I’ve been writing a lot about the unjustified and premature hype over hydroxychloroquine, an anti-malarial drug with mild immunosuppressive activity that is also used to treat rheumatoid arthritis and other autoimmune diseases and how the drug probably doesn’t work against COVID-19, despite its being hyped by President Trump and his sycophants, toadies, and lackeys on Fox News, Dr. Mehmet Oz, Dr. Phil, Dr. Didier Raoult, and a bevy of irresponsible fame seeking doctors who have no idea how to do a proper clinical study. There are, however, other drugs being hyped out there, drugs that might actually have a better chance of turning out to be effective treatments for COVID-19. Chief among these is remdesivir, the experimental antiviral drug being tested by Gilead Sciences. Remdesivir is an adenosine (a nucleotide) analog that inhibits viral RNA polymerases. It is incorporated into RNA made by the virus, causing the premature termination of the RNA molecule, thus interfering with viral replication. The drug was originally developed to treat Ebola and Marburg but was ultimately found to be ineffective against these viruses. Because it inhibits the replication of a number of RNA viruses, it was only natural that it would be considered as a possible treatment for COVID-19, and Gilead has been relentlessly promoting it as such as the company has been working to carry out clinical trials.
What prompted me to write about remdesivir were headlines like Dr. Anthony Fauci says Gilead’s remdesivir will set a new ‘standard of care’ for coronavirus treatment that started popping up on Wednesday afternoon:
White House health advisor Dr. Anthony Fauci said Wednesday that data from a coronavirus drug trial testing Gilead Sciences’ antiviral drug remdesivir showed “quite good news” and sets a new standard of care for Covid-19 patients.
Speaking to reporters from the White House, Fauci said he was told data from the trial showed a “clear-cut positive effect in diminishing time to recover.”
Fauci said the median time of recovery for patients taking the drug was 11 days, compared with 15 days in the placebo group. He said the mortality benefit of remdesivir “has not yet reached statistical significance.”
The results suggested a survival benefit, with a mortality rate of 8% for the group receiving remdesivir versus 11.6% for the placebo group, according to a statement from the National Institutes of Health released later Wednesday.
“This will be the standard of care,” Fauci, director of the National Institute of Allergy and Infectious Diseases, added. “When you know a drug works, you have to let people in the placebo group know so they can take it.”
My skeptical antennae started twitching immediately, because on the same day a study from China was published in The Lancet that was far less impressive. In fact, it was a negative trial. What also got my skeptical antennae all aflutter twitching away was how the results of the remdesivir trial were announced. Normally, when a study is announced to the press, it’s upon publication of the paper, and the press release is issued either the same day or the evening before publication. As of last night, as I wrote this, however, the actual paper reporting the results of the clinical trial had not yet been published. As I perused Twitter on Wednesday, I found even more reasons for skepticism.
So, before I get to the study touted by Dr. Fauci, let’s review some history.
Remdesivir: The early days versus COVID-19 (like, you know, three weeks ago)
The first data published on remdesivir was a single-arm uncontrolled trial that somehow got published three weeks ago in The New England Journal of Medicine. This was peak COVID-19 publishing, when an uncontrolled case series of patients with severe COVID-19 treated with remdesivir under compassionate was published in a super high impact journal like NEJM and made headlines as a result. Be that as it may, the case series examined 61 patients with confirmed SARS-CoV-2 infection who had an oxygen saturation of 94% or less while they were breathing room air or who were receiving oxygen support. They received a 10-day course of remdesivir, consisting of 200 mg given intravenously on day 1, followed by 100 mg daily for the remaining 9 days of treatment. (Remdesivir is an intravenous drug.) The authors reported clinical improvement in 68% of evaluable patients:
Of the 61 patients who received at least one dose of remdesivir, data from 8 could not be analyzed (including 7 patients with no post-treatment data and 1 with a dosing error). Of the 53 patients whose data were analyzed, 22 were in the United States, 22 in Europe or Canada, and 9 in Japan. At baseline, 30 patients (57%) were receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68%) had an improvement in oxygen-support class, including 17 of 30 patients (57%) receiving mechanical ventilation who were extubated. A total of 25 patients (47%) were discharged, and 7 patients (13%) died; mortality was 18% (6 of 34) among patients receiving invasive ventilation and 5% (1 of 19) among those not receiving invasive ventilation.
The case series also did not collect viral load data to confirm potential antiviral activity in humans or any association between declines in viral load and clinical improvement. Basically, when you get right down to it, this study was not really much better than Didier Raoult’s crappy study of his hydroxychloroquine/azithromycin combination, but that didn’t stop the authors from concluding that comparisons with contemporaneous cohorts “suggest that remdesivir may have clinical benefit in patients with severe Covid-19.” In reality, like Raoult’s trials, this trial said nothing about the efficacy of remdesivir against COVID-19 other than that the drug could be given to COVID-19 patients with a reasonable safety profile.
Less than week later, as related by Derek Lowe, came news that two clinical trials of remdesivir in China, one for severe disease and one for moderate disease had been suspended. (They still are.) Lowe noted that both trials had the notice: “The epidemic of COVID-19 has been controlled well at present, no eligible patients can be recruited.” The apparent explanation was “the stringent inclusion criteria for the trials – apparently patients had to have no previous therapy with any other experimental agent to enroll, and that eliminates a lot of people.” Around the same time, Adam Feuerstein and Matthew Herper published a story in STAT, Early peek at data on Gilead coronavirus drug suggests patients are responding to treatment:
The University of Chicago Medicine recruited 125 people with Covid-19 into Gilead’s two Phase 3 clinical trials. Of those people, 113 had severe disease. All the patients have been treated with daily infusions of remdesivir.
“The best news is that most of our patients have already been discharged, which is great. We’ve only had two patients perish,” said Kathleen Mullane, the University of Chicago infectious disease specialist overseeing the remdesivir studies for the hospital.
Her comments were made this week during a video discussion about the trial results with other University of Chicago faculty members. The discussion was recorded and STAT obtained a copy of the video.
Derek Lowe discussed this story in depth, and I largely agree with him that the leak of the video to STAT was a serious breach of clinical trial ethics and protocol. (I’m not alone in suspecting that it was almost certainly intentional to jack up Gilead’s stock price, a result that was achieved.) Lowe also noted:
But now that it’s out there, let’s talk about what’s in the leak. Gilead stock jumped like a spawning salmon in after-market trading on this, and one of the reasons was that that 113 of the 125 patients were classed as having “severe disease”. People ran with the idea that these must have been people on ventilators who were walking out of the hospital, but that is not the case. As AndyBiotech pointed out on Twitter, all you had to do was read the trial’s exclusion criteria: patients were not even admitted into the trial if they were on mechanical ventilation. Some will have moved on to ventilation during the trial, but we don’t know how many (the trial protocol has these in a separate group).
Note also that this trial is open-label; both doctors and patients know who is getting what, and note the really key point: there is no control arm. This is one of the trials mentioned in this post on small-molecule therapies as being the most likely to read out first, but it’s always been clear that the tradeoff for that speed is rigor. The observational paper that was published on remdesivir in the NEJM had no controls either, of course, and that made it hard to interpret. Scratch that, it made it impossible to interpret. It will likely be the same with this trial – the comparison is between a five-day course of remdesivir and a ten-day course, and the primary endpoint is the odds ratio for improvement between the two groups.
Again, these data, such as they are, are no more useful than Didier Raoult’s data on hydroxychloroquine and azithromycin to treat COVID-19, but this brings us to the Chinese trial published in The Lancet on Wednesday.
The Chinese randomized clinical trial
The Chinese trial published two days ago is the first randomized, double-blind, placebo-controlled clinical trial of remdesivir to treat COVID-19, but it was also one of the studies halted. Eligible patients were adults admitted to the hospital with laboratory-confirmed SARS-CoV-2 whose symptoms had lasted less than 12 days before enrollment and who had an oxygen saturation on room air of 94% or less or a ratio of arterial oxygen partial pressure to fractional inspired oxygen of 300 mm Hg or less (another measure of hypoxia), and radiologically confirmed pneumonia. Patients were randomly assigned in a 2:1 ratio to intravenous remdesivir at the same dose as the NIH trial touted by Dr. Fauci or the same volume of placebo infusions for 10 days and were permitted concomitant use of lopinavir–ritonavir, interferons, and corticosteroids. The primary endpoint was time to clinical improvement up to day 28, defined at the time from randomization to the point of a decline of two levels on a six-point ordinal scale of clinical status (from 1=discharged to 6=death) or discharged alive from hospital, whichever came first. An intention-to-treat analysis was carried out.
Basically, this was a negative trial. Of the 255 patients screened, 237 met the eligibility criteria, and 158 were assigned to the remdesivir group, with 79 assigned to placebo control. Unfortunately, remdesivir treatment was not associated with a shorter time to clinical improvement, and mortality was not different between the two groups. Subgroup analysis looking for hypotheses found that there was a trend towards a shorter duration of symptoms (not statistically significant) in patients treated with remdesivir who had had symptoms for less than ten days. Most disappointingly, there was no detectable difference in viral load between the remdesivir groups and the placebo controls. Again, basically this was a negative study with only the barest hint that remdesivir might—I repeat, might—work if administered earlier in the course of COVID-19. That’s some pretty thin gruel.
Which brings us to the NIH trial of remdesivir touted by Anthony Fauci.
The NIH press release for its remdesivir trial.
The results of the NIH remdesivir trial can, unfortunately, only be gleaned from the press release and news stories so far:
For the first time, a major study suggests that an experimental drug works against the new coronavirus, and U.S. government officials said Wednesday that they would work to make it available to appropriate patients as quickly as possible.
In a study of 1,063 patients sick enough to be hospitalized, Gilead Sciences’s remdesivir shortened the time to recovery by 31% — 11 days on average versus 15 days for those just given usual care, officials said. The drug also might be reducing deaths, although that’s not certain from the partial results revealed so far.
“What it has proven is that a drug can block this virus,” the National Institutes of Health’s Dr. Anthony Fauci said.
“This will be the standard of care,” and any other potential treatments will now have to be tested against or in combination with remdesivir, he said.
Here is the press release, posted to the National Institute of Allergy and Infectious Diseases website:
Hospitalized patients with advanced COVID-19 and lung involvement who received remdesivir recovered faster than similar patients who received placebo, according to a preliminary data analysis from a randomized, controlled trial involving 1063 patients, which began on February 21. The trial (known as the Adaptive COVID-19 Treatment Trial, or ACTT), sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is the first clinical trial launched in the United States to evaluate an experimental treatment for COVID-19.
An independent data and safety monitoring board (DSMB) overseeing the trial met on April 27 to review data and shared their interim analysis with the study team. Based upon their review of the data, they noted that remdesivir was better than placebo from the perspective of the primary endpoint, time to recovery, a metric often used in influenza trials. Recovery in this study was defined as being well enough for hospital discharge or returning to normal activity level.
Preliminary results indicate that patients who received remdesivir had a 31% faster time to recovery than those who received placebo (p<0.001). Specifically, the median time to recovery was 11 days for patients treated with remdesivir compared with 15 days for those who received placebo. Results also suggested a survival benefit, with a mortality rate of 8.0% for the group receiving remdesivir versus 11.6% for the placebo group (p=0.059).
More detailed information about the trial results, including more comprehensive data, will be available in a forthcoming report. As part of the U.S. Food and Drug Administration’s commitment to expediting the development and availability of potential COVID-19 treatments, the agency has been engaged in sustained and ongoing discussions with Gilead Sciences regarding making remdesivir available to patients as quickly as possible, as appropriate. The trial closed to new enrollments on April 19. NIAID will also provide an update on the plans for the ACTT trial moving forward. This trial was an adaptive trial designed to incorporate additional investigative treatments.
As you can see, the difference in mortality was not statistically significantly different, although that could just be because of inadequate numbers. It’s also very important to note the part about the adaptive trial design of this trial, which puts Dr. Fauci’s comment about how remdesivir will become the “standard of care” going forward into the proper context. In this particular trial, multiple different drugs can be compared to placebo or standard of care. The idea is that, if a signal of efficacy is found with one drug, that drug becomes “standard of care” and the trial is adapted to study how adding other experimental drugs compares to the “standard of care.” So what Dr. Fauci meant was that, based on the finding, going forward remdesivir will become the “standard of care” arm for the trial and the experimental arm will become remdesivir plus another experimental therapeutic. However, given that the FDA is on the verge of issuing an emergency use authorization for remdesivir to treat COVID-19, it looks as though remdesivir will become standard-of-care in general soon.
But back to the results. Derek Lowe observed:
… it’s worth noting that had there been “clear and substantial evidence of a treatment difference” during the trial that the DSMB was to have halted the study at that point. We can infer that nothing rose to that level, then: we have a difference, but not substantial enough to have ended the trial prematurely.
It’s also worth noting some things posted on Twitter about the trial. For instance, Waller Gellad noted:
It’s very odd that the primary endpoint was changed:
This long Twitter thread explains:
I’ll summarize, so that you don’t have to scroll through a Twitter thread if you don’t want to. As James Heathers and Waller Gellad noted, the original primary outcome of the trial when it was registered on March 20. The original primary endpoint of the trial was an 8-point severity scale (death, on ventilator, hospitalized with oxygen, all the way down to discharged with no limits on activity) but was changed to time to recovery. There’s still a similar scale for the secondary endpoints, but no numbers for that were reported. (Any bets on whether the results are negative?) This change was apparently made on or around April 16.
Gellad also notes:
It does look very fishy to me. Endpoint or outcome switching, particularly late in a clinical trial is a huge red flag. Don’t get me wrong. There can be legitimate scientific reasons to switch primary endpoints of a trial. as James Heathers puts it:
There are also other reasons to question this trial, including how no confidence intervals were reported, that not even an abstract was published, just a press release with, as Heathers put it, “two results in four lines”:
Basically, if you have two “good” results and twenty “bad” or uninterpretable results, what do you do? What are you going to tell people? The two “good” results, of course!
Gary Schwitzer has a nice summary of the negative reactions to the trial and how it was announced.
The bottom line
I remain very suspicious that the NIH study was announced the same day that a negative study out of China of remdesivir was published. It just seems too…convenient. Maybe I’m being overly suspicious. Maybe I’m too suspicious. Maybe I’m falling prey to conspiracy mongering. However, in the Trump era, when the Trump administration has politicized previously (mostly) apolitical government agencies as never before, it’s hard not to wonder.
Adding to my suspicion is the fact that the study was reported in a press release, rather than being published, which makes me wonder if the press release was written to counter the negative study from China that would certainly have tanked Gilead’s stock prices. Yes, I know that the press release reported that this decis, apparently the announcement was decided upon after April 27 meeting of the data and safety monitoring board overseeing this trial, but the outcome switching so late in the trial makes me very suspicious. Yes, the explanation, which should have been in the press release, along with an acknowledgment that the primary outcome/endpoint had been changed, but wasn’t is not unreasonable:
Then there was this news report in which Fauci claimed that concerns about leaks fueled the announcement:
He expressed concern that leaks of partial information would lead to confusion. Since the White House was not planning a daily virus briefing, Fauci said he was invited to release the news at a news conference with Louisiana Gov. John Bel Edwards(D). “It was purely driven by ethical concerns,” Fauci told Reuters in a telephone interview.
“I would love to wait to present it at a scientific meeting, but it’s just not in the cards when you have a situation where the ethical concern about getting the drug to people on placebo dominates the conversation.”
An independent data safety and monitoring board, which had looked at the preliminary results of the NIAID trial, determined it had met its primary goal of reducing hospital stays.
On Tuesday evening, that information was conveyed in a conference call to scientists studying the drug globally.
“There are literally dozens and dozens of investigators around the world,” Fauci said. “People were starting to leak it.” But he did not give details of where the unreported data was being shared.
I smell bullshit here. What probably really happened is that he was under enormous pressure to release the results. It was also…unwise…to discuss the results with so many scientists until the manuscript reporting the results of the trial had at least been submitted for publication. I agree with the scientists who had “expected it [the trial data] to be presented simultaneously in a detailed news release, a briefing at a medical meeting or in a scientific journal, allowing researchers to review the data.” I also agree with Dr. Eric Topol, referring to the Chinese RCT and this one:
“That’s the only thing I’ll hang my hat on, and that was negative,” said Dr. Eric Topol, director and founder of the Scripps Research Translational Institute in La Jolla, California.
He was unimpressed by remdesivir’s modest benefit.
“It was expected to be a whopping effect,” Topol added. “It clearly does not have that.”
Indeed, given that the pre-test probability of remdesivir having a significant effect was low, meaning that this trial is probably just noise:
Indeed, I’m not only unimpressed with the modest benefit reported, I question whether there really was any benefit at all, particularly in light of the Chinese trial, which found zero difference in viral load in the remdesivir group.
The whole thing looks damned fishy, and we can’t judge the study until it’s actually published. Meanwhile, whatever the true reasons for releasing the study results this way, mission accomplished. The negative effect of the Chinese study on Gilead’s stock price was successfully countered and remdesivir becomes a de facto standard of care for patients hospitalized with COVID-19. Worse, no further trials of remdesivir versus placebo will be possible, because it’s been declared that remdesivir “works” against COVID-19 and is the new standard of care! As Mark Hoofnagle put it in a great Twitter thread, that echoes my thoughts:
It’s worse than that. If remdesivir is now the “standard of care” for hospitalized COVID-19 patients, it now becomes unethical to randomize them to a placebo group testing ANY new drug for COVID-19. Trials will now have to compare remdesivir alone to remdesivir plus experimental drug. We’ll probably never know now for sure if remdesivir is truly effective against COVID-19.
But Gilead will make billions and billions of dollars.
122 replies on “Remdesivir: Gilead wins with unimpressive results announced by press release”
Ohh! What a giveaway — That is exactly something a pharma shill would say.
Indeed.
I guess people should have jumped up and put the Robinhood app on their fondle slabs and ‘bought the dip’, after all.
https://investorplace.com/2020/04/buy-the-dip-in-gild-stock-because-remdesivir-may-not-be-a-flop/
Note that they say “inconclusive results” about the Chinese RCT and not “negative” (i.e. no reduction in viral load).
Things that make the SEC you go hmm.
Remember when Gilead, after it purchased Sofosbuvir from Pharmasett, refused to cooperate with the pharmaceutical company that owned Daclatasvir (Bristol Myers Squibb), the companion drug of the cure for some genotypes of hepatitis C? I suspected Gilead wanted to corner the market with its own companion drug, Ledipasvir, that took more time to develop while patients continued to suffer, sometimes dying, from hepatitis C. Remember the Initial $90,000 price tag for Harvoni? My suspicion could be incorrect, but I’ll always wonder.
https://statmodeling.stat.columbia.edu/2020/04/26/controversy-regarding-the-effectiveness-of-remdesivir/
a link from retractionwatchabove. seems even the monkey trial is suspect
For a long time, I wondered why The Lancet published Wakefield 1998 case series – why such high impact journal published a case series with only 12 children? My own answered to me was that no way The Lancet or other such impact journal would published case series like this anymore. Even less impact and relevant journals publicly state they don’t accept case series. Apparentely I was very wrong, as NEJM has published a case series with remdesivir for covid.
Actually one of my publications during my PhD did involve a case series: patients with primary antiphospholipid syndrome (APS) that had thrombosis again while being given rivaroxaban (direct oral anticoagulants – DOAC). We know we didn’t prove anything, but we hypothetize that triple positive APS patients were at higher risk of thrombosis when using DOACs.
Interestingly, the first place I submitted the paper didn’t accept it, so I had to submitted to a less relevant journal. Both journals definitely are way less relevant than The Lancet and NEJM, obviously.
Just to be clear. I think there is space to publish case series about diseases manifestations. But case series about treatment benefits looks like just that: an attempt to show something works without the proper method that would show it doesn’t.
I thin Brian Deer’s coming book will address why the Lancet published it (beyond your thoughtful points).
I was reading on CNN this morning that Trump is offering almost half a billion dollars to a company to produce a vaccine for the SARS CoV2 virus. The company has never brought a vaccine to market before, and it appears he selected them because they claim they can do it fast! I am so worried that some company will bring a bad vaccine to market (fast!) that not only will do harm to Covid 19 vaccinated people, but will add fuel to the anti-vaccine movement overall, causing an increase in measles and other diseases we should be done with. Either that, or they will be unable to produce it at all, and we’ve thrown away another half a billion
Indeed – the Orange Moron saying he is ‘in charge’ of Operation Warp Speed is hugely worrying. The man wants a vaccine pre Novemeber 3 – he wants to say he made it happen. How many safety protocols will be ignored? How many worrying side effects will be surpressed? How many researchers will be bullied into silencing their concerns? Could be a cure way worse than the disease. I stronlgy suspect OWS will come out with something within a few months – purey for politcal reasons. I won’t be lining up to take it… .. .
What does that do for all other trials? Does it just now require them to carry on but add a drip? Is that only in the US?
What about the ongoing tests for other stuff like the nicotine in France and the estrogen on the east and west coast here (both, probably not so rigourous clinical but because observational studies of who come into the hospital lead to they may have a positive effect no matter how little understood the mechanism.)?
I’m no doctor as the only medical training I had was puckering up to a doll after pumping it 5 times (now recommended 30 because CO2 stimulates one to breath) and having worked half way through Time-Life Home Surgery #3 of a 36 volume set. But my scatter-knowledged, self medicating, short bus commuter self would be getting on
— estradiol patch
— nicotine patch
— nitric oxide or NO+boner pills (treat me like a ‘blue baby’); provided one is not already intubated.
All of those things would seem to be innocuous; Is remdesivir safe as baking soda or counter indicated to any of the above or would a hospital just refuse my self-recommended course and, being the good little bureaucrat loyalists they are, tell me I can’t have a magnesium supplement and to stop pulling the remdesivir tube out and just deal with my rectal prolapse that gives me forevermore?
yes dosed up with vicks..vaporub ointment…and….the vicks inhaler…..& fresh air…for your lungs….yes …happy bob from oz cheers….8
@ robert walton
What’s a “vaporub ointment”? Please educate me…
vicks is a world wide product,,goggel up active ingredents,…i wipe my nose in lets with a cotton bud on bed time,,,with product or as i think i need another hit ?? & also there in halers i have used for over 35 years …i gave up smoking back then using this item,,hence …..just saying ..yes ..happy bob from oz cheers …8
Vicks Vaporub is a stenchiferous mixture of petroleum jelly, camphor, menthol, eucalyptus oil, turpentine oil, and other miscellaneous stinkum. It’s been around for over a century. Users believe it relieves nasal congestion. It is reputed to be useful, when applied right under your nose, for masking the smell of rotting corpses. I would agree that it smells somewhat better than the average rotting carcass.
That shit killed a thousand times more children from accidentally aspirating it back in the day than the latest scandal of Hunnycut vitamin E acetate vaping scandal that was killin’ off of thc vapers getting ripped off by it being diluted by the stuff.
It turns out that it is not so good to inhale oils or fats into one’s lungs.
ok tim…what protocol have u got for us ??? yes oils or fats passing into your/our lungs …oh really tim happy bob from oz cheers 8
Fuck me running, bob; the one I spouted above:
https://www.respectfulinsolence.com/2020/05/01/remdesivir-gilead-wins/#comment-426260
Aussie says american beer is a lot like making love in a canoe — It is fucking close to water.
Seriously? You’re only supposed to put Vaporub on the chest. Body heat turns it into a vapour that gets inhaled. Were people putting it in their mouths or nostrils?
@ Julian
“Were people putting it in their mouths or nostrils?”
They could do worse…
Yes, Julian Frost. Bob mentions smearing a little with a cotton ball — which should be perfectly safe — but my grandmother would dip her finger in and stick globs of it all around just inside the nostrils.
https://en.wikipedia.org/wiki/Lipid_pneumonia
(Should be ‘lipoid’?) I guess a sleeping, stuffy kid would maybe give a big sniffle and sometimes the jelly would get in their lungs.
It is unconscionable to me all the hype and fear generated and being used to push for vaping bans over something that was, in retrospect, obvious from day one (I think the bastards knew and just let it continue to make the case against thc/cbd vaping and the mommies of the world just extended that to all vaping).
https://www.leafly.com/news/health/some-vape-cart-additive-makers-pull-products-others-go-dark
Yah, back when I was an undergrad, we managed to convince my roommate that Noxzema was just the ticket for pruritus ani.
Annnd, was his itchy because you dripped urushiol on his toilet paper roll?
Power move, satan; You go boy.
@ Julian Frost May 2, 2020 at 5:54 am
I remember getting a bit of Vicks rubbed on my nose as a child. And just a few months ago my doctor recommended it for a bit of scar tissue–no open wound.
The best I have heard was a friend telling me she fed her 20-year-old cat about 20ml of Vick every day.
Maybe she gave the cat Vick’s because it has petrolatum – so for hairballs? Hairball formulae use it,
However, I wonder about the other ingredients like menthol, camphor and turpentine oil which could be toxic.
Cats sometimes have bizarre food preferences and have been know to savor antifreeze- dangerously -when it drips from cars,
The important question; did the cat live?
He expressed concern that leaks of partial information would lead to confusion. Since the White House was not planning a daily virus briefing, Fauci said he was invited to release the news at a news conference with Louisiana Gov. John Bel Edwards(D).
“To forestall the possibility of leaks of partial information, I’m going to leak partial information”.
Now listen here, you little shit…
p.s. where is the Limbaugh crowd when one is in need of blog hits? (sorry, Orac. You are gonna starve on this one) Yea, they have been advised not to pollute their computers by visiting this site (It has nasty trojans, and viruses, and thought.)
[…] ● NEWS ● #respectfulinsolence ☞ #Remdesivir : #Gilead wins with unimpressive results announced by press release https://www.respectfulinsolence.com/2020/05/01/remdesivir-gilead-wins/ […]
In long twitter exchange mainly led by James Heathers, has anyone noticed that there are a series of tweets by Didier Raoult ?
One tweet reads:
As Orac makes clear, the research is weak at best and even what does exist finds a shortening of duration; but not reduction in deaths or long term sequelae. However, even if one were to accept this, what about side-effects. In a quick search of the web I found the following two:
WHAT ARE SIDE EFFECTS OF REMDESIVIR (RDV)?
In the Ebola trial, researchers noted side effects of remdesivir (RDV) that included:
Increased liver enzyme levels that may indicate possible liver damage
Researchers documented similar increases in liver enzymes in three U.S. COVID-19 patients
Typical antiviral drug side effects include:
Nausea
Vomiting
Found at: https://www.rxlist.com/consumer_remdesivir_rdv/drugs-condition.htm
Side effects
The most common adverse effects in studies of remdesivir for COVID-19 include respiratory failure and blood biomarkers of organ impairment, including low albumin, low potassium, low count of red blood cells, low count of platelets that help with clotting, and yellow discoloration of the skin. Other reported side effects include gastrointestinal distress, elevated transaminase levels in the blood (liver enzymes), and infusion site reactions.
Other possible side effects of remdesivir include:
Infusion‐related reactions. Infusion‐related reactions have been seen during a remdesivir infusion or around the time remdesivir was given.[8] Signs and symptoms of infusion‐related reactions may include: low blood pressure, nausea, vomiting, sweating, and shivering.
Increases in levels of liver enzymes, seen in abnormal liver blood tests. Increases in levels of liver enzymes have been seen in people who have received remdesivir, which may be a sign of inflammation or damage to cells in the liver.
Found at: https://en.wikipedia.org/wiki/Remdesivir
So, if it does shorten duration, is it worth potential liver damage, respiratory failure and organ impairment? In other words is the cure potentially as bad as the disease.
And, as Orac and many commenters have made more than clear, one more example of Trump’s government, ignoring science, and jumping to conclusions.
And once more I suggest reading the following:
Jeanne Lenzer and Shannon Brownlee (April 28, 2020). Pandemic Science Out of Control. Issues in Science and Technology. Available at: https://issues.org/pandemic-science-out-of-control/
ADDENDUM
I found the following: “Particular laboratory features have also been associated with worse outcomes (table 2). These include: Elevated liver enzymes”
Found at: https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-epidemiology-virology-clinical-features-diagnosis-and-prevention?search=coronavirus-disease-2019-covid-19-…demiology-virology-clinical-features-diagnosis-and-prevention&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
So, one of the side-effects has been associated with worse outcomes. Not exactly a ringing endorsement of Remdesivir.
Thanks for making this point. I don’t believe I have noticed these, to me, subtly different uses or application of the “standard of care” phrase.
As for politics, spin, and jockeying for position by and within the Trump administration, it is now writ large and even decent people cannot seem to remain untouched by it.
For yet another drug that was supposed to be a game changer, I am unimpressed by its results. The whole mechanism is wrong. A drug with this mechanism would need to be almost a prophylactic for it to be hugely effective.
TWiV 608 has a good explanation of why these antiviral trials are unlikely to show strong results.
https://www.microbe.tv/twiv/
The peak viral activity occurs at about the time when noticeable symptoms appear. By the late period in the illness when Remdesivir is being tested, most of the virus has been cleared already.
But, we can’t start bringing everyone who has symptoms and tests postive in for daily IV treatments. EIDD-2801 being tested at Emory might be usable for that if it is effective since it is a pill.
You can listen to a real epidemiologist, Jeff Shaman from Columbia, explain the uncertainties in what our data are telling us about how this pandemic is spreading.
You can also hear him discussing what we are learning from mathematical models of this disease with Sarah Cobey from the University of Chicago on Science Friday from May 1.
https://www.sciencefriday.com/segments/covid-math-models/
Yes indeed. Even more, to be successful, it needs to be given early before virus load gets high.
How is remdesivir compared with favipiravir? Looks like we are doing a trial of favipiravir vs the whole hydroxycloroquine business vs current standard of care. A very quick scan of the news story seems to show that favipiravir is similar to remdesivir, in purpose anyway.
It has been stated, “The mortality benefit of remdesivir has not yet reached statistical significance.”
It can also be written. “Yet, the mortality benefit of remdesivir has not reach statistical significance.”
MJD says,
The word “yet’ must never be used in science-speak, it’s to misleading. With respectful insolence, Orac did use the word “yet” once in this post.
You are bordering on “not even wrong” territory, Michael.
In the sense of having crossed through it into uncharted waters, perhaps.
Oh, and the measurement problem has yet to be resolved.
Well, there is ‘many worlds’ and ‘pilot wave’, gasp.
Bohmmm!!!
https://arstechnica.com/science/2020/05/scientists-get-an-atomic-level-look-at-how-a-drug-blocks-the-coronavirus/
What is that saying about zinc? I’ve always heard that zinc was a good thing to have a high intracellular level of it to protect against viruses besides also being needed to make NO.
https://arstechnica.com/science/2020/05/nih-cuts-coronavirus-funding-amid-trump-comments-and-conspiracy-theories/
Oh my. The plot, it thickens.
These one-month-old comments by proponents of CQ/HCQ are getting past their ‘best use date’ very quickly.
In other Covid-19 news….
Someone we all know ( @ gorskon) highlights recent protests by gun-totin’ loons in his area. Truly horrendous, as were other activities in Orange County, CA, such as attempting to storm the closed beaches. With flags yet.
In contrast, here in Liberatopia, a general order to close parks has been partially rescinded so I went to a nearby open space/ sports area: while the fields, courts and boat launch were all closed, pathways were not. Parking was restricted to control volume of visitors ( some areas shut entirely and others allowing alternate rows of cars) People wore masks! They maintained social distancing! Little kids rode tiny bikes with masks! Runners wore masks! True, some of the residents are Korean or Japanese born but not everyone .
It is extremely diverse. I did see something that made me laugh: two young Black women sat on the grass with a tiny baby and two wacky, small dogs when an elderly white couple approached them with their two small, wacky dogs: all dogs were on rather long leashes ( over 6 feet long I’d estimate). The humans hesitated for a while, probably thinking : Do dogs have to socially distance? They did eventually allow the dogs to interact but kept their distance from each other.
I’m glad that I live in Liberatopia.
https://www.nbcnews.com/news/us-news/oklahoma-city-ends-face-mask-rule-shoppers-after-store-employees-n1198736
That really pisses me off. My respirator is a little, shall we say, unconventional (it is the 3rd iteration of an oreck vacuum cleaner bag on a short piece of dishwasher drain hose sticking out of a sealed mask from a cut off grape juice bottle and window seal stretch tape ankle wrap makes all the parts interchangeable between them and buying thirty bags made them only $2.50 a pop. (The OG model on the round v8 top restricted vision too much when looking down to use the chip reader machine)).
I’ll continue to wear that because nobody else around here can be arsed to even put on a wash cloth. What times we live in that some guy in a maga hat is going to stew me for perceived disrespect for Trump and looking silly at the same time. This is what black guys (and myself, a white guy) feel at traffic stops.
I’m sure cancellation of the Boil Festival in Lansing has left many with irritation.
Heh heh.
considering other loons:
see @ thereal_truther who tweeted an NYT story/ photo ( 20 hrs)
anti-vaxxers join anti-shutdown activists and lookie lookie!
It’s our old friends, the three women from CA who famously wore red, white ( remember that tiered, short dress?**) and blue holding flags upside down ( a distress signal) in CA, NY ( for RFK jr) and NJ protests.
Well, here they are again.
They made to the NYT. Fame, fame, fame. Is it any wonder?
** how could I forget? I don’t only recall good fashion choices
Orac wrote: “What prompted me to write about remdesivir were headlines like “Dr. Anthony Fauci says Gilead’s remdesivir will set a new ‘standard of care’ for coronavirus treatment” that started popping up on Wednesday afternoon …”
Fauci just dropped down a level or two in my estimation of his commitment to rationality.
@ Reality
So: “Fauci just dropped down a level or two in my estimation of his commitment to rationality.”
Let’s look at the “Reality”: “America needs a federal government that assertively promotes and helps to coordinate that, not one in which experts like Tony Fauci and Deborah Birx tiptoe around a president’s tender ego.” I wouldn’t want to be in Fauchi’s shoes. If he openly criticizes Trump, he is out and staying in allows him to have some effect. Damned if he does and damned if he doesn’t. So, he has to balance his “committment to rationality” to trying to modify/reduce the insanity of Trump. If he resigned or was fired, could he have more of an influence? Maybe, maybe not. I would not want to be in his shoes! ! ! Personally, I would probably resign and try to get our media to listen to me. Just standing next to Trump would turn my stomach.
So, maybe you should live up to your “name” and evaluate “reality” not an idealistic world.
So you wouldn’t say what Fauci said and would quit, eh, Joel?
I wouldn’t say what Fauci said about “standard of care” which is basically his endorsement of this.
I believe Orac wouldn’t make that statement endorsing Remdesivir as the “standard of care”.
I don’t know of any self-respecting scientist who would make such a statement no matter what the pressure.
If I was pressured by DJT I would object but maybe agree to not make any statement pro or con about the subject – so as to keep my position and influence… but if someone asked me to say something I thought was not true I would not do it and refuse.
.
Fauci didn’t seem to have any problem cautioning against unwarranted optimism for CQ/HCQ even while DJT was championing the stuff. What is different about this?
.
That is the Reality of this Fauci statement.
@ Reality
You write: “Fauci didn’t seem to have any problem cautioning against unwarranted optimism for CQ/HCQ even while DJT was championing the stuff. What is different about this?”
Yep; but the only studies promoting CQ/HCQ was a fraudulent one in France and an in vitro study.
What about Remdesivir? First it is a nucleic acid analogue designed to directly disrupt replication of the viral genome. Chloroquine/Hydroxychloroquine were not even remotely designed to target viruses, though they have a moderate dampening effect on immune reactions, so they work for autoimmune diseases (e.g., lupus, rheumatoid arthritis); but, as I wrote in a previous exchange, the immune response in an autoimmune disease compared to a cytokine storm is like comparing 20 mile per hour winds to a category 5 hurricane, 160 mph winds. In addition, chloroquine/hydroxychloroquine have a large number of mild side-effects and some really serious major ones.
So, what did Fauci say about chloroquine? ““We’ve got to be careful that we don’t make that majestic leap to assume that this is a knockout drug. We still need to do the kinds of studies that definitely prove whether any intervention is truly safe and effective,” Fauci, who is also a member of the White House coronavirus task force, said during an interview on “Fox & Friends. . . “We don’t operate on how you feel, we operate on what evidence and data is,” Fauci said, adding that it was “not a very robust study” or “overwhelmingly strong.”” (Concha, 2020 Apr 3)
Now, what did he say about Remdesivir: “Speaking to reporters from the White House, Fauci said he was told data from the trial showed a “clear-cut positive effect in diminishing time to recover.” Fauci said the median time of recovery for patients taking the drug was 11 days, compared with 15 days in the placebo group. He said the mortality benefit of remdesivir “has not yet reached statistical significance.” The results suggested a survival benefit, with a mortality rate of 8% for the group receiving remdesivir versus 11.6% for the placebo group, according to a statement from the National Institutes of Health released later Wednesday. “This will be the standard of care,” Fauci, director of the National Institute of Allergy and Infectious Diseases, added. “When you know a drug works, you have to let people in the placebo group know so they can take it.” “What it has proven is a drug can block this virus,” he said. (Lovelace, 2020 Apr 29)
“The data shows that remdesivir has a clear-cut, significant, positive effect in diminishing the time to recovery,” Fauci said at the White House on Wednesday. The data he referred to is from a large study of more than 1,000 patients from multiple sites around the world. Patients either received the drug, called remdesivir, or a placebo.
Dr. Michael Saag, associate dean for global health at the University of Alabama at Birmingham, said the results seemed promising. Antiviral drugs such as remdesivir tend to work earlier in the course of an illness, so “the thing that I think is important in this study is the patients had advanced disease,” said Saag, who is not involved with any remdesivir trials. (NBC News (2020 Apr 29)
Hospitalized patients with advanced COVID-19 and lung involvement who received remdesivir recovered faster than similar patients who received placebo, according to a preliminary data analysis from a randomized, controlled trial involving 1063 patients, which began on February 21. The trial (known as the Adaptive COVID-19 Treatment Trial, or ACTT), sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is the first clinical trial launched in the United States to evaluate an experimental treatment for COVID-19.
An independent data and safety monitoring board (DSMB) overseeing the trial met on April 27 to review data and shared their interim analysis with the study team. Based upon their review of the data, they noted that remdesivir was better than placebo from the perspective of the primary endpoint, time to recovery, a metric often used in influenza trials [my emphasis]. Recovery in this study was defined as being well enough for hospital discharge or returning to normal activity level. . . Results also suggested a survival benefit, with a mortality rate of 8.0% for the group receiving remdesivir versus 11.6% for the placebo group (p=0.059).
the group receiving remdesivir versus 11.6% for the placebo group (National Institute of Allergy and Infectious Diseases (2020 Apr 29).
So, first I’d bet you don’t understand how nucleic acid analogues work?
Second, though I tend not to rely on one study, this one was fairly large and the shortening of time to recovery was clinically significant, “defined as being well enough for hospital discharge or returning to normal activity level.” And Dr. Michael Saag: “Antiviral drugs such as remdesivir tend to work earlier in the course of an illness, so “the thing that I think is important in this study is the patients had advanced disease,”
Standard of Care is more a legal definition than a clinical one. Basically it reduces risk of malpractice lawsuits.
While I probably would not have called it “standard of care”, instead clearly stating that based on the recent trial, it is currently the best we have to offer or something to that effect.
So, Fauci didn’t call it a cure, didn’t claim it reduced mortality, though indications it did, and based on over 1,000 patients, found it reduced hospitalization and return to normal life by a clinically significant margin, the standard used for flu studies. Again, I would have been more cautious in my working; but your rank attack on a man who knows more about infectious diseases that you, I, and many others, a man who has dedicated his life to preventing and dealing with them is just plain sickening. Your black and white view of Fauci is how antivaccinationists and other adherers to unscience see the world. And an MPH probably means a couple of lower level epidemiology courses. So, the old saying: A little knowledge is a dangerous thing, coupled with a personality that prefers a dichotomous world is very very problematic.
Only time and further studies will tell if Remdesivir really does shorten recovery time and, perhaps, also lowers mortality. Right now, we have nothing else and I wouldn’t jump on something because of this; but the over 1,000 patient study isn’t nothing.
Just to be clear, Orac’s critique is valid; but, as he says, by this time one becomes perhaps overly skeptical given Trump’s insanity. How cautious should Fauci have been? People are becoming desperate. The risks from Remdesivir are extremely low, so currently, either use it or continue as is. If there were significant risks and the one study had been one a much smaller group, the scales would be different. And, though Orac is right they changed the outcome points, as mentioned, shortening of recovery time is a criterion used for treatment of flu, so, though not, perhaps, the best end-point, it is certainly not the same as some studies using endpoints such as lowered cholesterol without looking at deaths. They did look at deaths and though not significant, in the right direction. By the way, do you even understand significance levels? Though only one study, p=0.059 isn’t far from p=0.05.
References:
Concha, Joe (2020 Apr 3). Fauci warns there’s no ‘strong’ evidence anti-malaria drug works on coronavirus
Lovelace, Berkeley (2020 Apr 29). Remdesivir coronavirus drug trial: Dr. Fauci says it will set new standard of care. CNBC
National Institute of Allergy and Infectious Diseases (2020 Apr 29). NIH Clinical Trial Shows Remdesivir Accelerates Recovery from Advanced COVID-19
NBC News (2020 Apr 29). Remdesivir shows promising results for coronavirus, Fauci says
Yup, an IV treatment is just the ticket.
SPLORF. Do you understand significance levels? Can you actually define what they are supposed to mean? P = 0.05, as is widely known (psychologist Ulrich Schimmack’s gymnastics notwithstanding) to be, shall we (tinw) say, Not Scottish.
It’s time to take down your shrine to Fisher.
Oh dear.
Let me put it this way, a p <0.05 is OK for ordinary wear in the garden. If you are contemplating going on a hot first date, you would want something much smarter than this.
A p value of 0.059 is nothing to get excited about. It falls into the nearly pregnant category.
@ Chris Preston
First, the point I was making is that one of the currently used decision points, 0.05 with one or two more cases would have been reached. Second, a well-done study on a large sample size and 0.05 has been used for making decisions.
Historically, a number of studies that didn’t quite reach 0.05 when combined in a meta-analysis did. And one major problem is that journals often use 0.05 as cut-off criteria for publications, thus, not allowing for possible further replication studies or use in meta-analyses, which often manage to find unpublished studies.
So, once more we have someone who sees the world in black and white. Oh well. As numerous studies have found, more than 80% of Americans don’t really understand the basics of research. Check out the books I recommend in one of my comments. You might learn something.
Too skeptical an attitude leads to paralysis, too little skepticism can lead to harms. Somewhere in the middle, Aristotle’s Golden Mean, Swedish “lagom är bäst”, etc.
https://www.nytimes.com./2020/05/02/opinion/sunday/coronavirus-prediction-laurie-garrett.html
Careful, you’re getting close to receiving a misspelled rant with full caps and a strange punctuation style.
^ Rats, that was supposed to be in the Reality thread.
@ Narad
Yep, I understand what a p-value is. It is an artificial cut-off point to make a decision. The decision is simply was the result from the Independent variable(s) or some other uncontrolled variable(s) that by random chance ended up more in one group than the other. With a medical intervention, the decision is whether to apply it or not. And, no decision should be permanent, always possibility no matter how well one or a few studies are carried out, some later studies may find only subgroup valid or not. However, in epidemiology where the goal is to try to understand something, not make a decision, confidence intervals are used. So “It’s time to take down your shrine to Fisher” Not a shrine, simply acceptance that it isn’t an absolute; but a strategy for making decisions.
So get off your fucking high horse. Once more all you do is irritate rather than add to the discussion.
ADDENDUM
And do you even understand that when Fauci called it standard of care, he was simply saying that if doctors use it they are fairly protected against lawsuits, not that it has been shown by numerous studies to be strongly scientifically validated. In fact, we have a number of medical procedures used today that were not based on even one large placebo controlled randomized trials; but grandfathered in. Since most people don’t understand this, perhaps, it was a bad choice of terminology; but I certainly wouldn’t lower my respect for Fauci based on this; but, someone who arrogantly calls himself “Reality” and sometimes even you just want to see the world in black and white. Fauci’s, perhaps, poor choice of terminology and that erases a lifetime of achievements? And, just possibly he also reacted to several months of suffering of the American people and was glad something had “some” valid science behind it, not just a study of 1,000; but knowledge of how nucleic acid analogues work. On the whole, despite some negative studies, Remdesivir, a nucleic acid analogue, may work and the risk of severe side-effects in extremely low, so far raised liver enzymes, not found in the one large study.
Why are you addressing this to me? I haven’t said a damn thing about Fauci.
Is that the same “standard of care” when your local GP gives you or a loved one an influenzas vaccine and the next day you or that loved one is inexplicably disabled? It seems to be me that “Standard of Care” is part of an “out” for law suits not being made on the Vaccine company. I bet the Tobacco Companies in the 50s and 60s wish they had tagged that one somehow!
The irony, it burns.
@ Narad
You write: “Why are you addressing this to me? I haven’t said a damn thing about Fauci.”
True; but you jumped on the bandwagon when I addressed p-values and you make so many bull shit comments that I sometimes confuse you with other a-holes. As I’ve written several times, sometimes you actually contribute to the conversation, even link to worthwhile papers; but often you just interject worthless phrases.
As I wrote in another comment, I have NO problem admitting when I’m wrong which happens; but I don’t just make comments to irritate people. I comment when I disagree and try to martial a reasonable argument.
@Joel A strategy to make decisions? Well what framework do you use may I ask? Is it logical – hope so! Does it use all the information? Hope so! Your p-number is simply that – a piece of information. It has it own provenance which may lead you to be more or less certain about it itself. You have other information. How likely was the result -what was the prior.
Let me, in an entriely unprovable way – blow my own horn.When hydroxychloroquine started being touted as a otetial remedy I remarked to my parnter things like ‘if it works we may have dodged a bullet here!’ and ‘ maybe humanity has fluked its way ouot of it’. I have no real knowledge of the relevant fields, just the observation that the reasons for trying it seemed failry thin and the general knowledge that one does not normally cure a disease by just reaching up to the medicine cabinet. Do you think I was right to state that if hc was a cure that would have been a fluke? Did you have any prior thoughts on that?
For the corona virus specifically, there are so many influences – ranging from the altruistic, compassionate desire of researchers to find a cure, and quickly, to the venal corruption of some of the actors, and where doctors are saying things like ‘ so man are dying we don’t have time for controlled studies’ I would make sure you look at p numbers as information, not some form of definite reality.
When it comes to making those decisions I hope you do use a logical system that incorporates all the information – it would actually be irrational not to! There is such a system, but its name escapes me at the minute…
@ Jools
Do you know what a meta-analysis is? Combining a number of studies and, yep, they use p-values and confidence intervals. Biological plausibility is often added to the mix (but one can make a biological argument for almost anything). Benefit/cost analysis play a role (but depends how one weights them and which variables one chooses). What you, Reality, and Narad miss is that I was simply pointing out that a few decimals different and Fauci and others would have called the mortality reduction significant. I don’t even like the phrase “statistical significance” because it has nothing to do with importance, simply as I explained above, with whether one decides that an outcome was more or less likely to have been caused by unmeasured variables that ended up more in one group than the other. And whether 0.05, 0.001 etc. the result could have been due to something other than the independent variable. As more and more studies are done, the probability goes down; but never zero.
The best book I have ever read: Merwyn Susser (1973). Causal Thinking in the Health Sciences: Concepts and Strategies in Epidemiology. Used copies available on Amazon.com and in many university libraries
A short chapter is also good: Kenneth Rothman and Sander Greenland (1998). Modern Epidemiology (2nd Edition). Chapter 2: Causation and Causal Inference.
Also: Daniel Kahneman et al. (1982) Judgment under uncertainty: Heuristics and biases.
I’ve got many more; but bottom line is that “causation” is NEVER “proven” we just make a decision based on various criteria and heuristics.
@Joel The thing about Dr Faucci illustrates somewhat a point. A result can be said to be ‘statistically significant’ at a given level.
That is purely a definition. It might have better if it has been called ‘statistically moonish’ or something – it would have made zero difference to anything if it had.
But now we move from that definition to common language – ‘significant’ and binary classification, which then seems to be moved almost to ‘proven fact’ and it is this that is fed into decision making – even if one holds the inconsistent mental state that ‘it may change’.
Now P-numbers, confidence intervals, all that, can be given appropriate theoretical background, and indeed in many or most normal circumstances one pulls the handle, out pops the result and it does indeed have the weight you give it. Theres nothing wrong with handle pulling on mathematical procedures, lots of people including myself do it all the time, but you have to know – you should want to know – that there is theoretical justification, and you have to be aware of its implicit assumptions and limitations. Maybe you can go your entire career without these considerations, or maybe you can be trying to analyse a whole bunch of small, badly controlled studies carried out in an atmosphere where basic trust – from top to bottom in the process – is attenuated.
But – you have really managed to lower my confidence in medical decision making!
“Biological plausibility is often added to the mix (but one can make a biological argument for almost anything).
Benefit/cost analysis play a role (but depends how one weights them and which variables one chooses). ”
Say what? This sounds like we’re in real ad hoccery land and lost without a guide!
So what if one can make biological argument for almost anything? Are you suggesting that when biological plausibility is included its sort of some authority sticking their finger up in the air? This is not setting a prior. What the prior should be can often be a difficult question – it is actually a matter of research in general, it is the current limit of the science. So what? Science doesn’t guarentee giving you all the answers, or that it will make your life easy.And anyway I can easily think anyway of how we might go about getting useful priors in a systematic way.
Furthermore, just because you choose not to include it in your analysis is irrelevant.
It just means you have implicitly assumed priors on all other information such that they are neutral to the data.
Probably the implicit assumption that any potential cure is as likely to work as not work, or perhaps slightly lesser condition is that all potential cures are all as equally likely to work.
Its a good exercise to push to the boundaries. Trying saying aloud ‘Given new disease X all potential cures are biologically equally plausible’, or, ‘Given a new disease X compound Y is (biogically speaking) as equal to work as not’. These are ridiculous statements surely. So biological plausibility should be included in your analysis, and you should exert your maximum effort to do it properly.
Fortunately, most of the time the actual evidence far outways the setting of priors so you get off with iffy decision making process.
Your point about benefit /cost analysis made me say ‘what’ twice. I’m not sure I understand fully how medical decisions can be made without it. Also,’depends how one weights them and what variables you choose’ – it would be beyond bizarre if you were including factors in your analysis where this wasn’t the case.
But really, I think we’re in pretty much the same territory as above. Even if you don’t explicitly have them (still not clear what your decision criteria is without them..)
if you make several decisions using your ‘system’, and by pure chance your system happens to be consistent,(if it’s not consistent where does that leave you?) then we can probably derive a Cost/Benefit that ‘explains’ your decision. More than you can do apparently, though I stand to be corrected when you tell me how you explain the decision ‘We should give the patient X’ without using cost/benefit terms!
I need to get this book. https://www.amazon.com/Fauci-Science-Concealed-Syndrome-Epidemic/dp/B086C33Y64
Maybe you should start with the authors’ other books that claim that Chronic Fatigue Syndrome is an infectious disease and equate it to AIDS. Literally, apparently.
Sounds like very colorful reading.
Then again, you’re likely better off turning to a top fantasy or science fiction book for something like that; the accuracy will be as good or better, and the writing, plot development and characters guaranteed to be good. I recommend Lois McMaster Bujold or David Weber or David Brin for some very good examples.
Hi Dorit. Thank you for the recommendations. However, I find this kinda’ stuff way more interesting. https://wjla.com/news/local/cdc-shut-down-army-germ-lab-health-concerns
Oh, how is GSK doing in the run for the Convid-19, oops, I mean Covid-19 vaccine? How is your stock performing? https://www.gsk.com/en-gb/media/press-releases/clover-and-gsk-announce-research-collaboration-to-evaluate-coronavirus-covid-19-vaccine-candidate-with-pandemic-adjuvant-system/
Collaborating with China-based Clover Biopharmaceuticals…. Chinese biologics/biosimilars? Ew. Scary.
Do you even know what biologics/biosimilars are?
Sounds like very colorful reading.
I was impressed by the fact that the book is self-published. So conspiratorial and enriched with confabulated bullshit that not even Lighthorse would touch it.
Is there any point to Natalie’s post? The CDC doing their job and a pharmaceutical company doing pharmaceutical company things. I mean, it’s nice to know but it’s not the Vorkosigan saga.
NumberWang Or the Chalion series (yay Penric and Desdamona!).
I’d much rather re-read all of those than NW’s regular missives from her misanthropic bunker.
More proof you are very gullible. A very common issue with those who hate public health and children.
A journalist who thinks aids is caused by the herpes virus HHV 6 instead of HIV. Presumably his entire outlook is based on evil scientists hiding this fact (Dr Fauci among them). His foundation is very sandy.
Hmmm gain-of-function research? Wuhan lab given millions under Fauci? BG, Birx and Fauci – PEPFAR, aka the AIDS slush fund. So much $$$$$! Probably just more coincidences (nod/wink). https://www.newsweek.com/dr-fauci-backed-controversial-wuhan-lab-millions-us-dollars-risky-coronavirus-research-1500741
Irrelevant to your original statement.
Also, no evidence of genetic tampering with the virus has been detected, despite the article trying to imply that most scientists think its possible it was created in a lab. So no ‘gain of function’ carried out. So, wild virus.
Trump better shut up though, eh? If you follow that article through then America funded viral manipulation in China and indirectly caused the entire pandemic. China might sue.
@ Natalie White
Yep, go for it. The author devoted considerable time years ago trying to refute that HIV caused AIDS. Probably still believes it. He also has been touting a conspiracy hiding the real cause of chronic fatigue syndrome. So, yep, go for it. I’m sure any lunatic that confirms your moronic paranoid conspiracy theory will be welcome reading.
I suggest you also get a copy of the Protocols of the Elders of Zion and I’ll try to think of some other books that you might like.
Over at the increasingly irrelevant AoA, John Stone is flogging a letter written by the Alliance for Natural Health (all diseases can be cured by megavitamin therapy) and the British Society for Ecological Medicine (all diseases are due to allergies and Enzyme Potentiated Desensitisation will cure them) about the Government wanting to have a COVID-19 vaccine developed. Apparently, it is the Government’s fault that people are vaccine adverse, because the government indemnifies vaccine manufacturers and does not give the people all the raw data – and because adjuvants.
The comments are of course always a highlight.
Ah, the ANH, another wretched hive of scum and villainy. Despite their ‘international’ pretensions, the group is essentially a UK affair, and more precisely a Rob Verkerk affair. It serves as a front for the Natural Health Foundation when that latter group is lobbying in the EU against food-standard legislation.
As well as megavitamin supplement scamming, Verkerk is up to his armpits in colloidal-silver quacksalvery, because colloidal silver is a kind of vitamin.
@ Chris Preston
You should check out BMJ Rapid Responses. Stone often posts unchallenged. He is currently afraid that the usual long time protocol for developing vaccines will be shortened; but he isn’t the only one, Skeptical Raptor also is critical. See Skeptical Raptor (2020 May 3). “Coronavirus vaccine race — Operation Warp Speed could be a disaster”.
We don’t conduct large placebo control randomized trials for each year’s formulation of flu vaccine. If we did, by the time the trials were concluded the season would have already reached its peak. As long as the same stabilizers are used, the same adjuvants, the only difference is the mutated KILLED virus. While we do not currently have a coronavirus vaccine, if same stabilizers, same adjuvants are used as in flu vaccine and it is KILLED there is only one very small risk, besides it not working, that is, enhancing virulence from other viruses. This happened with the Dengue Virus vaccine because it didn’t include the one most virulent serotype and previous exposure to other serotypes actually resulted in Dengue Hemorrhagic Fever. However, if one looks at the areas where Dengue is prevalent, prior to vaccine many suffered from Dengue Hemorrhagic Fever as exposure to more than one of the serotypes happened often. An enhanced virulence to other viruses also occurred in first formulation of Respiratory Syncytial virus vaccine; but a change ended this. Finally, one or two early studies found this with early attempts at coronavirus vaccine; but further studies didn’t find this.
The major fear is that a coronavirus vaccine will make us more vulnerable to flu; but most studies didn’t find this and that is natural flu. If we also get flu vaccine, a different story.
So, I would be quite willing to get a killed COVID-19 vaccine as soon as possible, as long as stabilizers, adjuvants, and the virus is KILLED.
There are also other ways to make a vaccine, e.g., Vaccine-Like Particles where they take a sequence of amino acids from outer part of a virus, no genome, nothing that can lead to replication, grow large quantities in yeast or harmless bacteria and then use along with stabilizers and adjuvants to make a vaccine.
And there is a new approach whereby one actually injects modified RNA that only involves things similar to Vaccine-Like Particles, injects directly into cells in our body, and our cells manufacture. Our immune systems recognize as foreign and it primes our immune system.
However, one looks at it, based on my studies of how vaccines are made, work, etc. as long as FDA makes certain vaccine as formulated and produced correctly, I, for one, would immediately get it. My main worry is that it won’t work, not any risks.
So, Stone is wrong, as he always is, and I strongly disagree with Skeptical Raptor.
@ Narad
You asked for a reference when I stated that Remdesivir was fairly safe, few side-effects. I have done searches with irregular intervals of a number of topics related to COVID-19, including Remdesivir.
The first papers I found did not find serious side-effects or found rarely. I won’t bother to use them. Here are a couple later ones that did find a number of serious adverse reactions:
One small study of 61 severe cases found: “A total of 32 patients (60%) reported adverse events during follow-up (Table 2). The most common adverse events were increased hepatic enzymes, diarrhea, rash, renal impairment, and hypotension. In general, adverse events were more common in patients receiving invasive ventilation. A total of 12 patients (23%) had serious adverse events. The most common serious adverse events — multipleorgan-dysfunction syndrome, septic shock, acute kidney injury, and hypotension — were reported in patients who were receiving invasive ventilation at baseline. . . In this cohort of patients hospitalized for severe Covid-19 who were treated with compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%).” (Grein, 2020)
From Wikipedia [note that I checked out the references, even obtained most of the articles]:
“The most common adverse effects in studies of remdesivir for COVID-19 include respiratory failure and blood biomarkers of organ impairment, including low albumin, low potassium, low count of red blood cells, low count of platelets that help with clotting, and yellow discoloration of the skin. Other reported side effects include gastrointestinal distress, elevated transaminase levels in the blood (liver enzymes), and infusion site
reactions.
Other possible side effects of remdesivir include: Infusion‐related reactions. Infusion‐related reactions have been seen during a remdesivir infusion or around the time remdesivir was given. Signs and symptoms of infusion related reactions may include: low blood pressure, nausea, vomiting, sweating, and shivering. Increases in levels of liver enzymes, seen in abnormal liver blood tests. Increases in levels of liver enzymes have been seen in people who have received remdesivir, which may be a sign of inflammation or damage to cells in the liver.”
So, I was wrong about no serious side-effects based on earlier studies, something I have NO problem admitting as opposed to a-holes like you. However, as serious as these side-effects were, they were when Remdesivir was used on severe cases. I promise you that many medical interventions currently being used have serious side-effects, e.g., chemotherapy, immunotherapies, etc. that when one looks at benefit/cost ratio, are still being used. So, though the bar has been raised much higher, the question still remains whether Remdesivir’s benefit/cost ratio will be shown to be positive.
And I’ve given a couple of references of how nucleic acid analogues work (Gordon, 2020; Ko, 2020). I doubt you will read them or understand them.
And I repeat that “standard of care” is mainly a legal term that protects doctors to some extent from lawsuits, so, given currently we have no scientifically-based treatments for COVID-19 and the one randomized study of over 1,000 that found positive results, shorter time, and possibly reduced mortality, one can choose to use or not to use. It will be easier to judge the study when the peer-reviewed journal article is published. And more studies are done. It may turn out that the peer-reviewed study is highly flawed, in between, or extremely well-done and it may give details of adverse events. In the meantime, for someone who arrogantly calls himself “Reality” as if he represents validity to attack someone like Anthony Fauci who has 40 – 50 years of contributing to public health based on using “standard of care”, also showing Reality’s ignorance of what it really means, is outrageous; but doesn’t surprise me when one can basically post comments anonymously on blogs as you do.
Only time will tell. If the published article and/or further research on Remdesivir shows its benefit/cost ratio to be negative, again, I’ll have NO problem accepting that. I have NO vested interest.
My one real concern is if it does prove useful is Gilead using extortionist pricing. Believe it or not, I’ve investigated and while patent laws protect a company’s product they do NOT prohibit Congress from limiting profits/prices to reasonable levels. Our corrupt Congress just doesn’t choose to use its authority.
References:
Gordon CJ (2020 Apr 13). Remdesivir is a direct-acting antiviral that inhibits RNA-dependent RNA polymerase from severe acute respiratory syndrome coronavirus 2 with high potency. JBC Papers in Press.
Grein J et a. (2020 Apr 10). Compassionate Use of Remdesivir for Patients with Severe Covid-19. The New England Journal of Medicine;
Ko WC (2020 In Press). Arguments in favour of remdesivir for treating SARS-CoV-2 infections. International Journal of Antimicrobial Agents
Wikipedia (2020 May 5). Remdesivir
Disappointingly, the lock down seems to have made a number of people irrational.
Just a quick post to expound on my Fauci post for those who see the world as binary – ie: black or white.
These people think you either support Fauci 100% or 0% and a single criticism of any Fauci statement means 0% support of Fauci.
I do not happen to worship at the altar of Fauci or any scientist and recognize all are subject to errors – including myself.
I view the world in a more nuanced manner than those with the black/white delusion. I find I can disagree with some things a person says or stands for and agree with some other things they say or do.
My criticism of Fauci in regard to his remdesivir endorsement does not mean I have 0% support for Fauci… it means that with that statement and some others my positive view of him is now ~80% but not 100% and I will have to check up on what he is endorsing to make sure that I agree with it… just like I do with any other scientist/person.
BTW – If some were to check my Disqus account history (Reality022) you would find posts strongly defending Fauci against the Loony Libertarians who seem to think he is teh debil.
.
Now to a second point:
There appears to be a group of Fauci apologists who, to excuse Fauci’s statement, say it is due to ‘pressure from Trump/the administration’.
I do not subscribe to this excuse and think it is a horrible thing to say for 2 reasons:
1) There is absolutely no evidence that this statement was made under pressure. That idea is totally invented in the minds of the Fauci apologists in their attempt to exonerate Fauci.
2) It is a horrible thing to say about Fauci.
I take him at his word. If he said it he meant it.
The excuse actually means that Fauci’s word is so untrustworthy that he can be pressured into being dishonest about his scientific opinions and only the apologists can tell us when he is lying or actually relating his honest view.
The apologists are basically saying Fauci is dishonest.
I have much more respect for the man and believe he is honest but in this case merely wrong.
.
That is all I’m going to say about this subject as some people are going off the rails with their binary view of the world. (snicker)
@ Reality
And you continue to miss the point that “Standard of Care” is mainly a legal term. Are you that dense? It is you who stated your opinion of Fauci sank, so your binary view of the world. Try reading my other comments, closely, maybe you will learn something; but I doubt it. “Reality”, lacks reality testing.
I tend to agree. I am of the opinion that Fauci made a mistake here. The evidence for Remdesiver is nowhere near good enough for it to become the standard of care. But then I am not the one having to make these decisions under difficult circumstances. I don’t pretend to understand why Fauci might have made the comment, so don’t see a lot of point in speculating about it.
On the other hand, watching the White House performance from afar, I can see the administration is dysfunctional and is run by a narcissistic bully, who will publicly turn on anyone who disagrees with them. I also see there are people within and around the White House who are happy to tell whatever lies they think Trump wants to hear, either through fear or hope for advancement. I understand why people would add 2 and 2 and come up with 5.
Chris Preston said, “I am of the opinion that Fauci made a mistake here. The evidence for Remdesiver is nowhere near good enough for it to become the standard of care.”
I believe that is the main thrust of this Orac article – that the evidence for Remdesiver efficacy is sorely lacking.
Quoting Orac’s article above: “In reality, like Raoult’s trials, this trial said nothing about the efficacy of remdesivir against COVID-19 other than that the drug could be given to COVID-19 patients with a reasonable safety profile.”
.
I agree with your 2nd paragraph and think that Fauci is not one of those administration toadies and is being honest and has merely made a mistake perhaps brought about through grasping-at-straws desperation as described in a current SBM article.
I, as well, do not know why Fauci made the statement but to me it is very disrespectful of the man to use as an excuse that he is dishonest enough to lie like a toady when pressured by Trump.
I think we are essentially in agreement about this matter.
Have fun.
But… 2+2 == 5. Excepting the very narrow case of letting the value approach 4 for the purpose of aiming missiles.
re dysfunctional administration.. narcissistic bully et al
It seems that the aforementioned will now ” wind down” the Covid task force ( The Hill reports) but Drs Fauci and Birx will still be involved in some capacity.
AS though the battle is already won. Hah!
CA and the NY area are reporting lower numbers of deaths and hospital admissions BUT whilst
other areas are increasing theirs.
Maybe the Orange One imagines that if we discuss Covid less, people will think it’s gone, go back to work, buy stuff and the economy will flourish. Ignore it and it’ll go away. Wishful thinking as usual.
Although I am somewhat creative, I swear that I didn’t make this up:
Trump tours a factory that manufactures masks in Arizona with 3 men – all 4 of them without masks- as someone blares “Live and Let Die” over the PA system
@ Chris Preston
Apparently you lack understanding of English. As I explained even grandfathered in medical treatments with no hard scientific evidence are considered the standard of care, that is, if a doctor uses them he/she lessens risk of lawsuits. Standard of care doesn’t mean a high level of scientific validity. I guess I am wasting my time. Think of it this way, if allowed for compassionate use advised by ones doctor, then doctor may not be protected against lawsuits. Unfortunately, as something I read a long time ago, even in Colonial times Americans would rather sue than eat breakfast. Just one more sickness of American exceptionalism, so maybe, just maybe, all Fauci was doing was trying to reduce this risk.
No shit???
At least, he had the googles on; Wouldn’t want him to get fibres in his eyes.,
Conspiracy buffs shouldn’t miss Wayne McRoy’s 2019 book “The Autism Epidemic – Transhumanism’s Dirty Little Secret”. There’s lots of riveting material, including a chapter headlined “EMF Activation of Nanodevices and the Singularity”.
https://www.amazon.com/Autism-Epidemic-Transhumanisms-Little-Secret-ebook/dp/B07QNN614M/ref=sr_1_1?dchild=1&keywords=transhumanism+dirty+secret&qid=1588690438&sr=8-1
Don’t worry, vaccines get abundant attention.
@ Dangerous Bacon
Antivaccinationists continuously claim that they just want a fair hearing, to be listened to; but they have testified before Congress numerous times, before FDA, before Advisory Committee on Immunizations at CDC, before State Houses, etc. had large demonstrations, and have umpteen, some extremely well-funded, websites. When they claim they just want to be “listened” to, they really mean using “listen” as when a parent says: “you didn’t listen to me, so no TV tonight”, they mean didn’t agree, go along with them and, of course, that will NEVER happen. Even Fiona Godlee, Editor of BMJ, played into their hands with an editorial calling for more dialogue, missing the aforementioned.
So, yep, you are RIGHT, they, unfortunately, get abundant attention. I say “unfortunately” because it was fair to allow them to state their case; but at some point, by ignoring anything and everything that refutes their case, continuing to give them the floor only works because more and more people become aware of the refutations; but almost nothing I can think of will change the minds of many antivaccinationists because it is more a religion than anything else. Just look at Natalie White and Christine Kincaid, each and every comment refuted; but on and on they go.
I actually sent an e-mail to John Stone, UK Editor of Age of Autism, and suggested they rename the site:
The Church of the Age of Autism
He never responded.
@ Natalie White
You write: “Hmmm gain-of-function research? Wuhan lab given millions under Fauci? BG, Birx and Fauci – PEPFAR, aka the AIDS slush fund. So much $$$$$! Probably just more coincidences (nod/wink).”
First, moron, American labs have also conducted gain-of-function research. Second, Chinese researchers are quite good and given that previous corona virus outbreaks came from China, not from labs but from nature; and they have the largest wild meat markets, and millions of farm animals, pigs, ducks, chickens in close quarters they have easy access to corona viruses. The Wuhan lab is NOT a “controversial lab” as title of article you refer to includes. It is a top quality lab, plain and simple, American arrogance aside. Third, despite what you and article’s author chooses to believe, the genome, RNA positive sense, has been sequenced and many experts found it quite similar to SARS virus from 2003 and several bat viruses. Quite simply, nature is excellent without human help of creating deadly mutations. Fourth, we finance labs around the world, not just in China.
As usual, you find one or two papers that confirm your moronic paranoid conspiracy delusions and jump on them.
And maybe, though extremely unlikely, it will turn out that the virus did accidentally escape from the Wuhan lab, you probably are not aware that our own Biosafety Level 3 and 4 labs have had problems. So, we could have released some deadly virus (not just a Chinese problem); but, I repeat, scientists around the world have looked at the COVID-19 genome and it is well within the parameters of a natural mutation.
I’ve asked numerous times and will once more: what is your education? Why do you think you are right about anything? Except delusions and stupidity! ! !
@ Natalie White
You write: “Hi Dorit. Thank you for the recommendations. However, I find this kinda’ stuff way more interesting. https://wjla.com/news/local/cdc-shut-down-army-germ-lab-health-concerns
Oh, how is GSK doing in the run for the Convid-19, oops, I mean Covid-19 vaccine? How is your stock performing?”
First, I already mentioned leaks in American labs. So, do you want them closed down? If so, we will be totally unprepared for what nature has to offer. What we need to do is make sure such leaks don’t re-occur, including more funding and, yep, Trump cut funding.
As for Dorit’s stock, I have a 401k and many Americans have similar. Many are based on a wide-range of stocks and bonds, so, I probably have some shares in GSK and, if you, other family members or friends have a 401k or similar, so do you and/or they And, so her husband may have purchased a few shares, do you think that a couple with probably a combined income of $500k would prostitute themselves to earn a few hundred dollars on stocks? There is a classical psychological defense mechanism called projection where someone projects their own negative traits onto others. So, I can only assume that you are someone who would sell their soul to the lowest bidder.
So, despite overwhelming evidence COVID-19 is natural mutation, you bring up something we already knew about leaks in American labs to further your belief such occurred in Chinese lab and you attack someone’s integrity because her family might own a few stocks.
Once again, what do you base your opinion on? Education? Delusions? Just plain STUPIDITY?
You really are a despicable excuse for a human being! ! !
Not to mention that CDC closed the lab. So CDC is not part of great vaccine conspiracy, after all. Huge news, I would say.
One could mention, too, that Johnson & Johnson get COVID vaccine contract. So Dorit Reiss’ plots are not very effective, ater all.
Aarno, you made me curious about how much $$$$ and how many companies. A list of the Convid19, oops, I mean Covid19 cash! https://www.fool.com/investing/2020/04/07/here-are-all-the-companies-working-on-covid-19-vac.aspx
So you think that nobody really dies because of COVID-19 ? And all lockdowns are just a democratic plot ? What is your sorce of the thruth ?
I would say, tell the people in Italy, Spain, France, Great Brittain and other European countries nobody dies because of Covid-19.
@Aarno- Sometimes the CDC gets it right and sometimes, well….. sometimes you can’t truss it. https://arstechnica.com/science/2020/04/cdcs-failed-coronavirus-tests-were-tainted-with-coronavirus-feds-confirm/
Aarno writes, “Not to mention that CDC closed the lab.” Yes, sometimes they get it right. Then, they fail miserably like this…https://www.the-scientist.com/news-opinion/cdc-lab-contamination-delayed-coronavirus-testing-67438
Confidence meter…less than zero.
Hmm…. Problems with the Wuhan Lab and those nasty bats back in 2018. Just another coincidence, I suppose. Weird. So many coincidences. https://www.washingtonpost.com/opinions/2020/04/14/state-department-cables-warned-safety-issues-wuhan-lab-studying-bat-coronaviruses/
So now COVID 19 is a dangerous disease, caused by a lab leak. What is your opinion exactly ?
I was going to say the same thing. What exactly is our Nat actually getting at? What does she really want? More isolation? Less isolation? Blathering on about Wuhan and possible lab accidents as if it makes any difference at the moment. Random conspiracy theory nutbags unrelated to covid. Some guy caught in an unapologetic Chinese attempt to gain a technological edge? Seems like an attempt to weave a single rug without anything to hang the warp from. Or maybe throw enough shit at the wall and see if what sticks can be made to look like the Mona Lisa?
When it comes down to it, you’ve either got a careless team member at a lab researching existing viruses or an inevitable (given long enough) animal/human crossover at the market as likely sources. Neither of which helps at the moment but will no doubt be investigated in depth and spun for political ends by everyone and their dog.
Most likely, people who get the virus come through it fine. However, no pool of immunity means the at risk people are far more likely to come into contact with covid 19 if no measures are put in place. These people are the reason for caution. If even a fraction of this 2M or so fall ill in the UK the deaths will rocket. Not enough beds to cope. In the US you have around 1M hospital beds. Your vulnerable population must be up at the 8M at least? Not all hospital beds are suitable. What about people who don’t have covid but do need a bed? Rough figures, quickly gleaned but enough to send a chill down the spine of anyone responsible for organising a response to this. So Nat, what is your next facile comment going to be?
@ Natalie White
You write: Hmm…. Problems with the Wuhan Lab and those nasty bats back in 2018. Just another coincidence, I suppose. Weird. So many coincidences.”
From a recent article in the Atlantic:
scientists have also identified about 500 other coronaviruses among China’s many bat species. “There will be many more—I think it’s safe to say tens of thousands,” says Peter Daszak of the EcoHealth Alliance, who has led that work. Laboratory experiments show that some of these new viruses could potentially infect humans. SARS-CoV-2 likely came from a bat, too.
It seems unlikely that a random bat virus should somehow jump into a susceptible human. But when you consider millions of people, in regular contact with millions of bats, which carry tens of thousands of
new viruses, vanishingly improbable events become probable ones. In 2015, Daszak’s team found that 3 percent of people from four Chinese villages that are close to bat caves had antibodies that indicated a previous encounter with SARS-like coronaviruses. “Bats fly out every night over their houses. Some of them shelter from rain in caves, or collect guano for fertilizer,” Daszak says. “If you extrapolate up to the rural
population, across the region where the bats that carry these viruses live, you’re talking 1 [million] to 7 million people a year exposed.” Most of these infections likely go nowhere. It takes just one to trigger an epidemic.
Ed Yong (2020 Apr 29). Why the Coronavirus Is So Confusing. Available at: https://www.theatlantic.com/health/archive/2020/04/pandemic-confusing-uncertainty/610819/
Note. he links to peer-reviewed journal articles. So, as the second paragraph makes clear, antibodies to bat coronaviruses exist in the population, etc. Add this to the sequencing of the genome that shows just how close it is to the 2003 SARS corona virus and to bat coronaviruses and, as usual, your moronic “coincidences” just lacks any validity.
Note also that his article links to many other good ones.
As I’ve written before, nature is quite capable of creating really nasty microbes.
You are a MORON! ! !
Oh this guy needs a dishonorable mention, Harvard traitor, Charles Leiber. “has received more than $15,000,000 in grant funding from the National Institutes of Health (NIH) and Department of Defense (DOD).” Our tax dollars hard at work for this POS.
Dude is still collecting a paycheck. https://www.justice.gov/opa/pr/harvard-university-professor-and-two-chinese-nationals-charged-three-separate-china-related
This is our guy:
Charles M. Lieber
Semiconductor nanowires: A platform for nanoscience and nanotechnology
MRS Bulletin
Volume 36, Issue 12 (Laser micro- and nanofabrication of biomaterials)December 2011 , pp. 1052-1063
DOI: https://doi.org/10.1557/mrs.2011.26
So COVID 19 was not involved. One should indeed not serve two masters, DOD and a Chinese university
@ Natalie White
You write: “Hmm…. Problems with the Wuhan Lab and those nasty bats back in 2018. Just another coincidence, I suppose. Weird. So many coincidences.”
From a recent article by Ed Yong (2020 Apr 29). “Why the Coronavirus Is So Confusing: A guide to making sense of a problem that is now too big for any one person to fully comprehend.” The Atlantic. Available at: https://www.theatlantic.com/health/archive/2020/04/pandemic-confusing-uncertainty/610819/
Note that he links to a number of excellent articles, including the two that the following is based on:
“scientists have also identified about 500 other coronaviruses among China’s many bat species. “There will be many more—I think it’s safe to say tens of thousands,” says Peter Daszak of the EcoHealth Alliance, who has led that work. Laboratory experiments show that some of these new viruses could potentially infect humans. SARS-CoV-2 likely came from a bat, too.
It seems unlikely that a random bat virus should somehow jump into a susceptible human. But when you consider millions of people, in regular contact with millions of bats, which carry tens of thousands of new viruses, vanishingly improbable events become probable ones. In 2015, Daszak’s team found that 3 percent of people from four Chinese villages that are close to bat caves had antibodies that indicated a previous encounter with SARS-like coronaviruses. “Bats fly out every night over their houses. Some of them shelter from rain in caves, or collect guano for fertilizer,” Daszak says. “If you extrapolate up to the rural population, across the region where the bats that carry these viruses live, you’re talking 1 [million] to 7 million people a year exposed.” Most of these infections likely go nowhere. It takes just one to trigger an epidemic.”
So, 3 percent of people had antibodies to bat corona viruses. As the above explains, it is quite probable that the current virus came from someone infected by a bat. Now, since sequencing of the current SARS-Cov-2 has found its genome quite close to the 2003 SARS virus and to several bat coronavirus genomes, goes against your sick need to blame the Chinese. A coincidence is not even close to any type of proof, except in the mind of a moron like you looking to place blame. And there is a great book on “coincidences”: David J. Hand (2014). “The Improbability Principle: Why Coincidences, Miracles, and Rare Events Happen Every Day.” Basically, what someone might think is a rare coincidence isn’t.
And, the major blame for what is happening in the U.S. is a combination of Trump and overall American unappreciation for Public Health and, thus, pandemic preparedness. When it comes to cutting funding, first to go.
I realize that real research, logic, etc. have NO effect on moron’s like you; but, hopefully, others monitoring this exchange are open-minded.
And as Aarno pointed out, you attacked someone who had nothing to do with COVID. He worked with the Wuhan Institute of Technology; yep, in Wuhan and that’s it. It’s a large city dimwit. More importantly, he has been charged, not found guilty. I realize that the old adage innocent until proven guilty doesn’t apply to anyone you chose to attack. You just don’t know when to stop. YOU ARE DESPICABLE!
““What it has proven is that a drug can block this virus,” the National Institutes of Health’s Dr. Anthony Fauci said.”
*A* drug. To my ears it sounded like he was trying to imply that yes, *a* drug would work but it was not necessarily *this* drug.
He also compared the current situation to the early days of HIV drug therapy. I came on board in clinical HIV research in the middle of the AZT trials. Part of my orientation was to review the charts of the patients who had been in the trials, and it was immediately clear to me, as it would soon be to the world, that AZT had a positive effect. It wasn’t complete, it wasn’t universal, and it wasn’t long-lasting, but it clearly was a lot better than placebo
It was proof that *a* drug could be effective against HIV, but at the same time it was clear that AZT wasn’t *the* drug.
@ Old Rockin’ Dave
Some try to discredit AZT as the study found it didn’t extend life; but it definitely extended the period of time without any of the various illnesses suffered by those with HIV, e.g. pneumocystis, diarrhea. So, it did benefit people.
@ Orac
Completely off-topic: While I do appreciate the overhaul of the website as it does show dedication to your audience, I confess that I do miss the older layout.
I think I heard somewhere that Dr Fauci has ties to Gilead. Can’t seem to find anything suggesting such a connection in a quick google search. Any truth to it?
The reason you cannot find it might because someone just made it up.
Certainly. In retrospect, it may have been more useful to ask if anyone else had something similar, but hindsight and 20/20 and what have you.
I recognize that, since I couldn’t find anything myself, it could be that there’s no truth to it. But if it is true it’s concerning, and therefore the question is okay to ask. As such, I really don’t see a purpose in your condescension.
Telling you someone might have just made it up was an explanation not condescension. Sorry you felt slighted, but it was nice to see you were at least questioning the claim by looking for other sources.
Well…I certainly don’t wanna believe any old dirt on someone who appears to be unimpeachable the way Dr Fauci has been until now (the current situation notwithstanding.) At least not without significant corroboration.
And I apologize for being a bit combative – I may have been a bit sensitive. Probably an effect of the way dialogue on the internet tends to be.
Hear is a conversation with Dr. Fauci: https://www.microbe.tv/twiv/twiv-219-fauci-pharmacy/
Here is the transcript: https://www.microbe.tv/twiv/twiv-291-transcript-fauci-pharmacy/
I’ve been looking for the NIH Remdesivir data in print, anyone know what happened to it? I went looking and think I found better questions:
As of noon EDT, the clinicaltrials.gov page was last updated 5/7/20, is still open for recruitment and has no study data posted. This claim appears contrary to the NIAID news event page 4/29/20 announcing that the “trial was closed to new enrollments”. I followed up as best I could on clinicaltrials.gov and failed to find any point in the history where the study was NOT recruiting. The enrollment estimate is 800 and the news page says the study has enrolled 1063 patients. So what the heck is going on? Is every study “recruiting” until its published? Or is this study getting expanded because it looked so promising? And if it is expanding, why not publish what has been done and start a fresh study? Could this extra recruiting be normal or is it fishy?
<
blockquote>As of noon EDT, the clinicaltrials.gov page was last updated 5/7/20, is still open for recruitment and has no study data posted. This claim appears contrary to the NIAID news event page 4/29/20 announcing that the “trial was closed to new enrollments”.
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blockquote>
Those entries have to be updated by the researchers themselves; the site is passive.
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