| Is the lock down ending too soon? 04:59 - Jul 1 with 141040 views | Glyn1 |
That's basically it.
Thoughts please. [Post edited 1 Jul 2020 5:00]
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| Is the lock down ending too soon? on 14:48 - Sep 1 with 1708 views | Professor |
| Is the lock down ending too soon? on 13:33 - Sep 1 by Scotia |
I think the only particulally "interesting" reinfection is the guy from Hong Kong who'd flown back from Europe, and was asymptomatic after being hospitalised during the first bout.
As I understand another one appeared to be reinfected within a month - and if that was a major issue we would have seen it more frequently than just once in 25 million cases. Something fishy there!
Another reinfection involved a (I think Italian) woman who had an auto-immune disorder.
As you say only a handful of cases so no cause for alarm yet. |
The HK report is pretty rigorous, but only one person at this stage |  | | |
| Is the lock down ending too soon? on 15:00 - Sep 1 with 1699 views | A_Fans_Dad |
| Is the lock down ending too soon? on 12:03 - Sep 1 by Professor |
https://www.sciencemag.org/news/2020/06/three-big-studies-dim-hopes-hydroxychlor
https://www.nejm.org/doi/full/10.1056/NEJMe2020388
https://medicalxpress.com/news/2020-07-lopinavir-hydroxychloroquine-covid-.html
https://theconversation.com/why-hydroxychloroquine-and-chloroquine-dont-block-co
Anyone can cut and paste, Perhaps you should look at the website you posted more closely as multiple negative trials on there.
I take it you still don't know what a systematic or Cochrane Review is?
HCQ has no evidence as an effective treatment around SARS Co V2. It may yet have some pre-exposure prophylactic effect (as it does for malaria) but this is not certain.
I happy to use treatment if it works like dexamethasone and other re-purposed drugs. It remains vital. There are lots of studies and drugs such as tocilizumab used for arthritis may be helpful but are a lot safer than HCQ. I still hold hope for immune-based therapy like interferon beta and even passive transfer of antibodies.
The New England Journal of Medicine Article is interesting as it states that the use of HCQ is not driven by science but social media and political grandstanding.
A point worth raising is most of the serious infectious diseases in the world lack vaccines (HIV, Malaria, Trypansosmiaisis, Leishmania. invasive salmonellosis) or, in the case of TB, the vaccine has lost efficacy due to pathogen evolution. (since BCG is close to its centenary it is not surprising). Once deadly and widespread diseases like smallpox and polio have effective vaccines -very effective in these cases as either eradicated or virtually so. Vaccines work, are normally safer than drugs and most importantly, prevent, not treat. [Post edited 1 Sep 2020 12:07]
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I am glad you raised Malaria.
Uganda is the highest country in the world for malaria cases.
Have you looked at their COVID-19 statistics?
They have had COVID-19 in the country since March 21st, they have had 3037 cases and 32 deaths in a population of 46 million.
Ghana, number 2, have had COVID-19 in the country since March 12th, they have had 44298 cases and 276 deaths in a population of 31 million.
Congo, number 3, have had COVID-19 in the country since March 16th, they have had 3979 cases and 78 deaths in a population of 5.5 million.
Burkino Faso, number 4, have had COVID-19 in the country since March 9th, they have had 1370 cases and 55 deaths in a population of 21 million.
Kenya, number 5, have had COVID-19 in the country since March 14th, they have had 34201 cases and 577 deaths in a population of 54 million.
Zambia, number 6, have had COVID-19 in the country since March 18th, they have had 12097 cases and 288 deaths in a population of 18 million.
Pakistan, number 7, have had COVID-19 in the country since February 2nd, they have had 296149 cases and 6298 deaths in a population of 222 million.
So can you think of anything that these 3rd world countries might have in common that allows them to perform so much better than the majority of the western world countries?
Are their hospitals that much better than Europe's and the USA's that they are 10 to 100 times better had handling COVID-19? | | | |
| Is the lock down ending too soon? on 15:31 - Sep 1 with 1686 views | Professor |
| Is the lock down ending too soon? on 15:00 - Sep 1 by A_Fans_Dad |
I am glad you raised Malaria.
Uganda is the highest country in the world for malaria cases.
Have you looked at their COVID-19 statistics?
They have had COVID-19 in the country since March 21st, they have had 3037 cases and 32 deaths in a population of 46 million.
Ghana, number 2, have had COVID-19 in the country since March 12th, they have had 44298 cases and 276 deaths in a population of 31 million.
Congo, number 3, have had COVID-19 in the country since March 16th, they have had 3979 cases and 78 deaths in a population of 5.5 million.
Burkino Faso, number 4, have had COVID-19 in the country since March 9th, they have had 1370 cases and 55 deaths in a population of 21 million.
Kenya, number 5, have had COVID-19 in the country since March 14th, they have had 34201 cases and 577 deaths in a population of 54 million.
Zambia, number 6, have had COVID-19 in the country since March 18th, they have had 12097 cases and 288 deaths in a population of 18 million.
Pakistan, number 7, have had COVID-19 in the country since February 2nd, they have had 296149 cases and 6298 deaths in a population of 222 million.
So can you think of anything that these 3rd world countries might have in common that allows them to perform so much better than the majority of the western world countries?
Are their hospitals that much better than Europe's and the USA's that they are 10 to 100 times better had handling COVID-19? |
I don’t anyone thinks that- certainly there have been worries about capacity and simple things like Oxygen supply. Perhaps Africa has been lucky for once
What I have read is:
1. Population is much younger. Few over 70 and median age much lower.
2. Number of cases under diagnosed, though this is perhaps overstated as Blantyre in Malawi has high sero positivity. I think this may apply to Pakistan as remarkably different to India
3. Prior immunity to a related virus (possible)
4. An inherent difference related to genetics or microbiome
5. Fewer obese people
We have a big presence in Malawi, so the studies there may reveal something. Will let you know if anything come up. I think it is pretty clear that levels are lower, which you may expect in rural areas, but not in major cities with huge crowded slums like Nairobi or Addis. | | | |
| Is the lock down ending too soon? on 15:31 - Sep 1 with 1686 views | Scotia |
| Is the lock down ending too soon? on 15:00 - Sep 1 by A_Fans_Dad |
I am glad you raised Malaria.
Uganda is the highest country in the world for malaria cases.
Have you looked at their COVID-19 statistics?
They have had COVID-19 in the country since March 21st, they have had 3037 cases and 32 deaths in a population of 46 million.
Ghana, number 2, have had COVID-19 in the country since March 12th, they have had 44298 cases and 276 deaths in a population of 31 million.
Congo, number 3, have had COVID-19 in the country since March 16th, they have had 3979 cases and 78 deaths in a population of 5.5 million.
Burkino Faso, number 4, have had COVID-19 in the country since March 9th, they have had 1370 cases and 55 deaths in a population of 21 million.
Kenya, number 5, have had COVID-19 in the country since March 14th, they have had 34201 cases and 577 deaths in a population of 54 million.
Zambia, number 6, have had COVID-19 in the country since March 18th, they have had 12097 cases and 288 deaths in a population of 18 million.
Pakistan, number 7, have had COVID-19 in the country since February 2nd, they have had 296149 cases and 6298 deaths in a population of 222 million.
So can you think of anything that these 3rd world countries might have in common that allows them to perform so much better than the majority of the western world countries?
Are their hospitals that much better than Europe's and the USA's that they are 10 to 100 times better had handling COVID-19? |
When I was in Uganda / Kenya in 2012 I was advised that many areas had withdrawn Chloroquine as a treatment for malaria as there was a high degree of resistance to it. My father in law used to live in Zambia, contracted Malaria and wasn't treated with HCQ for the same reason.
I have no idea how much of it is used there nowadays to be honest but can think of a few things these countries would have in common:-
1, Spiritual healers / Witch Doctors / Juju
2, Lack of testing.
3, Lack of accurate death statistics.
4, Lack of cause of death records.
5, Absolute poverty
6, A far lower life expectancy (Average age for Covid death is 81, African life expectancy is often early 60'S)
If any of those countires have rolled out HCQ across the country as a prophylaxis and they are the results after considering the above points (and others) then they are on to soemthing. I wouldn't have thought that is the case. | | | |
| Is the lock down ending too soon? on 15:45 - Sep 1 with 1680 views | Professor |
| Is the lock down ending too soon? on 15:31 - Sep 1 by Scotia |
When I was in Uganda / Kenya in 2012 I was advised that many areas had withdrawn Chloroquine as a treatment for malaria as there was a high degree of resistance to it. My father in law used to live in Zambia, contracted Malaria and wasn't treated with HCQ for the same reason.
I have no idea how much of it is used there nowadays to be honest but can think of a few things these countries would have in common:-
1, Spiritual healers / Witch Doctors / Juju
2, Lack of testing.
3, Lack of accurate death statistics.
4, Lack of cause of death records.
5, Absolute poverty
6, A far lower life expectancy (Average age for Covid death is 81, African life expectancy is often early 60'S)
If any of those countires have rolled out HCQ across the country as a prophylaxis and they are the results after considering the above points (and others) then they are on to soemthing. I wouldn't have thought that is the case. |
it's not widely used as resistance to CQ and HCQ is endemic is sub-Saharan Africa. In fact resistance is greater in Plasmodium falciparum (the main agent in Africa) to HCQ. If people can afford (and few can) afford anti-malarial as therapy or prophylactic then malarone is used.
This is what you get prescribed for Malawi. We didn't bother for Ethiopia as levels are very low in highland areas we worked in. | | | |
| Is the lock down ending too soon? on 19:29 - Sep 1 with 1632 views | A_Fans_Dad |
| Is the lock down ending too soon? on 15:45 - Sep 1 by Professor |
it's not widely used as resistance to CQ and HCQ is endemic is sub-Saharan Africa. In fact resistance is greater in Plasmodium falciparum (the main agent in Africa) to HCQ. If people can afford (and few can) afford anti-malarial as therapy or prophylactic then malarone is used.
This is what you get prescribed for Malawi. We didn't bother for Ethiopia as levels are very low in highland areas we worked in. |
It just so happens that Uganda used HCQ to treat it's patients.
Even the basis of some Cough Medicines works against COVID-19, who would have thought.
The drug is Bromhexine, the study is here
https://bi.tbzmed.ac.ir/Files/Inpress/bi-23240.pdf
So we have yet another group of Doctors for you to slander, denigrate and insult.
Be my guest.
I notice that when presented with actual data you, like a good Climate Change proponent use the appeal to Authority.
Well in the case of Paul Garner of LSTM, you forgot the link.
Which I am now waiting for you to post so that I can view how many COVID-19 patients he has actually treated and how many clinical studies he has published on the subject. | | | |
| Is the lock down ending too soon? on 20:21 - Sep 1 with 1607 views | Professor |
| Is the lock down ending too soon? on 19:29 - Sep 1 by A_Fans_Dad |
It just so happens that Uganda used HCQ to treat it's patients.
Even the basis of some Cough Medicines works against COVID-19, who would have thought.
The drug is Bromhexine, the study is here
https://bi.tbzmed.ac.ir/Files/Inpress/bi-23240.pdf
So we have yet another group of Doctors for you to slander, denigrate and insult.
Be my guest.
I notice that when presented with actual data you, like a good Climate Change proponent use the appeal to Authority.
Well in the case of Paul Garner of LSTM, you forgot the link.
Which I am now waiting for you to post so that I can view how many COVID-19 patients he has actually treated and how many clinical studies he has published on the subject. |
https://www.google.co.uk/amp/s/www.buzzfeednews.com/amphtml/stephaniemlee/hydrox
That paper is Ok. It is too small in terms of size to be definitive and some of the methodology (LDH release) is a bit dubious. That said it is in a regional journal as a consequence of its limitations.
I checked it was at least a ‘real’ journal.
There is a lot of dubious stuff out there in what are called
Predatory journals.
Remember medicine is now driven by evidence-based approaches not the opinion of
Individuals. The days of the doctor as a deity are long gone.
You still have failed to explain what a systematic review does and why this is important in evidence-based medicine.
Paul Garner has more experience with Covid than most.
He was seriously ill with it this spring. | | | |
| Is the lock down ending too soon? on 20:24 - Sep 1 with 1603 views | A_Fans_Dad |
| Is the lock down ending too soon? on 20:21 - Sep 1 by Professor |
https://www.google.co.uk/amp/s/www.buzzfeednews.com/amphtml/stephaniemlee/hydrox
That paper is Ok. It is too small in terms of size to be definitive and some of the methodology (LDH release) is a bit dubious. That said it is in a regional journal as a consequence of its limitations.
I checked it was at least a ‘real’ journal.
There is a lot of dubious stuff out there in what are called
Predatory journals.
Remember medicine is now driven by evidence-based approaches not the opinion of
Individuals. The days of the doctor as a deity are long gone.
You still have failed to explain what a systematic review does and why this is important in evidence-based medicine.
Paul Garner has more experience with Covid than most.
He was seriously ill with it this spring. |
Oh, so he hasn't treated anybody then.
Which systematic review? | | | |
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| Is the lock down ending too soon? on 20:32 - Sep 1 with 1595 views | Professor |
| Is the lock down ending too soon? on 20:24 - Sep 1 by A_Fans_Dad |
Oh, so he hasn't treated anybody then.
Which systematic review? |
Any? Do you know what they are? In particular a Cochrane review
Why is treating someone important? My GP or my cousin who is a Gp treat people every day.
She makes no claim of being a scientist or offering insight.
What you don’t get it is you are looking at this without any functioning critical filter. | | | |
| Is the lock down ending too soon? on 20:51 - Sep 1 with 1579 views | A_Fans_Dad |
| Is the lock down ending too soon? on 20:32 - Sep 1 by Professor |
Any? Do you know what they are? In particular a Cochrane review
Why is treating someone important? My GP or my cousin who is a Gp treat people every day.
She makes no claim of being a scientist or offering insight.
What you don’t get it is you are looking at this without any functioning critical filter. |
Who will you go to when you need life saving treatment, some scientist in an ivory tower or a Doctor? | | | |
| Is the lock down ending too soon? on 21:04 - Sep 1 with 1575 views | Professor |
| Is the lock down ending too soon? on 20:51 - Sep 1 by A_Fans_Dad |
Who will you go to when you need life saving treatment, some scientist in an ivory tower or a Doctor? |
That was not what was asked. It’s a different question. Most fundamental discovery of drugs, vaccines, diagnostics are made by non-clinicians.
Their translation to use is more made by clinicians. So for treatment of course it would be a clinician, but because someone is not involved in treatment does not mean they are lot the best person to define or determine something. A fundamental immunologist would better explain a cytokine storm and routes to control one than most clinicians. Clinicians have the hands on experience. The best science is almost always partnerships of a range of people with differing skills.
So systematic review? | | | |
| Is the lock down ending too soon? on 21:18 - Sep 1 with 1562 views | A_Fans_Dad |
| Is the lock down ending too soon? on 21:04 - Sep 1 by Professor |
That was not what was asked. It’s a different question. Most fundamental discovery of drugs, vaccines, diagnostics are made by non-clinicians.
Their translation to use is more made by clinicians. So for treatment of course it would be a clinician, but because someone is not involved in treatment does not mean they are lot the best person to define or determine something. A fundamental immunologist would better explain a cytokine storm and routes to control one than most clinicians. Clinicians have the hands on experience. The best science is almost always partnerships of a range of people with differing skills.
So systematic review? |
I don't know what you are asking because you haven't provided any details or links. | | | |
| Is the lock down ending too soon? on 12:31 - Sep 3 with 1368 views | Catullus |
| Is the lock down ending too soon? on 21:18 - Sep 1 by A_Fans_Dad |
I don't know what you are asking because you haven't provided any details or links. |
I think he's asking do you understand what a systematic review is? Could be wrong.
BTW, those scientists in ivory towers, it was them who discovered most of the medical breakthroughs that we rely on today.
If not for scientists then doctors might still be recommending crazy stuff like cigarettes to cure asthma, amongst other crazy stuff,
https://www.boredpanda.com/weird-old-medical-treatments/?utm_source=google&utm_m | |
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| Is the lock down ending too soon? on 14:15 - Sep 3 with 1353 views | A_Fans_Dad |
| Is the lock down ending too soon? on 12:31 - Sep 3 by Catullus |
I think he's asking do you understand what a systematic review is? Could be wrong.
BTW, those scientists in ivory towers, it was them who discovered most of the medical breakthroughs that we rely on today.
If not for scientists then doctors might still be recommending crazy stuff like cigarettes to cure asthma, amongst other crazy stuff,
https://www.boredpanda.com/weird-old-medical-treatments/?utm_source=google&utm_m |
No, it was not Scientists in ivory towers, it was medical scientists in labs, plus a lot of doctors out in the field learning from natives.
Many of our modern medicines were derived from nature.
They end up in ivory towers and no longer interact with patients and yet tell the rest of their profession what to and what not to do with those patients.
There is massive corruption in the medical research profession, especially when creating study papers for printing. | | | |
| Is the lock down ending too soon? on 15:55 - Sep 3 with 1334 views | Scotia |
| Is the lock down ending too soon? on 14:15 - Sep 3 by A_Fans_Dad |
No, it was not Scientists in ivory towers, it was medical scientists in labs, plus a lot of doctors out in the field learning from natives.
Many of our modern medicines were derived from nature.
They end up in ivory towers and no longer interact with patients and yet tell the rest of their profession what to and what not to do with those patients.
There is massive corruption in the medical research profession, especially when creating study papers for printing. |
Which is pretty much what the Prof said - it is the interactions between science and medicine that creates the best results. Medical scientists don't just tell doctors what to do, developments in science come from evidence based science and various testing and review processes. Scientists aren't in "ivory towers", if they work alone they won't get very far in practice.
I wonder how many scientists you actually know?
Where do you think modern medicine would be without the work of Louis Pasteur? Was he a medical Doctor? No he wasn't.
Anyway I think Catullus was correct about the Systematic / Cochrane review question, especially around HCQ. | | | |
| Is the lock down ending too soon? on 16:18 - Sep 3 with 1329 views | A_Fans_Dad |
| Is the lock down ending too soon? on 15:55 - Sep 3 by Scotia |
Which is pretty much what the Prof said - it is the interactions between science and medicine that creates the best results. Medical scientists don't just tell doctors what to do, developments in science come from evidence based science and various testing and review processes. Scientists aren't in "ivory towers", if they work alone they won't get very far in practice.
I wonder how many scientists you actually know?
Where do you think modern medicine would be without the work of Louis Pasteur? Was he a medical Doctor? No he wasn't.
Anyway I think Catullus was correct about the Systematic / Cochrane review question, especially around HCQ. |
But a systemic review is only looking at published papers and collating the data, so I still don't understand the question.
Unfortunately the Prof did not point to a HCQ Cochrane review, so I don't know what is involved.
But HCQ is not the only medicine being ignored, the latest claim by the UK is that Hydrocortisone works for COVID-19 as if it is something new, it is not new.
It has been known that Steroids work and has been ignored for months.
This website, run by the Virginia School of Medicine in Norfolk USA has included steroids in it's COVID-19 treatment protocol for months.
https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critic
Where is the WHO or any other body that is spreading the good news?
All we hear is that there is no "cure", which is true, but the patient does not care that their life was saved by medicines that did not "cure" them, but only saved their lives. | | | |
| Is the lock down ending too soon? on 14:18 - Sep 7 with 1264 views | Andy1300 |
Coming to the U.K. soon
[Post edited 7 Sep 2020 16:40]
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| Is the lock down ending too soon? on 14:56 - Sep 7 with 1243 views | Professor |
| Is the lock down ending too soon? on 16:18 - Sep 3 by A_Fans_Dad |
But a systemic review is only looking at published papers and collating the data, so I still don't understand the question.
Unfortunately the Prof did not point to a HCQ Cochrane review, so I don't know what is involved.
But HCQ is not the only medicine being ignored, the latest claim by the UK is that Hydrocortisone works for COVID-19 as if it is something new, it is not new.
It has been known that Steroids work and has been ignored for months.
This website, run by the Virginia School of Medicine in Norfolk USA has included steroids in it's COVID-19 treatment protocol for months.
https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critic
Where is the WHO or any other body that is spreading the good news?
All we hear is that there is no "cure", which is true, but the patient does not care that their life was saved by medicines that did not "cure" them, but only saved their lives. |
Steroids are not being ignored- dexamethasone has been used widely and is a steroid. Has been well publicised. The Hydrocortisone evidence is newer, but has the same broad mode of action. Lots of anecdotal evidence of beclamethasone (the steroid 'preventer' inhaler' for asthma) too.
Still not right on the systematic review. There is more too it than that. | | | |
| Is the lock down ending too soon? on 16:29 - Sep 7 with 1229 views | A_Fans_Dad |
| Is the lock down ending too soon? on 14:56 - Sep 7 by Professor |
Steroids are not being ignored- dexamethasone has been used widely and is a steroid. Has been well publicised. The Hydrocortisone evidence is newer, but has the same broad mode of action. Lots of anecdotal evidence of beclamethasone (the steroid 'preventer' inhaler' for asthma) too.
Still not right on the systematic review. There is more too it than that. |
The use of Steriods has been put forward months before the Oxford trial of dexamethasone.
Methylprednisolone was part of the EVMS treatment protocol months before the Oxfrod trial.
As was clot busting drugs identified by the NY front line doctor.
I don't care what the systemic review shows if it is as biased as the studies that it will use as evidence, like the Oxford one. | | | |
| Is the lock down ending too soon? on 18:45 - Sep 7 with 1200 views | Andy1300 |
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| Is the lock down ending too soon? on 11:05 - Sep 8 with 1126 views | Scotia |
With Caerphilly heading in to lockdown and one of the conditions being that facemasks must now be worn in all shops - why hasn't this ever been rolled out across all of Wales, and why not now?
It either has an effect or it doesn't? If it doesn't why impose it in Caerphilly and if it does why not everywhere? | | | |
| Is the lock down ending too soon? on 11:27 - Sep 8 with 1118 views | exhmrc1 |
| Is the lock down ending too soon? on 11:05 - Sep 8 by Scotia |
With Caerphilly heading in to lockdown and one of the conditions being that facemasks must now be worn in all shops - why hasn't this ever been rolled out across all of Wales, and why not now?
It either has an effect or it doesn't? If it doesn't why impose it in Caerphilly and if it does why not everywhere? |
As you already know I dont believe Facemasks in shops is really necessary. I suspect due to the increased cases they are taking whatever can be done to reduced them.
One of the things I learned when I went into hospital for a CT scan is that staff only wore masks for close contact. They didnt wear them in corridors. The reason I was told is that in corridors there was only fleeting contact whereas when seeing patients it involved close contact over a longer period. This is probably why the figures kept reducing with shops open and very few wearing masks in them. The problem is the long time close contacts like classrooms in schools, offices and pubs and restaurants dont require masks and it is those environments that really need them.
It doesnt alter the position in that having Air Borders and pubs open has led to the explosion of cases we are now having. I notice that for all your criticism of the Senydd over the Greek Islands they Johnson government has now decided to remove them from the Air Bridges scheme. Perhaps you would like to explain why they havent done the same for Portugal which has higher rates of coronavirus. As of Friday the Welsh average rate was 7 per 100000. The Portugal rate last Wednesday was 23 and Zante last week was 15. | | | |
| Is the lock down ending too soon? on 11:42 - Sep 8 with 1111 views | Professor |
That is so badly written as to be untrue! Not what has been said, but the interpretation by the reporter.
What is true the test used (quantitative real time PCR) will detect virus that is no longer infective and that currently they are using positive/negative. It's easy to set a threshold to say that, but what is not being reported is that the test has enough sensitivity to work out whether there is a lot or a little virus and that interpretation around that (it's called the Ct number) could be reported too-bascially the fewer cycles to get signal, the larger the amount of viral target . That I agree with. Has it kicked up true false positives-very few. Is it detecting infected but no longer infectious patients-yes, but probably a low proportion. Viral RNA won't hang around in the body as its very unstable. Makes working with RNA hard going. | | | |
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