CR: COVID-19 --Political Talk

[triplehorn 2,664]

Just now, Anastasis said:

 

Tens of millions of dollars in data license fees.  That's what the company and Desai had to get in return.  

 

It doesn't always have to be a grand conspiracy triple.  Sometime the answer right in front of your face is the right answer. 

I'm not seeing why that should or would involve fraudulent data.  Data is data, right?  If data that says one thing over another brings in bigger license fees, then suddenly there's an incentive thrown into the mix.  I can still see it both ways, but I am extremely leery of the reach of big pharma when it comes to turning a profit. 

[Anastasis 23,480]

1 minute ago, triplehorn said:

I am extremely leery of the reach of big pharma when it comes to turning a profit.

As am I. This is not their MO though in terms of influence and use of research findings that serve their commercials interests. This whole thing looks like the MO of a con man running a con. 

[Mrs Whiggins 13,050]

I'm inclined to agree with this perspective. In order to run the con, one simply has to know the weak and exploitable areas. Those folks are not that different from the slightly knowledgeable homeowner who is a little frantic because there is water gushing everywhere and a solution is needed quickly. You know some things but not others and you need to get the water out of the house before the wood floors are ruined.

 

[jimmyjazz 46,000]

59 minutes ago, triplehorn said:

I'm not seeing why that should or would involve fraudulent data.  Data is data, right? 

You don't see why it might be lucrative for a small, upstart data mining company to make up data out of whole cloth instead of investing in the tools and personnel to mine the actual data?

I don't know that they faked the data, but it would seem unlikely that they did anything but, given the mismatch between the size of their operation and their alleged output.  This isn't my field, though, I'm just speculating.

[F250 28,802]

I saw some articles today that mentioned people with Blood Type A might be susceptible to getting proper fucked by C19. I have no idea what my blood type is, how does one find that out?

 

[Horn Dog 9,884]

2 minutes ago, F250 said:

I saw some articles today that mentioned people with Blood Type A might be susceptible to getting proper fucked by C19. I have no idea what my blood type is, how does one find that out?

 

Great... A+ here.  I donated blood a while back is how I found out.  If you have kids and know theirs and your baby momma’s blood type you may be able to figure it out.

can you link the article(s) you read?

[F250 28,802]

2 minutes ago, Horn Dog said:

Great... A+ here.  I donated blood a while back is how I found out.  If you have kids and know theirs and your baby momma’s blood type you may be able to figure it out.

can you link the article(s) you read?

 

Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

 

 

https://www.nytimes.com/2020/06/03/health/coronavirus-blood-type-genetics.html?action=click&module=Top Stories&pgtype=Homepage

[Message Board User 12,395]

Time to re-open all outdoor businesses without restriction.  

[Mrs Whiggins 13,050]

8 minutes ago, F250 said:

 

You might be able to phone the nurse in your doctor's office if you have a PCP and medical records somewhere.  Most of us women who've had children know because of the Rh testing.

[tchookem 3,905]

What's going on with HCQ? There's like 3 streams on this thread and jumping from one into the middle of the other then back is difficult.

 

Is the data that proved HCQ was harmful false? Is it just being reviewed?

 

I'm scrolling back, but some help would be appreciated, even if a link in the thread.

 

 

[DDD Dad 14,346]

What's going on with HCQ? There's like 3 streams on this thread and I'm jumping into the middle of them is difficult.

 

Is the data that proved HCQ was harmful false? Is it just being reviewed?

 

I'm scrolling back, but some help would be appreciated, even if a link in the thread.

[Message Board User 12,395]

20 minutes ago, tchookem said:

What's going on with HCQ? There's like 3 streams on this thread and jumping from one into the middle of the other then back is difficult.

 

Is the data that proved HCQ was harmful false? Is it just being reviewed?

 

I'm scrolling back, but some help would be appreciated, even if a link in the thread.

 

 

 

 

 

[F250 28,802]

36 minutes ago, Mrs Whiggins said:

You might be able to phone the nurse in your doctor's office if you have a PCP and medical records somewhere.  Most of us women who've had children know because of the Rh testing.

Thanks, I was wondering if I could just call the doctors office and see if it's in my records.

[Mrs Whiggins 13,050]

1 minute ago, F250 said:

Thanks, I was wondering if I could just call the doctors office and see if it's in my records.

I'm no physician, but it's the kind of thing that depending upon one's office, the nurse can sometimes call back at the end of the day or whatever time they do follow-up calls (if you call in the morning and have a message left with your inquiry).

[triplehorn 2,664]

3 hours ago, jimmyjazz said:

You don't see why it might be lucrative for a small, upstart data mining company to make up data out of whole cloth instead of investing in the tools and personnel to mine the actual data?

I don't know that they faked the data, but it would seem unlikely that they did anything but, given the mismatch between the size of their operation and their alleged output.  This isn't my field, though, I'm just speculating.

I haven't dug into this but one question is does this mean that all other Surgisphere data is bunk?  Is this Lancet/NEJM debacle a Surgisphere one-off data event?  If not, how many other published studies across various fields of medicine have used Surgisphere data?  Is some Surgisphere data valid while other is bunk?  Does Surgisphere know which of their data is valid and which is bunk?  

I don't believe the authors of the debunked study disclosed any present of past conflicts of interest with big pharma that have direct dogs in the hunt:  

Maybe @Anastasis can clarify if Mandeep Mehra and Frank Ruschitzka in fact don't have any present or past associations with Gilead to disclose, or Patel with Merck.  If anyone ever wondered why such disclosures are made before presentations and publications, this would be an example of why.  Maybe those author associations are twitter fabrications.  I really don't know.  

 

[Irieguy 1,059]

6 hours ago, triplehorn said:

The relevant parties understand this stuff inside and out.  They know what is legit and what isn't.  What (or who) would motivate a company to produce fraudulent data?  What does a company or person stand to get in return?   

[Irieguy 1,059]

6 hours ago, triplehorn said:

The relevant parties understand this stuff inside and out.  They know what is legit and what isn't.  What (or who) would motivate a company to produce fraudulent data?  What does a company or person stand to get in return?   

Your premise is flawed. The relevant parties don’t know the data inside and out. The people that buy the data don’t know exactly what’s under the hood. Combine that with a desire for expediency and they bought bad data. It happens. 

[Anastasis 23,480]

1 hour ago, triplehorn said:

Maybe @Anastasis can clarify if Mandeep Mehra and Frank Ruschitzka in fact don't have any present or past associations with Gilead to disclose, or Patel with Merck.  If anyone ever wondered why such disclosures are made before presentations and publications, this would be an example of why.  Maybe those author associations are twitter fabrications.  I really don't know.  

You’re asking me to invalidate something in a tweet that you won’t take the time to validate yourself? LOL. Come on triple. 
 

For what it’s worth, I did a quick lit search on MRM and FR and reviewed disclosures from their recent publications. Note that both of these guys are CV researchers and not ID, which should be a red flag. But neither had any disclosures related to Gilead in the few articles I reviewed. 
 

I do think that you should investigate the Leo Blavatnik Harvard medical school angle though.   Russian oligarch gives largest single donation in HMS history and you know there is something nefarious behind it. MRM has a Harvard affiliation. Russia sows political discord by creating division related to the politics of HCQ in America. Surprised you haven’t pulled on this string. Surely someone on Twitter is chasing that down?

 

Or maybe we just read the RCT results and acknowledge that the early signals wrt HCQ haven’t shaken out in hospitalized or prophy settings. And the likelihood of filling the remaining gaps in the treatment spectrum don’t appear particularly likely at this point.  

Edited June 7, 2020 by Anastasis

[jimmyjazz 46,000]

Acronym talk (AT) not going away.

[Anastasis 23,480]

5 minutes ago, jimmyjazz said:

Acronym talk (AT) not going away.

Author name

author name 

cardiovascular 

Harvard medical school

authir name

hydroxychloroquine

randomized controlled trial 

[Anastasis 23,480]

I left out infectious disease. 

[PsychMike 1,552]

On 6/3/2020 at 8:20 PM, triplehorn said:

Thanks.  This new study had a different design than the ICMR study I posted on the DT medical discussion thread.  I’d like to see more details but the WaPo says about this one:

”About two-thirds of the trial participants were health-care workers and the rest were a mix of other people exposed to someone with covid-19, he said. They were given hydroxychloroquine or a placebo for five days and then followed for two weeks to see who developed the disease.”

The ICMR study gave a loading dose then HCQ 400mg once weekly for about 6 weeks.  In particular, they observed a positive dose response curve preventing development of infection become notably more apparent after 4 weeks.  

@Captainant - I’d like to hear your thoughts on how differences in study design might hit on different cellular processes and timelines.

Also this about the Minny study:

“One weakness of the trial, he added, is that because testing was not widely available during the time of the trial, their analysis used a combination of lab-confirmed positive covid-19 tests and symptoms to count someone as infected.”

I’d like to know more about the presumed exposure/dosing lag relationship in this new study.

It’s a helpful study, but need more.

 

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.

[PsychMike 1,552]

2 hours ago, Message Board User said:

 

 

 

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. 

[Sawbonz 27,580]

3 hours ago, F250 said:

Thanks, I was wondering if I could just call the doctors office and see if it's in my records.

Probably not unless you’ve had emergency surgery or elective surgery with potential significant blood loss. 
 

If you’ve donated blood the blood bank can tell you. If you’ve never donated blood go donate you selfish asshole

[triplehorn 2,664]

1 hour ago, PsychMike said:

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.

I read the ICMR abstract and linked this article on another thread that elaborates the design specifics and positive findings including describing the observed dose dependent pre-exposure prophylactic effect of HCQ with once weekly dosing, most notable after 4-6 weeks of dosing.  The Boulware study in NEJM looks at post-exposure prophylactic effect with HCQ given for several consecutive days within 4 days of suspected exposure.  That's a very significant difference in designs with respect to intervention against the virus.  ----> You may have seen tv commercials for HIV prophylaxis medication.  Does a person take that type of medication as pre-exposure maintenance or post-exposure prophylaxis.  What happens if the initial dose is later than 48hrs after exposure?  Does it still have a prophylactic effect to HIV, or only if you had been taking it prior to exposure.  Different mechanism relative to COV19 and HCQ, but same critical considerations in timing.

Also  re the NEJM on the Boulware study, this is a weakness: "Adherence to the interventions [taking HCQ] could not be monitored, and participants reported less-than-perfect adherence, more notably in the group receiving hydroxychloroquine."  

 

 

1 hour ago, PsychMike said:

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. 

Nothing in that that we haven't known already for over two months.  That study involves initiating treatment with hospitalized patients (advanced complicated illness).  We know HCQ is ineffective if started late.

Apart from a replication/elaboration of the ICMR positive findings in the prophylaxis study, what we need is a study that tracks the course/progression of illness in patients who receive early intervention with HCQ.  Are they less likely to end up in the ICU, or dead from Cov19?  We don't have that done yet in a US study, and yet this is what the medical communities in multiple other nations have dialed in.

 

Edited June 8, 2020 by triplehorn

[tchookem 3,905]

Nothing in that that we haven't known already for over two months.  That study involves initiating treatment with hospitalized patients (advanced complicated illness).  We know HCQ is ineffective if started late.
Apart from a replication/elaboration of the ICMR positive findings in the prophylaxis study, what we need is a study that tracks the course/progression of illness in patients who receive early intervention with HCQ.  Are they less likely to end up in the ICU, or dead from Cov19?  We don't have that done yet in a US study, and yet this is what the medical communities in multiple other nations have dialed in.
 

Nothing in that that we haven't known already for over two months.  That study involves initiating treatment with hospitalized patients (advanced complicated illness).  We know HCQ is ineffective if started late.
Apart from a replication/elaboration of the ICMR positive findings in the prophylaxis study, what we need is a study that tracks the course/progression of illness in patients who receive early intervention with HCQ.  Are they less likely to end up in the ICU, or dead from Cov19?  We don't have that done yet in a US study, and yet this is what the medical communities in multiple other nations have dialed in.
 

So then what's the new development that you and Anastasis are discussing? Again, forgive me for jumping in midstream (Dammit Donnie!), but it sounds like data that halted HCQ testing was obtained from a questionable data mining source? Does this mean testing its back on?

[InkaUtexas 26,017]

40 minutes ago, Sawbonz said:

Probably not unless you’ve had emergency surgery or elective surgery with potential significant blood loss. 
 

If you’ve donated blood the blood bank can tell you. If you’ve never donated blood go donate you selfish asshole

Team O+ here. The friend staying with me has no idea her blood type. She asked her mom and no idea.... What the fuck? 

Edited June 8, 2020 by InkaUtexas

[triplehorn 2,664]

2 minutes ago, tchookem said:

So then what's the new development that you and Anastasis are discussing? Again, forgive me for jumping in midstream (Dammit Donnie!), but it sounds like data that halted HCQ testing was obtained from a questionable data mining source? Does this mean testing its back on?

 

 

 

Basically the study using fraudulent data published by Lancet said that patients hospitalized with Cov19 (advanced illness) who received HCQ had a higher incidence of death. 

Apart from that, to my knowledge Anastasis hasn't shown any awareness of or made any distinctions between pre-exposure vs post-exposure prophylaxis, and hasn't pointed out that early intervention/progression of illness studies are lacking in the US, but has splashed around with the general HCQ scaremongering.  

[Red Five 40,877]

2 minutes ago, InkaUtexas said:

Team O+ here. The friend staying with me has no idea her blood type. She asked her mom and no idea.... What the fuck? 

I bet if you posted a pic one of the doctors on here could tell. 

[Anastasis 23,480]

5 minutes ago, triplehorn said:

Apart from that, to my knowledge Anastasis hasn't shown any awareness of or made any distinctions between pre-exposure vs post-exposure prophylaxis, and hasn't pointed out that early intervention/progression of illness studies are lacking in the US

LOL.  That's funny triple.  The walls close in on the HCQ-of-the-gaps argument with every new well executed study published. Highlighting the absence of evidence is not a particularly strong position to advocate HCQ. I sincerely hope that whatever those lingering gaps are, maybe HCQ+Zinc+pre-exposure administration+shoving a quartz crystal up you ass and striking a tuning fork, shakes out.  I would love to see a low cost, highly effective treatment modality emerge. But the results of the RCTs are just not supporting the early enthusiasm we all shared.

[Anastasis 23,480]

On 6/5/2020 at 6:04 PM, Lurch said:

My impression is the virus load potential in an indoor space may legit be more risky than a mass protest outdoors. Singing may make it much worse.

That said, I didn’t go to our local protest last night as I don’t want to be near a bunch of yelling people even outdoors as we’re pretty sure that also increases load potential, particularly if the air is calm.

 

Definitely more acceptable from an epidemiological perspective than going to church with more than 9 other people. 

 

[Horn Dog 9,884]

50 minutes ago, Red Five said:

I bet if you posted a pic one of the doctors on here could tell. 

This is true.  If you post a pic of her tits I am reasonably sure I can tell you her blood type.

[jimmyjazz 46,000]

As I understood it, the Lancet paper seemed to corroborate a much smaller VA study.  Is that true?  

If true, is the VA study in any way impugned, or was it conducted outside the realm of the Sturgisphere data?

[Anastasis 23,480]

Just now, jimmyjazz said:

As I understood it, the Lancet paper seemed to corroborate a much smaller VA study.  Is that true?  

If true, is the VA study in any way impugned, or was it conducted outside the realm of the Sturgisphere data?

The VA study still stands. It’s primary limitation is the lack of generalizability. 

[Lurch 5,931]

Definitely more acceptable from an epidemiological perspective than going to church with more than 9 other people. 

 

Holy shit, do I actually get to both sides YOU?!? Kick Ass!

Yeah, both are bad for Covid transmission

[Anastasis 23,480]

4 minutes ago, Lurch said:

 

Holy shit, do I actually get to both sides YOU?!? Kick Ass!

Yeah, both are bad for Covid transmission

 

Now imagine that was an Easter service. 

[triplehorn 2,664]

19 minutes ago, jimmyjazz said:

As I understood it, the Lancet paper seemed to corroborate a much smaller VA study.  Is that true?  

If true, is the VA study in any way impugned, or was it conducted outside the realm of the Sturgisphere data?

The VA study also involved initiating treatment after the onset of complicated illness requiring hospitalization - just like the bunk Lancet study and the UK study referenced in the Gottlieb tweet above.  Initiating treatment after hospitalization is required is too late to do any good.  I think the world all agrees with that.

There are four phases to examine - pre-exposure prophylaxis, post-exposure prophylaxis, early post-infection treatment, and late-infection (rescue) treatment.  Today there are glaring research gaps in 2 out of the 4 groups with major implications for HCQ use:

1) pre-exposure prophylaxis 

2) as early as possible intervention with onset of detectable illness or positive test to possibly mitigate or prevent progression to hospitalization and/or death. 

The initial positive signal from the study by the Indian Council of Medical Research (ICMR) for pre-exposure prophylaxis, means this must get followed up.  It's not like we're going to dose our entire population prophylactically, but this could be extremely beneficial to health care workers, those who live or work at long term care facilities, and anyone regularly exposed to a lot of people in a relatively enclosed space (ie food processing).   The early intervention approach is also a no brainer given the highly favorable safety index for HCQ in uncomplicated cases, ie just like the circumstances in 1) and 2) above. 

But even if early intervention works, the pitfall for that strategy in the US is lack of coordinated mass screening and access to outpatient health care.  And really, this entire situation that we Americans uniquely find ourselves in relative to the rest of the world is rooted in the abject failure of anticipation, coordination, and leadership at the federal level starting at the top with an ignorant, self dealing, destructive despot for a president.  There are longer term issue we face as a nation re access to care, but it did not have to be this way.  We did not have to lose 110,000 Americans in the first 3 months of this fight.

 

 

[jimmyjazz 46,000]

2 minutes ago, triplehorn said:

The VA study also involved initiating treatment after the onset of complicated illness requiring hospitalization

Yeah, we get it.  You can stop pointing it out.  

[ChiTownDoc 21,154]

2 hours ago, Red Five said:

I bet if you posted a pic one of the doctors on here could tell. 

Here to help.  

[ChiTownDoc 21,154]

It’s comical how medicine/science is totally shit on by a large subset of the population.  Recruiting forum told me OU chose to wait until June 15 so Baylor and UT would have less time to implement their new offenses.  Best part is all 9 other teams agreed - but not based on any science...according to crootin tards.  Legit lol.  

[HenryJames 66,135]

2 hours ago, Anastasis said:

maybe HCQ+Zinc+pre-exposure administration+shoving a quartz crystal up you ass and striking a tuning fork

[NameAlreadyInUse 5,114]

3 hours ago, Sawbonz said:

Probably not unless you’ve had emergency surgery or elective surgery with potential significant blood loss. 
 

If you’ve donated blood the blood bank can tell you. If you’ve never donated blood go donate you selfish asshole

I would love to but I’m not allowed since I caught the gay and periodically have sex with my husband to prove it. 
 

But I had a super hot science teacher in 7th grade and one of our experiments was typing our blood. I figured that’s how everyone found out, though that shows I was in 7th grade before AIDS was a thing. AB- here. 
 

question I have is when they say type A do they just mean Type A or do they mean all the Types that start with A?

[Captainant 27,689]

7 minutes ago, NameAlreadyInUse said:

question I have is when they say type A do they just mean Type A or do they mean all the Types that start with A?

A is a type, and AB is another type but it can accept donations of A, in addition to B or AB, with the matching type being most preferred. I think with regards to COVID, it's only been observed to disproportionately impact type A patients. Someone, please correct me if I'm wrong though

Edited June 8, 2020 by Captainant

[Anastasis 23,480]

20 minutes ago, HenryJames said:

Tell me you are not intriqued by the thought of a vibrating quartz crystal on your sphincter and I am going to call you a liar.

WHAT DO YOU HAVE TO LOSE?

Edited June 8, 2020 by Anastasis
WHAT COULD IT HURT?

[NameAlreadyInUse 5,114]

Who in the hell would be against a vibrating quartz crystal on their sphincter?

[NameAlreadyInUse 5,114]

4 minutes ago, Captainant said:

A is a type, and AB is another type but it can accept donations of A, in addition to B or AB, with the matching type being most preferred

Yeah I understand they are different types. I’m trying to understand if corona sees is that way or if sees the blood type starting with a and gets ready to party. 

[Pig Bellmont 8,719]

11 hours ago, Anastasis said:

Now imagine that was an Easter service. 

 

[Anastasis 23,480]

41 minutes ago, Pig Bellmont said:

 

If you want to engage in a discussion of the public health aspects of the pandemic, unemployment, and the police state/police violence, I am happy to do so. But you are going to have to contribute something more to the exchange than tweets. 

[Biff Tannen 45,695]

50 minutes ago, Pig Bellmont said:

 

Punctuation.  Jesus.  Still not quite sure what this is trying to say.

[Pig Bellmont 8,719]

7 minutes ago, Anastasis said:

If you want to engage in a discussion of the public health aspects of the pandemic, unemployment, and the police state/police violence, I am happy to do so. But you are going to have to contribute something more to the exchange than tweets. 

Why? You complaining that epidemiologists recommend against church services is based not only on science, but now many examples of community spread. That said, the President says it’s essential, so take it up with your pastor and go to church. Scientists also say the protests will cause spread of the virus. People put their own value judgment on whether it’s worth it.