Latest Coronavirus - Yikes

[davethevol]

Hadassah doctors crack the cause of fatal corona blood clots

 

[FLVOL_79]

Universal Masking in Hospitals in the Covid-19 Era
List of authors.

• Michael Klompas, M.D., M.P.H.,
• Charles A. Morris, M.D., M.P.H.,
• Julia Sinclair, M.B.A.,
• Madelyn Pearson, D.N.P., R.N.,
• and Erica S. Shenoy, M.D., Ph.D.

https://www.nejm.org/doi/full/10.1056/NEJMp2006372

- We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic.

- What is clear, however, is that universal masking alone is not a panacea. A mask will not protect providers caring for a patient with active Covid-19 if it’s not accompanied by meticulous hand hygiene, eye protection, gloves, and a gown. A mask alone will not prevent health care workers with early Covid-19 from contaminating their hands and spreading the virus to patients and colleagues. Focusing on universal masking alone may, paradoxically, lead to more transmission of Covid-19 if it diverts attention from implementing more fundamental infection-control measures.

- It is also clear that masks serve symbolic roles. Masks are not only tools, they are also talismans that may help increase health care workers’ perceived sense of safety, well-being, and trust in their hospitals.

 

[McDad]

There is no pure isolation of that community. We are seeing a legitimate rise in both infections and hospitalizations in about 15 hotspots. There will be deaths to go along.

While it’s important to contextualize all of this against where we have been to assess risk - I think it’s also important (and I say this as a warning to myself because I’ve had this tendency) not to trivialize the situation because it isn’t as bad as where we’ve been. With a virus, the trend is your friend (or enemy) and it’s going absolutely the wrong way in some places. I hate it for those areas because if measures don’t reverse it, they’ll feel it.

It should be slower because none of these places are as dense as the cities in the northeast. The most at risk know it now and are taking additional precautions. But that doesn’t mean there’s nothing to worry about in these areas.

At this point I would put myself in the increasingly watchful eye camp for these communities.

Are you correlating increase hospitalizations in the 15 hotspots with the younger demographic or with the older who they may have transmitted the virus? Or, is that info quantified?

 

[0nelilreb]

Hadassah doctors crack the cause of fatal corona blood clots

That’s an amazing breakthrough .

 

[McDad]

Universal Masking in Hospitals in the Covid-19 Era
List of authors.

• Michael Klompas, M.D., M.P.H.,
• Charles A. Morris, M.D., M.P.H.,
• Julia Sinclair, M.B.A.,
• Madelyn Pearson, D.N.P., R.N.,
• and Erica S. Shenoy, M.D., Ph.D.

https://www.nejm.org/doi/full/10.1056/NEJMp2006372

- We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic.

- What is clear, however, is that universal masking alone is not a panacea. A mask will not protect providers caring for a patient with active Covid-19 if it’s not accompanied by meticulous hand hygiene, eye protection, gloves, and a gown. A mask alone will not prevent health care workers with early Covid-19 from contaminating their hands and spreading the virus to patients and colleagues. Focusing on universal masking alone may, paradoxically, lead to more transmission of Covid-19 if it diverts attention from implementing more fundamental infection-control measures.

- It is also clear that masks serve symbolic roles. Masks are not only tools, they are also talismans that may help increase health care workers’ perceived sense of safety, well-being, and trust in their hospitals.

This is interesting. I wonder if other qualified observers will conclude same.

 

[NurseGoodVol]

Hadassah doctors crack the cause of fatal corona blood clots

Anther old drug to the rescue. Colchacine is decades old.

 

[0nelilreb]

Universal Masking in Hospitals in the Covid-19 Era
List of authors.

• Michael Klompas, M.D., M.P.H.,
• Charles A. Morris, M.D., M.P.H.,
• Julia Sinclair, M.B.A.,
• Madelyn Pearson, D.N.P., R.N.,
• and Erica S. Shenoy, M.D., Ph.D.

https://www.nejm.org/doi/full/10.1056/NEJMp2006372

- We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic.

- What is clear, however, is that universal masking alone is not a panacea. A mask will not protect providers caring for a patient with active Covid-19 if it’s not accompanied by meticulous hand hygiene, eye protection, gloves, and a gown. A mask alone will not prevent health care workers with early Covid-19 from contaminating their hands and spreading the virus to patients and colleagues. Focusing on universal masking alone may, paradoxically, lead to more transmission of Covid-19 if it diverts attention from implementing more fundamental infection-control measures.

- It is also clear that masks serve symbolic roles. Masks are not only tools, they are also talismans that may help increase health care workers’ perceived sense of safety, well-being, and trust in their hospitals.

Very interesting indeed

 

[Purple Tiger]

Just destroyed some people.

Except for the fact that hospitalizations have increased by 10,000 since the beginning of June.

 

[newarkvol]

Well for one your clown news station CNN that only reports negativity about the right is backtracking and claiming hydroxychloroquine May have saved lives. Look I’m not a trump supporter, not by any means but at the end of the day we all want the same goal, eliminate this virus and it’s deaths. Well most of us, it seems several of you would rather have millions die at the expense of making trump look worse.

From trusted source:

Thee definitive randomized, standard-of-care-controlled, blinded study (the UK's Recovery Trial) has already been performed on HCQ and it showed the drug has no medical benefit, including no reduction in mortality in hospitalized patients. The Detroit study is another uncontrolled, retrospective observational study in hospitalized patients, which by definition, has far less ability to determine safety and efficacy.

https://www.recoverytrial.net/files/hcq-recovery-statement-050620-final-002.pdf

Moreover, most of the other retrospective studies showed no benefit (links from two of the best, from JAMA and the NEJM are also linked below), but some did, like this one, which is not unusual when there's no clinical benefit, i.e., retrospective studies will often show conflicting results when there's no benefit, due to simple lack of control of patients and variability of outcomes.
In addition, just looking at this study, one large red flag is that the control group (no HCQ) had a mean age of 68 while the HCQ group had a mean age of 63 and we know age difference (even 5 years) can be significant in patient outcomes.

Finally, the biggest indication that HCQ wasn't a gamechanger or even likely effective at all was the simple math that 60-85% of hospitalized NYC patients (and reportedly elsewhere in the US/Europe) were being treated with HCQ (as per the JAMA/NEJoM studies with thousands of patients) upon admission or soon thereafter and from 4/1 to 5/1, when the NYC and US case fatality rates roughly doubled - surely if HCQ were a gamechanger or even mildly effective there would've been some clear positive signal in the mortality data. But there wasn't.

https://www.nejm.org/doi/full/10.1056/NEJMoa2012410

Treatment With Hydroxychloroquine or Azithromycin and In-Hospital Mortality in Patients With COVID-19

 

[McDad]

From trusted source:

Thee definitive randomized, standard-of-care-controlled, blinded study (the UK's Recovery Trial) has already been performed on HCQ and it showed the drug has no medical benefit, including no reduction in mortality in hospitalized patients. The Detroit study is another uncontrolled, retrospective observational study in hospitalized patients, which by definition, has far less ability to determine safety and efficacy.

https://www.recoverytrial.net/files/hcq-recovery-statement-050620-final-002.pdf

Moreover, most of the other retrospective studies showed no benefit (links from two of the best, from JAMA and the NEJM are also linked below), but some did, like this one, which is not unusual when there's no clinical benefit, i.e., retrospective studies will often show conflicting results when there's no benefit, due to simple lack of control of patients and variability of outcomes.
In addition, just looking at this study, one large red flag is that the control group (no HCQ) had a mean age of 68 while the HCQ group had a mean age of 63 and we know age difference (even 5 years) can be significant in patient outcomes.

Finally, the biggest indication that HCQ wasn't a gamechanger or even likely effective at all was the simple math that 60-85% of hospitalized NYC patients (and reportedly elsewhere in the US/Europe) were being treated with HCQ (as per the JAMA/NEJoM studies with thousands of patients) upon admission or soon thereafter and from 4/1 to 5/1, when the NYC and US case fatality rates roughly doubled - surely if HCQ were a gamechanger or even mildly effective there would've been some clear positive signal in the mortality data. But there wasn't.

https://www.nejm.org/doi/full/10.1056/NEJMoa2012410

Treatment With Hydroxychloroquine or Azithromycin and In-Hospital Mortality in Patients With COVID-19

One "study" shows one thing. One study shows the opposite. So each group gets to quote their viewpoint. Fun.

 

[FLVOL_79]

Florida's got the best people. Really, Trump should just make Florida upbringing and/or residency a requirement for all his appointments.

The old dude is so drunk he can barely stand.....

 

[newarkvol]

One "study" shows one thing. One study shows the opposite. So each group gets to quote their viewpoint. Fun.

Please see bold in previous post--
The major advantage of Randomized Controlled Trial over an Observational Study is the ability to demonstrate causality i.e., cause-effect relationship.

Causal Hierarchy: Epidemiologists evaluate evidence to determine whether an exposure is directly responsible for an outcome. Studies follow a hierarchy in terms of the quality of evidence that they can provide. Strongest study is the “Randomized Controlled Trial” (RCT).

Randomized double blind placebo control studies, the “Gold Standard” in intervention based studies

 

[VolnJC]

Except for the fact that hospitalizations have increased by 10,000 since the beginning of June.

and down 25k daily from April

 

[GoBigOrangeUT]

Trump official claims China ‘deliberately’ sent coronavirus to US as cases soar across country

 

[TennTradition]

Are you correlating increase hospitalizations in the 15 hotspots with the younger demographic or with the older who they may have transmitted the virus? Or, is that info quantified?

If it’s quantified, I haven’t seen it. The fact that deaths still haven’t taken a noticeable and sustained kick up outside of Arizona (which although steadily increasing is still in control) I figure that you are still seeing a largely younger infected population. I’d love to be wrong - but I don’t think that the at risk population will isolate (or be isolated) enough to avoid infections, hospitalizations, and deaths in that community as infections rise in the general community. Slow burn can be managed but it isn’t a guarantee. That’s why I say watchful eye.

 

[volfanhill]

Neat idea

Walmart to turn 160 parking lots into drive-in movie theaters in August

 

[GoBigOrangeUT]

Neat idea

Walmart to turn 160 parking lots into drive-in movie theaters in August

Sweet. Can’t wait to be digging in to watch a movie and eating my popcorn only to be approached by a meth addict asking me if I have any money.

 

[508mikey]

 

[evillawyer]

How long do you reckon those take to get halfway across the world by cargo ship? Now, check to see how long the coronavirus can remain contagious outside of a host. Lemme know which one is longer.

 

[evillawyer]

Desantis just running up the score now. Maybe someone should tell him coronavirus is more like golf, where the lowest score wins.

 

[SmokyRiverDog]

There is no pure isolation of that community. We are seeing a legitimate rise in both infections and hospitalizations in about 15 hotspots. There will be deaths to go along.

While it’s important to contextualize all of this against where we have been to assess risk - I think it’s also important (and I say this as a warning to myself because I’ve had this tendency) not to trivialize the situation because it isn’t as bad as where we’ve been. With a virus, the trend is your friend (or enemy) and it’s going absolutely the wrong way in some places. I hate it for those areas because if measures don’t reverse it, they’ll feel it.

It should be slower because none of these places are as dense as the cities in the northeast. The most at risk know it now and are taking additional precautions. But that doesn’t mean there’s nothing to worry about in these areas.

At this point I would put myself in the increasingly watchful eye camp for these communities.

I am curious how you guarantee a rising death toll when the age of infected has decreased massively and the areas affected are not eradicating their nursing home residents with the virus?

 

[StarRaider]

oh boy my mask looks exactly like those.

 

[Franklin Pierce]

Sex workers in Africa lack food for taking HIV drugs during coronavirus outbreak

KIGALI, Rwanda —
As the coronavirus spreads in Africa, it threatens in multiple ways those who earn their living on the streets — people such as Mignonne, a 25-year-old sex worker with HIV.

The lockdown in Rwanda has kept many of her customers away, she said, so she has less money to buy food. And when she doesn’t eat, the antiviral drugs she takes for HIV can bring on pain, weakness and nausea, or even make her pass out.

“Yet it’s equally dangerous when you don’t take the drug,” Mignonne said in an interview. “You will die.”

Similar challenges exist elsewhere in Africa, which has the world’s highest burden of HIV.

Studies have shown that food insecurity is a barrier to taking the drugs daily and can decrease their efficacy, affecting not only sex workers but anyone who lives where food — or the money to buy it — is scarce.

Among sex workers in Zimbabwe’s capital, Harare, “most who are living hand-to-mouth have been lamenting that it’s making it difficult to adhere to treatment,” said Talent Jumo, director of the Katswe Sistahood, an organization for sexual and reproductive health.

That’s a danger as many sex workers around the world are excluded from countries’ social protection programs during the COVID-19 pandemic, researchers from the London School of Hygiene & Tropical Medicine and elsewhere wrote in a new commentary for the Lancet.

Sex workers in Africa lack food for taking HIV drugs during coronavirus outbreak

 

[allvol123]

Desantis just running up the score now. Maybe someone should tell him coronavirus is more like golf, where the lowest score wins.

You might be the only person rooting for deaths in FL, harder than Cuomo. Cause if they dont start piling up in FL asap, it's going to look worse than it already did in NY.

 

[0nelilreb]

How long do you reckon those take to get halfway across the world by cargo ship? Now, check to see how long the coronavirus can remain contagious outside of a host. Lemme know which one is longer.

it’s not that it has the Rona on it , it’s the fact that you will be breathing in and putting your face in these masks after they have been rolled up on that nice clean floor by those nice clean people that I’m sure never sweat , stand or drip on them . Why don’t you just find you a truck stop and start rolling around in the floor .