jerseygirl
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Post by jerseygirl on Apr 5, 2020 17:06:35 GMT -5
A newer study from Wuhan not yet peer reviewed It’s in this study that the observation that Corona infection was not observed in 80 lupus patients taking hydroxychloroquine. (In introduction) www.medrxiv.org/content/10.1101/2020.03.22.20040758v2.full.pdf+htmlApparently there is also a survey for rheumatologist s asking about their lupus patients, hydroxycloroquine, chloroquine and any Covid 19 infections Having large amounts of data from this survey might further the premise that hydroxy chloroquine/chloroquine is effective )or not) Also discussions about zinc being either stand alone or synergistic with the drug.
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Deleted
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Post by Deleted on Apr 5, 2020 17:13:02 GMT -5
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jerseygirl
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Post by jerseygirl on Apr 5, 2020 17:24:36 GMT -5
Read the paragraph that Kaiser is managing its supplies to meet the existing needs of patients that do not have viable alternatives ( including those with lupus). My sister had lupus and had multiple possible drugs. Chloroquine and hydroxy are not the only drugs available for lupus. If indeed the patient in the news could only take chloroquine or OH chloroquine statement implies she can get drug
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TheHaitian
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Post by TheHaitian on Apr 5, 2020 20:50:39 GMT -5
Wasn’t the Netherlands and UK trying to reach that? Herd immunity?
I think the UK gave up on that when the amount of deaths and sick got to much to handle; I believe the Netherlands was moving forward because they had a better hospital system and more people doctors on hand to help the sick.
I don’t know... my mom is a nurse and she had been hiding from me that she had a fever (my cousin called me and told me today). Her fever passed but she gave it to my 64 year old step dad...
She swears they are both ok and it is was just the fever. I am still worried and concerned because my pharmacist said the fever may past but down the road , a week from now her lungs may get affected. So trying to convince her to get tested (both of them); more so my sister has asthma.
So that made me realize: I am all for herd immunity till it is a loved one that is put at risk or in the line of fire. My two cousins that are nurses have been caring for them and that is making me think: If they did not wear proper PPE they may catch it + their families etc.
So yeah I am worried...
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lurkyloo
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Post by lurkyloo on Apr 5, 2020 21:20:19 GMT -5
The numbers I saw suggested we needed 50% of the population to be exposed in order to get effective herd immunity. If we do that Italy-style it would mean a good 4% of the population would die. Even if we keep it to 0.5% death rate that’s still over a million people dead in the US alone. And it’s not just high risk people dying either.
I don’t know what the answer is. I think we can keep this up for a couple of months more, but the thought of another 6-12-18 months of this is pretty bad.
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TheHaitian
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Post by TheHaitian on Apr 6, 2020 10:35:10 GMT -5
The numbers I saw suggested we needed 50% of the population to be exposed in order to get effective herd immunity. If we do that Italy-style it would mean a good 4% of the population would die. Even if we keep it to 0.5% death rate that’s still over a million people dead in the US alone. And it’s not just high risk people dying either. I don’t know what the answer is. I think we can keep this up for a couple of months more, but the thought of another 6-12-18 months of this is pretty bad. The next 2-3 months should be interesting. I think by May people will start going CRAZY!!!
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jerseygirl
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Post by jerseygirl on Apr 6, 2020 11:10:13 GMT -5
Just announced on radio Trench graves are being dug in NY city parks, crematories can’t keep up with need Both in NY and NJ the big temporary hospitals built by army are being used Very upsetting and sad and signs all over about appreciation for health care workers
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Deleted
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Post by Deleted on Apr 6, 2020 12:34:58 GMT -5
Just announced on radio Trench graves are being dug in NY city parks, crematories can’t keep up with need Both in NY and NJ the big temporary hospitals built by army are being used Very upsetting and sad and signs all over about appreciation for health care workers I saw on TV this morning that Louisiana's morgue is full and they are having problems having bodies removed when people pass away at home, similar to what's been happening in Italy.
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raeoflyte
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Post by raeoflyte on Apr 7, 2020 6:06:28 GMT -5
Read the paragraph that Kaiser is managing its supplies to meet the existing needs of patients that do not have viable alternatives ( including those with lupus). My sister had lupus and had multiple possible drugs. Chloroquine and hydroxy are not the only drugs available for lupus. If indeed the patient in the news could only take chloroquine or OH chloroquine statement implies she can get drug The insurance companies shouldnt be deciding what medications a person needs. It's just part of the same message that as long as only the old and compromised die we will have won.
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lurkyloo
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Post by lurkyloo on Apr 7, 2020 6:59:52 GMT -5
Read the paragraph that Kaiser is managing its supplies to meet the existing needs of patients that do not have viable alternatives ( including those with lupus). My sister had lupus and had multiple possible drugs. Chloroquine and hydroxy are not the only drugs available for lupus. If indeed the patient in the news could only take chloroquine or OH chloroquine statement implies she can get drug The insurance companies shouldnt be deciding what medications a person needs. It's just part of the same message that as long as only the old and compromised die we will have won. I have never been a fan of insurance companies approving or not approving medical care, and Kaiser has always struck me as far too Big Brother-esque for my taste. They were an option for my postdoc; I squinted at their policies and „what? no“. That said, someone needs to manage the supply of (hydroxy)chloroquine and we‘ve seen from the PPE debacle that Trump and his administration are not competent for the job. So, mixed feelings.
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jerseygirl
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Post by jerseygirl on Apr 7, 2020 8:54:03 GMT -5
Read the paragraph that Kaiser is managing its supplies to meet the existing needs of patients that do not have viable alternatives ( including those with lupus). My sister had lupus and had multiple possible drugs. Chloroquine and hydroxy are not the only drugs available for lupus. If indeed the patient in the news could only take chloroquine or OH chloroquine statement implies she can get drug The insurance companies shouldnt be deciding what medications a person needs. It's just part of the same message that as long as only the old and compromised die we will have won. Kaiser isn’t just an insurance company, large hospital system with many dictors
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raeoflyte
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Post by raeoflyte on Apr 7, 2020 9:02:14 GMT -5
The insurance companies shouldnt be deciding what medications a person needs. It's just part of the same message that as long as only the old and compromised die we will have won. I have never been a fan of insurance companies approving or not approving medical care, and Kaiser has always struck me as far too Big Brother-esque for my taste. They were an option for my postdoc; I squinted at their policies and „what? no“. That said, someone needs to manage the supply of (hydroxy)chloroquine and we‘ve seen from the PPE debacle that Trump and his administration are not competent for the job. So, mixed feelings. I just can't get behind that idea. I fight with the insurance company at least twice a year to keep the medications and dme that we need. How are they deciding who needs it most.... Triaging is one thing. Pre-emptively withholding needing medication just makes my skin crawl.
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raeoflyte
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Post by raeoflyte on Apr 7, 2020 9:04:16 GMT -5
The insurance companies shouldnt be deciding what medications a person needs. It's just part of the same message that as long as only the old and compromised die we will have won. Kaiser isn’t just an insurance company, large hospital system with many dictors Are the doctors making this decision with patients to try another medication? Are doctors even reviewing a patients file before refusing to fill it? Because it looks like the insurance (division) is making blanket medical decisions for patients.
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jerseygirl
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Post by jerseygirl on Apr 7, 2020 9:31:59 GMT -5
Kaiser isn’t just an insurance company, large hospital system with many dictors Are the doctors making this decision with patients to try another medication? Are doctors even reviewing a patients file before refusing to fill it? Because it looks like the insurance (division) is making blanket medical decisions for patients. Please reread the link, keeps repeating physician review Nothing about insurance
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Deleted
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Post by Deleted on Apr 7, 2020 9:48:30 GMT -5
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jerseygirl
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Post by jerseygirl on Apr 7, 2020 10:11:36 GMT -5
So? Letter said most should be fine, if not contact your physician There are alternatives It’s not a plot but trying to balance needs in an emergency
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hoops902
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Post by hoops902 on Apr 7, 2020 10:16:26 GMT -5
What am I missing? In an emergency, critical supplies go to the people who need it more than people who need it less. I'm not super familiar with lupus...but are those people going to die without this medication?
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raeoflyte
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Post by raeoflyte on Apr 7, 2020 10:16:56 GMT -5
Are the doctors making this decision with patients to try another medication? Are doctors even reviewing a patients file before refusing to fill it? Because it looks like the insurance (division) is making blanket medical decisions for patients. Please reread the link, keeps repeating physician review Nothing about insurance I did read it, tyvm, but we obviously read it differently.
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Post by The Walk of the Penguin Mich on Apr 7, 2020 10:27:50 GMT -5
What am I missing? In an emergency, critical supplies go to the people who need it more than people who need it less. I'm not super familiar with lupus...but are those people going to die without this medication? They may. I had a coworker die from it.....they could not get her stabilized. It is incredibly important to get an autoimmune disease stabilized. Lupus destroys many of your major organs, like kidneys. It is not that there are not other options, but many of the options are more toxic than hydroxychloroquine. Others are biologics, which leave you open to an increased risk of infection. What they are doing is asking those who have an autoimmune disease take more risks for an unproven treatment to help others. Whose life is more valuable?
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thyme4change
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Post by thyme4change on Apr 7, 2020 10:28:50 GMT -5
What am I missing? In an emergency, critical supplies go to the people who need it more than people who need it less. I'm not super familiar with lupus...but are those people going to die without this medication? In an emergency, we take medications that have been proven helpful to people for existing conditions and give it to the people who have a disease with no scientific proof that medication is working for them. I'm not against moving resources around for the greatest good, but shouldn't it be based on more than antedoctal evidence and a hunch? People can die from lupus, and lupus is painful. Most don't die because we have discovered good treatments. I don't know anything about them, so I'm not going to say that one is crucial and another inferior. Maybe taking the drug away from them.is the right thing to do, but I'm still baffled as to why we think this is a miracle against Covid.
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hoops902
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Post by hoops902 on Apr 7, 2020 10:32:47 GMT -5
What am I missing? In an emergency, critical supplies go to the people who need it more than people who need it less. I'm not super familiar with lupus...but are those people going to die without this medication? They may. I had a coworker die from it.....they could not get her stabilized. It is incredibly important to get an autoimmune disease stabilized. Lupus destroys many of your major organs, like kidneys. It is not that there are not other options, but many of the options are more toxic than hydroxychloroquine. Others are biologics, which leave you open to an increased risk of infection. What they are doing is asking those who have an autoimmune disease take more risks for an unproven treatment to help others. Whose life is more valuable? It depends if we're talking about 1 life...or lots of lives. Without knowing, I have to assume that one person's ongoing medication would be used to treat many people with a short term disease? I guess I'm more confused that people seem to think "Healthcare company is making healthcare decisions for people without their consent" is a new thing. It's not. Maybe they are specifically worried about this one decision (which would make more sense to me given how unsure anyone seems that this is even a viable COVID19 treatment). If it WAS a viable treatment though...this seems totally fine IMO. Just like I'd expect to see them taking someone in a lengthy coma off a ventilator if it meant potentially saving many more people who need it to live and have a high chance of living if given the treatment. There's always going to be some kind of tradeoff...I don't think we can avoid that. So then the question goes to whether the "It's going to stick with you for 40 days anyways" is true.
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thyme4change
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Post by thyme4change on Apr 7, 2020 10:40:40 GMT -5
I have a friend that has Lupus and uses Kaiser. She is also over 65. So, underlying health condition, advanced age and now she may be denied medication. Sounds like she may want to really respect that 6 foot limit.
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teen persuasion
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Post by teen persuasion on Apr 7, 2020 10:41:41 GMT -5
They may. I had a coworker die from it.....they could not get her stabilized. It is incredibly important to get an autoimmune disease stabilized. Lupus destroys many of your major organs, like kidneys. It is not that there are not other options, but many of the options are more toxic than hydroxychloroquine. Others are biologics, which leave you open to an increased risk of infection. What they are doing is asking those who have an autoimmune disease take more risks for an unproven treatment to help others. Whose life is more valuable? It depends if we're talking about 1 life...or lots of lives. Without knowing, I have to assume that one person's ongoing medication would be used to treat many people with a short term disease? I guess I'm more confused that people seem to think "Healthcare company is making healthcare decisions for people without their consent" is a new thing. It's not. Maybe they are specifically worried about this one decision (which would make more sense to me given how unsure anyone seems that this is even a viable COVID19 treatment). If it WAS a viable treatment though...this seems totally fine IMO. Just like I'd expect to see them taking someone in a lengthy coma off a ventilator if it meant potentially saving many more people who need it to live and have a high chance of living if given the treatment. There's always going to be some kind of tradeoff...I don't think we can avoid that. So then the question goes to whether the "It's going to stick with you for 40 days anyways" is true. What about the math? I've heard the dose for Covid-19 is 2.5 * the normal dosage (which is worrying, because of side effects). How many patients currently use the drug, vs the surge of Covid-19 patients? Even if this is useful for Covid-19 (still debated), this pandemic will drag on longer than 40 days, and likely completely exhaust supplies of the drug.
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pulmonarymd
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Post by pulmonarymd on Apr 7, 2020 10:50:23 GMT -5
If you have been watching the news, this is the first of many possible drug shortages. These sort of decisions may need to be made repeatedly. When we have scarce resources someone will suffer. And someone will need to make the decisions. Those decisions cannot be made at an individual level. Ultimately, some people will be hurt.
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Post by The Walk of the Penguin Mich on Apr 7, 2020 10:55:16 GMT -5
I also saw yesterday that 47% of the hydroxychloroquine that the US has comes from India. India has stopped exported shipments of the drug to the US. Is it a tit for tat?
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Post by The Walk of the Penguin Mich on Apr 7, 2020 10:56:22 GMT -5
If you have been watching the news, this is the first of many possible drug shortages. These sort of decisions may need to be made repeatedly. When we have scarce resources someone will suffer. And someone will need to make the decisions. Those decisions cannot be made at an individual level. Ultimately, some people will be hurt. Yep, apparently the drugs used to sedate patients on ventilators are getting scarce.
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pulmonarymd
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Post by pulmonarymd on Apr 7, 2020 11:00:14 GMT -5
If you have been watching the news, this is the first of many possible drug shortages. These sort of decisions may need to be made repeatedly. When we have scarce resources someone will suffer. And someone will need to make the decisions. Those decisions cannot be made at an individual level. Ultimately, some people will be hurt. Yep, apparently the drugs used to sedate patients on ventilators are getting scarce. We have an ongoing list of medications we might need to use, and an estimate of how long they would last. Like practicing in a third world country
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Post by The Walk of the Penguin Mich on Apr 7, 2020 11:04:09 GMT -5
They may. I had a coworker die from it.....they could not get her stabilized. It is incredibly important to get an autoimmune disease stabilized. Lupus destroys many of your major organs, like kidneys. It is not that there are not other options, but many of the options are more toxic than hydroxychloroquine. Others are biologics, which leave you open to an increased risk of infection. What they are doing is asking those who have an autoimmune disease take more risks for an unproven treatment to help others. Whose life is more valuable? It depends if we're talking about 1 life...or lots of lives. Without knowing, I have to assume that one person's ongoing medication would be used to treat many people with a short term disease? I guess I'm more confused that people seem to think "Healthcare company is making healthcare decisions for people without their consent" is a new thing. It's not. Maybe they are specifically worried about this one decision (which would make more sense to me given how unsure anyone seems that this is even a viable COVID19 treatment). If it WAS a viable treatment though...this seems totally fine IMO. Just like I'd expect to see them taking someone in a lengthy coma off a ventilator if it meant potentially saving many more people who need it to live and have a high chance of living if given the treatment. There's always going to be some kind of tradeoff...I don't think we can avoid that. So then the question goes to whether the "It's going to stick with you for 40 days anyways" is true. You are talking about an unproven treatment, that has shown questionable efficacy vs one that has proven efficacy. They are talking about taking this drug prophylactically as well. This is even more bothersome, considering the side effects of it. It seems irresponsible to promote giving someone a drug to take propylactically, where even at doses where it is taken for lupus patients(at a lower dose) it is monitored carefully for the possibly fatal side effects. As to whether the drug sticks with you for 40 days, anecdotally those who take it say a few days without and their symptoms are roaring back. The drug may stick around, but you still need a therapeutic level to prevent damage.
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hoops902
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Post by hoops902 on Apr 7, 2020 11:10:42 GMT -5
It depends if we're talking about 1 life...or lots of lives. Without knowing, I have to assume that one person's ongoing medication would be used to treat many people with a short term disease? I guess I'm more confused that people seem to think "Healthcare company is making healthcare decisions for people without their consent" is a new thing. It's not. Maybe they are specifically worried about this one decision (which would make more sense to me given how unsure anyone seems that this is even a viable COVID19 treatment). If it WAS a viable treatment though...this seems totally fine IMO. Just like I'd expect to see them taking someone in a lengthy coma off a ventilator if it meant potentially saving many more people who need it to live and have a high chance of living if given the treatment. There's always going to be some kind of tradeoff...I don't think we can avoid that. So then the question goes to whether the "It's going to stick with you for 40 days anyways" is true. You are talking about an unproven treatment, that has shown questionable efficacy vs one that has proven efficacy. They are talking about taking this drug prophylactically as well. This is even more bothersome, considering the side effects of it. It seems irresponsible to promote giving someone a drug to take propylactically, where even at doses where it is taken for lupus patients(at a lower dose) it is monitored carefully for the possibly fatal side effects. As to whether the drug sticks with you for 40 days, anecdotally those who take it say a few days without and their symptoms are roaring back. The drug may stick around, but you still need a therapeutic level to prevent damage. Actually, that was my entire point. There's an argument for "this drug isn't even good for this purpose" that's fine to make. But people seem surprised in general that a company would make healthcare decisions for people...that's common and to be expected in emergencies. There's a distinction between "is this particular decision a good one" and "is it ok that healthcare companies sacrifice one group to save another". The latter I think is fine, and isn't even anything new. The former can be discussed by people who know a lot more specifically about lupus and this particular medication than I do. And I'm not sure at all where the idea that "insurance companies are making healthcare decisions" came from, it's not true. An insurance company can choose what to pay for, they don't control your actual healthcare though.
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Post by The Walk of the Penguin Mich on Apr 7, 2020 11:18:28 GMT -5
Insurance companies have always made healthcare decisions. That is not unusual. I think that where the line blurs is that Kaiser both provides healthcare AND insurance.
That means the Kaiser as a business can take a political stance (despite no evidence, the drug should only be used for covid) and choose to leave another group of patients out in the cold. As Kaiser has taken this stance, Kaiser physicians must comply. So in a classic insurance company/physician setting, physicians can appeal this response.
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