"Coronavirus and the US" or "We are all going to die!!!!"

[repoman]

Ok, take as a give testing that is for either virus segments or antibodies. What is the workable protocol?

Say in a workplace there are ten people, A-J. All are tested on June 1st and A, D and F test positive for Covid-19. What stage of infection is not fully known. Maybe A and F have recovered and are not contagious while D is freshly infected and is contagious.

Tell me exactly what the course of action for the employer and (UNABLE TO WORK OFFSITE) employees BCEGHIJ should be.

 

[lpetrich]

Hong Kong controlled the coronavirus with the help of face masks. Here’s how. - Vox - "New research shows that universal mask-wearing may help slow the spread of Covid-19."

t’s worth noting that Hong Kong also implemented a strong testing, tracing, and isolation program, in addition to strengthening travel rules and closing bars at the end of March. Those moves, perhaps just as much as masks, have helped keep Hong Kong’s coronavirus death toll low.

But the masks, research shows, are still very important.

In April, researchers from the University of Hong Kong and the University of Maryland found that masks stopped sick people from spreading Covid-19.

A mask could catch a lot of the virus a sick person would otherwise be breathing or coughing out,” Ben Cowling, the head of epidemiology at the University of Hong Kong’s School of Public Health and a co-author of the study, told the Wall Street Journal at the time. “Wearing them at least provides some protection for others.”

On May 13, Vox’s Matthew Yglesias also pointed out that in April, researchers at the University of Hong Kong and in Europe calculated that if 80 percent of a population can be persuaded to don masks, transmission levels would be cut to one-twelfth of what you’d have in a mask-less society. However, that study has yet to be peer-reviewed.

If masks can stop exiting droplets, they can stop entering droplets. So even if you are healthy, wear one.

 

[George S]

Very interesting doctor in Orange County, California...

He is just one doctor, but he reports success using Hydroxychloroquine plus Zinc (and Zpac).
He advocates informing each patient of possible risks and letting them decide using risk management logic.
He mentions that people use masks wrongly and gives specific situations.
He claims that the lockdown is causing many deaths.
[YOUTUBE]W4ir6np7iCE[/YOUTUBE]

 

[fromderinside]

I've been waiting decades for this opportunity.

Orange County! Git a rope*

*^{_{the eyes of Texas-ah are upon you}}

 

[southernhybrid]

Hong Kong controlled the coronavirus with the help of face masks. Here’s how. - Vox - "New research shows that universal mask-wearing may help slow the spread of Covid-19."

t’s worth noting that Hong Kong also implemented a strong testing, tracing, and isolation program, in addition to strengthening travel rules and closing bars at the end of March. Those moves, perhaps just as much as masks, have helped keep Hong Kong’s coronavirus death toll low.

But the masks, research shows, are still very important.

In April, researchers from the University of Hong Kong and the University of Maryland found that masks stopped sick people from spreading Covid-19.

A mask could catch a lot of the virus a sick person would otherwise be breathing or coughing out,” Ben Cowling, the head of epidemiology at the University of Hong Kong’s School of Public Health and a co-author of the study, told the Wall Street Journal at the time. “Wearing them at least provides some protection for others.”

On May 13, Vox’s Matthew Yglesias also pointed out that in April, researchers at the University of Hong Kong and in Europe calculated that if 80 percent of a population can be persuaded to don masks, transmission levels would be cut to one-twelfth of what you’d have in a mask-less society. However, that study has yet to be peer-reviewed.

If masks can stop exiting droplets, they can stop entering droplets. So even if you are healthy, wear one.

I hope this is true because masks have become very controversial, even among health care professionals. I'm talking about cloth or surgical masks. I was on a medical discussion board last week. There were many doctors and nurses who were making claims that the masks are worthless. Other doctors and nurses said that it doesn't hurt to wear one, so why not. Some quoted research that gave very little support to the claims that masks protect us from each other. I will wear one because they certainly aren't going to hurt me, and they do remind me to be careful when I'm at the grocery store. Unfortunately, there are a lot of peoplein my area who have refused to wear masks and some are being very careless when out in public.

 

[bilby]

Very interesting doctor in Orange County, California...

He is just one doctor, but he reports success using Hydroxychloroquine plus Zinc (and Zpac).
He advocates informing each patient of possible risks and letting them decide using risk management logic.
He mentions that people use masks wrongly and gives specific situations.
He claims that the lockdown is causing many deaths.
[YOUTUBE]W4ir6np7iCE[/YOUTUBE]

You can find one doctor who endoses pretty much any treatment for anything, no matter how bizarre*. That's why it's important to consider the scientific consensus, and not just the opinion of one guy who is saying what you want to hear.





*Far more than one if you are dumb enough to consider YouTube a viable source of information.

 

[southernhybrid]

In other words, anecdotal evidence from one source is basically worthless. You need a fairly large study to be able to make any claims about a particular drug.

 

[George S]

In other words, anecdotal evidence from one source is basically worthless. You need a fairly large study to be able to make any claims about a particular drug.

I have worked developing models for the epidemiologists at The Upjohn Company. I can read the data on the safety of HCQ in its raw form which I have. It is safe and only possibly effective. So it is in the "can't hurt, might help." (There are a few contraindications in the data, but they are actually rare.) The property at issue is its efficacy and/or effectiveness. (Efficacy is when the reason it has a given effect is known chemically while effectiveness is whether or not it works even though the chemistry of why is unknown.)
There is a pile of effectiveness data. However, it is not clear whether those treated might have had a mild case anyway. Only deliberately not treating with a treatment under study -- possibly killing people needlessly in a controlled study sounds cruel. The safety is not in question.
There are controlled studies for efficacy because of being a Zn-ionophore. That is, it is given to healthy people and their blood is tested to see if, indeed, it is getting Zn, the anti-viral, inside cells. Early results look promising.
Apparently Trump's personal physician prescribed him HCQ as a prophylaxis. At the prophylactic dose, well below any therapeutic dose (as for Lupus), for a short time has, according to double-blind studies, close to zero side effects.
It is routine for physicians to prescribe off-label. All effects and side effects are reported to the manufacturer. One common example is doctors grinding up prescription minoxidil and using it to grow hair. I saw the epidemiology reports. That's when they decided to do the tests for effectiveness and the result was Rogaine. Never was an efficacy study. They have no clue why it grows hair.

 

[skepticalbip]

In other words, anecdotal evidence from one source is basically worthless. You need a fairly large study to be able to make any claims about a particular drug.

..... snip .....

I have worked developing models for the epidemiologists at The Upjohn Company. I can read the data on the safety of HCQ in its raw form which I have. It is safe and only possibly effective.

There should be no question of the safety of hydroxychloroquine used as a prophylaxis. It has been given to many millions as a prophylaxis for malaria over the last several decades. Whether it is useful to ameliorate the symptoms of the coronavirus seems to be debatable, some doctors swear by it and others say it is useless.

 

[Loren Pechtel]

Very interesting doctor in Orange County, California...

He is just one doctor, but he reports success using Hydroxychloroquine plus Zinc (and Zpac).
He advocates informing each patient of possible risks and letting them decide using risk management logic.
He mentions that people use masks wrongly and gives specific situations.
He claims that the lockdown is causing many deaths.
[YOUTUBE]W4ir6np7iCE[/YOUTUBE]

Every competent study of hydroxychloroquine has been stopped because it turned out to be worse than nothing.

 

[Loren Pechtel]

In other words, anecdotal evidence from one source is basically worthless. You need a fairly large study to be able to make any claims about a particular drug.

..... snip .....

I have worked developing models for the epidemiologists at The Upjohn Company. I can read the data on the safety of HCQ in its raw form which I have. It is safe and only possibly effective.

There should be no question of the safety of hydroxychloroquine used as a prophylaxis. It has been given to many millions as a prophylaxis for malaria over the last several decades. Whether it is useful to ameliorate the symptoms of the coronavirus seems to be debatable, some doctors swear by it and others say it is useless.

It's been used but even at the prophylaxis dose it's known for nasty side effects.

 

[bilby]

Very interesting doctor in Orange County, California...

He is just one doctor, but he reports success using Hydroxychloroquine plus Zinc (and Zpac).
He advocates informing each patient of possible risks and letting them decide using risk management logic.
He mentions that people use masks wrongly and gives specific situations.
He claims that the lockdown is causing many deaths.
[YOUTUBE]W4ir6np7iCE[/YOUTUBE]

Every competent study of hydroxychloroquine has been stopped because it turned out to be worse than nothing.

B..b..but YouTube.

 

[barbos]

Coronavirus super-spreader events reveal which gatherings to avoid - Business Insider

• An average person with the coronavirus infects about two other people, but sometimes an infected person passes the virus to far more people during a "super-spreader event."
• There have been reports of super-spreader events in South Korea and the US that have sparked local outbreaks.
• Most super-spreader events are similar: The infected person attends an indoor gathering with lots of people, like a religious service, choir practice, or birthday party.
• The commonalities of these events inform health officials about the types of gatherings with the highest chances of facilitating the virus' spread.

In mid-February, a 61-year-old woman attended church services in Daegu, South Korea. Soon after, she tested positive for the coronavirus — then so did dozens of others. South Korea's coronavirus case count quickly jumped from 29 cases on February 15 to more than 2,900 two weeks later.

Throughout this pandemic, clusters of coronavirus infections like this have cropped up almost overnight, sprouting outbreaks that spiral out of control. Such spikes in cases can often be traced back to a super-spreader event like the one in Daegu, in which one person infects an atypically large number of people.

...
During the last two decades, super spreaders have started a number of measles outbreaks in the United States," Elizabeth McGraw, an infectious-disease expert from Pennsylvania State University, wrote in The Conversation in January. "Sick, unvaccinated individuals visited densely crowded places like schools, hospitals, airplanes and theme parks where they infected many others."

Research has found time and again that the risk of the coronavirus spreading is much higher indoors, in poorly ventilated spaces where lots of people have sustained contact. That's because it primarily spreads via droplets that fly through the air when an infected person coughs, sneezes, or speaks.

A preliminary report from scientists in Japan (which has not been peer-reviewed) suggested that the odds that an infected person "transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment." Another preprint study examined 318 outbreaks in China that involved three or more cases and found that all but one involved the virus jumping among people indoors.

...
Singing and projecting your voice might be particularly risky activities, since that can send droplets farther than the recommended 6 feet of social distancing.

I like that research - it indicates what to watch out for. This raises an interesting question: how safe are large *outdoor* gatherings? They have the downside of crowding and the upside of being open-air.

Also, how might we make indoor environments more safe? Doing stronger air circulation with filtering? Getting air from outside?

Yeah, we already had this discussion about super-spreaders. I suspect that the crap we are in is mostly due to super-spreaders and if all people were following even basic rules this virus would not have spread.
Quarantine is fairly pointless when 10% of people don't give a fuck.

 

[skepticalbip]

There should be no question of the safety of hydroxychloroquine used as a prophylaxis. It has been given to many millions as a prophylaxis for malaria over the last several decades. Whether it is useful to ameliorate the symptoms of the coronavirus seems to be debatable, some doctors swear by it and others say it is useless.

It's been used but even at the prophylaxis dose it's known for nasty side effects.

Yes a small percentage of the population have negative reaction to hydroxychloroquine. But then a small percentage of the population have a severe negative reaction to aspirin, a small percentage of the population have a severe negative reaction to penicillin, there is even a small percentage of the population that have a really severe negative reaction to peanuts.

 

[southernhybrid]

t https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

The absence of an effective treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has led clinicians to redirect drugs that are known to be effective for other medical conditions to the treatment of COVID-19. Key among these repurposed therapeutic agents are the antimalarial drug chloroquine and its analogue hydroxychloroquine, which is used for the treatment of autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis.1, 2 These drugs have been shown in laboratory conditions to have antiviral properties as well as immunomodulatory effects.3, 4 However, the use of this class of drugs for COVID-19 is based on a small number of anecdotal experiences that have shown variable responses in uncontrolled observational analyses, and small, open-label, randomised trials that have largely been inconclusive.5, 6 The combination of hydroxychloroquine with a second-generation macrolide, such as azithromycin (or clarithromycin), has also been advocated, despite limited evidence for its effectiveness.7 Previous studies have shown that treatment with chloroquine, hydroxychloroquine, or either drug combined with a macrolide can have the cardiovascular adverse effect of prolongation of the QT interval, which could be a mechanism that predisposes to ventricular arrhythmias.8, 9
Research in context
Evidence before this study
We searched MEDLINE (via PubMed) for articles published up to April 21, 2020, using the key words “novel coronavirus”, “2019-nCoV”, “COVID-19”, “SARS-CoV-2”, “therapy”, “hydroxychloroquine”, “chloroquine”, and “macrolide”. Moreover, we screened preprint servers, such as Medrxiv, for relevant articles and consulted the web pages of organisations such as the US National Institutes of Health and WHO. Hydroxychloroquine and chloroquine (used with or without a macrolide) are widely advocated for treatment of COVID-19 based on in-vitro evidence of an antiviral effect against severe acute respiratory syndrome coronavirus 2. Their use is based on small uncontrolled studies and in the absence of evidence from randomised controlled trials. Concerns have been raised that these drugs or their combination with macrolides could result in electrical instability and predispose patients to ventricular arrhythmias. Whether these drugs improve outcomes or are associated with harm in COVID-19 remains unknown.
Added value of this study
In the absence of reported randomised trials, there is an urgent need to evaluate real-world evidence related to outcomes with the use of hydroxychloroquine or chloroquine (used with or without macrolides) in COVID-19. Using an international, observational registry across six continents, we assessed 96 032 patients with COVID-19, of whom 14 888 were treated with hydroxychloroquine, chloroquine, or their combination with a macrolide. After controlling for age, sex, race or ethnicity, underlying comorbidities, and disease severity at baseline, the use of all four regimens was associated with an increased hazard for de-novo ventricular arrythmia and death in hospital. This study provides real-world evidence on the use of these therapeutic regimens by including a large number of patients from across the world. Thus, to our knowledge, these findings provide the most comprehensive evidence of the use of hydroxychloroquine and chloroquine (with or without a macrolide) for treatment of COVID-19.
Implications of all the available evidence
We found no evidence of benefit of hydroxychloroquine or chloroquine when used either alone or with a macrolide. Previous evidence was derived from either small anecdotal studies or inconclusive small randomised trials. Our study included a large number of patients across multiple geographic regions and provides the most robust real-world evidence to date on the usefulness of these treatment regimens. Although observational studies cannot fully account for unmeasured confounding factors, our findings suggest not only an absence of therapeutic benefit but also potential harm with the use of hydroxychloroquine or chloroquine drug regimens (with or without a macrolide) in hospitalised patients with COVID-19.

I

I found this more extensive study regarding whether or not there was any benefit of using hydoxychloroquine for COVID-19. The study found there was no benefit, but there was an increased risk of death in some victims of the virus. This is the type of study that I'm more likely to find useful. If anyone is interested, the link contains very detailed information regarding methodology etc. reading this study.

 

[Elixir]

... there is even a small percentage of the population that have a really severe negative reaction to peanuts.

The percentage of those who have a dangerous reaction to hydroxychloroquine is higher among elderly, morbidly obese patients. (fingers crossed).

As pointed out by the latest Republican doctor to be trotted out, no controlled studies have confirmed any prophylactic effect. And the same is true of aspirin, grapefruit seed extract, prune juice and peyote cactus. Maybe prune juice is the ticket.
I'd add eye of newt to the list.

 

[skepticalbip]

... there is even a small percentage of the population that have a really severe negative reaction to peanuts.

The percentage of those who have a dangerous reaction to hydroxychloroquine is higher among elderly, morbidly obese patients. (fingers crossed).
.

I think you are conflating the effects of Covid-19 and the effects of HCQ. The overwhelming majority of old farts who died from Covid-19 were not on HCQ.

 

[crazyfingers]

https://www.cnn.com/2020/05/22/health/us-coronavirus-friday/index.html

Seriously ill Covid-19 patients treated with hydroxychloroquine and chloroquine were more likely to die or develop dangerous heart arrhythmias, according to a large observational study published Friday in the medical journal The Lancet.

Researchers looked at data from more than 96,000 Covid-19 patients from 671 hospitals. All were hospitalized from late December to mid-April and had died or been discharged by April 21. Just below 15,000 were treated with the antimalarial drugs hydroxychloroquine or chloroquine, or one of those drugs combined with an antibiotic.

Those treatments were linked with a higher risk of dying in the hospital, the study found. About 1 in 6 patients treated with chloroquine or hydroxychloroquine alone died in the hospital, compared to 1 in 11 patients in the control group.

 

[repoman]

https://www.cnn.com/2020/05/22/health/us-coronavirus-friday/index.html

Seriously ill Covid-19 patients treated with hydroxychloroquine and chloroquine were more likely to die or develop dangerous heart arrhythmias, according to a large observational study published Friday in the medical journal The Lancet.

Researchers looked at data from more than 96,000 Covid-19 patients from 671 hospitals. All were hospitalized from late December to mid-April and had died or been discharged by April 21. Just below 15,000 were treated with the antimalarial drugs hydroxychloroquine or chloroquine, or one of those drugs combined with an antibiotic.

Those treatments were linked with a higher risk of dying in the hospital, the study found. About 1 in 6 patients treated with chloroquine or hydroxychloroquine alone died in the hospital, compared to 1 in 11 patients in the control group.

Looks pretty bad, how was severity of illness controlled for?

 

[George S]

https://www.cnn.com/2020/05/22/health/us-coronavirus-friday/index.html

Seriously ill Covid-19 patients treated with hydroxychloroquine and chloroquine were more likely to die or develop dangerous heart arrhythmias, according to a large observational study published Friday in the medical journal The Lancet.

Researchers looked at data from more than 96,000 Covid-19 patients from 671 hospitals. All were hospitalized from late December to mid-April and had died or been discharged by April 21. Just below 15,000 were treated with the antimalarial drugs hydroxychloroquine or chloroquine, or one of those drugs combined with an antibiotic.

Those treatments were linked with a higher risk of dying in the hospital, the study found. About 1 in 6 patients treated with chloroquine or hydroxychloroquine alone died in the hospital, compared to 1 in 11 patients in the control group.

If you have taken HCQ for only 30 days or less and not ill and had a new heart arrhythmia let CNN know. It would be worth $1,000,000 to you.
It may be true that HCQ exacerbates existing heart arrhythmias. A contraindication for a given patient who has arrhythmia. Good info for prescribing doctors.
If those observational, retrospective studies are valid so is the use of HCQ based on observations by practicing physicians. They are anecdotal, not controlled, experiments. Experiments not done as experiments. As such the other factors not mentioned in the records observed could skew results.
Most critically, no mention is made as to the time of the start of treatment, nor zinc. Nor a distinction between HCQ and chloroqine. Nor dosage. Nor comorbidities. We know that using HCQ without Zinc is sometimes ineffective. We know that HCQ started late is futile. It is an anti-viral, not a treatment for the disease COVID19.
Somehow I don't believe that the prophylactic dose of 200 mg once a week of a safety-tested drug would be a problem even in someone with arrhythmia.
Do you know someone who has taken HCQ for Lupus or something else? Any side effects?