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CR: COVID-19 --Political Talk


Mrs Whiggins

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13 hours ago, Skipper said:

If you dive in closer to the current numbers, for example, you will note that of the deaths reported between Friday's detailed report and today's detailed report, 1 of the recently reported deaths actually occurred the week ending 4/25, 1 occurred week ending 5/2, 2 occurred week ending  5/16 and 1 occurred the week ending 5/23.   There is still a reporting lag that is pretty much inexcusable considering it's June but it is what it is. 

I'm no statistician. It seems that the you may be assuming that the current number accurately describes the current count, therefore it's inflated because of the inaccuracy of earlier reports.

Then you point out that the reporting lag still exists. Doesn't that contradict the above statement?

If there is an ongoing lag, doesn't that make it something of a constant to be assumed? If so, the same constant was present over the last week and an increase in the numbers is likely real rather than illusory.

I believe that you watch and think about the numbers. I wonder about your conclusion. What do you think?

Edited by RomaVicta
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1 hour ago, HenryJames said:

 

So you're saying he takes some responsibility, some responsibility at all?  

The guy that basically looks like he grew up wanting to be part of Hans Gruber's gang of international criminals has more integrity than our President?  

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1 minute ago, Lobo said:

The guy that basically looks like he grew up wanting to be part of Hans Gruber's gang of international criminals has more integrity than our President?  

Darth Vader has more integrity than our president.

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17 hours ago, BradInATX said:

We've been opening up slowly for basically a month now and haven't seen any real significant and consistent upward trend in cases as a whole. And memorial day weekend started 10 days ago, presumably we'd see an increase in hospitalizations already if we were going to see impact from that - we have not. 

Something is exerting downward pressure on the rate of growth of this thing. If it's not heat, then the most likely candidate is a combination of people being more vigilant, people not playing hero ball and going to work and social gatherings while they're sick, a lack of large gatherings, and general better practices. And those things, we have control over. 

I was a "wait two weeks" guy in the beginning and I still think that 1) with the info we had at the time, a lot of states and cities acted impulsively and stupidly and 2) a lot of people (both here and in leadership) were more concerned with the economy than human life. But I'm okay, as a "wait two weeks" guy, if being wrong means I can get the hell out of my house and go have a beer and watch some football.

Maybe it’s the tear gas

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48 minutes ago, RomaVicta said:

I'm no statistician. It seems that the you may be assuming that the current number accurately describes the current count, therefore it's inflated because of the inaccuracy of earlier reports.

Then you point out that the reporting lag still exists. Doesn't that contradict the above statement?

If there is an ongoing lag, doesn't that make it something of a constant to be assumed? If so, the same constant was present over the last week and an increase in the numbers is likely real rather than illusory.

I believe that you watch and think about the numbers. I wonder about your conclusion. What do you think?

No, I'm not assuming the current number describes the current count at all.  I'm actually fairly certain it doesn't.  I'm not spending hours developing a model but rough estimate is that hospitalization numbers are around 90% accurate a week out and >95% 2 weeks out.   So if you work within those assumptions, and you have access to all of the prior Dallas Tues/Fri hospitalization reports, you should still be able to detect a significant hospitalization spike. 

To the extent you are talking about "positive cases" I discount those numbers completely because there is zero consistency in reporting, lag time at various testing sites, or number of tests run.  I don't spend a ton of time on this and only focus on the numbers to see at a high level if things are getting better, worse or staying the same.  For that reason I also don't pay much attention to the deaths because deaths lag actual infection by 3-4 weeks.  

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1 hour ago, HenryJames said:

 

Sweden makes a mistake. Their government said from the start that they hoped it was the best plan, but no one could be sure. 

It turns out to be a bad plan. Sweden's government abandons the plan. The proponent of the plan takes responsibility in public. He is photographed clearly showing remorse.

Sweden changes its approach; they move forward.

Good government is probably easiest to identify in how it handles a mistake. It was a bad policy. No time was wasted, as far as I can tell, by finding a sacrificial lamb or denying the policy was a failure. There were certainly no efforts to confuse to public.

Move forward. Correct. Move forward. Correct. Move forward towards a solution.

It really doesn't seem that hard to adopt as an attitude. It's a shame we don't allow it over here. 

 

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Just now, RomaVicta said:

Agree, profoundly.

How are you doing, TB? If there was an update, I missed it. I hope well, my friend.

Both of my tests came back negative and I'm feeling much better, thanks. I'm scheduled to be back in the plaguelands next week, though.

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1 hour ago, trauma babe said:

Both of my tests came back negative and I'm feeling much better, thanks. I'm scheduled to be back in the plaguelands next week, though.

Looks like the government will be providing with a flood of new patients through idiotic covid policy and policy murder inspired demonstrations. Best wishes for you and all who pass before you.

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5 hours ago, Captainant said:

Thanks.  This new study had a different design than the ICMR study I posted on the DT medical discussion thread.  I’d like to see more details but the WaPo says about this one:

About two-thirds of the trial participants were health-care workers and the rest were a mix of other people exposed to someone with covid-19, he said. They were given hydroxychloroquine or a placebo for five days and then followed for two weeks to see who developed the disease.”

The ICMR study gave a loading dose then HCQ 400mg once weekly for about 6 weeks.  In particular, they observed a positive dose response curve preventing development of infection become notably more apparent after 4 weeks.  

@Captainant - I’d like to hear your thoughts on how differences in study design might hit on different cellular processes and timelines.

Also this about the Minny study:

“One weakness of the trial, he added, is that because testing was not widely available during the time of the trial, their analysis used a combination of lab-confirmed positive covid-19 tests and symptoms to count someone as infected.”

I’d like to know more about the presumed exposure/dosing lag relationship in this new study.

It’s a helpful study, but need more.

 

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3 minutes ago, triplehorn said:

Thanks.  This new study had a different design than the ICMR study I posted on the DT medical discussion thread.  I’d like to see more details but the WaPo says about this one:

About two-thirds of the trial participants were health-care workers and the rest were a mix of other people exposed to someone with covid-19, he said. They were given hydroxychloroquine or a placebo for five days and then followed for two weeks to see who developed the disease.”

The ICMR study gave a loading dose then HCQ 400mg once weekly for about 6 weeks.  In particular, they observed a positive dose response curve preventing development of infection become notably more apparent after 4 weeks.  

@Captainant - I’d like to hear your thoughts on how differences in study design might hit on different cellular processes and timelines.

Also this about the Minny study:

“One weakness of the trial, he added, is that because testing was not widely available during the time of the trial, their analysis used a combination of lab-confirmed positive covid-19 tests and symptoms to count someone as infected.”

I’d like to know more about the presumed exposure/dosing lag relationship in this new study.

It’s a helpful study, but need more.

 

Try NEJM for more details. 

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7 minutes ago, triplehorn said:

Looks like only 17% of subjects had a lab confirmed result for being infected or not. Is that what you’re seeing?  Not sure what to make of that if it’s the case.

 

 

Abstract

BACKGROUND

Coronavirus disease 2019 (Covid-19) occurs after exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For persons who are exposed, the standard of care is observation and quarantine. Whether hydroxychloroquine can prevent symptomatic infection after SARS-CoV-2 exposure is unknown.

METHODS

We conducted a randomized, double-blind, placebo-controlled trial across the United States and parts of Canada testing hydroxychloroquine as postexposure prophylaxis. We enrolled adults who had household or occupational exposure to someone with confirmed Covid-19 at a distance of less than 6 ft for more than 10 minutes while wearing neither a face mask nor an eye shield (high-risk exposure) or while wearing a face mask but no eye shield (moderate-risk exposure). Within 4 days after exposure, we randomly assigned participants to receive either placebo or hydroxychloroquine (800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 additional days). The primary outcome was the incidence of either laboratory-confirmed Covid-19 or illness compatible with Covid-19 within 14 days.

RESULTS

We enrolled 821 asymptomatic participants. Overall, 87.6% of the participants (719 of 821) reported a high-risk exposure to a confirmed Covid-19 contact. The incidence of new illness compatible with Covid-19 did not differ significantly between participants receiving hydroxychloroquine (49 of 414 [11.8%]) and those receiving placebo (58 of 407 [14.3%]); the absolute difference was −2.4 percentage points (95% confidence interval, −7.0 to 2.2; P=0.35). Side effects were more common with hydroxychloroquine than with placebo (40.1% vs. 16.8%), but no serious adverse reactions were reported.

CONCLUSIONS

After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure. (Funded by David Baszucki and Jan Ellison Baszucki and others; ClinicalTrials.gov number, NCT04308668. opens in new tab.)

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4 minutes ago, jimmyjazz said:

Did anyone see pushback on the data analysis in Lancet?  Have I missed that discussion?

Surgisphere under significant scrutiny. It's apparently an international EMR network, and their data quality SOPs are apparently highly suspect. 

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14 minutes ago, Anastasis said:

Abstract

BACKGROUND

Coronavirus disease 2019 (Covid-19) occurs after exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For persons who are exposed, the standard of care is observation and quarantine. Whether hydroxychloroquine can prevent symptomatic infection after SARS-CoV-2 exposure is unknown.

METHODS

We conducted a randomized, double-blind, placebo-controlled trial across the United States and parts of Canada testing hydroxychloroquine as postexposure prophylaxis. We enrolled adults who had household or occupational exposure to someone with confirmed Covid-19 at a distance of less than 6 ft for more than 10 minutes while wearing neither a face mask nor an eye shield (high-risk exposure) or while wearing a face mask but no eye shield (moderate-risk exposure). Within 4 days after exposure, we randomly assigned participants to receive either placebo or hydroxychloroquine (800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 additional days). The primary outcome was the incidence of either laboratory-confirmed Covid-19 or illness compatible with Covid-19 within 14 days.

RESULTS

We enrolled 821 asymptomatic participants. Overall, 87.6% of the participants (719 of 821) reported a high-risk exposure to a confirmed Covid-19 contact. The incidence of new illness compatible with Covid-19 did not differ significantly between participants receiving hydroxychloroquine (49 of 414 [11.8%]) and those receiving placebo (58 of 407 [14.3%]); the absolute difference was −2.4 percentage points (95% confidence interval, −7.0 to 2.2; P=0.35). Side effects were more common with hydroxychloroquine than with placebo (40.1% vs. 16.8%), but no serious adverse reactions were reported.

CONCLUSIONS

After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure. (Funded by David Baszucki and Jan Ellison Baszucki and others; ClinicalTrials.gov number, NCT04308668. opens in new tab.)

Your’re responding to me but not responding.  From above: “The primary outcome was the incidence of either laboratory-confirmed Covid-19 or illness compatible with Covid-19 within 14 days.“ It appears only 17% percent of subject outcome measures were laboratory-confirmed.  83% of determinations of infection were made without testing confirmation.  

Is that what you’re seeing?  

Not what I’d expect, if accurate, examining a bug that has a high incidence of asymptomatic positivity.  They indicate limited access to testing evidently.

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1 minute ago, triplehorn said:

Your’re responding to me but not responding.  From above: “The primary outcome was the incidence of either laboratory-confirmed Covid-19 or illness compatible with Covid-19 within 14 days.“ Only 17% percent of subject outcome measures were laboratory-confirmed.  83% of determinations of infection were made without testing confirmation.  

Is that what you’re seeing?  

Not what I’d expect, if accurate, examining a bug that has a high incidence of asymptomatic positivity.  limited access to testing evidently.

In all sincerity, what is it going to take for you to separate yourself from pimping HCQ?  I mean, I get the initial attachment.  I was right there in February. Let's give it a shot and see if the early data plays out.  Let's do some large observational research. It gave us nothing to grasp on to.  Let's do some acute treatment RCTs, understanding the situation we are in requires some flexibility as we move forward.  Those trials were negative. OK, lets see some early treatment, prophylaxis RCT data. Negative. 

There does not appear to be any clinical data of high quality that can move you to step back just a bit. Oddly reminiscent of your approach to other topics. 

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24 minutes ago, Anastasis said:

In all sincerity, what is it going to take for you to separate yourself from pimping HCQ? 

Another non-response response.  The new study as reported by WaPo got posted.  There are some relevant things to consider.  Namely, evidently that 83% of "positive infection outcomes" were determined without lab confirmation.  yeesh.  Walk me back.

The main thing that remains pretty clear is that, through various studies and in reports coming out of multiple countries, HCQ does not appear to represent a heightened imminent or direct safety threat in Cov19, and individual medical consideration basically eliminates it.  You scaremongered about it way back.  I think the safety notion has been shed.  

Taking this rapid post-exposure study at face value, the ICMR prophylaxis study, and studies of HCQ in hospitalized subjects with advanced illness, it looks like very early post-exposure and late post-exposure uses are not a hit.  To repeat - are not a hit. 

It could be that true prophylaxis is where the lone benefit vs Cov19 rests.  The ICMR study needs replication.  The ICMR study design is substantively different in that the study followed subjects at least 3 times as long as this UMinn study, ICMR used actual testing for all subjects for confirmation before and after, and ICMR study used pre-medication for weeks after first confirming with a negative test.  A greater separation in prophylactic benefit was observed beginning after 4 weeks of once weekly dosing of HCQ.  The presence of a dose response curve spanning weeks warrants further understanding.  Nothing crazy about wondering about that.  And if the ICMR results hold that true prophylaxis can reduce infection formation by up to 80% in frontline health care workers under frequent exposure, that would be good to know.  400mg HCQ once per week has been dosed 10's of millions of times since around 1955.  'bout $0.60 per dose.

 

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1 minute ago, RPM said:

I'm worried about the spike we are going to see from the protests. There's no way to do contact tracing in that chaos.

It will be telling.  Between Lake of Ozarks and Sixth Street type stuff the week before and now these protests, we ought to see some spikes in the next couple of weeks unless the number of asymptomatic from Feb-Apr was much, much greater than we thought.  

Setting the vaccine aside, an on-demand, reliable, antibody test can't come soon enough.  

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1 minute ago, triplehorn said:

Another non-response response.  The new study as reported by WaPo got posted.  There are some relevant things to consider.  Namely, evidently that 83% of "positive infection outcomes" were determined without lab confirmation.  yeesh.  Walk me back.

The main thing that remains pretty clear is that, through various studies and in reports coming out of multiple countries, HCQ does not appear to represent a heightened imminent or direct safety threat in Cov19, and individual medical consideration basically eliminates it.  You scaremongered about it way back.  I think the safety notion has been shed.  

Taking this rapid post-exposure study at face value, the ICMR prophylaxis study, and studies of HCQ in hospitalized subjects with advanced illness, it looks like very early post-exposure and late post-exposure uses are not a hit.  To repeat - are not a hit. 

It could be that true prophylaxis is where the lone benefit vs Cov19 rests.  The ICMR study needs replication.  The ICMR study design is substantively different in that the study followed subjects at least 3 times as long as this UMinn study, ICMR used actual testing for all subjects for confirmation before and after, and ICMR study used pre-medication for weeks after first confirming with a negative test.  A greater separation in prophylactic benefit was observed beginning after 4 weeks of once weekly dosing of HCQ.  The presence of a dose response curve spanning weeks warrants further understanding.  Nothing crazy about wondering about that.  And if the ICMR results hold that true prophylaxis can reduce infection formation by up to 80% in frontline health care workers under frequent exposure, that would be good to know.  400mg HCQ once per week has been dosed 10's of millions of times since around 1955.  'bout $0.60 per dose.

 

You have medical training clearly.  I have asked about the discipline previously.  You failed to respond. I'd wager you are a head shrinker based on your haphazard approach to evidence based medicine.  That is really not intended as an insult.  I love psychs, but your continual inability to approach medicine from an evidence based perspective is only one that I have witnessed from psychiatrists in my own experience. 

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3 hours ago, Anastasis said:

Surgisphere under significant scrutiny. It's apparently an international EMR network, and their data quality SOPs are apparently highly suspect. 

This is a pretty significant scandal. Surgisphere appears to be a fucking sham company. The fact that their fake study was ever actually considered real, posted and promoted in a respected medical journal and in fact had global implications on patient care, is frankly terrifying. You can believe what you will about the efficacy of Hydroxycloroquin therapy, and it has become a political football. But a sham study being promoted as fact, by respected medical publications and as a result in the media, is fucking inexcusable. 

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7 hours ago, Sejjr said:

This is a pretty significant scandal. Surgisphere appears to be a fucking sham company. The fact that their fake study was ever actually considered real, posted and promoted in a respected medical journal and in fact had global implications on patient care, is frankly terrifying. You can believe what you will about the efficacy of Hydroxycloroquin therapy, and it has become a political football. But a sham study being promoted as fact, by respected medical publications and as a result in the media, is fucking inexcusable. 

Yeah, the more I read about this, it's clear that the research has some problems, the data some irregularities that need to be addressed, and the company does not appear to have the resources necessary to pull off an international electronic medical record system. Really fucked up that both Lancet and NEJM published their studies without sufficient scrutiny. If it turns out to be sham data, or a sham company, I am fairly certain that some federal laws were broken in the process. There is a lot of garbage out there right now.  The vast majority of stuff getting thrown around is pre-review prints, and then you have the tier 1 journals getting duped. Get your shit together guys. 

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6 minutes ago, Bama Chick said:

This virus is so horrible.

My friend’s body is still being kept “alive” by machines but everything that made him who he was is gone.

Between these protests and personal grief, I am exhausted and broken.

Y’all please keep practicing social distancing and all the other safety precautions. My city’s numbers are the highest they’ve ever been and Alabama’s numbers are spiking despite our testing numbers remaining flat.

Our ICU is officially full.

Sorry I’m rambling. I’m a mess. Y’all be safe.

God that's terrible.  Thinking about you BC.  Stay safe!

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31 minutes ago, Hornius Emeritus said:

Covid testing in Texas increased by 36% last week but the number of confirmed infections rose 51%.  There was also an increase in the percentage of positive coronavirus tests.  This was testing that was done before the protests.

We're moving in the wrong direction.

Not great news, can you link me to charts/data backing that?

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10 hours ago, Queen Bitch said:

They’re going to blame the second wave on antifa, aren’t they

Yep.

 
 
 
 
Spoiler

 

Some are attempting to sell a narrative that the vast white people participating in demonstrations with BLM are Antifa operatives. That will shift to a narrative that all demonstrators are part of Antifa. It is an attempt to delegitimize the message and meaning of the protests against police violence. 

Some want a race war in the US. Antifa is about as impotent as they come in this realm. Prison gang affiliations have much more clout in the efforts to start race wars. 

 

 

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39 minutes ago, Anastasis said:

Yeah, I'd like to see that too.  @Hornius Emeritus there is a fair amount of data and discussion on cases and testing being shared in the "Texas Re-opening" thread.  Consider posting it there if you wish. 

 

Heard it on Public Radio this morning. I think it was the Texas Tribune.  I'll see if I can find the link.

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2 hours ago, Bama Chick said:

This virus is so horrible.

My friend’s body is still being kept “alive” by machines but everything that made him who he was is gone.

Between these protests and personal grief, I am exhausted and broken.

Y’all please keep practicing social distancing and all the other safety precautions. My city’s numbers are the highest they’ve ever been and Alabama’s numbers are spiking despite our testing numbers remaining flat.

Our ICU is officially full.

Sorry I’m rambling. I’m a mess. Y’all be safe.

Just so damned sorry to hear this, Bama.  We all gotta stay strong....sometimes that's really fucking hard.  And I'm sorry for that.

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51 minutes ago, Anastasis said:

Yeah, I'd like to see that too.  @Hornius Emeritus there is a fair amount of data and discussion on cases and testing being shared in the "Texas Re-opening" thread.  Consider posting it there if you wish. 


 

https://www.axios.com/coronavirus-cases-spike-in-texas-and-arizona-1819ce9f-8565-483a-b367-b678a607154d.html

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I think you will be able to logically point out the crowds at Memorial Day and then the crowds at the protests as sources of an increase in positive CV19 test results (provided people get tested)

It will be curious to see what impact these two events have on hospitalizations. I have seen people of all shapes and sizes at the protests and obviously at various Memorial Day events. I have no doubt we will see a spike, just a matter of how much and how bad.

I will say if we were looking to build some form of "herd immunity" in major metros the last 2-3 weeks I would imagine have set us well down that path.

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3 minutes ago, BrazilHorn said:

I will say if we were looking to build some form of "herd immunity" in major metros the last 2-3 weeks I would imagine have set us well down that path.

Isn’t herd immunity achieved after something like 70+% of population has antibodies? I don’t think that’s realistic even given the demonstrations

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