Coronavirus (COVID-19)

[WizeGuy]

3 minutes ago, Shanedorf said:

interesting, thx for posting.
Until it is peer reviewed, we won't learn much about the validity of these results. Our Immune system is like an orchestra with a hundred different "instruments" each playing a role. Its hard to tease out whether the tuba or the piccolo is the key component and each human is slightly different in their response.

I'll also note that they say antibodies couldn't be detected, which is different than saying there aren't any. Lots of variables to consider.

Linked in that Newsweek article is the study with Ivermectin, an approved anti-parasitic drug that is being studied at Monash University in Australia. That shows promise and Monash is part of the COVID-19 Therapeutic Accelerator funded by the Bill & Melinda Gates Foundation, so that's high quality work.
But its very early on in their COVID 19 testing, so far only "test tube" work , but there is a full set of safety studies in humans already, so that really expedites development time.

https://www.sciencedirect.com/science/article/pii/S0166354220302011

*Ivermectin is an inhibitor of the COVID-19 causative virus (SARS-CoV-2) in vitro. (test tubes)
*A single treatment able to effect ∼5000-fold reduction in virus at 48h in cell culture.•
*Ivermectin is FDA-approved for parasitic infections, and therefore has a potential for re-purposing.•
*Ivermectin is widely available, due to its inclusion on the WHO model list of essential medicines.

And Ivermectin does not have the same cardiac toxicity as the hydroxychloroquine drug so that's another big positive

Already FDA approved? Nice. Bill has the resources to mass produce this if need be as well.

I honestly think treatment is going to curb stomp this virus before a vaccine becomes available to the general public. Of course, a vaccine would be nice to ensure immunity, but if we can stifle the mortality rate and hospitalization rate with strong treatment and mass testing, then we may see society come back to normal sooner than expected. This is all just my optimistic view, of course. I'll keep my pessimistic views to myself, haha. 

[diehardlionfan]

On 2020-04-07 at 10:51 AM, mission27 said:

Negotiating with creditors in this situation is a different animal, believe me, I'm living it

Bankruptcy is absolutely an option and yes most of the airlines would probably survive, though there would likely be another round of consolidation and route cutting which hurts consumers and the airlines would have little incentive or ability not to furlough the vast majority of their staff.  Shouldn't we try to prevent that? 

I think its worth providing a band-aid for a couple months to avoid the kind of log term economic damage that would come from all of our airlines filing for bankruptcy at the same time in an environment with this much uncertainty and lack of access to capital 

Actually consolidation and decreased frequency is exactly what the industry needs to be healthy. Deregulation destroyed aviation and put infrastructure so far behind. Insane capacity demands at all major airports created in the name of flight frequency. It’s unsustainable as evidenced by the bankruptcy of almost all major airlines. Without systemic change they will all go bankrupt again.  The side no one sees is the crippling effect on the FAA that can’t procure funds for system modernization, building construction etc. Airports that are constantly struggling to increase capacity in the name of convenience. 

My underlying point is that during good times the cash is siphoned off yet when bad times hit the cash mysteriously doesn’t flow back into the company. If the shareholders in companies aren’t prepared to support their investment then its likely a company that won’t remain in business long anyway.

I understand how difficult capital markets are right now but when canabis growers can raise capital others can to. 

I realize fully the challenges that are presented. As a retired individual I’m probably more aware than most. There are currently MASSIVE amounts of cash sitting in some corporate accounts as well as ridiculous amounts of offshore cash. Corporations shouldn’t get a free taxation ride then access tax dollars to stay afloat. It’s a moot point As the bailout has been announced and thankfully there are some restrictions on accessing cash.

it must be nice to draw all the capital out of a company then use bankruptcy or taxpayers to remain afloat. I’m from the school of thought that you can always raise capital. It might be tough and you might not get full asset value however it can be done. 

Business needs to step up and invest some of their cash hoardes to keep the economy going. Companies like Berkshire, Microsoft, Alphabet, Apple, are just some of the companies with over 100 billion in cash. Others like Facebook, Oracle, Amazon, etc. around 50 billion. The system can’t support corporations banking profits, squeezing wages, paying few taxes then getting funded by the very people getting squeezed. You can bet Berkshire is bargain hunting and that’s exactly what should be happening. 

A number of years ago we faced financing challenges. So our corporation chose to become a private, not for profit, non share, capital corporation.(Still the only corporation of its kind globally) The result was the most over subscribed bond issue in Canadian history. Excess revenue is to be used either within the company or returned, pro rated to the customers. It was an outside the box solution used to create an awesome company.

 

 

[ramssuperbowl99]

7 minutes ago, WizeGuy said:

Already FDA approved? Nice. Bill has the resources to mass produce this if need be as well.

Sort of. @Shanedorf is gonna respond, but you don't just get a drug "approved". You get it approved at a specific dose for a specific indication with specific side effects and risk factors etc. etc. that all gets summarized on the label. The wording on that is outrageously specific and often negotiated/revised by an agency as part of the approval process. So if we had a cancer drug approved and it turned out to be effective against COVID-19, it's not just a copy+paste kind of thing. 

This is called off-label usage and it gets very case-specific and complicated quickly, so I don't want to speculate too much.

One thing I would say is that regulators take the seriousness of the disease and the potential benefits into consideration.

Edited April 8, 2020 by ramssuperbowl99

[mission27]

1 hour ago, LETSGOBROWNIES said:

Hopefully it is seasonal but to be fair, most of the people being ignorant were college aged kids who don’t get hit as hard with this.

Ive spoken to people in The Villages recently and the whole community has been taking things seriously for about as long as the rest of the country. I think the college kids just get the majority of the press.

 

As far as the seasonality, wouldn’t this be applicable to Nawlins then?  I mean, they seem to be one of the hardest hit areas.

The thing is even if the older people are being careful, I'd have expected the younger people to spread it to the older people, and the hospitals to be swamped with 80 year old retirees who caught it from their kids or grandkids or whoever they are buying food from.  The fact that we haven't seen that makes me think the spread is relatively low all things considered. 

New Orleans was in the high-40s low-50s in late February around Mardi Gras when this really got out of hand.  If you look at every single hot spot so far, cases have exploded somewhere between the high-30s and low-50s Fahrenheit, start with Wuhan, then parts of Europe and North America.  We've yet to see a real hot spot metro develop in a place where temps are high 60s or above (doesn't mean there haven't been cases, but the spread seems to be slower in these areas IMO) or on the flip side in a place where temps are consistently below freezing (may explain why US and Canada were relatively controlled in January and February, Wuhan is about 5-10 degrees warmer and while cold / dry is generally better for viruses, there's always an ideal range of temps, which I'm guessing for this is probably mid-30s to low-50s F)

Edited April 8, 2020 by mission27

[vikesfan89]

57 minutes ago, ramssuperbowl99 said:

There were a few other things, but yes for the most part it was the Biden/Bernie primary.

EDIT: And, this should have gone without saying, but just to be extra clear, my post had nothing to do with the choices people were making or politics at all. It was solely about how monumentally stupid, dangerous, and ultimately pointless it was to restrict polling places to a ridiculous level and make people stand outside for votes that don't matter as of a few hours ago.

I'm surprised that many still went out to vote. Too bad Bernie didn't drop out a day earlier

[mission27]

2 hours ago, dtait93 said:

It’s actully been pretty cool here compared to other years. And the major hot spot (Miami) isn’t as bad as a lot of people believe. The Miami Herald reported this weekend that hospitals are not swamped  and that most ventilators and ICU beds are  available.

https://www.miamiherald.com/news/coronavirus/article241785966.html

Cool compared to other years but I can tell ya its a lot warmer than its been up here in New York 

I'm really glad you guys aren't getting hit harder (yet) because with the age profile down there it could have been so ugly

[LETSGOBROWNIES]

Just now, mission27 said:

The thing is even if the older people are being careful, I'd have expected the younger people to spread it to the older people, and the hospitals to be swamped with 80 year old retirees who caught it from their kids or grandkids or whoever they are buying food from.  The fact that we haven't seen that makes me think the spread is relatively low all things considered. 

 

I think a lot of those kids aren’t necessarily locals though.  Grammy is on spring break vacation.

Just now, mission27 said:

New Orleans was in the high-40s low-50s in late February around Mardi Gras when this really got out of hand.  If you look at every single hot spot so far, cases have exploded somewhere between the high-30s and low-50s Fahrenheit, start with Wuhan, then parts of Europe and North America.  We've yet to see a real hot spot metro develop in a place where temps are high 60s or above (doesn't mean there haven't been cases, but the spread seems to be slower in these areas IMO)

This is really great tbh.  We need summer to get here ASAP if for nothing else than a respite for hospital staff and to allow for facilities to restock equipment and have a plan in place come October if a vaccine isn’t available.

 

I’ll be interesting to see what happens when the social distancing is eased up.

[mission27]

Just now, LETSGOBROWNIES said:

I think a lot of those kids aren’t necessarily locals though.  Grammy is on spring break vacation.

This is really great tbh.  We need summer to get here ASAP if for nothing else than a respite for hospital staff and to allow for facilities to restock equipment and have a plan in place come October if a vaccine isn’t available.

 

I’ll be interesting to see what happens when the social distancing is eased up.

That's a good point on them not being locals.  Either way, if not for seasonality, I think those extra weeks and everyone coming in and out of Florida would've led to a real explosion and once it starts spreading within the community you are screwed.  I think Florida was saved by being hot and humid af 

The good news on a wave 2 is even once you get into more mild temperatures because you'll likely be starting from a very low base of case, my guess is we don't see things really blow up until November, we should have a breather from mid-May through October or November and 5-6 months is a lot of time to scale up capacity, testing, tracing and develop treatments.  Fauci is more and more over the last few days coming around to what the MoL has said from the beginning (I have it on good authority he follows the MoLs) which is why you hear him being very hopeful about how things will be by this summer and also hopeful that we'll have enough time to get ready for wave 2

[ET80]

3 hours ago, Dome said:

Can I PLLLLEEEEEEEASE be your explosives expert?

ive never tried and it looks super fun, this might be my only chance  

I say, let's forget the movie and buy a ton of fireworks.

[mission27]

18 minutes ago, diehardlionfan said:

I realize fully the challenges that are presented. As a retired individual I’m probably more aware than most. There are currently MASSIVE amounts of cash sitting in some corporate accounts as well as ridiculous amounts of offshore cash. Corporations shouldn’t get a free taxation ride then access tax dollars to stay afloat. It’s a moot point As the bailout has been announced and thankfully there are some restrictions on accessing cash.

I generally agree with you, but what exactly do you want companies to do with this money?  Do you want them to keep the big piles of cash or do you want them to distribute that money to their shareholders (by buying back stock)?  I'm not sure what the other option is.

Anyway, the airlines are a very specific case.  We are asking them to continue to provide a service at a massive loss (flying planes all around the country with 1-2 passengers on board is incredibly unprofitable as you know) because our government has, probably correctly, deemed this critical infrastructure.  Without government subsidies the airlines would almost certainly decide to ground their planes and furlough everyone.  So in the case of the airlines I think the government is compensating them for providing a critical public service that they otherwise would not be compensated for, which fundamentally seems fair to me.  The airlines didn't cause COVID-19 and whether we think they are well run companies or not its not fair to expect them to continue to fly planes at a massive, potentially business crippling loss simply out of the goodness of their hearts.

[Shanedorf]

32 minutes ago, ramssuperbowl99 said:

Sort of.

spot on.
The short cut in re-purposing an already-approved drug is mostly on the safety side and by already having that completed, it allows them to move into the efficacy trials right away. But its not copy and paste as you noted.

It could be done in as little as 3-4 months because its not a long trial and the FDA and others would expedite. Any effects would be seen in a matter of days/weeks whereas for a new blood pressure med, they'd wanna study it for months/years because somebody is going to take that for the rest of their lives.
This is an acute dose treating an acute disease, so it goes much faster on the clinical trial side.

[ramssuperbowl99]

2 minutes ago, Shanedorf said:

spot on.
The short cut in re-purposing an already-approved drug is mostly on the safety side and by already having that completed, it allows them to move into the efficacy trials right away. But its not copy and paste as you noted.

It could be done in as little as 3-4 months because its not a long trial and the FDA and others would expedite. Any effects would be seen in a matter of days/weeks whereas for a new blood pressure med, they'd wanna study it for months/years because somebody is going to take that for the rest of their lives.
This is an acute dose treating an acute disease, so it goes much faster on the clinical trial side.

Admittedly I haven't seen anything like this, but I have definitely never seen regulators say "eh **** it let's see what happens" like they are right now. 

[mission27]

8 minutes ago, Shanedorf said:

spot on.
The short cut in re-purposing an already-approved drug is mostly on the safety side and by already having that completed, it allows them to move into the efficacy trials right away. But its not copy and paste as you noted.

It could be done in as little as 3-4 months because its not a long trial and the FDA and others would expedite. Any effects would be seen in a matter of days/weeks whereas for a new blood pressure med, they'd wanna study it for months/years because somebody is going to take that for the rest of their lives.
This is an acute dose treating an acute disease, so it goes much faster on the clinical trial side.

If we're talking 3-4 months to complete the trial, optimistically, at what point do we see early results and are those results shared with the medical community so doctors can make a more educated guess re which off label drugs to try when someone is seriously ill? 

[ramssuperbowl99]

1 minute ago, mission27 said:

If we're talking 3-4 months to complete the trial, optimistically, at what point do we see early results and are those results shared with the medical community so doctors can make a more educated guess re which off label drugs to try when someone is seriously ill? 

We already have doctors effectively live-tweeting off label treatments. The problem is separating what works from the noise.

Edited April 8, 2020 by ramssuperbowl99

[Shanedorf]

35 minutes ago, ramssuperbowl99 said:

We already have doctors effectively live-tweeting off label treatments. The problem is separating what works from the noise.

Yup and the MDs in LA touting 100% recovery based on their cocktail haven't stood up to scrutiny so far. That might be noise

MDs are beholding to their patients, they aren't responsible for what happens if you roll this out to millions/billions of people all with various underlying issues including diabetes, heart disease, high blood pressure, liver disease etc. 
That's the big problem with the hydroxychloroquine, fatal heart arrhythmia. 
And since many of the COVID19 patients are older -  they are both more likely to have other issues and more likely to be taking other meds

IF the results of the Ivermectin studies meet their clinical endpoints, the news will be shared and MDs will be updated on dosing guidelines

If you wanna see what a drug label looks like, here's one for Ivermectin and you can see how detailed the info is and how the dosing is different dependent on the patient age, weight, liver function, kidney disease, asthma etc. and for what disease you are treating.
All of this was negotiated with the FDA as you noted earlier

This linked info below came from clinical studies and because those studies have been completed, its a shorter path to use for COVID19 IF it shows efficacy against the virus. Asthma patients are listed as a special concern and that's tricky when you're talking about treating a respiratory disease with this medicine

https://m.pdr.net/drug-summary/Stromectol-ivermectin-391

Edited April 8, 2020 by Shanedorf