Coronavirus

[Cigarbutt]

I checked my result from Monday's testing:  again, 'negative'.  I give up.  What do I need next, an antibody test?

Given the description of the symptoms and 'epidemiological' circumstances, the two negative results are not enough to completely rule out CV.

So, the idea is to behave as if the virus disease is present. Behaviors (altered or not) depend on various beliefs but information coming out of imperfect collective organizations whose recommendations are based at least on some level of trust and peer-reviewed processes suggests that at least self-quarantine versus others that are presumed to not have the disease is the minimal way to go. Further testing may not be helpful unless there is a specific reason. The above assumes a gradual process to recovery.

 

If there is a specific reason to know or simply want to know, the way to go is to obtain another test in another testing area in order to control for collection technique, different lab, different test (antigen vs PCR) with a slightly different sensitivity/specificity (false negative, false positive) profile in general and evolving according to stage of clinical presentation. Another possibility is to wait for at least 2 to 3 weeks and get an antibody test.

[Cigarbutt]

Senate hearing testimony by Dr. George Fareed, a Harvard MD with honors and more profile given below:

https://www.hsgac.senate.gov/imo/media/doc/Testimony-Fareed-2020-11-19.pdf

Since early March both in my Brawley clinic and Dr. Brian Tyson’s The All Valley Urgent Care Clinic in El Centro (where I also work), over 25,000 fearful people were screened, over two thousand four hundred were COVID-19 positive and we treated successfully many hundreds of the high risk and symptomatic ones.

And this doctor has excellent credentials:

http://www.ivcommunityfoundation.org/media/managed/npd2019/NPD_2019_Program.pdf

PHILANTHROPIST OF THE YEAR Dr. George Fareed

Dr.  George  Fareed  graduated  with  honors  from  Harvard  Medical  School  in 1970  and  has  been  practicing  medicine  for  49  years.  He  spent  the  first  20 years after graduation researching and teaching at Harvard and UCLA. He was Assistant  Professor at  HMS  from  1973-1976.  He  was  Associate  Professor  at UCLA  from  1976-1996.  He  received  the  Soma  Weiss  Award  for  his  DNA                research.  He  founded  International  Genetic  Engineering,  Inc. in 1980 and Advanced Antigens, Inc. in 1991, the same year he opened his medical practice in  Brawley,  CA.  And,  he  was  the  US  Davis  Cup  tennis  team  physician  for  20 years and worked at 38 team matches and the US Olympics in Sydney in 2000.  In  the  memorable  1995  Davis  Cup  final  against  Russia  in  Moscow,  he  helped Pete Sampras bounce back from grueling leg cramps. He has been recognized for his many accomplishments including the 2004..........

........

You can read his full profile in the link...but my point is:

Whenever I went to doctor for my family one question I always had was how many they treated and what was the result and the doctors credentials.  If a doctor tells me they treated hundreds of patients and all of them are doing well, that usually works for me to take that treatment.

Why should not be taken seriously for Covid and ignore these doctors?

Short answer: The person may be right.

Longer answer: This opinion shows the challenge when there are 'competing' schools of thought. When this issue becomes driven by 'us vs them', constructive discussions become difficult and often deviate from basic data, reasoning, weight of evidence etc. The opinion also shows the challenge related to balancing personal and collective responsibility.

 

For various reasons, i've been involved in self-regulatory ventures which included to limit or terminate certain activities or even careers. A basic principle involved to respect alternative ways to think but the burden of proof should lie on the person voicing unusual or contrary opinions. So far, the evidence for the use of hydroxychloroquine at any stage of CV remains unconvincing and a lot of what the emerging school of thought is doing is to focus on the container, not the content. When assessing specific cases, the following type of comment sometimes appeared: [the] "doctor tells me they treated hundreds of patients and all of them are doing well". This was typically a massive red flag.

[ERICOPOLY]

I checked my result from Monday's testing:  again, 'negative'.  I give up.  What do I need next, an antibody test?

Given the description of the symptoms and 'epidemiological' circumstances, the two negative results are not enough to completely rule out CV.

So, the idea is to behave as if the virus disease is present. Behaviors (altered or not) depend on various beliefs but information coming out of imperfect collective organizations whose recommendations are based at least on some level of trust and peer-reviewed processes suggests that at least self-quarantine versus others that are presumed to not have the disease is the minimal way to go. Further testing may not be helpful unless there is a specific reason. The above assumes a gradual process to recovery.

 

If there is a specific reason to know or simply want to know, the way to go is to obtain another test in another testing area in order to control for collection technique, different lab, different test (antigen vs PCR) with a slightly different sensitivity/specificity (false negative, false positive) profile in general and evolving according to stage of clinical presentation. Another possibility is to wait for at least 2 to 3 weeks and get an antibody test.

 

The sample from Monday's test, 4 days ago, was done at my primary care doctor's parking lot in Folsom by a gowned nurse who came out to my car's window to swab me (but only 1 nostril).  That swab was sent to the lab at Quest Diagnostics and my online Quest account is where I viewed the result last night.  The type of test was "SARS CoV 2 RNA(COVID 19), QUALITATIVE NAAT".  Another online resource says that test "includes RT-PCR or TMA".

 

Off hand, I don't know which lab or which type of test it was from the testing done last Thursday (now 8 days ago) when we both were tested by the same PA at Med-7 in Roseville. Both nostrils were swabbed and my wife's came back positive.  I don't have online access to the test -- they notified me of the result by phone.  It is not showing up in my Quest Diagnostics account, so I assume they didn't process it at a Quest lab.

[ERICOPOLY]

It sounds like most of you haven't had covid-19 yet in your household.  Just in case, I recommend adding a fingertip pulse oximeter and a blood pressure monitor to your first aid supplies.  Do you really want to be in a situation at home with covid and not knowing what your readings are? 

 

For a period of time yesterday evening I started feeling weak like I was experiencing blood loss and my saturation dropped to 94.  Then the weakness subsided and went back up to 97.  If anything, it gives you something interesting to monitor while you pass the time.

[Liberty]

It sounds like most of you haven't had covid-19 yet in your household.  Just in case, I recommend adding a fingertip pulse oximeter and a blood pressure monitor to your first aid supplies.  Do you really want to be in a situation at home with covid and not knowing what your readings are? 

 

For a period of time yesterday evening I started feeling weak like I was experiencing blood loss and my saturation dropped to 94.  Then the weakness subsided and went back up to 97.  If anything, it gives you something interesting to monitor while you pass the time.

 

Seconded on the pulse oximeter. very cheap. I got one in March and thankfully haven't had to use it much, but you never know...

[Cigarbutt]

The sample from Monday's test, 4 days ago, was done at my primary care doctor's parking lot in Folsom by a gowned nurse who came out to my car's window to swab me (but only 1 nostril).  That swab was sent to the lab at Quest Diagnostics and my online Quest account is where I viewed the result last night.  The type of test was "SARS CoV 2 RNA(COVID 19), QUALITATIVE NAAT".  Another online resource says that test "includes RT-PCR or TMA".

Off hand, I don't know which lab or which type of test it was from the testing done last Thursday (now 8 days ago) when we both were tested by the same PA at Med-7 in Roseville. Both nostrils were swabbed and my wife's came back positive.  I don't have online access to the test -- they notified me of the result by phone.  It is not showing up in my Quest Diagnostics account, so I assume they didn't process it at a Quest lab.

Practical follow-up

Going for an additional test may increase the odds of a negative disease state, if negative but certainty is hard to achieve here. And then, if the test is positive, there's always the possibility that it's a false positive. Also, being free of disease today does not mean free of disease tomorrow. :)

Statistical follow-up (just in case somebody is interested)

Just like in any decision making process (health-related, investment etc), what you want are sensitive and specific 'tests' that help you keep or reject hypotheses (or investment targets).

 

                                        Disease

                                Y                      N

                      Y        a                        b

Test result

                      N        c                        d

 

Where false negatives come is from the sensitivity aspect (a/a+c). Specificity is (d/d+b). That's the disease perspective. Another instructing aspect is the predictive value (test) perspective. Positive predictive value = a/a+b. Negative predictive value = d/d+c.

So for a disease (or an investment) you want high sensitivity and high specificity tests for screening and high positive and negative predictive value on results to help delineate where the value is within the selected group.

This may seem dry and irrelevant but it's quite useful (people do it all the time without realizing it) when, for instance, you meet people for the first time. You may ask them if they like sports to screen and then calibrate by asking if they enjoy rugby.

By repeating the exact same test, you increase the odds for more precision but repeating the exact same test carries the same statistical limitations.

----

On the home oximetry.

i've been following an interesting company that offers home services for people affected by chronic lung conditions. i think it is becoming increasingly overvalued (i may be wrong) and think that they wrongly focus on the equipment rather than the services side at this point although this may be related to how insurers deal with 'product' under present conditions. Anyways, they have the potential to provide, in real time, online monitoring of different parameters including oximetry in order to timely intervene and likely reduce complications, hospitalizations etc

It's still unclear if the introduction of home oximetry would be cost effective on a large scale (for Covid-19 or otherwise) but, from an individual point of view, it's a reasonable option. There are smart watch options which are becoming interesting. Also, there are places where the idea is being tested.

https://www.bmj.com/content/371/bmj.m4151

One characteristic of Covid (not unique but quite representative) has been the combination of a relatively comfortable person with unusually low oxygen saturation levels at the initial measure. These people were often clinical ticking bombs with very real and rapid deterioration shortly thereafter so the idea to detect a significant and relatively asymptomatic aspect is an interesting feature. The oxygen saturation to oxygen concentration (pressure) curve is interesting and offers valuable lessons for other disciplines.

 

 

A very interesting feature happens when saturation reaches around and below 90%. This is related to a long evolutionary process meant to facilitate efficient oxygen unloading in peripheral tissues but has the side effect that the slope change around 90% can have sudden and disastrous consequences when it becomes systemic in the main circulation.

i've seen this this play out many times (ages ago it seems) when making money around securities entering or leaving financial distress as the cost of capital has historically been quite volatile during these transitions. Of course, i've become increasingly confused as the changing slope concept has existed for centuries and has recently become irrelevant with firms entering financial distress no longer submitted to this natural law. In fact, in parallel to the Covid spread in 2020, firms entering financial distress often had access to lower cost of capital options!? i continue to wonder if historical easy money conditions have anything to do with this. It seems it's the same concept that Mr. Minsky used to elaborate his unstable stability concept.

 

Anyways, home oximetry seems like a good and reliable idea if you're into self-monitoring. It is probably a better tool than home blood pressure monitoring. Home blood pressure devices are known to be quite imprecise. If you take it under standardized circumstances (ie once a day before breakfast), it may offer a reliable documentation of the underlying efficacy of non-pharma or pharma changes that are introduced. With blood pressure, there's the white coat syndrome aspect which basically means that your blood pressure may rise simply because you have reasons to believe that it should be, or needs to be, measured.

[ERICOPOLY]

With blood pressure, there's the white coat syndrome aspect which basically means that your blood pressure may rise simply because you have reasons to believe that it should be, or needs to be, measured.

 

My wife gets anxiety in a clinical setting and her self-administered-at-home blood pressure reading is far lower than what the nurse or doctor will see.

 

I took her into the Mercy Hospital ER a couple of days ago when her blood pressure dropped to 84/57 with a pulse of 91.  The triage nurse then took her blood pressure and it was way back up again.  This happens to my wife a lot, but she's never had a reading THIS low.  What the hospital should have done, but didn't, is lay her down on a bed in a quiet room alone with a machine periodically measuring her pressure every 5 minutes. 

 

Her primary care doctor has measured her low blood pressure using that method, and tells her to eat pickles and put salt on her food to manage it.  If not, she gets dizzy.

 

 

[Spekulatius]

With blood pressure, there's the white coat syndrome aspect which basically means that your blood pressure may rise simply because you have reasons to believe that it should be, or needs to be, measured.

 

My wife gets anxiety in a clinical setting and her self-administered-at-home blood pressure reading is far lower than what the nurse or doctor will see.

 

I took her into the Mercy Hospital ER a couple of days ago when her blood pressure dropped to 84/57 with a pulse of 91.  The triage nurse then took her blood pressure and it was way back up again.  This happens to my wife a lot, but she's never had a reading THIS low.  What the hospital should have done, but didn't, is lay her down on a bed in a quiet room alone with a machine periodically measuring her pressure every 5 minutes. 

 

Her primary care doctor has measured her low blood pressure using that method, and tells her to eat pickles and put salt on her food to manage it.  If not, she gets dizzy.

 

My mom get‘s crazy high blood pressure readings when she goes to her doctor for checkups. Then when she his home, it’s back to normal. She has some problems with heart arrhythmia lately, but her doc thinks the high readings SRE due to anxiety - I guess it’s the white cost Syndrome that cigarbutt  mentioned.

 

As for false negative COVID-19 tests that’s a problem at hospitals my wife works. Every patient get‘s tested but some test negative even though it looks like they have COVID-19- Then they retest the next day and they sometimes test positive. That means that everyone who with them Better gets a test too because they wear different PPE and follow different procedures based the first negative test result. Crazy.

[ERICOPOLY]

The test results from the hospital say that she came in presenting with a cough.  She never told them that, she hasn't coughed a single time during this entire episode.  Do they just make things up in hospitals?

 

Before bringing her to the ER, I called the hospital to ask what the procedure is for checkin.  Do we call from the parking lot, etc...  They told me to just bring her in the front door of the ER and register at the desk.  We do so and just inside the front door we tell a greeter that we both have covid-9 and she says it's okay for both of us to come to the front desk to register.

 

THEN they tell us to sit in the FLU section.  Are you kidding?  Seating my wife with a positive covid-19 test next to the people they think have the flu, and on purpose?

 

Finally, someone on staff tells me that I need to leave because there is a new hospital policy for NO VISITORS for covid patients.  Yet they didn't tell the person at the front door or the phone operator who I spoke to.

 

 

[Gregmal]

If the "pandemic" has taught us anything it is that the bureaucrats dont know what they are doing, ever, and the scientists need to stay in the labs and stick to research; nothing more. Letting these people make decisions and policy has been a disaster. Almost every position they've taken, they've at some point also taken the exact opposite position. Wear masks, dont wear masks. Stay home! Actually most covid transmissions occur at home! Remdesivir works. Oh actually it doesnt. Hospitals putting people on ventilators....oops, ventilators make it worse! The scientists and medical professionals have certainly come out of this thing looking quite poor. And then they wonder why people dont "listen to the science"...

 

My wife had to got to the hospital for a standard procedure a couple weeks ago....they make this whole big to-do about temperature checks and processing everything and make us wait several hours to do basic check in stuff and get her one of the rapid tests. I ended up just asking, "you've spent 2+ hours dicking around and making us wait...what if she tests positive for covid? Do you not take her or something". And I was floored by the response. "Oh no, then we just take extra precautions but proceed as normal"...What!?! LOL Why TF wouldn't you just take these precautions, with everyone who comes in, to begin with? My wife's family, almost all of the women are nurses. And the stories about the hospitals, big ones at that, running around clueless or winging it, making mistakes all over the place, etc....its insane. I've long maintained that the only way I'll ever know if I've had covid is if I end up in the ICU or dead. Because barring being in that type of condition, I'd imagine I'd just suck it up like I would with any other cold or flu...and get on with my life. No need to take chances or incorporate these people into the equation unless absolutely desperate and necessary.

[ERICOPOLY]

Stay home! Actually most covid transmissions occur at home!

 

And it would last two-three weeks and the pandemic would at that point be over.

 

Unless...  Unless...  Unless...

 

Someone leaves the house and spreads it to someone from ANOTHER household!

[Gregmal]

Except that is nearly impossible because you do have real essential workers...and its also unconstitutional. So yes, its an appealing option to an academic, which most science folks are...but to someone with a rational understanding of how the world works and how the US is setup, it should have been an obvious non starter. The problem with the politicians, is they dont care, and even if, like Cuomo, their policies are killing people, or like Newsome and Pelosi, they are total hypocrites, "we're saving lives" is a great campaign slogan.

[ERICOPOLY]

Except that is nearly impossible because you do have real essential workers...and its also unconstitutional. So yes, its an appealing option to an academic, which most science folks are...but to someone with a rational understanding of how the world works and how the US is setup, it should have been an obvious non starter. The problem with the politicians, is they dont care, and even if, like Cuomo, their policies are killing people, or like Newsome and Pelosi, they are total hypocrites, "we're saving lives" is a great campaign slogan.

 

It was Trump's slogan too until, as the Woodward tapes reveal, Kushner & Trump decided they would run a campaign to "reopen" and politicized the whole thing.

[Investor20]

Senate hearing testimony by Dr. George Fareed, a Harvard MD with honors and more profile given below:

https://www.hsgac.senate.gov/imo/media/doc/Testimony-Fareed-2020-11-19.pdf

Since early March both in my Brawley clinic and Dr. Brian Tyson’s The All Valley Urgent Care Clinic in El Centro (where I also work), over 25,000 fearful people were screened, over two thousand four hundred were COVID-19 positive and we treated successfully many hundreds of the high risk and symptomatic ones.

And this doctor has excellent credentials:

http://www.ivcommunityfoundation.org/media/managed/npd2019/NPD_2019_Program.pdf

PHILANTHROPIST OF THE YEAR Dr. George Fareed

Dr.  George  Fareed  graduated  with  honors  from  Harvard  Medical  School  in 1970  and  has  been  practicing  medicine  for  49  years.  He  spent  the  first  20 years after graduation researching and teaching at Harvard and UCLA. He was Assistant  Professor at  HMS  from  1973-1976.  He  was  Associate  Professor  at UCLA  from  1976-1996.  He  received  the  Soma  Weiss  Award  for  his  DNA                research.  He  founded  International  Genetic  Engineering,  Inc. in 1980 and Advanced Antigens, Inc. in 1991, the same year he opened his medical practice in  Brawley,  CA.  And,  he  was  the  US  Davis  Cup  tennis  team  physician  for  20 years and worked at 38 team matches and the US Olympics in Sydney in 2000.  In  the  memorable  1995  Davis  Cup  final  against  Russia  in  Moscow,  he  helped Pete Sampras bounce back from grueling leg cramps. He has been recognized for his many accomplishments including the 2004..........

........

You can read his full profile in the link...but my point is:

Whenever I went to doctor for my family one question I always had was how many they treated and what was the result and the doctors credentials.  If a doctor tells me they treated hundreds of patients and all of them are doing well, that usually works for me to take that treatment.

Why should not be taken seriously for Covid and ignore these doctors?

Short answer: The person may be right.

Longer answer: This opinion shows the challenge when there are 'competing' schools of thought. When this issue becomes driven by 'us vs them', constructive discussions become difficult and often deviate from basic data, reasoning, weight of evidence etc. The opinion also shows the challenge related to balancing personal and collective responsibility.

 

For various reasons, i've been involved in self-regulatory ventures which included to limit or terminate certain activities or even careers. A basic principle involved to respect alternative ways to think but the burden of proof should lie on the person voicing unusual or contrary opinions. So far, the evidence for the use of hydroxychloroquine at any stage of CV remains unconvincing and a lot of what the emerging school of thought is doing is to focus on the container, not the content. When assessing specific cases, the following type of comment sometimes appeared: [the] "doctor tells me they treated hundreds of patients and all of them are doing well". This was typically a massive red flag.

 

 

"doctor tells me they treated hundreds of patients and all of them are doing well". This was typically a massive red flag."

 

Many if not most patients go to a doctor and ask how the previous patients with similar situation did under their care.

 

"So far, the evidence for the use of hydroxychloroquine at any stage of CV remains unconvincing and a lot of what the emerging school of thought is doing is to focus on the container, not the content"

 

People have been talking over each other but talking about different treatments in different diseases.

 

First of all, Dr. Fareed was not talking about using Hydroxychloroquine alone.  From his testimony

"We have always used a triple HCQ cocktail: HCQ (3200 mg over 5 days), azithromycin or doxycycline and especially zinc, which is often left out in the studies"

 

They try to treat early.  Many studies are done in hospital (see below for example):

"The cocktail is best given early within the first 5 to 7 days while the patient is in the flu stage ( I have had success treating even as late as 14 days when patients have been sent home untreated from the ER).  The timing of the drug is when the virus is in the period of maximal replication in the upper respiratory tract"

 

He testified using in high risk patients. 

"I use it especially in high risk individuals (over 60 or with co-morbidities and anyone with moderate to severe flu symptoms)---the healthy do not need the treatment. I used this regimen to successfully treat 31 elderly nursing home residents in an outbreak in June and 29 recovered fully"

 

Now he added another agent

"I am routinely now combining Ivermectin in a quadruple HCQ/IVM cocktail with excellent results since Ivermectin is safe and has a different anti-covid action."

 

If you see few days back article by NIH (Nov 24)

Hydroxychloroquine doesn’t benefit hospitalized COVID-19 patients

https://www.nih.gov/news-events/nih-research-matters/hydroxychloroquine-doesnt-benefit-hospitalized-covid-19-patients

This randomized study is in hospitalized patients, doesnt mention zinc, and not ivermectin.

 

But the whole point of the treatment Dr. Fareed is talking about is to reduce hospitalization.

"The results are consistently good, often dramatic, with improvement within 48 hours·I have seen very few hospitalizations, and only a few deaths in patients that were sick to begin with and received the medication late while hospitalized."

 

That is after treating:

"over two thousand four hundred were COVID-19 positive and we treated successfully many hundreds of the high risk and symptomatic ones"

 

So when people say Hydroxychloroquine doesnt work....are they talking about using it early, in high risk patients with cocktail that includes zinc, azithromycin or doxycylin, and now ivermectin? Otherwise they are talking about different patient population and different medicines and different disease, IMO.

 

Not recommending any treatment. Only for discussion.

 

[ERICOPOLY]

In May, Trump claimed he was taking hydroxychloroquine to prevent covid-19:

https://www.foxnews.com/politics/trump-reveals-taking-hydroxychloroquine-coronavirus

 

And later when he had covid-19 they didn't give it to him at Walter Reed.

[Investor20]

In May, Trump claimed he was taking hydroxychloroquine to prevent covid-19:

https://www.foxnews.com/politics/trump-reveals-taking-hydroxychloroquine-coronavirus

 

And later when he had covid-19 they didn't give it to him at Walter Reed.

 

Trump was treated early with Antibodies, Remdesivir and bunch of other medicines.

 

The problem is both Antibodies or Remdesivir are IV infused and cannot be given at home.  Remdesivir requires five days of IV infusion.

 

Its impossible to treat 150,000 patients (lets say 10,000 high risk patients) every day and treat them with these IV medicines.

 

Dr. Mcculough talked about the oral medicines to treat early at home so that patients can be quarantined and need not go to hospitals.

 

For example Japan looked at Avigan an oral antiviral:

Even as Japan has allowed off-label use for the drug against COVID-19, Fujifilm have been careful not to trumpet the effects of their drug.

https://time.com/5814045/ebola-drug-coronavirus-favipiravir/

 

Fujifilm seeks approval for Avigan as COVID-19 treatment in Japan

https://www.reuters.com/article/health-coronavirus-fujifilm-avigan/fujifilm-seeks-approval-for-avigan-as-covid-19-treatment-in-japan-idUSKBN2741BB

 

China with Chloroquine:

However, it has recommended the use of a similar malaria drug called chloroquine.

https://www.scmp.com/news/china/society/article/3098021/coronavirus-conflicting-treatment-message-china-rejects-trump

 

Saudi Arabia with HCQ:

The Effect of Early Hydroxychloroquine-based Therapy in COVID-19 Patients in Ambulatory Care Settings: A Nationwide Prospective Cohort Study

https://www.medrxiv.org/content/10.1101/2020.09.09.20184143v1

 

Ivermectin has been tried in Bangladesh, Iran & Egypt:

https://www.trialsitenews.com/dhaka-medical-college-shares-results-of-randomized-controlled-trial-ivermectin-doxycycline-benefits-patients-with-mild-to-moderate-covid-19/

Dhaka Medical College Shares Results of Randomized Controlled Trial: Ivermectin & Doxycycline Benefits Patients with Mild to Moderate COVID-19

 

Ivermectin as an adjunct treatment for hospitalized adult COVID-19 patients: A randomized multi-center clinical trial

https://www.researchsquare.com/article/rs-109670/v1

 

https://www.researchsquare.com/article/rs-100956/v1

Efficacy and Safety of Ivermectin for Treatment and prophylaxis of COVID-19 Pandemic

"A multicenter randomized controlled clinical trial (RCCT) study design ....."

 

You need to be careful because some of these ivermectin studies were done in places where Hydroxychloroquine is part of standard of care and hence HCQ is there in both arms.

 

 

So what is US is doing? 

 

For Patients with COVID-19 Who Are Not Hospitalized or Who Are Hospitalized With Moderate Disease but Do Not Require Supplemental Oxygen

Recommendations: The Panel does not recommend any specific antiviral or immunomodulatory therapy for the treatment of COVID-19 in these patients.

https://www.covid19treatmentguidelines.nih.gov/therapeutic-management/

 

Trump got early treatment.  But that treatment by IV infusion wont be available for 99% of the world because there are only so many hospital beds.

 

Not suggesting any treatment.  Please consult your doctor or doctors. Only for discussion

[sleepydragon]

https://metro.co.uk/2020/05/14/west-wing-predict-pandemic-fans-freak-scene-similar-coronavirus-12701514/?ito=cbshare

 

[ERICOPOLY]

 

https://www.huffpost.com/entry/victoria-australia-no-new-coronavirus-cases_n_5fc2734ac5b61d04bfaa183a

 

Australia’s second-largest state, Victoria, once the country’s COVID-19 hotspot, said on Friday it has gone 28 days without detecting any new infections, a benchmark widely cited as eliminating the virus from the community.

 

The state also has zero active cases after the last COVID-19 patient was discharged from hospital this week, a far cry from August when Victoria recorded more than 700 cases in one day and active infections totalled nearly 8,000.

 

The spread of the virus was only contained after a lockdown lasting more than 100 days, leaving some 5 million people in Melbourne, Australia’s second largest city, largely confined to their homes.

 

 

 

 

[Peregrine]

 

https://www.huffpost.com/entry/victoria-australia-no-new-coronavirus-cases_n_5fc2734ac5b61d04bfaa183a

 

Australia’s second-largest state, Victoria, once the country’s COVID-19 hotspot, said on Friday it has gone 28 days without detecting any new infections, a benchmark widely cited as eliminating the virus from the community.

 

The state also has zero active cases after the last COVID-19 patient was discharged from hospital this week, a far cry from August when Victoria recorded more than 700 cases in one day and active infections totalled nearly 8,000.

 

The spread of the virus was only contained after a lockdown lasting more than 100 days, leaving some 5 million people in Melbourne, Australia’s second largest city, largely confined to their homes.

 

I'm not so sure that their lockdown is entirely responsible for their low case count. Australia is in summer right now and it's becoming increasingly clear that this virus is highly seasonal.

[ERICOPOLY]

 

https://www.huffpost.com/entry/victoria-australia-no-new-coronavirus-cases_n_5fc2734ac5b61d04bfaa183a

 

Australia’s second-largest state, Victoria, once the country’s COVID-19 hotspot, said on Friday it has gone 28 days without detecting any new infections, a benchmark widely cited as eliminating the virus from the community.

 

The state also has zero active cases after the last COVID-19 patient was discharged from hospital this week, a far cry from August when Victoria recorded more than 700 cases in one day and active infections totalled nearly 8,000.

 

The spread of the virus was only contained after a lockdown lasting more than 100 days, leaving some 5 million people in Melbourne, Australia’s second largest city, largely confined to their homes.

 

I'm not so sure that their lockdown is entirely responsible for their low case count. Australia is in summer right now and it's becoming increasingly clear that this virus is highly seasonal.

 

We didn't hit zero in the US during summer.  The numbers actually went UP as we entered summer coincident with lifting restrictions.

[Investor20]

https://ivmmeta.com/

"Ivermectin is effective for COVID-19: meta analysis of 21 studies"

 

 

They claim:

 

"100% of the 8 Randomized Controlled Trials (RCTs) report positive effects, with an estimated reduction of 72% in the effect measured using a random effects meta-analysis, RR 0.28 [0.13-0.59]. "

 

They provided the citations for these 8 Randomized controlled trials on Ivermectin ( see Figure 7) and one could go and check the veracity of statements from the citations.

 

The studies are from various countries such as Iraq, Iran, Bangladesh, Egypt...etc..

 

It is a drug among other things used:

https://www.sciencedaily.com/releases/2019/04/190404214753.htm

Mass drug administration reduces scabies cases by 90% in Solomon Islands' communities

Largest study of its kind provides important evidence for global strategy on scabies control

 

Old people in nursing homes is one population Scabies outbreaks are known...same population that is Covid vulnerable. 

 

https://www.nejm.org/doi/full/10.1056/NEJMe1712713

Mass Administration of Ivermectin in Areas Where Loa loa Is Endemic

 

 

What data does NIH need when they make this recommendation:

https://www.covid19treatmentguidelines.nih.gov/therapeutic-management/

 

For discussion only.  Please consult your doctor regarding treatment options.  Not suggesting any treatment

[Cigarbutt]

https://www.huffpost.com/entry/victoria-australia-no-new-coronavirus-cases_n_5fc2734ac5b61d04bfaa183a

Australia’s second-largest state, Victoria, once the country’s COVID-19 hotspot, said on Friday it has gone 28 days without detecting any new infections, a benchmark widely cited as eliminating the virus from the community.

The state also has zero active cases after the last COVID-19 patient was discharged from hospital this week, a far cry from August when Victoria recorded more than 700 cases in one day and active infections totalled nearly 8,000.

The spread of the virus was only contained after a lockdown lasting more than 100 days, leaving some 5 million people in Melbourne, Australia’s second largest city, largely confined to their homes.

I'm not so sure that their lockdown is entirely responsible for their low case count. Australia is in summer right now and it's becoming increasingly clear that this virus is highly seasonal.

We didn't hit zero in the US during summer.  The numbers actually went UP as we entered summer coincident with lifting restrictions.

This is interesting.

Seasonal and other factors specific to the Australia region played a role, especially for the Victoria region later in the spread but, by far, evidence overall points to a very large and dominant positive response to effective policy. There is a lot to learn from Australia. Using the CFR as a tool (like any ratio used in financial statements analysis, it is important to analyze both the num. and the denom. to get to the underlying meaning) and comparing to the US (and Canada), on the surface and on a first-level basis, the declining CFR points to an improving survival picture (as claimed). Australia, on the other hand, shows a rising CFR trend. On a second-level basis though, when, last September, the Australia curve crossed the US one, it was a signal or a leading indicator in the direction of their stated goal: reaching zero case. The Canada curve is also shown. If one subtracts the results from my province, the curve remains the same shape as before but gets lower than the US for the entire period. The officials in my province sometimes suggest that 'we' have done relatively well but, at times, they have difficulty finding a region or country doing worse.

Anyways, data is coming out for the Australia "flu" season and if it would be fair game to discuss the economic costs of measures that could be allocated to more than spontaneous and compliant reactions from citizens, but it looks like behavior modifications and restrictions had a massive effect (down) on seasonal flu numbers this year.

Australia has produced very strong numbers overall (cases, percent positive rates, hospit., deaths etc) and ivermectin continues to receive proportional attention but, even if proven to be effective, alone or in combination, it would not have made a material difference in the aggregate.

In his book Sapiens, Mr. Yuval Noah Harari, when explaining how humans came to dominate the earth, suggests that a main contributor to the course of events was the ability to cooperate in extremely flexible ways with countless numbers of strangers.

[Investor20]

https://www.huffpost.com/entry/victoria-australia-no-new-coronavirus-cases_n_5fc2734ac5b61d04bfaa183a

Australia’s second-largest state, Victoria, once the country’s COVID-19 hotspot, said on Friday it has gone 28 days without detecting any new infections, a benchmark widely cited as eliminating the virus from the community.

The state also has zero active cases after the last COVID-19 patient was discharged from hospital this week, a far cry from August when Victoria recorded more than 700 cases in one day and active infections totalled nearly 8,000.

The spread of the virus was only contained after a lockdown lasting more than 100 days, leaving some 5 million people in Melbourne, Australia’s second largest city, largely confined to their homes.

I'm not so sure that their lockdown is entirely responsible for their low case count. Australia is in summer right now and it's becoming increasingly clear that this virus is highly seasonal.

We didn't hit zero in the US during summer.  The numbers actually went UP as we entered summer coincident with lifting restrictions.

This is interesting.

Seasonal and other factors specific to the Australia region played a role, especially for the Victoria region later in the spread but, by far, evidence overall points to a very large and dominant positive response to effective policy. There is a lot to learn from Australia. Using the CFR as a tool (like any ratio used in financial statements analysis, it is important to analyze both the num. and the denom. to get to the underlying meaning) and comparing to the US (and Canada), on the surface and on a first-level basis, the declining CFR points to an improving survival picture (as claimed). Australia, on the other hand, shows a rising CFR trend. On a second-level basis though, when, last September, the Australia curve crossed the US one, it was a signal or a leading indicator in the direction of their stated goal: reaching zero case. The Canada curve is also shown. If one subtracts the results from my province, the curve remains the same shape as before but gets lower than the US for the entire period. The officials in my province sometimes suggest that 'we' have done relatively well but, at times, they have difficulty finding a region or country doing worse.

Anyways, data is coming out for the Australia "flu" season and if it would be fair game to discuss the economic costs of measures that could be allocated to more than spontaneous and compliant reactions from citizens, but it looks like behavior modifications and restrictions had a massive effect (down) on seasonal flu numbers this year.

Australia has produced very strong numbers overall (cases, percent positive rates, hospit., deaths etc) and ivermectin continues to receive proportional attention but, even if proven to be effective, alone or in combination, it would not have made a material difference in the aggregate.

In his book Sapiens, Mr. Yuval Noah Harari, when explaining how humans came to dominate the earth, suggests that a main contributor to the course of events was the ability to cooperate in extremely flexible ways with countless numbers of strangers.

 

Cigarbutt, for Ivermectin:

 

Efficacy: "100% of the 8 Randomized Controlled Trials (RCTs) report positive effects, with an estimated reduction of 72% in the effect measured using a random effects meta-analysis" from above meta-analysis

 

Safety profile:  Used for Mass administration in other endemics

Mass treatment with ivermectin: an underutilized public health strategy

https://www.who.int/bulletin/volumes/82/8/editorial30804html/en/

 

Cost: Less than 20$

https://www.goodrx.com/ivermectin

 

Do you want even more efficacious, safer and cheaper drug? What level of efficacy, safety and cost is acceptable to you?

 

The lockdowns on other hand are very crushing - I personally know two small business people who face bankruptcy.

 

https://www.nytimes.com/2020/05/30/world/europe/geneva-coronavirus-reopening.html

A Mile-Long Line for Free Food in Geneva, One of World’s Richest Cities

 

U.N. Report Says Pandemic Could Push Up To 132 Million People Into Hunger

https://www.npr.org/sections/coronavirus-live-updates/2020/07/13/890398347/u-n-report-says-pandemic-could-push-132-million-people-into-hunger

 

Only for discussion.  Please consult your doctor for any treatment. Not a suggestion for any treatment

[Cigarbutt]

...

Do you want even more efficacious, safer and cheaper drug? What level of efficacy, safety and cost is acceptable to you?

The lockdowns on other hand are very crushing - I personally...A Mile-Long Line for Free Food in...

Investor20,

i will engage here based on your question but have decided to avoid, to the extent possible, clogging this potentially great investment board with unnecessary and irrelevant posts. As you seem to know, my area has done VERY poorly handling the coronavirus episode but it’s not surprising given the chronic, well known (at least in certain circles) and deeply entrenched institutional weaknesses. However, I have been surprised by the extent of the underwhelming response in the US and I’ve spent time engaging in various online platforms dealing with the virus on America soil and i’m starting to understand better.

 

The ivermectin comment was related specifically to Australia. See their NPS website for general recommendations and specific and evolving guidelines for ivermectin. When all is said and done about Covid-19, it will be realized that several aspects that have been applied shouldn’t have and several aspects that haven’t been applied should have. Ivermectin is interesting and a case could be built that institutions did not move fast enough for specific issues. The point for Australia is that, in their specific case, policy design and application rendered the use of ivermectin (or hydroxychloroquine, zinc, vitamin D, melatonin, famotidine, aspirin, herbs etc) essentially a non-material aspect. And now, vaccines are coming and Australia’s plan is also likely to score high on sustainability, given residual path to herd immunity.

 

Your post assumes a certain level of allocation between the “costs” of the “lockdowns” and the economic costs directly related to the virus spread itself. You seem to assume that most costs are related to the “lockdowns” without really detailing the counterfactual used to analyze. You may be interested to know that institutions in Australia thought about this as the pandemic evolved. See pages 17-26 and 27-41 of the following document for the data, analysis and thought process. Australia is a nice example (there are others) showing that it is possible to collaborate and to cooperate in order to both minimize costs and minimize health outcomes without the need to rely on unproven treatments to save the day and without the irrational fear of permanent “control”.

https://grattan.edu.au/wp-content/uploads/2020/09/Go-for-zero-how-Australia-can-get-to-zero-COVID-19-cases-Grattan-Report.pdf

 

Anyways, at this point, in areas that used various forms of let-it-rip ‘strategies’ and various of other forms of race to reach herd immunity, with vaccines coming, ivermectin and related should continue to be looked into but are unlikely to represent significant breakthroughs.

 

Soon, Covid-19 will be, going forward, basically a non-event and what will remain are memories of unnecessary excess mortality, an extra 9.7T debt in the US (government and corporates, as of last November 26th) and a global debt situation that looks like this:

 

 

All this during an era when records are being broken, in stock markets but also in the length of lines at food banks, in developed countries and in the venerable USA.

Did you read and analyze the recent study using 500 times the recommended daily amount of vitamin D in Covid patients?

And I doubt ivermectin will make a difference but you can carry on.

 

PS Did you see the latest data released by CDC vs hospitalizations?; soon they will be right in showing a promising downward trend but that may be old news. See attached.

[Investor20]

...

Do you want even more efficacious, safer and cheaper drug? What level of efficacy, safety and cost is acceptable to you?

The lockdowns on other hand are very crushing - I personally...A Mile-Long Line for Free Food in...

Investor20,

i will engage here based on your question but have decided to avoid, to the extent possible, clogging this potentially great investment board with unnecessary and irrelevant posts. As you seem to know, my area has done VERY poorly handling the coronavirus episode but it’s not surprising given the chronic, well known (at least in certain circles) and deeply entrenched institutional weaknesses. However, I have been surprised by the extent of the underwhelming response in the US and I’ve spent time engaging in various online platforms dealing with the virus on America soil and i’m starting to understand better.

 

The ivermectin comment was related specifically to Australia. See their NPS website for general recommendations and specific and evolving guidelines for ivermectin. When all is said and done about Covid-19, it will be realized that several aspects that have been applied shouldn’t have and several aspects that haven’t been applied should have. Ivermectin is interesting and a case could be built that institutions did not move fast enough for specific issues. The point for Australia is that, in their specific case, policy design and application rendered the use of ivermectin (or hydroxychloroquine, zinc, vitamin D, melatonin, famotidine, aspirin, herbs etc) essentially a non-material aspect. And now, vaccines are coming and Australia’s plan is also likely to score high on sustainability, given residual path to herd immunity.

 

Your post assumes a certain level of allocation between the “costs” of the “lockdowns” and the economic costs directly related to the virus spread itself. You seem to assume that most costs are related to the “lockdowns” without really detailing the counterfactual used to analyze. You may be interested to know that institutions in Australia thought about this as the pandemic evolved. See pages 17-26 and 27-41 of the following document for the data, analysis and thought process. Australia is a nice example (there are others) showing that it is possible to collaborate and to cooperate in order to both minimize costs and minimize health outcomes without the need to rely on unproven treatments to save the day and without the irrational fear of permanent “control”.

https://grattan.edu.au/wp-content/uploads/2020/09/Go-for-zero-how-Australia-can-get-to-zero-COVID-19-cases-Grattan-Report.pdf

 

Anyways, at this point, in areas that used various forms of let-it-rip ‘strategies’ and various of other forms of race to reach herd immunity, with vaccines coming, ivermectin and related should continue to be looked into but are unlikely to represent significant breakthroughs.

 

Soon, Covid-19 will be, going forward, basically a non-event and what will remain are memories of unnecessary excess mortality, an extra 9.7T debt in the US (government and corporates, as of last November 26th) and a global debt situation that looks like this:

 

 

All this during an era when records are being broken, in stock markets but also in the length of lines at food banks, in developed countries and in the venerable USA.

Did you read and analyze the recent study using 500 times the recommended daily amount of vitamin D in Covid patients?

And I doubt ivermectin will make a difference but you can carry on.

 

PS Did you see the latest data released by CDC vs hospitalizations?; soon they will be right in showing a promising downward trend but that may be old news. See attached.

 

Whether lockdowns hurt the economy is not my "opinion".  I gave UN report stating 130 million people will go hungry.

 

How many Randomized clinical studies - let alone observational studies are needed for a treatment to be proven?

 

How many Randomized studies are there for Masks and Lockdowns that they work?

 

Hope vaccines work like they say they do but still there is time for everyone to get them. 

 

Early treatment is not just to reduce mortality.  It also reduces hospitalization and potentially (which some doctors claim) long term symptoms. Look at Trump who got his first treatment within 24 hrs of positive test.  Within 10 days he is campaigning.

 

https://www.who.int/news/item/15-07-2020-who-and-unicef-warn-of-a-decline-in-vaccinations-during-covid-19

"The World Health Organization and UNICEF warned today of an alarming decline in the number of children receiving life-saving vaccines around the world. This is due to disruptions in the delivery and uptake of immunization services caused by the COVID-19 pandemic."

 

Australia records worst economic slump as pandemic ends golden run

https://www.reuters.com/article/us-australia-economy-gdp/australia-records-worst-economic-slump-as-pandemic-ends-golden-run-idUSKBN25T0I8

 

Australia in first recession for nearly 30 years

https://www.bbc.com/news/business-53994318

 

Australia is also unique country.  Its an island with huge land and citiies far from each other.  We know distancing is an important part of Covid.  Even within NYC poorer areas had more Covid possibly because of smaller housing and crowding than richer areas.

 

According to Demographia’s list, out of the 1,040 cities surveyed, Melbourne’s population density of an estimated 1,500 people/ km2 is ranked 955th.

https://www.spacer.com.au/blog/population-density-how-does-australia-compare-to-the-rest-of-the-world

Please consult your doctor for any treatment. Not suggesting any treatment. For discussion only