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Post by svart on Apr 12, 2021 13:47:20 GMT -6
Matt, you mentioned : "It's well demonstrated at this point that HCL does not work." Actually, you're right, it hasn't worked well in the published controlled studies. Which begs the question : how come its working so well for actual doctors treating C19 with this method? The reason? Because the doctors that are actually using it give it along with Zinc, D, C and a Zpack while the "official studies" don't. Given the protocol that working doctors prescribing it are using, it's seems to be amazingly effective. Are they lying? Is the medical community lying? Who's lying? More BS political testing and manipulation on all sides from what I can tell. Makes me incredibly pissed and mis-trusting of the powers that be who think they are in charge of our collective health.... Pushing vaccines is making billions for the companies making them. Are politics involved? Absolutely. While I've read reports on both sides of the argument and it seems that if a study says that it "worked", then that data shows it really really worked. In the studies that showed it didn't work, then there was no real change in outcome which meant that trying it wouldn't have hurt anything to try. There was/is a very vocal crowd of "if it saves one life it was worth it" rabblerousers that were in favor of literally trying anything to find a cure, but just not hydroxychloroquine. why? But speaking of knee-jerk reactions and the "try something, anything" crowd.. One thing has always bothered me was the initial knee-jerk action of "ventilators, ventilators! ventilators!!!!". They've known that high-pressure ventilators cause lung trauma well before covid came along. Long-term ventilation has a history of opportunistic infections, lung bleeding, scarring and ultimately reduced lung function, yet they immediately threw a lot of people on these machines knowing full well that this was only going to complicate it, but did so because of "DO SOMETHING, ANYTHING!!" mentality. They did something, and 90% of all covid victims on ventilators died anyway. The number of people NOT on ventilators but with acute covid who died was much lower. Did the ventilators kill more people than would have died without them? The numbers right now say yes. In 5 years when they've had time to digest all the numbers and data that might change though. |
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Post by ragan on Apr 12, 2021 13:57:40 GMT -6
Matt, you mentioned : "It's well demonstrated at this point that HCL does not work." Actually, you're right, it hasn't worked well in the published controlled studies. Which begs the question : how come its working so well for actual doctors treating C19 with this method? The reason? Because the doctors that are actually using it give it along with Zinc, D, C and a Zpack while the "official studies" don't. Given the protocol that working doctors prescribing it are using, it's seems to be amazingly effective. Are they lying? Is the medical community lying? Who's lying? More BS political testing and manipulation on all sides from what I can tell. Makes me incredibly pissed and mis-trusting of the powers that be who think they are in charge of our collective health.... Pushing vaccines is making billions for the companies making them. Are politics involved? Absolutely. While I've read reports on both sides of the argument and it seems that if a study says that it "worked", then that data shows it really really worked. In the studies that showed it didn't work, then there was no real change in outcome which meant that trying it wouldn't have hurt anything to try. There was/is a very vocal crowd of "if it saves one life it was worth it" rabblerousers that were in favor of literally trying anything to find a cure, but just not hydroxychloroquine. why? But speaking of knee-jerk reactions and the "try something, anything" crowd.. One thing has always bothered me was the initial knee-jerk action of "ventilators, ventilators! ventilators!!!!". They've known that high-pressure ventilators cause lung trauma well before covid came along. Long-term ventilation has a history of opportunistic infections, lung bleeding, scarring and ultimately reduced lung function, yet they immediately threw a lot of people on these machines knowing full well that this was only going to complicate it, but did so because of "DO SOMETHING, ANYTHING!!" mentality. They did something, and 90% of all covid victims on ventilators died anyway. The number of people NOT on ventilators but with acute covid who died was much lower. Did the ventilators kill more people than would have died without them? The numbers right now say yes. In 5 years when they've had time to digest all the numbers and data that might change though. In my view, a much more obvious meaning to the "people who weren't put on ventilators didn't tend to die as much as those who were put on ventilators" thing is that the reason people are put on ventilators is because they're in the worst shape and are heading for death. I know docs who work on this stuff. One who flew out to NY during that first big ugly wave and worked in ERs there (he also got Covid). Nobody is cavalier about putting a patient on a ventilator. It's a last resort. It would be shocking to me if the data said anything other than "ventilated patients have higher death rates than non-ventilated patients". These are the patients that are in really, really bad shape. There are, of course, nuances to what goes into the decisions to ventilate patients and that stuff has all evolved as docs/nurses have fought this thing for a year+. |
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Post by svart on Apr 12, 2021 14:40:57 GMT -6
While I've read reports on both sides of the argument and it seems that if a study says that it "worked", then that data shows it really really worked. In the studies that showed it didn't work, then there was no real change in outcome which meant that trying it wouldn't have hurt anything to try. There was/is a very vocal crowd of "if it saves one life it was worth it" rabblerousers that were in favor of literally trying anything to find a cure, but just not hydroxychloroquine. why? But speaking of knee-jerk reactions and the "try something, anything" crowd.. One thing has always bothered me was the initial knee-jerk action of "ventilators, ventilators! ventilators!!!!". They've known that high-pressure ventilators cause lung trauma well before covid came along. Long-term ventilation has a history of opportunistic infections, lung bleeding, scarring and ultimately reduced lung function, yet they immediately threw a lot of people on these machines knowing full well that this was only going to complicate it, but did so because of "DO SOMETHING, ANYTHING!!" mentality. They did something, and 90% of all covid victims on ventilators died anyway. The number of people NOT on ventilators but with acute covid who died was much lower. Did the ventilators kill more people than would have died without them? The numbers right now say yes. In 5 years when they've had time to digest all the numbers and data that might change though. In my view, a much more obvious meaning to the "people who weren't put on ventilators didn't tend to die as much as those who were put on ventilators" thing is that the reason people are put on ventilators is because they're in the worst shape and are heading for death. I know docs who work on this stuff. One who flew out to NY during that big, first ugly wave and worked in ERs there (he also got Covid). Nobody is cavalier about putting a patient on a ventilator. It's a last resort. It would be shocking to me if the data said anything other than "ventilated patients have higher death rates than non-ventilated patients". These are the patients that are in really, really bad shape. There are, of course, nuances to what goes into the decisions to ventilate patients and that stuff has all evolved as docs/nurses have fought this thing for a year+. I guess I can see how you'd rationalize that but it's also specious. I suppose in my haste to write, I didn't make it clear that I'm talking about the ones who didn't get ventilators due to shortages. They were considered bad enough but didn't get them at the time.. And yet a higher percentage lived. I do see that they're using the ventilators much much less these days after finding less physiologically invasive treatments, which I believe stems from the hard-learned lessons above. I too know a few doctors, and at least one has said that they resisted putting people on ventilators because they've had a high rate of secondary bacterial infections that end up killing the covid victims on ventilators. They haven't had that many deaths even though their emergency room was pretty much 100% covid for most of the last 6 months of 2020. The other doctor I know was told by management that they MUST put anyone with an O2 level below some threshold on a ventilator due to insurance/malpractice reasons or face firing. They're currently short staffed because doctors were quitting. |
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Post by ragan on Apr 12, 2021 14:49:39 GMT -6
In my view, a much more obvious meaning to the "people who weren't put on ventilators didn't tend to die as much as those who were put on ventilators" thing is that the reason people are put on ventilators is because they're in the worst shape and are heading for death. I know docs who work on this stuff. One who flew out to NY during that big, first ugly wave and worked in ERs there (he also got Covid). Nobody is cavalier about putting a patient on a ventilator. It's a last resort. It would be shocking to me if the data said anything other than "ventilated patients have higher death rates than non-ventilated patients". These are the patients that are in really, really bad shape. There are, of course, nuances to what goes into the decisions to ventilate patients and that stuff has all evolved as docs/nurses have fought this thing for a year+. I guess I can see how you'd rationalize that but it's also specious. I suppose in my haste to write, I didn't make it clear that I'm talking about the ones who didn't get ventilators due to shortages. They were considered bad enough but didn't get them at the time.. And yet a higher percentage lived. I do see that they're using the ventilators much much less these days after finding less physiologically invasive treatments, which I believe stems from the hard-learned lessons above. Gotcha. That is a little different, though the same principle would still apply. If you’re a doc and you’ve got 5 patients you’d like to give ventilators to but you’ve only got 2 available, you’re gonna give those to the worst 2 patients of the bunch. But yeah, though I have no special expertise at all, I’ve been reading for months about how docs have been figuring out ways to keep more patients off vents. Which seems good! The early onslaught had medical staff scrambling. Lots of lessons learned as the sprint turned into a marathon. |
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Post by drbill on Apr 12, 2021 14:55:54 GMT -6
The only HCQ FIRST HAND experience I've had is with a buddy's doctor in LA. He's treated hundreds of patients for C19. He generally treats early, fast and with HCQ. So far he has batted 100% when HCQ is used with Zinc, C, D and a Zpack and is caught relatively early in the timeframe. Most of his patients have recovered 100% and quickly. Yeah, I know - not an "official study". But excellent results that are far better than many (most?) other treatments.
My doctors take on it (and I am at risk) the three times I've asked about preventative, proactive treatment : 1st time - don't worry about it; 2nd time - take Tylenol if you really feel bad, and if you feel REALLY, REALLY bad - like completely exhausted and can't breathe - go to the hospital; 3rd time "get the vaccine - I did and I'm still alive!". Used to trust the guy. Not so much anymore. Why not jump on a C19 infection EARLY instead of waiting for hospitalization, or a untested vaccine where the developers require indemnification?
Why do hospitals send you home and tell you to take Tylenol until you are REALLY sick? Why does the media and CDC, etc. say HCQ will kill you - but millions of people are on it constantly for a variety of things? Why are some sources essentially branding you a traitor to the human race if you do not take an essentially untested vaccine? Why are many doctors using "unqualified cures" successfully "off the medical community grid"?
The whole situation is F'd up. Medical institutions thousands of miles away mandating how I should be treated....on the ground doctors stating the complete opposite with pragmatic verifiable successes. Crazy times. Roll the dice I guess. Everyone I know that has had it has had mild no virtually no real symptoms - including my extremely frail 92 y/o FIL who WAS hospitalized, and over it in 3 days. From the media I know there are others who I don't know who were not so lucky.
Who knows? Certainly not the experts from what I've seen..... Still waiting to be convinced on any form of treatment / prevention.....
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Post by svart on Apr 12, 2021 15:10:39 GMT -6
The only HCQ FIRST HAND experience I've had is with a buddy's doctor in LA. He's treated hundreds of patients for C19. He generally treats early, fast and with HCQ. So far he has batted 100% when HCQ is used with Zinc, C, D and a Zpack and is caught relatively early in the timeframe. Most of his patients have recovered 100% and quickly. Yeah, I know - not an "official study". But excellent results that are far better than many (most?) other treatments. My doctors take on it (and I am at risk) the three times I've asked about preventative, proactive treatment : 1st time - don't worry about it; 2nd time - take Tylenol if you really feel bad, and if you feel REALLY, REALLY bad - like completely exhausted and can't breathe - go to the hospital; 3rd time "get the vaccine - I did and I'm still alive!". Used to trust the guy. Not so much anymore. Why not jump on a C19 infection EARLY instead of waiting for hospitalization, or a untested vaccine where the developers require indemnification? Why do hospitals send you home and tell you to take Tylenol until you are REALLY sick? Why does the media and CDC, etc. say HCQ will kill you - but millions of people are on it constantly for a variety of things? Why are some sources essentially branding you a traitor to the human race if you do not take an essentially untested vaccine? Why are many doctors using "unqualified cures" successfully "off the medical community grid"? The whole situation is F'd up. Medical institutions thousands of miles away mandating how I should be treated....on the ground doctors stating the complete opposite with pragmatic verifiable successes. Crazy times. Roll the dice I guess. Everyone I know that has had it has had mild no virtually no real symptoms - including my extremely frail 92 y/o FIL who WAS hospitalized, and over it in 3 days. From the media I know there are others who I don't know who were not so lucky. Who knows? Certainly not the experts from what I've seen..... Still waiting to be convinced on any form of treatment / prevention..... 1: "why not jump on C19 infection early?" It's a whole lot easier to defend yourself against malpractice if you're doing status-quo treatment rather than off-label treatments that are actively being denounce by the mass media. 2: "Why do hospitals send you home?" Fear. Irrational fear of plowing through resources for the large numbers of those who are mildly sick but cantankerously demanding treatment and thus leaving the very few who have acute disease without. We know now that the "overrun hospitals" trope was a bit overblown but in order to project a feeling of security at the time, they had to triage quite heavily. 3: It's a virus doing what viruses do. It has a singular goal, to infect as fast as possible to the most hosts as possible. The SARS experts said there really wasn't anything we could do but allow it to take it's course, but they did say that there was one thing that we shouldn't do if we wanted to avoid the mutations.. And that was lockdown and draw it all out and create pockets of viral reservoirs. c'est la vie. |
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Post by matt@IAA on Apr 12, 2021 15:30:20 GMT -6
The plural of anecdote isn’t data, and so it’s hard to compare one doctors experience. That’s why we do studies. Many many things don’t pass studies that should, or seem to work.
Just from raw numbers a disease with a 0.5% fatality rate would need a doctor to see 1000 patients just to see 5 fatalities. If a successful treatment cuts this in half you’re talking about seeing 3 vs 5 fatalities in 100 patients. That’s incredibly difficult to measure on a small scale. Add in the potential skew from patient selection and it gets worse - if you’re a family practice doc the fatality rate would be far lower. If you work in a nursing home far higher. Really tough to get perspective from any one practice.
When we scale up, many of these drugs just don’t work. HCQ, ivermectin, and the others just strike out. And that isn’t that surprising.. there aren’t many good treatments for viruses in general (so I’m told anyway, I’m not a doctor). There’s many drugs failed as COVID treatments that you haven’t heard of just because they didn’t become political footballs.
Think about this way. HCQ won’t kill you except in extremely rare cases. But if It doesn’t help prevent fatality from covid, why put patients at risk for those rare cases? Statistically it provides no benefit, but definitely provides a very very small downside.
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Post by matt@IAA on Apr 12, 2021 15:36:15 GMT -6
Speaking of random side effects and reasons to NOT get COVID. My doctor best friend roommate told me the other day of a patient that they had who died of Guillain-Barré syndrome - virus side effect causing ascending paralysis. This is an incredibly rare thing, but COVID can cause it. It’s just bizarre to me how many incredibly rare side effects this disease can cause, seemingly with no understood mechanism or reason.
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Post by RealNoob on Apr 12, 2021 15:51:53 GMT -6
The only HCQ FIRST HAND experience I've had is with a buddy's doctor in LA. He's treated hundreds of patients for C19. He generally treats early, fast and with HCQ. So far he has batted 100% when HCQ is used with Zinc, C, D and a Zpack and is caught relatively early in the timeframe. Most of his patients have recovered 100% and quickly. Yeah, I know - not an "official study". But excellent results that are far better than many (most?) other treatments. My doctors take on it (and I am at risk) the three times I've asked about preventative, proactive treatment : 1st time - don't worry about it; 2nd time - take Tylenol if you really feel bad, and if you feel REALLY, REALLY bad - like completely exhausted and can't breathe - go to the hospital; 3rd time "get the vaccine - I did and I'm still alive!". Used to trust the guy. Not so much anymore. Why not jump on a C19 infection EARLY instead of waiting for hospitalization, or a untested vaccine where the developers require indemnification? Why do hospitals send you home and tell you to take Tylenol until you are REALLY sick? Why does the media and CDC, etc. say HCQ will kill you - but millions of people are on it constantly for a variety of things? Why are some sources essentially branding you a traitor to the human race if you do not take an essentially untested vaccine? Why are many doctors using "unqualified cures" successfully "off the medical community grid"? The whole situation is F'd up. Medical institutions thousands of miles away mandating how I should be treated....on the ground doctors stating the complete opposite with pragmatic verifiable successes. Crazy times. Roll the dice I guess. Everyone I know that has had it has had mild no virtually no real symptoms - including my extremely frail 92 y/o FIL who WAS hospitalized, and over it in 3 days. From the media I know there are others who I don't know who were not so lucky. Who knows? Certainly not the experts from what I've seen..... Still waiting to be convinced on any form of treatment / prevention..... Exactly. I do know many who have recovered through the HCQ/Z/Z-pack treatment. It works well. My doctor is a family friend and has already treated at least hundreds, if not thousands. Like you and I, he is for the fast response. I too don't understand why any healthcare professional would have someone wait until "hospital sick" to do anything. |
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Post by RealNoob on Apr 12, 2021 15:54:26 GMT -6
This isn't an argument, and this isn't necessarily a direct response to Rob -- but there's a kind of persistent misinformation floating around these shots. I'm not a doctor, but in my day job I was volunteered into coordinating the COVID response for the Americas for a multibillion dollar company. This doesn't make me smart or anything but I have been kind of forced into being well-informed, as we have had to answer questions for our employees over the past year. First, it is true there are are no long term studies of these particular vaccines. This is kind of obvious, seeing as they are new. However, we have studied vaccines for around a hundred years in the modern era. We've been studying DNA and mRNA vaccines for around a decade. It is kind of similar to saying there are no long term studies of an all-new 2021 vehicle, but we have a pretty decent handle on cars in general at this point (note that there are recalls from time to time!). The second one - no one really knows the impact of these injections. But this is too vague to be useful. At this point we know the direct impact, because there were multi-phase clinical trials done for each. You can read Pfizer's report here, for example. In short, in the third phase of the trial they did a randomized, blind, placebo-controlled study with 43,548 participants. This is a very large sample size, and a gold-standard kind of study (far better than any kind of study performed on hydroxychloroquine or other politically-controversial treatments). They followed them for two months, and looked at the results. That was last November or so. These shots are still being tracked, and by now millions and millions of people have received them. At this point we know the impact of these injections: they very clearly work as intended in preventing severe covid cases. And what's being done is absolutely not without precedent. In 1947 New York City vaccinated 6 million people against smallpox in less than a month after an outbreak. Most people at the time had been vaccinated as children, but the immunity waned over their life. And that vaccine had known side effects, sometimes lethal ones like encephalitis. But it was the right thing to do. Forgive me but this is part of that persistent misunderstanding. Your cells are like little protein factories. DNA is the management team of the factory, and RNA is the instructions. The RNA vaccine is an instruction list. Your cell factories get these instructions like a work order, and manufacture the proteins accordingly. Or maybe another analogy. Your cell is like a restaurant, and the DNA is the chef and kitchen staff. The RNA are orders that come in. After the orders are made, the RNA is consumed. RNA absolutely does not cause your cells to mutate. It causes the cells to manufacture the spike protein from the coronavirus that causes COVID. Your cells are constantly manufacturing proteins naturally by the same process. The mRNA just slips an order in with the normal orders. All vaccines work on this same basic premise. You need an antigen that makes your body get an immune response. They make this antigen in different ways - using a dormant or non-infectious virus, using a different virus that's less dangerous, whatever. In this case, you send an "order" for protein antigens made by your body. After they are produced, your body sees them and responds, and this immune response makes antibodies. My best friend and college roommate is a doc who works in a hospital in Louisiana. The standard of care changes nearly weekly for them, because we are still learning how to treat. It's well demonstrated at this point that HCL does not work. I don't know why it became a political issue (I mean, I do but it's depressing that it did). The kind of dirty secret is that none of the therapeutics work very well when you actually subject them to clinical trials. Please talk to your doctor about treatments, don't take my word for it. The 'state of the art' is changing fast. I also don't recommend the fight it off mentality. While it is true that the majority of people have no issues, it almost seems random how it affects people. We have had a 42 year old employee with no known comorbidities die in Washington and another 51 year old in South Africa. At our location employees I know have ranged from minor response (like a stuffy nose) to missing two weeks (a 29 year old health nut) to being hospitalized. My other college roommate lost his mother (60s) and older brother (40s) within a week. The plural of anecdotes does not make data, so these aren't making a scientific point. Scientifically it's probably going to be minor if youre under 50 and not overweight, or high blood pressure, or diabetic. But just as scientifically there is a risk for anyone of severe illness or some really really crappy side effects (like neurological issues). Over the past year I went from thinking about like you - I'd rather just get it as I am young and healthy and it doesn't look so bad - to doing a hasty 180 and noping right away from that. I've seen what it can do, and I absolutely have no interest in that kind of gamble. But that's your choice, and that's the way it should be. This is not correct. The current guidance from the CDC is you can get your second shot as soon as your symptoms subside (same as the ten day isolation guidance) if you get COVID before your first shot or between two rounds. The exception is if you were treated with plasma or antibody treatment - then you should wait 90 days. And while antibodies do go away (over months), your body does not forget how to make them. This is crucially important! If you've had a measles vaccine, for example, you probably do not have measles antibodies in your blood right now. However, if you were exposed to measles your body would be able to make the antibodies, and protect you. This long-term immunity changes for different viruses, but it is usually years and decades, not months. We don't know how durable the immunity will be. So far we know the vaccine gives protection for six+ months. Why only six? Because that's as long as we've been giving it. We don't know if we'll need it again - health types are being conservative because we might. I suspect not, unless a very very different strain comes out that the antibodies from this one won't work.*** And, you say "still aren't safe." This is maybe a misunderstanding. If you've been fully vaccinated, your risk of severe illness drops to basically zero. Your risk of hospitalization and death is effectively zero regardless of age once vaccinated - an amazing thing! The reason they want people to continue to wear masks is because you might still get infected and be able to infect others. Personally I think this is way overboard to the risk-averse side, and I expect these kind of restrictions to go away shortly mainly because the vaccines are working really well. Conclusion: if you want masks to go away, and things to go back to normal, the best thing to do is hope for most people to get vaccines. The worst thing would be if a huge portion of the population doesn't get it. The sooner you hit ~50-75% of the population either already having had COVID or being vaccinated the sooner all of this goes away! But again, I'm an optimist and I think by June the combination of seasonality and the incredibly high rate of vaccination plus recovered folks will mean it's over. I think in some places like Texas it already is effectively over. Hope this was helpful. ***as an aside, the reason you need a flu shot every year is because the viruses that cause flu are super variable, and change from year to year. The virus that causes the 'rona is much more stable, and doesn't have the fundamental mechanism that flu does that makes it change so much. I'm a big time optimist. Matt, Not a direct reply though you quoted me and worked to debunk me. Well, my friend, you don't have to believe what I write but don't pretend to correct me and then claim not to. I shared my experience and understanding which has some medical backing just as you claim to. So what? Feel feee to share your perspective but like I told the other guy, you're not in a position to correct me. Anyone who searches for RNA injection dangers of vaccine, if you want to call it that, can easily find the possibility of unintended immune system reactions including automation-immune disorders. |
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Post by RealNoob on Apr 12, 2021 16:02:28 GMT -6
This isn't an argument, and this isn't necessarily a direct response to Rob -- but there's a kind of persistent misinformation floating around these shots. I'm not a doctor, but in my day job I was volunteered into coordinating the COVID response for the Americas for a multibillion dollar company. This doesn't make me smart or anything but I have been kind of forced into being well-informed, as we have had to answer questions for our employees over the past year. First, it is true there are are no long term studies of these particular vaccines. This is kind of obvious, seeing as they are new. However, we have studied vaccines for around a hundred years in the modern era. We've been studying DNA and mRNA vaccines for around a decade. It is kind of similar to saying there are no long term studies of an all-new 2021 vehicle, but we have a pretty decent handle on cars in general at this point (note that there are recalls from time to time!). The second one - no one really knows the impact of these injections. But this is too vague to be useful. At this point we know the direct impact, because there were multi-phase clinical trials done for each. You can read Pfizer's report here, for example. In short, in the third phase of the trial they did a randomized, blind, placebo-controlled study with 43,548 participants. This is a very large sample size, and a gold-standard kind of study (far better than any kind of study performed on hydroxychloroquine or other politically-controversial treatments). They followed them for two months, and looked at the results. That was last November or so. These shots are still being tracked, and by now millions and millions of people have received them. At this point we know the impact of these injections: they very clearly work as intended in preventing severe covid cases. And what's being done is absolutely not without precedent. In 1947 New York City vaccinated 6 million people against smallpox in less than a month after an outbreak. Most people at the time had been vaccinated as children, but the immunity waned over their life. And that vaccine had known side effects, sometimes lethal ones like encephalitis. But it was the right thing to do. Forgive me but this is part of that persistent misunderstanding. Your cells are like little protein factories. DNA is the management team of the factory, and RNA is the instructions. The RNA vaccine is an instruction list. Your cell factories get these instructions like a work order, and manufacture the proteins accordingly. Or maybe another analogy. Your cell is like a restaurant, and the DNA is the chef and kitchen staff. The RNA are orders that come in. After the orders are made, the RNA is consumed. RNA absolutely does not cause your cells to mutate. It causes the cells to manufacture the spike protein from the coronavirus that causes COVID. Your cells are constantly manufacturing proteins naturally by the same process. The mRNA just slips an order in with the normal orders. All vaccines work on this same basic premise. You need an antigen that makes your body get an immune response. They make this antigen in different ways - using a dormant or non-infectious virus, using a different virus that's less dangerous, whatever. In this case, you send an "order" for protein antigens made by your body. After they are produced, your body sees them and responds, and this immune response makes antibodies. My best friend and college roommate is a doc who works in a hospital in Louisiana. The standard of care changes nearly weekly for them, because we are still learning how to treat. It's well demonstrated at this point that HCL does not work. I don't know why it became a political issue (I mean, I do but it's depressing that it did). The kind of dirty secret is that none of the therapeutics work very well when you actually subject them to clinical trials. Please talk to your doctor about treatments, don't take my word for it. The 'state of the art' is changing fast. I also don't recommend the fight it off mentality. While it is true that the majority of people have no issues, it almost seems random how it affects people. We have had a 42 year old employee with no known comorbidities die in Washington and another 51 year old in South Africa. At our location employees I know have ranged from minor response (like a stuffy nose) to missing two weeks (a 29 year old health nut) to being hospitalized. My other college roommate lost his mother (60s) and older brother (40s) within a week. The plural of anecdotes does not make data, so these aren't making a scientific point. Scientifically it's probably going to be minor if youre under 50 and not overweight, or high blood pressure, or diabetic. But just as scientifically there is a risk for anyone of severe illness or some really really crappy side effects (like neurological issues). Over the past year I went from thinking about like you - I'd rather just get it as I am young and healthy and it doesn't look so bad - to doing a hasty 180 and noping right away from that. I've seen what it can do, and I absolutely have no interest in that kind of gamble. But that's your choice, and that's the way it should be. This is not correct. The current guidance from the CDC is you can get your second shot as soon as your symptoms subside (same as the ten day isolation guidance) if you get COVID before your first shot or between two rounds. The exception is if you were treated with plasma or antibody treatment - then you should wait 90 days. And while antibodies do go away (over months), your body does not forget how to make them. This is crucially important! If you've had a measles vaccine, for example, you probably do not have measles antibodies in your blood right now. However, if you were exposed to measles your body would be able to make the antibodies, and protect you. This long-term immunity changes for different viruses, but it is usually years and decades, not months. We don't know how durable the immunity will be. So far we know the vaccine gives protection for six+ months. Why only six? Because that's as long as we've been giving it. We don't know if we'll need it again - health types are being conservative because we might. I suspect not, unless a very very different strain comes out that the antibodies from this one won't work.*** And, you say "still aren't safe." This is maybe a misunderstanding. If you've been fully vaccinated, your risk of severe illness drops to basically zero. Your risk of hospitalization and death is effectively zero regardless of age once vaccinated - an amazing thing! The reason they want people to continue to wear masks is because you might still get infected and be able to infect others. Personally I think this is way overboard to the risk-averse side, and I expect these kind of restrictions to go away shortly mainly because the vaccines are working really well. Conclusion: if you want masks to go away, and things to go back to normal, the best thing to do is hope for most people to get vaccines. The worst thing would be if a huge portion of the population doesn't get it. The sooner you hit ~50-75% of the population either already having had COVID or being vaccinated the sooner all of this goes away! But again, I'm an optimist and I think by June the combination of seasonality and the incredibly high rate of vaccination plus recovered folks will mean it's over. I think in some places like Texas it already is effectively over. Hope this was helpful. ***as an aside, the reason you need a flu shot every year is because the viruses that cause flu are super variable, and change from year to year. The virus that causes the 'rona is much more stable, and doesn't have the fundamental mechanism that flu does that makes it change so much. I'm a big time optimist. Matt, Not a direct reply though you quoted me and worked to debunk me. Well, my friend, you don't have to believe what I write but don't pretend to correct me and then claim not to. I shared my experience and understanding which has some medical backing just as you claim to. So what? Feel feee to share your perspective but like I told the other guy, you're not in a position to correct me. Anyone who searches for RNA injection dangers, or vaccine, if you want to call it that, can easily find the possibility of unintended immune system reactions including automation-immune disorders. |
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Post by ragan on Apr 12, 2021 16:04:01 GMT -6
As is always the case, there is a huge amount of murkiness going on with correlation/causation/coincidence. People take HCL (or whatever the alt-therapy du jour is) and have a mild case. Look, it works! The vast majority of people are going to have mild cases anyway. Give them sugar pills and they will "work" too. My wife's 92-year-old grandmother had a mild case (thank God). A mid-40s guy I know of (tangentially) died. Neither of these prove anything. If you really want to know what's going on, you have to zoom out and do real, actual study. The kind that's boring and difficult and time-consuming. The sexy stuff (HCL, the Elites™️ are trying to control you, etc) is better fodder for pundits and mouthpieces and it will always be with us, the same way "Real Housewives" or fad diets or whatever will always be with us. We humans like noisy, flashy stuff. We can't help it. But getting at the real truth of things is usually a long, slow, unsexy process.
For my part, I like my scientific information like I like my gear - designed by someone who knows what the hell they're doing and with a nice, high SNR.
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Post by drbill on Apr 12, 2021 17:14:44 GMT -6
The best thing, most honest, most straightforward without political agenda attached information that I've seen is the EXTREME importance of having good vitamin D levels in your system.
I've seen several video's on D, but the two most compelling ones were a Doc that stated that we have a Vitamin D pandemic, not a Covid pandemic - and he backed it up. To the point of saying that half the US mortalities could have been prevented with mega doses of D instead of trying to treat in the hospital. He had compelling credentials, practical experience, and data. But I still take that with a grain of salt.
The second was a video of an equally credentialed doctor that laid out over a dozen worldwide D studies and how Vit D applies / interacts with Covid. Studies on age, co-morbidities, race, enithicity, work, location, etc. Pretty much anything you could imagine studying, there are studies on it. It was not motivated in either direction, but laying out the data from over a dozen international D studies in relation to Covid. Kind of made my eyes glaze over, and I almost checked out several times, but hung thru it and came to the conclusion that by far the #1 most important thing we can do (aside from being blessed with the right gene's that will keep us safe) is to have extra high levels of D in our system.
BTW, the experts tend to agree that living anywhere N of Flagstaff and it's impossible to get your D from the sun, and in the winter, virtually all of the US is impossible to get your D from the sun. So mega doses and vitamin D heavy foods are the way to go for protection against Covid. Even if you get it, the studies show that it will be a milder case with healthy D levels in your bloodstream. There's really no downside to maxing out on D, and it's almost - ALMOST - impossible to overdose on it.
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ericn
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Post by ericn on Apr 12, 2021 18:05:42 GMT -6
The only HCQ FIRST HAND experience I've had is with a buddy's doctor in LA. He's treated hundreds of patients for C19. He generally treats early, fast and with HCQ. So far he has batted 100% when HCQ is used with Zinc, C, D and a Zpack and is caught relatively early in the timeframe. Most of his patients have recovered 100% and quickly. Yeah, I know - not an "official study". But excellent results that are far better than many (most?) other treatments. My doctors take on it (and I am at risk) the three times I've asked about preventative, proactive treatment : 1st time - don't worry about it; 2nd time - take Tylenol if you really feel bad, and if you feel REALLY, REALLY bad - like completely exhausted and can't breathe - go to the hospital; 3rd time "get the vaccine - I did and I'm still alive!". Used to trust the guy. Not so much anymore. Why not jump on a C19 infection EARLY instead of waiting for hospitalization, or a untested vaccine where the developers require indemnification? Why do hospitals send you home and tell you to take Tylenol until you are REALLY sick? Why does the media and CDC, etc. say HCQ will kill you - but millions of people are on it constantly for a variety of things? Why are some sources essentially branding you a traitor to the human race if you do not take an essentially untested vaccine? Why are many doctors using "unqualified cures" successfully "off the medical community grid"? The whole situation is F'd up. Medical institutions thousands of miles away mandating how I should be treated....on the ground doctors stating the complete opposite with pragmatic verifiable successes. Crazy times. Roll the dice I guess. Everyone I know that has had it has had mild no virtually no real symptoms - including my extremely frail 92 y/o FIL who WAS hospitalized, and over it in 3 days. From the media I know there are others who I don't know who were not so lucky. Who knows? Certainly not the experts from what I've seen..... Still waiting to be convinced on any form of treatment / prevention..... Bill 2 of the biggest problems with medicine is we don’t know as much as we think we do and there are just way too many variables. We like things nice and neat quite often that isn’t the case. You add in the fact that the cure can be as dangerous as the cure, well you have to be careful what you say in public. Over the last 20 years I have heard the words “you are the protocol “ from some of the most respected MD’s on the planet. The only thing I hear more often comes from young physicians “ no way your a 97 burn, you would be published in every text. What these young guys seldom realize even in a world of publish or perish there are Dr’s who are just to busy flying by the seat of their pants and saving people. Funny enough we were watching the Shameless finale last night and both my wife and I were in hysterics when they thought they were being dramatic by showing Frank’s chart being wheeled in a full grocery cart, that’s nothing! Why is this relevant because in order to publish you have to do a complete chart review of every little note, on complicated cases that can be a career in its self. I found this out as a child as I was told about my uncle who was probably the very first bone marrow transplant ever. You won’t find his name anywhere, it was simply a last ditch effort to save somebody by taking a rib out of his brother, breaking off one of his and grafting in his brothers 5 years before the official first bone marrow transplant, ironically the UW didn’t know they did it. See the biggest problem with science is you need someone nuts enough to suggest what seams at the time completely nuts and somebody who is nuts enough to let them try. |
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Post by matt@IAA on Apr 12, 2021 18:17:12 GMT -6
@robsmith nah not looking for an argument my dude. You were talking about some very common concerns that a lot of people have, and some that I think there are good answers for based in fact, from reliable sources. I hope they helped clarify some things.
As for mRNA, you are correct there have been problems with other mRNA therapies. Not because cells mutate, but because they were doing prolonged mRNA injections - try to develop treatments for things like cancer. This is a different use, so it’s reasonable to expect a different outcome. Also, those studies provide valuable insight, some of which enabled the development of these vaccines. (Also aside, the J&J vaccine is a DNA vs mRNA vaccine. The instructions are DNA, but the basic idea is the same).
Cheers!
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Post by ericn on Apr 12, 2021 19:15:23 GMT -6
@robsmith nah not looking for an argument my dude. You were talking about some very common concerns that a lot of people have, and some that I think there are good answers for based in fact, from reliable sources. I hope they helped clarify some things. As for mRNA, you are correct there have been problems with other mRNA therapies. Not because cells mutate, but because they were doing prolonged mRNA injections - try to develop treatments for things like cancer. This is a different use, so it’s reasonable to expect a different outcome. Also, those studies provide valuable insight, some of which enabled the development of these vaccines. (Also aside, the J&J vaccine is a DNA vs mRNA vaccine. The instructions are DNA, but the basic idea is the same). Cheers! I’ll add the concept of an RNA vaccine and most of the research has been around for years, it’s just with COVID for the first time there was the money to go down that road. |
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Post by Tbone81 on Apr 12, 2021 19:43:32 GMT -6
While I've read reports on both sides of the argument and it seems that if a study says that it "worked", then that data shows it really really worked. In the studies that showed it didn't work, then there was no real change in outcome which meant that trying it wouldn't have hurt anything to try. There was/is a very vocal crowd of "if it saves one life it was worth it" rabblerousers that were in favor of literally trying anything to find a cure, but just not hydroxychloroquine. why? But speaking of knee-jerk reactions and the "try something, anything" crowd.. One thing has always bothered me was the initial knee-jerk action of "ventilators, ventilators! ventilators!!!!". They've known that high-pressure ventilators cause lung trauma well before covid came along. Long-term ventilation has a history of opportunistic infections, lung bleeding, scarring and ultimately reduced lung function, yet they immediately threw a lot of people on these machines knowing full well that this was only going to complicate it, but did so because of "DO SOMETHING, ANYTHING!!" mentality. They did something, and 90% of all covid victims on ventilators died anyway. The number of people NOT on ventilators but with acute covid who died was much lower. Did the ventilators kill more people than would have died without them? The numbers right now say yes. In 5 years when they've had time to digest all the numbers and data that might change though. In my view, a much more obvious meaning to the "people who weren't put on ventilators didn't tend to die as much as those who were put on ventilators" thing is that the reason people are put on ventilators is because they're in the worst shape and are heading for death. I know docs who work on this stuff. One who flew out to NY during that first big ugly wave and worked in ERs there (he also got Covid). Nobody is cavalier about putting a patient on a ventilator. It's a last resort. It would be shocking to me if the data said anything other than "ventilated patients have higher death rates than non-ventilated patients". These are the patients that are in really, really bad shape. There are, of course, nuances to what goes into the decisions to ventilate patients and that stuff has all evolved as docs/nurses have fought this thing for a year+. Since you guys are mentioning ventilators I thought I'd jump in...as you some of you know from previous posts, I'm a licenses Respiratory Therapist...so ventilators are my jam. From what I experienced first hand, taking care of covid patients and literally being there on the front line from day one, you (Svart and Ragan) are both right, and both wrong. Allow me to shed some light on how things worked out (or didn't work out) in the first few months.
Normally, we do everything we can to keep some one off a ventilator. I'm talking about in the context of medical cases here, not surgical cases etc. We know, and have well established data going back decades, that the longer you're on mechanical ventilation the more at risk you are for pneumonia, and ventilator induced lung injury (pulmonary fibrosis/scarring etc). Mechanical ventilation can also interfere with venous return the heart and cause cardiac complications, as well as the fact that it (generally) requires the patient to be heavily sedated. Being heavily sedated causes its own pharmacologic issues, as well as causes your muscles to atrophy at an alarming rate. Want to watch a healthy 30 year old cross fit fanatic waist away? Sedate him and leave him in bed for 3 weeks, unable to move. You'd be amazed at how much muscle mass will be lost. And that's true for any disease process, not just Covid.
Now when we first started seeing Covid patients all our doctors were studying the data coming from Wuhan, because that's all there was. They were also getting multiple updates per day, from the CDC, WHO, and State Health Dept. It took weeks, if not months for the CDC, WHO, and Health Dept to actually consolidate their directions so that we didn't have contradictory and/or conflicting directives. The data we had from Wuhan, and the what we were getting from the powers at be, all directed us towards early intubation. The thought was that these patients decompensate so quickly, from mildly sick to emergently sick, that any patient showing increasing oxygen needs needed to be intubated quickly. That way we could intubate in a controlled manner instead of running down the hall when a "Code Blue" is called over head. This turned out to be tragically wrong, but in all fairness we were seeing decompensate like this in real life, so in lack of a better strategy that's what we did. The criteria that was chosen was 4 lpm nasal cannula. That's approximately 33% oxygen...if you needed more than that you got intubated.
EDIT: Forgot to add a really important piece. We were directed by the powers that be to not use BIPAP or High Flow Nasal Cannula systems because of the belief that this would aerosolize the virus and spread it all over the hospital. This turned out to be false. Using BIPAP and High Flow Nasal Cannulas is what allowed us to save a great many lives and to keep a shit ton of people off ventilators.
And here Svart, you are right, there were tons of people screaming "do something, do something", and other people yelling "do this, do that". Guidelines from the CDC/WHO/Health Dept were changing 2-3 a day, every day. Regulations were being given that were impossible to follow. We were told to do things that weren't in any hospitals capacity to do. It was very clear to me that the people "in charge" were tripping over themselves to "do something", rather that take a day or two, evaluate your options and choose a wise coarse of action. It was also clear that the people making the rules had never worked in a hospital.
But Ragan, you're also right. There wasn't anybody happy about intubating these patients. This wasn't done flippantly or in a cavalier manner. But we didn't have a better plan...and big reason we didn't have a better plan was because we're all told from the higher ups, "do this, do that", and the standard of care became ventliation as pre-emptive strike instead of ventilation as a last resort. The irony is, is that if we had been left to our own devices, and had been free to manage these cases the way we would manage ANY viral pneumonia, the outcomes would have been a whole lot better. Lives would have been saved. Would we have managed this thing perfectly? No. Would we still have made mistakes? Yes. But its pretty hard to imagine, unless you lived through it like I did, just what a cluster fuck it was, from the top down.
IME, it was a result of a combination of group think/panic, incompetence, and fear. BUT Mostly it was just human nature. If you want to be good under pressure you have to train for it. Period. Human nature got the better of us and proved once again, that all of us can be fools, even if you have PhD, or MD, DO, etc after your name.
Here's an analogy I like to give. When you have a life threatening emergency, and your actions are critical in determining the outcome, you SHOULD NOT be moving as fast as you can. Why? Because there comes a point where you're moving too fast and now your likely hood for critical mistakes exponentially increases, thus negating the speed that you're moving at. You need to move quickly, with deliberate intent, while staying calm, BUT NOT RUSHING. One panicky person can change the mood and anxiety of the entire room. Likewise, one calm person can put the whole room at rest, allowing everyone to use more brain power. I've literally seen Doctors rush into a patient's room, attempt to grab the intubation supplies that I've prepared right out of my hands, knock everything on the ground (meds, syringes, endotracheal tube, etc etc) and now ruin every supply we just readied. All because they couldnt take 2 seconds to actually assess the situation. That 2 seconds they saved now just cost us 5 minutes.
Covid was the same, just on a macro level. Those of us on the ground made the best decisions we could with the info we had. But there were NO voices of reason. Only a chorus of people adding to the chaos.
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Post by drbill on Apr 12, 2021 20:27:48 GMT -6
<snip> It was very clear to me that the people "in charge" were tripping over themselves to "do something", rather that take a day or two, evaluate your options and choose a wise coarse of action. It was also clear that the people making the rules had never worked in a hospital.
<snip> But its pretty hard to imagine, unless you lived through it like I did, just what a cluster fuck it was, from the top down.
At this point in time, I think most of us can pretty much imagine it. No, I'll never know the day to day hell and frustration that you had to live thru, but I can sure see the F-Ups. At least in hindsight. Thanks for your service from the bottom of my heart. Without folks like yourself, the outcome would have been much worse. But forgive me if I don't rush out today to follow the orders of those who screwed things up so badly as this rolled out....the craziness is just as rampant now, although focused in a new direction. The future and hindsight will be eye opening for sure. PS - how are things in your hospital now? Where we are we are at about 1/25th of the Covid cases admitted to the hospital compared to where things were 4-5 months ago. Def getting better. Even far before the vaccines rolled out. |
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Post by dmo on Apr 13, 2021 1:00:48 GMT -6
Few quick comments since I'm the one who started the thread - not trying to change anyone's mind and as adults you're all entitled to your own opinions and to draw your own conclusions. I'm going to try to just provide data/facts - draw your own conclusions
Background - I am a board certified Emergency Physician, so basically I'm supposed to rapidly and accurately differentiate between "sick/not sick" and determine who needs admitted and further specialty care and who can safely go home (with or without prescription medications). In addition, I have extensive background in CBRNE response and disaster planning (and actually once upon a time had input on the planning of the pandemic national stockpiles - another long story). Former senior medical officer for the USMC Chemical Biological Incident Response Force (CBIRF) post 9/11, and was involved in the Anthrax and Ricin events at the Capitol. So although not an "expert" I spent 4 years in a unique job that taught me a great deal about chemical and biological warfare - so probably better prepared than most.
Key issue in any discussion regarding "treatments" for Covid - as a virus where about 50% are asymptomatic or only mildly ill and overall 80% do not require hospitalization, it is essentially impossible to determine causality from correlation (discussed in previous post 1st page). So when a community Doc says "I treat patients with x/y/z early and they all do well" - you really can't say that they did well because of the meds they were given. You simply can't prove it one way or the other. Historically we have very limited treatments for any viral infections, and given the severity of Covid in the 20% who really get ill and end up hospitalized, I'm not surprised people tried looking "outside the box", but I think many of the "treatments" lacked much (if any) scientific basis.
Prime example, the ubiquitous "Z-pack", a variation of erythromycin (an antibiotic). Provides coverage for bacterial infections of upper resp tract, good for folks with Penicillin allergies. No current known benefit for any viral illness, including Covid. Has become one of the most overly prescribed antibiotics (Abx) as most people (in US at least) now seem to expect that when they go in for an upper respiratory infection or sinus symptoms. Problem is, over 70% of these are caused by virus (viral illness), so the Z pack isn't needed or effective. But since most viral illnesses are less than 7 days duration, folks feel better soon after they get the Z pack so it must be the cure. But correlation can be very powerful, and it's really hard to convince someone otherwise (Can't begin to tell you how many times I've been yelled at, cursed, etc for not giving out z paks). Potential side effect of azithromycin - it can cause QT prolongation (affects cardiac conduction) and can predispose to life threatening arrhythmias.
On to drug #2 - the now infamous hydroxychloroquine. Originally developed for malaria, now used for SLE (lupus) and RA (rheumatoid arthritis). No current known benefit for Covid (and has been looked at rather extensively given the initial anecdotal reports of benefit). Known side effect - QT prolongation. In general, not usually a good idea to take (or prescribe) 2 medications that can cause conduction issues simultaneously. Basic premise of medicine - "first, do no harm". Personally, I'd be very uncomfortable prescribing these two meds together unless there was some very strong evidence that the benefit outweighed that risk. And currently (to the best of my knowledge) that evidence does not exist. Maybe that will change in time - but so far not supported by validated studies.
Roles of various vitamins - not sure we really know. Not aware of specific vitamin/viral illness studies but as an ER guy not an area I have kept up with. We do know vitamins can have impacts on immune system/response, so definitely feasible. Covid specific vitamin interactions, harder for me to see from a strictly pathophysiologic perspective but I'm open to the concept. In general, we assume healthier immune system equals fewer infections, although Covid does seem to trigger an immune response "storm" in some patients. Will be interesting to see what comes out as we get more/better data.
Current accepted "treatments". Only a few antivirals/monoclonal antibodies so far. Remdesivir (only approved antiviral) was the first, initial trials looked promising but further experience less supportive, some use but little proven benefit. Bamlanivilmab (Eli-Lilly) - (under emergency authorization) got a lot of press for a while, I questioned the validity of the initial studies and was skeptical, now concerns over not covering variants well. Casirivimab and imdevimab (Regereron) have some press release data that sounds promising, but until actual study data released hard to know for sure. Including link if you want more info.
Vaccines - in general a well studied and accepted method of preventing certain illnesses. Examples include polio and smallpox (eliminated via the herd immunity concept). Not perfect, some severe reactions (anaphylaxis), bad side effects (myocarditis, Guillian-Barre). Many require periodic "booster" vaccines to remain effective (tetanus). Some susceptible to decreased effectiveness from variants (influenza). Covid vaccine newer technology (mRNA), unknown duration effectiveness, missing variants possible, not 100% effective (around 90%) but so far appears to limit severity.
Did "we" (health care, public health, society) handle this well? Not really, but doesn't mean that a lot of folks didn't try to do the right thing. I was at my older sisters 20th b'day (leap year baby) in Austin when we started hearing about this in the press. I called back to where I work, told a fellow EM doc this is going to be bad and pushed to set up external screening triage to keep symptomatic folks out of the hospital (isolate the illness). Couldn't get the command to do this for several weeks. Again - I spent 4 years planning/training for CBRNE response scenarios (represented US and helped develop the 2004 Summer Olympics response plan) - this is what I was trained for - and no one wanted to listen/implement aggressive actions up front. Still have friends at CDC and Homeland Security - they also raised concerns. But getting responses implemented - we were too slow. Local commands waiting on guidance from higher commands, city health waiting on state, state waiting on federal - just a total Charlie Foxtrot. But no one was ready to lock down the country 1 MARCH last year - and I don't think we could have effectively done so even if we had tried.
Not sure what changes have been made to the national response plans - but it was originally designed to stop something like SARS/MERS where it's fairly easy to identify those who are ill. Very different trying to isolate asymptomatic people who are infectious, especially when we didn't realize that at the start of the pandemic. Everything planned was always to identify and isolate the sick, since most illnesses have patients who are symptomatic before infectious. Covid threw us a curve ball - and we were slow to adapt. One of the things I was taught at the War College - no plan survives first contact with the enemy. Ours didn't, and we didn't do a good job of adapting initially. But we studied Covid, and with time developed a better understanding of how it presents, how it progresses. We learned how to manage those requiring hospitalization more effectively. We developed tests, vaccines and potential treatments in an incredibly short time. As we learn more, we'll continue to adapt to this virus and figure out how to protect ourselves better and limit it's risks. But like the flu, Covid is unlikely to completely go way and I suspect will be with us for the near future.
Stay safe out there!!
John K - sorry if this thread is causing any headaches/concerns, feel free to close if necessary.
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Post by ragan on Apr 13, 2021 2:00:24 GMT -6
Thanks for your input, dmo. I for one find it really valuable. Same with you, Tbone81. Firsthand perspective like yours (and other medical professionals I know) is something I weight pretty heavily. I think it would be totally needless to lock/close this thread (at this point). It’s true that some powerful forces decided to turn Covid into a culture war and that means everything, communication-wise, is inflamed. Sides get chosen and then every piece of information gets filtered through that choice. That’s why stuff that wouldn’t have merited any prolonged interest in less-polarized times (like the fleeting hope with HCL) becomes an identity touchstone and hangs around. That phenomena sucks and has made this whole thing a lot worse. But, one way or another, we’re all facing this mess, and we all (ostensibly) wanna get out of it with as few people getting sick/dying as possible. Your initial post was just about your experience with vaccination, and much of this thread is that. The usual (in the aforementioned poisoned-well, hyper-polarized paradigm we find ourselves in) stuff has come up, along with the firsthand vaccination accounts, but, for my part, I think we’ve all handled ourselves reasonably well. And I don’t see why we can’t continue to. Naive? Maybe so. I dunno though. I feel like we survived the requisite HCL stuff without any major fireworks going off. Maybe a thread of sane, adult behavior is possible after all? |
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Post by svart on Apr 13, 2021 8:13:09 GMT -6
A couple more thoughts.
As someone who's sensitive to certain antibiotics (I can't take fluoroquinolones as they attack my connective tissues i.e., ligaments/tendons, causing tremendous pain and swelling right after the first dose) I've done a lot of research into what antibiotics I need to take for certain things.
I'm just going to come right out and say it, most general practice doctors don't really "get" that people like me can't take certain medications despite the fact that they literally ASK what medications I'm "allergic" to.
I've had multiple primary care doctors tell me that I don't know what I'm talking about, that fluoroquinolone sensitivity doesn't exist.. And one that refused to prescribe me anything else because of the cliche'd "your 5 minutes of research on youtube doesn't overcome my medical degree". The internet is filled with studies showing that these drugs destroy connective tissues in some people, have permanently handicapped people and they have removed many of the drugs from the market for these issues. I'd wager that most docs don't even know that the "internet" was invented so that universities could share data between themselves.. And also there are AI that scour the internet looking at ALL medical literature and making diagnoses based on symptoms, and they do it at a MUCH higher success rate than any single doctor by averaging the diagnosis on a bell curve. So technically the internet IS the best place to look for medical information, lol.
Anyway, from being required to be my own best advocate for my health, I have done years worth of research into it, and antibiotics in general. And before someone says anything, I was 2 years into pre-med before switching to electronics. I'm no doctor, but I had enough anatomy/physiology, organic chemistry, microbiology, etc, to understand what I'm looking at, so I'm no rube either.
While doing this research, it's interesting to see the off-label testing for various drugs, including antibiotics. It's not something that's widely known, even to doctors. There are actually a number of well-known antibiotics out there that they do not know exactly how they even work. With this, they have also noticed that a lot of antibiotics have other actions on the body. Some destroy tendons and ligaments, and yet others seem to have a body-wide anti-inflammatory effect more powerful than something like Tylenol, which is possibly why a lot of patients feel "better" soon after taking antibiotics despite it being a viral infection, etc.
The point being, that while a doctor might say "there's no reason an antibiotic works against viruses", which is true in the broadest of definitions, the fact that these chemicals have far-reaching and unknown effects on the body shouldn't be discounted, but it IS with regularity. Why? Because it's not necessary knowledge for most doctors, and as humans, they do like the rest of us and don't bother learning about anything that's not applicable to life and work or at least tickling some kind of interest.
If a drug can have a bad side effect, why can't it have good side effects too?
So why are we dismissing potential treatments when we don't actually know if they do/don't work? Mainly because someone we expect to know these things doesn't know and hedges on the side of "better safe than sorry", also known as "do no harm", but as litigious as humans are, the focus is almost entirely on the bad side effects since those are the ones that will harm folks. Unless you can market the side effects, like Viagra..
But that leads to my next thought, and one I struggle with too..
When you specialize in something, your focus narrows and you begin to dismiss anything that doesn't particularly aid in your field. Queue up the next cliche of "thinking inside the box", because that's what specialization means, an increasingly narrow focus of skill.
I see it everyday in the electronics field where folks with 30 years of experience need to solve a problem but can't think about anything other than their expertise. Everything becomes about validating their knowledge. Higher learning and years of being an "expert" mean that you have achieved enlightenment, right? I've seen some really high profile experts who charge 200$ an hour to consult utterly fail at simple things that others might find banal or easy because their focus is on the things they have, well, focused on. Cliche #3: When you're a hammer, everything is a nail.
So that's why when someone comes around and says "listen to me, I'm an expert" I have to take pause. I respect the time and work it took to get there and I'm not going to immediately dismiss what they're saying, but I will take some time to look at all facets of the statements being made because they come from a place of narrowed focus. Just like the docs that keep telling me that my sensitivity to certain drugs is "not real", humans are apt to follow singular lines of thinking which take work to avoid and that becomes extremely hard over time when reinforcement of assurance is made.
We've seen it in real time, and we've had admissions of it here. "We need to do something but nobody knows what to do so we do what we know how to do" and for better or worse it's all we had because nobody was willing to step back and take some time to analyze. We might have had a larger spike at the beginning, but we might not have had 3 waves if we had let the first one go on longer so we could have acquired more data and done more trials/testing of methods and solutions.
Remember, nobody knows exactly how gravity works, only how it behaves in certain situations.
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Post by ragan on Apr 13, 2021 8:55:51 GMT -6
Good points well said, svart. While I have a lot of scorn for the current culture of anti-expertise (because I find it intellectually lazy and fraudulent), I would never advocate for blind allegiance to it. And I think even most docs would agree that you (as a patient) have to be your own biggest advocate. You know your own body and when something is up, whether you, your doc, or anyone has the correct answer about it or not, you’re the one who’s experiencing the symptoms and that’s the main evidence anyone in the whole process has. |
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Post by matt@IAA on Apr 13, 2021 9:28:13 GMT -6
If docs only prescribed meds with a known method of action a lot of stuff wouldn’t be used at all. There’s a reason that medicine is basically empirically derived. People aren’t not prescribing z packs because they don’t know how it will work. They started because there was a proposed or theorized method of action. The problem is when it was tested in studies, it doesn’t beat placebo. To me, there’s no other way to try to do anything like this and be sane. We should all be incredibly skeptical of everything, even published studies.
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Post by drbill on Apr 13, 2021 10:00:52 GMT -6
From my understanding, HQL does nothing....without ZINC. Not a mention of Zinc above. HQL without it will not accomplish anything successful for C19. It's the Zinc that does the work, and the HQL is just the transportation to get it where it needs to be. (From my feeble understanding of things).
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Post by dmo on Apr 13, 2021 10:56:46 GMT -6
Svart, I'll be the first one to admit that we (science in general, medicine specifically) know less than what we think we know, and personally if someone tells me they have a reaction to a medication I avoid that medication. At the same time, we have developed what I feel are unrealistic expectations that, for lack of a better way to phrase, there's a pill or cure for everything and that any illness requires treatment. And even though I think all of us recognize that really isn't true, the amount of pharmaceutical advertising we are exposed to does create a situation where some/many patients are disappointed if told it's likely a viral process and no treatment is needed.
I agree that we frequently don't fully understand the mechanism of action of many drugs. And I've written for off label use over the years where there is enough evidence to support it. But knowing that all drugs have potential risks makes me very cautious in using them indiscriminately. Look at Ciprofloxacin - it had a huge practice impact when first on market as it allowed us to treat kidney infections as an outpatient vice admitting them for 7-10 days of IV antibiotics. It also allowed more severe pneumonia to be treated as outpatients. Sounds like a win/win, good for patients and save costs of hospitalization. But over time everyone started writing for Cipro for simple urinary tract infections - some argued to avoid a potential progression to a kidney infection. It took years to get enough data to recognize the connective tissue effects of fluoroquinolones, and even before that we developed Cipro resistant e. coli (the bacteria most frequently causing urinary tract infections). So now I rarely use Cipro except for real kidney infections, and have seen a few patients that I need to admit for a simple urinary tract infection because by culture they have strains of e coli resistant to every oral antibiotic. So while I'm open to the concept of off label benefit from antibiotics, the risks of developing antibiotic resistance are very real and well documented so would need some strong evidence of benefit outweighing risk.
I'll respectfully disagree with two of your points. First, the internet was developed by DARPA/funded by DoD as a means of maintaining communication in the event of nuclear strikes, not to allow universities to share information (Actually, wasn't it invented by Al Gore?). As a pre internet/home computer existence person, I appreciate many of the things it allows us to do (such as chat on this forum) but also worry about the unintended consequences (like misinformation sharing and AI algorithms "enhancing" your experience). I look at my kids and see them locked into their devices and worry at times. Secondly, while a computer may be able to come up with a diagnosis based on symptoms more effectively than I (not surprising given computer capacity versus my little old brain) IF the patient presents with all the typical symptoms - I've seen many patients present without the textbook symptoms of a given illness multiple times so I'm not very worried about being replaced by AI quite yet. One of the last heart attacks I admitted came in for a "cold", yes he had a slight cough but otherwise looked healthy with normal vitals but had no symptoms concerning for heart disease. Something that I can't explain worried me enough to get an ECG - which had a very minor/subtle change. Got cardiac labs which confirmed NSTEMI (non ST elevation myocardial infarction). Doubt AI would find that one based on presentation - but I could be wrong.
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