Lostin76

Just now, 5fouls said:

Is the trial you are referencing the one in Brazil where they gave the patients higher than recommended dosage?  Maybe, just maybe, if they had stuck within the guidelines of drug, the people would have lived.  Don't blame the drug when it's misused.

https://www.nytimes.com/2020/04/12/health/chloroquine-coronavirus-trump.html

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. 

2 minutes ago, Reacher said:

Here is an alternate viewpoint- https://www.breitbart.com/the-media/2020/04/12/fact-check-new-york-times-claims-trump-could-have-seen-what-was-coming-on-coronavirus/

Dr. Anthony Fauci cautioned Jan. 21 that while we should “take it seriously,” the virus was “not a major threat to the people of the United States, and this is not something that the citizens of the United States right now should be worried about.”

I can't fault the federal response. The implementation has been shoddy in areas. My bigger concern is seeing how various local leaders from Mayors to Governors have handled it. Banning hydroxychloroquine? 

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.

3 minutes ago, IUFLA said:

Instead of wringing our hands over this, let's act as Americans always have...come together despite our differences and defeat this thing...do any little thing you can to help. 

Give blood if you can...

Volunteer if you can...

Help your neighbors if they need it...

Support our first responders and medical professionals...

Finger pointing serves no purpose at this point, beyond the obvious political opportunism I posted about earlier...

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.

2 minutes ago, IUFLA said:

Got this from USAA...

 

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.

Quote

Then the texts stopped. I called the hospital, asking for information. I called several times the next day. A nurse or a clerk working in Dad’s unit sounded testy: “They have thirty-five critical patients, and they just can’t talk to everyone. They will call if there is a change in your dad’s care.

Texts from my Father in Elmhurst Hospital, Queens

Just now, milehiiu said:

I may have mentioned this before.  I forget. However, my neighbors have taken to take chairs out onto the street/sidewalk.  And converse across and down the street. Maintaining social distance.... while continuing social interaction.  Never seen anything like this before. 

This makes me happy. I can totally picture it.

4 minutes ago, mrflynn03 said:

Not trying to diminish this in anyway but the government overreach is out of control. Just read where Michigan is banning travel from 1 residence to another. It's basically house arrest.  Seems when 1 state gets an idea others follow.  And so many others things we are letting them do. 

2 minutes ago, Proud2BAHoosier said:

And let's not forget the high unemployment has been pretty much self-inflicted......

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."

6 minutes ago, mrflynn03 said:

Keep seeing this being called the pandemic of the century, and it being compared to the 1918 Spanish Flu.

Either willfully, or out of ignorance 

The 1957-58 Asian Flu  70-116000 US deaths

https://en.m.wikipedia.org/wiki/1957–58_influenza_pandemic

and the 1968 Hong Kong Flu ~100,000 US deaths 

https://en.m.wikipedia.org/wiki/Hong_Kong_flu

Seem to be ignored. 

Where was the mass hysteria, economic shutdown then?  I haven't read about it anywhere. 

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.

4 minutes ago, milehiiu said:

From downtown Indianapolis to a high rise in what ? Brooklyn ?  My hat's off to you. Not my life style. But more power to you. Not a condemnation. Just not for me.

Along the lines you proposed.  I can't understand why a news source, such as the Indy Star and others would block people from reading their internet sources.  After all. Aren't they here to distribute the news for us all ?  I would have no problem with them taking in advertising, to help support their sites. But to block their sites from the get go, is something I don't understand.  For me.... the result is for those that I know that block, unless you are a subscriber.... I just don't go there. 

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.

23 minutes ago, milehiiu said:

Well one thing I will say. At least the NYT allows peons like me to read their website. Unlike the Indy Star.  I was able to read your link without immediately  getting blocked. Thanks for that.

I will stand on my statement. Not just the newspapers but also the East Coast media. Rarely report what is going on in the rest of the country.  Recently we have had some extra ordinary events happening in Colorado. Nothing. And have yet to hear about the recent tornadoes in Indiana reported by Mr. Flynn and others .

Not directed at you.  You already know you are on my most favored HSN member list.  Just not happy with the East Coast bias from the media.

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!

2 minutes ago, 5fouls said:

On this point, while the U.S. may have the highest total number of deaths, we will not approach the deaths as a percentage of population that we are seeing in Europe.  Not even close.  Righ now, Spain's is close to 7 times that of the U.S., Italy 6 times, France 3 times, etc.

And then you factor in highly populated countries where the number of deaths being reported are most assuredly not accurate, like China and Russia, and it's unfair to compare the U.S. to them.

I'm not saying out response was what it should have been, but I think in the overall grand scheme of things, if you look beyond the raw numbers like number of cases and number of deaths, and I think the U.S. has done better than most other industrialized countries.

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.

2 minutes ago, 5fouls said:

It was.  But, what I'm saying is the numbers are trending much better out there now.   

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.

18 minutes ago, milehiiu said:

And neither know that there is another part of the country. If it isn't happening in NYC or Washington D.C..... it isn't happening.

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.

Quote

Fire Department data shows that 1,125 patients were pronounced dead in their homes or on the street in the first five days of April, more than eight times the 131 deaths recorded during the same period last year.

Paramedics are not testing those they pronounce dead for the virus, so it is almost impossible to say how many of the people were infected with it. Some may have been tested before they died and either were not admitted to hospitals or were discharged.

But the huge jump in the numbers suggests that the virus was involved in many of the recent deaths.

“The driver of this huge uptick in deaths at home is Covid-19,” Mayor Bill de Blasio said on Thursday. “And some people are dying directly of it, and some people are dying indirectly of it, but it is the tragic ‘X’ factor here.”

Nearly 120 morgue workers and soldiers are working around the clock to retrieve the bodies of up to 280 people a day who are dying at home in New York City, many of them probably having succumbed to the coronavirus without being counted in the official death toll.

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!

13 minutes ago, milehiiu said:

Don't stop.  You are in the epicenter of this thing.  Personally appreciate all you share with us. 

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

27 minutes ago, Drroogh said:

And you said I was the expert? Face it, at this point nobody is an expert! Anybody that comes off like everybody else is wrong, like the press or politicians is the biggest idiot of them all!!

There is the old story of a meeting about product failures. I believe it was Coleman but I could be wrong, very wrong! Anyway, supposedly the meeting had digressed to finger pointing and the CYA! Finally the CEO stood up and walked to the door and stopped. He turned back around and said unless you all start trying to figure out how to solve the problem you are all fired and walked out the door!

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

6 minutes ago, tdhoosier said:

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 theres 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 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. 

 

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.

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.

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.

33 minutes ago, Drroogh said:

Lostin, I don’t disagree with you! But you and I having experience with the FDA we need to realize it is no where near that simple! I used to be a certified ISO13485 auditor!  Rapid change in the medical device and pharmaceuticals is not a good idea!! Streamlining the approval system is much needed!

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. 😛