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Reacher

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18 minutes ago, Lostin76 said:

I think you are actually much more of an expert in FDA research than I am. The research we do is mostly Quality Improvement (QI) and patient safety. I'm "around" clinical trial stuff in our department, but not as familiar with the ins and outs.

My staff do have to deal with the IRB, but not really big clinical trial stuff. We do have a Rapid RCT Lab that has to register on the Clinical Trial website, but my division deals more with process changes over drugs/devices. So, I might be speaking from a position of relative ignorance. Would not be the first time. 😛

And I was hoping you were the expert !

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2 hours ago, Lostin76 said:
2 hours ago, Lostin76 said:

A faculty member in our department is co-leading a 2,000 patient clinical trial testing it. We are very seriously looking at it as a possible way to lessen the severity of symptoms.  I don't think anyone here in NYC is against is b/c of politics, that would be idiotic. I think it's just a sense of the unknown interactions and an overabundance of caution.

I would hope there isn't really anyone opposed to it, hopefully they are just unconvinced or too cautious. Who are these people? Everyone I know are all hoping that it can help.

We wasted so much time as a nation and our leaders for the most part have failed us. It's time to try everything we can to lessen suffering, illness, and death.

 

Lostin, you are on the ground in NY. I'm hearing the hospitals are overcrowded and that is partially because Corona patients can'y get hydroxy chloro-quinine from their Dr. Why would you want to overburden the hospitals by bringing in all these people unnecessarily? If you are not high risk, let the family Dr prescribe it. I'd be pissed if I was a personal physician.

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21 minutes ago, Reacher said:

Lostin, you are on the ground in NY. I'm hearing the hospitals are overcrowded and that is partially because Corona patients can'y get hydroxy chloro-quinine from their Dr. Why would you want to overburden the hospitals by bringing in all these people unnecessarily? If you are not high risk, let the family Dr prescribe it. I'd be pissed if I was a personal physician.

When you hear advertising about medicine, you hear the reward vs risk! All medicine and medical treatment come with risks! That is why you get to hear the auctioneer litany of risks at the end of the advertising.  

Edited by Drroogh
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59 minutes ago, Reacher said:

Lostin, you are on the ground in NY. I'm hearing the hospitals are overcrowded and that is partially because Corona patients can'y get hydroxy chloro-quinine from their Dr. Why would you want to overburden the hospitals by bringing in all these people unnecessarily? If you are not high risk, let the family Dr prescribe it. I'd be pissed if I was a personal physician.

Not on the ground thankfully, but I run a center that belongs to the School of Medicine for one of the big hospital systems here. We are one of the sites for the clinical trial for hydroxychloroquine, so our docs are using it as part of the trial. Hospitals are overcrowded, especially here in Brooklyn and also in Queens. Our hospital is doing a little better, b/c we were preparing early. But, there are not enough staff or PPE. One of my docs started today on the wards for two weeks and he told me that they get one N95 mask per week. Not cool.

Not sure what personal docs locally are doing as far as prescribing. I'm sure there is some "off-label" prescribing happening, but the message here is "do not seek medical care of any kind unless it's a life threatening emergency." No doctor visits and no hospital visits, unless absolutely necessary. The EMS system is severely overtaxed. We are pretty used to hearing sirens at night on a regular basis, but now it's sirens almost constantly, day and night - especially at night though.

Honestly, I think the decision to use hydroxychloroquine or not is far down the list of issues for those on the front line. We don't really know if it works, but hopefully this trial will help shed some light on it. I think @Drroogh is probably our local IU message board expert on how much to trust a drug at what point. My docs personally feel "why not try it" if someone is struggling. But, they are also not ready to tell others that they should use it.

One thing I do know is that politicians (governors and prez) should keep the heck out of it. They are not helping things. Their job should be to keep their mouths shut, listen to the docs, and keep the supplies flowing to the front line.

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5 minutes ago, mrflynn03 said:

Anytime the media starts to dismiss something, in this case hydroxychloroquin, I believe the opposite to be true. 

There are some good journalists out there but most are just blowhards who regurgitate what is being fed to them. 

This is probably not a good time to be listening to anyone who is not a doctor or a medical specialist. If the media (or politicians) are getting information straight from qualified medical professionals, then that's great. If not, then good to be skeptical.

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5 minutes ago, Lostin76 said:

This is probably not a good time to be listening to anyone who is not a doctor or a medical specialist. If the media (or politicians) are getting information straight from qualified medical professionals, then that's great. If not, then good to be skeptical.

 I dont know what's going on. Neither do these media people. And I was born a skeptic. I seriously doubt they are getting qualified information.

But I dont go around bloviating about whether this works or not. I just trust the people on the ground doing the work that know what they are doing. BTW I hope it's as simple as a 70 year old malaria drug and antibiotic, for all of us. 

My take, follow the money. Pharma doesnt make money on healthy people and cheap one off drug treatments.  

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So back when the wife and I started out I didnt want to spend the money on her going to a stylist.  So I was her stylist, haircuts, coloring, the whole shebang.  And I have to admit I wasnt half bad. 

Tomorrow she is going to do her first hair job on me. She got some professional tools from a stylist friend but i expect to end up completely bald tomorrow evening. Guess i can grow a goatee.

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33 minutes ago, mrflynn03 said:

So back when the wife and I started out I didnt want to spend the money on her going to a stylist.  So I was her stylist, haircuts, coloring, the whole shebang.  And I have to admit I wasnt half bad. 

Tomorrow she is going to do her first hair job on me. She got some professional tools from a stylist friend but i expect to end up completely bald tomorrow evening. Guess i can grow a goatee.

I am not going to let my wife anywhere near my neck with a sharp object.  I will probably look like one of those mad scientists before all this is over.

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SIAP - I am about 2 weeks behind this thread. When projecting when the USA/State/community hits the peak, it is better to look at new cases instead of deaths. Deaths are a lagging indicator meaning someone who is dying today, first contracted the virus 2-3 weeks ago. 

Regarding Hydroxychloroquine, a plant is opening in West Virginia that is planning on making 50 million tablets, enough for 1.5 million people, by mid-April.

Here's how I see it playing out: By May 1st, Indiana and most of the USA will have been quarantined for 6 weeks. That is sufficient time to find hot spots and stop the spread. As soon as this HCQ is fully available, the direction will be to get a test (which will become easier and more widely available), start taking the HCQ ASAP (it works best at the onset of symptoms and prevents the spread throughout the cells), then quarantine for 2 weeks. We will continue social distancing and non-high risk groups will go back to work. Here in Indiana, we'll peak in deaths next week. Here's the website Dr. Birx from the taskforce referenced. 

https://covid19.healthdata.org/projections

 

 

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11 hours ago, Lostin76 said:

This is probably not a good time to be listening to anyone who is not a doctor or a medical specialist. If the media (or politicians) are getting information straight from qualified medical professionals, then that's great. If not, then good to be skeptical.

Yeah, don’t listen to me either, I was in the medical device field! I know practically nothing about pharmaceuticals!

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"Giuliani said he thought New York Gov. Andrew Cuomo needed to make the drug easier to access.

“I think this situation on hydroxychloroquine alone is a terrible, terrible mistake,” Giuliani said. “If it deprives one person of the medicine and that person dies, it’s a terrible mistake.”"

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I just don't get what is going on here - 

DrBill (@DrBill_MD_) Tweeted:
I am a licensed physician in Utah. I tried to prescribe hydroxychloroquine but the pharmacist said the state had taken over the distribution of the drug. Even though I’m licensed, I cannot prescribe it. This is WRONG! https://twitter.com/DrBill_MD_/status/1246862791585087489?s=20

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I am going off memory here from watching CBS this morning where they were talking ethnicity and the virus.

IIRC 70% of Milwaukee's positive cases are African-Americans.  African-Americans make up 28% of the population of Milwaukee.

IIRC 80% of Chicago's deaths due to the virus are African-American.

They also had a doctor from New York that said a majority of the patients she saw were African-American or Latino...but she did not have the numbers.

 

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Regarding Hydroxychloroquine, I just find it amazing that everybody has turned into a scientist, doctor or pharmacist overnight. Whether it's reporters, politicians, economists or just people in general. This is getting a little silly. 

I don't buy that this is political either. Peter Navarro who is an economist in Trump's administration just said this morning there is a debate with in the White House about this drug....a debate amongst everybody who is on the same side politically. It's not political; it's weighing risk vs. reward when nobody has any conclusive proof of the drug's side effects or its success. The facts are that it may have harmed some patients, it may have helped some patients or it might not have done anything at all. This is all anybody really knows right now and to suggest otherwise is not truthful. 

It's not an easy call. There's valid points on both sides of the issue. It's expected that there'd be some disagreement in this scenario. 

I don't have an opinion either way because I'm not an expert and I'd rather have the experts figure this out. I'd also rather listen to experts as @Lostin76 suggested. Listen to the scientists, not the pundits or politicians. 

 

Edited by tdhoosier
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