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


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37 minutes ago, Cheeseweasel said:

Yeah, I feel like the impact in all areas is going to be hard.

I also feel like we've gone from the "we need to flatten the curve" phase to the "we need to prevent everyone from getting sick" phase. This is where the real debate will begin. 

Funny how that works....

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2 hours ago, Anastasis said:

Posted this on the #stonk thread, because I am inclined to short GILD each time they pull one of these bullshit announcements. 

I believe that this is the right study. https://clinicaltrials.gov/ct2/show/NCT04280705  The primary endpoint they are touting is time to recovery.  They are quiet on the secondary mortality endpoints in the releases that I read. I be interested to hear @ChiTownDoc @Newdoc and others chime in, I would be more interested if it actually reduces mortality, time to discharge, hospitalization days, etc. A time to recovery outcome could represent a very modest benefit, similar to antivirals for treatment of flu. They also bloated the release up with some open label results that don't provide any real insight into effectiveness.  

Aways easy to slam big pharma, but this is a good first trial with additional data coming. Details of the trial:

  • Two, randomized multi-center Phase 3 trials in countries with high COVID prevalence
  • 397 patients received 200mg on the first day, followed by 100mg until day 5 or day 10 in addition to standard of care
  • Patients had severe COVID manifestations: pneumonia but not under mechanical ventilation
  • An additional expansion phase of the study will enroll and additional 5,600 patients including those on mechanical ventilation, conducted at 180 trial sites (US, China, France, Germany, Hong Kong, Italy, Japan, Korea, Netherlands, Singapore, Spain, Sweden Switzerland, Taiwan, UK)
  • A second trial will read out in May, comparing safety and efficacy of 5 and 10-day durations compared to standard of care. The first data from 600 patients will be available at the end of May. 

Data from the trial:

  • Study sought to see if 5-day was as effective as the shorter 5-day course (10-day is currently being used world-wide)
  • 10-day treatment course as effected in achieving clinical status as 5-day
  • No new safety signals seen
  • Benefit as measured by improvement in clinical score as determined by a seven point scale including hospital discharge, increasing levels of oxygen support, and death
  • Patients achieved clinical recovery if they no longer required oxygen support and medical care or were discharged from the hospital. 
  • Time for clinical improvement for 50% of patients was 10 days in the 5-day treatment, and 11 days in the 10-day treatment
  • Clinical outcomes varied by geography - Outside of Italy, the overall morality rate at day 14 was 7% across both groups
  • 61-64% of patients were discharged from the hospital on the 5 and 10 day regimens, respectively
  • Patients who received the drug within 10 days of symptom onset had improved outcomes compare to those treated after 10 days
  • Worst tox I see is Grade 3 ALT in 7% of patients, with 3% discontinuing due to liver tox. 
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So for your morning livestock update, fresh pork values were slightly lower with loins dropping off sharply. I'd anticipate the PM report shows gains as the loins looks fluky. Beef prices continued to skyrocket, with choice almost to $350, and showing no signs of a peak yet. I'd guess we will at least test 375 there. 

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2 hours ago, Newdoc said:

Also, the protocols are all borked from a surface glance. The drug is given to various people at various stages in their illness. End points appear to discharge or death. You’re going to need a LARGE sample size to get good data out of that.

 

It's kind of important to understand when in the patient management cycle the drug will be effective. Obviously if you are in the middle of CRS and multi-organ failure, the clinical situation is more complicated. But that's why you run the study with wide inclusion criteria. 

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1 hour ago, UT_OB1 said:

I can’t speak for Port A, but I do have 2 Airbnbs in Galveston, and while things are picking up, we still aren’t close to “normal” levels of searches and bookings in the area. I’d say the overwhelming majority are still too nervous to book, and not just for fear of getting the virus, but also the uncertainty around what is open now (how many restaraunts for example) and what may or may not be open by the time they come stay.  

Are the prices down too? I did a quick search the other day and the prices appeared to be normal pricing but I don't look enough to compare it.

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2 minutes ago, bigup2dahorns said:

 

We are a decade removed from the earlier Coronavirus (SARS) and still without a vaccine.  I have little faith 18 months from now this will change.  I hope it will, but pinning the removal of SIP on a vaccine seems incredibly dangerous.  

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14 minutes ago, Txzen said:

Aways easy to slam big pharma, but this is a good first trial with additional data coming. Details of the trial:

  • Two, randomized multi-center Phase 3 trials in countries with high COVID prevalence
  • 397 patients received 200mg on the first day, followed by 100mg until day 5 or day 10 in addition to standard of care
  • Patients had severe COVID manifestations: pneumonia but not under mechanical ventilation
  • An additional expansion phase of the study will enroll and additional 5,600 patients including those on mechanical ventilation, conducted at 180 trial sites (US, China, France, Germany, Hong Kong, Italy, Japan, Korea, Netherlands, Singapore, Spain, Sweden Switzerland, Taiwan, UK)
  • A second trial will read out in May, comparing safety and efficacy of 5 and 10-day durations compared to standard of care. The first data from 600 patients will be available at the end of May. 

Data from the trial:

  • Study sought to see if 5-day was as effective as the shorter 5-day course (10-day is currently being used world-wide)
  • 10-day treatment course as effected in achieving clinical status as 5-day
  • No new safety signals seen
  • Benefit as measured by improvement in clinical score as determined by a seven point scale including hospital discharge, increasing levels of oxygen support, and death
  • Patients achieved clinical recovery if they no longer required oxygen support and medical care or were discharged from the hospital. 
  • Time for clinical improvement for 50% of patients was 10 days in the 5-day treatment, and 11 days in the 10-day treatment
  • Clinical outcomes varied by geography - Outside of Italy, the overall morality rate at day 14 was 7% across both groups
  • 61-64% of patients were discharged from the hospital on the 5 and 10 day regimens, respectively
  • Patients who received the drug within 10 days of symptom onset had improved outcomes compare to those treated after 10 days
  • Worst tox I see is Grade 3 ALT in 7% of patients, with 3% discontinuing due to liver tox. 

There are at least two studies being reported today, if I am following the reports right. Maybe a third negative chinese study in more severe patients too.  Hard to track it all in real time in the background. 

1. A GILD run phase 3, uncontrolled open label study focused on comparison of 5d vs. 10d. Results suggest that there is not difference, which would be a good thing as the drug supply could be stretched if a 5 day supply is sufficient.

2. An NIAID study using a randomized placebo controlled design.  This study found a shorter time to recovery 11 vs. 15 days.  No statistically significant difference in mortality rates. He may have mentioned some of the other outcomes, but I didn't catch them. 

I can't find a clinicaltrials.gov entry for the GILD study, but I believe that this is the one for the NIAID study: https://clinicaltrials.gov/ct2/show/NCT04280705

 

Any good news is good news. I'd like to see something that has a measurable impact on mortality. 

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15 minutes ago, Iceman said:

lolz, as Macanudo used to drop a well timed ‘wife died’ joke on us; I feel a kindred spirit with any shot at child abuse.

Not sorry I Surled...and you know you laughed.  

spacer.png

 

Anthony Jeselnik is one of my favorite comedians, and that sounds like something he would say. so yeah I laughed

Edited by Dennis Taylor
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3 minutes ago, Anastasis said:

I'd like to see something that has a measurable impact on mortality. 

IMO if we can get widespread use in susceptible patients early in the course of disease I bet we have a chance at reducing morbidity and mortality more significantly. That’s my hope at least.  The 5 vs 10 day is not a shocker at all bc maximum benefit based on the mechanism of action is probably within the first 48 hours.

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23 minutes ago, BabaYaga said:

We are a decade removed from the earlier Coronavirus (SARS) and still without a vaccine.  I have little faith 18 months from now this will change.  I hope it will, but pinning the removal of SIP on a vaccine seems incredibly dangerous.  

That gives me pause as well, though I'm still hopeful. In the end, SARS didn't have nearly the long-lasting or global impact, and so I think there was less motivation to continue with the research. The paucity of infectious disease research in large pharma I think also contributed to this - in the last 10 years so many have gotten out of the business all together. So perhaps there are some economical and business factors driving this (as well as some potential scientific hurdles posed by the coronovirus itself). 

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3 minutes ago, Txzen said:

That gives me pause as well, though I'm still hopeful. In the end, SARS didn't have nearly the long-lasting or global impact, and so I think there was less motivation to continue with the research. The paucity of infectious disease research in large pharma I think also contributed to this - in the last 10 years so many have gotten out of the business all together. So perhaps there are some economical and business factors driving this (as well as some potential scientific hurdles posed by the coronovirus itself). 

We can "hope", but hope is not a plan.  Nor does the economy or people's livelihood have 18 months to gamble on this.  In 18 months if maintaining our current SOP of being locked up, would make the Great Depression look like a wet fart in a windstorm.  

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17 minutes ago, Anastasis said:

There are at least two studies being reported today, if I am following the reports right. Maybe a third negative chinese study in more severe patients too.  Hard to track it all in real time in the background. 

1. A GILD run phase 3, uncontrolled open label study focused on comparison of 5d vs. 10d. Results suggest that there is not difference, which would be a good thing as the drug supply could be stretched if a 5 day supply is sufficient.

2. An NIAID study using a randomized placebo controlled design.  This study found a shorter time to recovery 11 vs. 15 days.  No statistically significant difference in mortality rates. He may have mentioned some of the other outcomes, but I didn't catch them. 

I can't find a clinicaltrials.gov entry for the GILD study, but I believe that this is the one for the NIAID study: https://clinicaltrials.gov/ct2/show/NCT04280705

 

Any good news is good news. I'd like to see something that has a measurable impact on mortality. 

Just noticed your avatar....nice work!

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39 minutes ago, BabaYaga said:

We are a decade removed from the earlier Coronavirus (SARS) and still without a vaccine.  I have little faith 18 months from now this will change.  I hope it will, but pinning the removal of SIP on a vaccine seems incredibly dangerous.  

Ball game?

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2 minutes ago, huge said:

My sanity wont allow it.

Yep.  Much longer and people start doing the math.  

If I keep cooped up, there is a 100% chance my business, livelihood, and entire economic future fails.

There is also a 100% chance my wife kills me and I choke one of my kids......or open up to a virus, which is Texas, has less than a 1% chance of killing me.  

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Just now, BabaYaga said:

Yep.  Much longer and people start doing the math.  

If I keep cooped up, there is a 100% chance my business, livelihood, and entire economic future fails.

There is also a 100% chance my wife kills me and I choke one of my kids......or open up to a virus, which is Texas, has less than a 1% chance of killing me.  

This. I like my odds. Worse case, I get sick as shit and stay in bed for 2 weeks. That sounds like a win-win.

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16 minutes ago, BabaYaga said:

We can "hope", but hope is not a plan.  Nor does the economy or people's livelihood have 18 months to gamble on this.  In 18 months if maintaining our current SOP of being locked up, would make the Great Depression look like a wet fart in a windstorm.  

There are way more resources being thrown at COVID-19 than SARS across the entire pharma industry right now. There is a plan, and hope. 

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2 minutes ago, Hate said:

That’s less than a 1% chance to kill you if you catch it.  

Edit: meant to quote BabaYaga

correct. and if 100K die the chance of you surviving this pandemic on average over all ages will have been 99.97%.  Even higher if you don't live in NY/NJ.

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1 minute ago, Txzen said:

There are way more resources being thrown at COVID-19 than SARS across the entire pharma industry right now. There is a plan, and hope. 

You willing to bet your entire life's savings on that?  Your house?  Your car?  Your job?  Your family?  All I'm saying is this can't continue.  Big pharma is not the light at the end of the tunnel.  If they are, we should all be scared.  Destroying generational wealth for a virus with a mortality rate of less than 1% isn't going to cut it for much longer.  

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1 minute ago, BabaYaga said:

You willing to bet your entire life's savings on that?  Your house?  Your car?  Your job?  Your family?  All I'm saying is this can't continue.  Big pharma is not the light at the end of the tunnel.  If they are, we should all be scared.  Destroying generational wealth for a virus with a mortality rate of less than 1% isn't going to cut it for much longer.  

Clearly I won't waste my time talking science with you. Carry on. 

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Big pharma is absolutely the answer to returning to normal. In the mean time, most people will have to accept the risks and precautions that go along with this new normal. The wheel must keep spinning, but it’s going to spin a little differently until big pharma has a solution for this.

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Texas-based Prestige Ameritech Ltd. nearly went out of business as a result of boosting production before demand faded, said owner Mike Bowen. The company laid off 150 of its 250 employees.

In 2014, CDC officials met with about 10 manufacturers to discuss worrisome data the officials were getting about capacity. Even in the most conservative scenario for a pandemic, the U.S. would need 1.7 billion to 3.5 billion respirators, and would need 7.3 billion in the highest-demand scenario, according to models the CDC reported the next year. That was far above stocks and U.S. manufacturing capacity.

The CDC officials explored possible solutions, such as having the manufacturers maintain stockpiles, according to people familiar with the discussions.

Manufacturing executives say companies were leery because of their experience in 2009. Some faulted a lack of a commitment by government and hospitals to buy domestically made masks.

“Everybody calls me when they can’t get masks,” said Mr. Bowen of Prestige Ameritech. “When everything goes back to normal, everyone goes back to the foreign masks.”

We heard that first on this thread

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1 hour ago, pacman said:

Are the prices down too? I did a quick search the other day and the prices appeared to be normal pricing but I don't look enough to compare it.

Well, at least in Galveston, all STRs and hotels were shut down to nonessential workers or people moving to.  So quite a few just left their prices as they were and blocked their calendars since they didn't know when things were going to open.  We dropped ours quite a bit just to get some income.  For the summer, from what I've seen, prices are down somewhat, but I think there is still so much uncertainty that people are in wait and see mode.  

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4 minutes ago, Hate said:

Big pharma is absolutely the answer to returning to normal. In the mean time, most people will have to accept the risks and precautions that go along with this new normal. The wheel must keep spinning, but it’s going to spin a little differently until big pharma has a solution for this.

Which was the point.  This new idea of keeping the world on lock-down until the hopes of a vaccine materialize is neither prudent nor viable.  

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So livestock slaughter runs continued to decline with cattle down to 72K, and yesterday was revised 4K lower to 72K, and hogs were down 12K to 271K, so we are about to 60% on cattle run rates, and almost 50% on hogs. So no instant impact from the defense production act, it does sound like worker turn out is starting to improve which should start to show some improvement soon. 

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36 minutes ago, dcar00 said:

correct. and if 100K die the chance of you surviving this pandemic on average over all ages will have been 99.97%.  Even higher if you don't live in NY/NJ.

You don’t know how statistics work, or I don’t know sarcasm. 
 

do you think the death rate is higher in ny/nj?  Do you think the 99.97% survival rate applies to each person, regardless of their age and health?

Edited by Pato del Muerto
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43 minutes ago, BabaYaga said:

Yep.  Much longer and people start doing the math.  

If I keep cooped up, there is a 100% chance my business, livelihood, and entire economic future fails.

There is also a 100% chance my wife kills me and I choke one of my kids......or open up to a virus, which is Texas, has less than a 1% chance of killing me.  

https://www.nytimes.com/2020/04/29/style/coronavirus-anger.html

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4 hours ago, Newdoc said:

I don’t like this release bc it’s the same old pharma BS in comparing the drug against itself. I want to see placebo controls but don’t know if that is ethical in compassionate use situations.

Also, the protocols are all borked from a surface glance. The drug is given to various people at various stages in their illness. End points appear to discharge or death. You’re going to need a LARGE sample size to get good data out of that.


In defense of the company, the drug may fare better if given to a larger, low acuity population earlier in their illness. The way most antivirals work is to cease replication of the virus. Giving the medicine to someone with a high viral load is trying to plug a damn after it breaches.

This is how you know you belong here.

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16 minutes ago, Royalfan5 said:

So livestock slaughter runs continued to decline with cattle down to 72K, and yesterday was revised 4K lower to 72K, and hogs were down 12K to 271K, so we are about to 60% on cattle run rates, and almost 50% on hogs. So no instant impact from the defense production act, it does sound like worker turn out is starting to improve which should start to show some improvement soon. 

Assuming they are healthy workers...

Any precautions for screening?

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


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