What you need to know about the virus in China "2019 Novel Coronavirus (2019-nCoV)"

[MediumRare]

I never "Ignored" anybody here before. I kind of feel bad about it. But I'll get over it.

 

[MarcT]

The trouble with HCQ is that its not well tested for COVID19.

It also has the potential for cardiac trouble so to save someone from COVID19 and then let them later die of cardiac trouble is not really a cure.

The French researcher got good results because he excluded those who didnt respond well to the treatment which gives a false impression that it works on a majority. Its easy to score a 100 on a test if you ignore all the incorrect answers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760572/

Well, that doesn't make any sense. To be able to say that they "didn't respond well to the treatment", they would have to have been treated, which means that they would not have been excluded. Also, even if he excluded patients with a history of arrythmias or other cardiac conditions, that has nothing to do with any efficacy of HCQ in the patients he actually did treat with it.

Also, that paper is from 2013, so it is not associated with Dr. Raoult's current treatment protocol. And, while cardiac events can clearly occur, it also indicates that it is extremely rare, and describes a case of a patient who had been on HCQ for 15 years:

"In conclusion, we have presented, to our knowledge, only the fifth reported biopsy-proven case of HCQ cardiotoxicity, presenting as a rapidly evolving non-ischaemic biventricular dysfunction in a 52-year-old female with RA and multiple other comorbidities on long-term HCQ therapy."

I am in no way denying that there is some cardiac risk, but the treating doctor will have to balance that risk with the risk of death from covid-19. And also bear in mind that covid-19 patients are being treated with HCQ for a short duration of days.

 

[dwkdnvr]

Well, that doesn't make any sense. To be able to say that they "didn't respond well to the treatment", they would have to have been treated, which means that they would not have been excluded. Also, even if he excluded patients with a history of arrythmias or other cardiac conditions, that has nothing to do with any efficacy of HCQ in the patients he actually did treat with it.

https://www.sciencemag.org/news/202...ump-s-embrace-risky-malaria-drugs-coronavirus

relevant quote:

Many scientists have criticized the French trial as riddled with enough methodological flaws to render its findings unreliable or misleading. Biostatisticians from the United Kingdom and Ireland cited a basic failure: Investigators didn’t randomize the groups—essential to ensuring dependable comparisons. They also noted that six of the treated patients were lost to the study, five of whom fared badly—one died, three entered intensive care, and one stopped treatment because of nausea. Yet they were dropped from the analysis, potentially skewing the outcome.

C'mon dude, criticism of the Raoult study is all over the place. If you're going to evangalize you should at least try to come in with complete info. There are absolutely reasons to be skeptical of Raoult's results - not to discard them necessarily, but to be cautious. The other 'positive' study is the Chinese one where the drug fared well, but not better than the control group of anti-viral meds. So, once again rather inconclusive.

This is exactly why what appears to be the haphazard current approach - cautious use of HCQ to build up more data - is the right one.

 

[gikigill]

So we are playing Russian Roulette with peoples lives by giving them HCQ and then praying for the best?

https://blogs.sciencemag.org/pipeli...e-on-cloroquine-azithromycin-and-on-dr-raoult

He concluded his study abruptly too so doesn't inspire confidence.

 

[gikigill]

https://www.sciencemag.org/news/202...ump-s-embrace-risky-malaria-drugs-coronavirus

relevant quote:


C'mon dude, criticism of the Raoult study is all over the place. If you're going to evangalize you should at least try to come in with complete info. There are absolutely reasons to be skeptical of Raoult's results - not to discard them necessarily, but to be cautious. The other 'positive' study is the Chinese one where the drug fared well, but not better than the control group of anti-viral meds. So, once again rather inconclusive.

This is exactly why what appears to be the haphazard current approach - cautious use of HCQ to build up more data - is the right one.

The fact that he dropped patients and didnt list them in the failed part to show better results shows the study was not conducted properly.

 

[MarcT]

https://www.sciencemag.org/news/202...ump-s-embrace-risky-malaria-drugs-coronavirus

relevant quote:


C'mon dude, criticism of the Raoult study is all over the place. If you're going to evangalize you should at least try to come in with complete info. There are absolutely reasons to be skeptical of Raoult's results - not to discard them necessarily, but to be cautious. The other 'positive' study is the Chinese one where the drug fared well, but not better than the control group of anti-viral meds. So, once again rather inconclusive.

This is exactly why what appears to be the haphazard current approach - cautious use of HCQ to build up more data - is the right one.

Yes, I agree with having a healthy skepticism of his data, or any data from an observational study, and it should be peer reviewed. But I still believe that community doctors should be able to try HCQ in certain patients, with informed consent.

 

[MarcT]

So we are playing Russian Roulette with peoples lives by giving them HCQ and then praying for the best?

https://blogs.sciencemag.org/pipeli...e-on-cloroquine-azithromycin-and-on-dr-raoult

He concluded his study abruptly too so doesn't inspire confidence.

That is a good article. But I will say, there are numerous MDs in the comments section who are basically making the same argument that I am about giving HCQ a try on an outpatient basis, for patients at danger of having to be admitted.

 

[gikigill]

And if he had conducted his study properly, he would be able to establish who should be administered HCQ while avoiding or minimising side effects.

He has conducted a half baked, half correct study and trying to palm it off as scientifically sound.

 

[PierreV]

That is a good article. But I will say, there are numerous MDs in the comments section who are basically making the same argument that I am about giving HCQ a try on an outpatient basis, for patients at danger of having to be admitted.

Yes, MDs, just like audiophiles, have different opinions. That's precisely why a rigorous comparison needs to be made.
Those are ongoing

https://www.sciencemag.org/news/202...al-four-most-promising-coronavirus-treatments

 

[PierreV]

As far as raw numbers are concerned, there is a clear outlier in the west and that is, obviously Germany. But you don't hear them trumpeting about miraculous cures. So why? Yes, the Germans have an outstanding health care system, but that isn't the whole story. I chatted with a German MD a few days ago and his analysis was that because Germany did extensive contact tracing and tested a lot (and is testing an awful lot right now), they did detect a lot of benign cases, in what appears to be a younger population, that would have flown under the radar in other countries.

Now, again, that is just his (informed) opinion and I am sure the differences in mortality rates will be scrutinized later and may reveal other factors - regardless, they will provide very valuable lessons there for the future.

 

[MarcT]

As far as raw numbers are concerned, there is a clear outlier in the west and that is, obviously Germany. But you don't hear them trumpeting about miraculous cures. So why? Yes, the Germans have an outstanding health care system, but that isn't the whole story. I chatted with a German MD a few days ago and his analysis was that because Germany did extensive contact tracing and tested a lot (and is testing an awful lot right now), they did detect a lot of benign cases, in what appears to be a younger population, that would have flown under the radar in other countries.

Now, again, that is just his (informed) opinion and I am sure the differences in mortality rates will be scrutinized later and may reveal other factors - regardless, they will provide very valuable lessons there for the future.

Yes, Germany is interesting. Do you have any information on their population density, relative to Italy and/or Spain? I also wonder how prevalent multi-generational living arrangements are in Germany. It seems like I heard that Italy has a high prevalence of grand parents, children, and grand children living in the same spaces. Of course, that sort of living arrangement is a petri dish for infections to spread.

An interesting note about Sweden, if it is true, I heard a report that fully 50% of the population lives alone. That seems astounding to me, and I wonder if they have a population sustainable birth rate.

 

[andymok]

Let's recap what HCQ does to our body.

 

[Dave Zan]

As far as raw numbers are concerned, there is a clear outlier in the west...

Not sure if you missed Australia because it doesn't count as the "west" or just because we are quiet but we are an even clearer outlier.
Case fatality rate less than half that of Germany, new cases in decline for 3 weeks, recently moved to more people recover than new cases.
Statistically notable is the test ratio per reported case, it's >50 to 1, a lot more than Germany and ten times the USA.
The response has also been remarkably bipartisan.
Over the past few decades I have often been ashamed or appalled by Australian behaviour, this is a rare surprise.
But New Zealand seems to have done even better, one death so far in the entire country.
It helps to be an island, of course, but truly impressive.

I wonder if they have a population sustainable birth rate.

No, but it's pretty close, actually more than most of the developed world, or the USA.

Best wishes
David

 

[gikigill]

As far as raw numbers are concerned, there is a clear outlier in the west and that is, obviously Germany. But you don't hear them trumpeting about miraculous cures. So why? Yes, the Germans have an outstanding health care system, but that isn't the whole story. I chatted with a German MD a few days ago and his analysis was that because Germany did extensive contact tracing and tested a lot (and is testing an awful lot right now), they did detect a lot of benign cases, in what appears to be a younger population, that would have flown under the radar in other countries.

Now, again, that is just his (informed) opinion and I am sure the differences in mortality rates will be scrutinized later and may reveal other factors - regardless, they will provide very valuable lessons there for the future.

Germany and Australia also have good universal healthcare so the capability to serve their populations is already built in plus the Australian Govt has instructed private hospitals to deal with the pandemic, share beds and equipment and stop non essential services so that adds to the capacity of the overall system.

 

[Deleted member 65]

Yes, Germany is interesting. Do you have any information on their population density, relative to Italy and/or Spain? I also wonder how prevalent multi-generational living arrangements are in Germany. It seems like I heard that Italy has a high prevalence of grand parents, children, and grand children living in the same spaces. Of course, that sort of living arrangement is a petri dish for infections to spread.

An interesting note about Sweden, if it is true, I heard a report that fully 50% of the population lives alone. That seems astounding to me, and I wonder if they have a population sustainable birth rate.

39% are single households in Sweden. Two reasons:
1. People/kids move out from parents/home between age 19-21.
2. Elderly people.

 

[maty]

Sólo el 1,2% de los mayores de 80 años ingresados por coronavirus entró en la UCI
[Spanish] https://www.elindependiente.com/vid...s-ingresados-por-coronavirus-entro-en-la-uci/

[ The graph shows how intensive care admissions plummeted after the age of eighty. While 12.3% of people hospitalized between 60 and 69 years are admitted to the ICU, the figure drops to 10.2% among those admitted between 70 and 79 years and only 1.2% of those admitted over 80 years old enter the ICU. ]

 

[maty]

Las residencias en Catalunya suman ya más de 1.000 muertos
[Spanish] https://www.elperiodico.com/es/sociedad/20200408/datos-muertos-residencias-catalunya-abril-7921359

[ The Ministry of Treball, Afers Socials i Família reported this Tuesday at midnight that Catalonia has registered a total of 1,047 deaths with coronavirus in nursing homes since March 15 (138 more than those registered the previous day) and 1,906 positive cases (they are isolated), with data provided by the residences to the Govern.

The department details in a statement that, of the total number of affected, 448 are hospitalized; and, of the total of Catalan residences, 239 have people diagnosed with coronavirus and 335 have people with symptoms. The Catalan system is made up of 1,073 retirement homes.

The Generalitat explains that in 2019 10,979 people died in nursing homes throughout Catalonia, and the previous year there were 11,402: a monthly average of more than 900 deaths.

In Catalonia there are 64,093 elderly people who live in public and private residential places; the average age of the residents is 84, the majority are dependent and large dependents, and 90% have previous illnesses. ]

 

[vert]

Okay, I guess I was mistaken that people here would want to be informed of what was going on in the treatment of this virus. Maybe I was mistaken. With respect, how is a legitimate news story "not information"? Perhaps you should log a complaint with the news station for informing the public of what is going on. If you don't agree with what a doctor is doing, that's fine. Just explain why you disagree with what he is doing. Lots of people, even in medicine, disagree with how many illnesses are treated by various doctors.

As to your point about "waiting to see whether the evidence will mount", the people who are now seriously ill with this virus do not have time for your "evidence" to "mount", if by that you mean randomized, double blind trials. Those will take weeks or months to be conducted. Meanwhile, reports of success with HCQ continue to mount, both in hospital and out. Also, much of the standard of care that is employed in some infectious diseases has NOT been garnered via large, controlled and randomized clinical trials. Actually, at some point, as the evidence of positive outcomes with a particular medication grows, it will no longer be ethical to deny that medication to study patients, which means that you could not do a comparative clinical trial anyway.

A large number of doctors are saying it is effective. In a recent poll covering 30 countries, 37% of doctors ranked HCQ as the best treatment. Just from what I read in recent days, doctors from Denver, New Jersey, New York, and another heading a hospital named after Henry Ford, I can't remember in which state, as well as some major medical figures in France and Italy. It also appears that Dr. Fauci was promoting use of HCQ in 2013 for a SARS type virus without any large precautions, and has completely reversed his stance since - why? Simple question to those who demand large-scale formal studies while people are falling left and right - setting aside the potential epistemological errors of this approach (see http://jdmichel.blog.tdg.ch/archive/2020/04/06/covid-l-imposture-evidence-based-305631.html) : how is it even ethical in a crisis situation to put people at the risk of dying being part of a control group. Those who warn about potential HCQ side effects do not seem bothered in the least by this. Dying for an ideology, for the cause of evidence-based medicine, is a-ok. And please stop misrepresenting the Raoult study, he didn't even call it a study. He said he would publish it to confirm the Chinese results and go on with his duty as a doctor which is to treat people, about which his 800-staff hospital reports every day https://www.mediterranee-infection.com/covid-19/. Then I read people gushing over what's being done Germany, while bashing HCQ advocates and Pr. Raoult for peddling a "miracle" drug (which Raoult, again, never did), rather than following such a strategy, and strangely ignoring the fact that that kind of massive screening is precisely what has been advised by the same Pr. Raoult for the past two months, with such advice falling on deaf ears at least as far as the French authorities are concerned... again I have to ask why ?

 

[astr0b0y]

Maybe it does work, but there are significant complications and side effects from HCQ which is why it requires carefully consideration before prescribing and requires careful and ongoing observation of users to ensure they don’t end up with irreversible damage of death from using it. Here‘s a good write up that comes from a skeptical point of view.

Hydroxychloroquine and COVID-19: Science-based medicine has no chance against Donald Trump, Peter Navarro, and Dr. Oz

 

[Thomas savage]

Super best friends medical forum.