My opinions on covid-19 testing (my 2 cents)

Off Topic
#21

Again, no one here said to go get some and try it out if you have a sniffle. Your original posting argued that there was no point to testing. I think that this is a bad idea, as testing can determine risk groups and help identify likely asymptomatic vectors (i.e. Typhoid Mary).

Your statement about “no treatment” is also, clearly, wrong. If you would have said “early indications of an effective treatment” or “possible treatment”, I wouldn’t have objected.

People self-medicate all the time. Aspirin can cause hemorrhages and strokes. Tylenol has one of the narrowest therapeutic margins of all OTC pain-killers and is the major factor for acute liver failure in the US.

Planquenil (hydroxycloroquine) is available OTC in France. The retinal damage of which you speak typically manifests after years of taking the drug [1].

So, I don’t think you should sit at home until your lips turn blue, if you think you’ve got the SARS-CoV-2 virus. Better, faster tests are being developed in what seems like days. Go get tested and, if you don’t have risk factors for cardiac issues, why the heck not get an Rx for a drug that you’d take just to go to a 3rd world country for a vacation?

[1] https://www.aao.org/eyenet/article/rx-side-effects-new-plaquenil-guidelines-more

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#22

one reason might be causing shortages for people whose “need” pre-dates this current uprising, yet are having trouble putting their hands on their beloved medications: https://creakyjoints.org/treatment/hydroxychloroquine-shortage-coronavirus-impact-lupus-rheumatoid-arthritis/

but it looks like the FDA agrees it might be useful, and says the industry is ramping up production as quickly and safely as they know how:

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#23

Not an unreasonable statement about my use of no treatment, note my subsequent use of evidence based treatment.

Your other points about side effects of OTC medicines are valid as well.

I didn’t know hydroxychloroquine was available OTC anywhere. Seems unwise to me.

At least in Dallas, they were only testing people with fever so your point about asymptomatic vectors is invalid. The point I was trying make about testing is that it doesn’t change treatment at this point so it is less important for the individual. Especially since it was taking days to get a result. I would agree that it has some usefulness in predicting the extent of disease, but we seem to know now that the disease is extensive. A positive test will indicate that someone should quarantine, but I would submit since the specificity of the test is not known anyone with symptoms should quarantine as well.

I still think off label use of hydroxychloroquine is a bad idea!

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#24

Based the most easily found/listed side effects, which are mostly trivial, and the chance that a dose of HCLQ is potentially life-saving or at least hospitalization-saving, I generally disagree with your concern:

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Off-label uses for drugs are incredibly common, this would just be another example of that. And
note, @zmetzing already pointed out Tylenol has far more concerning side-effect.

Also of note: all the side-effects listed for HCLQ are very similar to those associated with being a DMS member. So there’s that…

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#25

I appreciate and respect your polite and researched disagreement. We will just have to agree to disagree.

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#26

Opps, forgot to mention you are right about off label use being extremely common, usually based on an understanding of the medicine and the particular disease process being treated. I don’t have this understanding in the instance we are discussing.

Also, @zmetzing is correct that Tylenol has a narrow therapeutic index meaning the difference between a therapeutic dose and a toxic dose is small. I wouldn’t really describe that as a side effect, but that’s more of a semantic thing.

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#27

Yep…and, BTW, I fully agree with your perspective that self-medicating is generally a no-no. The good news is that, with the advent and accelerated adoption of tele-medicine, if one really believed they were exposed to Covid-19 or in it’s earliest stages (which is where HCLQ is most efficacious, apparently), getting on the computer with a doctor and chatting with him/her so that all of the factors involved are being fully consider by a licensed healthcare practitioner, and then being issued a prescription if indicated has never been easier.

#28

Again you are right, and quite frankly I sincerely hope that a treatment can be found and soon. I will be happy if it’s hydroxychloroquine as I am at least somewhat familiar with it. We need something.

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#29

Dr. Wallace asserts that HydroxyChloroquine has been safely prescribed since 1955 to 10s of millions of patients, and that it isn’t even required to first perform an EKG. So much for “dangerous cardiac complications”

I guess Dr. Wallace would know a little about the drug, he has one of the largest Lupus Clinics in America, and prescribes HydroxyChloroquine regularly to his 2000 patients.

I would say that we’ve been pranked again by the main stream media…

#30

My guestimate is that it’ll still be here come fall. We’re flattening the curve of the first surge, but there will be others as it propagates around the country and the world. Until 80ish percent of the population gets exposed and dies or recovers, without a vaccine it’ll be hard to stop at this point.

Grim prediction, but this’ll likely be a several months’ problem - not a several weeks problem.

My goal: don’t get infected in the next 30 days. Next week’s goal is the same: don’t get infected for the next 30 days from then.

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#31

What if the R0 factor for Covid-19 is actually blunted by a pharma therapy?

It appears that a cocktail of HydroxyChloroquine, Zinc, and Azith is very effective.

Please explain why Gov. Cuomo and several other Dem Governors issued executive orders preventing Doctors from prescribing these meds for the Covid-19 patients in their states.

I smell a big fat subway rat. Why are 1/3 of the cases, and 1/2 of the deaths in Gov. Cuomo’s state? There is something very wrong here.

#32

They banned it so people won’t take an unproven “cure” and then proceed to ignore all the actual prevention methods, further spreading the disease.

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#33

Yes, there is even the cautionary tale of the couple who drank Fish Tank Cleaner, poisoning themselves.

During the run-up to the 1st Iraq War, the MSM flashed the horror stories of Saddam’s Army in Kuwait. Exasperated reporters tearfully read the news, “In cleaning out hospital equipment, they’re yanking babies out of incubators”.

This never happened; but the story moved the herd.

#34

Is it this one?

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#35

Keep serving the Kool-Aid…

First, it was hydroxychloroquine is DANGEROUS…that was debunked.

Next, it was “we need 2 years of double-blind randomized trials”…not in an epidemic where efficacy has already been demonstrated by some highly respected Doctors in France and Spain.

Finally, it’s “Trump owns shares in a French pharma!”…really???

This is a generic drug which has been in production for 65 years, hardly a profit center for global pharmaceutical companies…try again, something has to stick to the wall.

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#36

Strange, I’ve been requested to calculate damages for a half-dozen generic drug price fixing class-action lawsuits over the past few months, because they are a huge profit center and a difference of a few hundredths of a cent per dose of a popular drug can mean millions in profit.

But hey, I just work in healthcare analytics, I’m sure you have a greater grasp on how pharmaceutical pricing works than me.

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#37

Well, at least that would seem to indicate you don’t have the Covid! So that’s the good news.

Most of us couldn’t agree more…luckily there’s a solution for you:

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#38

Some Assumptions (feel free to try your own):

  • 360,000,000 population (US only)
  • 60% infection rate (80% is more likely 1 year in)
  • 15% of infected needing more intensive treatment (probably low if the cure is effective)
  • 10% drug sale market share (since there are likely other manufacturers of the drug)
  • $0.50 profit per pill (a swag)
  • 30 pill regimen per treatment (another swag)

360,000,000 x 0.60 x 0.15 x 0.10 x 0.5 x 30 = $48.6 Million in the US.

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#39

Your profit per pill estimate is probably high. But if you have the head of state pushing the drug every time a TV camera is pointed at him, you can make it up in volume.

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#40

They are swags for a ROM (rough order of magnitude) estimate.

I’m also only looking at US population where most pharma companies sell world-wide.

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