tdiddy23

https://nationalpost.com/news/canada...-canadian-icus

some anecdotal insight into our experience north of the border

narvik

Animation of COVID-19 cases spread:

https://public.flourish.studio/visua...0/embed?auto=1

nk15

Well, as China and Italy found out it is not a sprint, it's a marathon...

nk15

There are some RCTs testing HCQ as prophylaxis, here is one:

https://clinicaltrials.gov/ct2/show/NCT04318444

There are 68 studies of HCQ registered on that site.

Another one:

https://www.pennmedicine.org/news/ne...revent-covid19

fransknorge

Obviously deaths will be the last thing to flatten and drop.

MSPeconomist

What's the "it" here? Is Zithromax not an antibiotic?

FlyBitcoin

Typically studies on drugs are done and paid for by the manufacturer. When studying an off-label use of a generic, it is virtually unheard of for multiples to be done simultaneously since little drug company money is available. Usually one center gets an NIH grant and studies it. These are different times and a different foe.

The number 68 is definitive proof that this drug has been politicized. Frankly, I am not sure I will believe any single positive or negative work that comes out of those. Medical studies that have a definite profit (or less likely political) motive can be full of errors. Not all of them outright lie or fabricate data, although that has happened. Here are some of the things that researchers have been caught doing in the past:

• Selecting patients for treatment and control groups to give a slight advantage for the desired outcome. Like a multi-level marketing company wants to prove their miracle vitamins work, but the treatment group is slightly younger, slightly healthier and has a lower body fat. Or the weight loss product includes women who are 4 weeks post-partum in their treatment group but not control group.
• Discontinuing the study when the results are not working out. In the early 1990's the few "definitive" studies on the benefit of SSRI's for depression get the headlines but nobody talked about the 25 studies that were shelved during phase III and not published. 22 of 25 of those were showing no benefit.

How many of these studies will rush to release results in October or November? How many will release after election day? Is there a reason for that?

Also, we are treating something that generally has a good outcome. Over 99% of infected people survive. We still do not know how many people are even infected in the first place. Are the studies seeking out asymptomatic carriers to test their "cure"? Or are they only enrolling a group that requires hospitalization or oxygen need where the outcomes are better known?

For prophylaxis, one will easily need thousands of patients in both a control group and a treatment group to even begin to have power to reach a conclusion regarding infection rate, progression to hospitalization, progression to ICU, and mortality. Will the control group and the treatment group get as many swab tests? Will the "good nurse" who always gets a complete sample only test the control group and raise the infection rate? Antibody testing can remove that sampling error.

So keep that in mind as these results start to hit the mainstream, and clickbait internet media. Also, make sure you go back to the link above and see how many of these studies have closed without reporting results.

Zithromax is.
The post was about HCQ.

In general, any non-bacterial cause of respiratory damage (inhalation injury, drug reaction, viruses) can make the damaged tissue vulnerable to bacterial superinfection.
Therefore, antibiotics can be used for that reason even though bacteria was not the cause of the primary infection.

FlyBitcoin

https://news.yahoo.com/coronavirus-f...231032581.html

Read this and come to your own conclusions.
Is there a link to the primary source article?
Is the headline indicative of the content?
Who did the study and could there be a political agenda?

Here is the primary work: Notice how the 13 feet part (4m) is the outlier extreme chance finding not repeated in the majority of their assessments: https://wwwnc.cdc.gov/eid/article/26/7/20-0885_article

And after reading all of that, the entire study is discredited by their own limitations: Our study has 2 limitations. First, the results of the nucleic acid test do not indicate the amount of viable virus. Second, for the unknown minimal infectious dose, the aerosol transmission distance cannot be strictly determined.

Be careful, there is a lot of work, done in China over 5 weeks ago that could have been released a lot sooner, with headlines that are scarier about spread of the virus than their data would indicate. https://wwwnc.cdc.gov/eid/ shows "expedited articles" on the front page. That means that peer review has been substandard, yet Yahoo picks it up regardless. Is this all a friendly warning to countries who are now affected? Or is is a way to shape lockdowns and economic damage from afar. I encourage you to read the entire primary work for each one and read their self-admitted limitations of the study. There are lots of clues when the work is great and when it is poor.
Finally, any data on airborne spread needs to show an AMOUNT of virus per cubic meter in the air samples. Not just what percent were positive and not just test surfaces where a droplet from a cough can land and leave an RNA remnant for weeks. And I have yet to see cultures for live virus done in these studies. Just looking for viral RNA remnants, which can persist on surfaces for weeks (CDC Diamond princess cruise ship). A patient in a hospital bed lying face up coughs and droplets collect on the air return grate and add up for each cough and persist for weeks. How is that applicable to two people waking past each other in a store? Or a hairdresser wearing a mask working on a client? It is not.

FlyBitcoin

Another study, this time from Singapore looking at airborne virus...
https://www.medrxiv.org/content/10.1...557v1.full.pdf

Basically, the quantified the viral particles in the air in a sick hospital patient's room, and found a whopping 3,000 per cubic meter.

That is the volume of 2,000 human breaths at 500 cc per breath.

Therefore, in that patients hospital room, you risked inhaling 1.5 virus particles per breath on average.

You can get measles from a single virion. For this you probably need the order of 200,000 - 700,000 times that.

nk15

Good points, these are some of the problems with science and good science. I agree that many of the studies will have problems recruiting adequate numbers and maintaining scientific integrity throughout, as the pandemic also has its own course and it is evolving.

The fact that all these studies are run by independent research teams, many in Ivies, with no apparent conflicts of interest and ties to drug manufacturers (I assume), it will be less likely to have fraud/data manipulation or strong investigator allegiance effects. I am personally very critical and skeptical of the drug industry research, due to the severe conflicts of interest, lax regulation, and their TV ads, but here I assume there is an urgency to solve an actual problem, although that may also create a perverse motive for certain results.

But then it comes down to are we going to trust medical research at all or are we going to throw everything out of the window...But all these are good points, hopefully a bunch of decent quality independent studies will converge in one direction...

FlyBitcoin

HCQ in the US has become politically charged. That is the "68" number. Maybe I would trust the studies from outside the US more. But each one deserves to be read on its own merits.

Best daily data read on how the people (not necessarily the politicians) are doing to control spread in different states and countries.
https://drive.google.com/drive/folde...hs_wO-t71DJOo0
Authors Twitter feed: https://twitter.com/isfBob

While the media focuses on the round numbers of cumulative cases, deaths, and rankings, the real conclusions lie here in first and second derivatives of that data.

Also, if you use the Western states vs the Northeast as a proxy for Asian-origin vs European-origin you see a virus that has been around a lot longer out West and they are further along the curve, vs the East which appears to have received a larger dose over a shorter period of time.

Loren Pechtel

Yeah, it's been quite obvious that the last couple of days of stats are always bad, especially over weekends. Everywhere, not just France.

stimpy

Yeah I'm not sure what to make of it. French stats for yesterday were just released. 310 more hospital deaths and 251 more in nursing homes. 508 more hospitalizations but 38 less in ICU. 795 people returned home from the hospital. But there were 1613 new people testing positive. Maybe this is just what stats will look like everywhere when you are at the top of the curve?

FlyBitcoin

Another point about this alarmist study I mentioned above....
https://wwwnc.cdc.gov/eid/article/26/7/20-0885_article

It did not even control for the fact that a nurse or the patient himself getting up and using the bathroom could have stirred up some virus on clothing or from another surface feet away from the head of the bed which could have resulted in that positive "4m away". No controls whatsoever and there is a lot of activity in a patient room, especially one who is ambulatory. The conclusions are junk and alarmist.

this will get fixed in peer review one can only hope.

Smiley90

One of the most surprising things to me has been that this somehow doesn't appear to affect people with asthma any worse on both an infection and severity level. Does anyone have any sources or thoughts at hand that go more into why this might be? I'm genuinely curious.