Coronavirus thread

[the Schwartz]

One morning last week I drove from my garage to campus in 16 minutes. My previous record has been something like 21 minutes. A month ago, if anyone had told me that I could make it from my garage to work in 16 minutes, I would have told them that they were absolutely crazy. My hope is that a number of things that were impossible last month will come to pass next month.

We have three of four clinical trials starting here, one of which is a multicenter study that we are lead on. Some of the others involve chloroquine. I'm not involved in any of those studies, but if we have three or four ready to go, larger places will certainly have even more planned. As of right now, clinicaltrials.gov returns 202 hits for "COVID-19." Eighty-eight of these trials are already recruiting. For off-label use of approved drugs, the toxicity/pharmacology/safety is already known from previous trials. All we need is to show efficacy, and for a disease that lasts less than three weeks, efficacy, or the lack thereof, will be determined very very quickly. Solving this problem is not something that "will" happen but rather "is" happening. We're in present tense now.

Given the brevity of resolving the disease (hopefully ≤ 3 weeks), I wonder...does the use of HydroxyChloroquine/Chloroquine therapy (assuming in combination with azithromycin) for such a short-term pose an issue in terms of prolonged QT and QRS complex and Atrial-Fib?

[Joe S]

Unfortunately, NYC is not on board with this program and is still half-assing the necessary social distancing to allow a quick seasonal resolution. Making matters worse, the region has become a virtual shipping center for infection around the country. Every hour this continues the likelihood of a quick, 2-3 month return toward some semblance of normalcy goes down.

Are you talking stricter enforcement of the stay at home order? Looking for clarification, not trying to be intentionally obtuse or pick an argument.

[shootist26]

Are you talking stricter enforcement of the stay at home order? Looking for clarification, not trying to be intentionally obtuse or pick an argument.

There needs to be stricter enforcement, period. Many european countries are fining people who are going out for nonessential trips (i.e. not grocery/medical care type trips) large sums of money.

Sorry but Americans suck at voluntary compliance in the name of public health. It's just cultural. We are more like Italians, not Scandinavians.

I live in a city with a major case load and lockdown (all nonessential businesses closed) and yet every day the parks/trails/takeout restaurants are packed to the gills with people like it is a summer holiday.

[pangloss]

Given the brevity of resolving the disease (hopefully ≤ 3 weeks), I wonder...does the use of HydroxyChloroquine/Chloroquine therapy (assuming in combination with azithromycin) for such a short-term pose an issue in terms of prolonged QT and QRS complex and Atrial-Fib?

I have no idea, but if you're dead in the short term, what happens in the long term doesn't matter much. As I've said previously, if I had a bad case of this, I'd be very open to trying off label use of most anything. Taking my chances on some weird drug combination and dying is a whole lot better than dying because there aren't enough ventilators to go around. Either way I'm dead, but we might as well learn as much as we can from the process.

[YVK]

Given the brevity of resolving the disease (hopefully ≤ 3 weeks), I wonder...does the use of HydroxyChloroquine/Chloroquine therapy (assuming in combination with azithromycin) for such a short-term pose an issue in terms of prolonged QT and QRS complex and Atrial-Fib?

The risk is low but at the minimum I would want a baseline ECG. I would be very hesitant to start it if baseline QTc was high to begin with.

[Caballoflaco]

I have no idea, but if you're dead in the short term, what happens in the long term doesn't matter much. As I've said previously, if I had a bad case of this, I'd be very open to trying off label use of most anything. Taking my chances on some weird drug combination and dying is a whole lot better than dying because there aren't enough ventilators to go around. Either way I'm dead, but we might as well learn as much as we can from the process.

[shootist26]

There needs to be stricter enforcement, period. Many european countries are fining people who are going out for nonessential trips (i.e. not grocery/medical care type trips) large sums of money.

Sorry but Americans suck at voluntary compliance in the name of public health. It's just cultural. We are more like Italians, not Scandinavians.

I live in a city with a major case load and lockdown (all nonessential businesses closed) and yet every day the parks/trails/takeout restaurants are packed to the gills with people like it is a summer holiday.

Case in point in Louisiana (which is about to get fucked)
https://www.washingtontimes.com/news...ts-coronaviru/

Idiots. But let me take a wild ass guess, they think "god will protect them from the virus"

It's like how some people stop and gawk when they see the ocean recede from the shore, completely oblivious to the fact that it indicates a tsunami is about to fucking hit them

[Dov]

Those are kind of a poor man's endotracheal tube/mechanical ventilator. They were historically most used for poliovirus - not TB. I'll explain why this is important momentarily.

Essentially, a mechanical ventilator forces air in and out of your lungs using a bellows. Somewhat intuitive how that works.

the iron lung does the opposite - it generates negative pressure around your chest cavity, which makes it easier for your lungs to expand. Imagine blowing up a balloon under water vs. blowing up a balloon on air - it's easier to force air into the balloon when there is less pressure pushing against you. The iron lung generates enough negative pressure that it helps people who have trouble drawing breath because the muscles they use to breathe are either too weak or paralyzed.

This gets at why the iron lung was used for polio. Polio causes an ascending weakness/paralysis of your skeletal muscles, including the ones that you use to breathe. However, their lungs themselves were otherwise healthy. In COVID19/other causes of ARDS, the problem is the lung tissue itself. We use mechanical ventilation to force 100% pure oxygen into their lungs to compensate for damaged lung function - not because the cannot draw air in and out of their lungs on their own.

Let me know if this makes sense...

Does prone aid breathing with things like Sleep Apnea & CPAP as well or is it limited to high volume oxygen treatments?

[Sensei]

Are you talking stricter enforcement of the stay at home order? Looking for clarification, not trying to be intentionally obtuse or pick an argument.

People in NYC need to stop circulating in public and traveling to other states. Call it stricter enforcement, quarantine, whatever.

[SeriousStudent]

People in NYC need to stop circulating in public and traveling to other states. Call it stricter enforcement, quarantine, whatever.

This is true.