may have if you rely on getting a test and waiting for a positive result. What does the NY docs report suggest? Consideration should be made by medical authority to offer treatment of presumptive covid infection in patients presenting with influenza-like symptoms and shortness of breath at any age, or patients with any ILI symptoms and co-morbid risk factors without waiting for a positive covid test result.

Yes: "The Food and Drug Administration on Sunday issued an emergency use authorization for hydroxychloroquine and chloroquine, decades-old malaria drugs championed by President Donald Trump for coronavirus treatment despite scant evidence. The agency allowed for the drugs to be "donated to the Strategic National Stockpile to be distributed and prescribed by doctors to hospitalized teen and adult patients with COVID-19, as appropriate, when a clinical trial is not available or feasible," HHS said in a statement, announcing that Sandoz donated 30 million doses of hydroxychloroquine to the stockpile and Bayer donated 1 million doses of chloroquine. (Diamond, 3/29)" Also note supply is not the issue right now, early detection is. Since the testing problem will take weeks at best to sort out, better to treat unconfirmed cases as soon as possible with medical review of history to assess safety of rx for each individual. If you've got any ILI with shortness of breath, or co-morbid risk factors with any ILI, you get it with your informed consent. Have that stuff prepackaged asap and handed out in 5 day bubble packs without need to go to the pharmacy.

No need to leverage myself when Ive got you and Sydney doing the heavy lifting. I guarantee you there are any number of people with access to concierge medical service who, in addition to their access to testing, have been getting this treatment for weeks. It's just so shitty that we didn't get a unified message out to contain the spread of this in time with aggressive social measures. There would have been more than adequate resources to help everyone better.

That's a blatant one for sure. He's also trying to put the toothpaste back in the tube in Michigan after shitting all over their Gov. If he had a prayer at swinging WA, he'd change his tune with WA Gov., but alas the assault continues. Trump is just an all around corrupt piece of shit who couldn't care less about saving lives if it doesn't boost his personal ambitions.

I've been a proponent of this approach all along (obviously). Note that due to lack of testing and poor turn around time when a test is available, this doc is using clinical presentation divided into 3 categories for presumptive positive treatment of covid. Even if blinded randomized controlled studies show that not only does HCQ/Azith tx help, but that it helps a lot more with early intervention compared to when advanced complications occur, we're still fucked because of our totally inadequate testing capacity and infrastructure. So this doc isn't letting that prevent him from what appears to be a life saving approach in war zone conditions. Good on him.

Sometimes you don't even need a test. South Austin's mom is AB+

Last sentence of the new study's abstract: "We believe other teams should urgently evaluate this cost-effective therapeutic strategy, to both avoid the spread of the disease and treat patients as soon as possible before severe respiratory irreversible complications take hold." I'm bullish on this. Again, MUST generate capacity for mass testing for everyone, symptomatic or not, with rapid turnaround (Abbot has their 15min test ready to go) and meds at the ready to dispense, ideally at point of testing and put on blast. *I know it's premature with obvious unknowns, but my gut tells me these things taken together for early intervention could be huge.

I still haven't read the study, but yes - the key is mass testing with emphasis on rapid results turnaround for early intervention. 4-7 day results turnaround is a death sentence for a lot of people who otherwise could respond to timely intervention.

Thanks - getting back online and up to speed now

Yes, the French study DID include a voluntary consenting non-medicated control group. The 3 groups just weren't blinded or randomized. The medicated groups went viral PCR negative significantly faster even at day 3 of 6. At day 6 the effect was more pronounced. Addition of azithromycin to CHQ in a third group had even better response. Limited sample size and study design but statistically valid.

100,000-200,000 deaths? He's making it sound like peaches compared to 2.1 Million. We should be grateful for his acumen, foresight, and steady hand. Meanwhile SK has a total of 152 deaths managing this fight almost twice as long.

I count at least twice Birx qualified the mitigation measures as being most needed in "metropolitan" cities/areas. That does everyone not in a large city a deadly disservice. When asked about his comments on an Easter pullback, Trump said "we've learned a lot in the last 2-3 weeks." No, that was you on Thursday, you dip.

Florida is the 3rd most populous state ahead of NY, has a bunch of tinder box “little Italy’s”, and a Trumper governor. What could go wrong ?

Covid is in every state spreading at a high rate where aggressive measures haven’t been in place. Stating the obvious, but unless you shut it down within your own borders, securing a perimeter does less than zero. Worse, it can give people a false sense of security to not yet have to buckle up. That’s deadly. Maybe Trumper Governors think they’ll get a golden reward in money and supplies by toeing the public line to continue support of Trump’s deadly denial of reality. But that reward never appears because once Trump returns a debt, he loses a measure of control.

So Florida lags NY by 7 days to match each logarithmic (x10) milestone. Each new log milestone takes 7 days to achieve.

"How # Taiwan tripled its mask production AFTER the outbreak of the Corona crisis: Government installed 92 new production facilities in a few weeks for around EUR 10 million. Capacity 13 million # masks / day. If own needs secured, export / auxiliary deliveries." This largely requires a federal level of mobilization and coordination. Continuation of the ongoing pattern of "reacting to and chasing" developments at the highest levels leads to sustained failure.

lol. just using your graphs.

I'm keeping an eye on these tables here, (scroll down to see day over day bar graphs for each country) What's really striking about those graphs is the y-axis values for Japan, Singapore, and SK. Their total cases to date are a fraction of the total we're already adding each day. Japan and SoKo deaths are doubling every 13 days right now.

please, elaborate with an example or two. I'm open to seeing things differently. I looked at China only because they spiked then flattened. What I'm looking at is roughly how long did it take to flatten after strict isolation started and by how many multiples did numbers continue to increase after isolation started before flattening. SK,HK,Sing,Taiwan all recognized what what happening in China jumped on it right away with masks, testing, and distancing so never had the spike Europe and the US are experiencing. Absent China, there's no other available comparison. that's all. A big chunk of Italy was in lockdown the first week of March and national lockdown by the 13th. But even today, Italy's case rate and death rate are still doubling every 7 days. That's a significant improvement compared to doubling every 3 days like the US and 4 days (France, Spain), but it's still serious ongoing expansion. What separates the US is our comparatively high baseline case/death rate numbers when SIP started, and SIP is a very loose term for what's happening across our nation as a whole. We'll be at 500 deaths/d today, so potentially at around 4000 deaths/d 9 days from now. 3 days after that, 8000 deaths/d ? I can't imagine actually seeing something like 8k US deaths/d, but that's what the math says happens less than two weeks after SIP starts, and we're not doing all the things that boost SIP like the countries have that are showing sustained success, masks being a huge one. Probably what we'll see is numbers not be full throttle hopefully starting next week due to regional rolling SIP that began in early March. We'll see rates improve/stabilize first in the centers initially hit (SEA/NY/NJ/CA) while later expand/mushroom in the last places to seriously implement SIP measures.

Care to add to that ? Ballpark ratios at the start of total shutdowns vs topping out numbers is all I’m looking at. Italy and Spain proportionally are about the same or worse, worse when deaths are factored in. It’s just that our numbers without even a full shutdown today already are off the charts and we have a big population relative to ITA and ESP. Brace for a lot of American deaths in April and May.