LIST OF QUESTIONS FOR MPS
From @ClareCraigPath and Dr Jonathan Engler:
.
1.Why are SARS-CoV-2 antibody levels flat or dropping across all age groups since May if the pandemic is still going?
https://t.co/SAVtoyNbia
#COVID19 letter to #MPs
— Ian James Seale (@IanJamesSeale) November 28, 2020
Pleas Copy/Paste, e-mail and RT.
Drs' Claire Craig FRCPath & Jonathan Engler, have kindly written the following list of 20 questions, which demand answers, especially prior to any vote regarding SARS-Cov-2, Covid-19 restrictions.https://t.co/nj1GIlEUOw
More from Robin Monotti Graziadei
The problem with meta-analysis like this is that it obfuscates the most important issue of treatment, which is timing.
This meta-analysis of controlled trials only looks at hospitalized patients. How long were the patients ill for before being hospitalized? One week? Two? Three? Too late for zinc ionophores (HCQ) (+ZINC? No zinc no point..) to work. Severe illness becomes bacterial in nature.
Was azythromycin administered when the bacterial infections were also too advanced? I have seen Azythromycin work with my very own eyes but that's not to say that if administered too late it may not save the patient. How many patients were given AZT & ventilated? It's all timing.
All the meta-analysis is telling us is if you leave it too late you may have missed the early window for antiviral zinc treatment (Zn+HCQ) & that if you are given AZT when you are ventilated or very severe it may too late for it to save you & corticosteroids may be last resort.
And of course antibiotics need also probiotics, or they may harm the bacterial flora which is part of the immune response. Difficult to tell from a meta-analysis how this problem was managed.
#BMJResearch update: Corticosteroids probably reduce mortality and mechanical ventilation in patients with covid-19 compared with standard care, whereas azithromycin, hydroxychloroquine, interferon-beta, and tocilizumab may not reduce either https://t.co/oQ3lTWUqaz
— The BMJ (@bmj_latest) December 18, 2020
This meta-analysis of controlled trials only looks at hospitalized patients. How long were the patients ill for before being hospitalized? One week? Two? Three? Too late for zinc ionophores (HCQ) (+ZINC? No zinc no point..) to work. Severe illness becomes bacterial in nature.
Was azythromycin administered when the bacterial infections were also too advanced? I have seen Azythromycin work with my very own eyes but that's not to say that if administered too late it may not save the patient. How many patients were given AZT & ventilated? It's all timing.
All the meta-analysis is telling us is if you leave it too late you may have missed the early window for antiviral zinc treatment (Zn+HCQ) & that if you are given AZT when you are ventilated or very severe it may too late for it to save you & corticosteroids may be last resort.
And of course antibiotics need also probiotics, or they may harm the bacterial flora which is part of the immune response. Difficult to tell from a meta-analysis how this problem was managed.
I have now re-examined this document:
It clearly does indicate both the risks of bacterial infection & to prescribe broad spectrum antibiotics as part of treatment:
"Collect blood cultures for bacteria that cause pneumonia and sepsis, ideally before antimicrobial therapy. DO NOT
delay antimicrobial therapy"
"6. Management of severe COVID-19: treatment of co-infections
Give empiric antimicrobials [broad spectrum antibiotics] to treat all likely pathogens causing SARI and sepsis as soon as possible, within 1 hour
of initial assessment for patients with sepsis."
"Empiric antibiotic treatment should be based on the clinical diagnosis (community-acquired
pneumonia, health care-associated pneumonia [if infection was acquired in health care setting] or sepsis), local epidemiology &
susceptibility data, and national treatment guidelines"
"When there is ongoing local circulation of seasonal influenza, empiric therapy with a neuraminidase inhibitor [anti-viral influenza drugs] should
be considered for the treatment for patients with influenza or at risk for severe disease."
On the 19th March 2020 the WHO released this guidance intended for healthcare workers (HCWs), healthcare managers and IPC teams at the facility level & at national and district/provincial level:https://t.co/C4aV2BnMPj pic.twitter.com/tCk1EyLskV
— Robin Monotti (@robinmonotti) December 21, 2020
It clearly does indicate both the risks of bacterial infection & to prescribe broad spectrum antibiotics as part of treatment:
"Collect blood cultures for bacteria that cause pneumonia and sepsis, ideally before antimicrobial therapy. DO NOT
delay antimicrobial therapy"
"6. Management of severe COVID-19: treatment of co-infections
Give empiric antimicrobials [broad spectrum antibiotics] to treat all likely pathogens causing SARI and sepsis as soon as possible, within 1 hour
of initial assessment for patients with sepsis."
"Empiric antibiotic treatment should be based on the clinical diagnosis (community-acquired
pneumonia, health care-associated pneumonia [if infection was acquired in health care setting] or sepsis), local epidemiology &
susceptibility data, and national treatment guidelines"
"When there is ongoing local circulation of seasonal influenza, empiric therapy with a neuraminidase inhibitor [anti-viral influenza drugs] should
be considered for the treatment for patients with influenza or at risk for severe disease."
I’m not just a lockdown sceptic. I know lockdowns increase infections rather than decrease them because I read research first hand. I’m a citizen in a democracy who wants Government policy to be evidence-based, not epidemiological modelling based. Crazy, I know.
Lockdowns increase infections because they lower immunity & therefore increase the disease. After hospitals & care homes households account for the largest number of transmissions. Schools/universities act as a break in transmission of the disease. All evidence based.
Transmission does not mean infection. I can transmit SARSCoV2 but I can't transmit Covid19. Whether SARSCoV2 develops at all into mild or severe Covid19 depends entirely on the immune system of the recipient. Early treatment prevents severe Covid19, the right treatment cures it.
"Children act more as a brake on infection," said Prof. Reinhard Berner, the head of pediatric medicine at Dresden University Hospital and leader of the study. "Not every infection that reaches them is passed
Closing schools increases transmission of respiratory viral infection because children act as a break on the community transmission of the virus. We have known this since 1918:
https://t.co/TPRYQ1LAAJ
Lockdowns increase infections because they lower immunity & therefore increase the disease. After hospitals & care homes households account for the largest number of transmissions. Schools/universities act as a break in transmission of the disease. All evidence based.
Transmission does not mean infection. I can transmit SARSCoV2 but I can't transmit Covid19. Whether SARSCoV2 develops at all into mild or severe Covid19 depends entirely on the immune system of the recipient. Early treatment prevents severe Covid19, the right treatment cures it.
"Children act more as a brake on infection," said Prof. Reinhard Berner, the head of pediatric medicine at Dresden University Hospital and leader of the study. "Not every infection that reaches them is passed
Closing schools increases transmission of respiratory viral infection because children act as a break on the community transmission of the virus. We have known this since 1918:
https://t.co/TPRYQ1LAAJ
More from Education
You asked. So here are my thoughts on how osteopathic medical students should respond to the NBOME.
(thread)
Look, even before the Step 2 CS cancellation, my DMs and email were flooded with messages from osteopathic medical students who are fed up with the NBOME.
There is *real* anger toward this organization. Honestly, more than I even heard about from MD students and the NBME.
The question is, will that sentiment translate into action?
Amorphous anger on social media is easy to ignore. But if that anger gets channeled into organized efforts to facilitate change, then improvements are possible.
This much should be clear: begging the NBOME to reconsider their Level 2-PE exam is a waste of your time.
Best case scenario, you’ll get another “town hall” meeting, a handful of platitudes, and some thoughtful beard stroking before being told that they’re keeping the exam.
Instead of complaining to the NBOME, here are a few things that are more likely to bring about real change.
(thread)
I think most of us are over here waiting to see what @jbcarmody has to say about the latest NBOME email pic.twitter.com/bVWkS23V7z
— Jake Berg (@jberg521) January 28, 2021
Look, even before the Step 2 CS cancellation, my DMs and email were flooded with messages from osteopathic medical students who are fed up with the NBOME.
There is *real* anger toward this organization. Honestly, more than I even heard about from MD students and the NBME.
The question is, will that sentiment translate into action?
Amorphous anger on social media is easy to ignore. But if that anger gets channeled into organized efforts to facilitate change, then improvements are possible.
This much should be clear: begging the NBOME to reconsider their Level 2-PE exam is a waste of your time.
Best case scenario, you’ll get another “town hall” meeting, a handful of platitudes, and some thoughtful beard stroking before being told that they’re keeping the exam.
Instead of complaining to the NBOME, here are a few things that are more likely to bring about real change.
The outrage is not that she fit better. The outrage is that she stated very firmly on national television with no caveat, that there are no conditions not improved by exercise. Many people with viral sequelae have been saying for years that exercise has made them more disabled 1/
And the new draft NICE guidelines for ME/CFS which often has a viral onset specifically say that ME/CFS patients shouldn't do graded exercise. Clare is fully aware of this but still made a sweeping and very firm statement that all conditions are improved by exercise. This 2/
was an active dismissal of the lived experience of hundreds of thousands of patients with viral sequelae. Yes, exercise does help so many conditions. Yes, a very small number of people with an ME/CFS diagnosis are helped by exercise. But the vast majority of people with ME, a 3/
a quintessential post-viral condition, are made worse by exercise. Many have been left wheelchair dependent of bedbound by graded exercise therapy when they could walk before. To dismiss the lived experience of these patients with such a sweeping statement is unethical and 4/
unsafe. Clare has every right to her lived experience. But she can't, and you can't justifiably speak out on favour of listening to lived experience but cherry pick the lived experiences you are going to listen to. Why are the lived experiences of most people with ME dismissed?
Why is it such a source of collective outrage that a person with fatigue following a viral illness gets better?https://t.co/5lcwQBPLU5
— Trisha Greenhalgh \U0001f637 #CovidIsAirborne (@trishgreenhalgh) January 30, 2021
And the new draft NICE guidelines for ME/CFS which often has a viral onset specifically say that ME/CFS patients shouldn't do graded exercise. Clare is fully aware of this but still made a sweeping and very firm statement that all conditions are improved by exercise. This 2/
was an active dismissal of the lived experience of hundreds of thousands of patients with viral sequelae. Yes, exercise does help so many conditions. Yes, a very small number of people with an ME/CFS diagnosis are helped by exercise. But the vast majority of people with ME, a 3/
a quintessential post-viral condition, are made worse by exercise. Many have been left wheelchair dependent of bedbound by graded exercise therapy when they could walk before. To dismiss the lived experience of these patients with such a sweeping statement is unethical and 4/
unsafe. Clare has every right to her lived experience. But she can't, and you can't justifiably speak out on favour of listening to lived experience but cherry pick the lived experiences you are going to listen to. Why are the lived experiences of most people with ME dismissed?
Time for some thoughts on schools given the revised SickKids document and the fact that ON decided to leave most schools closed. ON is not the only jurisdiction to do so, but important to note that many jurisdictions would not have done so -even with higher incidence rates.
As outlined in the tweet by @NishaOttawa yesterday, the situation is complex, and not a simple right or wrong https://t.co/DO0v3j9wzr. And no one needs to list all the potential risks and downsides of prolonged school closures.
On the other hand: while school closures do not directly protect our most vulnerable in long-term care at all, one cannot deny that any factor potentially increasing community transmission may have an indirect effect on the risk to these institutions, and on healthcare.
The question is: to what extend do schools contribute to transmission, and how to balance this against the risk of prolonged school closures. The leaked data from yesterday shows a mixed picture -schools are neither unicorns (ie COVID free) nor infernos.
Assuming this data is largely correct -while waiting for an official publication of the data, it shows first and foremost the known high case numbers at Thorncliff, while other schools had been doing very well -are safe- reiterating the impact of socioeconomics on the COVID risk.
A group of Ontario experts led by SickKids has updated its guidance for school operation during the COVID-19 pandemic. The living document, COVID-19: Updated Guidance for School Operation During the Pandemic, can be read here: https://t.co/rotLqDqkQh pic.twitter.com/q7kVezAPoG
— SickKids_TheHospital (@SickKidsNews) January 21, 2021
As outlined in the tweet by @NishaOttawa yesterday, the situation is complex, and not a simple right or wrong https://t.co/DO0v3j9wzr. And no one needs to list all the potential risks and downsides of prolonged school closures.
1/It's the eve of provincial announcements on schools reopening for in-person instruction.
— Nisha Thampi (@NishaOttawa) January 20, 2021
Households are under stress and experts are divided on whether schools are unicorns or infernos.
Everyone wants to do right by kids, who have borne so much throughout this pandemic.
On the other hand: while school closures do not directly protect our most vulnerable in long-term care at all, one cannot deny that any factor potentially increasing community transmission may have an indirect effect on the risk to these institutions, and on healthcare.
The question is: to what extend do schools contribute to transmission, and how to balance this against the risk of prolonged school closures. The leaked data from yesterday shows a mixed picture -schools are neither unicorns (ie COVID free) nor infernos.
Assuming this data is largely correct -while waiting for an official publication of the data, it shows first and foremost the known high case numbers at Thorncliff, while other schools had been doing very well -are safe- reiterating the impact of socioeconomics on the COVID risk.
