March Madness and Covid-19

[stormspencer]

The thing about hydroxychloroquine is not that it is a mythical drug, but it has shown in vitro activity "killing" the virus, and it also has immunomodulation properties which may tamper down the immune/cytokine response -- most people who end up dying from COVID do so because of a type Adult Respiratory Distress Syndrome (ARDS) which is not the virus killing you, it's the body's overwhelming response to virus killing you. So the immune system is actually the problem in a disease like this. It's why doctors have also tried steroids, but those don't show much benefit so far.

Azithromycin is not added to fight the virus. People with viral pneumonia often develop a super infection from a bacteria, which the antibiotic would treat. Any antibiotic that treats bacterial pneumonia could be used in its place. But that French guy used it, so there we are.

Hydroxychloroquine is cheap and has widespread availability. During a mass pandemic, that's a great option when you have little else.

I can confirm that hydroxychloroquine is part of the standard treatment protocol for COVID patients at 4 different academic centers (including the Oklahoma Health Sciences Center where I work, University of Kansas, UT Southwester, and Washington). Probably many more, those were just the first places I checked because I know people there.

And there is red tape holding people back from using it. Some states have kept doctors from prescribing it outpatient (where it is probably best used) and limited it to only inpatient. Completely asinine. Doctors prescribe medicine for off-label uses all of the time. No one should be telling the doctors they can't prescribe it for their patients. It has become political, which is unfortunate.

We need better data on it. But there is A TON of stuff in medicine that we do that does not have sufficient data.

People are getting confused by Fauci saying "it's not a magic bullet and we need more evidence." I agree with Fauci, but I also believe we should be using it. You can think both of those things at the same time.

Dr. Fauci was asked if he would prescribe it for one of his patients. What did he say? Yes.

https://townhall.com/columnists/lar...ne-to-patient-suffering-from-covid19-n2565678

This is a good post. Hydroxychloroquine has been around for decades. Physicians know the side effects and should prescribe it accordingly. I don't hear anyone saying that it is a "cure", but more of a stop-gap for a number of patients who have seen positive results. Yes, it's anecdotal....but if I'm sick and running out of options, I would gladly take it.

Unfortunately, we don't have the luxury of a clinical study at this moment. Hopefully, over time, we can conduct a study along these lines that will give us more conclusive data.

 

[stormspencer]

We should be basing our policies on worst-case scenarios. We are not out of the woods, we are about to start seeing deaths in the 2k-3k per day range. Also, South Korea is seeing a resurgence in cases, and there have been reports of reinfections. I'm not trying to be the bad guy, but look at Oklahoma, it's just starting here, look at the graph, go to the OSDH website. I don't understand why everyone is acting like this is over and we can stop worrying about it. We probably are not going to be able to completely stop the mitigation efforts until a vaccine is developed.

Also, if you do mitigation properly it's going to look like you never needed to do it in the first place. Look at Y2K. Everyone says "Y2K was nothing!" Yeah, it was nothing because thousands of programmers worked day and night to make sure it was nothing.

I'm not acting like it's over....absolutely not. I believe we will see tens of thousands more deaths. But, initially we were being told it could be in the "millions", then it was "100K to 250K", now it is around "80K". Pardon my skepticism when it comes to "experts", "models", and "projections". I'm not a clinician or epidemiologist, but I'm also smart enough to see that, although accomplished/experienced, these "experts" aren't anywhere close to knowing everything about the situation. I'm not necessarily blaming them, but some serious questions about data and inputs need to be addressed.

 

[BoulderSooner]

FYI the models saying 2mil dead then 240k dead now 80k dead assumed total social distancing in their models

 

[BoulderSooner]

First, one death is too many (we can all agree on this).

from a personal Point of view sure one death is too many


from the Gov POV or society POV


no one death is not too many .... we make that judgement as a country every day

 

[steverocks35]

I'm not acting like it's over....absolutely not. I believe we will see tens of thousands more deaths. But, initially we were being told it could be in the "millions", then it was "100K to 250K", now it is around "80K". Pardon my skepticism when it comes to "experts", "models", and "projections". I'm not a clinician or epidemiologist, but I'm also smart enough to see that, although accomplished/experienced, these "experts" aren't anywhere close to knowing everything about the situation. I'm not necessarily blaming them, but some serious questions about data and inputs need to be addressed.

First of all, the UW model conflicts with many other models.

https://www.washingtonpost.com/health/2020/04/06/americas-most-influential-coronavirus-model-just-revised-its-estimates-downward-not-every-model-agrees/

Second of all, I'll repost this:
https://fivethirtyeight.com/features/why-its-so-freaking-hard-to-make-a-good-covid-19-model/

 

[WTSooner]

Because there is exponential growth, and of course I will be happy if we have fewer deaths, which can be attributed to the extreme social distancing measures put in place. Many of the early models assumed no social distancing.

Hmmm.....you are going to end up playing both sides of this.

If we come in way under the projections on deaths, you are going to do exactly what you did here and say that the extreme social distancing was why.

But all you've said, EVERY day on here, is that we aren't doing enough. Those ideals don't really line up. And the models (the real ones, not your projections) have been consistent in stating that their estimates are based on social distancing. So actually doing that, really isn't affecting their analysis.

 

[WTSooner]

from a personal Point of view sure one death is too many


from the Gov POV or society POV


no one death is not too many .... we make that judgement as a country every day

One death is too many from a humanity aspect, but that isn't how we should be evaluating this.

We should be looking at it in terms of given the situation, what number is basically out of our hands. We can certainly all agree that there was absolutely nothing our government could have done to keep the death rate at 0.

 

[BoulderSooner]

One death is too many from a humanity aspect, but that isn't how we should be evaluating this.

We should be looking at it in terms of given the situation, what number is basically out of our hands. We can certainly all agree that there was absolutely nothing our government could have done to keep the death rate at 0.

is the USA outlawed cars auto deaths would go way way down and we would save lives


if we just had an auto helmet law (for all passengers) that would save thousands of lives


we make these choices every day

 

[steverocks35]

Hmmm.....you are going to end up playing both sides of this.

If we come in way under the projections on deaths, you are going to do exactly what you did here and say that the extreme social distancing was why.

But all you've said, EVERY day on here, is that we aren't doing enough. Those ideals don't really line up. And the models (the real ones, not your projections) have been consistent in stating that their estimates are based on social distancing. So actually doing that, really isn't affecting their analysis.

We are not doing enough, I will keep saying it. The more we do, the more lives we will save. Having half-measures is costing lives, even now. I could not believe that the beaches in Georgia are open as of yesterday. If what we are doing is mitigating the deaths then we need to do more of it.

 

[coolm]

I've noticed there's a bit of another double whammy in this proposed treatment technique.

Aside from the potassium "binding" or whatever MO quinines use to limit ion xfer across the cell membrane (which can wreak havoc with heart muscles and create arrhythmia) you also have the fatty layer of myelination in neurons which is penetrated by the quinine and causes neural firing disruptions. These are the problems with just the quinine.

The zpack is another story. that mycin is one of those macrolides (like emycin) that works by disrupting protein synthesis within the cell. It also has the unfortunate side-effect similar to antiarrhythmic meds of prolonging the QT period of the heart's beating and affecting the resting period of the heartbeat. So if you have heart issues this is a bad course of action.

 

[steverocks35]

Okay I have wasted way too much time here, I need to get some work done between meetings, have a great day gents.

 

[stormspencer]

One death is too many from a humanity aspect, but that isn't how we should be evaluating this.

We should be looking at it in terms of given the situation, what number is basically out of our hands. We can certainly all agree that there was absolutely nothing our government could have done to keep the death rate at 0.

Agree with everything above.

 

[AdaSooner]

I'm not acting like it's over....absolutely not. I believe we will see tens of thousands more deaths. But, initially we were being told it could be in the "millions", then it was "100K to 250K", now it is around "80K". Pardon my skepticism when it comes to "experts", "models", and "projections". I'm not a clinician or epidemiologist, but I'm also smart enough to see that, although accomplished/experienced, these "experts" aren't anywhere close to knowing everything about the situation. I'm not necessarily blaming them, but some serious questions about data and inputs need to be addressed.

No one is acting like it’s over. He sees a post with a glimmer of hope, and he gets all bent out of shape worrying about our safety I suppose. I appreciate that about steverocks35. But he needs to relax a little and give people credit for being able to think for themselves.

My family and I have been sheltered in place like hermits living in a cave for six weeks or more. This is not my idea of fun by any means. I realize there may be some out there who are not taking this virus seriously. That group doesn’t include me, members of our family in five different states, or anyone we know for that matter. Everyone we have talked to or communicated with by email, text and social media is doing the same thing.

If Covid-19 has a positive, it’s that it has brought people together in one accord like nothing I have seen before in my lifetime!

 

[hoopsaustin]

Hmmm.....you are going to end up playing both sides of this.

If we come in way under the projections on deaths, you are going to do exactly what you did here and say that the extreme social distancing was why.

But all you've said, EVERY day on here, is that we aren't doing enough. Those ideals don't really line up. And the models (the real ones, not your projections) have been consistent in stating that their estimates are based on social distancing. So actually doing that, really isn't affecting their analysis.

Youre right. Just white noise imo, couched in politics. Ive appreciated some of his science based posts tho but we all know the motives. We do need to keep it up and even ramp the efforts more and get this nonsense over with asap

 

[hoopsaustin]

No one is acting like it’s over. He sees a post with a glimmer of hope, and he gets all bent out of shape worrying about our safety I suppose. I appreciate that about steverocks35. But he needs to relax a little and give people credit for being able to think for themselves.

My family and I have been sheltered in place like hermits living in a cave for six weeks or more. This is not my idea of fun by any means. I realize there may be some out there who are not taking this virus seriously. That group doesn’t include me, members of our family in five different states, or anyone we know for that matter. Everyone we have talked to or communicated with by email, text and social media is doing the same thing.

If Covid-19 has a positive, it’s that it has brought people together in one accord like nothing I have seen before in my lifetime!

Dogs are the big winners

 

[MsProudSooner]

I listened to some doctors talk about Paquenil today on Doctor Radio. They said the cases cited in the article that had been published didn't constitute a double blind study. They said the people who had improved after taking the drug didn't have a heavy virus load in the test that was administered prior to taking the drug and that patients who had a heavier virus load didn't have the same good results. They didn't reject the drug outright but said much more testing must be done.

 

[steverocks35]

Youre right. Just white noise imo, couched in politics. Ive appreciated some of his science based posts tho but we all know the motives. We do need to keep it up and even ramp the efforts more and get this nonsense over with asap

Glad you're a mind-reader, that's the best form of analysis. Thanks!

 

[steverocks35]

I listened to some doctors talk about Paquenil today on Doctor Radio. They said the cases cited in the article that had been published didn't constitute a double blind study. They said the people who had improved after taking the drug didn't have a heavy virus load in the test that was administered prior to taking the drug and that patients who had a heavier virus load didn't have the same good results. They didn't reject the drug outright but said much more testing must be done.

If it is not a double blind study with a representative number of participants then the results will not be reliable. That was one of the big problems with the study in France that started this whole frenzy.

 

[SoonerJK12]

If it is not a double blind study with a representative number of participants then the results will not be reliable. That was one of the big problems with the study in France that started this whole frenzy.

The question becomes how much uncertainty you are willing to tolerate in a disaster situation in which we have no current treatments.

If you wait for a double blinded controlled trial with an adequate number of participants for everything, then a lot of diseases would never be treated. Especially if you were on a time crunch.

 

[BoulderSooner]

IHME projection (the one most of the response has been based on )

now says 60k total deaths