COVID COVID-19 Coronavirus Containment Efforts

[Astronuc]

It's not a prophylactic if he is already is infected with the virus.

Experience with other antivirals (such as tamiflu) suggests that these types of treatments are more likely to be effective at preventing severe symptoms if administered early in the course of the disease.

I heard an interview today that used the term prophylactic with respect to Remdesivir, since it was started early, and the use was intended to prevent worsening of the infection. Apparently, in earlier patients, it was tried once they were on a ventilator, as was the case in one of the earliest infections in New Jersey. Perhaps, it took so long to get a dose approved. I believe Remdesivir was rationed to the worst cases.

 

[Ygggdrasil]

I heard an interview today that used the term prophylactic with respect to Remdesivir, since it was started early, and the use was intended to prevent worsening of the infection. Apparently, in earlier patients, it was tried once they were on a ventilator, as was the case in one of the earliest infections in New Jersey. Perhaps, it took so long to get a dose approved. I believe Remdesivir was rationed to the worst cases.

A prophylactic drug would be given to healthy individuals to prevent them from being infected with the disease (e.g. pre-exposure prophylaxis [PrEP] for HIV). For example, see this page about using tamiflu for treatment vs prophylaxis:

Q. What do the terms treatment of the flu and prevention (prophylaxis) of the flu mean?
A. Treatment is used when a person is given Tamiflu because they have the signs and symptoms of the flu or have been diagnosed with the flu. Tamiflu has been shown to lessen the amount of time people are sick with the flu.

Prevention (prophylaxis) is a term used when someone who does not have flu symptoms is given Tamiflu to help stop them from getting the flu because they are exposed to or come into close contact with someone (for example live with or take care of someone) who has the flu.

https://www.fda.gov/drugs/postmarke...viders/tamiflu-consumer-questions-and-answers

Treatment with antiviral drugs should generally be started early in order to prevent worsening of the infection. For example, Tamiflu, an antiviral drug from the Influenza virus, is effective at decreasing the duration and severity of illness, but only if taken within 36-48 hours of the onset of symptoms.

"One of the problems is that Tamiflu is seen by the public as a drug that will save you from all cases of the flu," he says. "Tamiflu can decrease the duration of illness by 30% to 40%, and decrease flu severity by about 40% -- but only if taken in the first 36 to 48 hours of illness. And you know that will not happen all the time."

https://www.webmd.com/cold-and-flu/news/20121114/does-tamiflu-work-questions-continue

For clinical trials of Remdesivir, it is true that the drug has generally been given only to severe cases, though this is likely due to limited availability of the drug and it's method of administration (it can only be delivered intravenously and not orally).

 

[Evo]

Interesting, I've read this elsewhere.

Updated at 4:55 p.m. ET

President Trump tweeted early Friday morning that he tested positive for the coronavirus. But questions remain about what exactly happened before and after — when the president was first diagnosed, started experiencing symptoms and what treatment he received and when.

On Saturday, for example, White House physician Sean Conley told reporters Trump was "72 hours" into his diagnosis, but later said in a memo later on that he meant to say Day 3. Conley refused to say whether Trump had ever received supplemental oxygen this week, and another doctor said Trump received treatment 48 hours ago — also quickly walked back by the White House.

Good information

https://www.npr.org/sections/latest...e-know-of-president-trumps-covid-19-diagnosis

 

[StevieTNZ]

Also this:

US President Donald Trump went through a “very concerning” period and the next 48 hours will be critical in terms of his care as he battles the Coronavirus at a military hospital, White House chief of staff Mark Meadows has said.

The comments came after it was revealed that Trump was administered supplemental oxygen on Friday morning (local time) at the White House before he was transported to the hospital, although staff insisted he had only mild symptoms.
...
According to a person familiar with Trump’s condition, Trump was administered oxygen at the White House on Friday before he was transported to the military hospital. The person was not authorised to speak publicly and spoke to The Associated Press on condition of anonymity.

-- https://www.stuff.co.nz/world/ameri...er-very-concerning-period-in-coronavirus-care

 

[Vanadium 50]

I am so old I remember when anonymous sources required confirmation. This is how we get Kim Jong-Un dying in April. And again in August.

I'm also so old I remember when news organizations did not leak medical information to the press. (In this case, not just the President's, but also Hope Hicks').

 

[mfb]

Conflicting reports raise concerns about severity of Trump's Covid condition

The source of the graver prognosis was subsequently identified as Mark Meadows, the White House chief of staff, who was observed talking to the reporters and was recorded on camera asking for his comments to be “off the record”, although he has not confirmed this.

 

[jim mcnamara]

@Vanadium 50 So you remember Woodrow Wilson's wife, Edith - who essentially ran the country while WW was incapacitated by a stroke for last years of his term?

https://en.wikipedia.org/wiki/Edith_Wilson

Apparently, she and some inner circle advisers managed to keep WW's actual very poor health a secret. From 1919 until the end of his term in 1921.

 

[StevieTNZ]

US President Donald Trump has released a new hospital video in which he says he's starting to feel better and hopes to “be back soon”.
In the four-minute video posted to Twitter, Trump says he “wasn't feeling so well” when he was admitted to Walter Reed National Military Medical Center after testing positive for the coronavirus.

...

The Trumps diagnosis joins a growing number of other Republican figures who have also tested positive, most recently including former New Jersey Governor Chris Christie, who helped Trump prepare for last week’s debate with former Vice President Joe Biden.

Other prominent people within Trump’s circle who have also tested positive include his campaign manager Bill Stepien and his former advisor Kellyanne Conway.

-- https://www.stuff.co.nz/world/ameri...rom-military-hospital-after-covid19-diagnosis

 

[Vanadium 50]

So you remember Woodrow Wilson's wife, Edith

I'm not that old.

But I do know the story.

 

[Astronuc]

For clinical trials of Remdesivir, it is true that the drug has generally been given only to severe cases, though this is likely due to limited availability of the drug and it's method of administration (it can only be delivered intravenously and not orally).

Back in March, that was the situation, and supplies were extremely limited, and trials had only just begun. Enrollment for Adaptive Covid-19 Treatment Trial (ACTT-1) began on February 21, 2020, and ended on April 19, 2020.

https://www.nejm.org/doi/full/10.1056/NEJMoa2007764

 

[Evo]

Well, we can only hope he has a fast and good recovery. There will always be secrecy around a President's health, so the secrecy here is nothing new.

The issue , I guess, is this president's denial of the ease of spread of the virus, against all medical advice, so I guess that will be a good thing.

I just want to know why the President didn't insist on being treated by only hydroxychloroquine!

 

[StevieTNZ]

I just want to know why the President didn't insist on being treated by only hydroxychloroquine!

And that he called it COVID-19 in his initial tweet, rather than "Chinese (or China) virus".

 

[Ygggdrasil]

The issue , I guess, is this presidents denial of the ease of spread of the virus, against all medical advice, so I guess that will be a good thing.

Yes, it's not a good look to go from mocking his opponent's mask wearing habits in the debate on Tuesday to announcing that he's been diagnosed with Covid just three days later.

 

[StevieTNZ]

I am so old I remember when anonymous sources required confirmation. This is how we get Kim Jong-Un dying in April. And again in August.

Here is your confirmation about Trump needing oxygen - https://www.stuff.co.nz/world/ameri...-discharged-from-hospital-as-early-as-tuesday

Hope that satisfies your condition.

 

[Astronuc]

Conley left murky the issue of whether the president needed supplemental oxygen and declined to discuss exactly when he fell ill. Conley also revealed that Trump began exhibiting “clinical indications” of Covid-19 on Thursday afternoon, earlier than previously known.

https://www.stuff.co.nz/world/ameri...er-very-concerning-period-in-coronavirus-care
He was administered supplemental oxygen, but there seems to be no indication that he needed oxygen, nor that he didn't need it. I would imagine that doctors were being cautious.

I've read statements that Trump would be released on Monday, now it may be Tuesday. Either way, it was earlier reported that the treatment with Remdesivir would last 5 days (Fri, Sat, Sun, Mon, Tue), which has been the minimal treatment. Perhaps he has a mild case and is improving, but then stopping treatment prematurely would seem risky. Others have seemingly recovered only to take a turn for the worse.

Meanwhile, CNN reported that Wisconsin has seen an increase in hospitalizations for COVID-19.
https://www.cnn.com/2020/09/30/health/us-coronavirus-wednesday/index.html
https://www.cnn.com/interactive/2020/health/coronavirus-us-maps-and-cases/

 

[StevieTNZ]

From my previous link:

US President Donald Trump has “improved”, according to White House physician Sean Conley, but experienced significant oxygen drops on Friday and Saturday (local time). His doctors said he has had no fever since Friday morning and could be discharged as early as Monday.

and

At a news briefing on Sunday morning, Conley publicly acknowledged for the first time that the president was administered supplemental oxygen on Friday at the White House and had a “high” fever at the time.

 

[mfb]

I've read statements that Trump would be released on Monday, now it may be Tuesday.

Monday in the US is Tuesday in New Zealand (- a few hours).

 

[Astronuc]

As a determination of the team based predominantly on the timeline from the initial diagnosis that we initiate dexamethasone. – White House physician Dr. Sean Conley

and apparently some comment that supplemental oxygen was needed.

 

[Astronuc]

Monday in the US is Tuesday in New Zealand (- a few hours).

True, however the source I read was from some medium in the US. I assume there is some positive spin on the recovery, but from Friday to Monday would be inconsistent with a 5-day course of Remdesivir. So, we wait and see.

 

[Astronuc]

Traveling soon in the US?

https://www.cnn.com/travel/article/us-state-travel-restrictions-covid-19/index.html

 

[StevieTNZ]

White House press secretary tests positive for Covid-19 - https://www.stuff.co.nz/world/ameri...yleigh-mcenany-tests-positive-for-coronavirus

 

[mfb]

WHO estimates that ~10% of the world population got infected. That's a factor 20 above the official case counts, but it means 90% are still at risk - hoping it will go away because of herd immunity won't work generally. We have seen how the healthcare systems struggled with these 10% spread over almost a year now.

Traveling soon in the US?

https://www.cnn.com/travel/article/us-state-travel-restrictions-covid-19/index.html

It's odd to use a stock photo from a volcano for that article. But what's going on in Kansas?

Kansas
If you're in any of the following categories, you need to quarantine for 14 days after arrival in Kansas (this includes residents and visitors):
-- Traveled to Aruba on or after September 24.
-- Attended mass gathering events (out-of-state) of 500 people or more.
-- Took a sea or river cruise ship since March.

Aruba only is oddly specific, and being on a cruise ship in April means you need to quarantine now?

 

[Jarvis323]

WHO estimates that ~10% of the world population got infected. That's a factor 20 above the official case counts, but it means 90% are still at risk - hoping it will go away because of herd immunity won't work generally. We have seen how the healthcare systems struggled with these 10% spread over almost a year now.

It's odd to use a stock photo from a volcano for that article. But what's going on in Kansas?

Aruba only is oddly specific, and being on a cruise ship in April means you need to quarantine now?

I don't know why anyone should have confidence in an estimate done by the WHO.

 

[mfb]

I don't know why anyone should have confidence in an estimate done by the WHO.

Do you have any more specific criticism, or do you just dismiss it because you don't like the WHO?

 

[Jarvis323]

Do you have any more specific criticism, or do you just dismiss it because you don't like the WHO?

They have a bad track record, not peer reviewed, tend to contradict the scientific community, influenced by politics, and have been criticized by their own employees as being unreasonably hard headed.

I would try to carefully review their work if you can before taking anything they say seriously.

 

[BillTre]

I like The Who:
However, this Who prediction ("we won't get fooled again") does not seem to have worked (Bad Track Record).
Also, I don't recall them being Peer Reviewed (by other bands?).
They are Influenced By Politics.
However, I don't know that they tend to Contradict The Scientific Community.

 

[gmax137]

I like The Who:

@BillTre you beat me to it, I was thinking of exactly this song as I read down through the thread :)

 

[mfb]

Do you have any more specific criticism, or do you just dismiss it because you don't like the WHO?

They have a bad track record, not peer reviewed, tend to contradict the scientific community, influenced by politics, and have been criticized by their own employees as being unreasonably hard headed.

I would try to carefully review their work if you can before taking anything they say seriously.

Okay, so it's just because you don't like the WHO in general, not because you would have any criticism of this estimate here.

 

[Astronuc]

COVID-19 cases at Appalachian State University, part of North Carolina’s state university system, spiked sharply last week. The school’s dashboard shows more than 700 confirmed COVID-19 cases at the 20,000-student campus since early June. However,

Aside from athletes, who must be tested under NCAA rules, Appalachian State has not conducted the kind of costly, widespread mandatory testing and tracing of people with and without symptoms that has helped control the virus at some campuses. Rather, the school has offered voluntary testing at its student health center and at “pop-up” test sites where students can walk up and be tested twice weekly.

https://news.yahoo.com/student-dies-campus-gets-serious-184001668.html

A 19-year-old student Chad Dorrill, with no apparent underlying or pre-existing medical conditions, died from COVID-19. He apparently had a severe neurological reaction to the virus.
https://www.wsoctv.com/news/local/1...-19-complications/X4AAXZ7JQBBRLFICKM3QIE3BZI/

The university (ASU in NCSU system) reported a new high of 159 current COVID-19 cases among students on Tuesday. Nearly 550 students have tested positive for the virus since in-person classes resumed last month. Appalachian State remains open for in-person instruction.

Three North Carolina colleges, including UNC-Chapel Hill, North Carolina State University and East Carolina University, have halted physical classes for undergraduate students, after reporting a series of Coronavirus outbreaks shortly after students returned to campus. Nearly 1,000 UNC students have tested positive for COVID-19 since classes resumed in August. ECU surpassed 1,000 cases earlier this month, followed shortly thereafter by NC State.

https://www.cbsnews.com/news/appalachian-state-student-chad-dorrill-dies-covid-19/Side topic: Dexamethasone

Among mountaineers, dex is often taken preventatively—and controversially, since it raises ethical questions as a performance enhancer—to reduce brain swelling and improve one’s summit chances. National Park Service rescuers on Denali, in Alaska, use it to circumvent the slow process of acclimatization, and guides often wear doses of it around their neck or keep an injectable syringe full of it in their pocket in case a client stops moving due to cerebral edema.

https://www.outsideonline.com/2415005/coronavirus-treatment-mountaineering-dexamethasone

 

[Astronuc]

Aruba only is oddly specific,

Aruba, Jamaica, . . . . you know.