10 minutes ago, DEagle7 said:

1 hour ago, we_gotta_believe said:

And he told me that he makes me look like a fool!! Lmao. 

3 hours ago, Dave Moss said:

What's it gonna take?

Not clicking on that.  It might be Covid

Weekly update from the Doc

https://www.nothingbutthetruthmd.com/2020/09/92020-covid-19-udpdate.html

REMDESIVIR

This is an antiviral drug that has received significant press for its benefits in the treatment of Covid-19, and I am not sure why.

In May, the FDA, in another questionable call, gave Emergency Use Authorization for this drug in the treatment of Covid 19.

At the time of this approval, there had been TWO randomized controlled trials (RCT) of the drug.  One from China, which showed no benefit, and one reported in the NEJM in May which showed a shorter recovery time but no death benefit.  Other than politics I can't imagine why the FDA granted EUA to this drug.  The FDA has made similar bad decisions with Hydroxychloroquine and convalescent plasma therapy.  The credibility of the FDA is quickly sinking.

There has now been a third RCT, open label study (reported this month) comparing a 5 day or 10 day course of Remdesivir to standard care.  The patients at the time of enrollment had room air saturations greater than 94%.  There was no difference between the 10 day course and standard care.  The 5 day course showed improved clinical outcomes of UNCERTAIN CLINICAL IMPORTANCE!!

We now know that culturable virus is not present after about day eight to ten.  (reported in previous emails)  In the third study, which was open label, the median time to starting treatment was day 9, when their should be very little if any live virus circulating.  Why would an antiviral agent be expected to have ANY effect on a patient with no live virus?

Open label bias, the inability to explain why a 10 day treatment had no benefit compared to standard therapy when a five day treatment in the same study did, (of uncertain clinical importance) and used at a time when antiviral agents should not be expected to exert beneficial effect, raises more questions than answers about any possible efficacy of this drug.  Tens of millions of dollars will be spent on a treatment that has no proven scientific efficacy.  The FDA has sullied its reputation at a time when society is depending on integrity

MONOCLONAL ANTIBODY

Drug maker, Eli Lilly, announced on Wednesday that its monoclonal agent LY-CoV555 has shown a beneficial effect in treating Covid-19.  The report, was issued on interim data that has not as yet been peer reviewed.  This drug is also being tested in nursing homes.  Lilly is also recruiting patients for another drug which is a combination of two monoclonal antibody agents.

Although the duration of benefit (if it is proven) is unknown, this agent acts against the spike protein preventing attachment of the virus on to the cell surface and there should be no reason that this agent could not be given prophylactically to prevent infection.  Unlike remdesivir (which has little if any proven benefit in sick patients) the monoclonal antibodies could prevent infection and have a potential benefit on those infected if given early.  (in the first few days of disease) Like other therapeutics targeting the activity of the virus I would not expect this agent to show efficacy after days 7 - 10 of infection.  More succinctly, I would expect diminishing returns as time passes after inoculation with the virus.  Monoclonals do not depend on a successful stimulation of the immune response.  Therefore no time lag from the time of administration to the the time of effect and no worry of a lack of seroconversion (lack of response to a vaccine).

Lilly is saying that their phase three studies may be completed by November, which would be great news.  These agents should have very little risk in the way of side effects.  If a monoclonal antibody is approved, at the very least, EVERY new positive case should be offered the medication immediately.  There should be administration sites open 24/7.  If we are in a situation where EUA are necessary, then certainly 24/7 administration centers should be part of the response.

When will WE  have a vaccine?

Understanding questions and Answers about Covid-19 Vaccination

Drs. Bloom, Nowak, Orenstein

NEJM

9-19-20

"When will we have a vaccine.  The obvious answer to the question will be when a candidate vaccine is demonstrated to be safe and effective and available.  That can be determined only by scientific data, not by a target calendar date."

"But we realize that such a response, although accurate, overlooks much of what people are ultimately seeking to understand."

The authors presume, in their discussion, to know what the people need and are seeking to understand, and the usual suspects are honesty, openness, trust. and transparency.

What people need and are seeking to understand is not nearly so obvious to me.  I would have thought by now, that people would have understood the seriousness of this pandemic,  the need to wear masks and distance, to refrain as much as possible from participating in activities that could not be accomplished safely.  Obviously many don't, not just in this country, but in many countries around the world.  There have been many deaths and infections, but that does not seem to be stimulating enough.  A more lethal variant affecting  younger age groups, as did the Spanish Flu, I suspect would have resulted in a higher compliance.

Also, "opening" has been equated with, "no more worries" and obviously that is not true, and maybe that was just poor messaging (not mixed messages)

The authors accept the idea that 60-70% of the population would have be to immune, either as a result of natural infection or vaccination, to achieve herd immunity.  That would necessitate 200 Million Americans and 5.6 Billion people worldwide, being vaccinated to end the Pandemic.  Ending the Pandemic does not mean an end to Covid-19 infections however.  Over 90% of US citizens are immune to measles but in 2019 there were 1282 new cases of measles in the US, so let us be clear on meaning.

The authors suggest that it could take years to vaccinate effectively.  We do not know the duration of immunity of any successful vaccine candidate but I doubt it will be years, so we need to think outside the box, as was done with WARP SPEED in developing a vaccine, to expedite distribution.

WHEN and WE are both considerations for successful vaccine uptake.  Recognizing this may help public health officials and scientists to hone current messaging related to Covid-19 vaccine.  The authors talk about educating patients and parents.  For the foreseeable future we will not have to educate parents because children will not be getting the vaccine.

A successful vaccination program will be difficult to accomplish given the the fake news, fake vaccine experts and others who appear to be disengaged.  Are these Academicians seeing the pictures of over crowded beaches, bars, boardwalks and biker rallies?  Millions of people!  My sense; if there is a vaccine approved by December, by the end of January we will have more vaccine than people willing to receive it.  Whatever we do, must be better than what we have done so far.

NUMBERS

Deaths - 199,265

Bed Utilization compared to week of 9/13

South Carolina was the only state to see an increase in bed utilization

New Weekly cases compared to 9/13

Every state that I follow but Alabama, Louisiana  and Michigan saw an increase in weekly cases.

New Jersey for the fourth week in a row.

Texas up by 77%

Wisconsin up by 62%

This significant increase in new cases is undoubtedly related to the labor day festivities. 

Bed utilization and deaths usually lag new cases, so I would expect to see those rise by next weekend.

In case you missed my previous post, I did an interview on Friday with Dr. Chris Eagle, Professor at Emory University in the Center for the Study of Human Health.  If you are interested in viewing it, below is the link.

 

 

 

2 hours ago, vikas83 said:

 

Sounds like all positive news. 

Down here in PR we've had some of the more draconian measures in all of US and it has worked.  But we've been forced to open up and give businesses a breather and now the surge is hitting pretty hard.  I'm learning about more and more known people within 1 degree coming down with it and getting pretty damn sick.

Fauci absolutely demolishes Rand Paul.  RIGHT INTO MY VEINS PLEASE. 

Guy is clearly running out of patience for this pseudoscience BS an I'm here for it. F Rand Paul with a cactus.

7 minutes ago, DEagle7 said:

Fauci absolutely demolishes Rand Paul.  RIGHT INTO MY VEINS PLEASE. 

Guy is clearly running out of patience for this pseudoscience BS. Rand is absolutely pathetic.

Yeah nice one.  I see nothing wrong with Paul asking the tough questions at this point though and there are many uncertainties still out there.  Pointing at studies is useful but there are many many studies and they often contradict each other.  We just simply are not working with a full picture of data or final conclusions at this point.  Fauci knows that as well.

 

5 hours ago, DrPhilly said:

Yeah nice one.  I see nothing wrong with Paul asking the tough stupid questions at this point though and there are many uncertainties still out there.  Pointing at studies is useful but there are many many studies and they often contradict each other.  We just simply are not working with a full picture of data or final conclusions at this point.  Fauci knows that as well.

fyp

Was this discussed in here?

 

6 hours ago, DrPhilly said:

Yeah nice one.  I see nothing wrong with Paul asking the tough questions at this point though and there are many uncertainties still out there.  Pointing at studies is useful but there are many many studies and they often contradict each other.  We just simply are not working with a full picture of data or final conclusions at this point.  Fauci knows that as well.

It's not a tough question, it's an idiotic one. There's really no data to support the idea that NYC has reached herd immunity. Paul is a licenced physician and knows better. Just because we don't have a full picture doesn't mean people can just make up whatever narrative they want when the data we do have points elsewhere. It's moronic and partisan and Fauci was absolutely right to call him out on it. 

How are we doing on knowing what the long term effects are? Just heart and lung scaring, no big deal 

11 minutes ago, DaEagles4Life said:

How are we doing on knowing what the long term effects are? Just heart and lung scaring, no big deal 

We're not far enough to know the long-term effects, but there are measurable effects on the cardiovascular systems even of world class athletes who have had this.

I'm not surprised that more people are surviving this. We're 8 months in, and the medical community is much more capable at treating this than they were when it started. They only had their intuition to go on at the beginning, but now they have a sense for what works and what does not in different cases, so more people with severe cases are surviving.

It's good news. That doesn't mean we start to relax like it's no big deal, because it's still very deadly and long-term effects are still unknown. But it's certainly good.

2 hours ago, we_gotta_believe said:

fyp

Ok, not sure why you think the questions are stupid.  What is stupid though is if Paul or anyone else just decides they aren't going to accept the answer.

2 minutes ago, DrPhilly said:

Ok, not sure why you think the questions are stupid. 

Watch the full video on youtube. Paul comes off as a huge moron with Redfield too.

Quote

What is stupid though is if Paul or anyone else just decides they aren't going to accept the answer.

That's essentially what he's doing because he's been grinding this axe since May. There's a reason why Fauci got snippy with him and it's precisely because he's losing his patience with Rand after months of the same stupid horseshit from him.

1 hour ago, DEagle7 said:

It's not a tough question, it's an idiotic one. There's really no data to support the idea that NYC has reached herd immunity. Paul is a licenced physician and knows better. Just because we don't have a full picture doesn't mean people can just make up whatever narrative they want when the data we do have points elsewhere. It's moronic and partisan and Fauci was absolutely right to call him out on it. 

The question isn't ridiculous.  The attitude delivered with it is though.  Like any thing else it is always quite important to ask every single question possible to be able to determine if something is causal or not when it comes to any actual scientific or medical analysis.  That's just 101.

3 minutes ago, we_gotta_believe said:

Watch the full video on youtube. Paul comes off as a huge moron with Redfield too.

Haven't seen that.  Yeah, all I'm saying is the question itself isn't stupid though Paul may be stupid for asking it the way he does and in the context.

2 minutes ago, DrPhilly said:

Haven't seen that.  Yeah, all I'm saying is the question itself isn't stupid though Paul may be stupid for asking it the way he does and in the context.

Watch it. I'm willing to bet you won't be defending his questions anymore after you've seen the whole thing.

2 hours ago, Kz! said:

Was this discussed in here?

 

Given its lethality, is it fair to question if shutting down our economy causing the loss of millions of jobs and contributing to a steep rise in deaths of despair (suicides and drug overdoses), was the right call?

2 minutes ago, DrPhilly said:

The question isn't ridiculous.  The attitude delivered with it is though.  Like any thing else it is always quite important to ask every single question possible to be able to determine if something is causal or not when it comes to any actual scientific or medical analysis.  That's just 101.

It absolutely is. There is nothing to support the idea that NYC has hit herd immunity and Paul isn't a layman trying to educate themselves. He's a licensed physician who has been trained to critically analyze data and should know the answer to that question if he even put in the smallest amount of research. Not to mention that Fauci points out in his response that this kind of nonsense has become a pattern for Paul. He's not getting the answer he wants (democrat NYC bad) so he just keeps up with the partisan spin. 

You're really reaching here. 

3 minutes ago, we_gotta_believe said:

Watch it. I'm willing to bet you won't be defending his questions anymore after you've seen the whole thing.

Ok, I bet you're right.  I'll see if I can find time to watch it later.