Corona virus

[Fantaztic7]

I want to add....so much luck involved for some of us.

Had this happened another time, like when we were working, the kids still lived with us, and my parents' lives both changed drastically (one spring), I don't know how I would have dealt with it all. My dead died 3 months later (moved from hospital to care center) and my mother lost her way, and we had to try to find out what was best for her. It was terrible at the time, but I can't imagine if it all happened now. Similarly I can not imagine the issues that folks are dealing with. Some of it seems almost impossible.

Yes, same here with our circumstances. Not to say we have no risk, but we’re not in a crowded place. We’ve had few cases and no deaths in our county. My in laws have stayed healthy so far and they’re getting up there in age. My wife visited them briefly to take some things but kept distance and wore an N95 mask to be on the safe side.

One of my colleagues volunteered for a week at a Covid-19 rehab center. She saw some people in tough shape but said everyone she saw survived. Bless her heart she’s so kind.

At the onset of the pandemic our church was in the rotation to house homeless guests for a week. We have a project here with churches to house and feed the homeless for the entire winter (mild here but can still be cold). Anyway, some volunteers dropped out which was understandable. We stuck with it - probably not the smartest idea to risk exposure but it worked out fine. I look back at that and not sure I would do it again, but probably would anyway.

[Rastic]

I have two close family members who have autoimmune conditions which are common ones and for which they have received a number of different medications each of which compromises their immune system. Are you a rheumatologist? If not, I'll thank you for not lecturing me on the subject and not dispensing unwanted medical advice.

That’s pretty rich after dispensing medical advice, at least your version of dispensing medical advice. Information posted on the internet isn’t medical advice, which requires a physician-patient relationship.

I'd like to think nobody is giving medical advice here one way or another.

[Fantaztic7]

I'd like to think nobody is giving medical advice here one way or another.

I agree. In my day job, I educate physicians and their staff on some of the products they use, including clinical and operational considerations, payer access points for patients, efficient practice management and contracting. My weekend time never involves giving medical advice, for that matter any advice.

[dizzolve]

Read we just crossed a threshold with Covid 19

Right now more Americans have died to the virus than have died to Vietnam War

[Fantaztic7]

During the early days of the Covid-19 pandemic hydroxychloroquine received a lot of media attention. Clinical trials are on-going to evaluate the efficacy and safety of hydroxychloroquine. Let’s hope this drug with or without azithromycin proves beneficial.

Recent emergency approval by the FDA of remdesivir is a positive step. Results from the interim analysis are positive.

Several other drugs are under investigation to treat SARS-CoV-2: IL6, IL6R and TNF inhibitors.

Here’s an article from The Lancet on the call to evaluate anti-TNF inhibitors:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30858-8/fulltext

[Peanut]

During the early days of the Covid-19 pandemic hydroxychloroquine received a lot of media attention. Clinical trials are on-going to evaluate the efficacy and safety of hydroxychloroquine. Let’s hope this drug with or without azithromycin proves beneficial.

Recent emergency approval by the FDA of remdesivir is a positive step. Results from the interim analysis are positive.

Several other drugs are under investigation to treat SARS-CoV-2: IL6, IL6R and TNF inhibitors.

Here’s an article from The Lancet on the call to evaluate anti-TNF inhibitors:

https://www.thelancet.com/journals/l...858-8/fulltext

That's the med I take (hydroxychloroquine), so I've been following the story. It sounded promising at the beginning, but if I'm not mistaken, the FDA and CDC have backed out of it. Heart failure was a big reason and some other side effects. I haven't seen anything recently, so it may have changed.



Thunderbirds and the Blue Angels did a fly over MD and DC today. Couldn't see or hear them, but saw pictures and videos. Awesome!

Maj. Trevor Aldridge, left wing pilot, U.S. Air Force Air Demo Squadron, explained to 11 News what these flights mean to those in the cockpits.

"They are on the front lines. We are used to being on the front lines, but now they are the ones on the front lines, and this is our way to try and say thank you for putting yourself out there and taking these risks," Aldridge said.

[dizzolve]

That's the med I take (hydroxychloroquine), so I've been following the story. It sounded promising at the beginning, but if I'm not mistaken, the FDA and CDC have backed out of it. Heart failure was a big reason and some other side effects. I haven't seen anything recently, so it may have changed.



Thunderbirds and the Blue Angels did a fly over MD and DC today. Couldn't see or hear them, but saw pictures and videos. Awesome!

Well there's always Aquarian maintenance

[Fantaztic7]

That's the med I take (hydroxychloroquine), so I've been following the story. It sounded promising at the beginning, but if I'm not mistaken, the FDA and CDC have backed out of it. Heart failure was a big reason and some other side effects. I haven't seen anything recently, so it may have changed.



Thunderbirds and the Blue Angels did a fly over MD and DC today. Couldn't see or hear them, but saw pictures and videos. Awesome!

The NIH is funding several studies related to Covid-19. involving hydroxychloroquine. Two are currently recruiting patients and two have not started recruiting:

https://clinicaltrials.gov/ct2/results?cond=COVID-19&intr=%22Hydroxychloroquine%22&fund=01

Several of the studies include a control arm (placebo) which will help better understand the efficacy and safety in patients being treated for SARS-CoV-2.

[FL BRONCO]

Thread cleaned.

Please keep the personal out of it and lets stick to the subject.

[Fantaztic7]

Read we just crossed a threshold with Covid 19

Right now more Americans have died to the virus than have died to Vietnam War

It’s difficult to determine the accuracy of the reports. One nursing home in New York presumed half of the deaths were Covid-19 related.

https://nypost.com/2020/05/02/nyc-nursing-homes-staggering-coronavirus-deaths-dont-match-state-reports/

[Peanut]

Well there's always Aquarian maintenance

That was a sad situation.

The NIH is funding several studies related to Covid-19. involving hydroxychloroquine. Two are currently recruiting patients and two have not started recruiting:

https://clinicaltrials.gov/ct2/results?cond=COVID-19&intr=%22Hydroxychloroquine%22&fund=01

Several of the studies include a control arm (placebo) which will help better understand the efficacy and safety in patients being treated for SARS-CoV-2.

As I said, I have not seen anything recently. Hopefully, they will do things in a logical way. Not like they did in the beginning. And use the donated meds so that those of us who need it on a daily basis are able to receive our meds.

[Fantaztic7]

Earlier I posted comments on some medications not necessarily affecting the broader immune system. The comments weren’t specific to any immune disorder. It depends on which cytokine(s) are targeted by the medication. Some medications in and of themselves do not increase the risk of infection. Some medications have been developed to be highly specific without having an impact on the broader immune system.

Recent article related to Covid-19:

Not All Biologics Compromise the Immune System

http://www.medscape.com/viewarticle/928209

“APRIL 06, 2020 -- The biologics used to treat conditions such as asthma, chronic hives, eczema, and sinusitis are unlike the ones used to treat autoimmune disorders, which target specific molecules in the immune system involved with inflammation.

The "biologics we use for allergy and asthma work on the allergic arm of the immune system," said Jeffrey Factor, MD, from the Connecticut Asthma & Allergy Center in West Hartford. "That means they are not in conflict with the part of the immune system fighting off infection."

These biologics have not been shown to increase the risk for COVID-19 or to increase complications related to the disease in people who do become infected with the virus, he pointed out.

Biologics were going to be the focus of the recently canceled American Academy of Allergy, Asthma and Immunology (AAAAI) 2020 Meeting. "We've never concentrated on biologics before in the meeting, so we were all looking forward to the discussions and sessions on the topic," he told Medscape Medical News.

Patients who are immunocompromised are now encouraged to use autoinjectors, if possible, said Mitchell Grayson, MD, from the Nationwide Children's Hospital in Columbus, Ohio, who was scheduled to present at the AAAAI meeting.

Grayson said he advises his patients with asthma to be diligent about ensuring that they have a rescue inhaler at home, and that it has not expired.

For COVID-19, "what increases risk is not simply having asthma, its having to come in and get an infusion," said Grayson.

For patients who are not already on biologics, this is probably not be the time to start a new treatment regimen, he pointed out. An adverse reaction could make it necessary for the patient to visit to the office or even the hospital.

Don't Try This at Home

One of the main biologics used in allergy practices is omalizumab, an anti-IgE antibody used to treat severe, persistent asthma and chronic urticaria, explained Sanjiv Sur, MD, from the Baylor College of Medicine in Houston.

It is administered subcutaneously and, because it comes with a risk for anaphylaxis, cannot be administered at home, he warned, adding that patients should be evaluated on an individual basis assess to its risk–benefit ratio.

In this time of crisis, some "patients can be switched to oral medicines to manage their urticaria so that they need not be exposed to the risk of coming to the hospital or clinic to receive their injection," said Sur. However, if a switch is not possible, patients "should continue to receive their injection to prevent losing control of their asthma."

Similarly, patients who receive biologics like subcutaneous mepolizumab and intravenous gamma globulin, which must be administered in an infusion center or doctor's office because of the risk for severe adverse effects, should continue to receive them for asthma control, he said.

But there are asthma-focused biologics that can be used at home.

Other Options

One is dupilumab, a monoclonal antibody that blocks interleukin (IL)-4 receptor alpha, which is also used to treat atopic dermatitis and chronic sinusitis. Another is benralizumab, which blocks IL-5 receptor alpha.

Fortunately, all of these biologics continue to be available during the COVID-19 pandemic and there has been no indication that a shortage will occur, said Sur.

When it comes to the up-and-coming treatments being researched, though, momentum to bring them from the lab to the market could be slowing.

"We will come back to the point of looking at new, promising biologic options, but it requires putting that exploration on hold for now," said Grayson. "All of the conversations we were going to have at the AAAAI meeting will still happen, but it's likely this pause may push us back a bit in terms of research and treatment rollouts."

Obviously public information from the internet is not a substitute for clinical judgement by healthcare providers.

The above article speaks to the comments I was expressing.

Edit: Additional article on the specificity of some medications and the relationship to risk of infection:

https://www.nature.com/articles/s41577-020-0312-7

[CanDB]

As an aside....

My brother in law passed away before Christmas (not of covid) and he was in his 70s. To this day (about 5 months later), his wife, kids and granddaughter are still not back on track. They will survive and do well, but my sister in law may never quite be the same. And I don't consider her old. And my niece still seems a bit lost. Then there's her daughter, a wonderful, bright, caring young teenager who is like a granddaughter to me, who has lost both grandpas within the last 9 months. Two "cornerstones" in her young life, who gave her structure. The term "elders" has more value to it than we sometimes think.

As for my bro, he was a character, wise, funny as heck, cool, strong, caring, and thoughtful. He was a force in our family. In terms of age, he was getting older, but in terms of life, he was a beautiful model.

I am definitely not saying that folks here are ruling off the seniors. I just think that we need to respect the value of those over a certain age, even it they may appear weaker in some ways. Just as the younger, vulnerable people are. And for that matter, I don't see a number that defines elderly. Just like some young folks are much more mature than their age. Lets protect our elders as much as we can, given what is possible. They serve a significant purpose. As do all age groups.

Here's to the old folks!!

[58Miller]

That was a sad situation.



As I said, I have not seen anything recently. Hopefully, they will do things in a logical way. Not like they did in the beginning. And use the donated meds so that those of us who need it on a daily basis are able to receive our meds.

In a letter to Gov. Doug Ducey of Arizona, the Association of American Physicians and Surgeons (AAPS) presents a frequently updated table of studies that report results of treating COVID-19 with the anti-malaria drugs chloroquine (CQ) and hydroxychloroquine (HCQ, Plaquenil®).

To date, the total number of reported patients treated with HCQ, with or without zinc and the widely used antibiotic azithromycin, is 2,333, writes AAPS, in observational data from China, France, South Korea, Algeria, and the U.S. Of these, 2,137 or 91.6 percent improved clinically. There were 63 deaths, all but 11 in a single retrospective report from the Veterans Administration where the patients were severely ill.

https://aapsonline.org/hcq-90-percent-chance/

[58Miller]

the Korea Centers for Disease Control and Prevention, the Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, Korean Society of Pediatric Infectious Diseases and a tuberculosis association recommended the use of Kaletra, an anti-HIV medication, in combination with HCQ, to treat Covid-19.

This was bolstered by a French study that showed HCQ had an antiviral effect against Covid-19 in confirmed cases. Used in conjunction with the azithromycin Z-Pak, most patients cleared the virus in three to six days rather than the 20 days observed in China, drastically narrowing the period during which a patient can spread the virus to others.

To be clear, these scientists and doctors now recommend HCQ as a treatment, not a preventive measure, for Covid-19. They argue that a positive effect of using HCQ early is the reduction of virus transmission to other people given the shorter number of days the patients remain contagious, thereby flattening the curve sooner.

Written by:
Dr. Christina Lin is a California-based foreign policy analyst specializing in China-Middle East relations. She has extensive US government experience working on national security and economic policy planning, and was a research consultant for Jane's CBRN Assessments Intelligence Centre.