Coronavirus

[bhzmark]

Not to squash the party, but it’s in vitro effects are well documented for a loooong time now.

In VIVO anyone? We do have some, but we need all the results on that now. Seems to have been used on thousands of patients show us the numbers.

Not to squash the party, but the distinction between in vitro and in vivo is well documented for a loooooooong time now. Pointing out this distinction doesn't really add anything new to the world of knowledge and really just pollutes the thread.

The evidence and anecdotes and information, sloppy and imperfect as it may be, should still be shared and I hope others don't resist sharing information just because a few people make themselves feel important by pointing out a boringly obvious distinction.

But meanwhile, for people interested in actually doing interesting contributions to the advancement on this issue:

French researcher posts successful Covid-19 drug trial

And yes, we can see that it is a small sample size. and I never heard of "French Connexxion" either or the other french sites that are carrying this. And if you find a picture of Raoult you will think he should be working on flux capacitors rather than infectious diseases. The whole thing is probably a bitcoin scam . . . But there it is.

Also see Coronavirus : la chloroquine est-elle vraiment un remède miracle ?

 

[sixela]

I'm going by worldometers.info. If you have better numbers, fork 'em over.

No one has robust numbers for the number of infected people, which is what you're trying to estimate.

Everyone has numbers about confirmed infections, but the fraction of people that might have an infection that are getting tested is not accurately known in many countries.

 

[sixela]

Deaths appear to lag new cases by a week or two, so I look at new cases to see when the peak infection spread occurred. That gives you an idea of peak death date.

Indeed, "new cases" as an indicator leads "deaths", but it's a lot less robust.

In Belgium they only test people with severe symptoms (i.e. pneumonia, not always attributable to SARS-CoV-2) and health workers.

Doctors are now treating all more benign respiratory infections as "possibly COVID-19", but if you're ill, you're only confirmed as suffering from COVID-19 if you're unlucky enough to need to be hospitalised.

The protocols about who gets tested or not and how well you get treated change over time (in Belgium the criteria for getting tested narrowed over time while the numbers of people needing to be in hospital shot up, since the test capacity did not grow with the same doubling time as the infections). Unfortunately that means the ratio of deaths over confirmed infections doesn't even have a fixed relationship to the true morbidity (deaths over infections).

 

[gerebgraus]

The link was posted before, and that opinion piece was _really_ poor (and not an article that will be peer reviewed). Scroll back a few pages...

You're darn right he is "unusual", though.

I do not bother to scroll back. I am fairly confident in my professional expertise in evaluating epidemiology work. And respectfully most of it is crap. I have not seen any errors from Ioannidis. But when he points out errors in others he is always correct. To attack an opinion piece bu the fact that it will not be a peer reviewed publication lacks seriousness.

My offer to you. Pick one substantial criticism on the article that you think is correct. I am happy to show that it is BS.

 

[bkp_duke]

Correct, but the number of deaths is a more robust (albeit lagging) indicator. Deaths are not usually undercounted, especially in a country with a health service like e.g. the Italian one.

You are assuming that the system is not so overwhelmed that the reporting of deaths is not delayed.

I've known more than a few pathologists (the guys that do autopsies). I'm certain that they are inundated right now, and they are the medical professionals that have to sign off on cause of death.

 

[sixela]

My offer to you. Pick one substantial criticism on the article that you think is correct. I am happy to show that it is BS.

Well, if you don't bother to scroll back, then it's going to be hard to address the points I brought up.

Since obviously you're more interested in contributing your pearls of wisdom and claims of expertise than in reading what others have to say, I'll provide a link.

Coronavirus

I have a sense of déjà vu -- I had some UK friends parrot the UK governement's very similar points (made last week). Because it was all opinion and little number crunching, that would all be substantiated with a study done by Imperial College on Tuesday, which would validate the government's stance.

Except on Tuesday when the numbers were crunched, suddenly the same claims were no longer made and the policy changed.

If you're interested:
COVID-19 reports | Faculty of Medicine | Imperial College London

 

[bkp_duke]

Not to squash the party, but the distinction between in vitro and in vivo is well documented for a loooooooong time now. Pointing out this distinction doesn't really add anything new to the world of knowledge and really just pollutes the thread.

Says that guy that posts every single in vitro study he can find on chloroquine. . .

 

[Lessmog]

I do not bother to scroll back. I am fairly confident in my professional expertise in evaluating epidemiology work. And respectfully most of it is crap. I have not seen any errors from Ioannidis. But when he points out errors in others he is always correct. To attack an opinion piece bu the fact that it will not be a peer reviewed publication lacks seriousness.

My offer to you. Pick one substantial criticism on the article that you think is correct. I am happy to show that it is BS.

Not to but in, but ...
I also do not bother to click a non-link. Was that any more helpful?

 

[EinSV]

France is preparing to conduct a larger trial of HCQ to see if the initial results from Didier Raoult can be replicated.

This appears to be a treatment trial, which would be a nice complement to the use as a preventative being conducted in the US. The French health authorities apparently are waiting confirmation of the preliminary results before deciding to roll out treatment to the public.

French health minister Olivier Véran has said that new tests will now go ahead in order to evaluate the results by Professor Raoult, in an attempt to independently replicate the trials and ensure the findings are scientifically robust enough, before any possible decision might be made to roll any treatment out to the wider public.

He said: “I am aware of the results [by Professor Raoult] and I have now authorised a larger study by other teams to be started as soon as possible, on a larger number of patients.”

He added: “[I hope] to add to the interesting results [by Professor Raoult, but] it is absolutely fundamental that we base all public health decisions on validated scientific data, and this validation process is non-negotiable.”​

French lab offers ‘millions of doses’ of Covid-19 drug

@traxila

 

[dl003]

Oh how I would have loved Texas if not for its shitty weather
"At this moment, xxx is not recommending school closures at this time because children have not been shown to be at high risk for serious cases of COVID-19. When some schools briefly closed during the H1N1 influenza pandemic, children still gathered in group settings and thus still had exposure to one another. Additionally, closing schools would put a strain on our workforce, including healthcare and emergency workers who are essential to the COVID-19 response."

 

[jbcarioca]

Do you have data for that, for South Korea? I have been watching the South Korea numbers for some time, and the fatality rate is definitely going up over time! About a week ago they were at about 50-60 deaths with a very similar case count to now. Guess I need to pull up the Way Back machine on Worldometer.
...

Roughly 60% of total South Korean cases came from the same religious group, which tends towards relatively younger healthier people than does the population as a whole. More than that the entire South Korean approach differed materially from almost all others. First, the testing was massive. Second, the case epidemiology was comprehensive. Third, source data and infectee movements prior to treatment were tracked, stripped of personal details, and made widely available so that people could self-identify whether they had had close contact with an infected person(s).

Such tactics are only possible in a high-trust environment. Does anyone imagine that such information could be used that way anywhere in Europe or the Americas? Anyway this process needs early alacrity among health professionals. South Korea began testing preparation only a week or so after the first wuhan cases were identified publicly.

To be clear the South Korean situation could only happen if all parts of the process were dominated by science, divorced from politics and with clear competence. What other countries come to mind which have those characteristics?

Finally the South Korean health infrastructure understands epidemics and the cost of poor preparation. Not just a person or two, but the entire infrastructure is dedicated to avoiding a poor response to communicable disease.
FWIW, I spent a year working with a South Korean group while they were coping with a situation they and not previously faced but other countries had. They were exhaustive in the efforts to find analogies. They were equally exhaustive in their efforts to find the limitations of the analogies they found. In several decades of working with/around South Korean professionals I have always found those characteristics.

Just as with every other aspect of CIVID-19 investigation we must also understand the context.
The difference between Lombardy and South Korea results demonstrate process differences rather than anything else.

Every country that has had the first response to block entry seems to have poor results. Italy and the US both took the most dramatic and less effective measures first:
Italy Banned Flights From China Before America - It Didn’t Work

Now the world is in a huge mess with rational responses no longer possible. Sad!

 

[gerebgraus]

Not to but in, but ...
I also do not bother to click a non-link. Was that any more helpful?

Link again: In the coronavirus pandemic, we're making decisions without reliable data

 

[bkp_duke]

Link again: In the coronavirus pandemic, we're making decisions without reliable data

Proverbial chicken and the egg . . .

If we wait for a complete dataset, people will die that could have been saved if we worked from a partial dataset.

Physicians face this problem every day. We simply make the best informed decisions we can from the data we have, and try our hardest to separate out the reliable data from the noise. There is a lot of both right now.

 

[SageBrush]

CSSEGISandData/COVID-19

I graphed with this data the outbreaks that have reached 1000 cases. Log-normal used to make it easier to identify taper trends

 

[uselesslogin]

Apparently there is another (in development?) drug showing promising results. This sounds nowhere near as available as the chloroquine drugs.

Japanese flu drug could be effective in treating coronavirus, report says

 

[Doggydogworld]

My offer to you. Pick one substantial criticism on the article that you think is correct. I am happy to show that it is BS.

South Korea numbers directly contradict his 0.3% fatality rate assumption. Which he arrived at by "adjusting" Diamond Princess 1% rate, which itself is probably too low because tracking got spotty while there were still lots of unresolved cases.

I agree with his headline - we don't have reliable data in the US yet (due to total FUBAR by the federal government). Poor data means we have to do MORE, not less. If you know the hurricane's path you can focus your preparation. If you don't, then everyone along the entire coast has to board up and evacuate.

 

[EinSV]

And if you find a picture of Raoult you will think he should be working on flux capacitors rather than infectious diseases. The whole thing is probably a bitcoin scam . . . But there it is.

True

(pic from his Twitter profile)

On the other hand, there are many eccentric but brilliant scientists in the world.

 

[linux-works]

amazon reprioritizing what its going to store in its warehouses:

Amazon is banning its warehouses from stocking nonessential items during the coronavirus pandemic

"Faced with merchandise shortages in the United States and Europe due to the Covid-19 coronavirus pandemic, Amazon has instituted sweeping changes on which products it will store and ship from its warehouses over the next three weeks, in a move it said was aimed at keeping essential items in stock and speeding up orders.

Early Tuesday morning, Amazon said it would be “temporarily prioritizing household staples, medical supplies, and other high-demand products coming into our fulfillment centers so that we can more quickly receive, restock and deliver these products to customers.”

By “prioritizing,” Amazon means it will no longer accept new shipments to its warehouses for discretionary items through April 5. During that time, Amazon will continue to sell all types of products on its websites, but sellers listing discretionary items will have to store and ship them on their own if they aren’t already in, or on their way to, an Amazon warehouse as of Tuesday."

 

[gerebgraus]

Proverbial chicken and the egg . . .

If we wait for a complete dataset, people will die that could have been saved if we worked from a partial dataset.

Physicians face this problem every day. We simply make the best informed decisions we can from the data we have, and try our hardest to separate out the reliable data from the noise. There is a lot of both right now.

Unfortunately, physicians and even epidemiologists are not trained well to make decisions based on incomplete data. E.g. with all due respect virtually all dietary recommendations of Harvard School of Public Health are erroneous. This is not the right place to go into details. Ultimately they come up with results that supports either their philosophy in life or financial interest of the sponsors. The current recommendations in place optimize the emergency room operations (shortage of ventilators, etc. an unquestionably important issue) and not the overall health of population.

 

[bkp_duke]

Unfortunately, physicians and even epidemiologists are not trained well to make decisions based on incomplete data. E.g. with all due respect virtually all dietary recommendations of Harvard School of Public Health are erroneous. This is not the right place to go into details. Ultimately they come up with results that supports either their philosophy in life or financial interest of the sponsors. The current recommendations in place optimize the emergency room operations (shortage of ventilators, etc. an unquestionably important issue) and not the overall health of population.

We can nit-pick specific examples of course, but physicians are better at this than everyone else when it comes to a pandemic.

You think things are bad now, just wait till parts of the US starts doing what Italy is doing. Triaging those we think have a chance to fight off the virus, and giving those we cannot save palliative care.