SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

P-Ro said:
I read the BBC article about the remdesivir trial and what struck me is that they gave people the drug as well as a placebo. I know for testing purposes its vital that you have a percentage of people given a placebo but in these literally life and death scenarios it strikes me as a bit harsh that the ones who weren't given the drug had a higher mortality rate (albeit statistically not significant). I would assume that pretty much everyone who went on this trial actually wanted to be given this drug and I imagine it must be hard on the families of those who died having been given a placebo because if the deceased were given the option of being administered the drug they would have taken it.
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It has always been like that, there is no other choice.

Bear in mind that the drug might actually have detrimental effects, so it actually might make things worse (I think that hydroxychloroquine actually made things worse for some people, and eventually was put out of clinical studies in Sweden).
 
P-Ro said:
I read the BBC article about the remdesivir trial and what struck me is that they gave people the drug as well as a placebo. I know for testing purposes its vital that you have a percentage of people given a placebo but in these literally life and death scenarios it strikes me as a bit harsh that the ones who weren't given the drug had a higher mortality rate (albeit statistically not significant). I would assume that pretty much everyone who went on this trial actually wanted to be given this drug and I imagine it must be hard on the families of those who died having been given a placebo because if the deceased were given the option of being administered the drug they would have taken it.
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The alternative is no trial. One that can't possibly have meaningful results is pointless and little more than rolling a drug out untested.
 
spiriticon said:
My comment was a joke, but regardless...

Sweden willingly let a large number of their country die as collaterals. I really have a big issue accepting that from any government. Yes, 2k+ deaths may not be a lot compared to the US/UK, but for Scandinavia it's a rather big number.

All the eggs are put in the 'long-term immunity' basket. This is unproven. If people get re-infected after a few months after having already had the virus, it really means you've thrown 2000 lives away to achieve nothing.

Eventually everyone will have to live with this virus, that's true. But its about caring for your population as much as it is keeping the economy afloat. Just because Joe Larsson is 70+ and not working anymore does not mean he has to be sacrificed.
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And you may need in excess of 80% infected (or vaccinated) before herd immunity is achieved so Sweden won't be anywhere near there yet. To get there it means lots more deaths or a vaccine. If a vaccine the avoidable deaths prior to that are for nothing.
 
Wibble said:
The alternative is no trial. One that can't possibly have meaningful results is pointless and little more than rolling a drug out untested.
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Perhaps I'm missing something but I don't follow the logic of administering a placebo when there is plenty of data of the death/survival rate of patients who haven't been administered the drug in the local area. I've never heard of drug companies administering placebos to cancer patients testing new experimental treatments, but you're implying this does happen? I always thought that the placebo was administered primarily on healthy human testers, rather than those suffering from the disease, to study the side effects of the new drugs.
 
P-Ro said:
Perhaps I'm missing something but I don't follow the logic of administering a placebo when there is plenty of data of the death/survival rate of patients who haven't been administered the drug in the local area. I've never heard of drug companies administering placebos to cancer patients testing new experimental treatments, but you're implying this does happen? I always thought that the placebo was administered primarily on healthy human testers, rather than those suffering from the disease, to study the side effects of the new drugs.
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Further to this. I just looked up placebos in cancer drug treatment and whilst it says they do administer placebos for some types of treatment testing, there is this caveat:
Furthermore, patients randomly assigned to a placebo must not be substantially more likely than those in active treatment group(s) to: die; suffer irreversible illness, disability, or other substantial harms; suffer reversible but serious harm; or suffer severe discomfort.
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P-Ro said:
Perhaps I'm missing something but I don't follow the logic of administering a placebo when there is plenty of data of the death/survival rate of patients who haven't been administered the drug in the local area. I've never heard of drug companies administering placebos to cancer patients testing new experimental treatments, but you're implying this does happen? I always thought that the placebo was administered primarily on healthy human testers, rather than those suffering from the disease, to study the side effects of the new drugs.
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Probably no placebo, but for sure they would administer some other medicament to the other people, and see the difference between the new treatment and the old one.

For covid-19, there is no treatment so the alternative is to give placebo treatment. Otherwise, there is no way on understanding if the treatment is doing anything or not (especially considering that 99% of patients survive without treatment, and the vast majority of them have only a mild disease). Just giving the treatment to everyone, you cannot get any conclusion at all, it would be literally impossible to know if the treatment is doing anything, or people just got better on their own. It would be 'anecdotal' evidence, a bit like what happened with hydroxychloroquine when a lot of people said that it saved their lives, but on clinical trials, so far it doesn't seem that it is doing anything, and more than likely those people just got better on their own (same as countless people who did not get any treatment).
 
P-Ro said:
Perhaps I'm missing something but I don't follow the logic of administering a placebo when there is plenty of data of the death/survival rate of patients who haven't been administered the drug in the local area. I've never heard of drug companies administering placebos to cancer patients testing new experimental treatments, but you're implying this does happen? I always thought that the placebo was administered primarily on healthy human testers, rather than those suffering from the disease, to study the side effects of the new drugs.
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I'm no expert but a placebo control group is standard practice I thought. You need to compare drug results with placebo results and no treatment results. If the results for the placebo and the real drug are the same but different from no treatment you know the drug isn't working. If you didn't do the placebo treatment you might think there was an effect when there wasn't. It will inform our understanding of side effects as well of course. I think you need to use a placebo control group to get regulatory approval in most countries.
 
Furthermore, patients randomly assigned to a placebo must not be substantially more likely than those in active treatment group(s) to: die; suffer irreversible illness, disability, or other substantial harms; suffer reversible but serious harm; or suffer severe discomfort.
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The drug could help, make no difference or do harm, so I don't think this is intended to stop placebo's being used as a control on the basis that the drug might have helped. My mate's wife runs drug trials for a Uni - I'll see if she knows what this means in practice.
 
Wibble said:
I'm no expert but a placebo control group is standard practice I thought. You need to compare drug results with placebo results and no treatment results. If the results for the placebo and the real drug are the same but different from no treatment you know the drug isn't working. If you didn't do the placebo treatment you might think there was an effect when there wasn't. It will inform our understanding of side effects as well of course. I think you need to use a placebo control group to get regulatory approval in most countries.
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Can that really happen? Shouldn't placebo and no treatment give the same results? I thought that placebo drug is given only to fool the patients so they thought that they got some drug, but instead they get nothing.
 
Revan said:
Can that really happen? Shouldn't placebo and no treatment give the same results? I thought that placebo drug is given only to fool the patients so they thought that they got some drug, but instead they get nothing.
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Not if there is a placebo effect. And yes to your second sentence - to test if there is a placebo effect.
 
Revan said:
But does that really happen often? I thought it is more a legend than a real thing.
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I think it looks placebo is actually a myth except when it involves something the mind can influence e.g. mood or pain but not a virus or cancer

That said I think it still has to be considered because it is not always clear when the mind is involved and regulations also change slowly.
 
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Another embarassment for WHO, who posted Chinese draft on failure of Remdesivir.

Although it's not a cure but it certainly a step in that direction.
 
pratyush_utd said:
Another embarassment for WHO, who posted Chinese draft on failure of Remdesivir.

Although it's not a cure but it certainly a step in that direction.
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Why is publishing their findings embarrassing? The limitations of the study was also published.
 
Wibble said:
Why is publishing their findings embarrassing? The limitations of the study was also published.
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I would imagine for an organization of WHO stature should know that initial draft which isn't peer reviewed should not be published on its main site. It's not a gossip site. It's official WHO website.

It's like how you don't tweet initial findings of Chinese government without checking first that human to human transmission was not likely.
 
pratyush_utd said:
I would imagine for an organization of WHO stature should know that initial draft which isn't peer reviewed should not be published on its main site. It's not a gossip site. It's official WHO website.

It's like how you don't tweet initial findings of Chinese government without checking first that human to human transmission was not likely.
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The reports from the US aren't peer reviewed. Things are evolving too fast to say nothing until peer reviewed journal publication.
 
pratyush_utd said:
I would imagine for an organization of WHO stature should know that initial draft which isn't peer reviewed should not be published on its main site. It's not a gossip site. It's official WHO website.

It's like how you don't tweet initial findings of Chinese government without checking first that human to human transmission was not likely.
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The current study is not peer-reviewed too. For most part, peer-reviewed means that a few folks thought that the research is alright, but it hardly makes it bullet proof.
 
P-Ro said:
I read the BBC article about the remdesivir trial and what struck me is that they gave people the drug as well as a placebo. I know for testing purposes its vital that you have a percentage of people given a placebo but in these literally life and death scenarios it strikes me as a bit harsh that the ones who weren't given the drug had a higher mortality rate (albeit statistically not significant). I would assume that pretty much everyone who went on this trial actually wanted to be given this drug and I imagine it must be hard on the families of those who died having been given a placebo because if the deceased were given the option of being administered the drug they would have taken it.
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It's the chance you take when you consent to take part in the RCT. Sometimes the people given the proposed treatment drug will suffer ill-effects from it, of course - in which case it's better to have been in the placebo group.
 
redshaw said:


With news coming out of Switzerland of kids don't spread the virus and grandparents can hug their grandchildren it could be important to read this and wait for more information.
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To be honest they don't really have a lot of observations in those two lowest age groups.
 
Wibble said:
The reports from the US aren't peer reviewed. Things are evolving too fast to say nothing until peer reviewed journal publication.
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The difference is Fauci explains why he is making it public. Says it's ethical to explain to other members of group who are on placebo that the other drug works and they have the right to switch.

WHO posted a botched up trial report which wasn't peer reviewed. Some would argue it was motivated report created by a country who is at information warfare with the world right now. To use that report and publish on their website is extremely unprofessional.
 
P-Ro said:
I read the BBC article about the remdesivir trial and what struck me is that they gave people the drug as well as a placebo. I know for testing purposes its vital that you have a percentage of people given a placebo but in these literally life and death scenarios it strikes me as a bit harsh that the ones who weren't given the drug had a higher mortality rate (albeit statistically not significant). I would assume that pretty much everyone who went on this trial actually wanted to be given this drug and I imagine it must be hard on the families of those who died having been given a placebo because if the deceased were given the option of being administered the drug they would have taken it.
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When they started the trial there was no evidence that the drug would help. It might even cause harm.

That is why they set up an independent panel of experts (the DSMB) to constantly monitor safety and efficacy to stop the trial early if patients on the drug were being harmed or on placebo were missing out on benefit.

The DSMB stopped this study early to allow placebo patients switch to drug, when they realised there was a clear benefit.
 
pratyush_utd said:
I would imagine for an organization of WHO stature should know that initial draft which isn't peer reviewed should not be published on its main site. It's not a gossip site. It's official WHO website.

It's like how you don't tweet initial findings of Chinese government without checking first that human to human transmission was not likely.
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Their aim is to publicise developments not endorse findings. I'm not sure why you think they'd need to check the latter point when it was just a statement of fact. Their wasn't evidence at that point as monitoring was ongoing.
 
pratyush_utd said:
The difference is Fauci explains why he is making it public. Says it's ethical to explain to other members of group who are on placebo that the other drug works and they have the right to switch.

WHO posted a botched up trial report which wasn't peer reviewed. Some would argue it was motivated report created by a country who is at information warfare with the world right now. To use that report and publish on their website is extremely unprofessional.
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That’s not a reason to go to the press.

That said, when a DSMB stops a big, important study early pharma companies will often issue a press release. As it’s important information for financial markets.
 
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Smores said:
Their aim is to publicise developments not endorse findings. I'm not sure why you think they'd need to check the latter point when it was just a statement of fact. Their wasn't evidence at that point as monitoring was ongoing.
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WHO didnt need to put out that development without fact checking. Initial developments should not be publicized by WHO. That could have easily come out of Chinese government and WHO should have waited for its own independent inquiry before making it public. Atleast that's what i expect from WHO.
 
https://www.power987.co.za/news/western-cape-expects-80-000-covid-19-cases-per-week-by-august/

Seems our peaks are far from being reached - July and August being currently envisaged for us (Cape Town), based on their modelling.

The developing world is going to suffer. We've done so well, doing a stringent lockdown very early because of our "unique" society. Truth be told, we don't have the economy that is strong enough to sustain any form of lockdown, so we're having to open up a bit now (after 5 weeks of one of the strictest lockdowns around the world). Now the virus has started spreading through the townships (informal settlement) and there the people just physically cannot self isolate. (imagine families or homes, no bigger than your kitchen, housing 4-7 individuals and they are stacked one on top of the other).

Then we have the issue of aids and TB within the population as well. It's a pity, really. Because we've acted early and we acted swiftly, but there's just no way we had the resources to get ahead of it for a sustained period.

Hope for the best but prepare for the worst I guess.
@kouroux @Shakesey
 
We're down the rabbit hole with BBC News having a live news feed page exclusively on Cpt Tom Moore's 100-year birthday. It's getting more coverage than any scrutiny of the government, on the day when they are going to have a swing and a massive miss at their very public testing target.
 
pratyush_utd said:
WHO didnt need to put out that development without fact checking. Initial developments should not be publicized by WHO. That could have easily come out of Chinese government and WHO should have waited for its own independent inquiry before making it public. Atleast that's what i expect from WHO.
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Your expectations don't mean anything to be fair but fact check what exactly?

I assume you're referring to the above tweet which is completely factual. It doesn't say there's no human to human transmission or that it won't occur it's merely highlighting evidence at that date.

Let's go down that rabbit hole though, who do you think was failed this by tweet?
 
Pogue Mahone said:
When they started the trial there was no evidence that the drug would help. It might even cause harm.

That is why they set up an independent panel of experts (the DSMB) to constantly monitor safety and efficacy to stop the trial early if patients on the drug were being harmed or on placebo were missing out on benefit.

The DSMB stopped this study early to allow placebo patients switch to drug, when they realised there was a clear benefit.
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I do understand that the evidence of the drug's effectiveness was sketchy and anecdotal but nonetheless I'm still unsure of the reason for a placebo to be administered in the first place. I'm struggling to see how the placebo effect could have any influence on the immune system's response to a novel virus. In my mind it's the same as comparing the mortality rate of those who received remdesivir with those who have gone to a witch doctor to be cured. The drug's effectiveness is based on mortality and not on anything that a placebo should have any effect on. It was said by @Revan earlier that the results would be anecdotal if the placebo wasn't administered, but it can't be just anecdotal if you've got a large set of data from those who have survived/died having not taken remdesivir but who have received the same type of care as the others in the trial, minus the drugs. I'm clearly no medical professional so I'll happily be explained the reasoning behind it.
 
Smores said:


Your expectations don't mean anything to be fair but fact check what exactly?

I assume you're referring to the above tweet which is completely factual. It doesn't say there's no human to human transmission or that it won't occur it's merely highlighting evidence at that date.

Let's go down that rabbit hole though, who do you think was failed this by tweet?
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But evidence was already there as late as December 2019. There is nothing factual in that tweet even at that time. Not sure how much WHO knew at that time but i was merely pointing out that reporting Chinese authority findings is not WHO job. Same case in aborted trial report. Not sure why you are so touchy about WHO criticism.
 
sport2793 said:
Na it's definitely real. Shows how funny human psychology can be.
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Shakesey said:
The power of placebo is unimaginable. It consistently proves the power of the mind, which should never be underestimated.
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Wouldn't this support the views of those out-there hippy/new age types who believe in curing certain illnesses through the power of positive thought and your diet? I mean, if people get better because they believe they are getting better, it baffles me why nobody gives these new age types anything but scorn when they claim to be able to defeat illness without anything else.

Obviously not talking about stuff as serious as covid19, but isn't it quite interesting that so much scorn is thrown at these people? It's almost as though it would be financially damaging to big pharmaceutical companies if it was common knowledge that their drugs weren't needed for certain ailments......



TMDaines said:
We're down the rabbit hole with BBC News having a live news feed page exclusively on Cpt Tom Moore's 100-year birthday. It's getting more coverage than any scrutiny of the government, on the day when they are going to have a swing and a massive miss at their very public testing target.
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I keep saying, we are living in an episode of Brasseye and the majority of the population are happy to be starring in it.
 
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