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

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Fascinating study by a host of universities and institutions in Massachusetts, looking at the early days of the pandemic in late February/early March and the use of viral phylogeny to trace a host of the early infections, especially via a few superspreader events, including one at the Biogen Worldwide Conference, one at at skilled nursing facility, and a couple at homeless shelters, all in the Boston area. Links to a WaPo article on this and to the source paper (excerpted below) are below.


By discovering that a dual mutation in two amino acids (very minor with no impact on the virus or patients) on the virus was present in one of the earliest superspreaders at the Biogen conference, the research team was then able to show that hundreds and eventually thousands of subsequent infections featured this same mutation.

This was all discovered retrospectively, but the authors make a case that doing this in real time could greatly aid in diagnosing transmissions and clusters and could help stop them much more quickly. And even if genetic sequencing isn't always possible, simply having rapid testing available is essential to reopening schools, workplaces and any kind of pubic events safely.

Conclusions: We present here an analysis of SARS-CoV-2 genomic epidemiology primarily in the Boston area, which was severely affected early in the US COVID-19 epidemic. Through dense sampling of the early phase of the epidemic we show the frequency of importation events—over 80 independent introductions—and the impact of early superspreading events in driving amplification and community transmission, likely accelerating the transition from containment to mitigation strategies. Besides better understanding of outbreak dynamics, viral sequencing and phylogenetic analysis can also provide immediately actionable insights. In the current study, we were able to rule out linked nosocomial spread in two episodes, reassuring hospital management that a failure of infection control practice in these wards had not led to a nosocomial cluster, and showed that despite multiple introductions of SARS-CoV-2 into a SNF, one introduction was responsible for 90% of cases. Real-time genomic epidemiology may be increasingly valuable as schools and workplaces navigate the challenges of reopening, as it can help distinguish between local outbreaks within institutions and introductions from outside.

Our findings repeatedly highlight the close relationships between seemingly disconnected groups and populations: viruses from international business travel seeded major outbreaks among individuals experiencing homelessness, spread throughout the Boston area, and were exported to other domestic and international sites. It also illustrates the role of chance in the trajectory of an epidemic: a single introduction had an outsize effect on subsequent transmission because it was unfortunately amplified by superspreading in a highly mobile population very early in the outbreak, before many precautions were put in place and when its effects would be further amplified by exponential growth. By contrast, other early introductions led to very little onward transmission, and another superspreading event in a SNF, while devastating to the residents, had little large-scale effect because it occurred later and in a more isolated population. This study provides direct evidence that superspreading events may profoundly alter the course of an epidemic and implies that prevention, detection, and mitigation of such events should be a priority for public health efforts.
 

Misleading tweet headline, which is not unusual. The article actually makes some good points and has some misses, IMO. The initial quotes in the article sound like bluster with the later comments sounding more realistic. Here's the first part:

Prof Woolhouse OBE, a member of the Scientific Pandemic Influenza Group on Behaviours that advises the Government, said: “Lockdown was a panic measure and I believe history will say trying to control Covid-19 through lockdown was a monumental mistake on a global scale, the cure was worse than the disease.

“I never want to see national lockdown again. It was always a temporary measure that simply delayed the stage of the epidemic we see now. It was never going to change anything fundamentally, however low we drove down the number of cases, and now we know more about the virus and how to track it we should not be in this position again.


And here's what is said later:

He said: “At the time I agreed with lockdown as a short term emergency response because we couldn’t think of anything better to do, but it was always clear that the moment we started to relax enough measures we were likely to see infection rates rise again either nationally or locally. “My hope was that we would have learnt how to handle the virus better so lockdown would no longer be necessary.

“But we haven’t made much progress in finding a viable alternative to lockdown. My concern is that far too many people involved in managing this pandemic have in mind that it will somehow burn itself out. I don’t expect it to. “I would not dignify waiting for a vaccine with the term ‘strategy’. That’s a hope not a strategy. But we do need to get on with providing an alternative to lockdown.”


Clearly, Woolhouse realized that the lockdowns that were used were understandable at the time, which does not come through in a tweet (part of why I hate Twitter). I think everyone would agree that massive lockdowns are not how we want to respond to a pandemic. They're horrible, but without doing the appropriate investments in testing, PPE. tracing/isolating, we and many other countries (it was not just the US) were woefully unprepared for the pandemic and when infections spiraled out of control in March, lockdowns were about the only tool left to use and they did work to greatly reduce transmissions, but at a steep price.

However, as I've detailed painstakingly (and reiterated last night), there were some countries who were far more proactive and prepared and were able to contain the outbreaks in their countries before they got out of hand, without resorting to draconian lockdowns at all (South Korea, Taiwan, Vietnam, etc.), while some used targeted or even complete lockdowns (along with testing/tracing/isolating and masking/distancing) to keep transmissions/deaths way down vs. the US/others (New Zealand, Australia, Denmark, Norway, China, Finland, etc.).

And as I said last night about several of these countries, if they can continue doing well (even despite recent spikes) for a few more months, until there's a vaccine, they'll likely have been able to keep deaths and serious illnesses per capita to about 1/20th to 1/100th of what the US's will eventually be, so actually, counter to what Woolhouse said, that's not a bad strategy. I will always believe that we could have been one of those "successful" countries, given our wealth and scientific expertise, but sadly we did not choose to follow our own pandemic playbook (which others did, successfully). And I still believe we can do worlds better than we're doing now.
 
I was "reaching" about the Hopkins site change as much as I am "reaching" regarding the behavior of the apple news app that came with my iphone. Surprisingly, when Biden was officially nominated last week... there was a pop up alert from the Apple News App to tell me about that "breaking" news. (Was this nomination ever in doubt since May?) There have been maybe 2-3 other events that have been newsworthy enough over the last 5 months that resulted in this pop up alert. Meanwhile Trump was officially nominated earlier this afternoon. No alert...... what a shocker !! I guess there was no nefarious political motivation from Apple in that decision either.

Get help.
 
Misleading tweet headline, which is not unusual. The article actually makes some good points and has some misses, IMO. The initial quotes in the article sound like bluster with the later comments sounding more realistic. Here's the first part:

Prof Woolhouse OBE, a member of the Scientific Pandemic Influenza Group on Behaviours that advises the Government, said: “Lockdown was a panic measure and I believe history will say trying to control Covid-19 through lockdown was a monumental mistake on a global scale, the cure was worse than the disease.

“I never want to see national lockdown again. It was always a temporary measure that simply delayed the stage of the epidemic we see now. It was never going to change anything fundamentally, however low we drove down the number of cases, and now we know more about the virus and how to track it we should not be in this position again.


And here's what is said later:

He said: “At the time I agreed with lockdown as a short term emergency response because we couldn’t think of anything better to do, but it was always clear that the moment we started to relax enough measures we were likely to see infection rates rise again either nationally or locally. “My hope was that we would have learnt how to handle the virus better so lockdown would no longer be necessary.

“But we haven’t made much progress in finding a viable alternative to lockdown. My concern is that far too many people involved in managing this pandemic have in mind that it will somehow burn itself out. I don’t expect it to. “I would not dignify waiting for a vaccine with the term ‘strategy’. That’s a hope not a strategy. But we do need to get on with providing an alternative to lockdown.”


Clearly, Woolhouse realized that the lockdowns that were used were understandable at the time, which does not come through in a tweet (part of why I hate Twitter). I think everyone would agree that massive lockdowns are not how we want to respond to a pandemic. They're horrible, but without doing the appropriate investments in testing, PPE. tracing/isolating, we and many other countries (it was not just the US) were woefully unprepared for the pandemic and when infections spiraled out of control in March, lockdowns were about the only tool left to use and they did work to greatly reduce transmissions, but at a steep price.

However, as I've detailed painstakingly (and reiterated last night), there were some countries who were far more proactive and prepared and were able to contain the outbreaks in their countries before they got out of hand, without resorting to draconian lockdowns at all (South Korea, Taiwan, Vietnam, etc.), while some used targeted or even complete lockdowns (along with testing/tracing/isolating and masking/distancing) to keep transmissions/deaths way down vs. the US/others (New Zealand, Australia, Denmark, Norway, China, Finland, etc.).

And as I said last night about several of these countries, if they can continue doing well (even despite recent spikes) for a few more months, until there's a vaccine, they'll likely have been able to keep deaths and serious illnesses per capita to about 1/20th to 1/100th of what the US's will eventually be, so actually, counter to what Woolhouse said, that's not a bad strategy. I will always believe that we could have been one of those "successful" countries, given our wealth and scientific expertise, but sadly we did not choose to follow our own pandemic playbook (which others did, successfully). And I still believe we can do worlds better than we're doing now.
A fair and balanced post, until the silly So Korea, Taiwan and Vietnam comparisons again....🙄
 
The CDC changed the site on Monday. Here's what it says now: "If you have been in close contact (within 6 feet) of a person with a COVID-19 infection for at least 15 minutes but do not have symptoms, you do not necessarily need a test unless you are a vulnerable individual or your health care provider or State or local public health officials recommend you take one."

 
The CDC changed the site on Monday. Here's what it says now: "If you have been in close contact (within 6 feet) of a person with a COVID-19 infection for at least 15 minutes but do not have symptoms, you do not necessarily need a test unless you are a vulnerable individual or your health care provider or State or local public health officials recommend you take one."


I don’t get why the CDC would suggest testing is not necessary in that situation. Why wouldn’t you get tested to be in the safe side?
 
HCQ more success.

Large scale observational study shows a 30% decrease in mortality in 3,451 hospitalized patients-late treatment, not early use.


Retrospective study of 8,075 hospitalized patients shows a 35% reduction in mortality



But, but, but . . . . . .
 
HCQ more success.

Large scale observational study shows a 30% decrease in mortality in 3,451 hospitalized patients-late treatment, not early use.


Retrospective study of 8,075 hospitalized patients shows a 35% reduction in mortality



But, but, but . . . . . .

Oh you just opened a can of hornets
 
Really strange times at the FDA . First , they allow Remdesiver to change its trial endpoint of mortality , because it didn’t have any benefit , to reduced hospitalization from 15 days to 11 days , not an incredible benefit , but they allow that to be used as the standard for care months ago . Now Convalensce Plasma , which has some promising hope to treat Covid , but has not completed any randomized double blinded trials, NIH and Fauci chime in and Hahn do not allow it until trials are done. Then 3 days later , Trump and his team , get Hahn to switch course, and they give EUA, and then Hahn totally misstates the efficacy in the Mayo Clinic trial and retracts the next day since it didn’t have a 35% mortality reduction but only 3%. Plus the other patients were receiving dexamethazone so not sure if that helped the severe to critical or CP. Now they have allowed 2 drugs to have EUA on questionable efficacy.
Then we have Cytodyn , this little US company that is the only company that has finished a double blinded randomized placebo vs. Leronlimab 1:2 study of mild to moderate patients , and besides safety which is off the charts good , like better than water, shows efficacy in its NEws score , which will prevent mild/ moderate patients from becoming more sick (50% to 20% with a p value of 0.02, significant ). Although it did not have significance at Day 14 in the symptom score , the primary endpoint , because almost all mild to moderate get better at Day 14, it had clinical significance at Day 3 in symptoms score (90% to 71% placebo). This is a Phase 2 trial so primary or secondary endpoints that show efficacy are important for approval. The FDA has had the data for 10 days. Lots of people following Leronlimab thought when Sunday’s press conference spoke about” major breakthrough “, he was going to announce Leronlimab., because plasma is not a major breakthrough and has been around a long time and exactly how effective it is is unknown but early reports are promising. There is no other drug before the FDA now that deserves an EUA than Leronlimab especially with the low bar set for CP and Remdesiver , which I hear from many doctors is not doing much . News should come soon but really do not know what the FDA is waiting for since we are in a pandemic and cases were really spiking a week ago. If you can get people out of a hospital quicker by giving them this subcutaneous injection or better yet keep them out of a hospital and let them get the injection at the doctor’s office that would be incredibly cost effective on our system.

Leronlimab is also in the midst of a severe/ critical Covid trial that in earlier in the month the Data Safety Monitoring Board took a safety look at 149 patients( enrollment target 390 and 195 or 50% needed for interim look) and determined Leronlimab was safe and the trial did not need modifying and the trial should continue . The efficacy interim look could not occur until 195 were enrolled and then 28 days for the primary endpoint, mortality . Yesterday , the 195 patient enrolled. There are 12 Us sites and the U.K. has agreed to enroll in the trial as well so enrollment should pick up more quickly. Besides The FDA , the mild to moderate trial results have been sent to the U.K., the EU, the Philippines and Mexico and Israel seeking EUA . The severe / critical results will not be unblinded until the end of September and results in the second week of October. The FDA might wait until the severe trial but the more prudent approach considering what they have done so far, is to give EUA for the mild/ moderate use now , and full approval , if warranted when October rolls around . The FDA can even do both, make Cytodyn do a Phase 3 for the mild to moderate and allow EUA at the same time. It is an unnecessary waiting game now, and the FDA will be feeling the heat over It’s bungling of CP , and is probably being extra careful but they have real proof. Hopefully their loaded Gilead and Big Pharma board is not holding back its decision .
 
Both Pfizer and Moderna released more data recently showing their vaccines trigger a good response out of older people as well. Just has to actually work now, really hope Phase 3 goes well for these two.


Neutralizing antibodies were produced, which scientists believe will be required to develop immunity to the virus. They also produced killer T-cells. The antibodies produced were higher than what was observed in convalescent patients—often significantly higher. As mentioned above, the geometric mean titer (GMT) was 109 in the convalescent sera, whereas it was 267 in the 18-55-year-olds, 235 for the 56-70-year-olds, and 242 for the 70+ group.”
 
HCQ more success.

Large scale observational study shows a 30% decrease in mortality in 3,451 hospitalized patients-late treatment, not early use.


Retrospective study of 8,075 hospitalized patients shows a 35% reduction in mortality



But, but, but . . . . . .
Yes, but 2 randomized, controlled trials in hospitalized patients showed no benefit from HCQ or HCQ/Az. RCT >>>> observational (and many observational studies showed no benefit either).
 
HCQ more success.

Large scale observational study shows a 30% decrease in mortality in 3,451 hospitalized patients-late treatment, not early use.


Retrospective study of 8,075 hospitalized patients shows a 35% reduction in mortality



But, but, but . . . . . .
Release the #neverHCQ Hounds!
release_the_hounds.gif


giphy.gif
 
Yes, but 2 randomized, controlled trials in hospitalized patients showed no benefit from HCQ or HCQ/Az. RCT >>>> observational (and many observational studies showed no benefit either).
Can you refresh my memory on those 2 RCTs in hospitalized patients (summarized in layman's terms)? Thanks
 
Fascinating study by a host of universities and institutions in Massachusetts, looking at the early days of the pandemic in late February/early March and the use of viral phylogeny to trace a host of the early infections, especially via a few superspreader events, including one at the Biogen Worldwide Conference, one at at skilled nursing facility, and a couple at homeless shelters, all in the Boston area. Links to a WaPo article on this and to the source paper (excerpted below) are below.


By discovering that a dual mutation in two amino acids (very minor with no impact on the virus or patients) on the virus was present in one of the earliest superspreaders at the Biogen conference, the research team was then able to show that hundreds and eventually thousands of subsequent infections featured this same mutation.

This was all discovered retrospectively, but the authors make a case that doing this in real time could greatly aid in diagnosing transmissions and clusters and could help stop them much more quickly. And even if genetic sequencing isn't always possible, simply having rapid testing available is essential to reopening schools, workplaces and any kind of pubic events safely.

Conclusions: We present here an analysis of SARS-CoV-2 genomic epidemiology primarily in the Boston area, which was severely affected early in the US COVID-19 epidemic. Through dense sampling of the early phase of the epidemic we show the frequency of importation events—over 80 independent introductions—and the impact of early superspreading events in driving amplification and community transmission, likely accelerating the transition from containment to mitigation strategies. Besides better understanding of outbreak dynamics, viral sequencing and phylogenetic analysis can also provide immediately actionable insights. In the current study, we were able to rule out linked nosocomial spread in two episodes, reassuring hospital management that a failure of infection control practice in these wards had not led to a nosocomial cluster, and showed that despite multiple introductions of SARS-CoV-2 into a SNF, one introduction was responsible for 90% of cases. Real-time genomic epidemiology may be increasingly valuable as schools and workplaces navigate the challenges of reopening, as it can help distinguish between local outbreaks within institutions and introductions from outside.

Our findings repeatedly highlight the close relationships between seemingly disconnected groups and populations: viruses from international business travel seeded major outbreaks among individuals experiencing homelessness, spread throughout the Boston area, and were exported to other domestic and international sites. It also illustrates the role of chance in the trajectory of an epidemic: a single introduction had an outsize effect on subsequent transmission because it was unfortunately amplified by superspreading in a highly mobile population very early in the outbreak, before many precautions were put in place and when its effects would be further amplified by exponential growth. By contrast, other early introductions led to very little onward transmission, and another superspreading event in a SNF, while devastating to the residents, had little large-scale effect because it occurred later and in a more isolated population. This study provides direct evidence that superspreading events may profoundly alter the course of an epidemic and implies that prevention, detection, and mitigation of such events should be a priority for public health efforts.
Didn't New Jersey's first recorded COVID-19 patient attend that conference?
 
Release the #neverHCQ Hounds!
release_the_hounds.gif


giphy.gif

There was early anecdotal evidence that HCQ was effective. Trump, always one to sell good news, latched on to it. When evidence contradicted the early anecdotal evidence, he refused to be wrong.

If he had never mentioned it, and btw he has no qualifications whatsoever to justify a position other than “I’ve heard good things” (nor do I), would we even be talking about it?

I can say why I’m anti-HCQ, multiple clinical trials didn’t find a benefit*. To work myself into the other position I have to: (1) put greater belief in anecdotal evidence; (2) believe in some kind of conspiracy?

Why is anyone going through those gymnastics to support a position taken by someone who has no qualifications to opine on the topic in the first place?

*edit: in some cases, didn’t find a benefit that outweighed the risks
 
There was early anecdotal evidence that HCQ was effective. Trump, always one to sell good news, latched on to it. When evidence contradicted the early anecdotal evidence, he refused to be wrong.

If he had never mentioned it, and btw he has no qualifications whatsoever to justify a position other than “I’ve heard good things” (nor do I), would we even be talking about it?

I can say why I’m anti-HCQ, multiple clinical trials didn’t find a benefit. To work myself into the other position I have to: (1) put greater belief in anecdotal evidence; (2) believe in some kind of conspiracy?

Why is anyone going through those gymnastics to support a position taken by someone who has no qualifications to opine on the topic in the first place?
There does seem to be a strange emotional attachment to HCQ around here.
 
NC State just postponed their FB game at Virginia Tech (Blacksburg) from September 12 to September 26 due to a C19 outbreak in the Raleigh program. 27 athletes tested positive.
 
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Does it? Brazil ain’t looking so hot these days.
The amazing thing to me is that we're 6+ months into the pandemic, over 24 million cases (and almost 1 million deaths) around the world, and still no one has done the proper controlled study to determine how effective HCQ and the various combinations might be. All we're left with are anecdotes.
 
Some not so great info on the long term effects from Covid. I found the SARS comment a little worrisome....didn’t know that.


“The new coronavirus, which has previously been detected in some heart tissues, can also invade heart muscle cells, or myocytes, researchers have found. In Brazil, doctors found the virus in cardiac myocytes of an 11-year-old with multisystem inflammatory syndrome related to COVID-19 who died of heart failure, according to a report in The Lancet Child & Adolescent Health. In Italy, six adults who died of COVID-19 respiratory failure had active coronavirus in cardiac myocytes, with varying degrees of myocyte injury and cell death, doctors reported on Wednesday on medRxiv ahead of peer review. None of the Italian patients had cardiac symptoms or a history of heart disease. The Italian doctors point out that 40% of patients who recovered from the genetically related SARS virus outbreak in 2002-2003 later developed cardiovascular abnormalities. The new findings, they say, suggest that recovered COVID-19 patients should be monitored for heart problems even when they do not appear to be at risk, "since the cardiovascular long-term outcome of COVID-19 patients may mirror SARS patients.”
 
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Yes, but 2 randomized, controlled trials in hospitalized patients showed no benefit from HCQ or HCQ/Az. RCT >>>> observational (and many observational studies showed no benefit either).

Sounds like selective approval of "science."


"Indeed, some version of the statement, “only randomized control trials are useful” has become boilerplate during the COVID-19 crisis. It is uttered as though it is self-evidently the mainstream medical position. When other kinds of studies come out, we are told they are “flawed,” or “fatally flawed,” if not RCTs (especially if the commentator doesn’t like the result; if they like the result, not so often). The implication is that the RCT is the sole reliable methodological machine that can uncover truths in medicine, or expose untruths. But if this is so self-evident, why then, do major medical journals continue to publish other study designs, and often praise them as good studies, and why do medical schools teach other methods?

They do because, as extraordinary an invention as the RCT is, RCTs are not superior in all situations, and are inferior in many. The assertion that “only the RCTs matter” is not the mainstream position in practice, and if it ever was, it is fading fast, because, increasingly, the limits of RCTs are being more clearly understood. Here is Thomas R. Frieden, M.D., former head of the CDC, writing in the New England Journal of Medicine, in 2017, in an article on the kind of thinking about evidence that normally goes into public health policy now:
Although randomized, controlled trials (RCTs) have long been presumed to be the ideal source for data on the effects of treatment, other methods of obtaining evidence for decisive action are receiving increased interest, prompting new approaches to leverage the strengths and overcome the limitations of different data sources. In this article, I describe the use of RCTs and alternative (and sometimes superior) data sources from the vantage point of public health, illustrate key limitations of RCTs, and suggest ways to improve the use of multiple data sources for health decision making. … Despite their strengths, RCTs have substantial limitations."

But, but, but, but he is not an epidemiologist or he does not have impressive credentials. . . . . .
 
The amazing thing to me is that we're 6+ months into the pandemic, over 24 million cases (and almost 1 million deaths) around the world, and still no one has done the proper controlled study to determine how effective HCQ and the various combinations might be. All we're left with are anecdotes.
You can't be serious. So far all 5 RCTs have shown no benefit from HCQ in a broad range of sick patients and as a prophylactic. And the observational trials are all over the map, which is what happens for a drug with no medical benefit, due to the inconsistencies and inaccuracies of such trials.

 
Sounds like selective approval of "science."


"Indeed, some version of the statement, “only randomized control trials are useful” has become boilerplate during the COVID-19 crisis. It is uttered as though it is self-evidently the mainstream medical position. When other kinds of studies come out, we are told they are “flawed,” or “fatally flawed,” if not RCTs (especially if the commentator doesn’t like the result; if they like the result, not so often). The implication is that the RCT is the sole reliable methodological machine that can uncover truths in medicine, or expose untruths. But if this is so self-evident, why then, do major medical journals continue to publish other study designs, and often praise them as good studies, and why do medical schools teach other methods?

They do because, as extraordinary an invention as the RCT is, RCTs are not superior in all situations, and are inferior in many. The assertion that “only the RCTs matter” is not the mainstream position in practice, and if it ever was, it is fading fast, because, increasingly, the limits of RCTs are being more clearly understood. Here is Thomas R. Frieden, M.D., former head of the CDC, writing in the New England Journal of Medicine, in 2017, in an article on the kind of thinking about evidence that normally goes into public health policy now:


But, but, but, but he is not an epidemiologist or he does not have impressive credentials. . . . . .
The linked article is fantastic:
"The idea that “only RCTs can decide,” is still the defining attitude, though, of what I shall describe as the RCT fundamentalist. By fundamentalist I here mean someone evincing an unwavering attachment to a set of beliefs and a kind of literal mindedness that lacks nuance—and that, in this case, sees the RCT as the sole source of objective truth in medicine (as fundamentalists often see their own core belief). Like many a fundamentalist, this often involves posing as a purveyor of the authoritative position, but in fact their position may not be. As well, the core belief is repeated, like a catechism, at times ad nauseum, and contrasting beliefs are treated like heresies. What the RCT fundamentalist is peddling is not a scientific attitude, but rather forcing a tool, the RCT, which was designed for a particular kind of problem to become the only tool we use. In this case, RCT is best understood as standing not for Randomized Control Trials, but rather “Rigidly Constrained Thinking” (a phrase coined by the statistician David Streiner in the 1990s)."
 
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admit it, no matter what Trump says or does people will blast him for it. He doesn't mention any hopeful signs like HCQ then he is all doom and gloom.. he does and he is pushing unproven drugs

I’m going to keep it to this issue so we don’t end up wandering left field.

If he said “we’re hopeful this proves to be a game-changer, we’re following it closely“ in the beginning, and then: “the studies aren’t going the way we hoped, but there are other drugs out there we’re hopeful about, and we’ll keep watching the results. In the meantime, prevention is still our best weapon against the disease.”

Who would complain? How do you make that partisan? And that’s what any normal person would do; he puts all of his eggs in one basket, and then claims conspiracy and plays partisan politics when things out of his control don’t turn out as hoped. It’s ridiculous.

Now we’re still debating it, and tossing around links showing new studies that suggest maybe it reduces mortality 30% — when we’ve already moved on to a drug that reduces it by 60%.

We have loyalty to pharmaceutical molecules in this country right now — that’s absurd.
 
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