Coronavirus: How dangerous a threat?

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Among other things, people who aren’t tested before they die are listed as dying of whatever the major complications are. This is a matter of resources obviously but it plays into public relations. Here in the US as much as anywhere

On hydroxychloroquine

“The French study that Fox News had touted had ultimately involved a treatment group of only twenty patients. Six dropped out. Three went to intensive care. One died. In a clinical trial, “dying, and doing worse, are important outcomes to measure,” Marino told me. “When they say it was ‘a hundred per cent’ successful, they’re ignoring the fact that patients were cut out of the results.””

and

 
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They mentioned 4th quarter death, but that hardly seems relevant. The infection started sometime in December, with first hospital reports late December. For the infection to really spread and people to start dying, it takes a while, so in December you would not expect more than a few, or a few dozen covid-deaths. Certainly less than you would be able to detect statistically. Even first quarter 2020 deaths would likely not be very helpful as such, as you'd expect less deaths from traffic accidents, air pollution, etc.
Yep. The numbers are going to be complex to interpret.
View: https://mobile.twitter.com/SidSanghi/status/1244268782341799938

There will be postmortem conducted and I'll bet much of the information coming out of China wrt this pandemic will prove to be highly suspect.



Let me know if you can spot the irony with your quote above.


Then;

Zach Weinberg, one of the co-founders of Flatiron Health...“Sometimes people confuse saying, ‘the study doesn’t tell you anything’ with saying the drug doesn’t work,” Weinberg said. “That’s a really important distinction. They’re not the same thing. I’m not saying the drug doesn’t work or does work. What I’m actually saying is nobody knows if the drug works or doesn’t work.”

Exactly.
Pretty simple. I looked at the data and came to a conclusion. Has nothing to do with anybody's nationality. Of course you cut out the direct question i asked you.

When you have 98%+ of the patients that survive without intervention, confirmation bias can come into play when assessing outcomes. That is why you need to do large multicenter randomized clinical trials with thousands of patients. Look back through my posting history and it will tell you that I already said their study didn't tell us anything meaningful because it was so poorly constructed. Based on further reading, I still suspect misconduct. It is difficult to believe their choices were innocent. So, I guess we are now in agreement.

The study didn't show anything conclusively. But, a lot of time can be wasted running down blind alleys. There are better drug leads for COVID-19 IMO.

Conventional wisdom is that the virus has a lower R naught in the tropics and places where it is summer. Doubtful it will be a magic bullet for the USA, but it will probably help to a degree. There are other factors and that has been discussed upthread.

If you let hope cloud your judgement as a scientist, you should get a new profession. My dad lives in an assisted living facility, so I have a lot of desire to see treatments that work. Please don't rehash old arguments. This is not the time or place.
 
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I've been wondering about the viral load.

Since there have been younger doctors dying in high infected areas, was it partly because they were working in conditions in which the virus was omnipresent

And to follow on from that, can one get a higher viral load by being around one person who has the infection constantly?

So say in a group of people living together, if just one person there gets the disease, even if they get a very low dose, they then become infectious and give high viral loads to everyone around them once they become infectious. Presumably then the last person to get infected would be most screwed.

Or is that not how it would work?
 
The infection started sometime in December, with first hospital reports late December. For the infection to really spread and people to start dying, it takes a while, so in December you would not expect more than a few, or a few dozen covid-deaths. Certainly less than you would be able to detect statistically. Even first quarter 2020 deaths would likely not be very helpful as such, as you'd expect less deaths from traffic accidents, air pollution, etc.

The first known infected individual reported symptoms in early December. He was connected to the wet market. But his wife, who reportedly never went to that market, developed symptoms a few days later. Within a few weeks, doctors were reporting a cluster of cases of viral pneumonia in Wuhan, including two doctors themselves. Hindsight is 20/20, but a later analysis by the the NEJM found clear evidence of human-human transmission beginning by the middle of December.

Yet on Dec. 31, the Wuhan Municipal Health Commission announced there was no clear evidence of human-to-human transmission or of infection of medical staff. Two days later, a study published in the Lancet of 41 infected individuals, found that about a third of them had no known connection with the wet market. The study--again, this was published on Jan. 2-- concluded "evidence so far indicates human transmission for 2019-nCoV. We are concerned that 2019-nCoV could have acquired the ability for efficient human transmission." But a day later, the WMHC repeats its claim of "no clear evidence of human-human transmission." Two days later, again, the same statement. Again, on Jan. 11. Regional meetings of Hubei officials began in the middle of January, and there was no mention at all of coronavirus.

The genome sequence was reported to WHO on Jan. 3. But AFAIK, it was not made available to other scientists until a week later. And even as late as Jan. 14, WHO maintained there was "no clear evidence of human-human transmission." This was after all the studies clearly indicating there was such evicence, and the infection of doctors, including LI Wenliang, whose hospitalization two days earlier could hardly have been a more obvious sign.

Tell me, how do you suppose an antibiotic that kills bacteria is decreasing the amount of viral RNA?

Technically, that's not what they claimed. They said it enhanced the effect of HCQ. In some patients, bacterial infections are likely to be a problem, detracting from the individual's resources to fight the virus.

Also, our knowledge of antibiotic action is not so complete that we can completely rule out antiviral activity. Azithromycin, the antibiotic used in their study, like many antibiotics, binds to one of the bacterial ribosomes, interfering with protein synthesis. These antibiotics are not supposed to bind in the same manner to ribosomes of eukaryotic cells; if they did, they would be toxic to the cells, and defeat their purpose. But all we know about azrithomycin is that it doesn't bind to eukaryotic ribosomes in a way that interferes with protein synthesis by these cells. It's not out of the question that they could interact with these ribosomes in a way that would interfere with the virus's use of them in replicating itself.

Gautret now claims he's performed another study, on 80 patients, and that four out of five responded favorably. I don't think the paper itself has yet been released, but others familiar with some of the details are criticizing it heavily. Again, I'm not touting this drug. I doubt it will turn out to be helpful. But many of these patients are in a nothing-to-lose situation.
 
Agreed. Until we have something much better, there is a legit reason to use it considering the dire situation around the nation. The FDA said as much tonight, granting chloroquine and hydroxy chloroquine emergency use authorization. It would be terrific if it was effective, even marginally so. Time will tell. China allegedly has more trials to report. I would enjoy the reversal if one of those labs reported positive findings. "Sorry can't be trusted".
 
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The state department has this out on mass. Soliciting for medical anybody to apply. First and second module students currently enrolled in U.S. doctor certification got this..some from the state department,some got it relayed through Facebook.
There have been a couple of articles about nurse shopping..as pointed out about rural communities..they had few human medical resources to start with and now a (another) bidding war.
Another was a nurse making @$38 in Florida..@$100 in NY
 
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Chris Gadsden

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Agreed. Until we have something much better, there is a legit reason to use it considering the dire situation around the nation. The FDA said as much tonight, granting chloroquine and hydroxy chloroquine emergency use authorization. It would be terrific if it was effective, even marginally so. Time will tell. China allegedly has more trials to report. I would enjoy the reversal if one of those labs reported positive findings. "Sorry can't be trusted".

Trust but verify. Which means we won’t trust the results until we do our own study. That’s where we are with China... on this situation anyway.
 
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If everybody enjoyed the debate over chloroquine, wait until we start re-litigating the use of masks for personal use.

View: https://twitter.com/jaweedkaleem/status/1244467350000132097


I mentioned the comparison between Seattle and NYC earlier. Looks like the former has done a lot to bring R naught down with telework and social distancing. It is still over one though.

View: https://twitter.com/ByMikeBaker/status/1244415096203296769
 
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nevele neves

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They mentioned 4th quarter death, but that hardly seems relevant. The infection started sometime in December, with first hospital reports late December. For the infection to really spread and people to start dying, it takes a while, so in December you would not expect more than a few, or a few dozen covid-deaths. Certainly less than you would be able to detect statistically. Even first quarter 2020 deaths would likely not be very helpful as such, as you'd expect less deaths from traffic accidents, air pollution, etc.
Yeah I am confident that only 3 thousand died in China from the virus.
 
Once COVID 19 starts to be contained in the second half of the year, then the vexed issue of international travel becomes an issue - I am in charge of Government then I only allow people who have a positive anti-body test to travel overseas - This may need to happen for a further 12 months until the virus is completely eradicated.
 
Supposedly they are going to start rolling out antibody tests later this week. Just saw this on MSNBC. They are saying it supposed to be in the hundreds of thousands of these tests this week and millions within the next couple of weeks.
 
Not just international travel; people probably need to wonder if that will become a new requisite to use shared and mixed spaces.


Yes, in three or four month's time minimum, they'll have to start opening up gyms, pubs restaurants etc, for economic and social reasons. But lets say they manage to have tested everyone by then, and the suppression measures mean only 10-15% have the antibodies, will they be the only ones allowed to have fun?

Or will there be a short period of fun for all, followed by another lockdown?

This assumes that a widely available treatment (not vaccine) hasn't been found by then
 
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Chris Gadsden

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Agreed. Until we have something much better, there is a legit reason to use it considering the dire situation around the nation. The FDA said as much tonight, granting chloroquine and hydroxy chloroquine emergency use authorization. It would be terrific if it was effective, even marginally so. Time will tell. China allegedly has more trials to report. I would enjoy the reversal if one of those labs reported positive findings. "Sorry can't be trusted".

More anecdotal positive results from patients treated with Hydroxychloroquine/Azithromax are beginning to trickle in.

https://www.sciencedirect.com/science/article/pii/S0924857920300996


View: https://twitter.com/DrJeffColyer/status/1244669297005223936/photo/1
 
Yes, in three or four month's time minimum, they'll have to start opening up gyms, pubs restaurants etc, for economic and social reasons. But lets say they manage to have tested everyone by then, and the suppression measures mean only 10-15% have the antibodies, will they be the only ones allowed to have fun?

Or will there be a short period of fun for all, followed by another lockdown?

This assumes that a widely available treatment (not vaccine) hasn't been found by then

I suspect currently we are buying time for treatments to hit the market. It is possible for one of the treatments in testing to be approved (if one or more works) by late spring.

We need the antibody testing as well as more virus tests. We know many who have had the virus were never tested, so the antibody testing will definitely help figure that out as well.



Also heard that today through April 9th, Spain has put their country into an even more restrictive lock down. It sounds like they have 5 provinces that have their hospitals and medical workers overwhelmed.