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Dr. Fauci is over rated.

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6 minutes ago, Gerry Maddoux said:

Well, it's not quite that bad. Giliad developed Remdesivir for Ebola and Marburg--two of the meanest, highest mortality viruses in the world. It worked. Since these are rare diseases, Giliad received an "orphan" status designation for the drug, which means that no one can produce a copycat for seven years. 

They tested the drug against several other single-stranded RNA viruses, especially those causing severe airways disease: Ripah, Respiratory Syncytial Virus, and finally coronavirus. So Remdesivir has been a) well shown to have antiviral activity against these single-stranded RNA viruses and b) seems relatively safe. 

They've actually given it to some patients with this disease. Giliad, to their credit, dropped the orphan status, which allows any drug company to manufacture this drug for a nominal cost. Maybe they did that under pressure but it tells me that they think it may have a place. 

Am I pushing Remdesivir? No, of course not. But it has been subjected to some of the rigorous scrutiny that other drugs have to undergo. 

My hunch is it's going to wind up being the "Big Drug" in treating this virus--simply because it is so close in design to the other viruses out there with proven efficacy. But who knows? HCQ/Z may wind up being the ticket. I just wish they'd start giving us a down to earth update on this on a daily basis. Quite a few doctors have sequestered HCQ/Z--and I don't blame them; they're on the front lines. 

Good info

Thanks

Can you get HCQ/z ?

Edited by BLA
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7 minutes ago, BLA said:

Can you get HCQ/z ?

Not unless you're sick with a positive test result. And then only if you're lucky.

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8 hours ago, Gerry Maddoux said:

Really? Strange, I was a cardiologist in the thick of things for over three decades and never saw this. I saw some doctors gut-check a lot of times, and I saw some tough guys crying like babies in the changing room, but I must say, I never once came across a doctor who simply didn't care. Jaded? All the time. Caring? Nope. I'm sure there are those; I just never came across one.

Some people do not have the ability to emote and treat patients at their best at the same time. Men, especially. So we just do the job the best we can without the very best bedside manner. Surgeons often fall into this category. Men are often just numb to get through stress. You don't know their inner emotions. I would rather have the best outcome than the best emoting. 

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(edited)

7 hours ago, Gerry Maddoux said:

Okay, here's anecdotal: I just called one of the nurses who worked with me closely for years. She is the nursing supervisor for a 1250 bed hospital. Amongst the patients they have are two thirty-something men who were previously healthy and nonsmokers, a forty-something, and a patient in his fifties. All are on ventilators. All are receiving the kitchen sink: chloroquine and Zithromax, etc. Nothing is working. Nothing. 

Now, if one extrapolates from that, Plaquenil and Z-Pack are losers. We're done. No good. 

But what if these are outliers for some reason? What if, when you run the same experiment on a thousand people from all different backgrounds, different geographic situations, different co-morbid health problems, the combo worked to the tune of 75%?

I rest my case. 

So if your patient is having a heart attack, do you prescribe a statin? 

I rest my case ;)

Edited by Ward Smith
Stupid auto-corrects

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13 hours ago, BLA said:

Fauci does say what he wants. He goes on all the news programs.  

My, and many other's problem is he has no sense of urgency. The highly respected French viral PhD that ran the very successful trial with HCQ said it's immoral and unethical to wait to administer the therapy.

Fauci has a problem. . . .  it wasn't his idea.  

I do have a great deal of respect for Dr. Fauci. .   .   .   but

You realize that Fauci said in January the United States does not have to worry about coronavirus.  He also stated at one point the virus transmits by contact only, not airborne.  This was repeated by state Health Commissioners ( including mine) around the country.

I realize China withheld (still is withholding ) key data.  But how can one make a blanket claim like that based on no facts, no data. 

PS the Zpak is an antibiotic that treats or limits the development of the pneumonia , the ultimate killer 

That was the CCP party line. Intended to lull everyone into letting their guard down. CDC bought it while we here were talking about how the CCP are hiding the extent, communicability and mortality of the Wuhan Coronavirus. 

They lied and our bureaucrats and Trump for a while, bought it too. 

 

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11 hours ago, Yoshiro Kamamura said:

Hydroxychloroquine does nothing against COVID-19. 

Is that your Big Head talking again Todd?

@James Regan will get the connection here...

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8 hours ago, Gerry Maddoux said:

Okay, here's anecdotal: I just called one of the nurses who worked with me closely for years. She is the nursing supervisor for a 1250 bed hospital. Amongst the patients they have are two thirty-something men who were previously healthy and nonsmokers, a forty-something, and a patient in his fifties. All are on ventilators. All are receiving the kitchen sink: chloroquine and Zithromax, etc. Nothing is working. Nothing. 

Now, if one extrapolates from that, Plaquenil and Z-Pack are losers. We're done. No good. 

But what if these are outliers for some reason? What if, when you run the same experiment on a thousand people from all different backgrounds, different geographic situations, different co-morbid health problems, the combo worked to the tune of 75%?

I rest my case. 

Already, just with the talk of "amazing" efficacy of Hydroxychloroquine/Zithromax, there is a total shortage of both . . . for clinically proven conditions. The combo may or may not work (I don't personally see how they would but maybe they do). Doctors on the front lines in Texas and Oklahoma are known to be sequestering these things for their own use--and for their family's use. People are scared! If we don't run some sort of parallel studies, we'll have a mess. I personally used a drug for a whole decade, thinking along with everyone else that it dramatically improved heart failure. The initial clinical trial had been interrupted and the seal was broken--it looked inhumane to withhold the drug from patients. And then the numbers began folding upon themselves. When a better, larger, blinded study was finally performed again, alas, there was no difference between that drug and . . . nothing whatsoever. That was one of the darkest days of my career. So you can see, this cuts both ways. We probably didn't hurt anybody with our endeavors, but we built up hope for nothing, and we spent an awful lot of money doing it. 

I would not think that the trial is going to last long. It is clearly a way to buy the high cost medications on parallel trials some time and a chance to shine so as to make the industry money. HCQ/Zithromax is not funded. Everyone is doing it for free but for the cheap drugs. 

The French study is clear cut and statistically strong. The FDA requirements are pedantry and no more. Definitely will have better stats as it progresses, but it will be halted long before, so long as they don't focus on late stage patients. 

The drugs will do nothing to undo the damage to the lungs. Only prevent the viral activity from progressing. The cytokine storm requires a separate treatment. The hope and success to date is with early stage mild presentations and as a prophylactic for high risk people - either because of their high risk for consequences or high risk of exposure (like medical staff).  

The guys on ventilators already only have a low chance of survival whether the drugs kill off the virus or not. 

There is an issue with SARS vaccines that cause a serious problem, that when you get exposed to a SARS virus after vaccination you get the cytokine storm triggered immediately even at tiny viral loads. Which is why I don't expect a traditional vaccine would be successful. Concentrated clonal antibodies would be the best thing to try. 

Again, the FDA will require a "from scratch" approval process even if you show that it is the identical molecule to the direct human antibody isolated from the serum of recovered patients. 

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11 hours ago, Yoshiro Kamamura said:

Hydroxychloroquine does nothing against COVID-19. 

There are multiple studies with statistical significance to say that the HCQ is effective in combination with azithromycin and effective but less so without it. 

You lie. 

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1 hour ago, 0R0 said:

There are multiple studies with statistical significance to say that the HCQ is effective in combination with azithromycin and effective but less so without it. 

Do you have a reference for that? About the only things I have read are the French doctor's anecdotal cases--thirty or forty, I think, totally uncontrolled--and truly anecdotal twos and threes here and there. It takes a lot of patients to get to statistical significance, with a P-Value that will really convince any skeptic of the results. 

Don't get me wrong: I would dearly love to see that a low-cost, safe, easily manufactured solution can knock this thing on its butt. Your statement seems to imply that that data is already available. 

I'll freely admit that it's a reality jam with me: There's really no reason why those two drugs should work. If they do, great, but if they don't, we've got a lot of people all hopped up on joy juice. Anyway, if you've got the data to back up that claim, I'd like to look at it. And so should Dr. Fauci.  

 

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29 minutes ago, Gerry Maddoux said:

Do you have a reference for that? About the only things I have read are the French doctor's anecdotal cases--thirty or forty, I think, totally uncontrolled--and truly anecdotal twos and threes here and there. It takes a lot of patients to get to statistical significance, with a P-Value that will really convince any skeptic of the results. 

Don't get me wrong: I would dearly love to see that a low-cost, safe, easily manufactured solution can knock this thing on its butt. Your statement seems to imply that that data is already available. 

I'll freely admit that it's a reality jam with me: There's really no reason why those two drugs should work. If they do, great, but if they don't, we've got a lot of people all hopped up on joy juice. Anyway, if you've got the data to back up that claim, I'd like to look at it. And so should Dr. Fauci.  

 

 

Based on what I can tell, all of the HCQ studies have flaws so far

some opinions and a link to a statistical study on the HCQ studies here:

https://www.statnews.com/2020/03/27/we-dont-know-hydroxychloroquine/

After reading this I can see why people might be hopeful about remdesivir:

https://www.statnews.com/2020/03/16/remdesivir-surges-ahead-against-coronavirus/

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1 hour ago, Gerry Maddoux said:

Do you have a reference for that? About the only things I have read are the French doctor's anecdotal cases--thirty or forty, I think, totally uncontrolled--and truly anecdotal twos and threes here and there. It takes a lot of patients to get to statistical significance, with a P-Value that will really convince any skeptic of the results. 

Don't get me wrong: I would dearly love to see that a low-cost, safe, easily manufactured solution can knock this thing on its butt. Your statement seems to imply that that data is already available. 

I'll freely admit that it's a reality jam with me: There's really no reason why those two drugs should work. If they do, great, but if they don't, we've got a lot of people all hopped up on joy juice. Anyway, if you've got the data to back up that claim, I'd like to look at it. And so should Dr. Fauci.  

 

Besides Dr Raoult study is not a standardized test, but is hardly "anecdotes", you can win a Noble prize with less. The tight statistical single variable requirement of the FDA is foolproof science that excludes the vast bulk of treatments from consideration. It is for high school graduates and first year science students like the background MDs have. It is the most primitive base for scientific verification. Treatment regimens need to be altered to fit the patient and the stage of the disease and complications. Multivariate analysis can be conducted at good levels of certainty. The single variable large sample trials are simply a fetish of the FDA and have nothing to do with having sufficient information. They substitute one narrow subset of the scientific method for the entirety of it. 

The drug industry has given up on getting a complex drug combo through the FDA. All those that exist are not approved outright. 

Doctors are reporting their recent treatment histories with HCQ/Z for mild symptomatic CV19 positive cases. They can't report about their virus free status yet because test guidance is still too restrictive to allow for it outside the hospital, where it is a criterion for release. It should be the next step in expanding testing. The main observation is that none or very few had to be hospitalized.  There are also reports from Korea and China. I suggest you look it up yourself. I spent enough time on it to convince myself. 

Dr Raoult is publishing a broader study the coming week, and someone was working on consolidating statistics from doctors treating with the drug cocktail but did not have a stated publication date target. Not entirely definitive, but certainly enough to be a probable treatment. 

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14 minutes ago, 0R0 said:

Besides Dr Raoult study is not a standardized test, but is hardly "anecdotes", you can win a Noble prize with less. The tight statistical single variable requirement of the FDA is foolproof science that excludes the vast bulk of treatments from consideration. It is for high school graduates and first year science students like the background MDs have. It is the most primitive base for scientific verification. Treatment regimens need to be altered to fit the patient and the stage of the disease and complications. Multivariate analysis can be conducted at good levels of certainty. The single variable large sample trials are simply a fetish of the FDA and have nothing to do with having sufficient information. They substitute one narrow subset of the scientific method for the entirety of it. 

The drug industry has given up on getting a complex drug combo through the FDA. All those that exist are not approved outright. 

Doctors are reporting their recent treatment histories with HCQ/Z for mild symptomatic CV19 positive cases. They can't report about their virus free status yet because test guidance is still too restrictive to allow for it outside the hospital, where it is a criterion for release. It should be the next step in expanding testing. The main observation is that none or very few had to be hospitalized.  There are also reports from Korea and China. I suggest you look it up yourself. I spent enough time on it to convince myself. 

Dr Raoult is publishing a broader study the coming week, and someone was working on consolidating statistics from doctors treating with the drug cocktail but did not have a stated publication date target. Not entirely definitive, but certainly enough to be a probable treatment. 

Multivariate analysis requires large data sets.  If you start over-splitting groups you are faking the stats.

 

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23 hours ago, Ward Smith said:

One of my best friends is an ER physician. He actually switched hospital groups to get away from a colleague like that. My other good friend and neighbor is also a cardiologist. He builds up personal relationships with his patients much more than an ER doctor would. He too gets broken up a bit when he "loses" one. 

How would you like to be part of a double blind trial with a heart patient who's clearly getting worse and you know good and well his "treatment" is a placebo? What if that patient were a friend? This is what Fauci wants. Huge blind trials, and if people die? Science. 

You misunderstand the whole concept of a double blind trial.  The physicians administering the trial do not know what they're giving the patients. Otherwise, the trial would be biased.  If you're a good trader, you probably depend on statistics.  That's how science works too, man.

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23 hours ago, Ward Smith said:

One of my best friends is an ER physician. He actually switched hospital groups to get away from a colleague like that. My other good friend and neighbor is also a cardiologist. He builds up personal relationships with his patients much more than an ER doctor would. He too gets broken up a bit when he "loses" one. 

How would you like to be part of a double blind trial with a heart patient who's clearly getting worse and you know good and well his "treatment" is a placebo? What if that patient were a friend? This is what Fauci wants. Huge blind trials, and if people die? Science. 

You misunderstand the whole concept of a double blind trial.  The physicians administering the trial do not know what they're giving the patients. Otherwise, the trial would be biased.  If you're a good trader, you probably depend on statistics.  That's how science works too, man.

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On 3/27/2020 at 8:10 PM, Gerry Maddoux said:

Not unless you're sick with a positive test result. And then only if you're lucky.

If your arthritis picks up you can write yourself a prescription.  

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On 3/27/2020 at 7:12 AM, BLA said:

How many time in the last week have you heard. " I have a great deal of respect for Dr Fauci but  .   .   .   .   . "

When I was a junior designer in 1968, my first review commented, "Too technical."  That may also apply to Dr. Fauci.  On the other hand, it may also be that Big Pharma operates on a billable hour basis, with attendant lengthy test protocols.  Dr. Fauci may not realize he is conditioned to act this way.  On the other hand, you can't get to the top of an organization if you don't understand your business model.  I matured to retire as a principal engineer at the same company.  It wouldn't have happened if I had remained "too technical".  President Trump needs to be wary of Big Pharma, another Deep State.  Do we like drug pricing?

Glad to see that the Justice Department went after the medical supply scalpers this week.

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Dr Fauchi is very well respected in TIBET, TIBET TIBET

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