The diseases and organisms which may pose particular risks vary in different parts of the world but include tuberculosis; streptococcal infection; gastro-intestinal organisms; Creutzfeldt-Jakob disease; viral hepatitis, HIV infection, MERS, and other viral infections (particularly viral haemorrhagic fevers such as Lassa, Marburg, or Ebola); and possibly meningitis and septicaemia (especially meningococcal) (seeTable 41.2). In general, good practice, the use of appropriate protective clothing, will greatly reduce the risk of acquiring infection, but some additional precautions may be advisable for particular infections, for example, when dealing with infectious agents transmitted by a vector that is resident on the deceased (e.g. body lice and typhus, fleas, and plague), as these will leave the deceased and may move onto those handling the cadaver putting them at risk.
One would think it was protocol to wear protective gear during the mass burials, apparently not everywhere. When the inmates buried the early AIDS victims on Hart Island in NYC they wore haz-mat style gear - it wasn't known how it was transmitted until later on. I imagine (hope) whoever is doing the burials out there now is doing the same.
"The best available evidence does not support the use of hydroxychloroquine in COVID-19."
A just-reported Chinese study compares the clinical outcomes of COVID-19 patients treated with hydroxychloroquine with those of patients receiving standard of care. The results, alas, are disappointing.
I summarized that study in my roundup yesterday of COVID-19 therapeutic research, pointing out that this randomized controlled trial of 150 patients "found no difference in the rate of viral load reduction or symptom alleviation between the group treated with hydroxychloroquine and the one that had not been." Now the University of Vermont pulmonologist Josh Farkas has published his own analysis of the results, delving more deeply into the data.
The patients in both arms of the study were well-matched demographically and clinically, Farkas notes. Most suffered relatively mild cases of the disease, and treatment was initiated fairly lateâabout 16 to 17 days after disease onset. Twenty-eight days into the trial, the researchers found essentially no difference between the two cohorts with respect to the percent of patients in which the virus was undetectable.
Tang et al.
Farkas adds:
This endpoint most directly addresses the question: does hydroxychloroquine exert anti-viral activity in vivo? The answer seems to be: nope. Even if the drug were administered too late to affect the clinical course of the infection, if it exerted any anti-viral activity then we might expect to see that effect here. If anything, there might be a trend towards delayed viral clearance in patients treated with hydroxychloroquine.
The study also found that fever and respiratory symptoms did not abate any faster in patients who had been treated with hydroxychloroquine.
The best evidence for it's ineffectiveness it the fact that Trump said it works. Bigly.
"The best available evidence does not support the use of hydroxychloroquine in COVID-19."
A just-reported Chinese study
compares the clinical outcomes of COVID-19 patients treated with
hydroxychloroquine with those of patients receiving standard of care.
The results, alas, are disappointing.
I summarized that study in my roundup yesterday of COVID-19 therapeutic research, pointing out that this randomized controlled trial of 150 patients "found no difference
in the rate of viral load reduction or symptom alleviation between the
group treated with hydroxychloroquine and the one that had not been."
Now the University of Vermont pulmonologist Josh Farkas has published his own analysis of the results, delving more deeply into the data.
The
patients in both arms of the study were well-matched demographically
and clinically, Farkas notes. Most suffered relatively mild cases of the
disease, and treatment was initiated fairly lateâabout 16 to 17 days
after disease onset. Twenty-eight days into the trial, the researchers
found essentially no difference between the two cohorts with respect to
the percent of patients in which the virus was undetectable.
Tang et al.
Farkas adds:
This endpoint most directly addresses the question: does hydroxychloroquine exert anti-viral activity in vivo? The answer seems to be: nope.
Even if the drug were administered too late to affect the clinical
course of the infection, if it exerted any anti-viral activity then we
might expect to see that effect here. If anything, there might be a
trend towards delayed viral clearance in patients treated with
hydroxychloroquine.
The study also found that fever
and respiratory symptoms did not abate any faster in patients who had
been treated with hydroxychloroquine.
Now, after listening to the plan for opening the country, why do I feel that I am either too stupid to understand it or there is something troubling?
Every time we listen to him we come away just a little more stupid even if it as we change channels. A microsecond of viewing kills x amount of our brain cells.
Local infectious disease specialists said they would evaluate the potential of asthma treatment ciclesonide (brand name: Alvesco) against the new coronavirus.
Recently, the Institute Pasteur Korea (IPK) suggested that ciclesonide and niclosamide, an ingredient of animal tapeworm drug, as two medicines with a possible potency against the deadly virus that has no cure or vaccine.
Researchers at the IPK said they narrowed down 48 drugs authorized by the U.S. Food and Drug Administration to 24, which have shown the potential to become a Covid-19 treatment. Then, they picked the two medicines that showed antiviral activities in animal models.
The infectious disease experts said they would evaluate ciclesonide, one of the two picked by IPK.
Professor Kim Woo-ju of the Infectious Disease Department of Korea University Guro Hospital said he applied for an investigator-initiated study to test ciclesonideâs clinical effectiveness in Covid-19 patients with mild symptoms. The Ministry of Food and Drug Safety gave the nod on March 27.
Infectious disease department professors at 11 university hospitals are participating in the study.
The clinical trial will enroll 141 mild Covid-19 patients and divide them into three groups â ciclesonide alone group, ciclesonide plus hydroxychloroquine group, and conservative standard treatment group. The patients will be randomly assigned for observation.
Patients will orally inhale ciclesonide 320ug twice a day at 12-hour intervals for 14 days, and hydroxychloroquine 400mg, once daily for 10 days.
Primary endpoints include the negative rate of respiratory virus (on day 7, 14), the time until the virus turns negative (days), the period until clinical improvement (days), and the fraction of clinical failures.
Kim, the principal investigator of the study, said he has been closely monitoring news articles that said ciclesonide was effective in Covid-19 treatment. He said, âThe IPK said ciclesonideâs viral suppression in a lab test showed a good outcome and proposed to me that I could do the trial. After discussion within the Korean Society of Infectious Diseases, I decided to lead the study.â
Kim assumed that ciclesonide, which is inhaled orally, would have antiviral and inflammatory control effects locally in the respiratory system. âI assume that it will improve clinical symptoms, shorten the hospitalization period, and prevent the worsening of severe cases by removing the virus quickly in mild patients, rather than in severe patients,â he added.
