Yes of course, that is the path forward. You have people relax but not end the social distancing policies, couple that with treatments that reduce severity and mortality, and gradually approach herd immunity. Then when the vaccine is introduced you can get closer to the old normal.
COVID-19 Pandemic: Transmissions, Deaths, Treatments, Vaccines, Interventions and More...
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Back in the late '80s when we were first using PCR, the time for the "cycling" time would last a several hours. As the technique was optimized and the reagents got much better, this time was cut down dramatically - with really good reagents, it could be more like 45 minutes.
From what I have been told, the CDC's first PCR set up was using the old, very long cycling times that took hours.
That's so adorable - Drbeen is going to teach me science. :WideSmile:
Did you know that HCQ is actually immunosuppressive? For example, it blocks AP-1 activation in CD4 T cells by altering phosphorylation of c-JUN. CD4 T cells initiate the adaptive immune response. It down regulates interferon activation - interferons are key anti-viral effector molecules. I can go on, but I hope you get the point - throwing this drug into people can certainly do harm. There are a couple of in vitro studies (cancer cell lines in plastic dishes) that showed reduced infection, but there are no credible (throw the French study out) studies that showed it works in vivo.
Feel free to search pubmed yourself and read the scientific literature on use for other viruses - here's one example that came up: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4941887/
Conclusions Although in vitro results were promising, chloroquine was not effective as preventive therapy in vivo in standard mouse and ferret models of influenza virus infection. This dampens enthusiasm for the potential utility of the drug for humans with influenza.
They were waiting hours because so many people were trying to get a test when so little were available.
And from reading that article even if we had enough swabs, there was never going to be enough lab testing. Even with so few swabs our labs could not come handle the #'s.
It was that lack of lab space that threw the process off the rails.
Maybe so, but the moment this strays too far into politics, poof, off it goes to the CE Board. And the OP knows that.
It is certainly a hindrance in today's right here/right now world...but it shouldn't be. As there is no cure for Covid-19, so in a way, it doesn't matter if you are tested or not. Once any symptoms arise, you have an illness and should treat those symptoms (fever, headache, body ache, diarrhea, etc)....and stay away from people. Many doctors have opted to not test their patients and treat them as if they were positive. The prescription? Acetaminophen, hydration, rest, isolation. This saves the time to get tested and the exposure risk to and from society. If you get really sick, go to the hospital. The big plus of testing is the ability to notify others if they had come in contact with a person who was positive, so they can vigilant and isolate themselves in order to prevent further spread of the virus.
New COVID-19 dashboard just for the US offers rich, county-level data
https://arstechnica.com/science/202...ust-for-the-us-offers-rich-county-level-data/
https://coronavirus.jhu.edu/us-map
https://arstechnica.com/science/202...ust-for-the-us-offers-rich-county-level-data/
https://coronavirus.jhu.edu/us-map
For the patient, I agree that the test result wouldn't change the medical treatment. However, like you said, the most important thing is isolation and that's one area we have done poorly on, as many people either isolate in their homes or don't even isolate at all, meaning they might infect others. I like the approach in South Korea and some other countries where positives (and contacts of positives) are quarantined in a separate facility, greatly reducing transmission.
The other thing massive testing can do is identifying asymptomatic, but infected carriers and quarantining them, as they make up at least half of infected people (and some have estimated 10X as many as those who are symptomatic). I get that that's not easy without instant, frequent testing, but that should be the goal.
Facilities like these in Hong Kong?
https://edition.cnn.com/2020/04/09/...onavirus-quarantine-diary-intl-hnk/index.html
Somewhat related to the topic above, here's a really good opinion piece in the Times, from Marc Lipsitch, Prof of Epidemiology and Infectious Diseases at Harvard, entitled, "Who Is Immune to the Coronavirus?" It provides a lot of background on immunity studies with other coronaviruses, as well as some of the early indications from this one, but it also makes the point that, unfortunately, "decisions with great consequences are being made, as they must be, based on only glimmers of data."
https://www.nytimes.com/2020/04/13/...57eosUe6DB67MDhsbcWyjJQxOCpvHc5I_0W6VL5NIQKJc
Germany is on the verge of restarting professional soccer in empty stadiums. Good to see.
https://www.latimes.com/sports/socc...ndesliga-plan-empty-stadiums-salvage-tv-money
I hope that the various levels of government in the U.S. are on the ball with getting tests (like, for example, the one recently developed by Rutgers) mass-produced. If so, reasonable first steps should begin to be taken where it makes sense to do so soon.
https://www.latimes.com/sports/socc...ndesliga-plan-empty-stadiums-salvage-tv-money
I hope that the various levels of government in the U.S. are on the ball with getting tests (like, for example, the one recently developed by Rutgers) mass-produced. If so, reasonable first steps should begin to be taken where it makes sense to do so soon.
Have you been following Chris Martenson at all? On his video yesterday he was talking about research that suggests covid might be able to infect t-cells through a different pathway (compared to the ace-2 pathway used on other cell types). Similar to how HIV works. I browsed through the papers he referenced but that stuff is a bit out of my pay grade. Kind of makes sense with some of the clinical data, especially the fact that covid patients often have low WBC levels (not sure if its total WBC or only the lymph portion) and how it appears there may be cases where the disease relapses or reactivates. Could have significant implications for vaccine development, as they might have to target both the spike protein and whatever the other pathway is.
https://www.cnn.com/2020/04/14/health/coronavirus-prone-positioning/index.html
proning showing positive effects for the hospitalized...
proning showing positive effects for the hospitalized...
Hello fellow New Jerseyans, a question more out of curiousity, has anyone had any luck getting tested at any of the testing centers or atleast seen one open? I live right near the testing center in Holmdel and I have driven by it multiple times including today and have yet to see it open and don’t understand why our testing centers are closed if there is such a high priority on testing. Are they just out of tests? Makes no sense.
Full clarification I am not seeking a test at this time, just hoping this ends sooner than later.
Full clarification I am not seeking a test at this time, just hoping this ends sooner than later.
For a second, I thought it was a goof with the first word spelled a bit differently, lol. That's pretty interesting stuff, thanks.
if that "other" option were to work, i don't think the gender split of serious cases would be so skewed towards men.
https://covid19.nj.gov/locations?qu...s,resources,status,NJfaqs,AASfaqs,coronavirus
It's not open every day. The link tells the days they are open.
update on remdesivir. still expecting the bigger test phase 3 results at the end of this month.
https://www.fool.com/investing/2020/04/14/how-good-is-gileads-latest-news-for-coronavirus-dr.aspx
and not sure if this is a bad news yet
https://www.newsweek.com/coronavirus-mutation-study-covid-19-1497745
https://www.fool.com/investing/2020/04/14/how-good-is-gileads-latest-news-for-coronavirus-dr.aspx
and not sure if this is a bad news yet
https://www.newsweek.com/coronavirus-mutation-study-covid-19-1497745
State health commissioner says NJ cases will peak on April 25 as per NJ.com article today https://www.nj.com/coronavirus/2020...alizations-expected-health-officials-say.html
I know I brought this up before but this chart had us peaking last week. That's a 2 week difference in projections. So should we disregard this chart?https://covid19.healthdata.org/united-states-of-america/new-jersey
I know I brought this up before but this chart had us peaking last week. That's a 2 week difference in projections. So should we disregard this chart?https://covid19.healthdata.org/united-states-of-america/new-jersey
To me, that model has been fraught with so many errors that rendered it magnitudes off of reality, I put about zero stock in it at this point. Frankly, I'm not sure how anyone could rely on it even a little.
Part of the reason may be that they are just trying to do too much. I'm sure they meant well, but comparing their data to news reports from authority figures, even that model's past data isn't accurate.
As the incident commander I have to do that too. And it can involve greater consequences and less than a glimmer of data. Some decisions have to be made on the spot and in split seconds.
God bless them and good luck.
April 14, then April 25, then becomes May 12 and so on.
Many people gathered for Easter I'm hearing, people in NJ are making this much worse because they rebel against authority
Or, are the models simply wrong?
Unfortunately, more data are coming in on HCQ not showing any clinical efficacy. First link is to a new French study (not peer reviewed yet, but discussed in the 2nd link, too), entitled, : "No evidence of clinical efficacy of hydroxychloroquine in patients hospitalised for COVID-19 infection and requiring oxygen: results of a study using routinely collected data to emulate a target trial." We still need to see the results of carefully controlled, randomized, double-blind clinical studies to truly determine clinical efficacy and safety, but so far, it's not looking great.
https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v1.full.pdf
Second link is to Oxford's Centre for Evidence Based Medicine (CEBM) group and it analyzes five clinical trials of HCQ/HCQ combos (including the original Raoult study) and has the following verdict:
Current data do not support the use of hydroxychloroquine for prophylaxis or treatment of COVID-19. There are no published trials of prophylaxis. Two trials of hydroxychloroquine treatment that are in the public domain, one non-peer reviewed, are premature analyses of trials whose conduct in both cases diverged from the published skeleton protocols registered on clinical trial sites. Neither they, nor three other negative trials that have since appeared, support the view that hydroxychloroquine is effective in the management of even mild COVID-19 disease.
https://www.cebm.net/covid-19/hydroxychloroquine-for-covid-19-what-do-the-clinical-trials-tell-us/
https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v1.full.pdf
Second link is to Oxford's Centre for Evidence Based Medicine (CEBM) group and it analyzes five clinical trials of HCQ/HCQ combos (including the original Raoult study) and has the following verdict:
Current data do not support the use of hydroxychloroquine for prophylaxis or treatment of COVID-19. There are no published trials of prophylaxis. Two trials of hydroxychloroquine treatment that are in the public domain, one non-peer reviewed, are premature analyses of trials whose conduct in both cases diverged from the published skeleton protocols registered on clinical trial sites. Neither they, nor three other negative trials that have since appeared, support the view that hydroxychloroquine is effective in the management of even mild COVID-19 disease.
https://www.cebm.net/covid-19/hydroxychloroquine-for-covid-19-what-do-the-clinical-trials-tell-us/
I have been following Martenson religiously and also have no idea of its veracity. I have also read that there are at least two different strains of the virus, one that hit the west coast and one that hit the east coast.
There is just so much we don't know that I find it inconceivable that this added to less than 1% being tested would have some folks thinking we are going to all go back out in two weeks.
The genome analysis has revealed that most of the NYC area cases came from Italy whereas most of the west coast cases came from China. So there are definitely differences though I don't think anyone knows whether those differences are significant enough to impact transmission or virulence. On the other hand, the NYC area seems to have been hit harder than the west coast, similar to Italy and much of Europe so maybe there is something there. Or maybe it just has to do with the populations affected (ages, co-morbidities, density, etc).
Agree that we don't really know very much. So many variations in how the virus attacks (including symptoms), no evidence that any of the treatments work. The latter doesn't really surprise me since it's pretty much impossible to treat any of the common viruses. Even stuff like tamiflu doesn't seem to work all that well for influenza. And vaccines are a whole other issue. Opening everything back up at once in 2 weeks would lead to a repeat of the past few weeks.
SIAP, but I might just sign up for this NIH study, since they're looking to do antibody tests on people who haven't had COVID symptoms (presumably looking to see how many still got the virus, but didn't get sick, but now have antibodies). Can even do the test at home, although you might not get results for weeks.
https://www.washingtonian.com/2020/...Krvx9FpE9QbeT7TK-bu-nCjtRxSYxWDvZZPHNp6TU4yl8
https://www.washingtonian.com/2020/...Krvx9FpE9QbeT7TK-bu-nCjtRxSYxWDvZZPHNp6TU4yl8
I heard about that yesterday, and am considering it myself. I wish they gave you some sort of "certificate of immunity" or something if you show antibodies.
Much agreed with you and the article. It is pretty plain and simple like the article says and it helps promote better oxygenation before, during (if intubation needed) and after using a ventilator in these Covid-19 patients.
The parent is the WH Group, a name derived from the initials of "Wanzhou Holdings." It is headquartered in Luohe, Henan, China. That's central China. Not Taiwan.
Edit: the Hong Kong offices are misleading, methinks. WH Group was also incorporated in the Cayman Islands, for what that's worth.
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It is owned by a Hong Kong , Taiwan company... that was on the not fake news yesterday.
Just like Samsung had China plants, US car companies shave China plants, Taiwan companies do as well... which gives China political influence in.. Formosa or whatever it is they call that "province".
Example: check out the Taiwan company FOXCONN
Data are now in, showing HCQ and AZ prescriptions are being written in increasing numbers, based on a survey of 1662 physicians treating COVID-19 patients (out of 5000 surveyed), with HCQ being prescribed now by 44% of physicians treating COVID-19 patients and AZ by 50%. And in Italy, HCQ is being prescribed by 71% of physicians.
While I think there's likely no connection between HCQ/AZ usage being so high (and increasing) and the increasing death rates we've seen in the US and Italy, there will be people who point at these stats and will "blame" these treatments. I think it's far more likely it's simply ineffective but reasonably safe, for most and I'd simply prefer us to stop using these treatments in so many patients with zero clinical proof they're effective. Also, if HCQ/AZ were in any way an actual "cure" there's simply no way we'd still be seeing such high hospitalization and death rates with over half of doctors prescribing it.
What I'd like to see is far more emphasis on trying some other promising drugs and ratcheting up the efforts on using convalescent plasma more, based on the comments from the survey, where over half of the small number of physicians who have prescribed (a few dozen) this treatment (or know about it) gave it a 4 or 5, or “very or extremely effective,” on a scale of 0-5 (it's the most highly rated treatment).
Having said all of the above, this is an opinion survey of physicians and not an actual "study" of any sort, so take it with a decent-sized grain of salt.
Excerpt from first link:
The Week 2 data from Sermo, a global health care polling company, released Wednesday found that 44% of physicians reported treating or having seen coronavirus patients treated with hydroxychloroquine, up from 33% in the Week 1 survey posted April 2.
“The treating physician percentage for Hydroxychloroquine went up across the board globally,” said the survey analysis. “COVID treaters reported having prescribed or seen Hydroxychloroquine prescribed increase by 11% (from 33% to 44%) week over week and Azithromycin increase by 9% (from 41% to 50%).”
In addition, “Italy had the highest increase in having prescribed or seen Hydroxychloroquine prescribed (from 50% to 71%). Reported usage in New York nearly doubled (23% to 40%), week over week.”
The most commonly prescribed treatments were azithromycin (50%), hydroxychloroquine (44%) and bronchodilators (36%).
The study of 5,000 physicians, 1,662 of whom had been involved in COVID-19 cases, found only 5% had used plasma from patients who had recovered from COVID-19, and 11% had seen others use it, but 52% of those gave it a 4 or 5, or “very or extremely effective,” on a scale of 0-5.
“Plasma, however, is reported as one the least utilized treatments, suggesting either a lack of availability, scalability, or awareness,” said the analysis.
https://www.washingtontimes.com/news/2020/apr/8/hydroxychloroquine-usage-for-coronavirus-climbs-wh/
https://www.businesswire.com/news/h...roxychloroquine-Usage-Expands-Globally-Plasma
SIAP, but this is a fascinating and very scary account of living through a serious coronavirus infection, including the dreaded "cytokine storm" of an overreacting immune system in the lungs, by a pulmonologist in NYC. Yeah, this is not just the flu.
https://www.salon.com/2020/04/05/what-it-feels-like-to-survive-covid-19s-dreaded-cytokine-storm/
https://www.salon.com/2020/04/05/what-it-feels-like-to-survive-covid-19s-dreaded-cytokine-storm/
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