Caronavirus & Tokyo 2020

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Perhaps I didn't make myself clear. The reason I added "I feel bad for Fauci" at the end was that the couple decided to trust Trump instead of Fauci. Seriously? What's the point of having Fauci on the podium then? Only to correct him(apparently not working) so that the democrats can't go after him?

https://www.businessinsider.com/dr-fauci-facepalm-covered-his-face-after-stuck-lozenge-2020-3

Chloroquine has been arguably effective in treating many people. The argument between Trump.and Fauci was about evidential standards and not about whether the drug was really promising or not. Someone who saved his life after using chloroquine places credit with the drug. Trump didn't tell people to use what they had for their fish supplies and overdose on it. Let's be reasonable here.

https://nypost.com/2020/03/22/florida-man-with-coronavirus-says-drug-touted-by-trump-saved-his-life/
 
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Anecdotal evidence like that is close to worthless and if it is in the NY Post even more so. With that said, I still suspect chloroquine will have some value, mainly based on Chinese case reports and some in vitro evidence (effects in isolated cells in a dish). In biomedical sciences there are different levels of evidence. Case reports are the lowest standard of clinical evidence but there is a long tradition of using them at the very early stages. It is a far cry from any sort of clinical trial. Chloroquine is used in autoimmune diseases and can produce some pretty weird effects in people in that setting but that is a really long term treatment, not like what would be done in this kind of disease.

Trump should not be arguing with Fauci about anything to do with infectious disease, and the fact that he sees fit to do so is part of his megalomania. But it is true, if you are so deep into the Trump cult that you are willing to take his words and then poison yourself with aquarium cleaner, and say stuff suggesting that old people should be willing to die for the economy, then you need professional help (and should not be a leading politician in one of the largest states in the US). The stuff that Trump has been saying in the last few days is the exact opposite of what EVERY public health authority and infectious disease specialists thinks he should be saying.
 
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So much revisionist history already.
The libtards howled and screamed when Trump took action to stop Chinese citizens from flying to the US.
This was long before the corrupt and incompetent WHO called this a pandemic.
Poor Italy didn't stop flights until it was way too late. Their health care system was rated 2nd best by the WHO. It may be under normal circumstances but is makes no difference if if is taken by surprise.
So Baal, which one of the libtards was saying we should do more? What more? Even spending a trillion dollars or more will not help that much except for perhaps get us ready for the next one that may occur in the next 100 years. Money can be used only so fast efficiently. Do you remember hurricane Harvey? This CCP virus is similar to a 100 year flood or Harvey.

The mortality rate isn't getting much better. Actually it is getting much worse if you don't count the bogus Chinese data.

Baal want to criticize Trump when it was Baal that was repeating the lame stream media number of 0.6%. Heck, 0.6% that doesn't look like a big problem but 10%+ mortality rates are. Even if you only look at the case fatality rate of deaths/infected the rate is 4.36% (17115/392176) even if you include the bogus Chinese data. If you don't include the Chinese data then things look dim and grim.
I can't believe kids want to play on the beaches during spring break.

I am working at home and self isolating now. None of my practice partners don't want to come to my table at work so there is no need for me to go to work. I have a rowing machine. Usually I get more exercise stepping over it than using it.
I am actually working on a simulation but not for epidemics.
Non-essential businesses in Washington State must close within 48 hrs. I don't know for how long. My company has been deemed essential but what we need to do doesn't require most people to be at work. Also, orders are slow.

Brokenball, you have no idea what you are talking about. I will leave it at that. Your contributions to this thread have been laughable, and for an engineer you are remarkably innumerate. Here on out I will simply ignore you and advise everyone else to do so also.
 
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Update. A couple of very small randomized chloroquine or hydroxy chloroquine clinical trials are out now ( <30 patients, none with severe or critical disease). Conclusion is no effect on viral load or clinical outcomes. Need much bigger trial. Covid-19 cases in Australia are increasing with same pattern as other countries.

Both of these things are very disappointing.

Chloroquine in occasional patients can produce severe cardiac arrythmias. A colleague just reminded me of this. I should have remembered, we used to use an analaog, quinidine, to inhibit K+ channels in experiments. If a patient has the usual electrolyte disturbances that occur with severe viral respiratory infections they are already prone to arythmuas. Hydroxy CQ is safer.
 
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So much revisionist history already.
The libtards howled and screamed when Trump took action to stop Chinese citizens from flying to the US.
This was long before the corrupt and incompetent WHO called this a pandemic.
Poor Italy didn't stop flights until it was way too late. Their health care system was rated 2nd best by the WHO. It may be under normal circumstances but is makes no difference if if is taken by surprise.
So Baal, which one of the libtards was saying we should do more? What more? Even spending a trillion dollars or more will not help that much except for perhaps get us ready for the next one that may occur in the next 100 years. Money can be used only so fast efficiently. Do you remember hurricane Harvey? This CCP virus is similar to a 100 year flood or Harvey.

The mortality rate isn't getting much better. Actually it is getting much worse if you don't count the bogus Chinese data.

Baal want to criticize Trump when it was Baal that was repeating the lame stream media number of 0.6%. Heck, 0.6% that doesn't look like a big problem but 10%+ mortality rates are. Even if you only look at the case fatality rate of deaths/infected the rate is 4.36% (17115/392176) even if you include the bogus Chinese data. If you don't include the Chinese data then things look dim and grim.
I can't believe kids want to play on the beaches during spring break.

I am working at home and self isolating now. None of my practice partners don't want to come to my table at work so there is no need for me to go to work. I have a rowing machine. Usually I get more exercise stepping over it than using it.
I am actually working on a simulation but not for epidemics.
Non-essential businesses in Washington State must close within 48 hrs. I don't know for how long. My company has been deemed essential but what we need to do doesn't require most people to be at work. Also, orders are slow.
bb
i am shocked and saddened by your rant.
for an educated man of the world to be using words like libtard and to be complaining of people criticising Trump is just mind boggling. Get real, doesnt Trump deserve criticism.
Didnt all that education teach you to recognise the evil that Trump stands for, with his fascism, his racism, and above all his incompetence.
Do you want him to remain in office? its evil madness.
 
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硫酸羟氯喹治疗普通型2019冠状病毒病(COVID-19)患者初步研究
陈军( ),刘丹萍,刘莉,刘萍,徐庆年,夏露,凌云,黄丹,宋树丽,张丹丹,钱志平,李涛,沈银忠,卢洪洲*( )
上海市公共卫生临床中心感染与免疫科, 上海 201508
A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19)
CHEN Jun( ),LIU Danping,LIU Li,LIU Ping,XU Qingnian,XIA Lu,LING Yun,HUANG Dan,SONG Shuli,ZHANG Dandan,QIAN Zhiping,LI Tao,SHEN Yinzhong,LU Hongzhou*( )
Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China

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摘要:目的: 初步评价硫酸羟氯喹治疗普通型2019冠状病毒病(COVID-19)患者疗效和安全性。方法: 收集2020年2月6日至25日在上海市公共卫生临床中心住院治疗的30例普通型COVID-19确诊患者。患者1:1随机分配到试验组和对照组。对照组接受常规治疗,试验组在常规治疗的基础上口服硫酸羟氯喹(400 mg,1次/d,疗程为5 d)治疗。比较两组治疗第7天时咽拭子病毒核酸转阴率等指标。研究获上海市公共卫生临床中心伦理委员会批准,并登记注册(NCT04261517)。结果: 在治疗过程中,试验组1例患者发展为重症。入组后第7天,试验组中13例(86.7%)和对照组中14例(93.3%)咽拭子病毒核酸检测为阴性(P>0.05)。在2周的访视期内,所有受试者的咽拭子核酸检测均转为阴性,其中试验组咽拭子核酸转阴时间为入院后第4(1~9)天,对照组为第2(1~4)天,差异无统计学意义(U=83.5,P>0.05)。试验组在入院后第1(0~2)天体温恢复正常,对照组在入院后第1(0~3)天体温恢复正常。在影像学上,试验组5例(33.3%)和对照组7例(46.7%)均在入院3 d后的复查中出现了进展,所有患者在随后的复查中均提示病灶好转。试验组和对照组分别有4例(26.7%)和3例(20.0%)出现一过性的腹泻和肝功能异常等不良反应(P>0.05)。结论: 目前普通型COVID-19患者预后较好,以病毒转阴率、重症化率为主要终点的研究难以对药物的疗效进行比较。开展后续的研究需要确定更合适的人群和终点事件,并充分考虑样本量等试验的可行性问题。
关键词: 严重急性呼吸综合征冠状病毒2; 2019冠状病毒病; 新型冠状病毒肺炎; 硫酸羟氯喹; 治疗效果; 安全性
Abstract:Objective: To evaluate the efficacy and safety of hydroxychloroquine (HCQ) in the treatment of patients with common coronavirus disease-19 (COVID-19). Methods: We prospectively enrolled 30 treatment-na?ve patients with confirmed COVID-19 after informed consent at Shanghai Public Health Clinical Center. The patients were randomized 1:1 to HCQ group and the control group. Patients in HCQ group were given HCQ 400 mg per day for 5 days plus conventional treatments, while those in the control group were given conventional treatment only. The primary endpoint was negative conversion rate of COVID-19 nucleic acid in respiratory pharyngeal swab on days 7 after randomization. This study has been approved by the ethics committee of Shanghai public health clinical center and registered online (NCT04261517). Results: One patient in HCQ group developed to severe during the treatment. On day 7, COVID-19 nucleic acid of throat swabs was negative in 13 (86.7%) cases in the HCQ group and 14 (93.3%) cases in the control group (P>0.05). The median duration from hospitalization to virus nucleic acid negative conservation was 4 (1-9) days in HCQ group, which is comparable to that in the control group[2 (1-4) days, (U=83.5, P>0.05)]. The median time for body temperature normalization in HCQ group was 1 (0-2) after hospitalization, which was also comparable to that in the control group 1 (0-3). Radiological progression was shown on CT images in 5 cases (33.3%) of the HCQ group and 7 cases (46.7%) of the control group, and all patients showed improvement in follow-up examination. Four cases (26.7%) of the HCQ group and 3 cases (20%) of the control group had transient diarrhea and abnormal liver function (P>0.05). Conclusions: The prognosis of common COVID-19 patients is good. Larger sample size study are needed to investigate the effects of HCQ in the treatment of COVID-19. Subsequent research should determine better endpoint and fully consider the feasibility of experiments such as sample size.
Key words: Severe acute respiratory syndrome coronavirus 2 Corona virus disease-19 Novel coronavirus pneumonia Hydroxychloroquine Treatment outcome Safety

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Anecdotal evidence like that is close to worthless and if it is in the NY Post even more so. With that said, I still suspect chloroquine will have some value, mainly based on Chinese case reports and some in vitro evidence (effects in isolated cells in a dish). In biomedical sciences there are different levels of evidence. Case reports are the lowest standard of clinical evidence but there is a long tradition of using them at the very early stages. It is a far cry from any sort of clinical trial. Chloroquine is used in autoimmune diseases and can produce some pretty weird effects in people in that setting but that is a really long term treatment, not like what would be done in this kind of disease.

Trump should not be arguing with Fauci about anything to do with infectious disease, and the fact that he sees fit to do so is part of his megalomania. But it is true, if you are so deep into the Trump cult that you are willing to take his words and then poison yourself with aquarium cleaner, and say stuff suggesting that old people should be willing to die for the economy, then you need professional help (and should not be a leading politician in one of the largest states in the US). The stuff that Trump has been saying in the last few days is the exact opposite of what EVERY public health authority and infectious disease specialists thinks he should be saying.

I agree that the quality of evidence based on the news article is low. That said, I still find blaming the President for people taking aquarium cleaner is a bit much. But to each his own. My main point is that the President wasn't going on zero evidence - after all you feel/felt that chloroquine was likely promising. He said what he felt based on the evidence he had and Faucci did the right thing by maintaining the kind of standards that a scientist should maintain. Even if Trump was wrong, there is nothing there that justifies people taking aquarium cleaner. or dosing themselves with chloroquine and that is my main point. As to whether it is Trump's fault that your deputy governor wants to sacrifice senior citizens, you know that better than I do.
 
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Please people, can we not argue with one another during this time. No matter what you think about Trump, now is the time to pull together and unite. Yes we should have civil debate, but abusing people because of what they think, even if you think that what they think is completely asinine is surly not a good way to come together during this time. We are after all, Table Tennis players, and we all (I assume) agree that Table Tennis is truly one of the best sports. Lets come together in this time, have civil discussion and together, get COVID-19 under control. God bless, :D
 
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That said, I still find blaming the President for people taking aquarium cleaner is a bit much. But to each his own.

I also think it is a bit suspect that some news outlets are leaving out that what the couple took was aquarium cleaner and are just using the word chloroquine. So....some information is being manipulated rather than clearly reported.

It really is a bit of a stretch to think the thing that cleans your fish tank is the same thing as a drug that had been prescribed in a specific dosage in China and some other countries.

Like, if a Dr prescribed a specific dosage of nitroglycerin to a high blood pressure patient, for relief of chest pain (angina), would it be wise to go to your handy dandy explosives kit and simply take the nitroglycerin from there thinking it was what the Dr had suggested. :)
 
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There are a few people who are suggesting this thread should be closed because the Olympics have been postponed or because they don't like the discussion, or that it is not about Table Tennis.

I, however, do believe that, in spite of some odd comments, most of the discussion is useful and informative.

You guys who are not interested, you can choose not to participate, just like with any other thread you are not interested in. I feel I have gotten information on here that is as good as any from the news and some information has been better than anything presented in the media.

Anyone who thinks TTDaily should be about table tennis and only table tennis, I would direct you to the list of forums and ask you to note the forum titled "Interactive Community Forums" and also note the subheading: "General Off Topic Discussion" and the forum subsections: "Football", "Music", "Announcements, Feedback & Requests" and "Technology & Gaming".....Since its inception, TTDaily has had space in its forum for things members do outside of TT.

This current subject is actually quite pertinent to the lives of most of us. However, if you are not here for this subject....No Problem....just select a different thread.
 
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I have access to a complete university medical library and I am following this pretty closely, so I'll try to distill the best info as I become aware of it. It was 88F in Houston today and a bit humid, a lot hotter than New South Wales. This may be where we will be able to learn something about temperature. Large cities here in Texas are all shelter in place now. That has to help.

As for the thread itself, I figured money people in Japan wanted the Games to go on but the actual national sports federations would never go along with it. And I suspected maybe a lot of it was Kabuki theater, and Abe knew all along he would need to postpone. But I dont know Japanese politics, so I'm guessing about that part.

Similarly I dont think very many older people are actually willing to die for the economy even if certain Fox News/GOP cult members are suggesting it is reasonable -- and lying by saying they would be willing. But then again maybe someone is mixing up large vats of laced KoolAid as we speak. Maybe they'll use fish bowl cleaner. As a scientist it pays to wait for the data.

Stay healthy everyone!
 
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Chloroquine has been arguably effective in treating many people. The argument between Trump.and Fauci was about evidential standards and not about whether the drug was really promising or not. Someone who saved his life after using chloroquine places credit with the drug. Trump didn't tell people to use what they had for their fish supplies and overdose on it. Let's be reasonable here.

https://nypost.com/2020/03/22/florida-man-with-coronavirus-says-drug-touted-by-trump-saved-his-life/

Anecdotal. That man was administered different drugs so it's not clear if it was chloroquine alone that helped. And then we have the following to keep us level-headed.

https://www.bloomberg.com/news/arti...no-better-than-regular-covid-19-care-in-study
One patient treated with hydroxychloroquine progressed to severe disease during the study. Four patients given the medicine developed diarrhea and signs of potential liver damage, compared with three getting conventional treatment.

HK went through something similar during the SARS outbreak. Ribavirin combined with steroids showed encouraging effect at first, with 90% of patients recovering. Then, the death rate went through the roof and they started increasing the dosage, resulting in bone infarction in 15% of recovered patients.

10 years later, in 2013, it was determined ribavirin was ineffective and the use of high-dose steroids actually made things worse.

https://orientaldaily.on.cc/cnt/news/20130220/00176_075.html
中大回顧當年醫治沙士經驗,他指,病人在發病首十天,即使醫生處方抗病毒藥「利巴韋林」,並無明顯療效;之後發現病人肺部受自體免疫系統攻擊,加劇炎症,遂轉為處方高劑量類固醇,以壓抑自體免疫系統。他指,事後發現若病人體內仍有病毒,當高劑量類固醇壓抑免疫系統,卻令病毒大量繁殖,並可能經血液游走全身,造成反效果。病人發病初期不應處方高劑量類固醇,這用藥指引已獲世界衞生組織確認。
CUHK reviewed the experience of treating SARS that year. He pointed out that in the first ten days of the onset of the disease, even if the doctor prescribed the antiviral drug "ribavirin", there was no obvious effect. Later, he found that the patient's lungs were attacked by the autoimmune system, which exacerbated inflammation, prompting the switch to prescribing high-dose steroids to suppress the autoimmune system. He pointed out that it was discovered afterwards that if the patient still has the virus, when high doses of steroids suppress the immune system, the virus multiplies in large quantities and may travel through the bloodstream, causing adverse effects. Patients should not be prescribed high-dose steroids at the beginning of the onset of disease, and this medication guidelines have been confirmed by the World Health Organization.
 
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We can go on about how the guy who died trying to make his own chlorique was inspired by a speech from the president. We might see 50 or 500 deaths of this. Each one wrong, but lets look at a larger scale of deaths from medical professionals in USA.

Now wouldn't it be nice if you had an actual health system instead of a health industry?
 
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Now wouldn't it be nice if you had an actual health system instead of a health industry?

In this case, I don't think neither the health system nor the health industry would help if Trump acts as he acts. I've heard that he already want's to ease the measures to keep the economy as lively as possible (his key message to his constituents is that he is the one who keeps it rolling...)

but in general, well said!
 
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Politicians are clowns. If they don't make one speech or one announcement at least once a day, they feel they're not doing their job. So they say a lot of stupid things all the time

Too easy, Takkyu. Too easy, too sweeping.

In fact, many politicians actually try their utter best to do what's right. What does not help, is that nuance and unwelcome measures do get punished at the box ballot. Typically by people claiming that all politicians are clowns, corrupt swamp creatures, and then go on to vote for the populist sock puppet du jour pretending to be the current-day anti-politician, only to find out moments later that voting for pond slime will do quite the contrary thing to actually draining the pond.

It's all nice to stick it to them, and to dismiss all people competently trying to make the best of a broken system. But it doesn't help. The better thing would to would be to empower the people who actually in best faith try to heal the broken system and work towards improvement — not shunning the complicated and painful message in doing so, even if that's a hard sell to voters not willing to spend one brain cell to contemplate their lot.
 
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It might be helpful if I explain a little about how clinical knowledge is advanced and compare this to anecdotes.

I'll start with the lowest standard of evidence, the case report, which you can find in medical journals, usually for very unusual things, and also in grand rounds and conferences, and for training students and residents.

A case report starts by describing the patient and symptoms. "A 44-year old African-American male presented complaining of pain in the lower back, etc. etc." A physical description of any unusual appearance (e.g. the patient had purple striations along the abdomen and upper legs and the face appeared swollen with indications of periorbital edema). Various initial measurements must be given (blood pressure was 140/100, heart rate 95 bpm, respiration 18. Pitting edema +2 was detected in lower limbs). Then any initial laboratory measurements (blood measurements that might be relevant, which always include things like blood glucose, electrolytes, certain enzymes and blood biomarkers that might be relevant to the initial presentation or eventual course of the disease, since these are always written after the fact). Then the treatment is described, including drugs, dose, route and frequency of adminitration, responses including adverse ones, and time course of the clinical response. The clinical response must include quantitative responses including lab values (which might include blood gasses, serum electrolytes, inflammatory markers, etc. in the case of a respiratory infection), as well as the results of any imaging that was done. Of course all adverse effects of the treatment are documented in detail, indeed if an unexpected bad response was observed this might be the whole point of the case report. Eventually the final outcome is described: The patient got better, and maybe was released from the hospital (happy ending) or didn't get better and is still dealing with the problem (not so happy) or died (definitely the least happy outcome). And lastly, a brief discussion of what it might all mean in the context of existing consensus.

Case reports are useful when a disease that seemed to usually follow one course suddenly followed another unexpected course in a patient with a set of preexisting conditions, or when a new treatment seemed to work, or didn't work, etc. etc. You get the idea. We use them a lot for teaching medical students and even occasionally undergraduates because it can make learning the basic science a lot more interesting, even to the instructor.

But the thing is, without all of that information about the patient, including the quantitative lab information, a case report is worthless. Compare this to the anecdote in the NY Post (owned by Rupert Murdoch, who also owns Fox News as part of his media empire), where it amounts to "I was really sick and it seemed like I was going to die and they gave me a single dose of this magic drug pill and I got better by the next day, and God Bless Donald Trump". The last few words are implicit because after all, it is the NY Post.

And hence my really skeptical response.
 
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