Coronavirus (COVID-19)

[seriously27]

2 minutes ago, ramssuperbowl99 said:

I think this is the takeaway. For most people it won't be a relevant option, but this potentially in combination with other treatments can help get people out of the hospital it could help with capacity issues and help mitigate the risk of opening things up.

Yup. Just have to get enough antibody tests and enough people willing to donate plasma who have the antibodies in their system. This could be tricky if the idea that people can still get sick again, even after they have had it once, keeps popping up. People may not be willing to donate blood because it will weaken their immune system for a time if they think there is a chance they can get it again.  

[mission27]

4 minutes ago, mistakey said:

so either seasonality is responsible for everything, or seasonality is at least half as important as the aggressive public health response, so which one is it?

It probably depends on the region + what public health measures they are taking

I think they are both impactful and its hard to separate the two, but the relationship between hot spots and temperature continues to be very strong

[mistakey]

1 minute ago, mission27 said:

It probably depends on the region + what public health measures they are taking

I think they are both impactful and its hard to separate the two, but the relationship between hot spots and temperature continues to be very strong

yeah, or its the overwhelming global aggressive public health measures and a small but statistically significant element of seasonality.  

[mistakey]

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

In this study of adult patients admitted to hospital for severe COVID-19, remdesivir was not associated with statistically significant clinical benefits. However, the numerical reduction in time to clinical improvement in those treated earlier requires confirmation in larger studies.

Edited April 29, 2020 by mistakey

[mission27]

19 minutes ago, ramssuperbowl99 said:

So these are the sickest group of COVID-19 patients, and the mortality rate here was 7%. I don't have the data in front of me and I'm too lazy to look it up, but I think once you were hospitalized the mortality was in the 15-20% range from previous data right?

If so, this is a gamechanger.

I think potentially even higher for patients who were admitted rather than just tested at hospital and sent home

We've seen populations where hospitalization rate is as low as 1% (New Rochelle for example).  7% of 1% would be seasonal flu levels of fatality.  Yes I know that misses a lot of deaths in nursing homes but if we could get case fatality outside of nursing homes down below 0.1% with mass production of remdesivir in a few months plus the other things we are doing to flatten the curve, it becomes a much more isolate issue of senior living environments (which honestly is how a lot of countries are starting to look at this anyway given increasing evidence that CFR is 0.5% or below and much lower for under-65 group)

Clearly would be a gamechanger

[mission27]

2 minutes ago, mistakey said:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

In this study of adult patients admitted to hospital for severe COVID-19, remdesivir was not associated with statistically significant clinical benefits. However, the numerical reduction in time to clinical improvement in those treated earlier requires confirmation in larger studies.

The study was flawed and both Gilead and researchers who were on the team conducting the study have come out and said they believe the way this was reported was misleading.  I wouldnt pay any attention to this.

[mistakey]

1 minute ago, mission27 said:

The study was flawed and both Gilead and researchers who were on the team conducting the study have come out and said they believe the way this was reported was misleading.  I wouldnt pay any attention to this.

its not like you have a monetary stake in gilead or anything though

[mistakey]

unless you were lying pages back

[Glen]

Just now, mistakey said:

unless you were lying pages back

Lying, on the internet?

[ramssuperbowl99]

5 minutes ago, mistakey said:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

In this study of adult patients admitted to hospital for severe COVID-19, remdesivir was not associated with statistically significant clinical benefits. However, the numerical reduction in time to clinical improvement in those treated earlier requires confirmation in larger studies.

One group running into adverse events and the other not running into any unexpected new safety issues despite being given virtually the same regimen doesn't make sense.

Something doesn't add up. Which isn't to say I'm dismissing these results, it just doesn't make sense.

[mistakey]

1 minute ago, ramssuperbowl99 said:

One group running into adverse events and the other not running into any unexpected new safety issues despite being given virtually the same regimen doesn't make sense.

Something doesn't add up. Which isn't to say I'm dismissing these results, it just doesn't make sense.

counter point - nothing about this disease makes sense.  

[mistakey]

heres the point though that one of my stats profs who did a lot of biostats made, is that as much as we tlak about statistical signifcance ,sometimes that doesnt match up with practical significance.  and in this case, it does seem like there is practical significance to the drug - it did help people, just didn't do it as much as we wanted.  and for now that may be good enough, especially for compassionate use.

[mission27]

7 minutes ago, mistakey said:

yeah, or its the overwhelming global aggressive public health measures and a small but statistically significant element of seasonality.  

Perhaps, but that wouldn't explain why colder climates like NYC, Canada, London, Russia, Scandinavia, and Eastern Europe were hit later than warmer climates like Italy, Spain, Washington State, and parts of Asia.  Its not really explainable by travel patterns.  It could be a coincidence but there is circumstantial evidence IMO that the disease is thriving between 35-50 F and spreads more slowly in warmer or much colder environments

Was reading last night about an Israeli epidemiologist who compared these outbreaks and his position is that the outbreaks all tend to eb and flow within ~70 days regardless of lockdown measures (although the total amount of cases at any given time may be higher without a lockdown, the timeline of peak and downswing is similar no matter what you do).  He wasnt sure why although he did mention seasonality as a potential factor along with herd immunity within clusters.  Temperate climates go through ~2 months in the late winter where temperatures are in this ideal range for spread and you can see this disease hitting large cities across the northern hemisphere in a clean wave as each of these cities went through that band of temperatures 

[mission27]

9 minutes ago, mistakey said:

its not like you have a monetary stake in gilead or anything though

Yes I do have a significant monetary stake in Gilead because its a great company and I believe in the drug 

Gilead isn't running some sort of pump and dump scheme here though.  They've been cautious and reasonable.  I will listen to what they say on this topic, don't think they are trying to get out over their skis 

[seriously27]

1 minute ago, mistakey said:

counter point - nothing about this disease makes sense.  

I would counter that even by saying this virus is doing exactly what it wants to do. Survive and multiply as effectively as possible. It's one of the most effective virus stains the world has ever seen. Multiplies quickly and in high numbers, is transmittable before the host even shows symptoms, is able to live in open space for an extended period of time, doesn't kill the host quickly and also has a high propensity for the host to not show symptoms at all. In fact I would say this virus is almost perfect in what it wants to be.