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The Trump Presidency | Biden Inaugurated
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In the latest episode of the United Hour Podcast, Nik @Rood and Imran @Annihilate Now! start with the good news by celebrating Manchester United Women's emphatic FA Cup win over Spurs at Wembley and the future of manager Marc Skinner.
Then it's the bad news and the ever worsening form of our Men with losses to Arsenal and Palace.
Finally the main debate - ETH Out now or keep him until the end of the season - if not longer. Are you Team Nik or Team Imran?
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Mika is mad as hell and is not going to take it anymore!!!
The point is there are multiple studies ongoing right now. Multiple studies in the UK (2-3 in my hospital alone, as part of an international collaboration), multiple in America and I’m sure countless others in countries I don’t particularly follow or can’t read their language. Trials usually take some time, they’re not open and shut within a couple of weeks.
With respect, scientists across the world aren’t going to make trial decisions (with respect to Zinc) based on what Trump or his ‘medical advisors’ say.
I’m not really sure why you’ve linked me multiple non RCT trials when I’ve specifically said RCTs are ongoing for those treatments.
For the RCT you’ve linked; for problem 1, it would be ethically very sketchy to give someone a Covid treatment that can give severe side effects (and we’ll come to this later) when they don’t have the disease. So it is very reasonable to wait for the positive result. There isn’t really much you can do about the timings of when people present, especially as people are presenting in such different ways anyway. And this obsession with Zinc is….a bit strange. Zinc is not a deal breaker and other trials are looking into it.
They will have mentioned the blood tests, along with the self swab in a cohort of patients, to see whether those different methods of collection are equally efficacious. The current swab we have to do is pretty brutal, time consuming and usually elicits coughing. It would be great if we could start to diagnose this respiratory condition without making people cough all over us.
If you're that bothered about Zinc:
https://clinicaltrials.gov/ct2/show/NCT04373733?term=zinc&cond=Coronavirus&draw=2&rank=2
https://clinicaltrials.gov/ct2/show/NCT04334512?term=zinc&cond=Coronavirus&draw=2&rank=6
https://clinicaltrials.gov/ct2/show/NCT04370782?term=zinc&cond=Coronavirus&draw=2&rank=7
These are the RCTs, there are other types of trials which are using Zinc in combination with various medications too. As well as trials around the world looking into all kinds of different drugs ie
https://clinicaltrials.gov/ct2/show/NCT04392427?term=zinc&cond=Coronavirus&draw=2&rank=8
https://clinicaltrials.gov/ct2/show/NCT04373733?term=zinc&cond=Coronavirus&draw=2&rank=2
https://clinicaltrials.gov/ct2/show/NCT04334512?term=zinc&cond=Coronavirus&draw=2&rank=6
https://clinicaltrials.gov/ct2/show/NCT04370782?term=zinc&cond=Coronavirus&draw=2&rank=7
These are the RCTs, there are other types of trials which are using Zinc in combination with various medications too. As well as trials around the world looking into all kinds of different drugs ie
https://clinicaltrials.gov/ct2/show/NCT04392427?term=zinc&cond=Coronavirus&draw=2&rank=8
I think sadly, in your rush to make a political point, you have missed a rather important point. The dose used in malaria prophylaxis is not at all similar to the doses we use them for in rheumatological disease, nor in Covid. For an example, the dose of Chloroquine in malaria prophylaxis is about 300mg once a week. For lupus, its 155mg a day. For Covid, we’re tending to give it at doses of >500g a day. Even for malaria treatment, where the dose is higher than prophylaxis, we're still giving high doses compared to that. There are other issues with their data too, including the difficulty in picking up good data from many of the countries in which malaria is endemic and the presence of children in many of the trials as well. In addition, in other parts of the article, they have mentioned the presence of sudden death due to QTc prolongation (only in NA and Europe, where such data can be easily collected...what a surprise) and...unsurprisingly, in over half the cases, the drug wasn't being taken for anything t do with malaria (ie higher dose).
Going back to the Paracetamol point, if I give you 1 gram because of a fever, you’ll almost certainly be ok. If I give you 30g, I’ve probably caused liver damage and a horrible, slow death unless you get further medical attention (and still likely despite that).
This is really the important bit in the WHO article:
It is notable that with the extensive global usage of quinine in the first half of the 20th century and the enormous use of chloroquine (and to a lesser extent amodiaquine) in the second half, there have been no reports of sudden unexplained death suggestive of cardiac arrhythmia at the doses used for malaria treatment.
I could write a similar point about Paracetamol. There have been no reports of fulminant liver damage at the doses used for pyrexia. I mean, that’s not wrong but someone who’s taken a Paracetamol OD is not taking it at pyrexia doses and we’re not giving Hydroxy/chloro at normal malarial doses, we’re giving it at almost 20 times the weekly dose at times, especially when compared to prophylactic doses.
Some QT prolongation and ventricular arrhythmias in Hydroxychloroquine used in SLE/Covid doses:
https://www.sciencedirect.com/science/article/pii/S1547527120304355
https://www.tandfonline.com/doi/full/10.1080/15563650500514558
https://www.hindawi.com/journals/cric/2016/4626279/
https://pubmed.ncbi.nlm.nih.gov/9922366/?from_single_result=9922366&expanded_search_query=9922366
The ACA link...is pretty much just copying the WHO article, in terms of its research?
Actually, the CDC does very much mention QTc prolongation: https://www.cdc.gov/malaria/new_info/2020/chloroquine.html
The issue is that you've gone on the factsheet for patients, where they will obviously change the language to cater for lay-people, not to mention that a) prolonged QT is not a side-effect where you can feel a symptom, unless its a very severe symptom and b) as we've already outlined, that factsheet is for patients taking it as a malarial prophylaxis dose, not at the doses we're talking about for Covid.
Aspirin is indeed also a very dangerous drug and can cause severe issues, including death in overdose. Which...again, comes back to the point I've been making multiple times in this post. Take 75mg Aspirin once? (though if you take even this dose daily for a while, you're at risk of developing stomach ulcers). Take Paracetamol 1g once? Take Chloroquine 300mg once a week? You'll almost certainly be fine.
If you take 10g Paracetamol? 5g Aspirin? 600mg Chloroquine every day for a period? You may still be totally fine...but it isn't the same as the former.
Actually, that isn't really true. We don't go around giving people anti viral medications just in case they develop viral infections for the most part. Though we might give it to people who are at incredibly high risk of certain conditions. It is again a risk-benefit thing with regards to these drugs and timing. Also I feel obliged to point out that malaria is not a virus, nor is HCQ an antiviral. Malaria is a parasite and HCQ is an anti-malarial that also happens to have anti-viral properties.
How early are we talking though? You seem to think within 24 hours of presentation is late?
The problem with your post is you are almost forcing me into taking a stance I do not actually hold because of the way you present it, you politicising it and the frankly dangerous misinformation you're writing. Firstly, the scientific world does not jump just because Trump says something. Secondly, there is a huge amount of research, on all manner of drugs, including HCQ/CQ/Zinc all across the world and that's just in the western world where we get enough exposure. Like most doctors/ scientists, I am waiting on good data before I make definitive statements either way.
We are in the middle of a global pandemic, only really 2-3 months or so into its effect on the West. Clinical trials, especially good ones, don't happen at the click of a finger. You need to design the study, you need to get ethical approval, you need to recruit, you need to make sure staff are aware, you need to make sure you have enough supplies, you need to actually do the study, then collect and analyse data and then send it to a reputable journal. You need to make sure you're minimising confounding factors and biases because things are not always as they seem initially. The issue is that Covid has led to a bit of a Science wild west, where any centre is publishing what is essentially rubbish on these pre-print sites/ dropbox/ google drive whatever and its diluting the actual important work. What I noticed initially was your dismissive attitude about its potential effects.
Right, of course they can. The issue is that you seem to genuinely believe (or at least be hinting at) that pretty much the entire world outside of Trump's inner circle doesn't want to bother making correct studies and accurate treatments and would rather people die...because of Trump. That people are making flawed studies to prove Trump wrong. The irony of course being that the original HCQ study from France was a pretty crap study. Even more ironic considering so many normal people/ politicians/ journalists latched onto it as a potential wonder cure with no understanding of the science behind it or having looked at the study design itself.
I would love for it to be amazing in terms of its outcomes but the evidence I've seen so far is not particularly promising. I hope the ongoing trials show better outcomes, for whatever drug.
Boom!
I think that's called a smackdown!
I think that's called a smackdown!
D.C residents can vote in the general election I believe. They ‘just’ have no representation in Congress or Senate, which yes is utterly ridiculous.
Thanks very much for your post, @africanspur.
With all the random swathes of blank space in it, @Atze-Peng's post had the distinct whiff of a copy/paste merchant.
With all the random swathes of blank space in it, @Atze-Peng's post had the distinct whiff of a copy/paste merchant.
Excellent post @africanspur
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You keep on misrepresenting what I am saying. Obviously giving you the benefit of a doubt and assuming it is a misunderstanding. So let's go at it from the start.
The original quote I reacted to was:
I said to it:
What points do I make?
1. HCQ isn't as bad as the media campaign currently is making it out to be.
2. HCQ seems to work when it's given early and doesn't work when it's given late - which Trump is refering to.
3. We need a proper study on HCQ and Covid19 before jumping to conclusions.
4. Trumps recommendation for HCQ is being politicised rather than simply expression some concerns and wait for a proper study to be conducted.
Your reaction to it:
1. Irrelevant to what I said.
2. Which we agree on, but again not about what I said.
3+4. Not what I said, but relevant to the point of HCQ being recommendet - thus I gave evidence on HCQ not being as dangerous as it is made out to be with a specific focus on the risk for cardiac issues.
4. You asked for studies that imply there could be benefits to HCQ early on. I provided those.
5. You are strawmanning what I said about it being politicised by hyperboling it to the ridiculous - which I clarified.
Now to get to your last reply:
And why Zinc? Because I defended Trumps statement (specifically refering to HCQ + Zinc and not in general towards Trump) when people keep shitting on it despite there being no further proof, yet. People want to disprove his statement? Use Zinc. Plus it's not exactly a big secret that Zinc has antiviral benefits. And as it turns out, Covid19 is indeed a virus.
Flying over it, the first one does look rather promising in it's methodology, though.
2. That's why we need proper studies so we can know the effectivity and dosage for HCQ. Assuming it works, the next step would obviously be figuring out the dosage. Including there being the possibility that the dosage can be lower when used earlier.
3. Proof for those deaths and HCQ being the cause and not just so happens to be used simultaneously?
So as we rely on hospital patients and people are already in an progressed state, then the tiem duration from arriving with the symptoms and getting the lab results could very well make a difference in the success of the treatment. Currently it is assumed 1-2 days, albeit in high outbreak areas it could (have been) way longer prior. Still, 1-2 days when going to the hospital for at least somewhat severe symptoms can already be the difference between medium severity and ICU. And assuming HCQ works better the earlier it is used - as well as assuming HCQ works at all with Covid19 - it would make a difference, don't you think?
And worst case is after 1-2 days of using it without having Covid19 the treament is stopped.
In addition you think I am forcing you into a stance, because you are misunderstanding my point which I explained above.
For example when people like Dr. William Schaffner say out "The nail has virtually been put in the coffin of HCQ" in reference to this study, then there clearly is politicising at work. And this isn't the only example by any means - I just gave a crystal clear one. And looking at people in this thread, it's hard to deny that this bias also effects the public opinion - albeit that is quite anecdotal.
Additionally I will not post another pages long reply here. Especially since I do not think we are that far apart in what we mean and want. So, if there are some major disagreements, feel free to point them out, but don't expect me to go all out.
The original quote I reacted to was:
I said to it:
What points do I make?
1. HCQ isn't as bad as the media campaign currently is making it out to be.
2. HCQ seems to work when it's given early and doesn't work when it's given late - which Trump is refering to.
3. We need a proper study on HCQ and Covid19 before jumping to conclusions.
4. Trumps recommendation for HCQ is being politicised rather than simply expression some concerns and wait for a proper study to be conducted.
Your reaction to it:
1. Irrelevant to what I said.
2. Which we agree on, but again not about what I said.
3+4. Not what I said, but relevant to the point of HCQ being recommendet - thus I gave evidence on HCQ not being as dangerous as it is made out to be with a specific focus on the risk for cardiac issues.
4. You asked for studies that imply there could be benefits to HCQ early on. I provided those.
5. You are strawmanning what I said about it being politicised by hyperboling it to the ridiculous - which I clarified.
Now to get to your last reply:
Irrelevant to what I said there not being a study about it so far. Give me one that provides evidence through proper methodology to base the current clear cut claims on HCQ not working at all. Not future ones that could come out eventually, but ones that exist right now on the 21th May 2020.
They don't. But then you should be just as critical about unbased criticism of his recommendations as I am. Which is my entire point. People around here and in media as well as people like Fauci keep shitting on this without proper evidence on the matter rather than just saying "let's wait for proper research to be done".
Because you are arguing a point I didn't make while I keep arguing my point.
Depends on the dosage. Which is why I linked the two Lupus based researches that - and you yourself confirm that later in your comment - require lower dosages of HCQ while still seemingly having positive effects. So a proper study with early treatment could be conducted while using lower HCQ dosages. Especially since HCQ is such an old and commonly used drug that it is perfectly known when it becomes risky. So what exactly are you arguing here?
And why Zinc? Because I defended Trumps statement (specifically refering to HCQ + Zinc and not in general towards Trump) when people keep shitting on it despite there being no further proof, yet. People want to disprove his statement? Use Zinc. Plus it's not exactly a big secret that Zinc has antiviral benefits. And as it turns out, Covid19 is indeed a virus.
Independant of our discussion - has it been confirmed yet that Covid19 is a respiratory condition and not a blood clotting issue that just so happens to attack the more fragile areas such as the respiratory system first?
Which are future studies. Glad they are testing it, but that is again off my point - the point being I defended Trump by pointing out a study using old, late-stage patients.
Flying over it, the first one does look rather promising in it's methodology, though.
1. I am not rushing to a political point: I am forced to defend Trump, because people rush to a political point about him suggesting HCQ. Essentially I am saying "wait for proper research" before we jump to conclusions rather than using lackluster and flawed studies. Clear difference.
2. That's why we need proper studies so we can know the effectivity and dosage for HCQ. Assuming it works, the next step would obviously be figuring out the dosage. Including there being the possibility that the dosage can be lower when used earlier.
3. Proof for those deaths and HCQ being the cause and not just so happens to be used simultaneously?
See above. All about dosage and point of illness when the treatment is started. And again there is a chance that the dosage can be lower when the treatment is started earlier. Doesn't disprove my point nor do I disagree with higher dosages being a potential risk.
Which proves my point that HCQ isn't a particulary dangerous drug. It has side-effects like all other drugs out there. Which we both agree. What made doctors decide for higher dosages in concerns to Covid19? That you have to ask said doctors. But my initial point was again that we lack proper studies (including ideally testing different dosages) where HCQ is applied early since as an antiviral drug it is the most effective then. I don't think we disagree here.
I purposefully used a paper pre-Covid to show it wasn't a particulary big concern prior to it. I didn't say that it doesn't happen at all.
Which we both agree on. And which again requires proper studies to be conducted before jumping to conclusions.
If Covid19 is as dangerous as anticipated + the risk of mutation and it turns out HCQ does actually work well at a Malaria-level dosage used pre-emptively, then it surely should be a consideration. But for that we first need to have the proper studies conducted.
As early as possible, but most studies rely on people getting tested in hospitals. Thus they already are at worse symptoms and thus in a worse stage than the average Covid19 patient. Ideally we would test people who first get positively tested at a general practicioner - albeit that causes some logistical issues.
So as we rely on hospital patients and people are already in an progressed state, then the tiem duration from arriving with the symptoms and getting the lab results could very well make a difference in the success of the treatment. Currently it is assumed 1-2 days, albeit in high outbreak areas it could (have been) way longer prior. Still, 1-2 days when going to the hospital for at least somewhat severe symptoms can already be the difference between medium severity and ICU. And assuming HCQ works better the earlier it is used - as well as assuming HCQ works at all with Covid19 - it would make a difference, don't you think?
And worst case is after 1-2 days of using it without having Covid19 the treament is stopped.
No, the scientific world doesn't jump, because Trump says something. But as long as we do not have reasonable proof on HCQ working or not neither should media and experts jump. Which they clearly did.
In addition you think I am forcing you into a stance, because you are misunderstanding my point which I explained above.
We both agree here as well. Albeit it was known to be potentially quite a dangerous outbreak in late January (by WHO standards for a pandemic - which they themselves ignored - it would have been considered a pandemic early february), so that's 4 months. But not my point, either. I am criticising jumping conclusions before proper data occurs.
I am not implying that. But it doesn't quite matter what happens behind the scenes silently. What has an impact on people is what the loud minority is spouting - and it is something they usually spout out of any sort of self-interest, lobbyism and/or politicising.
For example when people like Dr. William Schaffner say out "The nail has virtually been put in the coffin of HCQ" in reference to this study, then there clearly is politicising at work. And this isn't the only example by any means - I just gave a crystal clear one. And looking at people in this thread, it's hard to deny that this bias also effects the public opinion - albeit that is quite anecdotal.
Agreed. I hope we get proper researches done right so when it's out we do not have discussions about the studies being flawed or not and can use the drugs as treatment.
Additionally I will not post another pages long reply here. Especially since I do not think we are that far apart in what we mean and want. So, if there are some major disagreements, feel free to point them out, but don't expect me to go all out.
Why end long a post with saying you don't want a series of long posts? It's having your cake and eating it too.
Kind of feels like he's saying "don't want to make the thread messy and I'll read any long posts that come after mine but I won't make anymore myself". Could be wrong though.
Sorry but this is just nonsense. Trump made it a political point when he started recommending people take it without any firm evidence it helps (which you concede) and without any firm evidence that it doesn’t cause harm (which you also concede). The fact that scientists and doctors have early indications that it could be quite harmful is reason enough for Trump and his defenders to shut their mouths until the proper studies are carried out.Atze-Peng said:
No you don’t get to use a lack of existing studies as a reason to defend using a potentially harmful substance.
Just read like an attempt to get the last (long) word in to me.
Sure, but then if he really wanted to avoid making the thread messy, he wouldn't have made that long post either.
I don’t know why we wouldn’t trust this guy’s views on medical science...
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Could have saved yourself a lot of work by just admitting you don't know more than other posters here who are medical professionals. No shame in that.
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What a surprise . They voted in Betsy Devos and Ben Carson. Only the best people.
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Off to OAN then for this coming campaign.
Hydroxychloroquine. Helluva drug
Is the Fox love affair over then?
It does look like Trump is looking for a new propaganda machine . OAN already as Eric's wife on there and Don Jnr's girlfriend is also joining them.
Which will be explosive... publishing blocked... sentence commuted and decide it’s best the book was never released.
Michigan AG says as far as her department is concerned, Trump is ‘no longer welcome’
https://www.rawstory.com/2020/05/mi...ment-is-concerned-trump-is-no-longer-welcome/
Must be his replacement for the Trump News Network that would have been in full swing right now had he lost the election like he intended.
It’s actually “you can’t eat your cake and have it too”.
[/unabomber]
So much for the illusion of an independent press.
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The OG incel.
Yeah. It’s easy to forget with all the shit this administration brings, but having a president explicitly saying that it’s Fox’s job to help get him re-elected is.. well, so Trumpian. It’s incredible how far standards have fallen in just three years.
I would positively towards the positively love to see him punched in the face.
Super duper positive negative test missile.
It was, without questin, the best coronavirus test result in the history of the world.
When a positive proton and a negative electron bind together they form a neutral hydrogen atom. A lot of gas. The best gas.
A beautiful, perfect test. As perfect as the transcript.
Good genes.
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