Coronavirus (No politics)

[AM64]

I noticed the little dude - Dr. Fauci - wasn’t there today either. Perhaps the Pres did not need him pooh-poohing the early use of the malaria drug anymore right now.

You've got to know when to hold 'em
Know when to fold 'em

Apparently the little guy isn't a gambler at all. When your back is against the wall and something has been working elsewhere, then it's time to give it a try instead of playing bureaucratic games. I know if doing nothing meant a bad outcome for me, I'd sure gamble on something promising.

 

[AM64]

Word. IMPEDIMENT.

I caught part of the press conference; it looked like they were trying a different approach. Instead of talking about spread, what they believe will happen, what they believe is needed, etc this seemed to be all about what they are actually doing and how it's being handled. Probably what should have been going on all along, but the earlier stuff was more about educating people and trying to get people to be compliant and understanding of what was necessary to slow the spread down.

 

[AM64]

I doubt Donald Trump just came up with the name of random drug to fight against the Coronavirus considering it is used to treat Malaria which is nearly unheard of in the climate of the US with the exception of a few areas. I would say it was brought up by several doctors in meetings as a possible treatment and he ran with it.

There is a very small French study presented here:

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an openlabel non-randomized clinical trial

As kiddiedoc says Hydroxychloquine isn't without risk, but then you won't find many drugs on the market today without a similar laundry list of warnings. If something shows promise, you don't have anything better, and the alternative isn't looking promising, then why not? Just make sure you document use so that the results (positive or negative) and how applied are known for continued application or modification. Spur of the moment life saving measures on the battlefield and in field hospitals have lead to medical advancements, too.

 

[Vol Main]

Exactly. Thank You. Man these people in here are giving me a headache. Common sense is a thing of the past.

That is easy for you to say.

 

[Coug]

Are they? We are camping in Townsend and were wondering if it's "business as usual" over there. We did drive the CC loop yesterday, in the least time I can ever recall.

GSMNP picnic and campgrounds are now closed. They will stay closed until April 30th.

 

[feathersax]

Nothing from that man's mouth can be accepted as true. He lies about almost everything.

Such as?

 

[UT_Dutchman]

Yes you have to be careful and not step out of line, though there is definitely a double standard on what some can post versus what others can post.

 

[vollygirl]

I am just glad that peoples' attitudes like yours "then" were not responsible for covid-19 blowing up across the country. Oh wait

You are way WAY off base on this one. You don't know this woman at all.

 

[GAVol]

You are way WAY off base on this one. You don't know this woman at all.

Seriously... we went through this in the Politics thread too. There’s no point going back to January and calling somebody out for an opinion based on something that looked like a regional illness like SARS or Ebola.

 

[Orange_Vol1321]

 

[Orange_Vol1321]

Mother of Vonore child with COVID-19 wants you to take it seriously

 

[mrmax86]

Alex had a confirmed case of COVID-19.

Since then, Hyde said the community has gathered around her family, leaving gifts on their front step and words of support on social media.

"We've had a lot of people offer to bring stuff. We've actually had people offer to drop stuff on our porch for us. He's doing better," she said.

The family has been in constant contact with the Tennessee Department of Health since Alex's diagnosis.[/SIZE][/FONT]

Hyde said four of the five people in her home have run a fever the past few days and had a cough. They were told it was not necessary for them all to get tested because of a shortage in the number of tests available.

The family will remain in quarantine until April 1, but that quarantine could be longer if Alex continues exhibiting symptoms.

This is why the numbers are spiking. Family members caring for those who got the virus already. As long as they follow the rules, it should not spread outside that household.

 

[VolnJC]

100k that had the virus now recovered..28% 234k worldwide active cases

 

[tbh]

You too, It's rough in Clarke county from what I've read.

At this point the brunt of the impact here is being felt by the restaurants, bars, shops, etc...I've left my apartment complex once in the past 10 days or so, so I don't have much of a view of how things are around town. We're under a 'voluntary' 24hr shelter in place order that runs through April 7, but communications from the office have me thinking it will be the new normal through May, at best.

Y'all stay safe and healthy!

 

[Orange_Vol1321]

Sorry, wrong forumn.

 

[bigdaddy]

I work in direct patient care and I took a 50% salary cut for the foreseeable future. If this goes on longer than 4 weeks. I’m looking at being unemployed.

 

[Orange_Vol1321]

I tell you what, big boy: go back to school, get your license, and start ponying up for your required multi-million dollar malpractice policy before you start preaching at me. I'm in the middle of a $@#* storm right now, and I've done nothing but try to bring as much information and civil discussion to this topic as I can.

Hydroxychloquine and several other therapies are being rapidly investigated, allowed for compassionate use, and pushed for approval at an unprecedented rate. I am, in no way, involved in the trials or their approval, so perhaps your frustration is misplaced?

In addition, the following are known adverse effects of the medication in question. You can Google them and decide for yourself how severe they are.

*******

Serious Reactions

• agranulocytosis
• thrombocytopenia
• aplastic anemia
• leukopenia
• seizures
• angioedema
• bronchospasm
• exfoliative dermatitis
• Stevens-Johnson syndrome
• drug rxn w/ eosinophilia and systemic sx
• toxic epidermal necrolysis
• psoriasis exacerbation
• porphyria exacerbation
• retinal damage (high dose or long-term use)
• retinopathy (high dose or long-term use)
• macular degeneration (high dose or long-term use)
• myopathy
• fulminant hepatic failure
• cardiomyopathy
• QT prolongation
• torsades de pointes
• suicidality
• hypoglycemia

Common Reactions

• dizziness
• ataxia
• headache
• abdominal pain
• nausea
• vomiting
• diarrhea
• pruritus
• weight loss
• hair bleaching
• photosensitivity
• tinnitus
• vision changes

I'll chime in on this again. My mom, sister, and aunt has been taking 200mg of this drug, twice a day, for at least 5 years for lupus and joint pain. They couldn't live without it. They said no side effects listed bother them at all. And lets be honest, if you Googled any med for a list of side effects some Dr prescribed you then you would probably never take it. It's all there to cover the drug makers tail.

 

[VolnJC]

I'll chime in on this again. My mom, sister, and aunt has been taking 200mg of this drug, twice a day, for at least 5 years for lupus and joint pain. They couldn't live without it. They said no side effects listed bother them at all. And lets be honest, if you Googled any med for a list of side effects some Dr prescribed you then you would probably never take it. It's all there to cover the drug makers tail.

My Dr used to accuse me when I would talk about getting a possible side effect of reading the prescribing leaflets that come with the bottles... I'm like I teach pharmacology I have to read those lol

 

[ABINGDON VOL FAN]

well add the ones that would have died anyway and you get ?

999

 

[Orange_Vol1321]

My Dr used to accuse me when I would talk about getting a possible side effect of reading the prescribing leaflets that come with the bottles... I'm like I teach pharmacology I have to read those lol

Lol. Well I know they have no problem with it. Does it work on this virus? Who knows. Guess it's worth a try.

 

[xavierbballfan]

I'll chime in on this again. My mom, sister, and aunt has been taking 200mg of this drug, twice a day, for at least 5 years for lupus and joint pain. They couldn't live without it. They said no side effects listed bother them at all. And lets be honest, if you Googled any med for a list of side effects some Dr prescribed you then you would probably never take it. It's all there to cover the drug makers tail.

So that would be what is called anecdotal evidence. Which means it hasn't caused a problem in a limited number of people without comparing it to anyone else. It is great that Hydroxychloroquine may be effective in treating Covid. It's great that the drug has been around previously so we know that patients can tolerate it.

However, just because "they said no side effects listed bother them at all" as if it is a justification that it is safe for everyone is rubbish. Plaquenil would not be what I would call a "safe" medication. It has very real risks albeit in the setting of long term use of macular degradation (see blindness, rarely) for which many patients are routinely monitored by an ophthalmologist with routine special testing. I think the bigger concern acutely would be in patients having the cardiac arrhythmia I previously mentioned and it would probably be prudent to monitor most patients with serial EKGs to watch their QT interval and thereby try to identify higher risk patients and discontinue their therapy if necessary. I fully admit that this is all uncharted territory in many ways but scientific evidence is the foundation of medicine and the only reason we aren't constantly plagued by the legions of infectious disease that our ancestors were forced to accept. If we abandon it now to appease fear, it will not lead to better outcomes.

All that is to say that the practical considerations involved in implementing new treatments are much less straightforward than "Trump says it works and the bureaucrats are in the way." In a case by case basis we are certainly at the point where individual providers and patients can enter into shared decision making regarding whether to utilize the treatment or not. In patients with more severe disease and lower chances of survival it's also likely a reasonable option. I fully support a provider using the medication on that basis and there is no impediment to that at this time that I am aware of. The FDA is not simply signing off on the medication because that adds no value in this situation. The medication can already be used by providers "off label"! But, there is not good evidence behind it and a rubber stamp from the FDA will not change that.

In "normal life" different providers have different requirements for evidence (studies) and guidelines before directing new care for their patients. The FDA is very often far behind on these issues because their job is to primarily assess safety. That does not stop people from utilizing treatments when there is good data (insurance coverage often does, as an aside). Physicians will use their "common sense" as everyone is fond of saying which they will balance between the data available and each individual patient they see. The only reason it's being pushed as "an issue" so heavily in press conferences, in my opinion, is because the administration can set up a scenario where it is ostensibly fighting to get people treatment that science and medicine is "afraid" to provide. Somehow clearing the way for the magic bullet treatment. Meanwhile, they neither discovered the medication nor made it more accessible. All the practical public health benefits that should have been provided (masks, testing) were not done and it's an attempt to rewrite history to put them in a positive light that they frankly do not deserve. Providers can use this already when they deem it appropriate. It is inappropriate to endorse it on a national level tantamount to "a cure" because the data doesn't support it and the risks are unknown. Just like we all want Tennessee to win the NC for the next 10 years, unfortunately, we can't just proclaim it preseason and hoist the trophy. You have to prove it on the field.

To be clear, I believe the medication has promise. However as a cure all that everyone should stockpile, take daily, or utilize for mild cases likely to recover on their own, the benefits begin to be more questionable with the risks. If your 18 year old daughter without co-morbidities is diagnosed with Covid 19 but feeling well and asymptomatic should she get the drug? I would argue that given the extremely limited evidence, no she is not a good candidate.

More specific to Covid, if the very small trial is wrong and it actually does more harm than good then we could potentially be hurting patients by giving them the drug. There has been some postulation that many of the severe cases are related to acute respiratory distress in the setting of a "cytokine storm" which is an autoimmune reaction. If this is the case, will utilizing an antibiotic like Azithromycin (in the same French study with increased efficacy in combination with Hydroxychloroquine) expose the body to more "foreign stuff" when it breaks down bacteria and increase the immune response that is already in overdrive? That's just a hypothesis that could sound good but may be complete garbage. The point is we don't know until we look at studies. I believe and am hopeful that the studies will pan out. Don't put the cart before the horse, though. And please don't disparage the people who are out there in the field trying to make these difficult decisions with real people, not statistics who know the potential burden of a misstep. The people working now are doing it because they care and because they believe in their responsibility. No provider is trying to deny treatments that can be beneficial, there is a burden to temper hope with reason.

 

[Orange_Vol1321]

Florida man with coronavirus says drug touted by Trump saved his life

 

[vollygirl]

I'll chime in on this again. My mom, sister, and aunt has been taking 200mg of this drug, twice a day, for at least 5 years for lupus and joint pain. They couldn't live without it. They said no side effects listed bother them at all. And lets be honest, if you Googled any med for a list of side effects some Dr prescribed you then you would probably never take it. It's all there to cover the drug makers tail.

My mom was on 11 different kinds of chemo in the six years she fought ovarian cancer, and everytime she got a new prescription for something, we joked about which side effects she would have. Cause she was like a walking ad for side effects. I don't say this to be funny. It was horrible. It is absolutely something you have to be ready for.

 

[xavierbballfan]

Florida man with coronavirus says drug touted by Trump saved his life

Sounds like a completely reasonable patient to use the medication in.

 

[vollygirl]

I think we can all agree we want nothing more than something that can wipe this thing out and get things back to normal.

But it just isn't going to be that easy.