She’s 97 with diabetes, heart disease and more. Coronavirus should have taken her ...

[CPRAFAN]

https://www.sun-sentinel.com/coronavirus/fl-ne-97-year-old-coral-springs-beats-coronavirus-others-can-too-20200414-ex2vmqfjeve2lj3iuirvlzpzwi-story.html#nt=oft-Double%20Chain~Feed-Driven%20Flex%20Feature~top-chain~centerpiece~~1~yes-art~automated~automate

Commenter: "TrumpCare (HCQ) >>> 0bamaCare (fiasco)"

[Transient]

I have difficulty with any claim that says hydroxychloroquine was the fix. Here's why.

And then from this: https://blogs.sciencemag.org/pipelin...te-for-april-6

Finally, commentary from a career ICU nurse:

The ARDS symptoms that many of the CoVid 19 victims have are NOT directly from infection but rather from INFLAMMATION leading to increasing resp distress and eventually to Resp Failure. The anti-inflamatory action of the hydroxychlorquine may be the cause of decreased inflammation in thee lungs of those suffering from the terrible resp problems many of these patients are afflicted with.

The above is supposition of mine taken from 30 years working as an RN in Adult Critical Care in the Neuro Shock Trauma ICU environment. And as a diabetic who is taking metformin the heart rhythm problems associated with hydroxychloroquine by itself and the additions adverse problems when given concurrently with metformin are noted!

Furthermore, the symptoms for COVID-19 are very similar to pneumonia. And, the COVID-19 test is 70% accurate. My argument is assumptive, and relies on us not knowing the details. Are we sure she didn't just have pneumonia?
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[small hole shooter]

https://www.sun-sentinel.com/coronavirus/fl-ne-97-year-old-coral-springs-beats-coronavirus-others-can-too-20200414-ex2vmqfjeve2lj3iuirvlzpzwi-story.html#nt=oft-Double%20Chain~Feed-Driven%20Flex%20Feature~top-chain~centerpiece~~1~yes-art~automated~automate

Commenter: "TrumpCare (HCQ) >>> 0bamaCare (fiasco)"

Just not her time to check out yet. Maybe a slip and fall in the shower or a walker collision at the rest home might be how she goes.

[OleCuss]

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Furthermore, the symptoms for COVID-19 are very similar to pneumonia. And, the COVID-19 test is 70% accurate. My argument is assumptive, and relies on us not knowing the details. Are we sure she didn't just have pneumonia?
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OK, it turns out that saying the Covid-19 test is 70% accurate just doesn't mean anything to me.

For a clinical test there are typically 4 measures you need to know about a test.

1. Sensitivity. This is the ability of the test to show a positive result if the condition is present.
2. Specificity. This is where the tests correctly shows negative when the condition is not present.

Then you get to the related, but different values of positive predictive value and the negative predictive value. I turns out that these values change based on the population you are testing.

1. Positive Predictive Value is the probability that people in that particular population and situation will really have the disease if the test result is positive.
2. Negative Predictive Value is the probability that the person in that particular population and situation will not have the disease if the test result is negative.


So if you test a hundred people who have a high likelihood of having the disease, the positive predictive value is better and your negative predictive value is poorer.

If you test 100 people who are exceedingly unlikely to have a disease then the negative predictive value is better and your positive predictive value is poorer.


BTW, you also want to know how good your sampling is. If the samples are not collected properly then you have another problem.

It doesn't help that the sensitivity can depend on the viral load. On test for Covid-19 is cited as having a sensitivity of 85% if the viral load is positive and only 60% if the viral load is low.


So now we have a problem. If we are relying on these tests for diagnosis and some of the tests will be right and some will be wrong? It will end up where the diagnosis is a clinical one rather than a laboratory diagnosis. The lab test can be supportive or not-supportive of the diagnosis.


But there is the fact that there are actually different kinds of tests as well as different brands. The NAAT (Nucleic-Acid Amplification Test) seems to be very sensitive (I can't find the numbers for Covid-19) but it is not likely to be as widely available and it can be sufficiently sensitive that a very slightly contaminated workspace can cause a false positive.

And then there is culturing. . .


Well, the point is that when they tell you that a test is 70% accurate you might want to ask them what they mean.

Are they talking 70% sensitivity?
70% specificity?
70% PPV? And if so, in what population?
70% NPV? And if so, in what population?

They should also tell you which test they are talking about.


Just a couple of other points I'd make.
1. Hydroxychloroquine with Azithromycin may be pretty effective but I'd probably leave off the Azithromycin due to a probable increased risk of cardiac dysrhythmias and interactions with other medications you might use in a sick person. It doesn't help that Azithromycin has a long half-life so if you get complications/interactions they may be a concern for far longer than you wish. I really don't know of any decent information suggesting the combination is better than Hydroxychloroquine alone.
2. The rate of serious infections in people taking Plaquenil/Hydroxychloroquine is really not all that high. It doesn't seem to really suppress the ability to fight of infections by much. It does prevent infection by malaria and may do that for some viruses.

One other oddity? You'll hear/read in the news about Plaquenil being good for Rheumatological diseases and for malaria and maybe for some viruses. But there is one other which might be interesting for Covid-19 patients with diabetes.

I've yet to see it used for this in the USA, but I've seen at least one study showing that Plaquenil is as effective as lowering the A1c in patients with diabetes as is Invokana (a far more expensive drug intended for treating diabetes). I believe Plaquenil use for diabetes has actually gotten official approval in India but I could be mis-informed about that.

So if you have a diabetic patient with Covid-19 and you put them on Plaquenil you may want to pay a little extra attention to their sugars and to their diabetic medications. You wouldn't want them to go hypoglycemic!

[recpark99]

I thought this was another RBG thread.

[Transient]

Red Blue Green?

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[Epaphroditus]

Inflammation and other effects due to over active immune response (which was also present in Spanish flu) would be mitigated by suppressing immune system. Seems counter intuitive but it's not unreasonable. ZPac to offset depressed immune response also make sense.

[small hole shooter]

Good thing I can read up to 10,000 wpm.

[recpark99]

RBG

Red Blue Green?

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Ruth Bader Ginsberg

[The War Wagon]

SHHHHHHHHHHHHHHHHHHHHHH!!!! You're screwing up "THE NARRATIVE!!!"