Inside Medicine. What Are You Seeing? [COVID-19 medical news]

I continue to have educated Facebook friends post links to dubious articles with comments such as “Grateful this Doctor has found a cure for covid. No need for a vaccine!” Good Lord.

Then when people ask for peer-reviewed studies, other people make comments like, “The proof is in the pudding. If you’re going to use something unstudied, may as well use the thing that cures you now rather than watching them die until there is a vaccine. ?‍♀️?‍♀️. People seriously have ceased to make any sense to me.” I responded by quoting the last sentence and saying that was something we could agree on. ?

It’s more than that. His research is retracted from the publications. The article goes on to list cases he has been unreliable.

Dr. Desai refused to share his raw data with anyone. The studies based on that data have been retracted. Those studies showed an increase risk of death in Covid patients who took hydroxychloroquine.

We have the results of multiple radomized, double-blind, placebo-controlled, peer -reviewed studies which used reliable data. They have not shown an increase risk of death with HCQ, nor have they shown any benefit.

The following quote is from a July 14th Chemistry World article. “Actionable results”, means a treatment that reduces the harm caused by Covid:

More studies on HCQ:

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

https://www.2minutemedicine.com/visualabstract-hydroxychloroquine-in-nonhospitalized-adults-with-early-covid-19/

https://twin-cities.umn.edu/news-events/early-treatment-mild-covid-19-university-minnesota-trial-shows-hydroxychloroquine-has-no

https://www.nejm.org/doi/full/10.1056/NEJMoa2019014

https://clinicaltrials.gov/ct2/show/NCT04304053

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And in my school district, desks will only have to be 3’ apart. I expect plenty of mask exemptions being granted, also.

What could possibly go wrong?
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In my local school district, the talk is the same - 3 feet. Where is this 3 feet coming from other than convenience? I haven’t read/heard anywhere prior to these discussions on reopening schools that 3 feet is a safe distance.

Are you aware of any controlled trials using HCQ with zinc?

In my local school district, the talk is the same - 3 feet. Where is this 3 feet coming from other than convenience? I haven’t read/heard anywhere prior to these discussions on reopening schools that 3 feet is a safe distance.

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That’s exactly where it came from - wishful thinking and a misinterpretation of the WHO saying that in some cases, 3’ could be safe briefly when masked (and IIRC outdoors).

In my local school district, the talk is the same - 3 feet. Where is this 3 feet coming from other than convenience? I haven’t read/heard anywhere prior to these discussions on reopening schools that 3 feet is a safe distance.

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The AAP guidelines say that. I think it originated in the thought that smaller bodes exhale less breath. And in my district’s case, they have to have smaller class sizes if there has to be 6’ apart. Not so (they claim) with 3’ apart between desks. They think they can pack 'em in and teach ‘em! (Wrong!) The older kids can transmit the virus as efficiently as adults, and they need 6’ between desks. Is that going to happen. Apparently not, at least here.

The three feet comes from WHO guidelines, which many countries are using. Neither the 3 ft (WHO) or 6 ft (CDC) recommendations are supported by good data, and not SARS-COV-2 specific data either.

Chicago Public Schools are looking at the 3ft distance too.

No, I’m not. NYU Grossman did a study with HCQ, azithromycin and zinc. However, it was observational and retrospective, not randomized, blinded or placebo controlled. Their results are also still in pre-print (not peer reviewed). If HCQ were a big game changer, though, I would think that studies would have shown some positive results, even without the zinc.

I wish we had a nationally coordinated system for research trials so that resources and willing participants were not used for improperly designed or underpowered trials. Federal coordination would also make sure that we don’t put our eggs in too few baskets, and that more different approaches can be studied.

We could have had one huge HCQ trial with arms for plain HCQ, plus zinc, plus antibiotics, preventative, out-patient, hospitalized, etc. It’s too bad that we gave it to so many thousands of patients, and don’t have the data to show for that. With that said, I think more hope lies in an antiviral developed specifically for SARS-CoV-2.

Well, the assertions I have read argue that it’s the zinc which is inactivating the virus, but that without an ianophore, it can’t get across the lipid membrane. Allegedly the HCQ is the ianophore that ushers zinc in. So if zinc is the key, than HCQ alone is pointless.

I have no idea if any of this is actually true in real practice, just that some doctors are touting its efficacy. I would prefer to see a strong controlled study to verify these claims rather than just accepting their word.

With everyone indoors for an hour or several at a time, distance may not matter so much as the fact that a contagious person could fill the air in the room with virus-laden droplets to infect everyone in the room. Remember the examples of the restaurant and the office where a contagious person infected people far more than 6 feet away?

https://www.erinbromage.com/post/the-risks-know-them-avoid-them

If they have class outdoors, or at least in classrooms with large windows that are kept open, that may mitigate the risk. But weather can make doing that inconvenient.

Covid-19 is not known to spread through food or food packaging, FDA commissioner says
From CNN’s Gisela Crespo

Coronavirus is not known to spread through food or food packaging, US Food and Drug Administration Commissioner Dr. Stephen Hahn said on Tuesday.

In pre-recorded remarks for the National Food Policy Conference, Hahn said that although there are still a lot of questions about Covid-19, “what we do know is that the virus is not known to be transmitted via food or food packaging. It is much more likely to be spread through person-to-person transmission.”

Hahn said that while the US food supply chain “remains strong,” the FDA and US Department of Agriculture are monitoring for potential nationwide and regional shortages.

The agency has also provided flexibility on things such as packaging and label requirements to “help clear new paths to the retail market” for food producers who found themselves with a surplus due to schools and restaurants closing, Hahn explained.

https://www.youtube.com/watch?v=W1dA9VhL60A

Dr. Seheult’s (MedCram) 100th coronavirus update linked above. Short and sweet he recaps some of the info he has covered since late January, shared some new info on an inhaled medication that looks promising (Interferon Beta), mentioned TWIV and how he will be hosting Dr. Michael Mina on August 5th to talk more about the rapid testing and wrapped up with a personal segment that was very enjoyable. @3SailAway I’m sure will find this interesting and I plan on watching the August 5th episode as well.

Yes, I would like to see more studies on this as well. Here’s a hypothesis re: Zn that I think @Nrdsb4 will find interesting.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247509/

“It is well known that zinc (Zn) possesses a variety of direct and indirect antiviral properties, which are realized through different mechanisms. Administration of Zn supplement has a potential to enhance antiviral immunity, both innate and humoral, and to restore depleted immune cell function or to improve normal immune cell function, in particular in immunocompromised or elderly patients. Zn may also act in a synergistic manner when co-administered with the standard antiviral therapy, as was demonstrated in patients with hepatitis C, HIV, and SARS-CoV-1. Effectiveness of Zn against a number of viral species is mainly realized through the physical processes, such as virus attachment, infection, and uncoating. Zn may also protect or stabilize the cell membrane which could contribute to blocking of the virus entry into the cell. On the other hand, it was demonstrated that Zn may inhibit viral replication by alteration of the proteolytic processing of replicase polyproteins and RNA-dependent RNA polymerase (RdRp) in rhinoviruses, HCV, and influenza virus, and diminish the RNA-synthesizing activity of nidoviruses, for which SARS-CoV-2 belongs. Therefore, it may be hypothesized that Zn supplementation may be of potential benefit for prophylaxis and treatment of COVID-19.”

I did enjoy it—thanks, @rjm2018 !
Looking forward to the interview with Michael Mina in hopes of a positive update on the progress towards cheap, fast, frequent and widely available testing.

Trump to use Defense Production Act to turn Kodak into a pharmaceutical company
From CNN’s Nikki Carvajal

President Trump said his administration will use the Defense Production Act to turn Kodak into a pharmaceutical company, an announcement he called “one of the most important deals in the history of US pharmaceutical industries.”

“With this new agreement, my administration is using the Defense Production Act to provide a $765 million loan to support the launch of Kodak pharmaceuticals,” the President said at a news conference.

Trump called it a “different field” for the company known mostly for its cameras and film, saying they had “hired some of the best people in the world.”

“It’s a breakthrough in bringing in pharmaceutical manufacturing back to the United States,” Trump said.
Some context: The move is the 33rd time the Trump White House has used the DPA after facing criticism for not enacting it earlier in the pandemic.

“Remember when you were saying I didn’t use it enough, I didn’t use it enough?” he asked reporters rhetorically, “and now you heard it’s the 33rd use. We don’t talk about it all the time, we used it and we used it as a little bit of a threat, frankly, with certain companies that weren’t doing as we were asking them to do, and it came through as both a threat and a usage. But this is our 33rd use of the Defense Production Act.”

The company will produce generic active pharmaceutical ingredients, Trump said, “using advanced manufacturing techniques Kodak will also make the key starting materials that are the building blocks for many drugs in a manner that is both cost competitive and environmentally safe will be competitive with almost all countries and soon with all countries.”

I have taken hydroxychloroquine in the past for two reasons. First, systemic lupus which makes me get sick in the sun. In that case, I have to take it 6-8 weeks before summer. So I wonder if effectiveness might prove greater if taken as a preventative, well in advance. My assumption has been that it tamps down immune response, so another question might be whether the drug would only help the cytokine storm/hyper immune response, and might harm the initial immune defense. So there are timing questions, I would think.

I also took hydroxychloroquine for Lyme disease. It helps antibiotics like azithromycin and Biaxin better enter cells due to an effect on cell pH.

I am neither doctor nor scientist so these are just random thoughts from a person who has used the drug. At this point, I need to consult my cardiologist and I did not take my usual regimen of hydroxychloroquine because another drug, Zofran, prolonged my QT interval, the same heart problem that hydroxychloroquine may cause.

Not sure if linked here already. Here’s to hoping we’ve had previous exposure to a virus that gave us T cells to fight COVID-19!

https://www.nature.com/articles/s41586-020-2598-9

Can you summarize this in layman’s terms?

^I think it is saying people infected with SARS in the past may have developed some immunity against COVID, loosely speaking.