Is anyone at all concerned that the leader of the free world...against all recommendations...is taking hydroxychloroquine as a preventative measure...despite having high cholesterol?
Or that a doctor felt OK prescribing such to the leader of the free world despite said concerns? I mean HOLY COW!?!?!? How many will be banging down doors now to follow suit???
Quote
Several doctors questioned the wisdom of taking the unproven drug, given the possible risks.
“I think it’s a very bad idea to be taking hydroxychloroquine as a preventive medication,” said Dr. Eric Topol, a cardiologist and the director of the Scripps Research Translational Institute in La Jolla, Calif. “There are no data to support that, there’s no evidence, and in fact there is no compelling evidence to support its use at all at this point.”
Dr. Topol said that the risk of developing a potentially fatal arrhythmia because of hydroxychloroquine could come without warning and did not happen only in people with heart conditions. “We can’t predict that; in fact, it can happen in people who are healthy,” he said. “It could happen in anyone.”
Dr. David Maron, a cardiologist and the chief of the Stanford Prevention Research Center, said in an interview that in his opinion “the risk-benefit ratio doesn’t make sense.”
Are there NO repercussions for this kind of insanity??? Sorry...but WOW!!. Am good and would get the hell out of this field if I could for sooo many reasons right now...but opening a restaurant right now is out and that's what I'd wanna do...rofl.
Specializes in Critical care, tele, Medical-Surgical.
More Mask Use, Worry About Lack of Social Distancing in U.S.
As the number of COVID-19 cases in the U.S. is rising sharply, 54% of Americans say they are worried about the lack of social distancing in their local area. Gallup's June 22-28 polling marks the first time that this measure has reached the majority level, and it coincides with a record-high 86% of U.S. adults saying they have worn a mask in public in the past week...
... Heightened news media attention may explain why the majority now say they are worried about the lack of social distancing in their own communities. This includes 19% who are "very worried" and 35% "moderately worried." One-quarter are "not too worried," and 21% are "not worried at all."
Gallup first began tracking this measure in its probability-based online survey in early April when COVID-19 cases in the U.S. were spiking. At that point, 50% of Americans said they were worried about social distancing in their local area. Worry declined to a low of 41% in early June when state restrictions across the country had been eased, but it has been rising since then, as cases have once again surged. In addition to the surge in the number of COVID-19 cases, there has been increased attention on places where the public is not practicing social distancing -- including bars, beaches and protests -- which may contribute to the level of worry...
It's past time to be Holy Crap concerned. This interview is crazier than the Wallace interview.
It was kind of hard to listen to this. President Trump refused to answer most questions and he repeatedly interrupted Axios National Political Correspondent, Jonathan Swan. He interrupted and talked over Mr. Swan.
President Trump insisted that the pandemic is under control, and that it makes no sense to look at deaths per population. He says the only way to look at it is deaths per cases. And - he says - the only reason we have so many cases is because we have tested so many. He talks in circles.
I managed to listen to the whole interview, but it was difficult.
Specializes in NICU, PICU, Transport, L&D, Hospice.
20 minutes ago, Kitiger said:
It was kind of hard to listen to this. President Trump refused to answer most questions and he repeatedly interrupted Axios National Political Correspondent, Jonathan Swan. He interrupted and talked over Mr. Swan.
President Trump insisted that the pandemic is under control, and that it makes no sense to look at deaths per population. He says the only way to look at it is deaths per cases. And - he says - the only reason we have so many cases is because we have tested so many. He talks in circles.
I managed to listen to the whole interview, but it was difficult.
Did you notice the data graphics that Trump's staff provides to inform him? They appeared very simplistic. All of that leaves a very distinct impression that the president is poorly informed and his staff feed his beliefs with spun numbers.
It was kind of hard to listen to this. President Trump refused to answer most questions and he repeatedly interrupted Axios National Political Correspondent, Jonathan Swan. He interrupted and talked over Mr. Swan.
President Trump insisted that the pandemic is under control, and that itmakesnosensetolookatdeathsperpopulation. Hesaystheonlywaytolookatitisdeathspercases. And - he says - the only reason we have so many cases is because we have tested so many. He talks in circles.
I managed to listen to the whole interview, but it was difficult.
There is no perfect method to measure the exact fatality rate of a novel virus when the epidemic is ongoing. CFR is probably the least accurate number.
If anyone thinks that a CFR that varies between 0.2% and 28.8% (!) is a good way to measure the risk this virus poses to a population I need to bring out my facepalm emoji —> ?♀️
The death rate per 100,000 has been increasing quite rapidly in the last couple of weeks in the U.S., one assumes due to the surge in infections that started over a month ago. That current number of deaths/ 100,000 probably looks less ”palatable” than 3.3% (which is the current case fatality rate in the U.S. according to the linked data). I would assume that’s the reason he prefers to look at those numbers, as opposed to the preference being based on a legitimate epidemiological rationale.
If testing doesn’t ”capture” the true number of infected individuals, CFR will be overestimated. So a country’s testing strategy can have a significant effect on CFR.
Cases that are detected and active, but not resolved, may die in the future and this can lead to CFR being underestimated. This effect can be significant during the exponential growth phase of a pandemic.
Deaths per 100,000 is probably a more reliable way to measure the impact the disease has on a given population. However, since the accuracy/degree of correct attribution of Covid-19 related deaths is also a variable, this needs to be assessed together with excess mortality for the time period in question. Many countries show a significant discrepancy between the number of Covid-19 related deaths reported and the total number of deaths that have occurred.
Specializes in Psychiatric and Mental Health NP (PMHNP).
22 hours ago, macawake said:
There is no perfect method to measure the exact fatality rate of a novel virus when the epidemic is ongoing. CFR is probably the least accurate number.
If anyone thinks that a CFR that varies between 0.2% and 28.8% (!) is a good way to measure the risk this virus poses to a population I need to bring out my facepalm emoji —> ?♀️
The death rate per 100,000 has been increasing quite rapidly in the last couple of weeks in the U.S., one assumes due to the surge in infections that started over a month ago. That current number of deaths/ 100,000 probably looks less ”palatable” than 3.3% (which is the current case fatality rate in the U.S. according to the linked data). I would assume that’s the reason he prefers to look at those numbers, as opposed to the preference being based on a legitimate epidemiological rationale.
If testing doesn’t ”capture” the true number of infected individuals, CFR will be overestimated. So a country’s testing strategy can have a significant effect on CFR.
Cases that are detected and active, but not resolved, may die in the future and this can lead to CFR being underestimated. This effect can be significant during the exponential growth phase of a pandemic.
Deaths per 100,000 is probably a more reliable way to measure the impact the disease has on a given population. However, since the accuracy/degree of correct attribution of Covid-19 related deaths is also a variable, this needs to be assessed together with excess mortality for the time period in question. Many countries show a significant discrepancy between the number of Covid-19 related deaths reported and the total number of deaths that have occurred.
You are partially correct. The number that is most useful is INFECTION fatality rate.
The CASE fatality rate is 3.7%. That is very different from the INFECTION mortality rate. “If someone is infected with COVID-19, how likely is that person to die? This question is simple, but surprisingly hard to answer. The key point is that the “case fatality rate”, the most commonly discussed measure of the risk of dying, is not the answer to the question, for two reasons. One, it relies on the number of confirmed cases, and many cases are not confirmed; and two, it relies on the total number of deaths, and with COVID-19, some people who are sick and will die soon have not yet died. These two facts mean that it is extremely difficult to make accurate estimates of the true risk of death.
In the media, it is often the “case fatality rate” that is talked about when the risk of death from COVID-19 is discussed.But this is not the same as the risk of death for an infected person – even though, unfortunately, journalists often suggest that it is. The CFR is very easy to calculate. You take the number of people who have died, and you divide it by the total number of people diagnosed with the disease. So if 10 people have died, and 100 people have been diagnosed with the disease, the CFR is [10 / 100], or 10%.
What we really want to know is the Infection Fatality Rate. The IFR is the number of deaths from a disease divided by the total number of cases. If 10 people die of the disease, and 500 actually have it, then the IFR is [10 / 500], or 2%. To work out the IFR, we need two numbers: the total number of cases and the total number of deaths. “ (1) But we don’t know the actual total number of cases, because many people with COVID have no symptoms and also because we haven’t tested everyone.
Per the Ioannis analysis: “Among people <70 years old, infection fatality rates ranged from 0.00% to 0.57%” (2)
However, if you don’t like Ionannis, there are other sources to consider. Timothy Russell, a mathematical epidemiologist at the London School of Hygiene and Tropical Medicine: “The studies I have any faith in are tending to converge around 0.5–1%” (3)
We also know that the risk of dying from COVID, or becoming seriously ill, vary enormously by age and pre-existing conditions, such as diabetes, hypertension, etc. Older people have a far higher risk of dying from COVID than a healthy young person. The risk of a person under 45 years of age with no other health conditions dying from COVID is miniscule. (4)
“On Thursday [July 16, 2020], after the World Health Organization held a two-day online meeting of 1,300 scientists from around the world, the agency’s chief scientist, Dr. Soumya Swaminathan, said the consensus for now was that the I.F.R. is about 0.6 percent — which means that the risk of death is less than 1 percent.” (5)
“The C.D.C. relies on a “symptomatic case fatality ratio” that “is not necessarily equivalent to the number of reported deaths per reported cases.” The best estimate for the United States [Infection Fatality Rate] is 0.4 percent, according to a set of planning scenarios released in late May.” (5) CDC has just changed IFR estimate to “t0.26% to 0.65%.”
The IFR will also vary among countries.
References
This site does a beautiful job explaining the different measures of mortality Mortality Risk of COVID-19 - Statistics and Research
You are partially correct. The number that is most useful is INFECTION fatality rate.
The CASE fatality rate is 3.7%. That is very different from the INFECTION mortality rate. “If someone is infected with COVID-19, how likely is that person to die? This question is simple, but surprisingly hard to answer. The key point is that the “case fatality rate”, the most commonly discussed measure of the risk of dying, is not the answer to the question, for two reasons. One, it relies on the number of confirmed cases, and many cases are not confirmed; and two, it relies on the total number of deaths, and with COVID-19, some people who are sick and will die soon have not yet died. These two facts mean that it is extremely difficult to make accurate estimates of the true risk of death.
In the media, it is often the “case fatality rate” that is talked about when the risk of death from COVID-19 is discussed.But this is not the same as the risk of death for an infected person – even though, unfortunately, journalists often suggest that it is. The CFR is very easy to calculate. You take the number of people who have died, and you divide it by the total number of people diagnosed with the disease. So if 10 people have died, and 100 people have been diagnosed with the disease, the CFR is [10 / 100], or 10%.
What we really want to know is the Infection Fatality Rate. The IFR is the number of deaths from a disease divided by the total number of cases. If 10 people die of the disease, and 500 actually have it, then the IFR is [10 / 500], or 2%. To work out the IFR, we need two numbers: the total number of cases and the total number of deaths. “ (1) But we don’t know the actual total number of cases, because many people with COVID have no symptoms and also because we haven’t tested everyone.
However, ifyoudon’tlikeIonannis, thereareothersourcestoconsider. TimothyRussell, amathematicalepidemiologistattheLondonSchoolofHygieneandTropicalMedicine: “ThestudiesIhaveanyfaithinaretendingtoconvergearound0.5–1%” (3)
We also know that the risk of dying from COVID, or becoming seriously ill, vary enormously by age and pre-existing conditions, such as diabetes, hypertension, etc. Older people have a far higher risk of dying from COVID than a healthy young person. The risk of a person under 45 years of age with no other health conditions dying from COVID is miniscule. (4)
“On Thursday [July 16, 2020], after the World Health Organization held a two-day online meeting of 1,300 scientists from around the world, the agency’s chief scientist, Dr. Soumya Swaminathan, said the consensus for now was that the I.F.R. is about 0.6 percent — which means that the risk of death is less than 1 percent.” (5)
“The C.D.C. relies on a “symptomatic case fatality ratio” that “is not necessarily equivalent to the number of reported deaths per reported cases.” The best estimate for the United States [Infection Fatality Rate] is 0.4 percent, according to a set of planning scenarios released in late May.” (5) CDC has just changed IFR estimate to “t0.26% to 0.65%.”
The IFR will also vary among countries.
References
This site does a beautiful job explaining the different measures of mortality Mortality Risk of COVID-19 - Statistics and Research
Thanks for your reply and the resources you linked. Ourworldindata is one that I visit regularly.
Perhaps it wasn’t clear by my answer, and I don’t know if your information was for my benefit or just general information? But I am well aware of what IFR is ? The reason I didn’t mention it is twofold. First, it’s not data that’s (for obvious) reasons reported in daily/weekly updates on sites that provide Covid updates. Since I’m European, I tend to get my updates from ECDC. And Johns Hopkins that I linked in my post also reports deaths per 100,000 and deaths per cases. The second reason I only compared per capita and per reported cases numbers, was because my post was in response to another post about your President’s interview. He wasn’t discussing IFR.
I assume that you agree with me that using CFR in order to compare your ”numbers” to other countries isn’t very meaningful? And that was the context he was using it in when he said that we shouldn’t be looking at deaths/100,000.
Please note that I only said that deaths per 100,000 is a morereliable way to measure the diseases’ impact on a country (than CFR), not that it is the golden standard for figuring out the risk of dying, should you contract the disease.
FullGlass, I really don’t understand the part of your post I’ve bolded. I haven’t argued that the risk of dying if contracting Covid-19 is x or y.
Why wouldn’t I ”like” Ionannis? That’s not how it works. The relevant part is how he, or anyone else arrives, at their conclusions. Scientific data isn’t about whether I like them or not. Perhaps I’m misunderstanding you here?
An estimate of IFR in my country (early on in the pandemic), landed at an overall IFR (all ages) of 0.6%. And split up in two large age groups: 0-69 years: 0.1% and >70: 4.3%. (Can’t remember the confidence intervals off the top of my head, and am too lazy to check ?). IFR is tricky though, as I’m sure you know. Especially early on in the pandemic when the number in the denominator can be quite difficult to estimate.
Specializes in Psychiatric and Mental Health NP (PMHNP).
19 minutes ago, macawake said:
Thanks for your reply and the resources you linked. Ourworldindata is one that I visit regularly.
Perhaps it wasn’t clear by my answer, and I don’t know if your information was for my benefit or just general information? But I am well aware of what IFR is ?
Thank you for the response. I just wanted to provide general information and help educate people. Epidemiology should be a required course for all nurses IMHO.
Specializes in NICU, PICU, Transport, L&D, Hospice.
It's pretty clear that the president has no understanding of epidemiology and is looking for numbers which support his narrative. From the looks of the papers Trump was pouring over, his staff feeds him simplified data in charts to make him feel good about the pandemic.
It's pretty clear that the president has no understanding of epidemiology and is looking for numbers which support his narrative. From the looks of the papers Trump was pouring over, his staff feeds him simplified data in charts to make him feel good about the pandemic.
I wonder if the charts are large and simplified because his vision isn't 20:20. Mine isn't. I would want the larger print if I wanted to find something specific under pressure. (I prefer at least 12 font.)
I wonder if the charts are large and simplified because his vision isn't 20:20. Mine isn't. I would want the larger print if I wanted to find something specific under pressure. (I prefer at least 12 font.)
Maybe...but the font looked pretty small...was just the colored bars that were ginormous. Go figure.
Specializes in NICU, PICU, Transport, L&D, Hospice.
2 hours ago, Kitiger said:
I wonder if the charts are large and simplified because his vision isn't 20:20. Mine isn't. I would want the larger print if I wanted to find something specific under pressure. (I prefer at least 12 font.)
herring_RN, ASN, BSN
3,651 Posts
More Mask Use, Worry About Lack of Social Distancing in U.S.
As the number of COVID-19 cases in the U.S. is rising sharply, 54% of Americans say they are worried about the lack of social distancing in their local area. Gallup's June 22-28 polling marks the first time that this measure has reached the majority level, and it coincides with a record-high 86% of U.S. adults saying they have worn a mask in public in the past week...
... Heightened news media attention may explain why the majority now say they are worried about the lack of social distancing in their own communities. This includes 19% who are "very worried" and 35% "moderately worried." One-quarter are "not too worried," and 21% are "not worried at all."
Gallup first began tracking this measure in its probability-based online survey in early April when COVID-19 cases in the U.S. were spiking. At that point, 50% of Americans said they were worried about social distancing in their local area. Worry declined to a low of 41% in early June when state restrictions across the country had been eased, but it has been rising since then, as cases have once again surged. In addition to the surge in the number of COVID-19 cases, there has been increased attention on places where the public is not practicing social distancing -- including bars, beaches and protests -- which may contribute to the level of worry...
https://news.gallup.com/poll/313463/mask-worry-lack-social-distancing.aspx