Are Ventilators the Wrong Metric?

 

According to a recent report by a doctor in New Orleans, 86% of the patients on ventilators don’t make it. Which means that ventilators are not the thing we are trying to maximize. By the time the patient is on the ventilator, the battle has almost certainly already been lost.

We must intercept the virus before it gets that bad. Hence the suggestions by other doctors to prescribe chloroquine for those with any symptoms, but not waiting until it gets bad enough for hospitalization.

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  1. Sandy Member
    Sandy
    @Sandy

    From what I have read of the progress of the disease, this sounds right.  In addition there is now a report of a new, larger French study on hydroxychloroquine and azithryomycin showing even more promise for those drugs.  This study involved 80 patients, with one death, one still in critical care, and the remainder showing “clinical improvement.”   The authors write that the study confirms “the efficacy of hydroxychloroquine associated with azithromycin in the treatment of COVID-19 and its potential effectiveness in the early impairment of contagiousness.”  

     

     

    • #1
  2. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    iWe:

    We must intercept the virus before it gets that bad. Hence the suggestions by other doctors to prescribe chloroquine for those with any symptoms, but not waiting until it gets bad enough for hospitalization.

    Manifest nonsense!

    Trump is evil, and Trump likes chloroquine. Ergo, every governor should ban chloroquine for coronavirus.

    Quod erat demonstrandum.

    • #2
  3. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    Seriously, though, you’re probably exactly right here.

    A bit of caution about chloroquine is still called for. Hardly anyone has any business self-medicating with chloroquine without checking with a doctor first.

    But assuming a few boxes (medical history, heart condition, other drugs, or whatever boxes doctors know to check!) are checked, the EMH is still right:

     

    • #3
  4. Hammer, The Inactive
    Hammer, The
    @RyanM

    The rolled out the hydroxychloroquine tests in NY on Tuesday, correct?  In the study, it said something like 6 days?  Frankly, I would expect to  have heard something already…  but, if it works as advertised, certainly in the next few days.  Otherwise, it may not be the cure that we’ve been hoping for.

    • #4
  5. Sandy Member
    Sandy
    @Sandy

    Hammer, The (View Comment):

    The rolled out the hydroxychloroquine tests in NY on Tuesday, correct? In the study, it said something like 6 days? Frankly, I would expect to have heard something already… but, if it works as advertised, certainly in the next few days. Otherwise, it may not be the cure that we’ve been hoping for.

    This report says that although the drugs got to New York on Tuesday, the trial won’t start til next week. As much as everyone wants this to proceed quickly, I can easily imagine that coordinating the trials would take that long.

    • #5
  6. The Reticulator Member
    The Reticulator
    @TheReticulator

    Hammer, The (View Comment):

    The rolled out the hydroxychloroquine tests in NY on Tuesday, correct? In the study, it said something like 6 days? Frankly, I would expect to have heard something already… but, if it works as advertised, certainly in the next few days. Otherwise, it may not be the cure that we’ve been hoping for.

    I don’t know if it even needs to be a cure, so long as it messes with the coronavirus enough to allow my body to recover. 

    • #6
  7. Sisyphus (Rolling Stone) Member
    Sisyphus (Rolling Stone)
    @Sisyphus

    Hammer, The (View Comment):

    The rolled out the hydroxychloroquine tests in NY on Tuesday, correct? In the study, it said something like 6 days? Frankly, I would expect to have heard something already… but, if it works as advertised, certainly in the next few days. Otherwise, it may not be the cure that we’ve been hoping for.

    Even when the world is not staring at them with bated breath, some studies like to check their data and maybe even think about the conclusions and get to a statistically significant result before blabbering to CNN. You just don’t normally hear about them for some reason.

    • #7
  8. Hammer, The Inactive
    Hammer, The
    @RyanM

    Sisyphus (Rolling Stone) (View Comment):

    Hammer, The (View Comment):

    The rolled out the hydroxychloroquine tests in NY on Tuesday, correct? In the study, it said something like 6 days? Frankly, I would expect to have heard something already… but, if it works as advertised, certainly in the next few days. Otherwise, it may not be the cure that we’ve been hoping for.

    Even when the world is not staring at them with bated breath, some studies like to check their data and maybe even think about the conclusions and get to a statistically significant result before blabbering to CNN. You just don’t normally hear about them for some reason.

    What I mean is…  if they were giving this to patients in NY (or anywhere else) and those patients were recovering quickly, we’d be hearing about that.  If from nobody else, we’d hear from doctors and nurses on the ground.

    • #8
  9. Sandy Member
    Sandy
    @Sandy

    Hammer, The (View Comment):

    Sisyphus (Rolling Stone) (View Comment):

    Hammer, The (View Comment):

    The rolled out the hydroxychloroquine tests in NY on Tuesday, correct? In the study, it said something like 6 days? Frankly, I would expect to have heard something already… but, if it works as advertised, certainly in the next few days. Otherwise, it may not be the cure that we’ve been hoping for.

    Even when the world is not staring at them with bated breath, some studies like to check their data and maybe even think about the conclusions and get to a statistically significant result before blabbering to CNN. You just don’t normally hear about them for some reason.

    What I mean is… if they were giving this to patients in NY (or anywhere else) and those patients were recovering quickly, we’d be hearing about that. If from nobody else, we’d hear from doctors and nurses on the ground.

    We are hearing about it.  See my comment #1, and also #5.  

    • #9
  10. Annefy Member
    Annefy
    @Annefy

    Sandy (View Comment):

    Hammer, The (View Comment):

    The rolled out the hydroxychloroquine tests in NY on Tuesday, correct? In the study, it said something like 6 days? Frankly, I would expect to have heard something already… but, if it works as advertised, certainly in the next few days. Otherwise, it may not be the cure that we’ve been hoping for.

    This report says that although the drugs got to New York on Tuesday, the trial won’t start til next week. As much as everyone wants this to proceed quickly, I can easily imagine that coordinating the trials would take that long.

    “Trial”, as in no patients are getting the drugs til then?

    I’m totally confused by the info I’m getting. Here on the west coast we have this nightmare scenario being described to us 24-7 whereby people are on 5th Ave fighting each other over last ventilator.

    Are people dying or not? Are those people getting the drugs? Do those people getting the drugs improve?

    Yes?

    No?

    Trial my touchas.

    Just answer the GD questions.

    • #10
  11. aardo vozz Member
    aardo vozz
    @aardovozz

    Saint Augustine (View Comment):

    Manifest nonsense!

    Trump is evil, and Trump likes chloroquine. Ergo, every governor should ban chloroquine for coronavirus.

    Quod erat demonstrandum.

          Oy vey ist mir.

    • #11
  12. Annefy Member
    Annefy
    @Annefy

    Is this true ? False ? I have no idea. The media refuses to do its actual job, instead they’re busy speaking “truth to power” … or simply Orange Man Bad. 

    There’s a lot I can deal with. But I’m at the end of my rope trying to determine fact from fiction from BS. 

    • #12
  13. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    Looks real to me.

    • #13
  14. Sandy Member
    Sandy
    @Sandy

    Annefy (View Comment):

    Is this true ? False ? I have no idea. The media refuses to do its actual job, instead they’re busy speaking “truth to power” … or simply Orange Man Bad.

    There’s a lot I can deal with. But I’m at the end of my rope trying to determine fact from fiction from BS.

    Not to be cynical or anything but these are very cheap drugs.  Maybe if there were some real money in it.  Nah.  Drug companies wouldn’t care about that.

    • #14
  15. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    Sandy (View Comment):

    Not to be cynical or anything but these are very cheap drugs. Maybe if there were some real money in it. Nah. Drug companies wouldn’t care about that.

    They’re not all heartless monsters–anyway, not much more than the rest of us, or at any rate not much more than the lawyers and politicians who accuse them of being heartless monsters.

    I believe Pfizer or some other big pharma company donated a zillions chloroquine pills.

    But I would think right now there’d be lots of money to be made selling super-cheap chloroquine, much like super-cheap face masks.

    • #15
  16. Annefy Member
    Annefy
    @Annefy

    Okay.  If it’s true, why isn’t it being  yelled from the roof tops ? 

    Is it not a game changer ?

    Personally I think some local tyrants are going to milk this panic as long as they can. 

    • #16
  17. Hammer, The Inactive
    Hammer, The
    @RyanM

    Saint Augustine (View Comment):

    Looks real to me.

    I saw something about this zelenko guy, though, and how many of those patients didn’t have covid (or aren’t being tested). Don’t quote me. Again, I really hope it’s true, and I hope it’s a game changer.  But I also think we shouldn’t be too quick to pop the champagne corks…

    • #17
  18. Stad Coolidge
    Stad
    @Stad

    iWe: According to a recent report by a Dr in New Orleans, 86% of the patients on ventilators don’t make it.

    It could be that because you’re on a ventilator, your case is extremely bad.  Perhaps they make the patient more comfortable until the end.

    On the cynical side, a Governor announcing “We have more ventilators!” makes him appear to be a hero, just in time for the next election . . .

    • #18
  19. Kozak Member
    Kozak
    @Kozak

    Annefy (View Comment):

    Sandy (View Comment):

    Hammer, The (View Comment):

    The rolled out the hydroxychloroquine tests in NY on Tuesday, correct? In the study, it said something like 6 days? Frankly, I would expect to have heard something already… but, if it works as advertised, certainly in the next few days. Otherwise, it may not be the cure that we’ve been hoping for.

    This report says that although the drugs got to New York on Tuesday, the trial won’t start til next week. As much as everyone wants this to proceed quickly, I can easily imagine that coordinating the trials would take that long.

    “Trial”, as in no patients are getting the drugs til then?

    I’m totally confused by the info I’m getting. Here on the west coast we have this nightmare scenario being described to us 24-7 whereby people are on 5th Ave fighting each other over last ventilator.

    Are people dying or not? Are those people getting the drugs? Do those people getting the drugs improve?

    Yes?

    No?

    Trial my touchas.

    Just answer the GD questions.

    How do  you expect doctors to answer the GD question without a period of giving the drug and comparing it to other therapies then analyzing the results?  

    I personally think hydroxychloroquine looks  like it has promise as a therapy.  That’s my opinion.  Facts would be nice.

    • #19
  20. iWe Coolidge
    iWe
    @iWe

    Hammer, The (View Comment):
    I saw something about this zelenko guy, though, and how many of those patients didn’t have covid (or aren’t being tested).

    Tests are still few and far between. It is widely known that Kiryas Joel was very heavily hit by Corona, though, and that is where he practices.

    Assume some (or many) are not. It is still a statistical win.

    • #20
  21. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    Heard something on Facebook about The Who doing some chloroquine tests. Not sure what an old British rock band has to do with anything, but I guess we’ll take all the chloroquine experiments we can get.

    • #21
  22. Annefy Member
    Annefy
    @Annefy

    True? Not true? I have no idea. I am assuming at this point that everyone is lying. I don’t know who to believe and I’m sick of it. And what, exactly, constitutes a “trial”? Notice the word “another trial” in the following. 

    • #22
  23. Hammer, The Inactive
    Hammer, The
    @RyanM

    iWe (View Comment):

    Hammer, The (View Comment):
    I saw something about this zelenko guy, though, and how many of those patients didn’t have covid (or aren’t being tested).

    Tests are still few and far between. It is widely known that Kiryas Joel was very heavily hit by Corona, though, and that is where he practices.

    Assume some (or many) are not. It is still a statistical win.

    The real win will be when New York starts mounting up recoveries and the doctors and hospitals can feel like they’re on top of this. I’m definitely rooting for that outcome!

    • #23
  24. iWe Coolidge
    iWe
    @iWe

    Hammer, The (View Comment):
    and the doctors and hospitals can feel like they’re on top of this.

    The current “victim culture” does not help. Everyone wants to be the oppressed hero these days – even doctors and nurses. 

    • #24
  25. Kenton Hoover Thatcher
    Kenton Hoover
    @KentonHoover

    Anecdotes are data, not clear evidence. NYC seems to be running 50% on survival on those with ventilators, so there are lots of different stories. We have a lack of clear data, lots of cherry-picking, and too many channels for data to flow through. I read stories every day that are clearly just about that same study someone else wrote a story on rewritten with new quotes. 

    It would be nice to know what to do and have it be clear. And aside from a small number of things, that isn’t going to happen anytime soon. What we do know works isn’t flashy – don’t get it in the first place (wash your hands, stay away from others), if you get it keep away from others at all costs, have a pulse oximeter so if you get it you have a clear metric if you are devolving, and live somewhere where the medical services won’t get totally overwhelmed – and we don’t have any real ability to stop what’s going to happen. Much as in real life, I guess.

    • #25
  26. E. Kent Golding Moderator
    E. Kent Golding
    @EKentGolding

    Saint Augustine (View Comment):

    iWe:

    We must intercept the virus before it gets that bad. Hence the suggestions by other doctors to prescribe chloroquine for those with any symptoms, but not waiting until it gets bad enough for hospitalization.

    Manifest nonsense!

    Trump is evil, and Trump likes chloroquine. Ergo, every governor should ban chloroquine for coronavirus.

    Quod erat demonstrandum.

    My Governor has banned chloroquine,  and will sic the state government after doctors who prescribe or pharmacists who fill the prescriptions.   There is a cost to electing democrats.

    • #26
  27. Kenton Hoover Thatcher
    Kenton Hoover
    @KentonHoover

    Anecdotes are data, not clear evidence. NYC seems to be running 50% on survival on those with ventilators, so there are lots of different stories. We have a lack of clear data, lots of cherry-picking, and too many channels for data to flow through. I read stories every day that are clearly just about that same study someone else wrote a story on rewritten with new quotes. 

    The data we do have is so noisy. Multiple public health agencies have changed their reporting methods during this time so even error bars are off. States have different approaches to how they count things. The death rate might tell you something except for the prior undiagnosed deaths and the cases where people died with COVID-19 rather than of it. The consolidated numbers from the CDC are about as useful as a single national weather prediction for knowing what’s going on in any given place.

    • #27
  28. Unsk Member
    Unsk
    @Unsk

    To second Sandy, and Michael Coudry:  ( From Techstartups.com)

    March 27, 2020 Update 9: BREAKINGFrench researchers just completed new additional study on 80 patients, results show a combination of Hydroxychloroquine and Azithromycin to be effective in treating COVID-19 patients. The team found that, by administering hydroxychloroquine combined with azithromycin, they were able to observe an improvement in all cases, except in one patient who arrived with an advanced form, who was over the age of 86, and in whom the evolution was irreversible.

    On March 18, we published a story about a new study published by NIH which shows that Hydroxychloroquine has been found to be more effective and potent than chloroquine in vitro treatment of coronavirus. While the media is focused on the vaccine race and leaving the discussion of THERAPEUTICS almost completely neglected, a recent well controlled clinical study conducted by Didier Raoult​ M.D/Ph.D, et. al in France showed that 100% of patients that received a combination of HCQ and Azithromycin tested negative and were virologically cured within 6 days of treatment. According to a new unearthed paper, new evidence shows CDC knew since at least 2005 that chloroquine is effective against coronaviruses.

    In the meantime, the Food and Drug Administration (FDA) has approved the ‘compassionate use’ of chloroquine to treat coronavirus patients in the United States. In addition, recent guidelines from South Korea and China report that hydroxychloroquine and chloroquine are effective antiviral therapeutic treatments for novel coronavirus.

    Now who is this quack Dr. Didier Raoult who is promoting this so-called Hydroxychloroquine remedy, that has been so damningly  refuted by our mainstream media to the point my Bank Manager was telling me yesterday it doesn’t work? Well let’s see from Wiki:

    Didier Raoult initiated the construction of a new building to host the Institut Hospitalo Universitaire (IHU) Méditerranée Infection.The IHU Mediterranée Infection, which opened in early 2017,[6] is dedicated to the management and study of infectious diseases and combines diagnostic, care, research and teaching activities in one location.[7]

    On 19 November 2010, he was awarded the “Grand prix de l’Inserm” for his career.[8] In 2015, Raoult was awarded the “Grand Prix scientifique de la Fondation Louis D.” of the Institut de France. He shared the €450.000 prize money with biologist Chris Bowler from the Institut de Biologie de l’Ecole Normale Supérieure in Paris.[9]

    In 2014, according to ISI Web of Knowledge, he is the most cited microbiologist in Europe, and the 7th worldwide.[10][11]

    In 2020, the website Expertscape ranks him 1st expert in the world for communicable diseases.[12][13]

    According to the Thomson Reuters source “Highly Cited Researchers List”, Raoult is among the most influential researchers in his field and his publications are among the 1% most consulted in academic journals. He is one of the 99 most cited microbiologists in the world and one of the 73 most highly cited French scientists.[15] 

     

    • #28
  29. Henry Racette Member
    Henry Racette
    @HenryRacette

    I continue to think you’ve asked an important question. I’m slightly distrustful of the “86%” figure, as it exactly mirrors a number published in Lancet in late February, based on, I think, a small-N Chinese report, here.

    It isn’t anecdotal, but it is limited by size and, I suspect, by quality of medical care available.

    With improved understanding and treatment options, I expect the survival rate will rise significantly.

    • #29
  30. James Gawron Inactive
    James Gawron
    @JamesGawron

    Saint Augustine (View Comment):

    Looks real to me.

    Aug,

    Fantastic, can’t wait to see the followup reports.

    Regards,

    Jim

    • #30
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