Corona Virus #7

[RSR]

1) there is no antiviral drug for coronavirus at this point.
2) the "evidence" for chloroquine is at this point non existent. The French doctor's article is no evidence at all.
3) the combination of chloroquine and azithromycin (an antibacterial) is just a "wildass guess" at an antiviral regimen
4) I'd rather just have a beer as there is just as much valid data that drinking your favorite brew is helpful as there is for chloroquine at this point
5) I'd happily sign up for a clinical trial where I might get either the experimental drug or a placebo as I do think that we should be doing good clinical trials

I'm curious how you come to these conclusions? I'm assuming you're referring to the peer reviewed article:

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial - ScienceDirect

I tend to put a reasonable amount of faith in peer reviewed journal articles in journals with an impact factor of 4.6.

It isn't a complete study (what study really is? - there are always improvements to be made) but it provides some pretty compelling evidence.

Trying to discredit someone based on appearance/social norms is quite myopic.
Einstein was pretty crazy looking.

 

[riptides]

Sure,the Dr is highly regarded with a bonified clinical trial.

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial - ScienceDirect

A Dr in NY has treated nearly 700 patients and kept all out of the hospitals.

UPDATE: Dr. Zelenko Has Now Treated 699 Coronavirus Patients with 1% SUCCESS RATE -- Using Hydroxychloroquine, Zinc and Z-Pak

The FDA push and the other trials seem to be getting smashed in peer reviews. Seems larger sampling and better controls are being saught.

PubPeer - Hydroxychloroquine and Azithromycin as a treatment of COVID-...

 

[shooterdon]

I have never faced death before. I know I will be grasping at straws. I would "risk" taking a drug that has not been extensively tested but has been safely used for over half a century. What would I have to lose?

As for those who say it is not proven...that is a measured and reasonable statement. I question the agenda of anyone who says drinking a beer will be just as effective...but hey, have the beer. We are not sure if alcohol helps or not, so you can be a member of another uncontrolled study.

I understand the rationale that taking a "useless" drug deprives those who need it for other aliments. But those other aliments are not life threatening. In the US we have less than 3500 Covid-19 cases that are serious/critical. Even if we treated all of them with a "useless" drug, and it took 10 pills each, it does not seem like a "flood" of demand that deprives others.

One last question. WHAT ARE WE WAITING FOR! Ask 500 of the serious patients if they want to roll dice. Then go and tell another 500 they cannot get it. You have your study. The way this virus progresses, we will have an answer in two weeks. KISS. People are dying.


Edited to add:
Hydroxychloroquine Dosage Guide with Precautions - Drugs.com

There are 1.5 million in the US suffering from Lupus
Assume 20% use hydroxychloroquine for treatment at 1 pill per day.
Usage will be 300,000 per day...over 100 million tablets for Lupus alone
How can current patients be running out of this drug with so few Covid-19 patients?

I hope one of the medical guys can correct my assumptions as I am just guessing.

 

[MossRoad]

Thread pruned yet again. Some of you literally have no self control. None. Couldn't go an 8 hour shift.

 

[downsizingnow48]

This new study is now being referenced in various newspapers around the country. It projects useful measurements state by state, including deaths and hospital resource use (beds, ICU beds, ventilators). There is a link so you can see their methods and data sources.

COVID-19

 

[newbury]

Just so I'm clear on this - putting the package in a household freezer is only slightly better than leaving it on the counter - ?

Actually they may have it wrong if your counter gets sunlight. Then the counter is better.

This new study is now being referenced in various newspapers around the country. It projects useful measurements state by state, including deaths and hospital resource use (beds, ICU beds, ventilators). There is a link so you can see their methods and data sources.

COVID-19

That graph shows 15 days until peak resource use on April 15, 2020.
But the administration may have taken care of that.
Treasury Secretary Steven Mnuchin announced that tax day will be delayed from April 15 to July 15. ... At @realDonaldTrump's direction, we are moving Tax Day from April 15 to July 15.
Maybe he can move peak resource use also.

 

[dragoneggs]

Have her check out that ZOOM app that allows for teleconferencing with multiple people. She could do her bible study face-to-face with multiple parties, still interact with all of them simultaneously, yet not be in close proximity to them.

My wife and her gaggle of sisters got together for happy hour (40min limit) last night to share a toast and some laughs.

Deleted. Maybe too political.

Ha ha... in the spirit of self-quarantining some are self-moderating as well :thumbsup:

1) there is no antiviral drug for coronavirus at this point.
2) the "evidence" for chloroquine is at this point non existent. The French doctor's article is no evidence at all.
3) the combination of chloroquine and azithromycin (an antibacterial) is just a "wildass guess" at an antiviral regimen
4) I'd rather just have a beer as there is just as much valid data that drinking your favorite brew is helpful as there is for chloroquine at this point
5) I'd happily sign up for a clinical trial where I might get either the experimental drug or a placebo as I do think that we should be doing good clinical trials

Rather have a beer? Feels like you dodged the question posed to you.

Have you seen a photo of the French doc? Would you want your physician to prescribe for you based on what someone posted in a YouTube video? Would you be comfortable believing his opinion without evidence that he followed a randomized controlled trial protocol and had other physician scientists reviewing his work before publication? I think he looks like a nutjob.

And Einstein? I was taught 'not to judge a book by its cover'.

I have never faced death before. I know I will be grasping at straws. I would "risk" taking a drug that has not been extensively tested but has been safely used for over half a century. What would I have to lose?

As for those who say it is not proven...that is a measured and reasonable statement. I question the agenda of anyone who says drinking a beer will be just as effective...but hey, have the beer. We are not sure if alcohol helps or not, so you can be a member of another uncontrolled study.

I understand the rationale that taking a "useless" drug deprives those who need it for other aliments. But those other aliments are not life threatening. In the US we have less than 3500 Covid-19 cases that are serious/critical. Even if we treated all of them with a "useless" drug, and it took 10 pills each, it does not seem like a "flood" of demand that deprives others.

One last question. WHAT ARE WE WAITING FOR! Ask 500 of the serious patients if they want to roll dice. Then go and tell another 500 they cannot get it. You have your study. The way this virus progresses, we will have an answer in two weeks. KISS. People are dying.

Well said.

 

[ultrarunner]

California governor when pressed said modeling being used indicates peak surge mid May... very sobering.

Also waiver of traditional medical licensing to increase available healthcare workers..

We are living in times where "Never" would/could happening is happening.

 

[DarkBlack]

I have never faced death before. I know I will be grasping at straws. I would "risk" taking a drug that has not been extensively tested but has been safely used for over half a century. What would I have to lose?

As for those who say it is not proven...that is a measured and reasonable statement. I question the agenda of anyone who says drinking a beer will be just as effective...but hey, have the beer. We are not sure if alcohol helps or not, so you can be a member of another uncontrolled study.

I understand the rationale that taking a "useless" drug deprives those who need it for other aliments. But those other aliments are not life threatening. In the US we have less than 3500 Covid-19 cases that are serious/critical. Even if we treated all of them with a "useless" drug, and it took 10 pills each, it does not seem like a "flood" of demand that deprives others.

One last question. WHAT ARE WE WAITING FOR! Ask 500 of the serious patients if they want to roll dice. Then go and tell another 500 they cannot get it. You have your study. The way this virus progresses, we will have an answer in two weeks. KISS. People are dying.

Good post.

 

[IslandTractor]

I'm curious how you come to these conclusions? I'm assuming you're referring to the peer reviewed article:

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial - ScienceDirect

I tend to put a reasonable amount of faith in peer reviewed journal articles in journals with an impact factor of 4.6.

It isn't a complete study (what study really is? - there are always improvements to be made) but it provides some pretty compelling evidence.

Trying to discredit someone based on appearance/social norms is quite myopic.
Einstein was pretty crazy looking.

1) The key issue here is the value of an "open-label non-randomized clinical trial". FDA never accepts these as they are chock full of uncontrolled bias that can be difficult to weed out. It is a fancy way of saying "I gave the drug to whomever I wanted to and excluded patients I didn't want to get it for whatever reason". In addition, in this paper it is clear that they didn't even have a control group in their own hospital. They used a different hospital for controls. That is almost never acceptable as you don't know what the differences in patient populations are. For example, one hospital might be a middle class referral center (think Mayo Clinic) and the other might be an inner city gun and knife club filled with addicts and poorly nourished patients (this is obviously and extreme example). You simply cannot legitimately use a control from another facility unless you know the hospital populations are very similar and that the criteria for admission, testing, supportive care, laboratory quality etc etc are the same. The fact that the study wasn't randomized means that the investigators get to choose who they treat and that simple fact introduces another whole type of potential bias called selection bias. The type of study done by the French is equivalent to cherry picking opinions on the Internet without knowing anything about the people posting. Not a good idea. That's why FDA insists on double blind (investigator nor patient knows whether they get the experimental drug or placebo so there cannot be bias in assessing the effectiveness later) and randomized (investigator doesn't get to choose who gets put in which arm of the trial).

Regarding the journal International Journal of Antimicrobial Agents: not a top tier journal for starters. Not terrible but not read nearly as much as Lancet, NEJM or a couple of dozen infectious disease journals etc etc. Why not publish in a more widely read journal if you are trying to get the word out??? Several reasons. For starters it is the type of trial that rarely is published anymore for the reasons I just reviewed. Another reason is that that journal is run by an editor who is in Marseille the same city where the study is done. Home town advantage?? I would not consider this to have been a peer reviewed study based on what I can see. It is more likely an old boy's club review and as the senior author is a well known politically powerful character, I doubt it was a vigorous review at all.

I agree it isn't a complete study. In fact it needs to be completely redesigned in order to generate any useful data. Randomized double blinded controlled trial with external review. Fair enough to point out that such a trial would take more time (but not that much more) but knowing that an anecdotal report (which is all that an open-label non-randomized clinical trial is) is next to useless in making serious medical decisions, it should never have been presented as something that should be immediately adopted. I don't expect Trump to know that but Trump should know to listen to Fauci and Fauci knows exactly that which is why he refused to endorse chloroquine.

I was half joking about the appearance of the senior author and indeed I pointed out that I have worked with some pretty weird looking scientists who I hold in high regard. Einstein didn't announce his theories on YouTube!