Wuhan Coronavirus Resource Thread

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chola
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Re: Wuhan Coronavirus Resource Thread

Postby chola » 24 Mar 2020 12:45

kvraghav wrote:The "Hydroxychloroquine" might be to block the usage of CD147 by the corona virus, same as malaria. This is something new that corona virus uses to invade the cells apart from ACE2 . I think this is why "Hydroxychloroquine" works initially because it blocks the route used by malaria, thus effectively reducing the rate of intrusion to the cell and helping the cell to fight back but once the cells has been largely infected, it is useless to close the second door. This might be the reason China is also having lower infection. They might have found a way to reduce the rate of infection initially but them being China want their price to disclose it. This might be why Iran is also claiming that they have found a Chinese medicine which they wont share with others. The advisory by ICMR to use this by healthcare professionals and close contacts of infected might also be pointing to this that use this to reduce the cell infection rate and help immunity fight it out.


Seems Chinis are/had been disclosing this to "allies" in the Ummah.

At the very least we now have something that works as treatment. But it is not a cure.

https://www.channelnewsasia.com/news/world/turkey-using-drug-china-coronavirus-covid-19-12569598

A packet of Nivaquine, tablets containing chloroquine, a commonly used malaria drug that has shown signs of effectiveness against coronavirus, according to a study conducted in several Chinese hospitals. (GERARD JULIEN/AFP)

ANKARA: Turkey's health minister said on Monday (Mar 23) that the country is using a drug sent from China on patients suffering from the novel coronavirus.

"From this morning we have brought a special drug used in China which is claimed to have resulted in improvements in intensive care patients, cutting their time in care from 11-12 days to four days," Fahrettin Koca told reporters.


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Re: Wuhan Coronavirus Resource Thread

Postby arvin » 24 Mar 2020 12:46

Suraj wrote:Taiwan implements cellphone geofencing of quarantined patients, notifies authorities when individuals move out of home or turn off phones

Something doable in India - geofenced people get called the moment they step out and are told to go home, with phone connections restricted outside geofenced area.


NTRO had used mobile signals to determine the strike rate on feb27 last year.
https://www.indiatoday.in/india/story/d ... 2019-03-04

Its a good idea to use mobile location to determine movement. Since cases in India are due to flyers coming in and later transmitting, this would be particularly useful in enforcing home quarantine. Specially after international flights are resumed next sunday.

chola
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Re: Wuhan Coronavirus Resource Thread

Postby chola » 24 Mar 2020 12:52

Seems chinis are making a heavy push into "aiding" the peacefuls (after infecting them.)

https://www.thejakartapost.com/news/2020/03/23/military-aircraft-carrying-medical-equipment-from-china-arrives-in-jakarta.html


An Indonesian Military (TNI) Hercules C-130 aircraft arrived at Halim Perdanakusuma Air Base in East Jakarta on Monday morning after picking up medical equipment from China to help medical personnel working against COVID-19.
...

The operation was a response to Defense Minister Prabowo Subianto’s request for the TNI to provide military aircraft to transport the medical kits from Shanghai, following his limited meeting with President Joko “Jokowi” Widodo last week.

...

“The Chinese minister of defense asked about our needs and I sent our list. This is a form of international cooperation between countries and they already have the experience. Now that they are giving assistance to us, we accept the offer,” he said.


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Re: Wuhan Coronavirus Resource Thread

Postby kvraghav » 24 Mar 2020 12:59

There are three stages in the fight against this disease:

1) When it is trying to infect the cells: This is where vaccines come into picture since the cell memory will be used to create antibodies. The Chinese will simply piggyback on the west fro this since this is a costly affair and high risk of failure or business irrelevance.
2) Once infected, control rate of spread: This is were Chinese are ahead. They have figured out how the corona spreads and trying existing drugs to block the spread. They are using this to make some quick bucks.
3) Significant spread of infection: At this point, it is the will of the almighty that the body will fight it back. Here we need the antibiotics that can kill the virus which no one has yet found. Research is also going on this but it is very rare for this to succeed. This is why most of the viruses have no treatment including something like dengue. Only bacterial diseases have cure because they are also tougher to kill by the body.

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Re: Wuhan Coronavirus Resource Thread

Postby chetak » 24 Mar 2020 13:03

this is the chinese payback for trump's trade war and the bid to sabotage his election

the US's abdication of its global leadership position and xi's bid to fill the perceived vaccum is just beginning to playout.

xi is squeezing the US and shutting down medical PPE as well as APIs.

The folly of the US putting all its manufacturing eggs in the chinese basket has led them to this sorry pass.


Robbie Gramer@RobbieGramer·5h
Remarkable internal State Department email: An office that coordinates US foreign aid now directing American embassies to urgently ask other countries for help securing medical supplies for the US.




U.S. Appeals to Aid Recipients for Help in Fighting Coronavirus


U.S. Appeals to Aid Recipients for Help in Fighting Coronavirus


Request undercuts Trump’s claim that the U.S. has enough tests and medical equipment.

ROBBIE GRAMER, COLUM LYNCH | MARCH 23, 2020,

The U.S. State Department is instructing its top diplomats to press governments and businesses in Eastern Europe and Eurasia to ramp up exports and production of life-saving medical equipment and protective gear for the United States, part of a desperate diplomatic campaign to fill major shortcomings in the U.S. medical system amid a rising death toll from the new coronavirus.

The appeal comes as European governments are themselves struggling to cope with one of the worst pandemics to spread around the globe since the 1918 Spanish flu. It represents a stark turnaround for the United States, which has traditionally taken the lead in trying to help other less-developed countries contend with major humanitarian disasters and epidemics.

The request could also undercut claims by U.S. President Donald Trump, who has repeatedly insisted that the United States can handle demands for tests and medical equipment on its own, declining to fully implement the Defense Production Act to mandate that U.S. companies produce these products. “We have so many companies making so many products—every product that you mentioned, plus ventilators and everything else. We have car companies—without having to use the act. If I don’t have to use—specifically, we have the act to use, in case we need it. But we have so many things being made right now by so many—they’ve just stepped up,” Trump said at a press conference on March 21.

China, meanwhile, is pushing to refurbish its image by sending its doctors and tens of thousands of medical kits abroad to the countries hit the hardest by the coronavirus, after botching the initial response to the virus, helping lead to its spread across the globe.

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Re: Wuhan Coronavirus Resource Thread

Postby chola » 24 Mar 2020 13:12

kvraghav wrote:2) Once infected, control rate of spread: This is were Chinese are ahead. They have figured out how the corona spreads and trying existing drugs to block the spread. They are using this to make some quick bucks.


We know what it is now. It's chloroquine. In fact, it was recommended by Cheen and now the US:
https://industryglobalnews24.com/-china-recommends-chloroquine-for-covid-trump-elon-agrees

Our pharmaceuticals need to ramp up to protect our population until the vaccine comes.

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Re: Wuhan Coronavirus Resource Thread

Postby ramana » 24 Mar 2020 13:30

India is largest producer of chloroquine. Its 130 rupees a blister pack. But dont use with out doctor prescription.

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Re: Wuhan Coronavirus Resource Thread

Postby kvraghav » 24 Mar 2020 13:40

Looks like India is already facing a shortage for this and trying to limit exports. This is where US is using the Aid and friendship diplomacy.

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Re: Wuhan Coronavirus Resource Thread

Postby chola » 24 Mar 2020 14:01

ramana wrote:India is largest producer of chloroquine. Its 130 rupees a blister pack. But dont use with out doctor prescription.


Right, from what I read it is toxic so it can't be used as a preventative. But once you are infected this medication works.

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Re: Wuhan Coronavirus Resource Thread

Postby syam » 24 Mar 2020 14:13

It can be used as preventative. when you go to some malaria infected area, the doctor prescribes it to you. you have to use the full course. some weekly dose something. I am not doctor, so can't talk more than that. it will be damn useful for doctors and mild cases at least.
Last edited by syam on 24 Mar 2020 14:17, edited 1 time in total.

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Re: Wuhan Coronavirus Resource Thread

Postby milindc » 24 Mar 2020 14:16

chola wrote:
ramana wrote:India is largest producer of chloroquine. Its 130 rupees a blister pack. But dont use with out doctor prescription.


Right, from what I read it is toxic so it can't be used as a preventative. But once you are infected this medication works.


My BIL and sister are dermatologists. They prescribe this thing for Lupus related indications. They are saying it is one of the safe drugs and they regularly prescribe this drug in India. These patients take the hydroxychloroquine for long-term.

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Re: Wuhan Coronavirus Resource Thread

Postby anmol » 24 Mar 2020 14:41

This Coronavirus Patient Dodged A Bullet With Hydroxychloroquine. Is She A Harbinger Or Outlier? | forbes.com

EDITORS' PICK|361,669 views|Mar 22, 2020,01:43pm EDT

I am a fire-in-the-belly country journalist who found a scandal in my backyard and wrote a book on it. Government and medicine have systematically failed us on a spreading plague of ticks. And they know it.

Margaret Novins talked to me on her cellphone from a hospital bed at CentraState Medical Center in Freehold, N.J.

She had been ill since March 8, toughing it out through fatigue, a cough and fevers that brought on vicious chills for five evenings straight.

Finally, on March 15, she went to an urgent care center and, on March 16, to an emergency room. The attending there called it “conversational dyspnea.”

“I couldn’t breathe,” she said.

Novins, who shared her lab tests and medication list, got her diagnosis March 19. Next to the entry for SARS-CoV-2 were the words “Detected Critical.” She had the coronavirus, or COVID-19.To that point, Novins had been a pneumonia patient for three days, treated mainly with antibiotics. But within an hour, a new drug was added to her med list: hydroxychloroquine, a decades-old malaria-turned-autoimmune drug, also called by its brand name Plaquenil. President Trump is touting the drug, some say overselling it, as the possible answer to the COVID-19 crisis.

Novins’ responded to the treatment. She was better, though surely not well, the next day.“The fever,” which was still spiking when she was on other meds, “is now gone, which is fantastic,” she said on Saturday March 21, coughing at times but able to speak.A 53-year-old nurse who described herself as a nonsmoker with no medical issues, Novins spoke to me from the hospital that had cared for some of the seven members of a family ravaged by COVID; two adult brothers, a sister and their mother died from the infection.

“The doctor insisted the pharmacy get it to me the minute we got the positive,” she said of hydroxychloroquine. “It seemed like their go-to right away.”ImageAfter three nights in the hospital, Margaret Novins' COVID test came back positive: "Detected ... [+]PROVIDED BY MARGARET NOVINS

There are other anecdotal successes like Novins’, including one in which end-of-life discussions for an older parent had been broached — until Plaquenil apparently kicked in. In that case, the family had to plead for, rather than being offered, the drug. 

Anecdotes are surely not science, which for now is limited and new.Trump is basing his optimism mostly on one small study from Marseilles, France, that, combined with laboratory findings, has prompted ongoing trials in France and the United States. The just-released French study reported that 70 percent of hydroxychloroquine-treated patients, or 14 of 20, were negative for the virus at day 6, as were all six patients who were treated with hydroxychloroquine and the antibiotic azithromycin (which Novins also received). But the study was small – 20 treated patients and 16 controls – and had other serious limitations.

Of concern, six patients dropped out and were not considered in the reported efficacy rates. Three went to intensive care; one died; one left the hospital testing negative, and one opted out due to nausea.Two scientists at major university centers reviewed the French trial for me. They agreed, separately, that while the study is preliminary, small, and not without flaws, its findings were strong enough, given the drugs’ known safety records, to guide treatment decisions in a crisis.  “Despite the limitations of this study, in the absence of any effective treatment, in this urgent situation, this Plaquenil and Azithromycin combination therapy should be given to patients with COVID-19 as a treatment option,” Ying Zhang, a professor of microbiology at Johns Hopkins Bloomberg School of Public Health, wrote in an email. “For now, there is no time to wait.”

Working against the study, in Zhang’s view: It was not a randomized trial, which would avoid bias; the sample size was small, and the treatment and followup duration was too short. The findings are nonetheless “potentially interesting and justified,” he wrote. Brian Fallon, a research scientistand clinical trials investigator at the Columbia University Irving Medical Center, agreed on the study’s overall merit despite the patients who dropped out. After analyzing the data and counting all six dropouts as treatment failures, he said the overall rate of improvement was still statistically significant for the entire group, though not for the hydroxychloroquine group alone. He too had reservations, in particular that the combination therapy group was very small, six patients, and that high doses of the two drugs together carry “serious risk of cardiac arrhythmias.” Physicians must be warned of this, he suggested.  

Nonetheless, he wrote in an email, “Given the life and death situation of hospitalized patients with COVID-19 and the possibility that hydroxychloroquine plus azithromycin may be helpful, it was valuable and ethical for the authors to report these promising, preliminary results.” Others agreed. Lorraine Johnson, who has published on the use of collected data to improve health care outcomes, said, “It is important right now to take the gloves off clinicians and give them access to all available tools; patients are dying and can’t wait for clinical trials.”At the same time, she and Zhang, who has published on treatments for difficult infections like tuberculosis and Lyme disease, said a database should be set up to track patients, like Margaret Novins, in order to document drug performance. “I would recommend real-time online posting of treatment evaluation results of the Plaquenil+Azithromycin at multi-center sites across the US and the Globe,” Zhang wrote. “Someone has to coordinate this online registry and resources.” He added that other treatments should be included.

Supply issues raised

In a 1982 drug bulletin, the FDA encouraged so-called off-label use of approved drugs: “Valid new uses for drugs already on the market are often first discovered through serendipitous observations and therapeutic innovations, subsequently confirmed by well-planned and executed clinical investigations.” 

In the real world, however, a rush to put a relatively safe approved drug to a vastly expanded new use may reduce supplies for others who need it, including lupus, rheumatoid arthritis and Lyme disease sufferers.

Kenneth Farber, president of the Lupus Research Alliance, said there were shortages of Plaquenil throughout the United States and especially in New York and California. 

Asked about supplies, a spokesperson for CVS Health, T.J. Crawford, said the drug-store chain has an “adequate supply on-hand” of hydroxychloroquine but supply of a related drug, chloroquine, “is tight across the marketplace.”

Jane Marke, a New York City psychiatrist who takes Plaquenil for Lyme disease, said she had trouble getting her prescription filled at several city chains. After reading the French study, she understands why. “It is really possible that this is a major breakthrough,” she said, envisioning a time when a good test could pick up early infections and the drug would stop the epidemic in its tracks.In that vein, the University of Minnesota is organizing a trial to treat 1,500 people with hydroxychloroquine who were exposed to the virus from infected family members or as healthcare workers but are not yet ill. The study relied on laboratory experiments in China that found hydroxychloroquine inhibited the infection. “If effective, this may become a worldwide standard of care for helping prevent disease in other healthcare workers and people exposed,” Dr. David Boulware, a U of M professor of medicine, said in announcing the study.

A key advantage of an off-patent generic drug like hydroxychloroquine: “A five-day treatment course would cost approximately $12,” Boulware said.

Novins, meantime, is expecting to leave the hospital in a day or two. As a nurse for a medical equipment company, she believes she contracted the infection not from a patient but while conducting a day-long training session.

Nonetheless, she said in a text, “I feel fortunate.”

“From my notes it is clear that my fevers and horrible chills I fought hard from 3/8-3/18 turned the corner the day I started Plaquenil 3/19,” she wrote.

While she said COVID is a “violent illness,” Novins never was in intensive care or on a respirator. The French study offers a mere glint of hope for more serious cases too. Of five patients with lower respiratory infection, four turned negative by day 6, three of them on both drugs.

In the meantime, scientists said larger, more rigorous studies must be launched to answer questions of efficacy, dosing, duration, and potential adverse drug interactions — for this and other COVID treatments.  

chola
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Re: Wuhan Coronavirus Resource Thread

Postby chola » 24 Mar 2020 14:45

syam wrote:It can be used as preventative. when you go to some malaria infected area, the doctor prescribes it to you. you have to use the full course. some weekly dose something. I am not doctor, so can't talk more than that. it will be damn useful for doctors and mild cases at least.


milindc wrote:
chola wrote:
Right, from what I read it is toxic so it can't be used as a preventative. But once you are infected this medication works.


My BIL and sister are dermatologists. They prescribe this thing for Lupus related indications. They are saying it is one of the safe drugs and they regularly prescribe this drug in India. These patients take the hydroxychloroquine for long-term.


Thanks for correcting me on that! I definitely don't want to pass on bad information in times like this.

Sounds like something can be given safely to a large number of people? Do we have enough of it and would it affect people needing the drug for other things if we use it as a preventative?

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Re: Wuhan Coronavirus Resource Thread

Postby syam » 24 Mar 2020 14:55

it's something like,

1 million+ passive cases ) 251,388 mild cases ) 12,079 critical cases ) 16,578 deaths

So if we can give the drug to those 251,388 cases , they won't make it to the next level. by doing that they reduce the stress on icu wards and ventilates.

Also the drug can protect the doctors while treating the patients.

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Re: Wuhan Coronavirus Resource Thread

Postby chetak » 24 Mar 2020 14:57

milindc wrote:
chola wrote:
Right, from what I read it is toxic so it can't be used as a preventative. But once you are infected this medication works.


My BIL and sister are dermatologists. They prescribe this thing for Lupus related indications. They are saying it is one of the safe drugs and they regularly prescribe this drug in India. These patients take the hydroxychloroquine for long-term.


unless you have trusted medical advice do not take this drug, and also, most importantly, do not self medicate.

chloroquine is poisonous in large doses and usually fatal.

laypersons have no idea as to what constitutes a "large dose".


Nigeria reported two cases of chloroquine poisoning after U.S. President Donald Trump praised the anti-malaria drug as a treatment for the novel coronavirus.


trump is no medical authority. Trusted medical advice is your best bet.

Trump said Thursday that chloroquine and its less-toxic cousin hydroxychloroquine had shown “tremendous promise” to treat the new illness.
Last edited by chetak on 24 Mar 2020 15:03, edited 1 time in total.

chola
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Re: Wuhan Coronavirus Resource Thread

Postby chola » 24 Mar 2020 15:02

syam wrote:it's something like,

1 million+ passive cases ) 251,388 mild cases ) 12,079 critical cases ) 16,578 deaths

So if we can give the drug to those 251,388 cases , they won't make it to the next level. by doing that they reduce the stress on icu wards and ventilates.

Also the drug can protect the doctors while treating the patients.


Exactly. This would ease the pressure on the front line considerably.

The reason I thought the drug was toxic comes from this:
https://moneymaven.io/mishtalk/economics/chloroquine-poisoning-and-deaths-but-hey-it-works-7xxAPyTT5Ue-M81x-fCyaQ

Apparently there were chloroquine-related deaths in Nigeria. Overdoses according to the report. Also prices for the drug had gone up 400% with detrimental effect for those needing to be on it long term.

(Edited: Thanks Chetak for your posting on dangers.)

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Re: Wuhan Coronavirus Resource Thread

Postby milindc » 24 Mar 2020 15:10

chetak wrote:
milindc wrote:
My BIL and sister are dermatologists. They prescribe this thing for Lupus related indications. They are saying it is one of the safe drugs and they regularly prescribe this drug in India. These patients take the hydroxychloroquine for long-term.


unless you have trusted medical advice do not take this drug, and also, most importantly, do not self medicate.

chloroquine is poisonous in large doses and usually fatal.

laypersons have no idea as to what constitutes a "large dose".


Nigeria reported two cases of chloroquine poisoning after U.S. President Donald Trump praised the anti-malaria drug as a treatment for the novel coronavirus.


trump is no medical authority. Trusted medical advice is your best bet.

Trump said Thursday that chloroquine and its less-toxic cousin hydroxychloroquine had shown “tremendous promise” to treat the new illness.


I don't know what is trusted advice. These are renowned dermatologists using this drug in regular practice and in fact stock it in their pharmacy. They have been giving this long term to treat Lupus related skin conditions. Of course, one needs to consult the doctor before starting any medication but that it is poisonous is stretching it considering there is decades of evidence available.

Given our healthcare facilities in India, I don't think we have the luxury of double blinded control study to validate the efficacy of this drug before prescription. Of course it might give false hope to patients but there is nothing else available. The standard protocol treatment will continue regardless.

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Re: Wuhan Coronavirus Resource Thread

Postby nam » 24 Mar 2020 15:14

Although I agree people should not self-medicate, Nigeria would not be a good place to consider the results. Nigeria has a huge problem of fake drugs.

Chinis, who else, selling fake drugs, sometimes labelled as Indian made.

If tests see hope that early stage of infection can be contained, then it will be tremendous boost in preventing hospitalization.

Regarding the drug, we are probably the largest producers. Malaria is major issue in southern regions, which receive heavy rainfall.

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Re: Wuhan Coronavirus Resource Thread

Postby syam » 24 Mar 2020 15:19

chola wrote:Exactly. This would ease the pressure on the front line considerably.

The reason I thought the drug was toxic comes from this:
https://moneymaven.io/mishtalk/economics/chloroquine-poisoning-and-deaths-but-hey-it-works-7xxAPyTT5Ue-M81x-fCyaQ

Apparently there were chloroquine-related deaths in Nigeria. Overdoses according to the report. Also prices for the drug had gone up 400% with detrimental effect for those needing to be on it long term.

(Edited: Thanks Chetak for your posting on dangers.)

Never trust those media crooks. Even paracetamol can be toxic, if you take 20 of them in one go. Pharma medicines are not safe in any given circumstances.

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Re: Wuhan Coronavirus Resource Thread

Postby kvraghav » 24 Mar 2020 15:36

If we look at the Chinese daily cases graph, there was a three fold increase to around 14K cases on Feb 12 and from then on, the cases started reducing. This was as sudden spike and then it started going down.

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Re: Wuhan Coronavirus Resource Thread

Postby pankajs » 24 Mar 2020 15:38

https://twitter.com/RemaNagarajan/statu ... 8991304705
Rema Nagarajan @RemaNagarajan

Here is list of covid-19 test kits evaluated by ICMR-NIV
Two approved (Altona & MY LAB) out of 9
Altona a Singapore company and MY LAB in Pune
ICMR says these kits can be used in govt & pvt labs
One hitch-Altona unable to supply right away, MY LAB too needs time to start supply
Image

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Re: Wuhan Coronavirus Resource Thread

Postby Haresh » 24 Mar 2020 15:57

Meanwhile in blighty.............
never miss an opportunity to blame India!!!!

https://www.dailymail.co.uk/news/articl ... r-comments

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Re: Wuhan Coronavirus Resource Thread

Postby SriKumar » 24 Mar 2020 16:36

Just as a single datum point ..... I've had malaria a couple of times in the past, and was prescribed chloroquine- don't recall exact name (or whatever version was sold in the local medical store). Once or twice the diagnosis was not even confirmed by a blood test (was based on just visible symptoms). I hear plasmodium germ is difficult to detect? I made a fine recovery in all cases. No issues with side-effects or toxicity for me anyway. At that time I got the impression prescribing that was 'not a big deal', unlike say cancer drugs which are infamously toxic.
Last edited by SriKumar on 24 Mar 2020 16:42, edited 1 time in total.

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Re: Wuhan Coronavirus Resource Thread

Postby chetak » 24 Mar 2020 16:42

milindc wrote:
chetak wrote:
unless you have trusted medical advice do not take this drug, and also, most importantly, do not self medicate.

chloroquine is poisonous in large doses and usually fatal.

laypersons have no idea as to what constitutes a "large dose".




trump is no medical authority. Trusted medical advice is your best bet.



I don't know what is trusted advice. These are renowned dermatologists using this drug in regular practice and in fact stock it in their pharmacy. They have been giving this long term to treat Lupus related skin conditions. Of course, one needs to consult the doctor before starting any medication but that it is poisonous is stretching it considering there is decades of evidence available.

Given our healthcare facilities in India, I don't think we have the luxury of double blinded control study to validate the efficacy of this drug before prescription. Of course it might give false hope to patients but there is nothing else available. The standard protocol treatment will continue regardless.



there is also decades of evidence available to conclude that these drugs can be poisonous in the wrong hands and especially if self medicated.

One can have Vitamin A poisoning if one doesn't know what one is doing.

In India, we have our own professional bodies who put out national guidelines. and they do it very quickly and it is tailored to local Indian conditions. This works best for us. Even some vaccine strains are made available in different parts of India at specific times depending on which strain of the virus etc is dominant at the time.

for instance, vaccination protocols in India and the US are not the same.

you will not find any Indian doctor following US protocols or vice versa.

the US don't use all the vaccines that is mandated in India and some of their time lines are different too.

Private sector uses more vaccines in India than are generally given in public hospitals because of the cost and affordability factor. As usual, the rich are better protected.

Since when did dermatologists become specialists of choice to treat the chinese virus. Pulmonologists would be the wiser option.

trusted medical advice means exactly what it says.

Go to the right qualified medical professional as and when recommended by your family doctor after a proper referral.

For me specifically, I would never blindly follow some trumped up protocol (pun intended) or USFDA inputs unless some Indian guidelines were prescribed.

I have attended many hundreds (yes many hundreds ) of medical seminars, CMEs because I am the driver of choice for many of my doctor relatives for these late evening events. Over the years, and by sheer osmosis some few things have percolated into my brain

I see how these guidelines are debated, discussed and adapted and implemented by top and learned professionals as always influenced by local practices and conditions.

Many of the speakers are goras who are at great pains to extrapolate their research findings to consider Indian socio economic and public, private infrastructure conditions and seasonal and regional variations.

Cost of vaccines are a great factor here and not so much in developed countries. So if the corona vaccine turns out to be expensive then it may not be widely availed by the general population here and the GoI simply may not be able to afford it in public hospitals.
Last edited by chetak on 24 Mar 2020 16:53, edited 1 time in total.

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Re: Wuhan Coronavirus Resource Thread

Postby g.sarkar » 24 Mar 2020 16:50

Haresh wrote:Meanwhile in blighty.............
never miss an opportunity to blame India!!!!
https://www.dailymail.co.uk/news/articl ... r-comments

If it were 1920, the viceroy, with the stroke of his pen, would have simply banned the use of paracetamol on Indians and earmarked it for 100% export to UK. What a difference time makes.
Gautam

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Re: Wuhan Coronavirus Resource Thread

Postby Mukesh.Kumar » 24 Mar 2020 16:53

SriKumar wrote:Just as a single datum point ..... I've had malaria a couple of times in the past, and was prescribed chloroquine- don't recall exact name (or whatever version was sold in the local medical store). Once or twice the diagnosis was not even confirmed by a blood test (was based on just visible symptoms). I hear plasmodium germ is difficult to detect? I made a fine recovery in all cases. No issues with side-effects or toxicity for me anyway. At that time I got the impression prescribing that was 'not a big deal', unlike say cancer drugs which are infamously toxic.


CHLOROQUININE WITHOUT DOCTOR PRESCRIPTION IS POTENTIALLY DEADLY. Ask your doctor first

Trust me on this. My parents were doctors and both worked in Tropical medicine. Growing up in childhood in Calcutta we used to get malaria every year. Even with a 104 fever my parents always insisted on blood test before they prescribed because the side effects of giving chloroquinine without malaria is deadly.

In university I saw this first hand where a quack misdiagnosed malaria and almost killed my batch mate. I have also seen an Italian friend go bat shit crazy on preventive anti malaria therapy. He had to be hospitalized. Be careful

Please check with your doctor first

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Re: Wuhan Coronavirus Resource Thread

Postby g.sarkar » 24 Mar 2020 16:56

SriKumar wrote:Just as a single datum point ..... I've had malaria a couple of times in the past, and was prescribed chloroquine- don't recall exact name (or whatever version was sold in the local medical store). Once or twice the diagnosis was not even confirmed by a blood test (was based on just visible symptoms). I hear plasmodium germ is difficult to detect? I made a fine recovery in all cases. No issues with side-effects or toxicity for me anyway. At that time I got the impression prescribing that was 'not a big deal', unlike say cancer drugs which are infamously toxic.

Like you I have been prescribed chloroquine many times during the 70s, for malaria. Each time I recovered, the only side effect was weakness, which is common for malaria. No one told me it was toxic, though all medicines can become toxic if not used properly.
Gautam

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Re: Wuhan Coronavirus Resource Thread

Postby sajo » 24 Mar 2020 17:06

Not sure if this has been shared before. This needs to go viral. A brave attempt by WION news.

http://youtu.be/kN08StvCWgU

Traffic seems sparse, but not disappeared completely like it did on Sunday, for most internal roads in Pune. I can see this myself from my window, and reports by friends and colleagues.

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Re: Wuhan Coronavirus Resource Thread

Postby Primus » 24 Mar 2020 17:15

ramana wrote:
One of our members posted a gif on how isolation dramatically reduces the propagation.

My hats of to him for it. I Will post it once I find it.

----

https://twitter.com/pd_8888/status/1241 ... 36608?s=20


I downloaded the original gif from the New Zealand site, here it is for easy download and forwarding. This is truly the simplest yet most powerful graphic I've seen so far.

Image

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Re: Wuhan Coronavirus Resource Thread

Postby milindc » 24 Mar 2020 17:20

chetak wrote:
milindc wrote:
I don't know what is trusted advice. These are renowned dermatologists using this drug in regular practice and in fact stock it in their pharmacy. They have been giving this long term to treat Lupus related skin conditions. Of course, one needs to consult the doctor before starting any medication but that it is poisonous is stretching it considering there is decades of evidence available.

Given our healthcare facilities in India, I don't think we have the luxury of double blinded control study to validate the efficacy of this drug before prescription. Of course it might give false hope to patients but there is nothing else available. The standard protocol treatment will continue regardless.



there is also decades of evidence available to conclude that these drugs can be poisonous in the wrong hands and especially if self medicated.

One can have Vitamin A poisoning if one doesn't know what one is doing.


Sorry..no offence but I do trust MDs who practice and see 100s of patients each day than some random gibberish of how drugs are poisons without any facts to back up the claim. The thing is that we are once in a century event and any protocol showing significance is considered.
Another data point for others on the forum. My wife's brother and his wife are NHS consultants who manage large wards. One in ITU specialist and another is Cardiac, both have been asked to only prepare for covid patients. Both currently are Ok with using hydroxychloroquine + azithromycin for India. They are also Ok with using hydroxychloroquine as prophylactic.
Of course take it for its worth.

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Re: Wuhan Coronavirus Resource Thread

Postby syam » 24 Mar 2020 17:25

These are side effects of the drug as per webmd,

Blurred vision, nausea, vomiting, abdominal cramps, headache, and diarrhea may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

~ read rest on their website.


Also from cdc website:
Who can take chloroquine?

Chloroquine can be prescribed to adults and children of all ages. It can also be safely taken by pregnant women and nursing mothers.

Who should not take chloroquine?

People with psoriasis should not take chloroquine.

How should I take chloroquine?

Both adults and children should take one dose of chloroquine per week starting at least 1 week before traveling to the area where malaria transmission occurs. They should take one dose per week while there, and for 4 consecutive weeks after leaving.

What are the potential side effects of chloroquine?

Chloroquine is a relatively well-tolerated medicine. The most common adverse reactions reported are stomach pain, nausea, vomiting, and headache. These side effects can often be lessened by taking chloroquine with food. Chloroquine may also cause itching in some people.All medicines may have some side effects. Minor side effects such as nausea, occasional vomiting, or diarrhea usually do not require stopping the antimalarial drug. If you cannot tolerate your antimalarial drug, see your health care provider; other antimalarial drugs are available.

Other considerations

• Good choice for longer trips because you only have to take the medicine once per week.
• Overdose of antimalarial drugs, particularly chloroquine, can be fatal. Medication should be stored in childproof containers out of the reach of infants and children.


How long is it safe to use chloroquine?


CDC has no limits on the use of chloroquine for the prevention of malaria. When chloroquine is used at higher doses for many years, a rare eye condition called retinopathy has occurred. People who take chloroquine for more than five years should get regular eye exams.

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Re: Wuhan Coronavirus Resource Thread

Postby SriKumar » 24 Mar 2020 17:45

One thing is clear- Indian doctors and medical community at large have multiple decades (5+) of field experience prescribing chloroquine (probably the highest in the world, my opinion). The knowledge is institutional now. I think they will have an understanding of the limits and side effects and its applicability quite well, by now.

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Re: Wuhan Coronavirus Resource Thread

Postby DrRatnadip » 24 Mar 2020 17:56

Many doctors in India i know are taking HCQ prophylaxis.. I have taken it too.. Best way to avoid infection is staying at home.. But if you have accidently exposed to or have high chances of future exposure due to your profession then HCQ is reasonably safe drug.. I wont recommend it without doctor's prescription though..

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Re: Wuhan Coronavirus Resource Thread

Postby arvin » 24 Mar 2020 18:08

sajo wrote:Not sure if this has been shared before. This needs to go viral. A brave attempt by WION news.

http://youtu.be/kN08StvCWgU

.


Sanctions should start with stopping medical university studies in wuhan\china . There are 21000 indian students studying medicine in china.

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Re: Wuhan Coronavirus Resource Thread

Postby Primus » 24 Mar 2020 18:27

We've all used Chloroquine in India before we moved Westward. I agree, Indians probably have enough experience with the medication.

One thing people are forgetting is that it is given over a very short period, about five days, which is less than what we give routinely for common infections even. However, both chloroquine and azithromycin prolong the QT interval in the cardiac cycle. This predisposes a person to a fatal arrhythmia called Torsades de pointes (turning of the points) which is basically a form of ventricular tachycardia that is extremely unstable and rapidly deteriorates into ventricular fibrillation which is death.

If you are taking other medications that also prolong the QT intervals (common antibiotics like Cipro, anti-nausea meds like Zofran, cimetidine/famotidine, many anti-anxiety meds etc - the list is long), then the risk of TdP is very high. This is why one must not take these medications without discussing with a physician.

The only comfort factor is that the course of treatment is rather short.

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Re: Wuhan Coronavirus Resource Thread

Postby chola » 24 Mar 2020 18:31

Soooo. Do we hope they fail and get hit with a second wave of infections? Or do we hope that countries can restart their economies without getting clobbered again? Because if Cheen can't -- with their controls and a compliant population -- then it is probably twice as hard fir anyone else.

Their economy CONTRACTED by 9% which is probably what everyone will see with lockdowns.

https://www.cnn.com/2020/03/24/economy/china-economy-coronavirus/index.html


China is trying to revive its economy without risking more lives. The world is watching

Analysis by Laura He, CNN Business
Updated 7:10 AM ET, Tue March 24, 2020

Hong Kong (CNN Business)China is trying to jump-start its huge economy without triggering a second wave of coronavirus cases. It's a high-stakes experiment that could provide clues for countries agonizing over how long to keep their shutdowns in place as a global recession begins and millions of jobs are lost.

The country where the pandemic began was almost completely shut down in late January as the number of coronavirus cases mounted. The drastic measures appear to have brought the virus under control: Locally transmitted infections have plummeted, and a lockdown on most of Hubei province — ground zero of the pandemic — is being lifted this week.

But the lockdown also brought activity in much of the world's second biggest economy to a standstill for weeks on end, and is likely to result in China's first contraction in decades. Analysts at Goldman Sachs recently forecast that China's GDP may fall by 9% in the first quarter of the year, compared to the same period in 2019.


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Re: Wuhan Coronavirus Resource Thread

Postby Tanaji » 24 Mar 2020 18:41

Where is AmberG and the Yak herder? Miss their posts.

Hope they are alright...

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Re: Wuhan Coronavirus Resource Thread

Postby Uttam » 24 Mar 2020 19:55

The following news is from Czech Republic. It is in local language. I used Google translator.

Coronavirus rapid tests from China have an error rate of up to 80 percent

Rapid tests with coronavirus detection in the Moravian-Silesian Region will not help much. Their error rate is about 80 percent. They would probably be used mainly as verification tests for people in quarantine who have never been tested positively. After the Regional Crisis Staff meeting on Monday said regional hygienist Pavla Svrčinová.

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Re: Wuhan Coronavirus Resource Thread

Postby Kati » 24 Mar 2020 20:29

SriKumar wrote:Just as a single datum point ..... I've had malaria a couple of times in the past, and was prescribed chloroquine- don't recall exact name (or whatever version was sold in the local medical store). Once or twice the diagnosis was not even confirmed by a blood test (was based on just visible symptoms). I hear plasmodium germ is difficult to detect? I made a fine recovery in all cases. No issues with side-effects or toxicity for me anyway. At that time I got the impression prescribing that was 'not a big deal', unlike say cancer drugs which are infamously toxic.


The most common brand in Desh is LARIAGO.

People take it like they are taking "Jhaal-moori" (spicy puffed rice).
Pretty much every year, during the rainy season, we also take a course of Lariago (without waiting for the doc's advice) to prevent
any mosquito-borne nonsense. Yes, it does cause a little nausea, but never had any other problem after a full course (once a week, for four weeks).

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Re: Wuhan Coronavirus Resource Thread

Postby Zynda » 24 Mar 2020 20:39

Starting midnight, India is going in to a complete & total lockdown for 21 days...


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