From: Eat This Not That
Date: April 30, 2020
Author: Leah Growth
You've heard by now that the coronavirus can affect anyone, at any age. However, signs, symptoms, and severity of the highly infectious and deadly virus can vary from person-to-person, and more specifically, by age group. Read on to find your age and the symptoms that may befall you, so you can spot the virus when it strikes.
Older Adults Over 60
Older adults and/or people with existing chronic medical conditions are at greater risk of becoming seriously ill with COVID-19. In fact, according to the CDC the overwhelming majority of fatalities—80 percent—have been over the age of 65
Symptoms if You're Over 60
Older adults are also more likely to develop ARDS (acute respiratory distress syndrome). According to a JAMA study, more than 40% of individuals in the study who were hospitalized with severe and critical COVID-19 developed the lung condition—and over 50% of those diagnosed died from the disease.
The CDC lists people over 65 or people who live in a nursing home or long-term care facility as "people who are at higher risk for severe illness."
Atypical Symptoms if You're Over 60
According to the Kaiser Health Network, older adults with COVID-19 may have several "atypical" symptoms, complicating efforts to ensure they get timely and appropriate treatment. They claim that older adults may have none of the usual symptoms and may simply just seem "off" and not acting like themselves early in the infection.
"They may sleep more than usual or stop eating. They may seem unusually apathetic or confused, losing orientation to their surroundings. They may become dizzy and fall. Sometimes, seniors stop speaking or simply collapse," they claim.
Middle Aged Adults 40s-50s
The chance of death due to COVID-19 does increase in this age group, according to the CDC.
As with the previous age group, blood clots and strokes have been reported in those who are asymptomatic or suffering mild symptoms.
According to the CDC, fewer deaths have been reported in the United States in adults up to the age of 40. People in this age group also tend to experience COVID-19 symptoms in a milder manner than those who are over 40.
However, blood clots—and even strokes, which are incredibly uncommon for younger people—have been reported in otherwise asymptomatic people in their 30s to 40s infected with the virus. The Washington Post recently reported that three large US medical institutions are getting ready to publish data on the subject after an overwhelming amount of patients under the age of 50 have died due to coronavirus-related strokes.
Children Under 18
Based on the evidence, children are at a much lower risk for COVID-19 than adults, and there have been very few coronavirus-related deaths of those under 18, per the CDC.
While many of the symptoms for children are similar to adults, children with confirmed COVID-19 generally experience them in a milder capacity. In fact, one Chinese study found that 90% of those who tested positive for the virus had mild symptoms or none at all.
Reported Symptoms for Those Under 18
Reported symptoms in children, according to the CDC, include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported. However, keep in mind that children and young adults are less likely to experience one of the main and most damaging symptoms of the virus—shortness of breath.
One bizarre symptom reported in young people has been dubbed "COVID toes." On April 9 the General Council of Official Colleges of Podiatrists in Spain issued a report after podiatrists began "registering numerous cases of sick people, mainly children and young people, who had small dermatological lesions on their feet." These purple-colored lesions, usually appearing on the tips of toes, were often in the absence or prior to an individual experiencing other COVID-19 symptoms. Luckily, most cases clear up on their own within a few weeks.
A Rarer Symptom if You're Under 18
The World Health Organization is also "urgently" investigating a possible link between the virus and Kawasaki syndrome, an illness of unknown cause that primarily affects children under 5. Symptoms of the condition include "fever, rash, swelling of the hands and feet, irritation and redness of the whites of the eyes, swollen lymph glands in the neck, and irritation and inflammation of the mouth, lips, and throat," according to the CDC.
How to Protect Yourself at Any Age
The most common symptoms of COVID-19 include cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, and muscle pain, according to the CDC. Other reported symptoms include conjunctivitis (aka pink eye) and digestive issues such as diarrhea, vomiting, and nausea.
"There are things you can do to reduce your risk of getting sick," reports the CDC:
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Date: April 26, 2020
Author: David Wallace-Wells
Over the last few weeks, the country has managed to stabilize the spread of the coronavirus sufficiently enough to begin debating when and in what ways to “reopen,” and to normalize, against all moral logic, the horrifying and ongoing death toll — thousands of Americans dying each day, in multiples of 9/11 every week now with the virus seemingly “under control.” The death rate is no longer accelerating, but holding steady, which is apparently the point at which an onrushing terror can begin fading into background noise. Meanwhile, the disease itself appears to be shape-shifting before our eyes.
In an acute column published April 13, the New York Times’ Charlie Warzel listed 48 basic questions that remain unanswered about the coronavirus and what must be done to protect ourselves against it, from how deadly it is to how many people caught it and shrugged it off to how long immunity to the disease lasts after infection (if any time at all). “Despite the relentless, heroic work of doctors and scientists around the world,” he wrote, “there’s so much we don’t know.” The 48 questions he listed, he was careful to point out, did not represent a comprehensive list. And those are just the coronavirus’s “known unknowns.”
In the two weeks since, we’ve gotten some clarifying information on at least a handful of Warzel’s queries. In early trials, more patients taking the Trump-hyped hydroxychloroquine died than those who didn’t, and the FDA has now issued a statement warning coronavirus patients and their doctors from using the drug. The World Health Organization got so worried about the much-touted antiviral remdesivir, which received a jolt of publicity (and stock appreciation) a few weeks ago on rumors of positive results, the organization leaked an unpublished, preliminary survey showing no benefit to COVID-19 patients. Globally, studies have consistently found exposure levels to the virus in most populations in the low single digits — meaning dozens of times more people have gotten the coronavirus than have been diagnosed with it, though still just a tiny fraction of the number needed to achieve herd immunity. In particular hot spots, the exposure has been significantly more widespread — one survey in New York City found that 21 percent of residents may have COVID-19 antibodies already, making the city not just the deadliest community in the deadliest country in a world during the deadliest pandemic since AIDS, but also the most infected (and, by corollary, the farthest along to herd immunity). A study in Chelsea, Massachusetts, found an even higher and therefore more encouraging figure: 32 percent of those tested were found to have antibodies, which would mean, at least in that area, the disease was only a fraction as severe as it might’ve seemed at first glance, and that the community as a whole could be as much as halfway along to herd immunity. In most of the rest of the country, the picture of exposure we now have is much more dire, with much more infection almost inevitably to come.
But there is one big question that didn’t even make it onto Warzel’s list that has only gotten more mysterious in the weeks since: How is COVID-19 actually killing us?
We are now almost six months into this pandemic, which began in November in Wuhan, with 50,000 Americans dead and 200,000 more around the world. If each of those deaths is a data point, together they represent a quite large body of evidence from which to form a clear picture of the pandemic threat. Early in the epidemic, the coronavirus was seen as a variant of a familiar family of disease, not a mysterious ailment, however infectious and concerning. But while uncertainties at the population level confuse and frustrate public-health officials, unsure when and in what form to shift gears out of lockdowns, the disease has proved just as mercurial at the clinical level, with doctors revising their understanding of COVID-19’s basic pattern and weaponry — indeed often revising that understanding in different directions at once. The clinical shape of the disease, long presumed to be a relatively predictable respiratory infection, is getting less clear by the week. Lately, it seems, by the day. As Carl Zimmer, probably the country’s most respected science journalist, asked virologists in a tweet last week, “is there any other virus out there that is this weird in terms of its range of symptoms?”
You probably have a sense of the range of common symptoms, and a sense that the range isn’t that weird: fever, dry cough, and shortness of breath have been, since the beginning of the outbreak, the familiar, oft-repeated group of tell-tale signs. But while the CDC does list fever as the top symptom of COVID-19, so confidently that for weeks patients were turned away from testing sites if they didn’t have an elevated temperature, according to the Journal of the American Medical Association, as many as 70 percent of patients sick enough to be admitted to New York State’s largest hospital system did not have a fever.
Over the past few months, Boston’s Brigham and Women’s Hospital has been compiling and revising, in real time, treatment guidelines for COVID-19 which have become a trusted clearinghouse of best-practices information for doctors throughout the country. According to those guidelines, as few as 44 percent of coronavirus patients presented with a fever (though, in their meta-analysis, the uncertainty is quite high, with a range of 44 to 94 percent). Cough is more common, according to Brigham and Women’s, with between 68 percent and 83 percent of patients presenting with some cough — though that means as many as three in ten sick enough to be hospitalized won’t be coughing. As for shortness of breath, the Brigham and Women’s estimate runs as low as 11 percent. The high end is only 40 percent, which would still mean that more patients hospitalized for COVID-19 do not have shortness of breath than do. At the low end of that range, shortness of breath would be roughly as common among COVID-19 patients as confusion (9 percent), headache (8 to 14 percent), and nausea and diarrhea (3 to 17 percent). That the ranges are so wide themselves tells you that the disease is presenting in very different ways in different hospitals and different populations of different patients — leading, for instance, some doctors and scientists to theorize the virus might be attacking the immune system like HIV does, with many others finding the disease is triggering something like the opposite response, an overwhelming overreaction of the immune system called a “cytokine storm.”
The most bedeviling confusion has arisen around the relationship of the disease to breathing, lung function, and oxygenation levels in the blood — typically, for a respiratory illness, a quite predictable relationship. But for weeks now, front-line doctors have been expressing confusion that so many coronavirus patients were registering lethally low blood-oxygenation levels while still appearing, by almost any vernacular measure, pretty okay. It’s one reason they’ve begun rethinking the initial clinical focus on ventilators, which are generally recommended when patients oxygenation falls below a certain level, but seemed, after a few weeks, of unclear benefit to COVID-19 patients, who may have done better, doctors began to suggest, on lesser or different forms of oxygen support. For a while, ventilators were seen so much as the essential tool in treating life-threatening coronavirus that shortages (and the president’s unwillingness to invoke the Defense Production Act to manufacture them quickly) became a scandal. But by one measure 88 percent of New York patients put on ventilators, for whom an outcome as known, had died. In China, the figure was 86 percent.
On April 20 in the New York Times, an ER doctor named Richard Levitan who had been volunteering at Bellevue proposed that the phenomenon of seemingly stable patients registering lethally low oxygen levels might be explained by “silent hypoxia” — the air sacs in the lung collapsing, not getting stiff or heavy with fluid, as is the case with the pneumonias doctors had been using as models in their treatment of COVID-19. But whether this explanation is universal, limited to the patients at Bellevue, or somewhere in between is not yet entirely clear. A couple of days later, in a pre-print paper others questioned, scientists reported finding that the ability of the disease to mutate has been “vastly underestimated” — investigating the disease as it appeared in just 11 patients, they said they found 30 mutations. “The most aggressive strains could generate 270 times as much viral load as the weakest type,” the South China Morning-Post reported. “These strains also killed the cells the fastest.”
That same day, the Washington Post reported on another theory gaining traction among American doctors treating the disease — that one key could be the way COVID-19 affects the blood of patients, producing much more clotting. “Autopsies have shown that some people’s lungs are filled with hundreds of micro-clots,” the Post reported. “Errant blood clots of a larger size can break off and travel to the brain or heart, causing a stroke or a heart attack.”
But the bigger-picture perspective the newspaper offered is perhaps more eye-opening and to the point:
One month ago, as the country went into lockdown to prepare for the first wave of coronavirus cases, many doctors felt confident that they knew what they were dealing with. Based on early reports, covid-19 appeared to be a standard variety respiratory virus, albeit a very contagious and lethal one with no vaccine and no treatment. But they’ve since become increasingly convinced that covid-19 attacks not only the lungs, but also the kidneys, heart, intestines, liver and brain.
That is a dizzying list. But it is not even comprehensive. In a fantastic survey published April 17 (“How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes,” by Meredith Wadman, Jennifer Couzin-Frankel, Jocelyn Kaiser, and Catherine Matacic), Science magazine took a thorough, detailed tour of the ever-evolving state of understanding of the disease. “Despite the more than 1,000 papers now spilling into journals and onto preprint servers every week,” Science concluded, “a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen.”
In a single illuminating chart, Science lists the following organs as being vulnerable to COVID-19: brain, eyes, nose, lungs, heart, blood vessels, livers, kidneys, intestines. That is to say, nearly every organ:
And the disparate impacts were significant ones: Heart damage was discovered in 20 percent of patients hospitalized in Wuhan, where 44 percent of those in ICU exhibited arrhythmias; 38 percent of Dutch ICU patients had irregular blood clotting; 27 percent of Wuhan patients had kidney failure, with many more showing signs of kidney damage; half of Chinese patients showed signs of liver damage; and, depending on the study, between 20 percent and 50 percent of patients had diarrhea.
On April 15, the Washington Post reported that, in New York and Wuhan, between 14 and 30 percent of ICU patients had lost kidney function, requiring dialysis. New York hospitals were treating so much kidney failure “they need more personnel who can perform dialysis and have issued an urgent call for volunteers from other parts of the country. They also are running dangerously short of the sterile fluids used to deliver that therapy.” The result, the Post said, was rationed care: patients needing 24-hour support getting considerably less. On Saturday, the paper reported that “young and middle-aged people, barely sick with COVID-19, are dying from strokes.” Many of the patients described didn’t even know they were sick:
The patient’s chart appeared unremarkable at first glance. He took no medications and had no history of chronic conditions. He had been feeling fine, hanging out at home during the lockdown like the rest of the country, when suddenly, he had trouble talking and moving the right side of his body. Imaging showed a large blockage on the left side of his head. Oxley gasped when he got to the patient’s age and covid-19 status: 44, positive.
The man was among several recent stroke patients in their 30s to 40s who were all infected with the coronavirus. The median age for that type of severe stroke is 74.
But the patient’s age wasn’t the only abnormality of the case:
As Oxley, an interventional neurologist, began the procedure to remove the clot, he observed something he had never seen before. On the monitors, the brain typically shows up as a tangle of black squiggles — “like a can of spaghetti,” he said — that provide a map of blood vessels. A clot shows up as a blank spot. As he used a needlelike device to pull out the clot, he saw new clots forming in real-time around it.
“This is crazy,” he remembers telling his boss.
These strokes, several doctors who spoke to the Post theorized, could explain the high number of patients dying at home — four times the usual rate in New York, many or most of them, perhaps, dying quite suddenly. According to the Brigham and Women’s guidelines, only 53 percent of COVID-19 patients have died from respiratory failure alone.
It’s not unheard of, of course, for a disease to express itself in complicated or hard-to-parse ways, attacking or undermining the functioning of a variety of organs. And it’s common, as researchers and doctors scramble to map the shape of a new disease, for their understanding to evolve quite quickly. But the degree to which doctors and scientists are, still, feeling their way, as though blindfolded, toward a true picture of the disease cautions against any sense that things have stabilized, given that our knowledge of the disease hasn’t even stabilized. Perhaps more importantly, it’s a reminder that the coronavirus pandemic is not just a public-health crisis but a scientific one as well. And that as deep as it may feel we are into the coronavirus, with tens of thousands dead and literally billions in precautionary lockdown, we are still in the very early stages, when each new finding seems as likely to cloud or complicate our understanding of the coronavirus as it is to clarify it. Instead, confidence gives way to uncertainty.
In the space of a few months, we’ve gone from thinking there was no “asymptomatic transmission” to believing it accounts for perhaps half or more of all cases, from thinking the young were invulnerable to thinking they were just somewhat less vulnerable, from believing masks were unnecessary to requiring their use at all times outside the house, from panicking about ventilator shortages to deploying pregnancy massage pillows instead. Six months since patient zero, we still have no drugs proven to even help treat the disease. Almost certainly, we are past the “Rare Cancer Seen in 41 Homosexuals” stage of this pandemic. But how far past?
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In early April, when Americans began to embrace the idea of wearing face masks to flatten the curve of the coronavirus, President Donald Trump suggested it wouldn’t hurt the public to wear masks, but that scarves could be a perfectly suitable substitute.
“It doesn’t have to be a mask. It can be a scarf,” Trump said. “What I do see people doing here is using scarves. And I think in a certain way, depending on the fabric, I think in a certain way, a scarf is better, it’s actually better.”
A new study of the best and worst materials for DIY face masks just proved he was absolutely incorrect.
Smart Air, a social enterprise and certified B-Corp that promotes cost-effective, data-backed air filters as a solution to indoor particulate air pollution, has released the results of their latest research on DIY face mask materials, in which they tested over 30 different materials ― including bra pads, coffee filters, pillow cases, electrostatic cloths, cotton T-shirts, wool, bed sheets, polyester, bandanas and more ― for their effectiveness in filtering coronavirus-sized microparticles, as well as their breatheability.
Both those factors are vital, because while some materials may test high for filtration, they test low for breathability ― a mask you can’t actually breathe in isn’t exactly helpful to anyone.
Among the key takeaways: Trump’s scarves tested among the least effective materials, while denim, canvas and paper towels were among the best.
How the testing worked
Smart Air aimed to mimic the test setup used by Cambridge University researchers, known as a Henderson apparatus, in which a fan blows air and particles through the mask material. The materials were tested for their ability to filter large-sized (1 micron, similar to the size of the Ebola virus) and small-sized (0.3 micron, the size of the smallpox virus) particles and for their breatheability factor. For reference, COVID-19 coronavirus particles measure 0.06-0.14 microns in size, but 5-10 microns when in droplets.
The testing was done to clear up some myths about which face masks are best for public health. Smart Air had previously released data before COVID-19 reached its peak, but the company said the findings were “incomplete.” Over the past several weeks, it tested more crucial materials the earlier study left out, as well as guidelines for variables like thread count.
“There is a huge demand for information worldwide right now about what makes a safe and effective DIY face mask, but there is also a lot of fear and misinformation,” Smart Air CEO and aeronautical engineer Paddy Robertson said in a press release. “By releasing this data, and continuing to be totally transparent about our methodology, we hope to help individuals, institutions and potentially even governments make good, data-backed decisions about how to make face masks that will actually protect them.”
Coffee filters are no longer recommended for DIY masks.
The new study showed that while coffee filters are extremely effective at filtering microparticles, they score very poorly on the breatheability scale, knocking them off the list of recommended DIY mask materials.
“Coffee filters, although very effective at filtering virus-sized particles, won’t make great masks,” Robertson said in the release. “They’re just too difficult to breathe through.”
Scarves failed the test, big time
“Trump’s suggestion of using scarves as face masks may not be the best choice,” Robertson said. “Our tests showed that the three scarves we tested scored consistently low on their ability to capture tiny particles. Perhaps Trump should check out our data and update the general public.”
The best overall materials for DIY face masks
Based on a combination of breatheability and filtration effectiveness, the study recommended denim, bed sheets (80-120 thread count), paper towels, canvas (0.4-0.5mm thick) and shop towels for homemade masks.
Keep in mind, however, that paper towels are not washable or reusable.
The 0.4-0.5mm thick canvas material ranked as being easier to breathe through than a surgical mask, while still performing fairly well at filtering particles. But if thick fabrics aren’t available to you, the study’s data showed that 100% cotton T-shirts, layered up, are also still effective options for homemade masks. (More on this below.)
In general, natural materials are a better option than synthetic ones. Because synthetic fibers (like polyester) tend to be smooth, they don’t filter out particles as well as the rougher texture of natural fibers (like 100% cotton).
What happens when you use multiple layers of a material?
Many DIY face masks incorporate at least two layers of fabric, and sometimes up to 16 or even 32 layers if you’re making multiple folds. So how does that increase the material’s effectiveness?
Testing in this study was done on one and two layers. Robertson told HuffPost, “Doubling the layers increased 0.3 micron efficiency from 2% to 15%, whilst also reducing breatheability. It’s difficult to give an exact ‘formula’ for each material on how doubling layers increases effectiveness, as air resistance plays a major part. We want to work on this though.”
Robertson said Smart Air plans to continue its research and release a third edition of the study with more information on layering the materials.
Best materials for blocking large-size particles
The majority of materials tested in Smart Air’s study blocked more than 50% of 1-micron particles, but some of the worst-scoring materials were the wool scarf, bandana (100% cotton) and light scarf (keep in mind, these were each tested in a single layer ― increasing layers slightly increases how many particles can be blocked).
Best materials for blocking small-size particlesFor 0.3-micron particles, Smart Air found “a much wider range in effectiveness.” The N95 mask, HEPA filter and surgical mask performed best, all capturing over 75% of small particles. But in terms of household materials, the best blockers were Hero-brand coffee filters. In the study, only four other materials filtered more than 48% of small particles: the 40D nylon, Chemex coffee filter, kitchen towel and canvas.
According to the study, “some materials were only slightly better than nothing.” The bandana, neck-warmer, scarves, cleaning cloths and 100% cotton T-shirt (one layer) all captured less than 10% of small particles.
No matter what your mask is made of, make sure to wear it responsibly. Whichever material you choose to make your mask from, and no matter how you choose to make it ― sewing, no-sew, folding ― it’s not a guaranteed protector against COVID-19.
Masks do not replace social distancing. While DIY face masks may be useful in situations like grocery stores and pharmacies where you cannot always stay six feet away from people, masks should not be used as a replacement for social distancing.
And remember: By covering your face in public, you are helping others to stay safe from anything you may be carrying. It’s more about their protection than your own.
You can read the original article from HUFFPOST here.
This article states that the corona virus can adhere to surfaces like stainless steel and plastic for 4 days and on face masks, from 7 days or more. Do not touch the outside of a face mask. You may contaminate your hands and spread it to your face by touching it.
You can find the original article from South China Morning Post here.
Published By Elizabeth Cohen and Dr. Minali Nigam, CNN
Updated 2258 GMT (0658 HKT) April 10, 2020
Publisher of hydroxychloroquine study touted by Trump says the research didn't meet its standards
Trump's speculation caused some to hoard this drug.
(CNN)President Trump has been a cheerleader for the drug hydroxychloroquine, pointing in a tweet and in person to a French study as evidence that one particular drug combination might be "one of the biggest game changers in the history of medicine."
But now the medical society that published the French research has issued a statement saying they're reviewing the study again and "a correction to the scientific record may be considered."
Dr. Kevin Tracey, president and CEO of the Feinstein Institutes for Medical Research in New York City, gave an even more pointed assessment of the French research.
"The study was a complete failure," he said.
"It was pathetic," added Art Caplan, head of the division of medical ethics at the New York University School of Medicine.
The small French study of 20 people found that taking hydroxychloroquine was associated with the "viral load reduction/disappearance in COVID-19 patients," noting that the effect was "reinforced" with azithromycin, an antibiotic better known as a Z-pack.
Tracey and Caplan pointed out that several patients who took the drug, and ended up faring poorly, dropped out of the trial, and their outcomes were not factored into the study's final conclusions.
The International Society of Antimicrobial Chemotherapy published the study online in its journal, the International Journal of Antimicrobial Agents, on March 20.
The society and the publisher of the journal, Elsevier, issued a joint statement that "concerns have been raised regarding the content, the ethical approval of the trial and the process that this paper underwent to be published within International Journal of Antimicrobial Agents."
According to the statement, the study authors had been contacted to address concerns, and that "additional independent peer review is ongoing to ascertain whether concerns about the research content of the paper have merit."
One of the study's co-authors, Jean-Marc Rolain, is also editor-in-chief of the journal.
The statement noted that Rolain was not involved in the peer review of the manuscript.
The statement from the society and Elsevier is dated April 3, but a previous statement with the same date was on the same webpage and has since been removed.
That statement by Andreas Voss, president of the society, said the study "does not meet the Society's expected standard" and that "although ISAC recognises it is important to help the scientific community by publishing new data fast, this cannot be at the cost of reducing scientific scrutiny and best practices."
Voss, Rolain and Didier Raoult, a lead study author, did not immediately respond to CNN emails seeking comment.
Trump's glowing reviews of an unproven drug
Rarely does one unproven drug make such headlines, but hydroxychloroquine did due to Elon Musk, conservative media and Trump.
A recent article in Vanity Fair laid out the sequence of events.
On March 16, Musk, the Tesla CEO, tweeted that it "maybe worth considering chloroquine for C19." Hydroxychloroquine is a derivative of chloroquine, and C19 is Covid-19, the medical term for the disease caused by the coronavirus.
Two days later, Breitbart and The Blaze wrote glowing articles about chloroquine.
The day after that, Trump said chloroquine was possibly a "game changer" at a White House briefing.
Two days later, on March 21, Trump referred to the French study in a tweet, saying that the combination of hydroxychloroquine and azithromycin "have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains -- Thank You!"
Trump's enthusiasm for hydroxychloroquine hasn't waned with time, even though it's one of many drugs being studied to prevent or treat coronavirus, and none of them have been proven to be safe or effective.
"We have some very good results and some very good tests. You've seen the same test that I have," he said at an April 5 briefing. "In France, they had a very good test."
Doctor says hydroxychloroquine still worth studying
In its statement, the society that published the paper mentioned concerns about "the lack of better explanations of the inclusion criteria" in the study, which took place at the Méditerrannée Infection University Hospital Institute in Marseille, France.
Trump says this drug has 'tremendous promise,' but Fauci's not spending money on it
The study started out with 26 patients taking the hydroxychloroquine, but six were "lost in follow up during the survey because of early cessation of treatment," according to the study.
Three left because they ended up in the intensive care unit, another patient died, and a fifth stopped treatment due to nausea. It turned out the sixth patient didn't actually have coronavirus.
Leaving out the five patients who took the drug and didn't fare well is "cherry picking," said Caplan, the bioethicist.
"That's not science," he said. "You've got your thumb on the scale."
The remaining 20 patients took hydroxychloroquine, some with the antibiotic azithromycin and some without, and their outcomes were compared with patients who did not take either drug.
The study authors wrote that "100%" of patients who took the drug combination were "virologically cured" compared to 57.1% of the patients who took hydroxychloroquine alone and 12.5% of the control group. The authors did not fully explain what they meant by "virologically cured."
Caplan added that even without the "cherry picking" issue, a study with such a small number of patients is basically meaningless.
"It's just a jumbled mess," he said.
Several centers are doing clinical trials on hydroxychloroquine to prevent or treat coronavirus, including Harvard, Columbia, New York University and Henry Ford Health System in Detroit.
Tracey, the researcher at the Feinstein Institutes in New York City, is also conducting a study on the drug. He said despite the French study being "seriously flawed," it's still worth looking at hydroxychloroquine to see if it's safe and effective for a subset of coronavirus patients.
First, he noted that hydroxychloroquine has anti-inflammatory properties. The US Food and Drug Administration has approved its use against lupus and rheumatoid arthritis, both diseases that involve inflammation.
Hydroxychloroquine might help coronavirus patients who experience what's called a "cytokine storm," a potentially deadly inflammatory process.
And small studies other than the "seriously flawed" French one have shown that the drug might work, he added.
"There's a lot of small studies in humans and in the lab that frame an appropriate question that's never been answered in a clinical trial," he said. "It's important to know if it works and if it's safe in some people with coronavirus."
Amy Roberts contributed to this story.
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