News unfit to print

Posted on by

1.

To date, the total number of reported patients treated with HCQ, with or without zinc and the widely used antibiotic azithromycin, is 2,333, writes AAPS, in observational data from China, France, South Korea, Algeria, and the U.S. Of these, 2,137 or 91.6 percent improved clinically. There were 63 deaths, all but 11 in a single retrospective report from the Veterans Administration where the patients were severely ill.

Source here. I recommend the whole article (short).

They are not talking about a controlled study. Remdesivir shows some small mortality benefits in a controlled study, plus it is not tainted by association with President Trump. Which drug would you want if you were diagnosed positive?

2. Concerning Sweden,

This individual-based modelling project predicts that with the current mitigation approach
approximately 96,000 deaths (95% CI 52,000 to 183,000) can be expected before 1 July, 2020.

Source here. That model-based forecast was made on April 10. As of April 29, one widely-used site gives Sweden’s cumulative deaths as 2462. The model predicts a peak in the first half of May. New deaths on April 29 in Sweden were 107. If this is the peak, we will not make it to the bottom of the 95 percent confidence interval for the model.

Pointer from Dan Klein. This story makes Sweden look good and a model look bad. So you know I am bound to like it. Discount accordingly.

19 thoughts on “News unfit to print”

  1. It’s looking like everyone should have been using the RAND Function in excel for all the model outputs to be correct at least half the time… maybe a chicken on graph paper?

  2. Remdesivir, and it isn’t close. No remotely decent study has shown any effects at all for HCQ, particularly in the population the NIAID remdesivir study did (severely ill), where getting any effect at all from an antiviral is almost miraculous. Moreover, there’s actually a decently understood mechanism, which should increase your belief that the drug works, as opposed to the malaria drugs (we shouldn’t outsource our mental apparatus entirely to RCTs). Remdesivir isn’t a cure, but it likely cuts time in hospital and mortality by ~30%.

    • Correct, but I believed you miss the point. HCQ has (virtually) no potential benefit to a patient who is already “severely ill”. The unproven-but-indicated benefits are prophylactic — they prevent patients from becoming severely ill or dying.

  3. So I will repeat my “silly question” [first asked here 4/23], the answer to which seems to this layman to be not-overly-difficult to obtain, but which no one seems interested in answering …

    We know the number of persons prescribed/taking(?) HCQ for RA or lupus (very likely several million). We know (with arguably reasonable precision) the number of persons both: a) hospitalized for Covid-19 “symptoms”, AND b) died “due to Covid-19″.

    Can we obtain (rapidly, at low-cost, and with relatively low error rate), a count of those ALREADY taking HCQ at admit in order to determine if they are admitted/dying at a statistically-significant different rate than expected ??

    I was provided a link to . Unfortunately, the data there is not useful to address/answer my question. Which is understandable given their role as an advocacy group; Yes, we know persons with RA/lupus are becoming infected and dying. And these persons should not stop taking their meds. And they should be given priority access to potentially-newly-limited supply should large # of others begin taking HCQ for COVID-19. But, “How many of your deaths were taking HCQ prior/at infection ??”

  4. Plus it is not tainted by association with President Trump.

    Really here? Not tainted by association with Prez Trump who was hawking other drugs with no signs of benefit or testing. (And there was a pilot study that Hydroxychloroquine did not show any benefits although it was way too quick and small to prove anything conclusive.) The weird aspect here is aids probably told Trump they are testing Remdesivir as potential drug to control the disease impact but he was not listening.

    Remdesivir has shown some benefits in controlling the impact of COVID-19 but not curing it. Also it is weird hearing conservatives/libertarians defend long term peer review studies by the FDA. But the reality is most medical test would take over 12 months to fully understand the impact.

    2) Sweden has seen both a wide spread but as bad as the models so there are aspects of the disease that we don’t fully understand. (I still of the camp there are similar viruses in the past that some of the population has had antibodies and is one reason Asian and possibly California spreads have been lower. It still does not make sense California spread has been controlled for far.)

  5. “Which drug would you want if you were diagnosed positive?”

    Both, provided I got good recommendations from a doctor familiar with my conditions.

    It’s been amazing to me how much the left has gone “pro virus” just to spite Trump. They’d rather people die than some drug he mentioned help people. The same people who downplayed this in February/early March simply to spite Trump and call everyone racist.

    What do you think a bunch of clinical studies are going to be finished so you can give a CYA endorsement of any treatments. When the plague is already over.

    Here are my thoughts on HCQ:

    https://www.youtube.com/watch?v=va6j4JITJoE

    This is a generally leftist source so don’t tell me that it’s fake.

    In general, as part of TDS, a lot of people media outlets have been down on these drugs. I’d like to give them a fair hearing.

    As you saw in the video, one of the ways these drugs help is by suppressing the auto immune response. I myself have an auto immune disorder and my life was saved by a drug that suppressed it, so I know first hand how bad things get when your body turns on itself. I sweated blood. My body turned all black and blue. Your immune system can be your own worst enemy.

    It also appears to work best when it’s given earlier in the viruses run, to help stop an auto immune feedback death loop from ever getting rolling rather than being able to stop it once your fully in the throws of a negative feedback loop.

    Some people say that there isn’t enough “evidence” and call for a battery of clinical studies to prove its “safe and effective”.

    On the “safe” part that is just silly. These are approved drugs, they were approved because they are “safe”. Like every single drug on the market they have potential side effects, and doctors need to be aware of their interaction with other drugs and medical conditions. In this case, one should use extra caution if the patient has a heart condition. But prudent prescribing is what we do with “safe” drugs all the time.

    So what we are left with is “effective”. Specifically, effective against COVID-19, and “off-label” use of the drug. Off label use has been approved, but in a bid to get one over on Trump/cover ones own ass, people point out that there is no battery of clinical trials that show its effective against COVID.

    And there won’t be for a long time…when the plague has already passed.

    So what are people to do for the next 18 months? Is there enough evidence, maybe not multiple clinical study level evidence, but evidence all the same, to warrant thinking it might be effective enough to use today. We’ve got a theory of how it works. We see it seems to work in a lab culture. We have some small scale examples of it working on live patients.

    Ultimately, if you get COVID-19 tomorrow, there will be only one clinical trial that matters to you. It has a sample size of one, no control group, and it is only going to last the next couple of weeks.

    Answers on this will vary person to person and doctor to doctor, but if you fit the profile you should at least consider these drugs. I know that given my auto immune risks I will be asking my doctor about it should I get COVID-19.

    —-

    I’m aware of the one study against HCQ, but the study itself says that HCQ was given to the sickest patients as a desperation move, meaning it’s biased. That’s also not when HCQ is effective.

    • It’s been amazing to me how much the left has gone “pro virus” just to spite Trump.

      I have theorized that HRC were President the politics would have even worse and I believe no President would have been reelected under this crisis. (The only one close would have been Bill Clinton after 1994.)

      In reality probably 80% of the population of both left and right don’t have an opinion on Hydroxychloroquine and would like to see a good defined study. Most science theorized that HC could be a positive effect at controlling the disease worst symptoms and the VA ran a quick 2 – 3 week pilot study that showed no evidence of benefits of HC. Of course, my initial reaction was any health study on several hundred patients should not prove anything at all and would automatically fail to disprove the null hypothesis. And a similar pilot study for Remdesivir showed some benefits at controlling symptoms. (For what I read probably the biggest weakness of HC is it would benefit patients the most really early in the disease to the protect the lungs so by the time the disease symptoms are strong the drug has less effect.)

      • You should read up on the VA study. It was only a records review, conducted by ophthalmologists, not clinicians experienced in treating respiratory viruses, did not list individual or cumulative doses given, and the patients were just this side of dead. All it proves is that HCQ is no Miracle Max drug.

        On the other hand, Remdesivir has only been shown to shorten the treatment period of people who would already recover. So it is valuable only in lessening the burden on the healthcare system.

        If I had to choose, I would go with the HCQ cocktail. It has a long history of safe use, noted efficacy and the side effects are known and easily managed. Remdesivir does not have a long term impact history yet.

        • The VA pilot study was completely thrown together in a couple week and borderline useless. Even a good peer review study with ~500 patients would have such high Margin Of Error that the the results would be inconclusive either way. And benefits of Remdesivir appear modest as well and the study is also inconclusive.

          The weird reality of HC supporter is the Null Hypothesis is HC improves patients with Coronavirus instead of HC has no noticeable improvements on Coronavirus patients. And one of the realities is results may vary on patient conditions and when the treatments start.

      • “VA ran a quick 2 – 3 week pilot study that showed no evidence of benefits of HC”

        The VA gave HCQ to its sickest patients most likely to die as a last resort Hail Mary. They mention this is the study. If the people you give it too are sicker than the control group, its not much of a study.

        It’s also not when it’s most useful. It’s better when you take it early, to prevent a cytekoine storm, rather than to stop one in process. I apologize if I’m misspelling cytekoine.

  6. I’d be willing to hear a defense of HCQ that demonstrated some basic clarity of scientific thought. The article you linked to does not. The headline is the worst part: “Hydroxychloroquine Has about 90 Percent Chance of Helping COVID-19 Patients” is pure post-hoc-ergo-propter-hoc. It’s highly likely that the vast majority of those would have recovered anyway, because the vast majority who aren’t given any drug recover anyway!

  7. 1. Unlike HCL, the governors have not yet banned individuals’ access to vitamin D.

    “vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25 (OH) D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D 3 for a few weeks to rapidly raise 25 (OH) D concentrations, followed by 5000 IU/d. The goal should be to raise 25 (OH) D concentrations above 40–60 ng/mL (100–150 nmol/L).”

    https://scholar.google.com/scholar?hl=en&as_sdt=0%2C21&q=vitamin+d+covid&btnG=#d=gs_qabs&u=%23p%3Dy-GlZT6735EJ

  8. I would not take Remdesivir as a prophylactic or with a mild case of COVID-19. Almost nothing is known about even the mid-term side-effects of this drug. I would only take it if there was a greater than 20% chance of me dying.

    On Sweden:

    That model was prepared specifically to force the Swedish government to abandon its policy- that is the primary explanation for why it was so “wrong” in its predictions at a time where there was actually enough data from Sweden to know it was an outlandish prediction. Sweden serves as a very politically damaging counter-example to lockdown theater, and they attempted to scare the Swedish government into rejoining the flock of sheep.

  9. I had some mild symptoms of COVID-19: shortness of breath, a fever and a mild cough. My pulse oximeter always showed above 98%. I still got tested, but the results came back negative. I have heard that the false negative rate for that test in mild cases might be as high as ~30%, however. My blood work, meanwhile, showed I had lymphocytopenia and neutrophilia–a combination associated with COVID-19. As to what I took: I got my doctor to prescribe me hydroxychloroquine, azythromycin, and zinc on my first day of symptoms. I took them for 5 days at a low dose, so I went with a partial Didier Raoult treatment. The cost of that treatment is low. By the way, a doctor has assembled all the latest evidence on this treatment and continually updates it in a google doc format: https://docs.google.com/document/d/1O6Cls-Oz2ZAgJuyDbnICEGjMvQPEyM-aaXARUomR9Ww/edit.

  10. I had Acute respiratory distress syndrome caused by Covid19. I was treated with hydroxychloroquine, azythromycin, and zinc when I first was in the ICU. My doctor said the HCQ was to suppress a cytokine storm, an inflammatory auto-immune response they were monitoring via blood tests. I left the hospital 13 days later.

Comments are closed.