SSHoya
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Apr 20, 2020 11:36:18 GMT -5
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Post by SSHoya on Apr 20, 2020 11:36:18 GMT -5
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HoyaNyr320
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Post by HoyaNyr320 on Apr 20, 2020 20:33:17 GMT -5
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SSHoya
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Apr 21, 2020 4:38:23 GMT -5
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Post by SSHoya on Apr 21, 2020 4:38:23 GMT -5
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Deleted
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Post by Deleted on Apr 21, 2020 12:12:42 GMT -5
A new analysis found that 11% of veterans with Covid-19 died when they received standard care — but the death rate rose to 28% when they were also given hydroxychloroquine, the malaria drug touted by Trump.
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Elvado
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Apr 21, 2020 12:23:12 GMT -5
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Post by Elvado on Apr 21, 2020 12:23:12 GMT -5
A new analysis found that 11% of veterans with Covid-19 died when they received standard care — but the death rate rose to 28% when they were also given hydroxychloroquine, the malaria drug touted by Trump. That is a scary and sobering number. How many were given the drug as a last, desperate resort? That might define the value of that number. Without that distinction, that data is kind of like saying that 80% of people who get last rites die.
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blueeagle
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Post by blueeagle on Apr 21, 2020 14:35:59 GMT -5
That is a good question. It is typical though for randomized controlled studies to have the treatment and control groups populated by subjects with similar demographic and clinical profiles. In the context of using hydroxychloroquine to treat COVID 19, I would anticipate that it would require observing critically ill patients on placebo vs. critically ill patients on hydroxychloroquine.
I think we are beginning to see the probable answer to the question "what do we have to lose?" More lives.
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SSHoya
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Apr 21, 2020 14:52:19 GMT -5
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Post by SSHoya on Apr 21, 2020 14:52:19 GMT -5
That is a good question. It is typical though for randomized controlled studies to have the treatment and control groups populated by subjects with similar demographic and clinical profiles. In the context of using hydroxychloroquine to treat COVID 19, I would anticipate that it would require observing critically ill patients on placebo vs. critically ill patients on hydroxychloroquine. I think we are beginning to see the probable answer to the question "what do we have to lose?" More lives. Politico has a link to the study and it was only a retrospective review of medical records so it lacked the randomized controlled studies and control group you mentioned,i.e, there is no indicia of a randomized clinical trial that would withstand peer review as such. www.politico.com/news/2020/04/21/malaria-drug-virginia-coronavirus-study-198590
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SSHoya
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Post by SSHoya on Apr 21, 2020 15:50:20 GMT -5
More "deep state" fake news!! Ignore it!! Listen to Dear Leader instead!! Even as states move ahead with plans to reopen their economies, the director of the Centers for Disease Control and Prevention warned Tuesday that a second wave of the novel coronavirus will be far more deadly because it is likely to coincide with the start of flu season. www.washingtonpost.com/health/2020/04/21/coronavirus-secondwave-cdcdirector/
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Filo
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Post by Filo on Apr 21, 2020 17:05:02 GMT -5
That is a good question. It is typical though for randomized controlled studies to have the treatment and control groups populated by subjects with similar demographic and clinical profiles. In the context of using hydroxychloroquine to treat COVID 19, I would anticipate that it would require observing critically ill patients on placebo vs. critically ill patients on hydroxychloroquine. I think we are beginning to see the probable answer to the question "what do we have to lose?" More lives. Politico has a link to the study and it was only a retrospective review of medical records so it lacked the randomized controlled studies and control group you mentioned,i.e, there is no indicia of a randomized clinical trial that would withstand peer review as such. www.politico.com/news/2020/04/21/malaria-drug-virginia-coronavirus-study-198590Yeah, unfortunately, there are no randomized controlled trials of HCQ alone or in combination with other meds. This VA study is actually stronger than the French study that created all of the excitement to begin with, but there are certainly no definitive answers either way. It does seem like there may be some benefit to HCQ (possibly with zinc and an antibiotic) for early onset, but without a RCT we have no way of knowing if the patients receiving the treatment would have improved without it. It also seems like the treatment may be a real problem for patients who are very ill, but the same caveats apply.
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Deleted
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Post by Deleted on Apr 21, 2020 17:26:04 GMT -5
A new analysis found that 11% of veterans with Covid-19 died when they received standard care — but the death rate rose to 28% when they were also given hydroxychloroquine, the malaria drug touted by Trump. That is a scary and sobering number. How many were given the drug as a last, desperate resort? That might define the value of that number. Without that distinction, that data is kind of like saying that 80% of people who get last rites die. I think the point is it's not the miracle cure the President and Fox News pushed it to be and it was dangerous for them to do so. I mean they pushed this stuff as a miracle cure. As a leader, and as a news organization, in a time of crisis I would hope their duty would be to try their best to provide reliable information to a scared populace not sell snake oil. The article in context doesn't say it killed the people. It just says it hasn't shown to be beneficial. It also can cause damage to other organs.
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Deleted
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Post by Deleted on Apr 21, 2020 17:26:30 GMT -5
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hoyajinx
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Apr 22, 2020 10:32:44 GMT -5
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Post by hoyajinx on Apr 22, 2020 10:32:44 GMT -5
Intuitively, it makes sense that Fox News, in particular Sean Hannity, is responsible for a greater number of deaths than would otherwise be the case. The fact that it can actually be quantified how toxic his misinformation has been is interesting. This increase in deaths is in comparison to Tucker Carlson based news “reporting”. Imagine the increase if he were compared to an actual legitimate source? And this is also Trump’s primary source of information. As an aside, I would suggest watching the most recent Last Week Tonight with John Oliver to see just how insidious the Fox News/Trump feedback loop is. It’s as if he gets all of his worst ideas from Fox, but he obviously doesn’t really need any help coming up with terrible ideas. www.vox.com/policy-and-politics/2020/4/22/21229360/coronavirus-covid-19-fox-news-sean-hannity-misinformation-death
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Nevada Hoya
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Post by Nevada Hoya on Apr 22, 2020 13:00:26 GMT -5
David Fajgenbaum, N'07, is directing his battle against Castleman's disease to the Covid-19 coronavirus: chasingmycure.com/video/
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blueeagle
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Post by blueeagle on Apr 22, 2020 13:47:16 GMT -5
The Washington Post just reported of a mentally-ill, military veteran in the Philippines was shot dead by police for flouting lock down measures. When confronted by a team of policemen for being disruptive in public, the man apparently reached into his bag resulting in preemptive gunfire and his death.
Duterte did not pull the trigger himself. But he has created an atmosphere where institutionalized violence to preserve peace and order is prioritized over individual human rights. Taking a life to protect lives. Who knew that irony could be fatal?
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DanMcQ
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Post by DanMcQ on Apr 22, 2020 13:48:33 GMT -5
That is a good question. It is typical though for randomized controlled studies to have the treatment and control groups populated by subjects with similar demographic and clinical profiles. In the context of using hydroxychloroquine to treat COVID 19, I would anticipate that it would require observing critically ill patients on placebo vs. critically ill patients on hydroxychloroquine. I think we are beginning to see the probable answer to the question "what do we have to lose?" More lives. Politico has a link to the study and it was only a retrospective review of medical records so it lacked the randomized controlled studies and control group you mentioned,i.e, there is no indicia of a randomized clinical trial that would withstand peer review as such. www.politico.com/news/2020/04/21/malaria-drug-virginia-coronavirus-study-198590A couple of points: This, like many things being released currently, is a pre-print (a study submitted for publication that has not yet been peer reviewed). The Didier Raouolt study of hydroxychloroquine + azithromycin was also a pre-print. It, however, did not include any controls. This study was a retrospective review of all patients at the VA associated with UVa with COVID19 disease treated up until 4/11/2020. They divided them into 3 groups: those treated with HQ, those treated with HQ + azithro, and those treated with "standard care". So there WAS a control group, although this was not a randomized trial. Since HQ has no convincing RCT data proving efficicacy in COVID19 disease, an IRB shouldn't have any problem with HQ versus a standard treatment (ie., no HQ) group if one wanted to do a trial. Disclaimer: I am so busy taking care of COVID patients I have not had time to do more than skim this. It does nothing to dissuade me from my anecdotal view that HQ offers little more than some anti-inflammatory effect and the chance to have a whole bunch of adverse effects to my patients. Here is a link to the study itself: www.medrxiv.org/content/10.1101/2020.04.16.20065920v1
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blueeagle
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Post by blueeagle on Apr 22, 2020 14:08:41 GMT -5
Yes, Dan. I meant to state that the VA study would likely have been structured as a study with a control group and not a typical RCT.
But regardless of the specifics of this VA study, the bigger point is that so much uncertainty still surrounds the utility of HQ in treating COVID 19. So people in leadership should be extremely careful in their statements touting its effectiveness or downplaying its risks.
This is true for all therapies being presented as possible cures such as Remdesivir, a cocktail of IV steroids with ascorbic acid, Pluristem, hot ginger tea, etc. I think that the most effective intervention so far has been the intermittent use of prone positioning for patients in respiratory distress.
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DanMcQ
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Post by DanMcQ on Apr 22, 2020 14:35:48 GMT -5
Yes, Dan. I meant to state that the VA study would likely have been structured as a study with a control group and not a typical RCT. But regardless of the specifics of this VA study, the bigger point is that so much uncertainty still surrounds the utility of HQ in treating COVID 19. So people in leadership should be extremely careful in their statements touting its effectiveness or downplaying its risks. This is true for all therapies being presented as possible cures such as Remdesivir, a cocktail of IV steroids with ascorbic acid, Pluristem, hot ginger tea, etc. I think that the most effective intervention so far has been the intermittent use of prone positioning for patients in respiratory distress. Totally agree. As much as we all want to have the intervention that works for our patients, data like this has to be taken with a grain of salt until we have real data that is free from bias and demonstrates an effect, good or bad, or no effect.
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SSHoya
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Apr 22, 2020 16:23:28 GMT -5
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Post by SSHoya on Apr 22, 2020 16:23:28 GMT -5
Trump got him out for not being a "team player." WASHINGTON — Rick Bright, one of the nation’s leading vaccine development experts and the director of the Biomedical Advanced Research and Development Authority, is no longer leading the organization, officials told STAT. The shakeup at the agency, known as BARDA, couldn’t come at a more inopportune time for the office, which invests in drugs, devices, and other technologies that help address infectious disease outbreaks and which has been at the center of the government’s coronavirus pandemic response. www.statnews.com/2020/04/21/rick-bright-out-at-barda/A doctor who was removed as head of the federal agency that is helping develop a vaccine for the coronavirus said he was ousted because he called for resistance to widespread adoption of a drug promoted by President Donald Trump as a treatment for Covid-19. Bright also wrote, "Specifically, and contrary to misguided directives, I limited the broad use of chloroquine and hydroxychloroquine, promoted by the administration as a panacea, but which clearly lack scientific merit," he said. www-cnbc-com.cdn.ampproject.org/v/s/www.cnbc.com/amp/2020/04/22/coronavirus-treatment-vaccine-doctor-says-worry-about-trump-idea-led-to-ouster.html?amp_js_v=a2&_gsa=1&usqp=mq331AQIKAGwASDAAQE%3D#aoh=15875907502322&referrer=https%3A%2F%2Fwww.google.com&_tf=From%20%251%24s&share=https%3A%2F%2Fwww.cnbc.com%2F2020%2F04%2F22%2Fcoronavirus-treatment-vaccine-doctor-says-worry-about-trump-idea-led-to-ouster.html
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DanMcQ
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Post by DanMcQ on Apr 22, 2020 22:32:16 GMT -5
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SSHoya
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Post by SSHoya on Apr 23, 2020 8:12:57 GMT -5
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