PsychMike

Thanks for sharing this. The caveat here is "They have not been peer-reviewed or published in a medical journal." However, given quotes from study authors this does look like a randomized trial and I tend to agree with Scott Gottlieb's comments.

Triple, have you seen the entire publication of the Chatterjee (ICMR) study? I've only seen the abstract so I can't follow their data. They are describing it as a case-control design and the only randomized aspect is how cases were selected from a database. So it is not going to be a high enough level of evidence from which to draw much conclusion. I've looked carefully at the Boulware study in NEJM. It's an RCT and the journal has made everything available: the protocol, the data, appendix with sub-analyses. It is one of the best designed Covid studies I've seen. It's unfortunate that there was no significant benefit on the primary outcome or any pre-specified subgroup analysis. I hope there is a way to tease out what characteristics of patients who benefited from HCQ (i.e., pharmacogenetics) so as to inform future study design and decision making.

Yeah, I don't think that's correct on authorship agreements. There is a requirement for the corresponding author to disclose whether they had full access to the data. In my experience, authors may have solely been involved in interpreting data and in many cases they may not have even been involved as a PI for a site. When I first skimmed the original publication, it seemed legit. When I saw The Guardian article, I came away with the impression that Surgisphere and its founder Desai were almost certainly illegitimate. You could argue that the authors should have figured that out, and I don't disagree, especially since nobody could extract from the database except Surgisphere. But I'm sure the authors were focused on analyzing, interpreting, and publishing the data quickly to get information out to everyone, good or bad. There needs to be some kind of task force to look at the handling of Covid-19 data dissemination and try to set up better standards for every entity involved in the process to see how to keep integrity intact while allowing the public quick access in dire circumstances. Here's the link to the Lancet author form: https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Lancet/authors/tl-author-signatures.pdf Here's the Guardian link to the article from one week ago: https://www.theguardian.com/world/2020/may/29/covid-19-surgisphere-hydroxychloroquine-study-lancet-coronavirus-who-questioned-by-researchers-medical-professionals

Dude, are you in the mental health field? Seriously, that's a very educated breakdown and I like the post. I would mention that "much more efficient political transaction" is something that disturbs me in particular. Why is this still the case? Hell, numerous jail diversion programs have demonstrated cost savings. The Bexar County project was around 15 years ago, so the Great State of Texas should have implemented it and made it a conservative thing. I don't know if it's R vs D, or if it's something more like building more jail space takes care of "General Dynamics" or whatever. I just wish it would change. At least state Medicaid programs are figuring out that you can save $ by spending higher for long-acting injectable antipsychotics, which reduces the number of 7/11 scenarios you described.

Damn right. I've read that this was an important event for his rise to prominence.

I realize this is not about mail in voting, but unfounded allegations of voting fraud abound. What is the common thread here?

John T. Scopes Monkey Trial: the Sequel, IMO.

So the federal government has been spending lots of $ advertising on Twitter and FB?

Hydroxychloroquine-induced photosensitivity is a real thing.

Does anyone know of a way to have your Twitter account auto-block anyone with certain shit in their profile, like #WWG1WGA? Sorry, but checked my settings before and couldn't figure it out. I'm actually proud to admit I am only semi-literate in twittersphereshit.

It also reminded me of this from the Galveston paper: “We haven’t noticed anything different other than having to stand in line at the restaurant,” said David McGinnis, who drove to Galveston from Belton, about five hours away, on Friday. His family’s trip to Galveston this weekend was a small makeup for a canceled April trip to Mexico. “Personally, I feel if God’s going to call you home, he’s going to call you home here, at home or in Canada,” McGinnis said. “So it doesn’t matter. But, I mean, we’re not being stupid and shaking hands with everybody we meet.” It's as if they are all listening to the same talk radio shows.

Perhaps we could get Tom Selleck to straighten things up, then? He's been around long enough to know what's what.

There are pass catchers and there are Pluckers. Pluckers really know how to wing it, IMO.

During my early football days (late 70s-early 80's) I was told that the reason we used 40 yard dash to time football player is because that's the distance where we typically reach maximal speed. That said, I would wager that every individual has their own curve. Take a look at this acceleration curve from the world's fastest sprinter. He continues to accelerate well beyond 40m, although the increment is smaller moving to the right. I would imagine that could explain the disparity of a person's 200m time vs 40. I wouldn't trust any conversion table, because I imagine a well-designed study generating such table would contain sizable error bars.

Hello!

From early on in this pandemic, when people started to discuss HCQ with or without AZ, they would cite the known safety data. But what they failed to acknowledge or understand, is that that safety data was not reported from Covid-19 patients. Yes, there can be real differences in toxicity. It's what we in the clinical pharmacy world refer to as drug-disease interactions. I didn't predict problems, I was concerned that people were overlooking potential problems that had not been studied under controlled conditions. The more safe people are convinced it is, the higher the potential risk for therapeutic misadventures. Fast forward to "The QT interval in patients with COVID-19 treated with hydroxychloroquine and azithromycin" by Chorin et al. April 24, 2020 in Nature Medicine (I accessed it at nature.com) The following excerpt provides preliminary evidence that yes, active Covid infection (at least higher severity cases) put patients at higher risk of toxicity. Thankfully, there were no incidents of Torsade de Pointes. Deaths in the HCQ/AZ patients were not related to arrhythmias and their ECGs were normal. But let me tell you: a mean prolongation of 24 msec and 11% incidence of QTc over 500 msec will make the cardiologists and intensivists pucker up. The patients were living in powder kegs and giving off sparks. "The effectiveness of HZ/AZ in treating SARS-CoV-2 infection has been demonstrated in one small human study so far2. Previously, the combination of HY/AZ resulted in mild QTc prolongation when given to young healthy volunteers8. In our work, we found that in patients with COVID-19 who were treated with HY/AZ, the QTc was significantly prolonged. This discrepancy suggests that QT prolongation may be influenced by patient attributes such as the presence of co-morbidities and the severity of the disease9. Of note, recent guidance suggested ECG screening with QTc assessment for patients with COVID-19 who are candidates for novel therapies, including HY/AZ10. In our cohort, five of nine patients with severe QTc prolongation had a normal QTc at baseline. We therefore suggest that the QTc should be followed repeatedly in patients with COVID-19 who are treated with HY/AZ, particularly in those with co-morbidities and in those who are treated with other QT-prolonging medications." I hope for the best for patients on these drugs. But don't let anyone try to convince you of their safety for Covid-19 based on old safety data in other populations.

Heffernan's thread is an enlightening read that proves the veracity of this thread's title beyond a reasonable doubt.

Yeah, I wish I could've let him know you can learn about the benzodiazepine receptors without keeping a supply of alprazolam tablets on hand.

This seems like a good idea. I hope it works. It will almost certainly be fun to watch.

I get that, but I thought he set up the zero argument like a straw man, intended to keep people from criticizing an important (hypothetical) spike in transmission rates rather than what we would hope to achieve: maintain flat curve or even begin regression.

I think you're spot on, GoLL.

Thanks for sharing this information. I wasn't lucky enough to get there 10 years ago, but their taproom is #1 or #1A that I've ever been to for great tasting samples. The Hunahpu may be the best beer I've had. Buying Jai Alai from my Kroger in Galveston may not be in the same ballpark as the good ole days but it's still damn good. Oh and I bought Marshal Zhukov's Imperial Stout from Spec's this weekend, can't wait to try it this week.

You're spot on, he is in fact a fat fucking retard.