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Honesty, that’s like level three evidence
Supreme leader Trump believes it'll work. So **** your science.
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have there been any randomized and blinded studies out that weren't negative?
Nope. Absolute jack ****
New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?
Recently, a novel coronavirus (2019-nCoV), officially known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China. Despite…
There's a news report that 100 patients in China got better. There's animal data for SARS. That is it.
This isn't even Vitamin C. It's an unprecedented level and I have no idea how programs like Michigan, Columbia and the likes are using it.
Germany's numbers are fudged beyond belief. They are attributing Covid deaths to comorbidities, no matter how mild. Are you a 45 year old male with Stage 1 htn and died of Covid? Then Germany will not ascribe your death to Covid and instead you died of your "pre-existing condition."
Just look at their numbers as of today, they have 22,000 cases but only 2 people listed as having serious illness! Either this virus is orders of magnitude less deadly than the common cold (but then why Wuhan and Italy and increasingly NYC?), the Germans are uniquely blessed by the gods and are somehow immune to it, or the Merkel government is playing its population for fools, much like it did during the 2015 migrant crisis.
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deleted643396
Louisiana may not be far behind NYC. Mardi Gras was not that long ago...
www.propublica.org
A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients
“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy ****, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube.”
www.propublica.org
Anecdotal evidence for something seems like benefits > risk. U disagree?Nope. Absolute jack ****
New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?
Recently, a novel coronavirus (2019-nCoV), officially known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China. Despite…www.sciencedirect.com
There's a news report that 100 patients in China got better. There's animal data for SARS. That is it.
This isn't even Vitamin C. It's an unprecedented level and I have no idea how programs like Michigan, Columbia and the likes are using it.
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deleted171991
You mean like this?
Nigeria Has Chloroquine Poisonings After Trump Praised Drug
Nigeria reported two cases of chloroquine poisoning after U.S. President Donald Trump praised the anti-malaria drug as a treatment for the novel coronavirus.
www.bloomberg.com
China has had this since a couple months ago. Did they publish their experience and guidelines from Wuhan? Shouldn’t they know what works and what doesn’t
Of course, the cure involves a soldier with an AR standing outside your house...
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deleted171991
It's all anecdotal at this point, and it can't be different, because one cannot design and direct a proper study in such a short time. Remember all the misbeliefs about HIV, and low long it took to prove them wrong. Or to find a medication that worked (AZT).
Plus there are different strains out there, a lot of them, which also muddies the waters.
You mean like this?
Nigeria Has Chloroquine Poisonings After Trump Praised Drug
Nigeria reported two cases of chloroquine poisoning after U.S. President Donald Trump praised the anti-malaria drug as a treatment for the novel coronavirus.
If you follow the guidelines published by the world famous French researcher Plaquenil is safe. The treatment is for 5 days. 400 mg PO BID for day 1 followed by 200 mg PO BID for 4 days.
I hardly think that I am going to develop Chloroquine poisoning from that protocol. This treatment will help (possibly) while my immune system does the rest.
Professor Didier Raoult from infection hospital l'Institut Hospitalo-Universitaire (IHU) Méditerranée Infection in Marseille (Bouches-du-Rhône, Provence-Alpes-Côte d'Azur), published a video explaining the trials on Monday March 16.
Professor Raoult is an infectious diseases specialist and head of the IHU Méditerranée Infection, who has been tasked by - and consulted by - the French government to research possible treatments of Covid-19.
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deleted171991
That's the hydroxychloroquine dose, doctor.
I do get what you're saying. What I was trying to show is that medications have side effects. Decisions have consequences. Absent a reliable trial, (hydroxy)chloroquine may do more harm than good; it may depress immunity and kill the patient during the viral phase.
US academic study concurs
A new academic study, published on Friday March 13 by US scientific researchers, also said that chloroquine appeared to be an effective treatment, and appears to align with the findings in France.
It said: “Use of chloroquine (tablets) is showing favorable outcomes in humans infected with Coronavirus including faster time to recovery and shorter hospital stay…
“Research shows that chloroquine also has strong potential as a prophylactic (preventative) measure against coronavirus in the lab, while we wait for a vaccine to be developed.
“Chloroquine is an inexpensive, globally available drug that has been in widespread human use since 1945 against malaria, autoimmune and various other conditions…[it] can be prescribed to adults and children of all ages.
"It can also be safely taken by pregnant women and nursing mothers [and] has been widely used to treat human diseases, such as malaria, amoebiosis, HIV, and autoimmune diseases, without significant detrimental side effects.”
A new academic study, published on Friday March 13 by US scientific researchers, also said that chloroquine appeared to be an effective treatment, and appears to align with the findings in France.
It said: “Use of chloroquine (tablets) is showing favorable outcomes in humans infected with Coronavirus including faster time to recovery and shorter hospital stay…
“Research shows that chloroquine also has strong potential as a prophylactic (preventative) measure against coronavirus in the lab, while we wait for a vaccine to be developed.
“Chloroquine is an inexpensive, globally available drug that has been in widespread human use since 1945 against malaria, autoimmune and various other conditions…[it] can be prescribed to adults and children of all ages.
"It can also be safely taken by pregnant women and nursing mothers [and] has been widely used to treat human diseases, such as malaria, amoebiosis, HIV, and autoimmune diseases, without significant detrimental side effects.”
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I truly hope you have some Plaquenil set aside for your wife and yourself. This is not the time or place to let hubris get in the way of a potential life-saving treatment which costs less than $30 (that includes the cost of the Z pack as well).
"He said that the first Covid-19 patients he had treated with the drug chloroquine had seen a rapid and effective speeding up of their healing process, and a sharp decrease in the amount of time they remained contagious."
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deleted171991
The first thing one learns, during an ICU fellowship, is that the medical world is full of poorly-proven dogmas, and they put all that garbage in our books and heads and call it science. So we become very skeptical. Earth would still be flat if everybody still believed in dogmas. Oh, wait, there is a ton of people who do.
For all our sakes, I hope Plaquenil (or something else) will work, and we'll all reminisce about these times one year from now.
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Louisiana may not be far behind NYC. Mardi Gras was not that long ago...
A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients
“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy ****, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube.”
It’s just the flu bruh! It’s going to rip through louisiana like the Italians. The whole state is basically obese, diabetics and smokers. If it gets a foothold in the Southern states and Trump reopens everything up, all I can say is that they are going to call the National Guard to pick up all the dead bodies.
Thanks.
Global MediXchange for Combating COVID-19(GMCC)
Global MediXchange for Combating COVID-19 is a medical exchange program to promote valubale experience sharing and communication in combating the global outbreak of COVID-19.covid-19.alibabacloud.com
Sponsored by Alibaba, China's Amazon.
Example of resource:
Handbook of COVID-19 Prevention and Treatment (68 pages) - Compressed Version (small screens)
Handbook of COVID-19 Prevention and Treatment (68 pages) - Standard Version
Interesting read.
Pertinent to pissing match above, they used Plaquenil when other stuff failed.
Report from Norway(5m):
Only 7 dead so far from confirmed covid, a few comorbidities with all of them, at least two got to die in their nursing homes, no vents. Less than 50000 tests administered, 2200 confirmed cases, 150 or so hospitalized, 28 on vents, 50-60 in ICUs total. Mainly in southern parts of the country, city areas and adjacent suburbs. About 9000 hcw in quarantine at the moment.
Govt went on lockdown, sort of, a week ago, but they're flailing. Got to protect those businesses, see!
The northern part of the country's municipalities quarantine anyone for 14 days if they've spent time in the south, due to the spread pattern present. Our secretary of justice isn't all too pleased about it, but we don't care right now. Seems to keep rates of infection low.
All truly elective surgery is stopped indefinitely. The back log will be astounding. Cancer surgery is still being done.
Our shop (rural) is being prepared for the wave of patients suspected to come, but including all anesthesia machines, we still only have a max of 10 vents for a population of 20k. Not too bad, I guess.
Anesthesia dept is expected to be actively involved in the critical care side of things, but we are seven nurse anesthetists and a grand total of two attendings, so I don't think the attendings are going to be put on the sacrificial covid intubation altar too often. I hope, for team cohesion's sake. Anesthesia docs and nurses are the only people in our system credentialed for intubation, not even paramedics(hems crew excepted) are allowed.
On the plus side, we have a nice pile of n95s, though last I heard, we're short on disposable gowns.
I realize most here are organized differently from the Norwegian system of hospital employment, so ymmv.
Funny to see how Idaho is faring, compared to CT or NYC. Perfectly parallell to Oslo, Bergen or Stavanger vs the rest of the country.
Sent from my LYA-L29 using SDN mobile
Only 7 dead so far from confirmed covid, a few comorbidities with all of them, at least two got to die in their nursing homes, no vents. Less than 50000 tests administered, 2200 confirmed cases, 150 or so hospitalized, 28 on vents, 50-60 in ICUs total. Mainly in southern parts of the country, city areas and adjacent suburbs. About 9000 hcw in quarantine at the moment.
Govt went on lockdown, sort of, a week ago, but they're flailing. Got to protect those businesses, see!
The northern part of the country's municipalities quarantine anyone for 14 days if they've spent time in the south, due to the spread pattern present. Our secretary of justice isn't all too pleased about it, but we don't care right now. Seems to keep rates of infection low.
All truly elective surgery is stopped indefinitely. The back log will be astounding. Cancer surgery is still being done.
Our shop (rural) is being prepared for the wave of patients suspected to come, but including all anesthesia machines, we still only have a max of 10 vents for a population of 20k. Not too bad, I guess.
Anesthesia dept is expected to be actively involved in the critical care side of things, but we are seven nurse anesthetists and a grand total of two attendings, so I don't think the attendings are going to be put on the sacrificial covid intubation altar too often. I hope, for team cohesion's sake. Anesthesia docs and nurses are the only people in our system credentialed for intubation, not even paramedics(hems crew excepted) are allowed.
On the plus side, we have a nice pile of n95s, though last I heard, we're short on disposable gowns.
I realize most here are organized differently from the Norwegian system of hospital employment, so ymmv.
Funny to see how Idaho is faring, compared to CT or NYC. Perfectly parallell to Oslo, Bergen or Stavanger vs the rest of the country.
Sent from my LYA-L29 using SDN mobile
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deleted87051
Anyone notice Belgium and the Netherlands have very high mortality? Seems like they are undercounting total cases. Are they short of testing kits?
You mean it’s no longer a democratic hoax or fake news? Crap.
With all due respect to Blade, that's what unintelligent people do. Elon Musk, Donald Trump and plenty of their flock of sheep. They live in a reality where they can live off of hope because they've never been exposed to a harsh reality where **** doesn't work and people die.
We all have a bias/heuristic that since things have always turned out ok in the past, they will turn out in the future. You think Donald Trump has ever had to face a health care situation where there is no treatment? Let alone a pandemic that has hit once every 100 years. It's pure, unadulterated stupidity sitting atop our nation's pyramid. And the sheep continue to graze.
I truly do not understand your committed cynicism about the potential for HCQ as a treatment. Dr. Raoult isn't a no-name, greasy celeb doctor. He's an MD/PhD, ID-trained, and a pretty big deal in the field. That's not to say that he can't be wrong - I know plenty of intelligent people who are bad outside their limited areas of expertise - but your skepticism seems to come from a high degree of bias. BTW, I can't think of anyone who would seriously claim that Musk is unintelligent.
Pulm CCM started using plaquenil at my hospital yesterday. I'm gonna check in with them over the next couple days and gauge their anecdotal experience.
Anecdotal compared to what? If you give it to everyone what r u comparing to?
We have a drug that's now on shortage because a few people publicized a theoretical basis. There's already so much hysteria and misinformation going around, it's so unbelievably frustrating to see medical folks caught up in it without knowing.
I mainly practice in an ICU setting. I would love to have a magic drug that I can give to patients in the coming days that will make them better. But there's literally not a shred of evidence out there that shows a clinical improvement from use of hydroxychloroquine. We do so much harm to our patients, we don't need more possible weapons.
One of the killers of patients with coronavirus is cardiac arrest and a rapidly spiraling cardiomyopathy. Chloroquine has known effects of cardiac toxicity and QT prolongation. Who's to say we're not causing these cardiac issues with trialling anti-virals and drugs we've never studied in this context. There's a huge possibility of causing harm and we're tossing our expertise out the window because of our fear and desperation rather than focusing on what we know already works.
I have the same frustration when it comes to non-invasive ventilation in COVID patients. We've done it for years for patients, but now we're so afraid of aerosolization (with also very poor evidence), that we're intubating patients once they hit 6L NC. Time and time again it has been proven that less is more when it comes to medicine, critical care and pretty much everything. Yet in this wave of hysteria, we're throwing all caution to the wind and risking serious harm to our patients. There's a big reason Fauci hasn't gone out and said anything positive about this, because he's smart enough to realize that it likely won't help.
Let's take this from the theoretical to the practical.
If you were symptomatic and tested positive for Sars-CoV-2, would you take the (azithro +) HCQ?
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deleted643396
No.
Nope. I've already had a close proximity exposure to a positive patient and will not be taking it nor enrolling in the UofMN study.
They're not giving it to everyone. Pretty much maximum EBM therapy has to have been tried with either no improvement or minimal improvement. I don't think it'll be that impressive since if it does do anything, it likely needs to be given very early in the disease course (just like most critical care therapeutics). The PCCM I spoke to though says that standards ARDSnet measures appear to be working fine for most people.
To repeat, Ronin, I'm not asking about ppx; I'm asking about treatment after +test + sx.
Thx for responses. I definitely would, being young with no comorbidities but having read too many horror stories about young, healthy pts ending up dead from this. Interesting to learn perspectives from crit care colleagues.
The sensationalism around young people is pissing me off to no end. Every time there's a freak covid death in a healthy 39 year old it immediately blows up news and social media.....it's unfortunate that the tens if not hundreds of thousands of young people who are totally asymptomatic /don't even know they have it isn't the headline
That's the crux of the matter. I think even in the data we have from other countries, they've stated that giving these interventions, whether antimalarials or antivirals, doesn't do much once the patient is in critical condition. Conducting a trial where you give these drugs only to people on death's door then reject them for lacking efficacy could lead to dismissing potentially helpful medications because they don't literally raise the dead.
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deleted643396
I will probably just eat my wife’s chicken soup. It’s probably just as effective, less side effects, and freakin’ delicious.
Maybe your patients are just too sick or too late stage for the drug to be useful. I will take it if I think I contract or am exposed to it.
Plaquenil and Zpack are best utilized EARLY in the disease process. My plan is to take them if/when I become symptomatic. If my symptoms are mild and I don't notice the Covid19 infection then I have no need for the meds. But, if I come down with a fever, cough and/or dyspnea I am starting those meds right away.
What each of you decide to do is your decision. For those of us who have some health issues and are over a certain age the meds MAY make all the difference in the world.
One last point is that expert is anything but a hack and he is the reason I chose to purchase Plaquenil. Donald Trump played NO ROLE In my decision making process.
I recommend each and everyone of you to start the meds as recommended if you show any signs of infection- earlier is better IMHO.
What each of you decide to do is your decision. For those of us who have some health issues and are over a certain age the meds MAY make all the difference in the world.
One last point is that expert is anything but a hack and he is the reason I chose to purchase Plaquenil. Donald Trump played NO ROLE In my decision making process.
I recommend each and everyone of you to start the meds as recommended if you show any signs of infection- earlier is better IMHO.
That's fine. Your choice but arrogance kills.
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deleted131481
Ok I've been playing with some numbers on covid19 projections. Feel free to humor me if you've got a few minutes. I think it is clear there will be incredible regional variation. I'm going to use NYC as an example as I think it will be hardest hit due to density and early onset.
Assumptions:
1) 3/21: Documented infections ~10k
2) 100k is true incidence of infections. I use a multiple of 10x. Obviously a very big assumption, but given Iceland data and some anecdotal data (2+/500 congressman, 10+/300 NBA players - understandably high risk groups) I think true infections are much higher than documented.
3) 20% growth rate per day of infections
4) 5% hospitalization rate, 2% ICU rate, 1% ventilation needed, 0.5% death rate - NYC currently has 8k cases, ~1500 hospitalizations, ~370 in ICU
5) Curve will start to flatten at 2 million infected (at the peak)
Results:
At 17 days will peak, total of 2.2 million total incidence infected with outcomes:
111k hospitalized
44k ICU
22K ventilation
11k deaths (will lag behind a couple weeks)
Based on this very unscientific assumption, I think NYC will peak around 17 days and start to back off the shut down at 3 to 4 weeks. I expect this to be perhaps the worst or one of the worst examples in the country, but to have pockets of outbreaks for weeks or months to come.
Feel free to critique:
Assumptions:
1) 3/21: Documented infections ~10k
2) 100k is true incidence of infections. I use a multiple of 10x. Obviously a very big assumption, but given Iceland data and some anecdotal data (2+/500 congressman, 10+/300 NBA players - understandably high risk groups) I think true infections are much higher than documented.
3) 20% growth rate per day of infections
4) 5% hospitalization rate, 2% ICU rate, 1% ventilation needed, 0.5% death rate - NYC currently has 8k cases, ~1500 hospitalizations, ~370 in ICU
5) Curve will start to flatten at 2 million infected (at the peak)
Results:
At 17 days will peak, total of 2.2 million total incidence infected with outcomes:
111k hospitalized
44k ICU
22K ventilation
11k deaths (will lag behind a couple weeks)
Based on this very unscientific assumption, I think NYC will peak around 17 days and start to back off the shut down at 3 to 4 weeks. I expect this to be perhaps the worst or one of the worst examples in the country, but to have pockets of outbreaks for weeks or months to come.
Feel free to critique:
Ugh, I wasn't going to keep harping on this, but that study would never be published if this wasn't a pandemic. Theres a reasons it's spread on Google Drive and not in a journal. I dont care who the expert is. The control didn't even have their viral load tested. It's a sham study.
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The Food and Drug Administration (FDA) issued emergency authorization Saturday for a novel coronavirus (COVID-19) test kit made by Cepheid Inc. that can yield results in a matter of hours instead of days.
The new tool is called the "Cepheid Xpert Xpress SARS-CoV-2 test" and will be made available to the public by the end of the month.
"The test we're authorizing today will be able to provide Americans with results within hours, rather than days like the existing tests, and the company plans to roll it out by March 30," the FDA said in a press release.
Health and Human Services (HHS) Secretary Alex Azar added: "With new tools like point-of-care diagnostics, we are moving into a new phase of testing, where tests will be much more easily accessible to Americans who need them."
Cepheid, which is based out of Sunnyvale, Calif., provided Fox News with footage of the test kit that they claim can bounce back positive or negative results, in as little as 45 minutes.
The new tool is called the "Cepheid Xpert Xpress SARS-CoV-2 test" and will be made available to the public by the end of the month.
"The test we're authorizing today will be able to provide Americans with results within hours, rather than days like the existing tests, and the company plans to roll it out by March 30," the FDA said in a press release.
Health and Human Services (HHS) Secretary Alex Azar added: "With new tools like point-of-care diagnostics, we are moving into a new phase of testing, where tests will be much more easily accessible to Americans who need them."
Cepheid, which is based out of Sunnyvale, Calif., provided Fox News with footage of the test kit that they claim can bounce back positive or negative results, in as little as 45 minutes.
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Ugh, I wasn't going to keep harping on this, but that study would never be published if this wasn't a pandemic. Theres a reasons it's spread on Google Drive and not in a journal. I dont care who the expert is. The control didn't even have their viral load tested. It's a sham study.
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Like I said it's your life and your decision. I appreciate those results and am grateful to have the meds readily available. You can expect many more "rushed" trials as we all try to get ahead of this pandemic. Phase 1 of 30-50 patients may lead right into clinical use without phase 2.
FYI, I do agree with that the trial was full of holes. In no way do I believe Plaquenil and Z pack are the answer to this pandemic. But, even though I am skeptical of their effectiveness I am not willing to forgo treatment based on my hubris. These drugs MAY help early on in reducing lung scarring and keeping me out of the ICU.
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You can expect many more 'Emergency release" of medications by the FDA. Trump has given orders to approve anything and everything that may work.
FDA grants ‘emergency use’ coronavirus test that can deliver results in 45 minutes
PUBLISHED SAT, MAR 21 20203:13 PM EDTUPDATED 3 HOURS AGO
FDA grants ‘emergency use’ coronavirus test that can deliver results in 45 minutes
PUBLISHED SAT, MAR 21 20203:13 PM EDTUPDATED 3 HOURS AGO
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deleted59964
the virus won't stand a chance
In some ways Trump is at war against Covid 19 with a time clock. Unless he convinces Wall Street by September the economy is back on track, which means he has a treatment for Covid 19, he loses the war and gets voted out of office.
I am a total optimist we will recover by Dec/Jan 2021 but really doubtful that Wall street and the economy stabilize by September. I truly hope so but I wouldn't bet on it.
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deleted643396
So does stupidity.
Choosing not to put an unproven pharmaceutical into my body when it is already vulnerable is arrogance? I’m probably better off taking some elderberry supplements.
