Coronavirus Health - Health and Wellbeing

[redsturgeon]

I think that in the medical and scientific community the relevant people are looking at all possible means of ameliorating the effects of C19. The over hyping of any particular drug regime is not helpful to this process and unfortunately Trump is one of the main culprits in this regard. It is not the job of newspapers or reporters or politicians to speculate on unproven drugs or treatment based on anecdotal evidence.

There is no MSM conspiracy to stop the "truth" coming out. Please put the tin foil hats away. Remember that Trump is also an anti-vaxxer. Let the medics and scientist do their job.

Are we talking about the same Donald Trump? From April 2019

"They have to get the shots’: Trump, once a vaccine skeptic, changes his tune amid measles outbreaks"

https://www.statnews.com/2019/04/26/trump-vaccinations-measles/

"President Trump on Vaccines: From Skeptic to Cheerleader"

https://www.nytimes.com/2020/03/09/health/trump-vaccines.html

So many people are desperate for hydroxychloroquine and chloroquine to fail solely because Trump has pointed it out. If Obama had done the same they'd probably have been saying what a visionary he is.

Many doctors have been using hydroxychloroquine with the antibiotic azithromycin and have been getting decent results. Sure, this doesn't meet the double blind standards of the FDA but meeting that standard is going to take years.

You're right, I should have said Trump "was" an anti vaxxer. The point being that Trump actual doesn't necessarily hold any particular view any longer than it is necessary for the best outcome for himself and does not need any evidence to back up his world view on anything.

Not wishing to go off topic, the main point of agreement is that Trump being so pro hydroxychloroquine and chloroquine is not helping matters. They may work, they may not. Trump has no more idea than anyone else. We should let the scientists do their work unhindered by politics.

[alphab1]

https://www.bloomberg.com/news/articles ... of-science

"Malaria Drug Hype Lures Macron as Hope Gets Ahead of Science"

(snip)
A 65-year-old malaria drug that hasn’t been proven to work against the new coronavirus appears to have captured the imagination of another president.

France’s Emmanuel Macron unexpectedly flew to Marseille Thursday and spent more than three hours meeting with Didier Raoult, the researcher whose work has propelled a medicine called hydroxychloroquine from fringe to famous in just three weeks. Raoult’s unconventional studies won over U.S. President Donald Trump, who suggested he’d be willing to take the medicine himself.

Doctors say the hype has gotten ahead of the science, though many have tried hydroxychloroquine on patients because they don’t have anything better. Based on little more than a small but encouraging study, the U.S. has stockpiled 29 million doses. India temporarily banned its export. Patients in Nigeria poisoned themselves with it. And others still, who need it for chronic illnesses, are now finding it’s in short supply.
(snip)

This is a more recent article, and the tone confirms my belief that the drug would have received a warmer and more encouraging reception if it was not advocated by the POTUS. It is sad that the message is being killed because one does not like the messenger. It should not have mattered AT ALL at other times. But now, when countries are thinking of resuming normal economic activities, a promising drug like hydroxychloroquine should be examined without bias. The risk of a long term recession or a depression due to a prolonged shut down has to be balanced against the anecdotal reports of harmful effects of a drug which has been in use for 65 years, as the report acknowledges.

[sg31]

This is a more recent article, and the tone confirms my belief that the drug would have received a warmer and more encouraging reception if it was not advocated by the POTUS. It is sad that the message is being killed because one does not like the messenger. It should not have mattered AT ALL at other times. But now, when countries are thinking of resuming normal economic activities, a promising drug like hydroxychloroquine should be examined without bias. The risk of a long term recession or a depression due to a prolonged shut down has to be balanced against the anecdotal reports of harmful effects of a drug which has been in use for 65 years, as the report acknowledges.

I don't think many people want Hydroxychloroquine to fail as a treatment. Any sensible person would want any possible medicine to work. The fact that Trump touted it's use is totally irrelevant.

Maybe in the US some people want it to fail for political reasons but that is hardly likely to be the case in the UK. We are sufficiently distanced from the tribalism of American politic that we can look at Hydroxychloroquine with an open mind.

My own concern is that there is insufficient evidence to justify the hype. It's too early to say if it works or not. Anecdotal evidence exists that suggests it might work but there is just as much evidence that it doesn't. Some advocates insist it works when combined with zinc, some suggest certain vitamins are needed, others insist Azithromycin is also administered. Which are we to believe? We need to find out.

Until we get the results of further testing It seems best not to jump on any band wagon and prejudge what will work and what won't.

[alphab1]

Please see the message from SalvorHardin in the parallel string:
viewtopic.php?f=83&t=22737&p=300437&hilit=coronavirus#p300437

I think the Sermo report is very encouraging.

[sg31]

Please see the message from SalvorHardin in the parallel string:
viewtopic.php?f=83&t=22737&p=300437&hilit=coronavirus#p300437

I think the Sermo report is very encouraging.

See also,

https://fullfact.org/health/covid-19-hy ... treatment/

this poll by Sermo doesn’t really tell us how many doctors prefer this treatment or how effective it is. The reporting of the poll has also suffered from inaccuracy and overstatement.

The first thing to note is that Sermo’s poll is not representative of all doctors so we can’t say whether these drugs really have the backing of the worldwide medical community.

Polls, by design, ask a relatively small group of people (the “sample”) what they think, and try to make sure that those people represent the wider population—meaning a survey is only as useful as the people it surveys.

Sermo’s methodology shows that the sample it surveyed did not match the profile of doctors worldwide and the data wasn’t weighted afterwards to adjust for that.

So all we can say is that these results are the views of the 6,227 doctors who did the survey, not doctors in general.

[alphab1]

"So all we can say is that these results are the views of the 6,227 doctors who did the survey, not doctors in general."

Can't disagree. Still quite encouraging.

And, no one was suggesting that this drug can be used for self-medication - I believe the drug can only be purchased with a prescription.

There is no harm in hoping that this very inexpensive and readily obtainable drug is found to be successful in treating most (if not all) Covid patients.

[look]

I think that in the medical and scientific community the relevant people are looking at all possible means of ameliorating the effects of C19. The over hyping of any particular drug regime is not helpful to this process and unfortunately Trump is one of the main culprits in this regard. It is not the job of newspapers or reporters or politicians to speculate on unproven drugs or treatment based on anecdotal evidence.

There is no MSM conspiracy to stop the "truth" coming out. Please put the tin foil hats away. Remember that Trump is also an anti-vaxxer. Let the medics and scientist do their job.

John

I think the contrary avout this part:
" It is not the job of newspapers or reporters or politicians to speculate on unproven drugs or treatment based on anecdotal evidence"

I think it is their job.
And the politicians have also the job of make it easier to use several medicines not approved.
Aproved or not aproved is burocracy. If some doctors think some remedy is good, in this case it should be used.
There is no proven drug for the virus and will will take years for that. Nobody has the right to block people of using medicines, blocking of medicines (even that have only anecdotal references) is a crime that should justify death penalty. It's my sincere opinion.

[alphab1]

https://www.upmc.com/coronavirus?emb=CT ... _Apr-20_e6

UPMC Launches Clinical Trial to Fast-Track COVID-19 Therapies
>>
A novel clinical trial by researchers at the University of Pittsburgh School of Medicine has launched at UPMC to address one of the most important debates of the COVID-19 pandemic: How should doctors decide between quickly adopting new treatments, such as the anti-malarial drug hydroxychloroquine, and waiting until they are tested in longer clinical trials?

The effort uses a type of artificial intelligence, known as reinforcement learning, to identify the best therapy for COVID-19 at a much faster rate than the traditional method.

“We must throw out old ways of thinking and fuse clinical care and clinical research into one extremely efficient system,” said Derek Angus, MD, chair of the Department of Critical Care Medicine at the University of Pittsburgh.
>>

Italics are mine.
It is good to see serious attempts are being made to expedite drug trials using advanced scientific research tools.

[redsturgeon]

https://www.upmc.com/coronavirus?emb=CTA3Button_covid19_5&et_cid=787310&et_rid=7544&utm_medium=email&utm_source=exacttarget&utm_campaign=covid19&utm_content=UPMC-covid19-database-email-6&em_id=tr_UPMC-covid19-database-email-6_Apr-20_e6

UPMC Launches Clinical Trial to Fast-Track COVID-19 Therapies
>>
A novel clinical trial by researchers at the University of Pittsburgh School of Medicine has launched at UPMC to address one of the most important debates of the COVID-19 pandemic: How should doctors decide between quickly adopting new treatments, such as the anti-malarial drug hydroxychloroquine, and waiting until they are tested in longer clinical trials?

The effort uses a type of artificial intelligence, known as reinforcement learning, to identify the best therapy for COVID-19 at a much faster rate than the traditional method.

“We must throw out old ways of thinking and fuse clinical care and clinical research into one extremely efficient system,” said Derek Angus, MD, chair of the Department of Critical Care Medicine at the University of Pittsburgh.
>>

Italics are mine.
It is good to see serious attempts are being made to expedite drug trials using advanced scientific research tools.

This is a good idea.

John

[redsturgeon]

I think that in the medical and scientific community the relevant people are looking at all possible means of ameliorating the effects of C19. The over hyping of any particular drug regime is not helpful to this process and unfortunately Trump is one of the main culprits in this regard. It is not the job of newspapers or reporters or politicians to speculate on unproven drugs or treatment based on anecdotal evidence.

There is no MSM conspiracy to stop the "truth" coming out. Please put the tin foil hats away. Remember that Trump is also an anti-vaxxer. Let the medics and scientist do their job.

John

I think the contrary avout this part:
" It is not the job of newspapers or reporters or politicians to speculate on unproven drugs or treatment based on anecdotal evidence"

I think it is their job.
And the politicians have also the job of make it easier to use several medicines not approved.
Aproved or not aproved is burocracy. If some doctors think some remedy is good, in this case it should be used.
There is no proven drug for the virus and will will take years for that. Nobody has the right to block people of using medicines, blocking of medicines (even that have only anecdotal references) is a crime that should justify death penalty. It's my sincere opinion.

No I'm sorry but governments have agencies such as the MHRA and NICE in the UK to ensure that no harm is done by using unproven treatments. Unfortunately NICE also plays a role in limiting certain proven medicines on cost/benefit grounds but we can't afford everything. So NICE already blocks the use of some proven medicines here...the death penalty may be a little harsh for them.

As to letting doctors use whatever they like, unfortunately that would not work in many instances since the doctors may be motivated by money as well as altruism in their decisions and some rules have to be in place to stop the snake oil salesmen.

John

[sg31]

Lopinavir and Ritonavir,

https://www.nejm.org/doi/full/10.1056/NEJMoa2001282

Results

A total of 199 patients with laboratory-confirmed SARS-CoV-2 infection underwent randomization; 99 were assigned to the lopinavir–ritonavir group, and 100 to the standard-care group. Treatment with lopinavir–ritonavir was not associated with a difference from standard care in the time to clinical improvement (hazard ratio for clinical improvement, 1.24; 95% confidence interval [CI], 0.90 to 1.72). Mortality at 28 days was similar in the lopinavir–ritonavir group and the standard-care group (19.2% vs. 25.0%; difference, −5.8 percentage points; 95% CI, −17.3 to 5.7). The percentages of patients with detectable viral RNA at various time points were similar. In a modified intention-to-treat analysis, lopinavir–ritonavir led to a median time to clinical improvement that was shorter by 1 day than that observed with standard care (hazard ratio, 1.39; 95% CI, 1.00 to 1.91). Gastrointestinal adverse events were more common in the lopinavir–ritonavir group, but serious adverse events were more common in the standard-care group. Lopinavir–ritonavir treatment was stopped early in 13 patients (13.8%) because of adverse events.
Conclusions

In hospitalized adult patients with severe Covid-19, no benefit was observed with lopinavir–ritonavir treatment beyond standard care. Future trials in patients with severe illness may help to confirm or exclude the possibility of a treatment benefit. (Funded by Major Projects of National Science and Technology on New Drug Creation and Development and others; Chinese Clinical Trial Register number, ChiCTR2000029308. opens in new tab.)

[sg31]

"So all we can say is that these results are the views of the 6,227 doctors who did the survey, not doctors in general."

Can't disagree. Still quite encouraging.

And, no one was suggesting that this drug can be used for self-medication - I believe the drug can only be purchased with a prescription.

There is no harm in hoping that this very inexpensive and readily obtainable drug is found to be successful in treating most (if not all) Covid patients.

I absolutely agree. I want any medicine to work, we really need something to save lives and reduce suffering. I just don't think we can tell at this stage which one it will be.

As I posted above one quite heavily promoted treatment has proved to be of no benefit in a small but proper trial.

[sg31]

For anyone seriously interested in the research behind the coronavirus this paper from 26 Feb is a good place to start.

Potential Rapid Diagnostics, Vaccine and Therapeutics for 2019 Novel Coronavirus (2019-nCoV): A Systematic Review

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141113/

[sg31]

This more recent paper lists the current state of play regarding treatments

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139247/

Coronavirus disease 2019 (COVID-19): current status and future perspectives

[sg31]

A more detailed study from a month ago.

Research and Development on Therapeutic Agents and Vaccines for COVID-19 and Related Human Coronavirus Diseases

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7094090/

[AJC5001]

Chloroquine study on Covid-19 patients halted over risk of heart complications

https://www.irishtimes.com/life-and-sty ... -1.4228016

" A small study in Brazil was halted early for safety reasons after coronavirus patients taking a higher dose of chloroquine developed irregular heart rates that increased their risk of a potentially fatal heart arrhythmia.
Chloroquine is closely related to the more widely used drug hydroxychloroquine. US president Donald Trump has enthusiastically promoted them as a potential treatment for the novel coronavirus despite little evidence that they work, and despite concerns from some of his top health officials. Last month, the US’s Food and Drug Administration granted emergency approval to allow hospitals to use chloroquine and hydroxychloroquine from the national stockpile if clinical trials were not feasible. Companies that manufacture both drugs are ramping up production."

[look]

Chloroquine study on Covid-19 patients halted over risk of heart complications

https://www.irishtimes.com/life-and-sty ... -1.4228016

" A small study in Brazil was halted early for safety reasons after coronavirus patients taking a higher dose of chloroquine developed irregular heart rates that increased their risk of a potentially fatal heart arrhythmia.
Chloroquine is closely related to the more widely used drug hydroxychloroquine. US president Donald Trump has enthusiastically promoted them as a potential treatment for the novel coronavirus despite little evidence that they work, and despite concerns from some of his top health officials. Last month, the US’s Food and Drug Administration granted emergency approval to allow hospitals to use chloroquine and hydroxychloroquine from the national stockpile if clinical trials were not feasible. Companies that manufacture both drugs are ramping up production."

they used chloroquine, the right thing is hidroxichloroquine.
so, my opinion is the same.
Hicroxichloruquine, give them immediately, it's a task for yesterday.

the mais difference between them is just that the hidroxi c. has less collateral effects.

[alphab1]

https://seekingalpha.com/news/3560849-g ... y-in-china

Gilead slips on suspension of second remdesivir study in China

>>
" The second study was also suspended for low enrollment. RBC's Brian Abrahams believes that preliminary results were probably inconclusive since a relatively high number of patients (n=237) had been enrolled, adding that the probability that remdesivir shows substantial efficacy in COVID-19 is a coin toss."
>>
Sad to see the end of one possible remedy of COVID.

[sg31]

I posted these studies earlier in the snug. I will repost them here as they may be of interest.

This study shows no benefit in administering Hydroxychloroquine in seriously ill patients

https://www.medrxiv.org/content/10.1101 ... 1.full.pdf

It doesn't cover use in the early stages of infection.
----------------------
A randomised study of the use of hydroxychloroquine...

https://www.medrxiv.org/content/10.1101 ... 1.full.pdf

No antiviral benefit but it does help as an anti-inflamatory.

[SalvorHardin]

" The second study was also suspended for low enrollment. RBC's Brian Abrahams believes that preliminary results were probably inconclusive since a relatively high number of patients (n=237) had been enrolled, adding that the probability that remdesivir shows substantial efficacy in COVID-19 is a coin toss."
>>
Sad to see the end of one possible remedy of COVID.

I wouldn't read too much into this for several reasons.

1) Cancelling a trial because of low enrollment doesn't mean that the drug doesn't work. Instead the number of patients in the trial has fallen below the level needed for a statistically significant trial.

Chinese trials are often contaminated because of the use of other medicines by patients and doctors, especially Chinese traditional medicine. The official reason for cancelling seems to be because the epidemic has been well controlled and they have difficulty in recruiting patients:

"Suspended (The epidemic of COVID-19 has been controlled well at present, no eligible patients can be recruitted.)"

https://clinicaltrials.gov/ct2/show/NCT04252664

2) Is China telling the truth? China is notorious for fiddling its statistics and lying to the media (especially about the Coronavirus). China covered up the Wuhan Coronavirus for over a month, persecuted scientists and doctors who didn't follow the party line and is currently engaging in a disinformation campaign to play down its role in the outbreak. I don't trust anything that China says.

3) There are a lot of Remdesivir trials still being conducted all over the world. In countries without the same degree of political interference as China.