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Finally, Light at the End of the Pandemic


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I live in a county that is embarrassingly outdoing the whole damn state in numbers of cases.

Folks just don't get it - or no longer care.

Almost 20% of students who returned to a local high school are positive.

HOW MANY will they spread it to? How many who will get really sick or die?

We don't have a cure but we do know how to slow it down or stop the spread.

I am tired of arguing about what needs to be done to protect oneself and others. 

WEAR A DAMN MASK.

DON'T GATHER IN GROUPS.

DON'T DO STUPID THINGS.

Counting on an immunologic cure or a miracle drug is not working for anyone.

There is no magic pill or IV.

Nothing will get better until people have self responsibility to do the right thing and be citizens.

Darwin is spinning like a rotisserie in his grave.

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9 hours ago, EMEDPA said:
The article was a bit of a buzz kill. This was buried in the middle of the article, so the jury may still be out on Remdesiver.
 
"The emerging data appear inconsistent with more robust evidence from multiple randomized, controlled studies published in peer-reviewed journals validating the clinical benefit of Veklury (remdesivir). We are concerned that the data from this open- label global trial have not undergone the rigorous review required to allow for constructive scientific discussion," Gilead said in a statement".
"The benefits of Veklury have been demonstrated in three randomized, controlled clinical trials, including a randomized, double-blind, placebo-controlled clinical trial -- the gold standard for evaluating the efficacy and safety of investigational drugs."
 
 
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8 hours ago, EMEDPA said:

I think the only treatments I have a high degree of faith in at this point are dex and convalescent serum.

I think there is a subgroup of folks out there who just don't get covid. I think we need to find them, study them, and base treatments on that. Is it diet? supplements? BMI? genetics?

I am knocking on wood here, but I think I may be one of them. I have had at least three, probably more,  significant and extended exposures without adequate PPE (both at work and outside of work) to folks who were later confirmed to be positive within hours of me seeing them and I have had 4 negative tests so far(again, knocking on wood).

I agree.

In addition to my Mt. gig for a little over year I've been working in a 23 bed ED in Az. Early in this thing I had extended exposure to COVID + pts. while only wearing a surgical mask. And I was in the room(s) long enough to intubate, place central lines and the like. And i have not gotten sick.  When we hit our peak we had a 67% positive rate and were holding 6+  COVID+ pts in the ED for hours to days. We were seeing 100+ pts a day with one doc and 2 apps.

  I do think BMI plays a role my experience is that over weight people don't do well. And over weight diabetics seems to be very bad combo. 

On a side note, none of our providers have gotten sick but several nurses have. One even passed away. 

 

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57 minutes ago, Evolute said:
The article was a bit of a buzz kill. This was buried in the middle of the article, so the jury may still be out on Remdesiver.
 
"The emerging data appear inconsistent with more robust evidence from multiple randomized, controlled studies published in peer-reviewed journals validating the clinical benefit of Veklury (remdesivir). We are concerned that the data from this open- label global trial have not undergone the rigorous review required to allow for constructive scientific discussion," Gilead said in a statement".
"The benefits of Veklury have been demonstrated in three randomized, controlled clinical trials, including a randomized, double-blind, placebo-controlled clinical trial -- the gold standard for evaluating the efficacy and safety of investigational drugs."

When the manufacturer says something works, and independent investigators say it doesn't, the safe money is that it doesn't work well enough to be worth the patented price the manufacturer wants for it.  If you have to squint to see a benefit... it's not much of a benefit.  What's the NNT going to be, if there even is one? 500? 1000?

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13 hours ago, Evolute said:
The article was a bit of a buzz kill. This was buried in the middle of the article, so the jury may still be out on Remdesiver.
 
"The emerging data appear inconsistent with more robust evidence from multiple randomized, controlled studies published in peer-reviewed journals validating the clinical benefit of Veklury (remdesivir). We are concerned that the data from this open- label global trial have not undergone the rigorous review required to allow for constructive scientific discussion," Gilead said in a statement".
"The benefits of Veklury have been demonstrated in three randomized, controlled clinical trials, including a randomized, double-blind, placebo-controlled clinical trial -- the gold standard for evaluating the efficacy and safety of investigational drugs."
 
 

You mean to tell me the guys/gals who are looking to make $$$ off of this therapy are saying that literature published with less than robust results are crap?

I'm surprised they came out against the article, and am a little confused.  I'm assuming they are referencing the final report published on October 8th, which showed a decreased duration of symptoms as shown earlier.  Only real let down was no decrease in mortality at 28 days, which I don't think anyone was expecting to see.  Maybe that'll hit them in the pocketbook, won't be able to charge as much as they'd hoped.

Edit: I see that they are referencing the not-yet published WHO study. I'm an idiot.

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19 hours ago, EMEDPA said:

I just wanted to point out the lack of rabid attacks on this news story despite it coming from a highly biased source (CNN).

News is news.  It ALL has a bias that readers must examine it through.

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1 hour ago, Boatswain2PA said:

I just wanted to point out the lack of rabid attacks on this news story despite it coming from a highly biased source (CNN).

News is news.  It ALL has a bias that readers must examine it through.

I'm old enough to remember when the news was the news. It was someone reading a story about what happened. I long for those days

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1 hour ago, Boatswain2PA said:

I just wanted to point out the lack of rabid attacks on this news story despite it coming from a highly biased source (CNN).

News is news.  It ALL has a bias that readers must examine it through.

That’s because it’s an objective review with no bias in the article whatsoever as compared to the ones you post. Pretty obvious you don’t thrive unless there is active disagreement within the thread. 

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10 minutes ago, sas5814 said:

I'm old enough to remember when the news was the news. It was someone reading a story about what happened. I long for those days

I think the news has always had a little bias one way or another, but we had mostly professional journalists whose goal was to make sure their readers/listeners couldnt tell what their bias was.  That used to be a primary goal.

Now much of the news sources seek stories to push their bias.  For example - almost nothing in the "mainstream" media (cnn, NBC, ABC etc) on the Hunter Biden emails that show he was selling his daddy's influence to China, but it is covered by Fox.  Many other stories mostly ignored by fox but covered by the mainstream.

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3 hours ago, Boatswain2PA said:

I just wanted to point out the lack of rabid attacks on this news story despite it coming from a highly biased source (CNN).

News is news.  It ALL has a bias that readers must examine it through.

1 hour ago, Boatswain2PA said:

I think the news has always had a little bias one way or another, but we had mostly professional journalists whose goal was to make sure their readers/listeners couldnt tell what their bias was.  That used to be a primary goal.

Now much of the news sources seek stories to push their bias.  For example - almost nothing in the "mainstream" media (cnn, NBC, ABC etc) on the Hunter Biden emails that show he was selling his daddy's influence to China, but it is covered by Fox.  Many other stories mostly ignored by fox but covered by the mainstream.

oh geez

so one network (who IMO happens to have sold their independent journalists soul and is so far right it is merely a speak channel for tRump it should be just labeled Channel tRump) says something contrary to the mainstream media and somehow the Fox network is not bias, but everyone else is??  I just don't understand (guess I am not drinking the cool aid.....  instead I try to form my own thoughts and look at all the evidence.). When it is pretty much only fox that is bringing this and repeating it over and over does not make it true.   

https://www.theatlantic.com/culture/archive/2020/09/fox-news-trump-language-stelter-hoax/616309/

 

If you want to see what the actual data shows.... this is a review of the different sites - appears most major ones are "most reliable" but FoxNews falls well outside this...

https://www.adfontesmedia.com/static-mbc/

you can't just keep saying something over and over to make it true......

 

 

 

oh but here is an interesting twist on the Hunter Biden issue - Russian trolls.....    I looked all over FoxNews for mention of this (would seem to be exceptionally relevant as we know the Russians interfered last time, and now have possible evidence that this is their work again...... ). seems like a data point that a good investigative journalist would want to investigate, and try to find the truth - not just ignore....

 

    https://www.cnn.com/2020/10/16/politics/russian-disinformation-investigation/index.html

 

 

MODS please consider closing this thread as it obviously is off course

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3 hours ago, Boatswain2PA said:

I just wanted to point out the lack of rabid attacks on this news story despite it coming from a highly biased source (CNN).

News is news.  It ALL has a bias that readers must examine it through.

 

1 hour ago, Boatswain2PA said:

I think the news has always had a little bias one way or another, but we had mostly professional journalists whose goal was to make sure their readers/listeners couldnt tell what their bias was.  That used to be a primary goal.

Now much of the news sources seek stories to push their bias.  For example - almost nothing in the "mainstream" media (cnn, NBC, ABC etc) on the Hunter Biden emails that show he was selling his daddy's influence to China, but it is covered by Fox.  Many other stories mostly ignored by fox but covered by the mainstream.

Dude. If you can read the CNN story and the NR story side by side and don't see a difference in reporting quality and style then I don't know what to tell you. The reason nobody is attacking the CNN sorry is because it is a professionally written OBJECTIVE piece of reporting.

You want to know why no one is reporting on tje supposed Hunter Biden emails? Because the story came from a Hannity producer, Steven Bannon and Giuliani. Can't imagine a less trustworthy group as all have a strong history of misinformation. You want professional journalism and then complain that the NEW YORK POST piece by those three isn't widespread? Even the Murdoch owned WSJ isn't backing it.

Edit: Ventana and I posted at the exact same time, this wasn't a ganging up thing

Edited by MediMike
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And the first story about Clinton having an affair with his intern came from a far right wing guy with a website called drudge.

Funny thing with the Hunter email story....nobody on the Biden campaign are calling them false.  Just saying "we have looked at the official schedule at the time and there was no indication of a meeting." No declarations that these are falsified (like the Dan Rather papers about Bush).

I think both stories are well written.

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Just admitted a morbidly obese intubated gal in her 70s will all the comorbidities. COVID+, was able to wean her pressors down pretty quickly but bedside echo has her EF pretty reduced.

50yo with abdo px and a lactate of 9 got killed by an outlying community hospital, ROSC and transfer. Has influenza B and ugly ugly lungs.

Gonna be a fun season!

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There was a f/u article on remdesivir where a UCSF doc was quoted stating this conclusion was inappropriate since the study's end point was mortality reduction when the largest study was supporting remdesivir reducing hospitalization and convalescent times not mortality reduction. So remdesivir may not reduce (or will not reduce) mortality but will reduce convalescent times... I tried to find the article... I'll edit and post it when I find it.  

 

Edit found it! https://www.google.com/amp/s/www.sfchronicle.com/health/amp/Study-says-popular-COVID-drug-remdesivir-is-not-15654316.php

 

Here's a quote from the doc:

 

“Tell me something new because nobody has shown a mortality benefit with remdesivir,” Chin-Hong said. “The previous studies have shown decreased time to recovery, so people got better faster. I think it was on the order of 4 or 5 days, and that is pretty significant.”

 

Sent from my SM-G975U using Tapatalk

 

 

 

 

 

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23 minutes ago, Joelseff said:

“Tell me something new because nobody has shown a mortality benefit with remdesivir,” Chin-Hong said. “The previous studies have shown decreased time to recovery, so people got better faster. I think it was on the order of 4 or 5 days, and that is pretty significant.”

So it is the Tamiflu of covid: won't save your life, but for $3100 dollars you will feel better a few days sooner. 

https://www.npr.org/sections/health-shots/2020/06/29/884648842/remdesivir-priced-at-more-than-3-100-for-a-course-of-treatment

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So it is the Tamiflu of covid: won't save your life, but for $3100 dollars you will feel better a few days sooner. 
https://www.npr.org/sections/health-shots/2020/06/29/884648842/remdesivir-priced-at-more-than-3-100-for-a-course-of-treatment
[emoji23] I guess so... But much better recovery (4-5x is much better than a half day faster with Tamiflu) and from a deadlier disease with longer sequelae. If my insurance covered it and I got COVID I would want it. I may still die though... [emoji17]

Sent from my SM-G975U using Tapatalk

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I think this highlights how new this disease is.  We dont yet KNOW what works on whom and when, but we are increasing our treatment modalities, and getting data.  And we are getting better at it.
 
I agree. And there is "good news" if we can call it that regarding a disease that has killed 1MM lives but the CFR in America is much lower now at 2.7%, which is still very high but continues to drop, than the 6% we had in June despite reports of increased cases.

The optimist in me is looking forward to a viable and effective vaccine, the pessimist is saying we all finna die and the realist in me is saying, it is really bad and we have/will have lost many people in the end, but this isn't the end of the human race...

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3 minutes ago, Joelseff said:

The optimist in me is looking forward to a viable and effective vaccine, the pessimist is saying we all finna die and the realist in me is saying, it is really bad and we have/will have lost many people in the end, but this isn't the end of the human race...

The realist in me is saying this sucks because its killed people, made people sick, and has severely damaged an economy that was doing absolute wonders for the majority of Americans (and thus much of the world).

I also think we dodged a bullet.  Nine months ago reasonable people were saying this could be the black swan event that could kill ten PERCENT of the global population.

Obviously this is not the case, but we have extended our two week "flatten the curve" efforts into something that has no apparent end to it.

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On 10/15/2020 at 2:35 PM, ventana said:

Gotta know your source......

 

from. https://www.allsides.com/news-source/national-review

The National Review, a magazine which some have called the "bible of American conservatism," has a far right bias. One of the National Review’s core convictions is that centralized government should solely exist to protect citizens’ lives, liberty and property. Describing itself as libertarian, it believes all other activities of government tend to diminish freedom and hamper progress. The National Review was given an AllSides Bias Rating™ of far right, a rating with which a majority of community members agree.

 

 

My personal opinion is this is merely a marketing trick by tRump

He knows he failed the response and the only thing he can do is try to say it is over.....

from CNN https://www.cnn.com/videos/politics/2020/10/10/trump-comments-since-testing-positive-covid-coronavirus-orig-me.cnn.  

 

From ABC news

https://abcnews.go.com/Health/live-updates/coronavirus/?id=73623859&cid=clicksource_4380645_7_three_posts_card_hed

 

 

But this takes the cake

 

https://www.cnn.com/2020/10/14/opinions/white-house-herd-immunity-reckless-idea-sachs/index.html

and CNN or ABC is not biased? They won't even talk about Biden's sandal...just to name ONE. All sources are not perfect but it seems hard for some to accept other sources. We do this in medicine so why not with other things? 

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On 10/15/2020 at 3:46 PM, mcclane said:

Outta here with your persecution complex.

 

On 10/15/2020 at 6:35 PM, mcclane said:

I'm sorry, I thought this was a medical forum. I do not read articles by journalists for medical news about treatments. I subscribe to the NEJM and Medscape and a host of other services to push information to me daily. Reliable sources that do not require that I continuously attempt to parse through propaganda to find the nuggets of truth. That is why no one here should be clicking on your link, period, despite your bizarre pleas for people to do so.

Just like the LANCET....very credible. You cannot out one source but say others are invalid. Just cause it is medical news does not mean physician experts don't review them. Do you believe anything that a physician talks about or comments on for a certain news station?  I like to know where your line is?

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On 10/15/2020 at 7:15 PM, Cideous said:

Chris Christie just out of the unit after being in ICU for 7 days.  He almost died.  He got all the crap that they threw at Trump.  Good for him, I'm glad he's not dead for his wife and family.  His tune though has changed.  Why does it take Republicans having a near death experience to finally listen to what science and scientists are telling them?????  How many average people are going to continue to die because asshats like him have to nearly die to get it through their thick skulls.

 

https://www.nbcnews.com/politics/politics-news/chris-christie-says-he-was-icu-7-days-battling-covid-n1243589

Why are you calling out republicans? So me evidence of this...I work with a democrat that has a Biden sticker on her vehicle that is a anti-masker... Also Chris Christie is a obese comorbid person...shocker he had issues with Covid. Maybe if we focused on HEALTH in this country we wouldn't suffer so much from these terrible illness. Support your immune system and snack cakes/coke do not count...  

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