Lostin76

That's one of them. They had two dosage levels. And I'm not blaming a drug or anything. I'm also not desperately clinging to a questionable treatment. I sincerely hope it can offer relief, but not at the expense of unnecessary death. I think I've mentioned that our department is doing a big clinical trial with it as a prophylaxis for exposed cases. We want it to work, but there is not enough data. And the real data we have so far? It's not great.

A second clinical trial has now been stopped early b/c of cardiac deaths from hydroxychloroquine. Also this from a doctor: "Patients with lupus, arthritis, other conditions are *already* on hydroxychloroquine. And we are diagnosing them with covid19 LEFT AND RIGHT "

We are getting crazy winds here in Brooklyn this morning. I had to bring in some flowers and plants that I planted over the weekend, b/c they were being battered to death. Was texting with my Dad who lives in Southern Indiana and he was out working all weekend b/c of weather. He has been a lineman all his life and now supervises crews.

It's so easy for us to spend time blaming governors and the federal government after the fact to score political points. It's also not that helpful. This is a good reminder. There will be plenty of time after this is all over to see what a catastrophic failure this was on so many levels, both governmental and societal. Now is a good time to take care of ourselves and each other. It's easy for me to get annoyed at a post by @mrflynn03 that I may disagree with, but I also have to realize that I'm sitting at home safe and still receiving a paycheck (my wife is too), while his wife is forced to stop working. We are all coming at this from different directions and being affected differently b/c of our own situations and geographic locations.

Yep, got the same email from USAA. I'll take it since I haven't really needed to use our car but once since this started.

Texts from my Father in Elmhurst Hospital, Queens

This makes me happy. I can totally picture it.

Lots of opinions about this and if we may be over-reacting. This is the reality on the ground here though, so it's difficult for me to see your sides in this. "The surge of critically ill COVID-19 patients has now given way to a crush of bodies that has overwhelmed hospital morgues, fleets of additional refrigeration trucks, and the funeral homes and crematoriums meant to help loved ones find some form of closure. More than 1,500 people died in a 48-hour period in New York City this week, according to the city Health Department. That still fails to capture the full extent of the crisis, as city officials are still not releasing numbers of probable COVID-19 deaths where tests were not conducted. At one hospital in Queens, a physician who oversees an intensive care unit said the hospital was struggling to find places to put the dead."

There's a lot of recency bias in reporting. People tend to think or feel that what's happening now is more serious, more important, or more severe. Does it make it right, but it is something that happens. Interesting thing about the Hong Kong Flu in 1968 - it was in two waves. The second was more severe than the first.

We owned a condo down on Mass Ave and now we rent here in Brooklyn. We are not in a high rise - on top floor of a modest four floor building. And the crazy thing is that our neighborhood in Brooklyn is much, much quieter and chill than living in Indy. It's like Mayberry here in Prospect Heights. That's why I love Brooklyn so much.

Mile, you raise an important point. I absolutely HATE the Indy Star. I can't read any IU articles from it. It's useless to me unless I subscribe. And I lived in downtown Indy for years, but that paper is dead to me b/c of all of the annoying ads and the strict paywall. And I appreciate you not taking my post personally. I'm pretty partial to the Midwest and my upbringing, so I'm very sensitive to East Coasters trashing or dismissing the rest of the country. We are all in this together no matter where we live!

You are right. That's an important point. It's also just impossibly to know here, b/c of our lack of testing. I'm actually kind of hoping that many more of us have had it or have it and not fallen sick. That would make our death rate much lower.

Jealous of their trends and numbers. They are doing really well. Also impressed with the governor of Montana. I read an interview this morning with him in the NYT. They are handling things really well. It's impressive.

Mile, that's just not true. I've been a subscriber to NYT for over a decade. They routinely cover the entire world, including the Midwest and the South. If anything they are light on local coverage for those of us who live in NYC. That's one of the frustrating things for us as NYT subscribers. We have to read Gothamist, or the NY Post to get local news - it's weird. Just a quick search for the term "rural" gives me over a dozen articles in the last week from the NYT about how COVID-19 is affecting rural areas. Some really good articles too. The article about the funeral in GA was especially well done. I'm an Indiana kid. Born in IN, raised in IN, graduated HS in IN, and also graduated from IU Bloomington. I know there's this sense that the east coast doesn't care about the rest of the country, but it's not the case in reality. Hell, many of us that live here are from the Midwest! I'm not going to argue about the media on here though, b/c I know we can't do politics. It's just sad that the number of actual people who are dying (these are real people with families) are starting to be used to score political points. We as a country failed to get a jump on this and we will be the country with the most cases and deaths when this is all over. This is disheartening to me as we have the resources for the opposite outcome.

From the NYT this morning: Undercounting COVID-19 Deaths

The idea that hospitals are inflating the number of cases to get more money is just conspiracy theory twaddle. I'm ashamed that we actually have politicians of the stripe that would stoop to this and websites that would try to spread such trash AND profit off of it. If anything COVID-19 deaths are actually being under reported. Our leadership is DESPERATELY looking for less COVID-19 deaths. It's all we think about - are there less admissions/deaths, etc? It's the most important thing in the world right now to see cases drop, not rise. We are losing so much money by cancelling elective services and regular appointments that we just want this to flatten out or disappear.

Admissions are plateauing here in NYC for our institution - we have three hospitals. We are holding steady around 1,500 positive patients admitted, but about 23% of those are intubated and on ventilators. That's a lot. So many medical staffers from other areas have been pulled to ICUs and makeshift units. It's basically all hands on deck right now, but we are hopeful that the admissions stay flat for a bit. Deaths are still increasing however - up to 779 in NY state reported today. It seems like the shelter in place is working, so hopefully people won't see encouraging numbers and then change their behavior. I think we will see the hotspot attention shifting away from NYC, and the South will really start to peak in the next couple of weeks.

Nice one, Archie! And welcome to the IU family, Logan! Think we all needed some good news!

Thanks, Mile. Didn't want to annoy people.

A couple updates from Brooklyn (if these are irrelevant to people, please let me know and I'll zip it, but everyone I know is always asking about things here, so I thought I would share.) First a good update: every night at 7pm, people have been coming out to the terraces and balconies to clap, yell, and make noise for about 3-5 minutes as a thank you to medical personnel. Our outdoor space is sacred and it's neat to see (and hear) so many people from our terrace making noise together. Now, a bad update: we live within walking distance of an ultra-orthodox Jewish population. Many people in that neighborhood are still having large gatherings and religious events. The top photo in the link below is from a funeral Sunday night (the funeral was for someone who died of COVID-19). It's kind of terrifying that people are still gathering like this and it's not going to end well. Hasidic Funeral Crowds in Brooklyn Neighborhoods

Yep, we are all trying to figure out this new paradigm. Heck, I think scientists are struggling with this one.

There are tons of clinical trials ongoing right now for drugs and treatments and a bunch for this drug. It looks like a clinical trial in Sweden was halted early by the DSMB b/c of seizures and vision problems. Vision problems are a common side effect. I talked to one of our docs who just came off the ward. He's not too hopeful about chloroquine and says there are too many side effects including cardiovascular problems. He's a cardiologist and won't use it. I also don't think it's necessarily political. But I do think there are really desperate politicians searching for a silver bullet to get us out of this mess. I would love for a drug or treatment, any drug or treatment, to show promise and a quick cure/solution. I'm sure we all would. But in reality, I think it will probably be a menu of hard choices and difficult personal choices over many months until we come out of this.

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.

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.

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. 😛