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Tags Coronavirus , diseases

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Old Yesterday, 02:59 PM   #201
Trebuchet
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Originally Posted by Orphia Nay View Post
Someone studying the virus said yesterday that the virus's favourite conditions are low humidity under 10 degrees Celsius.
Which is exactly the opposite of conditions in Houston, one of the USA's worst hotspots.
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Old Yesterday, 03:32 PM   #202
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Originally Posted by Skeptic Ginger View Post
But they didn't "assign" them. They looked back at patients already given the meds.

Unless you read something I didn't.
They didn't give HQ to patients with certain heart issues.

Look at the mortality chart. After 7 days 5% of the HQ patients died while 17% of the standard treatment patients died. Difference is even stronger at 4 days.

Also, the mean age of the HQ patients was 63 v 68. But supposedly the overall risk score was matched. Hmm.

That's just weird. Something doesn't make sense.
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Old Yesterday, 04:01 PM   #203
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Originally Posted by marting View Post
A new observational study in conflict with most previous ones on Hydroxychloroquine showing significant (50%) mortality reduction.

Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19

https://www.ijidonline.com/article/S...534-8/fulltext
Does it seem a little curious that the mortality rate with hydroxychloroquine alone was lower than with hydroxychloroquine plus an antibiotic? Then I read the CNN report:

Quote:
The combination of hydroxychloroquine plus azithromycin was reserved for selected patients with severe COVID-19
Oh, the treatments weren't selected at random.

Further down in the CNN report, there's this gem:

Quote:
Finally, concomitant steroid use in patients receiving hydroxychloroquine was more than double the non-treated group.
Oh, there was more difference in the treatment than just hydroxychloroquine.

https://www.cnn.com/2020/07/02/healt...udy/index.html
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Old Yesterday, 04:22 PM   #204
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Originally Posted by TellyKNeasuss View Post
Oh, there was more difference in the treatment than just hydroxychloroquine.
https://www.cnn.com/2020/07/02/healt...udy/index.html
Quite a few it seems, but they matched up the risk scores! Sure? I find the death curves v days in the hospital just stranger than hell. The immediate reductions in mortality were so astoundingly good they would have created a lot of noise way back when they were first doing this.

Still, might be something there but it strikes me as fishy so not holding my breath.

I'll wait til there's actually multiple controlled studies.
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Old Yesterday, 04:41 PM   #205
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Originally Posted by Trebuchet View Post
Which is exactly the opposite of conditions in Houston, one of the USA's worst hotspots.
I wonder what role air conditioning might play...
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Old Yesterday, 04:43 PM   #206
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Originally Posted by marting View Post
They didn't give HQ to patients with certain heart issues.

Look at the mortality chart. After 7 days 5% of the HQ patients died while 17% of the standard treatment patients died. Difference is even stronger at 4 days.

Also, the mean age of the HQ patients was 63 v 68. But supposedly the overall risk score was matched. Hmm.

That's just weird. Something doesn't make sense.
It makes sense that they excluded patients given the meds that had heart disease. Remember, it wasn't a clear factor at first.

Patient might die: give hC.

Patients given HC are dying of heart disease. Stop giving HC.


IMO, this is old data rehashed or something.
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Old Yesterday, 04:45 PM   #207
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Originally Posted by marting View Post
A new observational study in conflict with most previous ones on Hydroxychloroquine showing significant (50%) mortality reduction.

Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19

https://www.ijidonline.com/article/S...534-8/fulltext
This journal also included a letter criticizing the article:

https://www.ijidonline.com/article/S...30-0/fulltext#

Among the interesting observations in the letter was that the fatality rate for the non-treated significantly exceeded the rate at which they were put into the ICU.
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Old Yesterday, 05:47 PM   #208
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James Fallows is a contributor to The Atlantic and a private pilot.

Hereís a recent article where he compares analyzing what went wrong with the coronavirus response with what happens when an aircraft accident is investigated.

Itís long, but I think itís a worthwhile read.

https://www.theatlantic.com/politics...-wrong/613591/

Note: Iím going to cross-post this to a Trump thread as well.
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Old Yesterday, 06:36 PM   #209
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Originally Posted by Skeptic Ginger View Post
But they didn't "assign" them. They looked back at patients already given the meds.

Unless you read something I didn't.
I think he means that patients who had been given HCQ were not selected randomly. It isn't double blind unless neither patient nor doctor know if it is placebo or remedy.

If the doctor knows that he is administering HCQ there can be bias.
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Old Yesterday, 06:41 PM   #210
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Originally Posted by TellyKNeasuss View Post
Does it seem a little curious that the mortality rate with hydroxychloroquine alone was lower than with hydroxychloroquine plus an antibiotic? Then I read the CNN report:



Oh, the treatments weren't selected at random.

Further down in the CNN report, there's this gem:



Oh, there was more difference in the treatment than just hydroxychloroquine.

https://www.cnn.com/2020/07/02/healt...udy/index.html
Yes, this doesn't look good.
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Old Yesterday, 07:10 PM   #211
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Originally Posted by Ulf Nereng View Post
I think he means that patients who had been given HCQ were not selected randomly. It isn't double blind unless neither patient nor doctor know if it is placebo or remedy.

If the doctor knows that he is administering HCQ there can be bias.
That is not the point I was making. Blinded has nothing to do with it.

Randomly assigning patients to treatment groups is the issue. They were not randomly assigned.

The researchers attempt to make up for it by ruling out variables in other ways. That's not enough.
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Old Yesterday, 08:21 PM   #212
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Originally Posted by Skeptic Ginger View Post
Randomly assigning patients to treatment groups is the issue. They were not randomly assigned.
Right. And no one, including me, said they were randomly assigned. However, they were selected into 4 groups that were given one, or the other, or both, or neither of two medications. Far from being randomly assigned, grouping was limited based on certain pre-existing conditions.

And as far as I see no part of the study was blinded.
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Old Today, 03:25 AM   #213
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Aaaand... the USA reclaims the one-day record for new cases, 57,209 on July 3rd, from those upstart Brazilians who tallied 54,771 on June 19th.

To achieve this in a mere two weeks, the U.S. had to reverse its (admittedly meager) earlier declines, and recruit whole additional regions and demographic groups into the effort (since New York and the Northeast didn't want to play any more). An amazing accomplishment.
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Old Today, 04:39 AM   #214
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Well, this is nothing yet compared to the USA, but cases are on the rise again in Japan.

http://www.asahi.com/ajw/articles/13515393

https://toyokeizai.net/sp/visual/tko/covid19/en.html

I wonder how long until they declare another state of emergency.
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Old Today, 08:26 AM   #215
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Anecdotal only:

Here on the campus for the elderly where I live with my mom, virus was kept almost completely at bay for 2 months or so. Now, with ramped-up testing, there's a cluster of cases in the nursing home and assisted living parts of campus. Meanwhile "independent living" has just one case. The spread seems to be from people in close contact for an hour or more and it seems to have crept in from the staff (generally young folks).

Independent living - separate apartments - is not struck nearly so hard, leading me to believe that truly casual contact is not a big factor in the spread. Hours in close proximity seems to be required. On the other hand there has been little testing of people in Independent Living, so it may be down to that.

With relatively small numbers and points of restricted access, contact tracing is feasible here and I expect it will be pursued vigorously.

ETA: Air conditioning is continuous use. Not enough evidence to conclude that AC is the culprit but it is does seem to be much worse with shared air. Not quite sure how that works in the apartments.

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Old Today, 09:25 AM   #216
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Originally Posted by Minoosh View Post
Anecdotal only:

Here on the campus for the elderly where I live with my mom, virus was kept almost completely at bay for 2 months or so. Now, with ramped-up testing, there's a cluster of cases in the nursing home and assisted living parts of campus. Meanwhile "independent living" has just one case. The spread seems to be from people in close contact for an hour or more and it seems to have crept in from the staff (generally young folks).
It seems that locking down the nursing home/assisted living part from the start might have been the only way to avoid it, with the staff inside and all material/food etc fully cleaned/sanitised etc on delivery. Not sure many nursing homes are set up for that sort of lockdown, nor that the staff would be prepared to remain on site for however long it takes.

Originally Posted by Minoosh View Post
Independent living - separate apartments - is not struck nearly so hard, leading me to believe that truly casual contact is not a big factor in the spread. Hours in close proximity seems to be required. On the other hand there has been little testing of people in Independent Living, so it may be down to that.

With relatively small numbers and points of restricted access, contact tracing is feasible here and I expect it will be pursued vigorously.

ETA: Air conditioning is continuous use. Not enough evidence to conclude that AC is the culprit but it is does seem to be much worse with shared air. Not quite sure how that works in the apartments.
It might depend on whether the A/C has any filtration in the system and whether it is fine enough and changed often enough.

Last edited by novaphile; Today at 03:23 PM. Reason: Fixed quote tags
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Old Today, 09:48 AM   #217
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Originally Posted by Lplus View Post
It seems that locking down the nursing home/assisted living part from the start might have been the only way to avoid it, with the staff inside and all material/food etc fully cleaned/sanitised etc on delivery. Not sure many nursing homes are set up for that sort of lockdown, nor that the staff would be prepared to remain on site for however long it takes....
I am a nurse in a senior citizen residence. Early on during Germany's epidemic, there was an option of last resort to quarantine some staff with infected residents in a separate wing. The most difficult practical problem would obviously be that there is no room, and hardly a free bed, to house the staff on site.

Luckily, we were spared the virus, and I have not heard of a house where this has been done.

But this is also proof that you CAN "avoid it" - it takes good governance and a compliant public, which we mostly had.
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Old Today, 09:59 AM   #218
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Originally Posted by Oystein View Post
I am a nurse in a senior citizen residence. Early on during Germany's epidemic, there was an option of last resort to quarantine some staff with infected residents in a separate wing. The most difficult practical problem would obviously be that there is no room, and hardly a free bed, to house the staff on site.

Luckily, we were spared the virus, and I have not heard of a house where this has been done.

But this is also proof that you CAN "avoid it" - it takes good governance and a compliant public, which we mostly had.
I was talking about locking down the entire nursing home before the virus got in, not quarantening infected patients, and I have heard of it happening in the UK, reasonably local to me.

If you avoided it whilst still changing shifts and having staff come in from outside you were lucky, but yes it can happen.
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Old Today, 01:02 PM   #219
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Originally Posted by Myriad View Post
Aaaand... the USA reclaims the one-day record for new cases, 57,209 on July 3rd, from those upstart Brazilians who tallied 54,771 on June 19th.

To achieve this in a mere two weeks, the U.S. had to reverse its (admittedly meager) earlier declines, and recruit whole additional regions and demographic groups into the effort (since New York and the Northeast didn't want to play any more). An amazing accomplishment.
Pathetic achievement.

With just a little effort USA can pass 100k infections a day, easy. Late August would be my guess for when that happens.

I think the only challenger USA might have is India, and since they don't worry about things like testing or death certificates, you wouldn't know.
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Old Today, 01:14 PM   #220
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Meanwhile, in Australia, as it grapples with a surge that elsewhere in the world would be seen as a blip, with only a couple of hundred cases outside quarantine, we're able to see some valuable insights into the spread of the disease.

Since they only have one major cluster to deal with, Aussie scientists are giving superb, real-time evidence as to what happens.

The event seems to start with a single* super-spreader employed at a quarantine facility: https://www.nzherald.co.nz/world/new...ectid=12345350

Then, the trouble really starts when it gets to a housing complex of vulnerable people - poor, public housing, likely insanitary conditions, lots of indoor shared spaces, lifts, stairs, etc & people with a variety of health issues. Boom! Suddenly, you have 23 cases in just 12 households.

We need to find out what causes super-spreading asap.

Melbourne also matches what we know from China, Italy & USA - high-density housing is a huge problem. Shared indoor spaces are big trouble.



*If he wasn't single at the start, he will be now, as it looks like intimate physical contact may have been occurring.
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Old Today, 01:25 PM   #221
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Originally Posted by Lplus View Post
I was talking about locking down the entire nursing home before the virus got in, not quarantening infected patients, and I have heard of it happening in the UK, reasonably local to me.

If you avoided it whilst still changing shifts and having staff come in from outside you were lucky, but yes it can happen.
Same problem, we wouldn't have rooms for staff to live in.
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Old Today, 02:08 PM   #222
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Sweden continues to be interesting.

Very high overall death count (.054%) but the daily death rates have been declining nearly continuously and are about 1/10th the peak in early Apr. This differs from the USA where the reduction from peak has only been about 1/4 and has reached a plateau with a very slight decline in deaths overall. Strong decline in areas hard hit early but above R=1 with plateaued deaths in some areas lightly hit like Florida.

The other notable thing about Sweden is that while new cases have increased much of this is from testing, not positive percentages. And new cases continue at a pretty constant rate. But the really big factor is that people 65 and over now account for a very small portion of new cases ( < 10%) . And this is what's causing the nice, and consistent, decline in daily deaths.

Could be their strategy to protect the elderly but let younger people get covid is now working though they have paid a significant price in the .054% of the population that's died, which includes about 1/3 from nursing homes.
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Old Today, 02:40 PM   #223
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Originally Posted by marting View Post
Sweden continues to be interesting.

Very high overall death count (.054%) but the daily death rates have been declining nearly continuously and are about 1/10th the peak in early Apr. This differs from the USA where the reduction from peak has only been about 1/4 and has reached a plateau with a very slight decline in deaths overall. Strong decline in areas hard hit early but above R=1 with plateaued deaths in some areas lightly hit like Florida.

The other notable thing about Sweden is that while new cases have increased much of this is from testing, not positive percentages. And new cases continue at a pretty constant rate. But the really big factor is that people 65 and over now account for a very small portion of new cases ( < 10%) . And this is what's causing the nice, and consistent, decline in daily deaths.

Could be their strategy to protect the elderly but let younger people get covid is now working though they have paid a significant price in the .054% of the population that's died, which includes about 1/3 from nursing homes.
The freedoms for all ages to mix in a carefree manner in New Zealand afford a sense of national unity, and make Sweden look totally insane. Surprisingly it is fashionable to praise Sweden with right wing commentators.
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Old Today, 03:04 PM   #224
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Originally Posted by Samson View Post
The freedoms for all ages to mix in a carefree manner in New Zealand afford a sense of national unity, and make Sweden look totally insane. Surprisingly it is fashionable to praise Sweden with right wing commentators.
New Zealand, like for instance S. Korea, was able to control Covid-19. Sweden, the UK, France, Spain, Italy, etc. were not and, with the exception of Sweden, implemented controls that, while not as strong as China were stronger than the lighter ones that Sweden did and produced more societal harm on top of more deaths.

I will start off saying I'm surprised Sweden has dropped its daily death rate so consistently given its policies. I did not expect this.

But it isn't true that Sweden didn't implement controls. Sweden implemented partial school closures, limits on group size, social distancing. Not to the degree in most other places and still resulted in a lot of deaths pretty typical of other locations like France, Spain, Italy, UK, etc.

However, the really large reduction in new cases of older people apparent in the last month is beyond what's seen in other countries. There is obviously a conscious effort to reduce exposure of vulnerable people in Sweden we do not see to the same degree most elsewhere. If they keep this up it's entirely possible they could reach herd immunity with under .1% of the population dying while just letting it rip w/o protecting the vulnerable might kill .4% to .6% of Sweden.

.1% is still a lot of people.
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Old Today, 03:36 PM   #225
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Originally Posted by The Atheist View Post
Pathetic achievement.

With just a little effort USA can pass 100k infections a day, easy. Late August would be my guess for when that happens.

I don't think that's going to happen. Every time the virus has reached a point where it seemed nothing short of saturation was going to slow it down in some region, it's slowed down. I have no idea why. Not knowing why has been driving me crazy. But it's been a very consistent pattern.

Quote:
I think the only challenger USA might have is India, and since they don't worry about things like testing or death certificates, you wouldn't know.

I agree with you about India.
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Old Today, 04:35 PM   #226
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Originally Posted by The Atheist View Post
Pathetic achievement.



With just a little effort USA can pass 100k infections a day, easy. Late August would be my guess for when that happens.



I think the only challenger USA might have is India, and since they don't worry about things like testing or death certificates, you wouldn't know.
Late August? Late July seems more likely!
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Old Today, 05:17 PM   #227
Ulf Nereng
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Originally Posted by marting View Post
Sweden continues to be interesting.

Very high overall death count (.054%) but the daily death rates have been declining nearly continuously and are about 1/10th the peak in early Apr. This differs from the USA where the reduction from peak has only been about 1/4 and has reached a plateau with a very slight decline in deaths overall. Strong decline in areas hard hit early but above R=1 with plateaued deaths in some areas lightly hit like Florida.

The other notable thing about Sweden is that while new cases have increased much of this is from testing, not positive percentages. And new cases continue at a pretty constant rate. But the really big factor is that people 65 and over now account for a very small portion of new cases ( < 10%) . And this is what's causing the nice, and consistent, decline in daily deaths.

Could be their strategy to protect the elderly but let younger people get covid is now working though they have paid a significant price in the .054% of the population that's died, which includes about 1/3 from nursing homes.
It would be good to hear from our Swedish members what, if anything new, has been done recently to get the deaths down. I assume that mistakes that were made early on wrt to care homes are not being repeated, at least. And perhaps the populace have become more conscious of the dangers so that they socially distance better or somesuch?
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Old Today, 05:30 PM   #228
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Originally Posted by Ulf Nereng View Post
It would be good to hear from our Swedish members what, if anything new, has been done recently to get the deaths down. I assume that mistakes that were made early on wrt to care homes are not being repeated, at least. And perhaps the populace have become more conscious of the dangers so that they socially distance better or somesuch?
Agreed. I don't claim to understand Sweden, but the USA's populace is highly fragmented. Even in California, there are some areas that take things seriously and other areas that are "What? me worry? Covid-19 is fake" And friends with connections tell me anecdotally that people in the regions spiking cases tend to think Covid-19 is either overblown or outright fake news. My hope is that older people are taking it more seriously. There is some evidence of this.

Quite amazing and our leadership as done squat to create consensus. Quite the opposite. Very frustrating from the POV of someone that just wishes to see the facts and skip the politics.
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