COVID-19 | science, damage limitation, NO POLITICS

[Alan Klein]

Alan apparently wants a number from the CDC -- like, you know, 42,136 flu deaths. He won't get it. But the estimates are based on reasonable assessments of deaths, generally what are called "excess deaths" above the expected death rate minus what ever epidemic is being experienced. The Covid-19 deaths are "confirmed" in one way or another, and the "excess death rates" in the US have been reported for several different states and then reported in the newspapers (like the NY Times.) The excess death rates in the US areas sampled during the Covid-19 epidemic are generally in excess of the reported rate although in some states, (Montana is one, if I remember correctly) the low number of Covid-19 cases, combined with a lockdown that limited alcohol and driving, produced a death rate lower than expected.

Edit: here's one such story from WAPO.

https://www.washingtonpost.com/graphics/2020/investigations/coronavirus-excess-deaths-may/

Are you referring to me?  I never said that. Apparently? Why are you making things up?

[Alan Klein]

Well, this is one problem it appears I don't have to worry about.

Popular blood pressure medicines do not put patients at greater COVID-19 risk, new study finds
https://news.yahoo.com/popular-blood-pressure-medicines-not-233005710.html

[faberryman]

Well, this is one problem it appears I don't have to worry about.

Popular blood pressure medicines do not put patients at greater COVID-19 risk, new study finds
https://news.yahoo.com/popular-blood-pressure-medicines-not-233005710.html

Why do you trust these experts? The scientific article has not even been peer reviewed.

[LesPalenik]

Well, this is one problem it appears I don't have to worry about.

Popular blood pressure medicines do not put patients at greater COVID-19 risk, new study finds
https://news.yahoo.com/popular-blood-pressure-medicines-not-233005710.html

Next week, another study will be released disputing this one.

[armand]

Next week, another study will be released disputing this one.

So far all the data supports this, so no, it's unlikely that next week there will be one with opposite findings.
The so called "contradictions" came from early theoretical scenarios that were not confirmed with data.

[Alan Goldhammer]

Well, this is one problem it appears I don't have to worry about.

Popular blood pressure medicines do not put patients at greater COVID-19 risk, new study finds
https://news.yahoo.com/popular-blood-pressure-medicines-not-233005710.html

the group that did that research was started by my colleagues and I at PhRMA back in 2005-06.  I was the project manager for it and made the presentation to the PhRMA Board for the first $20 million to get it started.  To that point, I hadn't even asked my father for $500.  The group morphed into what it is today, The Observational Health Data Sciences and Informatics (or OHDSI, pronounced "Odyssey") program is a multi-stakeholder, interdisciplinary collaborative to bring out the value of health data through large-scale analytics.

I still stay somewhat involved with them and it was the single best accomplishment of my working career.

[Alan Klein]

Well, I hope they're right.

[Manoli]

Human trials will begin this week of a candidate Covid-19 vaccine that could protect the British population from the disease for about £3 per person

https://www.thetimes.co.uk/edition/news/human-trials-for-3-jab-expected-to-start-this-week-69xwqvzmk

Researchers at Imperial College London are seeking to harness a potentially powerful, but as yet unproven, technology. It could allow vast numbers of doses to be produced rapidly, using equipment bought off the shelf.

If it works, the team has pledged to make the jab available at the lowest possible cost in Britain and the developing world. It would be licensed to outside manufacturers via a so-called social-enterprise company called VacEquity Global Health (VGH), which would waive royalty payments. VGH is being supported by Imperial and by Morningside Ventures, an investment company run by the billionaire Chan family of Hong Kong.

The vaccine consists of about a thousandth of a thousandth of a gram of genetic material known as RNA, which would be injected into muscle tissue.

A litre could contain enough for 200 million people, Robin Shattock, a professor of mucosal infection and immunity at Imperial and the project leader, said. “It really is a tiny dose,” he said. “That’s very good from a safety point of view but also in terms of production — it makes it much easier to scale up.”

[faberryman]

FDA ends emergency use of hydroxychloroquine for coronavirus:

https://www.politico.com/news/2020/06/15/fda-ends-emergency-use-of-hydroxychloroquine-319872

[Alan Goldhammer]

FDA ends emergency use of hydroxychloroquine for coronavirus:

https://www.politico.com/news/2020/06/15/fda-ends-emergency-use-of-hydroxychloroquine-319872

This is meaningless as HCQ is an approved drug and doctors may prescribe it if they believe it will help their patients.  Quite frankly, FDA should never have given the emergency use exemption in the first palce since it was a largely symbolic political decision without any scientific justification.  It reflected poorly on the Agency.

[Alan Klein]

This is meaningless as HCQ is an approved drug and doctors may prescribe it if they believe it will help their patients.  Quite frankly, FDA should never have given the emergency use exemption in the first palce since it was a largely symbolic political decision without any scientific justification.  It reflected poorly on the Agency.

The FDA has many times allowed unapproved drugs to be used because of political pressure from the people even though there's no or little scientific justification to use these drugs.  Patients argue that it's their choice.  They shouldn't be prevented from using these drugs on the outside chance it may help them especially drugs that have had little baleful effects for decades.  So the FDA bowed to the pressure in those cases as well.  In this case it was the president who made the case as a citizen and the president.  It wasn't as if he didn't treat himself.  He put himself on the firing line and used it.  Also, CDC and the FDA are in the Executive Branch and report to the President who responds to the people who vote for him.  While I agree most of their work should be relatively independent, in the end they too report to the people just as all the other organs of government.

[Alan Klein]

N.J. coronavirus reopening Stage 2 starts today. Here are all the details and restrictions.
https://www.nj.com/coronavirus/2020/06/nj-coronavirus-reopening-stage-2-starts-today-here-are-all-details-and-restrictions.html

[Alan Goldhammer]

The FDA has many times allowed unapproved drugs to be used because of political pressure from the people even though there's no or little scientific justification to use these drugs.  Patients argue that it's their choice. 

You are missing the point.  Both chloroquine and hydroxychloroquine are approved drugs.  Any FDA approved drug may be prescribed for a condition that it is not approved for and it will be dispensed.  the only exceptions are narcotics classified as such by the Drug Enforcement Administration.  FDA never had to issue the Emergency Use Exemption for the two malaria drugs as doctors were already prescribing them.

[Manoli]

Imperial College London update:

Rather than giving people a weakened form of the illness, the Imperial vaccine instead uses synthetic strands of genetic code based on the genetic material of Sars-CoV-2, the “novel coronavirus” responsible for the pandemic.

Robin Shattock, the Imperial College London professor leading its development, has told Bloomberg that early protective vaccines might not completely stop a person contracting the virus. “Is that protection against infection? Is it protection against illness? Is it protection against severe disease? It’s quite possible a vaccine that only protects against severe disease would be very useful.”

When injected, the Imperial experimental vaccine instructs muscle cells to produce virus proteins to protect against future infection. In animal tests, the vaccine was shown to be safe and showed “encouraging signs of an effective immune response”, Shattock’s team said.

[KLaban]

Not sure if this has been reported here previously. BBC article, Dexamethasone is first life-saving coronavirus drug.

Dexamethasone

[Alan Goldhammer]

Not sure if this has been reported here previously. BBC article, Dexamethasone is first life-saving coronavirus drug.

Correct!  It was a very robust trial as well.  https://www.recoverytrial.net/files/recovery_dexamethasone_statement_160620_final.pdf  It should now be the standard of care for those on oxygen or ventilation.  It does not have any effect on mild COVID-19 cases.

[Jeremy Roussak]

Reported in February by a Spanish team:
https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(19)30417-5.pdf

That paper is not describing the use of dexamethasone in treating covid-19 respiratory syndrome. Your post, before I edited it, was dangerously close to politics and should not have been re-posted (unnecessarily) here. Consider yourself warned.

Jeremy

[armand]

Correct!  It was a very robust trial as well.  https://www.recoverytrial.net/files/recovery_dexamethasone_statement_160620_final.pdf  It should now be the standard of care for those on oxygen or ventilation.  It does not have any effect on mild COVID-19 cases.

I hope they publish the entire thing sooner than later.


I think this exposed one of the failures in US, the lack of a organized research frame ready to go when a major issue like Covid starts. We had a lot of disparate efforts, many times duplicated. On this account UK seems to have done much better.

[jeremyrh]

That paper is not describing the use of dexamethasone in treating covid-19 respiratory syndrome. Your post, before I edited it, was dangerously close to politics and should not have been re-posted (unnecessarily) here. Consider yourself warned.

Jeremy

It doesn't mention covid-19 per se, but it does address a life-threatening complication of covid-19 that seems to be implcated in a large proportion of the fatality, so to pretend that the two are unrelated is not warranted.

https://www.health.com/condition/infectious-diseases/coronavirus/what-is-ards

The majority of people—about 80% according to research—only suffer mild symptoms with COVID-19. Others may require hospitalization—but for some patients, the new coronavirus can be deadly.

One life-threatening complication that can arise is acute respiratory distress syndrome, commonly referred to as ARDS. And new research from the JAMA Internal Medicine suggests that more than 40% of individuals in the study hospitalized for severe and critical COVID-19 developed ARDS—and over 50% of those diagnosed died from the disease.

February - Spanish team publish paper showing efficacy of a drug in treatment of ARDS
February to June - lots of people with COVID19 die with ARDS
June - British team issue press release showing efficacy of drug in treating patients with COVID19.

[Alan Goldhammer]

I hope they publish the entire thing sooner than later.


I think this exposed one of the failures in US, the lack of a organized research frame ready to go when a major issue like Covid starts. We had a lot of disparate efforts, many times duplicated. On this account UK seems to have done much better.

I was thinking the same thing.  Of course it's easier to run a large trial within the NHS system as opposed to the US where multiple sites would have to be set up.  I wrote a short paper on this very point a couple of months ago and sent it around to some of my friends in the academic community.  The problem is the all are invested in their own institutions and not necessarily looking at how to do large trials such as the RECOVERY trial in the UK.  If you are interested the paper is on my COVID-19 site:  https://agoldhammer.com/covid_19/

There was a good story in the Washington Post today about the value of wearing masks.  https://www.washingtonpost.com/business/2020/06/17/masks-salons-missouri/ discusses the hair salon where two workers were infected and potentially exposed scores of customers.  By regulation they were all wearing masks and none of the customers came down with COVID-19.