Biology and Medicine

[Typhoon]

Data show panic and disorganization dominate the study of Covid-19 drugs

Dicredited article right here:

The analysis, conducted in partnership with Applied XL, a Newlab Venture Studio company, found that one in every six trials was designed to study the malaria drugs hydroxychloroquine or chloroquine, which have been shown to have no benefit in hospitalized patients.

The Studies of HCQ were done of late stage patients. HCQ is thought to inhibit the reproduction of the COVID virus inside the cells by promoting cell infusion of Zinc into the cells.
This is an anti-virual drug. It does not fix damage in late stages. Even CNN has a story on HCQ cutting the mortality rate by 50%

https://www.cnn.com/2020/07/02/health/h ... index.html
Note the headline was changed to make it more negative after it was published

Study finds hydroxychloroquine may have boosted survival, but other researchers have doubts

By Maggie Fox, Andrea Kane, and Elizabeth Cohen, CNN

Updated 1:31 PM ET, Fri July 3, 2020

(CNN)A surprising new study found the controversial antimalarial drug hydroxychloroquine helped patients better survive in the hospital. But the findings, like the federal government's use of the drug itself, were disputed.
A team at Henry Ford Health System in southeast Michigan said Thursday their study of 2,541 hospitalized patients found that those given hydroxychloroquine were much less likely to die.

. . .

Publication by press release or, even worse, by CNN is worth less than zero.

- Findings of this observational study . . .

Unless it is a properly designed and properly performed double-blind clinical trial, a non-trivial undertaking, then the reported results are worth nada. To be generous, any observational study should be taken with a large crystal of salt.

There are exceptions, such as the discovery of insulin and penicillin, where the outcomes were invariably binary - survive or die. However, once one starts talking about percentage improvement then the above necessary, but not sufficient, conditions apply.

The only problem with your double blind trial study is that everyone that has been done with HCQ has either be canceled because of now retracted studies or seems to have been designed for the drug to fail. Almost as if it had been planned that way.

Conspiracy claims arising from parochial national politics are neither useful or informative with regards to biology and medicine.
Please direct them to the "Pandemic" thread.

But the Henry Ford study has been sharply criticized by scientists who said it shouldn’t be used to change policy. It was an observational study, considered much less rigorous than a randomized trial, in which patients are randomly assigned to receive a treatment or not. And its results fly in the face of three major randomized trials that have found hydroxycloroquine is not effective in treating or preventing covid-19.

Critics also noted that twice as many of the Henry Ford patients who received hydroxychloroquine also got a steroid — which has been shown to benefit covid-19 patients — compared to those who didn’t get hydroxychloroquine. That made it hard to know which drug benefited the patients, they said. The authors made statistical adjustments to account for that, but other scientists said the methodology wasn’t clear and that it is very hard to correct studies in that way.

“You want to look at the totality of the data,” said Eric Topol, director of the Scripps Research Translational Institute. “The totality is overwhelmingly in the opposite direction. You have to conclude with the Henry Ford study is an outlier and there’s some kind of confounder that is skewing the data and not representing the truth.”

[kmich]

One U.K. trial is transforming COVID-19 treatment. Why haven’t others delivered more results?

[Nonc Hilaire]

One U.K. trial is transforming COVID-19 treatment. Why haven’t others delivered more results?

Not enough virus in the UK to study. It’s vanishing before the studies can set up.
https://www.google.com/amp/s/www.cbsnew ... ca-brazil/

[noddy]

after testing all the hopefuls, my country has settled on Remdesivir (steroids) for the bad covid cases.

https://www.abc.net.au/news/2020-07-11/ ... a/12446036

[kmich]

after testing all the hopefuls, my country has settled on Remdesivir (steroids) for the bad covid cases.

https://www.abc.net.au/news/2020-07-11/ ... a/12446036

Remdesivir is nucleotide analog antiviral that has been shown to shorten recovery time for hospitalized patients.

The steroid currently deployed is dexamethasone which has been shown toreduce death by up to one third in hospitalized patients with severe respiratory complications of COVID-19.

Its has been good to read that Australia has had its public health act together, hope you can hang in there for the expected long haul. We are in one hot mess over here. Perhaps we can learn some lessons from your country's experience , but I am not at all optimistic.

[noddy]

One of our cities (Melbourne) has escalating cases again but one thing we still currently have, which you guys seem to have lost, is the ability for politics to become bitpartisan when its actually serious.

Their are a few contrarians but largely our federal and state governments formulated a plan and followed it across party lines.

Also, we have a lower population density than most, so its probably easier.

[Doc]

Data show panic and disorganization dominate the study of Covid-19 drugs

Dicredited article right here:

The analysis, conducted in partnership with Applied XL, a Newlab Venture Studio company, found that one in every six trials was designed to study the malaria drugs hydroxychloroquine or chloroquine, which have been shown to have no benefit in hospitalized patients.

The Studies of HCQ were done of late stage patients. HCQ is thought to inhibit the reproduction of the COVID virus inside the cells by promoting cell infusion of Zinc into the cells.
This is an anti-virual drug. It does not fix damage in late stages. Even CNN has a story on HCQ cutting the mortality rate by 50%

https://www.cnn.com/2020/07/02/health/h ... index.html
Note the headline was changed to make it more negative after it was published

Study finds hydroxychloroquine may have boosted survival, but other researchers have doubts

By Maggie Fox, Andrea Kane, and Elizabeth Cohen, CNN

Updated 1:31 PM ET, Fri July 3, 2020

(CNN)A surprising new study found the controversial antimalarial drug hydroxychloroquine helped patients better survive in the hospital. But the findings, like the federal government's use of the drug itself, were disputed.
A team at Henry Ford Health System in southeast Michigan said Thursday their study of 2,541 hospitalized patients found that those given hydroxychloroquine were much less likely to die.

. . .

Publication by press release or, even worse, by CNN is worth less than zero.

- Findings of this observational study . . .

Unless it is a properly designed and properly performed double-blind clinical trial, a non-trivial undertaking, then the reported results are worth nada. To be generous, any observational study should be taken with a large crystal of salt.

There are exceptions, such as the discovery of insulin and penicillin, where the outcomes were invariably binary - survive or die. However, once one starts talking about percentage improvement then the above necessary, but not sufficient, conditions apply.

The only problem with your double blind trial study is that everyone that has been done with HCQ has either be canceled because of now retracted studies or seems to have been designed for the drug to fail. Almost as if it had been planned that way.

Conspiracy claims arising from parochial national politics are neither useful or informative with regards to biology and medicine.
Please direct them to the "Pandemic" thread.

The CCP lied about human to human transmission
The WHO lied about human to human transmission, and said that the CCP was doing an outstanding job
All the medical experts were saying that masks were not needed because there was no airborn transmission. Then he admitted he lied about it because he was worried that there would not be enough masks because while the CCP and the WHO were claiming no human to human transmission the CCP was buying and shipping back to China half the world annual supply of PPE

This is not "conspiracy theory claims" THESE ARE FACTS. Facts that directly relate to the studies mentioned here.

But the Henry Ford study has been sharply criticized by scientists who said it shouldn’t be used to change policy. It was an observational study, considered much less rigorous than a randomized trial, in which patients are randomly assigned to receive a treatment or not. And its results fly in the face of three major randomized trials that have found hydroxycloroquine is not effective in treating or preventing covid-19.

Critics also noted that twice as many of the Henry Ford patients who received hydroxychloroquine also got a steroid — which has been shown to benefit covid-19 patients — compared to those who didn’t get hydroxychloroquine. That made it hard to know which drug benefited the patients, they said. The authors made statistical adjustments to account for that, but other scientists said the methodology wasn’t clear and that it is very hard to correct studies in that way.

“You want to look at the totality of the data,” said Eric Topol, director of the Scripps Research Translational Institute. “The totality is overwhelmingly in the opposite direction. You have to conclude with the Henry Ford study is an outlier and there’s some kind of confounder that is skewing the data and not representing the truth.”

Indian is running out of the meds that these same experts and the media are pushing. Remdezivire a drug that has been proven to releive symptoms in some but has not been proven to save lives. That the Manufacturer in the US wants $3250 per patient They won't charge as much in most countries. However, in Indian at least, the only way to buy remdezivire is on the black market. At ten times the non black market price. One has to wonder how it is that Black marketers are able to buy so much of it from the supply chain.

Bolsonaro is saying that the suicide rate in parts of Brazil is now 3 times higher. People don't have work. Don't have money. Don't have food. and don't have any hope left. Untreated starvation is 100% fatal. So is a person that is starving for lack of money going to spend money on food or a drug that help relieve symptoms?

I don't see that the "Medical Experts" and "critics" have done anything to make the situation better. We are 6 months in to this pandemic, and and so far no drug treatment that saves lives Eric Topol should that take and shove it up his "Big picture" So far they have only figured out which their treatment kill people faster.

[Doc]

One of our cities (Melbourne) has escalating cases again but one thing we still currently have, which you guys seem to have lost, is the ability for politics to become bitpartisan when its actually serious.

Their are a few contrarians but largely our federal and state governments formulated a plan and followed it across party lines.

Also, we have a lower population density than most, so its probably easier.

My problem is that so many in authority have either been caught lying about the virus or freely admitted they lied. All knowing that when they lied people were going to die. At that point who am I supposed to trust? Climate science alarmists?

[Doc]

after testing all the hopefuls, my country has settled on Remdesivir (steroids) for the bad covid cases.

https://www.abc.net.au/news/2020-07-11/ ... a/12446036

Remdesivir is nucleotide analog antiviral that has been shown to shorten recovery time for hospitalized patients.

The steroid currently deployed is dexamethasone which has been shown toreduce death by up to one third in hospitalized patients with severe respiratory complications of COVID-19.

Its has been good to read that Australia has had its public health act together, hope you can hang in there for the expected long haul. We are in one hot mess over here. Perhaps we can learn some lessons from your country's experience , but I am not at all optimistic.

I hadn't even heard of dexamethasone until a few days ago. But hardly a magic bullet.

Conclusions: In patients hospitalized with COVID-19, dexamethasone reduced 28-day mortality among those receiving invasive mechanical ventilation or oxygen at randomization, but not among patients not receiving respiratory support.

It saves some of the patients that are dying of lung infections. Does nothing for those dying of covid infection in other parts of the body. Presumably does nothing for long lasting disabilities of survivors. The list of disabilities is apparently quite long. Including by some reports mental illness.

[kmich]

Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19) - A Review

[noddy]

One of our cities (Melbourne) has escalating cases again but one thing we still currently have, which you guys seem to have lost, is the ability for politics to become bipartisan when its actually serious.

Their are a few contrarians but largely our federal and state governments formulated a plan and followed it across party lines.

Also, we have a lower population density than most, so its probably easier.

My problem is that so many in authority have either been caught lying about the virus or freely admitted they lied. All knowing that when they lied people were going to die. At that point who am I supposed to trust? Climate science alarmists?

I dont believe bipartisan is found in the American dictionary, its a slippery slope to communism!

still, the long run hasnt played out yet so holding back the infection rate might not yet be the winning strategy, its impossible to say, you just throw the dice and hope.

i am just lucky my state is isolated and while tourism is important, its not a vital part of our economy.

[Typhoon]

One of our cities (Melbourne) has escalating cases again but one thing we still currently have, which you guys seem to have lost, is the ability for politics to become bitpartisan when its actually serious.

Their are a few contrarians but largely our federal and state governments formulated a plan and followed it across party lines.

Also, we have a lower population density than most, so its probably easier.

To-date, Australia has been exemplary:

daily-covid-deaths-per-million-7-day-average.png (5.31 MiB) Viewed 2496 times

[kmich]

Communicating Science in the Time of a Pandemic

[Typhoon]

Communicating Science in the Time of a Pandemic

A good layman summary with regards to reported medical research:

Science-based Medicine | Pitfalls in Research: Why Studies Are More Often Wrong than Right

[Typhoon]

Medical hypothesis.

AAAS | Age-Related Inflammation May Worsen COVID-19 Outcomes in Older Individuals

[kmich]

Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19

Abstract

BACKGROUND
Hydroxychloroquine and azithromycin have been used to treat patients with coronavirus disease 2019 (Covid-19). However, evidence on the safety and efficacy of these therapies is limited.

METHODS
We conducted a multicenter, randomized, open-label, three-group, controlled trial involving hospitalized patients with suspected or confirmed Covid-19 who were receiving either no supplemental oxygen or a maximum of 4 liters per minute of supplemental oxygen. Patients were randomly assigned in a 1:1:1 ratio to receive standard care, standard care plus hydroxychloroquine at a dose of 400 mg twice daily, or standard care plus hydroxychloroquine at a dose of 400 mg twice daily plus azithromycin at a dose of 500 mg once daily for 7 days. The primary outcome was clinical status at 15 days as assessed with the use of a seven-level ordinal scale (with levels ranging from one to seven and higher scores indicating a worse condition) in the modified intention-to-treat population (patients with a confirmed diagnosis of Covid-19). Safety was also assessed.

RESULTS

A total of 667 patients underwent randomization; 504 patients had confirmed Covid-19 and were included in the modified intention-to-treat analysis. As compared with standard care, the proportional odds of having a higher score on the seven-point ordinal scale at 15 days was not affected by either hydroxychloroquine alone (odds ratio, 1.21; 95% confidence interval [CI], 0.69 to 2.11; P=1.00) or hydroxychloroquine plus azithromycin (odds ratio, 0.99; 95% CI, 0.57 to 1.73; P=1.00). Prolongation of the corrected QT interval and elevation of liver-enzyme levels were more frequent in patients receiving hydroxychloroquine, alone or with azithromycin, than in those who were not receiving either agent.

CONCLUSIONS

Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care.

[Nonc Hilaire]

Did the study say why zinc was left out? That was an essential part of the hcq tx. It’s like they wanted the study to be inconclusive and only demonstrate lack of harm.

[kmich]

Mathematical models to guide pandemic response

[Nonc Hilaire]

Mathematical models to guide pandemic response

But the mathematical models have proven to be spectacularly wrong. They predicted 3% deaths when data showed deaths at .02% deaths highly skewed to septuagenarians in long term care.

[kmich]

Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System

[Doc]

Mathematical models to guide pandemic response

But the mathematical models have proven to be spectacularly wrong. They predicted 3% deaths when data showed deaths at .02% deaths highly skewed to septuagenarians in long term care.

The Spanish flu most effected the old the first(out of three) time it went around the world. The last was the most devastating and it hit the young hardest. People were dying within 12 hours of showing the first symptoms

[Doc]

Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System

Thrombosis would explain why people walking down the street suddenly collapse and die on the spot.
WX2qBAGRssM

[kmich]

Need for sustainable biobanking networks for COVID-19 and other diseases of epidemic potential

[kmich]

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

In this cohort study including 100 patients recently recovered from COVID-19 identified from a COVID-19 test center, cardiac magnetic resonance imaging revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), which was independent of preexisting conditions, severity and overall course of the acute illness, and the time from the original diagnosis.

[Typhoon]

Early pre-clinical research report. Still a long road from bench to beside. A road on which most potential treatments falter.
However, research as reported in the link may one day lead to a clinical treatment.

Sci Transl Med | 3C-like protease inhibitors block coronavirus replication in vitro and improve survival in MERS-CoV-infected mice