DON'T PANIC.... well, maybe a little bit.

centurion

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Not so good news on the HCQ/CQ front. A large retrospective study by the Lancet covering over 90k patients over 600+ hospitals showed that those treated with HCQ/CQ had higher death rates than standard of care, and those treated with HCQ/CQ + macrolide (azithromycin) had an even higher death rate.


Based on this study the WHO has recommended stopping treatment using HCQ/CQ. Indonesia has stopped its use on its WHO solidarity trail study, but is still using them for other patients.


The study, while appearing robust, has drawn criticism from other scientists, particularly over the origin of the data used.


This really leaves me wondering why a proper double-blinded study is not being done by anyone? It seems both proponents and detractors of using HCQ/CQ to treat Covid-19 are more interested in advancing their theories rather than actually doing a proper study.
The Indian government refused to stop HCQ and is even expanding it to prophylaxis for government officials and anybody who could be touch with coronavirus. However, the explanation is very interesting:

"Currently, as per protocols set by the Indian government to treat severe coronavirus patients requiring ICU management, HCQ dosages are administered in the following way- 1st day a heavy dose of 400mg HCQ dose once in the morning and one at night, followed by 200 mg HCQ one in the morning and one at night to be followed for the next four days. The total dosage administered to a patient in 5 days, therefore, amounts to 2400 mg. "

and underlying the WHO Solidarity trial:

"...Internationally in Solidarity trial COVID-19 patients are being administered with--800 mg x 2 loading doses 6 hours apart followed by 400 mg x 2 doses per day for 10 days. The total dosage given to a patient over 11 days is about 9600 mg which is four times higher than the dose we are giving to our patients," informed the official.
This indicates that in our treatment protocol, the efficacy of HCQ is good and patients are recovering quickly with less amount of dosage being administered," said the official."

Just to mention that overdose of HQC starts at 1000-2000 mg.
As per the producer's specifications, maximum loading dosage is 800 mg followed by 400mg 6 hours apart, and regular usage should not exceed daily 400mg/600mg in some cases.
 

dafluff

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I have an impression that hydroxychloroquine therapy became inefficient and deathly when Trump mentioned it for the first first time. Until then it was promising.
When Trump (and Jokowi) mentioned this, it was "promising" based on some very weak studies out of China, which as far as I know still haven't released their data, and on a study done in-vitro. Promising drugs fail all the time, in fact more fail than succeed. Probably a good reason for politicians to shut their mouths about stuff they don't know about.

The danger of using HCQ/CQ, especially in combination with other substances that mess with the heart rhythm, is well known. Even people in this thread who have taken this for malarial prevention attested to strong side effects. This is despite the dosages used for malarial prevention is only 1 dose per week.
 

scouser59

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When Trump (and Jokowi) mentioned this, it was "promising" based on some very weak studies out of China, which as far as I know still haven't released their data, and on a study done in-vitro. Promising drugs fail all the time, in fact more fail than succeed. Probably a good reason for politicians to shut their mouths about stuff they don't know about.

The danger of using HCQ/CQ, especially in combination with other substances that mess with the heart rhythm, is well known. Even people in this thread who have taken this for malarial prevention attested to strong side effects. This is despite the dosages used for malarial prevention is only 1 dose per week.
Current anti malarial use is once a week these days, in the 90s when I had the need to use it in east africa it was a daily dose, which I quickly stopped after all the bad side effects started ,bad stomach ,headaches, visual disturbance etc .
Thankfully I never caught malaria .

I never used it again on subsequent work trips .
 

centurion

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From France, 2 days ago:

Azithromycin and Hydroxychloroquine Accelerate Recovery of Outpatients with Mild/Moderate COVID-19
 

Bad_azz

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Here is a very interesting article:

'In April, blood clots emerged as one of the many mysterious symptoms attributed to Covid-19, a disease that had initially been thought to largely affect the lungs in the form of pneumonia. Quickly after came reports of young people dying due to coronavirus-related strokes. Next it was Covid toes — painful red or purple digits.
What do all of these symptoms have in common? An impairment in blood circulation. Add in the fact that 40% of deaths from Covid-19 are related to cardiovascular complications, and the disease starts to look like a vascular infection instead of a purely respiratory one... '

 

harryopal

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That would seem to suggest that cigarette smokers may be at greater risk with Corona virus. It would be useful to establish this as fact and provide another good reason for people to give up smoking.
 

Bad_azz

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That would seem to suggest that cigarette smokers may be at greater risk with Corona virus. It would be useful to establish this as fact and provide another good reason for people to give up smoking.
I fly in the face of adversity :p
 

centurion

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Doubts over Lancet study, WHO announced it would resume its global trial of hydroxychloroquine



 

R Cameron

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Yes, the Lancet study has fallen under serious critique, and they have issued what amounts to a partial retraction:

However, today the first properly done study ("a randomized, double-blind, placebo-controlled trial to evaluate postexposure prophylaxis with hydroxychloroquine after exposure to Covid-19") was released, the results showed no benefit (even with zinc):
https://www.nejm.org/doi/10.1056/NEJMoa2016638
 

centurion

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Dr John Campbell's comments about the first randomized, double-blind, placebo-controlled trial of hydroxychloroquine:

 

nd_eric_77

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It seems questionable just how ready we are to open back up. Yesterday, over 950 new cases, and now this... The JP article kind of buries the lede of the about the huge spike in the number of deaths (from 1296 to 1851). That is almost a 50% increase in a single day! I have to assume (or hope) that it was somehow caused by a sudden barrage of tests from a multi-day period arriving at the same time rather than all those people dying on the same day.
 

Helpful Herbert

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That was an editing error in the JP. Today's death total was 50, not 550, since at the end of yesterday it was 1801. Still way too early to open up mosques and malls, but we'll see ...
 

dafluff

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Denpasar finds 5 cases from people who were tested because they needed to travel. Indonesia now requires negative PCR swab tests for air travel.

This suggests that the infection is much more widespread, and many asymptomatic cases are out there. I wonder if this also means that it is more benign?

 

R Cameron

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Indonesia now requires negative PCR swab tests for air travel.
Do you have a source for that? I read that article and checked a few news sites and don't see that anywhere. Latest I heard was swab test within 7 days of travel or rapid test within 3 days, and I don't recall if that is just for certain locations or all domestic flights.
 

dafluff

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Do you have a source for that? I read that article and checked a few news sites and don't see that anywhere. Latest I heard was swab test within 7 days of travel or rapid test within 3 days, and I don't recall if that is just for certain locations or all domestic flights.
You are correct, in general either PCR test within the last 7 days, or rapid test within the last 3 days required for air travel in Indonesia.


However, Bali (and perhaps some other places) require PCR tests for air travel.


 

Helpful Herbert

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Daily infections have just hit 1000 for the first time (1043 today). So the actual number is probably 10k+ considering how few tests are carried out. And the trend is definitely upwards.
Interesting time to decide to re-open mosques, offices and malls!
 

dafluff

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Daily infections have just hit 1000 for the first time (1043 today). So the actual number is probably 10k+ considering how few tests are carried out. And the trend is definitely upwards.
Interesting time to decide to re-open mosques, offices and malls!
Yep, definitely going to have interesting times ahead. I think basically the Indonesian government (and many others, to be fair), have come to the realization that the pandemic is too far gone for any realistic containment, and now you just have to let it do what it does. Those who are healthy and/or able to shelter in place will survive, the rest are on their own.

Wear a mask, wash your hands with soap frequently, take some vitamins (especially vit C and D), avoid crowded places if you can and hope for the best!
 

dafluff

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The wife and I took some Vit D tests last week and just got results back today. Despite me taking about 1000 IU 3 x week and also making a point to get about 15 minutes of midday sun 3 x a week (since about 2 months), I barely make the sufficient cut off (30 ng/mL) at 30.9.

The wife who also takes 1000 IU 3 x week but does not partake in sunning, rated insufficient at 25.

The recommended numbers vary depending on who makes the recommendation, but in general there seems to be a benefit of keeping it around the 40-50 ng/mL level.
 

ChrisTex

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With schools suppose to open in July, it is going to be interesting to see how they decide to start the new term. Some of at my school joked we are going to teach in scuba(deep diving) gear.
 

fastpitch17

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With schools suppose to open in July, it is going to be interesting to see how they decide to start the new term. Some of at my school joked we are going to teach in scuba(deep diving) gear.
That just may be a good idea. The way the numbers surpass the previous days for positives is trying to send a message. Unfortunately, the Central Government is not paying attention. Oh, they say, "we are testing more so more positives are found," Well, I think testing more is just showing there are a lot more positives out there they didn't know about and they have possibly been spreading it. Testing more does not come close to testing enough. Contact tracing for the most part is a joke.

They can not control the population and get them to take it seriously. Too much of, we don't have to worry here came in the early days. If I had a child, the last place I would put them before maybe December is in a classroom. If I was married to a teacher, I would not want them in a classroom. Crazy
 

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