Near real time COVID-19 statistics

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TUPF
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Re: Near real time COVID-19 statistics

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FDA revokes approval for emergency use of hydroxychloroquine for treatment of COVID-19.

https://apple.news/ABm7dwfegQ1G3Tw7m3Y41jg
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Re: Near real time COVID-19 statistics

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As a rheumatologist, I am a bit happy, because I am tired of trying to write for the medication for patients with lupus, rheumatoid arthritis, etc. I actually got a denial today and was told that this medication, which I have been writing for nearly 30 years needed a prior authorization for an FDA-approved indication.

At the same time, I wish that it had panned out as a treatment; in my specialty there are at least 5 different medications that we use that are being considered as having potential for treatment. Kevzara and Actemra work to reduce the "cytokine storm" via effects on Interleukin-6, while Olumiant, Rinvoq and Xeljanz can block Janus-kinase (a membrane bound activator) that can trigger the "cytokine storm.

Ignore the stuff above unless you are a real wonk. suffice it to say that these other medications run about $50K for a year's supply, compared to several hundred dollars for generic plaquenil. Granted, one would give 2-3 doses per patient at the most, costing about $3000 or less; still, it can certainly add up pretty quickly, and the availability of these medications is far more limited than HCQ.
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Re: Near real time COVID-19 statistics

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Meanwhile, this whole thing looks like it's about to blow back up again. I know I'm pegged as an alarmist (though I have posted articles from Dr. Kasten which actually say we were too careful about some things previously)... but basically politics, news cycle top headlines, and exhaustion have made too many people think that "it's over". And it's not, not even close. I'm not following politicians and news people's recommendations, I'm following doctors' recommendations. Very few are.

My doctor friend in Nashville (the one who had an entire story written on him in the Tennessean, I posted it a few pages prior here) who was vehemently pushing for quarantining before it was nationwide (back in mid-March) recently posted a story on Facebook about how it's blowing up in Tennessee. A friend of theirs responded "we're all getting sent back home again, aren't we?". My friend very astutely responded (with an implied heavy sigh), "not during this election cycle".

The fact that politicians are trying to appease their constituents (and, barring something major, will continue to do so until November), coupled with news headlines that have bumped a three-month-long pandemic down the page, have such a massive effect on the overall public opinion of whether this is "important" or not is sad. Couple that with exhaustion (a friend of ours told my wife, "Yeah, we're pretty much just done with coronavirus", and she works as a pharmacist at Wal-Mart administering tests to symptomatic people :shock: )... My family is still following all the recommendations but we watch the number of friends we could potentially visit with dwindle daily as they post pictures on Facebook of them getting together with other families, and taking photos of all their kids in a big (unmasked, close-together) group. Our community rec center (since summer activities were canceled) has been publishing suggestions of fun family activities to do, and this past weekend they encouraged families to have a backyard campout on Saturday night; on Sunday morning, we see pictures on Facebook where multiple families did it together, including all their kids sleeping in shared tents. Our community pool opened a few weeks ago with very specific guidelines, all of which went out the window the minute little kids walked into the pool deck. And then there's the 3 or 4 families who are all sharing multiple babysitters because the parents "just really miss going out together." If you've given up, you've given up. If you thought it was BS from the start, then you thought it was BS. But these people are educated and they seem to think they are still following the rules. I'm astounded by all of it. As I heard someone say, "this is all going to go very badly because Americans are either stupid or stubborn." That's not entirely wrong.
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Re: Near real time COVID-19 statistics

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It really is astounding. Yes, we've flattened the curve, for now. Locally, youth sports are ramping up. Drive by a softball complex, full parking lot, at least 3 games going at once. Because the pro sports are planning to reopen (in a quarantined bubble, mind you) we can all just resume life as normal? I mean, I get that we can't live in bubbles forever, but let's ease into it, yeah? Meanwhile, wife and I are to the point that we're holding our daughter out of kindergarten in the fall. There just isn't a scenario I see as safe and a value add for her and/or us. So, homeschool dad, thatsa me!
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Re: Near real time COVID-19 statistics

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My old submariner shipmates and I are bemused by all of the “I can’t take the isolation and I’m done with coronavirus” folks. We may have been crazy bastards in a lot of ways (it does take a few screws loose) but we know how to follow procedures that if ignored will most certainly cause the death of everyone. We have enough inner strength that isolation for months on end is no big deal. I guess that’s why there is a real push to have former submariners serve on future missions to Mars.

Pete, you keep doing what you know is best even if your peers do not. Just because you did not die by not buckling your seat belt on the next drive to the market does not mean it isn’t a prudent practice.
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Re: Near real time COVID-19 statistics

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To be clear, I'm past "guilting" others about their bad behaviors or being guilted myself about staying at home. I'm just astounded at the people who seem to THINK they are on the side of being safe and staying home, but they are having kid playdates, using babysitters, etc. It's like they're completely unaware of the hypocrisy of what they are doing.
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Re: Near real time COVID-19 statistics

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No more alcohol on flights in order to reduce passenger/attendant interaction because of COVID fears?
https://www.msn.com/en-us/travel/news/a ... li=BBnb7Kz
That's not going to (ahem) fly. :lol:
Seriously, they're already struggling to get customers and they're taking away booze?
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Re: Near real time COVID-19 statistics

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PeteRasche wrote: Tue Jun 16, 2020 11:07 am No more alcohol on flights in order to reduce passenger/attendant interaction because of COVID fears?
https://www.msn.com/en-us/travel/news/a ... li=BBnb7Kz
That's not going to (ahem) fly. :lol:
Seriously, they're already struggling to get customers and they're taking away booze?
Daughter and son-in-law flew last night on the one daily British Airways flight from JFK to Heathrow on a Boeing 777. Flights from PHL to LHR are still sparse. They said there were only about 80 people on the aircraft so even though in coach, distancing was not an issue.

Back in my frequent international travel days one of the perks of my job was all International flights on business class with a pretty hefty price tag to match. Flat sleep seats and great meals with plenty of booze was a definite plus, as was the equally lux international business lounges in places like Istanbul, Kuwait City, and Seoul. Now, I don’t see how those practices will continue at least for many months to years and how they will be able to justify $5000-$7000 tickets.
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Re: Near real time COVID-19 statistics

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Here is a drug with promise, dexamethasone, with major caveats. https://apple.news/AO634jY-mSkSNrpjqx5pmcA

It’s for use when you are already in deep trouble and on a ventilator. Right now it is a steroid commonly prescribed in the UK for rheumatoid arthritis and is super cheap. Of course this means our Pharma will be jacking up the price a thousand fold. :?
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Re: Near real time COVID-19 statistics

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Great, another medication my specialty uses.

To be honest, I am a bit surprised that it was not tried early in the patient care. Since the disease seems to be related to an excessive response by the patient's immune system (the "cytokine storm"), I would have thought of giving pulse corticosteroids to the sick patients would have made sense. It is possible they might have given piddling doses at first, and the new studies are with higher doses.
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Re: Near real time COVID-19 statistics

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AO Sig wrote: Tue Jun 16, 2020 5:23 pm Great, another medication my specialty uses.

To be honest, I am a bit surprised that it was not tried early in the patient care. Since the disease seems to be related to an excessive response by the patient's immune system (the "cytokine storm"), I would have thought of giving pulse corticosteroids to the sick patients would have made sense. It is possible they might have given piddling doses at first, and the new studies are with higher doses.
AOSig, my reading says this drug is really a last ditch effort for patients on oxygen or a ventilator when you are probably going to die anyway. Good to have a Hail Mary in your ditty bag. I’d rather none of us get there first, so I’ll continue to do what we know works and not end up needing a Flutie pass and leave the drug for good doctors like you to do preventive work.
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Re: Near real time COVID-19 statistics

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I don't think that it should be considered a last ditch drug. We have used corticosteroids for decades; I have given high-dose steroids to countless patients who have RA, lupus (often with nephritis), various vasculitic disease processes, etc. without incident and a lot of benefit in getting their inflammatory disease under control. when I was in college I spent two summers in a kidney transplant lab, and those going into transplant rejection would get 1000 mg IV solumedrol for three consecutive days. I personally think that if someone is having a significant flare of an inflammatory process, it certainly should be tried a lot sooner than "last ditch." Just my opinion, based on my experiences with inflammatory diseases. If I come down with it, I am already planning which meds I want to get...
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Re: Near real time COVID-19 statistics

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Decent summary.
https://www.msn.com/en-us/news/us/cauti ... li=BBnb7Kz

From one side:
In Raleigh, North Carolina, Ryan Fournier, founder and co-chairman of Students for Trump, a nonprofit that aims to mobilize college students to re-elect the president, said that "COVID feels like old news now."
From the other (a healthcare worker):
"Whenever I see people out in public who aren't wearing masks, I just want to tell them this is part of the reason I can't hug my daughter," she said, adding that she doesn't know when she will feel comfortable bringing Remy home. "They think they're not going to get sick. But it's not just about you: You have to think about everybody as a whole."
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Re: Near real time COVID-19 statistics

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PeteRasche wrote: Wed Jun 17, 2020 6:26 am
"They think they're not going to get sick. But it's not just about you: You have to think about everybody as a whole."
Good luck with that.
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Re: Near real time COVID-19 statistics

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On the one hand, the Covid-19 is "old news", but that doesn't mean the virus isn't still with us or deadly. Here is the full quote from Ryan Fournier:

In Raleigh, North Carolina, Ryan Fournier, founder and co-chairman of Students for Trump, a nonprofit that aims to mobilize college students to re-elect the president, said that "COVID feels like old news now."

"If you're going to allow these massive protests and massive crowds without people getting fined and arrested under the current conditions in these states due to COVID, you should be opening up other places, like places of worship. Small businesses should be able to open their doors," Fournier, 24, said. "Enough is enough."
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Re: Near real time COVID-19 statistics

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I missed your point.
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Re: Near real time COVID-19 statistics

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Spend 5 minutes in Jefferson Parish and you'd think that it was all over. Local leadership there has been minimal at best to non-existent.
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Re: Near real time COVID-19 statistics

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TUPF wrote: Mon Jun 15, 2020 11:35 am FDA revokes approval for emergency use of hydroxychloroquine for treatment of COVID-19.

https://apple.news/ABm7dwfegQ1G3Tw7m3Y41jg
And maybe 63 million doses available, cheap!

https://apple.news/Ap3Xk2iadSyi9iqTsfskPJg
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Re: Near real time COVID-19 statistics

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TUPF wrote: Wed Jun 17, 2020 9:38 pm
TUPF wrote: Mon Jun 15, 2020 11:35 am FDA revokes approval for emergency use of hydroxychloroquine for treatment of COVID-19.

https://apple.news/ABm7dwfegQ1G3Tw7m3Y41jg
And maybe 63 million doses available, cheap!

https://apple.news/Ap3Xk2iadSyi9iqTsfskPJg
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Re: Near real time COVID-19 statistics

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TU77CAL82 wrote: Wed Jun 17, 2020 9:24 pm Spend 5 minutes in Jefferson Parish and you'd think that it was all over. Local leadership there has been minimal at best to non-existent.
St. Tammany is like Jefferson on steroids...
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Re: Near real time COVID-19 statistics

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https://twitter.com/aegallo/status/1274116749257052160


More than 100 people corndogs who were at Tigerland bars over the weekend near LSU have tested positive for coronavirus. Everyone who was there this weekend is now being told to quarantine for 14 days.

Reason # 1,769 why I hate LSU fans.............
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Re: Near real time COVID-19 statistics

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Louisiana has completely fallen off the wagon. Over 2,000 new cases reported today. 8.83% positive on tests. Hospitalizations up. Only 55 new cases in Orleans, but we're surrounded.
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Re: Near real time COVID-19 statistics

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Jefferson is at least saying they're going to be much stricter on masks. Businesses have been informed that they are facing fines of $500 per person (staff or customer) on their premises without a mask. We'll see if they actually enforce it; they could fund the parish budget for the next year with one visit to Walmart if they follow through....
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Re: Near real time COVID-19 statistics

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Everyone I saw in Walmart this morning had a mask. Not necessarily covering their nose and mouth, but they had them.
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