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COVID-19 Pandemic: Transmissions, Deaths, Treatments, Vaccines, Interventions and More...

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Don't think we've ever had the need for massive antibody testing before, but it's easy to do (blood is already screened for many things to ensure its safety at the donation point). It should identify anyone who was ever infected and recovered, even if they never had a virus test, as close to half of the people who test positive for the virus don't have symptoms (when doing aggressive testing of people including those without symptoms).

This test is also far easier and simpler than the virus test (most of the tests should only require a finger prick of blood and would theoretically be able to be done at home). I think a lot of it will be self-driven, by folks like yourself who just want to know (me too - I'd just like to know, as would my family, since we know the virus was here by the end of 2019). But you and the GF, in particular, should really think of signing up for the plasma donation program, as you both sound like the kind of person they're looking for. Easy for them to do the antibody test and if you've gone 14 days since your last symptoms, I'm pretty sure you'd meet their criteria. Thead below has details on the convalescent antibody-plasma treatment trials being done in NYC. Your antibodies could save lives...

https://rutgers.forums.rivals.com/t...tential-breakthrough-antibody-therapy.193511/
Update on this. The CDC announced, today, that three major antibody test surveys will be done with one of them already underway, on hotspot areas. A national survey will be done this summer, probably because doing one now while things are changing rapidly will be of less value; another will be done soon on health care workers and some local hospitals will be doing their own shortly. We know there are significant numbers of people who test positive without symptoms, but we have no idea how many there are and how many of these are infectious carriers. On the Diamond Princess cruise ship, about 19% of passengers tested positive (they tested everyone on board) and of those almost half had no symptoms.

So far, no country has tested more than about 1% of their population and no country has more than about 0.2% of their population with positive results, which is way less than on the DP. The big question is whether we already have 1, 5, 10, 20% of people in the US or in hotspots that were actually infected and don't know it (and likely have antibodies/immunity). There are some experts out there speculating that 5-10% of the population have already been infected (will post on this later, when I have some time). This is really important testing...

The Centers for Disease Control and Prevention has begun preliminary studies to try to determine how many Americans have already been infected with SARS-CoV-2, the virus that causes Covid-19, an agency official revealed Saturday. On Friday, the agency said nearly 240,000 people in the country have been infected with the virus and nearly 5,500 have died.

Joe Bresee, deputy incident manager for the CDC’s pandemic response, said the agency hopes to flesh out the portion of cases that have evaded detection using three related studies.

The first, which has already begun, will be looking at blood samples from people never diagnosed as a case in some of the nation’s Covid-19 hot spots, to see how widely the virus circulated. Later, a national survey, using samples from different parts of the country, will be conducted. A third will look at special populations — health care workers are a top priority — to see how widely the virus has spread within them. Bresee said the CDC hopes to start the national survey in the summer; he gave no timeline for the health workers study.


“We’re just starting to do testing and we’ll report out on these very quickly,” Bresee said at a media briefing. “We think the serum studies will be very important to understand what the true amount of infection is out in the community.”

These studies — called sero-surveys — involve drawing blood from people never diagnosed as a case to look for antibodies to the virus. They are conducted by taking a representative sample of people in a city, for instance, ensuring people from different age groups are included.

https://www.politico.com/news/2020/04/04/cdc-coronavirus-blood-tests-165116
 
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so hearing some stuff that the baby that died in CT may have not died from coronavirus but something else...tested positive for it but not the cause of death....if true, its very important people get this right, the Gov of CT quickly was tweeting the death of this infant out. Cannot confuse the public

Please don't pass along this kind of thing unless you have a source to link to. Otherwise, it's hard to know what's truth and what's rumor.
 
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Summary of today's (4/3) presser by Cuomo...
  • 260K tested in NY/113K in NYC to date; 22K/9K tested yesterday in NY/NYC (vs. 19K/8K tested the day before in NY/NYC, a slight bump up.
  • The Earth hit 1,000,000 positive cases yesterday, with 245K positive cases in the US (215K yesterday): 102.8K, 92.3K, 83.7K, 75.7K, 66.5K positives in NY the last 5 days, meaning 10.5K, 8.6K, 8.0K, 9.2K new cases the past four days in NY and 57.1K, 51.8K, 47.4K, 43.1K, 38.0K in NYC the last 5 days, meaning 5.3K, 4.4K, 4.3K, 5.1K new cases the past three days in NYC. Over the last week or so, new cases have leveled off in NY/NYC, but yesterday’s bump up is concerning (hopefully just a daily blip).
  • 6070 total deaths in the US (up 968 from yesterday) and 2935 total deaths in NY, up 562 from yesterday (was up 430 two days ago), so that is still growing, as expected, as deaths lag hospitalizations by at least a week or two; 539 deaths in NJ (537 yesterday)
  • Total of 14.8K currently hospitalized in NY (1400 new vs. 1200 new yesterday and 1300 new the day before); not clear if the bump up yesterday is meaningful or not.
  • Total of 3731 currently in ICU in NY, which means on ventilators, usually (3396 yesterday, so 335 new vs. 374 yesterday)
  • 8886 discharged from hospitals in NY (7434 as of yesterday, so 1452 discharged yesterday vs. 1292 the day before; good sign. Note that new hospitalization rate has been pretty close to the discharge rate for a few days, which is good news.
  • 245K cases in the US and over last 4 days here are the total cases for selected states: 102.8K/92.3K/83.9K/75.9K in NY, 25.6K/22.2K/18.7K/16.6K in NJ, 11,000/9800/8500/7200 in CA, 10,700/9300/7600/6500 in MI, 9000/7700/6600/5800 in MA, 9000/7800/ 6700/5700 in FL, 6600/5800/5500/5200in WA (slowest growing state, but bumped up yesterday), 7700/7000/6000/5100 in IL, 9200/6400/5200/4000 in LA (42% jump yesterday), 7000/6000/5000/4100 in PA, and 5400/4700/4100/3000 in GA.
  • Unbelievable to him that the US can’t make surgical masks, N95 respirators, gowns, faceshields, gloves, etc. – he showed how simple they are. Still major issues with ventilators – trying everything.
  • Every governor says this is a national disaster and need far more from the Federal Government, especially with supplies; peaks are occurring at different times, so in absence of more supplies, triage supplies in early areas and redeploy to later peaking states afterwards. Help NY now and NY will help others later.
  • With so little activity in NY, far less car accidents, other accidents and crime, as well as all elective procedures being postponed, so “baseline” hospitalization rates have gone down, which is helpful.
  • NY budget was passed at 3 am, but the State is broke, basically, and needs more Federal help.

Summary of today's (4/4, so most recent data is for 4/3) presser by Cuomo...
  • 284K tested in NY/125K in NYC to date; 24K/12K tested yesterday in NY/NYC (vs. 22K/9K tested the day before in NY/NYC, a bit of a bump up.
  • The Earth hit 1.16MM cases on 4/3 vs. 1.01MM on 4/2, with 277K positive cases in the US (245K on 4/2)
  • NY/NYC Cases: 113.7K, 102.8K, 92.3K, 83.7K, 75.7K, 66.5K positives in NY the last 6 days, meaning 10.8K, 10.5K, 8.6K, 8.0K, 9.2K new cases the past five days in NY; 63.3K, 57.1K, 51.8K, 47.4K, 43.1K, 38.0K in NYC the last 6 days, meaning 6.1K, 5.3K, 4.4K, 4.3K, 5.1K new cases the past five days in NYC. Over the last week or so, new cases are still increasing a bit in NY/NYC, but slowly.
  • NJ (not in presser but added in): as of 4/4, total tests up to 75K, total positive cases up to 34K, with 4300 new cases and total deaths up to 846, with 200 new deaths.
  • 3565 total deaths in NY, up 630 from yesterday; total deaths the previous three days were 2935, 2371, and 1941, so the daily death rate is still growing, as expected, as deaths lag hospitalizations by at least a week or so.
  • Total of 15.9K currently hospitalized in NY vs. 14.8K yesterday for a net increase of 1100 and increases of 1400, 1200 and 1300 the previous three days. In previous reports, I’ve been saying these were “new hospitalizations” since that’s what the pressers say/show, but it turns out that these are net new.
    • So, if the “net new” is 1400 and 1600 were discharged that means there were actually 3000 new patients admitted for a net increase of 1400 in the hospital (not sure how deaths are being counted in this – if 1000 people die and are no longer in the hospital, that probably means 4000 admitted – 1600 discharged – 1000 deaths for an overall hospital population increase of 1400 – this is me guessing since those details have not been provided).
  • Total of 4126 currently in ICU in NY (which means on ventilators, usually) vs. 3731 yesterday for an increase of 395 and vs increases of 335, 374 and 312 the previous three days.
  • 10,500 cumulative to date discharged from hospitals in NY as of yesterday vs. 8886 the day before. This means that 1592 were discharged yesterday vs. 1452, 1292 and 1167 the previous three days.
  • 277K cases in the US and over last 5 days here are the total cases for selected states: 113.7K/102.8K/92.3K/83.9K/75.9K in NY, 29.9K/25.6K/22.2K/18.7K/16.6K in NJ, 12.6K/11,000/9800/8500/7200 in CA, 12.7K/10,700/9300/7600/6500 in MI, 10.4K/9000/7700/6600/5800 in MA, 10.2K/9000/7800/ 6700/5700 in FL, 7000/6600/5800/5500/5200in WA (slowest growing state), 8900/7700/7000/6000/5100 in IL, 10.3K/9200/6400/5200/4000 in LA, 8400/7000/6000/5000/4100 in PA, and 6300/5400/4700/4100/3000 in GA.
  • 7121 total deaths in the US vs. 6070 yesterday (up 1051) and here are total deaths for selected states: 3565 in NY, 647 in NJ, 478 in MI, 282 in CA, 192 in MA, 370 in LA, 169 in FL, 211, in IL, 102 in PA, and 293 in WA.
  • Models now predicting the apex being in about 7 days, plus or minus a few days.
  • China donated 1000 ventilators today, Oregon sending 140 ventilators (their apex is in May and NY will send them back, plus more), and 500 more found across state. Could still be a very close call on ventilators.
 
Would make sense if cases peak in 5-7 for system overload and deaths to peak on a lag a week after.

I believe the info he shared was the number of hospitalizations as a result of individuals having contracted the virus.

Most projections of the "peak" are for peak cases. Peak hospitalization comes maybe 5-7 days after cases peak and deaths can lag 1-2 weeks longer. I would think NY will peak in cases in 3-5 days and NJ a few days after that, based on what I've seen (both are no longer on the exponential growth phase at all, so social distancing is working, just not as well as we'd like).

This video does a nice job of explaining the various curves and how they relate to each other (7 minutes in has a nice overall graphic).

 
when do you think a test like that would be widespread available for all residents in NJ

Ask your doctor about getting an antibody test or where you can get one, especially if you think you may have had the virus and recovered (and consider donating your plasma then, as it might save 2-3 lives). The tests were approved for use (by doctors) 2 days ago and are starting to roll out, but I would think they'll be hard to get for awhile, as they'll likely be reserved for people on the front lines; at-home tests are also being reviewed by the FDA, but they may take a month or so before approval. However, as we've seen with many things like this, the situation can change really fast, so stay tuned. The UK has promised at home tests in the next few days and if that happens I'm sure there will be pressure on other countries, but having said that, the at-home tests still aren't good enough yet, as per the link.

https://www.businessinsider.com/cor...s-accuracy-covid-19-immunity-passports-2020-4
 
Update on this. The CDC announced, today, that three major antibody test surveys will be done with one of them already underway, on hotspot areas. A national survey will be done this summer, probably because doing one now while things are changing rapidly will be of less value; another will be done soon on health care workers and some local hospitals will be doing their own shortly. We know there are significant numbers of people who test positive without symptoms, but we have no idea how many there are and how many of these are infectious carriers. On the Diamond Princess cruise ship, about 19% of passengers tested positive (they tested everyone on board) and of those almost half had no symptoms.

So far, no country has tested more than about 1% of their population and no country has more than about 0.2% of their population with positive results, which is way less than on the DP. The big question is whether we already have 1, 5, 10, 20% of people in the US or in hotspots that were actually infected and don't know it (and likely have antibodies/immunity). There are some experts out there speculating that 5-10% of the population have already been infected (will post on this later, when I have some time). This is really important testing...

The Centers for Disease Control and Prevention has begun preliminary studies to try to determine how many Americans have already been infected with SARS-CoV-2, the virus that causes Covid-19, an agency official revealed Saturday. On Friday, the agency said nearly 240,000 people in the country have been infected with the virus and nearly 5,500 have died.

Joe Bresee, deputy incident manager for the CDC’s pandemic response, said the agency hopes to flesh out the portion of cases that have evaded detection using three related studies.

The first, which has already begun, will be looking at blood samples from people never diagnosed as a case in some of the nation’s Covid-19 hot spots, to see how widely the virus circulated. Later, a national survey, using samples from different parts of the country, will be conducted. A third will look at special populations — health care workers are a top priority — to see how widely the virus has spread within them. Bresee said the CDC hopes to start the national survey in the summer; he gave no timeline for the health workers study.


“We’re just starting to do testing and we’ll report out on these very quickly,” Bresee said at a media briefing. “We think the serum studies will be very important to understand what the true amount of infection is out in the community.”

These studies — called sero-surveys — involve drawing blood from people never diagnosed as a case to look for antibodies to the virus. They are conducted by taking a representative sample of people in a city, for instance, ensuring people from different age groups are included.

https://www.politico.com/news/2020/04/04/cdc-coronavirus-blood-tests-165116

Long post on whether we might actually have tens of millions infected already...

A perspective I haven't seen before is in the link below. Not sure I buy it, but the authors claim that we had 10 million cases (~3+% of the population) of symptomatic SARS-CoV-2 as of the week of 3/15, from looking back at CDC influenza tracking data on "Non-Influenza Influenza Like Illnesses," as there was a surge of such reports at that time - and they estimate the symptomatic case detection rate of the coronavirus as being only between 1/100 and 1/1000. I don't claim to understand all of their paper, as it's very math heavy and I wasn't about to try to check their calculations/models. Just thought it was interesting...

https://github.com/jsilve24/ili_surge/blob/master/Silverman_and_Washburne.pdf

If true, this would actually be fantastic, as it would mean we might have 5-10% (or more) of the population right now walking around with antibodies and likely immune, which would allow them to not worry about the virus and would mean any second wave would be deprived of a large number of targets. As per the post above, this is why doing antibody testing of a random, representative population is so important, so we can know what percentage of the general population is actually infected and likely immune (the Diamond Princess did show 19% of passengers with CV2, about half of which were asymptomatic). Or at least test every passenger from the DP for antibodies to get a good first guess of the total actual infection rate in the overall population.

This would also mean that the actual IFR (infection fatality rate) is way lower than the CFR (case fatality rate). In the US, for example, the CFR is 2.7% (8454 deaths per 311,600 positive cases), while if we had, say, 33MM infections by now (10% of the population), the IFR would only be 0.02%.

However, to make a meaningful comparison to something like the flu, we'd need the symptomatic illness fatality ratio, which is what the CDC tracks, which is roughly 35,000 deaths per year out of 35,000,000 symptomatic illnesses, which is where the 0.1% "fatality rate" we often see comes from. The CDC doesn't actually track and test all of these illnesses, obviously - they use models, which typically extrapolate from hospitalization rates.

https://www.cdc.gov/flu/about/burden/index.html

Getting back to COVID-19, we know the number of people with actual symptoms is far, far less than 33MM and a decent guess of how many have symptoms is probably the number of tests we've run, so far, since most areas are only testing symptomatic people (1.65MM tested so far). So 8454 deaths/1.65MM symptomatic cases (0.5% of the US population) would be 0.5%, which is about 5X the death rate for the flu. Most projections right now are guesstimating 70-200K deaths (mine has been ~85K) from the coronavirus, assuming fairly aggressive social distancing is maintained and 5X the flu death rate would be 175K deaths, which is in that range, so it's possible this theory isn't crazy.

On the flip side, the reason i'm skeptical is that, so far, the Telluride antibody test program, where they're testing the entire 8000 person county for free, is only showing 1% of the population with antibodies after testing 1000 people, although another 2% had indeterminate results and could be positive. Even at 1%, though, that's still a lot more than the positive case percentage in the US of 0.5% (and Colorado's 0.1% positive cases per capita), but 1% is also a far cry from 10% of the US infected.

https://www.cpr.org/2020/04/02/tell...e-positive-results-but-also-more-uncertainty/

Another issue I have with having so many infections in March, is why didn't we see a lot more infections and deaths in Feb or even Jan, since they can't all come at once in March into April? And then I thought maybe it's possible that we had 5K infected by the end of January and 50K infected by the end of February (with maybe a few hundred deaths in Jan/Feb being erroneously ascribed to flu, as we know we had COVID cases back then, looking back at samples and people with symptoms that weren't recognized as COVID) and we now have millions infected today, actually, (not the 311K positive cases). Maybe this is all crazy, I don't know. Having a hard time reconciling so much conflicting data, probably because we're simply missing so much data, which is not unusual in the first few months of a pandemic.
 
Long post on whether we might actually have tens of millions infected already...

A perspective I haven't seen before is in the link below. Not sure I buy it, but the authors claim that we had 10 million cases (~3+% of the population) of symptomatic SARS-CoV-2 as of the week of 3/15, from looking back at CDC influenza tracking data on "Non-Influenza Influenza Like Illnesses," as there was a surge of such reports at that time - and they estimate the symptomatic case detection rate of the coronavirus as being only between 1/100 and 1/1000. I don't claim to understand all of their paper, as it's very math heavy and I wasn't about to try to check their calculations/models. Just thought it was interesting...

https://github.com/jsilve24/ili_surge/blob/master/Silverman_and_Washburne.pdf

If true, this would actually be fantastic, as it would mean we might have 5-10% (or more) of the population right now walking around with antibodies and likely immune, which would allow them to not worry about the virus and would mean any second wave would be deprived of a large number of targets. As per the post above, this is why doing antibody testing of a random, representative population is so important, so we can know what percentage of the general population is actually infected and likely immune (the Diamond Princess did show 19% of passengers with CV2, about half of which were asymptomatic). Or at least test every passenger from the DP for antibodies to get a good first guess of the total actual infection rate in the overall population.

This would also mean that the actual IFR (infection fatality rate) is way lower than the CFR (case fatality rate). In the US, for example, the CFR is 2.7% (8454 deaths per 311,600 positive cases), while if we had, say, 33MM infections by now (10% of the population), the IFR would only be 0.02%.

However, to make a meaningful comparison to something like the flu, we'd need the symptomatic illness fatality ratio, which is what the CDC tracks, which is roughly 35,000 deaths per year out of 35,000,000 symptomatic illnesses, which is where the 0.1% "fatality rate" we often see comes from. The CDC doesn't actually track and test all of these illnesses, obviously - they use models, which typically extrapolate from hospitalization rates.

https://www.cdc.gov/flu/about/burden/index.html

Getting back to COVID-19, we know the number of people with actual symptoms is far, far less than 33MM and a decent guess of how many have symptoms is probably the number of tests we've run, so far, since most areas are only testing symptomatic people (1.65MM tested so far). So 8454 deaths/1.65MM symptomatic cases (0.5% of the US population) would be 0.5%, which is about 5X the death rate for the flu. Most projections right now are guesstimating 70-200K deaths (mine has been ~85K) from the coronavirus, assuming fairly aggressive social distancing is maintained and 5X the flu death rate would be 175K deaths, which is in that range, so it's possible this theory isn't crazy.

On the flip side, the reason i'm skeptical is that, so far, the Telluride antibody test program, where they're testing the entire 8000 person county for free, is only showing 1% of the population with antibodies after testing 1000 people, although another 2% had indeterminate results and could be positive. Even at 1%, though, that's still a lot more than the positive case percentage in the US of 0.5% (and Colorado's 0.1% positive cases per capita), but 1% is also a far cry from 10% of the US infected.

https://www.cpr.org/2020/04/02/tell...e-positive-results-but-also-more-uncertainty/

Another issue I have with having so many infections in March, is why didn't we see a lot more infections and deaths in Feb or even Jan, since they can't all come at once in March into April? And then I thought maybe it's possible that we had 5K infected by the end of January and 50K infected by the end of February (with maybe a few hundred deaths in Jan/Feb being erroneously ascribed to flu, as we know we had COVID cases back then, looking back at samples and people with symptoms that weren't recognized as COVID) and we now have millions infected today, actually, (not the 311K positive cases). Maybe this is all crazy, I don't know. Having a hard time reconciling so much conflicting data, probably because we're simply missing so much data, which is not unusual in the first few months of a pandemic.

There are a lot of anecdotal stories of people being very sick in Jan. My brother was very sick even passing out a few times. Another person I know was also sick and lost her sense of smell. Could hove been the flu maybe not.
 
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There are a lot of anecdotal stories of people being very sick in Jan. My brother was very sick even passing out a few times. Another person I know was also sick and lost her sense of smell. Could hove been the flu maybe not.
Check my post a few pages back (yesterday morning?) about a guy I know who had a fever for 17 days in December and had all the other symptoms including the ground glass CT scan. He may end up being part of an article on this. He "recovered" but still has some cognition/GI issues.
 
Really hitting close to home now. Two friends, I learned just passed. One of them had triple bypass surgery one year ago and was on blood thinner. Tested positive 2 weeks ago and seemed "fine". Low grade fever for two weeks and then suddenly was rushed to the hospital last night because he had a hemorrhaging. He passed this morning. He was 49 years old.
 
Really hitting close to home now. Two friends, I learned just passed. One of them had triple bypass surgery one year ago and was on blood thinner. Tested positive 2 weeks ago and seemed "fine". Low grade fever for two weeks and then suddenly was rushed to the hospital last night because he had a hemorrhaging. He passed this morning. He was 49 years old.

Sorry for your loss. Sadly, as this virus spreads throughout our circles, these occurrences will be more and more common place. This virus has a mind of it's own and affects people in all different ways. My condolences again.
 
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Sorry for your loss. Sadly, as this virus spreads throughout our circles, these occurrences will be more and more common place. This virus has a mind of it's own and affects people in all different ways. My condolences again.

Thanks. What seems to be more and more common is that this virus lingers for a very long time. And when it sees an opening, it pounces. This is why it is imperative, people really quarantine and stay home.
 
Thanks. What seems to be more and more common is that this virus lingers for a very long time. And when it sees an opening, it pounces. This is why it is imperative, people really quarantine and stay home.
My cousin is in a hospital on long island on O2 for now, but may end up vented. 36 years old, healthy half marathoner, who was already wfh. Only places he went after his company went to WFH was the beach to run and to the gym. He also infected my uncle, who is older with significant comorbidities, and my aunt and other cousin are sick with symptoms, but can't get tested because their symptoms aren't severe enough.

My wife's sister is a pregnant ob/gyn in a hospital in PA. She's been exposed to two known cases and has been tested. She's been waiting for over a week for the results, while still seeing patients at the hospital's orders. She's terrified that she'll infect her patients or her husband and two young kids at home. Some of her patients are very cavalier and dismissive of the risk of contracting the virus, thinking that they live in an area of the country that won't get it.

I still can't believe that people are acting like this virus won't touch them or their loved ones. Ideas like not wearing a mask because it's either dumb looking or uncomfortable, having get togethers with friends and neighbors, using politics or lame excuses to try to reason out why certain activities should be allowed... these are only going to prolong this crisis and lead to more deaths of family and loved ones. It's time to stop acting like whiny little bitches and do the right thing for the good of everyone else.
 
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My cousin is in a hospital on long island on O2 for now, but may end up vented. 36 years old, healthy half marathoner, who was already wfh. Only places he went after his company went to WFH was the beach to run and to the gym. He also infected my uncle, who is older with significant comorbidities, and my aunt and other cousin are sick with symptoms, but can't get tested because their symptoms aren't severe enough.

My wife's sister is a pregnant ob/gyn in a hospital in PA. She's been exposed to two known cases and has been tested. She's been waiting for over a week for the results, while still seeing patients at the hospital's orders. She's terrified that she'll infect her patients or get husband and two young kids at home. Some of her patients are very cavalier and dismissive of the risk of contracting the virus, thinking that they live in an area of the country that won't get it.

I still can't believe that people are acting like this virus won't touch them or their loved ones. Ideas like not wearing a mask because it's either dumb looking or uncomfortable, having get togethers with friends and neighbors, using politics or lame excuses to try to reason out why certain activities should be allowed... these are only going to prolong this crisis and lead to more deaths of family and loved ones. It's time to stop acting like whiny little bitches and do the right thing for the good of everyone else.


Two dangerous things I am seeing are 1) asymptomatic carriers and 2) folks who fought it off thinking all is well. My bro-in law was diagnosed two weeks ago cause he had severe coughing and fever. He got better. However, he is also diabetic, so after two weeks and staying quarantined and not being careful with his diet, his diabetes flared up and the virus pounced. He was in the ICU two days ago but thankfully seems to be recovering.

Stay home people. Stay home.
 
Thanks. What seems to be more and more common is that this virus lingers for a very long time. And when it sees an opening, it pounces. This is why it is imperative, people really quarantine and stay home.

There seems to be a pattern after the first wave of immune response. Some are getting better or basically staying the same and then a second wave hits...possibly an autoimmune response. This is the cytokine release syndrome which can progress to cytokine storm. I think we have bounced back a few posts to each other about this, so this isnt directed at you but for the masses. A secondary response after a week or so of symptoms, with accompanying increasing shortness of breath, should not be taken lightly. Seek medical attention with progressive shortness of breath. A simple call to your practitioner may be all that's needed. Use emergency services only when necessary.
 
Crazy how long it can take to recover for some and also how long it may stay in your system, although you may not be infectious anymore at that point even if still lingering in your system.

From CNN:

It can take several weeks to fully recover from illness caused by the novel coronavirus, Dr. Mike Ryan, executive director of the World Health Organization's Health Emergencies Programme, said during a briefing in Geneva in early March.

"It takes anything up to six weeks to recover from this disease," Ryan said. "People who suffer very severe illness can take months to recover from the illness."

Ryan added that recovery is often measured as the patient no longer exhibiting symptoms and having two consecutive negative tests for the virus at least one day apart -- but some countries may measure "recovery" differently.

Also, confirming recovery can differ from confirming whether someone is still carrying the virus -- and that's where some confusion may emerge.

The data showed that among the survivors, the median duration of which the virus could be detected was 20 days from the onset of their illness. The shortest observed duration of viral shedding among survivors was eight days and the longest was 37 days, the researchers found.

Among those who died, the researchers found that "the virus was continuously detectable until death." The researchers wrote in the study, "sustained viral detection in throat samples was observed in both survivors and non-survivors."

Specifically, testing "doesn't give you any information if that virus is what we call viable or can live and can cause subsequent infections," Hota said. "So the testing can detect the genetic material, but it doesn't mean that somebody's necessarily still infectious."

https://www.cnn.com/2020/04/04/health/recovery-coronavirus-tracking-data-explainer/index.html
 
Ask your doctor about getting an antibody test or where you can get one, especially if you think you may have had the virus and recovered (and consider donating your plasma then, as it might save 2-3 lives). The tests were approved for use (by doctors) 2 days ago and are starting to roll out, but I would think they'll be hard to get for awhile, as they'll likely be reserved for people on the front lines; at-home tests are also being reviewed by the FDA, but they may take a month or so before approval. However, as we've seen with many things like this, the situation can change really fast, so stay tuned. The UK has promised at home tests in the next few days and if that happens I'm sure there will be pressure on other countries, but having said that, the at-home tests still aren't good enough yet, as per the link.

https://www.businessinsider.com/cor...s-accuracy-covid-19-immunity-passports-2020-4

For @bac2therac and others: the description and status of various types of antibody tests, including which ones and types are approved in the US and elsewhere, are nicely detailed in this link. The table below summarizes the types of tests (the one approved in the US is an RDT test from Cellex, but more to come soon).

jM0vXnv.png


http://www.centerforhealthsecurity....2JsMM54HNEXdKNVqOFViCJslpNU1th0j9r48mGkERxX0M
 
Long post on whether we might actually have tens of millions infected already...

A perspective I haven't seen before is in the link below. Not sure I buy it, but the authors claim that we had 10 million cases (~3+% of the population) of symptomatic SARS-CoV-2 as of the week of 3/15, from looking back at CDC influenza tracking data on "Non-Influenza Influenza Like Illnesses," as there was a surge of such reports at that time - and they estimate the symptomatic case detection rate of the coronavirus as being only between 1/100 and 1/1000. I don't claim to understand all of their paper, as it's very math heavy and I wasn't about to try to check their calculations/models. Just thought it was interesting...

https://github.com/jsilve24/ili_surge/blob/master/Silverman_and_Washburne.pdf

If true, this would actually be fantastic, as it would mean we might have 5-10% (or more) of the population right now walking around with antibodies and likely immune, which would allow them to not worry about the virus and would mean any second wave would be deprived of a large number of targets. As per the post above, this is why doing antibody testing of a random, representative population is so important, so we can know what percentage of the general population is actually infected and likely immune (the Diamond Princess did show 19% of passengers with CV2, about half of which were asymptomatic). Or at least test every passenger from the DP for antibodies to get a good first guess of the total actual infection rate in the overall population.

This would also mean that the actual IFR (infection fatality rate) is way lower than the CFR (case fatality rate). In the US, for example, the CFR is 2.7% (8454 deaths per 311,600 positive cases), while if we had, say, 33MM infections by now (10% of the population), the IFR would only be 0.02%.

However, to make a meaningful comparison to something like the flu, we'd need the symptomatic illness fatality ratio, which is what the CDC tracks, which is roughly 35,000 deaths per year out of 35,000,000 symptomatic illnesses, which is where the 0.1% "fatality rate" we often see comes from. The CDC doesn't actually track and test all of these illnesses, obviously - they use models, which typically extrapolate from hospitalization rates.

https://www.cdc.gov/flu/about/burden/index.html

Getting back to COVID-19, we know the number of people with actual symptoms is far, far less than 33MM and a decent guess of how many have symptoms is probably the number of tests we've run, so far, since most areas are only testing symptomatic people (1.65MM tested so far). So 8454 deaths/1.65MM symptomatic cases (0.5% of the US population) would be 0.5%, which is about 5X the death rate for the flu. Most projections right now are guesstimating 70-200K deaths (mine has been ~85K) from the coronavirus, assuming fairly aggressive social distancing is maintained and 5X the flu death rate would be 175K deaths, which is in that range, so it's possible this theory isn't crazy.

On the flip side, the reason i'm skeptical is that, so far, the Telluride antibody test program, where they're testing the entire 8000 person county for free, is only showing 1% of the population with antibodies after testing 1000 people, although another 2% had indeterminate results and could be positive. Even at 1%, though, that's still a lot more than the positive case percentage in the US of 0.5% (and Colorado's 0.1% positive cases per capita), but 1% is also a far cry from 10% of the US infected.

https://www.cpr.org/2020/04/02/tell...e-positive-results-but-also-more-uncertainty/

Another issue I have with having so many infections in March, is why didn't we see a lot more infections and deaths in Feb or even Jan, since they can't all come at once in March into April? And then I thought maybe it's possible that we had 5K infected by the end of January and 50K infected by the end of February (with maybe a few hundred deaths in Jan/Feb being erroneously ascribed to flu, as we know we had COVID cases back then, looking back at samples and people with symptoms that weren't recognized as COVID) and we now have millions infected today, actually, (not the 311K positive cases). Maybe this is all crazy, I don't know. Having a hard time reconciling so much conflicting data, probably because we're simply missing so much data, which is not unusual in the first few months of a pandemic.

I'd love to believe that there's already a huge percentage of the population that has been infected and recovered, but it just doesn't seem likely. Heck, my wife had an upper respiratory infection about a month ago. Would be great if that was a mild covid case and we are both now immune.

If we work back...the index case(s) of covid is believed to have occurred in the Wuhan area in mid to late November. It took 2 months for things to get bad enough that Wuhan was locked down. Now take NYC...cases really started exploding in mid-late March (say March 22). Go back 2 months and that takes us to mid-late January. So while it's likely that a few sporadic cases were imported into the US as far back as December, the main seeding probably occurred starting in mid January (and then over time we also got imports from Italy, Iran etc). This makes it relatively unlikely that anyone who experienced a severe flu-like illness in December or January had covid. Not impossible, but unlikely. If it was already widespread by January we would have seen the impact in the hospitals before mid March.

The Telluride study will be interesting. I checked one of the websites that lists cases by county and it looks like they have 9 confirmed cases (by the PCR method I assume). So if the 80/20 rule is accurate, i.e. 80% of cases are mild or asymptomatic (thus presumably not tested) that would suggest 45 total cases in the county. Right now they've got 8 solid positives with 12% tested which would work out to about 64 total. If all the indeterminate cases are actually positive that would work out to 248. Then 9/248 = 3.6% symptomatic and 96.4% asymptomatic. Of course, some of those could become symptomatic over time.

Hopefully they'll find a harder hit relatively small community somewhere in the NY area (maybe 10k pop) where they can run a similar test.
 
For those expecting a successful vaccine anytime soon...there has been some discussion here before about the risk that a vaccine can lead to a heightened immune response (cytokine storm). If interested, I came across an interesting twitter discussion about this topic. Link below.

My crude understanding is that under some conditions, antibodies can bind to the virus in such a way that when they (virus+antibody complex) are ingested into a macrophage, they cause the macrophage to malfunction and spew out a bunch of cytokines. If this happens on a large scale you get the cytokine storm and inflammatory destruction of the lungs. I'm not sure if this is due to a problem with the way the antibodies are created or if it's a problem with the macrophages (or both or something else). This could explain why some people who seem to be recovering on their own go on to have the severe cytokine storm process after a week or two, as that is when antibody production really ramps up.

This has been observed with other viruses - especially dengue, where people who survive infection with one strain can then have a very severe reaction to a second infection with a different strain. It was also seen in tests of SARS-1 vaccines in animals.

I'm not a biologist so if there's anyone here with the background to talk about this ADE (antibody-dependent enhancement) process that would be great.

 
Most projections of the "peak" are for peak cases. Peak hospitalization comes maybe 5-7 days after cases peak and deaths can lag 1-2 weeks longer. I would think NY will peak in cases in 3-5 days and NJ a few days after that, based on what I've seen (both are no longer on the exponential growth phase at all, so social distancing is working, just not as well as we'd like).

This video does a nice job of explaining the various curves and how they relate to each other (7 minutes in has a nice overall graphic).

Most projections of the "peak" are for peak cases. Peak hospitalization comes maybe 5-7 days after cases peak and deaths can lag 1-2 weeks longer. I would think NY will peak in cases in 3-5 days and NJ a few days after that, based on what I've seen (both are no longer on the exponential growth phase at all, so social distancing is working, just not as well as we'd like).

This video does a nice job of explaining the various curves and how they relate to each other (7 minutes in has a nice overall graphic).


#s. Nice explanation of trends. Any idea who it is or qualifications of presenter?

GO RU
 
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My mother and step dad both have underlying conditions and developed pneumonia in early February. Both went to hospitals. Mom was at hospital for over three weeks. Step dad in hospital for a week. Both recovered from pneumonia. Causes were undetermined. A month later Covid19 becomes a pandemic.

Personally feel the Corona virus was in NJ before we started taking it seriously.

GO RU
 
I see that Dr. Birx is advising that no one go out, not even for grocery shopping for at least a week. https://www.usatoday.com/story/news...birx-warn-jump-deaths-coming-week/2949219001/

For @RU848789 and others, should we be following this advice? Not going out even for groceries or pharmaceuticals is asking a lot, particularly with delivery services doing so poorly.
If you have to go out, you have to go out. Wear a mask, keep away from people, don't touch your face, wash your hands and/or use sanitizer.

It would be great if the whole country could just "stay in" (literally) for like 2 weeks but I don't think that's practical. But talk about mixed messages...they want everyone to say in yet liquors stores are still open, golf courses are still open, most restaurants are open for take out and delivery. Still, if you can stay in you should.

My wife and I haven't been out anywhere public in almost 2 weeks, but we stocked up pretty good before the panic buying started and we've used grocery delivery twice now to top up. She is in the immuno-compromised group so we're really trying to limit exposure.
 
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I see that Dr. Birx is advising that no one go out, not even for grocery shopping for at least a week. https://www.usatoday.com/story/news...birx-warn-jump-deaths-coming-week/2949219001/

For @RU848789 and others, should we be following this advice? Not going out even for groceries or pharmaceuticals is asking a lot, particularly with delivery services doing so poorly.


I am almost thinking she misspoke a little. It was definitely vague in a way and what sucks is that the MEDIA asked no follow up...these are the questions that they should be asking..the questions on how everyday Americans should act. If she misspoke there should be clarification, if not then its signifcant because that would be the first time that they ever told us not to go to pharmacies and grocery stores....the media needs to follow up on this and get clarification

If she meant just essential visits, then that should be said, I do realize many are still going to the grocery store everyday and that should be cut back on. But unless the government is dropping off food for the masses, they should make their position very clear on this
 
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Now take NYC...cases really started exploding in mid-late March (say March 22). Go back 2 months and that takes us to mid-late January. So while it's likely that a few sporadic cases were imported into the US as far back as December, the main seeding probably occurred starting in mid January (and then over time we also got imports from Italy, Iran etc).
That's been my view all along, that this hit our shores in earnest in mid-January and, given how contagious it is, has seeded our population on both coasts. That's why it's taken longer to start having an impact in the heartland. Now it remains to be seen if the social distancing there will have an effect or if that was implemented too late.
 
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https://www.contagionlive.com/news/results-from-a-controlled-trial-of-hydroxychloroquine-for-covid19

The initial results from a placebo-controlled trial of hydroxychloroquine for COVID-19 indicate that patients hospitalized with mild illness recovered more quickly with addition of the drug than with placebo at the start of a standard treatment. The results also suggest that hydroxychloroquine might convey some protection against the illness worsening.

Post from Tuesday on this trial. Promising, but way too small to be definitive. Also, with reportedly 30% or more of patients already being treated with HCQ, if it were truly saving lives, I think we'd know about it by now, as opposed to seeing deaths and fatality rates continuing to climb. That's why we need larger, randomized, placebo-controlled, double-blind clinical studies with enough statistical power (comes from size) to truly determine safety and efficacy, i.e., the clinical "gold standard."

And if I were going to "gamble" on an unproven therapy, I'd be giving the convalescent antibody-plasma therapy to every seriously ill patient today, since the very small trial in China showed 5 people recovering from that therapy after being on ventilators. That's far more impressive than any reported HCQ or HCQ/azithromycin results to date, but again is not enough to start giving it to everyone even if it were available.

Well, some possibly promising results from a Chinese study with hydroxychloroquine (HCQ) only (no azithromycin) was just published as a preprint (not peer reviewed yet). Trial was small (31 patients in each group), but blinded and standard of care treatment-controlled, and showed some evidence of efficacy with respect to TTCR (time to clinical recovery). Below is the abstract. I'm sure even partial responses like this with surrogate endpoints are going to result in a run on HCQ. But what we truly need is a trial large enough to really look at death rates or ICU-intubation rates for HCQ vs. standard of care to see if there's truly a significant benefit.

Abstract

Aims: Studies have indicated that chloroquine (CQ) shows antagonism against COVID-19 in vitro. However, evidence regarding its effects in patients is limited. This study aims to evaluate the efficacy of hydroxychloroquine (HCQ) in the treatment of patients with COVID-19. Main methods: From February 4 to February 28, 2020, 62 patients suffering from COVID-19 were diagnosed and admitted to Renmin Hospital of Wuhan University. All participants were randomized in a parallel-group trial, 31 patients were assigned to receive an additional 5-day HCQ (400 mg/d) treatment, Time to clinical recovery (TTCR), clinical characteristics, and radiological results were assessed at baseline and 5 days after treatment to evaluate the effect of HCQ. Key findings: For the 62 COVID-19 patients, 46.8% (29 of 62) were male and 53.2% (33 of 62) were female, the mean age was 44.7 (15.3) years. No difference in the age and sex distribution between the control group and the HCQ group. But for TTCR, the body temperature recovery time and the cough remission time were significantly shortened in the HCQ treatment group. Besides, a larger proportion of patients with improved pneumonia in the HCQ treatment group (80.6%, 25 of 32) compared with the control group (54.8%, 17 of 32). Notably, all 4 patients progressed to severe illness that occurred in the control group. However, there were 2 patients with mild adverse reactions in the HCQ treatment group. Significance: Among patients with COVID-19, the use of HCQ could significantly shorten TTCR and promote the absorption of pneumonia.


https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v1.full.pdf+html

With regard to my comment on surrogate endpoints, here's how an MD on another board put it. So, promising, yes, but definitive, no.

One thing I’ve noticed for the trials so far looking at hydroxychloroquine is the rampant use of surrogate end points. Time to clinical recovery, the primary end point in this trial. Is a composite of cessation of cough and return of body Temp normalcy. They show pretty drastic differences between the two groups. My question is what relationship does that “surrogate” end point have to any meaningful end point. For example, rate of ICU admission, progression to needing a ventilator, length of hospitalization, and most importantly death. Other surrogate end points I’ve seen used are time for viral rna to return to normal and rate of decline of rna viral load. I’m not trying to say it’s not possible this drug works, just find it interesting the end points that they’re choosing. The studies in the US are better designed and larger (much larger) and will therefore be the gold standard for whether or not the drug works

In fairness they do comment (with poor English) that 4 patients who got severely ill were in the control group and there was radiographic improvement in the pneumonia’s more commonly in the treatment arm but because of small samples sizes the p values are not significant
 
I see that Dr. Birx is advising that no one go out, not even for grocery shopping for at least a week. https://www.usatoday.com/story/news...birx-warn-jump-deaths-coming-week/2949219001/

For @RU848789 and others, should we be following this advice? Not going out even for groceries or pharmaceuticals is asking a lot, particularly with delivery services doing so poorly.
Yes, everyone should be staying inside as much as humanly possible, except for emergencies and situations where it's easy to maintain good social distancing of 6 feet or more. I don't think she's saying you can't go out if you must, but if you do, be smart about it. For example if you can, order ahead and have food/groceries/medicines dropped off in your trunk or at your house (I do this with takeout and basic perishables/sundries from a local deli).

And if you have to go to a larger store (and I doubt most "have" to), don't go when everyone else goes - people can go during off hours to space things out. And wear a mask, in case you're infected to keep from giving it to others and, of course wash/decon your hands while out and when you get home. And outside of densely packed cities, going out and walking around shouldn't be an issue either, as keeping 6+ feet away is very easy in suburban/rural areas, at least.
 
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I think most people have to go once a week. I shop for me and my 84 year old mother and i know she needs fresh stuff once a week for lunch, dinner, new dairy and fruits

I am a fan of Birx but she needed to make herself clear..and msm should be asking these questions not what Trump said in February and what ICE is doing
 
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Post from Tuesday on this trial. Promising, but way too small to be definitive. Also, with reportedly 30% or more of patients already being treated with HCQ, if it were truly saving lives, I think we'd know about it by now, as opposed to seeing deaths and fatality rates continuing to climb. That's why we need larger, randomized, placebo-controlled, double-blind clinical studies with enough statistical power (comes from size) to truly determine safety and efficacy, i.e., the clinical "gold standard."

And if I were going to "gamble" on an unproven therapy, I'd be giving the convalescent antibody-plasma therapy to every seriously ill patient today, since the very small trial in China showed 5 people recovering from that therapy after being on ventilators. That's far more impressive than any reported HCQ or HCQ/azithromycin results to date, but again is not enough to start giving it to everyone even if it were available.

The link I provided had more details plus it referenced other ongoing trials including the one with 1300 people in France. Maybe I missed that being mentioned somewhere last week.

Also worth mentioning that per Novartis CEO, "Pre-clinical studies in animals as well as the first data from clinical studies show that hydroxychloroquine kills the coronavirus," Narasimhan told the newspaper. "We're working with Swiss hospitals on possible treatment protocols for the clinical use of the drug, but it's too early to say anything definitively."

I also highlighted that the small study showed promise for folks who had not progressed to ventilators. That is my hope for the combo treatment. If we can reduce the number of Cytokine Storm cases it would be worth pursuing. I am more hopeful for the combo therapy. Several of the anecdotal evidences of combo included drugs that regulate IL-6 expression and reduce the storm. That is what I hope at least.
 
The link I provided had more details plus it referenced other ongoing trials including the one with 1300 people in France. Maybe I missed that being mentioned somewhere last week.

Also worth mentioning that per Novartis CEO, "Pre-clinical studies in animals as well as the first data from clinical studies show that hydroxychloroquine kills the coronavirus," Narasimhan told the newspaper. "We're working with Swiss hospitals on possible treatment protocols for the clinical use of the drug, but it's too early to say anything definitively."

I also highlighted that the small study showed promise for folks who had not progressed to ventilators. That is my hope for the combo treatment. If we can reduce the number of Cytokine Storm cases it would be worth pursuing. I am more hopeful for the combo therapy. Several of the anecdotal evidences of combo included drugs that regulate IL-6 expression and reduce the storm. That is what I hope at least.
I saw a covid treatment flowchart for one of the major hospitals somewhere on line. If I can find it again I'll post but it indicated treatment with tocilizumab is one of their standards, I think possibly every patient that was getting hospitalized was getting it, but definitely those on vents. It's an immuno-suppressant uses to treat cytokine release (storm) syndrome. I believe they were also using the hydroxychloroquine as part of their regular treatment protocol.
 
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The link I provided had more details plus it referenced other ongoing trials including the one with 1300 people in France. Maybe I missed that being mentioned somewhere last week.

Also worth mentioning that per Novartis CEO, "Pre-clinical studies in animals as well as the first data from clinical studies show that hydroxychloroquine kills the coronavirus," Narasimhan told the newspaper. "We're working with Swiss hospitals on possible treatment protocols for the clinical use of the drug, but it's too early to say anything definitively."

I also highlighted that the small study showed promise for folks who had not progressed to ventilators. That is my hope for the combo treatment. If we can reduce the number of Cytokine Storm cases it would be worth pursuing. I am more hopeful for the combo therapy. Several of the anecdotal evidences of combo included drugs that regulate IL-6 expression and reduce the storm. That is what I hope at least.
We hope for the same things, but medical science shouldn't rely on hopes, but on controlled clinical studies. With the vast majority of people getting better on their own, it makes it very difficult to measure efficacy without large trials, as per the Chinese study I posted last week, where 14 of 15 patients that weren't seriously ill yet got better without HCQ and 13 of 15 got better with HCQ. Do we believe that study or the one you and I cited with 62 patients? The answer is neither.

The ongoing international (sponsored by WHO) and US (sponsored by the FDA) have also been discussed but I don't mind discussing them again (it's impossible for any of us to keep up - I've repeated multiple things others have said without knowing) - the point is these are the kinds of trials we need results on before deciding to blindly give the drug to everyone, especially when there are lupus and RA patients who absolutely need the drug.

It would be fantastic if these or the IL-6 or the various anti-viral (like remdesivir) therapies score a major hit. I'll remain skeptical until that happens, though, maybe because I've been in Pharma for 30+ years in R&D and have seen the vast majority of drugs I've worked on (and any drugs in R&D really) simply not pan out and retrofitting older drugs for new purposes usually fails (thalidomide is one huge exception).
 
We hope for the same things, but medical science shouldn't rely on hopes, but on controlled clinical studies. With the vast majority of people getting better on their own, it makes it very difficult to measure efficacy without large trials, as per the Chinese study I posted last week, where 14 of 15 patients that weren't seriously ill yet got better without HCQ and 13 of 15 got better with HCQ. Do we believe that study or the one you and I cited with 62 patients? The answer is neither.

The ongoing international (sponsored by WHO) and US (sponsored by the FDA) have also been discussed but I don't mind discussing them again (it's impossible for any of us to keep up - I've repeated multiple things others have said without knowing) - the point is these are the kinds of trials we need results on before deciding to blindly give the drug to everyone, especially when there are lupus and RA patients who absolutely need the drug.

It would be fantastic if these or the IL-6 or the various anti-viral (like remdesivir) therapies score a major hit. I'll remain skeptical until that happens, though, maybe because I've been in Pharma for 30+ years in R&D and have seen the vast majority of drugs I've worked on (and any drugs in R&D really) simply not pan out and retrofitting older drugs for new purposes usually fails (thalidomide is one huge exception).

I gave you a like only because you know about Rev ... :)
 
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I think most people have to go once a week. I shop for me and my 84 year old mother and i know she needs fresh stuff once a week for lunch, dinner, new dairy and fruits

I am a fan of Birx but she needed to make herself clear..and msm should be asking these questions not what Trump said in February and what ICE is doing
That's great that you do that for your mom (and I know it's hard, but just don't hug her, since you're out and about in the world). We took in our son and his girlfriend knowing they'd be safer with us than in a NB apartment with roommates who didn't really care much.

Good point on the media and as much as I've not been a fan of the POTUS on this, I wish the media would spend a bit less time dissecting what went wrong (it absolutely needs to be done, but there is more to talk about than that) and highlighting all of the bad things and more time sharing some success stories and talking about the medical science of potential treatments and such. It's why I generally try to minimize my injection of politics into this thread (but yes I do it once in awhile).
 
#s. Nice explanation of trends. Any idea who it is or qualifications of presenter?

GO RU
As far as I know he's just a guy on the internet with free time and some math/science skills, kind of like me, lol. I think he might be a HS math teacher, since the link was sent to me by a teacher I know.
 
We hope for the same things, but medical science shouldn't rely on hopes, but on controlled clinical studies. With the vast majority of people getting better on their own, it makes it very difficult to measure efficacy without large trials, as per the Chinese study I posted last week, where 14 of 15 patients that weren't seriously ill yet got better without HCQ and 13 of 15 got better with HCQ. Do we believe that study or the one you and I cited with 62 patients? The answer is neither.

The ongoing international (sponsored by WHO) and US (sponsored by the FDA) have also been discussed but I don't mind discussing them again (it's impossible for any of us to keep up - I've repeated multiple things others have said without knowing) - the point is these are the kinds of trials we need results on before deciding to blindly give the drug to everyone, especially when there are lupus and RA patients who absolutely need the drug.

It would be fantastic if these or the IL-6 or the various anti-viral (like remdesivir) therapies score a major hit. I'll remain skeptical until that happens, though, maybe because I've been in Pharma for 30+ years in R&D and have seen the vast majority of drugs I've worked on (and any drugs in R&D really) simply not pan out and retrofitting older drugs for new purposes usually fails (thalidomide is one huge exception).

I guess I was lucky. I started my career in Pharma R&D and was heavily involved with three projects (also small involvement with many more). All three made it to market, one was the first drug approved to treat Alzheimer's, the second was and still is the largest selling drug of all-time and the third is still around selling billions of dollars annually. There is always hope.
 
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