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Discussion in 'General Discussion' started by babe, Mar 17, 2020.
^^^ Exactly what I expect when I open a thread promising "rational discussion"
According to a Sermo study (I'll post it later) 75% of the doctors in Spain are treating with Hydroxychorloquine. By far the most in any country. And their morality rate is neck and neck with Italy for the worst in the world.
How long have they been using Hydroxychorloquine? Spain has started to flatten out regarding both infected and and deaths.
Each flu vaccine is different. So while they're not "chuck[ing] a bunching of random stuff" into it [also hard to argue that one medication already on the market qualifies as "a bunch of random stuff"], the actual vaccine that gets approved hasn't been tested on any kind of population to determine its actual effectiveness against the flu. It's assumed by antibodies. But even that's not a perfect correlation. The point I'm making is that we don't have any outcome on the flu vaccine before it hits the market.[/quote]
How many are you talking to?
Tough to determine. I have no idea what the rate is of hydroxychloroquine use is in the US, but based on informal discussion I'm seeing in the community of treating physicians, I'd be led to believe that most are using this inpatient. Variables for a high death rate in places like Spain and Italy are difficult to determine the cause, as I had mentioned back a couple weeks ago when people said we were on a trajectory like Italy (we are having far less fatalities per capita than Italy was 11 days ago) was that Italy had a population that's median age is 10 years older, smokes 50% more, and has 1/3 the amount of critical care beds that we have. As far as Spain, their median age is 7 years older, smoking rate is nearly twice as high, and they have even less critical care beds per capita than Italy.
Interestingly enough Germany had the smallest percentage of usage and about the lowest death rate. Maybe they didn't have enough serious cases.
Germany has roughly as many critical care beds per capita as we do.
Obviously a few years old but should give some relative idea of proportion.
Right, we don't have an experimental outcome. Instead, it's based on known, tested principals with a relatively well-understood mechanism, aka science.
I've read a few tweet streams.
Since babe now believes China and is rumors... Lol
Rumors are that
is what killed the Chinese eye doctor who was the whistle blower. He posted on his WeChat that he thought it was a cure but not prescribed yet. He got it from a friend and had a bad reaction along with many others after some anecdotal evidence showed it was working.
Thanks for this bit about immunoglobulin therapy.
IT is a presumptuous sort of superstitious/magical thinking exercise whose basic axiom is that if we get milk or plasma from something that has immunity to our disease, it will include the working antibodies that can trigger our own immune system..... as good as having a vaccination, lets say.
Some of the assumptions can be untrue in real case scenarios, plus some of those zillions of antibodies from a cow or a pig might do harm.
However, lacking any kind of evidence to the contrary, it is as likely that this IT therapy "cause of death" is just another "rumor". I mean, did they actually do anything to determine the cause of death????
also, I like your humor about me believing China and its rumors.....just putting them in the range of possibilities is not "belief".
you should expect me to take exception to sources like CNN, and maybe our federal bureaucrats as well. Political elements rise to the surface in the "news".
I know they approved off-label doctor prescription, and that they have initiated at least one large scientific study with I think 1100 patients.
Probably the most relevant statistic is the available specific immunological or genotype diagnostic tests, and how they have been used.
Identify and isolate..... I think Germany is one of the countries that has done that better, along with South Korea and Singapore, I think. (rumors, all)
Most of the people I read for medical wisdom don't wear their politics on their sleeves, and are just as dismissive of left-wing anti-science lunacy (e.g., Stein anit-vax positions and Paltrow's Goop) as of right-wing anti-science lunacy.
I agree that adding in more ways to sanitize would improve subway conditions, and you could add space between people by increasing the number of trains, as opposed to decreasing.
I look forward to the results of the 1100 patient study.
So here is an excellent article.
I should have started the thread with this, I think.
I will pull the statement that Covid-19 is a RNA virus and the little comment on its chemical vulnerabilities.
Highly pathogenic RNA viruses belong to various virus families. These include the Arenaviridae (Lassa and Argentine hemorrhagic fever (AHF) viruses), the Bunyaviridae (Crimean-Congo hemorrhagic fever (CCHF) virus and hantaviruses), the Coronaviridae (severe acute respiratory syndrome (SARS) coronavirus), the Filoviridae
. Like other CoVs, it is sensitive to ultraviolet rays and heat. Furthermore, these viruses can be effectively inactivated by lipid solvents including ether (75%), ethanol, chlorine-containing disinfectant, peroxyacetic acid and chloroform except for chlorhexidine.
chloroquine was added as a recommended antiviral for treatment of COVID-19 in China 
Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020 Mar 16;14(1):72-73Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020 Mar 16;14(1):72-73
Hydroxychloroquine has been demonstrated in SARS and other RNA virus as having specific antiviral effects. Here is a discussion of just what those effects are.
Social Distancing/Isolation/Mass Public Health programs are now showing significant effective results....
As a gross world statistic, the new cases added to existing cases has been, for three days, about 6% increase daily, down from around 20% before. A significant number of "carriers" are either isolated or not moving around to infect others.
One question is how many of these are going non-infective day by day, meaning without ever being diagnosed, tested, or known, they are returning to the unaffected and non-infective population.
About the only way we can know for sure how many people have gone through the disease in whaterver mode, is by a test specific for the antibodies to Covid. Most quick assays are directed at antigen presence, not the antibody presence. The PCR genetic analysis, the most error-free analysis, is still being done, tens of thousands a day, but the more rapid and less expensive immunoassay is being done now at a rate of over 100,000/day.
Adding in all these positive tests is changing the ratio of non-patients tested/patients tested. This will drive most of our most inflammatory scare-mongers back into their holes.
Just pulling numbers outta my general observatory calculator, which works pretty good sometimes.....
If we have tested a million people now, vs 350,000 patients, we have about 357 million unaffected persons who have not been brought to the doctors....
And it looks like less than 10% of the unaffected nonpatients are showing up positive on the tests, and the case positive ranks are only going up 20k/d in the USA there must be 180k unaffected/negative tests, and probably most of the positives are walk-ins (not random statistics)….
so I'm still guessing 97% of us are unaffected, unexposed, vulnerable folks hunkered down, waiting for around 150K infective persons, to recover and become non-infective.
However, about 2% of those exposed will likely remain long-term infective carriers unknown to the doctors or the government or us.
So we need a prophylactic/curative agent like HCQ, available literally off the grocery store shelves.
And a vaccine.
well, actually, despite official denials about no effective antivirals, there are several.....
As things are, this week looks to me like the turning point. Most people like me don't do their work in public traffic, there' no reason to stay home if we can screen everyone with a good test.....and have a handy remedy....
So I think the political uses of this pandemic are almost run out. We'll be over-cautious about returning to normal, but we will recover economically and even accelerate beyond what we had.
But hey...… social distance whatever you do, and get a mask or shield, and wash everything often.
Now having taken some time to read this report, I thank you for giving us the link. There was no assessment of results of any treatment regime in this report, and it appears to be objectively done, and a factual survey of the opinions and methods within the treating professional set of respondents, biased only---- perhaps--- by the "selection" of respondents.... voluntary, within the contact base of Sermo.
I was glad to see how many were actually using HCQ, and to know something about prescription regimens. I had thought the "right" prescription was 400 mg initial dose and 200mg twice a day for ten days. The doctors are using 400 mg, sometimes once a day, sometimes twice daily generally. It looks like they do mostly 5 day prescriptions.
I had thought that six days was generally effective at the dosage I was looking at.
HCQ as a preventative or prophylactic is hard to evaluate without a matched control group. I have heard one doctor literally calling out for anyone who has been using HCQ while contracting Covid, apparently having not seen a single instance of that appearing in his practice.
I have my doubts about how many ARDS patients, already severely impacted, can be turned around by HCQ when they are literally on death's doorstep to start.
People who have a history of smoking...… where Spain is perhaps the top statistic on the planet....also have a worse prognosis generally. Maybe other impaired lung situations as well.
According to Mark Levin, and now admitted by our national expert, we are counting everyone who dies having Covid as any reference on their medical history as a Covid death. This is systematic overcounting. Many of the people who die with a positive Covid showed up at the doctor for other reasons in the first place. This is absolutely going to make damn sure we don't undercount the deaths because of any reason....
I mean, if you are shot in the head, and taken to the hospital, and the Covid test is positive, you are a Covid death, not a gunshot death.
So this dismisses the argument that we are somehow undercounting or lying to the public about the seriousness of Covid…… like we accuse China of doing so much......
I rarely feel glad about unnecessary blindness and heart complications being induced by a medicine that provides no benefits.
So we have now, in the USA, tested over 2M folks for Covid. In every test, we need some stats regarding accuracy and precision. Accuracy would involve the idea of getting a "right" answer, "precision" would involve the idea of not missing cases. Poor accuracy would involve, say, getting H1N1 or SARS or other Corona viruses giving a positive Covid test result where Covid is not actually the exact virus giving the positive result. Poor precision would involve on getting positive Covid results some fraction of the time where Covid is indeed present.
We know nothing about either of these parameters, and could only expect or presume some value or meaning in our testing. However, we have judgment, from experience generally, about all of our methods.
A diagnosis based on clinical observations..... acute pneumonia, fever, dry cough, little upper respiratory congestion..... might be 90% accurate/70% if not obviously explained by something else known to be a cause....
Any kind of "crude" positive antibody or antigen assay might be 95% accurate/90% precise.
A good test developed with positive and negative controls in the panel could do much better, but still miss a case or two in a thousand, and still pick up a positive from some other source in a hundred or so tests. There will be no such thing as an inerrant test.
That said, I note a propensity in human psychology for seeing what we are looking for at the moment, for erring on the side of amplification of our concerns. I have no means to quantify this phenomena, but to say, it's possible it's significant, maybe ten percent, maybe one percent, who knows.
But in 2M tests, we report 400k positives.
Considering the claim, with some supporting data, that as many as 80% of Covid cases are not serious enough to prompt a doctor visit..... and that tests are being done only on people who show up to ask for the test, sometimes for good reason..... And that we are reporting ALL the serious cases and deaths...… we can write an equation....
Tot#Covid = #Positive Test Results + Untested/Unknown Positives. The latter can be estimated from available data.
For reasons I discussed a few posts above, we are probably overstating #CovidDeaths, but this number does claim a positive Covid test result. Our stats on #Critical Covid Cases is likely understated, because some people just don't get that attention. And if our psycology is normal, and our tests are pretty good, we are likely overstating the #Positive Test Results by, perhaps.... in my judgment, aroung 2%. Not really a headliner there. But I will include it in the equation.
The next thing is to evaluate the probable extent of Covid cases out and about, walking around unknown and undetected. The best data for estimating this would be the percent of positives being found in persons who have no signs or symptoms of Covid who have been tested, or the rate of positives in the testing lines where, presumably, worried folks with some signs are hurrying to get tested. The first subset would be an underestimate, the second a fairly large overestimate....
Another useful test for evaluation of extent in the general public would be an antibody test rather than an antigen test like what we are now doing. The antibody result would tell us how many people have been exposed and lived to show it.