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Covid-19 - Treatments & Vaccines

per my cousin:

"british study was with dexamethasone. It's a steroid. Everyone on a ventilator or who has labored breathing got steroids everywhere in the world. What is unique about the UK is that you cannot prescribe drugs off label in the hospital. So they had to do studies to try and try drugs like any proper studies they did not throw 8 drugs at a patient. Only the Brits NHS is so cheap to try the cheapest single drug imaginable. They tried dozens of different drugs and only dexamethasone worked. Its the most commonly used IV corticosteroid. Prednisone will work also and is an oral pill. Everyone with pneumonia gets these drugs in the US, but we didn't do the study of any single drug.

The British study was helpful because they actually proved what others assumed and were the only ones willing to constrain treatment of COVID. Not really newsworthy because everyone is also using the same steroids with other anti virals/inflammatories. The British without care in a shameful way. They found that witholding steroids allowed more Brits to die than other Europeans, Americans and Asians who were all getting steroids. It's a nothing burger, but they proved we should keep using them."

Palma, I don't know where to start, but none of this information from your cousin is good. Why kind of physician is he/she? Dexamethsone and prednisone are both steroids, but prednisone has some signals that it makes things worse, and dexamethasone has signals that it improves outcomes. There is no good evidence that hydroxchloroquine helps, and some evidence that it makes things worse.
 
Palma, I don't know where to start, but none of this information from your cousin is good. Why kind of physician is he/she? Dexamethsone and prednisone are both steroids, but prednisone has some signals that it makes things worse, and dexamethasone has signals that it improves outcomes. There is no good evidence that hydroxchloroquine helps, and some evidence that it makes things worse.

He’s a pharma ceo that’s on the board of another company testing covid therapeutics.
 
He’s a pharma ceo that’s on the board of another company testing covid therapeutics.

Ahhh, that makes sense. Essentially, none of what he told you is correct.
 
Trump doesn’t trust his doctors

would you if they told Trump he was the healthiest man in the world (or whatever nonsense they have been spewing)?

We all know trump is morbidly obese. We all know he doesn't have bone spurs (not the way he ran down to the basement during the riots).

Why wouldn't he believe them?
 
Ahhh...well I'm sure he knows more about CEO stuff.

So he's not correct that the drug people on here were talking about was a drug that in America everyone would be taking already and therefore it's not going to improve the outcomes of American patients?
 
So he's not correct that the drug people on here were talking about was a drug that in America everyone would be taking already and therefore it's not going to improve the outcomes of American patients?

Yes, that's not correct. The most common oral steroid in the US is prednisone, and the most common IV steroid in the ICU is either methlyprednisolone or hydrocortisone. Dexamethasone is mainly used for swelling in the central nervous system, like what occurs with brain tumors, although it does have other uses. Most of the initial studies have indicated that steroids provide minimal benefit with COVID and may make things worse, so they were being avoided. If dexa works, then that will be a big paradigm shift.
 
He’s a pharma ceo that’s on the board of another company testing covid therapeutics.

so your pharmabro told you to listen to the doctors, but to also insist that you get this medicine even if the doctors didn't recommend it?
 
so your pharmabro told you to listen to the doctors, but to also insist that you get this medicine even if the doctors didn't recommend it?

well he was saying that in the sense that most doctors elsewhere in the world are still recommending it, and that it should likely be used early in the disease progression as opposed to later on. (although I note the date on the article)

https://nypost.com/2020/04/02/hydroxychloroquine-most-effective-coronavirus-treatment-poll/
 
After talking to my cousin more it does seem like he's got extensive knowledge in the industry but it's mixed with anecdotal conversations with his various doctor network. In talking with me he's also likely assuming he's talking to a laymen, which he is.

Rafi - Steroids were being avoided for people with acute lung failure? My cousin finds that hard to believe. He's noting a difference in "routine" steroids that WHO posted

https://www.uspharmacist.com/articl...-treatment-of-suspected-coronavirus-infection

vs high dosage IV steroids that would be used in an ICU.

So his general take is that all of the severe patients were already getting steroids, so the fact that the british would actually withold them from critical patients.... no one else would actually do. That's just killing people. So doesn't think this is a significant development.

I mean I guess what I'm trying to get at, is the news releases on dexa seems to indicate that this drug could potentially reduce the liklihood of death by 20-30%, yet I'm hearing from him it's more likely significantly less important than that, for the reasons listed in whatever posts I'm basically copy/pasting as I have no knowledge on any of this myself.

Now merging the two conversations, it would seem the question would be if dexa has a different result from the more common IV steroids you mentioned for the reasons you mentioned (something about the central nervous system, or other unique properties of the drug). Oral steroids aren't used for patients on a vent.

It would seem relatively quick and easy to get some data on using one brand of IV steroid vs another.
 
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Again, he’s confused or misinformed.


If the dexamethasone research released in the press holds up as described, it’s very significant. And not just for the British.

Yes some patients with COVID-19 have been receiving steroids. But hardly as a matter of routine, even when ventilated.

This study apparently shows overall benefit not only for ventilated patients but also for those “merely” requiring supplemental oxygen.

I suspect (but don’t know) the benefit, if actual, will be similar for most commonly used corticosteroids. BTW, dexamethasone also comes in pills, but I think this study used IV formulation.

This British study won’t be the final answer on dexamethasone. And there’ll be lots more to come, bad and good, regarding other treatments. The reasonably rushed pace of current efforts is likely to result in lots of careening from hope to disappointment. And confusion. That’s just how it’s gonna be.
 
After talking to my cousin more it does seem like he's got extensive knowledge in the industry but it's mixed with anecdotal conversations with his various doctor network. In talking with me he's also likely assuming he's talking to a laymen, which he is.

Rafi - Steroids were being avoided for people with acute lung failure? My cousin finds that hard to believe. He's noting a difference in "routine" steroids that WHO posted

https://www.uspharmacist.com/articl...-treatment-of-suspected-coronavirus-infection

vs high dosage IV steroids that would be used in an ICU.

So his general take is that all of the severe patients were already getting steroids, so the fact that the british would actually withold them from critical patients.... no one else would actually do. That's just killing people. So doesn't think this is a significant development.

I mean I guess what I'm trying to get at, is the news releases on dexa seems to indicate that this drug could potentially reduce the liklihood of death by 20-30%, yet I'm hearing from him it's more likely significantly less important than that, for the reasons listed in whatever posts I'm basically copy/pasting as I have no knowledge on any of this myself.

Now merging the two conversations, it would seem the question would be if dexa has a different result from the more common IV steroids you mentioned for the reasons you mentioned (something about the central nervous system, or other unique properties of the drug). Oral steroids aren't used for patients on a vent.

It would seem relatively quick and easy to get some data on using one brand of IV steroid vs another.

What ConnorEl said is all correct and good info. I'll add a few things: it's not a different brand, it's a different steroid; "routine" does not refer to the steroid type, it refers to the practice of giving it to everyone with COVID; oral steroids can be given to an intubated patient (through the feeding tube), but this isn't typically done; the dexamethasone approach in this study is unlike any routine care for COVID that was being done in the US (our really anywhere).
 
Looks like Remdesivir is going to cost over $3000 for a course of treatment in the US. $520 per vial, six vials needed per patient. Considering this was developed mostly with NIH money, seems like a rip off of American taxpayers.
 
Seems like a fairly slow rollout of results of trials on things. Science should move faster.
 
I think this is probably the right thread for this:

 
Trump is holding a presser this afternoon to discuss how he will be ending Covid. He has authorized Putin to kill all Covid testers in America. No testers=no tests - No tests=No Covid cases- No Covid cases = No Pandemic

Simple!
 
Good news from Andy Slavitt today. In other news, it seems like the Bubonic Plague is back. Case in China yesterday.
 
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