Coronavirus/COVID-19, Thread 2

[claycarver]

I don't know, I mean a Yale epidemiology professor is someone worth at least listening to. But it's just super difficult to take him seriously when he confidently makes extraordinary assertions about the effectiveness of HCQ like that it could prevent a majority of COVID-19 deaths (his interview on Fox he said 100k lives), while in this article he is citing unreviewed claims from charlatans like Dr. Zelenko who is currently shilling for the "alien DNA" doctor on Twitter:

Read on Twitter

?cxt=HHwWhsC9qa_zn-EjAAAA.

More broadly, I think you can find some not-crazy people who disagree on this point and think HCQ might be effective based on available evidence, and that's all fine. But a huge part of my social circle consists of doctors and medical science researchers - current and former colleagues of my wife, including a few of whom are currently working at NIH and FDA. A lot of them were excited about HCQ a couple months ago, and now it feels like there's just a pretty broad consensus in their academic community that there isn't a lot of evidence for HCQ as an effective COVID treatment, and that there is much better evidence for other more promising treatments.

I also don't buy that this is because of animus against Trump. I think there are things where animus against Trump causes people to jump to bad conclusions (eg, Trump's rush to reopen businesses and schools without preparing to make it sae has resulted in a liberal backlash against the general idea of reopening businesses and schools, which is intractable as a long term policy). And while I could see this driving ideas about effective COVID treatments for activists and politicians and randoms on Twitter and RealGM, I have trouble believing that my friends - people whose job it is to treat people, and all of whom would be very excited to have learned that there is an effective treatment for the most challenging health crisis of our lifetimes - just hate Trump too much to be willing to acknowledge a corpus of evidence that conclusively establishes HCQ as an effective COVID treatment, which is what Risch seems to be claiming here. I just have trouble imagining that. If there was convincing evidence that HCQ was effective enough to cut deaths in half, my friends and wife would be super excited.

Thanks Slax, I appreciate your response. There are very few opportunities to ask questions or present information that conflicts with "settled" conclusions. Which is so freaking annoying given a subject we know little about in an environment where conclusions have already been altered.

I honestly have no idea if Risch's assertions hold water. But I do have a couple questions. Are you thinking that the 5 studies Risch cited in his Journal article (and the 7 others he mentions) are invalid or likely oversold somehow? I'm sure your friends would be aware of the studies he cites and have come to different conclusions than he has, but I'd like to know why. And second, do you think the risks of the drug are being oversold? It's said to be dangerous, but I was never told that when I was made to take it before my trip overseas to stave off malaria. I get that it might be ineffective (and taking it without cause exasperates a shortage) but I'm skeptical of the claim that it's dangerous.

[threrf23]

I mean, I like HCQ in general, and I fully suspect it helps against Covid more than it hurts, used early and/or used right, if not in general. I haven't really seen any good indications to contrary. I am even willing to give an ear to Dr. Zelenko, who has also been using Ivermectin as part of his protocol (edited after the fact, I was confusing Zelenko for a Dr. Ratjer, I glanced at Zelenko's Twitter and the guy's a nut). Granted, I'm not claiming to be an expert, I'm not sure it is the best option for treatment relative to others in use, and if there is a supply shortage that cannot be fixed quick then that needs to be taken into account.

I def feel that there are agendas against HCQ that currently influence the public perception of HCQ - some derive from partisan politics, some from financial concerns and support from big pharma, some are probably well intentioned. Maybe there are some liability concerns as well.

That doesn't mean that some pushing HCQ aren't also just spewing partisan or contrarian nonsense. I am reluctant to take that Newsweek piece too seriously, in part because of...

Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been "natural experiments." In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

I have to presume that testing in and around the Brazilian state of Para ramped up significantly by May 22, and that social distancing behavior et al likely began to increase exponentially after an initial outbreak. I'm not sure what death rate is being referred to, but there are so many possible explanations for a falling death rate, and if the author won't even address or acknowledge this, I can't really take him seriously.

The author also points out how the death rate increased fourfold on May 10 after HCQ was banned, and then that the death rate started to plummet in Switzerland on May 22nd, a week or two after an HCQ ban was retracted - but if you chart out Switzerland Covid deaths, you see that the spike on May 10 was likely due to reporting, and if you chart out cases you also see that diagnosed cases peaked sharply around the beginning of April and that there were hardly any new cases being diagnosed come mid May.

[Slax]

Are you thinking that the 5 studies Risch cited in his Journal article (and the 7 others he mentions) are invalid or likely oversold somehow? I'm sure your friends would be aware of the studies he cites and have come to different conclusions than he has, but I'd like to know why.

Per one of my friends at NIH, all the peer reviewed studied with control groups don't look promising right now. He says there were some credible claims and preprints suggesting that patients treated with HCQ had better outcomes, but that none of these had control groups, and that based on the results of better designed studies that produced good data, he thinks it's likely that other factors like selection bias explained the good results in the earlier preliminary research.

And second, do you think the risks of the drug are being oversold? It's said to be dangerous, but I was never told that when I was made to take it before my trip overseas to stave off malaria. I get that it might be ineffective (and taking it without cause exasperates a shortage) but I'm skeptical of the claim that it's dangerous.

NIH friend: "Dangerous is a relative term. It's more about lack of evidence for efficacy. If we had evidence for efficacy, nobody would be talking about danger or side effects."

Take it with a grain of salt - it's just one person giving his opinion.

[exculpatory]

Are you thinking that the 5 studies Risch cited in his Journal article (and the 7 others he mentions) are invalid or likely oversold somehow? I'm sure your friends would be aware of the studies he cites and have come to different conclusions than he has, but I'd like to know why.

Per one of my friends at NIH, all the peer reviewed studied with control groups don't look promising right now. He says there were some credible claims and preprints suggesting that patients treated with HCQ had better outcomes, but that none of these had control groups, and that based on the results of better designed studies that produced good data, he thinks it's likely that other factors like selection bias explained the good results in the earlier preliminary research.

And second, do you think the risks of the drug are being oversold? It's said to be dangerous, but I was never told that when I was made to take it before my trip overseas to stave off malaria. I get that it might be ineffective (and taking it without cause EXACERBATES (NOT exasperates) a shortage) but I'm skeptical of the claim that it's dangerous.

NIH friend: "Dangerous is a relative term. It's more about lack of evidence for efficacy. If we had evidence for efficacy, nobody would be talking about danger or side effects."

Take it with a grain of salt - it's just one person giving his opinion.

I believe that I am the only published Professor of Medicine posting in this thread.

Slax - Your severe skepticism regarding Risch’s article is well taken. Your friend at NIH is spot the **** on. NOT ALL STUDIES ARE EQUAL. Many of the studies cited by Risch were GARBAGE.

Threrf23 & Clay - Apparently, neither of you bothered to read my last couple of detailed posts regarding HCQ - including peer-reviewed/randomized/prospective/controlled studies published in the NEJM & the Annals of Internal Medicine (the best of the best) demonstrating the lack of efficacy of HCQ in OUTPATIENTS (meaning that these were QUALITY STUDIES - not the garbage Risch cited). Therefore, I have copied & pasted below 2 of my recent posts with all of the links included. I suggest you actually read them.

(ALSO, if you happen to be someone who has a prolonged QTc interval & then get exposed to HCQ +/- azithromycin, you MOST DEFINITELY have an increased risk of a potentially lethal form of ventricular tachycardia called torsade de pointes (I have already posted about this at least 10 mother **** times in our 2 COVID threads [WITH REFERENCES]).

Copied & pasted my post from 7/21/2020:

HCQ failed to improve outcomes in early or mild COVID-19, according to two recent studies.

One trial, published by Clinical Infectious Diseases on July 16, randomized 293 outpatients with recently confirmed SARS-CoV-2 infection and less than five days of symptoms to either hydroxychloroquine or no antiviral treatment. No significant differences were found in the mean reduction of viral load at day 3 or at day 7, risk of hospitalization, or time to complete resolution of symptoms. “Our findings provide the scientific community and policymakers with essential insights on the inefficacy of [hydroxychloroquine] as a therapeutic candidate for SARS-CoV-2, at least in similar settings and conditions to ours,” the authors wrote.

The other trial, published by Annals of Internal Medicine on July 16, included 423 outpatients with laboratory-confirmed or probable COVID-19 randomized to either hydroxychloroquine or placebo. There were no significant differences in changes in symptom severity over 14 days, or in rates of hospitalization or mortality, both of which were rare. An accompanying EDITORIAL highlighted failures on the part of the producers, publishers, and consumers of scientific research during the “saga” of hydroxychloroquine. “The scientific community needs to do a good bit of stock-taking and soul-searching about its performance in meeting the challenges of the pandemic and how it will meet these challenges in future pandemics that are certain to emerge,” the editorialist wrote.
[/i]


My comment on the second study (in response to some stuff you guys wrote after my last detailed post regarding this paper): Comparison of the values on their face is MEANINGLESS. Why? The p values were not just insignificant. They were freaking light years insignificant. They would have to enroll a ridiculously MASSIVE number of patients in a very likely UNSUCCESSFUL attempt to confirm that the trends in favor of HCQ were actually statistically significant.

These authors, the Annals of Internal Medicine & the ACP are all top of the line. The editorial I originally posted provides critical context. NOTHING WHATSOEVER ‘reeks of agenda.’ The original HCQ studies from France & wherever were disgracefully poor publications & then moronic & ignorant politicians & media took over & reprehensibly publicized the drug.


https://acpinternist.org/weekly/archives/2020/07/21/1.htm

Copied & pasted my post from 7/23/2020:

And I have published plenty over the years - albeit in endocrine.
To wit:
1. I would potentially agree with you if the non significant p values ‘just missed’ at 0.055 to 0.06 - rather than being off the charts statistically insignificant.
2. The editorial I posted earlier accompanying that study in the Annals of Internal Medicine was excellent & provided excellent context & a summary of the HCQ trials/fiasco/cluster **** to date.
https://www.acpjournals.org/doi/10.7326/M20-5041
3. The other recent paper published on 7/16/2020 in Clinical Infectious Diseases (which I also included in my earlier post - https://www.acpjournals.org/doi/10.7326/M20-5041) with similar efficacy endpoints showed ZILCH significance - WITHOUT any ‘positive appearing trends’.
4. The original + French study was pure trash & in the more recent + Henry Ford Hospital study, many more patients in the HCQ group also received dexamethasone (which has been found to be highly efficacious - which certainly casts doubt on the reported + findings).
5 I will wait to see the published, peer reviewed results of the remaining numerous ongoing HCQ trials, but, IMO, this drug is a loser.
6. Oh yeah, and a significant number of patients prolong their QTc intervals putting them at risk for lethal torsade de pointes/V Tach - severely damaging the risk benefit analysis.
https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7211688&blobtype=pdf
7. Although I am VERY much to the right on many non-COVID matters & I am acutely aware of the flagrant anti-DJT bias of the MSM, the politicization of HCQ was primarily performed by the WH & Fox.

Edit

And then there was this paper PUBLISHED TODAY in the NEJM - 0 efficacy of HCQ in hospitalized Covid-19 patients,

https://www.nejm.org/doi/full/10.1056/NEJMoa2019014?query=RP

PS Clay, the word you want to use is EXACERBATE - NOT EXASPERATE.

[claycarver]

PS Clay, the word you want to use is EXACERBATE - NOT EXASPERATE.

You're right, thank you.

threrf23 and slax, you guys have been really helpful. I appreciate it.

[exculpatory]

PS Clay, the word you want to use is EXACERBATE - NOT EXASPERATE.

You're right. Thank you.

At your service,

[SuperDeluxe]

Read on Twitter

[exculpatory]

Read on Twitter

You beat me to it, SD.
Here is the actual medical reference.

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2768952

https://dgalerts.docguide.com/study-finds-young-children-have-high-amounts-sars-cov-2-viral-rna-their-nasopharynx-vs-older?nl_ref=newsletter&pk_campaign=newsletter&nl_eventid=53327&nl_campaignid=3641&pw_siteID=25&ncov_site=covid-19&MemberID=103021761

For Canman & anyone else who has kids less than 16.
READ THIS.
Preliminary but very concerning & scary as ****!

[Ernest]

Why are they wearing masks in the bubble?

[threrf23]

Why are they wearing masks in the bubble?

To be extra cautious, I presume. One case could ruin at all (and put some coaches at serious risk) and the bubble is only as safe as it's weakest link.

Testing isn't 100% accurate, Disney employees aren't confined to the bubble, the players aren't watched on surveillance 24/7, and then there's the incubation period. I don't know all the science behind it, but popular info says the median incubation period is five days, max incubation period is 14 days, and a person may test negative yet be contagious during this time.

Of course, this is why I'm a little concerned that the NBA lowered its initial quarantine from ten days to four days. Maybe that would at least serve some real purpose come playoff time, but they did it solely to try and get more tv time for Zion.

[FlatearthZorro]

Well, guys, all I wanna say is stay safe! We will get through this!

As for COVID, in Bulgaria most people don't believe it exists and we're headed towards our peak. We got between 200 and 300 ppl a day.

A guy I grew up with(he's a doctor in the biggest hospital in Bulgaria) had the virus and went through it for a weak, he had only flu like symptoms.

[sam_I_am]

I mean, I like HCQ in general, and I fully suspect it helps against Covid more than it hurts, used early and/or used right, if not in general. I haven't really seen any good indications to contrary. I am even willing to give an ear to Dr. Zelenko, who has also been using Ivermectin as part of his protocol (edited after the fact, I was confusing Zelenko for a Dr. Ratjer, I glanced at Zelenko's Twitter and the guy's a nut). Granted, I'm not claiming to be an expert, I'm not sure it is the best option for treatment relative to others in use, and if there is a supply shortage that cannot be fixed quick then that needs to be taken into account.

I def feel that there are agendas against HCQ that currently influence the public perception of HCQ - some derive from partisan politics, some from financial concerns and support from big pharma, some are probably well intentioned. Maybe there are some liability concerns as well.

That doesn't mean that some pushing HCQ aren't also just spewing partisan or contrarian nonsense. I am reluctant to take that Newsweek piece too seriously, in part because of...

Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been "natural experiments." In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

I have to presume that testing in and around the Brazilian state of Para ramped up significantly by May 22, and that social distancing behavior et al likely began to increase exponentially after an initial outbreak. I'm not sure what death rate is being referred to, but there are so many possible explanations for a falling death rate, and if the author won't even address or acknowledge this, I can't really take him seriously.

The author also points out how the death rate increased fourfold on May 10 after HCQ was banned, and then that the death rate started to plummet in Switzerland on May 22nd, a week or two after an HCQ ban was retracted - but if you chart out Switzerland Covid deaths, you see that the spike on May 10 was likely due to reporting, and if you chart out cases you also see that diagnosed cases peaked sharply around the beginning of April and that there were hardly any new cases being diagnosed come mid May.

For what it’s worth, HCQ was used liberally and often in MA in April and May. Mortality for Covid in MA is amongst highest in country and world.....even higher than Sweden which is also amongst worst. It did squat.

[threrf23]

For what it’s worth, HCQ was used liberally and often in MA in April and May. Mortality for Covid in MA is amongst highest in country and world.....even higher than Sweden which is also amongst worst. It did squat.

Biogen conference was late February, weeks before most people realized Covid was going to be an issue here. And there may have been spread before that. Like NYC or Italy, MA was unknowingly Sweden, or worse actually for a bit b/c lots of spread occurred before it was known about, acknowledged, and understood by leaders. Testing criteria wasn't relaxed until late April. MA's official case count is way lower than it's true case count.

Overall, while Sweden's true death count is unclear, Mass almost definitely has seen more deaths per capita. But it's also worth noting that Mass is markedly denser then Sweden, and also part of a denser region - NYC is much denser than Mass is much denser than Sweden and the implications can be exponential. Mass had a tougher task at hand to begin with, and there was no time to prepare initially.

I don't know how often HCQ was used in Mass, but I wasn't even really saying I feel confident that HCQ is generally outright effective. My presumption is simply that it helps more than it hurts, and all things considered in not overall "dangerous," particularly so where it is used early and/or properly and/or under proper supervision. Maybe a moot point for the sake of argument; obviously there is lots of evidence that, at best, it isn't that effective.

[exculpatory]

For what it’s worth, HCQ was used liberally and often in MA in April and May. Mortality for Covid in MA is amongst highest in country and world.....even higher than Sweden which is also amongst worst. It did squat.

Biogen conference was late February, weeks before most people realized Covid was going to be an issue here. And there may have been spread before that. Like NYC or Italy, MA was unknowingly Sweden, or worse actually for a bit b/c lots of spread occurred before it was known about, acknowledged, and understood by leaders. Testing criteria wasn't relaxed until late April. MA's official case count is way lower than it's true case count.

Overall, while Sweden's true death count is unclear, Mass almost definitely has seen more deaths per capita. But it's also worth noting that Mass is markedly denser then Sweden, and also part of a denser region - NYC is much denser than Mass is much denser than Sweden and the implications can be exponential. Mass had a tougher task at hand to begin with, and there was no time to prepare initially.

I don't know how often HCQ was used in Mass, but I wasn't even really saying I feel confident that HCQ is generally outright effective. My presumption is simply that it helps more than it hurts, and all things considered is not overall "dangerous," particularly so when it is used early and/or properly and/or under proper supervision. Maybe a moot point for the sake of argument; obviously there is lots of evidence that, at best, it isn't that effective.

How many mother freaking posts (including links to HIGH QUALITY, PROSPECTIVE, RANDOMIZED, PLACEBO CONTROLLED STUDIES peer reviewed/published by the most esteemed journals on the planet & NOT some of the earlier irredeemably & fatally flawed studies hyped by a few idiot ‘physicians’ & **** morons in the media & the WH) do I have to post for you to understand that there is a 99% likelihood that HCQ has NO efficacy in early, middle or late COVID, and that if you happen to have a prolonged QTc interval on your EKG for any one of a number of reasons (not very common - but not uncommon), exposure to HCQ (especially together w azithromycin) may result in lethal ventricular tachycardia/torsades de pointes.

IN NO WAY, SHAPE OR FORM, does it “help more than it hurts.”
With all due respect, your presumptions as a lay person are vastly incorrect.
SMMFH.

[threrf23]

How many mother freaking posts (including links to HIGH QUALITY, PROSPECTIVE, RANDOMIZED, PLACEBO CONTROLLED STUDIES peer reviewed/published by the most esteemed journals on the planet & NOT some of the earlier irredeemably & fatally flawed studies hyped by a few idiot ‘physicians’ & **** morons in the media & the WH) do I have to post for you to understand that there is a 99% likelihood that HCQ has NO efficacy in early, middle or late COVID, and that if you happen to have a prolonged QTc interval on your EKG for any one of a number of reasons (not very common - but not uncommon), exposure to HCQ (especially together w azithromycin) may result in lethal ventricular tachycardia/torsades de pointes.

I mean, I've seen you post a bunch of studies indicating "no clinical benefit" to HCQ (in at least one or two cases no anecdotal benefit), as well as studies documenting the risk of lethal (and I presume non-lethal) ventricular tachycardias. I don't doubt the legitimacy of any of that. And maybe I have missed something in between where there is clinical proof or even good anecdotal evidence that HCQ leads to more deaths/symptoms/hospitalizations/etc than no HCQ. I'll just take my L.

[exculpatory]

How many mother freaking posts (including links to HIGH QUALITY, PROSPECTIVE, RANDOMIZED, PLACEBO CONTROLLED STUDIES peer reviewed/published by the most esteemed journals on the planet & NOT some of the earlier irredeemably & fatally flawed studies hyped by a few idiot ‘physicians’ & **** morons in the media & the WH) do I have to post for you to understand that there is a 99% likelihood that HCQ has NO efficacy in early, middle or late COVID, and that if you happen to have a prolonged QTc interval on your EKG for any one of a number of reasons (not very common - but not uncommon), exposure to HCQ (especially together w azithromycin) may result in lethal ventricular tachycardia/torsades de pointes.

I mean, I've seen you post a bunch of studies indicating "no clinical benefit" to HCQ (in at least one or two cases no anecdotal benefit), as well as studies documenting the risk of lethal (and I presume non-lethal) ventricular tachycardias. I don't doubt the legitimacy of any of that. And maybe I have missed something in between where there is clinical proof or even good anecdotal evidence that HCQ leads to more deaths/symptoms/hospitalizations/etc than no HCQ. I'll just take my L.

My eloquent & very well written Celtic colleague:
I will address your question later today I hope.
I want to do my workout now & watch our boys squash these mother ****.

[exculpatory]

How many mother freaking posts (including links to HIGH QUALITY, PROSPECTIVE, RANDOMIZED, PLACEBO CONTROLLED STUDIES peer reviewed/published by the most esteemed journals on the planet & NOT some of the earlier irredeemably & fatally flawed studies hyped by a few idiot ‘physicians’ & **** morons in the media & the WH) do I have to post for you to understand that there is a 99% likelihood that HCQ has NO efficacy in early, middle or late COVID, and that if you happen to have a prolonged QTc interval on your EKG for any one of a number of reasons (not very common - but not uncommon), exposure to HCQ (especially together w azithromycin) may result in lethal ventricular tachycardia/torsades de pointes.

I mean, I've seen you post a bunch of studies indicating "no clinical benefit" to HCQ (in at least one or two cases no anecdotal benefit), as well as studies documenting the risk of lethal (and I presume non-lethal) ventricular tachycardias. I don't doubt the legitimacy of any of that. And maybe I have missed something in between where there is clinical proof or even good anecdotal evidence that HCQ leads to more deaths/symptoms/hospitalizations/etc than no HCQ. I'll just take my L.

IIRC, there are at least 2 studies (in inpatients I believe) where HCQ resulted in more mortality & morbidity. When I have the time, I will search the Covid publication folder I created (which I added to my massive endocrinology & critical care folders back in 3/2020).

Beyond that, I will say this (Fauci BTW said the same thing to Congress on Fri 7/31): IF any peer reviewed, properly designed & powered, randomized trial EVER demonstrated statistically significant efficacy in ANY Covid sub-population (post-exposure, asymptomatic outpatient, symptomatic outpatient, non-ICU inpatient, ICU inpatient usually on a vent - which at this point would shock me), & the study was replicated by another A+ group, & baseline EKG & medication history (to R/O other drugs known to prolong the QTc interval) were obtained, I would have NO hesitation whatsoever supporting the use of HCQ (with periodic F/U EKGs at appropriate intervals TBD by how sick the patient is).

Let me conclude with a comment that REALLY matters (and remember, with the HUGE exception of the historically incompetent Covid management cluster ****, I mostly viscerally abhor the policies of the left). As per Dr. Fauci last Friday, & Dr. Birx today, if the WH AND all of our Governors/Mayors AND our millennial protestors AND our Red State citizens who somehow think wearing a mask infringes on their **** civil liberties do not once & for all wake the **** up & put on a **** full court press of masking (including INDOORS in multi-generational households) & social distancing (while we simultaneously continue to mega-maximize quick turnaround & accurate testing & tracing when feasible) during the next few weeks in August (while we hope & pray for a vaccine or vaccines in Q1/Q2 of CY 2021), our already indescribably disastrous death count of 155K will **** double or triple during the next few months. Count on it.

PS I must say that, even though you were wrong on the science, you write very well. :0)

[threrf23]

PS I must say that, even though you were wrong on the science, you write very well. :0)

Thanks man.

And I mean, you're a Professor of Medicine arguing that there is zero evidence HCQ is effective, and I'm just some random dude arguing there is no evidence it is ineffective. So I'm being kind of stupid regardless of right or wrong.

Let me conclude with a comment that REALLY matters (and remember, with the HUGE exception of the historically incompetent Covid management cluster ****, I mostly viscerally abhor the policies of the left). As per Dr. Fauci last Friday, & Dr. Birx today, if the WH AND all of our Governors/Mayors AND our millennial protestors AND our Red State citizens who somehow think wearing a mask infringes on their **** civil liberties do not once & for all wake the **** up & put on a **** full court press of masking (including INDOORS in multi-generational households) & social distancing (while we simultaneously continue to mega-maximize quick turnaround & accurate testing & tracing when feasible) during the next few weeks in August (while we hope & pray for a vaccine or vaccines in Q1/Q2 of CY 2021), our already indescribably disastrous death count of 155K will **** double or triple during the next few months. Count on it.

It has def been a big cluster****.

That said, I kind of enjoy making analytical predictions. Based in part on where Sweden appears to have ended up (first wave at least), where NYC ended up, based on the US' population density relative to Sweden and NY, based on two mega metro areas being based in the progressive state of Cali, based on the fact that even states like AZ/TX/FL have certain restrictions in place and are at least showing some progress, and because universal contact tracing will become more feasible once labs are no longer backlogged and taking weeks to return results...I think we max out around 230 mil (edit 235k) tops...ignoring the possibility of a second wave which hopefully is much milder or is made moot by a vaccine.

[sam_I_am]

PS I must say that, even though you were wrong on the science, you write very well. :0)

Thanks man.

And I mean, you're a Professor of Medicine arguing that there is zero evidence HCQ is effective, and I'm just some random dude arguing there is no evidence it is ineffective. So I'm being kind of stupid regardless of right or wrong.

Let me conclude with a comment that REALLY matters (and remember, with the HUGE exception of the historically incompetent Covid management cluster ****, I mostly viscerally abhor the policies of the left). As per Dr. Fauci last Friday, & Dr. Birx today, if the WH AND all of our Governors/Mayors AND our millennial protestors AND our Red State citizens who somehow think wearing a mask infringes on their **** civil liberties do not once & for all wake the **** up & put on a **** full court press of masking (including INDOORS in multi-generational households) & social distancing (while we simultaneously continue to mega-maximize quick turnaround & accurate testing & tracing when feasible) during the next few weeks in August (while we hope & pray for a vaccine or vaccines in Q1/Q2 of CY 2021), our already indescribably disastrous death count of 155K will **** double or triple during the next few months. Count on it.

It has def been a big cluster****.

That said, I kind of enjoy making analytical predictions. Based in part on where Sweden appears to have ended up (first wave at least), where NYC ended up, based on the US' population density relative to Sweden and NY, based on two mega metro areas being based in the progressive state of Cali, based on the fact that even states like AZ/TX/FL have certain restrictions in place and are at least showing some progress, and because universal contact tracing will become more feasible once labs are no longer backlogged and taking weeks to return results...I think we max out around 230 mil (edit 235k) tops...ignoring the possibility of a second wave which hopefully is much milder or is made moot by a vaccine.

I am far more pessimistic than you because every day I wake up it is like the movie Ground Hog Day and it’s as if our politicians have learned nothing in the last 5 months. 100k of first 150k deaths were primarily from a dozen states hard hit in March and April. A month from now, Texas, Florida and California are going to have 25k deaths each just based on cases accumulated in July and there are another 15-20 states starting to surge. The death toll over next 5 months will likely be worse than first 5 months were (excluding NYC which took full hit during flu season with no precautions at all.) I think we will see closer to 350k cases by Jan 1. Our GDP also took a 32% hit in second quarter far worse than anywhere else in the world and the rush to reopen and subsequent surge of cases will probably lead to another shutdown and then economic collapse. Perfect set of circumstances for a wannabe dictator.

HCQ didn’t work in China, didn’t work in Italy, wasn’t tried in NY but failed in MA which was tried despite knowledge of Chinese studies. Brazil and India gave it out like candy and it’s not stopping the deaths from piling up there either. It would be great if there was a place for it but honestly, it isn’t even worth the time to study it let alone the oxygen I used to type this post based on information available so far. Any benefit it could possibly have will be marginal and if it weren’t for politics nobody like us would care at all to discuss it.

[exculpatory]

PS I must say that, even though you were wrong on the science, you write very well. :0)

Thanks man.

And I mean, you're a Professor of Medicine arguing that there is zero evidence HCQ is effective, and I'm just some random dude arguing there is no evidence it is ineffective. So I'm being kind of stupid regardless of right or wrong.

Let me conclude with a comment that REALLY matters (and remember, with the HUGE exception of the historically incompetent Covid management cluster ****, I mostly viscerally abhor the policies of the left). As per Dr. Fauci last Friday, & Dr. Birx today, if the WH AND all of our Governors/Mayors AND our millennial protestors AND our Red State citizens who somehow think wearing a mask infringes on their **** civil liberties do not once & for all wake the **** up & put on a **** full court press of masking (including INDOORS in multi-generational households) & social distancing (while we simultaneously continue to mega-maximize quick turnaround & accurate testing & tracing when feasible) during the next few weeks in August (while we hope & pray for a vaccine or vaccines in Q1/Q2 of CY 2021), our already indescribably disastrous death count of 155K will **** double or triple during the next few months. Count on it.

It has def been a big cluster****.

That said, I kind of enjoy making analytical predictions. Based in part on where Sweden appears to have ended up (first wave at least), where NYC ended up, based on the US' population density relative to Sweden and NY, based on two mega metro areas being based in the progressive state of Cali, based on the fact that even states like AZ/TX/FL have certain restrictions in place and are at least showing some progress, and because universal contact tracing will become more feasible once labs are no longer backlogged and taking weeks to return results...I think we max out around 230 mil (edit 235k) tops...ignoring the possibility of a second wave which hopefully is much milder or is made moot by a vaccine.

I am far more pessimistic than you because every day I wake up it is like the movie Ground Hog Day and it’s as if our politicians have learned nothing in the last 5 months. 100k of first 150k deaths were primarily from a dozen states hard hit in March and April. A month from now, Texas, Florida and California are going to have 25k deaths each just based on cases accumulated in July and there are another 15-20 states starting to surge. The death toll over next 5 months will likely be worse than first 5 months were (excluding NYC which took full hit during flu season with no precautions at all.) I think we will see closer to 350k cases by Jan 1. Our GDP also took a 32% hit in second quarter far worse than anywhere else in the world and the rush to reopen and subsequent surge of cases will probably lead to another shutdown and then economic collapse. Perfect set of circumstances for a wannabe dictator.

HCQ didn’t work in China, didn’t work in Italy, wasn’t tried in NY but failed in MA which was tried despite knowledge of Chinese studies. Brazil and India gave it out like candy and it’s not stopping the deaths from piling up there either. It would be great if there was a place for it but honestly, it isn’t even worth the time to study it let alone the oxygen I used to type this post based on information available so far. Any benefit it could possibly have will be marginal and if it weren’t for politics nobody like us would care at all to discuss it.

Sadly, you just restated in a slightly different way exactly the points I made yesterday about how the worst is yet to come (unless we begun a true full court press TODAY) & the worthlessness of HCQ.