Sunshine State

Moj mali holandski gradic nema jos nijednog zarazenog, ❤️ iako je broj zarazenih u NL vec 2051 😞

Sad kad me Mek napadne 😄

@vilhelmina ili ko zna - sta su Svedjani, Danci i Norvezani uradili poslednjih par dana, pa im brojke novozarazenih padaju - ca 50-ak dnevno? Sta god da su, izgleda da funkcionise (osim ako su smanjili broj testiranja) - prepisujmo od njih!

Zivim blizu Fruske Gore - autom malo do Rohalj baza, pa setnja po pustoj sumi - radim od kuce, sedim po 9-10 sati, okruzena vestima, komentarima, etc... moram zarad psihickog, a i fizickog, mira izaci

@bohumilo To se zove price gouging i kaznjivo je, bar u US

Tacno je, vec postojeci lekovi, ako se pokazu uspesni, mogu da se koriste kao off label lekovi. Koleginica mi prosledila ovu vest veceras (taj lek sam vec navodila par stranica ranije): https://www.genova24.it/2020/03/coronavirus-a-genova-il-primo-paziente-ufficialmente-guarito-era-stato-curato-con-remdesivir-232794/ Genova. Prvi pacijent zaražen koronavirusom službeno je izliječen u Genovi. Matteo Bassetti, direktor klinike za zarazne bolesti bolnice San Martino u Genovi, najavio je to tijekom streaming konferencije za novinare s predsjednikom Giovannijem Totijem i ostalim menadžerima Ligurskog zdravstva. "Imamo prvo istinsko izliječenje, podvrgnuto dva tampona, oba negativna - rekao je Bassetti - pacijent hospitaliziran 7. ožujka, star 79 godina. Sada se može vratiti svojoj kući u Lombardiju ". Važna vijest je da je čovjek liječen Remdesivirom, učinkovitim eksperimentalnim lijekom protiv ebole, koji je San Martino naručivao izravno u Washingtonu, gdje se proizvodi: "Čini se da djeluje", kaže Bassetti, "i ova stvar nas čini oduševljenima." Liječnik je rekao da će stići i druge zalihe lijeka koji će se i dalje koristiti pacijentima hospitaliziranim u Genovi zajedno s drugima, poput Tocilizumaba, koji se obično koristi protiv artritisa, ali koristan za borbu protiv upale pluća.

Malo me stigla neka panika posle vasih kataklizmicnih predvidjanja, pa samu sebe obradovah kad sam videla da je karantin u Kini uspeo da odrzi broj zarazenih ispod 0.15 % stanovnistva - u slucaju Srbije to bi bilo oko 10 000, i uz neku prosecnu smrtnost od oko 2-3 %, umrlo bi oko 200-300 ljudi. I jedan je previse, da se razumemo, ali verovatno i od obicnog gripa umre par stotina ljudi godisnje.

Znaci Kina je uspela da karantinom zadrzi broj zarazenih na oko 0.13 %

Gledam worldometer - koja neravnomernost u smrtnosti, ca. u % Kina 4 % Italija 8 % Nemacka 0.25 % US 1.6 % Norveska 0.2 % J. Koreja 1%

Mozemo i u pozoriste virtuelno: https://www.narodnopozoriste.rs/narodno-pozoriste-pocinje-sa-emitovanjem-predstava-putem-interneta

Doktor je naveo jedan simptom koji nije spominjan na listi najcesce navodjenih simptoma - dve trecine su opisale gubitak mirisa i ukusa koji traje nekoliko dana, toliko da jedna majka cak nije osecala "miris" sadrzaja pelene njene bebe: Fast alle Infizierten, die wir befragt haben, und das gilt für gut zwei Drittel, beschrieben einen mehrtägigen Geruchs- und Geschmacksverlust. Das geht so weit, dass eine Mutter den Geruch einer vollen Windel ihres Kindes nicht wahrnehmen konnte. Evo njegovog objasnjenja - slicno onom od strane WHO - testirati, testirati, testirati: U Italiji su testirani samo vrlo teški simptomatski slučajevi. Na primer, trenutna studija iz Shenzhena je otkrila da se deca zaraze patogenom jednako često kao i odrasli, ali oni razvijaju samo blage ili nikakve simptome. Ako se prati studija i pretpostavi se da 91% Covid-19 ima samo blage ili umerene simptome, Italijani su se u početku usredotočili na preostalih 9 %. Pored toga, mrtvi se naknadno testiraju i na Sars-CoV-2. I u Kini se na početku naglo povećao broj smrtnih slučajeva, ali ne i broj zaraza, jer su se skoncentrisali na mrtve. Sada je obrnuto, jer u Kini ima puno više testiranja. U Nemačkoj su od pocetka testirani i pacijenti sa samo blagim simptomima. Na primer, naš indeksni pacijent u Bonnu imao je samo ogrebotinu u grlu; siguran sam da se to nikad ne bi testiralo u Italiji.

Bold - pa to je super vest, jer u tom slucaju na 40 000 zarazenih imamo 20 umrlih, te je smrtnost manja nego kod redovnog gripa! Naravno, uvek postoji mogucnost onog sto @ciao napisa, sto otezava neke zakljucke Ja uopste nisam odusevljena holandskim zdravstvenim sistemom (bar ono sto licno znam), ali brojke (opet te brojke) kazu drugacije: https://worldpopulationreview.com/countries/best-healthcare-in-the-world/ Healthcare outcomes are changes in health that result from specific measures or investments. Healthcare outcomes include amenable mortality, readmission, and patient experience. The Healthcare Access & Quality (HAQ) Index ranks healthcare outcome scores on a scale of 0 to 100, with 100 being the best. Countries with the best healthcare systems in the world have scores between 90-96.1. The Netherlands holds the highest score of 96.1.

Neko pametniji ( @Doorn ) da objasni ovoliku razliku u brojkama/procentima u dve EU zemlje sa, relativno, istim standardom, zdravstvom, etc...Naravno, velicina / naseljenost drzave igra vaznu ulogu, no svejedno, smrtnost ne bi trebala da bude toliko razlicita: Nemacka: zarazenih 8000 umrlih 20 (0.25 %) serious 2 Holandija: zarazenih 1705 - umrlih 43 (2.5 %) serious 45

Razmisljam naglas i racunam, uzimajuci u obzir brojke lekara iz Johns Hopkins - ako ima 25-50 zarazenih na jednog potvrdjeno zarazeno, brojke u ovom trenutku za US su onda ovako: Zarazenih: 4700, znaci 120 k - 250 k (in reality) Umrlih: 93 U kriticnom stanju: 12

Johns Hopkins professor estimates at least 50,000 people have coronavirus in US “Don’t believe the numbers when you see, even on our Johns Hopkins website, that 1,600 Americans have the virus,” Makary said. “No, that means 1,600 got the test, tested positive. There are probably 25 to 50 people who have the virus for every one person who is confirmed.” https://thehill.com/policy/healthcare/487562-johns-hopkins-professor-estimates-at-least-50000-people-have-coronavirus-in

Ako je zaista tako (ovde opet dolazimo do toga koliko je sve nepoznato i nepotrvrdjeno), odakle jos uvek 233 (1/3) active cases na Diamond Princess, koji je u karantinu jos od 1 februara? A tu su kontrolisani uslovi, pretpostavljam da je ozbiljan karantin/izolacija, pa vec 6 nedelja traje agonija, uz trecinu jos uvek aktivnih slucajeva.

Evo na TC sam, opet nam lekari iz US ponavljaju da se wave in the US ocekuje u julu, avgustu... 😞

Gde pise "dugotrajna terapija", recimo u ovom dole? Izdvajam: "... that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used..... The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications helps confirm that the association seen in the observational studies is indeed likely to be causal" Prof Paul Little, Professor of Primary Care Research, University of Southampton, said: “There is now a sizeable literature from case control studies in several countries that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used – both respiratory or septic complications (1-10) and cardiovascular complications (11, 12). The observational evidence is always difficult to interpret due to so called protopathic bias/confounding by indication (i.e. were the NSAIDs prescribed at an early stage of the complications developing and so the NSAID use reflects the complications or a more severe illness rather than causing it), but where this has been controlled for the associations still persists(2). The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications (13, 14) helps confirm that the association seen in the observational studies is indeed likely to be causal. Advice to use paracetamol is also less likely to result in complication

Pa ne pricam ja, pricaju neki pametniji od mene: Prof Paul Little, Professor of Primary Care Research, University of Southampton, said: “There is now a sizeable literature from case control studies in several countries that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used – both respiratory or septic complications (1-10) and cardiovascular complications (11, 12). The observational evidence is always difficult to interpret due to so called protopathic bias/confounding by indication (i.e. were the NSAIDs prescribed at an early stage of the complications developing and so the NSAID use reflects the complications or a more severe illness rather than causing it), but where this has been controlled for the associations still persists(2). The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications (13, 14) helps confirm that the association seen in the observational studies is indeed likely to be causal. Advice to use paracetamol is also less likely to result in complications(13).” Prof Ian Jones, Virologist at the University of Reading, said: “The advice relates to Ibuprofen’s anti-inflammatory properties, that is, it dampens down the immune system, which may slow the recovery process. In addition, it is likely, based on the substantial literature around SARS I and the similarities this new virus (SARS-CoV-2) has to SARS I, that the virus reduces a key enzyme which part-regulates the water and salt concentration in the blood and could be part of the pneumonia seen in extreme cases. Ibuprofen aggravates this while paracetamol does not. It is recommended that people use paracetamol to reduce temperature if you are feverish.” Prof Paul Little, Professor of Primary Care Research, University of Southampton, said: “There is now a sizeable literature from case control studies in several countries that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used – both respiratory or septic complications (1-10) and cardiovascular complications (11, 12). The observational evidence is always difficult to interpret due to so called protopathic bias/confounding by indication (i.e. were the NSAIDs prescribed at an early stage of the complications developing and so the NSAID use reflects the complications or a more severe illness rather than causing it), but where this has been controlled for the associations still persists(2). The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications (13, 14) helps confirm that the association seen in the observational studies is indeed likely to be causal. Advice to use paracetamol is also less likely to result in complications(13).” Prof Ian Jones, Virologist at the University of Reading, said: “The advice relates to Ibuprofen’s anti-inflammatory properties, that is, it dampens down the immune system, which may slow the recovery process. In addition, it is likely, based on the substantial literature around SARS I and the similarities this new virus (SARS-CoV-2) has to SARS I, that the virus reduces a key enzyme which part-regulates the water and salt concentration in the blood and could be part of the pneumonia seen in extreme cases. Ibuprofen aggravates this while paracetamol does not. It is recommended that people use paracetamol to reduce temperature if you are feverish.” Dr Tom Wingfield, Senior Clinical Lecturer and Honorary Consultant Physician, Liverpool School of Tropical Medicine, said: “In the UK, paracetamol would generally be preferred over non-steroidal anti-inflammatory drugs (“NSAIDS”) such as ibuprofen to relieve symptoms caused by infection such as fever. This is because, when taken according to the manufacturer’s and/or a health professional’s instructions in terms of timing and maximum dosage, it is less likely to cause side effects. Side effects associated with NSAIDs such as ibuprofen, especially if taken regularly for a prolonged period, are stomach irritation and stress on the kidneys, which can be more severe in people who already have stomach or kidney issues. It is not clear from the French Minister’s comments whether the advice given is generic “good practice” guidance or specifically related to data emerging from cases of Covid-19 but this might become clear in due course. It should also be noted that, in the UK, we would not commonly use cortisone to relieve infection-related symptoms such as fever.” Dr Rupert Beale, Group Leader in Cell Biology of Infection at The Francis Crick Institute “There is a good reason to avoid ibuprofen as it may exacerbate acute kidney injury brought on by any severe illness, including severe COVID-19 disease. There isn’t yet any widely accepted additional reason to avoid it for COVID-19. Patients taking cortisone or other steroids should not stop them except on advice from their doctor. The Society for Endocrinology has issued advice for patients who are taking hydrocortisone or other steroids for pituitary or adrenal deficiency. https://www.endocrinology.org/news/item/14050/Coronavirus-advice-statement-for-patients-with-adrenal%2fpituitary-insufficiency.”

Ja razumem o cemu pricas, i prva stvar i u mojoj struci, kao i u medicini je "do no harm" - da nije tako, pola lekova bi bilo na trzistu posle dva meseca, a ne posle 10 godina ispitivanja. U konkretnom slucaju, ibuprofen vs. paracetamol - koji je, actually, harm, ako neko poslusa, pa uzme paracetamol umesto ibuprofen? Nikakav, ili skoro zanemarljiv ... stoga, ne vidim cemu tolika buna oko ovog - ja licno, i inace, uzimam paracetamol (acetaminophen)/caffeine (Panadol extra, ), a ne ibuprofen/ Brufen/Advil

Sacekacu s povratkom dok ne postignete herd immunity! Popicemo kafu negde na leto 🙂

Ma da, svi cemo skociti da pijemo masnu sodu, ako nam ti/mediji kazu - daj malo vise poverenja bar u ljude koji ovde kuckaju. Hajde hipoteticki - ako se potvrdi da je ibuprofen stvarno stetan, kako ces to objasniti umrlima, koji su (mozda), umrli zbog toga, a mogli su da uzmu paracetamol?

Postavih ranije neki link koji su nam juce slali, da ce sve vezano za COVID-19 biti fast track, nece ici redovnim, najcesce dugogodisnjim procedurama. S jedne strane treba naci vakcinu, lek, testirati da je efikasno, a s druge osigurati da nije stetno....nece sutra, svakako - plasim se da cemo pre doci do herd immunity, nego do approved vakcine/leka, koja je "potvrdjena" ( by McLeod)

Bold - nek si nam i kaz'o! Mi, inace, ne znamo, nego iz dosade i radoznalosti prenosimo ono u sta i malo strucniji od nas nisu sigurni. Ja radim na jedno klinickoj studiji vec 5-u godinu, pa jos se ne moze sa sigurnocu potvrditi niti da nema serious adverse effects, niti da je efikasan toliko da ga treba odobriti,.... a ne da ocekujem da, u jeku nepoznatog virusa, bilo ko na svetu ima POTVRDJENE podatke, terapije, etc za taj isti virus.... Bold: To je vec stvar drzave - ne mozes u Nemackoj opustositi apoteku, ako je lek na recept, taman da se svaki minut vrti na svim medijima da taj lek leci coronu.

Ne postoji approved lek/tretman za COVID-19, kao sto svi znamo.... ovo sto se daje/pokusava je vise empirijski, na osnovu tretmana slicnih virusa Postoje neka saznanja na osnovu dosadasnjih slucajeva, i mora se od neceg krenuti, npr. laboratorijski nalazi koji mogu da ukazuju na COVID-19: Laboratory findings — In patients with COVID-19, the white blood cell count can vary. Leukopenia, leukocytosis, and lymphopenia have been reported, although lymphopenia appears most common [23,37-39]. Elevated lactate dehydrogenase and ferritin levels are common, and elevated aminotransferase levels have also been described. On admission, many patients with pneumonia have normal serum procalcitonin levels; however, in those requiring intensive care unit (ICU) care, they are more likely to be elevated . High D-dimer levels and more severe lymphopenia have been associated with mortality. Certain investigational agents have been described in observational series or are being used anecdotally based on in vitro or extrapolated evidence. It is important to acknowledge that there are no controlled data supporting the use of any of these agents, and their efficacy for COVID-19 is unknown. ●Remdesivir – Several randomized trials are underway to evaluate the efficacy of remdesivir for moderate or severe COVID-19 [71]. Remdesivir is a novel nucleotide analogue that has activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro and related coronaviruses (including SARS and MERS-CoV) both in vitro and in animal studies [72,73]. The compassionate use of remdesivir through an investigational new drug application was described in a case report of one of the first patients with COVID-19 in the United States [74]. Any clinical impact of remdesivir on COVID-19 remains unknown. ●Chloroquine/hydroxychloroquine – Both chloroquine and hydroxychloroquine inhibit SARS-CoV-2 in vitro, although hydroxychloroquine appears to have more potent antiviral activity [75]. A number of clinical trials are underway in China to evaluate the use of chloroquine or hydroxychloroquine for COVID-19 [76]. ●Lopinavir-ritonavir – This combined protease inhibitor, which has primarily been used for HIV infection, has in vitro activity against the SARS-CoV [77] and appears to have some activity against MERS-CoV in animal studies [78]. The use of this agent for treatment of COVID-19 has been described in case reports [79-81], but its efficacy is unclear. In one report of five patients who were treated with lopinavir-ritonavir, three improved and two had clinical deterioration; four had gastrointestinal side effects. It is being evaluated in larger randomized trials. ●Tocilizumab – Treatment guidelines from China's National Health Commission include the IL-6 inhibitor tocilizumab for patients with severe COVID-19 and elevated IL-6 levels; the agent is being evaluated in a clinical trial [82]. Other interventions of interest but with limited or no clinical data include interferon beta and convalescent serum.