Covid-19

[noteggs]

Haha damnit, sorry I was trying to simplify it as much as I could, it's easier if I have a piece of paper and can draw things out, helps me organize my thoughts. I'm completely with you in understanding that if you have a serious illness that you'd want anything. Strangely from what I've read in the journals, it seems mild/moderate cases treated with HCQ + Azithro are more beneficial than severe cases. I actually absolutely despise that people are prescribing it for themselves and their families, because HCQ is used in a large amount of patients with autoimmune diseases, it's poor practice for a dentist or ophthalmologist to prescribe 300 pills for himself and entire family. I know that they're still giving them as "possible treatments" to patients that are in the hospital, in that setting I think it's fine since you can be monitored, have correct dosing, etc. I'm not a big fan of the preventative prescriptions where people don't know the proper dosing, etc. That's how you end up drinking fish tank cleaner and killing yourself.

If beneficial, I heard one of the concerns is we don’t really know the correct dose for the Coronavirus. As you know, there is a somewhat broad range in HCQ dosing for various disease states.

One improvement the FDA has made over years is with drug PI’s. With that said, HCQ is so old and phase 3 trials were designed completely different. However we have a ton of Pharmacovigilance data to look at safety. As you rightfully mentioned in another post QT(c) prolongation is a major concern. From what I have read, when used for current indications the probability has been a rare occurrence with prior ECG’s.

However, a slightly bigger concern for me is limited controlled studies on patients older than 65. As you’re aware, age increases the QT risks along with other factors. Truly like the promise though, but as I mentioned in a earlier post, whatever we decide to do in this situation it’ll bring an interesting case study going forward.

[Juice]

How about some education before we throw out the baby with the bathwater or crucify someone for making the best public interest decisions possible.

I’ve worked with models a lot in my work; here’s how modeling works:

1. Available data are compiled and evaluated
2. Related factors are established based on the data (e.g., Ro, fatality rate, etc.)
3. Other variables affecting the future changes are estimated, like the impact of social distancing
4. The model is run, and results compared to actual data
5. Factors and variables are adjusted to calibrate to the historical data
6. The model is run for future predictions.
7. After time passes, newly available data is used to refine and re-run the model
8. Repeat 7. as appropriate.

In the case of COVID-19 data, there was little historical data due to the novelty of the virus, and what was available was questionable. So the initial models were weak. That doesn’t mean they were worthless. To make an analogy, it’s like driving through a rainstorm with bad wiper blades. It’s hard to see, so be very cautious, but don’t stop looking out the window!

Acton and DeWine relied on that data - the best available at the time - to make decisions in the best interest of Ohioans by implementing early and rigorous social distancing. Those initial models underestimated the positive impacts of social distancing measures. That’s why we now seeing numbers (cases, deaths) much lower than the original model predictions, and why the newly updated models are forecasting lower numbers. You can look State-by-State and see the more rigorous the social distancing, the greater deviation from the original model (like in Ohio).

For those second guessing the social distancing measures, it’s like taking Tamiflu when the flu is coming on, not getting the flu, then claiming the Tamiflu wasn’t necessary! Keep in mind the sole purpose of social distancing is to prevent the number of cases from exceeding the capacity of the medical system. Doing this greatly lowers deaths due to COVID-19, and collateral deaths related to inability to treat other medical conditions. The actions of DeWine and Acton have done this. They have saved lives, and Ohio is now much closer than many other States to returning to normal.

I get what you're saying but Acton only cares about the medical/health aspects of this. She has no concern or understanding about the economic effects that will soon follow and cripple this state. She won't have to answer for that.

And I get the part about saving our medical system from a large surge but allegedly the peak was today in Ohio, and we weren't even close to the limits on hospitalizations, needed ventilators, ICU beds, etc. Either we did an awesome job of social distancing in this state or they were wayyyyy off.

[Muskie in dayton]

I get what you're saying but Acton only cares about the medical/health aspects of this. She has no concern or understanding about the economic effects that will soon follow and cripple this state. She won't have to answer for that.

And I get the part about saving our medical system from a large surge but allegedly the peak was today in Ohio, and we weren't even close to the limits on hospitalizations, needed ventilators, ICU beds, etc. Either we did an awesome job of social distancing in this state or they were wayyyyy off.

Agreed, it’s both - Ohio was extremely proactive and aggressive, and the original models way underestimated the effectiveness off social distancing.

You’re right that Acton is not accountable for the economic impacts, but DeWine is. I am confident he’ll continue to do what is best and start to ease the social distancing. Conservatively we wait a week to watch the numbers then make some strategic and closely monitored easing. If cases stay down, keep easing up. Just my opinion based on the data.

[xu82]

Laugh for the day!

My Self-Isolation Quarantine Diary:
Day 1 – I Can Do This!! Got enough food and wine to last a month!

Day 2 – Opening my 8th bottle of Wine. I fear wine supplies might not last

Day 3 – Strawberries: Some have 210 seeds, some have 235 seeds. Who Knew??

Day 4 – 8:00pm. Removed my Day Pajamas and put on my Night Pajamas.

Day 5 – Today, I tried to make Hand Sanitizer. It came out as Jello Shots!!

Day 6 – I get to take the Garbage out. I’m So excited, I can’t decide what to wear.

Day 7 – Laughing way too much at my own jokes!!

Day 8 – Went to a new restaurant called “The Kitchen”. You have to gather all the ingredients and make your own meal. I have No clue how this place is still in business.

Day 9 – I put liquor bottles in every room. Tonight, I’m getting all dressed up and going Bar hopping.

Day 10 – Struck up a conversation with a Spider today. Seems nice. He’s a Web Designer.

Day 11 – Isolation is hard. I swear my fridge just said, “What the hell do you want now?”


Day 12 – I realized why dogs get so excited about something moving outside, going for walks or car rides. I think I just barked at a squirrel.

Day 13 – If you keep a glass of wine in each hand, you can’t accidently touch your face.

Day 14 – Watched the birds fight over a worm. The Cardinals led the Blue Jays 3–1.

Day 15 – Anybody else feel like they’ve cooked dinner about 395 times this month?

[Lloyd Braun]

I found this case study interesting published by the CDC. Basically the implications of close contact with an infected individual even though that individual was not severely ill at all. A single event resulted in 16 infections and 3 deaths.

[Juice]

Agreed, it’s both - Ohio was extremely proactive and aggressive, and the original models way underestimated the effectiveness off social distancing.

You’re right that Acton is not accountable for the economic impacts, but DeWine is. I am confident he’ll continue to do what is best and start to ease the social distancing. Conservatively we wait a week to watch the numbers then make some strategic and closely monitored easing. If cases stay down, keep easing up. Just my opinion based on the data.

Weren't the original models assuming full social distancing? And let's be honest, that didn't happen. So the models assumed us being fully compliant, reality is that we weren't full compliant, and yet the models still completely overestimated the seriousness of it all.

I think this was serious but I think the measures taken (shutting down businesses, locking people in their homes, suspending civil liberties, etc.) were overly burdensome and downright unconstitutional. I think we are both at the point that we hold our certain views on this and no back and forth will change them.

[Lloyd Braun]

Realistically we won’t know what the best approach would be until this is all said and done. Going back to Sweden, they are receiving a lot of flak from neighboring countries on their lax approach. They have even stated that their approach will result in thousands of deaths. What they are banking on essentially is that come November-December if there is another surge of infections they will have better herd immunity and not be affected at that time. While I don’t agree with this approach, it will be interesting to see the end outcomes assuming they do not implement stricter policies.
Yes the economy is important, but it would be fair to say that the overestimation of economic damage may mirror the overestimation of deaths caused from the virus. The truth lies somewhere in the middle, like most things these days.

[xavierj]

Realistically we wonÂ’t know what the best approach would be until this is all said and done. Going back to Sweden, they are receiving a lot of flak from neighboring countries on their lax approach. They have even stated that their approach will result in thousands of deaths. What they are banking on essentially is that come November-December if there is another surge of infections they will have better herd immunity and not be affected at that time. While I donÂ’t agree with this approach, it will be interesting to see the end outcomes assuming they do not implement stricter policies.
Yes the economy is important, but it would be fair to say that the overestimation of economic damage may mirror the overestimation of deaths caused from the virus. The truth lies somewhere in the middle, like most things these days.

Do you really believe that on the economic damage? Unemployment will be ridiculously high through the end of the year, if not longer. A lot of small businesses will just not reopen and I can't imagine health insurance rates won't sky rocket. The Government is giving out bailouts and states are giving people on unemployment an extra $600 per week for 39 weeks. Who is going to actually pay for all the extra money being given out for unemployment?

Big business will probably be alright in the long run, but the little guys are the ones who will get stung the most and small business is extremely important for our country. We are only three weeks into the shutdowns and if this thing continues for another month or longer, its going to be brutal.

[Lloyd Braun]

Do you really believe that on the economic damage? Unemployment will be ridiculously high through the end of the year, if not longer. A lot of small businesses will just not reopen and I can't imagine health insurance rates won't sky rocket. The Government is giving out bailouts and states are giving people on unemployment an extra $600 per week for 39 weeks. Who is going to actually pay for all the extra money being given out for unemployment?

Big business will probably be alright in the long run, but the little guys are the ones who will get stung the most and small business is extremely important for our country. We are only three weeks into the shutdowns and if this thing continues for another month or longer, its going to be brutal.

I’m not saying those things won’t happen, it will be brutal. I do however believe once the restrictions are lifted there are a lot of people that will want to spend money which should soften the blow. Things will certainly look and feel a lot different. I do not foresee a recession that lasts several years as some forecasters are projecting. And I certainly don’t trust big bank CEOs forecasting the worst. I’m not an economist with a formula for recession so I could be way off. However many economists use unemployment rates to calculate recession length, and those on furlough that will have a job when this is over are being used to calculate these numbers.

[xubrew]

I feel different about this every day.

Today, I feel like they should just infect 85 percent of us, let us develop the herd immunity, and let us get back to normal. Protect the most at risk, and let the rest of us try and tough it out. I volunteer. Inject it in me today. But PLEASE can we get this over with!

Now, tomorrow I will probably feel differently.