COVID-19/Coronavirus Information and Support Thread (see OP for useful links)

[Dotini]

Recently, New York Governor Cuomo said this,

None of this is predetermined. This is all a function of what we do today going forward. And the smarter, more disciplined we are, the lower that infection rate will climb. The lower the infection rate climbs, the more you increase the economic activity… it is a formula, it is math.​

I personally feel that each individual bears some responsibility for his own well-being, and it is not entirely the responsibility of others to ensure his health, wealth and happiness. Each time we drive down a strange road, we must take responsibility when we turn left or right. We cannot and do not wait for peer-reviewed science to tell us which way we turn. Accordingly, leadership in other areas have the duty to make decisions without 100% perfect knowledge of all the facts. Being constrained by political and financial ties to one or more factions involved is as big a problem as inexact knowledge. So I cannot utterly condemn the Who and call for Dr. Tedros's head on a spike. He is a sock puppet. As fun as it undeniably is to examine and remark upon the actions and failings of others, it is our duty to examine our own actions and failings, both as persons and as a species.

 

[Scaff]

Whatever he's talking about? Well there's a huge difference between give a medicine or a vaccine to an already sick person.

Vaccines don't work on people who already have the virus.

Doctors are using sick people for testing all the time. Since... forever. Heck sometimes they gave wrong diagnose too. What about placebo? Or side effects that most drugs have. Yet we are still giving them to sick people.

As @Famine has already explained that would be the fourth stage of testing and would only still be done under controlled conditions, otherwise it's worthless.

Medicine is about saving lives. If there's a possibility that a drug can save lives it should be considered as an option.

And then put through the standard testing routine, so it doesn't end up killing people rather than saving them.

Because there is no cure as of right now. This is a health emergency we didn't experience for hundred of years.

Neither of which is a valid reason to ignore the right way to ensure any vaccine or medication is both as safe as possible to use and effective against the condition it's treating.

Is it really that strange that extreme measures are suggested or taken daily?

Yes. It's not strange to look at what can be done to shorten the steps as much as can be safely done to speed up the development of safe effective treatments, but what you are suggesting is throwing out all controls, and that simply stupid, as it means that you not only don't know if a treatment is safe but also don't know if it's even effective.

 

[Famine]

Whatever he's talking about?

Yes. I haven't seen the full clip to know what the precise thing he's talking about is, but it's not strictly relevant because he's asking why we're testing in a test tube (which we aren't) and just give the stuff to ill people. The answer is because it skips out every stage of trials.

Well there's a huge difference between give a medicine or a vaccine to an already sick person.

Yes, a vaccine won't help someone who already has the virus in any way (and may kill them) - so if he's talking about untested vaccines it's pretty stupid, as opposed to if he's talking about untested medicine which would be intensely dangerous.

Doctors are using sick people for testing all the time. Since... forever. Heck sometimes they gave wrong diagnose too. What about placebo? Or side effects that most drugs have. Yet we are still giving them to sick people.

Yes, and this comes some considerable time after we've done the in vitro testing. A doctor can't even give a drug or vaccine to a patient if it hasn't been through pre-clinical trials, because there isn't a drug or vaccine to give.

That's literally the point. He's asking why do the in vitro testing when we could skip all the stuff we do to make sure the thing is safe and effective, and with minimal side-effects (or with side-effects that are less harmful than what we're treating) and just go right to poorly humans. The answer is because that skips all the stuff we do to make sure the thing is safe and effective, and with minimal side-effects.

 

[strela]

Yes, and this comes some considerable time after we've done the in vitro testing. A doctor can't even give a drug or vaccine to a patient if it hasn't been through pre-clinical trials, because there isn't a drug or vaccine to give.

That's literally the point. He's asking why do the in vitro testing when we could skip all the stuff we do to make sure the thing is safe and effective, and with minimal side-effects (or with side-effects that are less harmful than what we're treating) and just go right to humans. The answer is because that skips all the stuff we do to make sure the thing is safe and effective, and with minimal side-effects.

Your argument is valid for normal situation when you have the time. In extreme situations you will try different solutions if you want results. And it needs a lot of courage and responsibility to make this changes. And patients will be threated in a safe environment with professional staff. We are not talking about Mengele and Auschwitz.

 

[Scaff]

We are not talking about Mengele and Auschwitz.

Actually that's exactly what you are talking about.

Without the prior steps, you have no idea at all if it will be safe or effective, as such you are just giving people something and just seeing what the hell happens, regardless of if it will kill them, cause an untold amount of pain and suffering, all without even knowing if it will be remotely effective.

 

[Famine]

Your argument is valid for normal situation when you have the time.

It's not an argument. It's literally the drug (and vaccine) development process. No in vitro, no drug to give.

In extreme situations you will try different solutions if you want results.

Yes, like necking pond cleaner because it says it's got a drug in it that the President says works (without any actual studies). How did that work out again?

And it needs a lot of courage and responsibility to make this changes. And patients will be threated in a safe environment with professional staff. We are not talking about Mengele and Auschwitz.

I mean, you are. Giving drugs that don't exist to patients with no idea of what they might do to them is the very definition of conducting human medical experimentation on the weak.

In any case, a doctor cannot give a drug that doesn't exist. A drug doesn't exist until it has been through the in vitro stage (Trump's "test tube"), because that's how we test different compounds to see if there is any viability as a drug. You cannot bypass this stage, because if you do there's no drug at all.


If he's talking about a vaccine rather than an anti-viral (again, I don't know because I haven't seen the full video), it's actually a dumber question. Vaccines stop you from catching the disease by training your immune system to recognise the virus without having the virus in your body hijacking your cells. Vaccinating someone against a disease they already have will have no effect on whether they catch the disease because... they already have it. Worse, the immune response to the vaccine on top of the immune response to the virus might just kill them.

 

[strela]

It's not an argument.

Argument in sense of reasoning not quarrel.

Yes, like necking pond cleaner because it says it's got a drug in it.

Is this the best you can come with? Really? Is this really the same as giving an experimental drug?

I mean, you are. Giving drugs that don't exist to patients with no idea of what they might do to them is the very definition of conducting human medical experimentation on the weak.

Like Placebo?

In any case, a doctor cannot give a drug that doesn't exist. A drug doesn't exist until it has been through the in vitro stage (Trump's "test tube"), because that's how we test different compounds to see if there is any viability as a drug. You cannot bypass this stage, because if you do there's no drug at all.

I don't get it. Are you saying they would give some random stuff to patients just to se the reaction? I know there are experimental drugs that are given to patients. Clinical researches that involves humans are also not uncommon. And you will still need some approval from the patient or relative. Dont you think?

 

[Scaff]

Is this the best you can come with? Really? Is this really the same as giving an experimental drug?

You're not talking about an experimental drug, you talking about missing out the steps that gets something to that stage.

Like Placebo?

Nope, you clearly don't know what that word means.

I don't get it. Are you saying they would give some random stuff to patients just to se the reaction? I know there are experimental drugs that are given to patients. Clinical researches that involves humans are also not uncommon. And you will still need some approval from the patient or relative. Dont you think?

Once again, clinical research that involves humans only happen after the steps that Trump and you want to skip, so yes, what the two of you are demanding is giving random stuff to people just to see what happens.

 

[strela]

Once again, clinical research that involves humans only happen after the steps that Trump and you want to skip, so yes, what the two of you are demanding is giving random stuff to people just to see what happens.

Now I see. It's about me and Trump.

 

[Famine]

Argument in sense of reasoning not quarrel.

It's neither. You cannot give drugs that haven't been through the in vitro stage because they do not exist to give.

Is this the best you can come with? Really? Is this really the same as giving an experimental drug?

It's an example of someone taking risks to try a drug they have no idea about.

In addition "an experimental drug" must have been through the in vitro stage or it doesn't exist to give.

Like Placebo?

A placebo is something inert (usually a tablet with no active ingredient, or an injection of saline) given in place of a drug without either the doctor's or the patient's knowledge - this is known as double-blinding. And guess what? It's used during clinical trials to determine the in vivo effectiveness of the drug, by giving you something to compare against (active drug vs no drug) without operator bias. And guess what? That comes two steps down the chain after the in vitro stage. You don't have a drug to do clinical trials on if it hasn't been through the in vitro stage.

I don't know what's complicated about this concept. The "test tube" phase is what gives you the drug you can later do clinical trials with. There is no skipping of it, because there's no drug if you skip it.

I don't get it. Are you saying they would give some random stuff to patients just to se the reaction?

No, this is what Trump asked in the video clip. Did you actually watch it? He said:

"Why should we be testing it in a test tube for a year and a half when we have thousands of people that are very sick - they're very, very sick - and we can use it on those people."

The "test tube" is one of the first steps of the drug research process. It's where the compounds you think might work are tested to see if they have any effect against the thing you want it to have an effect against, without any concerns like biology getting in the way. You don't come up with a bunch of compounds and whack them into sick people to see if they have any effect. There's a whole process that you must go through before it comes anywhere near a living human being - among many other things, even if it works you have to know what an effective dose is, and what a lethal dose is (sometimes these amounts are very, very close to each other) so you're not killing people. And that's why you have to test it in a test tube.

I know there are experimental drugs that are given to patients. Clinical researches that involves humans are also not uncommon. And you will still need some approval from the patient or relative. Dont you think?

Experimental drugs and clinical research is what comes after you have created the drug and tested it in vitro. If you don't do the test tube phase, there isn't a drug to experiment with.


If it's a drug that already exists, but being used for a different disorder - such as the anti-malarial hydroxychloroquine and COVID-19 - it's already been through the "test tube" phase and we know what safe doses are. That can go into clinical trials for the new disorder, to see if it is effective.

 

[strela]

Experimental drugs and clinical research is what comes after you have created the drug and tested it in vitro. If you don't do the test tube phase, there isn't a drug to experiment with.

Why would you assume "the drug" haven't even been tested in vitro? It's been several months since the virus came out. Some research sure have been made. And what would you call it before it become experimental drug?

If it's a drug that already exists, but being used for a different disorder - such as the anti-malarial hydroxychloroquine and COVID-19 - it's already been through the "test tube" phase and we know what safe doses are. That can go into clinical trials for the new disorder, to see if it is effective.

So there is a way to experiment a drug on sick patients even when we don't know the consequences, that is somehow acceptable.

 

[Famine]

Why would you assume "the drug" haven't even been tested in vitro?

Seriously? I've literally just quoted Trump's statement for you. Here's what he said again:

"Why should we be testing it in a test tube for a year and a half when we have thousands of people that are very sick - they're very, very sick - and we can use it on those people."

It's in this post, which started this discussion.

He is straight up asking why the drug needs to be tested in a test tube - in vitro. I'm not assuming anything, I'm answering the question of why we don't just give some drugs to people without doing the test tube bit.

The answer is because you don't have a drug at all until you have done that, and you can't administer random quantities of random compounds you think might work, because you'll kill people.

So there is a way to experiment a drug on sick patients even when we don't know the consequences, that is somehow acceptable.

It's acceptable because all the pre-clinical testing that Trump wants to skip has already been done. We've done the in vitro testing, we know what's an effective dose, we know what's a lethal dose, we've done the non-human in vivo testing, we know it's safe to give to humans. Once that's all been done, we can give it to humans in a controlled, double-blind, clinical trial. And then, if it works, we can call it a treatment for that disorder and prescribe it as such.

What's the disconnect here? Trump is asking why we can't skip all the stuff where you do research into a drug and just give it to sick people because they're sick and why not experiment on them. The answer is because that stuff is where the drug actually comes from - without even touching the ethics of the second half of it.

 

[Scaff]

Now I see. It's about me and Trump.

He called for it and you're supporting that call, what part of my statement is inaccurate?

 

[Biggles]

I've got to say (after reading through this excruciating exchange), "very, very sick people" is not the same as "dead people". Someone who is very, very sick may still survive - the majority of Covid-19 patients in ICU do survive. Giving someone who is very, very sick a drug that may not work & may actually further compromise their chances of survival is not an ethically sound medical practice.

 

[CTznOfTime]

Wow. I really want to violate the AUP for this but I won't.

So tell me, exactly when should Trump have used his executive authority to shut down the American economy?

Thank you for not breaking AUP on my account, I am not worth it for you to be banned this way.

Although we may not see eye to eye, but our difference in point of view is what enrich this thread.

I am not saying I am right or wrong, but we are learning from each other.

IHMO, I am a fervant proponent of shutting down the country as of early Feb...

I clearly remember back then that I was yelling at the tele and at the world and at the tone deaf president several times a week that our country need to shut down in order to protect the citizens.... Regardless of the economic impact, because in time of crisis, economics will always be impacted but people can't just rise from the death....

And now look where we are...

I lost my job since then, but I still don't regret and still maintain that belief...

Loss of life is to be prevented over loss of finance...

Although loss of finance can lead to loss of life, but that is secondary effect....

Hope to read from you buddy.


Edit: in regards to the heated debate above, we should come back and analyze the exact words he used, not speculate on what he may or may not think... He doesn't

 

[Danoff]

Well, that letter gaslit you a fair amount, correlation doesn't equal causality and plenty of what is contained in that letter is wildly assumptive and without evidence to support it.

Let's take one example, that the WHO parroted China and were late in warning that Human to Human transfer could happen, as claimed was the case on 14th Jan (even that claim in Trump's letter has to quote-mine to make the point). Yet four days earlier the WHO had, in fact, warned all countries that it was possible:

"Though the mode of transmission of the causative agent(s) is not established, HCWs should assume the potential for respiratory spread."

and

"Infection prevention measurements for a novel coronavirus (route of transmission unknown but suspected to be respiratory)"

That's without listing the full PPE recommendations included in the briefing, a briefing that was publically available and sent to all countries.

https://apps.who.int/iris/bitstream...oratory-2020.1-eng.pdf?sequence=1&isAllowed=y

https://www.theguardian.com/world/2...smission-risk-in-january-despite-trump-claims

The letter also infers that the WHO did not gain access to Wuhan until late Feb 2020, which is utter nonsense, as a WHO team was in Wuhan on the 20th and 21st Jan 2020, around a month before the letter claims the WHO was given access!

https://www.who.int/china/news/detail/22-01-2020-field-visit-wuhan-china-jan-2020



Keep in mind that given the exact same information by the WHO the majority of countries in the world have managed to handle the outbreak significantly better than the US (or for that matter the UK, Brazil and Sweden). I mean it's not like Trump was banging on about one of his miracle solutions again last night was it, oh wait.....

He's trying to paint himself the victim of misinformation. This way he can give a reason why he thought it was a hoax and not important and didn't require response... because the WHO was misleading him. It's passing the buck (great leadership) so that he can save face in the election cycle.

Although loss of finance can lead to loss of life, but that is secondary effect....

No, it's what finances are primarily used for.

 

[strela]

What's the disconnect here? Trump is asking why we can't skip all the stuff where you do research into a drug and just give it to sick people because they're sick and why not experiment on them. The answer is because that stuff is where the drug actually comes from - without even touching the ethics of the second half of it.

There are doctors at the end of the chain. They would give the treatment. They bear the responsibility. They will decide what is right or not. The product they would receive sure would have some background. You can also make something safe even without extensive testing. Or you can do some safe testing on the field. If the whole testing wouldn't require such extensive time there would be no problem to begin with.

 

[ryzno]

No, it's what finances are primarily used for.

I think he was talking about suicide due to loss of finances. IDK...

 

[Danoff]

There are doctors at the end of the chain. They would give the treatment. They bear the responsibility.

"Doctor" is not the same as "biotech research analyst" or "pharmaceutical engineer".

 

[Famine]

There are doctors at the end of the chain. They would give the treatment. They bear the responsibility. They will decide what is right or not. The product they would receive sure would have some background. You can also make something safe even without extensive testing. Or you can do some safe testing on the field. If the whole testing wouldn't require such extensive time there would be no problem to begin with.

Dude...

... they don't have a drug to give if there is no initial drug development. You can't skip "the test tube" because there would not be a drug to give. The "background" you refer to is the "test tube" stage that Trump wants to skip. It's where "the chain" starts.

You really need to listen to the video and read what I transcribed for you. Trump asked why we need to test "in a test tube" when we could just give drugs to "very, very sick people". It's because the "test tube" is where the drug comes from. No "test tube" stage, NO DRUG. It doesn't exist without it. How are you not following this?

 

[Joey D]

Why would you assume "the drug" haven't even been tested in vitro? It's been several months since the virus came out. Some research sure have been made. And what would you call it before it become experimental drug?

It can take a hot minute to test drugs in a lab setting. Just because the virus has been known about by the wider world since December, doesn't mean that we've realistically performed enough lab tests to safely move onto clinical trials yet. There's a big difference between a drug that is currently known and using it experimentally to see if it helps and just shotgunning whatever compounds to see if they work.

For example, where I work is currently doing clinical trials on hydroxychloroquine and azithromycin, both known drugs that have been used for a long time. We're doing a study to see if they give any improvement to COVID-19 patients that meet certain criteria. All patients are briefed and they must give written, informed consent to be apart of the trial. They are monitored and tested frequently. This is acceptable and what we should be doing. Now if where I work was just picking some random compounds, formulating them, and giving them to a patient to see what would happen, that's not OK. Thankfully, no legit organization would ever do that.

What Trump is suggesting is that we take random compounds that a researcher thinks might work and give them to patients to see what would happen. It might cure them, it might kill them, or it might just cause life-altering side effects like cancer, cardiovascular issues, etc. This is not an OK thing to do, even in an emergency situation.

I agree, we should fast track some stuff, especially because the FDA has a metric ton of red tape to wade through. However, just because we should fast track stuff, doesn't mean we should ignore a reasonable scientific approach to make sure we mitigate as much risk as we can. Researchers still need to test the compound in a laboratory to see what could happen. Then they need to move it human analogs as see how it works on a living being. Only after all of that can we start to get informed consent from patients to trial the drug. It very well could end up not working or having dire consequences, but by going through the process we will have greatly reduced that chance.

 

[Touring Mars]

There are doctors at the end of the chain. .... They bear the responsibility.

... which is exactly why no doctor in their right mind will do it.

 

[Dotini]

... which is exactly why no doctor in their right mind will do it.

Do what? Prescribe off label drugs?

 

[Joey D]

Do what? Prescribe off label drugs?

Prescribe untested, experimental drugs on patients.

 

[Dotini]

Prescribe untested, experimental drugs on patients.

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

Does this differ from what you are complaining about?

 

[Joey D]

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

Does this differ from what you are complaining about?

Off label prescribing isn't prescribing untested, experimental drugs.

 

[Dotini]

Off label prescribing isn't prescribing untested, experimental drugs.

What doctor prescribed an untested experimental drug?

 

[Danoff]

What doctor prescribed an untested experimental drug?

... which is exactly why no doctor in their right mind will do it.

They're not.

 

[Joey D]

What doctor prescribed an untested experimental drug?

Did you miss the previous line of posts? No one is prescribing them, what many of us are saying is that no doctor would do it because it's unethical and definitely malpractice.

 

[Dotini]

They're not.

So, no doctor has prescribed an untested experimental drug. They don't do that. So what is there to worry about?