Covid-19 News

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, I first would take Ivermectin & Heparin as these two are side effect free, but these are not that easy to get in most western countries

Yes, sure, heparin is side effect free as long as you do not consider a stroke or bleeding to death as side effects. Definitely side effect free in that case. And, actually, I live in a very Western part of a very Western country and my down the street pharmacy stocks Heparin, at least the low molecular weight form (Lovenox) while the hospital pharmacy stocks the other type. All any licensed provider has to do is write a prescription or an order for it. Yup. Hard to get!

Ivermectin in human doses for humans is in fact, relatively safe but not completely so.

Quote from Bob#2

Right now, HCQ + Zn + Azithromycin seems to be the front runner by FAR when looking at the entire package above.

Nothing wrong with having an EKG in anticipation but to be safe, you will need another one when the drug is taken and thereafter for reasons I noted above. But no, these drugs are not front runners. All the studies, pro and con, of which there are about the same number, are of extremely poor quality. In other words, they do not speak correctly as to effectiveness and risk. So basically, the value of those drugs is as yet unknown. Completely unknown!

If you get a severe case, you do not want to foreclose the possibility that you might be helped by a variety of antivirals including remdesivir (also lacking adequate studies as of yet). You will also want to consider anti-cytokine monoclonal antibodies and finally, there is a great deal of promise for convalescent serum.

This will all get straightened out and more strategies will be developed but this will take a ton of work, money and time. Meanwhile, you should pay a lot of attention to prevention with masks, social distancing and washing of hands, surfaces, and anything brought into the house after other people handled it. And people you come into frequent contact with should be tested, both for virus and for antibodies.

Quote from Shane D.

They must be so afraid, they are even afraid to tell any reporters.

Nonsense. There are tons of reports about doctors using HCQ with and without AZI and zinc off label to treat COVID. And, there are published studies! Some reluctance to come forward when you publish a study with up to 20 (in one case) physician authors! Siwwie wabbit.

Quote from Navid

Yes I do.

Dr. Bhattacharya, Stanford, Center for Primary Care and Outcomes Research. “This disease is on the order of the flu.” On May 17, 2020 his expectation (based on antibody testing at various locales) is this on the high end is 0.2% IFR.

The problem with all numbers is we have a poor # of deaths - we were killing people with ventillators and overcounting covid deaths. We have physicians on records for both. With treatments that exist we can probably do a lot better.

Bad flu.

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Navid,

Evidence is not one person asserting something. It is overall the evidence pointing that way. I've posted for you above a recent meta-analysis (showing 0.5% - 1%). Now, what does Dr. B have that makes him so special (other than a minority view that agrees with your wishes?).

Please post here if he is relying on a lot of very recent US evidence we have not seen? It would be very good news.

The only antibody evidence I know showing very low IFR has been widely criticised (the Santa Maria study) and was clearly very sensitive to noise. It is an outlier. What about the NY evidence (much lower noise because higher prevalence)? The many other studies?

Engaging with the real worls is about looking at all the evidence and judging. Not cherry picking.

If, OTOH, you believe Dr., B. has done a complete non-partial LS please could you link his publication for us to view and (often a good idea) look at the comments on? The COVID preprints are very variable quality but they do often attract knowledgable comments. I'm sure any substantive analysis showing outlying low IFR would get a lot of attention. Everyone would like that to be true.

Before you accuse ME of bias, let me refer you to earlier in this thread when in absence of evidence I was still hoping for a very low IFR. andrea.s put me right by referring me to a number of studies I had not seen.

Quote from THHuxleynew

Navid,

Evidence is not one person asserting something. It is overall the evidence pointing that way. I've posted for you above a recent meta-analysis (showing 0.5% - 1%). Now, what does Dr. B have that makes him so special (other than a minority view that agrees with your wishes?).

Please post here if he is relying on a lot of very recent US evidence we have not seen? It would be very good news.

The only antibody evidence I know showing very low IFR has been widely criticised (the Santa Maria study) and was clearly very sensitive to noise. It is an outlier. What about the NY evidence (much lower noise because higher prevalence)? The many other studies?

Engaging with the real worls is about looking at all the evidence and judging. Not cherry picking.

If, OTOH, you believe Dr., B. has done a complete non-partial LS please could you link his publication for us to view and (often a good idea) look at the comments on? The COVID preprints are very variable quality but they do often attract knowledgable comments. I'm sure any substantive analysis showing outlying low IFR would get a lot of attention. Everyone would like that to be true.

Before you accuse ME of bias, let me refer you to earlier in this thread when in absence of evidence I was still hoping for a very low IFR. andrea.s put me right by referring me to a number of studies I had not seen.

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You can find the publications, commentary on is assessment and his response online.

Our challenge at this time is that we have a whole slew of factors that make the IFR hard to pin point. Some people claim 18% CFR in Wuhan at a time. We have bad data all over the place, poor treatment (ventillators - which has gotten better now), or no treatment (no drugs early on).

So you will quickly realize that summing together a bunch of datapoints and claiming you have a valid scientific answer is laughable. We are all a little in the dark, and it takes some guesswork (cherry picking, if you will) to find out what's probably going on.

For your information, I've talked to the senior scholar at John Hopkins Center for Health Security and he said they all along expected this was going to be 0.5% IFR or less and still assume that.

You won't find him saying that on MSM.

This is why we have new “models” almost daily, as we find the previous ones were inaccurate.

We will probably never have an accurate count on total global cases or deaths.

Quote from seven_of_twenty

Good question. I am not absolutely sure of the difference between testing requirements when HCQ is given for malaria, or for lupus, or for COVID-19. It probably works something like this.

For malaria prophylaxis and also for treatment, the total dose is smaller than for COVID-19 and the length of treatment or frequency of treatment are much less. See: https://reference.medscape.com…hloroquine-sulfate-343205

Also, azithromycin, which also alters the heart's conduction system, is not used against malaria.

In the case of lupus, again, azithromycin is not used. I have read that internists treating lupus with hydroxychloquine rarely if ever see cardiac complications but when they start treatment, I am sure they do an initial EKG and several after before they increase the interval between EKG's to months.

Finally, in the case of COVID-19, not only is the hydroxychloroquine used often with azithromycin (and in very sick patients, all sorts of other drugs), but the heart can be also damaged by the virus increasing the risk of ventricular fibrillation and cardiac arrest. There is also the VA study showing cardiac issues though it is pretty awful study. It just seems prudent to monitor EKG until the use of the drugs is better understood. I would feel pretty terrible if I prescribed this drug without monitoring and the patient suffered a heart attack (MI) or died from cardiac causes. Liver function and renal function have been known rarely to be adversely affected by the drugs and I would think a COVID patient might be more vulnerable so I'd check those. It's easy.

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Thank you for your informed response. It is appreciated.

Per the last paragraph however, my intention would be to take this VERY early on BEFORE any heart damage or other organ damage could occur. So hopefully that is not as much an issue. Again, my intention is to be very proactive and on the offense against this virus and not defensively, lying in a hospital until it is decided I need to be put on a ventilator! I do NOT want to reach that stage.

I agree that one should only perform this under a competent physician's oversight. That is the reason why I want to have this planned worked out well in advance BEFORE it is needed. Perhaps that physician may need a few days to research his own education as not all doctors will be experts on HCQ initially.

But once agreed upon and the EKG is taken, I am more convinced that having this plan ready to implement at the very first stage is crucial. To use a crude comparison, I can stomp a lit cigarette out easily with no repercussions, but once it has grown into a thousand acre forest fire, it is unstoppable. It appears that to the small percentage where Covid-19 is really dangerous, getting that early start is imperative. I do not want to wait a second if taking the combo is low risk.

Thanks again.

Quote from seven_of_twenty

Nothing wrong with having an EKG in anticipation but to be safe, you will need another one when the drug is taken and thereafter for reasons I noted above. But no, these drugs are not front runners. All the studies, pro and con, of which there are about the same number, are of extremely poor quality. In other words, they do not speak correctly as to effectiveness and risk. So basically, the value of those drugs is as yet unknown. Completely unknown!

If you get a severe case, you do not want to foreclose the possibility that you might be helped by a variety of antivirals including remdesivir (also lacking adequate studies as of yet). You will also want to consider anti-cytokine monoclonal antibodies and finally, there is a great deal of promise for convalescent serum.

This will all get straightened out and more strategies will be developed but this will take a ton of work, money and time. Meanwhile, you should pay a lot of attention to prevention with masks, social distancing and washing of hands, surfaces, and anything brought into the house after other people handled it. And people you come into frequent contact with should be tested, both for virus and for antibodies.

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"But no, these drugs are not front runners. " Well, which ones would you call front runners?

I have not read any really good studies and truthfully, a really good study is going to take a long time. I do not think it wise to wait for that! It could be many months.

The circumstantial evidence reported of physicians in the front lines of other countries indicate that HCQ combo is the front runner. I have seen very little success stories about remdesivir or others. And again, I am not going to wait until I am really sick! (IF that should happen, then my doctor should be calling the shots at that time)

Yes, it may get sorted out, but not for many months. As I mentioned, I will take precautions to avoid heavy initial dose, such as distancing where I can, washing hands and possible use of masks. (Although masks are really more effective against transmitting than avoiding the virus) Still, better than nothing.

I am convinced that the world is going to need a change in approach and that being ..... this is not going away. We cannot stay shut down forever.... and a vaccine is to far in the future and likely not a silver bullet. Shutdowns cannot and should not last for months and months. We need to start efforts on how to live with this virus much as we do with the "standard" flu, except this type will require more aggressive, early treatment.

We can hype all we want about distancing, etc. but is now clearly a useless tactic for the long term. Every country that had some success at confinement has seen bursts of cases when starting only minor re-openings and then attempt to close down again. That simply cannot continue for the long term (and I mean months.)

So unless a different strong candidate comes forth, HCQ+Zn+azithromycin it is!

Quote from Wyttenbach

Was this HCQ study bad too? https://www.preprints.org/manuscript/202005.0057/v1

All depends on the number of people with antibodies and the number that have a genetic resistance. Even for AIDS 2-10% (later is a rare case) have a "built in" resistance.

Good point re genetic resistance. It is difficult to get evidence on that - except for the single high infection environments where most people have caught it with antibodies. That means any such "infected, primary immune response before antibodies form" effect is relkatively small. I'd put it at 20% max but worth watching. If it were 50% we could halve the effective IFR. Although these "no antibody" people are presumably at risk of catching it again and spreading... Make this just one more uncertainty but no evidence it is better than other similar diseases.

It is very good news if we get a whole load of reputable positive studies on HCQ - even if they are observational - as long as good quality observational.

OK - I've looked at this observational study.

It is not possible to conclude anything from this or the following reason.

(1) HCQ/ not HCQ decision was made largely temporally at different stages in the epidemic when disease severity and average age could be different

There were significant differences in age mean in the HCQ / non-HCQ groups with severe
disease at admission. This could be explained due to the higher comorbidities of elder patients
with severe condition at admission, what may have led clinicians to decide limitation of
therapeutic effort in some of them. Anyway, this should be studied deeper in further studies.

The higher non-HCQ age, counted naively, would lead to the observed worse by a factor of 2 death rates etc.

(2) Relying on statistical techniques to deal with effects from age difference only works if either age is treated as a discrete variable (with some adaptive method that equalises effects, and a large number of buckets) or if age is transformed to a

roughly linear severity-related form - approx exp ([age/years] / 7) Otherwise linear treatment of statistics will not decorrelate the effect of age.

The previous (May 1) observational study had better statistics and swayed my opinion a bit towards cautiously positive. This one, having looked at it, does not alter my opinion one iota. It is worthless without better processing.

BTW that negative US Vets study, on reflection, I give no weight to as well. Statistics not good enough given obvious extreme bias of datasets.

Alan Smith at least the animal rights groups will be pleased that for once horses, dogs, cats and rabbits are being treated so well with ivermectin whilst humans are deprived by the medical profession and pharmacies of any sensible prophylactic or acute antiviral therapy. And what is the UK government doing after 33,000 deaths now? Improving the infrastructure by filling in potholes now that the roads are empty. Whatever next?

Last Friday we had our first relative die 'with' covid-19. My uncle (not blood related) was in his early 90s and I had known him for a few decades. Always very lean and seemingly fit, clean living, he was a contractor for building very nice high end homes. In the last few years he was diagnosed with dementia and last year he and his wife moved into a seniors care residence together. He had been hospitalized recently for various things and was down to about 100 pounds, but his last hospitalization was due to dehydration from not eating or drinking much. They put him on IV and oxygen. They tested him and lo and behold he had the virus. His wife also tested positive for the virus but is doing OK. He was in hospital for about a week before he passed. The funeral was yesterday, via Zoom.

So an older generation passes away and a younger generation rises up.

Came across a couple of Youtube videos which reminded that the younger generation holds much promise and individual talent. And ah the times when people congregated freely without fear, just months ago. Enjoy (I did). To my uncle.

Mark U

I will remind you that a civilization does not write off it's older members. And while some, like your unfortunate uncle, acquire dementia, others do not. One interesting example of a "useful" elder is Dr. Anthony Fauci who is 79. Biden, Trump, Pence and many other prominent politicians are not exactly "young people." Shall we simply write them off as useless and expendable? I don't know where you live, Mark U, but that is not USA tradition and practice. All lives are valuable here.

If you do get COVID-19, the story below may happen to you and it can happen even to relatively young and productive people, if that matters to you. This is from a health care provider - ETA, correction: from David Norton, M.D. a pulmonologist in SoCal USA via Facebook.

"So, there will be four of us in the room. Three of us will be wearing protective gear and you won’t be able to hear us all that well. You’ll be lying there and I’ll be just above your head. As they draw up the etomidate, rocuronium and fentanyl, we’ll share a moment. It’ll seem like your whole world has just become you and I. And, in some ways, it has. I’ll say something attempting to be comforting, but it probably will not bring you peace. The phrase “If you can’t breathe, nothing else matters” may drift through your mind right about then.

Anyway, in that moment, just let me know if the trip to the crowded social event last week was worth it. Let me know your opinion now about social distancing and wearing masks and staying away from public beaches. Anything you want me to pass along to the others you’ve infected since?

You’re about to go to sleep for the next several weeks and we’ll just have to see how things go. I’m about to have a conversation with your family, one of many, where I will use phrases like “hopeful”, “supportive care”, “best available data suggests that...”. I will not use phrases like “cure” or “clinically proven therapy”.

There is no vaccine we can use to prevent this.

There are no therapies that have been rigorously studied and proven to be significantly effective yet.

The virus is easily transmissible and it is all around you and everybody you care about.

As you venture out, take this shit seriously. Wear a mask all the time when you are close to others - it really doesn’t protect you well but it will help keep you from causing harm to others. Stay away from clusters of people.

This virus is not behind us, not even close. Until there is an effective vaccine or at least herd immunity, you should assume that every single human you come in contact with is infectious or can be infected by you.

If your town or state is opening up, it’s not because things are getting better. It’s because there are ICU beds available to house you for the next 3-5 weeks so someone like me can share a moment or two with you and your family. Unfortunately, I can make no promises about how this will all turn out. Young and healthy? The virus doesn’t care. It’s not personal."

We haven’t solved anything yet. Nothing. Take this as seriously today as you did two months ago. This is not politics and this doesn’t have squat to do with what you want. This is a faceless, ubiquitous enemy against whom the only effective weapon is avoidance. Save your live free or die speeches. You’re just as good a host for the virus as anybody.

Stay safe. Keep others safe."

Sorry to hear about that Mark U

Why can our institutions now lie admittedly about who dies and of what, and we don't bat an eye.

See: 2:11 for open admission of Covid fraud:

This isn't about Covid folks. It is about the biggest thing, control and power. They have the world locked in their homes, think about that.

Our next generation cannot move forward - until the truth is told. We must all educate ourselves

and then share with them the truth, be skeptical but the evidence is clear.

Our kids have a snake wrapped around their future, and nobody wants to even point that out.

It's odd.

If you're into the technology of "RSI" (rapid sequence induction) of anesthesia and paralysis as is used on ventilator patients, this will tell you more than you would want to know. Being placed on a ventilator is something anyone sane would want to avoid at all costs. Most of those folks advocating for rapid and uncontrolled "opening" of the society are advocating a lot more of this:

https://www.jems.com/2019/05/1…le-of-the-rsi-paralytics/

Just FYI: https://www.statnews.com/2020/…s-simpler-safer-ancestor/