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Post by matt@IAA on Apr 13, 2021 11:20:37 GMT -6
From my understanding, HQL does nothing....without ZINC. Not a mention of Zinc above. HQL without it will not accomplish anything successful for C19. It's the Zinc that does the work, and the HQL is just the transportation to get it where it needs to be. (From my feeble understanding of things). It's been a mixed bag, all kinds of things have been proposed. But the thing is, it's not on the onus of the clinical trial to disprove the theory. The burden of proof is the other way around. We basically assume that things don't work until they can be shown to be effective, from a clinical point of view. The null hypothesis is that the drug doesn't work. There hasn't been a single study that validates or supports the claim that hydroxychloroquine with this or that or not or whatever actually does anything for people with COVID19. It does some things in vitro, we know that. Zinc does stuff in high enough concentrations. It may be a zinc ionophore, whatever. The problem is a known method of action in one way doesn't necessarily mean the thing will work like that in treatment. And the truth is the evidence has actually been to the contrary. Not only does hydroxychloroquine as a treatment not appear to work in clinical studies, the largest studies we've seen is that it appears to be actively harmful. In the largest randomized study I know of ( NEJM) with patients receiving hydroxychloroquine were less likely to be discharged alive within 28 days and more likely to be ventilated or die. And this excluded people with QT prolongation from the study, which is probably a bigger risk that sits on top if you're talking about mass treatment. What is incredible to me is that the list of failed therapeutics for COVID is long and distinguished. There's no particular conspiracy against hydroxychloroquine - it just got a TON of publicity because the POTUS brought it up, and he is a polarizing figure. If anything it got more than its fair share of funding and chances to prove out because of that publicity. Tons of drugs don't work. Most that have been tried have been shown to be completely ineffective. No doctor wants the drugs to not work, any of them. We really collectively as a society are suffering because of the politicization of... everything. |
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Post by svart on Apr 13, 2021 11:24:00 GMT -6
Svart, I'll be the first one to admit that we (science in general, medicine specifically) know less than what we think we know, and personally if someone tells me they have a reaction to a medication I avoid that medication. At the same time, we have developed what I feel are unrealistic expectations that, for lack of a better way to phrase, there's a pill or cure for everything and that any illness requires treatment. And even though I think all of us recognize that really isn't true, the amount of pharmaceutical advertising we are exposed to does create a situation where some/many patients are disappointed if told it's likely a viral process and no treatment is needed.
I agree that we frequently don't fully understand the mechanism of action of many drugs. And I've written for off label use over the years where there is enough evidence to support it. But knowing that all drugs have potential risks makes me very cautious in using them indiscriminately. Look at Ciprofloxacin - it had a huge practice impact when first on market as it allowed us to treat kidney infections as an outpatient vice admitting them for 7-10 days of IV antibiotics. It also allowed more severe pneumonia to be treated as outpatients. Sounds like a win/win, good for patients and save costs of hospitalization. But over time everyone started writing for Cipro for simple urinary tract infections - some argued to avoid a potential progression to a kidney infection. It took years to get enough data to recognize the connective tissue effects of fluoroquinolones, and even before that we developed Cipro resistant e. coli (the bacteria most frequently causing urinary tract infections). So now I rarely use Cipro except for real kidney infections, and have seen a few patients that I need to admit for a simple urinary tract infection because by culture they have strains of e coli resistant to every oral antibiotic. So while I'm open to the concept of off label benefit from antibiotics, the risks of developing antibiotic resistance are very real and well documented so would need some strong evidence of benefit outweighing risk.
I'll respectfully disagree with two of your points. First, the internet was developed by DARPA/funded by DoD as a means of maintaining communication in the event of nuclear strikes, not to allow universities to share information (Actually, wasn't it invented by Al Gore?). As a pre internet/home computer existence person, I appreciate many of the things it allows us to do (such as chat on this forum) but also worry about the unintended consequences (like misinformation sharing and AI algorithms "enhancing" your experience). I look at my kids and see them locked into their devices and worry at times. Secondly, while a computer may be able to come up with a diagnosis based on symptoms more effectively than I (not surprising given computer capacity versus my little old brain) IF the patient presents with all the typical symptoms - I've seen many patients present without the textbook symptoms of a given illness multiple times so I'm not very worried about being replaced by AI quite yet. One of the last heart attacks I admitted came in for a "cold", yes he had a slight cough but otherwise looked healthy with normal vitals but had no symptoms concerning for heart disease. Something that I can't explain worried me enough to get an ECG - which had a very minor/subtle change. Got cardiac labs which confirmed NSTEMI (non ST elevation myocardial infarction). Doubt AI would find that one based on presentation - but I could be wrong.
This is what I found for the internet, on the internet, which is strangely meta: "ARPANET was a great success but membership was limited to certain academic and research organizations who had contracts with the Defense Department. In response to this, other networks were created to provide information sharing." So yeah it was government based but still mainly for academics to share info quickly. In any case, the totality of human knowledge resides on the internet at this point. In 20 years it'll all be AI curated I'm sure. Maybe by then there'll be a panel of blood tests run on every single patient and AI makes all decisions on those results. In 50-100 years, if humanity survives that long, we'll have autodocs that take those results and formulates specific cures. What a time to be alive. |
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Post by Tbone81 on Apr 13, 2021 11:57:28 GMT -6
<snip> It was very clear to me that the people "in charge" were tripping over themselves to "do something", rather that take a day or two, evaluate your options and choose a wise coarse of action. It was also clear that the people making the rules had never worked in a hospital.
<snip> But its pretty hard to imagine, unless you lived through it like I did, just what a cluster fuck it was, from the top down.
At this point in time, I think most of us can pretty much imagine it. No, I'll never know the day to day hell and frustration that you had to live thru, but I can sure see the F-Ups. At least in hindsight. Thanks for your service from the bottom of my heart. Without folks like yourself, the outcome would have been much worse. But forgive me if I don't rush out today to follow the orders of those who screwed things up so badly as this rolled out....the craziness is just as rampant now, although focused in a new direction. The future and hindsight will be eye opening for sure. PS - how are things in your hospital now? Where we are we are at about 1/25th of the Covid cases admitted to the hospital compared to where things were 4-5 months ago. Def getting better. Even far before the vaccines rolled out. Thanks for the kind words drBill. I don't blame you at for being skeptical...I sure am. Its hard to maintain your trust in the system when the goal post keep getting moved and the narrative keeps changing. My hospital has been doing good for a while now. We're collectively much better at treating this and for at least the last 6 months our ICU admissions have been a fraction of what they were, despite having higher/lower numbers of covid patients at any given time. |
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Post by jcoutu1 on Apr 13, 2021 12:36:41 GMT -6
Hey All,
Anyone that got the shot (specifically Pfizer) experience pins and needles in their legs/feet? Within a half hour, I was tingling in the legs.
All I can find online is that it could be a severe effect and to contact my doc.
I'm not really doing bad, but it's obvious that I don't feel "right", if that makes sense.
Called my PCP (who I think is an idiot) and haven't heard back a couple hours later.
Anyway, if you guys don't hear from me again, assume I kicked the bucket.
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Post by ragan on Apr 13, 2021 12:49:10 GMT -6
Hey All, Anyone that got the shot (specifically Pfizer) experience pins and needles in their legs/feet? Within a half hour, I was tingling in the legs. All I can find online is that it could be a severe effect and to contact my doc. I'm not really doing bad, but it's obvious that I don't feel "right", if that makes sense. Called my PCP (who I think is an idiot) and haven't heard back a couple hours later. Anyway, if you guys don't hear from me again, assume I kicked the bucket. Hey Jesse. I got Pfizer and I didn’t have any of that. I did feel kind of “off” with the first shot. The way you might if you think “am I coming down with something?” But that’s pretty rational given that it’s an immune response being induced in either case. Can you call a consulting nurse phone number to get some quicker consult? |
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Post by dmo on Apr 13, 2021 12:59:49 GMT -6
jcoutu1, tingling/pins and needles (paresthesias) can occur for lots of reasons but I haven't heard of it specifically following any of the vaccines acutely/immediately. A more delayed reaction, especially if any weakness, would be Guillian-Barre syndrome, which is an ascending nerve disorder that starts peripherally (hands/feet) and progressed upwards. Occurs with some viral infections, sometimes after vaccines, occasionally for no identifiable cause. But not usually so acute related to trigger.
Any rash or itching? Feeling harder to breathe or swallow? If so, may be an anaphylactic reaction and should go to ER immediately. But if not and only leg symptoms, if persistent and bothering you probably warrants a visit sooner versus later to be safe- these vaccines are new enough that we don't know all the potential reactions yet and you should get it documented as a potential adverse reaction. Hope you're feeling better soon.
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Post by drbill on Apr 13, 2021 13:56:41 GMT -6
But the thing is, it's not on the onus of the clinical trial to disprove the theory. The burden of proof is the other way around. We basically assume that things don't work until they can be shown to be effective, from a clinical point of view. Is that how the vaccines rolled out??  . Have they been "proven and effective" clinically? |
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Post by drbill on Apr 13, 2021 13:58:47 GMT -6
Anyway, if you guys don't hear from me again, assume I kicked the bucket. haha!! Checking back in... You OK? |
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Post by matt@IAA on Apr 13, 2021 14:38:43 GMT -6
Absolutely they have! All of them, in multiple phase clinical trials over the course of a year including massive randomized, placebo-controlled, blind trials for the phase 3s. Here's Pfizer www.nejm.org/doi/full/10.1056/NEJMoa2034577randomized, observer-blinded, placebo-controlled trial, 30,420 participants. 94.1% efficacy at preventing illness during the study. No safety concerns identified. 196 people of that group got covid, 185 in placebo and 11 in vaccine. Severe covid occurred in 30 participants with one fatality - all in the placebo group. Here's Moderna www.nejm.org/doi/full/10.1056/nejmoa2035389randomized, observer-blinded, placebo-controlled trial, 43,538 participants. 95% efficacy at preventing illness during study. Safety similar to that of other viral vaccines. 190 people got covid, 162 in placebo and 8 in vaccine. Severe covid occurred in 10, 9 in the placebo group and one in vaccine. Here's the results for J&J trial, I don't think it's hit publications yet. Phase 1-2a www.nejm.org/doi/full/10.1056/NEJMoa2034201Phase 3 www.fda.gov/media/146265/downloadwww.fda.gov/media/146264/downloadrandomized, observer-blinded, placebo-controlled trial, 43,783 participants 66% efficacy at preventing illness during the study. Safety accepable profile, mild and transient events, comparable to placebo. 723 people got covid, 541 in placebo and 182 in vaccine group. Severe/critical covid in 113, 94 in placebo and 19 in vaccine. 45 placebo cases hospitalized vs 2 cases vaccinated. This is an interesting study because its one shot, but it also was done when the overall level of infection in the population was higher. You see 1.6% of the study got sick, while the others were much lower. This is also a single-shot regime, and the shot provides stronger protection over time. Of the folks who got it with J&J, 40% got it in the 14 day window after the shot. This is demonstrated, statistically relevant results that show efficacy. |
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Post by svart on Apr 13, 2021 14:45:53 GMT -6
It's quite amazing to see that out of ~40K people, the deciding "it's effective" number is less than 200 people. I wonder if anyone has asked why only 200 people out of 40,000 caught covid?
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Post by jcoutu1 on Apr 13, 2021 14:47:18 GMT -6
jcoutu1, tingling/pins and needles (paresthesias) can occur for lots of reasons but I haven't heard of it specifically following any of the vaccines acutely/immediately. A more delayed reaction, especially if any weakness, would be Guillian-Barre syndrome, which is an ascending nerve disorder that starts peripherally (hands/feet) and progressed upwards. Occurs with some viral infections, sometimes after vaccines, occasionally for no identifiable cause. But not usually so acute related to trigger.
Any rash or itching? Feeling harder to breathe or swallow? If so, may be an anaphylactic reaction and should go to ER immediately. But if not and only leg symptoms, if persistent and bothering you probably warrants a visit sooner versus later to be safe- these vaccines are new enough that we don't know all the potential reactions yet and you should get it documented as a potential adverse reaction. Hope you're feeling better soon.
No other real issues so far. A little brain fog, but otherwise OK right now. Even the pins and needles is fairly minor. Nothing that is be concerned about if it was listed as something to expect. I Googled to see if I should be worried about the pins and needles and found this... "Serious side effects after receiving the vaccine are rare. However, should you develop any of the following adverse reactions within three days of receiving the vaccine, seek medical attention right away or call 911 if you are severely unwell: o hives o swelling of the face or mouth o trouble breathing o very pale colour and serious drowsiness o high fever (over 40°C) o convulsions or seizures o other serious symptoms (e.g., “pins and needles” or numbness)." |
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Post by matt@IAA on Apr 13, 2021 15:51:31 GMT -6
It's quite amazing to see that out of ~40K people, the deciding "it's effective" number is less than 200 people. I wonder if anyone has asked why only 200 people out of 40,000 caught covid? Well, that was within the study window of ~2 months. If you figure only the placebo (no fair counting the vaccinated people as they showed to be immune, they'd be removed from the SIR model right?) that's around 1% of the population under scrutiny. For the J&J vaccine, which was done in the fall when infections were higher around 1.6% got sick. Expand 1% to 200 million adults in the US with an arbitrary fatality rate of 0.5% and that's 2 million sick, 10,000 dead in a two month period. Or, put another way - if you did this same study with the entire US, vaccinating only half, you'd have saved around 5,000 lives in two months. Now, can we subject hydroxychloroquine or whatever to the same scrutiny and get the same kind of results? |
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Post by ericn on Apr 13, 2021 15:55:55 GMT -6
Hey All, Anyone that got the shot (specifically Pfizer) experience pins and needles in their legs/feet? Within a half hour, I was tingling in the legs. All I can find online is that it could be a severe effect and to contact my doc. I'm not really doing bad, but it's obvious that I don't feel "right", if that makes sense. Called my PCP (who I think is an idiot) and haven't heard back a couple hours later. Anyway, if you guys don't hear from me again, assume I kicked the bucket. Gee Jesse welcome to my normal world! If it’s mostly in the arm you got the shot in I wouldn’t be to worried. |
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Post by drbill on Apr 13, 2021 16:25:44 GMT -6
This is demonstrated, statistically relevant results that show efficacy. One man's statistical efficacy is another man's experimental. |
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Post by drbill on Apr 13, 2021 16:27:31 GMT -6
Now, can we subject hydroxychloroquine or whatever to the same scrutiny and get the same kind of results? yup. would love to see those tests get the same treatment that the doctors having success are using. Instead of a similar (but significantly different - like the lack of zinc) test. |
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Post by drbill on Apr 13, 2021 16:28:19 GMT -6
Hey All, Anyone that got the shot (specifically Pfizer) experience pins and needles in their legs/feet? Within a half hour, I was tingling in the legs. All I can find online is that it could be a severe effect and to contact my doc. I'm not really doing bad, but it's obvious that I don't feel "right", if that makes sense. Called my PCP (who I think is an idiot) and haven't heard back a couple hours later. Anyway, if you guys don't hear from me again, assume I kicked the bucket. Gee Jesse welcome to my normal world! If it’s mostly in the arm you got the shot in I wouldn’t be to worried. Jesse mentioned it was in his legs and feet Eric! |
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Post by matt@IAA on Apr 13, 2021 16:57:01 GMT -6
Bill there’s more than enough zinc in your body to do whatever the proposed method of action is. This approach of “well this..” or “but that...” or “was Venus in retrograde...” is never ending. You have a year of positive results in multiple phases from many countries on the one hand, and nothing but failed trial after failed trial on the other.
You can go look at the original thread, I was very hopeful about HCQ. But it just doesn’t work. The vaccines do. If those studies don’t convince you on both accounts, I guess I’m curious what would? It seems like heads I win tails you lose.
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Post by ericn on Apr 13, 2021 17:07:43 GMT -6
Gee Jesse welcome to my normal world! If it’s mostly in the arm you got the shot in I wouldn’t be to worried. Jesse mentioned it was in his legs and feet Eric! Yeah, just years of being around medicine and Medicine professionals has taught me asking specifics for clarification is not a bad thing besides I know I will see Children’s Mercy’s Lead Covid vaccine researchers husband at breakfast 😎, and I know that will be his first question😁 |
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Post by drbill on Apr 13, 2021 17:52:19 GMT -6
If those studies don’t convince you on both accounts, I guess I’m curious what would?. I have yet to be convinced on either side - and there's too much politics in play for that to happen now. Trying to see the big picture....the big picture..... There is quite literally only ONE thing I am sure of with Covid. Everyone I know that has had it - including my wife, 90+ year old and frail in-laws, friends, associates, etc. - has only been minimally sick and has fully recovered without any long term issues. Coincidence? Don't ask me...I have no idea. Too much politics.... I don't trust a politician further than I can throw them - and I'm supposed to believe in them to protect me from "the virus"? With Billions in low hanging fruit. LOL. Good luck with that. Still waiting for a compelling reason to do anything other than write more music.... |
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Post by ericn on Apr 13, 2021 18:13:40 GMT -6
If those studies don’t convince you on both accounts, I guess I’m curious what would?. I have yet to be convinced on either side - and there's too much politics in play for that to happen now. Trying to see the big picture....the big picture..... There is quite literally only ONE thing I am sure of with Covid. Everyone I know that has had it - including my wife, 90+ year old and frail in-laws, friends, associates, etc. - has only been minimally sick and has fully recovered without any long term issues. Coincidence? Don't ask me...I have no idea. Too much politics.... I don't trust a politician further than I can throw them - and I'm supposed to believe in them to protect me from "the virus"? With Billions in low hanging fruit. LOL. Good luck with that. Still waiting for a compelling reason to do anything other than write more music.... Damn wish I could say the same. |
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Post by matt@IAA on Apr 13, 2021 18:23:45 GMT -6
You’re lucky no one you know died. Wish I could say the same.
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Post by drbill on Apr 13, 2021 18:43:26 GMT -6
Don't get me wrong, my condolences and deepest sympathies go out to all who lost a loved one. But I think it's fairly obvious that our personal viewpoints and paradigms are formed by one of two things. What the politicians and news tells us, and/or what our actual daily experience is. For me, those two are at odds. At this point, I'm not compelled to hang on the media's every word when what I ACTUALLY see (including not just my friends/family, but the local hospitals) shows me. Call me stubborn. I'm not ready to indemnify Pfizer or Moderna just yet with something they are not willing to solidly stand behind. Call me in 9 more years when the real studies come in....
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Post by matt@IAA on Apr 13, 2021 19:04:11 GMT -6
I don't recall quoting the politicians or the news. I've been posting studies. Personal experience absolutely is not a guide for something like this! On average you'd need to know 200 people with it to know someone who died. I don't know 200 people with it, so I'm unlucky. Can you name 200 people with COVID? I can't, and I'm responsible for 1500 people. We've only had ~150 cases among our employees - and 15 hospitalizations, 2 deaths.
I mean...9 years?? You want 9 years of "real" studies and dismiss double blind randomized placebo controlled clinical trials with hundreds of thousands of participants for the vaccines, but you will campaign for hydroxychloroquine because...why? Surely not the news and politicians, eh?
Your proposal precludes a vaccine, which means in the US somewhere between 1 and 2 million people will die as we reach herd immunity. I'm pretty sure that whatever side effects these vaccines cause, they'll be a net positive in terms of lives saved in spades.
I'm not telling you to get one - do or don't. But your approach is incredibly inconsistent. If you apply the same rigor to HCL as you do to the vaccine you'd never take it.
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Post by ragan on Apr 13, 2021 19:12:55 GMT -6
If those studies don’t convince you on both accounts, I guess I’m curious what would?. I have yet to be convinced on either side - and there's too much politics in play for that to happen now. Trying to see the big picture....the big picture..... There is quite literally only ONE thing I am sure of with Covid. Everyone I know that has had it - including my wife, 90+ year old and frail in-laws, friends, associates, etc. - has only been minimally sick and has fully recovered without any long term issues. Coincidence? Don't ask me...I have no idea. Too much politics.... I don't trust a politician further than I can throw them - and I'm supposed to believe in them to protect me from "the virus"? With Billions in low hanging fruit. LOL. Good luck with that. Still waiting for a compelling reason to do anything other than write more music.... Are you under the impression that “politicians” carried out the clinical trials? And are you really wondering if the handful of people you know who’ve had Covid having had mild cases is a “coincidence”? The vast majority of people who get it have mild cases. That has always been the case. When you know a few people who’ve had Covid, it would be statistically surprising if many or most or even any of them had a severe case. I’m generally sympathetic to skepticism. I think it’s (generally) healthy. But deflecting good science in favor of these few anecdotal accounts (which are confirmed by the science, not in opposition to it) feels like an ideological approach more than anything. Especially when embracing something that does go against the existent science (HCL) and is only even A Thing because of “politicians” and “media”, which you claim to be so skeptical of. |
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Post by drbill on Apr 13, 2021 19:43:52 GMT -6
I've been posting studies. Just to be clear - I've not made up my mind one way or the other. I'm not an HCQ fanatic. I would like to see a study where they used HCQ, Zinc, Zpac and mega doses of Vitamin D and C upon start of treatment if you can recall one. Maybe I missed it. Most of the HCQ studies I've seen have somehow left out some or most of the components that doctors I am familiar with have had success with. I would call that an inadequate or incomplete study as to the effective treatment that some doctors are doing. Would love to see a study where they didn't. And my 9 year statement was in response to how long it generally takes the FDA to clear a drug for use - not the current EUA. I suppose under these circumstances they could probably hurry it up to 6 or 7 years. Cheers, |
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