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This has been mentioned here before, but for those that want the published, raw data, dig in.

The only caveat to this is that it should be interpreted as a "snapshot" for a SINGLE LOCATION (bay area) at a SINGLE POINT IN TIME (late Feb).

Sample Pooling as a Strategy to Detect Community Transmission of SARS-CoV-2
 

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Of course everything you say is relevant, but the conclusion you keep coming back to is that someone who is not a doctor cannot be taken seriously in this discussion. I disagree. If you keep looking at studies that are less than perfect but continue to show efficacy, and you compare countries that used chloroquine to those that mostly shunned it and the ones that used chloroquine or HCQ show consistently better results, then these are just more data points suggesting that the drugs can produce benefits.

Like I said earlier, I respect your opinions as a doctor. That doesn't mean that there's no room for discussion, however.

Part of the problem is the whole concept of efficacy relationship to a disorder is seen as kind of binomial either it works or it doesn't. And we've adopted as a gold standard of efficacy whether or not something works in isolation as a sole treatment. Those Concepts have held back a lot of progress in relationship to refractory problem. Most of them don't have single Factor treatments with any efficacy. I suspect that if hydroxychloroquine has any advocacy it's much more shaded and contextual and conditional. I think we've seen enough to know that it does not appear to work in Advanced or severe cases where patients have essentially runaway pneumonia, sepsis, and severe pro-inflammatory States. Whether it works in a much more conditional and contextual sense in patients before they get to that level of disease in terms of changing the trajectory or whether it might work in combination with something in milder patients is an open question. We just don't know. Protease Inhibitors by themselves failed in HIV but in combination with other drugs they proved pretty effective. We may find something similar in relationship to covid-19.

Part of the problem is because viruses in a sense are kind of minimalist packages and they depend on heavily selected processes to co-opt the cell and turn it into a viral factory, it's very hard to inhibit that hijacking without inhibiting other processes that are vital to the cell and its daily work. After all ribosomes are essential to almost everything that a cell might build.
 
The published title of the study is: No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection
Doesn't that jive with precisely what you state above? Do you still believe it's a conspiracy to hide valid treatment for some unknown reason?

The most important thing you can do when it comes to studies of any type is read a headline, scroll through the "article" until you find a link to the study, and read the study instead of the article. If the article doesn't include a link to the study, ignore the headline as well.

I didn't see the title of the study. In that case, the study has performed a service, but with sketchy methodologies used. I retract my claim that the study was aimed at shooting down all use of HCQ. On the other hand, ScienceAlert is a guilty party because its article took a reasonable conclusion and expanded it to unreasonable lengths by using the title:
Small Trial Suggests Antimalarial Drugs Not Effective For Treating Coronavirus
 
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Your answer here exposes the real problem. Your previous response was useful because it pointed out potential shortcomings in using country data to draw conclusions. Your current response is just ridicule, which is so detrimental to the aim of this thread, which is to further a discussion on the COVID-19 phenomenon.

The biggest problem with this thread right now is that there are a handful of regulars here who are hard-over antagonistic to people who challenge their views. We all know who they are. My request to you is to continue laying out counter-arguments like you did in your previous response, but stay away from the ridicule because it is un-professional and harms the value of this thread.
To be candid, several of the people you allege to be antagonistic to...challenge... are nothing of the sort. Several of us ask for data to support allegations. In the specific case benefits are alleged without regard to known side effects and without any solid evidence. That is why people ask for evidence. A statistical background does help as does epidemiological background. Wishful thinking or generalizations from uncontrolled observations simply is not convincing.

Trying things untested in hope is often very dangerous. Only controlled testing can establish either efficacy or lack of undesirable side effects.
 
Another study is out (pre-publication) suggesting that covid-19 transmission decreases significantly at higher temperatures.

This study finds a strong correlation between temperature and new cases per the figure below.

In addition, they find a sweet spot (I would call it a sour spot) of transmission at a mean maximum temperature of 7.5 C and very little transmission above 22.5 C (72.5 F).

My personal opinion is that it looks more and more like spring weather should help quite a bit.

https://www.medrxiv.org/content/10.1101/2020.04.02.20051524v1.full.pdf

View attachment 529824
The main reason I'm skeptical of this study: "Variance at the local level, however, could not be well explained by geography and temperature."
It's spreading like crazy in New Orleans and the highs were in the low 80s a couple weeks ago.
I certainly hope it's true! It would buy us a lot of time before next fall. Too bad it doesn't get very hot here in the summer. :(
 
I didn't see the title of the study. In that case, the study has performed a service, but with sketchy methodologies used. I retract my claim that the study was aimed at shooting down all use of HCQ. On the other hand, the article in ScienceAlert is a guilty party because it took a reasonable conclusion and expanded it to unreasonable lengths by using the title:
Small Trial Suggests Antimalarial Drugs Not Effective For Treating Coronavirus
Editorializing of studies is, sadly, the standard, which was why I put in my last suggestion in my previous post. It's also why lay people think that science keeps flip-flopping on issues and in my opinion, it leads to a distrust of science overall. If studies were represented appropriately, the news would be less bombshell click-worthy, and people would be significantly better educated. Reporting on studies about diet is possibly the worst for this.
 
The study reports "Near zero" transmission above mean maximum temperature of 72.5 F.

Average high temperature in Fremont:

April 69 F
May 72 F
June 75 F

Climate Fremont - California and Weather averages Fremont

Edit: While anecdotes shouldn't trump data I am a bit skeptical of this "hard" upper limit since, for example, Miami and Tampa have average high temperatures of 80F and 76 F in March, but Florida cases still seem to be growing ....
how do we explain the community transmission in India?
 
This has been mentioned here before, but for those that want the published, raw data, dig in.

The only caveat to this is that it should be interpreted as a "snapshot" for a SINGLE LOCATION (bay area) at a SINGLE POINT IN TIME (late Feb).

Sample Pooling as a Strategy to Detect Community Transmission of SARS-CoV-2
The postal service is going broke. Maybe they could pick up self-collected samples from everyone every day? Pool them optimally to minimize the number of tests using demographic and location data and maybe it would be possible to test everyone daily?
 
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Published today in JAMA:
Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

Full paper attached as a PDF for those that may not have access to the website.

Very good data here from nearly 1600 ICU patients. Most had at least one pre-existing medical condition. Vast majority were male. 26% of those admitted to the ICU died (this surprised me, I was expecting it to be higher).

The 26% fatality rate stated in the conclusion in that paper is a bit misleading as they report elsewhere in the paper that the 26% figure should be used with caution, since most patients (58%) were still in the ICU. The final death rate will be higher.

"In this study, at 5 weeks after the first admission
in ICU, the majority of the patients (58%) were still in
the ICU
, 16% of the patients had been discharged from the ICU,
and 26% had died in the ICU."
 
The conclusion in that paper is a bit misleading as they report elsewhere in the paper that the 26% figure should be used with caution, since most patients (58%) were still in the ICU. The final death rate will be higher.

"In this study, at 5 weeks after the first admission
in ICU, the majority of the patients (58%) were still in
the ICU
, 16% of the patients had been discharged from the ICU,
and 26% had died in the ICU."

Can probably roughly extrapolate that 16 / 26 % ratio.

That would give (at time of publication), "end point" patients (discharge or death) as:
38% dischared
62% death

Not very favorable odds.
 
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Random thoughts from the posts:

I would have assumed the experimental medicines with promise would be used today in C19-positive patients who had all the factors for high mortality prior to letting them circle the drain. By the time their body starts to shut down, any treatment is probably going to fail on a weakened victim. Sort of like giving someone oral penicillin to treat severe sepsis; too little too late.

Lethal myocarditis is sometimes seen in otherwise healthy hearts that are infected with H1N1 flu - sorry! I saw it on a Reality TV show, Dr. G, Medical Examiner. Myocarditis is what killed a 42 year old male who dropped dead on a sidewalk in Florida in 2010, not his infected lungs. The heart looked nasty, like it was a Chia Pet.

Trivia - During the 1918-1919 flu pandemic, President Wilson caught H1N1 while at the Paris peace talks in 1919 when Wilson was 63 years old. He became gravely ill.
"Wilson's administration worked furiously to keep Wilson's diagnosis a secret. Grayson told reporters that Wilson had a cold and just needed some rest, blaming the president's illness on the rainy weather in Paris. Meanwhile, Wilson’s condition worsened. And he began acting strange. “Generally predictable in his actions, Wilson began blurting unexpected orders,” A. Scott Berg wrote in his biography of Wilson. “Twice he created a scene over pieces of furniture that had suddenly disappeared,” even though the furniture had not moved. Wilson also thought he was surrounded by spies." "

Is this why people thought the President had C19? ;)
 
Published today in JAMA:
Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

Full paper attached as a PDF for those that may not have access to the website.

Very good data here from nearly 1600 ICU patients. Most had at least one pre-existing medical condition. Vast majority were male. 26% of those admitted to the ICU died (this surprised me, I was expecting it to be higher).
I wonder how the prevalence of those pre-existing conditions compare to their prevalence in the general population?
For example from what I can tell about half of older adults in the US have hypertension (which is the most common comorbidity in ICU patients).
 
From today's Worldometer US update:
United States Coronavirus: 364,258 Cases and 10,798 Deaths - Worldometer

"An estimated additional 180 - 195 deaths per day occurring at home in New York City due to COVID-19 are not being counted in the official figures. "Early on in this crisis we were able to swab people who died at home, and thus got a coronavirus reading. But those days are long gone. We simply don't have the testing capacity for the large numbers dying at home. Now only those few who had a test confirmation *before* dying are marked as victims of coronavirus on their death certificate. This almost certainly means we are undercounting the total number of victims of this pandemic," said Mark Levine, Chair of New York City Council health committee"
Mark D. Levine on Twitter

"A study by disease modelers at the University of Texas at Austin states that "Given the low testing rates throughout the country, we assume that 1 in 10 cases are tested and reported. If a county has detected only 1 case of COVID-19, there is a 51% chance that there is already a growing outbreak underway"
https://cid.utexas.edu/sites/defaul...-risk-maps_counties_4.3.2020.pdf?m=1585958755

Story Map Series
 
Random thoughts from the posts:

I would have assumed the experimental medicines with promise would be used today in C19-positive patients who had all the factors for high mortality prior to letting them circle the drain. By the time their body starts to shut down, any treatment is probably going to fail on a weakened victim. Sort of like giving someone oral penicillin to treat severe sepsis; too little too late.

Lethal myocarditis is sometimes seen in otherwise healthy hearts that are infected with H1N1 flu - sorry! I saw it on a Reality TV show, Dr. G, Medical Examiner. Myocarditis is what killed a 42 year old male who dropped dead on a sidewalk in Florida in 2010, not his infected lungs. The heart looked nasty, like it was a Chia Pet.

Trivia - During the 1918-1919 flu pandemic, President Wilson caught H1N1 while at the Paris peace talks in 1919 when Wilson was 63 years old. He became gravely ill.
"Wilson's administration worked furiously to keep Wilson's diagnosis a secret. Grayson told reporters that Wilson had a cold and just needed some rest, blaming the president's illness on the rainy weather in Paris. Meanwhile, Wilson’s condition worsened. And he began acting strange. “Generally predictable in his actions, Wilson began blurting unexpected orders,” A. Scott Berg wrote in his biography of Wilson. “Twice he created a scene over pieces of furniture that had suddenly disappeared,” even though the furniture had not moved. Wilson also thought he was surrounded by spies." "

Is this why people thought the President had C19? ;)

We need to identify patients who are mostly likely to need treatment and threat them early.

Identification could be done by something like this:-
https://www.smh.com.au/national/cov...-will-need-the-most-care-20200406-p54hja.html

When a patient is a likely candidate who needs treatment, I fully support the doctor trying something, even if data is lacking, and evidence is mixed, provided the best judgement of the doctor is that this is the best course.

The other good thing Australia is doing is now popping up clinics and doing intensive screening in "hot spots" of community transmission, essentially anywhere where there are a lot of cases of unknown origin...

The US is probably not yet at the stage where "hot spot" screening will be effective, but once you get to that stage, I think early detection, early treatment and improved risk assessment can make a substantial contribution to reducing the load on ICU wards.

EDIT:: I'm not sure why this post got a funny rating, I'm trying to be helpful and constructive. It seems like some think only doom and gloom is acceptable here.
 
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I submit that this study was undertaken with the expressed purpose of giving the earlier HCQ studies a black eye. Both the original 20 person study in France and this 11 patient rebuttal study have problems. What one needs to do is look at the entirety of the data to gain a clearer picture.
The clearer picture will emerge when 200,000 patient multi-drug WHO monitored study gets complete. Until then, everything is experimental.

BTW, from what I see (on r/COVID19 where actual frontline doctors post) - almost everyone is being given HCQ etc in NYC with little benefit to show. Problem seems to be - if the person is critical, it doesn't seem to help. If the person is not critical, how do we know it helped (if the person gets discharged) ?
 
Published today in JAMA:
Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

Full paper attached as a PDF for those that may not have access to the website.

Very good data here from nearly 1600 ICU patients. Most had at least one pre-existing medical condition. Vast majority were male. 26% of those admitted to the ICU died (this surprised me, I was expecting it to be higher).

Thanks for posting that. I was surprised and somewhat disappointed that they did not include any laboratory or other clinical findings in their data summary. Would have very much appreciated being able to compare that data with the Wuhan and Seattle ICU patient data.
 
You are cherry picking. There are much larger data sets, and you should remember that boris is fat.

I'll help you: overall 1/4 hospitalized end up on a vent and ~ 80% of those on a vent die.

Yep, and 80% is based on every patient being able to have a ventilator and trained staff taking care of said patient.
Otherwise, we may be looking at 95% or even 99% mortality... resulting in the original 2M estimate.