COVID COVID-19 Coronavirus Containment Efforts

[Ygggdrasil]

There was also a change around then, maybe earlier, that alters the way hospitals are reimbursed. "Admitted for X but also has Covid" is different for "Admitted for Covid but also has X".

(PS How does one decide if an action is by "The Trump Administration", or some executive branch health organization (like the CDC)?")

The post from the Covid Tracking Project describes numerous mechanisms by which the reporting change has made their hospitalization numbers less reliable (mainly because many state health department relied on reporting CDC numbers rather than getting the data directly from hospitals). Many experts had warned that this reporting switch could cause problems with reporting when it was announced, so it is very likely that the unreliability of current hospitalization data is a direct result from the change in reporting.

The post from the Covid Tracking Project does not metnion changes in the way hospitals are reimbursed as a potential factor in the changes to their data. After a quick Google Search, I could not any articles about the change in hospital reimbursement nor any information about whether public health experts expect it to affect hospitalization data reported to public health agencies.

The order issuing the change in reporting came from the Department of Health and Human Services, a cabinet-level department of the executive branch that is run directly by a member of President Trump's cabinet.

 

[Astronuc]

https://www.ucsf.edu/magazine/covid-body

SARS-CoV-2 (which stands for severe acute respiratory syndrome Coronavirus 2) is first and foremost a bad respiratory virus. If your immune system doesn’t defeat it at its landing site in your nose or throat, it will advance down your windpipe, infiltrating the cells lining your lungs’ branching air tubes. At the tubes’ ends, tiny air sacs called alveoli pass oxygen to your blood. As the virus multiplies, the alveoli may fill with fluid, shutting down this critical gas exchange. Your blood-oxygen level may drop and, typically about six days into an infection, you may start feeling short of breath.

What causes this mayhem? “Some of it is definitely caused by the virus itself,” says Michael Matthay, MD, a UCSF professor of medicine who has studied acute respiratory diseases for more than 30 years. Inevitably, a fast-replicating virus will kill or injure many of the lung cells it infects; the more cells it infects, the more ruin it will leave in its wake.

“One of the weirder things about this new Coronavirus is it doesn’t seem to be incredibly cytopathic, by which we mean cell-killing,” Krummel says. “Flu is really cytopathic; if you add it to human cells in a petri dish, the cells burst within 18 hours.” But when UCSF researchers subjected human cells to SARS-CoV-2, many of the infected cells never perished. . . .

The bigger provocation, he suspects, may be your own immune system. Like any pathogen, SARS-CoV-2 will trigger an immune attack within minutes of entering your body. This counterstrike is extraordinarily complex, involving many tactics, cells, and molecules. In a UCSF study called COMET (COVID-19 Multi-Phenotyping for Effective Therapies), Krummel and other scientists have been observing this immune warfare in more than 30 people admitted to UCSF hospitals with COVID-19 and other respiratory infections. . . .

So the appropriate treatment may be related to mitigating a severe immune response. Would diphenhydramine or chlorpheniramine work? Or rather, what mitigates a cytokine storm? How to identify those with a potential to develop a severe immune response.

 

[Ygggdrasil]

So the appropriate treatment may be related to mitigating a severe immune response. Would diphenhydramine or chlorpheniramine work? Or rather, what mitigates a cytokine storm? How to identify those with a potential to develop a severe immune response.

Researchers have found that dexamethosone, a corticosteroid that can be used to suppress inflamation and the immune system, can help reduce deaths in COVID-19 patients:

The Recovery trial, one of the biggest efforts to evaluate whether existing drugs can treat COVID-19, included 2104 patients given a relatively low dose of 6 milligrams of dexamethasone for 10 days. When their outcomes were compared with those of 4321 patients receiving standard care, the steroid reduced deaths by one-third in patients already on ventilators and by one-fifth in patients receiving supplemental oxygen in other ways, Recovery researchers announced in a press release.

https://www.sciencemag.org/news/202...rst-drug-shown-reduce-death-covid-19-patients'

The results have since been published in the New England Journal of Medicine:
https://www.nejm.org/doi/10.1056/NEJMoa2021436

A variety of companies and researchers are investigating other drugs that could potentially suppress the immune system to mitigate a cytokine storm (e.g. see https://blogs.sciencemag.org/pipeline/archives/2020/07/29/the-latest-repurposing-news).

 

[Astronuc]

The results have since been published in the New England Journal of Medicine:
https://www.nejm.org/doi/10.1056/NEJMoa2021436

The article states, "In the dexamethasone group, the incidence of death was lower than that in the usual care group among patients receiving invasive mechanical ventilation (29.3% vs. 41.4%; rate ratio, 0.64; 95% CI, 0.51 to 0.81) and among those receiving oxygen without invasive mechanical ventilation (23.3% vs. 26.2%; rate ratio, 0.82; 95% CI, 0.72 to 0.94) but not among those who were receiving no respiratory support at randomization (17.8% vs. 14.0%; rate ratio, 1.19; 95% CI, 0.91 to 1.55)." It seems to make a greater difference to those requiring invasive mechanical ventilation, in other words, those susceptible to the SARS effect. I'm assuming that folks were started on dexamethasone at different stages, and thus it seems that if one becomes ill with COVID-19, it's best to start treatment as early as possible, but then that seems on how one responds to the infection. Some folks were sent home only to become seriously ill, and in some cases, it was too late to intervene.

Then there are the other organs/systems affected:

Gut specialists are finding that 20% to 40% of people with the disease experience diarrhea, nausea, or vomiting before other symptoms, says gastroenterologist Michael Kattah, MD, PhD, a UCSF assistant professor. If you swallow virus particles, he says, there’s a good chance they will infect cells lining your stomach, small intestine, or colon. As in the lungs and heart, these cells are studded with vulnerable ACE2 portals.

Other specialists are also raising flags. Neurologists worry about reports of COVID-19 patients with headaches, “brain fog,” loss of the sense of smell, dizziness, delirium, and, in rare cases, stroke. Nephrologists worry about kidney stress and failure. Hepatologists worry about liver injuries. Ophthalmologists worry about pink eye. Pediatricians, meanwhile, worry about a peculiar COVID-related inflammatory syndrome that’s showing up in kids and young adults.

growing evidence suggests, SARS-CoV-2 can infect cells in the walls of blood vessels that help regulate blood flow and coagulation, or clotting. If true, this behavior could explain some of the virus’s weirder (and rarer) manifestations, such as heart attacks, strokes, and even “COVID toes.”

The bottom line is that it is best not to become infected, so wash hands, use sanitizers, and when in public, observer social/physical distancing, wear a mask, otherwise, avoid being in public.

 

[mfb]

I think the conclusion is that the expenditures should match the risk.

That is not an answer to my question.

----

BBC reports that Iran had significantly more cases and deaths than reported.

 

[Ygggdrasil]

The article states, "In the dexamethasone group, the incidence of death was lower than that in the usual care group among patients receiving invasive mechanical ventilation (29.3% vs. 41.4%; rate ratio, 0.64; 95% CI, 0.51 to 0.81) and among those receiving oxygen without invasive mechanical ventilation (23.3% vs. 26.2%; rate ratio, 0.82; 95% CI, 0.72 to 0.94) but not among those who were receiving no respiratory support at randomization (17.8% vs. 14.0%; rate ratio, 1.19; 95% CI, 0.91 to 1.55)." It seems to make a greater difference to those requiring invasive mechanical ventilation, in other words, those susceptible to the SARS effect. I'm assuming that folks were started on dexamethasone at different stages, and thus it seems that if one becomes ill with COVID-19, it's best to start treatment as early as possible, but then that seems on how one responds to the infection. Some folks were sent home only to become seriously ill, and in some cases, it was too late to intervene.

Because dexamethasone (dex) has immunosuppressive effects, it is probably not a good drug to administer early in the infection, especially in patients with mild symptoms where the patient's immune system is likely to be able to contain the disease. Accordingly, the US National Institutes of Health only recommends dex or other similar corticosteroids for severe cases where patients require mechanical ventilation or supplemental oxygen. They recommend against using dex in patients who do not require supplemental oxygen.

Fortunately, while dex is likely best used in severe cases late in the course of the disease, the other drug with good clinical evidence supporting its use against COVID-19, remdesivir, is an antivirals which is likely most effective when administered early. (Unfortunately, supplies of remdesivir are currently very limited, so the NIH recommends prioritizing use for hospitalized patients on oxygen). However, in theory, an optimal treatment plan would likely involve an antiviral like remdesivir (or some of the newly developed analogues that are orally available) upon the onset of symptoms and dexamethosone for those where the infection becomes severe and the cytokine storm causes severe respiratory issues.

The bottom line is that it is best not to become infected, so wash hands, use sanitizers, and when in public, observer social/physical distancing, wear a mask, otherwise, avoid being in public.

Agreed.

 

[morrobay]

Chloroquine phosphate also is an immune /cytokine storm suppressant. And as I believe @StatGuy2000 pointed out these other rare complications like pulmonary could be in a predisposed vulnerable subset of those infected. If this were not the case then 90% of those infected with mild/no symptoms unlikely.

 

[bhobba]

Further details have emerged of what happened in the quarantine hotels whose substandard security led to the second wave here in Aus. It makes enlightening reading about human psychology - and frightening.

From an investigation by the Australian:

'Security guards struggled to contain a “crazy floor” of locked up hotel quarantine guests at the Rydges Hotel in Melbourne’s Swanston Street. The Australian reports the poorly trained guards were overwhelmed by the screaming, crying and banging on walls of guests begging to be let out. They offered bribes to guards to escape for fresh air. In one case a distraught women made a dash for the door after collapsing in the hotel hallway complaining she needed to “breathe”. A guest, staying on the crazy floor, said “people going absolutely nuts”. “They were begging to be let out and running for the doors.” He said that the guards seemed ill-equipped to handle the situation. “The guards had no real authority … they gave the impression they could be talked around. And guests were going up to the security guards, begging and offering money to be let out. It was insane.”

The question is why? These were 4-5 star hotels - hardy a prison. Good food, admittedly not to everyones liking, was always provided. The not to everyones liking refers to what you often find in such places - chock chips cookies and other 'treats' available in abundance in the rooms. If you have diabeties etc not a good idea, but nobody was forcing it down their throats. Strange, very strange. The meals provided were from a set menu, so you had little choice, but from what I have seen were perfectly OK - I am rather picky and I would have no problem with them - eg fruit and cereal for breakfast. You could order just about anything at all via room service - but you had to pay for that. Some didn't like paying for their personal preferences, but that is no reason to go mad. I would have just paid for what I liked and chalked it up to one of the consequences of managing the virus.

Thanks
Bill

 

[Rive]

It makes enlightening reading about human psychology - and frightening.

Best non-joke from the recent science jokes thread by @BillTre

 

[bhobba]

Because dexamethasone (dex) has immunosuppressive effects,

My Rheumatologist mentioned that drug to me, but said the research he has read suggests the latest Biologics, like the one I am on, Cosentyx, were a better, although much more expensive choice. I was worried being on it would put me at greater risk of dying if I got Covid. But he said it is likely to increase your risk of getting it if exposed, but reduce your risk of dying from the cytokine storm many patients die from. If I ended up getting it he has visiting privileges at all the major hospitals here in Brisbane, and would be happy to treat me if things got that bad my already whacky immune system started to attack my body even more than it already does.

He is also the one that is dubious of Hydroxychloroquine because in his clinical experience it takes 6 weeks to work, but is generally safe so for most people its fine to give it a go. The exception is if you have, as 2-3% of the population does, psoriasis. Then you should not take it all all - it is definitely contraindicated.
https://www.jrheum.org/content/jrheum/early/2020/03/24/jrheum.200334.full.pdf

Thanks
Bill

 

[Astronuc]

Università di Bologna - The six strains of SARS-CoV-2
https://www.eurekalert.org/pub_releases/2020-08/udb-tss080320.php

Researchers at the University of Bologna drew from the analysis of 48,635 Coronavirus genomes, which were isolated by researchers in labs all over the world. This study was published in the journal Frontiers in Microbiology. It was then possible for researchers to map the spread and the mutations of the virus during its journey to all continents.

. . .
Currently, there are six strains of coronavirus. The original one is the L strain, that appeared in Wuhan in December 2019. Its first mutation - the S strain - appeared at the beginning of 2020, while, since mid-January 2020, we have had strains V and G. To date strain G is the most widespread: it mutated into strains GR and GH at the end of February 2020.
. . .
In North America, the most widespread strain is GH, while in South America we find the GR strain more frequently. In Asia, where the Wuhan L strain initially appeared, the spread of strains G, GH and GR is increasing. These strains landed in Asia only at the beginning of March, more than a month after their spread in Europe.

Globally, strains G, GH and GR are constantly increasing. Strain S can be found in some restricted areas in the US and Spain. The L and V strains are gradually disappearing.

 

[Astronuc]

https://coronavirus.wa.gov/news/covid-19-still-rising-washington-no-turnaround-yet

COVID-19 transmission continued to grow across the state as of early July. Best estimates place the reproductive number (the estimated number of new people each COVID-19 patient will infect) above one across the state – it’s estimated at 1.19 in western Washington and 1.08 in eastern Washington.

Test positivity in eastern Washington has been slowly decreasing; however at 14.6% it remains very high and is over three times as high as in western Washington (4.2%). The recent concentration of new cases in young adults has continued to spread into younger and older age groups. As noted in last week’s report, this trend in age distribution reflects a similar trend in Florida, where a high concentration of cases in young adults spread broadly into other age groups.

 

[Borg]

Interesting way to get infection metrics.

Sewage testing for Covid-19 begins in England

Scientists discovered early in the pandemic that infected people "shed" the virus in their feces.

Further research concluded that wastewater sampling could provide a signal of a Coronavirus outbreak up to a week earlier than medical testing.

The Department for the Environment, Food and Rural Affairs says this has begun at 44 wastewater treatment sites.

 

[atyy]

https://cns.utexas.edu/news/covid-19-vaccine-with-ut-ties-arrived-quickly-after-years-in-the-making
"In both viruses, a key protein responsible for infecting cells changes shape before and after infection. If the immune system encounters the protein in the first shape, it makes potent antibodies, but not so if the protein has taken on the second shape."

Quite a readable article about stabilizing the spike protein for use in vaccines. I suspect this is intended to have a similar function as the molecular clamp technology that the University of Queensland is using: https://www.precisionvaccinations.com/vaccines/uq-covid-19-vaccine

 

[bhobba]

Australia has spent $170 billion dollars on its responce to Covid. But the UQ vaccine people are asking for donations:
https://covid19vaccine.blackbaud-sites.com/

The Covax-19 vaccine from Flinders University can be used immediately to protect very high risk Nursing Home residents in Victoria as part of stage 2 trials. Doing that, then stage 3 trials overseas in countries like SA where it is really bad (or even here if the Victoria outbreak starts to exponentially ramp up - at the moment it's fairly flat) and manufacturing the vaccine at the same time, means we can deploy it throughout Australia in 3-4 months, according to its developer Professor Petrovsky. He just needs $10 million from the government. They said they have a committee looking into it. The government has announced however it is in negotiations to source vaccines from overseas.

This is crazy - these researchers could literally stop the pandemic in its tracks, or if like the Flu vaccine and it is only partially effective still make a huge difference. But they have to go begging for money.

I have posted about this on forums here in Aus, but it is always left in a state of pending ie awaiting approval. I often post political comments that are quite controversial and understand why they sometimes get censored - being a Mentor here I know only too well how hard it is to maintain a well run forum. But censoring this beats me totally.

The other thing that I do not understand is I thought Bill Gates was taking care of this via CEPI. Bill, if you are reading this, I know you have done a lot already, but please we still need your help.

Thanks
Bill

 

[jim mcnamara]

https://covidtracking.com/data

Even if this site mentioned above, it is worth repeating. It has detailed state by state data with exposition, especially how PCR testing changed reporting.

It also lists the state/territory websites associated with each data set. Someone like @OmCheeto, who craves details, will find lots of good and not so good sources. Have fun.

 

[Ygggdrasil]

The Covax-19 vaccine from Flinders University can be used immediately to protect very high risk Nursing Home residents in Victoria as part of stage 2 trials. Doing that, then stage 3 trials overseas in countries like SA where it is really bad (or even here if the Victoria outbreak starts to exponentially ramp up - at the moment it's fairly flat) and manufacturing the vaccine at the same time, means we can deploy it throughout Australia in 3-4 months, according to its developer Professor Petrovsky. He just needs $10 million from the government. They said they have a committee looking into it. The government has announced however it is in negotiations to source vaccines from overseas.

This is crazy - these researchers could literally stop the pandemic in its tracks, or if like the Flu vaccine and it is only partially effective still make a huge difference. But they have to go begging for money.

As noted by @atyy in a previous post, it's not clear how effective we would expect the vaccine being developed by Flinders University & the Australian company Vaxine to be. It is a protein-based vaccine, and we know from previous experience with many other vaccines as well as previous research on coronaviruses, that vaccines made from the spike protein often have problems inducing immunity to the virus. It is well known that, while protein subunit vaccines are generally safer and easier to produce than traditional vaccines (live attenuated virus or inactivated virus), it can often be difficult to induce strong immunity with these types of vaccines. This challenge is especially true for the spike glycoprotein of coronaviruses as the protein can exist in various different conformations and it is very important to target the correct conformation of the protein. Some groups (such as the University of Queensland team) are using technologies, such as molecular clamp technologies, to help ensure that the vaccine elicits antibodies to the correct form of the spike glycoprotein, but it does not seem like this is true for the Flinders/Vaxine vaccine.

Currently, the only source of information about the phase I trials of the Flinders/Vaxine vaccine that I can find come from statements by Prof Petrovsky (also founder and research director of Vaxine) to the media. None of the data from the trials has been released even through press releases from the company (the company's news page mentions beginning phase I trials in early July but does not have any information about the trials' results). Petrovsky mentions that the vaccine is safe (no adverse reactions in the 30 healthy volunteers dosed with the vaccine) and that the vaccine seems to elicit an immune response. It is certainly possible that the vaccine could elicit antibodies against the protein in the vaccine that do not protect against the virus. This is why further phase II clinical trials are needed to determine the efficacy of the vaccine against infection by the coronavirus. The safety data from the phase I trials certainly justify dosing ~400 volunteers for a phase II trial, but not dosing substantially more than that (especially in high risk groups such as the elderly) as testing just 30 healthy individuals is not sufficient to catch all safety issues.

It is by no means clear that it would be worth funding further development of the Flinders/Vaxine vaccine when there are other promising candidates, especially when the argument is based solely on comments to the media made by someone with a financial stake in the vaccine and there is no publicly available data about the vaccine that can be reviewed by independent experts.

 

[bhobba]

Fair enough comments. So let's leave the Flinders Vaccine aside for the moment. There was the issue with the money required by the UQ to bring their vaccine to fruition six months earlier and the public donations it is wanting. Why the government does not support that has me scratching my head. It is a CEPI vaccine and I thought Bill Gates was pushing its vaccines through as quickly as possible.

Thanks
Bill

 

[bhobba]

It is by no means clear that it would be worth funding further development of the Flinders/Vaxine vaccine when there are other promising candidates, especially when the argument is based solely on comments to the media made by someone with a financial stake in the vaccine and there is no publicly available data about the vaccine that can be reviewed by independent experts.

Further to Ygggdrasil's excellent reply another press release has appeared in our local newspaper (edited by me):

Start of Article

Professor Petrovsky said it was frustrating not to have the financial support of the Australian government. “That is a fact, we have applied for money and we were rejected and we have applied again and have an application currently in with the Medical Research Future Fund,” Prof Petrovsky said.

But the company has been approached by other countries to purchase the vaccine if successful. “We are talking to overseas countries about that, but no, it is a frustration we have had that we haven’t been contacted by Australian authorities,” he said. “All we can say is we have had a lot of interest from overseas governments and starting to get funding from overseas governments to support the development. “We are getting inquiries from those governments about the possibility of purchasing vaccine in the future, but we haven’t had either of those things happen with the Australian government. They have been very hands-off.

“We have been funded by the US government, so all our funding comes from the US government. We would love to give them our vaccine.” The United States has already pre-purchased 600 million doses of a vaccine under development by Pfizer, German company BioNtech and Chinese Fosun Pharma and will receive 100 million doses for US citizens by the end of the year in a deal costing $2.6 billion. The Japanese Government has also invested an undisclosed amount to supply of 120 million doses of the Pfizer vaccine to be provided in the first half of 2021.

The US government also paid $1 billion to a Johnson & Johnson vaccine in August for 100 million doses if the vaccine is approved. Europe has also moved to shore up supply of a vaccine, with Germany taking a 23 per cent state in German firm CureVac after President Donald Trump tried to lure its manufacturing to the US in March to ensure its vaccine, if successful, would be distributed to the US first. The European Commission pledged another $85 million to the firm, which already had support from a European vaccine consortium.

Currently there are more than 165 vaccines in development with 28 in human trials. University of Queensland scientists have received government funds to develop a vaccine. Australia so far has granted $5 million to the University of Queensland’s “molecular clamp” vaccine, which has also entered human trials.

“It is very mysterious to me why the Australian government after seven months have only invested $5 million in vaccines, they have given money for testing other drugs but the only money that has publicly been disclosed is $5m to UQ,” Prof Petrovsky said.

A spokesman for the federal Health Department said the Australian government is investing $19 million from the Medical Research Future Fund into vaccine development. Health Minister Greg Hunt is also in talks with the British Secretary of State for Health and Social Care regarding international licensing arrangements for COVID-19 vaccines to ensure access and supply for Australia to vaccines developed in the United Kingdom.

Greg Hunt’s officer (Greg is our health minister) also said that CSL would be enlisted to produce any vaccine onshore. “The Australian government is confident that CSL has the capacity to produce sufficient vaccine for the entire Australian population either for Australian-based vaccines or under license for leading international vaccines. Negotiations are well underway with both CSL and other leading international vaccine candidates,” the spokesman said.

End Of Article.

This does not give me a lot of confidence at all. I now think Professor Petrovsky is touting this too much for my liking and combined with his financial interest, despite the seriousness of the situation, something looks not quite right here. I think the vaccine should be watched, but in this case the caution of our government may be warranted.

Fortunately the UQ vaccine is not far behind. What concerns me about that vaccine is as I posted before they are asking for public donations to get it out six months earlier:
https://covid19vaccine.blackbaud-sites.com/

Exactly why the government is not coughing up the $4.5 million for that very laudable goal is quite strange. I am suspicious there is something going on behind the scenes that is not being disclosed in the press releases. I do know our Prime Minister has had a number of discussions with Bill Gates on the vaccine issue.

The good news though is I think most now believe a vaccine is likely. Our current situation is untenable long term. As many commentators have said - just what is the end game. A number of experts have said really there is only one answer to that - a vaccine.

Thanks
Bill

 

[Vanadium 50]

e just needs $10 million from the government. They said they have a committee looking into it.

Well, there are no fewer than 165 different vaccines under development. You might be reading more about Flinders because of local interest. Should they all get $10M? Should anyone claiming to work on a vaccine get $10M? Because if that was the policy, you'd have a lot more than 165 takers. (I call homeopathy! I want $10M to test distilled water! And maybe saline too.)

And if you say the government shouldn't give $10M to quacks and frauds, or even honest attempts with a low probability of success, someone has to separate the sheep from the goats. Isn't peer review the way to do that? And don't you want multiple viewpoints - i.e. a committee?

 

[bhobba]

Isn't peer review the way to do that? And don't you want multiple viewpoints - i.e. a committee?

Of course. I am starting to get the feeling what is being reported in the press is the tip of the iceberg of things going on behind the scenes.

Thanks
Bill

 

[bhobba]

On a totally different treatment, one of our national heroes for creating the cure for Ulcers, Thomas Borody, has come up with his own 'brew' for treating Covid consisting of Ivermectin, Zinc, and Doxycycline:
https://www.biospectrumasia.com/new...fective-triple-therapy-to-treat-covid-19.html

After my recent not so 'good' posts about vaccines, I would be interested in others views rather than make a comment myself. He believes it would stop the Victorian outbreak in 6-8 weeks and would complement a vaccine well when one comes along as most vaccines are not 100% effective.

Thanks
Bill

 

[mfb]

Anything on why exactly these three drugs beyond "because the doctor thinks they are a good combination"?

 

[Vanadium 50]

In the words of Borody (who also favors poop transplants to cure autism),

"Ivermectin proposes many potentials effects to treat a range of diseases, with its antimicrobial, antiviral, and anti-cancer properties as a wonder drug."

Doxycycline is an antibiotic, and Borody seems to be arguing for an antibiotic in the brew, not necessarily this one.

As for zinc, who doesn't like zinc? Everybody loves zinc!

 

[bhobba]

Anything on why exactly these three drugs beyond "because the doctor thinks they are a good combination"?

Other than saying he used the same strategies he used to create his peptic ulcer drug - no detail - just - trust me. Not really good enough.

Thanks
Bill

 

[Rive]

On a totally different treatment, one of our national heroes for creating the cure for Ulcers, Thomas Borody, has come up with his own 'brew' for treating Covid consisting of Ivermectin, Zinc, and Doxycycline

Amateur. Any decent one would add some vitamin and lots of snake oil too.
Also, in case of any antibiotic brew adding probiotic is a good selling point

And adding all those are expected to replace clinical trials too.
Well, kind of ... for some people

 

[Vanadium 50]

This is too important for clinical trials. Because science.

 

[bhobba]

In the words of Borody (who also favors poop transplants to cure autism),

At least he publishes in legit journals. Poop transplants seem a trendy research topic these days. Dr Michael Mosley wrote a book that amongst other things touts it. I am not a fan - but maybe I should have a more open mind

Thanks
Bill

 

[mfb]

Worldwide cases reached 20 million going by official numbers, US cases reached 5 million and Brazil reached 3 million.
~250,000 new cases, ~5000-6000 deaths per day. The latter has been pretty constant since April.

Russia is the last (partially) European country in the top 10 by cases.

 

[atyy]

On a totally different treatment, one of our national heroes for creating the cure for Ulcers, Thomas Borody, has come up with his own 'brew' for treating Covid consisting of Ivermectin, Zinc, and Doxycycline:
https://www.biospectrumasia.com/new...fective-triple-therapy-to-treat-covid-19.html

Doctors need some room to prescribe drug use off-label to do what they think is best for the patient. At the same time, without clinical trials, it will be difficult to know which treatments are effective. These are professional judgement calls and depend on the context in which medicine is being practised. Clinical trial data now suggests that Remdesivir helps reduce the length of hospital stays for COVID-19 patients, yet its first use for COVID-19 was off label and not in the context of a clinical trial. Another interesting example is dexamethasone, which from first principles was guessed by many clinicians guessed to be effective against cytokine storms thought to be a factor in COVID-19 severity, but data from earlier studies for SARS suggested that it might have no effect on outcomes and possibly slow viral clearance. So that had to be trialled, as the RECOVERY trial did. Even which trials to run requires judgement. If you run too many trials, they compete with each other for patients and administrative resources, and none will be able to reach a conclusion. It can be advantageous to have central coordination and prioritization for clinical trials in a large hospital system, or by national and international bodies. Among the links below is an interesting discussion by David Paterson, Director at The University of Queensland Centre for Clinical Research and a physician at the Royal Brisbane and Women's Hospital.

How much freedom should frontline clinicians have in treating COVID-19 patients?
Ten Common Questions (and Their Answers) About Off-label Drug Use
Treating COVID-19: Reckless cowboys vs the ivory tower academics by David Paterson (talk starts about about 20 minutes in)
Covid-19: The inside story of the RECOVERY trial

Even with a large and excellent trial like the RECOVERY trial, one must be cautious, since the results are obtained in the background of care conventions at a particular time in the UK, which may differ from elsewhere. This point is discussed in David Paterson's talk linked above at around 37:30 minutes. He also briefly mentions Ivermectin at around 44:45 minutes.