Maybe they’re going with some assumed multiple of actual infections vs observations.
Even with the calculator’s assumption’s it’s pretty significant it still puts a 35yr old with no health complications at about 3% for hospitalization. Add on common complicatons and it’s 5%+. Those are pretty high numbers.
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Dr. Jeffrey Dellavolpe: “Yesterday was probably the worst day I ever had.”
CNN: " Why?"
Dr. Jeffrey Dellavolpe: “I got 10 calls. Young people who would otherwise be excellent candidates to be able to put on ECMO. They’re so sick that if they don’t get put on if they don’t get that support, they are probably going to die. I have three beds. And just making that decision of who would benefit. It is a level of decision-making that I don’t think a lot of us are prepared for.”
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In other news:
Unexpected flip after the nonsense of previously prohibiting county and local from having such orders.
Our total #'s aren’t as high relatively but Oregon keeps hitting daily records.
And theres this :
Umatilla County, with a population of just under 78,000 residents, had the highest case count on Thursday with 88. The county in eastern Oregon averaged 40 cases per day in the last week for the second highest count in the state
Just my ZIP code in Portland Metro has about that many people and we don’t even have 88 total cases much less hitting that # in a single day.
I"m not seeing a unique situation (like that big church related outbreak) or other specific reason cited for the high counts in Umatilla.
One article cites people going to work when having symptoms and possibly graduation parties.
Maybe this is an exception or maybe we were wrong to think rural areas were better protected or had special circumstances deserving of different rules.
here’s a retrospective study out of Michigan hospitals comparing HCQ and/or AZ vs neither. They found a large benefit for HCQ, half the mortality risk give or take, not much for Az alone or as an additional marginal contributor to the HCQ. They gave HCQ on day 1 hospitalization in almost all cases, much earlier in the disease than most other studies, and observed no serious side effects.
https://www.henryford.com/news/2020/07/hydro-treatment-study
https://www.ijidonline.com/action/showPdf?pii=S1201-9712(20)30534-8
Overall crude mortality rates were 18.1% in the entire cohort, 13.5% in the hydroxychloroquine alone group, 20.1% among those receiving hydroxychloroquine+ azithromycin, 22.4% among the azithromycin alone group, and 26.4% for neither drug (p < 0.001).
In the multivariable Cox regression model of mortality using the group receiving neither hydroxychloroquine or azithromycin as the reference, treatment with hydroxychloroquine alone decreased the mortality hazard ratio by 66% (p<0.001), and hydroxychloroquine+azithromycin decreased the mortality hazard ratio by 71% (p<0.001). We did not find statistical significance in the relative effect of adjunct therapy and mortality.
Kaplan-Meier survival curves showed significantly improved survival among patients in the hydroxychloroquine alone and hydroxychloroquine+azithromycin group compared with groups not receiving hydroxychloroquine and those receiving azithromycin alone (Figure 1). The survival curves suggest that the enhanced survival in the hydroxychloroquine alone group persists all the way out to 28 days from admission.
a study of 1376 consecutive hospitalized COVID-19 patients in New York that used respiratory failure as the primary endpoint found no significant reduction in the likelihood of death or intubation among those receiving hydroxychloroquine compared to those who did not.19 In a separate multicenter cohort study of 1438 patients from 25 hospitals in New York, no reduction in hospitalized patient mortality was observed with hydroxychloroquine treatment.20 Among a number of limitations, this study included patients who were initiated on hydroxychloroquine therapy at any time during their hospitalization. In contrast, in our patient population, 82% received hydroxychloroquine within the first 24 hours of admission, and 91% within 48 hours of admission.
Yup. That’s the key. Good post, xerty.
Maybe some docs will pick up on this. But regrettably I think Trump has screwed the pooch regarding HCQS for a great many others. NOT for everyone. But sadly politics is more powerful than science for some people.
Also, and I’m gonna pound this one more time:
HCQS is very inexpensive. Having nothing whatsoever to do with POTUS, that fact alone is enough to make some docs wish it would go away.
Hydroxychloroquine is effective in treating COVID-19, says Henry Ford Health System study
Uh-oh! The truth is emerging, Trump is being proven right as usual. All this despite the desperate hopes on the left.
HCQS, based on this peer-reviewed USA study, simply WORKS!!
But do not look for this news in the Trump-hating American mainstream media.
https://www.cnn.com/2020/07/02/healt…udy/index.html
Here are some quotes from the article:
“Researchers not involved in the Henry Ford study pointed out it wasn’t of the same quality of the studies showing hydroxychloroquine did not help patients, and said other treatments, such as the use of the steroid dexamethasone, might have accounted for the better survival of some patients.”
“Researchers not involved with the study were critical. They noted that the Henry Ford team did not randomly treat patients but selected them for various treatments based on certain criteria.”
“As the Henry Ford Health System became more experienced in treating patients with COVID-19, survival may have improved, regardless of the use of specific therapies,” Dr. Todd Lee of the Royal Victoria Hospital in Montreal, Canada, and colleagues wrote in a commentary in the same journal
“Finally, concomitant steroid use in patients receiving hydroxychloroquine was more than double the non-treated group. This is relevant considering the recent RECOVERY trial that showed a mortality benefit with dexamethasone.”
Big shock
Yes, big shock that the peer reviewers say the same as the study authors. Oh wait… That’s not a shock at all! But since that conflicts with a politicized narrative you want to push, neither the authors or peer reviewers should be listened to.
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Dr. Zervos also pointed out, as does the paper, that the study results should be interpreted with some caution, should not be applied to patients treated outside of hospital settings and require further confirmation in prospective, randomized controlled trials that rigorously evaluate the safety and efficacy of hydroxychloroquine therapy for COVID-19.
“Currently, the drug should be used only in hospitalized patients with appropriate monitoring, and as part of study protocols, in accordance with all relevant federal regulations,” Dr. Zervos said.
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HCQS was attacked by the left because Trump touted it. As a result people died who otherwise would have become well.
Does the left give a damn? Not in the least. Only the attack on Trump matters. Politics, to them, is more important than people’s lives.
Doesnt that summarize as “We really dont want believe what we’re seeing.”? You can agree or disagree with that take, but that seems like it’s a pretty valid take regardless…
No, that’s not how science works. It’s not a “valid take” just because something “seems so” to someone.
The science of interpreting someone’s comments? The science is the study, the researcher’s subsequent commentary is highly subjective.
It wasn’t just someone’s comments, it’s in the actual paper that’s being referenced…
I don’t think that’s quite what the study says. Basically, they did not randomize treatment, they selected some patients for some treatment, some for other treatment and looked at the outcome. In that context, in layman terms, it means the study is inconclusive. And its critical reviews are based on that methodology which was not free of sampling bias.
Take a sample distribution of patients. Give no medication to the oldest and sickest (especially those with heart conditions), give some HCQ+AZ to the middle of the pack in age and risk factor, and then give HCQ to the youngest and healthiest cohort, what does the study tell you? Nothing because you have no baseline.
Compare two sports cars running on different fuels, with various level of mechanical issues, drive one 1 mile uphill with turns, and one straight downhill. The one going downhill is measured to go faster. What does it tell you about which fuel is best for them? Nothing conclusive.
Most of those issues are addressed via their regression models and matching of patients in order to get a very similar demographic group in each experimental and control group. Of course that can not be perfect and there may be factors you don’t know about and hence not include in your model. This is true of all retrospective studies. However, would not say it was “inconclusive” - the stats are very significant, but you are right to say there is the possibility of selection biases so this evidence should be viewed as less convincing than a prospective, randomized controlled trial.
I saw some comment that steroids (now known to help in those with severe disease) were used in addition to the HCQ treatment perhaps more than they were in the control group, so perhaps that’s a confounding factor. It would be a factor if true (I didn’t see those details), but given the health of the people in this study and how steroids only help somewhat and for those with severe disease (perhaps a 20-40% reduction in mortality, only for those needing oxygen or ventilation), I think it would be a stretch to say all the results we see in this study could be attributed to that steroid factor.
I think the thing with HCQS from the jump has been that it is more efficacious in certain situations and less in others. Ditto for dose: too much can either kill you or mess up your heart rhythm seriously. It has to be administered in the correct dose.
HCQS is a really old medicine. Many docs are WELL aware of the above limitations and dosing rules. It is straightforward for those seeking to disparage HCQS to administer it in a dose and at a point in the progression of the disease known in advance not to be advantageous for success.
There have been several. But the “study” that was most ridiculous was one in South America where they were giving the victims 600mg/day of HCQS! Those poor people. It’s fortunate more of them did not die. I mean, why not just SHOOT the study participants and be done with it?
But that asinine “study” was nevertheless a success in that it made HCQS appear ineffective and dangerous (QED), providing requisite fodder for the Trump-hating news media.
I think considering the cost, it’s worth doing the study like the UK is doing with their health workers. It’ll sort itself out eventually once there is large size randomized double blind controlled test.
Same with dexamethasone. Some early encouraging results need to be confirmed but since the drug is so cheap, it’s definitely worth studying compared to remdesivir where usefulness may be statistically shown to reduce hospital stay duration slightly but at $3k per dose, the benefits seem questionably worth it (since it was not proven to reduce mortality or long time side effects of COVID).
If I remember correctly what I read, it was not directly part of the COVID treatment but the rate of steroid use due to other conditions in patients given only HCQ was about twice that of the untreated group. That’s unfortunate because it muddles the results completely. Reduced mortality could then be due to HCQ alone, steroids alone, or both drugs with or without synergy. To me that just leaves too many questions open to be very useful.