discussion comment
5 years ago
Ah, I posted that before you posted leronimab results. If you're just framing this as "good news" that's awesome, I agree. But this thead is about policy change, so that's how I interpreted your initial post on hydroxychloroquine. Excuse me if that's not what you were implying
discussion comment
5 years ago
Mark, I'm actually fascinated to know what you think the reaction to the French study should be? No one is saying to ignore it -- but I'm not sure you understand how science works. The results of uncontrolled small studies (which is what this was) are something you think justifies re-thinking policies? It's great that there are positive signs, but the only thing this study tells us is, there's reason to do a bigger, controlled, better-constructed study. This study you're talking about was 36 patients, excluded anyone who went to the ICU or died, showed only that there was reduced viral shedding WITHOUT showing correlation with reduced clinical changes. Clinical changes -- fewer or reduced symptoms, fewer people dying, fewer people going to the ICU, fewer people going to the hospital, etc., -- are in the end what matters.
This small uncontrolled French study does not remotely justify changing the social policy -- laughable to suggest it might be so last week when you posted, as laughable right now. Yes, it indicates more study is warranted, but not policy change, man! As far as the actual epidemiologists, actual professional experts on this seem to think remdesivir (currently being used in trials in China) as an antiviral and mabs such as tocilizumab that moderate the cytokine storm hold more promise, but there is absolutely reason to continue studying hydroxychloroquine too.
But your notion that people are not supporting broad policy change based on hydroxychloroquine because Trump, rather than it being a tiny uncontrolled study that did not prove clinical improvement, is not realistic. This study is a bit of hopeful news -- maybe hydroxychlorquinine will be proven to actually help (or not) in upcoming weeks
discussion comment
5 years ago
In the club I go to most:
- When I first started SCing there in 2009, girls would stay for a loooong time. In a typical dayshift shift of 8-10 girls, each time I'd go, maybe 2 new girls each time I showed up? 10%-30% turnover? I loved it at the time, but in retrospect, the level of cliqueishness and drama between the girls was high and spilled over to customer
- In the past few years, with all the changes to SF clubs, the employee law, etc., I'm taking fewer trips (once a month or less), but turnover is typically 80%-100%
I definitely don't like the crazy turnover today, where I typically only know one or two girls each time I go. The sense of club culture has weakened as well -- 10 years ago, you were reasonably assured of a certain level of hustle and contact, now it's less certain, though a thread of club culture still exists among some girls. I think something like 25% turnover is good, enough new faces to potentially be pleasantly surprised with a newbie each trip, and at this rate, there's less chance of long-term cliques and enmities to rise up
discussion comment
5 years ago
Various interesting news from Medscape, in their newsletter (aimed at physicians):
- Reports of Plans being made to ration ventilators. the director of the Health and Human Services' Office of Civil Rights (OCR) announced they were opening investigations into the complaints. The OCR also issued a six-page bulletin to outline civil-rights statutes as they applied to the current situation, which states that those with disabilities "should not be denied medical care on the basis of stereotypes, assessments of quality of life, or judgements about a person's relative 'worth' based on the presence or absence of disabilities."
- Tension over Hydroxychloroquine: Even while hydroxychloroquine remains unproven for treating COVID-19, supplies of the drug have already dwindled. That's prompted some physicians to try and reassure patients who rely on the medication to prevent lupus or other rheumatic-disease flare-ups that it will remain available for them. Right now, there are only the "thinnest threads" of evidence that hydroxychloroquine or any other available medication are effective against the virus
- Mark94++ testing kits coming up! After 2 months of setbacks, COVID-19 diagnostics in the US finally got a win. A new test, just approved by the US Food and Drug Administration, can deliver COVID-19 results within minutes and can be used at the point of care in hospitals, urgent care centers, and physicians' clinics. Abbott Laboratories, which created the test, says they can begin distribution of the tests next week and plans to manufacture 50,000 of the tests per day.
discussion comment
5 years ago
I'd like to see the conversation turn to one of "under what conditions can we make a smart decision to 're-open'?" No matter what "side" you're on, what should be bothering you is that we can't make data-driven decisions (and the epidemiologists can't make fully data-driven recommendations) because, among other things, the lack of testing at scale means a lack of data. The re-open America people should be SCREAMING, more loudly than anyone, to turn the economy towards test kit, safety equipment, and (to the extent possible) ventilator production, because without those things, no re-opening is about to happen. Instead, we hear none of that, and just repeated bleating to re-open; it's the crowd being more cautious that is screaming for more focus on tests, etc. It doesn't make any sense, this should be an area of common cause.
discussion comment
5 years ago
25: this is also a sobering moment for as-a-service models. Hypotheticals about "the future of automobiles is autos as-a-service" (whether uber/lyft or a car sharing service) thought a huge part of the industry would go that route. Now, who in their right mind wouldn't have at least ONE car they personally own? No way I'd ever depend on my sole mode of transportation being either public or service-based
discussion comment
5 years ago
Rick: just a note, the headline on the article you sent me to is: "Nature may help diminish the pandemic if aggressive measures to control the spread of infections continue, experts say." There is also very little disagreement about aggressive measures being needed. But good news on the main thrust of the article: slower in hotter areas, probably.
Anyway, on the rate, I am saying it is a FACT that new infections have tripled in 4 days in FL (I started looking at Florida stats on Tuesday when you claimed FL was linear; one 4-day stretch doesn't mean it's a long-term trend, I'm just saying that it is a fact that during the 4 days I watched, it was exponential at around the same level as everywhere else. NYC may well be higher than everywhere else). We can try to explain it with increased testing, etc., but the exact same explanation applies in every other area also, and in those areas, "double every 3 days" tends to continue. More good news if it doesn't
discussion comment
5 years ago
My plans to retire in Arizona remain a high priority
discussion comment
5 years ago
Rick, you weren't replying to me, but jsut on this one: "- It is spreading much slower here than in NY despite the fact that there is no statewide shutdown." That is factually incorrect, at least based on the numbers I've seen. The confirmed case rate, I just posted the official numbers: it has tripled in 4 days. That is roughly on par with most areas. It seems to have started later, so overall rates are way way behind NY, NJ, Washington, etc., but you are on the exact same curve as most places. Yesterday's confirmed cases were 714, you are at 565 as of right now (4pm) today. CA new cases were 776 yesterday, currently at 189 today. FL is on an exponential curve, although NY's is probably a bit worse curve
discussion comment
5 years ago
docsavage: "Strippers always seem more attractive to me when I see them walking in and out of the club wearing their street clothes. This is because I can then mentally compare them to other women, none of whom normally wear stripper costumes. The average stripper is more attractive than the average female and it becomes more obvious when it's easier to make the mental comparison."
For sure, on that last statement, average stripper is more attractive than average female. That said, I find the vast majority of strippers come into the club wearing their "average girl" disguise -- little makeup, loose sweats, loose hoodie that may hide their hair, etc. I'm still fascinated to watch them walk in, but typically I don't think you see a stripper's full clothed potential until you take her on an OTC that includes dinner and drinking -- then they go full-on sex kitten party clothes, and, damn.
discussion comment
5 years ago
"the leap from GPS tracking of location of mobile devices once within 6 feet of each other on a particular FL beach to possibly infected humans carrying those devices to infected humans spreading the infection seems possible but tenuous. Moreover, the number tracked may be too small for meaningful extrapolation to much larger pop."
joker, agree. I don't think there's any strong claims being made. It's just a claim of "here's where the spring breakers returned to". I don't think we'll have data for months, if ever, on the conclusions we all naturally draw -- lots of spring breakers in close contact, spread covid19 around and brought it back to their local cities. There's already news stories of groups of spring breakers who partied together and all subsequently tested positive, but that's isolated data.
discussion comment
5 years ago
Rick, your last two points apply across the board -- increased rates include increased testing, for example, but the rate continues unabated.
In any case, in all honesty, I think the beaches -- particularly those populated by spring breakers -- are what everyone on the east coast should be worried about. Although I think the big beaches are closed?
discussion comment
5 years ago
Sorry, forgot the heatmap: https://twitter.com/TectonixGEO/status/1242628347034767361 I'm searching around to see if it's possible this company could really collect this data
discussion comment
5 years ago
FL's known cases still low at 3700ish, but from Tuesday to Friday, went from 240 cases diagnosed to about 750 yesterday, so triple in 4 days, which is roughly on track with the double-every-3-days that is commonly seen. 565 new cases today in FL, so far. So about on the usual rate.
discussion comment
5 years ago
Side topic: heat map of where all those spring breakers went: https://twitter.com/TectonixGEO/status/1242628347034767361 (watch & listen w/ sound)
I can't vouch for the veracity of Tectonix; this story is being cited widely in the media, along with the fact that groups of spring breakers have tested positive. In retrospect of all this, when we have the data, it will be interesting to see how the open beach policies impacted and ignited everywhere else (if they did), the way NYers are perhaps kicking up FL's rates.
discussion comment
5 years ago
Sorry, "delusional" is too strong. "premature".
discussion comment
5 years ago
You don't need to apologize regardless. We'll all be wrong about things, "I was wrong on that one" isn't an apology, it's a recognition of that. But your re-framing is ridiculous. The existence of a 45-minute test was widely known and nothing to take credit for. The whole purpose of this thread is that you think its mere existence (rather than rolling out at scale, which did not take a week, question is whether it will take a month or much longer) is enough to re-think everything. Look at the initial post where you cited two things which have had no im pact yet, as a reason to have a discussion to re-think.
When there is an indication that 45-minute tests, and a cure, are rolling out at scale, that's a great time to have that conversation. I think you picked on the right thing -- testing to generate data-driven decisions, and a cure -- with delusional timing
discussion comment
5 years ago
I think it's the standard question: do you look better in clothes, or naked? I looked better naked when I was younger, I definitely look better in clothes now lol
In general, you need a truly gorgeous body to look better naked. Less gorgeous bodies always look better clothed, clothes can way cover deficiencies and make the good parts absolutely tantalizing. That's why old people and fat people always look better clothed. Young people with amazing bodies always look better naked (although they amazing in clothes too). Young people whose bodies are less than amazing, still look better clothed
discussion comment
5 years ago
And the answer is, IN GENERAL, the promise that problems will be solved sometime in the future, but might not be, is never a reason to change a policy now. It makes no sense. Nor were you "right" about your predictions. It is insane you're still standing by all this man. Why not just say, "yes, the things I hoped would have happened have not happened yet, I jumped the gun". Would totally respect that. As I promised last week, I'm happy to do the same if my arguing with Rick's theory that people would be in open rebellion to the shelter in place by now (or next week max) doesn't pan out.
discussion comment
5 years ago
" that there would soon be a 45 minute test"
No, you implied that it would very quickly be available at scale, and justified rethinking whether we should still shelter in place or drop it right now, because of the mere existenceo f that test. You implied the same about a cure -- your suggestion we should re-think sheltering in place NOW, is based on it. Neither of those are true. The real problem here is that you want to tie things that might come to pass in weeks or months (all the tests needed available at scale, a cure available at scale) into re-thinking shelter-in-place now. You're absolutely wrong on both your contentions, and 1000x wrong on whether we should have dropped shelter-in-place a week ago (when you posted), wrong now. We shouldn't re-think policy based on what-might-be's
discussion comment
5 years ago
Strongly agree. It is a promising start, but one hospital placing an order, and in theory receiving their tests next week, is not what anyone is talking about. Evidence of Widespread availability of tests, at scale, is definitely a necessary but not sufficient condition for us to be changing the dialogue, IMO
discussion comment
5 years ago
To be clear, I'm rooting for you, not me. I'm hoping to come back and eat my words in a week. Mark called it, inexpensive easy treatment ready, 45 minutes tests available for all 300000+ people who need it (we're at 100,000 even with limited testing), we're over the peak. But the answer the important question: until there's evidence that these things have come to pass, absolutely no reason to rethink the shelter in place. Arguably, what we should all be screaming for is test availability, and the data to make data-driven decisions from there; probably to include considering how to direct resources for other critical needs such as safety equipment, ventilators, etc
discussion comment
5 years ago
Going back to the original assertions that this thread started with, a week ago:
------- quote
Two developments this week:
1. There is now a 45 minute test for Coronavirus using equipment already in place at most hospitals. The supplies needed for this test will start rolling out in about a week.
2. Early research and small sample tests suggest that Chloroquine can significantly benefit patients with CoVid. Larger sample tests are already underway in Wuhan and elsewhere.
So, in a matter of weeks, there will be a quick way of determining whether someone has the bug and a good chance of inexpensive treatment to shorten the period of sickness, reduce severity of the illness, and improve the mortality.
------------- end quote
1. the ability for "most hospitals" to do all the testing they need, is not in sight yet, much less available a week later, as per #1
2. there remains no convincing evidence that chloroquine is helpful
As anyone who is data driven -- rather than trying to grasp at and interpret any data in a way to support the conclusion they already have -- realizes, there was never a "good chance" either of these things would happen.
Just think it's worth going back to the original context of the thread occasionally.
discussion comment
5 years ago
While camming doesn't interest me for the most part, I think camming with strangers is completely mystifying. On the other hand, given the complete lack of female contact, camming with your CF, not of interest to me but at least I understand. I've had some video sessions with my SB, both in the past and recently ... with someone you're pretty close to, it can be fun, although again, I could totally 100% see why most guys would choose just free porn
discussion comment
5 years ago
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rickduganVerified and Certifiable Super-Reviewer
" I'm neither out of touch"
LOLOLOL Don't look now, LDK is headed straight towards this thread