Coronavirus thread

[Nephrology]

https://www.nytimes.com/2020/03/28/n...PmdHBRoelmHvy0

N.Y.C.’s 911 System Is Overwhelmed. ‘I’m Terrified,’ a Paramedic Says.

With coronavirus cases mounting, emergency workers are making life-or-death decisions about who goes to a hospital, and who is left behind.

This was the scariest quote from that article, IMO:

One New York City paramedic described responding to a suicide attempt of a woman who had drank a liter of vodka after her cancer treatments had been delayed, in part because hospitals were clearing their beds for coronavirus patients.

Another paramedic said she responded to so many cardiac arrests in one shift that the battery on her defibrillator died.

[RoyGBiv]

Aviation is not an area where I have contacts, but I did talk to the only well-placed person I know in civil aviation in China (who also flew in the US) to no avail. They said they would ask around and get back to me if anything changed, but at this point, there is just nothing they can do.

Thanks!

I may have solved a piece of this puzzle when a potential customer came to us yesterday. Told us they had airplanes if we have materials. I'm not going to go down the "can we land a private jet and leave with a load" rabbit hole until sufficient supplies can be confirmed. Now that we have monies promised we can place firm orders for meaningful quantities if our suppliers will take them. Next week we'll know more.

[Nephrology]

This seems to be a pretty thorough and objective collection and review of the Chloroquine developments. Working hypothesis:



https://docs.google.com/document/d/1...Gs/mobilebasic

The centralized links are helpful, but the author is clearly a non-SME so I don't really find value in his interpretation of the evidence.

All the in vitro stuff is just that: in vitro. Cells in a dish. Doesn't mean diddly squat except "This might be worth trying in people some day."

The clinical evidence is small and limited. Thus, right now, we simply don't know if it does or does not work. My suspicion is no. I am more optimistic about remdesivir but time will tell about that one too.

[Rick62]

Thanks!

I may have solved a piece of this puzzle when a potential customer came to us yesterday. Told us they had airplanes if we have materials. I'm not going to go down the "can we land a private jet and leave with a load" rabbit hole until sufficient supplies can be confirmed. Now that we have monies promised we can place firm orders for meaningful quantities if our suppliers will take them. Next week we'll know more.

As a guy whose PPE stash gets just a little bit smaller with each shift, thanks for you efforts to bring more material in country. I’m sure the Docs, RNs and other personnel feel the same way.


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[Caballoflaco]

Thanks!

I may have solved a piece of this puzzle when a potential customer came to us yesterday. Told us they had airplanes if we have materials. I'm not going to go down the "can we land a private jet and leave with a load" rabbit hole until sufficient supplies can be confirmed. Now that we have monies promised we can place firm orders for meaningful quantities if our suppliers will take them. Next week we'll know more.

There have been more and more reports of bogus med supplies out of China lately, hopefully you have some QC guys in country that can verify quality before you start buying. (The Netherlands just had to recall some 600,000 n95s that were defective)

https://www.google.com/amp/s/www.nyt...tests.amp.html

https://amp.dw.com/en/coronavirus-ne...ina/a-52949216

[Grey]

There have been more and more reports of bogus med supplies out of China lately, hopefully you have some QC guys in country that can verify quality before you start buying. (The Netherlands just had to recall some 600,000,000 n95s that were defective)

https://www.google.com/amp/s/www.nyt...tests.amp.html

https://amp.dw.com/en/coronavirus-ne...ina/a-52949216

Great post, was about to do the same. Hopefully this is just due to the insane demand for masks right now and not due to some profiteering fuckery and cutting QC corners.

[Stephanie B]

Not safe for work or sensitive ears.

[Kanye Wyoming]

The centralized links are helpful, but the author is clearly a non-SME so I don't really find value in his interpretation of the evidence.

All the in vitro stuff is just that: in vitro. Cells in a dish. Doesn't mean diddly squat except "This might be worth trying in people some day."

The clinical evidence is small and limited. Thus, right now, we simply don't know if it does or does not work. My suspicion is no. I am more optimistic about remdesivir but time will tell about that one too.

Understood and thank you again (and all the others in this thread to whom this applies) for what you’re doing on the front lines and for taking the time to share your analyses and keeping us up to date. It is invaluable.

Something that occurred to me for the medical folks on the front lines. They are going to be taking incoming. Body armor isn’t a panacea and some people aren’t able to tolerate it without great risk. But in battle it might prevent a lot of injuries that would otherwise have been inflicted.

Chloroquine is used safely for several conditions. As to health professionals on the front lines, except for those who shouldn’t take it because of a certain risk profile, might it not be a good idea to treat Hydroxychloroquine & Azithromyacin as analogous to body armor?

[Nephrology]

Chloroquine is used safely for several conditions. As to health professionals on the front lines, except for those who shouldn’t take it because of a certain risk profile, might it not be a good idea to treat Hydroxychloroquine & Azithromyacin as analogous to body armor?

Well, there is even LESS data (i.e. none) for its use as a prophylactic against the virus, so I would say no. Not only do we not have any reason to believe it would work that way, but it also causes pretty significant side effects (e.g. nausea, diarrhea) that can be debilitating to healthcare workers who are pulling extra hours and wearing full PPE. Not to mention that given the current shortage of HCQ, giving it to one person necessarily means depriving someone else who may need it more (eg lupus patient)

At the end of the day, we just need quality evidence, and while clinical studies can be expedited there is a necessary amount of time and effort that goes in to getting this information. Think of it this way: many medical scientists will spend their entire career trying to understand a basic scientific phenomenon and turn it into a treatment for human disease. It would be crazy to think we can figure it all out inside a few months.

The HIV/AIDS crisis is the closest thing we have to a recent, similar example, and it was indeed a resounding succcess story. HIV went from a death sentence to a very manageable chronic disease. However, even with expedited clinical trials and massive public outcry, it still took 30 years for this to happen. We know a lot more about this coronavirus than we did about HIV in the 80s, so it shouldn't take 30 years, but it won't really happen overnight either.

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