[gordontd]

pilowsky, on 2020-April-08, 20:32, said:

Do I have to charge for English lessons now? At most 50 million, and at least 50 million, mean the same thing.

I would suggest you pay for English lessons if you believe that.

[cherdano]

Here is what wikipedia says:

Quote

The death toll is estimated to have been anywhere from 17 million to 50 million, and possibly as high as 100 million,

Seems a bit silly to debate a number that no one really knows. (And yeah I know that's a bit rich coming from me )

[FelicityR]

"...And if hydroxychloroquine is a risk factor, it may be only administered as a last chance medication when the patient is desperately ill, by which time it might be too late anyway."
Pilowsky says: Unfortunately your comment is incorrect. The problem is that Trump is recommending a drug that people can buy over the internet. You might be used to going to a Doctor and going through exhaustive screening and careful checks before you take any drug but in the real world in the middle of a pandemic that is not how it works.

I'll be honest. I was not fully aware just how over-bullish Donald Trump was about this drug, and, how readily available hydroxychloroquine was online. That really surprised, actually shocked, me. I suppose in this scenario, there are genuine online pharmacies who won't prescribe to a person with Long QT syndrome, but there are probably others that won't be so conscientious, and there are also all the fraudsters cashing in online, too, not forgetting the patients who will willing lie to get hold of this drug.

I was unaware that this drug was being touted as a prophylactic as opposed to an acute or critical care drug used by doctors in hospitals. That truly is a disaster waiting to happen, but guessing Donald Trump's way of thinking, a few 100 deaths here and there would be a price worth paying to keep, let's say, 10-20% less of the population having to use acute/critical medical services in hospitals. Hospital beds cost money, and ICU units are very expensive to run.

[Cyberyeti]

Best article I've seen dissecting the British response:

https://www.reuters....yGZmwuwkdV5Wqc0

[pilowsky]

cherdano, on 2020-April-09, 03:50, said:

Here is what wikipedia says:

Seems a bit silly to debate a number that no one really knows. (And yeah I know that's a bit rich coming from me )

I think my poodles want to have an intelligent conversation with you.

[PassedOut]

pilowsky, on 2020-April-08, 20:32, said:

Do I have to charge for English lessons now? At most 50 million, and at least 50 million, mean the same thing. NOT more than 50 million. Are you two related?

Trump is (to use his own term) scum, and stupid to boot. But when you double down like this on a foolish statement of your own, it detracts from your criticism of Trump: the pot calling the kettle black.

[FelicityR]

Cyberyeti, on 2020-April-09, 06:10, said:

Best article I've seen dissecting the British response:

https://www.reuters....yGZmwuwkdV5Wqc0

I agree. An excellent read and analysis.

This article makes painful reading. There are plenty of 'Brainless Brits' who will make this lockdown longer that it needs be. It's about time the Police issued serious fines and arrested people for this type of behaviour. Telling them to 'disband the party and don't let it happen again' isn't getting through to the morons who have no conscience.

https://www.bbc.co.u...hester-52221688

[pescetom]

Today's statistics in Italy: positive 96877 (+2%), dead 18279 (+4%), no longer infected 28470 (+8%). Intensive care 3605 (-5%). Fatality rate 15.9%.
Before anyone gets excited about the improvement, the fatality rate gives the lie to the under-reporting of positives and there are still disturbing inconsistencies in the data: for instance, the 3605 in intensive care is cited as being 88 less than yesterday, but yesterday it was 3792.

[y66]

Cyberyeti, on 2020-April-09, 06:10, said:

Best article I've seen dissecting the British response:

https://www.reuters....yGZmwuwkdV5Wqc0

Quote

According to Medley, the chairman of the SPI-M pandemic modelling committee, no one now doubts, for all the initial reservations, that a lockdown was essential in Britain.

Medley added: “At the moment we don’t know what’s going to happen in six months. All we know is that unless we stop transmission now, the health service will collapse. Yep, that’s the only thing we know for sure.”

Can always do better next time.

[Chas_P]

pilowsky, on 2020-April-09, 03:16, said:

And people call me stupid!

I, like many others, could offer a comment here, but......

[kenberg]

Browsing around I saw this link for 1918.

https://www.medicine...ticlekey=228841

A couple of points.

1. If for some reason we want to compare 1918 with now, surely it matters that the world population in 1918 was considerably less than today's. In the time of Adam and Eve, for example, a flu that killed two people would have been very significant.

2. Surely we can recognize the Trump style by now. Trump displayed the absolute worst of his qualities during the last few months. So let's get people arguing about 1918. He is very good at this. He is totally incompetent at most endeavors, but great at shifting the topic. For some reason people bite again and again at the irrelevant.

[y66]

Clive Cookson at FT: Oxford recruits 2,700 virus patients for fast-growing drugs trial

Quote

The fastest-growing clinical trial in medical history has enrolled more than 2,700 Covid-19 patients in UK hospitals to test potential treatments for coronavirus disease — and thousands more are likely to join over the next few weeks.

Peter Horby, professor of infectious diseases at the University of Oxford, who is leading the project, said no controlled clinical trial — in which people are assigned at random to receive different drugs and the results compared — had ever expanded so quickly and on such a large scale.

“We need to recruit very fast while the epidemic is approaching its peak, so that we have enough patients to provide firm data,” he said. The trial is called Recovery, a somewhat tortured acronym for randomised evaluation of Covid-19 therapy. 

Prof Horby was involved in clinical trials carried out during the early weeks of the coronavirus epidemic in China. These generally ended up with too few subjects to provide firm evidence, he said, because the Chinese government’s clampdown on Covid-19 reduced transmission of the virus very quickly.

Scientists have not had nearly enough time to develop new treatments specifically for Covid-19, so Recovery is evaluating existing medicines that might be effective against coronavirus.

The trial started by examining three treatments recommended by an expert panel advising the chief medical officer. They are: the lopinavir-ritonavir combination used to treat HIV; dexamethasone, a steroid that reduces inflammation; and hydroxychloroquine, the malaria medicine.

Patients arriving at 130 NHS hospitals across the UK with confirmed Covid-19 are invited to take part. They are allocated randomly to four groups. Three are given one of the trial treatments and the fourth — the control group — just receives standard medical care.

“We can add further medicines to the trial within days,” said Prof Horby. “This week we are adding azithromycin, an antibiotic with anti-inflammatory properties.”

The trial also plans an extension to patients who become more severely ill, suffering a “hyper-inflammatory” reaction to Covid-19 that might destroy their lungs and other organs. They will probably receive a drug that blocks the action of interleukin-6, a molecule that plays a key role in hyper-inflammation. 

Recovery, funded by a £2.1m grant from the UK government, is the largest of many Covid-19 trials under way around the world. “We will co-ordinate as far as possible with the others,” said Prof Horby. “We have aligned the Recovery trial protocol with the World Health Organization’s Solidarity trial, using the same doses.”

Many of these trials are testing the same medicines, such as hydroxychloroquine, which President Donald Trump has mentioned on several occasions, because they are widely available and inexpensive.

The only clinical trial in China that has reported statistically significant results used the lopinavir-ritonavir anti-HIV combination. Prof Horby, who was part of that trial team, said: “Although the headline was that the findings were negative, most of the signals were in the direction of a positive benefit. My interpretation is that it provides a basis for a larger trial of the treatment.”

The Oxford team wanted to include remdesivir, the antiviral drug developed by Gilead of the US originally to treat Ebola, which some experts believe has a good chance of showing some effect against Covid-19. “But we just could not get access to enough remdesivir for our trial,” Prof Horby said. “There just isn’t enough available worldwide.”

Recovery has an “adaptive” design, with data analysed on a rolling basis so that any beneficial treatments can be identified as soon as possible and ineffective ones dropped from the trial.

Professor Kev Dhaliwal, who is about to launch a separate project at the University of Edinburgh to test anti-inflammatory drugs as Covid-19 treatments, said: “The UK is in a unique position to deliver large clinical trials because we have a unified NHS. It is difficult to carry them out in other parts of the world.”

Prof Horby said it was hard to give a timescale for his Recovery trial to deliver results. “The important thing is to continue recruiting very quickly and get the study done and dusted within a few weeks,” he said. “If we stretch it over four to six months we may run out of patients.

“We don’t want a repetition of the 2009 flu pandemic when, despite many millions of cases, there were no decent trial results — and we still don’t know what drugs work well against severe influenza.”

[Winstonm]

kenberg, on 2020-April-10, 07:47, said:

Browsing around I saw this link for 1918.

https://www.medicine...ticlekey=228841

A couple of points.

1. If for some reason we want to compare 1918 with now, surely it matters that the world population in 1918 was considerably less than today's. In the time of Adam and Eve, for example, a flu that killed two people would have been very significant.

2. Surely we can recognize the Trump style by now. Trump displayed the absolute worst of his qualities during the last few months. So let's get people arguing about 1918. He is very good at this. He is totally incompetent at most endeavors, but great at shifting the topic. For some reason people bite again and again at the irrelevant.

All discussions comparing the 1918 flu pandemic death totals to the present coronavirus pandemic totals are basically non-sensical as explained by this Smithsonian Magazine article:

Quote

The legacy of victims of the 1918 flu

The quest to understand the 1918 flu fueled many scientific advances, including the discovery of the influenza virus. However, the virus itself did not cause most of the deaths. Instead, a fraction of individuals infected by the virus were susceptible to pneumonia due to secondary infection by bacteria. In an era before antibiotics, pneumonia could be fatal.

A lack of knowledge about viruses and viral transmission combined with information system that was slow and unreliable - radio didn't really catch on until the 1920s and only about 35% of homes had phones in 1918 - contributed to the rapid spread of the virus.

Don't fall for yeahbutism as it is a cousin of whataboutism and both are designed to make you take your eye from the problem at hand.

[barmar]

pilowsky, on 2020-April-08, 20:32, said:

Do I have to charge for English lessons now? At most 50 million, and at least 50 million, mean the same thing.

This reminds me of an old Saturday Night Live sketch.

The supervisor of a nuclear reactor (played by Ed Asner) is retiring, and he's giving instructions to his subordinates on how to manage things in his absence. He reminds them "You can't put too much water into the nucelar reactor".

After he leaves, an alarm about a possible meltdown goes off. The workers now realize his statement was ambiguous. Did he mean:

1. You must not put too much water into the reactor, and exceeding the limit will cause more problems, or

2. it's not possible to put too much water into the reactor, so just keep adding water until the problem is resolved.

However, "at most" and "at least" are not ambiguous like this, except in Pillowsky's mind.

[Cyberyeti]

Not sure if this belongs here or in its own thread.

Coronavirus seems to be doing strange things to social media.

Take the story of the Belgian 500 person orgy which is completely fake and is shown with the debunking of it in this article https://www.thequint...alse-fact-check, basically a serious website saw it on a news website it didn't realise was satirical.

I've just had a friend (who admittedly has every reason to be very angry about her situation) unfriend me on FB because I dare to question allegedly independent articles, that are all on websites founded by Labour party hacks, and haven't had a verifiable source in any of them. She believes the Tories are trying to kill off all the old and infirm to save money.

[kenberg]

Cyberyeti, on 2020-April-10, 11:41, said:

Not sure if this belongs here or in its own thread.

Coronavirus seems to be doing strange things to social media.

Take the story of the Belgian 500 person orgy which is completely fake and is shown with the debunking of it in this article https://www.thequint...alse-fact-check, basically a serious website saw it on a news website it didn't realise was satirical.

I've just had a friend (who admittedly has every reason to be very angry about her situation) unfriend me on FB because I dare to question allegedly independent articles, that are all on websites founded by Labour party hacks, and haven't had a verifiable source in any of them. She believes the Tories are trying to kill off all the old and infirm to save money.

The problem of mis-information is serious and yes, it might deserve a thread if its own/ I was thinking the same when griping about DT. We probably should keep this thread to the virus itself.

We have to trust someone, at least provisionally, but there are a lot of people who we should not trust. Sorting it all out is not obvious.

[y66]

Steven Salzberger at Forbes: Prazosin Might Be A Treatment For COVID-19. More Data Is Urgently Needed

Salzberger is Bloomberg Distinguished Professor of Biomedical Engineering, Computer Science, and Biostatistics at Johns Hopkins University

Quote

Scientists around the globe are devoting enormous resources to trying to develop new treatments for COVID-19, the pandemic that is sweeping across the world. So far, though, we don't have any effective therapies or vaccines.

That might be about to change. What's particularly exciting is that this new treatment uses a widely-available drug that has already been shown to be safe in humans.

In a new preprint, a team of my colleagues at Johns Hopkins University School of Medicine, led by Maximilian Konig, Bert Vogelstein, Joshua Vogelstein, Susan Athey, Shibin Zhou, and Chetan Bettegowda, describe the potential of prazosin to slow down and possibly prevent one of the worst effects of COVID-19: the cytokine storm.

[Some background: a cytokine storm is an extreme immune response of your own body. When coronavirus (SARS-CoV-2) enters the lungs, your immune system responds with virus-fighting cells that release small proteins called cytokines. In some cases, the immune system just keeps amplifying its response, sending more and more cytokines even though the infection might be under control. If it gets too bad, the cytokine storm itself may be fatal. Cytokine storms have been implicated in other viral diseases, including influenza and SARS.]

Let me start with a caveat: if prazosin works, it isn't a cure. However, it might prevent the need to go on a ventilator, which would be a huge benefit in a country (and a world) that has a severe shortage of ventilators right now. Even more important, it might save patients with severe COVID-19 from dying.

Several of the scientists involved in this new study have shown previously that drugs like prazosin (which are known technically as alpha-1AR antagonists) can prevent a cytokine storm–in mice. They realized that results in mice often fail to translate to humans, but in the current pandemic, how could they find time to do a new study?

They didn't: instead, they looked at a medical database and collected records from 13,125 men who had acute respiratory distress (ARD) from a variety of causes in the years from 2007-2015. ARD is not the same as COVID-19, but it's similar; and if a cytokine storm occurs in ARD, patients are more likely to require a ventilator and/or die. Because prazosin is widely used by men (most commonly for enlarged prostates), they were able to compare the outcomes of men who had incidentally been taking prazosin to men who hadn't.

The results: men who had been taking prazosin had a 22% lower risk of either needing a ventilator or dying. That's not a huge effect, but it could be a game changer for our overwhelmed hospitals in the midst of this pandemic. Even a modest reduction in the number of patients needing ventilators–or dying–would be a huge win for public health. Also, the patients in this retrospective study weren't taking prazosin to treat their respiratory distress, and it's possible that higher doses might have a larger effect.

There are many more caveats here. First, the study I'm describing is a medRxiv preprint, meaning that it has not been peer-reviewed. In addition, the data are from a retrospective study of men who had a different disease, not COVID-19. So maybe prazosin won't work to prevent cytokine storms caused by the coronavirus.

But maybe it will. My colleagues shared their preprint with me because they are convinced that, if nothing else, their hypothesis needs to be examined by as many scientists and doctors as possible. They are starting their own clinical trial, but they hope that these preliminary findings "will inspire immediate clinical trials in countries now desperate for new ways to reduce hospital admissions, ventilator needs, sickness, and death."

[y66]

Matt Yglesias tweeted: Apple and Google are building a coronavirus tracking system into iOS and Android

[pilowsky]

barmar, on 2020-April-10, 09:34, said:

This reminds me of an old Saturday Night Live sketch.

The supervisor of a nuclear reactor (played by Ed Asner) is retiring, and he's giving instructions to his subordinates on how to manage things in his absence. He reminds them "You can't put too much water into the nucelar reactor".

After he leaves, an alarm about a possible meltdown goes off. The workers now realize his statement was ambiguous. Did he mean:

1. You must not put too much water into the reactor, and exceeding the limit will cause more problems, or

2. it's not possible to put too much water into the reactor, so just keep adding water until the problem is resolved.

However, "at most" and "at least" are not ambiguous like this, except in Pillowsky's mind.

One of the most important things about trying to be funny Barry is attention to detail. There is only one l in Pilowsky. So if I were to refer to you as Barry Mangolin that would be humorous - no doubt you copped that one a lot. My mother Marl also messed up words occasionally and my Father called them 'Marlopropisms' she was a demon at scrabble. Since I have a medical degree I suppose you could call me Pillowsky as a joke, but as my Father would say "it's like a joke except for the bit at the end". Your comment is unfortunately not far from the truth. In Australia, the Department of Health ran a campaign to stop pregnant people (women obviously for those not medically qualified, or Arnold Schwarzenegger) smoking because it would cause intrauterine growth retardation (small sick babies). Tragically, many women started smoking more so that they would have easier deliveries. To the point. At most 50 million people died. True. When it is stated that at least 50 million died this statistic is also true. BUT the true statistic is 20 to 50 million. many of which were CAUSED by the advice of the white house Surgeon-General and the cramming of unfortunate souls onto Troop ships (I wonder if some were cruise ships?). If it makes you feel better to make Pilowsky jokes in a time of personal difficulty, that's fine by me. You are at the end of a very long line. I'll go back to helping people: like you should be: any way that's what's in Pillowsky's mind.

[johnu]

Lots of new trials of drugs going on, most of them seem to have much more promise than chloroquine and other closely related drugs.

One is Alvesco Three Cases of the Early to Mid-stages of COVID-19 Pneumonia Improved by Inhalation of Ciclesonide

Quote

Emergency meeting on measures against new coronavirus infections" conducted on February 19, was started in 3 patients with hypoxia and CT findings on February 20, and we report the favorable progress. In the case report, it was explained to all patients, and the consent was obtained.

More anecdotal evidence, but some of these stories seem promising. Hope the trials prove that they are really effective.