On the Cure

[Latrinsorm]

We started getting reports in June (https://www.recoverytrial.net/files/recovery_dexamethasone_statement_160620_final.pdf) about the relative success of dexamethasone as a treatment for COVID-19, specifically reducing the mortality rate for the absolute sickest from 41% to 27% ± 8%. I say "relative" because 27% is still a miserable, horrific number, but "success" because it beats all h*ck out of 41%.

Today a meta-study has been published in a peer reviewed journal (https://jamanetwork.com/journals/jama/fullarticle/2770279?guestAccessKey=ec87204d-c42d-4d34-bef5-077a40bc86b0&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=090220) that finds the use of corticosteroids in general reduces mortality from 41% to 33%, of which dexamethasone was good at 26% ± 7%, hydrocortisone was probably good at 28% ± 14% (smaller sample so the statistical significance is questionable), and methylprednisolone we have no clue at 37% ± 53% (MUCH smaller sample). No matter which steroid was used, the rate of "serious" "adverse" side effects was indistinguishable from placebo. This extremely does not mean they have no side effects at all and we should all start gobbling them down: these steroids are used to reduce immune response, which is great when we're trying to keep our immune systems from killing or maiming us but not so great when we're trying to keep our immune systems killing just the stuff that's trying to kill or maim us.

When used in the right scenarios, we now know for a fact that dexamethasone is safe and somewhat effective.
It is by far and away the closest we've come to a "cure" for coronavirus.
It's a pill that costs 56 cents.

Science works! We're getting there, let's stay the course!

[Gelston]

Are you parodying yourself now?

[Suppa Hobbit Mage]

Gracias

[Latrinsorm]

An article I also just happened to notice (https://elemental.medium.com/a-supercomputer-analyzed-covid-19-and-an-interesting-new-theory-has-emerged-31cb8eba9d63) provides perhaps a critical point of clarification: that the specific type of inflammation is not cytokines (famous from the 1918 flu pandemic) but bradykinins. As the similar suffix indicates these are pretty much the same and can both be treated with steroids, but they are different and so the steroids like dexamethasone might not be as useful as the steroids like stanozolol. Unfortunately, as big track and field fans are already aware, stanozolol is an anabolic steroid, used perhaps most infamously by Ben Johnson to break his own world record and immediately have that record disqualified. This is an issue not because we're super duper worried about COVID survivors that are world class sprinters, but because this class of steroids has much more serious side effects than the first kind.

I should also be clear that while the bradykinin explanation has been peer reviewed, there has been absolutely no testing done on whether the already existing treatments for it (like stanozolol) work on COVID-19 too, but the general premise of anti-inflammation remains extraordinarily promising.

Every percentage point counts.

[Suppa Hobbit Mage]

Did I tell you guys how fucking delish my two day old meatloaf is? It's fucking amazing.

PM me if you want the recipe.

[Archigeek]

Did I tell you guys how fucking delish my two day old meatloaf is? It's fucking amazing.

PM me if you want the recipe.

That's penicillin, not cortico steroid.

[Suppa Hobbit Mage]

OK OK OK

I will share with you.

The secret, is using giant shiitake mushrooms as texture and flavor bombs. I get that mushrooms don't have flavor, but if you saute them beforehand in a variety of spices, you get some nuggets of flavor and texture in the meatloaf. Additionally, you must use some nice shallots, not onions, in your blend. It's very basic and simple, I know, but worth the effort.

PS - The world is ending and there is no cure, you all are gonna die of COVID.

[Suppa Hobbit Mage]

That's penicillin, not cortico steroid.

While we may not be politically aligned, I always get a laugh from you Kerl. Good times and hope life is treating you well.

[Taernath]

I get that mushrooms don't have flavor

Mushrooms have flavor! Especially shiitakes!

[Suppa Hobbit Mage]

Mushrooms have flavor! Especially shiitakes!

Ok, I'll give you that. But I think they are better vehicles for flavor than actually natural flavor themselves.

PS you will die from no cure of Covid.

[Archigeek]

While we may not be politically aligned, I always get a laugh from you Kerl. Good times and hope life is treating you well.

Life has been pretty crazy. 4 weeks after injuring myself in the BWCA, my ribs still fucking hurt. Other than that I'm really thankful to be working for a company that is going to weather this recession a lot better than most. Working in a cyclical industry that's a pretty big deal.

And I agree: no cure, and at best some shitty half-working vaccine.

[Latrinsorm]

Some more potential good news possibly (https://www.nejm.org/doi/full/10.1056/NEJMoa2029849?query=featured_home) with a treatment designed to keep mild COVID from becoming severe COVID - bamlanivimab!

Patients using it saw their viral load decrease by an average of .53 ± .45 on a log scale, which is great but reallllly close to overlapping with 0 i.e. no decrease i.e. the treatment does nothing. Even more concerning, only the most medium dose saw a statistically significant effect, which is not at all how it's supposed to work - certainly the lower dose not doing anything isn't worrisome, but they also tested a double dose which actually slightly increased patients' viral loads on average, which uh... we don't want that, guys. We want the opposite. The "dose response" curve usually means that the more you take of something the more it does, for better or worse - if you're drinking yourself nearly to death, you don't drink more to get better. If someone is drowning, you don't throw more water on them.

Of even greater concern is that the study doesn't evaluate change in mortality at all, like literally at all. I certainly agree I want less viral load, but if that decreased load is still enough to kill me I'm not throwing you a big ol' parade for the decreased load part, you know what I'm saying?

I would also be very, very, very concerned that the study makes no mention whatsoever of side effects, and that when I do a Google search of the World Wide Web this article pops up (https://endpts.com/researchers-shutter-eli-lilly-covid-19-study-after-monitors-flag-their-antibody-as-a-flop-for-hospitalized-patients-but-eua-hunt-continues/) saying "a Lilly spokesperson told me the program was halted in September due to futility. There were no safety issues involved." This... does not fill me with enthusiasm? This isn't our first rodeo, we know everything has side effects. Telling me not to worry about it because the treatment is futile, woof! Might have to go back to spokesperson school on that one, friend.

.

Bottom line it's probably not bad but that they're not definitively saying it's not bad is super suspicious, and the way they're saying it's good is super de duper suspicious.

Nope, don't like this at all.

[Suppa Hobbit Mage]

THANK GOD BIDEN FOUND THE CURE!

DESPACITO.