Coronavirus

[Singuy]

Um, FDA gave EMERGENCY approval for COVID-19 for COMPASSIONATE USE IN HOSPITALIZED PATIENTS WITH THE VIRUS.

Not outpatient, not determined to be safe and effective. I suppose if I were near the point where a ventilator is indicated, I'd opt for a try of it, but to promote this as a "cure" is an absurd slap in the face of medical science.

Don't make it seem like you guys are the only ones who know how to read clinical trials. Every infectious disease specialist understand the limitations of the study. No one is listening to what the president is saying because frankly everyone thinks he is a moron. As of right now everyone is using it because once there are limited evidence of efficacy, it has to be used when there's no other alternative or else it's an ethics issue. So please people stop with the high horse BS on this subject.

 

[AZRI11]

He misread the slide. 2687 were admitted, 1592 discharged. Net increase of 1095 hospitalized.

Korea traced contacts. They tested and found a lot of those asymptomatic cases. I'd guess they found most of them.

It's a delay in reporting to the governor, too. He said yesterday they don't have those results.

Sorry for going off topic with coronavirus info. Hopefully we can return to the important lazy Millenials/stupid Trumpers conversation. /s

EDIT: found on another board:

Yes he misread the slide. Rate of increase is slowing. Biggest problem are first responders and health care workers not being protected (PPE) spread won't slow down enough until this is not the case. Italy learned that hard lesson, and then corrected themselves.

 

[FoverM]

Addendum:
I tried to understand this. Since you can see yellow, I conclude that you have an approximately equal (but not complete) deficiency in red and green cones. If that is correct then you can see blue, and the color gamut that is a mixture of red and green screen colors that do not have blue admixed. E.g., can you see orange and lime ?

At a conference a few years ago I went to a poster that dealt with color palettes for data and colorblindness. The presenter had a smartphone camera app that let you see in real time approximately what colorblind people see.

I see there's an iPhone app called "Sim Daltonism" that appears to do the same thing. You might want to give it a try.

 

[MXLRplus]

If you want a plotted graph with multiple variables to be transportable, you can use the lines themselves.
_________
_ _ _ _ _ _
__ . __ . __
__ . . __ . . __
. . . . . . . . .
_________
_ _ _ _ _ _
__ . __ . __
__ . . __ . . __
. . . . . . . . .

Some systems allow markers, this is a shape that interrupts the line at intervals, such as circles, triangles, squares.

But this is pre-computer, pre-color printer graphing so it may not apply.

 

[bkp_duke]

The federal Emergency Medical Treatment and Active Labor Act of 1985 requires that all patients who seek emergency treatment be given an adequate medical screening examination and prohibits discrimination on the basis of patients' ability to pay. It was signed into law by President Reagan.
Robin

Very familiar with that act. It does NOT mean that I have to admit a patient considered "medically stable" (which means I do a preliminary exam). Most non-payers that show up to the ED are medically stable (current pandemic excluded).

 

[dfwatt]

Context: Climate Change Quote:
Climate Change is the defining issue of our time and we are at a defining moment.

Good thing Cuomo launched billion dollar campaign on climate change in February, instead of face masks and respirators, otherwise we would be in a heap of trouble with climate change. Quote:
We face a crisis for the planet and you only get one chance to fix it before reaching a point of no return.[/QUOTE]

@DanCar Can I just ask what you are smoking? I guess you're suggesting that climate change is the other hoax, along with this virus being a hoax right? Then there's the impeachment hoax, the Russia investigation hoax. How do you keep track of all the hoaxes?

PS we won't even touch the issue of whether or not the concept of a "China virus" is itself an offensive racist hoax, right? We'll all just look the other way on that one, right pal?

 

[bkp_duke]

Don't make it seem like you guys are the only ones who know how to read clinical trials. Every infectious disease specialist understand the limitations of the study. No one is listening to what the president is saying because frankly everyone thinks he is a moron. As of right now everyone is using it because once there are limited evidence of efficacy, it has to be used when there's no other alternative or else it's an ethics issue. So please people stop with the high horse BS on this subject.

Let me clarify this for you:
We (I am a physician) are using it NOT because there is evidence it works. We are using it because in most people it is not going to do harm, IF WE MONITOR THEM. You don't see outpatient docs prescribing this medication much, simply because it has heart complications. You DO SEE inpatient docs prescribing this because . . . the patient is on cardiac monitoring if admitted to the hospital.

There is a HUGE different between evidence of efficacy (which there is little of) and evidence of non-harm (which there is adequate evidence of but ONLY if monitored inpatient).

 

[rxlawdude]

As of right now everyone is using it because once there are limited evidence of efficacy, it has to be used when there's no other alternative or else it's an ethics issue. So please people stop with the high horse BS on this subject.

As a professor of bioethics, I think you misstate the ethical dilemma. Do you give an unproven treatment to many people based on "hope?" Or do you study the treatment to definitively ascertain it actually is safe and effective?
The whole idea of CQ/HCQ effectiveness is based on in vitro studies. The results of controlled trials so far do not show effectiveness.

And then there are the community pharmacists with patients using CQ/HCQ for autoimmune diseases (proven efficacy) that thanks to the demonstrably false statements by Trump, are scrambling to find any of these drugs in the supply chain.

Patients who definitely benefit from the drug are unable to obtain it because others are hoarding it in the hope it works.

Sad.

 

[Singuy]

Let me clarify this for you:
We (I am a physician) are using it NOT because there is evidence it works. We are using it because in most people it is not going to do harm, IF WE MONITOR THEM. You don't see outpatient docs prescribing this medication much, simply because it has heart complications. You DO SEE inpatient docs prescribing this because . . . the patient is on cardiac monitoring if admitted to the hospital.

There is a HUGE different between evidence of efficacy (which there is little of) and evidence of non-harm (which there is adequate evidence of but ONLY if monitored inpatient).

Wait I'm sorry, why are you not prescribing Claritin, Omeprazole, plavix, hundreds of other meds that show no evidence of it working but also do little harm?

Why are you picking hydroxychloroquine? That seems like a random drug to pick in which it's no better than the other hundreds of drugs that do no harm too right? Hey as a bonus you don't even need to monitor the pt with 90% of the drugs out there..why not pick those?

 

[bkp_duke]

Wait I'm sorry, why are you not prescribing Claritin, Omeprazole, plavix, hundreds of other meds that show no evidence of it working but also do little harm?

Why are you picking hydroxychloroquine? That seems like a random drug to pick in which it's no better than the other hundreds of drugs that do no harm too right? Hey as a bonus you don't even need to monitor the pt with 90% of the drugs out there..why not pick those?

I'm not picking HCQ. To be CRYSTAL clear - the ONLY intervention shown to decrease mortality are VENTILATORS. Go look back at my posts on HCQ in this thread, you will see that I think the evidence behind it is pretty much . . . nill.

I have physician colleagues in NYC and they are of the same opinion. They are adding it to their treatments "because of the hype" (their words, not mine) but "have little faith it is doing anything".

All the other drugs you mentioned have NOT been hyped up, so it is a specious and invalid comparison you are trying to make.

EDIT - those drugs do NOT have life-threatening cardiac complications either. Another flaw in your analogy.

 

[ohmman]

Here is the palette I can choose from.
Which 5 colors work best for you ? Please ID by (x,y) coordinates, so the bottom left would be (1,1) and the top left (1,8)

View attachment 529256

As someone without color limitations, I think your visualizations would be clearer with hashed lines instead of lightened versions of the same color. I’ve had a hard time discerning between some of them myself. Patterned lines might be easier to identify.

 

[Singuy]

I'm not picking HCQ. To be CRYSTAL clear - the ONLY intervention shown to decrease mortality are VENTILATORS. Go look back at my posts on HCQ in this thread, you will see that I think the evidence behind it is pretty much . . . nill.

I have physician colleagues in NYC and they are of the same opinion. They are adding it to their treatments "because of the hype" (their words, not mine) but "have little faith it is doing anything".

All the other drugs you mentioned have NOT been hyped up, so it is a specious and invalid comparison you are trying to make.

EDIT - those drugs do NOT have life-threatening cardiac complications either. Another flaw in your analogy.

You literally said "we are using it"..didn't think you were talking about ventilators and not HCQ, which was the topic you were replying too.

All the other drugs I mentioned were equivalent to HCQ to you because they all show no efficacy while also does little harm, which apparently was your inclusion criteria for usage.

 

[bkp_duke]

You literally said "we are using it"..didn't think you were talking about ventilators and not HCQ, which was the topic you were replying too.

We as in "physicians". I already gave you the reason. It's basically the media pressure of "this might work". No other intervention except ventilators has that pressure.

But what do I know. Screw being a board certified physician, I'm arguing with a dolt on a forum.

I'm going for a drive, enjoy your life.

 

[winfield100]

I can try. If you have the common type, can you tell me 5 screen colors you can see ?

@SageBrush
Yellow, blue, everything else is pretty much very faint shades close.
Remember pseudo ishiha. I can see the 12 on the first plate, most of the rest are vague hints
This test. https://enchroma.com/pages/strong-deutan-test-result
Says I’m a strong deutan

 

[Singuy]

We as in "physicians". I already gave you the reason. It's basically the media pressure of "this might work". No other intervention except ventilators has that pressure.

But what do I know. Screw being a board certified physician, I'm arguing with a dolt on a forum.

I'm going for a drive, enjoy your life.

You being a physician still need a coherent argument.

Oh hey did you know that sometimes physicians treat patients with no other alternatives based on case studies published? Even less credible than all the trials for HCQ. It's what happens when people are desperate to save lives.

You can dance around and have a field day of I told you so once the study from NYC comes out if you are proven right. Until then, why are you so against it? It's literally standard practice when there are no other alternatives

 

[Fobble]

These are better questions. You're moving the goalposts from your initial statement, though, which was incredibly condescending. Speaking of condescending:

I have not moved anything. That was exactly what I was conveying at the start. It was your whining and judgemental nature that started accusting without fully understanding the context. Appears that you are the one moving away from your initial conclusion

If you want to get personal, sure. I am absolutely the type who wants the cake and to eat it, too, because guess what? The cake is worthless if I can't eat it. I have loved every job I've ever had except one, and that was because it was nonstop travel. I started a business in my 20s and sold it when I was 38, working for the buyer until I retired at 40. I never took a vacation all of the years I had my business, and I worked 13 hour days. My smart wife pushed me to offload the business because we have children and she knew it would be important for them to have a father around.

I've enjoyed working for my cake and eating it. I'm assuming you just put yours in a decorative case?

We are so well off. What have to done to help those are impacted so far?

 

[MXLRplus]

I guess you're suggesting that climate change is the other hoax, along with this virus being a hoax right? Then there's the impeachment hoax, the Russia investigation hoax. How do you keep track of all the hoaxes?

It's pretty easy to keep track of them. Assume everything on the web is a hoax and you are good to go. You won't be far off.

 

[ohmman]

I have not moved anything. That was exactly what I was conveying at the start. It was your whining and judgemental nature that started accusting without fully understanding the context. Appears that you are the one moving away from your initial conclusion

I'm sorry my statements made you have to reflect. I assure you, there was no whining.

We are so well off. What have to done to help those are impacted so far?

I posted this upthread, and have continued distributions of grants from my personal foundation. I definitely suggest doing the same if you can. Some nonprofits can take advantage of the small business provisions in the package, but not all. And they still struggle with volunteer staff and distribution of services. Now is the time to front load every donation you can.

 

[Daniel in SD]

coherent argument.

Placebos work. If it makes patients feel better and the risks are low when being monitored by a doctor, why not?

 

[MXLRplus]

This is why we can't have nice things:

Real Estate Now an Essential Business, New York State Says