I've been wondering something about asymptomatic cases.
If someone contracts COVID-19 and is 100% asymptotic, how can we know that they have actually 'gotten over' the virus/infection and are then not contagious? I know it might be a newb question or comparison, but when I think of certain other types of viruses like HIV, you can 'have it' and not know it until the disease takes over and then you basically just get worse.
If someone shows no symptoms (after the incubation period), has the virus, then 'gets better', I mean how would we ever know they're not going to get sick from that same infection sometime later (like in the HIV comparison)?
Furthermore, how do we even test those people after the fact to check that? Is there a difference between testing for 'the virus' and testing for 'we know you HAD the virus'.... like a difference between 'active infection' vs 'prior infection'?
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Thread: COVID-19, let's put updates here
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03-24-2020, 11:15 AM #61
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"When I die, I hope it's early in the morning so I don't have to go to work that day for no reason"
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03-24-2020, 12:13 PM #62
I don't know the inner workings of HIV/herpes off the top of my head to give a great mechanistic answer, but essentially HIV is stuck with you once you get it. You can take several anti-HIV drugs to keep the viral load very low and thus it remains dormant and you shouldn't be able to infect others, but if you come off the meds you can then infect others again. Herpes will stay dormant and then sporadically erupt and can be shed (it can even be shed while asymptomatic) throughout one's life; to my knowledge it's unclear why this happens more frequently in some people than others.
For whatever reason (that I should likely know but admittedly don't), cold-like viruses do not do this. Once you clear it from your body it is gone and they don't stay dormant waiting to reemerge.
However, you can still test for it. The nasophrayngeal swabs will pick up active viral genetic material; the sensitivity is not perfect so if someone is asymptomatic they may have a negative test if they don't have enough viral load for the test to see it. If it is a true positive test though and later becomes negative you can assume you no longer have the virus (again, that only works if the test is good enough; unclear thus far how good our testing is). Additionally, IF we generate long term immunity then you will likely be able to do an antibody test at any time point. If there are IgM antibodies that implies an ongoing or recent infection. If there are IgG antibodies that implies an infection that occurred sometime in the past (maybe 2 months, maybe 20 years). If there are IgM & IgG antibodies that implies closer to 2 months or so.
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03-24-2020, 05:16 PM #63
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03-24-2020, 05:56 PM #64
Here is a few papers and information around with the UK near enough on lock down seems like endless amounts of information is being spread:-
********************/wintoncentre/how-...t-4539118e1196
https://www.bbc.co.uk/news/health-51979654
Analysis into the deaths in Britain and the estimate of how many of the deaths were actually 'avoidable' long term from infection of COVID-19 vs the usually death rate in the UK.
An analysis review comparing what is happening in government actions and the overall effect when the pandemic will end.
https://www.sciencenews.org/article/...distancing-end
The summary basically we will need 'herd immunity' long term, how we achieve this without overpowering the health services and actually ensure society maintains and doesn't cause too much permanent societal damage they have no idea its a very hard balancing act.
A small claim by leading conservation members of the possible transfer of COVID-19 to great apes. However no link of evidence just theories:-
https://www.nature.com/articles/d41586-020-00859-y
A study investigating the possibility that stressors of pandemics such as COVID-19 may have on sperm and future offspring:-
https://www.sciencedaily.com/release...0323132410.htm
Basically us poor males sperm RNA varies slightly but significantly under stress and this may effect brain development of future generations, how lovely more fun for us. Of course they did admit they didnt incorporate any implementation measures to reduce stress.
And finally to wrap up this fun science community. A study to question whether 'speed science' is actually causing more damage with false information then really is best advised. I guess no-one can win except the toilet roll companies I beat they are doing well:-
https://www.weforum.org/agenda/2020/...earch-academic
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03-24-2020, 06:46 PM #65
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First death of a minor in the USA here in LA
County today
https://www.cnbc.com/2020/03/24/los-...ronavirus.htmlNASM CPT
IG: jeff.galanzzi
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RIP my friend D4K
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03-25-2020, 02:20 AM #66
More people seem to getting mainly GI symptoms; remember a study I posted above indicates these people have a more severe course. https://www.wkbn.com/news/coronaviru...EdrKPfR9z154TY
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03-25-2020, 03:04 AM #67
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03-25-2020, 03:13 AM #68
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03-25-2020, 03:37 AM #69
im kinda worried iv had a cough on and off for about a year or so
and its came back in the last couple weeks
i personally think its due to me injuring my diaphram area/ possible hernia from lifting thats never been fixed but idk
i can still taste stuff and still working out just have a constant cough
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03-25-2020, 03:48 AM #70
If you have had a constant cough for 2 weeks with no progression of symptoms this is most likely NOT coronavirus-related. I don't want this to turn into a me dispensing medical advice thread, but the most common causes of constant cough are allergies, GERD, and asthma generally speaking. Do consider talking to your physician or empirically trying allergy/GERD medication (available over the counter) but don't stress about this being COVID-19 if you have had no progression in symptoms in 2 weeks. Obviously if symptoms do worsen then call your physician right away.
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03-25-2020, 07:41 AM #71
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Not a new article, but apparently 1 in 10 people can get re-infected:
https://www.zmescience.com/science/a...et-reinfected/"When I die, I hope it's early in the morning so I don't have to go to work that day for no reason"
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03-25-2020, 07:52 AM #72
Experience and observation. For HIV, we've had decades to and study the disease course. HIV reverse transcribes its RNA to DNA and inserts itself into the host genome which makes it very hard to attack. Fortunately, very few viruses can do this. Current treatment revolves around keeping it contained.
There are different types of tests. There are tests detects the virus itself, such at NAT (nucleic acid test) or antigen detection methods. Then there are virus-specific antibody tests that detects your body's immunity to the virus. If, for instance, you tested negative by NAT but positive by an antibody test, it would suggest that you had the virus in the past but not currently. Or you've been vaccinated against the virus (if there is a vaccine).Am I therefore become your enemy, because I tell you the truth?
Galatians 4:16
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03-25-2020, 08:45 AM #73
That's a month old; I think it's more likely the tests were just not very sensitive. I would await some data from the US or other countries regarding reinfection as the initial testing was not very sensitive (so someone could test positive, test negative, and then test positive again despite being infected the entire time).
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03-25-2020, 09:29 AM #74
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03-25-2020, 10:42 AM #75
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03-25-2020, 06:22 PM #76
A village of Hasidic Jews in NY is experiencing a high rate of COVID-19 infection. A doctor there decided to treat patients with shortness of breath or high risk patients with mild symptoms using a regimen of: hydroxychoroquine, azithromycin, and zinc sulfate in an outpatient setting. His plan was based on combining data from China, South Korea, and France.
He's treated 500 patients in three locations in NY. So far, his regime seems to prevent ARDS and the need for respiratory support. In the village where he practices, they've had no hospitalizations, no intubations, and no deaths. Patients in the other two places are also doing well.
https://www.thelakewoodscoop.com/new...ent-trump.html
I started listening to updates from a couple Commanders on the Army Post near me. One of them said the US is experiencing the same problems as Europe with many healthcare providers becoming infected. Among the military bases around here, they have 400 medical in quarantine right now. I was shocked because he mentioned a short time before this that they had only 4 confirmed cases and 2 civilian deaths. Perhaps military medical are helping out in civilian hospitals not just in NY? They should because most military live off base.
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03-26-2020, 02:30 AM #77
Quite interesting with the letter above regarding the treatment combination (though we are NOT supposed to list specific medications, foresail please edit your post to eliminate those names if you seen this). People are definitely putting in legit research/trials on these drugs now and we should have some good results in the coming weeks/months.
Regarding military medical helping out elsewhere, I don't have specific knowledge of that, but I do know many communities/counties/states/etc are taking an "all hands on deck" approach so it would not surprise me.
Here is a brief powerpoint on masks and sterilization methods: https://m.box.com/shared_item/https%...kVGOrLpq3H4jiY
One viral picture is a nurse realizing she can attach the loops of a surgical mask to a paperclip such that they go behind the head and not directly behind the ears, which can make it a lot more comfortable to wear for a full 12 hour shift. It's the little things like that which can make a huge difference with little effort that I always find really interesting; so many of us where these masks all the time and haven't thought of that.
Here's one of multiple links indicating people are going to start trying to use plasma from people who have recovered to aid those who have not: https://www.missourinet.com/2020/03/...r2btwWyZPA3c0Q
Also something I've had to spend a lot of time on ******** to clear up; there is no evidence to my knowledge of clinically distinct strands of the virus. All signs thus far point to a high stability of the genome and no clinically relevant mutations thus far. This was indicated here: https://onlinelibrary.wiley.com/doi/...1002/jmv.25762 . There are lots of rumors about an L strain and an S strain; that just refers to two mutations that segregated well in China but there is no indication of a clinical difference between them (see the addendum on page 25 of the paper that originally described these strains here: https://academic.oup.com/nsr/advance...2DwTcyTCV7o3Jc). This does altogether give more hope that once people are infected they will have longer lasting immunity and also gives more hope of a vaccine being generated. https://thehill.com/policy/healthcar...Oeee1KHmoykmns
How are we doing as a country? https://infection2020.com/ Over 1,000 deaths so far and no signs of slowing down yet. From what I've seen most people think that most places in the country are still several weeks away from peaking. How well we continue to socially distance and keep things shut down will play a huge part in when a peak occurs. If nothing else if the drugs mentioned above really do make a huge difference then hopefully we can keep everything shut down as much as possible until those drugs are mass produced such that we can have enough to treat people when it becomes widespread. At this point in time I do not know how long it would take to mass produce the drugs; that is something I will try to look into (obviously if it's a couple of weeks this seems feasible while if it's going to take say 6-8 months that seems less realistic to me).
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03-27-2020, 02:20 AM #78
ABSOLUTELY DO NOT even think about taking i... to treat any fever, if you get one!
I do not know the truth of this, but I've heard in the last week or so that it might spike the virus...and I just saw a video of a doctor warning, in no uncertain terms, that i... is suspect in making pneumonia FAR more likely, and that a good portion of people in ICU have i... in their systems.
Instead, a... (the active ingredient in the very common 7-letter branded pain reliever that's everywhere) is considered much safer. Again, I'm just saying what I've heard, but I'm starting to hear about it enough that I think there's some truth to it.
I'm being a little cryptic here, but you can figure it out...apparently we can't mention pharma names or brands here."Some people without brains do an awful lot of talking" - Ray Bolger (The Scarecrow), THE WIZARD OF OZ, 1939.
Build, for a man, a fire - and he'll be warm for a little while. Set a man on fire, and he'll be warm for the rest of his life.
:-) (-:
[ALOHA - as used in its traditional sense of greeting, best wishes, and an affirmation of life.]
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03-27-2020, 02:59 AM #79
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03-27-2020, 03:27 AM #80
Some more reading on the COVID-19 pandemic:-
https://www.imperial.ac.uk/media/imp...26-03-2020.pdf
The Imperial College are suggesting that extreme prevention methods across the globe could save 30 million lives. Seems like a very high number and I very much question is actually truth behind the claims seeing as it states in the paper by doing the measures currently in place across the globe (full isolation and testing measures) we will still have 10 million deaths over a 250 day period.
I am very sceptical about these forecast seeing as the first death was on the 11/01/2020 and to today's date that equals 77 days and we have had a estimated death rate of about 25000~ so in 173 days they estimate another 9975000 deaths. Even with infection rates increasing that is very very much stretching it IMO to go from 25000 to nearly 10 million with full prevention methods in place. Unless they are just saying people who had the disease and died from any possible cause (e.g. heart attack, liver failure, cancer etc) if that is case then the interpretation of the data is misleading as on average the global death rate is around 55-60 million a year even without COVID-19 (which of course some will be including in people already 'dying').
https://ourworldindata.org/births-and-deaths
Article of the risks and considerations of human testing for COVID-19:-
https://www.nature.com/articles/d41586-020-00927-3
And here is an image of the most famous little creature which is believed to carry COVID-19 and from eating was likely to start the pandemic (poor little thing it didn't want to be eaten must admit can't say it looks overall tasty either):-
https://scitechdaily.com/pangolins-n...ats-to-humans/
Looking at the effects of chloroquine and how it may help:-
https://cen.acs.org/pharmaceuticals/...estions/98/i12
Although caution as always as recently I read two people died from taking this drug thinking it may help so the side effects are likely quite unpleasant in this testing phase.Last edited by hardyboysare; 03-27-2020 at 07:38 AM.
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03-27-2020, 03:33 AM #81
I think that is just not enough evidence to advise stopping or taking it as NSAIDS at this time and the World Health Organisation don't know to be honest:-
https://www.healthline.com/health-ne...n-and-covid-19
https://science.sciencemag.org/content/367/6485/1434.1
https://www.gov.uk/government/news/i...d19coronavirus
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03-27-2020, 04:49 AM #82
Regarding the question above, there is no strong evidence against NSAIDs at this time. I think it is completely reasonable to prioritize tyl.... (still not sure if we can type these out) over ibu..... at this time as it does not seem that COVID-19 is hitting the liver very hard (which is the concern with tyl.....).
Another nice link to look at with projections of hospital beds/ventilators/deaths: https://covid19.healthdata.org/proje...mfrPo8RUJwbSSM
hardyboysare, I have not read that paper but part of the big increase in numbers would be from exponential growth; looking at the log plot of new deaths at infection2020.com it appears that the death rate in the US is doubling every 3 days or so. If that were to continue unimpeded then as an example:
Day 1: 100 deaths
Day 4: 200
Day 7: 400
Day 10: 800
Day 13: 1600
Day 16: 3200
Day 19: 6400
Day 22: 12800
Day 25: 25600
Day 28: 51200
Day 31: 102400
So the numbers can go up very high very quickly. Obviously that's not going to continue happening at the current rate if we have effectively locked things down (keep in mind there is an incubation period typically of 5-6 days but sometimes longer and then people don't start to have significant respiratory problems fro 7-10 days typically and then don't die for a couple of days beyond that, so any death rate number we see now reflects what was happening ~2 weeks ago prior to most of the shut down interventions taking place).
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03-27-2020, 05:51 AM #83
I can see how the numbers can add up there is a few questions I have always had about the reporting and analysis of the death rate of COVID-19. I am not belittling the effect of COVID-19 it has, I just find some of the reporting questionable and not transparent.
1) According to statistics (which of course we all know) people with underlying health issues and the elderly are mostly at risk this is pretty much a certainty with any virus. I wonder how many of these reported deaths by COVID-19 are actually the main cause or were these individuals unfortunately likely to die soon anyway with or without COVID-19 it would be interesting to know how they are recorded for example:-
Palliative care sufferers suddenly contracting COVID-19 and then die is this recorded as cause of death COVID-19 forgetting the fact they have suffered for years with a killer disease such as cancer.
2) How does this reflect to general death rate across each country? In the UK (include Scotland and Northern Ireland) we have about 600,000-700,000 deaths a year without COVID-19 and currently we have had 600~ deaths statistically this means very little. Of course if it keeps doubling over every few days then yes it will start adding up. But the problem with statistics it depends on what you use for the numbers (I am guilt for this as well)
3) I following a lot of what South Korea are doing (as China's numbers don't seem reliable) and they are successfully combating the virus without extreme isolation measures in place. Obviously they are doing fantastic job at tracking people isolating them and isolating everyone who has had contact with them + plus an amazing healthcare system. I feel governments should consider this as an effective measure without needing to potential cripple economic and societal living. I generally don't see many countries attempting this measure and strategy and wondering if this would be the best route (not yet have any answers obviously).
If we look at countries with strict isolation restrictions such as Italy and Spain the protocol of shutting everything down doesn't seem to be stemming the death rates. Its difficult to compare country to country due to 100's of differences but its odd no-one is attempting South Korea's strategy with much urgency. I did read America and Germany are trying (in relation to testing numbers) but other countries seem to jump straight to lockdown instead of controlled isolation and tracking.
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03-27-2020, 07:21 AM #84
1. It's unlikely to be making a big difference at this point. Right now what is being seen clinically is that people with COVID-19 do ok for some time, possibly even start to improve, and then tank quickly requiring ICU care. These are the people dying mostly from what I can gather. It's a fair question though; there was a case in California of I think a 17 year old dying and the media said it was from COVID-19 but what I've heard since is that patient had strep sepsis and incidentally also had COVID-19. It's just that the physicians on the front lines in New York and the other hot spots are seeing a ton of this and as the numbers are not astronomical (yet) I think most of the deaths attributed to COVID-19 are likely accurate.
2. Time will tell. In the US most are expecting this to peak mid/late April or even into May for some places. We'll see what's happening then. You are right though in the sense that if most die are elderly/high risk and many of them would have died anyway then the overall death rate of the country may not change much. Again, we'll see.
3. I think they are doing a great job and that is a great strategy. As I said above I'm not making this thread political but I'll just say we STILL do not have enough tests in this country to test everyone we need to test. Without the ability to test that strategy cannot be employed. I'll leave it there.
Keep in mind any impact of shutting things down will take a minimum of 1-2 weeks to generate results due to the incubation period and then the length of time before severe illness onsets. If thinks start improving in Italy that would be a good sign things are working; we'll see.
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03-27-2020, 08:00 AM #85
Very true hopefully more data will start to become available to give a better picture of the whole effect it which COVID-19 is effecting the globe. I think the big interest will soon switch to India, more of the middle east and I am afraid America. Although Europe is the main site at the moment it seems that individual countries are being hit not the continent. With the population numbers in the US and India it will be interesting to see the numbers coming out.
Just read a link to a radio analysis of death rates and kinda goes on the idea which I feel will become the main overall analysis of COVID-19 and how it can be misleading what you read in the papers:-
https://www.npr.org/sections/goatsan...n-be-deceiving
Another analysis but this on is looking at the effect COVID-19 is having on global environment:-
https://www.bbc.com/future/article/2...he-environment
Basically its helping the environment I guess we have to take positives where we can.
Another read if interested on how Canadian scientists actually isolated the coronavirus quite interesting how it happens:-
https://nationalinterest.org/blog/bu...navirus-137652
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03-27-2020, 05:08 PM #86
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03-28-2020, 12:44 AM #87
There seems to be enough anecdotal evidence out there for me to pay attention, though. I saw a video where some doctor was saying the "vast majority" of the dead had ib... in their blood (once they started looking at that, I guess), and it also said that ib... can make the disease "ten times" worse. I don't take that as "the gospel," though, especially the "ten times" part which I would think, at this point, is still quite unquantified by science, but yeah I will certainly use an alternative if I have any symptoms of...anything.
Part of this, of course, is the fact that test kits are ONLY NOW becoming at least SOMEWHAT more available, though still far from optimal. I think we've only seen the tip of the iceberg so far. I actually posted somewhere in here, probably now more than two weeks ago, that at least the number of CASES would really spike, not just exponentially but also as more testing is available, and both are happening.
Deaths, of course, are a much more "objective" measure (because they're entirely KNOWN) because autopsies (of people dying from "sickness") are including a post-mortem test if there were any suspect symptoms, probably whether they were previously known to be infected with SARS CoV-2 or not.
Death rates aren't slowing - YET - because it seems that a lot of the deaths don't come until two or even three weeks into the disease. Death often comes from catastrophic loss of lung capacity. The eventual organ failure can actually take a long time. Nothing much can be inferred so far from what's happening in the United States, that's for sure - both because of rather faulty numbers (including dearth of test kits), and because it can easily change dramatically when hospitals cannot meet the needs anymore...AND because there are reductions in the numbers of professionals, who themselves are getting sick.
it's no more than a week or two away, at most, before some places (notably NY City and New Orleans) may reach the situation where doctors will need to decide WHO WILL LIVE, AND WHO WILL DIE.
It's also NOT just a big city problem, either. Smallish Albany, Georgia has become a hot spot, and their hospital is already at maximum. They're not even close to an Interstate freeway, and it's not like it's a tourist destination or anything.Last edited by frankfrank3630; 03-28-2020 at 12:49 AM.
"Some people without brains do an awful lot of talking" - Ray Bolger (The Scarecrow), THE WIZARD OF OZ, 1939.
Build, for a man, a fire - and he'll be warm for a little while. Set a man on fire, and he'll be warm for the rest of his life.
:-) (-:
[ALOHA - as used in its traditional sense of greeting, best wishes, and an affirmation of life.]
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03-28-2020, 12:57 AM #88
Oh, that person who died from chloroquine? Actually, it was chloroquine PHOSPHATE...not the same thing. The aquarium-purifier just happens to have an unfortunate name that is very similar to the pharma that has shown some promise...and it's easy for somebody to make a fatal mistake.
Husband: Oh look, I just noticed that our aquarium cleaner is CHLOROQUINE PHOSPHATE. Wasn't that the thing that the president, and a number of other people, have been touting as a possible prophylactic or even cure?
Wife: Um...YES, that's what I think they're saying!
Husband: Good! We can use that to protect ourselves, and it doesn't even cost very much.
This could happen so easily."Some people without brains do an awful lot of talking" - Ray Bolger (The Scarecrow), THE WIZARD OF OZ, 1939.
Build, for a man, a fire - and he'll be warm for a little while. Set a man on fire, and he'll be warm for the rest of his life.
:-) (-:
[ALOHA - as used in its traditional sense of greeting, best wishes, and an affirmation of life.]
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03-28-2020, 02:11 AM #89
If you look back at Figure 1 here it's not 14 days maximum: https://www.thelancet.com/journals/l...Fp3AKy9Yq-o89A As for why some patients are deteriorating so rapidly (and it really is rapidly, some docs taking care of these patients why they do deteriorate say that it happens over a matter of hours), there is some thought they are undergoing a cytokine storm which can be a very rapid process once it begins. I don't have a great answer though.
frankfrank3630, good thoughts overall; I'll just chime in that a lot of the patients are not dying from lung issues directly but rather heart issues as later in the course for the severely ill a lot are getting myocarditis and other heart problems.
Additional things:
The GI study I alluded to previously suggesting onset of GI systems was associated with worse outcomes has been revised with additional data and no longer shows worse outcomes: https://journals.lww.com/ajg/Documen...G_Preproof.pdf
Only 5 patients but promising for treatment with convalescent plasma (much more research on this is going to be done without question in my mind): https://jamanetwork.com/journals/jam...C4ecjvIoLLlKMc
New study now indicating a CT scan likely does NOT have a role in diagnosis: https://www.thelancet.com/journals/l...RrAlJj4FaPI2y8
Lastly, I want to thank everyone so far for keeping things on topic and for great contributions. I have tried making a couple of informative posts in the religion & politics section and perhaps not surprisingly they didn't go over wonderfully with one high rep poster even thinking I'm not actually a doctor and being unwilling for me to provide any proof that I am. I realize that section is what it is and I will stay out of it moving forward, but if anyone here doubts I'm actually a doctor as I claim to be let me know and I can try to provide proof to a mod who can then vouch for me.
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03-28-2020, 03:21 AM #90
I agree with those individuals it was obvious that harm would occur from taking aquarium cleaner. However multiple reviews of Choloroquine have shown that the potential of toxicity is clearly possible:-
https://www.chemistryworld.com/podca...011414.article
https://blogs.sciencemag.org/pipelin...st-and-present
https://www.the-scientist.com/news-o...stified--67301
https://www.sciencedaily.com/release...0325212209.htm
I am not saying it won't help as some encouraging results have been noted in China and Australia. With also America conducting a significant study on patients currently which will hopefully offer some insight (they are using a weaker version Hydroxychloroquine):-
https://clinicaltrials.gov/ct2/show/...US%3AMN&draw=2
I hope it does help and in some way I believe it will but will it be significant and will it be maintainable over long term is yet to be known for the combat of COVID-19 symptoms.
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