Well this is some good news. Remdesivir appears to be hanging in there with its clinical trials.
The key part of this in my mind is that it is showing effectiveness on severe patients. That’s what we want to see, an antiviral working on people with severe symptoms. That is a good sign.
Gilead’s stock is going through the roof in after hours trading. So people like what they see here.
On March 10, Michael Osterholm suggested that obesity is likely to be comorbidity factor. The Chinese CCDC reported that diabetes increases the death rate to 9.2%. According to the New York Times, doctors are now saying that obese patients are dying at a higher rate. Even younger obese patients who are otherwise healthy. This is bad news for the U.S., because our population has more overweight and obese people than other countries. If this holds out, we can expect a higher fraction of young people to die than in other countries. See:
https://www.nytimes.com/2020/0…s-cases-live-updates.html
Early research on underlying health conditions associated with the virus has highlighted that obesity appears to be one of the most important predictors of severe cases of the coronavirus illness, but asthma does not.
New studies point to obesity as the most significant risk factor, after only older age, for patients being hospitalized with Covid-19, the illness caused by the virus. Some 42 percent of American adults — nearly 80 million people — live with obesity. Young adults with obesity appear to be at particular risk, studies show.
The research is preliminary, and not peer reviewed, but it buttresses anecdotal reports from doctors who say they have been struck by how many seriously ill younger patients of theirs with obesity are otherwise healthy.
For people with asthma, the outbreak of a disease that can lead to respiratory failure was particularly worrisome. Many health organizations have cautioned that asthmatics are most likely at higher risk for severe illness if they get the virus.
But data released this month by New York State shows that, only about five percent of Covid-19 deaths in New York were of people who were known to also have asthma, a relatively modest amount. Nearly eight percent of the U.S. population — close to 25 million people — has asthma, according to the Centers for Disease Control and Prevention. . . .
“We’re not seeing a lot of patients with asthma,” said Dr. Bushra Mina, a pulmonary and critical care physician at Lenox Hill Hospital in New York City, which has treated more than 800 Covid cases. The more common risk factors, he added, are “morbid obesity, diabetes and chronic heart disease.”
As to the protesters you mention; they were just one group you singled out -because I guess they are mostly conservative (small business owners). You took offense with, called them names and politicized the issue by accusing them of being ignorant right wing zealots.
I singled them out for two reasons. One, they blocked access for workers to a major medical center. Medical workers on the front lines could not get to work or those who had finished grueling shifts could not get home so these whackoes could exhibit their ignorance. Secondly, they did not follow social distancing nor did they use masks. That will cost many lives and considerable resources. I have no problem with any group demonstrating for any reason. With good sense and in an appropriate place and according to current distancing regulations. These people were behaving dangerously when it was completely unnecessary. They could have used a large park and maintained the rules. I have not followed other protests but regardless of source, if they don't follow the current guidelines, that are ignorant or just nutballs.
ETA: This is not peaceful demonstration. Nobody has the right to obstruct a public freeway where emergency vehicles and urgently needed medical people may need to go. These people in the links I gave, were not exercising first amendment rights- they were criminals, If I had been mayor, I would have ordered the police to block the highway with concrete trucks at both ends and send an army of officers to give every participant a $1000 ticket and if they resisted, I'd have carted them off to jail and impounded their cars. I suspect the mayor didn't do that because some of the perpetrators were probably both armed and drunk and he or she did not want anyone killed.
There is very little research by either group and less common ground.
Actually and fortunately, there is an enormous amount of research scientific, social and economic being done by many groups with varying persuasions, including industry, government, foundations, private companies and universities. "Very little research?" Not sure what you mean!
Mats Lewan evaluates the graphs.
Yeah, well, Mats Lewan still thinks Rossi has the secrets of limitless power generation.
Also, the link returns a 404 error... page not found. In my location, anyway.
Criminal malpractice and a virtually certain multi-million dollar lawsuit:
"Family of New York woman blames hydroxychloroquine combo for fatal heart attack
The 65-year-old woman was prescribed the malaria drug and an antibiotic by her doctor to treat coronavirus symptoms...
...
In early April, Ligia, a 65-year-old Queens resident, was given the drug by her general practitioner after she reported having a bad cough, fever and shortness of breath. Ligia’s last name is being withheld on the request of her children.
While Ligia’s symptoms were consistent with those of COVID-19, the illness caused by the coronavirus, she was never tested for the virus, her brother-in-law, Lee Levitt, told NBC News. Ligia received the drug after speaking by phone with her doctor, Levitt said. She was never evaluated in person and received no heart screening or warning about the potential side effects. “It was handed over like a bag of cookies,” ...
... Ligia was diabetic and had high blood pressure but no known history of heart disease, Levitt said. After taking three doses of the drug combination, Ligia suffered cardiac arrest early on the morning of April 7, and died before paramedics could reach her. Her 40-year-old daughter, guided over the phone by emergency medical technicians, had tried unsuccessfully to revive her...
...Donawald’s 32-year-old daughter, who had recently been diagnosed with myocarditis, an inflammation of the heart muscle, was given the prescription by a telemed doctor she’d never seen her before and who asked no questions about her underlying health conditions, Donawald said. Donawald recalled her conversation with Levitt, which took place as her daughter's husband was en route to fill the prescription. “Stop. Stop him right now,” Levitt told Donawald, who hung up and immediately called her son-in-law..."
https://www.nbcnews.com/health…tal-heart-attack-n1185451
This is so wrong in so many ways. Incredible, for both patients, the drug or drugs were prescribed without a physical examination and lab work, without an EKG and without verification of a positive COVID-19 test. In my opinion, this is criminal negligence and/or incompetence (the practitioner gets to choose) and should result in a long suspension or permanent loss of the practitioners' licenses.
The article also was incompetently written. It's misleading. There is no evidence that either HCQ or Azi caused the deaths. This individual was diabetic and had a febrile illness which was why she called the doctor to begin with. She could have sustained a respiratory, septic shock or cardiac death from her diabetes plus the new underlying condition, regardless of the drugs.
What a medical horror1
Pharmacological workaround for cardiac side effects of HCQ CQ
monitor QT ..add lidocaine mexilitene
Mita et al Northshore Uni..Hospital, New York
"
The addition of lidocaine or mexiletine may allow
this type of combination therapy even in patients
who have a prolonged QT interval.
Great find, thank you.
This is so wrong in so many ways. Incredible, for both patients, the drug or drugs were prescribed without a physical examination and lab work, without an EKG and without verification of a positive COVID-19 test. In my opinion, this is criminal negligence and/or incompetence.
The article also was incompetently written. It's misleading.
I am always suspicious of lawsuits. especially medical ones. You as well as I know that once the discovery starts, the real truth comes out. Sometimes favoring the patient, but more often for the doctor. That is why most medical malpractice suits nowadays are handled by very large law firms, with a large bank account, allowing them to survive the many losses, for those few big jackpots.
I posted another article last week about how US lawyers are positioning themselves to cash in on the COVID jackpot, so the timing of this article makes me even more suspicious. Will leave it at that until more is known.
Your article also brings up the issue of prescribing "off label" drugs, which I believe you were scratching your head about, as was I, when reading how it was described as somewhat normal. From my experience, and maybe yours, it is not (normal), and doctors do not just decide to go "off label" when they feel like it. Doing so without permission from their Department Head would likely get them in trouble. Then the hospitals Medical Staff/Credentials Committee, might get involved. More importantly, they know that using non-standard drugs. treatments, or procedures makes them more vulnerable to lawsuits...so they just do not do it.
In this case, the ladies doctor, over the phone, sight unseen, prescribes HCQ. Something stinks right there IMO. For one, HCQ was in very short supply, and from what I know, only prescribed for those in the hospital. But this is New York, so who knows, but I have read many accounts of charlatan doctors preying on their ethnic populations there, and elsewhere in places like Miami, California.
This sounds like another one of those. ABC called her doctors office, he answered, then hung up.
I posted another article last week about how US lawyers are positioning themselves to cash in on the COVID jackpot,
I do not think there will be much of a COVID malpractice jackpot. I believe the Congress passed a special law saying that no doctor can be sued for steps taken to deal with COVID during the pandemic. They are all except from malpractice lawsuits. It is a sensible move, given how little we know about the disease, and what the best practices should be.
Report: Covid-19 patients recovering quickly after getting experimental drug remdesivir
I do not think there will be much of a COVID malpractice jackpot. I believe the Congress passed a special law saying that no doctor can be sued for steps taken to deal with COVID during the pandemic. They are all except from malpractice lawsuits. It is a sensible move, given how little we know about the disease, and what the best practices should be.
Do you have a reference? I have been searching, and all I come up with is a Tort law article, saying they (lawyers) would look bad "suing hero's"...at the moment. Then another saying NY, NJ, and Ct made it a "little" harder to win a lawsuit. Nothing about any special Congressional law.
Report: Covid-19 patients recovering quickly after getting experimental drug remdesivir
Sort of a miserably poor excuse for an article. Not only no data but very little information. From what I have seen of real studies, remdesivir can be helpful but is far from a magic bullet.
I believe the Congress passed a special law saying that no doctor can be sued for steps taken to deal with COVID during the pandemic.
Even if true, this could be a special case. This unfortunate patient might not have had COVID-19 at all.
Actually and fortunately, there is an enormous amount of research scientific, social and economic being done by many groups with varying persuasions, including industry, government, foundations, private companies and universities. "Very little research?" Not sure what you mean!
SoT,
“Research”, by many is reading what you are told to read and coming to the conclusion you are told to come to.
This “Research” consists of cherry picking bits and pieces and parts of various data then twisting turning and perverting it to fit their political argument.
It is not research to find an answer, but more like they are preparing for a high school debate class.
I do not consider this research
The most recent actual study of remdesivir I could find, a compassionate use, open label study.
https://www.nejm.org/doi/full/10.1056/NEJMoa2007016
“Research”, by many is reading what you are told to read and coming to the conclusion you are told to come to.
No, siwwie wabbit. That is *literature* "research." Here are many many examples of actual research as well as theoretical work done on COVID-19 to date:
https://jamanetwork.com/journals/jama/fullarticle/2764727
(I don't think this requires any password anywhere- if wrong, pls let me know)
Report: Covid-19 patients recovering quickly after getting experimental drug remdesivir
I rate this anecdotal evidence higher than that for HCQ because (a) less politicised (b) remdesivir does NOT have a long record of failure in RCTs.
Here is a recent and good summary of current hopefuls:
https://www.pharmaceutical-jou…3.article?firstPass=false
Remdesivir has first RCT evidence the same time as HCQ has first (high quality) RCT evidence, before end of April.
My bet is on remdesivir doing very significantly better than HCQ. No bets from me that anything will be a magic bullet, but we can still hope with remdesivir, not now with HCQ...
(from video of private case conference)
STAT said it obtained and viewed a copy of the video discussion Mullane had last week with colleagues about the trial.
"Most of our patients are severe and most of them are leaving at six days, so that tells us duration of therapy doesn't have to be 10 days," she was quoted as saying.
Even if remdesivir does not much alter mortality, if it alters average treatment time say 20% downward it will be very highly sought after.
I find the reporting of HCQ to be slightly slanted against. I guess because there really is little evidence of benefit, and clear evidence of harm if HCQ supplies are denied to patients taking it for lupus etc.
https://edition.cnn.com/2020/0…oxychloroquine/index.html actual paper here
If you look at this (negative) meta-analysis all it says is that:
Very strong evidence this is no miracle drug, and no, "why not take it - what have you got to lose" is inappropriate without significant medical precautions.
As yet no evidence for or against small effects small effects.
Overall this is another negative, although not conclusive given the methodological issues.
The Germans seem to know something about Avigan (Favipiravir) that we don't. Maybe a fortuitous addition to our Z-pak Anti Bat (iV) (H) combo:
200 mg hydroxychgloroquine/250 mg chloroquine.
250 mg azithromycin or clarithromycin (doxycycline is another possible antibiotic)
Zn SO4 100 mg
Avigan 100 mg
Ivermectin (iV) 5mg
Herbal Remediies (H) - SASL (Sutherlandia, Angelica, Sceletium), Liquorice root exrract.
Vitamin C 1000mg, multivitamins, Ca + Vitamin D.
Twice daily at the first sign of fever, ie following WHO directive for Mass Fever Treatment (MFT) any other suggestions? Could also add Black Seed Oil and Coconut oil but these are more like food supplements, similarly flavonoids like Quercetin.
A shotgun approach to COVID-19 treatment - use anything where there is biochemical or anecdotal clinical evidence. Remember the President of Indonesia ordered millions of doses of Avigan and chloroquine from China more than a month ago? In the UK all we are doing so far is still restricting any drugs that might be useful and continuing the long standing intellectual debate as to whether wearing masks or not has some benefit. Duh! The only reason that rumour was put round (that they don't help) was to stop stockpiling which would have restricted supplies to doctors and nurses.
FRANKFURT -- The German government will purchase large amounts of the anti-influenza drug Avigan, developed by a unit of Fujifilm Holdings, to treat the new coronavirus, local media reported Thursday.
Berlin is aiming for short-term stockpiling of Avigan, Frankfurter Allgemeine Zeitung reported. The purchase will be in the millions of packs, which will be distributed through university hospitals and other institutions with the help of the military.
A Chinese government-affiliated institution said it has confirmed the efficacy of Avigan, developed by Fujifilm Toyama Chemical, against coronavirus infection in clinical trials, and there are growing expectations that it will help prevent the spread of the pandemic. Fujifilm Toyama Chemical has just begun its own clinical trials.
President Trump is expected to announce as soon as Thursday evening that the Centers for Disease Control and Prevention will hire hundreds of people to perform contact tracing in communities around the country as part of the president’s push to allow the country to go back to work and school, a top government official said. . . .
NSA/CIA does have several 10'000s of trained table fighters doing a live long contact tracing... Why not once use these guys for helping the own country??
Sort of a miserably poor excuse for an article. Not only no data but very little information. From what I have seen of real studies, remdesivir can be helpful but is far from a magic bullet.
Even if remdesivir does not much alter mortality, if it alters average treatment time say 20% downward it will be very highly sought after.
20% is what I did read already weeks ago what is a bit more than Kaletra does.
But Gillead did heavy lobbying (CDC relations??) starting at day one and all this looks like a fraudulent stock speculation...
Do not forget that both China and South Korea do use HCQ since about 6 weeks at least. Negative news most likely steam from speculation (as above), what is the worst you can do with patients live. Avigan seems to be the only drug with some real potential.
Further you should simply ignore all message that do only reference HCQ without added zinc (highly mandatory according Swiss blood tests).
I personally would look out for the side effect free herbs you can take without prescription. But, please share them with others as the production will not feed the need. I'm lucky as I always do have a stock to early treat classic corona.
