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Covid 19 virus inpacts sports, NHL,Season Tix other impacts

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23 hours ago, remkin said:

Not an RCT

rem, what is this? I don't recognize the anacronym? 1st let me be upfront and state that I've not taken the time to listen thru that video as have been swamped with my own mess, and now a law firm wants to depose me on a private autopsy I performed on a sickle cell patient several years ago??? Don't they know there's more urgent things afoot?

 

A comment on these several drugs that were hurriedly thrown into the breach so to speak, particularly remdesivir. I never read them as being curative, and perhaps I was incorrect as I AM NOT A CLINICIAN, but at the most, I understood that they could shorten the length of hospital stay, as well as possibly shorten the length of viral shedding? That to my limited mind never said they were life sparing at the height of the illness(? cytokine storm), thus not the magic bullet we anxiously await? Was this wrong?

 

Most recently, I have been reading on several much more SARS COV-2 virocentric (not sure thats a word) approaches to an effective treatment, including a monoclonal antibody aimed a specific regions on the virion's capsid, and specifically at the now infamous "spike protein" and others, LY-CoV555. Other groups are working on "diverse antibodies", anticipating the possibility of this virus mutating like influenza. But these are being greatly rushed thru trials as I thought it was possible they might?

 

Finally Lake, regarding your comment on this link to "thrombosis", since the COVID virus appears to hone in on ACE-2 receptor sites, and they are globally found in many organs/sites throughout the human body, the coagulopathy(namely hypercoagulation=thrombosis) being observed is predictable as endothelial cells, those lining blood vessels, are one such cell with ACE-2 receptors. Ergo the source of microthrombi (clots) in vessels.

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Thanks for the kind words 2ndSacker. Lake, I know you have a stats background, so such things are not really shocking to you, but I think that very few non science people are really aware of how imperfect even "good" science is. I had an academic upbringing in EM, and as such have both reviewed and listened to reviews of close to 10,000 articles combined (the vast majority listened to Jerry Hoffman and others). After a while one gets a pretty good foundation for the shortcomings of much of science. It's an enlightened place to be, but it's also a very frustrating place to be as the vast majority of providers, let alone the general public understandably rely on a combination of certain experts and the media to get their sense of what is most true. It is wrong as often as it's right. 

 

This is a study that I mention to medical students I teach pretty frequently. It is so elegantly simple. A group of researchers went back 10 years in the New England Journal of Medicine and identified all of the studies in cardiology that claimed to have proven that a specific treatment was effective. Once they were all identified by specific criteria, they went forward up to the the present to determine how many of those claimed treatments had been thoroughly disproven. It was around 44%. Nearly all of those treatments had experts touting them. But the reality is worse than that since the NEJM is one of the most prestigious journals in the world getting to pick only the best studies. There are hundreds of lesser journals publishing studies that are laughable at the outset. 

 

But it's even worse than that overall because of publication bias: the big journals want to publish the new breakthroughs far more than publishing a negative study that shows a thing doesn't work.

 

But even the NEJM is easily corrupted by drug company studies, and even increasingly political biases. 

 

The famous line delivered to incoming medical students by the dean of the Harvard medial school is apt: "Half of what we are about to teach you is wrong. We just don't know which half". 

 

Beware of people claiming "settled science".  That phrase and others have become a political tool. It's tricky out there.

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36 minutes ago, KJUNKANE said:

rem, what is this? I don't recognize the anacronym? 1st let me be upfront and state that I've not taken the time to listen thru that video as have been swamped with my own mess, and now a law firm wants to depose me on a private autopsy I performed on a sickle cell patient several years ago??? Don't they know there's more urgent things afoot?

 

A comment on these several drugs that were hurriedly thrown into the breach so to speak, particularly remdesivir. I never read them as being curative, and perhaps I was incorrect as I AM NOT A CLINICIAN, but at the most, I understood that they could shorten the length of hospital stay, as well as possibly shorten the length of viral shedding? That to my limited mind never said they were life sparing at the height of the illness(? cytokine storm), thus not the magic bullet we anxiously await? Was this wrong?

 

Most recently, I have been reading on several much more SARS COV-2 virocentric (not sure thats a word) approaches to an effective treatment, including a monoclonal antibody aimed a specific regions on the virion's capsid, and specifically at the now infamous "spike protein" and others, LY-CoV555. Other groups are working on "diverse antibodies", anticipating the possibility of this virus mutating like influenza. But these are being greatly rushed thru trials as I thought it was possible they might?

 

Finally Lake, regarding your comment on this link to "thrombosis", since the COVID virus appears to hone in on ACE-2 receptor sites, and they are globally found in many organs/sites throughout the human body, the coagulopathy(namely hypercoagulation=thrombosis) being observed is predictable as endothelial cells, those lining blood vessels, are one such cell with ACE-2 receptors. Ergo the source of microthrombi (clots) in vessels.

RCT is Randomized Clinical Trial. It's a stand in for prospective double blind, placebo controlled trial in most cases. 

 

The rest of this if for those who want to read some of my take on aspects of medical research that aren't necessarily in the field:

 

One of the problems with many many medical studies is the use of "surrogate markers" in place of clinically significant outcomes. The more ineffective the treatment the more these surrogate markers are used. For those not familiar, say that the most important thing that a treatment could do is prevent death. Then say disability. But if a treatment can't affect those at all, maybe it can affect length of stay, or admissions to the hospital. If not that, maybe a pain scale or lowering the white blood cell count. It can be a slippery slope to rather insignificant things being measured. Another major related problem is studying many different possible outcomes. Statistics are applied in large part a way to predict how likely an effect is random rather than due to the treatment. Generally we accept about a 5% chance of a thing being random as the lowest bar. That's 1/20. If I study 15 different outcomes there's a pretty good chance that one or two will look positive just due to randomness. I can then pick those two after the study is completed, and focus my written article on that positive effect. I can stress it in title and the abstract. Especially if I'm a drug company. 

 

I've read many studies where the title and abstract and conclusion (the part most people skip to) say one thing, but the body of the study says the opposite. 

 

An example of surrogate marker use is a study for a drug called Atrovent. It is cheap and safe and added to some albuterol treatments for asthma or COPD. Studies showed that it increased a person's ability to forcefully exhale after treatment, called peak flow. Most experts used peak flows a lot because, well because we love numbers and that gives you a number. Never mind that it's pretty unreliable since patient effort varies. Anyways, experts mostly recommended adding it, and a company even came up with a treatment that had both albuterol and atrovent in it.  But that same study showed that adding atrovent to the treatment did not improve any meaningful outcomes: no change in death, no change in admission rates, no change in length of symptoms, no change in needing intubation, etc etc. And further, if you looked closer at the study (the way Jerry Hoffman looks at that table in the remdesivir study) you'd see that the authors of the atrovent study used substandard doses of the albuterol they were adding to, which is an unfair comparison (and another common study flaw, or trick depending on your point of view). That study is years old, but Atrovent, and the combined treatment with albuterol are still in wide spread use. It's cheap, its safe, it maybe adds a touch, so why not? But it's only been "proven" for that surrogate marker of peak flow, if that. 

 

So if a study picks a bunch of surrogate markers and then goes in and picks one or two that seemed to work after the fact, that's bad science. What's supposed to happen is that they use those seemingly effective markers as the basis for a new prospective study and try to actually prove the concept. But there's little motivation for a drug company to go out and disprove their own drug now touted by experts (often on their payroll).

 

Medical and other science is so messy already, with all kinds of bias baked in. And that's before the turbo charger of bias that is politics gets in there.

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10 hours ago, LakeLivin said:

 

Good stuff rem. Is it really possible that they didn't prospectively specify the primary efficacy endpoints for the remdesivir study that was reviewed in the video? :huh: Isn't there an IRB that would have had to review and approve the study protocol? I wonder if maybe in a rush to get the study started there were shortcuts taken.  

 

As far as the reviewer's other big point, they should have been able to adjust for differences in baseline severity in the analysis.  Although, "should have been able to" doesn't necessarily mean that they did. It would be interesting to see the actual full study report.  

 

I ended up listening to the whole video; some pretty interesting stuff in there.  I hadn't been aware of the covid-19 link to thrombosis. And I find it a bit discouraging that even in NYC they estimate infections at only 14-20%.  That leaves a long way to go to get to herd immunity. 

 

How often to they put out updates like that? Maybe you could give us a heads up next time one comes out?

Oh yes. As I pointed out above science studies are a messy business. My arm's length relationship with just accepting a thing because an expert said it, is borne of 30 years of watching them fail over and over. One boiled down description of science is a method of attempting to remove all bias from observing the world. But there are so many types of bias it's astounding. There are studies on just different types of bias. Listening to Jerry Hoffman and others for years has been pretty eye-opening. It is very common for especially drug companies to set things up in their favor. Hoffman was surprised since this was apparently a government study, but the government has bias too (like finding a treatment fast). 

 

EM Rap is an outstanding product. It actually grew out of a product called Emergency Medical Abstracts where for years Jerry Hoffman and his partner reviewed about 20+ articles per month from a huge spread of journals and answered letters. Not only informing of what seemed promising or even "proven" but what we were likely to be sold as proven that at best needed better studies. EM Rap was initially a separate product started by Mel Herbert, (the Australian guy that leads these updates). He had his own product that provided deep dives into important areas. When Jerry and his partner retired, they sold their business to Mel and he put it all together along with some other products into one hugely deep data base of EM continuing education. 

 

Anyways, EM Rap (which includes EMA) costs about $500/year, but they've made the covid stuff free. Way back at the start of this thread I included one or two of their earliest updates. They continue to put these out free, just search EM RAP Covid on You tube. I get notifications of new ones coming up, I'll try to put it on here if I do.

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3 hours ago, remkin said:

Oh yes. As I pointed out above science studies are a messy business. My arm's length relationship with just accepting a thing because an expert said it, is borne of 30 years of watching them fail over and over. One boiled down description of science is a method of attempting to remove all bias from observing the world. But there are so many types of bias it's astounding. There are studies on just different types of bias. Listening to Jerry Hoffman and others for years has been pretty eye-opening. It is very common for especially drug companies to set things up in their favor. Hoffman was surprised since this was apparently a government study, but the government has bias too (like finding a treatment fast). 

 

EM Rap is an outstanding product. It actually grew out of a product called Emergency Medical Abstracts where for years Jerry Hoffman and his partner reviewed about 20 articles per month from a huge spread of journals. Not only informing of what seemed promising or even "proven" but what we were likely to be sold as proven that at best needed better studies. EM Rap was started by Mel Herbert, (the Australian guy that leads these updates). He had his own product that provided deep dives into important areas. When Jerry and his partner retired, they sold their business to Mel and he put it all together along with some other products into one hugely deep data base of EM continuing education. 

 

Anyways, EM Rap costs about $500/year, but they've made the covid stuff free. Way back at the start of this thread I included one or two of their earliest updates. They continue to put these out free, just search EM RAP Covid on You tube. I get notifications of new ones coming up, I'll try to put it on here if I do.

 

Rem, I'm actually pretty familiar with the principles relating to good clinical trials.  I worked for Glaxo (before all the mergers) and was one of the primary statisticians for the first ondansetron NDA.  Part of my job was reviewing study protocols for exactly the type of flaws you're pointing out. I've been out of the field for quite a while now, and it's a bit surprising and very disconcerting that the science has apparently ended up where it's at.  Aren't reputable publications supposed to be peer reviewed?  Don't protocols for new drug studies still need to go through an IRB (institutional review board for those unfamiliar)? At the places I worked, part of the role of the statistician was to serve as a "check" on the clinicians, who often were so invested in a drug (emotionally, not financially) that subconscious bias could be viewed as understandable.

 

When I first started in the field (early '80s) the FDA had a huge presence.  It was significantly reduced in, what, maybe the early 90s? I wonder if the apparent degradation in standards might be linked to that?  Over regulation can be a big problem. But regulation can serve a valuable purpose.  Like many things, I wonder if the proper balance might have been lost?  

 

As an aside, the regulation thing could be viewed as one example of what I perceive as perhaps the biggest challenge our society now faces, and that's extreme polarization.  Black or white, all or nothing.  Only in an environment like that could a phrase like "alternative facts" could be viewed with anything but complete ridicule.

Edited by LakeLivin

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 Interesting, though if he's recovered it seems like a non-issue

 
 
 
 
Edited by legend-1

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20 minutes ago, legend-1 said:

 Interesting, though if he's recovered it seems like a non-issue

 
 
If a player or a few players contracting the Virus will push implementation of the playoffs back  then they have no business attempting this. Or the next season or any season.  There will be cases and this is here to stay, vaccine or no.  Same as the flu has always hit sports teams.   Just my opinion.
 

 

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That raises an issue which I've been pondering, for all sports really, not just ours. But what happens if these playoffs get rolling, everyone is swimmingly certified as "virus free", then 1 of the daily tests we're told they will be performing comes back positive? Wonder what contingencies they have for that? Shut that player, his contacts or the entire team down, both teams competing, all teams in that one venue or what? Then, what if it's one of the support staff, or alternately one of the coaches? This could get real interesting?

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4 hours ago, KJUNKANE said:

That raises an issue which I've been pondering, for all sports really, not just ours. But what happens if these playoffs get rolling, everyone is swimmingly certified as "virus free", then 1 of the daily tests we're told they will be performing comes back positive? Wonder what contingencies they have for that? Shut that player, his contacts or the entire team down, both teams competing, all teams in that one venue or what? Then, what if it's one of the support staff, or alternately one of the coaches? This could get real interesting?

This is The Big Issue, and I haven't seen a good answer from any league on this except Korean Baseball where they pledge to pause the league for weeks should a positive occur.

 

Bundesliga has started and is tip toeing around the issue.  Their equivalent minor league has a team on lockdown right now.   Competition suffers.  But it isn't playoffs, so some missing minor league games don't matter.  Meanwhile the big league looks like the are just praying.

 

For the Stanley cup playoffs, games can't go missing.  So...  More praying??

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15 hours ago, legend-1 said:

 Interesting, though if he's recovered it seems like a non-issue

 
 

 

Well, the Penguins have dealt with a virus rampaging through their team before in the fairly recent past.  Arguably the league‘s best player at the time, Sydney Crosby, even came down with the virus.  This was a highly infectious virus but it had a very effective vaccine and Crosby had been vaccinated, but still got the virus anyway.  Will the initial COVID-19 vaccine be anywhere near as effective as the mumps vaccine?  Unlikely, so even when there is a vaccine, figuring out the risk levels and those ‘what if’ contingency plans when someone gets sick will be on-going by the league planners perhaps for years...

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BTW, this whole issue of someone getting the virus is complicated by the fact of the apparently long asymptomatic period.  You can take the player out, but he probably infected his team, or other teams. (You CANNOT social distance Face Offs!)

 

And you can't bubble wrap them.  We've bubble wrapped care homes, and they still get it by the service workers -- many asymptomatic -- coming through.

 

This can all happen even with frequent testing (every few days).  *maybe* daily testing will prevent it.  *maybe*.

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21 hours ago, LakeLivin said:

 

Rem, I'm actually pretty familiar with the principles relating to good clinical trials.  I worked for Glaxo (before all the mergers) and was one of the primary statisticians for the first ondansetron NDA.  Part of my job was reviewing study protocols for exactly the type of flaws you're pointing out. I've been out of the field for quite a while now, and it's a bit surprising and very disconcerting that the science has apparently ended up where it's at.  Aren't reputable publications supposed to be peer reviewed?  Don't protocols for new drug studies still need to go through an IRB (institutional review board for those unfamiliar)? At the places I worked, part of the role of the statistician was to serve as a "check" on the clinicians, who often were so invested in a drug (emotionally, not financially) that subconscious bias could be viewed as understandable.

 

When I first started in the field (early '80s) the FDA had a huge presence.  It was significantly reduced in, what, maybe the early 90s? I wonder if the apparent degradation in standards might be linked to that?  Over regulation can be a big problem. But regulation can serve a valuable purpose.  Like many things, I wonder if the proper balance might have been lost?  

 

As an aside, the regulation thing could be viewed as one example of what I perceive as perhaps the biggest challenge our society now faces, and that's extreme polarization.  Black or white, all or nothing.  Only in an environment like that could a phrase like "alternative facts" could be viewed with anything but complete ridicule.

Very interesting Lake! We use the heck out of ondansetron. 

 

While I have a few publications, I've been out of doing research for a long time. But I do know that hospitals still have IRB's. That would cover any research being done in the hospital setting. Not sure about the outpatient setting. However, IRB's are more focused on hospital liability and patient safety than on the study design in many cases. And especially if the hospital is to be one of several sites. At least that was my experience. 

 

It's interesting that you worked for a huge drug company. I am not anti-drug company at all, but over the years it's become apparent that the need for profit does affect the science as well as the sales people's spin on the science. I wonder if you felt any pressure to design studies set up to give the drug maximal chances of looking effective. You don't have to answer, but I wonder. I don't really know how it's changed, but for the 30 or so years I've been reviewing and listening to reviews, there are so countless many examples of drug company sponsored studies being, uh, a bit tricky, that the reviewer always points out that the study was drug company sponsored so keep that in mind. Not saying that there were not many excellent drug company sponsored studies, because there were, but the bad examples were so bad. 

 

I used to be the medical director of my last ER in El Paso. A drug rep came in one day to try to get us to buy Xopenex, which is basically albuterol, and was brand new at the time. I'm sure many here are familiar with albuterol as the main inhaled drug for asthma and COPD. OK, I'm not a chemist, but there are these things called optical isomers. Basically each drug is made up of roughly half of a molecule and half of it's mirror image. There has been a big move over many years to isolate one or the other of these mirror images and see if it is more effective by itself. Well, Xopenex is one of the mirror images of albuterol. The company claimed(s) that it provided more effect and less side effects than the 50-50 mix of both optical isomers. Anyway, I asked the rep for some studies and data showing this. He pulled out a lap top, and went to an Excel spreadsheet of an internal study done at one small hospital with about 100 patients. It hadn't even been presented as an abstract, let alone published. How can this be their only data? They're already sell it for crying out loud. Well, since it's basically still albuterol, it was already approved. For years I thought about doing a study to show that the claims of the drug company were wrong, but it would have been for free, so nah. Well about 15 years later someone finally did it. But the stuff is still in wide use.

 

This gets to my point about once a drug gets into wide use, further proof of it's lack of efficacy only slows it's roll. It can take years or decades for the drug to stop being used, unless it's shown to cause harm. It is said that it can take up to 19 years for a bad habit to work it's way out of medical practice. Almost need a large chunk of MD"s to retire with some things. And this plays into the Covid thing. As bad science shows a thing to seem to work or not work, it can become standard practice very quickly, and it can be hard to turn that ship around once the opposite is proven. I do think things move much more quickly in and out with Covid than anything else I've seen to date, but it's still a concern.

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If a player gets Covid during this thing, it will not all shut down. The NHL has already said that.

 

This is different than the general public in several key ways. 

 

First, these guys will be tested daily in a screening of everyone all the time. We are no where near anything remotely like that in the real world. The idea of asymptomatic spread should be greatly reduced by this. They will most likely know a guy has covid before he has any idea he has it. This is untrue in the real world. Second, they will be practicing all sorts of things to keep from spreading it, from full face screens to social distancing in the locker room, etc etc etc. The r naught, or number of people each Covid patient infects is 2-4. But that number is in people who do not know they have it for at least 5 days, and that's 2-4 people for the entire length of them being infective, usually spread to family members: the majority of people spread it to close contacts (family). Third, they will contact-trace and really zone in on separating contacts of any positives. 

 

Like CC said, if one positive shuts the whole thing down then they wouldn't do it. But it sure looks like they're doing it.

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4 hours ago, remkin said:

If a player gets Covid during this thing, it will not all shut down. The NHL has already said that.

That really does not address my concern totally, as I questioned rem, 1st what about the team on which it occurs? Does it just quarantine the player testing positive, his close contacts as well as him, or the entire team? It would seem that if only a player and his contacts are quarantined, you would quickly affect that teams ability to play? What about if the positive is a coach or assistant coach? Or training staff? So we've been told that "it will not all shut down" but if you eliminate a team that would seem pretty disruptive? And finally, what if it's one of the 2 in the finals? It would be weird to have the Stanley Cup awarded on the basis of forfeiture due to COVID-19, just saying? Lets just hope (and pray) that none of this unfolds, but look at the number of players on the Senators team who've tested positive?

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7 hours ago, remkin said:

Very interesting Lake! We use the heck out of ondansetron. 

 

While I have a few publications, I've been out of doing research for a long time. But I do know that hospitals still have IRB's. That would cover any research being done in the hospital setting. Not sure about the outpatient setting. However, IRB's are more focused on hospital liability and patient safety than on the study design in many cases. And especially if the hospital is to be one of several sites. At least that was my experience. 

 

It's interesting that you worked for a huge drug company. I am not anti-drug company at all, but over the years it's become apparent that the need for profit does affect the science as well as the sales people's spin on the science. I wonder if you felt any pressure to design studies set up to give the drug maximal chances of looking effective. You don't have to answer, but I wonder. I don't really know how it's changed, but for the 30 or so years I've been reviewing and listening to reviews, there are so countless many examples of drug company sponsored studies being, uh, a bit tricky, that the reviewer always points out that the study was drug company sponsored so keep that in mind. Not saying that there were not many excellent drug company sponsored studies, because there were, but the bad examples were so bad. 

 

I used to be the medical director of my last ER in El Paso. A drug rep came in one day to try to get us to buy Xopenex, which is basically albuterol, and was brand new at the time. I'm sure many here are familiar with albuterol as the main inhaled drug for asthma and COPD. OK, I'm not a chemist, but there are these things called optical isomers. Basically each drug is made up of roughly half of a molecule and half of it's mirror image. There has been a big move over many years to isolate one or the other of these mirror images and see if it is more effective by itself. Well, Xopenex is one of the mirror images of albuterol. The company claimed(s) that it provided more effect and less side effects than the 50-50 mix of both optical isomers. Anyway, I asked the rep for some studies and data showing this. He pulled out a lap top, and went to an Excel spreadsheet of an internal study done at one small hospital with about 100 patients. It hadn't even been presented as an abstract, let alone published. How can this be their only data? They're already sell it for crying out loud. Well, since it's basically still albuterol, it was already approved. For years I thought about doing a study to show that the claims of the drug company were wrong, but it would have been for free, so nah. Well about 15 years later someone finally did it. But the stuff is still in wide use.

 

This gets to my point about once a drug gets into wide use, further proof of it's lack of efficacy only slows it's roll. It can take years or decades for the drug to stop being used, unless it's shown to cause harm. It is said that it can take up to 19 years for a bad habit to work it's way out of medical practice. Almost need a large chunk of MD"s to retire with some things. And this plays into the Covid thing. As bad science shows a thing to seem to work or not work, it can become standard practice very quickly, and it can be hard to turn that ship around once the opposite is proven. I do think things move much more quickly in and out with Covid than anything else I've seen to date, but it's still a concern.

 

In my experience I never saw any of the issues you're concerned about.  The clinicians I worked with were all ethical scientists, and I never sensed pressure from the corporation to compromise the integrity of the studies.  FDA scrutiny of phase III studies is pretty intense, at least it was at the time I was working.  The type stuff you're talking about would have easily disqualified a study from supporting an NDA.  Couple things to keep in mind, though.

 

  • I've been out of the business for over 20 years so I don't know what might have changed.
  • I only worked for 2 drug companies, and they were big ones (Bristol Myers and Glaxo). Who knows what the culture might be like at a small company headed by someone like that human-cockroach cross breed Martin Shkreli?  
  • Ondansetron was a good drug right from the get go, so there was never the need for pressure. 
  • I only worked on phase III studies. Ours was a whole different division from the one that did postmarketing studies, which had much closer ties to sales and marketing.  In general, I trust the sales and marketing guys about as far as I can throw them (reference your experience with sales reps).

One note on the concerns about the questionability of the statistically significant finding in that remdesivir study. Even if it's invalidated (and if they fished for significance among a number of different endpoints, it would be) I don't know that's necessarily as discouraging to me as it was to the ED in the video.  I'd love to be able to look at the data.  If they cherry picked one of the few endpoints that showed better results from remdesivir, that would be really discouraging.  But if the vast majority of endpoints showed positive trends towards remdesivir, even without valid statistical significance due to study design flaws, the numbers are getting big enough that, given the current environment, it would seem to justify continued use as they fix the design issues and formally confirm that the trends aren't random noise.  And while, hopefully, they come up with the next iteration that is more effective.  All subject to an acceptable safety profile, of course.

 

Oh, and one ironic note about ondansetron; I had hernia surgery a while back, and post-op ondansetron didn't work for me.  If there was much of an effect, I hate to think what I'd have been like without it, lol.  

 

 

Edited by LakeLivin

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I haven’t seen any mention of this yet. Since it seems like we’re going to go ahead with the playoffs and they’re going to be in alternate site arenas, what are they doing about showing all of the playoffs in a manner where we can see even our home team which is normally on a black out?

Edited by caneswincup

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14 hours ago, KJUNKANE said:

That really does not address my concern totally, as I questioned rem, 1st what about the team on which it occurs? Does it just quarantine the player testing positive, his close contacts as well as him, or the entire team? It would seem that if only a player and his contacts are quarantined, you would quickly affect that teams ability to play? What about if the positive is a coach or assistant coach? Or training staff? So we've been told that "it will not all shut down" but if you eliminate a team that would seem pretty disruptive? And finally, what if it's one of the 2 in the finals? It would be weird to have the Stanley Cup awarded on the basis of forfeiture due to COVID-19, just saying? Lets just hope (and pray) that none of this unfolds, but look at the number of players on the Senators team who've tested positive?

Exactly, KJUN.  This is where Bundesliga and NHL are praying.

 

Bundesliga 2 had a team shut down due to a player or 2 on a team going positive.  There are complaints about fairness and equity specifically since one of the opponents of the team needed a win to move them close to promotion.  I.e. "We need to play that crummy team and move up!"  Forfeits apparently are not part of the plan (good thing, I think).  They are still trying to figure out what to do about the missing game.

 

But since it is the "AHL" equivalent, nobody cares much.  They would care if it were the big league.

Edited by wxray1

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10 hours ago, caneswincup said:

I haven’t seen any mention of this yet. Since it seems like we’re going to go ahead with the playoffs and they’re going to be in alternate site arenas, what are they doing about showing all of the playoffs in a manner where we can see even our home team which is normally on a black out?

Not sure what you mean, caneswincup.  The playoffs are typically widely televised.  The last few years NBC has made it a point to televise every game, even throwing alternates on stations like CNBC (financial network).  There shouldn't be blackouts.

 

As for the "play in" round of 5, that may be different.  I dunno.  I presume you are talking about the NHL network and "center ice" or whatever it is called? 

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Quote

DOCTORS CONCERNED OVER RISING HOSPITAL NUMBERS

The number of North Carolinians hospitalized with COVID-19 on any given day has jumped in the last two weeks to more than 600. It’s exceeded 700 four times since May 25, hitting a new high of 717 on Friday [yesterday].

 

That’s concerning for some doctors, who say hospitalizations are a better measure of slowing the spread than case numbers.

 

“If we’re seeing people get sick enough to be admitted to the hospital, that’s telling you we have not flattened the curve,” Dr. David Wohl, an infectious disease physician at the UNC School of Medicine in Chapel Hill, told The News & Observer.

Full daily update here.

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1 hour ago, wxray1 said:

Not sure what you mean, caneswincup.  The playoffs are typically widely televised.  The last few years NBC has made it a point to televise every game, even throwing alternates on stations like CNBC (financial network).  There shouldn't be blackouts.

 

As for the "play in" round of 5, that may be different.  I dunno.  I presume you are talking about the NHL network and "center ice" or whatever it is called? 

Yes, I don’t own a TV so was thinking Center Ice and specially the play in round, which wouldn’t be covered probably by the network’s contract with the league.

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4 minutes ago, caneswincup said:

Yes, I don’t own a TV so was thinking Center Ice and specially the play in round, which wouldn’t be covered probably by the network’s contract with the league.

Ah, I see.  I don't think they've announced anything.   Let's hope they are more permissive during these odd times so you can see the games.

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19 hours ago, KJUNKANE said:

That really does not address my concern totally, as I questioned rem, 1st what about the team on which it occurs? Does it just quarantine the player testing positive, his close contacts as well as him, or the entire team? It would seem that if only a player and his contacts are quarantined, you would quickly affect that teams ability to play? What about if the positive is a coach or assistant coach? Or training staff? So we've been told that "it will not all shut down" but if you eliminate a team that would seem pretty disruptive? And finally, what if it's one of the 2 in the finals? It would be weird to have the Stanley Cup awarded on the basis of forfeiture due to COVID-19, just saying? Lets just hope (and pray) that none of this unfolds, but look at the number of players on the Senators team who've tested positive?

I think if a player tests positive they will quarantine him, then try to determine if he had an very high risk exposure to another person. If not, they'd remove that player and go on. 

 

The thing is that they're testing everyone daily and they're going to have things in place to limit spread. Again, one person gives Covid to 2-4 people over the entire course of their disease mostly close contacts. In this case the person would be identified very early and removed. Also, everyone will be tested for 2 weeks prior to arriving. So everyone arriving should be disease free. These are not minor things. 

 

Is it possible that it spreads through a team? It is. If it does, this would derail that team. Is there a contingency for that? Probably, but I haven't heard it. 

 

Everyone arrives disease free, many social distancing and other precautions are in place, everyone is tested every day. I wish I worked in that setting.

 

 

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28 minutes ago, remkin said:

Everyone arrives disease free, many social distancing and other precautions are in place, everyone is tested every day. I wish I worked in that setting.

I mentioned much earlier that by the time the team is getting frequent testing, we better damn well have it for our health care folks.

 

It is looking more and more like capacity is becoming less of a problem than -- you guessed it -- MONEY, $$$$$$$$$$$$.  They can't even find enough people to test in some places.

 

Yes, testing capacity is still short in some places.  But let's say that's solved in the next month.  Then it will be all about $$$$.  If private enterprises like the NHL and NBA are testing daily, but our service workers in long term care facilities are getting no testing, then it is broken.  

 

What the NHL should do is dump an equivalent amount of $$$$ into a pot to allow our health care professionals to be tested more frequently. I.E., for every one test the players/coaches get, donate one for our front line works.   I'm specifically worried about LTC workers who go from facility to facility.  The NHL needs to give back in this effort.  It would be a fine time for management and players to cooperate on this, too.  They both have a few bucks I'm sure they could let go of.

 

 

Edited by wxray1
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2 hours ago, remkin said:

Again, one person gives Covid to 2-4 people over the entire course of their disease mostly close contacts. In this case the person would be identified very early and removed. Also, everyone will be tested

Okay, and I completely understand the scrutiny under which these games are being envisioned to proceed, however just this one snippet "one person gives Covid to 2-4 people" demonstrates how this is an apples to oranges rational. That ratio applies to everyday, non stressful activities, NOT to high impact, physically demanding sport of hockey, ratcheted up even more so during playoffs. And testing, no matter how frequent is not inerrant.

 

The other thing you mention rem also, like much of my thoughts is rather nitpicking, but "determine if he had any high risk exposure", I'm just not sure where you draw the line here? Oh well, I suppose there's nothing completely "risk free" and tremendous thought has been put into this venture, but I just see where things could go south fast. 

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38 minutes ago, KJUNKANE said:

 but I just see where things could go south fast. 

Someone mentioned mumps earlier?  Mumps went through the league like a knife through butter a few years ago.  Even among previously vaccinated guys (guess it weakened).  They say the R0 is 10 for mumps in a vulnerable population, but since this was a primarily vaccinated group, it had to be lower.  It still spread like wildfire.

sidney-crosby.jpg

Sidney says, "I'm fine.  No mumps.  What mumps?"

Edited by wxray1

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