Badace52 said:

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Rock1982 said:

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Reveille, if a patient is administered the drug as Prophylaxis, will that prevent developing an immunity to the virus?

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No it will not if the patient at some point catches the disease after/despite prophylaxis.

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Zn works on viral replication, and the supposed action is to increase Zn in the cell.

Hypothetically, if you get a small dose of virus, it enters cells and is shut down by the Zn, you might not have
enough exposure for the body to respond and build immunity. Get a big dose or repeated doses, you might have enough virus to trigger an immune response even if you don't get replication.

That said, it is unlikely that it will 100% shut down virus replication and more likely just to slow it down. If each virus is pumping out 100 or 1000 instead of a million, the then you get a much more mild infection, are less contagious, and still develop immunity. Think of it like flattening the curve in your body. You need time to develop immunity and build the immune response. If you get to that point with a small number of infected cells, no problem. If you infect a bunch of cells before your immune system can mount an effective response, a lot of damage can be done and your immune system is working from behind.

Rock1982 said:

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BiochemAg97 said:

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Badace52 said:

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Rock1982 said:

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Reveille, if a patient is administered the drug as Prophylaxis, will that prevent developing an immunity to the virus?

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No it will not if the patient at some point catches the disease after/despite prophylaxis.

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Zn works on viral replication, and the supposed action is to increase Zn in the cell.

Hypothetically, if you get a small dose of virus, it enters cells and is shut down by the Zn, you might not have
enough exposure for the body to respond and build immunity. Get a big dose or repeated doses, you might have enough virus to trigger an immune response even if you don't get replication.

That said, it is unlikely that it will 100% shut down virus replication and more likely just to slow it down. If each virus is pumping out 100 or 1000 instead of a million, the then you get a much more mild infection, are less contagious, and still develop immunity. Think of it like flattening the curve in your body. You need time to develop immunity and build the immune response. If you get to that point with a small number of infected cells, no problem. If you infect a bunch of cells before your immune system can mount an effective response, a lot of damage can be done and your immune system is working from behind.

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Thanks. That's what I was hoping.

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Also, the vaccines being currently tested will work completely differently, so I would not expect Zn to effect the vaccine when we get one.

Badace52 said:

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Saw my first really sick people from this thing over the past few days in Waco. Moving this from another thread where it might get more traffic. I think it needs to be seen and heard.

Shagga said:

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Quote:

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MARCH 23 9:48 a.m. Despite speculation and rumors, Harris County Judge Lina Hidalgo says she will not issue a "shelter-in-place" or "stay-at-home" order at this time. Hidalgo also says the term "shelter in place" is not the correct term for the Houston-area community. That term, she says, is typically reserved for hurricanes, active shooter drills, etc. She says local officials, from both the county and the City of Houston, continue to evaluate the needs of the Houston area and may provide an update later in the day Monday with "next steps" for our community.

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Wow. This is completely unexpected - common sense displayed.

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Wrong... Every major and minor city in Texas should be sheltering in place yesterday. Waco has started to see the first really sick people from this after getting our first confirmed cases about a week ago.

I can tell you from experience that this disease is a different animal. It will flat kill anybody with poor lung reserve or function.

Waco actually had the good sense to order a shelter-in-place this morning going into effect at midnight. Other cities would do well to do this before the bad cases start showing up in ERs.

Don't fool yourself. This stuff is everywhere and it looks and acts differently from anything I have ever seen.

I was cautious but not really scared until I saw the first people really sick from this. I am scared now

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This is absolutely correct!! This is a different animal than we are used to treating. People decompensate at a rapid rate around day 6 to 8 and without ventilators available there is no way to save them.

As doctors who fight bacteria and germs every day nothing as ever really scared me. I deal with MRSA, hepatitis, and HIV positive blood regularly without fear. But we understand the possible consequences of this disease and it is very scary! Your lungs get inflamed to the point oxygen will not pass through them and also your alveoli fill up with water and it suffocates you. Hopefully the automobile industry is able to start mass producing ventilators are the fatalities will rise if people do not stay home.

This is literally like world war III just with a faceless enemy. We are keeping our fatality rate low for now but we can not get overwhelmed and run out ICU beds or the fatalities will rise dramatically. That is why I agree every major city should be on lock down!

BiochemAg97 said:

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Badace52 said:

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Rock1982 said:

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Reveille, if a patient is administered the drug as Prophylaxis, will that prevent developing an immunity to the virus?

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No it will not if the patient at some point catches the disease after/despite prophylaxis.

---

Zn works on viral replication, and the supposed action is to increase Zn in the cell.

Hypothetically, if you get a small dose of virus, it enters cells and is shut down by the Zn, you might not have
enough exposure for the body to respond and build immunity. Get a big dose or repeated doses, you might have enough virus to trigger an immune response even if you don't get replication.

That said, it is unlikely that it will 100% shut down virus replication and more likely just to slow it down. If each virus is pumping out 100 or 1000 instead of a million, the then you get a much more mild infection, are less contagious, and still develop immunity. Think of it like flattening the curve in your body. You need time to develop immunity and build the immune response. If you get to that point with a small number of infected cells, no problem. If you infect a bunch of cells before your immune system can mount an effective response, a lot of damage can be done and your immune system is working from behind.

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Thank you for your explanation. The idea is not that this will completely prevent you from getting sick but if you slow down viral reproduction a little that maybe you only get mild symptoms. And once you have recovered you should have developed some immunity.

Thank you BiochemAg97 and Badace52 for all your contributions. .

Player To Be Named Later said:

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Ok, let's talk worst case scenario planning. I'm in Denton. I'm trying to decide if I have enough faith in either Denton Hospital ER (Presby or Medical City).

Somewhat debating if I should think of a better hospital ahead of time to consider. Anyone have thoughts?

I am somewhat nervous about whether either Denton Hospital will be using things like hydrochloroquine, or any of the other med showing promise.

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Every hospital I would suspect will be using these medications. We are all working together to find a treatment plan that is effective. Most of us doctors are scouring the medical literature as fast as it comes out on what is best. Researching older diseases like SARS from coronavirus to find the best way to save as many American lives as we can.

CowtownAg06 said:

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When you say lockdown, what do you mean? What is still happening in major Texas cities that needs to cut?

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Construction seems to be a non essential that just goes on like nothing is happening

Am I the only one wondering what is going on at our military bases? Young, healthy people in close proximity who can be ordered to be tested.

74OA said:

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RM1993 said:

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74OA said:

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..........and why the lack of outcry from docs to get it promptly FDA approved as a virus treatment?

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It doesn't have to be FDA approved for doctors to prescribe it off label.

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Yes, but that's not my question. If it's a good treatment for the virus, approve it as such and promote it.

Right now we have the federal medical folks still saying it's unproven and potentially unsafe.

Which is it? No company is going to up production to meet the need until the FDA commits.

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I think you are too caught up on "FDA approval". We use hundreds of drugs off-label daily. Companies have already stated they will ramp up production. This is a non-issue.

Nevertheless, we have no idea whether it is a good treatment. I really want to temper expectations regarding this drug, as people seem to have really bought into it as a cure without any evidence. Front-line docs saying they are seeing good results unfortunately holds little weight. The reason why is of course because people that are seeing good results are more likely to state this during a pandemic while individuals who are not seeing great results will remain quiet. Who likes to be the debbie downer during a pandemic? (Apparently me, I guess) This is why you might hear people say that anecdote is not data.

For people that don't realize why there are still many that are saying it is unproven, HCQ has been studied on essentially every major virus there is: HIV, HepC, Dengue, Chikungunya, etc. And almost universally it has performed well in in vitro studies, and then performed poorly in actual clinical trials. Given what is going on, it is reasonable to utilize it in severe cases, but I have to agree with individuals like Dr. Fauci who state that this is an entirely unproven therapy and we need more data (which should be coming soon).

I'm freaking out about a turnaround crew popping up with a few confirmed cases. What do you do then??

Humor time: my buddy is running a crew at a turnaround now. They said to start checking temps and anyone with a fever would have to go home. He replied without skipping a beat "does that include the two guys who have gonorrhea?"

3rd Generation Ag said:

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If you don't exempt construction and home repairs and we get hit by an epic hail storm or tornado outbreak then there would be no one to fix those broken windows or build a room back over your bedroom.

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Construction and home repairs are different categories. Home repairs for vital services like plumbing (clean water & sanitation), HVAC, etc. are absolutely essential and need to remain open. However, construction on projects like new homes, home additions, pagodas, etc. are not usually vital. Also, if a tornado has done enough damage that you need your bedroom rebuilt, you are relocating for a few months anyway at the very least in normal circumstances.

I'm dismissive of anecdotes when discussing efficacy, and unfortunately that's what front-line reports are. As I have mentioned, people are more likely to claim efficacy than to state they are not seeing good results, so the front-line reports you are hearing will be extremely biased towards positive. We just don't know yet whether this drug works. The French study was so flawed that its data is essentially uninterpretable, and as I have mentioned HCQ has a known history of performing well in in vitro studies, and performing poorly in clinical trials. I'm sure I am going to get pummeled again on here for stating this, but I really think expectations should be tempered a bit. Nevertheless, I'm not saying we shouldn't be trying this for severe cases or for those that are very high risk.

barnyard1996 said:

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Dont we have some idea with some evidence? You are a little dismissive to some front line reports.

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I'm a very positive thinker and I sincerely hope these drugs prove to be helpful. That being said, there really isn't a lot of hard data on this at all. What we need to see is numbers. Not just mortality. Length of stay in the hospital. ICU days. Vent days. I'm hoping the hospitals in New York who have had patients on these protocols for the last several days will publish some numbers soon. We know there will be a certain number of deaths regardless of treatment, just like in every other illness. Right now the most important thing with this disease is not just preventing death but getting people out of the hospital more quickly.

oh no said:

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Big Al 1992 said:

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Dr. Rev,
What do you say to the deniers - friends that are going about their business, drinking w friends, kids running in and out of their house, "there's only 51 cases in Harris County - this is overblown"

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are kids not allowed to be outside anymore? I'm seeing tons of people on the hike & bike paths around The Woodlands. I thought it was okay since no one is touching equipment that other people touch, people are distancing from other people, etc. Am I supposed to yell at clouds and refer to everyone outside walking, jogging, or riding a bike or kids running around out front or on their bikes as "deniers"?

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I'm thinking this post was referencing kids running in and out of each others' houses. No non-family contact.

Yes kids should be outside. Just not with each other.

Dr. Not Yet Dr. Ag said:

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I'm dismissive of anecdotes when discussing efficacy, and unfortunately that's what front-line reports are. As I have mentioned, people are more likely to claim efficacy than to state they are not seeing good results, so the front-line reports you are hearing will be extremely biased towards positive. We just don't know yet whether this drug works. The French study was so flawed that its data is essentially uninterpretable, and as I have mentioned HCQ has a known history of performing well in in vitro studies, and performing poorly in clinical trials. I'm sure I am going to get pummeled again on here for stating this, but I really think expectations should be tempered a bit. Nevertheless, I'm not saying we shouldn't be trying this for severe cases or for those that are very high risk.

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Thank you for the clarification and I now better understand your position.

Just an opinion, you are getting pummeled because your delivery is a buzz kill in a week full of buzz kills.

Yeah, I think your opinion is definitely accurate, but I think it is important information to relay to the general public. What I need is a Chris Traeger to my Ben Wyatt (hopefully some parks and recs fans get the reference).