Coronavirus Health - Health and Wellbeing

[sg31]

I agree that we can't read much into the Remdesivir trial from China that was cancelled. That won't stop people doing so.

On the other point I have friends who have worked and lived in China and they too warn that their statistics are likely to be false. Well they actually put it much more forcefully than that. I trust their views.

I have been quite impressed by a lot of the research documents coming out of Chinese medical facilities and some of their research institute papers seem to be quite advanced considering how quickly this situation arose. They are doing a lot of leading edge work.

What the Chinese have done isn't all bad.

[alphab1]

Gilead up 6% after hours on remdesivir buzz in COVID-19

Very Good News

Apr. 16, 2020 4:47 PM ET|About: Gilead Sciences, Inc. (GILD)|By: Douglas W. House, SA News Editor
STAT reports that preliminary results from a study in Chicago evaluating Gilead Sciences' (NASDAQ:GILD) remdesivir in severely ill COVID-19 patients are positive with rapid recoveries in fever and respiratory symptoms observed and almost all patients discharged in less than a week.

The news is lifting shares, up 6% after hours, a welcome bit of good news on the heels of two canceled studies in China due to low enrollment.

https://seekingalpha.com/news/3561503-g ... idminus-19

[redsturgeon]

Gilead up 6% after hours on remdesivir buzz in COVID-19

Very Good News

Apr. 16, 2020 4:47 PM ET|About: Gilead Sciences, Inc. (GILD)|By: Douglas W. House, SA News Editor
STAT reports that preliminary results from a study in Chicago evaluating Gilead Sciences' (NASDAQ:GILD) remdesivir in severely ill COVID-19 patients are positive with rapid recoveries in fever and respiratory symptoms observed and almost all patients discharged in less than a week.

The news is lifting shares, up 6% after hours, a welcome bit of good news on the heels of two canceled studies in China due to low enrollment.

https://seekingalpha.com/news/3561503-g ... idminus-19

Maybe...maybe not!

https://www.zerohedge.com/health/gilead ... ical-power

John

[sg31]

A list of articles from 'Nature' detailing a lot of the research into Covid 19. one using Llama antibodies looks interesting

https://www.nature.com/articles/d41586-020-00502-w

[SalvorHardin]

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.

A study published yesterday, casting doubt on the effectiveness of hydroxychloroquine, has seen much of the American media erupt with delight. Yes, they really want it to fail because Trump promoted it.

There's a good summary on PJ Media:

"As you could expect, the media pounced on the study. The Washington Post, CNN, Salon, TIME Magazine, and plenty of others were just itching to claim that Trump had been wrong or even irresponsible for touting hydroxychloroquine in the first place. International Business Times even wrote: "Trump's Hydroxychloroquine Caused More Deaths, Study Reveals."

https://pjmedia.com/trending/five-problems-with-the-study-that-claims-more-deaths-from-treating-coronavirus-with-hydroxychloroquine/

It isn't limited to the States. The Guardian has been highly negative about hydroxychloroquine from day one, even going so far as to falsely claim that the couple who drank fish tank cleaner (one died) were taking the same drug. It's comments sections have been filled with people wishing for it to fail.

Sky and the BBC have been almost as negative. But as the article points out, this new study has a lot of faults and is not definitive.

[sg31]

A study published yesterday, casting doubt on the effectiveness of hydroxychloroquine, has seen much of the American media erupt with delight. Yes, they really want it to fail because Trump promoted it.

There's a good summary on PJ Media:

"As you could expect, the media pounced on the study. The Washington Post, CNN, Salon, TIME Magazine, and plenty of others were just itching to claim that Trump had been wrong or even irresponsible for touting hydroxychloroquine in the first place. International Business Times even wrote: "Trump's Hydroxychloroquine Caused More Deaths, Study Reveals."

https://pjmedia.com/trending/five-problems-with-the-study-that-claims-more-deaths-from-treating-coronavirus-with-hydroxychloroquine/

It isn't limited to the States. The Guardian has been highly negative about hydroxychloroquine from day one, even going so far as to falsely claim that the couple who drank fish tank cleaner (one died) were taking the same drug. It's comments sections have been filled with people wishing for it to fail.

Sky and the BBC have been almost as negative. But as the article points out, this new study has a lot of faults and is not definitive.

That would be PJ Media the right wing media and opinion site.

https://en.wikipedia.org/wiki/PJ_Media

I can't understand the mentality of anyone who wouldn't be happy to find a treatment that helps save lives. Political point scoring is destructive whichever side is involved. Personally I don't think Trump suggesting Hydroxychloroquine was a game changer was helpful in any way but if it had proved to be useful then I would have been happy.

The latest study is the best evidence we have at the present time. There will be larger studies to follow, if they come up with a different result and Hydroxychloroquine works that will save lives.

Remdesivir looks promising at this stage as does Favipiravir currently in a trial in china combined with Actemra. Favipiravir is in tablet form which is it's big advantage over Rendesivir. All could fail miserably of course but we will have to wait for proper studies to guide us on that.

[supremetwo]

Doctors rethink rush to sedated mechanical ventilation.

https://uk.reuters.com/article/uk-healt ... ing%20News

In Germany, lung specialist Voshaar was also concerned. A mechanical ventilator itself can damage the lungs, he says.
This means patients stay in intensive care longer, blocking specialist beds and creating a vicious circle in which ever more ventilators are needed.

Of the 36 acute COVID-19 patients on his ward in mid-April, Voshaar said, one had been intubated - a man with a serious neuro-muscular disorder - and he was the only patient to die.
Another 31 had recovered.

https://news.sky.com/story/coronavirus- ... r-11977789
Doctors at Warrington Hospital have modified devices known as "black boxes" which usually treat sleep apnoea - a condition which means breathing stops and starts whilst sleeping.

The clinicians say by treating COVID-19 patients early with their "black boxes", it's meant there's less need for the more intrusive and invasive ventilators and they've experienced a far quicker recovery rate.

[look]

an oximeter can be used to detect the virus in early stage, before symptons.
it could save respirators.
dr. Levitan from new york

[servodude]

an oximeter can be used to detect the virus in early stage, before symptons.
it could save respirators.
dr. Levitan from new york

it was a pretty poorly written piece by him wasn't it?

an oximeter can be used to detect your SpO2 level
- if this drops below what you normally measure you likely have developed a problem in your lungs OR in your blood
- either of which might be due to COVID-19 (if the current thoughts of it mucking with the haemoglobin efficiency are true and we already know it gives you a good chance of pneumonia and/or fibrosis)

that's not detecting the virus, it's detecting a symptom (possibly earlier than you might have esp. if the person concerned was regularly short of breath)
- and it's a pretty routine thing to measure if someone has the possibility of a respiratory disorder

- sd

[redsturgeon]

I've just been listening to a piece on R4 in which the Swedish scientist behind their approach to the virus was explaining his thinking. It seems that he is under some pressure now that the Swedish death rate is considerably higher than neighbouring countries that have had tougher lockdowns. That piece got me thinking about where we are now in the UK and where we go from here.

Some thoughts based on the facts:

1. The lockdown was put in place to buy us time to ensure that our NHS ITU facilities were not overrun. That seems to have worked such that to my knowledge no patient was denied treatment due to shortages.

2. The lockdown was also to buy time to help with developing testing facilities and to secure PPE supplies. That seems to be happening, albeit slowly.

3. The lockdown was also put in place to buy time for vaccine development but AFAIK that will not be easy and it may not even be possible, no SARS or MERS vaccine has been found for example.

4.The lockdown may also buy time for drug treatments to be developed, but that again may take years rather than months if ever.

5. Removing the lockdown will cause an increase in cases but a robust test and trace process has been shown to be successful in suppressing infection rates in other countries.

6. It is becoming evident that it may be that covid19 will take it course under herd immunity is reached and there is little we can do about that.

7. If no vaccine or drug treatment becomes available before herd immunity is reached then all we can do is try to maintain the level of active cases at a level that the health service can manage by test and trace and repeated lockdowns if and when that fails.

8. Longer terms measures need to be put in place to ensure that we have enough stocks of all necessary medical supplies, including equipment, drugs, tests, PPE and of course trained staff in order to be able to cope into the future.

I am happy to be challenged on any of the above.

John

[bungeejumper]

Remdesivir looks promising at this stage

Aaah, what 48 hours can do.

Never mind, there's always washing out your bloodstream with disinfectant injections. And subcutaneous ultraviolet light. Or was it the other way round? I dunno, better ask the President. He's, like, a person that has a very good you-know-what, you know.

https://www.bbc.co.uk/news/world-us-canada-52407177


BJ

[Mike4]

5. Removing the lockdown will cause an increase in cases but a robust test and trace process has been shown to be successful in suppressing infection rates in other countries.

Has it?

As I understand it what actually helps is a robust test, trace and isolate process, but the "isolate" bit seems to be missing or glossed over from the proposals here.

Our mobile phone app in development for example, seems to rely totally on doing no more than telling people they have been close to someone else believed to be infected (not sure how they know this), and hoping they are responsible enough to self-isolate. I have grave doubts everyone will be as the personal cost will be high, for no particular benefit to the self-isolator.

Some means of forcing isolation appears to me to be a feature of the successful track, trace and isolate regimes in other places.

[bungeejumper]

Our mobile phone app in development for example, seems to rely totally on doing no more than telling people they have been close to someone else believed to be infected (not sure how they know this), and hoping they are responsible enough to self-isolate. I have grave doubts everyone will be as the personal cost will be high, for no particular benefit to the self-isolator.

This subject goes way above my head, technically, but as I understand it:

1) The government is going with the all-British NHSX programme, as distinct from the joint Apple/Google project.

2) The mobile project won't just accept an alert from anybody that they might have been infected (imagine what the scammers and the professional anarchists could do with it otherwise!). Instead, they'll need a confirmatory code from a health professional before the warning can go out.

3) There is still considerable uncertainty as to how close the Bluetooth contact needs to be, or for how long? (Bluetooth can travel for up to 15 metres. And I have a thousand schoolkids passing within 15 metres of my house every day, and many of them stop for a chat with their friends.)

4) Also AIUI, the NHSX project will only work if the user's phone is switched on (with an active screen showing), suggesting that battery life will be tragically short. And the tracker may go offline if he or she uses any other apps at the same time.

Here's hoping that's just media scaremongering, eh?

BJ

[redsturgeon]

5. Removing the lockdown will cause an increase in cases but a robust test and trace process has been shown to be successful in suppressing infection rates in other countries.

Has it?

As I understand it what actually helps is a robust test, trace and isolate process, but the "isolate" bit seems to be missing or glossed over from the proposals here.

Our mobile phone app in development for example, seems to rely totally on doing no more than telling people they have been close to someone else believed to be infected (not sure how they know this), and hoping they are responsible enough to self-isolate. I have grave doubts everyone will be as the personal cost will be high, for no particular benefit to the self-isolator.

Some means of forcing isolation appears to me to be a feature of the successful track, trace and isolate regimes in other places.

My bad, I assumed that test trace and isolate go together.

John

[UncleEbenezer]

Our mobile phone app in development for example, seems to rely totally on doing no more than telling people they have been close to someone else believed to be infected (not sure how they know this), and hoping they are responsible enough to self-isolate. I have grave doubts everyone will be as the personal cost will be high, for no particular benefit to the self-isolator.

Reports in the last couple of days suggest it's about keeping a record of bluetooth devices seen. The owners of those devices are then recorded contacts. When someone tests positive, the app has the bluetooth record of other devices it's been near, and whether it was a momentary passing encounter or something more extended.

Which begs the question: who the **** keeps bluetooth enabled when out-and-about?

[bungeejumper]

Which begs the question: who the **** keeps bluetooth enabled when out-and-about?

Until this week I'd have supposed that it was a stupid and unaffordable drain on the battery - but as I now understand it, most devices built in the last five years use a different chip that uses no more power than leaving your wifi capability permanently on. Which I suspect most of us do?

As to whether it's safe to leave Bluetooth on, that's well beyond my knowledge and capability! But I am a certified walking dead zone for Bluetooth - I have never persuaded it to work for longer than 25 seconds at a time - so I'm not sure I'll be queuing up for this app.

BJ

[Mike4]

Which begs the question: who the **** keeps bluetooth enabled when out-and-about?

Well I do for a start!

How else can I listen to the radio, make phone calls etc, through my Bluetooth earpiece?

Wonderful things.

[Mike4]

My bad, I assumed that test trace and isolate go together.

Yes me too initially.

But if you listen carefully to the R4 articles on the various test and trace plans in development, the "isolate" bit usually only gets mentioned as an afterthought, usually dismissed with no proper discussion.

I conclude it is being ignored by the designers of test and trace as it is an inconvenient irritation for someone else to handle, once they've done the interesting test and trace bit.

I'd be pleased if someone comes along to show I'm wrong.

[redsturgeon]

Yes me too initially.

But if you listen carefully to the R4 articles on the various test and trace plans in development, the "isolate" bit usually only gets mentioned as an afterthought, usually dismissed with no proper discussion.

I conclude it is being ignored by the designers of test and trace as it is an inconvenient irritation for someone else to handle, once they've done the interesting test and trace bit.

I'd be pleased if someone comes along to show I'm wrong.

I must admit I've missed that. I'd still assume that isolation is the end result but I think we definitely need to tighten the rules on isolation at that stage. Other countries use either phone based or even ankle bracelets to ensure strict quarantine.

John

[sg31]

Remdesivir looks promising at this stage

Aaah, what 48 hours can do.

Never mind, there's always washing out your bloodstream with disinfectant injections. And subcutaneous ultraviolet light. Or was it the other way round? I dunno, better ask the President. He's, like, a person that has a very good you-know-what, you know.

https://www.bbc.co.uk/news/world-us-canada-52407177


BJ

This is going to happen often. Promising candidates fall by the wayside when properly controlled studies come out. I read the reports from American sites earlier and the Remdesivvir study failed due in part to the lack of suitable candidates. What results it did provide weren't encouraging though.

Still, let's look on the bright side, we can now add bright lights and disinfectant to the list of candidates for serious studies.