Medicine

Jerry drew our attention last night to a radio interview by Dr Vladimir Zelenko. In this interview, he summarises his approach and rationale, giving results and making several announcements. (Unfortunately, the media cannot be embedded at UD as it is not YT. Kindly, go here; and make sure your browser has no active ad blocker.) On listening last night, here are my first observations on highlight points: Brazil and Israel are doing his early treatment, clinical diagnosis (backed up by nasal swab test), outpatient-oriented dosage for vulnerable patients protocol, ALT-1. He has treated 405 in that profile and sees 95% reduction on the expected death rate for the n-BAU baseline. He points out that the Raoult [by implication] protocol, which Read More ›

Here’s the report: As the new coronavirus took root across America, the US Centers for Disease Control and Prevention sent states tainted test kits in early February that were themselves seeded with the virus, federal officials have confirmed. The contamination made the tests uninterpretable, and—because testing is crucial for containment efforts—it lost the country invaluable time to get ahead of the advancing pandemic. The CDC had been vague about what went wrong with the tests, initially only saying that “a problem in the manufacturing of one of the reagents” had led to the failure. Subsequent reporting suggested that the problem was with a negative control—that is, a part of the test meant to be free of any trace of the Read More ›

It is clear that we need to re-think how we go about doing science to warrant approaches to the pandemic. So, allow me to headline a comment from the double-blind thread: KF, 16: >> I am also thinking back to the old “Scientific Method” summary we were taught in schools and its roots in Newton’s Opticks, Query 31: As in Mathematicks, so in Natural Philosophy, the Investigation of difficult Things by the Method of Analysis, ought ever to precede the Method of Composition. This Analysis consists in making Experiments and Observations, and in drawing general Conclusions from them by Induction, and admitting of no Objections against the Conclusions, but such as are taken from Experiments, or other certain Truths. For Read More ›

I am seeing a report: Gilead Science’s experimental antiviral medicine remdesivir is reportedly showing promise for the treatment of people plagued with the novel coronavirus, with nearly all patients in a closely monitored clinical trial at a Chicago hospital discharged in just days, an early assessment of data released this week revealed . . . . STAT, a medical news outlet, first reported that an early peek at the data from the clinical trial in Chicago suggested that coronavirus patients were responding to the Gilead Science drug. “The best news is that most of our patients have already been discharged, which is great. We’ve only had two patients perish,” Kathleen Mullane, the University of Chicago infectious disease specialist overseeing the Read More ›

Shortly after I posted yesterday on whether placebo based studies are properly a gold standard, one of our common objectors, JT, linked the Guardian. Perhaps, he did not realise just how aptly it illustrates my point. I therefore responded, as I now headline as a shop window case- in- point illustration of what is going wrong with medical testing, linked statistics and linked ethics . . . not to mention, too much of the media and the way we tend to think: This is part of why I have written as I have in the OP: [Guardian, annotated:] >>The French doctor Didier Raoult has claimed [–> has reported, on now almost 3,000 patients, under a test protocol approved by relevant Read More ›

As we have seen in recent weeks as Covid-19 and Hydrochloroquine cocktail treatments have been on the table, there is a clear tendency to view and treat double-blind placebo controlled testing as a “gold standard” yardstick and to then use such to discount and dismiss whatever does not “measure up” such as Professor Raoult’s work over in France. I will now argue in outline that such an attitude is selectively hyperskeptical, seriously ethically, epistemologically and logically flawed, and sets up a crooked yardstick. It is a commonplace in Medical research that arguably more lives were saved, net, than perished through the tainted medical studies in the Nazi death camps. However, the taint was seen as so serious that a programme Read More ›

Prof Raoult’s web site hosts an interesting map, under the title, “Pays où l’hydroxychloroquine est recommandée”: India, of course, has the further approval for prophylaxis. That’s significant, as talk on vaccines tends to point to 12 – 18 months and double-blind, placebo controlled tests in progress or about to start in the US look likely to take more than a year. Meanwhile, OWID tracks how time to double to current number of deaths — probably the best statistic — is continuing to stretch out: (Notice, the S-curves and driving impulses.) Likewise, we can see the daily cases clearly peaking (for THIS wave . . . notice, Wave 2 for China and even an uptick to a Wave 3): This is Read More ›

HT, BA77, here is a plot of CFR vs median age, with size of bubble keyed to number of fatalities: In this context, Prof Didier Raoult’s 1061 case study’s low fatality rate for elderly persons, 0.5% as reported, seems quite significant. Related, here is the Chinese CDC report on CFR by age: Then, we may note Raoult’s observed pattern for treatment: I trust these will be helpful. END

Recently, we here at UD saw that global trend lines are curving over from exponential growth in new Covid-19 cases. Likewise, health authorities have been talking of the US and the UK peaking in perhaps ten days. Where I am, we are still growing: one, two, five, nine total. (And no, Black the Ripper is not credibly a Covid-19 case.) Here’s a graphic that gives pause, with labelled phases — recall, the crest of new infections is the inflexion point on the growing arm of the S-curve of cumulative cases: But, the further consideration is, onward waves triggered by fresh outbreaks or new strains once lock-downs . . . which cannot be long sustained . . . are relaxed: These Read More ›

. . . and, they expect a secondary wave. Sermo is a global Doctors’ forum site, which allows building of a global consensus of Physicians. As a part of its efforts, it has had a “statistically significant” survey of over 6,000 doctors, regarding Covid-19. Excerpting the just linked report: Largest Statistically Significant Study by 6,200 Multi-Country Physicians on COVID-19 Uncovers Treatment Patterns and Puts Pandemic in Context April 2, 2020 Sermo Reports on Hydroxychloroquine Efficacy, Rise in Prophylaxis Use; Over 80% Expect 2nd Outbreak New York, New York – April 2, 2020 – Widespread confusion, conflicting reports, inconsistent testing, and off-indication use of existing and experimental drugs has resulted in no single source of information from the frontlines. To create a Read More ›

Here is a panel discussion for a rapidly organised conference: We need to hear this, where 44 million donated tablets are already in hand. END

As we continue to track, let some graphs tell a story, first up is Euro-CDC: That looks like a peaking, certainly it is not exponential surging in new cases. World in Data, on a 3-day, rolling avg will smoothen, highlighting key countries (including the USA): That looks like a flattening, trending to turning over on the driving impulse. Let’s see doubling times, which will track comparable exponential growth: Those were in the 2 – 3 day band previously. Now, the by country log-lin deaths, with the same 2,3,5 day doubling time rays since five cases as previous: Likewise, per country log-lin cumulative cases, with the same usual 2,3, 5 and 10 day doubling time from 100 cases rays: We see Read More ›

Yes, it is gross but necessary. Sorry in advance. The question of social distance is back on the table, at least according to the UK’s Daily Mail (reporting today on Dr Fauci’s nuanced answer to a question . . . and no, this isn’t Babylon Bee spoofing on April Fool’s Day): Illustrating, i/l/o a 2014 study — early progress of a super-sneeze or cough: Notice, the drifting cloud? Here’s MIT, in 2014: The next time you feel a sneeze coming on, raise your elbow to cover up that multiphase turbulent buoyant cloud you’re about to expel. That’s right: A novel study by MIT researchers shows that coughs and sneezes have associated gas clouds that keep their potentially infectious droplets aloft Read More ›

As MIT suggests, Almost every bed in a hospital has a manual resuscitator (Ambu-Bag) nearby, available in the event of a rapid response or code where healthcare workers maintain oxygenation by squeezing the bag. Automating this appears to be the simplest strategy that satisfies the need for low-cost mechanical ventilation, with the ability to be rapidly manufactured in large quantities. However, doing this safely is not trivial. Use of a bag-valve mask (BVM) in emergency situations is not a new concept. A portable ventilator utilizing an ambu-bag was introduced in 2010 by a student team in the MIT class 2.75 Medical Device Design (original paper here and news story here), but did not move past the prototype stage. Around the Read More ›

Here: Let us listen. END