Can touching a barbell in the gym get you sick with the coronavirus?

[Michael Scally MD]

Background: Hydroxychloroquine and chloroquine have antiviral effects in vitro against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2).

Purpose: To summarize evidence about the benefits and harms of hydroxychloroquine or chloroquine for the treatment or prophylaxis of coronavirus disease 2019 (COVID-19).

Data Sources: PubMed (via MEDLINE), EMBASE (via Ovid), Scopus, Web of Science, Cochrane Library, bioRxiv, Preprints, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and the Chinese Clinical Trials Registry from 1 December 2019 until 8 May 2020.

Study Selection: Studies in any language reporting efficacy or safety outcomes from hydroxychloroquine or chloroquine use in any setting in adults or children with suspected COVID-19 or at risk for SARS-CoV-2 infection.

Data Extraction: Independent, dually performed data extraction and quality assessments.

Data Synthesis: Four randomized controlled trials, 10 cohort studies, and 9 case series assessed treatment effects of the medications, but no studies evaluated prophylaxis. Evidence was conflicting and insufficient regarding the effect of hydroxychloroquine on such outcomes as all-cause mortality, progression to severe disease, clinical symptoms, and upper respiratory virologic clearance with antigen testing.

Several studies found that patients receiving hydroxychloroquine developed a QTc interval of 500 ms or greater, but the proportion of patients with this finding varied among the studies.

Two studies assessed the efficacy of chloroquine; 1 trial, which compared higher-dose (600 mg twice daily for 10 days) with lower-dose (450 mg twice daily on day 1 and once daily for 4 days) therapy, was stopped owing to concern that the higher dose therapy increased lethality and QTc interval prolongation.

An observational study that compared adults with COVID-19 receiving chloroquine phosphate 500 mg once or twice daily with patients not receiving chloroquine found minor fever resolution and virologic clearance benefits with chloroquine.

Limitation: There were few controlled studies, and control for confounding was inadequate in observational studies.

Conclusion: Evidence on the benefits and harms of using hydroxychloroquine or chloroquine to treat COVID-19 is very weak and conflicting.

Primary Funding Source: Agency for Healthcare Research and Quality.

Hernandez AV, Roman YM, Pasupuleti V, Barboza JJ, White CM. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19: A Living Systematic Review. Annals of internal medicine 2020. ACP Journals

 

[Michael Scally MD]

We need to open Gyms up safely and soon because home workouts will kill ya!

 

[Michael Scally MD]

The United States has now recorded 100,000 deaths due to the coronavirus.

It’s a moment to collectively grieve and reflect.

Even as we mourn for those we knew, cry for those we loved and consider also those who have died uncounted, I hope that we can also resolve to learn more, test better, hold our leaders accountable and better protect our citizens so we do not have to reach another grim milestone.

Through public records requests and other reporting, ProPublica has found example after example of delays, mistakes and missed opportunities. The CDC took weeks to fix its faulty test. In Seattle, 33,000 fans attended a soccer match, even after the top local health official said he wanted to end mass gatherings. Houston went ahead with a livestock show and rodeo that typically draws 2.5 million people, until evidence of community spread shut it down after eight days. Nebraska kept a meatpacking plant open that health officials wanted to shut down, and cases from the plant subsequently skyrocketed. And in New York, the epicenter of the pandemic, political infighting between Gov. Andrew Cuomo and Mayor Bill de Blasio hampered communication and slowed decision making at a time when speed was critical to stop the virus’ exponential spread.

COVID-19 has also laid bare many long-standing inequities and failings in America’s health care system. It is devastating, but not surprising, to learn that many of those who have been most harmed by the virus are also Americans who have long suffered from historical social injustices that left them particularly susceptible to the disease.

This massive loss of life wasn’t inevitable. It wasn’t simply unfortunate and regrettable. Even without a vaccine or cure, better mitigation measures could have prevented infections from happening in the first place; more testing capacity could have allowed patients to be identified and treated earlier.

The COVID-19 pandemic is not over, far from it.

 

[Plate Smacker]

The fact commercial airlines are allowed, but small businesses aren't, should tell everyone something isn't right.
But the government knows whats best for us right...

 

[ickyrica]

Ford Police Interceptor Utility can destroy coronavirus by baking it

Kinda cool, well hot but cool...

 

[CensoredBoardsSuck]

They never isolated the virus. If they never isolated the virus they can't possibly have a test for the virus and they can't possibly make a vaccine for the virus. Are you guys retarded? Does your body need to be eating it's own organs as your starving to death to realize that world government is killing us with a lie?

"The bigger the lie, the more it will be believed"
- Adolph Hitler

I sometimes wonder if we should be adding neuroleptics to the water supply. Posts like your make me think yes.

BTW, your choice of sig line and it's author are appropriate but I suspect the theory has never worked for you. Just a hunch. LOL

 

[ickyrica]

Lol

 

[ickyrica]

If you guys though you saw a primate in a tree in the woods (partially instructed view) and nobody was around to verify it, would you actually believe your eyes?

 

[Michael Scally MD]

[OA] Sport, Exercise and COVID-19, The Disease Caused by the SARS-Cov-2 Coronavirus

No health emergency in living memory has ever had greater repercussions for our health, economy and the way we live than the COVID-19 pandemic caused by SARS-CoV-2, commonly referred to as the “coronavirus”.

COVID-19 has many links to sport and exercise: sports events such as the champions league quarter final between Atalanta Bergamo and FC Valencia on the 19.02.2020 have contributed to the virus spread; control measures such as lockdowns and closures of gyms and other sport facilities have altered our exercise behaviours; major sporting events including the Tokio Olympics have been cancelled or postponed; sports and fitness providers such as sports clubs, gyms and swimming pools have been hard hit.

In this review, we will answer five questions in relation to COVID-19 from the perspective of sport and exercise. The questions deal with

1) how SARS-CoV-2 targets ACE2-expressing human cells via its spike protein,
2) the COVID-19 disease caused by it,
3) the COVID-19 pandemic and attempts to control it,
4) how the immune system responds to SARS-CoV-2 and how the immune system is affected by exercise training,
5) advice for exercise during the pandemic for healthy adults, athletes and elderly, and possible control measures to help to return to normal sport and exercise at the end of the pandemic before herd immunity or mass vaccination has been achieved.

Wackerhage H, Everett R, Krüger K, Murgia M, Simon P, Gehlert S, Neuberger E, Baumert P, Schönfelder M. Sport, exercise and COVID-19, the disease caused by the SARS-CoV-2 coronavirus. Dtsch Z Sportmed. 2020; 71: E1-E12. doi:10.5960/dzsm.2020.441 https://www.germanjournalsportsmedicine.com/archiv/archive-2020/issue-5/sport-exercise-and-covid-19-the-disease-caused-by-the-sars-cov-2-coronavirus/

 

[Michael Scally MD]

[OA] Smoking-Mediated Upregulation of the Androgen Pathway Leads to Increased SARS-CoV-2 Susceptibility

The COVID-19 pandemic is marked by a wide range of clinical disease courses, ranging from asymptomatic to deadly. There have been many studies seeking to explore the correlations between COVID-19 clinical outcomes and various clinical variables, including age, sex, race, underlying medical problems, and social habits. In particular, the relationship between smoking and COVID-19 outcome is controversial, with multiple conflicting reports in the current literature.

In this study, we aim to analyze how smoking may affect the SARS-CoV-2 infection rate. We analyzed sequencing data from lung and oral epithelial samples obtained from The Cancer Genome Atlas (TCGA). We found that the receptor and transmembrane protease necessary for SARS-CoV-2 entry into host cells, ACE2 and TMPRSS2, respectively, were upregulated in smoking samples from both lung and oral epithelial tissue. We then explored the mechanistic hypothesis that smoking may upregulate ACE2 expression through the upregulation of the androgen pathway.

ACE2 and TMPRSS2 upregulation were both correlated to androgen pathway enrichment and the specific upregulation of central pathway regulatory genes. These data provide a potential model for the increased susceptibility of smoking patients to COVID-19 and encourage further exploration into the androgen and tobacco upregulation of ACE2 to understand the potential clinical ramifications.

Chakladar J, Shende N, Li WT, Rajasekaran M, Chang EY, Ongkeko WM. Smoking-Mediated Upregulation of the Androgen Pathway Leads to Increased SARS-CoV-2 Susceptibility. Int J Mol Sci. 2020;21(10):E3627. Published 2020 May 21. doi:10.3390/ijms21103627 Smoking-Mediated Upregulation of the Androgen Pathway Leads to Increased SARS-CoV-2 Susceptibility

 

[Michael Scally MD]

COVID-19 Infection-Fatality Rates …

We just passed 100,000 deaths. Unfortunately, given a best-estimate IFR of ~0.64 (0.5 to 0.78%), this means only around 5% (4% to 6%) of the population has been infected with the virus. We still have a long way to go to get any sort of herd immunity.

Meyerowitz-Katz G, Merone L. A systematic review and meta-analysis of published research data on COVID-19 Infection-Fatality Rates. medRxiv 2020:2020.05.03.20089854. A systematic review and meta-analysis of published research data on COVID-19 infection-fatality rates

An important unknown during the COVID-19 pandemic has been the infection-fatality rate (IFR). This differs from the case-fatality rate (CFR) as an estimate of the number of deaths as a proportion of the total number of cases, including those who are mild and asymptomatic. While the CFR is extremely valuable for experts, IFR is increasingly being called for by policy-makers and the lay public as an estimate of the overall mortality from COVID-19.

Methods Pubmed, Medline, SSRN, and Medrxiv were searched using a set of terms and Boolean operators on 25/04/2020 and re-searched 14/05/2020 and 21/05/2020. Articles were screened for inclusion by both authors. Meta-analysis was performed in Stata 15.1 using the metan command, based on IFR and confidence intervals extracted from each study. Google/Google Scholar was used to assess the grey literature relating to government reports.

Results After exclusions, there were 25 estimates of IFR included in the final meta-analysis, from a wide range of countries, published between February and May 2020. The meta-analysis demonstrated a point-estimate of IFR of 0.64% (0.50-0.78%) with high heterogeneity (p<0.001).

Conclusion Based on a systematic review and meta-analysis of published evidence on COVID-19 until May, 2020, the IFR of the disease across populations is 0.64% (0.50-0.78%). However, due to very high heterogeneity in the meta-analysis, it is difficult to know if this represents the true point estimate. It is likely that different places will experience different IFRs. More research looking at age-stratified IFR is urgently needed to inform policy-making on this front.

 

[Michael Scally MD]

Get Smart had it first …

A man and a woman demonstrate dining under a plastic shield in a Paris restaurant on Wednesday, May 27, 2020. As restaurants in food-loving France prepare to reopen, some are investing in lampshade-like plastic shields to protect diners from the virus.

 

[Michael Scally MD]

[OA] [Opinion] Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis

More than 1.6 million Americans have been infected with SARS-CoV-2 and >10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality.

An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin.

Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients.

Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September.

Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease.

Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy.

Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is <20%, 9/100,000 users, compared to the 10,000 Americans now dying each week.

These medications need to be widely available and promoted immediately for physicians to prescribe.

[OA] Risch HA. Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis. American Journal of Epidemiology. Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis

 

[Michael Scally MD]

Things get even more surreal and idiotic with humanity’s creative attempts to cure COVID-19. India is now rolling out a Ayurvedic clinical trial with cow urine and manure, China continues playing with Traditional Chinese Medicine (TCM), while we in the progressive and enlightened West go for stem cells, phony vaccine promises from shady companies (Moderna), drugs which do not really work but are convincingly expensive (Remdesivir), and of course the miracle drug chloroquine and its derivative, hydroxychloroquine (HCQ).

And yet, we are possibly witnessing now the last act of the chloroquine circus, since the malaria drug was proven not just ineffective against coronavirus infections, but also dangerous, especially in combination with the antibiotic azythromycine. A personal setback for the Chloroquine Guru Didier Raoult: France’s government completely banned HCQ prescriptions for COVID-19 patients on 27 May 2020. Future historians will figure out how many people worldwide suffered or died because of the quack cure from Marseilles which whole nations blindly followed.

At the same time, the charismatic director of the IHU Méditerranée Infection research hospital in Marseilles, who once pronounced Fin de Partie (end of the game) for the coronavirus because of his chloroquine cure, is now facing a fin de partie for himself instead.

As it turned out, the IHU director and medical doctor Raoult has always been treating COVID-19 (or alleged COVID-19) patients in Marseilles with chloroquine drugs illegally, and he announced to continue regardless of any orders or bans from the French government and national authorities.

...

It is all a bad farce which stopped being funny long ago. The sooner the French dispose of Raoult, the better for the COVID-19 effort worldwide. Many lives will be saved for sure. But so far, the French government and the national authorities are afraid of an open confrontation with the Sun of Marseilles.

 

[Michael Scally MD]

Pr. Raoult has just released the “results” from his “study”.
Early diagnosis and management of COVID-19 patients: a real-life cohort study of 3,737 patients, Marseille, France – IHU

I will not detail why it proves nothing, as others have already done it. Let’s forget one moment who he is and how the study was performed and focus on the results. In his study, 3.737 patients, obviously with mild form of Covid (as per his protocol) were “enrolled” and 3 054 were treated by HCQ-AZ. The mean age of these patients was 45 year old.

Results: mortality rate of 0.9%. Guess what is the mortality rate in the general population with this age range after Covid infection? 0.1-0.3% (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext & https://www.thelancet.com/action/showPdf?pii=S1473-3099(20)30243-7)!

If we apply Raoult reasoning and compare what cannot be compared, we can conclude HCQ-AZ increases the mortality rate by 3 to 9 times.

 

[Michael Scally MD]

Ioannidis is a coauthor …

[OA] Peirlinck M, Linka K, Sahli Costabal F, et al. Visualizing the invisible: The effect of asymptomatic transmission on the outbreak dynamics of COVID-19. medRxiv 2020:2020.05.23.20111419. http://medrxiv.org/content/early/2020/05/26/2020.05.23.20111419.abstract

Understanding the outbreak dynamics of the COVID-19 pandemic has important implications for successful containment and mitigation strategies. Recent studies suggest that the population prevalence of SARS-CoV-2 antibodies, a proxy for the number of asymptomatic cases, could be an order of magnitude larger than expected from the number of reported symptomatic cases.

Knowing the precise prevalence and contagiousness of asymptomatic transmission is critical to estimate the overall dimension and pandemic potential of COVID-19. However, at this stage, the effect of the asymptomatic population, its size, and its outbreak dynamics remain largely unknown.

Here we use reported symptomatic case data in conjunction with antibody seroprevalence studies, a mathematical epidemiology model, and a Bayesian framework to infer the epidemiological characteristics of COVID-19. Our model learns, in real time, the time-varying contact rate of the outbreak, and projects the temporal evolution and credible intervals of the effective reproduction number and the symptomatic, asymptomatic, and recovered populations.

Our study reveals that the outbreak dynamics of COVID-19 are sensitive to three parameters:
· the effective reproduction number,
· the ratio between the symptomatic and asymptomatic populations, and
· the infectious periods of both groups.

For three distinct locations, Santa Clara County (CA, USA), New York City (NY, USA), and Heinsberg (NRW, Germany), our model estimates the fraction of the population that has been infected and recovered by May 13, 2020 to 6.2% (95% CI: 3.3%-9.0%), 22.7% (95% CI: 15.7%-29.8%), and 20.5% (95% CI: 17.0%-24.3%). Our method traces the initial outbreak date in Santa Clara County back to January 20, 2020 (95% CI: January 16, 2020 - January 24, 2020).

Our results could significantly change our understanding and management of the COVID-19 pandemic: A large asymptomatic population will make isolation, containment, and tracing of individual cases challenging. Instead, if needed, managing community transmission through increasing population awareness, promoting physical distancing, and encouraging behavioral changes could become more relevant.

 

[master.on]

[OA] Face Masks For The Public During The Covid-19 Crisis

The precautionary principle is, according to Wikipedia, “a strategy for approaching issues of potential harm when extensive scientific knowledge on the matter is lacking.” The evidence base on the efficacy and acceptability of the different types of face mask in preventing respiratory infections during epidemics is sparse and contested. But covid-19 is a serious illness that currently has no known treatment or vaccine and is spreading in an immune naive population. Deaths are rising steeply, and health systems are under strain.

This raises an ethical question: should policy makers apply the precautionary principle now and encourage people to wear face masks on the grounds that we have little to lose and potentially something to gain from this measure? We believe they should.

Greenhalgh T, Schmid MB, Czypionka T, Bassler D, Gruer L. Face masks for the public during the covid-19 crisis. BMJ 2020;369:m1435. Face masks for the public during the covid-19 crisis

Greenhalgh T. Face coverings for the public: Laying straw men to rest [published online ahead of print, 2020 May 26]. J Eval Clin Pract. 2020;e13415. doi:10.1111/jep.13415 Error - Cookies Turned Off

Background This article responds to one by Graham Martin and colleagues, who offered a critique of my previous publications on face coverings for the lay public in the Covid-19 pandemic. Their paper reflects criticisms that have been made of face coverings policies more generally.

Method Narrative rebuttal. Results I address charges that my coauthors and I had misapplied the precautionary principle; drawn conclusions that were not supported by empirical research; and failed to take account of potential harms But before that, I remind my critics that the evidence on face coverings goes beyond the contested trials and observational studies they place centre stage. I set out some key findings from basic science, epidemiology, mathematical modelling, case studies, and natural experiments, and use this rich and diverse body of evidence as the backdrop for my rebuttal of their narrowly framed objections. I challenge my critics' apparent assumption that a particular kind of systematic review should be valorised over narrative and real-world evidence, since stories are crucial to both our scientific understanding and our moral imagination.

Conclusion I conclude by thanking my academic adversaries for the intellectual sparring match, but exhort them to remember our professional accountability to a society in crisis. It is time to lay straw men to rest and embrace the full range of evidence in the context of the perilous threat the world is now facing.

Respiratory infections occur through the transmission of virus-containing droplets (>5 to 10 μm) and aerosols (≤5 μm) exhaled from infected individuals during breathing, speaking, coughing, and sneezing. Traditional respiratory disease control measures are designed to reduce transmission by droplets produced in the sneezes and coughs of infected individuals.

However, a large proportion of the spread of coronavirus disease 2019 (COVID-19) appears to be occurring through airborne transmission of aerosols produced by asymptomatic individuals during breathing and speaking. Aerosols can accumulate, remain infectious in indoor air for hours, and be easily inhaled deep into the lungs.

For society to resume, measures designed to reduce aerosol transmission must be implemented, including universal masking and regular, widespread testing to identify and isolate infected asymptomatic individuals.

…

Prather KA, Wang CC, Schooley RT. Reducing transmission of SARS-CoV-2. Science 2020:eabc6197. Reducing transmission of SARS-CoV-2

View attachment 130664

Masks reduce airborne transmission. - Infectious aerosol particles can be released during breathing and speaking by asymptomatic infected individuals. No masking maximizes exposure, whereas universal masking results in the least exposure.

Masks help quite a bit.
Of course the ones made out of fabric aren't 100% effective, but 50-60% effectiveness ain't bad for something so cheap and readily available.
Anyone who is not wearing a mask is a total covIDIOT.

The French health ministry is banning the use of hydroxychloroquine as a cure to coronavirus, according to a decree published Wednesday morning. Décret n° 2020-630 du 26 mai 2020 modifiant le décret n° 2020-548 du 11 mai 2020 prescrivant les mesures générales nécessaires pour faire face à l'épidémie de covid-19 dans le cadre de l'état d'urgence sanitaire | Legifrance

"Whether [in doctors offices] in the cities or in the hospital, this ... should not be prescribed for patients with COVID-19," the ministry said in a statement.

On Tuesday, the country’s public health agency advised against using hydroxychloroquine outside of clinical trials. Covid-19 : utilisation de l’hydroxychloroquine

Shortly after that, the national medicines regulator suspended its use in clinical trials. https://www.ansm.sante.fr/S-informer/Actualite/COVID-19-l-ANSM-souhaite-suspendre-par-precaution-les-essais-cliniques-evaluant-l-hydroxychloroquine-dans-la-prise-en-charge-des-patients-Point-d-Information

Great!
Less French people and more HCQ supply.

Background: Hydroxychloroquine and chloroquine have antiviral effects in vitro against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2).

Purpose: To summarize evidence about the benefits and harms of hydroxychloroquine or chloroquine for the treatment or prophylaxis of coronavirus disease 2019 (COVID-19).

Data Sources: PubMed (via MEDLINE), EMBASE (via Ovid), Scopus, Web of Science, Cochrane Library, bioRxiv, Preprints, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and the Chinese Clinical Trials Registry from 1 December 2019 until 8 May 2020.

Study Selection: Studies in any language reporting efficacy or safety outcomes from hydroxychloroquine or chloroquine use in any setting in adults or children with suspected COVID-19 or at risk for SARS-CoV-2 infection.

Data Extraction: Independent, dually performed data extraction and quality assessments.

Data Synthesis: Four randomized controlled trials, 10 cohort studies, and 9 case series assessed treatment effects of the medications, but no studies evaluated prophylaxis. Evidence was conflicting and insufficient regarding the effect of hydroxychloroquine on such outcomes as all-cause mortality, progression to severe disease, clinical symptoms, and upper respiratory virologic clearance with antigen testing.

Several studies found that patients receiving hydroxychloroquine developed a QTc interval of 500 ms or greater, but the proportion of patients with this finding varied among the studies.

Two studies assessed the efficacy of chloroquine; 1 trial, which compared higher-dose (600 mg twice daily for 10 days) with lower-dose (450 mg twice daily on day 1 and once daily for 4 days) therapy, was stopped owing to concern that the higher dose therapy increased lethality and QTc interval prolongation.

An observational study that compared adults with COVID-19 receiving chloroquine phosphate 500 mg once or twice daily with patients not receiving chloroquine found minor fever resolution and virologic clearance benefits with chloroquine.

Limitation: There were few controlled studies, and control for confounding was inadequate in observational studies.

Conclusion: Evidence on the benefits and harms of using hydroxychloroquine or chloroquine to treat COVID-19 is very weak and conflicting.

Primary Funding Source: Agency for Healthcare Research and Quality.

Hernandez AV, Roman YM, Pasupuleti V, Barboza JJ, White CM. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19: A Living Systematic Review. Annals of internal medicine 2020. ACP Journals

Great!
Less liberals and more HCQ supply left for us. How can that not be great?

COVID-19 Infection-Fatality Rates …

We just passed 100,000 deaths. Unfortunately, given a best-estimate IFR of ~0.64 (0.5 to 0.78%), this means only around 5% (4% to 6%) of the population has been infected with the virus. We still have a long way to go to get any sort of herd immunity.

Meyerowitz-Katz G, Merone L. A systematic review and meta-analysis of published research data on COVID-19 Infection-Fatality Rates. medRxiv 2020:2020.05.03.20089854. A systematic review and meta-analysis of published research data on COVID-19 infection-fatality rates

An important unknown during the COVID-19 pandemic has been the infection-fatality rate (IFR). This differs from the case-fatality rate (CFR) as an estimate of the number of deaths as a proportion of the total number of cases, including those who are mild and asymptomatic. While the CFR is extremely valuable for experts, IFR is increasingly being called for by policy-makers and the lay public as an estimate of the overall mortality from COVID-19.

Methods Pubmed, Medline, SSRN, and Medrxiv were searched using a set of terms and Boolean operators on 25/04/2020 and re-searched 14/05/2020 and 21/05/2020. Articles were screened for inclusion by both authors. Meta-analysis was performed in Stata 15.1 using the metan command, based on IFR and confidence intervals extracted from each study. Google/Google Scholar was used to assess the grey literature relating to government reports.

Results After exclusions, there were 25 estimates of IFR included in the final meta-analysis, from a wide range of countries, published between February and May 2020. The meta-analysis demonstrated a point-estimate of IFR of 0.64% (0.50-0.78%) with high heterogeneity (p<0.001).

Conclusion Based on a systematic review and meta-analysis of published evidence on COVID-19 until May, 2020, the IFR of the disease across populations is 0.64% (0.50-0.78%). However, due to very high heterogeneity in the meta-analysis, it is difficult to know if this represents the true point estimate. It is likely that different places will experience different IFRs. More research looking at age-stratified IFR is urgently needed to inform policy-making on this front.

Less than 1% of the population has been infected.
If herd immunity is for real, that's still too far away now.

Liberals can settle for having herd mentality while herd immunity arrives.

Things get even more surreal and idiotic with humanity’s creative attempts to cure COVID-19. India is now rolling out a Ayurvedic clinical trial with cow urine and manure, China continues playing with Traditional Chinese Medicine (TCM), while we in the progressive and enlightened West go for stem cells, phony vaccine promises from shady companies (Moderna), drugs which do not really work but are convincingly expensive (Remdesivir), and of course the miracle drug chloroquine and its derivative, hydroxychloroquine (HCQ).

And yet, we are possibly witnessing now the last act of the chloroquine circus, since the malaria drug was proven not just ineffective against coronavirus infections, but also dangerous, especially in combination with the antibiotic azythromycine. A personal setback for the Chloroquine Guru Didier Raoult: France’s government completely banned HCQ prescriptions for COVID-19 patients on 27 May 2020. Future historians will figure out how many people worldwide suffered or died because of the quack cure from Marseilles which whole nations blindly followed.

At the same time, the charismatic director of the IHU Méditerranée Infection research hospital in Marseilles, who once pronounced Fin de Partie (end of the game) for the coronavirus because of his chloroquine cure, is now facing a fin de partie for himself instead.

As it turned out, the IHU director and medical doctor Raoult has always been treating COVID-19 (or alleged COVID-19) patients in Marseilles with chloroquine drugs illegally, and he announced to continue regardless of any orders or bans from the French government and national authorities.

...

It is all a bad farce which stopped being funny long ago. The sooner the French dispose of Raoult, the better for the COVID-19 effort worldwide. Many lives will be saved for sure. But so far, the French government and the national authorities are afraid of an open confrontation with the Sun of Marseilles.

Great!
Less French (from not taking HCQ) and more supplies are left for us.

 

[MisterSuperGod]

Masks help quite a bit.
Of course the ones made out of fabric aren't 100% effective, but 50-60% effectiveness ain't bad for something so cheap and readily available.
Anyone who is not wearing a mask is a total covIDIOT.



Great!
Less French people and more HCQ supply.




Great!
Less liberals and more HCQ supply left for us. How can that not be great?



Less than 1% of the population has been infected.
If herd immunity is for real, that's still too far away now.

Liberals can settle for having herd mentality while herd immunity arrives.



Great!
Less French (from not taking HCQ) and more supplies are left for us.

How many rolls of toilet paper and bottles of hand sanitizer are you sitting on now that the initial panic is over? Couple thousand of each?

 

[master.on]

How many rolls of toilet paper and bottles of hand sanitizer are you sitting on now that the initial panic is over? Couple thousand of each?

Just a couple units of sanitizer and I didn't buy any additional toilet paper.

However, I did buy a couple bags of N95 masks at the local hardware store, 10 units each
but they were already priced at $4 each.

 

[SteroidsBro]

Liberals can settle for having herd mentality while herd immunity arrives.

Aren't liberals hiding in their homes better than anybody?

Covid19 doesn't exist; Dr. Scally's posts in this thread are pathetic.