Covid-19

[TheFallen]

Somewhat encouraging news on coronavirus today - and (no surprise) it's about a drug treatment showing definitive signs of efficacy in a statistically significant percentage of more serious cases, rather than there being any miraculously appearing vaccine or "cure".

Dexamethasone is first life-saving coronavirus drug

A cheap and widely available drug called dexamethasone can help save the lives of patients who are seriously ill with coronavirus.

UK experts say the low-dose steroid treatment is a major breakthrough in the fight against the deadly virus.

It cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth.

The drug is part of the world's biggest trial testing existing treatments to see if they also work for coronavirus.

Researchers estimate that if the drug had been available in the UK from the start of the coronavirus pandemic up to 5,000 lives could have been saved. Because it is cheap, it could also be of huge benefit in poor countries struggling with high numbers of Covid-19 patients.

Life-saver

About 19 out of 20 patients who get coronavirus get better without coming to hospital. Of those who are admitted to hospital, most also get better, but some may need oxygen or mechanical ventilation. These are the high risk patients that dexamethasone appears to help.

The drug is already used to reduce inflammation in a range of other conditions, and it appears that it helps stop some of the damage that can happen when the body's immune system goes into overdrive as it tries to fight off coronavirus.

The body's over-reaction is called a cytokine storm and it can be deadly.

In the trial, lead by a team from Oxford University, around 2,000 hospital patients were given dexamethasone and were compared with more than 4,000 who did not get the drug.

For patients on ventilators it cut death risk from 40% to 28%. For patients needing oxygen it cut death risk from 25% to 20%.

Chief investigator Prof Peter Horby said: "This is the only drug so far that has been shown to reduce mortality and it reduces it significantly. It's a major breakthrough."

Lead researcher Prof Martin Landray says the findings suggest that for every eight patients needing ventilators that you treat, you could save one life.

In patients on oxygen, you save one life for every 20-25 or so treated with the drug.

"There is a clear, clear benefit. The treatment is up to 10 days of dexamethasone and it costs about 5 UK pounds per patient. So essentially it costs 35 UK pounds to save a life. This is a drug that is globally available."

Prof Landray said, when appropriate, hospital patients should now be given it without delay, but people should not go out and buy it to take at home.

Dexamethasone does not appear to help people with milder symptoms of coronavirus - people who don't need help with their breathing.

The Recovery Trial has been running since March and included the malaria drug hydroxychloroquine that has now been ditched amid concerns that it increases fatalities and heart problems.

Another drug called remdesivir, an antiviral treatment that appears to shorten recovery time for people with coronavirus, is already being made available on the NHS.

Analysis by Fergus Walsh, Health Correspondent

The first drug proven to cut deaths from covid-19 is not some new, expensive medicine but an old, cheap-as-chips steroid.

That is something to celebrate because it means patients across the world could benefit immediately. That's why the topline results of this trial have been rushed out because the implications are so huge globally.

Dexamethasone has been used since the early 1960s to treat a wide range of conditions, such as rheumatoid arthritis and asthma. Half of all Covid patients who require a ventilator do not survive, so cutting that risk by a third would have a huge impact.

The drug is given intravenously in intensive care, and in tablet form for less seriously ill patients. The only other drug proven to benefit Covid patients is remdesivir, an antiviral treatment that has been used for Ebola.

That has been shown to reduce the duration of coronavirus symptoms from 15 days to 11, but the evidence was not strong enough to show whether it reduced mortality. Unlike dexamethasone, remdesivir is a new drug with limited supplies and a price has yet to be announced.

...and here's your link.

[SoulBiter]

Thats great news and I read about it earlier this morning. However it is NOT the first one to show statistical improvement. Its the first one in the UK that is being tested.

Vyrologix/leronlimab is within a week of finishing their double blind placebo testing and from anecdotal evidence shows better effectiveness. However it will be more expensive than Dexamethasone but much more cost effective than having to stay in the hospital.

All in all good news is coming on the Coronavirus front.

[peter]

That would have been the first drug reached for by any clinician worth his salt over the age of fifty. That it has taken five months to 'discover' it beggars belief. I've posted on this in the "What You Think Today" thread and am not going to repeat it here - but suffice to say I'm almost aghast that this should only now be being opted for. If this is indeed the case uncounted thousands will have died on the alter of clinical/therapeutic hubris - either that or a complete failure to understand the basic simplicity of therapeutics; that there are five classes of drugs and what is required is simply to use them - not to be blinded by the glossy advertising of ever more complex and contorted variations on a theme. It is the Covid-19 equivalent of discovering that aspirin helps in the control of heart disease. What is staggering is that it has taken this long to suss it out.

[Skyweir]

I read that the UK has topped the global COVID death charts

Oh and Bolsonaro is place tipped to join the intellectual powerhouse .. we are all in good hands Brazil figuring highly in the charts also.

[TheFallen]

I read that the UK has topped the global COVID death charts

Nope.

In terms of absolute numbers of deaths, we're third at the moment (behind the USA and Brazil). In terms of deaths per capita, we're currently second behind Belgium (of all places), looking at countries with populations of a million or more.

Here, Sky... knock yourself out with as many constantly updated COVID-19 stats as you like.

[SoulBiter]

Nice article from the AJC (Atlanta Journal) on that drug I was telling you about that is ready to be unblinded fom the placebo test.

The first half of the article talks about the lasting effects of COVID even after you are "recovered". After that it talks about this drug.

Reisman knew about a post-COVID trial for survivors of mild to moderate COVID 19 symptoms. Riley enrolled in the clinical trial for leronlimab, a drug that was originally developed to treat HIV, but is showing promise in the coronavirus fight. He had four injections in his stomach over two weeks.Riley said he immediately felt better. He returned to a faster pace, his blood pressure returned to normal and the other symptoms the anxiety, the insomnia faded.

Dr. Chris Recknor, a Gainesville internist who runs one of the six sites for the leronlimab clinical trial, is also a COVID 19 survivor. His conditioned worsened to the point where he thought he might have a heart attack. He ended up in ER at Northeast Georgia Medical Center three times and was twice admitted for overnight stays. I felt like my heart was pumping so hard, it felt like it was coming out of my ears, he said.His physician at the hospital obtained compassionate use permission from the Food and Drug Administration to prescribe leronlimab. Recknor said he felt better within two days after getting the medication and has fully recovered.

[peter]

The road into the UK lockdown was scientific; the road out was always going to be political. It is the same script that was written for the 2001 foot and mouth outbreak and driven by the same underlying necessities, this time writ large to an almost unimaginable scale. This time it is not simply the agricultural sector who have sustained the damage however (and the damage to the livestock industry was mitigated to a large extent by generous and widespread compensation for losses sustained), it is the whole nation that has been brought to its knees. It's to be hoped that the damage so sustained will be short term in it's consequences - but I have my doubts. The wisdom of this method of tackling pandemics will no doubt be the subject of much study in the years to come (and comparative studies on the differing methods taken by individual countries, and the efficacies thereof will form a big part of this), but as we sit here quaking in wait for a second spike to deliver (perhaps) the fatal blow, the question surely has to be entering our heads, "surely there has to be a better way?".

(Note; last week in my area of the UK the estimated 'R' number was the highest in the country - this week it is apparently the lowest. Is it wildly out on a limb to think maybe something is adrift here - that either the science behind the estimation is questionable or that statistics are being massaged this way and that to serve the prevailing need. Or maybe suddenly we all got much better at social distancing and stuff.)

[Hashi Lebwohl]

Cases are rising in the United States but for two very specific reasons: 1) increased testing, which automatically means they will find more cases and 2) mass protests--too many people all gathering together in too close an area. Many of the cases are also in prisons and nusing homes, which are full of vulnerable people who cannot distance sufficiently.

[TheFallen]

I actually think that a significant cause of the current rise in the US - and particularly in Florida - is probably the result of spring break, which several predicted here.

[Savor Dam]

Spring Break was quite some time ago. For Florida, it was in March, but even for those whose spring break was as late as Easter, that was mid-April. I would not expect the current uptick to be due to events two months ago. More likely, it is related to the relaxation of shelter-in-place recommendations and the concomitant increase in folks venturing out for social and economic interactions.

[Hashi Lebwohl]

Don't forget the folks venturing out to protest--large crowds of non-socially-distant people in a concentrated area.

Remember: the corona virus knows your political intentions, according to the media. If you are protesting police brutality then it's okay and you won't catch anything but if you are attending a Republican political rally then half the people are going to walk away with corona.

[peter]

Or maybe it's just that when you've lived at the shit end of the stick for generations, when you've experienced casual racism and the indifference of a political elite that doesn't give a flying f*** and never has and never will until the issue is rammed up it's fat complacent arse, and maybe when you've seen one of your number killed in brutal fashion and those sworn to 'protect and serve' standing by and watching while the life was squeezed out of a man ...... maybe then Covid and it's risks just don't seem so important.

[TheFallen]

There's something statistically different about the COVID-19 numbers from the US.

The US is showing a surprisingly high number of identified infections per head of population (7,121). In terms of countries with a reasonable overall population count (let's say 1 million or more), this puts the US in 4th place globally speaking, as per the following:-

Identified coronavirus infections per head of population.

1. Qatar (31,116)
2. Bahrain (12,808)
3. Chile (12,681)
4. Peru (7,735)
5. Singapore (7,234)
6. USA (7,121)
7. Armenia (6,948)
8. Spain (6,274)
9. Belarus (6,191)
10. Oman (6,091)
11. Panama (6.036)
12. Sweden (5,550)

Now before everyone steams instantly in and starts banging on about this being solely due to the huge amount of testing going on in the US... it really isn't.

Now sure, there'll be large numbers of countries who've not tested to anywhere near the level that the US has, so they'll all have a much higher number of currently unknown coronavirus cases.

But amongst nations with 1m of population or more, the USA only comes 16th in the "number of tests administered per head of population" category.

Qatar, Bahrain and Singapore have all conducted more tests per head of population than the USA, which almost certainly explains their high position in the above table... but so have another 12 substantially sized nations and none of those is showing as high a number of identified infections per head?

It does make you wonder why. Why is the US showing a markedly higher number of known cases of infection per head, when measured against a reasonable yardstick of its similar peers?

[Skyweir]

ugh I read an article today outlining medical practitioners experience with COVID19 patients ... and those that ... survive ... pretty nasty virus all round as it leaves permanent issues for them.

Heart issues, blood clotting issues, respiratory issues etc.

I expected scar tissue on the lungs as thats not particularly unexpected but all the other issues were surprising.

stay safe

[Hashi Lebwohl]

The current projections of the population of the United States is approximately 329,968,629 (clearly there is some error in that number, but let's go with it) and currently we have 2,292,867, which is an infection rate of 6.9487% with 120,121 deaths for a mortality rate of 5.2389%. The year is almost half over and corona deaths still haven't surpassed "death by accident"and won't get anywhere close to "deaths due to heart disease" or "death due to cancer".

I have been working part-time in a grocery store since November and, to date, no employee at the store--not even one--has contracted corona despite the hundreds of random strangers who visit the store on a daily basis.

I need to reiterate: corona is really a threat only to those with underlying health conditions (diabetes, those undergoing cancer treatment, etc), those who are in prison, or those who are in nursing homes. The rest of us will be fine with a little distancing and a mask if we go into a building.

Corona is only The Return of the Black Death to Democrats who need the economy to suffer so they can derail the reelection campaign.

[Obi-Wan Nihilo]

As I said upthread, there are vastly more people who are/have been infected than we're counting. A study from Penn State states that the infection rate may be 80 times greater than reported.

Further, less than a thousand Americans under 35 have died, and 80% of all deaths were over 65.

And the cost? Second quarter GDP to fall 53%. The IMF's got a rosy outlook too.

We're seeing an uptick in cases because we're finally getting out of the house. The lockdowns were never about stopping the disease. It was all about prolonging it and spreading the peak out, or flattening the curve if you prefer.

We've reached the point now that we're doing a much better job of treating the virus. We've also got the data that shows exactly what I've been saying - that this virus is very contagious, but not particularly dangerous to anyone other than the elderly or those with certain health issues.

Time to end this farce and move on.

[TheFallen]

As I said upthread, there are vastly more people who are/have been infected than we're counting. A study from Penn State states that the infection rate may be 80 times greater than reported.

Further, less than a thousand Americans under 35 have died, and 80% of all deaths were over 65.

And the cost? Second quarter GDP to fall 53%. The IMF's got a rosy outlook too.

We're seeing an uptick in cases because we're finally getting out of the house. The lockdowns were never about stopping the disease. It was all about prolonging it and spreading the peak out, or flattening the curve if you prefer.

I don't disagree with much of this so far. But then we get this.

We've reached the point now that we're doing a much better job of treating the virus.

Time to end this farce and move on.

The first part of that statement is indeed supported by the available data. The second part is a contradiction in terms.

By flattening the curve - and by the way, I don't know who you think ever said that lockdowns would stop the disease - we've bought ourselves the time to discover how to treat it more effectively. That will have saved large numbers of lives, which I don't consider to be a farce.

The only point left to argue is - and fully granted - has it been worth the cost?

[Obi-Wan Nihilo]

It's only a contradiction if you make it one.

This virus is dangerous to a certain portion of the population. Doctors now know what the virus is, what it does, and what's effective from a treatment standpoint. The vulnerable are less vulnerable now.

Nearly 45 million people forced out of work, the economy a shambles, and civil rights in tatters. Absolutely not worth the cost.

TF, you never said anything about the lockdowns stopping the disease. But the pearl-clutching currently going on over the increases in cases says otherwise.

[Vain]

Meanwhile at the ass end of the world aka New Zealand......

To be fair, if this place wasn't an island at the end of the world, the wombles in our government would have been burnt at the stake for their incompetence. But hey, as they say, in property the thing that matters most is location, location, location.

Of course with tens of thousands of Kiwis fleeing the rest of the world back here, it won't be long before this virus does what viruses do....spread. I surmise that the appetite for another lockdown might not be there though (although working from home was quite nice)

[Fist and Faith]

Vain?!? You've been around even less than I have!