Coronavirus

[linux-works]

Citation needed.

its been said, "if you are right 97% of the time, why argue about the remaining 5% ?"

 

[dfwatt]

5% of all people who attempted to go into space died.
We need to shut down the space program until it's under 0.005% fatalities.

That's the most ridiculous analogy of all time. Spaceflight is widely regarded as extremely dangerous, more so even than race car driving, which is another unsafe occupation. Living in a open society on the other hand, not so much. Unless you are a lunatic. Or exposed to COVID 19 and in a moderate to high risk group, in which case, 5% mortality is just about right. And something to be deeply afraid of, if you are not a lunatic. Present company excepted?

 

[linux-works]

as we all could have predicted, the plague rats are definitely out and actively infecting people:

Hair stylist worked while symptomatic, exposed clients to virus

A hair stylist in Springfield, Missouri, exposed as many as 91 people to coronavirus after working at a salon for eight days while symptomatic, health officials said Friday.

but I'm told, its the price of Freedums.

 

[Papafox]

FIRST - it is NOT 44% fewer deaths. I showed you that, clearly. You keep mis-reading that small study and mis-quoting an odds ratio for reduced death percentage. THEY ARE NOT THE SAME THING.

SECOND - I'm going to bottom line this for you:
LEGALLY, this is a lawsuit waiting to happen now for any physician that prescribes HCQ (with or without anything else in the mix). With an 8% arrhythmia rate (vs. 0.3% at baseline) and a death rate twice that of no treatment, no physician is going to risk being sued for malpractice. HCQ will never be approved as standard of care now because there is STRONG evidence against it, and no physician that wants to keep his license will prescribe it off-label anymore. The side effect profile is simply too risky, even if given "early in disease".

I said from day one when this was brought up that this is NOT a good drug in terms of side effect profile. In fact it is downright NASTY. But the lay public keeps clinging to it like it is an aspirin.

Hell, you even have a cardiologist on this forum going WTF when HCQ is mentioned. Need I say more?

Couldn't disagree with you more.

You're taking a broad brush and saying HCQ is bad period. The Lancet study shows that as it has been used in the past can produce net negative outcomes, but that doesn't mean that used properly with the right patients it cannot be a very positive treatment. Include zinc with the HCQ and only give to patients early enough in the disease progression for there to be time to knock down the viral counts and prevent the massive battle in the lungs. The NYU study shows enormous benefit of including zinc and also shows that for good results the treatment needs to begin before the patient is transferred to ICU.

Let's talk about this excerpt from Chart 4 of the NYU study. When HCQ+azithromycin+zinc was given to patients before ICU admission, 6.9% of patients either died or were moved to hospice. In contrast when zinc was excluded in that same scenario 13.2% of patients died or were moved to hospice. The .449 number gives the gains in preventing death that came from adding zinc when given before the patient reached the ICU.

Regarding the possible heart issues from HCQ, it really comes down to administering the treatment in a fashion that minimizes the risks and maximizes the benefits in order for the improved outcomes to significantly outweigh the risks of the treatment. As a patient becomes more severe with COVID19, the heart issues can become more apparent, both because of the patient's condition and other medications given that promote heart arrhythmia. This is a big part of the reason why the Lancet article showed negative results from HCQ. Given too late in the progression, the risks of the treatment clearly outweigh the benefits.

Why then give HCQ at all and take a risk? It's because for certain groups of at-risk patients, COVID19 can be a very deadly disease. You don't want to give the HCQ and zinc treatment to a young person who is not in an at risk group, but you may well be saving the patient's life by giving the treatment upon first indication of the disease when the patient is in an at risk group..

You say that you proved that the 44% improvement in fewer deaths is something you've already shown. I watched closely, and all you said was you have to use the study instead of the article. So, I read the NYU study and the chart 4 comes from that study. It backs up what the article says.

I ask you to show with data why this significant improvement really isn't an improvement. Don't descend to belittling the person with an opposing view. Keep this discussion professional. Thank you.

 

[bkp_duke]

Couldn't disagree with you more.

You're taking a broad brush and saying HCQ is bad period. The Lancet study shows that as it has been used in the past can produce net negative outcomes, but that doesn't mean that used properly with the right patients it cannot be a very positive treatment. Include zinc with the HCQ and only give to patients early enough in the disease progression for there to be time to knock down the viral counts and prevent the massive battle in the lungs. The NYU study shows enormous benefit of including zinc and also shows that for good results the treatment needs to begin before the patient is transferred to ICU.

View attachment 544225

Let's talk about this excerpt from Chart 4 of the NYU study. When HCQ+azithromycin+zinc was given to patients before ICU admission, 6.9% of patients either died or were moved to hospice. In contrast when zinc was excluded in that same scenario 13.2% of patients died or were moved to hospice. The .449 number gives the gains in preventing death that came from adding zinc when given before the patient reached the ICU.

You say that you proved that the 44% improvement in fewer deaths is something you've already shown. I watched closely, and all you said was you have to use the study instead of the article. So, I read the NYU study and the chart 4 comes from that study. It backs up what the article says.

I ask you to show with data why this significant improvement really isn't an improvement. Don't descend to belittling the person with an opposing view. Keep this discussion professional. Thank you.

Even the authors state clearly that their data should NOT be interpreted in the way you are trying to interpret it:

"In light of these limitations, this study should not be used to guide clinical practice. Rather, our observations support the initiation of future randomized clinical trials investigating zinc sulfate against COVID-19."





Let's put this in simpler terms:
1) The general consensus is people do not die from mild COVID-19 infections, only the serious infections that cause them to need to be intubated, ventilated, etc. It is that population of sick patients that needs a viable treatment, not those with mild disease.

2) HCQ is a nasty drug. Not a little bit bad, but BAD in terms of the side effect profile. You WILL CAUSE more death in those patients with MILD disease than would have occurred without the drug (2X the death rate according to the 96,000 patient study I quoted yesterday). All that for the attempt to shorten the course in those people that by pre-selection as MILD cases would have a low risk of dying.

As previously mentioned, the NNT (number needed to treat) and the NNH (number needed to harm) for this drug make it not acceptable as something that can be used widespread for prophylaxis against COVID-19. You literally will cause more harm than good in the population as a whole.


BTW, the study you quote and are holding so dearly to is from hospitalized patients on cardiac monitoring. You are not going to be able to cardiac monitor people outpatient. You are trying to extrapolate from one pool of people (sick and hospitalized) to another group (not hospitalized and by comparison relatively healthy). The data do not support that extrapolation, not at all.

 

[RandomJohnny]

I drove to a fine local coffee establishment and browsed the adjacent green space. 0 masks and a lot of people, dogs and children at play.

As I took a breath fresh air, inhaled and touched all the wonderful germs around me I looked into the beautiful horizon. I can confirm the curve has been flattened. I saw it with my own eyes. Time to open up folks.

As side note: I have noticed this for the last few weeks as I have ventured out on a daily basis. The lockdown has destroyed the public's driving skills and awareness. It has always been bad but this is another level of bad. Just another side effect I suppose. Be extra vigilant and defensive.

 

[Papafox]

Even the authors state clearly that their data should NOT be interpreted in the way you are trying to interpret it:

"In light of these limitations, this study should not be used to guide clinical practice. Rather, our observations support the initiation of future randomized clinical trials investigating zinc sulfate against COVID-19."
.

With the relatively small numbers involved in the study, that's my view too: Another study is needed to verify the implications of the NYU study. In this second study, only give to patients who are early in the disease progression and include zinc. Compare to a control arm where no HCQ is involved. That's the study I want to see.

 

[linux-works]

RJ is not even an interesting troll, anymore. time to add to my (short) ignore list.

note to trolls, at least try to be more interesting. its obvious when you are trolling, so at least give us some entertainment for our time.

 

[UnknownSoldier]

I drove to a fine local coffee establishment and browsed the adjacent green space. 0 masks and a lot of people, dogs and children at play.

As I took a breath fresh air, inhaled and touched all the wonderful germs around me I looked into the beautiful horizon. I can confirm the curve has been flattened. I saw it with my own eyes. Time to open up folks.

As side note: I have noticed this for the last few weeks as I have ventured out on a daily basis. The lockdown has destroyed the public's driving skills and awareness. It has always been bad but this is another level of bad. Just another side effect I suppose. Be extra vigilant and defensive.

All the stupid slow drivers who block the left lane doing the speed limit vanished during the lockdown. The essentials who have had to commute to work all this time were finally free to drive as fast as they wanted. Now the stupids are all back on the road blocking traffic and tempers are very short because all the essentials know these are the idiots who were cowering in their homes while they had to work every day and dodge the virus every day. It's just a microcosm of the fraying social fabric that the virus is exposing and accelerating.

 

[dfwatt]

Couldn't disagree with you more.

You're taking a broad brush and saying HCQ is bad period. The Lancet study shows that as it has been used in the past can produce net negative outcomes, but that doesn't mean that used properly with the right patients it cannot be a very positive treatment. Include zinc with the HCQ and only give to patients early enough in the disease progression for there to be time to knock down the viral counts and prevent the massive battle in the lungs. The NYU study shows enormous benefit of including zinc and also shows that for good results the treatment needs to begin before the patient is transferred to ICU.

View attachment 544225

Let's talk about this excerpt from Chart 4 of the NYU study. When HCQ+azithromycin+zinc was given to patients before ICU admission, 6.9% of patients either died or were moved to hospice. In contrast when zinc was excluded in that same scenario 13.2% of patients died or were moved to hospice. The .449 number gives the gains in preventing death that came from adding zinc when given before the patient reached the ICU.

Regarding the possible heart issues from HCQ, it really comes down to administering the treatment in a fashion that minimizes the risks and maximizes the benefits in order for the improved outcomes to significantly outweigh the risks of the treatment. As a patient becomes more severe with COVID19, the heart issues can become more apparent, both because of the patient's condition and other medications given that promote heart arrhythmia. This is a big part of the reason why the Lancet article showed negative results from HCQ. Given too late in the progression, the risks of the treatment clearly outweigh the benefits.

Why then give HCQ at all and take a risk? It's because for certain groups of at-risk patients, COVID19 can be a very deadly disease. You don't want to give the HCQ and zinc treatment to a young person who is not in an at risk group, but you may well be saving the patient's life by giving the treatment upon first indication of the disease when the patient is in an at risk group..

You say that you proved that the 44% improvement in fewer deaths is something you've already shown. I watched closely, and all you said was you have to use the study instead of the article. So, I read the NYU study and the chart 4 comes from that study. It backs up what the article says.

I ask you to show with data why this significant improvement really isn't an improvement. Don't descend to belittling the person with an opposing view. Keep this discussion professional. Thank you.

But what you are arguing, without perhaps realizing it, is simply for evidence that any ionophore combined with zinc, may be protective, and broadly so in relationship to many viruses. And that may be quite true in COVID19, although the RCT proof is still absent. But let's presume that it's still true. There is a HUGE catch in all this. For example, Quercetin, EGCG (principal polyphenolic in green tea) and several other compounds may promote this effect WITHOUT REMOTELY THE TOXICITY OF HCQ!! The benefit you are mentally accruing to HCQ may be therefore in some sense unmerited.

While we are on the subject of protection, keeping Vit D levels above 30 and probably even above 40 may have significant effects in terms of buffering disease severity and may explain some of the vulnerability of dark skinned individuals, and ironically Spain and Italy where vitamin D deficiency is more widespread, whereas there is more supplementation of vitamin D in northern latitude European countries which have shown significantly less mortality per capita. This is an example of a protective strategy that has far fewer downsides also then hydroxychloroquine and other upsides as well. In that sense it meets an optimal standard in terms of risk/benefit ratio meaning close to zero risk and possible to probable substantial benefits. We know from lots of other research that vitamin D buffers severity in relationship to other respiratory illnesses, and for folks looking for the latest on this see med cram vitamin D for video, and this link for Lancet review.

I appreciate that you're trying to think prophylactically and in terms of various bioprotective strategies. Here is one (Supplementation with vitamin D, quercetin, EGCG and zinc) with far better dividends In terms of overall risk-benefit ratio than hydroxychloroquine.

 

[HG Wells]

as we all could have predicted, the plague rats are definitely out and actively infecting people:

Hair stylist worked while symptomatic, exposed clients to virus

A hair stylist in Springfield, Missouri, exposed as many as 91 people to coronavirus after working at a salon for eight days while symptomatic, health officials said Friday.

but I'm told, its the price of Freedums.

The follow up should be interesting.
She keeped good records of customers, and wore a mask.

Want to know type of mask, adherence and number of customers infected.

 

[Doggydogworld]

Calling all mask fiends. What's up with the controlled trials mentioned here that showed masks had no effect on ILI?

 

[JRP3]

Calling all mask fiends. What's up with the controlled trials mentioned here that showed masks had no effect on ILI?

We did not consider the use of respirators in the community. Respirators are tight-fitting masks that can protect the wearer from fine particles (37) and should provide better protection against influenza virus exposures when properly worn because of higher filtration efficiency.

 

[SageBrush]

This is a big part of the reason why the Lancet article showed negative results from HCQ. Given too late in the progression, the risks of the treatment clearly outweigh the benefits.

Why don't you actually read the article

 

[SageBrush]

Calling all mask fiends. What's up with the controlled trials mentioned here that showed masks had no effect on ILI?

I answered that back in January.

Compliance

 

[MXLRplus]

Citation needed.

"As of April 9, 2020, a total of 566 people from 41 countries have gone into space according to the FAI criterion (574 people have qualified when including the US Department of Defense classification"

"As of December 2015, 22 crew members have died in accidents aboard spacecraft."

So for the ones actually trying to go up that looks like 3.8% unless you have documentation for a lot more people trying to go up your 5% number seems high.

and I'm being generous and not counting people that flew more than once, if you do the math by times each one of them flew vs the deaths it's an even lower percentage.

---

if you change your wording to ships not people then the numbers are

"As of the launch of Soyuz MS-16 on 09 April 2020, there have been 328 human spaceflight launch attempts. Three of these launches did not cross the Kármán line, and therefore do not qualify as spaceflights. "

with about 1% not making it up.

30 astronauts have died during manned space programs. Some were in training before launch, or on the pad.

Source: Astronomy.com

 

[dfwatt]

I answered that back in January.

Compliance

Yes. And there is this amazing and constant discrediting of partial protection, just because it's not bulletprooof. Studies have shown that masks block a significant and perhaps variable fraction of outgoing virus, and perhaps a lesser percentage of incoming. But it's still blocking a lot of virus!! So why are people always looking a gift horse in the mouth? It's like my colleagues in AD research looking at the 60-70% reduction in downstream risk of AD from diet and exercise and complaining, "gee, that's not so impressive! We want 100% protection." LOL! Like a lot of things, perfection is in the mind, but not in the real world. For most of us, most of the time, it's shades of gray, or as I like to put it to students, residents and fellows "you're shaving points off something deadly - Take it and quit complaining!!"

 

[jerry33]

Yes. And there is this amazing and constant discrediting of partial protection, just because it's not bulletprooof. Studies have shown that masks block a significant and perhaps variable fraction of outgoing virus, and perhaps a lesser percentage of incoming. But it's still blocking a lot of virus!! So why are people always looking a gift horse in the mouth? It's like my colleagues in AD research looking at the 60-70% reduction in downstream risk of AD from diet and exercise and complaining, "gee, that's not so impressive! We want 100% protection." LOL! Like a lot of things, perfection is in the mind, but not in the real world. For most of us, most of the time, it's shades of gray, or as I like to put it to students, residents and fellows "you're shaving points off something deadly - Take it and quit complaining!!"

There is no shame in wearing the masks you have as long as you wear them to the best of your ability. (Wash your hands as well.)

 

[HG Wells]

Yes. And there is this amazing and constant discrediting of partial protection, just because it's not bulletprooof. Studies have shown that masks block a significant and perhaps variable fraction of outgoing virus, and perhaps a lesser percentage of incoming. But it's still blocking a lot of virus!! So why are people always looking a gift horse in the mouth? It's like my colleagues in AD research looking at the 60-70% reduction in downstream risk of AD from diet and exercise and complaining, "gee, that's not so impressive! We want 100% protection." LOL! Like a lot of things, perfection is in the mind, but not in the real world. For most of us, most of the time, it's shades of gray, or as I like to put it to students, residents and fellows "you're shaving points off something deadly - Take it and quit complaining!!"

Didn't someone say something like.
"Perfection, is the enemy of the good ?

 

[dfwatt]

Didn't someone say something like.
"Perfection, is the enemy of the good ?

Yep it's a great expression.