Hydroxychloroquine + azithromycin combination being touted as a Corona treatment

plodder

mvl wrote: »

BCG is controversial, various studies from years ago - e.g. from https://www.ncbi.nlm.nih.gov/pubmed/29324233 :

"BCG induces epigenetic reprogramming in human monocytes in vivo, followed by functional reprogramming and protection against non-related viral infections, with a key role for IL-1β as a mediator of trained immunity responses."


But China does BCG vaccination too, and that says alot about this context imo.

How is this controversial?

McGiver

begbysback wrote:

It does seem that Czech Republic have been provisionally approved for the use of Remdesivir in serious cases, and maybe we can compare Dublin to Prague in population with regards to calculating death rate reduction if somewhat successful.

There are many factors, such as the policy (mandatory masks in public, effective quarantine and tracing), overall better healthcare system etc so hard to say it's Remdesivir.

Czechia - death rate 1.36% (deaths/cases)
Ireland - death rate 3.98% and increasing...

Cases per capita are double in Ireland. Testing coverage is about 8/1000 in CZ, hard to tell in Ireland as data isn't readily available (lack of transparency!) but will probably be less.

So more cases with less testing and higher mortality overall.

Wibbs

McGiver wrote: »

There are many factors, such as the policy (mandatory masks in public, effective quarantine and tracing), overall better healthcare system etc so hard to say it's Remdesivir.

Czechia - death rate 1.36% (deaths/cases)
Ireland - death rate 3.98% and increasing...

And yet Ireland's HSE mouthpieces are still peddling masks as useless, quarantine is self imposed and I see little evidence of tracking. If we did similar our cases should drop even further than the Czech Republic with it's much higher population density and shared living. Because of the latter Ireland's cases and deaths should be among the lowest in Europe and the West in general. For all the praise on the HSE response from some quarters it is my opinion that our relatively low rates are far more down to that population difference than our leadership. Certainly in the early stages.

McGiver

Wibbs wrote:

And yet Ireland's HSE mouthpieces are still peddling masks as useless, quarantine is self imposed and I see little evidence of tracking. If we did similar our cases should drop even further than the Czech Republic with it's much higher population density and shared living. Because of the latter Ireland's cases and deaths should be among the lowest in Europe and the West in general. For all the praise on the HSE response from some quarters it is my opinion that our relatively low rates are far more down to that population difference than our leadership. Certainly in the early stages.

CZ population density is double and it's more or less evenly distributed. Also several larger cities.

In Ireland it's just 3 cities or so (Dublin, Cork, Limerick). Low density outside of the Pale, and very low in the west and north. Despite that there's double the cases here.

begbysback

McGiver wrote: »

There are many factors, such as the policy (mandatory masks in public, effective quarantine and tracing), overall better healthcare system etc so hard to say it's Remdesivir.

Czechia - death rate 1.36% (deaths/cases)
Ireland - death rate 3.98% and increasing...

Cases per capita are double in Ireland. Testing coverage is about 8/1000 in CZ, hard to tell in Ireland as data isn't readily available (lack of transparency!) but will probably be less.

So more cases with less testing and higher mortality overall.

Apr 3rd on the wikipedia page says they had to specifically apply for use of Remdesivir in one case, so it seems it is not in general usage, from what I can make out on the page they seem to be using hydroxy.

They are lowering restrictions from today and seem to have consistently low numbers.

McGiver

begbysback wrote:

They are lowering restrictions from today and seem to have consistently low numbers.

Yep, daily increase at 4-5% last few days but I wouldn't say they've peaked.

Wibbs

McGiver wrote: »

CZ population density is double and it's more or less evenly distributed. Also several larger cities.

In Ireland it's just 3 cities or so (Dublin, Cork, Limerick). Low density outside of the Pale, and very low in the west and north. Despite that there's double the cases here.

begbysback wrote: »

They are lowering restrictions from today and seem to have consistently low numbers.

One major difference to here is that there was a groundswell of support for masks in public for everyone and soon after that became a requirement their R0 number fell below 1 in a fortnight. And yet the gobshite "experts" here are wilfully ignoring this, and the Asian experience.

begbysback

Re masks, I haven’t seen any in sale anywhere, though I haven’t been to any chemists - is there a shortage?

Also Czech seem to be lowering restrictions and one of those seems to be masks no longer required, think I read that on the page.

Wibbs

begbysback wrote: »

Re masks, I haven’t seen any in sale anywhere, though I haven’t been to any chemists - is there a shortage?

There is, but the Czechs got around that by a grassroots drive to make their own at home.

Also Czech seem to be lowering restrictions and one of those seems to be masks no longer required, think I read that on the page.

Sorry B, what page. Must have missed the link.

Wibbs

Googling around I found this on the recent Czech changes in restrictions.

In the Czech Republic, the head of the government’s crisis committee, Interior Minister Jan Hamacek, said he is proposing to scrap a ban on Czechs traveling abroad starting April 14. He said border checks that were introduced to contain the virus would remain in place and people would be allowed to travel only under rules that have yet to be finalized.

Currently, Czechs are barred from leaving the country and foreigners from entering it.

Czech Health Minister Adam Vojtech said the government also will discuss a proposal to allow more small stores to reopen, depending on the development of the epidemic. The Cabinet will decide on the measures later this week.

So they look to be still upholding the masks in public bit.

begbysback

Wibbs wrote: »

There is, but the Czechs got around that by a grassroots drive to make their own at home.

Sorry B, what page. Must have missed the link.

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_the_Czech_Republic#Policies_to_fight_the_contagion

the actual wording seems to indicate only specified activities without a mask, maybe normal walking around still requires a mask

Wibbs

The Czechs really got on top of this from the get go, with both good leadership from the top and leadership from the grassroots community. Fair bloody play to the Czechs.

iguana

Wibbs wrote: »

One major difference to here is that there was a groundswell of support for masks in public for everyone and soon after that became a requirement their R0 number fell below 1 in a fortnight. And yet the gobshite "experts" here are wilfully ignoring this, and the Asian experience.

I understand the need to make sure masks weren't bought up by the public when there was a clear shortage of them for HCPs. But I really, really don't understand why that couldn't have been made clear while also telling people how to make a face covering that would be effective in keeping people's own viruses contained. We aren't children. If you openly explain to people that covering your mouth and nose limits the spread of the virus by making it harder for infectious particles to spread and recommend that everyone wrap something over the mouth and nose out of consideration for everyone else, people will understand and go along with it. If everyone wore a scarf/snood/bandana/even an old t-shirt, around their mouth and nose, transmission rates would almost certainly be lower.

mvl

plodder wrote: »

How is this controversial?

Actually I was wanting to suggest this BCG vaccine saga is controversial, rather than the study linked (linking was meant to show it's not first time when BCG was associated with non TB related viral infections).
Now for example what I find confusing, is knowing what was said to us decades ago (e.g. BCG can only be given to newborns -> teenagers", and its protection is uncertain), but some of these recent BCG studies seem to refer to a revamped BCG vaccine, such as the one in Germany called VPM1002 - which can be given to adults, but has not completed testing yet ... ?!?
- maybe it would be more justice done to BCG if there weren't too many economic interests involved in the chase for the most efficient (TB) vaccine ...

iguana wrote: »

I understand the need to make sure masks weren't bought up by the public when there was a clear shortage of them for HCPs. But I really, really don't understand why that couldn't have been made clear while also telling people how to make a face covering that would be effective in keeping people's own viruses contained. We aren't children...

I agree with you 100%, I am also annoyed when the officials practice deceit (especially when dual morality is sometimes in place).
But have to say, nothing they've said about masks prevented me from buying the overpriced masks from a pharmacy in town centre when I found them, nor from going to the shops wearing a mask ...one of the reasons being that I am open to learning from Asian knowledge on this ...

The evidence for hydroxychloroquine continues to get poorer and poorer.

No change in mortality rate in ICU even after widescale use of hydroxychloroquine and azithromycin.

Caveat: Data is from the UK

https://www.icnarc.org/DataServices/Attachments/Download/76a7364b-4b76-ea11-9124-00505601089b

plodder

Deleted User wrote: »

The evidence for hydroxychloroquine continues to get poorer and poorer.

No change in mortality rate in ICU even after widescale use of hydroxychloroquine and azithromycin.

Caveat: Data is from the UK

https://www.icnarc.org/DataServices/Attachments/Download/76a7364b-4b76-ea11-9124-00505601089b

Did you link the wrong document ?

That doesn't even mention hydroxychloroquine or azithromycin.

mvl

plodder wrote: »

Did you link the wrong document ?

That doesn't even mention hydroxychloroquine or azithromycin.

Was just looking at this too, and do wonder if the NHS guidelines are linked somewhere on these threads ?!?
- when are NHS prescribing this combo, what phase of the virus evolution, are there other additions to the scheme for severe cases ? e.g. in Ireland/other EU they seem to include Tocilizumab for severe cases - was that included in the report ?

plodder

plodder wrote: »

Did you link the wrong document ?

That doesn't even mention hydroxychloroquine or azithromycin.

Sorry, the conditions for prescribing H+A are broadly similar in the HSE + NHS. Patients with moderate to severe COVID-19 with oxygen desaturation.

The combination was started in use in Ireland: 14/03/20

The NHS started doing similar at the same time. The use of H+A has no perceived effect on mortality in patients on ICU. It was a 50/50 chance before H+A and it remains 50/50 afterwards.

I have other data which backs up this information but it's not been published yet. I'll link to it when it is published.

plodder

mvl wrote: »

Was just looking at this too, and do wonder if the NHS guidelines are linked somewhere on these threads ?!?
- when are NHS prescribing this combo, what phase of the virus evolution, are there other additions to the scheme for severe cases ? e.g. in Ireland/other EU they seem to include Tocilizumab for severe cases - was that included in the report ?

The (actual confirmed) doctor that was posting on another thread said that these drugs are being used in Irish and UK hospitals, I think as much out of desperation as anything else. But, that kind of usage isn't being measured. We've no idea what extent it's being used. The only thing that will establish whether the drugs work or not are proper trials with controls all drawn from a similar cohort of patients.

mvl

mvl wrote: »

Was just looking at this too, and do wonder if the NHS guidelines are linked somewhere on these threads ?!?
- when are NHS prescribing this combo, what phase of the virus evolution, are there other additions to the scheme for severe cases ? e.g. in Ireland/other EU they seem to include Tocilizumab for severe cases - was that included in the report ?

Toculizimab is only indicated in patients who have a raised IL-6.

stockshares

https://twitter.com/laoneill111/status/1247873433658167304?s=19

stockshares

stockshares wrote: »

https://twitter.com/laoneill111/status/1247873433658167304?s=19

That article in chemrxiv is computer modelling, no in-vitro testing done. More than likely, another false dawn.

stockshares

Deleted User wrote: »

That article in chemrxiv is computer modelling, no in-vitro testing done. More than likely, another false dawn.

Luke O Neill doesn't seem to be the most reliable for info. He doesn't seem to give much attention to detail.

mvl

Deleted User wrote: »

Toculizimab is only indicated in patients who have a raised IL-6.

- I've linked earlier in the thread the HSE document stating where this is used, can be found at https://www.hse.ie/eng/about/who/acute-hospitals-division/drugs-management-programme/
But when we read about various combos for various scenarios as documented by HSE, I would expect the report use to conclude that H+A "give no change in mortality rate in ICU even after widescale use" includes what was the complete treatment used for these scenarios that didn't work, treatment duration ...

- Anyway, seeing now that HSE have in their current antiviral therapy doc updated (end of march) with "insufficient evidence to recommend systematic use of HCQ and azithromycin combination for the treatment of COVID-19 ..." .

(Note: this doc can be found under link above)

mvl

mvl wrote: »

- I've linked earlier in the thread the HSE document stating where this is used, can be found at https://www.hse.ie/eng/about/who/acute-hospitals-division/drugs-management-programme/
But when we read about various combos for various scenarios as documented by HSE, I would expect the report use to conclude that H+A "give no change in mortality rate in ICU even after widescale use" includes what was the complete treatment used for these scenarios that didn't work, treatment duration ...

- Anyway, seeing now that HSE have in their current antiviral therapy doc updated (end of march) with "insufficient evidence to recommend systematic use of HCQ and azithromycin combination for the treatment of COVID-19 ..." .

Surprised they said that. They are right of course. It is still been prescribed in hospital and I'm not sure the benefits outweigh the risks. This is the issue of basing treatment off case reports.

plodder

Deleted User wrote: »

That article in chemrxiv is computer modelling, no in-vitro testing done. More than likely, another false dawn.

I'm no expert, and most of it is gobbledy-gook to me, but would it be fair to say that it offers a possible explanation as to why hydroxy/chloroquine or Favipiravir might work, if it were validated with in-vitro and further testing?

The Hound Gone Wild

plodder wrote: »

I'm no expert, and most of it is gobbledy-gook to me, but would it be fair to say that it offers a possible explanation as to why hydroxy/chloroquine or Favipiravir might work, if it were validated with in-vitro and further testing?

No, it offers nothing in the way of an explanation. You might be able to use this paper as proof of concept to get ethics approval for testing in a mouse model, that's about it.

Not talking specificly about this paper but in general the quality of research that has been pumped out in the last few months has been embarrassing. In normal circumstances most of it wouldn't make it past the spam filter of some of the journals they're ending up in.

bo0li5eumx12kp

DIY stores were stocking FFP3 masks, whilst pharmacies and hospitals were totally cleared out.

FFP3 filters up to 0.007 micron particles, corona being 0.1 microns - they're basically the wizard cloth against the bad germs.

About regular cloth masks yeah I mean, why not?

But being health conscious I wouldn't even CONSIDER going grocery shopping without my FFP3 respirator.


BCG vaccines were mandatory in France up to 2007, they came in at 1500 deaths in the last 24 hours.

In contrast to Germany's death rates which are overall 20% that of France, despite having relatively identical infection rates - so, I guess we'd all love if that question is answered.

That doc in the twitter clip posted was basically saying this doesn't appear to be a pneumonia based illness, despite widespread respirator use.
It's clearly a respiratory tract/lung infection - but then he's just one clinician and I haven't seen that opinion being "peer reviewed".

So France Vs Germany - it's clearly not the BCG vaccine, unlikely to be pneumonia vaccine pre-administered.

Why the difference in mortality?

CIARAN_BOYLE

Eliezer Shrilling Grassland wrote: »

Why the difference in mortality?

We could suggest that it's testing.

According to worldometers Germany has done 3 times as many tests as France.

Let's say they've discovered a lot of mild cases that is flying under the radar in France.

Frances real infection rate might be significantly higher than Germany.

Maybe it didn't get into the nursing homes in Germany as much as it did in France or maybe Germany isnt reporting deaths where the cause of death is soemthing other than coronavirus as a coronavirus death.

The German cases started higher but ramped up slowed than France. This meant ICU facilities never really got overwhelmed and forced to make though decisions.

I don't know.

Jurgen Klopp

Germany from day 1 was not counting anyone with an underlying condition who died with c19 unless that's changed and had the numbers added on