Hacker News Reader

Cantbekhanon 1003 patients treated with AZM+HCQ, 1 death (Tweet from Dr Raoult, France)

I know the general sentiment about this man is not the best these days. Especially since the Trump intervention/tweets and because of his rather "unorthodox" methods.

But he's still a real Doctor in charge of a real (albeit small) hospital that is indeed specialized in infectious diseases.

And if what he claims is true (1003 patients treated with only 1 death), this is a pretty damn good result compared to the situation we have in Spain/Italy.

Cantbekhanon Cat confirmed infected and symptomatic with Covid19 by officials in Belgium/EU

“Recently, the veterinary medicine faculty in Liège reported that a coronavirus infection has been diagnosed in a cat. The cat lived with her owner, who started showing symptoms of the virus a week before the cat did,” said Van Gucht.

“We want to stress that this is an isolated case. Additionally, in this case, we are talking about a human-to-animal transmission, not the other way around. The risk of animal-to-human transmission, is very small,” he added.

Edit (update): https://www.brusselstimes.com/all-news/belgium-all-news/1030...

"The animal lived in close contact with its owner, and started showing symptoms a week after the woman did. “The cat had diarrhoea, kept vomiting and had breathing difficulties. The researchers found the virus in the cat’s faeces,” he added."

Cantbekhanon (03/23) Hypothesis:ACE inhibitors and ARBs may increase risks of severe Covid19

Again a new paper suggesting this interaction. This is adding to some other papers on the matter:

Sources:

https://www.nature.com/articles/s41569-020-0360-5

https://www.bmj.com/content/368/bmj.m406/rr-13

https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600...

https://academic.oup.com/eurheartj/advance-article/doi/10.10...

Cantbekhanon India OKs Hydroxychloroquine as Prophylaxis for Hcare Workers, Family Members

Actual official paper https://www.mohfw.gov.in/pdf/AdvisoryontheuseofHydroxychloro...

Cantbekhanon Covid-19 Rapid 15 minutes Test Kit

A small Belgian company has developed a very similar test kit. Its test is also claiming a result in 15 mins with around 60% sensivity.

The test in question has been fast tracked and approved by European regulations.

Here is their product sheet: https://www.corisbio.com/pdf/Products/SARS-COVID-19_20200324...

Here is their page: https://www.corisbio.com/Products/Human-Field/Covid-19.php

It seems to be quite similar but on this one you can see their test results and how effective it is.

Evaluation 1(n=99),95%,confidence interval:

-Sensitivity,60%,(40.7 to 76,8%)

-Sensitivity threshold,85.7%,on sampling with CT under 25(62.6 to 96.2%)

-Specificity,100%,(93.4 to 100%)

-Positive predictive value,100%,(78.1 to 100%)

-Negative predictive value,85.2%,(75.2 to 91.8%)

-Agreement,87.9%(87/99)

Evaluation 1(n=1 32),95%,confidence interval:

-Sensitivity,60.3%,(48.1 to 71.3%)

-Sensitivity threshold,76.7%,on sampling with CT under 25(61 to 87.7%)

-Specificity,98.3%,(89.7 to 99.9%)

-Positive predictive value,97.8%,(86.8 to 99.9%)

-Negative predictive value,66.7%,(55.7 to 76.2%)

-Agreement 77.3%(102/132)

It was developed by the ULB university in Brussels. It has been tested on 250 patients in two of Belgian's main university hospitals.

https://www.brusselstimes.com/all-news/belgium-all-news/1027...

This company seems to have a history of producing such tests (for Ebola, Influenza and other pathogens) and there are numerous pubmed publications about them...

Cantbekhanon Stanford researchers confirm N95 masks can be sterilized in oven

The dutch are doing it with hydrogen peroxide in their official recommendations https://www.rivm.nl/en/documenten/reuse-of-ffp2-masks

Cantbekhanon Dyson has announced it will develop a new type of medical ventilator for NHS

And I suppose it "doesn't lose breathing" ? Sorry I had to ...

Cantbekhanon About that Hydroxychloroquine for Covid-19 trial

As far as the netherlands are concerned, Lopinavir is now removed from their interim guidelines. The first line treatement is now hydroxichloroquine/chloroquine with maybe remdesivir for severe cases.

Source (in Dutch): https://swab.nl/nl/covid-19

But yes in Italy the current guidelines (which are still dated 13 February still mention lopinavir).

Source (in Italian): http://www.simit.org/medias/1569-covid19-vademecum-13-03-202...

It has also been removed from guidelines from Belgium: source (English) : https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_In...

I think the odd case is France wich I think is still not having Chloroquine/Hydroxichloroquine in their guidelines as of today.

I was not able to find the german guidelines.

Cantbekhanon About that Hydroxychloroquine for Covid-19 trial

It seems this man was treated with lopinavir–ritonavir ... Unfortunately according to this recently published study, it seems inefficient against Covid19.

https://www.nejm.org/doi/full/10.1056/NEJMoa2001282?query=fe...

It also seems some EU countries are now stopping the use of lopinavir due to this study.

Cantbekhanon About that Hydroxychloroquine for Covid-19 trial

Yes it seems they have 100 on one dosage, 100 one a different dosage and 100 in a placebo group.

According to the register, the study execution time should be "2020-01-31 To 2020-02-29"

But nobody seems to have any insight on the final results. But I would recommend this article with comments of the study leader (Dr Zhang Zhan). The article also explains how they initially discovered the efficiency of the drug by just noticing there were no lupus patients (who were under chronic treatment of hydroxichloroquine) infected with covid19.

https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...

Cantbekhanon About that Hydroxychloroquine for Covid-19 trial

If you are curious, this is the actual Chinese trial registration (edit: not results) about hydroxichloroquine (among the many citations in the pdf)

http://www.chictr.org.cn/showprojen.aspx?proj=48880

Cantbekhanon Covid19 DIY Face-Mask

As some other people mentioned in other threads, aliexpress seems to be restocked on some "alleged" FFP2 and shipping them including express shipping with DHL. Risky and expensive bet tho.

https://www.aliexpress.com/item/4000768665097.html

Cantbekhanon Covid19 DIY Face-Mask

If you just want a surgical type face mask, you can always do this https://www.youtube.com/watch?v=aNjpH5lBZ8w which is even easier to make.

Yes I know it's not the best filtration. I know it's also not sealed like it should be. It's not a respirator.

But at least it should keep some obvious droplets in/out. And it's still "better than nothing at all".

Bonus, also explaining how to make a quick DIY face shield.

Cantbekhanon (Upd EU/Be)Treatment Guidelines COVID19,Azithromycin+Chloroquine,ACE/ARBs Switch

This shows the updated (March 19) official Belgian treatment guidelines for COVID19 and comparison with treatment guidelines for France,Belgium,Switzerland,Netherlands.

Notably it shows now the addition of Azithromicyn as an addition to Chloroquine/Hydroxichloroquine (cf the controversial French study source: https://www.mediterranee-infection.com/wp-content/uploads/20...).

It's also clearly indicated that Remdesivir is now in short supply: " At this moment very restricted availability of remdesivir (long delay for supply) and very strict criteria released by Gilead "

France is still not considering hydroxichloroquine/chloroquine at this point officially for some strange reason.

Also this line seems important : " Lopinavir/ritonavir can still be therefore considered a second choice for the moment, when hydroxychloroquine is contraindicated, but only if this treatment could be administered early in the course of the disease (within 10 days after symptoms onset). We consider this treatment as futile if administered later "

So they seem to think Lopinavir/ritonavir is futile is not administered early.

And last but not least and in line with several hackernews threads. They do seem to somewhat advice physicians to possibly switch medications of infected patients with High Blood Pressure and ACE inhibitors/ARBs to an equivalent therapy.

Cantbekhanon Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

It's unfortunately not yet translated but I think the graphs and tables are clear enough and can easily be translated by Google Translate.

Personally my surprise is that it seems half of those deceased people did not receive any kind of antiviral therapy.

Cantbekhanon Why N95 masks are hard to make

It's been shown by a few documentaries (by ARTE european channel) that up to at least the 3rd of march and in Beijing, you are not authorized to go out without a face mask (for grocery shopping for instance). Each family has a few "permits" available to go out but facemask (chirurgical type) is not an option for those going.

Your temperature as well as your mask compliance will be checked pretty much at every venue/transportation/shop.

Source (in french): https://www.youtube.com/watch?v=OQD_-2KI244

Cantbekhanon Chloroquine has shown apparent efficacy in treatment of Covid-19

Sure look at my comments on other threads

Cantbekhanon Chloroquine has shown apparent efficacy in treatment of Covid-19

And as discussed previously before in many submissions, hydroxichloroquine is already actively being used against Covid19 by at least the following EU countries:

- Belgium - Netherlands - Switzerland - Italy

Cantbekhanon Open letter from Italy to the international scientific community

Same for many EU guidelines

Source as I posted on other submissions

Chloroquine is mostly admitted as a valid treatment now

https://news.ycombinator.com/item?id=22582374

Cantbekhanon Arguments in favor of remdesivir for treating SARS-CoV-2 infections

It should be noted that Remdesivir is already being actively given to patients in critical/severe state in several EU countries.

This is outside clinical trials.

See a compilation of updated guidelines I submitted yesterday.

These are the guidelines for Belgium, France, Italy, Switzerland and the Netherlands.

https://news.ycombinator.com/item?id=22574183

Or for direct link

https://web.archive.org/web/20200314093143/https://epidemio....

France is clearly pushing Remdesivir while others seem to consider it mainly for severe to critical cases. Surprisingly France is also somewhat dropping the cheap chloroquine option in favor of Remdesivir and Lopinavir/ritonavir.

Cantbekhanon COVID19 Treatment Guidelines for Belgium,Netherlands,France,Italy,Switzerland [pdf]

These are the updated (march 13th) interim treatment guidelines applied in Belgium for COVID19.

But the PDF also shows for comparison a clear view of the guidelines applied in Netherlands,France,Italy and Switzerland.

Cantbekhanon Coronavirus: Some recovered patients may have reduced lung function

It would be quite interesting to know what treatment those persons received... Steroids? Chloroquine? Lopinavir/Ritonavir? Something else? I suppose not remdesivir since the article seems to imply they're going to start trials of it.

Cantbekhanon Coronavirus: Some recovered patients may have reduced lung function

https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguid...

You could probably (at your own risk) try just leaving them alone in a paper bag in a well ventilated, heated and not too humid place... For about 10 days... If they're not obviously damaged/spoiled... See CDC guidance in case of mask shortage.

If I'm not mistaken, this study seems to indicate it shouldn't remain active more than 9 days on pretty much most surfaces(source : https://www.journalofhospitalinfection.com/article/S0195-670...)

Cantbekhanon Coronavirus: Some recovered patients may have reduced lung function

Why not ask your cardiologist to switch to a calcium channel blocker during the pandemic? Until we have a vaccine for instance ...

Cantbekhanon Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

Indeed most EU ICU services are already usually running at around 90% with the usual issues (including the Flu). And please also do consider that most of theses cases are within the Lombardy region and that most ICU patients are very difficult if not impossible to transfer safely to other regions. While the ICU beds are limited, the amount of ambulances equipped with ICU equipment is probably even smaller (and will also require an ICU nurse+doctor on board during the transfer).

Cantbekhanon Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

Warning tho with those statistics that are also to be found at Eurostat. Curative (acute) care beds are NOT ICU beds.

They're just normal hospital beds.

example, the netherlands have a total of around 1300 ICU beds (source https://healthmanagement.org/c/icu/issuearticle/organisation...).

the number there is 50k ... which is indeed about the amount of normal beds excluding ICU and other few specific beds.

Cantbekhanon Chloroquine phosphate has shown apparent efficacy in treating Covid-19

Some GPs in some EU countries did decide do take it prophylactically due to lack of PPE. But most around me agree this is a risky and probably bad advice. The current publicly available guidelines do not recommend taking it before you develop symptoms and do not recommend taking it at all if you are asymptomatic and/or very young. And also certainly they do not recommend any self medication without doctor's approval as there can be serious adverse effects with chloroquine (less with hydroxichloroquine).

Also this would have a terrible effect and indeed cause supply shortages as another commenter pointed out.

Cantbekhanon Chloroquine phosphate has shown apparent efficacy in treating Covid-19

I'm fairly certain finding the vaccine is really quite easy to develop and has been done by multiple companies small and large already. The main issue is to do the clinical trials and get it approved and mass produced in a timely fashion.

These trials and the validation can take about a year.

Here is the official list of currently being developed covid19 vaccines (all in pre-clinical stage)

https://www.who.int/blueprint/priority-diseases/key-action/n...

Cantbekhanon Chloroquine phosphate has shown apparent efficacy in treating Covid-19

This is old news by this time. As I commented on previous threads. https://news.ycombinator.com/item?id=22534339

Yes chloroquine has been shown effective in vitro (https://www.nature.com/articles/s41422-020-0282-0). Yes hydroxichloroquine has been shown effective in vitro very recently as well (https://academic.oup.com/cid/advance-article/doi/10.1093/cid...).

Yes both compounds are already actively being used and approved for use by Asian and EU countries against Covid19:

Here are the Netherlands treatment guidelines (in Dutch): https://lci.rivm.nl/covid-19/bijlage/medicamenteuze-behandel...

Here are the Italy treatment guidelines (in Italian): http://www.simit.org/medias/1555-covid19-linee-guida-trattam...

How they found out about it: https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...

Approval and recommendation of the chinese: https://pubmed.ncbi.nlm.nih.gov/32075365-expert-consensus-on... https://pubmed.ncbi.nlm.nih.gov/32074550-breakthrough-chloro...

I don't think there is much doubt left about it's efficiency at this stage. Hydroxichloroquine is much safer than chloroquine and it's just a 5 day course at pretty low dosage (2x400mg on day1 as a charge dose, then 2x200mg for 4 days).

More importantly, the drug is readily available, mass producded and doesn't cost 300$+/box like lopinavir/ritonavir. This drug isn't also 100% experimental and probably in the 3 digits rangs like remdesivir.

The only real issue is that with a lot of doctors using it, the temporary shortage of the drug could be troublesome for many Lupus patients around the world who depend on Plaquenil for their management.

Cantbekhanon COVID-19 Therapeutics Accelerator

Several EU countries in addition to China are already actively using chloroquine and hydroxichloroquine to treat COVID19 patients. And I mean outside trials.

For instance:

Here are the Netherlands treatment guidelines (in Dutch): https://lci.rivm.nl/covid-19/bijlage/medicamenteuze-behandel...

Here are the Italy treatment guidelines (in Italian): http://www.simit.org/medias/1555-covid19-linee-guida-trattam...

I think the anecdote on how they found out about the effectiveness of chloroquine in China is fascinating and has nothing to do with the in vitro efficiency study nor with the malaria usage but solely with the immunomodulator effect. They just noticed that there were no lupus patients infected with Covid19. And after investigating with the dermatology dept, they confirmed that indeed there were no reported lupus patients of that hospital infected with covid19.

Their common treatment was chloroquine...

Source: https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...

It should be noted that as far as the Chinese are concerned, it doesn't seem like there is any debate about chloroquine usefulness for COVID19.

Sources:

https://pubmed.ncbi.nlm.nih.gov/32075365-expert-consensus-on...

and https://pubmed.ncbi.nlm.nih.gov/32074550-breakthrough-chloro...