Coronavirus COVID-19 - Global Health Pandemic #58

[katydid23]

Study controlled for confounding factors. Which means you can't attribute higher death rate to history of heart disease.

"After controlling for multiple confounding factors (age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity), when compared with mortality in the control group (9·3%), hydroxychloroquine (18·0%; hazard ratio 1·335, 95% CI 1·223–1·457), hydroxychloroquine with a macrolide (23·8%; 1·447, 1·368–1·531), chloroquine (16·4%; 1·365, 1·218–1·531), and chloroquine with a macrolide (22·2%; 1·368, 1·273–1·469) were each independently associated with an increased risk of in-hospital mortality."
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

That ^^^is gobbledy gook, in my opinion.

The 'treatment' group has MORE patients with a history of heart arrhythmia than the control group.

"Ventricular arrhythmias were more common in the treatment groups compared with the control population. Mortality was higher in the treatment groups compared with the control population (p<0·0001; appendix pp 15–18).'

And then surprise, the treatment group had a higher number of patients who died from heart arrhythmia. So it is an obvious outcome. One group had more patients with a history of heart disease than the other group. So why ignore that in the final analysis?

 

[jjenny]

That ^^^is gobbledy gook, in my opinion.

The 'treatment' group has MORE patients with a history of heart arrhythmia than the control group.

And then surprise, the treatment group had a higher number of patients who died from heart arrhythmia. So it is an obvious outcome. One group had more patients with a history of heart disease than the other group. So why ignore that in the final analysis?

Controlling for confounding factors means differences between groups are taken into account when calculating stats. Which means that drug taking group had a higher death rate. And why would doctors give two drugs known for cardio toxic effects to patients that already had heart problems is beyond my understanding. Especially considering any benefits of such drugs are not proven.

 

[katydid23]

So basically a philosophy of "every man for himself" as opposed to a philosophy of "the needs of the many outweigh the needs of the few, or the one".

That is a very insightful, though perturbing, perspective. Thank you.

OR, it could be that travellers and tourists entering NYC brought it with them, and then everyone used the subways and the taxis and ate in crowded restaurants, and it spread like wildfire.

 

[katydid23]

Controlling for confounding factors means differences between groups are taken into account when calculating stats. Which means that drug taking group had a higher death rate. And why would doctors give two drugs known for cardio toxic effects to patients that already had heart problems is beyond my understanding. Especially considering any benefits of such drugs are not proven.

I don't know why they would do so, but apparently they did.

As to the claims that they controlled for confounding factors, they admitted it does not always work:

Our study has several limitations. The association of decreased survival with hydroxychloroquine or chloroquine treatment regimens should be interpreted cautiously.

Due to the observational study design, we cannot exclude the possibility of unmeasured confounding factors, although we have reassuringly noted consistency between the primary analysis and the propensity score matched analyses. Nevertheless, a cause-and-effect relationship between drug therapy and survival should not be inferred. These data do not apply to the use of any treatment regimen used in the ambulatory, out-of-hospital setting. Randomised clinical trials will be required before any conclusion can be reached regarding benefit or harm of these agents in COVID-19 patients. We also note that although we evaluated the relationship of the drug treatment regimens with the occurrence of ventricular arrhythmias, we did not measure QT intervals, nor did we stratify the arrhythmia pattern (such as torsade de pointes). We also did not establish if the association of increased risk of in-hospital death with use of the drug regimens is linked directly to their cardiovascular risk, nor did we conduct a drug dose-response analysis of the observed risks. Even if these limitations suggest a conservative interpretation of the findings, we believe that the absence of any observed benefit could still represent a reasonable explanation.

 

[CharlestonGal]

Add to that that there are plenty of people who are not of retirement age, but are not particularly healthy. They still have to go to work. I haven't heard any plans to pay such people to sit at home so they can self-isolate. I've seen plenty of posts here saying that there is no need for healthy younger people to sit at home, as they can work. But how not so healthy younger people are going to sit at home if they have bills to pay?

Tens of millions of us are apparently expendable burdens according to some schools of thought.

There seems to be a percentage of people who believe things are peachy keen as long as nothing happens to them or their families or their friends. As for the rest of us, it would seem to be okey-dokey if we just crawl away and die rather than inconvenience them.

I had to ax a friend who expressed that view the other day. I legit had no idea she was so self-centered.

 

[CSIDreamer]

This is great. Everyone who is young, healthy, go to work. The problem is that a lot of these folks may live with older parents, grandparents, or people who are immunocompromised.

They will go to work, and potentially bring home a virus to wipe out their family. Nice choice. Should I just relegate the basement to my daughter? Should I be parted from my husband forever, because I could bring home a virus from work that will kill him?

Wouldn't some common sense apply to any person's individual situation? Not every household has the same living arrangements.

 

[tresir2012]

When one person can infect numerous people, as soon as you start opening up, the numbers will go up. Because we didn't contain covid, unlike China.

Its not about containing it so much as managing it IMO. It has clearly proved impossible to contain it as we now have more than 300k deaths and 5 mill cases worldwide. Even China and South Korea have had relapses.

 

[Simply Southern]

This morning Cuomo is pretty much begging people again to get the covid test. Probably many reasons why NY'ers are not running in to be tested. For the first time since late March, NY deaths fell below 100.

My adult son went yesterday to his physician at NYU Med Center to get tested. Doc said he only needed an AB test (blood test) since he has had no symptoms at all since the shutdown. Told him it would be great if he had the ABs, but stressed (you know the drill) he would still need to be vigilant, wear mask, wash hands and stay out of the subway system, no one knows how long immunity lasts, etc. (Happy about the subway warning!).

Guess what! He told my son that 90% of his patients coming into the office for the test/s, have tested Negative for ABs. I'm surprised given that I've felt that many NY'ers were/are walking around spreading covid though they themselves were asymptomatic. He told him that there will be a second wave in NYC in Sept-Oct or Oct-Nov. I don't recall which months he said. Many of his 90% without ABs will contract covid then as they let up their vigilance and as the city opens up, but won't die if they aren't in the high risk age group and/or do not have the underlying health risks.

In the meantime, my son's bosses were begging him to come into the office last week even though he and they have been working from home. They "forgot" to send his paycheck after he refused to go in last week. He's under obvious pressure from them now. Oh, they are not an essential business.

Then there's his partner's mother, a small business owner, who opened her store last week even though she acknowledged several of her customers have died. That lasted about 7-10 days before NYPD visited and shut her down. But, she's gonna open again today! Another business across the street from her was fined and shut down that same day. Neither, are essential businesses.

Again, I wish I had been able to leave NYC before the shutdown. Thinking about trying to before the second wave hits.

Virginia was third place in the list of relocations of NY residents per travel tracking surveillance. Most headed to the Eastern part of the state, with beaches/larger cities. In rural SW VA we did see a rise in out of towners, mostly family, young adults returning home, and some friends.

Now is a good time to look around, if relocation is an option. I certainly don't want anyone to leave an area they love but, at the same time folks deserve to live in an environment they can enjoy. For those of us that don't have to work, can stay home, rural Virginia has gots some nice wide open space to breath and run your toes through the dirt.

 

[tresir2012]

They will have to work from home where it is possible, IMO

Add to that that there are plenty of people who are not of retirement age, but are not particularly healthy. They still have to go to work. I haven't heard any plans to pay such people to sit at home so they can self-isolate. I've seen plenty of posts here saying that there is no need for healthy younger people to sit at home, as they can work. But how not so healthy younger people are going to sit at home if they have bills to pay?

 

[CharlestonGal]

OR, it could be that travellers and tourists entering NYC brought it with them, and then everyone used the subways and the taxis and ate in crowded restaurants, and it spread like wildfire.

NYC is not even in the top 20 of the world's busiest airports.

 

[CSIDreamer]

68.7 million Americans are over the age of 60.

68.7 million Americans are over the age of 60.

Yep. That's why I'm all for sheltering these people.

 

[mickey2942]

Wouldn't some common sense apply to any person's individual situation? Not every household has the same living arrangements.

It would seem that way. But the reality is not. Go back to work, quit or get fired. There is no middle ground here.

 

[dixiegirl1035]

Starting at 14:15, there is a contest for the best video re covid19 for a public service announcement for why folks should wear a mask.

Winner to be announced Tuesday.

Submissions have been shown more days before which I did not capture. I know which one I would vote for!

Great idea, love involving folks and looking forward to the winner as I've enjoyed seeing all of them! Not just the top ones.

To view this content we will need your consent to set third party cookies.
For more detailed information, see our cookies page.

Accept third party cookies

attached is screen shot for submissions

 

[CSIDreamer]

NYC is not even in the top 20 of the world's busiest airports.

I'm thinking as far as international airports New York and New Jersey rank pretty high on the list for US airports. Combine that with population density and mass transit. Jmo

 

[Sundog]

This is great. Everyone who is young, healthy, go to work. The problem is that a lot of these folks may live with older parents, grandparents, or people who are immunocompromised.

They will go to work, and potentially bring home a virus to wipe out their family. Nice choice. Should I just relegate the basement to my daughter? Should I be parted from my husband forever, because I could bring home a virus from work that will kill him?

At first when Ohio's Governor ended the stay-at-home order and went to the "safer at home" order, I feel angry, bitter, and resentful. At high risk due to age and a high risk medical condition, it didn't seem fair that I might have to go back to work in the office, rather than remotely, as I am now doing.

But over time, I have come to see that I need to be proactive in figuring out how to keep our family safe as the reopening continues. I can't retire yet either, but I am following ADA acccommodation regulations, FMLA options, and tracking legislation proposed in the state legislature regarding options for high risk individuals who may want to continue to self-isolate. Many threads ago, I posted a message about the importance of public policy and working with state legislators and our U.S. senators and congress members, as we are their constituents, also.

Buying time is good, and if we can make it one more month and see where we are in early July - each month we will have more information and results regarding therapeutics, vaccine development progress, hospital capacity, etc.

In the worse case scenario, selling one's house and downsizing, and other such decisions might be necessary, so it is good to think about these things as a last resort, just in case. No one in their 60s or 70s wanted to spend their later years in this kind of situation, but it is what it is. I have some really great neighbors who are young families, and for them life is going on without much change. They aren't covidiots, they are decent people who have to raise their family and pay their mortgage, and also care for extended family members such as parents and grandparents. Everybody needs to make their own personal plan. The state should provide a safety net where it can, and people should lobby for assistance for their needs as a group, and the AARP is one organization that tries to do so. This is a difficult time, and may require drastic choices and actions, but every one has to make their own plan and face the reality of their situation. It has taken me several months to do so, but I try to focus on the options that I have and to generate more. JMO.

 

[10ofRods]

It would seem that way. But the reality is not. Go back to work, quit or get fired. There is no middle ground here.

Yes, that's how it's being handled most places. And from what I read on other forums, a lot of people are quitting. It's probably wise to go look for more protected work right now, than in summer when the UI runs out most places.

It's a terrible situation for those with immune-compromised kids and spouses, for sure.

 

[mickey2942]

Yes, that's how it's being handled most places. And from what I read on other forums, a lot of people are quitting. It's probably wise to go look for more protected work right now, than in summer when the UI runs out most places.

It's a terrible situation for those with immune-compromised kids and spouses, for sure.

What I really "like" about the "plan", is that the management makes these decisions, from their desk, at home, performing "tele-work".

 

[katydid23]

NYC is not even in the top 20 of the world's busiest airports.

It is one of the most diverse. And the people were being funnelled into a large crowded city with heavy reliance on mass transit.

Why coronavirus pandemic hit New York City so hard
A Financial Times analysis of hard-hit places has only Bergamo, Italy, and Guayas, Ecuador, running ahead of New York in percentage of excess deaths — not Madrid, London or Ile-de-France.

The epidemic started early in New York. According to one model, the city had its first 10 cases at the end of January or by the middle of February. By the time it had its first confirmed case on March 1, there may have been as many as 10,000 undetected cases.

The city was getting seeded constantly from abroad. A study published by medrxiv.org concluded that “introductions from Europe account for the majority of cases found in NYC in the first weeks of March 2020.” It found “isolates from Italy, Finland, Spain, France, the U.K. and other European countries from late February.”

Then, people coming from or through New York spread the disease elsewhere in the United States. A New York Times analysis found that the number of cases around the country correlated with how many travelers arrived from New York in early March.

New York’s connection to the world, especially Europe, its density and its mass transit system all made it a potent vector.

 

[dixiegirl1035]

OR, it could be that travellers and tourists entering NYC brought it with them, and then everyone used the subways and the taxis and ate in crowded restaurants, and it spread like wildfire.

NYC is not even in the top 20 of the world's busiest airports.

Katydid is correct Charleston MOO.

A poster, @Henry2326 who used to update us shared the genomes which proved such, and folks were 100% on board. Including ... well... most all now are on board. see next strain which we used to talk about on the threads.

Folks, including MSM aren't able to educate... unfortunately to what they publish to ...

You perhaps were not here on thread #1 and #2 through #10. We were discussing as folks with models came out and stated the 7 places in the US where it might come in from. They did modelling based on flights. I even posted for the first two threads each and every flight out of Wuhan.

It's not what is the busiest, but from an epidemiological standpoint, what airports had most traffic from the areas which were breakouts.

MOO

 

[musicaljoke]

dbm ugh


daunting, to say the least. What is bumfuzzled? Thats a new one, sortof fizzly.

I learned a new phrase too, "shack wacky", from the East Coast of Canada, as in, "Staying at home for Covid is making me go shack wacky".