Covid II: Medical Info and Implications

[Calm]

Quote

Since the last revision of this section of the Guidelines, the results of several randomized trials and retrospective cohort studies of ivermectin use in patients with COVID-19 have been published in peer-reviewed journals or have been made available as manuscripts ahead of peer review. Some clinical studies showed no benefits or worsening of disease after ivermectin use,^21-24 whereas others reported shorter time to resolution of disease manifestations that were attributed to COVID-19,^25-27 greater reduction in inflammatory marker levels,²⁶ shorter time to viral clearance,²¹ or lower mortality rates in patients who received ivermectin than in patients who received comparator drugs or placebo.^21,27

However, most of these studies had incomplete information and significant methodological limitations, which make it difficult to exclude common causes of bias. These limitations include:

• The sample size of most of the trials was small.
• Various doses and schedules of ivermectin were used.
• Some of the randomized controlled trials were open-label studies in which neither the participants nor the investigators were blinded to the treatment arms.
• Patients received various concomitant medications (e.g., doxycycline, hydroxychloroquine, azithromycin, zinc, corticosteroids) in addition to ivermectin or the comparator drug. This confounded the assessment of the efficacy or safety of ivermectin.
• The severity of COVID-19 in the study participants was not always well described.
• The study outcome measures were not always clearly defined.

Table 2c includes summaries of key studies. Because most of these studies have significant limitations, the Panel cannot draw definitive conclusions on the clinical efficacy of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide further guidance on the role of ivermectin in the treatment of COVID-19.

This makes sense to me for reasoning, but it is not up to date***. If there are conflicting studies, 20 positive and 20 negative or neutral, shouldn’t be approved especially if most studies aren’t well designed to show the drug’s action on its own. Needs more time. Has 5 months been long enough?  Don’t know, feels to me like it would have been approved for emergency use for high risk patients at least, but maybe they are treating us like children again because there are enough acting childish by using stuff for horses (I laugh at this a bit, because I do use a product that has a horse on its label and in the US is only approved for animals, but it’s approved in Canada for use with incubation tubes to cut down on contamination etc.  I also know the BYU prof who invented it and others involved in the clinical studies for sores due to diabetes that won’t heal otherwise, and they are advanced enough with no sign of danger unless something has recently popped up…I wonder if the trials were stalled with covid).
 

To those who say why not since it is well tolerated otherwise, drugs aren’t candy and when treated as such by patients or doctors, bad things happen (to me when it came to antidepressants and anti Parkinson drugs for RLS).  Using an unproven drug as a preventative scares me big time. Drugs are not our friends unless there is nothing else Imo (there may be a few exceptions, but powerful ones, always be cautious rather than eager).

***https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/

Edited August 3, 2021 by Calm

[bsjkki]

10 minutes ago, Calm said:

This makes sense to me for reasoning, but it is not up to date***. If there are conflicting studies, 20 positive and 20 negative or neutral, shouldn’t be approved especially if most studies aren’t well designed to show the drug’s action on its own. Needs more time. Has 5 months been long enough?  Don’t know, feels to me like it would have been approved for emergency use for high risk patients at least, but maybe they are treating us like children again because there are enough acting childish by using stuff for horses (I laugh at this a bit, because I do use a product that has a horse on its label and in the US is only approved for animals, but it’s approved in Canada for use with incubation tubes to cut down on contamination etc.  I also know the BYU prof who invented it and others involved in the clinical studies for sores due to diabetes that won’t heal otherwise).
 

To those who say why not since it is well tolerated otherwise, drugs aren’t candy and when treated as such by patients or doctors, bad things happen (to me when it came to antidepressants and anti Parkinson drugs for RLS).  Using an unproven drug as a preventative scares me big time. Drugs are not our friends unless there is nothing else Imo (there may be a few exceptions, but powerful ones, always be cautious rather than eager).

***https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/

Doctors use drugs for non FDA approved off label use all the time. And, from personal experience I know this can be dangerous. But, why are we so hyper about covid off label therapies and not all the other very common use of non fda approved uses of approved drugs?

 

 

Edited August 3, 2021 by bsjkki

[Calm]

We should have better info hopefully not too far in the future, looks like at least one well planned large study and other evaluations are in the works. 
 

Quote

In the UK, it was announced that ivermectin will be added to the Principle Trial, a large clinical study designed to assess potential COVID therapies for non-hospitalized therapies for patients at higher risk for severe disease," said Dr. David Shafran, head of pediatrics at telehealth app K Health. "This should demonstrate more definitively the efficacy of ivermectin in early-stage COVID infections. Fingers crossed because it's a cheap medication with a good safety profile. It would be great to add this to the armament of medication to fight COVID."

The Oxford University Principle Trial has more than 5,000 participants and will give a three-day course of oral ivermectin treatment to individuals randomly and compare their results to individuals who will receive standard care. 

In the US, the NIH is evaluating therapeutics for COVID-19 with its Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) master protocol. ivermectin was added in phase three of ACTIV-6, which will test the effectiveness of repurposed drugs. 

https://www.cnet.com/news/can-ivermectin-be-used-to-treat-covid-19-what-you-should-know/

[Rain]

3 minutes ago, bsjkki said:

Doctors use drugs for non FDA approved off label use all the time. And, from personal experience I know this can be dangerous. But, why are we so hyper about covid off label therapies and not all the other very common use of non fda approved uses of approved drugs?

 

 

I think some may be because one of the biggest criticisms against the vaccine is that it is not FDA approved.

I also think it might have something to do with the doctors you go to.  Some of my doctors wouldn't even think of it.  Others would say, "sure, why not". 

Or it might have to do with insurance.  When I was pregnant there was a much better med for my pre-eclampsia which is used in Europe.  But since it is not FDA approved then insurance wouldn't pay for it here.  

So there may be several things of whether someone will accept non FDA meds or not.  If you have hit a lot of times when insurance wouldn't approve of one it may turn you sour to one now.

Off topic:  I went to pick up some pills last week.  I have hit my out of pocket max so I was expecting to pay nothing.  When I got there the pharmacy said they didn't have enough so did I want to get what they had and then come back for more.  I was really wanting to start on them so I said yes.  But then I found out there was a charge.  The was a charge because I was only getting part of a prescription. If I waited a day and got the whole prescription then the insurance would cover it all.  How crazy is that?

[Calm]

1 minute ago, bsjkki said:

Doctors use drugs for non FDA approved off label use all the time. And, from personal experience I know this can be dangerous. But, why are we so hyper about covid off label therapies and not all the other very common use of non fda approved uses for approved drugs?

My view is it is likely because lots of people are wanting to use it as a preventative. That is quite a bit different than using a drug off label to help a serious existing problem. 
 

There is also some issue with interacting with other drugs, but if there were concerns about it interfering with treatments that are known to more likely help Covid, haven’t seen that yet.  I would be very concerned about that potential. 
 

I get the FDA and others probably don’t feel comfortable when the ‘public’ starts getting involved in medical research rather than just waiting to benefit from it, but it is a pandemic and exceptional behaviour is going to occur. It seems counterproductive to overreact to that, if that is one of the reasons. Given comments it is generally well tolerated when used as directed, off label use if at the same or lower dosages kind of make sense to me The rls anti Parkinson drugs were originally off label use, there were no drugs labeled for Rls when I was first diagnosed…otoh, I shouldn’t have taken those drugs, big, big mistake by my doctors who weren’t listening to the experts about augmentation. 

[Calm]

4 minutes ago, Rain said:

The was a charge because I was only getting part of a prescription. If I waited a day and got the whole prescription then the insurance would cover it all.  How crazy is that?

Weird. My pharmacy never charges me for partials.,.which is a good thing because they happen all the time with the opiate. 

[Hamba Tuhan]

6 hours ago, rongo said:

It's a lot more mainstream than that, with many solid members who don't subscribe to any of that ... It isn't a kook fringe minority. 

From what my sister in America tells me, I think you may be right.

But what you are describing would without doubt make a person part of the extreme 'kook fringe minority' here, probably on the far left. 

[Rain]

1 hour ago, Calm said:

Weird. My pharmacy never charges me for partials.,.which is a good thing because they happen all the time with the opiate. 

It wasn't the pharmacy.  It was the insurance requiring it.  Never had that happen before, but this insurance has a few quirks 

[The Nehor]

6 hours ago, bsjkki said:

I didn’t make the claim. Please show evidence of your claim.

No.

[Calm]

52 minutes ago, The Nehor said:

No.

Why not?  I truly want to be educated on this and am not seeing it reported to that level in what I am reading so far. Bsjkki is also someone who is putting a lot of effort into looking at original sources and understanding the science and not the least prone to buying pseudoscience I have seen. 

Edited August 3, 2021 by Calm

[The Nehor]

1 minute ago, Calm said:

Why not?

Because the CFR is ridiculous and the rule about it is ridiculous. It might have some validity when discussing esoteric topics or when you quote someone without being able to give a source that would be difficult to track down. A CFR for side effects of a drug is just silly. This information is publicly available and widely disseminated.

[Calm]

11 hours ago, The Nehor said:

Because the CFR is ridiculous and the rule about it is ridiculous. It might have some validity when discussing esoteric topics or when you quote someone without being able to give a source that would be difficult to track down. A CFR for side effects of a drug is just silly. This information is publicly available and widely disseminated.

Should I be offended here or not?   Too much effort. I vote not. 
 

I have been looking at a number of sites and studies. I can’t find one that gives a percentage on side effects, just possiblities, so I can’t tell which has overall more severe risks (once you remove the stupid treat me like a horse overdoses).  I would really like to have solid numbers because if it is more dangerous (and I am leaning towards it is though bsjkki may not be), it would be helpful in my discussions with friends and family that are making poor choices Imo and where I would love to find a way in (hey, you are okay with taking ivermectin but not a vaccine?  Look at these stats on its side effects and look at the stats we have for the vaccine!)

 I have got a just married niece who might decide it’s time if I can find just something to get her to sit back and question her assumption she has time to wait and see.  Sending her research on the risks of Covid vs risk of vaccines didn’t work. I plan, if I get a chance to discuss it with her…which may not happen since she is banned from the house since Covid took out almost everyone at my brother’s family reunion (took out meaning infected)…on using the info that side effects with vaccines show up pretty quickly even if we don’t know how long they might hang around, so we have a good idea what to expect even if stats aren’t set in stone yet.  I don’t know if she is into the idea of these unapproved treatments (she is not antigovernment and plans on taking the vaccine eventually, she wants more data on its safety though), but if she is, leverage maybe.

Exchange of favors?  I will do research for you sometime when more awake and organized on something that is too boring for you to plough through piles. 
 

Got to shut off as all this research is shifting me into the no sleep for all day zone and the quality of my research and understanding of what I am finding ain’t worth that. Maybe if you are lucky you are already out or playing with the sugar gliders (you still have the, right?). 

Edited August 3, 2021 by Calm

[pogi]

I really like Governor Cox.

Quote

 

The governor's office can't mandate masks in schools statewide because the legislature stripped him of that authority earlier this year. But since children under age 12 can't get vaccinated against COVID-19, Cox's office will provide the next best thing — an N95 or KN95 mask — for any child who wants one.

He pointed out that while the governor's office and legislature no longer have the authority to mandate masks in schools, local health departments can still institute mandates. However, health departments will have to seek approval from their county's elected body for such mandates after 30 days.

 

https://www.ksl.com/article/50217015/utah-gov-coxs-office-to-provide-masks-for-students-who-want-them-this-fall

It sounds like he is willingly and proactively suggesting a loophole for local health departments to mandate masks to get around the law which restricts mask mandates in schools. 

N95 masks free for children is absolutely great news!  I will be requesting one for my kindergartener. 

[Senator]

So, the little libertarian in me is raising its hand and saying, Folks we are awash in vaccine.  Its readily available to anyone.  So at this point, if you contract COVID and get seriously ill and possibly die.... its on you! By your own free will and choice.  The rest of us are going to get on with life.

[pogi]

22 minutes ago, Senator said:

So, the little libertarian in me is raising its hand and saying, Folks we are awash in vaccine.  Its readily available to anyone.  So at this point, if you contract COVID and get seriously ill and possibly die.... its on you! By your own free will and choice.  The rest of us are going to get on with life.

The little realist in me is raising its hand and saying, the vaccine actually is not available to anyone under 12.  It is also saying that when 50% of the population is not vaccinated and the Delta variant is going around, that is going to potentially have a severe impact on all of us by reducing the quality of medical care, potentially leading to hiatus on elective surgeries (we see that happening in Florida right now), pray that you don't need to go the ICU for a non-Covid issue!  -Straining the economy through missed work from quarantine and isolation (which also disrupts schooling and children's lives - requiring parents to take work off to care for their sick kids), -  Potential tighter restrictions in general, potential lockdowns, etc.  We can't pretend like it doesn't indirectly have an effect on all of us, travel restrictions to high risk area, etc. etc.  It really limits us in so many ways when we do not play as a team.  

Edited August 3, 2021 by pogi

[Senator]

I don't share that level of fret.

[pogi]

25 minutes ago, Senator said:

I don't share that level of fret.

Because it hasn't happened yet?  Did we both experience the same 2020?

The rest of us have been negatively impacted in one way or another from this virus directly or indirectly. 

Edited August 3, 2021 by pogi

[Senator]

Seeing your vehemence on the topic, I seriously doubt we did!

Edited August 3, 2021 by Senator
typo

[pogi]

18 minutes ago, Senator said:

Seeing you vehemence on the topic, I seriously doubt we did!

Fair enough.  I am passionate, you are right.  America took a hit.  The world took a hit.  I took a hit.  Take my testimony on top of the millions of other American testimonies that it has directly and/or indirectly affected us in negative ways.  Everything I said absolutely has and will continue to affect Americans.   Not getting vaccinated doesn't only affect you.  Can you at least accept that as true?

Edited August 3, 2021 by pogi

[The Nehor]

30 minutes ago, Senator said:

I don't share that level of fret.

And that is the problem. I bet you suddenly would fret if a loved one becomes seriously ill or has a heart attack or whatever and you find yourself desperately trying to find a hospital that can take them.

[Senator]

7 minutes ago, pogi said:

Fair enough.  I am passionate, you are right.  America took a hit.  The world took a hit.  I took a hit.  Take my testimony on top of the millions of other American testimonies that it has directly and/or indirectly affected us in negative ways.  Everything I said absolutely has and will continue to affect Americans.   Not getting vaccinated doesn't only affect you.  Can you at least accept that as true?

Sure!   It's the "effect" in relation to the human reaction that is in question.

[pogi]

13 minutes ago, Senator said:

Sure!   It's the "effect" in relation to the human reaction that is in question.

I'm not sure I understand.  Can you elaborate?

What does that mean in terms of job losses, business closures, inflation, death, long term disability, overwhelmed and stressed medical staff/hospitals, sub-par medical care, postponing surgeries, etc. as they relate directly or indirectly to Covid?  Are you suggesting that America is over-reacting to what has happened? Or, am I misunderstanding you?

[Senator]

3 minutes ago, pogi said:

  Are you suggesting that America is over-reacting to what has happened? 

In some/maybe many regards, yes.  But I'm not interested in hashing it out here.

[Senator]

20 minutes ago, The Nehor said:

And that is the problem. I bet you suddenly would fret if a loved one becomes seriously ill or has a heart attack or whatever and you find yourself desperately trying to find a hospital that can take them.

My lack of fret is the problem?  Hard pass on that one.

[pogi]

Quote

 

"We need to normalize wearing face coverings again," Salt Lake County Health Department spokesman Gabe Moreno said Monday, shortly before the Utah Department of Health reported 2,244 new COVID-19 cases and 15 additional deaths from the virus since Friday.

"We know that with the delta variant produces higher viral load in vaccinated people and therefore making them more contagious than other variants did," Moreno said. "We need to make sure we're wearing masks in indoor spaces and around other people whose vaccination status we do not know."

Dr. Eddie Stenehjem, an infectious diseases physician at Intermountain Healthcare, the region's largest health care provider, warned last week the coming school year could be worse because of the dominance of the delta variant first reported in India, believed to be as easily transmissible as the chickenpox.

"You're going to see this virus transmit in schools. And then those children are going to take the virus back to their homes and transmit it to susceptible parents and susceptible grandparents. That's just a fact. We know that if you put 30 people into an enclosed room, you're going to get transmission," he said. "This is a different virus."

Stenehjem said he's "skeptical" measures like separating students and encouraging hand-washing will be enough to slow the spread. "We know that masking works," he said, adding that if his children were old enough to be going to school, they would be wearing masks.

The University of Washington's Institute for Health Metrics and Evaluation estimates that daily COVID-19 infections in Utah may not peak until mid-September, at more than 4,500, if the population returns to pre-pandemic behaviors despite increased numbers and lagging vaccination rates, considered the worst-case scenario.

However, if 95% of Utahns wear masks in public — the best-case scenario — that estimate drops to around 224 cases by mid-September. By mid-October, the institute estimates up to another 146 Utahns could be dead from the virus — a number that drops to another 51 if everyone wore masks.

https://www.ksl.com/article/50216660/what-can-utahns-do-to-slow-this-surge-of-covid-19