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Posted
  On 3/27/2020 at 4:33 PM, Horn Dog said:

As long as the side effects are minor then I don't have a problem with that.   Our understanding of vaccines is pretty good now, and they are not using live virus, just surface proteins or snippets of viral RNA,  so making a non-fatal vaccine should not be that difficult.  Now whether it works or not is another story, but I know that no vaccine doesn't work.   At least make it available to medical personnel.  They understand the risk/benefits and need it now.  If they wait 18-24 months, the vaccine will be useless.

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One thing Dr. Fauci spoke about at yesterday's presser is that with this coronavirus, there is concern over a possible observed phenomenon where re-exposure to the bug after you form immunity can result in a fatal immune response when the lungs are involved.  In other words you drown from your own immune response targeting the lungs.  So that is something that is being carefully looked at and understood before rushing out with a vaccine.

Posted

Any of the front line docs here getting an early impression on hydroxychloroquine.  Apparently NY has trial(s) in progress.  The ID guys have to have a gut feel by now for whether we are seeing the same signal seen in the french study. 

Posted
  On 3/27/2020 at 4:33 PM, Horn Dog said:

 

As long as the side effects are minor then I don't have a problem with that.   Our understanding of vaccines is pretty good now, and they are not using live virus, just surface proteins or snippets of viral RNA,  so making a non-fatal vaccine should not be that difficult.  Now whether it works or not is another story, but I know that no vaccine doesn't work.   At least make it available to medical personnel.  They understand the risk/benefits and need it now.  If they wait 18-24 months, the vaccine will be useless.

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Just putting myself on the record, again, that a vaccine will be available sooner not later. Like, by fall.

One example of how they'll achieve this was mentioned by Fauci recently. Instead of waiting around to the end of Phase III trials to start producing vaccine, you can produce a billion samples beforehand. Simple, and it does nothing to compromise safety. There are a million tweaks like that one that will get you a vaccine a lot faster than the regular process. You can run phases concurrently, that's another tweak.

Keep in mind, you need an antibody to a surface protein on the virus. It's only a 30k base pair virus, it was sequenced months ago, it's not that hard to figure out how to copy the surface protein and create an immune response. I mean it's not easy but damn we have much better tools than we did even a decade ago.

 

Posted
  On 3/27/2020 at 4:44 PM, triplehorn said:

One thing Dr. Fauci spoke about at yesterday's presser is that with this coronavirus, there is concern over a possible observed phenomenon where re-exposure to the bug after you form immunity can result in a fatal immune response when the lungs are involved.  In other words you drown from your own immune response targeting the lungs.  So that is something that is being carefully looked at and understood before rushing out with a vaccine.

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asks russian GIF

Do you have a link on that? I tried to google but it looks like Fauci only spoke briefly about vaccines yesterday?

Posted (edited)
  On 3/27/2020 at 5:07 PM, Anastasis said:

Any of the front line docs here getting an early impression on hydroxychloroquine.  Apparently NY has trial(s) in progress.  The ID guys have to have a gut feel by now for whether we are seeing the same signal seen in the french study. 

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So far, what I’ve learned second hand is little to no clinical improvement or benefit noted once you’re in an ICU setting on O2/vent and have pneumonia.

Early intervention/prophylaxis is where I’d be focused looking at right now.  But then assuming clear benefit, applying that is dependent on access to mass testing and rapid results turnaround.  Absent that, treatment would be rendered relatively useless due to rapid progression to bilateral pneumonia on average 5 days after symptom onset.  
 

Edited by triplehorn
Posted
  On 3/27/2020 at 6:23 PM, gmr548 said:

asks russian GIF

Do you have a link on that? I tried to google but it looks like Fauci only spoke briefly about vaccines yesterday?

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I looked for it earlier today and haven’t found it yet.  His podium time yesterday was brief but very information dense.  It’s worth keeping an eye out for it.  Maybe a transcript pops up.

Posted
  On 3/27/2020 at 6:36 PM, triplehorn said:

I looked for it earlier today and haven’t found it yet.  His podium time yesterday was brief but very information dense.  It’s worth keeping an eye out for it.  Maybe a transcript pops up.

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https://www.ideastream.org/prepare-for-outbreak-surge-white-house-coronavirus-briefing-march-26-2020

Fauci starts at about 1:24:45 and speaks for a few minutes. at 1:28, he mentions that there are cases where potential vaccines end up making the disease worse and needing to avoid that being part of the vaccine testing timeline. That's the closest I could find.

Posted (edited)
  On 3/27/2020 at 7:00 PM, gmr548 said:

https://www.ideastream.org/prepare-for-outbreak-surge-white-house-coronavirus-briefing-march-26-2020

Fauci starts at about 1:24:45 and speaks for a few minutes. at 1:28, he mentions that there are cases where potential vaccines end up making the disease worse and needing to avoid that being part of the vaccine testing timeline. That's the closest I could find.

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Thanks.  Fauci speaks to the principle of avoiding “enhancement” of an infection after receiving a vaccine against said infection.  no bueno.

Fauci is a no bullshittin truth teller.  Glad we have him.

Edited by triplehorn
Posted
  On 3/27/2020 at 6:36 PM, triplehorn said:

 Maybe a transcript pops up.

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  On 3/27/2020 at 7:00 PM, gmr548 said:

https://www.ideastream.org/prepare-for-outbreak-surge-white-house-coronavirus-briefing-march-26-2020

Fauci starts at about 1:24:45 and speaks for a few minutes. at 1:28, he mentions that there are cases where potential vaccines end up making the disease worse and needing to avoid that being part of the vaccine testing timeline. That's the closest I could find.

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Here is a transcript from Dr. Fauci March 26:
 

  Reveal hidden contents

 

Posted
  On 3/27/2020 at 7:09 PM, triplehorn said:
Fauci speaks to the principle of avoiding “enhancement” of an infection after receiving a vaccine against said infection.


There have apparently been problems with immune enhancement with previous vaccine attempts with other coronaviruses. The vaccine makes the infection worse for people who get it.

So a lot of people keep wanting them to rush out a vaccine even if it’s only 70% effective because a mediocre vaccine beats no vaccine, but the reality is that a bad vaccine has the potential to make the problem worse. We can’t risk injecting most of the country with a vaccine that makes things worse.
  • Like 2
Posted
  On 3/27/2020 at 10:12 PM, wild_turkey said:


So a lot of people keep wanting them to rush out a vaccine even if it’s only 70% effective because a mediocre vaccine beats no vaccine, but the reality is that a bad vaccine has the potential to make the problem worse. We can’t risk injecting most of the country with a vaccine that makes things worse.

 

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It's pretty much how every movie about an infected outbreak begins.

Posted

----> Masks 

I appreciate this expert's demeanor and presentation.  Solid.  It's coming from the national MD spokesperson in SoKo, the country arguably doing the best job top to bottom managing covid.  A lot of it is familiar to most of us by now.

~16min in Masks rationale.  Really the highlight of the interview.

~22 min in: 20% of new infections today in SoKo are being imported via inbound foreign air travel 

~32 min: talks history and future of vaccines, references Dr. Fauci, and talks "repurposing" various drugs to treat Covid.  I'm still waiting to hear someone discuss the potential differences in outcomes between using CHQ/HCHQ for early intervention versus late intervention.  For now the emphasis still appears to be applying them to more advanced complicated cases.  fwiw, I think early app is where it's at.

 

  • Like 1
Posted

Houston Methodist first to try blood transfusion test https://www-houstonchronicle-com.cdn.ampproject.org/c/s/www.houstonchronicle.com/news/houston-texas/amp/Houston-Methodist-first-in-the-nation-to-try-15164229.php

  Quote

Houston Methodist Hospital Saturday night transfused the blood of a patient who has recovered from COVID-19 into a critically ill patient, the first hospital in the nation to try the experimental therapy.

A Houston individual who has been in good health for more than two weeks since being diagnosed donated the blood plasma for what’s known as convalescent serum therapy

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Posted (edited)

Relevant to ACE/ARB treatment. Some discussion of the mechanisms and interactions between the RAA system and COVID. 

https://www.nejm.org/doi/full/10.1056/NEJMsr2005760?

On the basis of the available evidence, we think that, despite the theoretical concerns and uncertainty regarding the effect of RAAS inhibitors on ACE2 and the way in which these drugs might affect the propensity for or severity of Covid-19, RAAS inhibitors should be continued in patients in otherwise stable condition who are at risk for, are being evaluated for, or have Covid-19 (see text box), a position now supported by multiple specialty societies (Table S2). Although additional data may further inform the treatment of high-risk patients with Covid-19, clinicians need to be cognizant of the unintended consequences of prematurely discontinuing proven therapies in response to hypothetical concerns that may be based on incomplete experimental evidence.69

Edited by Anastasis
Posted (edited)
  On 3/30/2020 at 2:00 AM, Anastasis said:
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Westchester county, 1 hr N of NYC, Dr (Hasidic community Dr.)says he has treated 450-500 cases with 100% success:

Rudy interviews him pretty well getting him to give a lot of good detail including his dosages:  Interview starts about 2 minutes in. @Newdoc @ChiTownDoc

  Reveal hidden contents

 

Edited by zork
Posted
  On 3/31/2020 at 12:35 AM, zork said:

Westchester county, 1 hr N of NYC, Dr (Hasidic community Dr.)says he has treated 450-500 cases with 100% success:

Rudy interviews him pretty well getting him to give a lot of good detail including his dosages:  Interview starts about 2 minutes in. @Newdoc @ChiTownDoc

  Reveal hidden contents

 

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I’m dead serious when I ask how you were able to make it through that interview?  I just couldn’t.  Rudy can barely get a sentence out and his questions are moronic.  ‘Why would your community be high risk?’  Lol.  Couldn’t watch. If you watch that and aren’t shaking your head, regardless of your political stance, I’m not sure what to tell you.   
 

I did read the paper about the regimen (azithromycin/chloroquine).  Anybody telling you they had 100% success with those 2 meds is totally full of shit.  U of C and NW have had some very minimal success.  100%?  Lol.  The success isn’t even attributable to the meds.  It may have just been that % if people are not affected or get better after X days.  Every ID doctor I spoke to says there’s minimal evidence it works and only 2 admit it might be worth a long shot.  A far cry from some miracle about to save us all.  Also the 4/5 well regarded ID docs who commented couldn’t figure out why the FDA approved choroquine.  Now the patients who need it for an actual indication like Lupus can’t get it.  Stupid all around.  

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Posted
  On 3/31/2020 at 12:53 AM, ChiTownDoc said:

I’m dead serious when I ask how you were able to make it through that interview?  I just couldn’t.  Rudy can barely get a sentence out and his questions are moronic.  ‘Why would your community be high risk?’  Lol.  Couldn’t watch. If you watch that and aren’t shaking your head, regardless of your political stance, I’m not sure what to tell you.   
 

I did read the paper about the regimen (azithromycin/chloroquine).  Anybody telling you they had 100% success with those 2 meds is totally full of shit.  U of C and NW have had some very minimal success.  100%?  Lol.  The success isn’t even attributable to the meds.  It may have just been that % if people are not affected or get better after X days.  Every ID doctor I spoke to says there’s minimal evidence it works and only 2 admit it might be worth a long shot.  A far cry from some miracle about to save us all.  Also the 4/5 well regarded ID docs who commented couldn’t figure out why the FDA approved choroquine.  Now the patients who need it for an actual indication like Lupus can’t get it.  Stupid all around.  

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The Dr says zinc is one of the keys and that the hydroxychloroquine opens up the pathways that actually allow the zinc to be effective at blocking the coronavid, that the z-pack is mainly to keep the lungs from developing into the bacterial infection.  I don't have a visceral reaction to Rudy but realize some do.  

Posted

All the best medical science is pushed out to clinicians and researchers through Hannity and Rudy. /noCR. 

I hope that the HCQ/A/Zn regimens shake out, but until it is demonstrated in a controlled study with random assignment it can only be considered a signal to be followed up on.  If physicians want to push the regimen out to patients in desperate situations, I have no problem with it.  But broad uptake really requires sound medical evidence.

  • Like 1
Posted

The evidence so far suggests that if it is a desperate situation, such as intubation is required, it is already too late for chloroquine to be effective. That apparent fact certainly leads to the mixed results we see.

And, given it appears that over 80% of cases recover on their own with mild or no symptoms, chloroquine may have no effect on those patients. Blind trials need to conducted with early stage patients to know for sure. 

Posted
  On 3/31/2020 at 12:59 AM, zork said:

The Dr says zinc is one of the keys and that the hydroxychloroquine opens up the pathways that actually allow the zinc to be effective at blocking the coronavid, that the z-pack is mainly to keep the lungs from developing into the bacterial infection.  I don't have a visceral reaction to Rudy but realize some do.  

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It may help with severity - I really hope it does.  But the best of the best out there don't have much hope for it.  I really hope they're wrong and I'm wrong.  The zinc makes some sense on a biological level - again, a reach.  But that orthodox community is so devastated with deaths and hospitalizations I have no idea what that doc is talking about?  I seriously know their relatives here in the orthodox community of Chicago and they're like wtf is this guy talking about?   Our family is dying left and right up there.  I'm really not trying to be an asshole.  We all hope some concoction will end all this shit. 

Posted
  On 3/31/2020 at 1:24 AM, RayDog said:

The evidence so far suggests that if it is a desperate situation, such as intubation is required, it is already too late for chloroquine to be effective. That apparent fact certainly leads to the mixed results we see.

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I think that the front line clinicians can triage their patients sufficiently well and make the appropriate front line determinations. At this point they likely know exactly what the profile of the high risk cases looks like the minute the roll in the door. 

  On 3/31/2020 at 1:24 AM, RayDog said:

And, given it appears that over 80% of cases recover on their own with mild or no symptoms, chloroquine may have no effect on those patients. Blind trials need to conducted with early stage patients to know for sure. 

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Blinding is not really the pivotal component.  What we need is random assignment with a suitable standard of care control group. 

Posted

Whatever doctoring they are doing in Westchester NY, given the latest from JH webstats, it seems people should listen to them:  

9326 confirmed positive tests

10 deaths.  To this point and of course there are delayed stats to come.  

 

 

Posted (edited)

Small chinese study on HCQ...

First American studies should be posting some results before end of week.

https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v2

Aims: Studies have indicated that chloroquine (CQ) shows antagonism against COVID-19 in vitro. However, evidence regarding its effects in patients is limited. This study aims to evaluate the efficacy of hydroxychloroquine (HCQ) in the treatment of patients with COVID-19.

Main methods: From February 4 to February 28, 2020, 62 patients suffering from COVID-19 were diagnosed and admitted to Renmin Hospital of Wuhan University. All participants were randomized in a parallel-group trial, 31 patients were assigned to receive an additional 5-day HCQ (400 mg/d) treatment, Time to clinical recovery (TTCR), clinical characteristics, and radiological results were assessed at baseline and 5 days after treatment to evaluate the effect of HCQ.

Key findings: For the 62 COVID-19 patients, 46.8% (29 of 62) were male and 53.2% (33 of 62) were female, the mean age was 44.7 (15.3) years. No difference in the age and sex distribution between the control group and the HCQ group. But for TTCR, the body temperature recovery time and the cough remission time were significantly shortened in the HCQ treatment group. Besides, a larger proportion of patients with improved pneumonia in the HCQ treatment group (80.6%, 25 of 32) compared with the control group (54.8%, 17 of 32). Notably, all 4 patients progressed to severe illness that occurred in the control group. However, there were 2 patients with mild adverse reactions in the HCQ treatment group.

Significance: Among patients with COVID-19, the use of HCQ could significantly shorten TTCR and promote the absorption of pneumonia.

Edited by Anastasis
Posted (edited)

Zork posted this in the No Politics thread, but I thought it needed to be seen here, as the possible effects of ACE inhibitors and ARDs had been discussed earlier.

 

"Interesting Italy demographics, etc:

  Quote
2. Demographic data
The average age of deceased and COVID-19 positive patients is 78 years (median 79, range 26-100, InterQuartile Range - IQR 73-85). There are 3088 women (30.8%). For 2 patients the age data was not available. The median age of COVID-19 positive deceased patients is more than 15 years higher than that of patients who contracted the infection (median age: patients who died 79 years - patients with infection 62 years). The graph shows the number of deaths by age group. Women who died after contracting COVID-19 infection are older than men (median ages: women 82 - men 78).
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https://www.epicentro.iss.it/coronavirus/sars-cov-2-decessi-italia

 

  Quote
3. Pre-existing pathologies
The graph presents the most common pre-existing chronic pathologies (diagnosed before contracting SARS-CoV-2 infection) in deceased patients. This figure was obtained in 909 deceased for which it was possible to analyze the medical records of hospitalization. The average number of pathologies observed in this population is 2.7 (median 3, Standard Deviation 1.6). Overall, 19 patients (2.1% of the sample) had 0 pathologies, 197 (21.6%) had 1 pathology, 223 had 2 pathologies (24.5%) and 470 (51.7%) had 3 or more pathologies . Prior to hospitalization, 28% of COVID-19 positive deceased patients followed ACE inhibitor therapy and 16% Sartani (angiotensin receptor blocker) therapy.
Number of pathologies
Pie chart with 4 slices.
positive COVID-2019 deceased patients
 
 
Numero di patologiepazienti deceduti COVID-2019 positivi2.1 %2.1 %21.6 %21.6 %24.5 %24.5 %51.8 %51.8 %
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go to the link above for the graphs/charts, browser needs to translate."

 Prior to hospitalization, 28% of COVID-19 positive deceased patients followed ACE inhibitor therapy and 16% Sartani (angiotensin receptor blocker) therapy.

 

As the bold text shows, of the 909 deaths in the study, 28% were on ACE inhibitors and 16% on ARBs before hospitalization.

 

 

Edited by Victor Lazlo
Posted
  On 4/1/2020 at 6:00 PM, Victor Lazlo said:

Zork posted this in the No Politics thread, but I thought it needed to be seen here, as the possible effects of ACE inhibitors and ARDs had been discussed earlier.

 

"Interesting Italy demographics, etc:

https://www.epicentro.iss.it/coronavirus/sars-cov-2-decessi-italia

 

go to the link above for the graphs/charts, browser needs to translate."

 Prior to hospitalization, 28% of COVID-19 positive deceased patients followed ACE inhibitor therapy and 16% Sartani (angiotensin receptor blocker) therapy.

 

As the bold text shows, of the 909 deaths in the study, 28% were on ACE inhibitors and 16% on ARBs before hospitalization.

 

 

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Ok.  But correlation and causation and such.  I mean, older folks are much more likely to be on such meds.  They are also the more vulnerable group.  Is it the meds, or is it that folks who happen to be more highly represented in the at-risk category also take those meds more than the average member of the population?

It's like saying that 25% of the deceased had watched Matlock reruns in the past month.  That doesn't mean that Matlock kills you.  It means that this virus kills old people, who happen to be the demographic that most watches Matlock*.

* Murder, She Wrote reruns would also be acceptable here.

Posted
  On 4/1/2020 at 6:17 PM, Brisketexan said:

Ok.  But correlation and causation and such.  I mean, older folks are much more likely to be on such meds.  They are also the more vulnerable group.  Is it the meds, or is it that folks who happen to be more highly represented in the at-risk category also take those meds more than the average member of the population?

It's like saying that 25% of the deceased had watched Matlock reruns in the past month.  That doesn't mean that Matlock kills you.  It means that this virus kills old people, who happen to be the demographic that most watches Matlock*.

* Murder, She Wrote reruns would also be acceptable here.

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A couple of weeks ago, Dr. Fauci was asked about those types of meds in a press conference. He said that it was an issue that needed to be looked at and that he was hoping to get info from the Italians.

From the study results, I - like you  - am not sure it can tell us much about causation.

Posted

The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro

•Ivermectin is an inhibitor of the COVID-19 causative virus (SARS-CoV-2) in vitro.

•A single treatment able to effect ∼5000-fold reduction in virus at 48h in cell culture.

•Ivermectin is FDA-approved for parasitic infections, and therefore has a potential for repurposing.

•Ivermectin is widely available, due to its inclusion on the WHO model list of essential medicines.

 

Posted
  On 4/4/2020 at 3:22 AM, triplehorn said:

The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro

•Ivermectin is an inhibitor of the COVID-19 causative virus (SARS-CoV-2) in vitro.

•A single treatment able to effect ∼5000-fold reduction in virus at 48h in cell culture.

•Ivermectin is FDA-approved for parasitic infections, and therefore has a potential for repurposing.

•Ivermectin is widely available, due to its inclusion on the WHO model list of essential medicines.

 

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Plain English please.

Posted
  On 4/4/2020 at 3:22 AM, triplehorn said:

The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro

•Ivermectin is an inhibitor of the COVID-19 causative virus (SARS-CoV-2) in vitro.

•A single treatment able to effect ∼5000-fold reduction in virus at 48h in cell culture.

•Ivermectin is FDA-approved for parasitic infections, and therefore has a potential for repurposing.

•Ivermectin is widely available, due to its inclusion on the WHO model list of essential medicines.

 

 

Pretty sure that's a dog heartworm med lol

 

Odd to me that there appears to be buzz around anti-parasitic drugs to deal with a coronavirus. I'm curious about that as a layman.

 

Posted (edited)
  On 4/4/2020 at 3:33 AM, Armybrat said:

Plain English please.

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It's a medication that already has an established safety profile when people take it, hence the FDA approval for use to treat parasites.  It's potent at knocking out this covid virus with a single dose in a petri dish.  Need to see if that knockout dose translates into a safe effective dose in people.  Hopefully you don't have to take x10 the normal parasite dose in order to kill the virus.

But basic re-purposing an established med would be fast head start.

 

Edited by triplehorn
Posted
  On 4/4/2020 at 4:03 AM, strangulation! said:

Would tests on people be the next stage? Or would they need to test on certain animals and then progress to humans?

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With this drug, they can go straight to human trials for Covid.  The article says that even relatively high dose of this med is safe in people from studies looking at dengue viral infection (which isn't particularly effective vs dengue)

"Importantly, recent reviews and meta-analysis indicate that high dose ivermectin has comparable safety as the standard low-dose treatment, although there is not enough evidence to make conclusions about the safety profile in pregnancy28,29. The critical next step in further evaluation for possible benefit in COVID-19 patients will be to examine a multiple addition dosing regimen that mimics the current approved usage of ivermectin in humans. "

There's also this important consideration:

"Ultimately, development of an effective anti-viral for SARS-CoV-2, if given to patients early in infection, could help to limit the viral load, prevent severe disease progression and limit person-person transmission."

With Covid, a lot appears to hinge on early detection and intervention.  If you wait until pneumonia has set in, the damage is done.  That's one area where testing limitations in availability and rapid results are still biting us in he butt.

  • Like 1
Posted
  On 4/4/2020 at 5:13 AM, Anastasis said:

The lack of interim HCQ data from NY at this point is concerning. 

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Compare looking at outcomes with early intervention vs intervention with complications present.  Selecting subjects for early intervention is a situation where the difference between efficacy or not will manifest in maybe 5 or less out of every 100 subjects who would otherwise end up in the ICU with pneumonia.  Showing that is more difficult than showing response between groups by selecting for subjects already having complications of infection.  

Since testing is a debacle, ideally we need a widely available med that anyone could take and that is safe enough to take even if you don't have confirmation of covid from a test (due to low availability and turnaround time).  That could allow rapidly attacking a virus with the greatest chance of success without waiting for confirmation.  It'd be ideal if a one-and-done single dose could work in people (as seen in vitro) as that would reduce med exposure to the vast majority of people who don't progress to complications.  You could refine recs for early intervention based on older age and/or existence of co-morbid medical conditions, or anyone with URI symptoms with airway restriction/dyspnea.

For now, the proven way to shut this bug down within weeks is extreme social distancing.  and everyone covering their nose and mouth with basically anything while in public.

Posted

I haven't seen this website talked about here but it's hard to parse out what's been posted due to the almost CR levels of bitching in the main thread.   I will link an article that shows a calculated and relative increased risk of Covid mortality across age groups. It looks to be a pretty good analysis and reported the correct way, could help Joe Public under 60 yo to calm down the "we're all gonna die". He does absolutely state that mitigation factors are critical however.

How much risk does Covid represent.

 

  Quote

This suggests that COVID-19 very roughly contributes a year’s worth of risk. There is a simple reality check on this figure. Every year around 600,000 people die in the UK. The Imperial College team estimates that if the virus went completely unchallenged, around 80% of people would be infected and there would be around 510,000 deaths.

So, roughly speaking, we might say that getting COVID-19 is like packing a year’s worth of risk into a week or two. Which is why it’s important to spread out the infections to avoid the NHS being overwhelmed.

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  Quote

This is because, both for COVID and in normal circumstances, much of the risk is held by people whom are already chronically ill. So for the large majority of healthy people, their risks of either dying from COVID, or dying of something else, are much lower than those quoted here. Although of course for every death there will be others who are seriously ill.

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  • Like 2
Posted
  On 4/5/2020 at 12:22 AM, Newdoc said:

I haven't seen this website talked about here but it's hard to parse out what's been posted due to the almost CR levels of bitching in the main thread.   I will link an article that shows a calculated and relative increased risk of Covid mortality across age groups. It looks to be a pretty good analysis and reported the correct way, could help Joe Public under 60 yo to calm down the "we're all gonna die". He does absolutely state that mitigation factors are critical however.

How much risk does Covid represent.

 

 

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That's a good way to look at it because it pretty succinctly sums up why most people don't need to panic, but also why we absolutely need to be taking distancing protocols very seriously. The odds of a relatively young, healthy person dying if you roll their annual risk into a week or two still isn't very high. A year's worth of critical cases coming into a hospital in the same timeframe would absolutely overwhelm the place and result in many unnecessary deaths due to care rationing.

People seem to have a really hard time understanding that both of those things are true.

  • Like 1
Posted
  On 4/4/2020 at 4:03 AM, strangulation! said:

Would tests on people be the next stage? Or would they need to test on certain animals and then progress to humans?

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Full disclosure, I'm a cancer research guy, not infectious disease. But certainly many of the animal models for human infectious diseases are fraught with limitations just like those in oncology. 

The Gilead drug remdesivir, for instance, looked good in vitro for Ebola, and pretty good in primate disease models models - but perhaps has not shown as much promise in the field. The primate models are so-called semi-permissive for Ebola (and also some respiratory viruses), meaning that the disease often doesn't quite take hold as well in monkeys or is not as sustained as it is in humans. So, testing of the drugs in these models often is early on after exposure to the infectious agent to show if it has an impact. 

Compare that to treating people in the field where Ebola has sprung up - people in all the various stages of disease, long after being infected with various levels of disease burden and the resulting complications of other systems involved. It's not so simple to make the leap from preclinical to clinical. 

It all highlights the need for the continued clinical trials of all of these agents alone or in combination, as is ongoing now. Sporadic reports of a few patients treated here or there is not conclusive evidence of efficacy. 

  • Like 1
Posted
  On 4/6/2020 at 5:13 PM, gmr548 said:

That's a good way to look at it because it pretty succinctly sums up why most people don't need to panic, but also why we absolutely need to be taking distancing protocols very seriously. The odds of a relatively young, healthy person dying if you roll their annual risk into a week or two still isn't very high. A year's worth of critical cases coming into a hospital in the same timeframe would absolutely overwhelm the place and result in many unnecessary deaths due to care rationing.

People seem to have a really hard time understanding that both of those things are true.

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That's the message that we have failed to get through and I think when it is all said and done, will be what others use as pushback that alot of the measures were too strenuous. And very smart people do not understand it. 

  • Like 1
Posted

The guys that work on Cytokine Storm Syndrome are pushing it to explain the mortality of a subset of patients and the interleukin blockade drugs as a means of counteracting the syndrome. 

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Posted
  On 4/1/2020 at 6:17 PM, Brisketexan said:

Ok.  But correlation and causation and such.  I mean, older folks are much more likely to be on such meds.  They are also the more vulnerable group.  Is it the meds, or is it that folks who happen to be more highly represented in the at-risk category also take those meds more than the average member of the population?

It's like saying that 25% of the deceased had watched Matlock reruns in the past month.  That doesn't mean that Matlock kills you.  It means that this virus kills old people, who happen to be the demographic that most watches Matlock*.

* Murder, She Wrote reruns would also be acceptable here.

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Do you even Diagnosis: Murder, bro?

Posted

Does anyone have a good place to see what fatalities have occurred amongst healthcare workers so far? I've heard of a couple of residents succumbing to it... but nothing official yet

Posted

This is pretty over my head but posting for medical professionals that might find it interesting.  Attia is a pretty sharp guy and his team is spending a ton of time reviewing all potential therapies out there so figure anything he thinks is worth posting is probably worth sharing:   https://peterattiamd.com/wp-content/uploads/2020/04/Exogenous-pulmonary-surfactant-as-a-potential-adjuvant-therapy-in-SARS-CoV-2-patients-experiencing-acute-respiratory-distress-syndrome_-3-1.pdf

Posted

Siap

https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

 

With ventilators running out, doctors say the machines are overused for Covid-19

By SHARON BEGLEY @sxbegle

APRIL 8, 2020

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