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onenickelmiracle
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April 1st, 2020 at 9:30:23 PM permalink
About remdesivir, the company has stated, "Remdesivir has not demonstrated safety or efficacy to date and so there is an inherent challenge in identifying the appropriate target population for this investigational agent. From a safety perspective, we exclude patients who might be at a higher risk for toxicity due to or evidence of end organ damage."

This I transcribed from an article on my phone about how people are having trouble getting experimental medicine(when those available such as the anti-malarial didn't work). This makes me think, they maybe can't even be sure remdesivir does work or what the true statistics of the disease even should be yet. If they're avoiding really sick patients, it could be because they don't want the drug to be scapegoated instead of the disease or because they suspect the drug will do some organ damage and they think it could push a really sick patient over the edge when the damage is already done. I've personally only have mostly seen articles which makes remdesivir seem to be genuinely the best option seen out there, but I do not know if it is true. For all we know remdesivir causes cancer, I doubt it because it was used and rejected as not being the best candidate for Ebola(don't think its safety was ever questioned then).
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TigerWu
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April 2nd, 2020 at 7:56:20 AM permalink
Quote: Keyser

SOOPOO,

Is it remotely possible that an older past vaccination from the 1960s or before, is causing the immune systems in older patients to over react and go haywire when they encounter the Covid-19? (Cytokine storm.)



Why do you keep posting about this smallpox thing? Do you have any kind of source for this or are you just fearmongering?
LuckyPhow
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April 2nd, 2020 at 8:55:31 AM permalink
Quote: TigerWu

Why do you (Keyser) keep posting about this smallpox thing? Do you have any kind of source for this or are you just fearmongering?



I think it just might be remotely possible it's just fearmongering. Anyone wishing to fearmonger, please bring data to substantiate thoughts you claim as "remotely possible."
onenickelmiracle
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April 2nd, 2020 at 9:25:05 AM permalink
Keyser isn't fear mongering, he is just speculating.
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gordonm888
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April 2nd, 2020 at 9:26:55 AM permalink
Quote: LuckyPhow

I think it just might be remotely possible it's just fearmongering. Anyone wishing to fearmonger, please bring data to substantiate thoughts you claim as "remotely possible."



IMO, it is perfectly reasonable for TigerWu to ask a person whether he/she has some rational and considered basis for speculating about some previously-unheard-of hypothesis for the lethality of a virus. Especially when that person persists in repeatedly posting about this novel speculation.
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SOOPOO
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April 2nd, 2020 at 11:42:58 AM permalink
Quote: Keyser

SOOPOO,

Is it remotely possible that an older past vaccination from the 1960s or before, is causing the immune systems in older patients to over react and go haywire when they encounter the Covid-19? (Cytokine storm.)



Certainly no expert on this, but I don't think so. I don't think that is why older people are dying at higher rates. It's just that older people have less reserve. If a young guy loses 50% of lung capacity he does fine. If an elderly person does he does not have enough reserve and dies. The virus might have hurt both person's lungs equally. It might actually be that older people have LESS of a 'cytokine storm' than younger people.

Think of it this way. If I were to hold young athlete's head underwater for 2 minutes he probably survives. A septuagenarian might die after 1 minute.
SOOPOO
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April 2nd, 2020 at 11:52:16 AM permalink
Quote: onenickelmiracle

About remdesivir, the company has stated, "Remdesivir has not demonstrated safety or efficacy to date and so there is an inherent challenge in identifying the appropriate target population for this investigational agent. From a safety perspective, we exclude patients who might be at a higher risk for toxicity due to or evidence of end organ damage."

This I transcribed from an article on my phone about how people are having trouble getting experimental medicine(when those available such as the anti-malarial didn't work). This makes me think, they maybe can't even be sure remdesivir does work or what the true statistics of the disease even should be yet. If they're avoiding really sick patients, it could be because they don't want the drug to be scapegoated instead of the disease or because they suspect the drug will do some organ damage and they think it could push a really sick patient over the edge when the damage is already done. I've personally only have mostly seen articles which makes remdesivir seem to be genuinely the best option seen out there, but I do not know if it is true. For all we know remdesivir causes cancer, I doubt it because it was used and rejected as not being the best candidate for Ebola(don't think its safety was ever questioned then).



My Vegas Dr. friend is prescribing it for COVID patients. I think it is called 'compassionate care' and basically shields both him and the manufacturer from lawsuits. Under normal circumstances, a double-blind study would be designed, lots of hoops to jump through, results would eventually be submitted to FDA. More studies would be done to try and replicate the results. So after a few years it would get approved. If you wonder why new drugs are so expensive, that's why. Remember, the overwhelming majority of new drugs DO NOT GET APPROVED.

These are NOT normal circumstances! ANY DRUG for COVID, if made to go through the usual rigorous safety and efficacy trials, will not be approved until after >100,000 would be dead. So someone (Fauci, Adams, etc...) has decided that the risk of using these drugs, although not fully vetted, is outweighed by the POTENTIAL benefit. Time will tell.
billryan
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April 2nd, 2020 at 1:23:06 PM permalink
I suspect a Faustian bargain was struck where the adults in the room reluctantly agreed to try this in return for a months extension on the distancing.
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gordonm888
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April 2nd, 2020 at 4:59:09 PM permalink
Quote: billryan

I suspect a Faustian bargain was struck where the adults in the room reluctantly agreed to try this in return for a months extension on the distancing.



Empty speculation based on no information and no experience in government. I have experience at high levels of government and "bargains" are not the way that decisions are made.

When there is one person in the room that everyone else reports to
Typically, the most powerful person in the room states that he wants something to happen and explains why. If his subordinates believe he is wrong they give their reasons and argue back. The subordinate in the room who heads the agency/organization that would have to perform the action carries a lot of weight in this discussion and usually/often wins the argument if he has different views - but not always. When the discussion is done, the most powerful person again states what he wants, now based on the discussion they have just had. And everyone agrees and complies. If they can't stand the decision, they might occasionally go to the boss of the most powerful person and complain (not relevant in this particular instance). Otherwise, they resign. But there are no flippety-flop bargains.

This is not as brutal or primitive as it sounds. In government, every powerful person needs the trust and loyalty of his subordinates and they are all share some common goals and are trying to make their organization successful. But sometimes the leader is trying to solve problems that his subordinates are not aware of.
So many better men, a few of them friends, are dead. And a thousand thousand slimy things live on, and so do I.
billryan
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April 2nd, 2020 at 5:37:14 PM permalink
Quote: gordonm888

Empty speculation based on no information and no experience in government. I have experience at high levels of government and "bargains" are not the way that decisions are made.

When there is one person in the room that everyone else reports to
Typically, the most powerful person in the room states that he wants something to happen and explains why. If his subordinates believe he is wrong they give their reasons and argue back. The subordinate in the room who heads the agency/organization that would have to perform the action carries a lot of weight in this discussion and usually/often wins the argument if he has different views - but not always. When the discussion is done, the most powerful person again states what he wants, now based on the discussion they have just had. And everyone agrees and complies. If they can't stand the decision, they might occasionally go to the boss of the most powerful person and complain (not relevant in this particular instance). Otherwise, they resign. But there are no flippety-flop bargains.

This is not as brutal or primitive as it sounds. In government, every powerful person needs the trust and loyalty of his subordinates and they are all share some common goals and are trying to make their organization successful. But sometimes the leader is trying to solve problems that his subordinates are not aware of.



That's cute. How high" were you?
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rxwine
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April 2nd, 2020 at 6:30:30 PM permalink
I think people should be able to sign a waiver that they can't pursue any damages, if they want to get any prescribed concoction regardless of how sick they are or aren't.

If you don't want to wait for drug trials, and willing to give up a right to sue, you should be able to try anything you can get prescribed.

Of course, I hear one problem with things like the malaria drug is there is not a giant supply available and other people use that medication.
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gordonm888
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April 2nd, 2020 at 6:42:59 PM permalink
Quote: billryan

Quote: gordonm888

Empty speculation based on no information and no experience in government. I have experience at high levels of government and "bargains" are not the way that decisions are made.

When there is one person in the room that everyone else reports to
Typically, the most powerful person in the room states that he wants something to happen and explains why. If his subordinates believe he is wrong they give their reasons and argue back. The subordinate in the room who heads the agency/organization that would have to perform the action carries a lot of weight in this discussion and usually/often wins the argument if he has different views - but not always. When the discussion is done, the most powerful person again states what he wants, now based on the discussion they have just had. And everyone agrees and complies. If they can't stand the decision, they might occasionally go to the boss of the most powerful person and complain (not relevant in this particular instance). Otherwise, they resign. But there are no flippety-flop bargains.

This is not as brutal or primitive as it sounds. In government, every powerful person needs the trust and loyalty of his subordinates and they are all share some common goals and are trying to make their organization successful. But sometimes the leader is trying to solve problems that his subordinates are not aware of.



That's cute. How high" were you?



I worked as a senior scientist in a national security related office; our office director reported to President Obama. I never worked directly with or met the President, but I worked with the Joint Chiefs of Staff, one cabinet member and I briefed and worked with several Senators and congressman. And I had many interactions with people that were one or two levels below those kind of senior people.
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gordonm888
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April 2nd, 2020 at 6:47:43 PM permalink
The Washington Post has reported on a survey of 6,800 doctors in which they were asked which treatment were they finding to be most effective for Covid-19. Reportedly, the overwhelming answer was hydroxychloroquine.

The State of Michigan had previously issued an order forbidding the use of hydroxychloroquine as a treatment for covid-19. Yesterday, they rescinded that order and placed a significant purchase order for that drug.
Last edited by: gordonm888 on Apr 2, 2020
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EvenBob
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April 3rd, 2020 at 12:45:07 AM permalink
Why do they say the economy is
'shut down'. That's ridiculous.
Millions are working in the food
production industry, trucking
and delivery, grocery chains,
dairies and farmers, mail and
package delivery, in retail
warehouses. Banks and doctors
offices, whole huge companies
are working at home. 3M is
making 10 mil masks a week,
Detroit is churning out medical
equipment, fast food drive thru's
are doing record business. Cops
and firemen and road crews and
infrastructure people are all at
their jobs.

PARTS of the economy are closed,
but it's hardly shut down.
"It's not called gambling if the math is on your side."
Minty
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April 3rd, 2020 at 1:07:14 AM permalink
Quote: EvenBob

Why do they say the economy is
'shut down'. That's ridiculous.
Millions are working in the food
production industry, trucking
and delivery, grocery chains,
dairies and farmers, mail and
package delivery, in retail
warehouses. Banks and doctors
offices, whole huge companies
are working at home. 3M is
making 10 mil masks a week,
Detroit is churning out medical
equipment, fast food drive thru's
are doing record business. Cops
and firemen and road crews and
infrastructure people are all at
their jobs.

PARTS of the economy are closed,
but it's hardly shut down.



Significantly large parts. In a system of hundreds of millions of people having several million more than normal being in a position to file for unemployment due to being furloughed or a reduction in hours it's a big deal.
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billryan
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April 3rd, 2020 at 3:07:05 AM permalink
The U.S. Navy hospital ship sent to NYC has one thousand beds on it. The Navy announced it would not house corona virus patients but didn't announce that there were fifty different medical conditions it would not treat. Three days after docking, it has accepted a total of twenty in patients. Meanwhile, trained Naval Corpsmen and Doctors stand by, unable to leave the ship.
The difference between fiction and reality is that fiction is supposed to make sense.
SOOPOO
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April 3rd, 2020 at 5:39:14 AM permalink
Quote: billryan

The U.S. Navy hospital ship sent to NYC has one thousand beds on it. The Navy announced it would not house corona virus patients but didn't announce that there were fifty different medical conditions it would not treat. Three days after docking, it has accepted a total of twenty in patients. Meanwhile, trained Naval Corpsmen and Doctors stand by, unable to leave the ship.



I’ve heard this. It’s what happens when a government bureaucracy is involved in healthcare. It just tends to get in the way of normal decision making. It will get fixed as it has now made the news. Bad publicity about the Naval hospital ship will not be allowed.
standbymyman
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April 3rd, 2020 at 8:38:20 AM permalink
Quote: SOOPOO

Remember, the overwhelming majority of new drugs DO NOT GET APPROVED.

Because they don't work, as many that are approved don't either!

TomG
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April 3rd, 2020 at 9:47:50 AM permalink
Quote: rxwine

I think people should be able to sign a waiver that they can't pursue any damages, if they want to get any prescribed concoction regardless of how sick they are or aren't.

If you don't want to wait for drug trials, and willing to give up a right to sue, you should be able to try anything you can get prescribed.



Under this proposal I could get whatever prescription amphetamines and opiods I wanted so long as I promise not to sue? I love it.
rxwine
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April 3rd, 2020 at 11:25:16 AM permalink
Quote: TomG

Under this proposal I could get whatever prescription amphetamines and opiods I wanted so long as I promise not to sue? I love it.



It takes too much work to write out an actual plan. But no, unless opiates turn out to be a legitimate treatment that's not available normally, that wouldn't apply.
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rxwine
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April 3rd, 2020 at 11:27:59 AM permalink
Not even sure if they will give you opiates when you may have a oxygenation problem. Unless you want to be on a machine too.
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April 3rd, 2020 at 1:44:34 PM permalink
Quote: Minty

Significantly large parts. In a system of hundreds of millions of people having several million more than normal being in a position to file for unemployment due to being furloughed or a reduction in hours it's a big deal.



I've just gone through the list of essential activities in the Tennessee governor's Executive Order for the coronavirus Shutdown.

Essential activities include:
Any business or organization that involves 10 or fewer people within its premises
All construction activities and craft trades
All financial services, real estate services and insurance services. Payday loans and pawnbrokers are specifically named as being essential.
Any service related to producing or distributing media, including bookstores, television show production, etc. (probably includes adult bookstores)
Any retail outlet that sells supplies to work from home, which would include computer and electronics and office supplies
Any outlet that sells food, alcoholic beverages, video games, firearms
Any religious services
Any hardware store
Hotels and motels
Accounting services
Transportation services, including marinas and docks (we have a lot of lakes in Tennessee)
Laundry services including dry cleaners

That is not the exhaustive list (which includes all health care services, food and medicine supply and most government services, etc.).

This is why the virus is continuing to spread. So much is allowed to be open.

What is mandated to be closed under this Tennessee order? By elimination:
Schools ( that are not providing food or other essential services)
Museums, entertainment (movie theaters, laser tag, theme parks, music venues), tourist attractions
On-premises consumption in restaurants
Stores that sell garments/clothing
Furniture and home decoration stores

That's all I can think of. I've probably missed a few items
So many better men, a few of them friends, are dead. And a thousand thousand slimy things live on, and so do I.
Keyser
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April 3rd, 2020 at 7:51:54 PM permalink
Quote: TigerWu

Why do you keep posting about this smallpox thing? Do you have any kind of source for this or are you just fearmongering?



I'm definitely not fearmongering. I'm into the math and science of it more than anything.

I'm part of the group that believes that we shouldn't have shut down the country. I think we should have very thoroughly quarantined the at risk and elderly, but that's pretty much it. I believe that we shouldn't give the CDC too much credit, since they screwed up so badly from the beginning. We should also strip some of the FDA's power.
They're slow moving and inefficient in their current format. Let private enterprise innovate and help save the day.
tringlomane
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April 3rd, 2020 at 9:25:50 PM permalink
Quote: gordonm888

The Washington Post has reported on a survey of 6,800 doctors in which they were asked which treatment were they finding to be most effective for Covid-19. Reportedly, the overwhelming answer was hydroxychloroquine.

The State of Michigan had previously issued an order forbidding the use of hydroxychloroquine as a treatment for covid-19. Yesterday, they rescinded that order and placed a significant purchase order for that drug.



Overwhelming????

Hardly.

https://www.washingtontimes.com/news/2020/apr/2/hydroxychloroquine-rated-most-effective-therapy-do/

The two most effective treatments for Covid-19 according to the survey.

hydroxychloroquine - 37%
Azithromycin (Z-Pak) - 32%
billryan
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April 3rd, 2020 at 9:59:31 PM permalink
Quote: tringlomane

Overwhelming????

Hardly.

https://www.washingtontimes.com/news/2020/apr/2/hydroxychloroquine-rated-most-effective-therapy-do/

The two most effective treatments for Covid-19 according to the survey.

hydroxychloroquine - 37%
Azithromycin (Z-Pak) - 32%



63% of the people surveyed felt hydroxi WAS NOT the most effective treatment. That seems fairly overwhelming.
The difference between fiction and reality is that fiction is supposed to make sense.
SOOPOO
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April 4th, 2020 at 6:29:30 AM permalink
Quote: rxwine

Not even sure if they will give you opiates when you may have a oxygenation problem. Unless you want to be on a machine too.



If you are a young, previously healthy coronavirus patient who is having trouble breathing you don't get opiates until it is determined that you will be on a ventilator. Once intubated, it is possible your doctor will use opiates as a sedative to help you tolerate having a tube down your throat.

If you are a demented 92 year old with a broken hip, suffering in pain, but also DNR, you will be given opiates which while helping to alleviate your pain, might push you over the edge as well. But when the end comes, you won't be intubated.
SOOPOO
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April 4th, 2020 at 6:36:58 AM permalink
Quote: Keyser

I'm definitely not fearmongering. I'm into the math and science of it more than anything.

I'm part of the group that believes that we shouldn't have shut down the country. I think we should have very thoroughly quarantined the at risk and elderly, but that's pretty much it. I believe that we shouldn't give the CDC too much credit, since they screwed up so badly from the beginning. We should also strip some of the FDA's power.
They're slow moving and inefficient in their current format. Let private enterprise innovate and help save the day.



What do you propose to tell the doctors taking care of the ever increasing dead without places to store the bodies in NYC? I wish we could holographically put you in the emergency room at Elmhurst hospital for an hour. Under your proposal maybe deaths double or triple or worse?
I have said for a while, when we do decide to 'open the country', it will not be 100% safe from coronavirus. I just want us to be at a level where our hospitals can normally accept the sick and dying without putting them in the lobby and cafeteria and tents in Central Park. I think in one of these threads I'd accept 200 deaths a day as the opening date.

Since you want the country open today, how many additional deaths are you willing to accept as 'acceptable'?
SOOPOO
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April 4th, 2020 at 6:42:42 AM permalink
Quote: tringlomane

Overwhelming????

Hardly.

https://www.washingtontimes.com/news/2020/apr/2/hydroxychloroquine-rated-most-effective-therapy-do/

The two most effective treatments for Covid-19 according to the survey.

hydroxychloroquine - 37%
Azithromycin (Z-Pak) - 32%



In any disease where 99% will just naturally get better in a few days WITHOUT ANY TREATMENT, the number of patients you must give a drug to to assess it's efficacy is in the tens if not hundreds of thousands. Any doctor, who took care of even 100 patients, will have seen the majority recover under any circumstances.

I have no direct knowledge of coronavirus, but I'd bet that chloroquin helps a little at least. But as I've said a bunch of times, if the death rate is around .6%, saving 10% of those would mean you'd need such a large sample to prove it was effective and not just variance.
TomG
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April 4th, 2020 at 8:32:23 AM permalink
Quote: Keyser

I'm definitely not fearmongering. I'm into the math and science of it more than anything.

I'm part of the group that believes that we shouldn't have shut down the country. I think we should have very thoroughly quarantined the at risk and elderly, but that's pretty much it. I believe that we shouldn't give the CDC too much credit, since they screwed up so badly from the beginning. We should also strip some of the FDA's power.
They're slow moving and inefficient in their current format. Let private enterprise innovate and help save the day.



Quarantining healthy people would be a far more drastic step than anything that has been done and would be the first step anyone has taken toward a nation-wide shutdown. The current steps taken have been extremely soft, mostly just let each individual state decide for themselves what they want to do. That generally means close some public institutions, like schools; close casinos and a few other private institutions that are considered non-essential, or give them the opportunity to innovate, eg take-out instead of sit-down dining. Otherwise, just suggest people stay home and wear a mask.

Taking away any power from the FDA would just make them even more slow moving and more inefficient.
Keyser
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April 4th, 2020 at 9:59:58 AM permalink
Quote: SOOPOO

What do you propose to tell the doctors taking care of the ever increasing dead without places to store the bodies in NYC? I wish we could holographically put you in the emergency room at Elmhurst hospital for an hour. Under your proposal maybe deaths double or triple or worse?
I have said for a while, when we do decide to 'open the country', it will not be 100% safe from coronavirus. I just want us to be at a level where our hospitals can normally accept the sick and dying without putting them in the lobby and cafeteria and tents in Central Park. I think in one of these threads I'd accept 200 deaths a day as the opening date.

Since you want the country open today, how many additional deaths are you willing to accept as 'acceptable'?





First off I'd tell them that I'm sorry that their state and local officials let them down and did not purchase the needed medical supplies when they were repeatedly warned that they were running critically low back in 2015. Back when they determined global warming was a bigger threat than a pandemic. The purchasing agents for some hospitals were clearly absent minded and unqualified for their jobs.

I don't think the death rate would be much higher if we would have done a better job of protecting the at risk and elderly. Quarantining seems like a neat idea on the surface, but what about the homes where one person gets sick but there are four or five other people living in the same house or small apartment in NY? Since they can't get out they're all destined to get sick as well.

Poverty kills too. What are you going to tell the people that run out of money and can't by the essentials that they need to survive? How about the food pantry lines over three miles long in New Orleans? What do you suppose is going to happen when the food pantries begin running short on food? What happens when the poor and desperate start raiding the markets and invading peoples homes? I'd tell the Drs. that they need to prepare to treat bullet wounds.

So how many people are you willing to let die? Arrogant and smug attitudes about the state of the economy are also short sighted and dangerous.
Last edited by: Keyser on Apr 4, 2020
SOOPOO
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April 4th, 2020 at 10:11:32 AM permalink
Quote: Keyser

Quote: SOOPOO

What do you propose to tell the doctors taking care of the ever increasing dead without places to store the bodies in NYC? I wish we could holographically put you in the emergency room at Elmhurst hospital for an hour. Under your proposal maybe deaths double or triple or worse?
I have said for a while, when we do decide to 'open the country', it will not be 100% safe from coronavirus. I just want us to be at a level where our hospitals can normally accept the sick and dying without putting them in the lobby and cafeteria and tents in Central Park. I think in one of these threads I'd accept 200 deaths a day as the opening date.

Since you want the country open today, how many additional deaths are you willing to accept as 'acceptable'?





First off I'd tell them that I'm sorry that their state and local officials let them down and did not purchase the needed medical supplies when they were repeatedly warned that they were running critically low back in 2015. Back when they determined global warming was a bigger threat than a pandemic. The purchasing agents for some hospitals were clearly absent minded and unqualified for their jobs.

I don't think the death rate would be much higher if we would have done a better job of protecting the at risk and elderly. Quarantining seems like a neat idea on the surface, but what about the homes where one person gets sick but there are four or five other people living in the same house or small apartment in NY? Since they can't get out they're all destined to get sick as well.

Poverty kills too. What are you going to tell the people that run out of money and can't by the essentials that they need to survive? How about the food pantry lines over three miles long in New Orleans? What do you suppose is going to happen when the food pantries begin running short on food? What happens when the poor and desperate start raiding the markets and invading peoples homes? I'd tell the Drs. that they need to prepare to treat bullet wounds.

So how many people are you willing to let die?



FAR fewer people are dying now due to trauma. So we ARE SAVING lives by this shutdown. I think I answered your question. When down to 200 deaths a day I'd say open it up. Looks like sometime in May.
Keyser
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April 4th, 2020 at 10:24:27 AM permalink
Some quarantines are being put into place for other reasons. Ordering a "shelter in place" type of quarantine is a way by which you can get people off the streets and cut down on civil unrest and looting. It has a better feel and sounds better than ordering a "curfew" or implementing marshal law. It enables the police to move around more freely and keep control of the city in the short term. But it only works for a while. When people can't work or you keep them confined for too long, all hell will inevitably break lose.

You can't make the cure worse than the disease. It will be interesting to see what happens in Sweden, where they're not doing it.
Keyser
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April 4th, 2020 at 10:28:07 AM permalink
Quote: SOOPOO

Quote: Keyser

Quote: SOOPOO

What do you propose to tell the doctors taking care of the ever increasing dead without places to store the bodies in NYC? I wish we could holographically put you in the emergency room at Elmhurst hospital for an hour. Under your proposal maybe deaths double or triple or worse?
I have said for a while, when we do decide to 'open the country', it will not be 100% safe from coronavirus. I just want us to be at a level where our hospitals can normally accept the sick and dying without putting them in the lobby and cafeteria and tents in Central Park. I think in one of these threads I'd accept 200 deaths a day as the opening date.

Since you want the country open today, how many additional deaths are you willing to accept as 'acceptable'?





First off I'd tell them that I'm sorry that their state and local officials let them down and did not purchase the needed medical supplies when they were repeatedly warned that they were running critically low back in 2015. Back when they determined global warming was a bigger threat than a pandemic. The purchasing agents for some hospitals were clearly absent minded and unqualified for their jobs.

I don't think the death rate would be much higher if we would have done a better job of protecting the at risk and elderly. Quarantining seems like a neat idea on the surface, but what about the homes where one person gets sick but there are four or five other people living in the same house or small apartment in NY? Since they can't get out they're all destined to get sick as well.

Poverty kills too. What are you going to tell the people that run out of money and can't by the essentials that they need to survive? How about the food pantry lines over three miles long in New Orleans? What do you suppose is going to happen when the food pantries begin running short on food? What happens when the poor and desperate start raiding the markets and invading peoples homes? I'd tell the Drs. that they need to prepare to treat bullet wounds.

So how many people are you willing to let die?



FAR fewer people are dying now due to trauma. So we ARE SAVING lives by this shutdown. I think I answered your question. When down to 200 deaths a day I'd say open it up. Looks like sometime in May.



That's a bit of a short sighted statement. To grasp the effect you have to look at the long term. You're not taking into account the number of businesses that will never reopen and the number of people that will remain out of work for an extended period of time. After this pandemic is over violence will increase as the poor struggle to survive. Poverty kills too.

We really won't be able to accurately determine what would have happened if we would have taken Sweden's approach. The death rate may have been lower or it may have been higher.
gordonm888
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April 4th, 2020 at 11:34:10 AM permalink
There has been some media chatter that the people who are dieing from covid-19 appear to disproportionately have

- a BMI (Body Max Index) > 30; .i.e., obesity

- diabetes (which itself has a significant correlation with obesity)

And that people with lower BMIs are much less likely to succumb/die.

Is this disease mostly killing people who are greatly overweight? Is this pandemic "the slimming of America?"- an aspect that the cable news networks are understandably reluctant to state?

I'm asking because some of the posters on this thread seem to have some impressive knowledge and expertise, I really want to know what you think? Also, because I have a lot of good friends that are at BMI>30.
So many better men, a few of them friends, are dead. And a thousand thousand slimy things live on, and so do I.
rxwine
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April 4th, 2020 at 11:38:33 AM permalink
Quote: gordonm888

There has been some media chatter that the people who are dieing from covid-19 appear to disproportionately have

- a BMI (Body Max Index) > 30; .i.e., obesity

- diabetes (which itself has a significant correlation with obesity)

And that people with lower BMIs are much less likely to succumb/die.



I'm also wondering if obese people can tolerate long periods on a ventilator as well as thin people. Maybe they should be on calorie restriction while ventilated.
There's no secret. Just know what you're talking about before you open your mouth.
Tanko
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gordonm888
April 4th, 2020 at 12:00:16 PM permalink
Quote: rxwine

...Maybe they should be on calorie restriction while ventilated.



Restrict calories when they need energy to fight the disease?

"Most coronavirus patients who end up on ventilators go on to die, according to several small studies from the U.S., China and Europe."

"Probably the best published information we have so far is from the Intensive Care National Audit and Research Center (ICNARC) in the UK. Of 165 patients admitted to ICUs, 79 (48%) died."
SOOPOO
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April 4th, 2020 at 12:12:21 PM permalink
Quote: gordonm888

There has been some media chatter that the people who are dieing from covid-19 appear to disproportionately have

- a BMI (Body Max Index) > 30; .i.e., obesity

- diabetes (which itself has a significant correlation with obesity)

And that people with lower BMIs are much less likely to succumb/die.

Is this disease mostly killing people who are greatly overweight? Is this pandemic "the slimming of America?"- an aspect that the cable news networks are understandably reluctant to state?

I'm asking because some of the posters on this thread seem to have some impressive knowledge and expertise, I really want to know what you think? Also, because I have a lot of good friends that are at BMI>30.



Sadly for me, lowish BMI but diabetic, it appears that diabetes is a bigger risk factor for dying than obesity. But both have clearly been identified as the major risk factors outside of pre-existing lung disease.
The overall health risks of obesity are too numerous to recite. I can assure you sugar is more dangerous than coronavirus.....
SOOPOO
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April 4th, 2020 at 12:16:26 PM permalink
Quote: rxwine

I'm also wondering if obese people can tolerate long periods on a ventilator as well as thin people. Maybe they should be on calorie restriction while ventilated.



Actually, surprisingly, nutrition or lack thereof while on a ventilator has shown to be harmful. For patients that will need to be on a ventilator more than a day or two, nutrition becomes important.
SOOPOO
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April 4th, 2020 at 12:20:31 PM permalink
Quote: Keyser

Quote: SOOPOO

Quote: Keyser

Quote: SOOPOO

What do you propose to tell the doctors taking care of the ever increasing dead without places to store the bodies in NYC? I wish we could holographically put you in the emergency room at Elmhurst hospital for an hour. Under your proposal maybe deaths double or triple or worse?
I have said for a while, when we do decide to 'open the country', it will not be 100% safe from coronavirus. I just want us to be at a level where our hospitals can normally accept the sick and dying without putting them in the lobby and cafeteria and tents in Central Park. I think in one of these threads I'd accept 200 deaths a day as the opening date.

Since you want the country open today, how many additional deaths are you willing to accept as 'acceptable'?





First off I'd tell them that I'm sorry that their state and local officials let them down and did not purchase the needed medical supplies when they were repeatedly warned that they were running critically low back in 2015. Back when they determined global warming was a bigger threat than a pandemic. The purchasing agents for some hospitals were clearly absent minded and unqualified for their jobs.

I don't think the death rate would be much higher if we would have done a better job of protecting the at risk and elderly. Quarantining seems like a neat idea on the surface, but what about the homes where one person gets sick but there are four or five other people living in the same house or small apartment in NY? Since they can't get out they're all destined to get sick as well.

Poverty kills too. What are you going to tell the people that run out of money and can't by the essentials that they need to survive? How about the food pantry lines over three miles long in New Orleans? What do you suppose is going to happen when the food pantries begin running short on food? What happens when the poor and desperate start raiding the markets and invading peoples homes? I'd tell the Drs. that they need to prepare to treat bullet wounds.

So how many people are you willing to let die?



FAR fewer people are dying now due to trauma. So we ARE SAVING lives by this shutdown. I think I answered your question. When down to 200 deaths a day I'd say open it up. Looks like sometime in May.



That's a bit of a short sighted statement. To grasp the effect you have to look at the long term. You're not taking into account the number of businesses that will never reopen and the number of people that will remain out of work for an extended period of time. After this pandemic is over violence will increase as the poor struggle to survive. Poverty kills too.

We really won't be able to accurately determine what would have happened if we would have taken Sweden's approach. The death rate may have been lower or it may have been higher.



I agree with you more than you think. I agree that the country will need to open up well before it is 'safe' to do so. I understand by doing so we will have many deaths that would have been avoided. I would want it open for the reasons you have stated.

I said 200 deaths per day. I could be convinced to adjust that up or down a little.
rxwine
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April 4th, 2020 at 12:40:42 PM permalink
Quote: SOOPOO

Actually, surprisingly, nutrition or lack thereof while on a ventilator has shown to be harmful. For patients that will need to be on a ventilator more than a day or two, nutrition becomes important.



I wouldn't doubt that nutrition is important, but that's not exactly the same as calories.
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rxwine
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April 4th, 2020 at 12:51:33 PM permalink
(idle speculation)

Folk medicine, Is it starve a fever, feed a cold.

Where is coronavirus on the scale? It's a fever.
There's no secret. Just know what you're talking about before you open your mouth.
rxwine
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April 4th, 2020 at 12:55:12 PM permalink
(more idle speculation)
Are diabetics more at risk with high blood sugar on a ventilator or low blood sugar? So, you wake up blind; you're still alive.
There's no secret. Just know what you're talking about before you open your mouth.
petroglyph
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April 4th, 2020 at 1:26:49 PM permalink
Quote: SOOPOO

IIf you are a demented 92 year old with a broken hip, suffering in pain, but also DNR, you will be given opiates which while helping to alleviate your pain, might push you over the edge as well. But when the end comes, you won't be intubated.

TIA
tringlomane
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April 4th, 2020 at 3:14:37 PM permalink
Quote: SOOPOO

In any disease where 99% will just naturally get better in a few days WITHOUT ANY TREATMENT, the number of patients you must give a drug to to assess it's efficacy is in the tens if not hundreds of thousands. Any doctor, who took care of even 100 patients, will have seen the majority recover under any circumstances.

I have no direct knowledge of coronavirus, but I'd bet that chloroquin helps a little at least. But as I've said a bunch of times, if the death rate is around .6%, saving 10% of those would mean you'd need such a large sample to prove it was effective and not just variance.



I wouldn't doubt if it helped somewhat. I was mainly criticizing Gordon's use of the word "overwhelming" with regard to that survey. Hydroxychloroquine + ZPak probably is better than no treatment at all, but it's not some miracle treatment either unfortunately.
Keyser
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April 4th, 2020 at 7:01:17 PM permalink
Quote: tringlomane

Hydroxychloroquine + ZPak probably is better than no treatment at all, but it's not some miracle treatment either unfortunately.



Watching the parade of doctors on TV, countless numbers of them from around the world appear to disagree with you. According to them the math also says that it's results are statistically relevant.
tringlomane
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April 4th, 2020 at 7:12:18 PM permalink
Quote: Keyser

Quote: tringlomane

Hydroxychloroquine + ZPak probably is better than no treatment at all, but it's not some miracle treatment either unfortunately.



Watching the parade of doctors on TV, countless numbers of them from around the world appear to disagree with you. According to them the math also says that it's results are statistically relevant.



I read more than watch TV. And those ~6000 doctors in that survey didn't seem to be heavily convinced. And Fauci doesn't seem heavily convinced either as far as I can tell. If it was a "miracle cure" the death rate should markedly decrease. Not just marginally.

But if those drugs give you hope, more power to you.
Keyser
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April 4th, 2020 at 7:17:54 PM permalink
Based on what I've read and viewed, the drs, and experts are saying otherwise. Perhaps you're falling victim to spin and social influencers.

Regarding Dr. Fauci...back in Dec/Jan. he really dropped the ball like the rest of the CDC. Their sole job is to foresee these things. They failed terribly at their job. Dr. Fauci said that the virus was nothing to worry about on CNN and that it would be no worse than the flu. I'm not real impressed with him.

Since Dr. Fauci screwed up so badly back then, how do we know that he's actually staying informed and up for the task now?
Last edited by: Keyser on Apr 4, 2020
rxwine
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April 4th, 2020 at 8:03:17 PM permalink
Quote: Keyser

Based on what I've read and viewed, the drs, and experts are saying otherwise. Perhaps you're falling victim to spin and social influencers.

Regarding Dr. Fauci...back in Dec/Jan. he really dropped the ball like the rest of the CDC. Their sole job is to foresee these things. They failed terribly at their job. Dr. Fauci said that the virus was nothing to worry about on CNN and that it would be no worse than the flu. I'm not real impressed with him.

Since Dr. Fauci screwed up so badly back then, how do we know that he's actually staying informed and up for the task now?



December and jan, did he have direct access to the virus except for the word of the Chinese?
There's no secret. Just know what you're talking about before you open your mouth.
Keyser
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April 4th, 2020 at 9:12:08 PM permalink
Quote: rxwine

December and jan, did he have direct access to the virus except for the word of the Chinese?



He's supposed to be the head guy! He's supposed to have access to all of the information and Intel. The president imposed the travel ban on Dec 31 and recognized the threat, why didn't Fauci???

Like I've said, I'm not impressed with the guy at all! I don't like the idea of him being in charge of recommending when we should impose or lift any kind of quarantine or social distancing.
EvenBob
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April 4th, 2020 at 9:44:40 PM permalink
Quote: Keyser

Like I've said, I'm not impressed with the guy at all!



When you go back and read and
listen to Fauci, it's frightening. He
was pooh-poohing this virus and
almost laughing at it. In Dec and
Jan he thought it was a big nothing
burger, and now he's the go to
expert? Wasn't he appalled when
Trump put the travel ban on China
early on?
I think he's embarrassed he screwed
up so badly and is now over compensating
in the other direction.

I'm also hearing that ventilators are not
helping, they are killing people. That this
is more of a blood disease like you get
with high altitude sickness and a ventilator
would just make that worse.
"It's not called gambling if the math is on your side."
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