Fear and Loathing, a Rat Flu Odyssey

[4matic]

#boomerremover lol.

[plugboots]

[Spats]

(Reposting this because it's actual lifesaving information for the medical professionals reading this thread)

UW Covid team is going to use Hydroxychloroquine for all patients warranting hospital admission. We came up with this quick and simple guideline for QTc cutoffs during treatment. Feel free to adapt and use if your hospital is using hydroxychloroquin for these pts. #COVID19
https://twitter.com/ArunRSridhar/sta...822639104?s=20

Here's the image with the protocol in it:


The full Raoult paper:
Hydroxychloroquine and azithromycin as a treatment of COVID-19
https://www.mediterranee-infection.c...t-of-covid-19/
Draft version here:
https://drive.google.com/file/d/186B...IlWSHnGbj/view

Hydroxychloroquine has low toxicity over short courses: toxicity seems to only be a problem with chronic use, like 1000+ grams taken over a lifetime. (Typical pills are 200mg.) It even seems to be safe for pregnant women:
https://www.ncbi.nlm.nih.gov/pubmed/14613284

Bayer steps up:

Bayer donates 3 million tablets of investigational coronavirus drug Resochin to the US
https://www.cnn.com/world/live-news/...aa87ae6325a11f
(Resochin is their trade name for chloroquine. Hydroxychloroquine seems to be more effective based on in vitro trials, but both are shown to help. That might also depend on relative dosages.)

Teva steps up EVEN BIGGER:

Teva to Donate Potential COVID-19 Treatment, Hydroxychloroquine Sulfate Tablets to Hospitals Nationwide
https://www.marketwatch.com/press-re...ide-2020-03-19
"Teva Pharmaceutical Industries Ltd. (nyse and tase:TEVA) announced today the immediate donation of more than 6 million doses of hydroxychloroquine sulfate tablets through wholesalers to hospitals across the U.S. to meet the urgent demand for the medicine as an investigational target to treat COVID-19."

6 million doses is enough to treat 200,000 patients via the Raoult protocol!

Of course, the corporate media would rather see more people die to own #orangeman:

Trump peddles unsubstantiated hope in dark times
https://www.cnn.com/2020/03/20/polit...ope/index.html

With Minimal Evidence, Trump Asks F.D.A. to Study Malaria Drugs for Coronavirus
https://www.nytimes.com/2020/03/19/h...loroquine.html

Virus Drug Touted by Trump, Musk Can Kill In Just Two Grams
https://www.msn.com/en-us/health/hea...ob-tw-enus-677
(Typical dose is 300mg base, 600mg base as a one-time dose in special circumstances. Breaking news: taking 7 times the prescribed dose of a drug might be bad!)

Trump Pushes Malaria Drug for Covid-19, But Evidence Is Lacking
https://www.bloomberg.com/news/artic...nce-is-lacking

Nigeria Has Chloroquine Poisonings After Trump Praised Drug
https://www.bloomberg.com/news/artic...p-praised-drug
(Two people. In the hospital. After self-medicating.)

Meanwhile: It took me literally TWO MINUTES on Pubmed to find out that we've known chloroquine has anti-coronaviral effects since (checks date) 2004. This is because of research during the SARS outbreak: SARS is also a coronavirus.

Biochem Biophys Res Commun. 2004 Oct 8;323(1):264-8.
In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine.
Keyaerts E1, Vijgen L, Maes P, Neyts J, Van Ranst M.
https://www.ncbi.nlm.nih.gov/pubmed/15351731

Virol J. 2005 Aug 22;2:69.
Chloroquine is a potent inhibitor of SARS coronavirus infection and spread.
Vincent MJ1, Bergeron E, Benjannet S, Erickson BR, Rollin PE, Ksiazek TG, Seidah NG, Nichol ST.
https://www.ncbi.nlm.nih.gov/pubmed/16115318

Are these "journalists" not able to type "chloroquine coronavirus" into Pubmed?

More importantly, why are major pharmaceutical companies donating OVER 9 MILLION DOSES of medication that is an "unsubstantiated hope" with "minimal evidence" and that "can kill in just two grams"?

====

5 STAR REVIEWS from the haters!
"Nonsensical speculation...A complete fucking kook" -Boissal
"A one-man disinformation campaign" -Danno
"Craven Trump dick-sucker" -Meadow Skipper
"Fuck. You." -seano732
"Fuck you right in the ear...You are on ignore." -BobMc

Don't believe my reviews? Read some examples for yourself!

Before You Panic! Testing vs. absolute # of cases vs. mortality

Yes, calling it "Wuhan coronavirus" and blaming China for its spread is justified

PSA: Want to help? Have and use a thermometer regularly

"He's just buying votes!"

[up an down]

#boomerremover lol.

Maybe a Republican politician remover?

[Benny Profane]

#boomerremover lol.

You wish. Daddy issues?

[rideit]

Second confirmed Teton County (WY) is a health-care worker.

[Ottime]

Tell us what you really think. And, yep.

USA's curve is already steeper than Italy's, 4700+ documented cases today. The USA pulled into 4th place on the documented infection rate race. Should be pulled into 3rd tomorrow, I give them less than a week to overtake Italy for documented infections. The USA will probably not have the same high mortality rate/infection only because they have more hospitals with more equipment but there will still be a shit ton of dead people.

It's not just the disease that will be killing people. The guy that got in a car accident? He's going to die because there is no place to treat him. The guy that crashed his mountain bike and broke his femur? He bled out internally on the gurney in the hallway. Appendicitis? He's fucked. ....

Agree on the medical emergency issues. So glad my FIL went through his open heart surgery last summer and and is well recovered by now. As well as my mother with her cancer about 18 months ago. Would hate to see either of them going to a hospital or clinic right now.

US numbers the past two days are due to a bunch more test being available so picking up way more people. It kind of fucks with our curve because of change in accessibility. CA/NY say they are now reserving tests for healthcare workers and those ill enough to seek hospital care. If you have fever and cough, assume you are positive and stay home.

My hands are chapped as well. Coordinated food service at a high school up until a few days ago. Still do, but pretty much just from hike now. Best thing about shelter in place is not washing / sanitizing my hands obsessively every two minutes. Now just like a regular person until I leave the house. Sanitize all the handles and door knobs when I come back in. Cardboard sits on the deck for a day.

[hikesalot]

interesting.

https://www.bloomberg.com/news/artic...p-praised-drug

[Rideski]

Yo Old Goat. Sounds like you might get drafted back into the matrix.

[Spats]

interesting.

https://www.bloomberg.com/news/artic...p-praised-drug

Two Africans hospitalized after self-medicating.
This should DEFINITELY stop the entire world's medical system from prescribing lifesaving medication under controlled conditions to people in direct danger of dying from a worldwide pandemic!

Could it be any clearer? They want you to die to own #orangeman.

====

Meanwhile, I hope no one expects me to defend Richard Burr! He sucks and should go down.
But don't forget Dianne Feinstein, or you're just being partisan.

Coronavirus: Complaint Alleges Feinstein, GOP Senators Possibly Violated Insider Trading Laws
https://losangeles.cbslocal.com/2020...sider-trading/
A nonpartisan group is calling for federal regulators to investigate California Senator Dianne Feinstein and other U.S. lawmakers for possibly violating insider trading laws after receiving classified briefings about the seriousness of the coronavirus threat.
According to CBS News, Feinstein (D-CA) sold as much as $6 million worth of shares in late and mid-February, around the same time the Senate Intelligence Committee was briefed on COVID-19.

====

5 STAR REVIEWS from the haters!
"Nonsensical speculation...A complete fucking kook" -Boissal
"A one-man disinformation campaign" -Danno
"Craven Trump dick-sucker" -Meadow Skipper
"Fuck. You." -seano732
"Fuck you right in the ear...You are on ignore." -BobMc

Don't believe my reviews? Read some examples for yourself!

ATTN: Medical professionals! QTc cutoffs for hydroxychloroquine, via UW Covid team

Before You Panic! Testing vs. absolute # of cases vs. mortality

Yes, calling it "Wuhan coronavirus" and blaming China for its spread is justified

PSA: Want to help? Have and use a thermometer regularly

"He's just buying votes!"

[old goat]

Re the chloroquine/hydroxychlorquine--that business about the QT cutoff. The drugs slow conduction of electricity through the heart. Too much stops it. You can't give it safely to someone who has too great a distance between the Q wave and the T wave of the EKG (like me last it was checked but I was on different meds then.) Have to stop any meds that slow the heart or conduction of electricity, like beta blockers (like me).

It’s an interesting discussion, and one that hospitals and states have been preparing for long before this. Our medical structure strongly favors a patient centered autonomy model, but in a national health emergency the focus appropriately shifts to public health. Clinicians are then empowered to make different decisions regarding offering care.

The hard part is yes, lawsuits will still likely follow, and these conversations doesn’t feel any less hard for clinicians. There is already a feeling of anticipatory dread about making these decisions among my colleagues.

The decisions should be based on clear, detailed, specific rules written at the state level or higher. I can't which state is working on that now--I posted a few hundred pages back. The attending physician should have no discretion. Confirmed by a second physician -- if there's someone available not up to their own neck in trouble. 11

Yo Old Goat. Sounds like you might get drafted back into the matrix.

I was looking at the california medical board and CMA websites today, nothing about calling up the reserves yet. I don't know if it's happening in other states. During the emergency physicians can practice across state lines. It is happening in England. It doesn't sound like hospitals have figured out how to use retired docs, especially those who worked in other hospitals during their careers. A lot of working in a new hospital is learning where things are, who to call for what, and of course the EMR. I would have to be retrained on the EMR even in my own hospital. Not to mention all the medicine I've forgotten. I wonder if I would be more of a help or a hindrance. Like everything else about this epidemic this is all stuff that should have been worked out ahead of time. Still, desperate times call for desperate measures. If someone thinks they need me I'll go, as long as I can get a spot in the doctors' parking lot and the doctors' lunch room. I refuse to park or eat with nurses, or god forbid, the general public.

Edit--I guess Chicago is doing it. Some bay area counties are thinking about it but doesn't sound like it's happening yet.
Edit edit--I could do stitches in the ER so the ER docs could take care of COVID!! Sign me up. Maybe they could just station me at Costco.

[Core Shot]

Yo Old Goat. Sounds like you might get drafted back into the matrix.

I don’t wanna get drafted
I don’t wanna go

[highangle]

So at altitude, you really don't have to turn your positive pressure suit up as high, right?

[Rideski]

Seems extra risky since you’re in the....high risk zone.
But yeah.
I wonder if you could help via video chat. Not kidding.
Play by play with a kid with a go-pro?

[old goat]

But don't forget Dianne Feinstein, or you're just being partisan.

Feinstein has a blind trust. She has no say in how her assets are managed. The stock that was sold was biotech--probably a bad move to sell it.

[MakersTeleMark]

Re the chloroquine/hydroxychlorquine--that business about the QT cutoff. The drugs slow conduction of electricity through the heart. Too much stops it. You can't give it safely to someone who has too great a distance between the Q wave and the T wave of the EKG (like me last it was checked but I was on different meds then.) Have to stop any meds that slow the heart or conduction of electricity, like beta blockers (like me).


The decisions should be based on clear, detailed, specific rules written at the state level or higher. I can't which state is working on that now--I posted a few hundred pages back. The attending physician should have no discretion. Confirmed by a second physician -- if there's someone available not up to their own neck in trouble. 11

I was looking at the california medical board and CMA websites today, nothing about calling up the reserves yet. I don't know if it's happening in other states. During the emergency physicians can practice across state lines. It is happening in England. It doesn't sound like hospitals have figured out how to use retired docs, especially those who worked in other hospitals during their careers. A lot of working in a new hospital is learning where things are, who to call for what, and of course the EMR. I would have to be retrained on the EMR even in my own hospital. Not to mention all the medicine I've forgotten. I wonder if I would be more of a help or a hindrance. Like everything else about this epidemic this is all stuff that should have been worked out ahead of time. Still, desperate times call for desperate measures. If someone thinks they need me I'll go, as long as I can get a spot in the doctors' parking lot and the doctors' lunch room. I refuse to park or eat with nurses, or god forbid, the general public.

Edit--I guess Chicago is doing it. Some bay area counties are thinking about it but doesn't sound like it's happening yet.
Edit edit--I could do stitches in the ER so the ER docs could take care of COVID!! Sign me up. Maybe they could just station me at Costco.

It's happening in Colorado. https://www.npr.org/2020/03/17/81735...e-back-to-work

[bodywhomper]

a pediatric pulmonologist friend in denver told me a few days ago that he may get cross-trained to care for adults, but it hadn't entered that level of crazy yet.

[Benny Profane]

Feinstein has a blind trust. She has no say in how her assets are managed. The stock that was sold was biotech--probably a bad move to sell it.

Here we go again with that "blind trust" thing.

[The AD]

I went for a walk in a park today and there were lots of people out. Other than what appeared to be families the only large groups I saw were young people. Seems like the social distancing thing isn't really getting through to them yet.

[4matic]

Don’t do it doc goat. You had heart surgery man. You’re a saint in my book and you’ve done enough. Maybe telemedicine but you stay out of the hospital.

[grinch]

Nothing to add really. Wishing everyone safe days ahead. A lot of my feeds are US feeds. Its concerning but theres also some bright spots. Just mixed up a few spray bottles with my 9 to 1 solutions of water to bleach. Wish i could post it because it made a lot of sense(in my fb messenger so cant copy/paste). Points out safe procedures adapted in china, spain and other coutries with some success. It says lots of warm/hot fluids to wash the viral bacteria(is that the right term?) Into the stomach through the throat past the lungs. Stomach will gases will kill it. Also warm water with vinegar or other foods with disenfectant qualities if you feel a sore throat coming on. Disenfects and washes it to the stomach before it can get into your lungs. Maybe some could confirm its effectiveness but it made sense to me

Sent from my SM-G950W using TGR Forums mobile app

[TG]

Feinstein has a blind trust. She has no say in how her assets are managed. The stock that was sold was biotech--probably a bad move to sell it.

and she and her higherups were not tweeting ti the country that everything is under control while at the same time selling because ghey knew shit was going to hit the fan

wake up, spats, you trumptard cunt.
trump got the same briefings that Burr got.
the one Burr sold his shares on
the one Burr relayed to his rich friends and told them to prepare for a crisis
trump heard the same briefings
then told the country that cases were about to go from 15 to 0

[MakersTeleMark]

I went for a walk in a park today and there were lots of people out. Other than what appeared to be families the only large groups I saw were young people. Seems like the social distancing thing isn't really getting through to them yet.

It's the opposite where I live. Just got back from the park and a lap around the lake. You could blindly drive on any road and not hit a car or person. You could sit in a roundabout and not get hit for over an hour. I saw 1 young kid (10ish?) sitting on a bench with his razer scooter contemplating the absolute silence. I really would love to know what was going on in his mind about his experience.

[El Chupacabra]

. Wish i could post it because it made a lot of sense(in my fb messenger so cant copy/paste). Points out safe procedures adapted in china, spain and other coutries with some success. It says lots of warm/hot fluids to wash the viral bacteria(is that the right term?) Into the stomach through the throat past the lungs. Stomach will gases will kill it. Also warm water with vinegar or other foods with disenfectant qualities if you feel a sore throat coming on. Disenfects and washes it to the stomach before it can get into your lungs. Maybe some could confirm its effectiveness but it made sense to me

Sent from my SM-G950W using TGR Forums mobile app

That's the same list of stuff that was debunked awhile back - purportedly from a Stanford doc, but was and is not true.

[CantDog]

Old Goat, maybe you posted this one? I waded into this thread late: https://www.health.ny.gov/regulation...guidelines.pdf

On my end I’m not covering inpatient services for another three weeks, although I’m expecting to be called in for backup before then. Currently going through my outpatient panel and making sure everyone has documented advance care planning, completed POLST forms. For my patients whom are borderline hospice eligible I’ve started to recommend hospice involvement sooner rather than later. And for the folks who want to avoid the hospital, this virus has meant I now have to ask myself, ‘how do I help people die at home without hospice support?’