OtherGround Forums OG doc. AMA on COVID-19

5/2/20 10:51 AM
2/4/09
Posts: 11272

A new paper on HCQ

 

Hydroxychloroquine application is associated with a decreased mortality in critically ill patients with COVID-19

 

https://www.medrxiv.org/content/10.1101/2020.04.27.20073379v1

5/2/20 1:09 PM
11/23/10
Posts: 251
NoNeed4aScreenName -

A new paper on HCQ

 

Hydroxychloroquine application is associated with a decreased mortality in critically ill patients with COVID-19

 

https://www.medrxiv.org/content/10.1101/2020.04.27.20073379v1

Sorry for being blunt, but oh boy is that a mess of a preprint. It is never going to get through a peer-reviewer worth his salt in it’s current state.

I suspect they’re fishing hard in their statistical analyses to show an effect - they don’t adjust for the variables which look to explain the differences in mortality: The non-HCQ group had a higher proportion of very old people (they try to hide it by dichotomizing age at +/- 60 years, which looks favorable for the HCQ group at first glance, but really is not). Antibiotic use is much higher in the non-HCQ-group, probably due to that group being more severely ill).

Also, the HCQ-group is on a much lower dose than is used for COVID-19, so something is very weird about that group.

And then they overstate their conclusion far beyond what their data can suppor: even if they’d done the study properly, you simply cannot evaluate the effect of a drug in an acute, severe illness in an observational study like this. RCTs are the only way.

I’ll have to run their numbers to be sure, but some of their p-values seem incompatible with their reported confidence intervals. And their sample size is too small in the HCQ group to be compatible with the confidence intervals they report in the crude vs adjusted (they would be MUCH wider in the adjusted analysis, but are reported to be almost exactly the same as the crude analysis)..

There’s also a comment on medrxiv from a user saying that it’s apparently using data from a study population, which at the same time was part of an RCT on traditional chinese medicine in COVID-19, which the authors don’t mention - and if true then the paper is even more useless.

5/2/20 5:48 PM
2/4/09
Posts: 11285
Job Security -
NoNeed4aScreenName -

A new paper on HCQ

 

Hydroxychloroquine application is associated with a decreased mortality in critically ill patients with COVID-19

 

https://www.medrxiv.org/content/10.1101/2020.04.27.20073379v1

Sorry for being blunt, but oh boy is that a mess of a preprint. It is never going to get through a peer-reviewer worth his salt in it’s current state.

I suspect they’re fishing hard in their statistical analyses to show an effect - they don’t adjust for the variables which look to explain the differences in mortality: The non-HCQ group had a higher proportion of very old people (they try to hide it by dichotomizing age at +/- 60 years, which looks favorable for the HCQ group at first glance, but really is not). Antibiotic use is much higher in the non-HCQ-group, probably due to that group being more severely ill).

Also, the HCQ-group is on a much lower dose than is used for COVID-19, so something is very weird about that group.

And then they overstate their conclusion far beyond what their data can suppor: even if they’d done the study properly, you simply cannot evaluate the effect of a drug in an acute, severe illness in an observational study like this. RCTs are the only way.

I’ll have to run their numbers to be sure, but some of their p-values seem incompatible with their reported confidence intervals. And their sample size is too small in the HCQ group to be compatible with the confidence intervals they report in the crude vs adjusted (they would be MUCH wider in the adjusted analysis, but are reported to be almost exactly the same as the crude analysis)..

There’s also a comment on medrxiv from a user saying that it’s apparently using data from a study population, which at the same time was part of an RCT on traditional chinese medicine in COVID-19, which the authors don’t mention - and if true then the paper is even more useless.

I thought I saw them say it was a retroactive study in the abstract. I think that would mean the same wouldn't it?

 

I'm not surprised it was a shit study. It came from china. I feel like chine is just feeding some of the papers put to continue to instigate political arguments over the drugs 

 

 

5/4/20 8:50 PM
4/15/16
Posts: 7623

Is there doctor in the house?

I have a question about antibody testing, but it seems he hasn't posted here in days.

5/5/20 7:13 AM
11/23/10
Posts: 252
Hashtag -

Is there doctor in the house?

I have a question about antibody testing, but it seems he hasn't posted here in days.

There are a few. I’m sure you’ll get a qualified response. I don’t know where OP doc went, but I hope he’s okay.

Edited: 5/5/20 8:19 AM
8/22/14
Posts: 3089

Without reading 95 pages,have any of you Dr's questioned the official story presented by the media.

I don't want to get sucked in by any snake oil salesman types but things dont seem to be all their made out to be.

Just finished watching a doco that shows how it was created and leaked from a lab in whuhan not the seafood market. 

When this broke earlier this year that bloke on rogan said their was virtually no chance that this was man made

This documentary was pretty methodical and the story was getting corroborated by sr US government officials. CIA intel ect

It was saying how the E-protein was a 100% match for the E- protein in this other virus ect ( im not pretending to know what they were saying but they were presenting it as pretty conclusive evidence among other things).

The one main question i have is, are the deaths that are being attributed to cov19 genuinely a direct result of cov19 ?

 

5/5/20 9:10 AM
2/22/11
Posts: 4349
mataleo1 -
Bukabuki - 

Oooh look. We have a death pill describing drug pushing doctor on here. The md might as well mean mcdonalds. Fuck off with your modern medical b.s..


What pill was I pushing?

There's no effective treatment as of yet. Some antivirals may work but we still don't know.

Here's an interesting read if interested:

COVID-19

 

5/5/20 9:26 AM
10/23/05
Posts: 3563

Hi all,

Apologies for not posting. I've had to cover 2 sick colleagues so i've been on call 9 days straight and it's been non-stop.

Situation getting better in Montreal (and NYC from what I can gather). Hoping there won't be a brutal second wave when things start to open up

5/5/20 9:33 AM
10/23/05
Posts: 3564
bungee up - 

Without reading 95 pages,have any of you Dr's questioned the official story presented by the media.

I don't want to get sucked in by any snake oil salesman types but things dont seem to be all their made out to be.

Just finished watching a doco that shows how it was created and leaked from a lab in whuhan not the seafood market. 

When this broke earlier this year that bloke on rogan said their was virtually no chance that this was man made

This documentary was pretty methodical and the story was getting corroborated by sr US government officials. CIA intel ect

It was saying how the E-protein was a 100% match for the E- protein in this other virus ect ( im not pretending to know what they were saying but they were presenting it as pretty conclusive evidence among other things).

The one main question i have is, are the deaths that are being attributed to cov19 genuinely a direct result of cov19 ?

 


As of this being man made in a Wuhan lab, I'm not going to project. A lot of the current info is and what I know about it is what is reported in the media.

As for your question, yes. I gave the example of a stroke. Imagine someone suffers from a massive stroke and dies 3 days later of aspiration pneumonia (quite common). Depending on where you work, the cause of death would be as pneumonia, in others as stroke. Nothing changed for COVID; none of MDs I work with have been pushed to under or over it as COVID. If you have fatal hypotension following COVID, the cause of death would be COVID. Exactly the same way that fatal hypotension after a flu could be as flu.

5/5/20 9:39 AM
10/23/05
Posts: 3565
used2wrestle - 
avnersch -
mataleo1 -
Believe in the Power of One - 

Also, are there tests in the US or not? Can you clear that up at all? I know they fucked the first kit up, but is there something better?

How close to a vaccine? 

Thank you!


I'm in NYC and we do have access to tests for patients considered at risk and those with typical symptoms.

Some teams already claim they have a vaccine but it still takes testing (pharmacokinetics, safety, immunogenic responses, etc...). I'd say we're about 6 months away to having vaccines available to large populations.

Not sure how you came up with the 6 months. This is completely unrealistic. Even if everything is perfect it takes 12-18 months. For some viruses we have never been able to develop vaccines like HIV, Herpes, and non of the Coronoaviruses. 

Wanted to note that the group in Oxford talking about a Sept. vaccine just partnered with AstraZeneca so the claim has more credibility now.


I'm just citing some colleagues who are working on this and were more knowledgeable than I am. You're likely right that it may take more than 12 months.

5/5/20 9:46 AM
10/23/05
Posts: 3566
The Stewed Owl - 
“At the moment when [the blood flow in] small vessels in the lungs is disturbed, the heart has to apply increased pressure to pump the blood through the lungs at all. This places an enormous strain on the right ventricle, which is normally only responsible for a low pressure. If the pressure requirements increase, it is quickly overtaxed, resulting in acute right heart failure. The left ventricle does not pump the blood into the lungs, but into the rest of the organism. It is capable of producing a pressure four to ten times greater than the pulmonary circulation. Regardless of whether it is caused by Covid or some other infection: as soon as the pressure in the pulmonary circulation is increased and the right heart is put under pressure, the patient can quickly die. […] So when the lungs are infected, the right heart has to run at full throttle for 1.5–2 weeks and is stressed far beyond normal levels. A young, fit person is more likely to cope with this than someone who already has a previous injury. But the virus is apparently also able to damage the heart itself. And the blood clots can of course also appear in vessels in the heart. So you have a heart that is pumping strongly, and suddenly the blood supply to the heart itself goes down. Then you have two hard strains, which can already be too much for the damaged heart.”
Q: [what about pre-existing conditions?]

“There is the old saying: A healthy patient is only a patient who has not been examined well enough. For example, high blood pressure is a disease of old age. In Germany, this will be about 35 percent of the total population. Up to now, mainly elderly people in Germany have died of Covid-19, which means that most Covid-19 deaths have had hypertension. Us being Germans, we also drink a lot of alcohol, so many citizens are overweight and have a fatty liver. The patient over 60 who has no previous illness – statistically there are only few. The important thing is not that there are pre-existing conditions, but which ones. And in what context do these have an influence on the probability of survival in the case of Covid-19 disease? It’s not enough to say, “This patient had something.” Rather, the previous illnesses must be systematically uncovered in relation to the population.”
“You have to separate whether someone died of, or with, a Covid-19 infection. It’s already affecting statistics. As far as we know, in Italy a corona test was carried out on every person who died and everyone who was found to have the virus was considered to have died of corona. In the case of pre-existing conditions, a distinction must also be made between diseases that generally shorten life expectancy and diseases that specifically increase the risk of corona infection and possible complications. This is somewhat muddled in the public discussion.”

Q: [brain involvement]
A [paraphrased]: we cannot conclusively rule out direct virus involvement, but the brain is so sensitive to disturbances in blood flow that blood clots quickly lead to headaches, then strokes.
[Paraphrased] “Overall, we know a lot about what happens at the cellular level with the virus, but relatively little about what happens at the organ level. Cell cultures can only tell you so much. So here is where autopsies come in.”

Translation at https://spinstrangenesscharm.wordpress.com/2020/04/29/covid19-update-yom-haatzmaut-edition-coronahotels-for-mild-cases-in-israel-pathology-professor-discusses-what-can-be-learned-about-covid19-from-autopsies/, which also has a story about how Israel is repurposing hotels into facilities for mild COVID-19, run by the IDF, cases to free up hospital space.


A lot can be said about this.

You cannot deny there has been a HUGE spike of death in selected parts of Italy, NY, Spain, France. We're talking 2-5 times the usual death rates. Regardless of how you want to COVID as cause of death, that says more than anything else. Nothing spikes up this death rate aside from earthquakes, massive starvation and pandemics. So, yeah, of course, i'm sure there are some mis as COVID, but I will venture and say that a large proportion are not reported.

5/5/20 9:52 AM
10/23/05
Posts: 3567
prof - This part from Stewed Owl's post alarmed me:

-----------------------

“When you have a nasty cold with a fever, there’s always the recommendation: “Don’t go to the gym.” The basic idea behind this is that any virus can, in principle, infect any organ. Normally you have a resting heart rate of 65 or 70, but if you want to be a tough guy and go to the gym and treadmill and give it all you’ve got, you have a pulse of 150, so your heart is pumping properly. The chance of the virus infecting the heart suddenly increases dramatically. When you are infected, the body fights most viral infections with lymphocytes that go to the heart muscles and kill the infected cells. And this heart muscle inflammation is the most common reason for heart transplants in people under the age of 25.”

------------------------


My layman's brain is saying: Hold on, if that's the case, maybe my daily exercising is more danger than help.

Like many I'm trying to stay in shape (I'm 56, no chronic health problems, BMI of 22), and that includes getting my heart rate up at some point every day. Sometimes it's jogging, often I'll also throw in some sprints or running up and down stairs to get the heart rate up. Part of it is for feeling and being fit, part for health, stave off things like hypertension, diabetes and other things that can come with getting too lazy with age.

Anyway, if that article is correct, stressing your heart while being infected with a virus can actually lead to "dramatic" increase in the possibility of the virus infecting the heart!

Well, if one is often asymptomatic for a while with COVID before symptoms show (or even are having an asymptomatic course of the disease), that suggests I may be out there running up some stairs stressing my heart while not knowing I have the virus, and hence increasing my risk of complications.

Can someone help me here? I need some 'splainin'....

No need to change anything. Common sense prevails.

When you feel sick, rest, drink fluids, stay at home. If you're asymptomatic, exercising won't kill you. You won't decompensate from heart failure if the virus is not causing any symptoms.

The article doesn't say the full story. Anything can affect the heart when you're sick. We see patients have mild attack when they have a flurry of massive symptoms from the flu, abdominal pain, a bone fracture, anything that stresses your body. But we're talking about vulnerable patients and/or major symptoms.

5/5/20 10:01 AM
10/23/05
Posts: 3568
Job Security - 
NoNeed4aScreenName -

Clinical trial guys. Does this significantly change the primary outcomes of the study?

 

As much as I dislike Didier, and as much as he’s the last person in the world entitled to criticize a scientific study for lack of transparency - he’s got a point here. Mata has more experience with RCTs than I, but here’s my take until he’s back:

It is a big difference to omit death as an outcome. It’s the most clinically important outcome, and it is also a competing risk to the other chosen outcomes, so you have to take it into account in the analysis of those tol. Still, they’re registering deaths, and will be analyzing and reporting on those as well, so it’s ultimately of less importance, more a question of formality and semantics.

The rest of the changes to the outcome are probably of less importance. It’s probably a question of adapting the 8-level ordinal outcome to a binomial model because they had issues with variance and/or statistical power. They probably had little-to-no data available before the trial to make accurate calculations of statistical power, so perhaps it is to be expected that they had to change it along the way. Still, it’s so far into the study that they changed it, that it’s susceptible to being an opportunistic choice. They must have had enough results in by that point to see which outcome yielded which result.

One thing to note though: This is a bonanza just like with tamiflu and swine flu, but crazier. The study investigators weren’t ready to make these preliminary results public. I can’t remember authorities ever disclosing preliminary results like this before. The study is still ongoing, the conclusions may change, and you can’t make valid preliminary conclusions like this unless you had a plan for it at the start.

TLDR: It’s very good news and seems to show that remdesivir is probably more potent against COVID-19 than tamiflu is against influenza. It’s premature to draw any conclusions until the investigators finish the study and report it in detail in a few weeks.


Pretty much agree with all this.

Keeping this simple here, but I think this was related to numbers needed, and an imprecise idea of mortality risk to predict difference between groups.

I'm always concerned when goalposts change during a study. That in itself is very concerning. At the end of the day, there aren't so many outcomes of interest (PIOs). Death, need for ventilators, days on ventilators, lung damage, length of ICU stay, length of hospital stay. These outcomes should and do drive most present trials.

5/5/20 10:05 AM
10/23/05
Posts: 3569
Barry_BondsMVP - 

My older cousin and his wife were on Facebook all day yesterday posting articles and memes downplaying this pandemic. They believe it’s a government hoax and not as bad as the media etc are making it out to be. He mentions that it’s a business, and hospitals are getting paid more if doctors write down a patient being Covid or deemed Ventilator necessary. 
 

https://amp.usatoday.com/amp/3000638001


No one has ever suggested that I write down "COVID" as a cause of death as a way for my hospital to make more money. I haven't heard that from any of my colleagues either.

I get why some people are playing this down. If you're away from the action and the only thing you see is business closing and shutting down, then I understand. Some places were hit hard, others weren't. Ask anyone living in NYC if this is a hoax.

5/5/20 10:07 AM
10/23/05
Posts: 3570
Job Security - 
NoNeed4aScreenName -
Job Security -
NoNeed4aScreenName -

Clinical trial guys. Does this significantly change the primary outcomes of the study?

 

As much as I dislike Didier, and as much as he’s the last person in the world entitled to criticize a scientific study for lack of transparency - he’s got a point here. Mata has more experience with RCTs than I, but here’s my take until he’s back:

It is a big difference to omit death as an outcome. It’s the most clinically important outcome, and it is also a competing risk to the other chosen outcomes, so you have to take it into account in the analysis of those tol. Still, they’re registering deaths, and will be analyzing and reporting on those as well, so it’s ultimately of less importance, more a question of formality and semantics.

The rest of the changes to the outcome are probably of less importance. It’s probably a question of adapting the 8-level ordinal outcome to a binomial model because they had issues with variance and/or statistical power. They probably had little-to-no data available before the trial to make accurate calculations of statistical power, so perhaps it is to be expected that they had to change it along the way. Still, it’s so far into the study that they changed it, that it’s susceptible to being an opportunistic choice. They must have had enough results in by that point to see which outcome yielded which result.

One thing to note though: This is a bonanza just like with tamiflu and swine flu, but crazier. The study investigators weren’t ready to make these preliminary results public. I can’t remember authorities ever disclosing preliminary results like this before. The study is still ongoing, the conclusions may change, and you can’t make valid preliminary conclusions like this unless you had a plan for it at the start.

TLDR: It’s very good news and seems to show that remdesivir is probably more potent against COVID-19 than tamiflu is against influenza. It’s premature to draw any conclusions until the investigators finish the study and report it in detail in a few weeks.

It doesn't seem like this is much better than HCQ butbthe media really is touting this one. 

 

Could it be sue to patent and price. I think its bullshit. Neither seem to be super great

If the preliminary results hold, then - as opposed to the HCQ-studies - this study actually examines the type of patients we want to treat (it is restricted to severe cases with long stays in hospital). So whereas we know nothing about the effect of HCQ in practice, remdesivir has that going for it.

The time-to-recovery measure of effect is somewhat similar to the effect measure that was able to show an effect of tamiflu against influenza (no effect has been shown of tamiflu on mortality afaik)  but remdesivir seems to shorten it by half a week, where tamiflu only shortened it by about 24 hours iirc (and only if treatment was initiatied shortly after symptom onset). So even if it’s a bullshit measure, it’s better bullshit than tamiflu.

And the old primary outcome (including deaths) is still going to be analyzed in the planned fashion, according to their protocol, just as a secondary outcome. In the end, not much has changed except the formalities, but I think they should have stuck to their guns and kept it as a primary outcome for sake of consistency. It’s just weird and unnecessary to switch them around. I don’t understand it at all - they will get an absurdly high impact even if they technically  only report a significant secondary outcome effect. It’s not like they have to inflate their results to get published. And even as a secondary outcome it would surely create enough equipoise that remdesivir would become the standard of care, similarly to what happened with tamiflu. Strange times.


Agreed again. Very weird. Just keep death as primary outcome. If any of the secondary outcomes come out with statistical difference, that is still 1000x better than the HCQ data (especially the bogus outcomes from the Raoult studies)

5/5/20 10:13 AM
10/23/05
Posts: 3571
used2wrestle - 

Remdesivir approved.

Obviously it's not a cure but it's better than nothing and at least based on a randomized dataset. Very sad how HCQ become a political debate and through this, fauci was labelled a science denier and the BARDA guy got reassigned.


I'm always weary of the "better than nothing".

That's what so many have said here about HCQ on this very forum: "use it", "better than dying", etc... However, HCQ was not a no-risk treatment. People did have malignant arrhythmias from it, some died from it. For something that is far from being convincing as a treatment.

Primum non nocere as they say.

I would use that term for treatments that are cheap and cause little to no toxicity (like vitamin C). Remdesivir appears to have a better safety profile than HCQ but it's still early.

5/5/20 10:18 AM
10/23/05
Posts: 3572
NoNeed4aScreenName - 
Job Security -
NoNeed4aScreenName -

A new paper on HCQ

 

Hydroxychloroquine application is associated with a decreased mortality in critically ill patients with COVID-19

 

https://www.medrxiv.org/content/10.1101/2020.04.27.20073379v1

Sorry for being blunt, but oh boy is that a mess of a preprint. It is never going to get through a peer-reviewer worth his salt in it’s current state.

I suspect they’re fishing hard in their statistical analyses to show an effect - they don’t adjust for the variables which look to explain the differences in mortality: The non-HCQ group had a higher proportion of very old people (they try to hide it by dichotomizing age at +/- 60 years, which looks favorable for the HCQ group at first glance, but really is not). Antibiotic use is much higher in the non-HCQ-group, probably due to that group being more severely ill).

Also, the HCQ-group is on a much lower dose than is used for COVID-19, so something is very weird about that group.

And then they overstate their conclusion far beyond what their data can suppor: even if they’d done the study properly, you simply cannot evaluate the effect of a drug in an acute, severe illness in an observational study like this. RCTs are the only way.

I’ll have to run their numbers to be sure, but some of their p-values seem incompatible with their reported confidence intervals. And their sample size is too small in the HCQ group to be compatible with the confidence intervals they report in the crude vs adjusted (they would be MUCH wider in the adjusted analysis, but are reported to be almost exactly the same as the crude analysis)..

There’s also a comment on medrxiv from a user saying that it’s apparently using data from a study population, which at the same time was part of an RCT on traditional chinese medicine in COVID-19, which the authors don’t mention - and if true then the paper is even more useless.

I thought I saw them say it was a retroactive study in the abstract. I think that would mean the same wouldn't it?

 

I'm not surprised it was a shit study. It came from china. I feel like chine is just feeding some of the papers put to continue to instigate political arguments over the drugs 

 

 


Studies from China can't be trusted, especially now.

I just submitted a COVID paper in the top journal of nephrology. It will likely be accepted and the review process is being sped up. If I had submitted any other study, it would have taken 3 months with a million of edits and corrections (with a less than 5% acceptance)

Journals are accepting very iffy papers nowadays because of the pandemic. Chinese researchers have a lot of vested interests in being published in "western journals", including academic promotions.

5/5/20 10:38 AM
7/26/15
Posts: 1795
mataleo1 -

Hi all,

Apologies for not posting. I've had to cover 2 sick colleagues so i've been on call 9 days straight and it's been non-stop.

Situation getting better in Montreal (and NYC from what I can gather). Hoping there won't be a brutal second wave when things start to open up

Welcome back doc. I was thinking the worst glad to see you're OK. My friends mother passed away from this yesterday. She was in her early 50s and healthy 

5/5/20 10:41 AM
10/23/05
Posts: 3574
Brother rabbitte - 
mataleo1 -

Hi all,

Apologies for not posting. I've had to cover 2 sick colleagues so i've been on call 9 days straight and it's been non-stop.

Situation getting better in Montreal (and NYC from what I can gather). Hoping there won't be a brutal second wave when things start to open up

Welcome back doc. I was thinking the worst glad to see you're OK. My friends mother passed away from this yesterday. She was in her early 50s and healthy 


I'm good, thank you.

We lost a few people I knew, including a young a healthy doc. A few orderlies too.

Edited: 5/5/20 11:34 AM
2/27/11
Posts: 11293
mataleo1 -
The Stewed Owl - 
“At the moment when [the blood flow in] small vessels in the lungs is disturbed, the heart has to apply increased pressure to pump the blood through the lungs at all. This places an enormous strain on the right ventricle, which is normally only responsible for a low pressure. If the pressure requirements increase, it is quickly overtaxed, resulting in acute right heart failure. The left ventricle does not pump the blood into the lungs, but into the rest of the organism. It is capable of producing a pressure four to ten times greater than the pulmonary circulation. Regardless of whether it is caused by Covid or some other infection: as soon as the pressure in the pulmonary circulation is increased and the right heart is put under pressure, the patient can quickly die. […] So when the lungs are infected, the right heart has to run at full throttle for 1.5–2 weeks and is stressed far beyond normal levels. A young, fit person is more likely to cope with this than someone who already has a previous injury. But the virus is apparently also able to damage the heart itself. And the blood clots can of course also appear in vessels in the heart. So you have a heart that is pumping strongly, and suddenly the blood supply to the heart itself goes down. Then you have two hard strains, which can already be too much for the damaged heart.”
Q: [what about pre-existing conditions?]

“There is the old saying: A healthy patient is only a patient who has not been examined well enough. For example, high blood pressure is a disease of old age. In Germany, this will be about 35 percent of the total population. Up to now, mainly elderly people in Germany have died of Covid-19, which means that most Covid-19 deaths have had hypertension. Us being Germans, we also drink a lot of alcohol, so many citizens are overweight and have a fatty liver. The patient over 60 who has no previous illness – statistically there are only few. The important thing is not that there are pre-existing conditions, but which ones. And in what context do these have an influence on the probability of survival in the case of Covid-19 disease? It’s not enough to say, “This patient had something.” Rather, the previous illnesses must be systematically uncovered in relation to the population.”
“You have to separate whether someone died of, or with, a Covid-19 infection. It’s already affecting statistics. As far as we know, in Italy a corona test was carried out on every person who died and everyone who was found to have the virus was considered to have died of corona. In the case of pre-existing conditions, a distinction must also be made between diseases that generally shorten life expectancy and diseases that specifically increase the risk of corona infection and possible complications. This is somewhat muddled in the public discussion.”

Q: [brain involvement]
A [paraphrased]: we cannot conclusively rule out direct virus involvement, but the brain is so sensitive to disturbances in blood flow that blood clots quickly lead to headaches, then strokes.
[Paraphrased] “Overall, we know a lot about what happens at the cellular level with the virus, but relatively little about what happens at the organ level. Cell cultures can only tell you so much. So here is where autopsies come in.”

Translation at https://spinstrangenesscharm.wordpress.com/2020/04/29/covid19-update-yom-haatzmaut-edition-coronahotels-for-mild-cases-in-israel-pathology-professor-discusses-what-can-be-learned-about-covid19-from-autopsies/, which also has a story about how Israel is repurposing hotels into facilities for mild COVID-19, run by the IDF, cases to free up hospital space.


A lot can be said about this.

You cannot deny there has been a HUGE spike of death in selected parts of Italy, NY, Spain, France. We're talking 2-5 times the usual death rates. Regardless of how you want to COVID as cause of death, that says more than anything else. Nothing spikes up this death rate aside from earthquakes, massive starvation and pandemics. So, yeah, of course, i'm sure there are some mis as COVID, but I will venture and say that a large proportion are not reported.

Yes, in the Bergamo area of Italy,  they had +500% more deaths compared to past years from Feb 20 to March 31.

Italy as a whole, +49%

In Italy we had few areas that were hit very hard while the rest of Italy is probably one of the less hit areas worldwide.

Rome had -9% deaths in march compared to past years.

I think that's because the Italian region of Lombardy was one of the first regions in the world outside of China where the contagion started and was detected, causing the lockdown of the rest of Italy way before other countries in Europe and the rest.

https://translate.google.com/translate?hl=it&sl=it&tl=en&u=https%3A%2F%2Fwww.bergamonews.it%2F2020%2F05%2F04%2Fcoronavirus-a-marzo-a-bergamo-568-di-morti-rispetto-agli-anni-precedenti%2F370110%2F

5/5/20 11:46 AM
1/13/10
Posts: 47808
mataleo1 -
Barry_BondsMVP - 

My older cousin and his wife were on Facebook all day yesterday posting articles and memes downplaying this pandemic. They believe it’s a government hoax and not as bad as the media etc are making it out to be. He mentions that it’s a business, and hospitals are getting paid more if doctors write down a patient being Covid or deemed Ventilator necessary. 
 

https://amp.usatoday.com/amp/3000638001


No one has ever suggested that I write down "COVID" as a cause of death as a way for my hospital to make more money. I haven't heard that from any of my colleagues either.

I get why some people are playing this down. If you're away from the action and the only thing you see is business closing and shutting down, then I understand. Some places were hit hard, others weren't. Ask anyone living in NYC if this is a hoax.

They bs people are coming up with to down play this is sad. There’s been protesting through out CA. And in my county there’s been three break outs at nursing homes and several packing houses and meat plants. 

5/5/20 12:52 PM
4/20/20
Posts: 589

Has anyone heard about people who have recovered getting reinfected? 

 

There was some smoke regsrdit that coming out of sk, but it seems they chalked that up to people still being infected and testing negative due to the virus going up and down in the body, curious if anyone had heard anything else.

5/5/20 1:20 PM
2/27/11
Posts: 11294
madmartigan -

Has anyone heard about people who have recovered getting reinfected? 

 

There was some smoke regsrdit that coming out of sk, but it seems they chalked that up to people still being infected and testing negative due to the virus going up and down in the body, curious if anyone had heard anything else.

Apparently it's still not clear.

Recovered getting reinfected could also be a result of faulty tests.

 

5/5/20 1:30 PM
1/1/01
Posts: 65726
madmartigan - 

Has anyone heard about people who have recovered getting reinfected? 

 

There was some smoke regsrdit that coming out of sk, but it seems they chalked that up to people still being infected and testing negative due to the virus going up and down in the body, curious if anyone had heard anything else.


I think the prevailing hypothesis was the virus "reactivating" rather than it being a proper reinfection. Either that or just tests still being a little unreliable:

https://www.livescience.com/coronavirus-reinfections-were-false-positives.html
5/5/20 1:34 PM
10/23/05
Posts: 3578
Tomato Can - 
madmartigan - 

Has anyone heard about people who have recovered getting reinfected? 

 

There was some smoke regsrdit that coming out of sk, but it seems they chalked that up to people still being infected and testing negative due to the virus going up and down in the body, curious if anyone had heard anything else.


I think the prevailing hypothesis was the virus "reactivating" rather than it being a proper reinfection. Either that or just tests still being a little unreliable:

https://www.livescience.com/coronavirus-reinfections-were-false-positives.html

According to the ID specialists I talk to, it's probably related to testing.

We haven't seen a case of someone getting really sick from COVID, getting cured, then falling really sick again (a month later). Considering all the cases we have, it seems like we'd see many such cases if re-infection was a big issue. I'm guessing you are likely to get at least partial immunity if you get it.