Stopping COVID19 in Nursing Homes is No Easy Task
My city, Louisville KY, recently had a spike in COVID19 infections. It came from a handful of nursing homes.
That nursing home and long-term care facilities account for large percentages of COVID19 cases has been well documented. In some cities, the majority of cases come from these facilities.
These facts have sprouted platitudes about “protecting our elderly.” What makes this a platitude is that it belies the challenges faced by nursing facilities.
Two recent papers shed light on these challenges.
First is an article by Chris Pope in the City Journal. Second is an academic-like defense of Stoc...
Source: Dr John M - May 26, 2020 Category: Cardiology Authors: Dr John Source Type: blogs
What ’s the Deal with Hydroxychloroquine and Diabetes?
Does the Trump-hyped drug hydroxychloroquine have the potential to treat diabetes? (Source: Diabetes Mine)
Source: Diabetes Mine - May 25, 2020 Category: Endocrinology Authors: Amy Tenderich Source Type: blogs
Murderous Idiocy
Derek Lowe in his Science Magazine blog asks the obvious question. Why the hell are we still conducting trials of hydroxychloroquine for Covid-19 and why are doctors giving it to people. The verdict is in. It doesn ' t work. On the contrary, it kills people. He discusses this paper inThe Lancet which is a retrospective observational study -- yes, yes, not a randomized controlled trial but quite compelling:[W]hen compared with mortality in the control group [i.e., people hospitalized with Covid-19 who did not receive HCQ] (9 ·3%), hydroxychloroquine (18·0%; hazard ratio 1·335, 95% CI 1·223–1·457), hydroxychloroquine ...
Source: Stayin' Alive - May 25, 2020 Category: American Health Source Type: blogs
Hydroxychloroquine for Covid-19 is Dead
(Source: EverythingHealth)
Source: EverythingHealth - May 24, 2020 Category: Consumer Health News Source Type: blogs
Covid-19 Reuters Newsmaker Broadcast with William Haseltine
I live-tweeted a fascinating and perhaps rather depressing meeting with William Haseltine via a Reuters Newsmaker Broadcast. His talk was upbeat but the message does not offer a positive outlook unless we can collaborate internationally to identify, trace, and isolate and go back to early antivirals to treat people urgently. A vaccine will probably never be found, we must stay on top of this virus when we get communities under control. Moreover, we must recognise that another emergent pathogen could appear any time.
These are essentially my notes from Haseltines’s talk.
Might we ever achieve herd immunity?
There is n...
Source: David Bradley Sciencebase - Songs, Snaps, Science - May 20, 2020 Category: Science Authors: David Bradley Tags: Sciencebase Source Type: blogs
Covid-19 Reuters Q & A with William Haseltine
I live-tweeted a fascinating and perhaps rather depressing meeting with William Haseltine via a Reuters Newsmaker Broadcast. His talk was upbeat but the message does not offer a positive outlook unless we can collaborate internationally to identify, trace, and isolate and go back to early antivirals to treat people urgently. A vaccine will probably never be found, we must stay on top of this virus when we get communities under control. Moreover, we must recognise that another emergent pathogen could appear any time.
These are essentially my notes from Haseltines’s talk.
Might we ever achieve herd immunity?
There is n...
Source: David Bradley Sciencebase - Songs, Snaps, Science - May 20, 2020 Category: Science Authors: David Bradley Tags: Sciencebase Source Type: blogs
Adverse effects of hydroxychloroquine
In case you were ever stupid enough to follow Trump’s lead you would have already injected ultraviolets in your eyeballs by now to save you from Covid and maybe bathed in Domestos or sulfuric acid or both! Anyway, his latest bullshine claim is that he’s been taking the antimalarial drug hydroxychloroquine to keep Covid at bay.
Well, for starters there is no evidence that this drug acts as a prophylactic against infection with SARS CoV-2 or indeed any pathogen other than the causative agent of otherwise drug-resistant malaria. It’s primary use is in treating lupus. There was some testing done weeks ago to...
Source: David Bradley Sciencebase - Songs, Snaps, Science - May 19, 2020 Category: Science Authors: David Bradley Tags: Health and Medicine Source Type: blogs
COVID19 and Finding Effective Medical Therapies
This post introduces a column I wrote over at TheHeart.org | Medscape Cardiology
—
The good news is that most people infected with coronavirus don’t need a hospital or doctor. But some do. Some get very ill.
The maddening thing is that doctors don’t have an effective treatment for the virus. There are no cures. The Worldmeter today shows nearly 5 million infections and more than 300,000 deaths. And no effective therapy.
Excluding a possibly modest effect of Remdesivir, our care is supportive, which is medical jargon for giving simple things like oxygen, acetaminophen, IV fluids and letting ...
Source: Dr John M - May 16, 2020 Category: Cardiology Authors: Dr John Source Type: blogs
Americans Are Worried About the Cost of Their Healthcare (and they have good reason)
By CASEY QUINLAN, HELEN HASKELL, BILL ADAMS, JOHN JAMES, ROBERT R. SCULLY, and POPPY ARFORD
Last year, the Patient Council of the Right Care Alliance conducted a survey in which over 1,000 Americans answered questions about what worried them most about their healthcare. We asked questions about access to care, concerns about misdiagnosis, and risks of treatment, which we reported on in our last THCB piece about the What Worries You Most survey.
We also asked people to rank their concerns about the costs of their care, in five questions that covered cost of care, cost of prescription drugs, cost and availability of in...
Source: The Health Care Blog - May 15, 2020 Category: Consumer Health News Authors: Christina Liu Tags: COVID-19 Health Policy Bill Adams Casey Quinlan cost of care Costs Economics Health Care Costs Helen Haskell John James Patient Council of the Right Care Alliance Poppy Arford Robert R. Scully Source Type: blogs
Will the Uncertainties of COVID Science Resurrect Blogs?
Health news was popular before the pandemic. Now, almost all news is health news.
It’s not only a rapt audience contributing to the deluge of COVID19 news. Two other factors: 1) the availability of preprint servers, digital archives where a scientific paper can be published without formal peer-review and 2) the attention economy.
Attention is currency. Since the business model of both scientific journals, internet-based medical news sites and mainstream media is attention (citations, views), both groups are eager to publish all that is COVID.
The slew of COVID papers are outpacing the normal vetting process. ...
Source: Dr John M - May 8, 2020 Category: Cardiology Authors: Dr John Source Type: blogs
VitalPatch Wins FDA Emergency Use Authorization for Cardiac Monitoring in COVID Patients
VitalConnect
announced that it has received FDA Emergency Use Authorization status for
use of its VitalPatch to detect changes in the QT interval of hospitalized
patients undergoing drug treatment for COVID-19.
Hydroxychloroquine
and chloroquine, used to treat some COVID-19 patients, are associated with risk
of prolonged QT interval that can lead to life-threatening arrhythmias. VitalPatch
allows clinicians to remotely and continuously monitor patients at risk of QT
prolongation due to COVID-19 treatment.
VitalPatch
is an FDA-approved device. Besides serving as a single-lead ECG, it monitors seven
other phy...
Source: Medgadget - May 8, 2020 Category: Medical Devices Authors: Cici Zhou Tags: Cardiology Medicine Source Type: blogs
Like Minds on COVID19
At the nearly the same time I posted yesterday, The Lancet published this editorial from Swedish epidemiologist Prof Johan Giesecke. Some excerpts:
It has become clear that a hard lockdown does not protect old and frail people living in care homes—a population the lockdown was designed to protect. Neither does it decrease mortality from COVID-19, which is evident when comparing the UK’s experience with that of other European countries.
…
Everyone will be exposed to severe acute respiratory syndrome coronavirus, and most people will become infected
—
There is very little we can do to prevent this spread: a l...
Source: Dr John M - May 5, 2020 Category: Cardiology Authors: Dr John Source Type: blogs
Can We Discuss Flatten-the-Curve in COVID19? My Eight Assertions
Conclusion:
I did not have a clear answer for my couple. But after thinking and writing about this question it seems that the most reasonable approach in this crisis is transparent information–no matter how stark. And, crucially, we must have space for public debate.
I hate this virus. I wish it never came. But we can make it worse by avoiding hard discussions on tradeoffs, the limits of modern medicine and risk.
JMM
P.S. I am very interested in your rebuttals to any of my assertions but will block vitriol and politicized nonsense.
Related posts:
The Debacle of Hydroxychloroquine and Azithromycin for ...
Source: Dr John M - May 4, 2020 Category: Cardiology Authors: Dr John Source Type: blogs
Vendor To Research Benefits of Remote Monitoring To Test Drug Response
Deploying remote monitoring has been a steadily more viable option in recent years as the technology improves and analyzing the data becomes more practical. One way to digest and share this option is the use of AI, which if deployed effectively can automate the analytical process and even recommend clinical options for treating these patients. […] (Source: EMR and HIPAA)
Source: EMR and HIPAA - May 4, 2020 Category: Information Technology Authors: Anne Zieger Tags: Clinical Health IT Company Healthcare IT Telemedicine and Remote Monitoring Azithromycin Cardiologs COVID-19 COVID-19 Studies Harvard Medical School Hydroxychloroquine Jag Singh University Hospital of Marseille Withings Source Type: blogs
Clinical Trials vs. Right to Try: Ethical Use of Chloroquine for Covid-19
Double-blind randomized clinical trials are the gold standard for answering the scientific question of whether a drug produces any effect, positive or negative, in Covid-19 patients. But is rational for a patient to choose to try a drug such as chloroquine for Covid-19 outside of a trial? Some patients may correctly hold that they have little to lose.
The post Clinical Trials vs. Right to Try: Ethical Use of Chloroquine for Covid-19 appeared first on The Hastings Center. (Source: blog.bioethics.net)
Source: blog.bioethics.net - April 29, 2020 Category: Medical Ethics Authors: Susan Gilbert Tags: Health Care Research Ethics chloroquine Clinical Trials and Human Subjects Research COVID-19 equipoise Hastings Bioethics Forum hydroxychloroquine right to try syndicated Source Type: blogs
