Jump to content

Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


InkaUtexas

Recommended Posts

https://www.nytimes.com/2020/03/26/health/plasma-coronavirus-treatment.html

 

Quote

By Denise Grady

March 26, 2020, 4:38 p.m. ET

Can blood from coronavirus survivors help other people fight the illness?

Doctors in New York will soon be testing the idea in hospitalized patients who are seriously ill.

Blood from people who have recovered can be a rich source of antibodies, proteins made by the immune system to attack the virus. The part of the blood that contains antibodies, so-called convalescent plasma, has been used for decades to treat infectious diseases, including Ebola and influenza.

“It’s kind of difficult scientifically to know how valuable it is in any disease until you try,” said Dr. David L. Reich, president and chief operating officer of the Mount Sinai Hospital, which will be using the treatment. “It’s not exactly a shot in the dark, but it’s not tried and true.”

Dr. Reich said it would be tried as a treatment for hospitalized patients who had a moderate form of the disease and had trouble breathing, but not for those who are in advanced stages of the disease.

ADVERTISEMENT

Continue reading the main story

”The idea is to get to the right patients at the right time,” he said. “But it’s experimental.”

Researchers at Mount Sinai were among the first in the United States to develop a test that can detect antibodies in recovering patients, an essential part of this treatment strategy.

On Tuesday, the Food and Drug Administration gave permission for the plasma to be used experimentally on an emergency basis to treat coronavirus patients, and hospitals in New York quickly began asking to participate, said Dr. Bruce Sachais, chief medical officer of the New York Blood Center, which will collect, test and distribute the plasma.

Coronavirus Live Updates: U.S. Now Has More Known Cases Than Any Other Country

March 26, 2020

“Our main focus is, how do we implement this quickly to help the hospitals get product to their patients,” Dr. Sachais said. “We have blood centers in New England, Delaware and the Midwest, so we can do the same thing in other regions. We’re working with other blood centers and hospitals that may collect their own blood and want to do this. We may not be able to collect enough plasma in New York to help the entire country, so we want to share with other centers to help them.”

Dr. Reich said that an email asking Mount Sinai staff members who had recovered to consider donating plasma went “a little viral,” and quickly drew 2,000 responses.

ADVERTISEMENT

Continue reading the main story

But volunteers will have to be carefully screened to meet strict criteria. The donors will include people who tested positive for the virus when they were ill, recovered, have had no symptoms for 14 days, now test negative — and have high levels, also called titers, of antibodies that fight the virus. Dr. Reich said that because there were delays and shortages in testing, the number of people who qualify may be low at first.

Latest Updates: Coronavirus Outbreak

President Trump says the hospital ship U.S.N.S. Comfort will head to New York Saturday.

The U.S. now leads the world in confirmed coronavirus cases.

Pelosi predicts bipartisan passage of $2 trillion stimulus in House.

See more updates

Updated 7m ago

More live coverage: Markets U.S. New York

“Our expectation, based on reports from the Chinese experience, is that most people who get better have high-titer antibodies,” Dr. Sachais said. “Most patients who recover will have good antibodies in a month.”

Image

Mount Sinai Hospital in Manhattan.Credit...Victor J. Blue for The New York Times

People who qualify will then be sent to blood centers to donate plasma. The procedure, called apheresis, is similar to giving blood, except that the blood drawn from the patient is run through a machine to extract the plasma, and the red and white cells are then returned to the donor. Needles go into both arms: Blood flows out of one arm, passes through the machine and goes back into the other arm. The process usually takes 60 to 90 minutes, and can yield enough plasma to treat three patients, Dr. Sachais said.

People who have recovered have antibodies to spare, and removing some will not endanger the donors or diminish their own resistance to the virus, Dr. Sachais said. “We may get rid of 20 percent of their antibodies, and a couple days later they’ll be back.”

Sign up to receive our daily Coronavirus Briefing, an informed guide with the latest developments and expert advice.

Sign Up

The plasma will be tested to make sure it is not carrying infections like hepatitis or H.I.V., or certain proteins that could set off immune reactions in the recipient. If it passes the tests, it can then be frozen, or used right away. Each patient to be treated will receive one unit, about a cup, which will be dripped in like a blood transfusion. As with blood transfusions, plasma donors and recipients must have matching types, but the rules are not the same as those for transfusions.

“We think this is going to be an effective treatment for at least some patients, but we don’t really know yet,” Dr. Sachais said. “Hopefully, we’ll get some data in the next few weeks from the first patients, to see if we’re on the right track.”

ADVERTISEMENT

Continue reading the main story

“In other coronavirus epidemics I don’t think we have strong evidence,” he said. “We don’t have controlled data. There were reports from SARS and MERS that patients improved.”

He said the decision to try this approach was based in part on reports from China that it seemed to help patients. But the reports are not based on controlled studies or definitive data.

Dr. Sachais said an article in a journal that was not peer-reviewed described treating 10 patients in China with one unit each of convalescent plasma, and said it appeared safe and seemed to quickly lower their virus levels.

“It’s anecdotal,” he said.

A researcher not associated with the new treatment plans said there was evidence to support using plasma from survivors.

“Four to six or eight weeks after infection, their blood should be full of antibodies that will neutralize the virus and that will theoretically limit the infection,” said Vineet Menachery, a virologist at the University of Texas Medical Branch.

In studies in mice, he said, “If you can drive the virus replication down tenfold to hundredfold, that can be the difference between life and death.”

He described the use of convalescent plasma as “a classic approach that is a really effective way to treat” — if there are enough donors with enough of the right antibodies.

ADVERTISEMENT

Continue reading the main story

A potential risk, he said, is that the patient’s immune system could react against something in the plasma, and cause additional illness.

Although hospitals will gather information about the patients being treated, the procedure is not being done as part of a clinical trial. There will not be a placebo group or the other measures needed to determine whether a treatment works.

“People are so desperately ill now, it isn’t the right time,” Dr. Reich said. “They’re in the hospital, they’re sick, in intensive care, on ventilators. Some get sick so quickly, and it’s such a severe illness in some people, we feel it’s not the right moment.”

He said the doctors were relying on science and evidence as much as possible.

But he added: “You see this steamroller coming at you, and you don’t want to sit there passively and let it roll over you. So you put together everything you have to try to fight it. This has the potential to help and also the potential to harm, but we just won’t know until it’s later in the process of the disease and people have had an opportunity to try different things.”

Survivors seem eager to help.

“We’re getting a lot of requests,” Dr. Sachais said. “One center sent a survey to patients who are getting better, and there were hundreds of responses saying they were interested in being donors. This is going to bring people together. People who’ve survived will want to do something for their fellow New Yorkers.”

 

Link to comment
Share on other sites

4 minutes ago, dcar00 said:

ha ha.  my blood is worth more than your blood

My blood lacks something that most have which makes it better for babies. They used to ask me to give blood all the time. But when I give blood I turn white as a ghost and get sick as shit, so I don't give anymore. Doctor recommends against it. Hope I don't get the 'rona and have people bugging me again when I recover.

Link to comment
Share on other sites

9 hours ago, NoName said:

how many CFOs in the system stroked out about 3 days into this? 

Ha, they’re sweating.  Kind of in their nature bc who the hell would blame them in the grand scheme?  They’re not done small pop and pop at risk of going belly up...

Link to comment
Share on other sites

6 hours ago, Brisketexan said:

If we end up at 1/10th that estimate, we will be at 200k deaths.  Note that this does NOT take into account the massive strain on our hospitals and the much higher number of critical care patients.  Also, to compare, the highest death rate we've had from the flu in the past 40 years (and note, this number is very arguable, as many believe the CDC's numbers are high) is 80k in 2018.  So, 2.5X the flu at its worst.  If we get out of this with that, it would be a big win.

Here's a thought: folks postulating that EITHER we're going to have 10k a day dying, OR that this will be no worse than the flu, are full of shit.  Toss out the best-case willful Pollyanna numbers....toss out the worst-case "we're all gonna die" numbers.  What is left in the middle...is still really fucking bad.

You do realize you were in the ‘we’re all going to die’ numbers crowd right? Your estimate that you claimed to be conservative had a million US deaths within its parameters. 

Edited by akhornfan
  • Fuck You 1
Link to comment
Share on other sites

11 minutes ago, akhornfan said:

You do realize you were in the ‘we’re all going to die’ numbers crowd right? Your estimate that you claimed to be conservative had a million US deaths within its parameters. 

Yes it did, you fucking dumbass.  Within its parameters.  A 7 figure number was the HIGH end.  Based on every assumption (from transmission rate to death rate to lack of mitigation measures) being on the high end.  That's why what I posted was a RANGE.  As we get better data, those numbers can be refined.  As we take mitigation measures, we can knock down that high end.

You really have no idea how, ummm, thinking, works, do you?

Edited by Brisketexan
  • Like 3
Link to comment
Share on other sites

34 minutes ago, landman said:

Around 1.200,000 people die in the US each year from cancer and heart disease. We know a number of contributing factors for both yet do nothing. This will not come close to that. Yet we are destroying our lives over it. 

And in the US, the death rate is approaching what it is for the flu. And that without factoring in the tens of thousands that have had it and never knew.  

The thing is they don't all up and do it within a 3-6 week period of each other.  That's the issue here. Our medical system, and facilities could be swamped to the point of overload, and then failure.  Then you'll see a cascade effect of people dying from non Covid related illnesses, and pre existing conditions because they weren't able to get a bed, services, or see a doctor or nurse.

Edited by Onboard 2.0
  • Like 5
Link to comment
Share on other sites

7 minutes ago, landman said:

Around 1.200,000 people die in the US each year from cancer and heart disease. We know a number of contributing factors for both yet do nothing. This will not come close to that. Yet we are destroying our lives over it. 

And in the US, the death rate is approaching what it is for the flu. And that without factoring in the tens of thousands that have had it and never knew.  

If we didn’t shelter in place the hospitals would be full and the death rate would be much much higher then the flu....  Not even close to the same thing to still be using the flu comparison....

Edited by Hook1997
Link to comment
Share on other sites

10 minutes ago, Brisketexan said:

Yes it did, you fucking dumbass.  Within its parameters.  A 7 figure number was the HIGH end.  Based on every assumption (from transmission rate to death rate to lack of mitigation measures) being on the high end.  That's why what I posted was a RANGE.  As we get better data, those numbers can be refined.  As we take mitigation measures, we can knock down that high end.

You really have no idea how, ummm, thinking, works, do you?

You can rant and rave all you want. But that you even put down a million as a possibility shows how much emotion you were letting into the situation versus how much you really understood it 

  • Like 1
  • Fuck You 7
Link to comment
Share on other sites

Just now, akhornfan said:

You can rant and rave all you want. But that you even put down a million as a possibility shows how much emotion you were letting into the situation versus how much you really understood it 

It.  Fucking.  IS.  A possibility.  At the very least, it was, based on how we were NOT mitigating the spread at the time.

A brush fire spreading into my neighborhood absolutely has the potential to do $100 million in damage....if it's already wide when it gets here....and resources can't get to enough of it....and we've got a 30 mph wind pushing it.  These fires happen.

Bp1KQRwvKjNb5SEgBdd4golvOK93M1nPxoowuKM8

A typical grass fire in our hood won't do any damage.  So a range of expected damage for a brush fire in our hood is $0  to $100 million.  Give me some more data -- like a 30 mph windy day, and I'm taking that $0 out of the analysis, and my range will go from $500k-$100 million.  Etc. etc.

You know that actuaries actually perform these exact types of analyses, right?  And epidemiologists have as well?

  • Like 1
Link to comment
Share on other sites

13 minutes ago, landman said:

Around 1.200,000 people die in the US each year from cancer and heart disease. We know a number of contributing factors for both yet do nothing. This will not come close to that. Yet we are destroying our lives over it. 

And in the US, the death rate is approaching what it is for the flu. And that without factoring in the tens of thousands that have had it and never knew.  

Are cancer and heart disease highly contagious?

  • Like 2
Link to comment
Share on other sites

Just now, Brisketexan said:

It.  Fucking.  IS.  A possibility.  At the very least, it was, based on how we were NOT mitigating the spread at the time.

A brush fire spreading into my neighborhood absolutely has the potential to do $100 million in damage....if it's already wide when it gets here....and resources can't get to enough of it....and we've got a 30 mph wind pushing it.  These fires happen.

Bp1KQRwvKjNb5SEgBdd4golvOK93M1nPxoowuKM8

A typical grass fire in our hood won't do any damage.  So a range of expected damage for a brush fire in our hood is $0  to $100 million.  Give me some more data -- like a 30 mph windy day, and I'm taking that $0 out of the analysis, and my range will go from $500k-$100 million.  Etc. etc.

You know that actuaries actually perform these exact types of analyses, right?  And epidemiologists have as well?

You should go back a read what you wrote alongside that prediction. You were talking a very strong likelihood. Not a possibility. Essentially anything can be a possibility. 
 

But at the time you were so sure you were using the best available numbers, but were insisting on ignoring the evidence that there were far more cases. 
 

it’s not going to hit your numbers. We both know it, but now you’re going with name calling and something about a fire. Come on. 

  • Like 1
  • Fuck You 8
Link to comment
Share on other sites

1 minute ago, akhornfan said:

You should go back a read what you wrote alongside that prediction. You were talking a very strong likelihood. Not a possibility. Essentially anything can be a possibility. 
 

But at the time you were so sure you were using the best available numbers, but were insisting on ignoring the evidence that there were far more cases. 
 

it’s not going to hit your numbers. We both know it, but now you’re going with name calling and something about a fire. Come on. 

What's your number?  What do you think our total number of deaths will be?  You throw a lot of darts, but don't have shit to offer.

Link to comment
Share on other sites

2 minutes ago, Brisketexan said:

Do you really think that we're going to stay at 1,000 dead? 

Anyone who believes that needs a remedial math lesson.

The death toll has been doubling every two to three days.  And that's before this disease overwhelms hospitals and every new case that needs a ventilator doesn't get one.

We're at over 1,000 deaths today with 17 days until Easter.  If the death total doubles 6 more times by then, we're looking at 64,000 dead Americans by Easter.  

Maybe it won't be that bad.  Social distancing will curb the rate of infections.  But the mortality rate may also increase in the short term due to lack of care.  It's tough to say.

But the death toll in America will absolutely hit five figures in the next few days.  It may hit six figures in the next few weeks.  It's not unthinkable that it hits seven figures before we get a vaccine.

Stay.  Home.  For a long time.   

  • Like 4
Link to comment
Share on other sites

18 minutes ago, landman said:

Around 1.200,000 people die in the US each year from cancer and heart disease. We know a number of contributing factors for both yet do nothing. This will not come close to that. Yet we are destroying our lives over it. 

And in the US, the death rate is approaching what it is for the flu. And that without factoring in the tens of thousands that have had it and never knew.  

I think someone is missing the aim of the social distancing policy.  Without them, a tsunami of cases overwhelms the system.  And many more die than is necessary.  And we would be asking healthcare workers to work past their breaking point.   

Link to comment
Share on other sites

19 minutes ago, landman said:

Around 1.200,000 people die in the US each year from cancer and heart disease. We know a number of contributing factors for both yet do nothing. This will not come close to that. Yet we are destroying our lives over it. 

And in the US, the death rate is approaching what it is for the flu. And that without factoring in the tens of thousands that have had it and never knew.  

How in the FUCKING HELL are we still getting this kind of fucking stupid ass take here?

  • Like 8
Link to comment
Share on other sites

1 minute ago, dcar00 said:

since this is much more contagious than swine I'm guessing as an estimate 100M to 125M will end up having had this in US.

I don’t know. We shut everything down- it seems hard for me to believe that we are getting to 40% of the population infected. 

I didn’t get swine flu and I was teaching school amongst an outbreak at the school. This time around nobody in my family has left the house in 2 weeks other than me, and for me it was just grocery store and pool store. It seems unlikely to me we are getting corona. Same the country over. Yes, we have some dipshits but I think most people are keeping their distance. 

Link to comment
Share on other sites

The supply chain being crippled on gloves, masks, hand sanitizer, disinfectant, and hand soaps isn’t great during a highly contagious pandemic.  Our front line medics can’t protect themselves right now which also means no one else can either, for a while at least.  

Edited by Hugo Stiglitz
Link to comment
Share on other sites

2 minutes ago, Wulaw Horn said:

I don’t know. We shut everything down- it seems hard for me to believe that we are getting to 40% of the population infected. 

I didn’t get swine flu and I was teaching school amongst an outbreak at the school. This time around nobody in my family has left the house in 2 weeks other than me, and for me it was just grocery store and pool store. It seems unlikely to me we are getting corona. Same the country over. Yes, we have some dipshits but I think most people are keeping their distance. 

maybe.  wish we had done this with swine.  12K people died

Link to comment
Share on other sites

Just now, Hugo Stiglitz said:

The supply chain being crippled on gloves, masks, hand sanitizer, disinfectant, and hand soaps isn’t great during a highly contagious pandemic.  Our front lines can’t even protect themselves right now which also means no one else can either for a while.  

Well, at least those are a list of things that shouldn't be in short supply the next time a world wide pandemic breaks out.  Right ?  Hell we still keep our helium supply protected, just in case another dirigible heavy war breaks out.

  • Like 2
Link to comment
Share on other sites

1 minute ago, Brisketexan said:

What's your number?  What do you think our total number of deaths will be?  You throw a lot of darts, but don't have shit to offer.

I have a pretty good feeling for what it’s NOT and have been calling bullshit on that when I see it. As in it’s not 3% CFR, it’s not 2%, it’s not 1.5%. It’s not whatever number we keep steeping down to as we see more cases. 
 

There just isn’t anywhere near enough data on total cases to put out an accurate prediction at this point. But there is enough, and has been for a while, to set some upward limits. And no offense, that’s where you missed - and I really think it was just emotional, which I understand. I bristled a bit at your comment about throwing out the high figures, because you were so recently right in that group. 
 

But if I had to take just a wild ass guess - I’d say under 100k US this calendar year.  

  • Like 2
  • Fuck You 4
Link to comment
Share on other sites

  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


×
×
  • Create New...