Coronavirus Updates

Kara Spengler

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To my mind, people who aren't medical researchers -- indeed, who aren't medically qualified at all -- need to wait until the results of large scale clinical trials like this one are known, and then, should they need to know for reasons other than simple curiosity, consult their doctor to find out whether they personally should be taking hydroxychloroquine (or any other medication) and, if so, whether they should be taking it as a prophylactic or as a precaution after coming into contact with someone who has tested positive, or only after they've developed symptoms, or what.

Everything else seems simply idle chatter.
I took part in phase 2 (dosage) trials of an anti-seizure medication last summer. Even my doctor (who was the study contact for this area) was surprized I had not been told what I received.
 

Innula Zenovka

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I took part in phase 2 (dosage) trials of an anti-seizure medication last summer. Even my doctor (who was the study contact for this area) was surprized I had not been told what I received.
It was presumably a double-blind trial, or maybe whoever administered the doses works on the basis that all trials are double-blind, since that assumption won't break anything if it's wrong, while telling you what you were receiving would mess up the results if it is a double-blind trial.
 

Innula Zenovka

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Trials for hydroxychloroquine as a prophylactic:


There are also 3 separate trials going on in the UK to examine the use of hydroxychloroquine as a therapy for Covid-19 in primary care, hospital and intensive care settings (details in the article)

In a bulletin to practices, NHS England said: 'While it is for every individual clinician to make prescribing decisions, we strongly discourage the use of off-licence treatments outside of a trial, where participation in a trial is possible.

'Use of treatments outside of a trial, where participation was possible, is a wasted opportunity to create information that will benefit others. The evidence will be used to inform treatment decisions and benefit patients in the immediate future.'

(my emphasis)
 
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Kara Spengler

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It was presumably a double-blind trial, or maybe whoever administered the doses works on the basis that all trials are double-blind, since that assumption won't break anything if it's wrong, while telling you what you were receiving would mess up the results if it is a double-blind trial.
Right, it was a double blind, sorry if I confused things. My point though was even someone involved to the level of one of the researchers may not know a year later when they would assume the blinder had came off.
 
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Pamela

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Adding Mongolia to my list of places to move if Trump doesn’t vacate the WH.

 
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Innula Zenovka

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Adding Mongolia to my list of places to move if Trump doesn’t vacate the WH.

True story -- back in the 1980s, when I lived in the Bay Area, I used to know a UC Berkeley classics prof who had once taken the Trans-Siberian railway from Moscow, via Mongolia and Ulan Bator, all the way to Beijing, which back then, at the height of the Cold War, was really quite something.

He was certainly the only person I'd ever met at the time who'd travelled through Outer Mongolia -- then a byeword for an incredibly remote place -- and I was anxious to know what the journey was like.

That part of the trip was rather a let-down, he told me.

"If I'd wanted a boring train ride through a rocky desert for a couple of days to visit a corrupt dictatorship full of ugly Stalinist architecture where the locals follow a strange mystery cult, I could have stayed home and taken Amtrak to Salt Lake City".
 
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Pamela

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True story -- back in the 1980s, when I lived in the Bay Area, I used to know a UC Berkeley classics prof who had once taken the Trans-Siberian railway from Moscow, via Mongolia and Ulan Bator, all the way to Beijing, which back then, at the height of the Cold War, was really quite something.

He was certainly the only person I'd ever met at the time who'd travelled through Outer Mongolia -- then a byeword for an incredibly remote place -- and I was anxious to know what the journey was like.

That part of the trip was rather a let-down, he told me.

"If I'd wanted a boring train ride through a rocky desert for a couple of days to visit a corrupt dictatorship full of ugly Stalinist architecture where the locals follow a strange mystery cult, I could have stayed home and traveled on Amtrak to Salt Lake City".
Yet Today makes the US look like a third world country by comparison.
 

Sovereignty

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The exchange was


That is, I was asking you whether it matters that people who don't have the scientific background and aren't part of the decision making process are, in your words, "prejudging the results of these trials because of Trump," since I don't see what effects their premature judgments will have, one way or another.

If you mean, it's bad that people are prejudging the trials by assuming that they should be taking hydroxychloroquine because Fox News and Trump tell them to, without waiting for the outcome of the trials, and go and waste their doctor's time by demanding an unproven treatment, then I agree, because that's jumping the gun and taking something with no proven medical benefit for their condition.

But since there's no difference in the outcome for someone who refrains from demanding hydroxychloroquine because she thinks Trump's an idiot and someone who refrains because she is keeping an open mind and waiting for the results of the studies before asking her doctor for a prescription, because she's following evidence-based medicine, I don't see it matters why they are acting as they do -- in effect, they are both following current medical advice.

If and when the results of the trials suggest that hydroxychloroquine does have some therapeutic value for Covid-19, then it will matter, but until then, what difference does it make why I'm not going to bug my GP with demands for an unproven drug that's not recommended to treat my particular illness , so long as I don't?

That's why I asked you why you though it matters that, in your words, "Unfortunately many people are prejudging the results of these trials because of Trump," because I don't see what it's got to do with anything in particular so long as they wait for the outcome of the studies and take medicines on the basis of evidence-based advice rather than conjecture.
The people who are prejudging the trials I'm referring to are in the news media. I expect more out of them, and it makes me distrust them. They are setting themselves up to lose credibility (playing into Trump's hands) if by some chance HCQ is found to be useful under the right conditions.

Given Trump's frequent attacks on the media, that's a pretty big "so what".

As it is, there already is evidence that HCQ is useful when combined with zinc. It allows zinc ions to enter cells where zinc can disrupt virus replication. Of course, HCQ is not the only drug that acts this way. Quercetin is another.

There was a third retrospective study of HCQ published in Lancet today. I found an article in The Economic Times that seemed to be much better reporting than what I usually see in the U.S. Perhaps they are insulated from Trump hysteria in India.

Not surprisingly, the British study came up with results similar to the two previous large retrospective studies in the U.S. In those two studies the drug was given to sicker, older people. Consequently, the poor results were not surprising. The question of whether the patients receiving HCQ in the British study were sicker or not is not answered in the Economic Times news article. I'd be interested to hear what a board certified pulmonologist and intensive care specialist reading the Lancet article would have to say about it.

For it's part The Economist article says:

However, they said it is not possible to exclude the possibility of unmeasured factors being responsible for the link.

They said this is due to the design of observational studies, and warned that randomised trials are urgently needed to validate the findings.
Note that I do not express personal opinions on medical questions in my posts. I always cite experts. ETA: Or I try to.
 
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Sovereignty

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Far better than a fawning attitude. Even the most competent leaders need to questioned and held to account. Trump, of course, is very far from being a competent leader so there's more meat for the media.
The key word here is "strange".

I think an oppositional attitude is necessary. I don't think we need one that leans into taking perverse/unnatural viewpoints.

Gov. Andrew Cuomo:
I think it would be unnatural not to hope that it [HCQ] works.
Yet, that is the position that seems to hold sway.
 

danielravennest

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"If I'd wanted a boring train ride through a rocky desert for a couple of days to visit a corrupt dictatorship full of ugly Stalinist architecture where the locals follow a strange mystery cult, I could have stayed home and taken Amtrak to Salt Lake City".
But yurts! the original mobile homes.

I built a couple of them in my historical re-enactment days. They make very sturdy camping tents. The walls collapse like pet gates and the rafters are a bunch of poles that socket into the roof ring. So it all breaks down for yak transport.

 

Romana

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As it is, there already is evidence that HCQ is useful when combined with zinc. It allows zinc ions to enter cells where zinc can disrupt virus replication. Of course, HCQ is not the only drug that acts this way. Quercetin is another.
I'm not sure Quercetin is considered a drug. It's a supplement readily available from vitamin stores. I just got some myself, actually.
 

Jopsy Pendragon

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I think an oppositional attitude is necessary. I don't think we need one that leans into taking perverse/unnatural viewpoints.
May his idiocy be the catalyst this nation needs to spawn a new generation of fact-based, critical thinkers who rise up like white blood cells to defeat a dangerous infection.
 

Innula Zenovka

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Cynics might answer the question by noting that the CDC were under considerable pressure from the Administration to produce figures demonstrating what a YUGE number of tests, more than anywhere else in the world many people are saying, were being performed, after complaints about how difficult it was to get a test, so combining the two sets of figures made for a chart that kept POTUS happy, because he's a very stable genius who likes happy charts.
 
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Romana

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Yep.

Effect of Quercetin on Prophylaxis and Treatment of COVID-19

Cynics might answer the question by noting that the CDC were under considerable pressure from the Administration to produce figures demonstrating what a YUGE number of tests, more than anywhere else in the world many people are saying, were being performed, after complaints about how difficult it was to get a test, so combining the two sets of figures made for a chart that kept POTUS happy, because he's a very stable genius who likes happy charts.
I can't understand how Fauci let that slide though.
 

Sovereignty

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Fauci's not in the CDC.

I poked around, and the bureaucracy seems complex. Wikipedia:

The National Institute of Allergy and Infectious Diseases (NIAID) is one of the 27 institutes and centers that make up the National Institutes of Health (NIH), an agency of the United States Department of Health and Human Services (HHS). NIAID's mission is to conduct basic and applied research to better understand, treat, and prevent infectious, immunologic, and allergic diseases.
I could be wrong, but it looks like the NIH and CDC each report to HHS. That puts Fauci off in another world, almost, compared to the CDC.

Speaking of the CDC, don't forget their disease of the week. This week it's cyclosporiasis.

Enough of viruses. Let's hear it for protozoans!
 
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