Coronavirus COVID-19 - Global Health Pandemic #50

[Deleted member 158085]

did they really suggest injecting cleaning agents into lungs??? omg

From what I just saw and heard (source is the latest press conference), yes.

Obviously not a good idea.

 

[tmar]

U.S. Scientists Not Allowed Into China to Investigate Coronavirus: Pompeo

David Brennan
11 hrs ago
...
Secretary of State Mike Pompeo has accused China of not allowing American scientists to visit the country and investigate the origins of the COVID-19 coronavirus outbreak, delivering yet another attack on Beijing's handling of the crisis.

Pompeo told Fox News' The Ingraham Angle on Wednesday that China is not allowing "the transparency and openness we need" regarding the pandemic, which originated in the central Chinese city of Wuhan and has now spread worldwide.

Pompeo has been among the most vocal critics of China over COVID-19, echoing President Donald Trump's attacks on Beijing and peddling a conspiracy theory suggesting the virus' may have originated in a scientific research lab in Wuhan. There is currently no evidence to support the theory, but this has not stopped Pompeo and Trump from alluding to it.

 

[tmar]

Australia making 'good progress' in fight against coronavirus. Catch up on the key points from Scott Morrison's latest update
16 hrs ago


Coronavirus growth figures are so low they would have been unimaginable just weeks ago.

This means Australian leaders are beginning to talk about the country working towards a so-called "COVID-safe economy".

But, as cases appear to be under control, they warn we can't get complacent because thousands of people are dying of the disease in counties with advanced healthcare systems like the UK, France and Germany.
...
Getting to a 'safe' economy
With just four cases recorded across the country on Thursday, Mr Morrison said Australia was "on the way back to a COVID-safe economy".
...
In the meantime, Mr Morrison said additional contact tracing measures and reliable supplies of testing kits and medical equipment will be protections against any future outbreaks.

 

[10ofRods]

I looked at your 2and to last link, USA today I think. What arrhythmia are they talking about? Arrhythmia is a pretty broad term. Jmo

When I realized who was asking, Dreamer, I did go through my links and find it. Not only is it an arrhythmia, it is a specific one that is associated with timing of the depolarization and polarization in heart cells. It's called the QT rhythm. Women are more likely than men to have a serious or potentially fatal version of this arrhythmia.

While it's difficult to provide an exact analogy, as someone with a congenital heart arrhythmia, I compare it to the rather uncomfortable situation that my heart has stopped. Obviously, it hasn't. Mine is a slightly different kind of arrhythmia (associated with Sudden Cardiac Death Syndrome). It's idiosyncratic, which means mine comes and goes (lots of people in my bio dad's family have the same thing).

People who already have arrhythmias, like me, are at increased risk from HC. This article is the one that explains the arrhythmia in fairly easy to understand terms, and gives a scoring system for who should not be on HC:

COVID-19 Hydroxychloroquine Treatment Brings Prolonged QT Arrhythmia Issues

Serum potassium is the one variable every doctor should check before prescribing (but that's not built into any of the research protocols, nor is it likely to be, at this point).

If a person reads that article and still wants to be prescribed HC, they can go for it. But the entire swing toward different kinds of medication make me certain, it's not a drug I'd want anyone with heart problems to be on, or anyone on high blood pressure meds or diuretics, or anyone with potassium deficiency. Merely being female is a low risk factor (but measurable). Prior similar QT arrhythmia is another nope.

Those "control group studies" are not selecting for those factors because of course they are trying to find out what the drug does to people in general. The study above is a much better analysis of what is known about HC at this point, and why it is risky for so many.

 

[tresir2012]

Most doctors consider giving placebos to very ill patients unethical and immoral. So, you will either have to accept these various closed-cohort retrospective studies or wait some nation decides to undertake this. HC has already been tested in completely non-sick people, but the study you are asking for would require everyone in the study to be equally sick (which is what happened in the Veterans study, more or less). Even better, would be good to take some mildly symptomatic people and put them in the study (with symptomology - this takes combing through medical records, often done by medical students and grad students - who are currently not permitted into CoVid heavy environments right now). Photocopying all those records is not a use a resources that most hospitals can sanction right now.

So, the only studies we have are of "CoVid patients" (sick) and no placebo group (CoVid patients - sick - given NOTHING." Doctors simply cannot "give nothing" to sick people in a pandemic to see if they die.

Have you listened to the podcast on the Guardian? It would help you understand the problems with HC. Here are some other studies, but again, no one is just testing CoVid patients who are sick and then putting them in a hospital bed and doing nothing other than watch them (and give them a known placebo, such as a sugar pill). Since the mechanism of this virus is better understood today than 10 days ago, it's unlikely you'll see many HC studies (as it is associated with more deaths and not fewer in the study we're discussing). That's not a positive indicator. People who got merely antibiotics did better. See the problem?

HC + Zinc seems to be doing better than HC + Zpac, but still not great.

BTW, since HC may actually be harmful, it would be interesting to back and back out all HC patients from every hospital study and see the stats. That'll get done and if it turns out that HC was actually upping mortality rates, then it's really been a bad idea for someone with a bully pulpit to tell people to take it.

The NIH says the data from all the studies that are published says there's neither data for OR against HC.

Therapeutic Options Under Investigation | Coronavirus Disease COVID-19

So rather than ask for the individual studies (all of which will have the problem you're pointing out), why not just go with what the experts say? If doctors do elect to prescribe HC, they need to monitor for specific heart problems, as that side effect seems to be significantly negative for CoVid patients (it's predictive of an increased risk of heart attack).

If there were *any* studies that gave HC a positive outcome, then perhaps the heart issues would simply mean that some patients couldn't take it, but the rest could

However, the NIH review of the literature shows absolutely no evidence that HC works, and the VA study shows that it might actually encourage a more severe course.

There is, however, a pharmaceutical company that has received FDA permission to conduct a test with placebos. The design calls for the patients to be pulled out of the placebo test if they worsen or if a doctor for any reason thinks they need something else. There's nothing in the design that would prevent, for example, those placebo patients from getting plasma. All patients will receive "standard of care," which means they may actually get some other drug in addition. This will take the placebo patients out of the placebo group, of course, and if the HC group and the HC+Z group also gets some other drug, they'll be out of the study as well.

In one study, ALL of the placebo patients were removed from the placebo group, so we shall have to see how this study goes.

Here are some links to studies about HC:

No Hydroxychloroquine Benefit in Randomized COVID-19 Trial

This is a 150 patient study where the non HC patients simply received basic standard of care (SoC). There was no difference in quality of symptoms, except that the HC group had a 10% chance of an added symptom that none of the non-HC group had (diarrhea). Two patients in the HC group progressed to more serious symptoms while that was not true of the non-HC group.

For the study where they had to stop the HC because of side effects, etc, see here:

Coronavirus drug chloroquine – touted by Trump – has test halted

The last study, while without placebo groups, was double blind (nurses and attendings did not know which patients were getting HC, but as they had to treat more symptoms, the researchers had to reveal that fact and in all cases, the attending doctor d/c'ed the HC).

The heart issues with HC are now well-documented and alarming enough to some doctors, that they recommend against it:

French officials report heart incidents in experimental coronavirus treatments with hydroxychloroquine

There were no studies of comatose, ventilated patients who all of a sudden started receiving HC on their last day of life. At least, I can't find any and naturally, those would be of little therapeutic or scientific value unless the patient made a miraculous recovery, which would likely be reported in Lancet and JAMA as anecdotal.

It's of interest that among the many trial drugs out there, physicians at university hospitals conducting such studies aren't studying HC. The one big study is sponsored by a big pharma company. Given that stark divide in research motivation, I don't think you'll see any large scale studies about HC except that one, in the near future.

The Zinc + HC guy in Los Angeles is facing federal charges regarding his claims.

TY for all the sources. I have also found this business insider article from a couple of weeks ago that covers a lot of the studies also.

Why experts are skeptical of studies that seemed to show promising results from using a decades-old malaria drug to treat the coronavirus

The last paragraph sums it up for me.

Why it's important to wait before jumping to conclusions
Derek Lowe spent three decades working on drug discovery in labs and now writes an industry blog called In the Pipeline, where for weeks he has cautioned people about prematurely reaching conclusions based on very early reports on COVID-19 drugs.

In a post on Monday, Lowe wrote that often in drug research, early results that look positive end up falling apart with more rigorous study.

"After you've experienced this a few times, you take the lesson to heart that the only way to be sure about these things is to run sufficiently powered controlled trials," Lowe wrote. "No short cuts, no gut feelings — just data."

By "sufficiently powered," Lowe means enrolling enough patients — hundreds, if not thousands — to notice the effect size of the intervention, he said.

There are large, high-quality trials underway to test hydroxychloroquine in a range of uses. These include not just testing hospitalized COVID-19 patients, but seeing whether it can prevent hospitalizations in early infections or even prevent infections in the first place.


In the meantime, one-off reports about COVID-19 patients taking the drug and recovering are likely to come out, given the sheer number of prescriptions being written and the fact that most COVID-19 patients recover, regardless of treatment.

"If you haven't done this stuff, you can look at a report of people responding to such a treatment and figure that the answer is here — right here, and anyone who doesn't see it must have some ulterior motives in ignoring what's in front of their face," Lowe wrote. "But that's not how it works."

 

[10ofRods]

We spent a wonderful few days in Bozeman went we went to Yellowstone. We found it very tourist-friendly and very welcoming in general. I'd go back in a heartbeat (I'm from Texas). I have a local friend who went there for six weeks at a time several summers in a row.

It's super crowded after Memorial Day weekend. Some of the more distant hikes and locations are still tranquil, but in the last 5 years, Yellowstone has been so crowded that there are miles-long traffic jams near Old Faithful and the boardwalks at Old Faithful were so crowded when we last went that people were literally pushing each other off the walk and onto the fragile crust below)

This year should be different. My guess is that Yellowstone will NOT be crowded (because many hotels and lodgings will be closed or at reduced numbers). Camping should be awesome. The main campgrounds only rarely see grizzlies, but it happens often enough that we felt more comfortable storing our stuff in the tent and sleeping in the SUV. We went around May 10 a couple of years ago and it was magnificent. So we decided to go again around June 10. Major mistake - way less wildlife, terrible crowds, roads, roads blocked by people in the road every time they saw anything other than a bison.

It's chilly in May but oh so worth it.

 

[TMAN2014]

Dr. Fauci is talking at the NFL draft in a commercial.

 

[CSIDreamer]

When I realized who was asking, Dreamer, I did go through my links and find it. Not only is it an arrhythmia, it is a specific one that is associated with timing of the depolarization and polarization in heart cells. It's called the QT rhythm. Women are more likely than men to have a serious or potentially fatal version of this arrhythmia.

While it's difficult to provide an exact analogy, as someone with a congenital heart arrhythmia, I compare it to the rather uncomfortable situation that my heart has stopped. Obviously, it hasn't. Mine is a slightly different kind of arrhythmia (associated with Sudden Cardiac Death Syndrome). It's idiosyncratic, which means mine comes and goes (lots of people in my bio dad's family have the same thing).

People who already have arrhythmias, like me, are at increased risk from HC. This article is the one that explains the arrhythmia in fairly easy to understand terms, and gives a scoring system for who should not be on HC:

COVID-19 Hydroxychloroquine Treatment Brings Prolonged QT Arrhythmia Issues

Serum potassium is the one variable every doctor should check before prescribing (but that's not built into any of the research protocols, nor is it likely to be, at this point).

If a person reads that article and still wants to be prescribed HC, they can go for it. But the entire swing toward different kinds of medication make me certain, it's not a drug I'd want anyone with heart problems to be on, or anyone on high blood pressure meds or diuretics, or anyone with potassium deficiency. Merely being female is a low risk factor (but measurable). Prior similar QT arrhythmia is another nope.

Those "control group studies" are not selecting for those factors because of course they are trying to find out what the drug does to people in general. The study above is a much better analysis of what is known about HC at this point, and why it is risky for so many.

I was just coming back to say prolonged QT aha!

Definitely a good point about testing potassium. I'm on several supplements. Low sodium V8 is my potassium source.

It's also called Long QT if anyone is interested:

Long QT Syndrome | National Heart, Lung, and Blood Institute (NHLBI)

 

[10ofRods]

TY for all the sources. I have also found this business insider article from a couple of weeks ago that covers a lot of the studies also.

Why experts are skeptical of studies that seemed to show promising results from using a decades-old malaria drug to treat the coronavirus

Thank you!

All of you are so studious and industrious. If I gave even a fraction of these articles to my online students (who are supposed to be studying the factors involved in human life/death and specifically, RNA and DNA) their eyes would glaze over.

 

[Inthedetails]

Louisiana should be fine this summer. Our humidity reaches near 100% every day. The moisture is so thick that you can cut it with a butter knife. Shoots, a month or so ago we have to turn on the air conditioner to reduce the humidity inside.

Well, if people are inside with the a/c on to keep cool and reduce humidity, not sure how humidity and sunshine would have any affect. ?

jmo

 

[10ofRods]

TY for all the sources. I have also found this business insider article from a couple of weeks ago that covers a lot of the studies also.

Why experts are skeptical of studies that seemed to show promising results from using a decades-old malaria drug to treat the coronavirus

The last paragraph sums it up for me.

Why it's important to wait before jumping to conclusions
Derek Lowe spent three decades working on drug discovery in labs and now writes an industry blog called In the Pipeline, where for weeks he has cautioned people about prematurely reaching conclusions based on very early reports on COVID-19 drugs.

In a post on Monday, Lowe wrote that often in drug research, early results that look positive end up falling apart with more rigorous study.

"After you've experienced this a few times, you take the lesson to heart that the only way to be sure about these things is to run sufficiently powered controlled trials," Lowe wrote. "No short cuts, no gut feelings — just data."

By "sufficiently powered," Lowe means enrolling enough patients — hundreds, if not thousands — to notice the effect size of the intervention, he said.

There are large, high-quality trials underway to test hydroxychloroquine in a range of uses. These include not just testing hospitalized COVID-19 patients, but seeing whether it can prevent hospitalizations in early infections or even prevent infections in the first place.


In the meantime, one-off reports about COVID-19 patients taking the drug and recovering are likely to come out, given the sheer number of prescriptions being written and the fact that most COVID-19 patients recover, regardless of treatment.

"If you haven't done this stuff, you can look at a report of people responding to such a treatment and figure that the answer is here — right here, and anyone who doesn't see it must have some ulterior motives in ignoring what's in front of their face," Lowe wrote. "But that's not how it works."

Okay, I read it and of course it refers to the studies I've already linked to. Which do NOT show "promising results." At all! Both studies show "no better than anything else" in the raw data and both show "can cause an uptick of 1-3%" in terms of deaths. How is that deemed "promising"? Because it didn't outright kill a bunch of people?

Okay, I'm done discussing drug treatment advances. It's not my field of expertise, and I'm going to go with the experts. Like Dr Fauci or NIH or any other number of people. The news article linked is written by a journalist with apparently no understanding of heart rhythms, co-treatments, drug cocktails or anything else. I'm not blaming journalist, but the headline supports a certain point of view that is false.

It's clickbait for people who want to believe. In France, it's the "smokers are doing better than non-smokers" thing. All of it is ridiculous and I'm personally exhausted by it.

 

[tresir2012]

I'm utterly convinced it travels through the heating/cooling system. My mother lives in an apartment building for senior citizens and disabled. It hasn't leveled them and I dont know why. I've seen them ignore mask and social distancing rules. A bit hard to social distance / mask up when a lot of them have hearing issues. I'm convinced it's because they all have their own heating/cooling units in their apartments. Jmo

Did you see the article and study I posted yesterday about the Ghangzhou restaurant where the 1 table infected two other tables via the air conditioning. There was a table plan in the article. I think that is a real possibility. Also thinking of the London and NY subway systems with the thru air running through all the carriages.

 

[dixiegirl1035]

Watch from 1:16:20 to 1:32:00 for new researched information on the virus.

Thanks and Done - I see he is stating what we have said here many times after reading research report here such as https://www.nejm.org/doi/full/10.1056/NEJMc2004973 and what is expected with viruses.

He is with Frederick Maryland lab studies (place that did Anthrax studies)
emerging work he shared as to trends... he positions this as new discoveries.

Reviewed 1/2 life = Humidity and UV lights decrease 1/2 life. (We have talked about this on many of the threads and reviewed many reports that stated this... heat, humidity and UV affect the virus)

He reviews heat and humidity to suppresses (nothing new)
He talks about moving activities outside as sunlight impedes virus transmission (nothing new - except he used the word "impedes transmission vs. decreases the 1/2 life)
He talks about how disinfectants, bleach and isopropyl achohol kills the virus (nothing new)
Lives longer on non porous surfaces. (nothing new)

We could say nothing new/unexpected.... but guess this is new to most folks watching who don't read here at WS. MOO

He's saying this information will be used in decision making as to helping governors opening up certain areas. That if on playground equipment, will kill more if in sunlight vs. in shade.

MOO

 

[Trino]

And how many people in the US have really had the virus?

"A preliminary study of 3,000 New Yorkers found that 13.9% tested positive for coronavirus antibodies, Gov. Andrew Cuomo said Thursday.
If those rates hold for the state's 19.5 million people, then about 2.7 million people in the state had the virus -- numbers that are multiple times higher than the official state counts.
The tests were performed on 3,000 random adults who were outside of the home, he said, so it was not an entirely random sample."
Coronavirus spread 'under the radar' in US major cities since January, researchers say - CNN

 

[Alathea]

JaneEyre said: ↑
Well, this is a bit maddening. We should not have unqualified people at the helm. It can cost lives.
Special Report: Former Labradoodle breeder tapped to lead U.S. pandemic task force

I don't understand appointments like this, especially at this level of importance. We have a nation with experienced, top-notch people willing to serve the nation....and we get labradoodle guy.

jmo

Simply astonishing that a dog breeder is leading the US Pandemic task force. This article from Reuters is a MUST READ - all the way through. The fact that he's a dog breeder is the least concerning part.
Special Report: Former Labradoodle breeder was tapped to lead U.S. pandemic task force

"Harrison, 37, was an unusual choice, with no formal education in public health, management, or medicine and with only limited experience in the fields. In 2006, he joined HHS in a one-year stint as a “Confidential Assistant” to Azar, who was then deputy secretary. He also had posts working for Vice President Dick Cheney, the Department of Defense and a Washington public relations company."

 

[CSIDreamer]

Did you see the article and study I posted yesterday about the Ghangzhou restaurant where the 1 table infected two other tables via the air conditioning. There was a table plan in the article. I think that is a real possibility. Also thinking of the London and NY subway systems with the thru air running through all the carriages.

Yes, I did. Thank you for that!

 

[Seattle1]

The new coronavirus appears to be causing sudden strokes in adults in their 30s and 40s who are not otherwise terribly ill, doctors reported Wednesday.

They said patients may be unwilling to call 911 because they have heard hospitals are overwhelmed by coronavirus cases.
There's growing evidence that Covid-19 infection can cause the blood to clot in unusual ways, and stroke would be an expected consequence of that.

Dr. Thomas Oxley, a neurosurgeon at Mount Sinai Health System in New York, and colleagues gave details of five people they treated. All were under the age of 50, and all had either mild symptoms of Covid-19 infection or no symptoms at all.
"The virus seems to be causing increased clotting in the large arteries, leading to severe stroke," Oxley told CNN.

video

Video: Doctors finds disturbing trend of strokes in young coronavirus patients

Covid-19 causes sudden strokes in young adults, doctors say - CNN

How does COVID-19 lead to acute respiratory distress syndrome (ARDS)?

Similar to many other viruses, coronaviruses—including the novel coronavirus, or SARS-CoV-2—can infect and damage the lung cells, setting the stage for the occurrence of ARDS, explains Dr. Takyar.

“It is thought that the infection-induced damage and inflammation cause a malfunction of the lung vasculature [the pulmonary vessels within the lungs]," he says. When that happens, the exchange of oxygen within the body is impaired. Among viruses, the ones that cause pneumonia (like COVID-19) are more likely to cause ARDS.

When patients are in the late stages of novel coronavirus infection—after severe damage has already been done to their lungs—their body will try to fight off the virus by sending immune cells to the lungs, which is what ultimately causes the inflammatory reaction, explains Dr. Takyar.

In fact, ARDS in coronavirus “seems to be less directly due to the virus itself and more related to inflammation, or the body’s response to the virus,” adds Jaimie Meyer, MD.

While experts are still in the early stages of learning about COVID-19, research surrounding ARDS and coronavirus has found that the two often go hand-in-hand.

According to the earlier JAMA study, researchers also concluded that an older age translated to a higher risk factor of developing ARDS and dying, "likely owing to less rigorous immune response," per the study authors.

Additionally, the authors noted that if an ARDS patient was running a higher fever, they were more likely to recover, due to the body fighting off the infection.

How Can the Coronavirus Become Deadly? This Disease is Commonly to Blame

 

[10ofRods]

“Here is when the model estimates your state will be able to reopen as of April 23:

IHME reopen estimate

Alabama
May 19

Alaska
May 7

Arizona
June 26

Arkansas
June 22

California
May 18

Colorado
May 26

Connecticut
June 9

Delaware
May 19

District of Columbia
June 4

Florida
June 14

Georgia
June 22

Hawaii
May 6

Idaho
May 16

Illinois
May 19

Indiana
May 21

Iowa
June 26

Kansas
June 21

Kentucky
June 14

Louisiana
May 23

Maine
May 13

Maryland
June 4

Massachusetts
June 10

Michigan
May 20

Minnesota
May 31

Mississippi
May 29

Missouri
June 10

Montana
May 6

Nebraska
July 3

Nevada
May 20

New Hampshire
May 16

New Jersey
May 27

New Mexico
May 24

New York
May 27

North Carolina
May 11

North Dakota
July 19

Ohio
May 14

Oklahoma
June 17

Oregon
May 27

Pennsylvania
May 27

Rhode Island
June 10

South Carolina
June 8

South Dakota
June 27

Tennessee
May 20

Texas
June 8

Utah
June 23

Vermont
May 10

Virginia
June 4

Washington
May 28

West Virginia
May 8

Wisconsin
May 21

Wyoming
May 25”

We might say "soft reopening" and also point out that IMHE itself now acknowledges that it was wrong in its algorithms in many areas (it's completely off for California - we are now following IMHE's original curve, not the one that's currently up on its site).

Thankfully, IMHE has also encouraged each region to use its own data and algorithms, which works for larger states with major research teams. It's especially great if there are several different scientific viewpoints, and if they are closely tailored by local region. Bakersfield is very different from San Francisco. Ojai is very different from Huntington Beach.

It's the same where ever you live. Actual human beings with knowledge, intelligence and common sense are going to have to work this out locally, in conjunction with the availability of state and local resources. If you're in a state where all the bail-out money just went to hotel chains, that's very different than if you're someplace where the State is filling the gap with actual small business loans.

If I lived somewhere dependent on small businesses, I'd be wanting local groups and authorities to be helping out - the Feds are reaching the end of their largesse.

 

[roche.analisa]

RSBM

I'm convinced it was on the West Coast earlier than we initially thought.

Dr. Campbell thinks, based on February deaths, that it was probably in California as early as December.

Additionally, the authors noted that if an ARDS patient was running a higher fever, they were more likely to recover, due to the body fighting off the infection.

Dr. Campbell has also said repeatedly that meds should not be taken to lower fevers if at all possible, as they are so important for killing the virus.

 

[tresir2012]

Okay, I read it and of course it refers to the studies I've already linked to. Which do NOT show "promising results." At all! Both studies show "no better than anything else" in the raw data and both show "can cause an uptick of 1-3%" in terms of deaths. How is that deemed "promising"? Because it didn't outright kill a bunch of people?

Okay, I'm done discussing drug treatment advances. It's not my field of expertise, and I'm going to go with the experts. Like Dr Fauci or NIH or any other number of people. The news article linked is written by a journalist with apparently no understanding of heart rhythms, co-treatments, drug cocktails or anything else. I'm not blaming journalist, but the headline supports a certain point of view that is false.

It's clickbait for people who want to believe. In France, it's the "smokers are doing better than non-smokers" thing. All of it is ridiculous and I'm personally exhausted by it.

Did you read the last paragraph that I C/P into my post? That sort of illistrates my POV. You have to wait until thousands of examples are available for the results to be suffiently meaningful. There are still large high quality of trials going on involving hundreds, maybe thousands of patients.