Fear and Loathing, a Rat Flu Odyssey

[iceman]

Mask the people.

Unmask the aliases.

[summit]

I agree... looks like a glitch in your quoting me twice?


On another note, does anyone know if N95 masks have an expiration date? I found a stash that I placed in a closet not long after 911. Lots of talk about biological terrorism, so I put a box on the top closet shelf. Things are at least 18 years old, so I'd hate to donate to a hospital/ Doctor and find out they were no longer any good.

18 years is pretty old. the elastic straps are probably bad and you need those to keep a seal, but if the elastic is still good the masks are probably g2g

[summit]

if you had any doubt Trump is an asshole

https://www.cbc.ca/news/politics/tru...rday-1.5522003

The news comes as Minnesota-based company 3M revealed Friday that because of the Trump administration's invocation of the Defence Production Act — which allows the president to boost industrial production of critically needed goods — the manufacturer is under orders not to send U.S.-made masks to other countries, including Canada.

In a statement, 3M said that halting such exports could adversely affect America's own supply if other countries choose to retaliate, prompting President Donald Trump to reveal that his administration was "not at all happy" with the company.

3M faces pressure from Trump order to stop exporting N95 masks to Canada

Updated
Fight over N95 masks shows Trump testing ethical, legal limits in COVID-19 crisis



Trudeau addressed the dispute during his Friday briefing, stating that failing to send supplies destined for Canada "could end up hurting Americans as much as it hurts anybody else."

But the prime minister said Saturday that he wasn't seeking retaliatory measures against the U.S. — such as blocking Canadian nurses from Windsor, Ont., from travelling across the American border to Detroit.

Oh 3M is pure asshole in this one. PURE asshole. SOP for 3M. And their distributors.

They painted a GIANT target on themselves by knowing about and enabling their distributors to continuously sell promised PPE orders out from under SEMA/FEMA and US hospitals/emergency services to foreign buyers. They continued to do this AFTER the DPA was put into force. That is waving your dick at your countrymen while rolling in $$$.

Don't invite the man into your lives.

Don't expect ham fisted stupid government measures to understand global supply partnerships.

But whats better than that is don't be a fucking asshole in a national crisis in a way that defies national order and demands government intervention. Then nobody will DPA your ass.

[AK47bp]

I agree... looks like a glitch in your quoting me twice?


On another note, does anyone know if N95 masks have an expiration date? I found a stash that I placed in a closet not long after 911. Lots of talk about biological terrorism, so I put a box on the top closet shelf. Things are at least 18 years old, so I'd hate to donate to a hospital/ Doctor and find out they were no longer any good.

I’d think the rubber bands would be brittle.


Sent from my iPhone using TGR Forums

[Name Redacted]

I haven’t seen anything about the actual trials. I thought the trials started a week and a half ago in NY. I’d think we’d know some results?

I’m just assuming that trials usually take many months to produce reliable results and need to be gone over with a fine tooth comb before official release. Obviously under these circumstances we need a little more urgency and maybe they could be out a little faster, but still a few weeks seems like a pretty ambitious timeline.

I think that it is one of the many things that the medical community is struggling with. We don’t need perfect answers that are going to be printed in the NE journal of medicine, just tell us if there’s any glimmer of hope that it’ll work!

But I’m just a glorified barista who didn’t even stay at a holiday inn express last night.

[BigDaddy]

18 years is pretty old. the elastic straps are probably bad and you need those to keep a seal, but if the elastic is still good the masks are probably g2g

I’d think the rubber bands would be brittle.

Thanks... that seems to be the one issue. It's only a box of 10, but if one mask was not sealed, that would still be f'd. And with the Kraft recent delivery to this area, probably no reason to take this risk. I'm not going to put these in circulation (except for local/resident dentists).

[Core Shot]

i posted in the whiteroom
bout all i memberries is soothing fonts
#unclemoeswantsyou

nicklechangers.com
and yeah i skied with that guy too.

no touchy though

Boo yah

World needs powder

[summit]

Thanks... that seems to be the one issue. It's only a box of 10, but if one mask was not sealed, that would still be f'd. And with the Kraft recent delivery to this area, probably no reason to take this risk. I'm not going to put these in circulation (except for local/resident dentists).

remember also they should be fit tested so if they aren't of a common type or all given to one user, they will probably be used as droplet masks... which is OK too

[Yonder_River]

Actually, it's true. Hospitals and clinics are losing big money because patients are cancelling appointments. Hospitals and clinics throughout WA have announced layoffs and big pay cuts.

ETA: Pullman Regional Hospital Cuts Employee Pay by 25% due to Revenue Drop From Coronavirus Mandates

Yep, it's even worse for subcontracted private doc groups who work in hospitals, clinics and surgery centers. Many have a 80% drop in income. Not enough need for hospitals to pull them in full-time and actually pay them if they can just overwork their existing intensivists, er docs and nurses.

[Yonder_River]

I wonder how quickly the hospitals will bounce back once restrictions are lifted. For the most part, those elective surgeries and doctor visits are still going to need to happen. I could see the hospitals being extra busy this summer and next fall.

It's going to bankrupt many if this continues unfortunately. Surgery centers especially. Obviously caseload will eventually go up a bit but it will never look like before simply because many surgeries that fall under "elective" will be too expensive given the economic fallout in society. Also, there's a good chance insurers will restrict what they will pay for.

[Diamond Joe]

No, clearly your post takes that crown. Point out one thing that's incorrect about what he posted.

This thing is bringing out the JONGs in force and enpowering them to mouth off. (Are we sure these are aliases and not just JONGs??) edit: Not Iceman obviously, the person he was responding to here

Elect a clown, expect a circus.

Ha! I'm stealing that too. Thats gold

[Diamond Joe]

This is so awesome lol needs to be reposted in case anybody missed it. I played it for my wife 10 minutes ago, now she walking around humming "you gotta keep that distance! its all about that social distance!!"

[Lvovsky]

Elect a clown, expect a circus.

Bumper sticker worthy

[Mustonen]

This thing is bringing out the JONGs in force and enpowering them to mouth off. (Are we sure these are aliases and not just JONGs??) edit: Not Iceman obviously, the person he was responding to here



Ha! I'm stealing that too. Thats gold

Aren’t we all iceman, though?

[subtle plague]

I've been iceman since 2007.


Efit:the 4 years before I had Been blurred.

[highangle]

Oh 3M is pure asshole in this one. PURE asshole. SOP for 3M. And their distributors.

They painted a GIANT target on themselves by knowing about and enabling their distributors to continuously sell promised PPE orders out from under SEMA/FEMA and US hospitals/emergency services to foreign buyers. They continued to do this AFTER the DPA was put into force. That is waving your dick at your countrymen while rolling in $$$.

Don't invite the man into your lives.

Don't expect ham fisted stupid government measures to understand global supply partnerships.

But whats better than that is don't be a fucking asshole in a national crisis in a way that defies national order and demands government intervention. Then nobody will DPA your ass.

Given the lack of leadership, why wouldn't a bigass company with lots of payroll and lots of shareholders continue BAU?
It's how they make money. Asking a big fat corporate citizen to have your morals and tribal spirit is a little much, don't you think?
Perhaps we'd all do well to remember that corporate citizens are not created for moral or humanitarian purposes, but to make money for their owners.

[old goat]

I’m just assuming that trials usually take many months to produce reliable results and need to be gone over with a fine tooth comb before official release. Obviously under these circumstances we need a little more urgency and maybe they could be out a little faster, but still a few weeks seems like a pretty ambitious timeline.

I think that it is one of the many things that the medical community is struggling with. We don’t need perfect answers that are going to be printed in the NE journal of medicine, just tell us if there’s any glimmer of hope that it’ll work!

But I’m just a glorified barista who didn’t even stay at a holiday inn express last night.

A clinical trial is designed by statisticians to enroll so many patients, using calculations based on the estimated magnitude of the benefit as to how many patients are required to produce statistically meaningful results. While most of the docs involved in the study will not know who is getting treatment and who is getting placebo, there is usually someone monitoring the study who knows and if they have the impression that there is an overwhelming benefit (or danger) from the treatment they may analyze the data early. If an overwhelming benefit or risk is discovered they will stop the study and announce results before peer review and publication. There are places where you can look up the design of clinical studies--I used to know where that was but I'm sure anyone with moderate search skills and time on their hands (most of us qualify for the latter) can find it.

Here is one small study that seems to show some benefit. https://www.medrxiv.org/content/10.1....22.20040758v2

If one opens the study results prematurely there is a danger of Type II error--that the study will miss a benefit of the treatment that would have been discovered if more patients had been studied. It could very well be that HCQ shortens the disease by a small but measureable amount or even reduces the progression to intubation or death by a small percentage--getting results like that could take quite a while and a lot of patients. What everyone is hoping for--a dramatic reduction in respiratory failure and death--should be apparent very quickly, but based on our record of treating viral diseases I think that's unlikely.

One thing to look for is whether results are reported as absolute or relative risk reduction. If a treatment improves survival from 1% to 2% that's is often expressed as a 100% improvement, or a doubling of survival, which is technically accurate but very misleading in that it hides the fact that the treatment helped 1% of the patients it was given to. You can find the actual figures if you read the paper; if you only read the press release you will get the falsely optimistic relative risk reduction. If the press release said the treatment reduced mortality from 99% to 98% no one would read it.

[iceman]

Bumper sticker worthy

git sum: https://www.google.com/search?client...UTF-8&oe=UTF-8

[Lvovsky]

Awful people:

https://twitter.com/thedailyshow/sta...523453957?s=21

[Ted Striker]

I've been iceman since 2007.


Efit:the 4 years before I had Been blurred.

I've been John Malkovich the whole time.

[The AD]

I've been John Malkovich the whole time.

I'm Spartacus!

[BigDaddy]

A clinical trial is designed by statisticians to enroll so many patients, using calculations based on the estimated magnitude of the benefit as to how many patients are required to produce statistically meaningful results. While most of the docs involved in the study will not know who is getting treatment and who is getting placebo, there is usually someone monitoring the study who knows and if they have the impression that there is an overwhelming benefit (or danger) from the treatment they may analyze the data early. If an overwhelming benefit or risk is discovered they will stop the study and announce results before peer review and publication. There are places where you can look up the design of clinical studies--I used to know where that was but I'm sure anyone with moderate search skills and time on their hands (most of us qualify for the latter) can find it.

Here is one small study that seems to show some benefit. https://www.medrxiv.org/content/10.1....22.20040758v2

If one opens the study results prematurely there is a danger of Type II error--that the study will miss a benefit of the treatment that would have been discovered if more patients had been studied. It could very well be that HCQ shortens the disease by a small but measureable amount or even reduces the progression to intubation or death by a small percentage--getting results like that could take quite a while and a lot of patients. What everyone is hoping for--a dramatic reduction in respiratory failure and death--should be apparent very quickly, but based on our record of treating viral diseases I think that's unlikely.

One thing to look for is whether results are reported as absolute or relative risk reduction. If a treatment improves survival from 1% to 2% that's is often expressed as a 100% improvement, or a doubling of survival, which is technically accurate but very misleading in that it hides the fact that the treatment helped 1% of the patients it was given to. You can find the actual figures if you read the paper; if you only read the press release you will get the falsely optimistic relative risk reduction. If the press release said the treatment reduced mortality from 99% to 98% no one would read it.

Thanks... that's enlightening. Great to have a resident MD on the forum (or retired)

[huckbucket]

Thanks... that's enlightening. Great to have a resident MD on the forum (or retired)

All of the trials to date have been smaller and looked at surrogates to infection resolution primarily because proving the difference between a 97% infection resolution (SOC) and 99% or 100% on HCQ requires a few hundred patients which takes time. By surrogates I mean things like reduction in coughing and reduction of viral load via the QRT-PCR detection test.

Does it work? Does it not work? The answer may be more subtle than that. For example, HCQ is published to reduce the expression of proteins called toll-like receptors (TLRs). These proteins are critical for mediating what's called innate immunity. Innate immunity is your body fast, first line immune defense against pathogens. Contrast that with adaptive immune with includes B and T cell responses (think antibodies and long term immunity like that achieved with a vaccine). If HCQ knocks down TLRs, then it might not be suitable for prophylactic use as it might blunt the initial immune response to infection which ironically could make it worse. All of the studies to date have been on patients confirmed to be infected either by QRT-PCR, x-ray of the lungs, or both.

Here's another little anecdote to be aware of HCQ has been tested in combination with metformin which is a very commonly used oral diabetes med. The combination was lethal in 30-40% of mice regardless of immune status (immune competent or incompetent mice). I can post the paper if anyone wants to see the dosages used. It may sound like a stretch, but perhaps this contributes to the higher fatality rate in diabetics?

We need to do well controlled tests out of fear that we will hurt people unnecessarily. This is why pumping untested drugs is so dangerous.

[huckbucket]

Still can't upload images to give the daily tally.

A reminder that this is still probably your best resource:
https://www.ft.com/coronavirus-latest

[splat]

Mask the people.

Unmask the aliases.

I think it's time.