https://www.realclearpolitics.com/coronavirus/
23 March 2020
Update: Which drugs work best against Covid19?
This man claims his life was saved by plaquenil
Update: Covid19 Treatment & Vaccine tracker — updated daily
Hydroxychloroquine and Azithromycin
Doctors in France, South Korea and the U.S. are using an antimalarial drug known as hydroxychloroquine with success… researchers in France treated a small number of patients with both hydroxychloroquine and a Z-Pak, and 100% of them were cured by day six of treatment. Compare that with 57.1% of patients treated with hydroxychloroquine alone, and 12.5% of patients who received neither.
What’s more, most patients cleared the virus in three to six days rather than the 20 days observed in China. That reduces the time a patient can spread the virus to others. One lesson that should inform the U.S. approach: Use this treatment cocktail early, and don’t wait until a patient is on a ventilator in the intensive-care unit.
… As a matter of clinical practice, hydroxychloroquine should be given early to patients who test positive, and perhaps if Covid-19 is presumed—in the case of ill household contacts, for instance. It may be especially useful to treat mild cases and young patients, which would significantly decrease viral transmission and, as they say, “flatten the curve.”
Emergency rooms run the risk of one patient exposing a dozen nurses and doctors. Instead of exposed health workers getting placed on 14-day quarantine, they could receive hydroxychloroquine for five days, then test for the virus. That would allow health-care workers to return to work sooner if they test negative.
President Trump touted hydroxychloroquine in his Thursday press conference as a potential treatment… __ Jeff Colyer and Daniel Hinthorn from the Wall Street Journal
We should expect a lot more reports of off-label uses of different drugs against coronavirus, from medical clinicians around the world. It is up to governments to smooth the way for these efforts to fight back against the China virus.
Antivirals Being Used in Other Countries
There are a large number of anti-viral drugs on the market. Some of them are approved in some countries and not in others. In the case of life threatening ARDS from Wuhan coronavirus, national drug regulators should not stand on ceremony, but should arrange for rapid approval for those drugs which display effectiveness.
Doctors in Wuhan have aggressively treated patients with antivirals not approved in the U.S. The drug they utilized most often was Arbidol, manufactured by the Russian company JSC Pharmstandard. One preliminary study showed that Arbidol could drastically improve chest CT scans and speed the body’s clearing of the virus, perhaps by inhibiting viral replication. The antiviral drug Favipiravir, approved in Japan and China, could be more efficacious than Arbidol according to a sizable randomized clinical trial yet to be peer reviewed. While these early studies are promising, neither of these drugs should be regarded as effective until additional research is performed. Given COVID-19’s swift expansion, there should be plenty of opportunities to explore their potential. __ https://www.realclearscience.com/quick_and_clear_science/2020/03/23/doctors_in_china_treated_covid-19_with_antivirals_not_approved_in_the_us.html
Pandemic Models Can be Turned On their Heads by Effective Drugs
The things we think we know about the coronavirus pandemic are mostly wrong. The more we look into the problem — and possible treatments — the clearer will be the way ahead. Politicians such as Nancy Pelosi who are trying to grab massive political and economic power for herself and her cronies, should be sorted out.
To the extent that there is a solution, it is in releasing people from isolation without risking their lives. The medical system is the only one that can do that. It is a system built on the avoidance of all risk possible in the introduction of medicines and vaccines. This is not only a practical consideration but a deep ethical principle of medicine. But given both the damage wrought by the disease and the damage caused in combatting the disease, including the very real risk of economic and social havoc, I wonder whether the medical ethic of first doing no harm can be extended to the economic and social reality. A principle of calculated risk, with the federal government passing laws to protect error, might shift the medical timeline sufficiently to short circuit non-medical risks. I know nothing about the creation of medical solutions and am not speaking with any knowledge of that, but in looking at the problem, the rapid introduction of medicines, even those with some potentially disastrous side effects, might align the timelines to give us a softer landing. Otherwise, we cannot withstand months of isolation and social distancing.
… For now, the crisis is not only the virus but the inability to combat it without massive economic cost, and ultimately social unrest. During Europe’s great Black Death, citizens marched with torches and burned those they felt were ill and those they felt were responsible for the illness. It was not only the plague that created a time of horror but the legitimate fear it generated in people and the inability of the state to protect them, in a world where kings were as likely to die as peasants. The virus is dangerous. The follow-on effect can be far more dangerous. __ George Friedman
Shelter in Place Cannot Go On for Very Long
The economic costs of “hunker in place” are tremendously high. Only the extremely wealthy can afford it for long.
We should … consider more selective containment efforts. After a two-week period of quarantine—corresponding to the upper limit of the incubation period of the disease—some regions will see less community spread than others. We can then lift restrictions in these areas, permit more business activity, and institute border checks to enter cleared zones. Such a strategy may violate traditional views of America as a land of unrestricted free movement. But just as oil tankers separate interior compartments to minimize the disruption of a spill, we may need temporarily to isolate certain regions in order to revive some economic activity in others.
We should also propose different quarantine procedures for the young and the old, recognizing the reality that the elderly are far more likely to require hospitalization and face a substantially higher mortality risk than the young. In addition, individuals with preexisting health conditions such as cardiovascular disease, diabetes, and chronic respiratory disease, as well those with compromised lung function (for instance, due to smoking) face elevated mortality risks. We must find ways to ensure that these vulnerable populations can quarantine themselves and stay safe, while mitigating their economic losses and allowing lower-risk individuals to return to work.
… We must take advantage of the time that we gain from these essential, but costly, shelter-in-place measures and invest now in strategic planning to lift the quarantine. We need an open debate about the costs and benefits of widespread quarantine efforts, the data that would help us make better decisions, and the investments required to minimize disease transmission. Each day that Americans aren’t working, shopping, or attending school represents progress in preventing Covid-19 transmission—but also countless losses to ordinary workers, who will suffer other health and financial consequences. __ City Journal
People can be trained to limit the opportunities for the virus to spread. In fact, rather than propagating fear and panic, governments and media should have been promoting education for the populace in how to protect themselves and those around them — while going about most of their ordinary day to day activities.
Each location of outbreak will dictate its own logic for response. China has probably been faking many of its mortality and morbidity numbers, but then we expect that kind of dishonesty from China. It is likely, though, that numbers from Taiwan, Singapore, Hong Kong, Japan, and South Korea, are reasonably accurate. And none of those countries have suffered to any degree like Wuhan, Italy, Iran, Spain, or any other of the countries with deaths/million population greater than 10. (see table at top of page)
As More Effective Drugs and Vaccines Become Available Everything Will Change
We are being smothered in a miasma of viral doom by journalists and politicians. We should keep a record of how they are trying to use viral panic against us, to create long-term damaging social and economic change. We should not forget how they have tried to use a tragedy for their own benefit.
More:
Moderna COVID19 (Wuhan Virus) vaccine may be available by Fall of 2020
Two Canadian vaccine efforts: here and here
In other news: Costco refuses to refund toilet paper purchases
al fin next level 