Global Pandemic Part II: Sequel Escalation

[Hewson]

Typical spring

 

[Headache in a Suitcase]

Just an Ordinary Spring

 

[MrsSpringsteen]

I love how the Lakers spokesperson words his statement like the Lakers just were given the loan because they qualified. You have to fill out an application through your bank, And then you have to provide payroll records to confirm the amount of the loan you qualify to receive I know as I went through the process for my company. Its a much easier process for larger corporations who have an accounting staff and have all the info at the ready than for most actual small businesses. That's why the bigger businesses were the first to complete the process and get approved in the majority of cases.

So the Lakers are trying to act like "golly the government just gave us this money but we were good guys and gave it back to help out the little guys" when in fact they sought the money out.
League should dock them a first round pick. And Lebron should have to pick up trash on PCH every Sunday for 2 months

I'm all in favor of LeBron doing that-maybe it would give him the closure he was looking for.

Seriously, the loan program ran out of money for people who actually need it. And that's the bottom line Lakers.

 

[MrsSpringsteen]

Very sad story about Dr. Lorna Breen, the NYC ER director who was treating covid patients and contracted the virus herself. She wanted to go back to work and her hospital sent her home. She went home to Charlottesville VA and committed suicide this past Sunday.

Saw her father on CNN last night, just very sad. She was 49 years old and had no history of mental illness.

 

[Hewson]

Very sad story about Dr. Lorna Breen, the NYC ER director who was treating covid patients and contracted the virus herself. She wanted to go back to work and her hospital sent her home. She went home to Charlottesville VA and committed suicide this past Sunday.

Saw her father on CNN last night, just very sad. She was 49 years old and had no history of mental illness.

That's just horrible and certainly indicative of the potentially large though as yet mostly unseen problem we're facing from the stay at home orders with regards to depression and mental health issues.

 

[anitram]

Very sad story about Dr. Lorna Breen, the NYC ER director who was treating covid patients and contracted the virus herself. She wanted to go back to work and her hospital sent her home. She went home to Charlottesville VA and committed suicide this past Sunday.

Saw her father on CNN last night, just very sad. She was 49 years old and had no history of mental illness.

I read that story too, really sad.

I watched an interview with a psychiatrist the other day who had an interesting point - that yes, his patients who have a history of anxiety and depression were initially very concerning to him and he thought that they would need extra time with him and a plan as to how to cope at work (or without work) and so on. But that he found that the strongest and most acute responses were actually in the group that was new to him, in other words, without a history of mental illness. And he hypothesized that his patients with anxiety and/or depression actually recognized that their symptoms were worsening, sought out help and were almost prepared to an extent because they knew what it was like to live with this condition 24/7. But those who had not experienced it in any meaningful way were almost like hit by a truck and totally without a sense of reference or what was happening to them or how to deal with it.

It makes a lot of sense to me.

 

[BEAL]

We’ll break 60k in the death toll today (and that number is underreported).

The UW model the White House uses has updated to now say around 74k by August.

Are we expecting a severe drop off after this week? We are averaging just over 2k a day, and that was with majority of states locked down.

Now that the South and parts of Midwest are opening up this week and next how does the model reflect that ?

Trump said yet again during the presser that he believes this virus will just go away! Maybe to come back in the fall.

Read about CA plans. We are in phase one still for another week or two. If people don’t fudge up, we could start to see more outdoor parks / beaches opening soon. As well as limited small businesses.

Phase three is still months away, where a majority of us are able to go to places we used to. Restaurants, bars, retails, but with severely limited capacity.

Phase four is vaccine or treatment available. So who knows

 

[LJT]

I read that story too, really sad.

I watched an interview with a psychiatrist the other day who had an interesting point - that yes, his patients who have a history of anxiety and depression were initially very concerning to him and he thought that they would need extra time with him and a plan as to how to cope at work (or without work) and so on. But that he found that the strongest and most acute responses were actually in the group that was new to him, in other words, without a history of mental illness. And he hypothesized that his patients with anxiety and/or depression actually recognized that their symptoms were worsening, sought out help and were almost prepared to an extent because they knew what it was like to live with this condition 24/7. But those who had not experienced it in any meaningful way were almost like hit by a truck and totally without a sense of reference or what was happening to them or how to deal with it.

It makes a lot of sense to me.

I've read an interesting and similar but also slightly different take on this, in that people who have had a history of anxiety etc some are reporting feeling better, hypothesis that modern life causes some of these issues and now that modern life is essentially paused (i'm assuming this is for people with little financial concerns at the moment) they are feeling much better.

 

[BEAL]

Could be a misery loves company mindset too.

Knowing that we’re all in this together, that life has changed and there’s uncertainty....less of a feeling of “I” am anxious and now it’s “we” are anxious.

 

[Jerry Dunk]

The main takeaway I have in reading the Gilead study is that the main things that would move the needle are what America is unwilling to do: widespread testing and universal healthcare. Early treatment of the virus is the main avenue towards lowering the mortality rate of those infected, and if people are unable to get testing and/or afraid of going to the hospital because they cannot afford the treatment, the ability of these treatments to move the needle will be hindered.

 

[MrsSpringsteen]

For Dr. Breen it was not only dealing with the death and the stress, but some reports are suggesting that the virus itself also creates mental health issues in some patients. Depression, anxiety, lack of mental clarity..the brain fog that people with depression and anxiety live with.

My personal experience is that this pandemic has made my depression and anxiety worse. I have the added stress of worrying about my Dad in a facility, they continue to have cases and my Dad has tested negative multiple times. For me all that stress creates a PTSD situation after caring for my Mom and losing her. Caregivers sometimes get PTSD, I did.

Being locked down alone is extremely difficult. And I was looking for a new job before this all started so now I have serious worries about that too.

For me it is true though that I'm more in touch with how this affects my mental health issues, I do my appointments via telehealth and I increased them to twice a week.

I've said from the beginning that this will make the mental health crisis in this country even worse than it already was. If people don't do something about it in state and national governments during and after pandemics and lockdowns then they never will. It's shameful, and it's also shameful that people with these health issues are stigmatized.

 

[anitram]

The main takeaway I have in reading the Gilead study is that the main things that would move the needle are what America is unwilling to do: widespread testing and universal healthcare. Early treatment of the virus is the main avenue towards lowering the mortality rate of those infected, and if people are unable to get testing and/or afraid of going to the hospital because they cannot afford the treatment, the ability of these treatments to move the needle will be hindered.

I agree with you in principle.

But in reality, we DO have universal healthcare here and the Europeans have it too and the struggle has been massive even in that case. You can argue that our numbers would be even worse without it, but to me, the biggest difference maker is the extent of physical distancing measures.

 

[Jerry Dunk]

Universal healthcare isn't going to make it easy, by any stretch. A pandemic is a pandemic. But not having it is a huge hindrance to successfully treating it, as well as dealing with it in anything resembling a timely manner. And the US is already starting to throw its hands up on physical distancing measures.

 

[MrsSpringsteen]

Dr. Fauci says we are not ready in terms of testing for sports to resume this season, some sports may need to skip this season.

 

[BEAL]

Nah. Trump said the stadiums will be full of people and it’ll be just like it was before.

The Kush came out today and said we’ll be back to normal in June. This effort has been a success.

Trump and Pence have discussed rolling back the federal guidelines for social distancing.

If you just believe this virus goes away, it will.

 

[MrsSpringsteen]

FDA expected to issue an emergency authorization for Remdesivir for Covid 19. Dr. Fauci said it has a clear cut effect in diminishing recovery time. Mortality rate is lower too, I don't know how much lower.

 

[MrsSpringsteen]

Nah. Trump said the stadiums will be full of people and it’ll be just like it was before.

The Kush came out today and said we’ll be back to normal in June. This effort has been a success.

Trump and Pence have discussed rolling back the federal guidelines for social distancing.

If you just believe this virus goes away, it will.

I have an idea-Trump, Pence, and nepotism Ken play against each other in different sports. Free to watch for everyone.

Ivanka is a cheerleader.

I know in the grand scheme of things it's not as important as other things right now. Except of course for those employed by teams and sports related activities and businesses. And obviously the athletes will get by just fine. But it's just so demoralizing to not have sports and to face that they might not come back.

No matter what's awful in my life watching sports and loving my teams has always been an escape for me.

My Mom actually gave me my love for sports. I grew up with all her stories about baseball. We loved going to games and watching them on tv. The last trip we ever took together was to the Baseball Hall of Fame.

We also enjoyed basketball and football together.

 

[LemonMelon]

Remdesivir has had its arms tied behind its back in these studies because it's generally been administered to the critically ill. The drug primarily works to stop viral replication, which is why Dr. Fauci claims it "blocks" the virus, not kills it. Once it's out of control, all remdesivir does is buy the patient time.

The challenge is in administering remdesivir early enough in the infection that it makes a big difference when it takes so long for COVID-19 symptoms to appear. Another reason why testing is so crucial.

 

[DaveC]

Dr. Fauci says we are not ready in terms of testing for sports to resume this season, some sports may need to skip this season.

i fully expect that there will be no sports or concerts at all in 2020.

thankfully i don't need the money right now but i've got a bunch of "postponed" concert tickets and raptors and blue jays tickets for games that will obviously not happen and will be cancelled, without any way of getting that money back until they actually cancel the seasons, which of course the leagues won't do until they absolutely have to. i would be ready to burn ticketmaster to the ground right now if i had lost my job and had no income coming in.

the major sports leagues would all be better off if they just accepted that this season is a write-off and start preparing for next year.

 

[Hewson]

I have an idea-Trump, Pence, and nepotism Ken play against each other in different sports. Free to watch for everyone.

Nobody would watch this (but Pence would dominate).

Ivanka is a cheerleader.

I might be persuaded to watch this. (Donald will be watching with a full bottle of Jergen's.)

 

[zuma]

Universal healthcare isn't going to make it easy, by any stretch. A pandemic is a pandemic. But not having it is a huge hindrance to successfully treating it, as well as dealing with it in anything resembling a timely manner. And the US is already starting to throw its hands up on physical distancing measures.

It seems like the perfect storm in the US really. A lack of universal healthcare, likely a large number of undiagnosed chronic conditions, this wild west leftover attitude of the government is out to get me, an individualistic society of extreme capitalism coupled with just about the worst leadership imaginable.

Any one of these are a challenge during a pandemic but this is a terrible combination and really spells disaster.

 

[LuckyNumber7]

i fully expect that there will be no sports or concerts at all in 2020.

thankfully i don't need the money right now but i've got a bunch of "postponed" concert tickets and raptors and blue jays tickets for games that will obviously not happen and will be cancelled, without any way of getting that money back until they actually cancel the seasons, which of course the leagues won't do until they absolutely have to. i would be ready to burn ticketmaster to the ground right now if i had lost my job and had no income coming in.

the major sports leagues would all be better off if they just accepted that this season is a write-off and start preparing for next year.

I’m willing to bet that most of the leagues will resume play without audiences.

 

[BEAL]

Remdesivir has had its arms tied behind its back in these studies because it's generally been administered to the critically ill. The drug primarily works to stop viral replication, which is why Dr. Fauci claims it "blocks" the virus, not kills it. Once it's out of control, all remdesivir does is buy the patient time.



The challenge is in administering remdesivir early enough in the infection that it makes a big difference when it takes so long for COVID-19 symptoms to appear. Another reason why testing is so crucial.

Sounds like we should all just take it then!! Remdesivir cocktails for everyone!!

WHO is pumping the brakes a little bit on this.

I’m sure Trump will be very careful to not tout this as a miracle

 

[Irvine511]

sort of along these lines, i find this fascinating:

A new clinical trial is underway in Spain that will assess whether Truvada, a drug commonly used as PrEP for HIV prevention, can stave off COVID-19 infection among medical practitioners seeking to treat patients amid the pandemic.

If successful, the trial may have broader implications for the general public and not just health workers. But the next step would be awaiting the result of the trials before the drug is determined to be effective.

The study, which began April 1 and is expected to run through the summer, is being conducted at Ramón y Cajal University Hospital in Madrid and sponsored by the Spanish National AIDS Plan, an arm of the Spanish government.

An estimated 4,000 participants will participate in the study, each of whom are medical workers age 18 to 65 working in areas of Spain heavily afflicted with the coronavirus.

Dr. Jose Arribas, research director of HIV and infectious diseases at La Paz Hospital in Madrid, said in Spanish via email to the Washington Blade one underlying basis for testing Truvada against COVID-19 is his findings that relatively few HIV-positive people have the disease.

“We are seeing few cases of HIV-positive people with severe COVID-19,” Arribas said. “This is surprising because the immune system of an HIV-positive person has similarities to that of older people who do have severe cases of COVID-19. Furthermore, there is evidence from in vitro studies that supports Truvada can have an immunomodulatory effect.”

Asked whether Truvada could be used for everyone, not just health care workers, if shown to have a positive impact in the study, Arribas replied, “You have to wait for the results of the study before we can answer this question.”

The National Institutes of Health in the United States posted a notice Monday about the test on the agency’s website, which lists ongoing or upcoming clinical trials across the globe.

According to the abstract, the study will seek to assess whether the components of Truvada — as well as hydroxychloroquine, a drug with well publicized potential use against COVID-19 — are effective in preventing coronavirus infection among medical practitioners because “healthcare workers are particularly at risk of SARS-CoV-2.”

“In the absence of a vaccine, other strategies aiming to reduce the development of COVID-19 in the population, more specifically in healthcare workers is being sought,” the abstract says. “Administration of effective drugs to people at risk of developing an infectious disease is well accepted and is part of clinical practice.”

The choice of Truvada for the study, according to the abstract, is the result of anecdotal evidence the medicine may be effective against COVID-19.

“Existing recent and scarce literature shows that RNA synthesis nucleos(t)ide analogue inhibitors, acting as viral RNA chain terminators, like TDF, abacavir or lamivudine, amongst others, could have an effect against SARS-CoV-2 infection,” the abstract says.

Over the course of the 12-week study, administrators will provide daily doses of Tenofovir Disoproxil Fumarate and Emtricitabine, the components of Truvada, Hydroxychloroquine and placebos to study participants.

One group will receive a daily dose of Truvada and a hydroxychloroquine placebo; another will receive hydroxychloroquine and a Truvada placebo; another will receive both drugs; and another will receive a placebo of both drugs.

The trial will assess confirmed infections of COVID-19 as a primary outcome measure, then the severity of disease, including its duration, among confirmed infected participants as a secondary outcome measure.

The initial results of the study are expected to be compiled by June 30, but the study won’t be completed until July 31, the abstract says.

Overseeing the test will be Dr. Rosa Polo of the Spanish National AIDS Plan and Miguel Hernan, an epidemiologist at the Harvard School of Public Health, according to the abstract.

Ramón y Cajal University Hospital in Madrid and the Spanish National AIDS Plan didn’t respond to a request for comment.

Truvada has been brought up as a potential drug to test against COVID-19 among many other medications being assessed for use against the epidemic. Also in the mix is Remdesivir, an antiviral drug the medical experts have said may hold the best chance against COVID-19.

https://www.washingtonblade.com/202...revent-covid-19-infection-in-medical-workers/

 

[Hewson]

i fully expect that there will be no sports or concerts at all in 2020.

thankfully i don't need the money right now but i've got a bunch of "postponed" concert tickets and raptors and blue jays tickets for games that will obviously not happen and will be cancelled, without any way of getting that money back until they actually cancel the seasons, which of course the leagues won't do until they absolutely have to. i would be ready to burn ticketmaster to the ground right now if i had lost my job and had no income coming in.

the major sports leagues would all be better off if they just accepted that this season is a write-off and start preparing for next year.

https://www.espn.com/mlb/story/_/id/29108891/mlb-fans-now-get-refunds-lost-games

MLB today has announced that teams will now draft their own policies for refunds for games not played (seems they have finally accepted 162 games is definitely not happening), so check the Blow Jays website for specifics there.

As for Ticketmaster, they are just pure evil. Fortunately I don't have a lot tied up with them, my biggest concert purchase so far this year was Boston Calling Festival (used Front Gate Tickets, not TM) and they finally implemented a refund policy, though they are going to take their sweet time actually issuing the refunds. But, like you, I'm not put out by the lack of funds. Lots of folks however are, and Ticketmaster/Live Nation (I occasionally see folks defend Ticketmaster saying they don't have the money, the promoter does, they fail to understand in the vast majority of cases the concert's promoter is Live Nation, who is Ticketmaster, they are the same corporation) should be allowing refunds. This BS that an event is merely postponed so you have to wait for the announcement of new dates is borderline illegal. Once an event has been deemed not to happen on its intended date, the ticket buyer is supposed to have the option of a refund or can choose to hold the tickets for a rescheduled date.

 

[LemonMelon]

Sounds like we should all just take it then!! Remdesivir cocktails for everyone!!

WHO is pumping the brakes a little bit on this.

I’m sure Trump will be very careful to not tout this as a miracle

Considering a single dose of remdesivir will probably cost thousands of dollars and can't be found under the kitchen sink, I'm not too worried about Trump's homespun medical advice.

We just need the drug to work. If it doesn't, there are dozens of other candidates.

 

[BEAL]

This drug has been used on severe cases correct ? Through an IV ?

Is this how it would be used going forward? Or is there a version that can be taken without being hospitalized ?

And as you said, if taken early enough maybe it does have a good chance to reduce or even block out the virus effects. But since we can’t get tested until it’s nearly too late, seems like a catch 22

 

[LuckyNumber7]

This drug has been used on severe cases correct ? Through an IV ?

Is this how it would be used going forward? Or is there a version that can be taken without being hospitalized ?

And as you said, if taken early enough maybe it does have a good chance to reduce or even block out the virus effects. But since we can’t get tested until it’s nearly too late, seems like a catch 22

Typically it’s a lot easier to get patients on trials or a lot easier to test medications in mercy-mode when the patient is desperate.

It’s not a catch 22, it’s just the natural format that they’re the trial patients. There’s more of them.

If it proves to be effective in go-around one, I’m sure they’ll expand the trial to asymptomatic patients and minor conditional patients, which are harder to find and monitor... and harder to remove noise from... so you probably need even more of them.

Rambling because all I’m doing is speculating, but I think you’re getting ahead of yourself in thinking that this type of treatment is simply only available when it’s too late.

 

[MrsSpringsteen]

I read something about Ticketmaster being forced to give refunds, that they were originally not going to give refunds for postponed events.

I had a ballet ticket, not through TM. The ballet sells their own. It was cancelled and I donated the cost just to do my very small part to support them. Riverdance postponed to September, doubt it will happen. Will want a refund.

I have a Lady Gaga ticket for August, that won't happen. I definitely want my money back on that, not cheap. I hadn't bought any sports tickets.

 

[LemonMelon]

Typically it’s a lot easier to get patients on trials or a lot easier to test medications in mercy-mode when the patient is desperate.

This. And I think it's made the drug seem a lot less helpful than it could be.

If we had contact tracing, remdesivir could be supplied early and effectively. A few states are building a system, but it's a long way off.