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Nzoner's Game Room>***NON-POLITICAL COVID-19 Discussion Thread***
JakeF 10:28 PM 02-26-2020
A couple of reminders...

Originally Posted by Bwana:
Once again, don't come in this thread with some kind of political agenda, or you will be shown the door. If you want to go that route, there is a thread about this in DC.
Originally Posted by Dartgod:
People, there is a lot of good information in this thread, let's try to keep the petty bickering to a minimum.

We all have varying opinions about the impact of this, the numbers, etc. We will all never agree with each other. But we can all keep it civil.

Thanks!

Click here for the original OP:

Spoiler!

[Reply]
SAUTO 06:15 PM 04-16-2020
Originally Posted by Megatron96:
Uh, you should let an actual doctor do that. Definitely not a DIY type of thing.
I think he is
[Reply]
BigRedChief 06:17 PM 04-16-2020
Originally Posted by dirk digler:
Ready to give to mass population. Biggest obstacle will be massive production. He said they are working on that as well. Seems very promising.
Bill Gates says he is already setting up 6 factories to help manufacture whatever vaccine gets to market and approval.
[Reply]
eDave 06:18 PM 04-16-2020
Originally Posted by BigRedChief:
Bill Gates says he is already setting up 6 factories to help manufacture whatever vaccine gets to market and approval.
Way to go man. Here come the crazy people.
[Reply]
TLO 06:23 PM 04-16-2020
Originally Posted by BigRedChief:
Bill Gates says he is already setting up 6 factories to help manufacture whatever vaccine gets to market and approval.
Yep.

Maybe he can set up some factories to pump out Remdesivir too.
[Reply]
notorious 06:23 PM 04-16-2020
Originally Posted by BigRedChief:
Bill Gates says he is already setting up 6 factories to help manufacture whatever vaccine gets to market and approval.
Not to get political, but set those factories up in the US please.
[Reply]
TLO 06:25 PM 04-16-2020
Just get the vaccine right please.. I want one as quickly as possible too, but it has to be proven to work, and it has to be safe
[Reply]
TLO 06:28 PM 04-16-2020
So the guys over at the IHME must have been doing cocaine and eating sugar because their fucking update still hasn't come out.
[Reply]
dirk digler 06:38 PM 04-16-2020
Originally Posted by TLO:
So the guys over at the IHME must have been doing cocaine and eating sugar because their ****ing update still hasn't come out.
He is on CNN now. Update will be published late tonight.
[Reply]
'Hamas' Jenkins 06:41 PM 04-16-2020
Originally Posted by 2112:
https://www.marketwatch.com/story/ra...ort-2020-04-16

Hamas, what do you know about This drug remdesivir? may be the real deal. Driving the Dow futures up
Here is my description of it from March 9, discussing potential therapies for COVID-19.

Originally Posted by 'Hamas' Jenkins:
Remdesivir is the most likely candidate to be used based upon its mechanism of action and demonstrated activity against coronaviruses. It has already been used in compassionate use situations (where one can get around normal clinical trial hurdles) in Washington and China.

The original antiviral nucleoside analogues were based around other nucleosides, like thymidine or cytosine. Remdisivir is based around adenosine, which makes it a novel agent.

Originally Posted by TLO:
I'd also like to ask if it's a drug that we might have a decent stockpile of? I believe I've read where it's not currently all that readily available.
No, but it is a small molecule drug, so scaling up production is far easier than a biologic. With that said, most of those factories are going to be in India and China.

Here is a post from about five weeks ago with a description of how the trials will work and how one might analyze its efficacy.

Originally Posted by 'Hamas' Jenkins:
You'd get increased rollout through compassionate exemptions fairly quickly, and broader approval in maybe 4-6 months, but that's a very rough guess based upon past history and other previously untreatable epidemics (AIDS). The closest analogue is probably AZT, which was approved in 1987, in record time (6 months). However, early doses were far too high and people who took it often suffered substantial side effects (cytopenias, mostly) from such large doses.

You'd need large urban or academic centers in most cases. Quick, accurate testing (without the substantially high false positive rates of the original tests), likely confirmed by CT, which appears to be the gold standard at this point.

Since there aren't other standards of care, you could treat against placebo, then see how patients did in comparison, but remember that in a disease with a small case fatality rate, marginal decreases would lead to statistically significant declines based upon how you interpret the data.

Here's an example: 1000 people get coronavirus and 970 live without remdisivir. 1000 people get coronavirus and 990 live with it. What's my relative risk reduction?

My event rate (death) is 3% in the control group and 1% in the experimental group. My absolute risk reduction is only 2%, but my relative risk reduction is (0.03-0.01)/(/0.03) is 66.7%, which means that I've reduced my risk of death by 2/3. Now, how many people do I need to treat to avoid 1 death? In that case, I take 1/absolute risk reduction, which is 1/(0.02), which is 50. Thus, for every 50 patients I treat with remdisivir, I prevent one excess fatality. That's pretty good from a pharmacoeconomic standpoint, but if you're treating millions of people, that's going to be a substantial financial outlay.
FWIW, remdesivir is a failed Ebola drug, but there is a fairly long history of failed agents being approved later for other indications. Two of the best examples are AZT (which I actually mentioned in a post above--it was developed at NIH in 1964 for cancer, shelved for 20+ years, then was the first anti-HIV therapy) and Viagra, which was originally indicated to treat pulmonary hypertension (and is still used for that in some cases).
[Reply]
TLO 04-16-2020, 06:50 PM
This message has been deleted by TLO. Reason: Actually I don't think that's right...
TLO 06:54 PM 04-16-2020
Originally Posted by 'Hamas' Jenkins:
Here is my description of it from March 9, discussing potential therapies for COVID-19.

No, but it is a small molecule drug, so scaling up production is far easier than a biologic. With that said, most of those factories are going to be in India and China.

Here is a post from about five weeks ago with a description of how the trials will work and how one might analyze its efficacy.



FWIW, remdesivir is a failed Ebola drug, but there is a fairly long history of failed agents being approved later for other indications. Two of the best examples are AZT (which I actually mentioned in a post above--it was developed at NIH in 1964 for cancer, shelved for 20+ years, then was the first anti-HIV therapy) and Viagra, which was originally indicated to treat pulmonary hypertension (and is still used for that in some cases).
Awesome insight, per usual.
[Reply]
2112 06:57 PM 04-16-2020
Originally Posted by 'Hamas' Jenkins:
Here is my description of it from March 9, discussing potential therapies for COVID-19.






No, but it is a small molecule drug, so scaling up production is far easier than a biologic. With that said, most of those factories are going to be in India and China.

Here is a post from about five weeks ago with a description of how the trials will work and how one might analyze its efficacy.



FWIW, remdesivir is a failed Ebola drug, but there is a fairly long history of failed agents being approved later for other indications. Two of the best examples are AZT (which I actually mentioned in a post above--it was developed at NIH in 1964 for cancer, shelved for 20+ years, then was the first anti-HIV therapy) and Viagra, which was originally indicated to treat pulmonary hypertension (and is still used for that in some cases).

Thanks for the 411
[Reply]
TLO 06:59 PM 04-16-2020
If this continues to trend in a good direction, I wonder if the FDA will fast track approval to use it off-label?
[Reply]
'Hamas' Jenkins 06:59 PM 04-16-2020
Originally Posted by 2112:
Thanks for the 411
I told my boss to buy Gilead stock over a month ago. We'll see if I was right.
[Reply]
TLO 07:03 PM 04-16-2020
Originally Posted by 'Hamas' Jenkins:
I told my boss to buy Gilead stock over a month ago. We'll see if I was right.

[Reply]
2112 07:03 PM 04-16-2020
Originally Posted by 'Hamas' Jenkins:
I told my boss to buy Gilead stock over a month ago. We'll see if I was right.
Let’s all hope you’re right. We need a magic pill with no side effects.
[Reply]
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