COVID-19

[Legacy]

WHO launches global megatrial of the four most promising coronavirus treatments (Science)

Excerpt:

Scientists have suggested dozens of existing compounds for testing but WHO is focusing on what it says are the four most promising therapies: an experimental antiviral compound called remdesivir; the malaria medications chloroquine and hydroxychloroquine; a combination of two HIV drugs, lopinavir and ritonavir; and that same combination plus interferon-beta, an immune system messenger that can help cripple viruses. Some data on their use in COVID-19 patients has already emerged—the HIV combo failed in a small study in China-but WHO believes a large trial with a greater variety of patients is warranted.

Chloroquine and hydroxychloroquine
At a press conference on Friday, President Donald Trump called chloroquine and hydroxychloroquine a “game changer.” “I feel good about it,” Trump said. His remarks have led to a rush in demand for the decades-old antimalarials. (“It reminds me a little bit of the toilet paper phenomenon and everybody's running to the store,” says Caplan.)

The WHO scientific panel designing SOLIDARITY had originally decided to leave the duo out of the trial but had a change of heart at a meeting in Geneva on 13 March, because the drugs “received significant attention” in many countries, according to the report of a WHO working group that looked into the drugs’ potential. The widespread interested prompted “the need to examine emerging evidence to inform a decision on its potential role.”

The available data are thin. The drugs work by decreasing the acidity in endosomes, compartments inside cells that they use to ingest outside material and that some viruses can coopt to enter a cell. But the main entryway for SARS-Cov-2 is a different one, using its so-called spike protein to attach to a receptor on the surface of human cells. Studies in cell culture have suggested chloroquines have some activity against SARS-CoV-2, but the doses needed are usually high—and could cause serious toxicities.

Encouraging cell study results with chloroquines against two other viral diseases, dengue and chikungunya, didn’t pan out in people in randomized clinical trials. And non-human primates infected with chikungunya did worse when given chloroquine. “Researchers have tried this drug on virus after virus, and it never works out in humans. The dose needed is just too high,” says Susanne Herold, an expert on pulmonary infections at the University of Giessen, Germany.

Results from COVID-19 patients are murky. Chinese researchers who report treating more than 100 patients with chloroquine touted its benefits in a letter in BioScience, but the data underlying the claim have not been published. All in all, more than 20 COVID-19 studies in China used chloroquine or hydroxychloroquine, WHO notes, but their results have been hard to come by. “WHO is engaging with Chinese colleagues at the mission in Geneva and have received assurances of improved collaboration; however, no data has been shared regarding the chloroquine studies.”

Researchers in France have published a study in which they treated 20 COVID-19 patients with hydroxychloroquine. They concluded that the drug significantly reduced viral load in nasal swabs. But it was not a randomized controlled trial and it didn’t report clinical outcomes such as deaths. In guidance published on Friday, the US Society of Critical Care Medicine said that “there is insufficient evidence to issue a recommendation on the use of chloroquine or hydroxychloroquine in critically ill adults with COVID-19.”

Hydroxychloroquine in particular might do more harm than good. The drug has a variety of side effects and can in rare cases harm the heart. Since people with heart conditions are at higher risk of severe COVID-19, that is a concern, says David Smith, an infectious disease physician at the University of California, San Diego. “This is a warning signal, but we still need to do the trial,” he says. What’s more, a rush to use the drug for COVID-19 might make it harder for the people who need it to treat their rheumatoid arthritis or malaria.

Trump is a "big fan" of chloroquine but, as Fauci explained:
"We're trying to strike a balance between making something with a potential of an effect to the American people available, at the same time that we do it under the auspices of a protocol that would give us information to determine if it's truly safe and truly effective. But the information that you're referring to specifically is anecdotal, it was not done in a controlled clinical trial. So you really can't make any definitive statement about it."

Trump trumpeted that chloroquine had shown “very, very encouraging early results” and said “we’re going to be able to make that drug available almost immediately.” FDA Commissioner Stephen Hahn, an oncologist, clarified that the drug would be available “in the setting of a clinical trial — a large, pragmatic clinical trial — to actually gather that information and answer the question that needs to be answered and — asked and answered.”

 

[GATTACA!]

Geesh. The framework was fine and had bipartisan support (that is per dems and repubs alike), until in-walks-Pelosi. And any dem taking a hard stance on corporate bailouts of any kind needs to flash the fuck back to Obama's auto bailout and stimulus. He even supported the bank bailout.

As far as docs go, there's plenty that have said had he not shut down travel when he did (which the dems criticized), we'd be far worse. And the only blunder thus far has been delay of testing, and there's very specific reasons for those delays (which I've listed earlier) and have zero to do with Trump.

Anyway, this is getting political, so needs to be taken to the other side of the site. See you there if you'd like to debate with actual fact instead of anecdotal weak ass shit like the above.

McConnells bill was trash and deserved to be shot down. It was easily the worst of any of the proposals being thrown around. This is the third corona bill that will be passed and is supposed to help citizens not just be even more money to bail out corporations.

 

[Irish#1]

I don't blame him. I'd be annoyed too if I saw everyone around me working from home and I knew the only reason I wasn't being allowed was because everyone assumes I'll pull through if I get the virus.

Why not let him work from home?

The owner conferred with our labor attorney and created the guidelines which he published to everyone. It basically said one has to have a requirement (kids at home, elderly parents at home, etc.) due to COVID-19. He doesn't meet the requirements. He's a good worker and personally I would have no worries about him working from home. It takes a while for the owner to come around to these ideas. I suspect he will soften his stance in a couple of weeks unless the state mandates working from home before then. I just found his persistence amusing even with things being clearly spelled out.

 

[Irish#1]

I am in charge of hospital operations, so let me tell you what this week has been like. Besides the constant planning for the impending crush, I was on a state-wide call where our hospital association told us that some facilities in Washington State were triaging vents. They are in crisis mode. Anyone over 80 y/o was not going to go on a vent; he/she was going to be discharged home because the hospitals needed to use the resource on patients with a better chance for recovery. I read through the disaster plan of a hospital on another island. Their plan calls for similar resource-saving decisions should they reach their overflow capacity. Anyone over 65 has seven (7) days to show improvements on a vent, or the vent will be pulled and redeployed to another patient. The gallows-humor of this plan is that it makes Sarah Palin's death panels come to life!

Hey pops, you've had a good run. We decided your life isn't of any value to us anymore, so suck it up.

 

[Irish#1]

lol

<blockquote class="twitter-tweet"><p lang="en" dir="ltr">It’s starting. Sh*t’s getting weird.<br><br>Also, the internet is undefeated — and I’m dead...😂🤣😭💀💀 <a href="https://t.co/GUe4golWHP">pic.twitter.com/GUe4golWHP</a></p>— Rex Chapman🏇🏼 (@RexChapman) <a href="https://twitter.com/RexChapman/status/1241423796453638145?ref_src=twsrc%5Etfw">March 21, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>

LMAO

 

[Irish#1]

lol
holy cow, I think that's Irish#1

You know me too well. lol

 

[Irishize]

https://www.mediterranee-infection.com/epidemie-a-coronavirus-covid-19/

So it looks like the French are recommending mainstreaming the cocktail that Trump mentioned (and was slammed for by MSNBC, CNN, WAPO, and others).

You can hit the language button at the top right for the English version.

Hey pops, you've had a good run. We decided your life isn't of any value to us anymore, so suck it up.

Unless pops was politically connected or wealthy

 

[Irishize]

These Places Could Run Out of Hospital Beds as Coronavirus Spreads (NYT from Harvard Global Health)

Click on their ProPublica link to search your area.

‘Could’ is the operative word and gives the author cover as he/she goes on to posit this as a worst case scenario. As an excerpt from the article states:

These numbers are not exact predictions. In many ways, they reflect a worst-case scenario, since they do not take into account the efforts hospitals can make to quickly increase capacity during an emergency. Around the country, hospitals have begun canceling elective operations and speeding home patients with less critical ailments. Those efforts could increase the number of free beds available for coronavirus patients. In a half-dozen interviews, hospital executives estimated that they could increase their capacity between 20 percent and 70 percent.

Two things: 1) You’re just the messenger Legacy so I’m not criticizing you personally 2) I’m not saying this isn’t serious & shouldn’t be taken that way but the media, IMHO; has taken this hysteria to the Nth degree.

News outlets are competing for ad dollars and those who control the media, control the culture. We trust them to be fair & balanced. I believe they are taking it too far for what they believe are altruistic reasons.

Italy has 2nd oldest population (over age of 60). So. Korea is on opposite end of that range. Italy has a disparity in expenditures on ICU beds. They haven’t invested in their health care over the past decade. This is a result of that (sorry, socialized medicine fans). They have half the # of ICU beds as America per capita.

We have fewer acute hospital beds than most countries. Why? Because we have a large number of out patient clinics, centers, etc that reduce the cost/need for extended stay. So if the media wants to strictly count acute/ICU beds, then yes; America is at a disadvantage. If you count ALL hospital beds, the US is one of the world’s leaders. To think our system won’t convert these beds shows little faith in our countrymen/women.

I listened to a physician yesterday who is on the front lines discuss this aforementioned info. He had just treated four patients who presented w/ flu-like symptoms. One had para-influenza type 4, one had meta-pneumovirus, one had rhinovirus & one had coronavirus. All four had the SAME symptoms. All four will be considered coronavirus patients until tested. In the meantime, every MA, LPN, RN, tech, APRN, MD, etc who enters that room has to re-gown, re-mask, re-glove, etc EVERY time they enter that room to reduce spread. That’s what is putting the burden on our healthcare in his opinion.

By the way, the doc sadly lost one of those four aforementioned patients...the para-influenza patient. His coronavirus patient was treated w/ plaquenil and other typical supportive measures (steroids, etc). I can’t believe the media is making it sound like voodoo science b/c a physician is using a drug off-label. The benefits outweigh the risks. Typically effective drugs have side effects which is why there is a specific dose range. While Plaquenil was originally approved as an anti-malarial drug it became a standard of care in rheumatoid arthritis & lupus where it’s still used today. My understanding is that if taken for a long period of time, the patient has a risk of losing color in their eyesight. Consequently, they are ordered to get vision tests on a regular basis and would stop the med if any issues were found.

Personally, I’d rather have coronavirus vs a chronic, autoimmune disease.

 

[Henges24]

Michigan will be under a stay-at-home order starting at midnight tonight.

 

[GrangerIrish24]

Michigan will be under a stay-at-home order starting at midnight tonight.

did they give a time frame?

 

[Henges24]

did they give a time frame?

3 weeks

 

[ACamp1900]

Michigan will be under a stay-at-home order starting at midnight tonight.

Meaning no leaving home at all?? So everyone must have three weeks supply of everything??

 

[wizards8507]

Meaning no leaving home at all?? So everyone must have three weeks supply of everything??

If it's anything like Connecticut, people who are "essential" can still go out, and "essential" businesses can stay open. Pretty much everything you can imagine besides retail is considered essential.

 

[notredomer23]

Meaning no leaving home at all?? So everyone must have three weeks supply of everything??

You can go to store, pharmacy, gas, convenience, restaurants for takeout, liquor stores etc still.

 

[Henges24]

Meaning no leaving home at all?? So everyone must have three weeks supply of everything??

Essentials you can still travel to. Basically the same exact thing that we've already been doing for the past 2 weeks.

On a side note: this political BS is getting tiresome. The governor couldn't even get through her speech without complaining about the lack of funding/help from Trump. She mentioned it twice to make sure she got her point across.

 

[IrishLion]

KY is under stay-at-home for all non-essential services, but auto repair/service/parts are all considered essential, so I'm still at work, dealing with people I don't know.

It's kind of discouraging, because my wife and kids are at home as part of the lockdown with daycare closed and my wife able to work from home, so they're doing what they need to do to stay safe and keep it from spreading.

But then I come home at 5:30pm after having interacted with people all day. I'll feel guilty as hell if I bring it into the house somehow, and I'm kind of pissed off that we're killing the economy to try and stop this, and yet probably not going as far as we should to make sure it works.

Maybe it's just a bad day, but it feels like this should be an all-or-nothing deal. Emergency services, food, and gas are essential. Everything else can wait for two weeks, right? Otherwise, what is this all about?

 

[Irish YJ]

McConnells bill was trash and deserved to be shot down. It was easily the worst of any of the proposals being thrown around. This is the third corona bill that will be passed and is supposed to help citizens not just be even more money to bail out corporations.

Funny how everyone was singing the same song until Pelosi enters the picture. Funny how it wasn't trash before... And I'm assuming you were critical of prior bailouts? BTW, Cuomo was just on CNN talking about the need to start talking about how to get people back to work in measured ways, and also talked about medicare waste. Had the other guy said any of that, he would have been completely destroyed by the MSM...

You know me too well. lol

I know you've already got a black market toilet paper economy up and running out there. Just don't get too fat on the doughnuts my friend.

Meaning no leaving home at all?? So everyone must have three weeks supply of everything??

Grocery delivery rocks. I even talked my local convenient store guy into delivering cheap beer and wine as necessary.....

 

[IrishSteelhead]

Holcomb just dropped the hammer on Indiana, starting tomorrow.


Sent from my iPhone using Tapatalk

 

[Irish YJ]

McConnell talking now about some of the sticking points....

So one side of the aisle is holding things up over
1. carbon footprint for the airline industry
2. tax credits for solar panels....


WTF do those things have to do with the current crisis...

So the deal is trash, but it's OK to hold things up to leverage inserting one side's Green New Deal policies.

Sorry, that's BS.

 

[Irish YJ]

Reported now that the deal was actually green lighted by Pelosi. She pulled back once she found out that 5 GOPs were quarantined.....

That, along with the pork, is a very bad look.

 

[Irish YJ]

UK calls in army and warns people to stay home or face lockdown

https://www.reuters.com/article/us-...e-to-stay-home-or-face-lockdown-idUSKBN21A1CF

 

[Legacy]

Delaware, Louisiana, Ohio can be added to the shelter-in-place orders. Have Illinois and NJ been mentioned?

Cities and counties:
Philadelphia, St. Louis, which also applies to St. Louis County, begins Monday, and Kansas City and its metro area goes into effect Tuesday and New Orleans.
San Miguel County, Colorado, is under a shelter-in-place order until April 3.
Athens-Clarke County, Georgia, is under a shelter-in-place order until April 7.
and Blaine County, Idaho,.

 

[koonja]

How funny is it that "liquor stores" are essential?

I love this country at times.

 

[Irish YJ]

Delaware, Louisiana, Ohio can be added to the shelter-in-place orders. Have Illinois and NJ been mentioned?

Cities and counties:
Philadelphia, St. Louis, which also applies to St. Louis County, begins Monday, and Kansas City and its metro area goes into effect Tuesday and New Orleans.
San Miguel County, Colorado, is under a shelter-in-place order until April 3.
Athens-Clarke County, Georgia, is under a shelter-in-place order until April 7.
and Blaine County, Idaho,.

ATL Mayor has been slow on this. Very surprised no stay at home order yet. My county (a portion of ATL) at least has a State of Emergency declared and specific limitations. My town (outside of ATL) has had a 9pm-6am curfew in place for a while now along with several others.

 

[Irish YJ]

How funny is it that "liquor stores" are essential?

I love this country at times.

Weed places too in the legalized states.

I'm guessing 1) they don't want alcoholics going through detox during this, and 2) they'd rather have folks drunk at home, then out trying to find an open bar that doesn't exist. Pacify the masses..

 

[Greenore]

McConnell talking now about some of the sticking points....

So one side of the aisle is holding things up over
1. carbon footprint for the airline industry
2. tax credits for solar panels....


WTF do those things have to do with the current crisis...

So the deal is trash, but it's OK to hold things up to leverage inserting one side's Green New Deal policies.

Sorry, that's BS.

The new priority needs to be, in order, medicine/science then the economy and finally, politics. If people don't get this then they need to get the hell out of the way.

Cheers and Go Irish!!

 

[Irish YJ]

Merkel's tests look to be negative.

UK has a huge spike in deaths, and call in army.

EU begging countries to open borders to allow in freight.

 

[Irish2155]

Holcomb just dropped the hammer on Indiana, starting tomorrow.


Sent from my iPhone using Tapatalk

I don't think it starts until Wednesday as an fyi. The date range I'm seeing is 3/25 through at least 4/7.

 

[Irish YJ]

The new priority needs to be, in order, medicine/science then the economy and finally, politics. If people don't get this then they need to get the hell out of the way.

Cheers and Go Irish!!

Yup. Trying to add on pork in this situation is beyond inhumane. I'm fine if folks want to negotiate on relevant measures, but trying to tack on unrelated crap should be a crime. Perhaps we need "crisis rules" for the House and Senate.

 

[Irish YJ]

I don't think it starts until Wednesday as an fyi. The date range I'm seeing is 3/25 through at least 4/7.

https://www.indystar.com/story/news...indianapolis-covid-19-latest-news/2896967001/

Gov. Eric J. Holcomb on Monday told Hoosiers to stay at home starting at midnight March 25 until at least April 7.

The order, issued during a Monday news conference, asks all Hoosiers to refrain from anything outside of essential travel. The order is not a complete lockdown and still allows residents to leave their homes for work, medical care, buying groceries and other activities essential to the health and safety of people and pets.

Essential businesses will remain open and are defined by the state as businesses that "include but are not limited to grocery stores, pharmacies, gas stations, police stations, fire stations, hospitals, doctor’s offices, health care facilities, garbage pickup, public transit and public service hotlines such as SNAP and HIP 2.0."

Otherwise, Holcomb is asking "Hoosiers to hunker down."

“The next two weeks are critical if we are to slow the spread of COVID-19, and we must slow the spread. You must be part of the solution, not the problem,” said Holcomb. “I’m setting the example by sending state government personnel home to work to the maximum extent possible and closing our facilities to public interaction beginning Tuesday, for at least the next two weeks.”