Coronavirus

[rav3n]

For one of the comments above that I can no longer find-- hydroxychloroquin is now undergoing a randomized control study at the academic hospital over here.
At work last week I was surprised to learn that people think the hospitals (in CA) are experiencing chaos and overcrowding...? The ED attending living here has been able to stay home for 3 scheduled shifts for the first time ever in 9 years. There are ~10 people in the ICU at the neighboring non-academic hospital. The "covid tents" at the other major non-academic hospital are relatively unused (--nearly all get sent home).
We should be cautious with the virus moving forward, but as someone who is involved with public mental health, I'm now far more concerned with the consequences of long-term isolation than I am with the death rate of COVID-19. When this all started I worried quite a bit for the 3 "frontline" healthcare workers and one 94-year old I'm related to, but at this point, we need to consider the potential implications of what we're doing to "keep people safe".

This article consolidates the results of a number of studies and clinical trials about hydroxychloroquine. It doesn't appear to be significantly effective.

A study about chloroquine, resulted in many deaths and irregular heartbeat rhythms.

FDA Issues Warning About Hydroxycholorquine Over Heart Issues

 

[JAVO]

For one of the comments above that I can no longer find-- hydroxychloroquin is now undergoing a randomized control study at the academic hospital over here.
At work last week I was surprised to learn that people think the hospitals (in CA) are experiencing chaos and overcrowding...? The ED attending living here has been able to stay home for 3 scheduled shifts for the first time ever in 9 years. There are ~10 people in the ICU at the neighboring non-academic hospital. The "covid tents" at the other major non-academic hospital are relatively unused (--nearly all get sent home).

Interesting. This matches what I've observed at at least one hospital in my nearby large city.

We should be cautious with the virus moving forward, but as someone who is involved with public mental health, I'm now far more concerned with the consequences of long-term isolation than I am with the death rate of COVID-19. When this all started I worried quite a bit for the 3 "frontline" healthcare workers and one 94-year old I'm related to, but at this point, we need to consider the potential implications of what we're doing to "keep people safe".

And these are consequences which may not be evident for months. It will be interesting to watch the mental health statistics over the next few years. I don't think the people making the closure decisions are monitoring them currently.

 

[laintpe]

This article consolidates the results of a number of studies and clinical trials about hydroxychloroquine. It doesn't appear to be significantly effective. A study about chloroquine, resulted in many deaths and irregular heartbeat rhythms. FDA Issues Warning About Hydroxycholorquine Over Heart Issues

Hydroxychloroquine may not be very effective with the virus or its residual complications, but when properly administered (or prescribed-- and followed) it shouldn't cause toxicity issues. After it was recommended as a tx through media outlets, the group here did have a couple calls via the poison center-- because people self administered sources that weren't meant for them (or meant for humans in general) and took way too much.

 

[lunalum]

I'd say hydroxychloroquine has not been completely ruled out as a treatment. It is an immunosuppressant, and so it would make sense as a treatment for the cytokine storm that sometimes leads to multiple organ failure. I would hope these studies are looking at this specifically, and not just an umbrella treatment for C19.
But at this point I have more hope for remdesivir, which is an antiviral. My local hospital has started a remdesivir trial. I would think it it is an antiviral that works on C19, it should be pretty broadly effective no matter the severity of the case, and hopefully with lower viral loads, there will be less contagion.

 

[á´…eparted]

Hydroxychloroquine may not be very effective with the virus or its residual complications, but when properly administered (or prescribed-- and followed) it shouldn't cause toxicity issues. After it was recommended as a tx through media outlets, the group here did have a couple calls via the poison center-- because people self administered sources that weren't meant for them (or meant for humans in general) and took way too much.

I'd say hydroxychloroquine has not been completely ruled out as a treatment. It is an immunosuppressant, and so it would make sense as a treatment for the cytokine storm that sometimes leads to multiple organ failure. I would hope these studies are looking at this specifically, and not just an umbrella treatment for C19.
But at this point I have more hope for remdesivir, which is an antiviral. My local hospital has started a remdesivir trial. I would think it it is an antiviral that works on C19, it should be pretty broadly effective no matter the severity of the case, and hopefully with lower viral loads, there will be less contagion.

Hydroxychlorquine pretty much has been ruled out, and its extremely evident it hasn't been nor will it be a viable treatment. It didn't make any scientific or medical sense at the start either. It needs to be put to bed as an idea. It's done. It wasn't even a good one to begin with.

Also, sadly, it looks like remdesivir might not be a viable treatment either. The report IS questionable though. That one did have FAR more promise though as it is an antiviral and has known activity against other coronviruses. The viability is different though in a dish vs. and organism. It's still being investigated though as potential remains and there is more meaningful data to collect, and the scientific communitity needs to be able to look through the data more closely first.

Medicine and pharmacology is really complex.

 

[lunalum]

Hydroxychlorquine pretty much has been ruled out, and its extremely evident it hasn't been nor will it be a viable treatment. It didn't make any scientific or medical sense at the start either. It needs to be put to bed as an idea. It's done. It wasn't even a good one to begin with.

Also, sadly, it looks like remdesivir might not be a viable treatment either. The report IS questionable though. That one did have FAR more promise though as it is an antiviral and has known activity against other coronviruses. The viability is different though in a dish vs. and organism. It's still being investigated though as potential remains and there is more meaningful data to collect, and the scientific communitity needs to be able to look through the data more closely first.

Medicine and pharmacology is really complex.

I'll have to keep reading up on the mechanisms of hydroxyq then. But I still don't understand even if every single trial has been a resounding failure, how could it be ruled out in only 5 months?

 

[á´…eparted]

I'll have to keep reading up on the mechanisms of hydroxyq then. But I still don't understand even if every single trial has been a resounding failure, how could it be ruled out in only 5 months?

Give any one of these 3 articles for a read/overview on the matter.

More on Hydroxychloroquine/Azithromycin. And On Dr. Raoult. | In the Pipeline

The Latest Hydroxychloroquine Data, As of April 11 | In the Pipeline

The Politics of Hydroxychloroquine | In the Pipeline

 

[lunalum]

Give any one of these 3 articles for a read/overview on the matter.

More on Hydroxychloroquine/Azithromycin. And On Dr. Raoult. | In the Pipeline

The Latest Hydroxychloroquine Data, As of April 11 | In the Pipeline

The Politics of Hydroxychloroquine | In the Pipeline

Okay, so what I gathered in reading these

(1) HCQ + Z-Pack = problematic (already knew that)

(2) HCQ should not be available to the public to self-medicate (I agree)

(3) The methodology of the trials studying HCQ treatment for C19 all suck. This was the most common thread and this is why I say that we just don't know one way or another. I did notice a discussion of a study showing HCQ treatment linked to higher mortality. That is a problem. And unfortunately, we don't know if this because of an inherent problem with the treatment or the awful methodology. This here though is the strongest case for prioritizing the study of other avenues of treatment.

 

[laintpe]

I'll have to keep reading up on the mechanisms of hydroxyq then. But I still don't understand even if every single trial has been a resounding failure, how could it be ruled out in only 5 months?

The hydroxychloroquine study that is happening in this academic hospital is the first NIH funded study through NHLBI (Vanderbilt being the lead site). Nothing may come of it, but that isn't known now. Even JAMA has an article on the uncertainty of the effectiveness of hydroxychloroquine.

 

[á´…eparted]

What I wouldn't give to never hear the word hydroxychloroquine ever again.

Can we pleeeeeeease stop talking about this thing? It doesn't work, it's never going to work, and is distracting from meaningful science research and treatments going into the coronavirus.

 

[laintpe]

You'll have to let the NIH know--

NIH clinical trial of hydroxychloroquine, a potential therapy for COVID-19, begins | National Institutes of Health (NIH)

 

[á´…eparted]

You'll have to let the NIH know--

NIH clinical trial of hydroxychloroquine, a potential therapy for COVID-19, begins | National Institutes of Health (NIH)

Just because a study exists doesn't speak much to its validity or viability.

This isn't personal against you, but I am really, REALLY tired of this thing being brought up in this thread. It was talked about to death a few weeks ago here and I am beyond done with having explain, and re-explain what is going on with this, what is behind it, and why there is almost no scientific or medical basis behind this treatment in the first place. Even on the face of it it doesn't make sense.

There are other, better more viable treatments under review. Triage of viability and validity is a factor and this is so bottom of the barrel it's rediculous.

Now (and this isn't directed at you, but just in general) can we PLEASE move on from this?!

 

[rav3n]

Unfortunately, hydroxychloroquine will likely linger like a bad smell because DC and 22 states stockpiled it, hence wasted taxpayer dollars on it. A lot of very wealthy people also invested in the companies that manufacture the drug, including Trump and his family.

U.S. states build stockpiles of malaria drug touted by Trump - ABC News

 

[laintpe]

Just because a study exists doesn't speak much to its validity or viability. This isn't personal against you, but I am really, REALLY tired of this thing being brought up in this thread. It was talked about to death a few weeks ago here and I am beyond done with having explain, and re-explain what is going on with this, what is behind it, and why there is almost no scientific or medical basis behind this treatment in the first place. Even on the face of it it doesn't make sense. There are other, better more viable treatments under review. Triage of viability and validity is a factor and this is so bottom of the barrel it's rediculous. Now (and this isn't directed at you, but just in general) can we PLEASE move on from this?!

I understand that you are frustrated, but shouldn't the gold standard of studies be applied to any potentially helpful medication?
Also, there is scientific basis for looking into it. I don't know if you meant to sound absolute (maybe you meant that it isn't very promising, which would be a fair statement), but I took your statement literally. My spouse is part of a team that laid out potential mechanisms of 6 proposed COVID medications-- that being one of them. He's a MD/professor of medicine who saw one of the first cases of community spread in the country. The people on that team aren't looking to waste time-- they're considering every possibility to reduce mortality.

 

[á´…eparted]

I understand that you are frustrated, but shouldn't the gold standard of studies be applied to any potentially helpful medication?
Also, there is scientific basis for looking into it. I don't know if you meant to sound absolute (maybe you meant that it isn't very promising, which would be a fair statement), but I took your statement literally. My spouse is part of a team that laid out potential mechanisms of 6 proposed COVID medications-- that being one of them. He's a MD/professor of medicine who saw one of the first cases of community spread in the country. The people on that team aren't looking to waste time-- they're considering every possibility to reduce mortality.

A major part of my frustration is it's be touted by the Trump administration, co-opted by people who don't understand medicine and are looking to make a profit, and is being disseminated through the public as part of the massive ongoing disinformation campaign. Almost every time it is brought up it is pounced on by Trump supporters who have no idea what they are talking about.

Of course it was worth looking at initially, I was extremely skeptical but my first thought was "that doesn't make any sense at all... but, well, alright it can't hurt if there are potential leads" and yes I am aware of a theoretical mechanism on how it could work (it's a stretch). Still, worth a look, as we need to try any and all leads, and follow the ones that pass the marks as we go as needs to be done in drug discovery and reappropriation of orphan drugs. It was pretty unlikely going in, and it is looking increasingly unlikely the further we go.

The core of my frustration is all of these "well, maybe's" gets uses as vaidation and twisted into disinformation by trump supporters, and by bad operators seeing to sow discord the world over. It's being overhyped and painted in far more of a positive light than it should be. It's becoming a game of telephone in the worst way. It's being passed upwards to doctors and nurses in treatment rooms and they're taking what seems like trustworthy valid advice on the medicine, when it hasn't been nearly as vetted and validated as it needs to be. What ideally should be happening is it is worked on quietly in labs, and as we gain meaningful results, it gets sent up the clinical chain. Because of the media it's being dragged through the mud and causing harm. It's a major reason why I want people to stfu about this stuff and I get so upset when people say "well, there's potential" because it often comes with no sense of scale for the lay person to understand.

 

[rav3n]

Can't remember if it was on this site or another but I recalled a convo with people about South Korean C19 recovered patients testing positive where people didn't believe the possibility of reinfection or reactivation and claimed they were testing errors. Well...apparently, this has been occurring in South Korea, China, Italy and Japan. Some are even testing positive up to 70 days after being cleared so they're definitely not testing errors.

Recovered coronavirus patients in China are testing positive weeks later: new report | TheHill

• Doctors in Wuhan said the patients tested negative at some point during their recovery, but then began testing positive again without symptoms.
• Some were testing positive again as much as 70 days after being cleared.
• South Korea, Japan and Italy have reported similar instances.

 

[EcK]

A few. But those are individuals and will likely pay the price for defying the party/Trump. It's also the reason this garbage human can walk around with this sign, with zero repercussions.

Ah come on - that got to be a Troll or plant. This looks like how hard leftists imagine people on the right are in their wet dreams about being moral superiors. It's a bit too convenient.

 

[Virtual ghost]

Ah come on - that got to be a Troll or plant. This looks like how hard leftists imagine people on the right are in their wet dreams about being moral superiors. It's a bit too convenient.

That would stand in the case that the president, high faces in GOP and conservative media don't publicly advocate for this message. In USA right wing SJWs are a real thing and just like the left wing counterparts they also mostly wear cheap clothing made in Bangladesh (since they are equally poor).

 

[ceecee]

Ah come on - that got to be a Troll or plant. This looks like how hard leftists imagine people on the right are in their wet dreams about being moral superiors. It's a bit too convenient.

I know, it's hilarious.

Was a 'Sacrifice the Weak' Sign Shown at a COVID-19 'ReOpen Tennessee' Rally?

Dozens rally at TN capitol, call for Gov. Lee to re-open state immediately | WTVC

 

[Maou]