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COVID-19 Thread

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Online  Re: COVID-19 Thread
Posted: July 02, 2020, 12:27 PM Post
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homer said:
Are you using nationwide data for decreased hospitalizations?

I would like to find data that excludes NY and NJ as they seem to be big outliers.


See the link in my post above (and below):

LouisEly said:
All of the data for all of the states and countries reporting, plus projections:

https://covid19.healthdata.org/united-states-of-america

Interesting that even with the recent spikes, they are not projecting the daily total number of deaths to rise for the next couple of weeks.


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Offline  Re: COVID-19 Thread
Posted: July 02, 2020, 2:36 PM Post
Posts: 21611
Now hydroxychloroquine is good again.

"Masks don't do any good protecting you from the virus. Wait, yes they do. Definitely wear a mask always." "Hydroxychoroquine looks like a promising treatment. Actually no, don't take it, it actually makes you more likely to die from COVID. No wait, we just don't know enough to say that conclusively. Actually wait, it's significantly helpful."

https://www.detroitnews.com/story/news/ ... 365090002/

It gets hard to "trust the experts" when the information we've received from March until now has been constantly conflicting.


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Offline  Re: COVID-19 Thread
Posted: July 02, 2020, 3:02 PM Post
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adambr2 said:
Now hydroxychloroquine is good again.

"Masks don't do any good protecting you from the virus. Wait, yes they do. Definitely wear a mask always." "Hydroxychoroquine looks like a promising treatment. Actually no, don't take it, it actually makes you more likely to die from COVID. No wait, we just don't know enough to say that conclusively. Actually wait, it's significantly helpful."

https://www.detroitnews.com/story/news/ ... 365090002/

It gets hard to "trust the experts" when the information we've received from March until now has been constantly conflicting.


What does a news article about one study at one hospital have anything to do with what the experts say? Are the experts saying "Now hydroxychloroquine is good again.". No, they're not.


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Offline  Re: COVID-19 Thread
Posted: July 02, 2020, 3:12 PM Post
Posts: 21611
owbc said:
adambr2 said:
Now hydroxychloroquine is good again.

"Masks don't do any good protecting you from the virus. Wait, yes they do. Definitely wear a mask always." "Hydroxychoroquine looks like a promising treatment. Actually no, don't take it, it actually makes you more likely to die from COVID. No wait, we just don't know enough to say that conclusively. Actually wait, it's significantly helpful."

https://www.detroitnews.com/story/news/ ... 365090002/

It gets hard to "trust the experts" when the information we've received from March until now has been constantly conflicting.


What does a news article about one study at one hospital have anything to do with what the experts say? Are the experts saying "Now hydroxychloroquine is good again.". No, they're not.


That wasn't really my point at all. I wasn't saying it was unanimous. I don't expect any drug to have unanimous backing from all medical experts for a long time.

I was saying that information from various experts regarding numerous COVID-19 information has been in constant conflict for months (and yes, a peer reviewed Henry Ford Health system backed study published in a reputable medical journal qualifies as "expert").


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Offline  Re: COVID-19 Thread
Posted: July 02, 2020, 3:38 PM Post
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adambr2 said:
Now hydroxychloroquine is good again.

"Masks don't do any good protecting you from the virus. Wait, yes they do. Definitely wear a mask always." "Hydroxychoroquine looks like a promising treatment. Actually no, don't take it, it actually makes you more likely to die from COVID. No wait, we just don't know enough to say that conclusively. Actually wait, it's significantly helpful."

https://www.detroitnews.com/story/news/ ... 365090002/

It gets hard to "trust the experts" when the information we've received from March until now has been constantly conflicting.


From my admittedly little understanding, hydroxychloroquine is already out in the world for anyone to incorporate into a treatment if they so choose.

If it is actually helpful, it would then presumably be much cheaper (& maybe even more effective) than the $3,200 Gilead Remdesivir treatment course.

Though I can't imagine the government or the health care industry would ever chase profit over the best interests of public health.


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Offline  Re: COVID-19 Thread
Posted: July 02, 2020, 8:34 PM Post
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I would say that people running that study could be considered experts; it is a professional health care organization. Or did you mean other experts? The WHO? CDC? Mayo Clinic? Johns Hopkins? No one is really unanimous here. Lots of information in a short period of time that conflicts doesn't help people gain confidence in health recommendations if studies keep conflicting with each other.

At least 4 of 5 dentists still recommend Trident.


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Offline  Re: COVID-19 Thread
Posted: July 02, 2020, 8:42 PM Post
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"Experts" to me is just a general term encompassing medical scientists and doctors who specialize in infectious diseases, respected medical journals and peer reviewed studies. But I'm sure everyone has their own definitions, which I'd generally be flexible on as long as it doesn't include A) Politicians, or B) Your Facebook friends.


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Offline  Re: COVID-19 Thread
Posted: July 03, 2020, 5:17 AM Post
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If people give themselves a moment they are actually rather familiar with this type of back and forth in the literature. Think of health/ nutrition science news stories. There are some additional complications like a large amount of vested interested funded studies in nutrition, and it being incredibly difficult to do double blind controlled type studies that make that field even worse at the back and forth. With these studies being primarily statistically designed the large number of studies actually increases the chances of getting 'outlier' type studies just by random chance. The large number of studies rapidly released directly to preprints also probably increases this type of back and forth noise. You might have noticed that I almost always seem a little hesitant sounding when posting about single studies. Some strategies for helping incorporate news like this:

1) Verifying that people involved are qualified and respectable. A number of the things to look for have come up before.
2) Sample size and good design like double blind.
3) What was the consensus before (if there was one)? How strong was the consensus?
4) What is the theory/ mechanism of action?
5) How well does the new idea mesh with existing theory/ how well supported is that theory?

The last 3 points can be tricky in areas that are less familiar, but very helpful in preventing you from feeling like experts are just constantly changing their mind (they aren't). When it comes to masks for example while the respiratory droplets where probably a newer idea to many of us, their role in spreading some diseases was well established. Similarly the method by which improvised masks (not the N95's) work is very consistent with the impact of humidity on decreasing the spread of other seasonal respiratory diseases. The only real question at the beginning was to what extent is Covid spread directly through the air vs. surfaces.
Similarly the majority of work indicates hydroxychloroquine does not seem to have a positive impact and much of it has been negative enough to force early stoppage of studies. How it would act protectively has always been a stretch at best, whereas other things like Remdesivir clearly target viral replication or other reports of potential benefits with anti-inflammatory drugs tie into the developing understanding that the runaway inflammation tends to be the biggest culprit of damage and death.


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Offline  Re: COVID-19 Thread
Posted: July 03, 2020, 8:05 AM Post
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But the authors of the trial wrote that the drug did not prevent all deaths.

"Given high mortality despite the use of remdesivir, it is clear that treatment with an anti-viral drug alone is not likely to be sufficient," they said.

About 7.1 percent of patients given remdesivir in the trial group died within 14 days—compared with 11.9 percent in the placebo group.

However, the result is just below the statistical reliability threshold, meaning it could be down to chance rather than the capability of the drug.


So if I'm following this all correctly (very possible I'm not), 70 million in taxpayer funds were used to develop a treatment of questionable efficacy which the US goverment subsequently ordered almost the entire supply of to sell back to infected taxpayers at 3,200 a pop...and it might even kind of work.


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Online  Re: COVID-19 Thread
Posted: July 03, 2020, 8:26 AM Post
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sveumrules said:
So if I'm following this all correctly (very possible I'm not), 70 million in taxpayer funds were used to develop a treatment of questionable efficacy which the US goverment subsequently ordered almost the entire supply of to sell back to infected taxpayers at 3,200 a pop...and it might even kind of work.

No, you're not following this correctly. Remdesivir was developed more than a decade ago as a Hepatitis-C treatment (didn't work well), and then studied as an Ebola treatment.

It takes years to develop a drug, so they are testing available drugs already on the market that have anti-viral or anti-inflammatory effects with the potential to counteract some of the known or hypothesized pathways of the disease.

As a FYI, the "cost" (before rebates, discounts, etc.) of an average Hepatitis-C drug is over $50K for about 8-12 weeks of treatment.


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Offline  Re: COVID-19 Thread
Posted: July 03, 2020, 8:37 AM Post
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LouisEly said:
sveumrules said:
So if I'm following this all correctly (very possible I'm not), 70 million in taxpayer funds were used to develop a treatment of questionable efficacy which the US goverment subsequently ordered almost the entire supply of to sell back to infected taxpayers at 3,200 a pop...and it might even kind of work.

No, you're not following this correctly. Remdesivir was developed more than a decade ago as a Hepatitis-C treatment (didn't work well), and then studied as an Ebola treatment.

It takes years to develop a drug, so they are testing available drugs already on the market that have anti-viral or anti-inflammatory effects with the potential to counteract some of the known or hypothesized pathways of the disease.

As a FYI, the "cost" (before rebates, discounts, etc.) of an average Hepatitis-C drug is over $50K for about 8-12 weeks of treatment.


Peter Maybarduk, a lawyer at the consumer group Public Citizen, called the price “an outrage.”

“This is a drug that received at least $70 million in public funding” toward its development, he said. “Remdesivir should be in the public domain.”

“The price puts to rest any notion that drug companies will ‘do the right thing’ because it is a pandemic,” Dr. Peter Bach, a health policy expert at Memorial Sloan Kettering Cancer Center in New York said in an email. “The price might have been fine if the company had demonstrated that the treatment saved lives. It didn’t.”


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Offline  Re: COVID-19 Thread
Posted: July 03, 2020, 9:33 AM Post
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Assuming nothing else questionable happening before hand it is worth pointing out that there is generally very little difference in the quality of evidence for a study whose results 'were almost statistically significant' vs. one that was just barely statistically significant. In this case knowing what the disease is and how the drug works, with just one study to go on the results lean very much toward it helps with mortality. But that's a lot like playing poker when your hand is a 2-1 favorite. You will be right a lot, but you'll also wrack up a lot of mistakes, so better proof is ideal. In any event when they first announced Remdesivir results the clearer finding was that it shortened hospital recovery time by 4 days. If you compare 4 days in the hospital to the drug cost I'm guessing it is pretty easy to come out ahead. Which shouldn't be taken to mean I agree with the price exactly, but Gilead did invest a lot of their money as well, but to my knowledge never really made any of it back because the drug ended up not performing super well for Hep-C. It is potentially a good example of how divergent the public vs. private interests are for drugs. Publicly cures are what we all want. Private companies though love treatments, the longer and more chronic the better.


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Offline  Re: COVID-19 Thread
Posted: July 03, 2020, 11:06 AM Post
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adambr2 said:
"Experts" to me is just a general term encompassing medical scientists and doctors who specialize in infectious diseases, respected medical journals and peer reviewed studies. But I'm sure everyone has their own definitions, which I'd generally be flexible on as long as it doesn't include A) Politicians, or B) Your Facebook friends.

A colleague died a few years ago from lung cancer. I heard his spouse was upset at the medical advice they received near the end from a colorectal oncologist. I was astounded that they would listen to a colorectal oncologist instead of the lung oncologist. Why, they're both oncologists? Because it makes a difference (lung biology is different than colon and the cancers are different).

All of these "experts" really need to be ranked based on their "expertise". Obviously, an infectious disease expert is better than a pediatrist, but a microbiologist is not as good as a communicable disease specialist (both infectious disease). Using WAR as an example we would see comm disease (6 WAR), microb (2 WAR), pediatrist (0.1 WAR).

"Medical Scientists" actually aren't that common. A Medical Doctor is not a scientist. They have likely never been trained in any way on performing research/studies. Most medical training is learning pattern recognition and probability - symptom X, Y, Z = disease I (42%), Disease II (25%), Disease III (19%), etc. Some MDs do "research" which often is similar to the study at the Henry Ford where they look at hospital records and look for any "findings". If the MD has a PhD then, yes they went through training to understand the principles of research. Having worked for 30 years with MD, MD/PhD and PhDs, there is a clear ranking of the average person within each field and yes, MD is by far the lowest in aptitude for research. That doesn't mean that the top %centiles don't have some good researchers, but that the vast majority are not good (like asking a pediatrist about coronavirus).

"Infectious Disease Experts" are hard to find because for too many years there has been no emphasis in medicine on this specialty. Most IDEs work on HIV. In my department we only have 2 and both are senior citizens (not the AARP kind, but collecting Social Security kind). There is almost a generation of faculty without a single expert in Infectious Disease. Mostly because it isn't sexy and specialization in medicine/research is to go for the sexy and where the money is and the money has not been in Infectious disease research. It's a disappearing specialty and we are seeing the effects of that with the current state of "experts".

"respected medical journals and peer reviewed studies" is an important consideration. The number of journals that publish scientific papers is astounding. In infectious Disease there are over 300! They aren't the same and where a study is published should be part of how it is ranked for importance/significance. The study from Henry Ford was published in the 62nd ranked journal in that field. Sure, there are other journals that are HIV specialized that are ranked higher, or publish only review articles and the rankings from 40-60 are likely pretty subjective, but this paper was not published in a highly respected journal. Why? Likely a multitude of factors, but none of which lead to a positive spin on the paper. As a scientist we learn how to "present" our data/papers in such a way that we are challenging the reviewers to question the findings. It's not uncommon to state "we found no side effects from treatment" when you haven't measured for anything (worst case) or when your measurements don't really capture side effects accurately (common). It's true that you didn't find anything. The challenge for the reviewer is to make sure the authors stated clearly what and how they measure for side effects. You can also be vague in your criteria hoping the reviewers don't catch something. Is this dishonest? Some would say yes, but ultimately you include very clear language about the impact, etc. and if someone gets an impression that isn't stated that's not the authors responsibility. In many ways it's a game. The game is best played when the reviewers are smart enough to catch the unclear, unstated issues. I teach a class on review of scientific literature. Year after year the students biggest surprise is that papers they thought were good and had no problems were actually riddled with issues and that almost every peer-reviewed published paper has inherent issues that can invalidate some or all of the findings.

Peer-reviewing has it's own issues. Scientists are busy and have their own careers to develop. I'm not going to review a paper from a 62nd ranked journal. I'll review for the top journals in the field because it's a valuable use of my time and I can put that onto my CV and it is a positive. So the reviewers for the 62nd ranked journal are the ones that can't get the 40th ranked journal to give them the time of day and won't stoop to review the 100th ranked journal. So you can drive tanks through the holes in a review if the reviewers aren't good (that's true also of higher ranked journals, but much less likely to happen - i.e. the reviewers will catch the issues). The former cancer center director at my institution would spend half of their lab meetings going over how you present the data for maximum impact. I stopped attending because a few months in I didn't need another reminder on the best font, title for a graph/table, etc. But for some it's all about presentation - putting lipstick on a pig. What friends and I call form over substance. While it's important to present the data in the best possible way, you should still have a clear finding that you are just improving. I reviewed a paper from a colleague prior to submission and asked why did you subset the subjects at point X. That was the only place they could subset the data for their to be a significant finding! So if you move point X by 5%? no finding. Is X relevant biologically? Nope. The author should not be publishing in that case and when they try the reviewer needs to find the problems. Unfortunately, the quality of the reviewer mirrors the quality of the journal.

The other reason so many of these studies never amount to anything is that there are severe biases that have been introduced. I worked with a FUNDED MD who insisted on knowing the status of a sample prior to running tests. DING DING DING. Alarms should be going off because as Igor stated blinded (double blinded) samples are critical. So we gave them a bunch of samples with random assignment of status and guess what? Every sample we labeled as a case, came back looking like a case and every sample labeled as a control came back looking like a control based on the "scientific testing". When we reassigned based on known case/control there was nothing. When presented with the data, the MD fought that this was an incorrect approach and their approach was better. Why? because the testing is subjective and they needed a "hint" for them to believe certain events within the test are "real". Many assays/tests are still subjective and don't rely on a clear value or metric. Unfortunately bias happens all the time in clinical trials as the inclusion of individuals in a study, or the arm they are put into can be influenced by bias. Removing subjects can also have bias and can skew the findings (all studies should have clear criteria for removing someone that isn't a function of the outcome you are measuring). That's why it's so important to increase sizes as much as possible, but more importantly have it repeated by others because they hopefully don't have the same criteria/bias. So the Henry Ford study could very well be effected by a clear bias in selection of how to put patients on each arm of the study, how to remove patients, when the endpoint is measured (yes, people will move the goalposts) that is driving the results. One study means nothing. And one principal investigator who believes a certain treatment is better than another can subconsciously (or even consciously - i.e. fraud) effect the outcome.

There's a lot that goes into how you should rank what is an expert. Most scientists are experts in a very narrow area and while they may have some knowledge of the general field, their knowledge of another very narrow area is not as good as those working in that area. Nobel Laureate? Nope, I've met some that are truly very bright people and others that are bumbling idiots (except in one very tiny specific area where they are THE expert). Titles are no guarantee. WAR might be a good example of the need for a metric that combines lots of different components into a measure of what is an "expert".

JosephC said:
Stearns probably had no interest in getting a C because the Brewers need a C. It makes much more sense to trade for 3B when it's not needed, and then move the other 3B to 2B, then trade for a 2B, but since the 3B is now at 2B, then the new 2B goes to SS


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Online  Re: COVID-19 Thread
Posted: July 03, 2020, 2:51 PM Post
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sveumrules said:
LouisEly said:
sveumrules said:
So if I'm following this all correctly (very possible I'm not), 70 million in taxpayer funds were used to develop a treatment of questionable efficacy which the US goverment subsequently ordered almost the entire supply of to sell back to infected taxpayers at 3,200 a pop...and it might even kind of work.

No, you're not following this correctly. Remdesivir was developed more than a decade ago as a Hepatitis-C treatment (didn't work well), and then studied as an Ebola treatment.

It takes years to develop a drug, so they are testing available drugs already on the market that have anti-viral or anti-inflammatory effects with the potential to counteract some of the known or hypothesized pathways of the disease.

As a FYI, the "cost" (before rebates, discounts, etc.) of an average Hepatitis-C drug is over $50K for about 8-12 weeks of treatment.


Peter Maybarduk, a lawyer at the consumer group Public Citizen, called the price “an outrage.”

“This is a drug that received at least $70 million in public funding” toward its development, he said. “Remdesivir should be in the public domain.”

“The price puts to rest any notion that drug companies will ‘do the right thing’ because it is a pandemic,” Dr. Peter Bach, a health policy expert at Memorial Sloan Kettering Cancer Center in New York said in an email. “The price might have been fine if the company had demonstrated that the treatment saved lives. It didn’t.”

I have no idea where you are quoting that from, but it costs $500M to $1B to develop a drug and bring it to market. $72M is a drop in the bucket when it comes to drug development costs, probably about 10% of the total development cost, and they have discounted remdesivir well over 10% for $3200/treatment.

Now, if you're referring to funding a study, that's a different story, as you haven't provided a link to whatever you are quoting that from. But drug development is damn expensive, and remdesivir wasn't developed to treat COVID-19.


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Offline  Re: COVID-19 Thread
Posted: July 03, 2020, 6:42 PM Post
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LouisEly said:
sveumrules said:

Peter Maybarduk, a lawyer at the consumer group Public Citizen, called the price “an outrage.”

“This is a drug that received at least $70 million in public funding” toward its development, he said. “Remdesivir should be in the public domain.”

“The price puts to rest any notion that drug companies will ‘do the right thing’ because it is a pandemic,” Dr. Peter Bach, a health policy expert at Memorial Sloan Kettering Cancer Center in New York said in an email. “The price might have been fine if the company had demonstrated that the treatment saved lives. It didn’t.”

I have no idea where you are quoting that from, but it costs $500M to $1B to develop a drug and bring it to market. $72M is a drop in the bucket when it comes to drug development costs, probably about 10% of the total development cost, and they have discounted remdesivir well over 10% for $3200/treatment.

Now, if you're referring to funding a study, that's a different story, as you haven't provided a link to whatever you are quoting that from. But drug development is damn expensive, and remdesivir wasn't developed to treat COVID-19.


The italicized quote is from here...https://www.nbcnews.com/health/health-n ... s-n1232385

Public Citizen's Remdesivir position is published on their website...https://www.citizen.org/news/gileads-re ... offensive/

This StatNews article offers a range of "expert" opinions on what an appropriate price might possibly be...https://www.statnews.com/2020/05/15/gil ... ronavirus/

I figured Gilead was named after the totalitarian state in The Handmaid's Tale, but it turns out they actually drew their inspiration from the ancient Balm of Gilead.

This passage from Reverend Becca Stevens book Snake Oil: The Art of Healing and Truth-Telling seems somewhat relevant..."I believe it's more of an idea, like Eden, than a geographic location. Gilead represents the place that holds the hope of healing. For everyone who has been wounded, hurt, or abused, Gilead represents the sacred place where borders fade and balms are poured out lavishly."

The only thing lavish about Remdesivir seems to be the price point & Gilead is actively working to put up borders (https://www.citizen.org/news/remdesivir ... nd-losers/) so it appears they have a different interpretation of their namesake than does the Reverend.


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Offline  Re: COVID-19 Thread
Posted: July 04, 2020, 12:38 PM Post
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The MLB restart is going to be interesting because you'll have a very specific pool of people, and they'll know exactly how many of these people get COVID. Same with the NBA people. It's like having a ready-made experiment.


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Offline  Re: COVID-19 Thread
Posted: July 04, 2020, 12:45 PM Post
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Interesting thing bit of info I have gotten from my wife.

Her organization is find that many people are reluctant to get tested. Even if they find out they have been exposed to someone with COVID. There is not - in the eyes of some - many positives to getting tested.

A positive test means they can't go to work (devastating for some people), and it could affect their family going to work (ditto). It's not like there is a cure or something they can take to help with it. So why go through the hassle of the test?

Now, you can argue they should do the testing so - if positive - they can isolate and help keep it from spreading. But the big reason they don't want to do it is they are afraid of losing income.

Her org is also running into people who refuse to get tested due to believing COVID is all a hoax and stuff like that.


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Offline  Re: COVID-19 Thread
Posted: July 04, 2020, 4:38 PM Post
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sveumrules said:
LouisEly said:
sveumrules said:

Peter Maybarduk, a lawyer at the consumer group Public Citizen, called the price “an outrage.”

“This is a drug that received at least $70 million in public funding” toward its development, he said. “Remdesivir should be in the public domain.”

“The price puts to rest any notion that drug companies will ‘do the right thing’ because it is a pandemic,” Dr. Peter Bach, a health policy expert at Memorial Sloan Kettering Cancer Center in New York said in an email. “The price might have been fine if the company had demonstrated that the treatment saved lives. It didn’t.”

I have no idea where you are quoting that from, but it costs $500M to $1B to develop a drug and bring it to market. $72M is a drop in the bucket when it comes to drug development costs, probably about 10% of the total development cost, and they have discounted remdesivir well over 10% for $3200/treatment.

Now, if you're referring to funding a study, that's a different story, as you haven't provided a link to whatever you are quoting that from. But drug development is damn expensive, and remdesivir wasn't developed to treat COVID-19.


The italicized quote is from here...https://www.nbcnews.com/health/health-n ... s-n1232385

Public Citizen's Remdesivir position is published on their website...https://www.citizen.org/news/gileads-re ... offensive/

This StatNews article offers a range of "expert" opinions on what an appropriate price might possibly be...https://www.statnews.com/2020/05/15/gil ... ronavirus/

I figured Gilead was named after the totalitarian state in The Handmaid's Tale, but it turns out they actually drew their inspiration from the ancient Balm of Gilead.

This passage from Reverend Becca Stevens book Snake Oil: The Art of Healing and Truth-Telling seems somewhat relevant..."I believe it's more of an idea, like Eden, than a geographic location. Gilead represents the place that holds the hope of healing. For everyone who has been wounded, hurt, or abused, Gilead represents the sacred place where borders fade and balms are poured out lavishly."

The only thing lavish about Remdesivir seems to be the price point & Gilead is actively working to put up borders (https://www.citizen.org/news/remdesivir ... nd-losers/) so it appears they have a different interpretation of their namesake than does the Reverend.



It actually costs over $2B to develop a drug now. It was over $1B back when I studied it in Econ classes on public policy in 2003. Part of the reason for the $2B+ number is that for each approved drug, you must account for the half dozen failed drugs. I wrote my senators in March to suggest they incentivize research by placing bounties on treatments. The rarer conditions often have little drug research as pharmaceutical companies target drugs where they can make their money back. My plan would be that regardless of rarity of condition, upon approval manufacturers would receive a check for 3-5 times the total development costs on the condition they set a gov’t mandated price. Additionally I would grant manufacturers 30 years of exclusive patent rights rather than 20 currently, as long as the prices continue to be fair. Basically I want private pharmaceutical companies to continue innovating. I want them to be profitable. I’d like to see long term consumer costs to go down once the drug is approved.


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Online  Re: COVID-19 Thread
Posted: July 05, 2020, 8:28 AM Post
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DHonks said:
It actually costs over $2B to develop a drug now. It was over $1B back when I studied it in Econ classes on public policy in 2003. Part of the reason for the $2B+ number is that for each approved drug, you must account for the half dozen failed drugs. I wrote my senators in March to suggest they incentivize research by placing bounties on treatments. The rarer conditions often have little drug research as pharmaceutical companies target drugs where they can make their money back. My plan would be that regardless of rarity of condition, upon approval manufacturers would receive a check for 3-5 times the total development costs on the condition they set a gov’t mandated price. Additionally I would grant manufacturers 30 years of exclusive patent rights rather than 20 currently, as long as the prices continue to be fair. Basically I want private pharmaceutical companies to continue innovating. I want them to be profitable. I’d like to see long term consumer costs to go down once the drug is approved.

Oh yes, if you factor in the costs of the drugs that fail it's going to be closer to $2B, but I was referring to bringing that specific drug to market.

As for the "bounty" idea, that is somewhat already in place now. Several states have basically "bid out" treating their Hepatitis-C patient population to pharma companies - the states will pay a flat fee to the pharma company to treat their entire population of Hepatitis-C patients instead of the states being billed through medicaid on a per-patient basis. Because the new treatments have a 98% cure rate, there really aren't any recurring costs of chronic care.


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Offline  Re: COVID-19 Thread
Posted: July 06, 2020, 6:30 AM Post
Posts: 1998
sveumrules said:
LouisEly said:
sveumrules said:
So if I'm following this all correctly (very possible I'm not), 70 million in taxpayer funds were used to develop a treatment of questionable efficacy which the US goverment subsequently ordered almost the entire supply of to sell back to infected taxpayers at 3,200 a pop...and it might even kind of work.

No, you're not following this correctly. Remdesivir was developed more than a decade ago as a Hepatitis-C treatment (didn't work well), and then studied as an Ebola treatment.

It takes years to develop a drug, so they are testing available drugs already on the market that have anti-viral or anti-inflammatory effects with the potential to counteract some of the known or hypothesized pathways of the disease.

As a FYI, the "cost" (before rebates, discounts, etc.) of an average Hepatitis-C drug is over $50K for about 8-12 weeks of treatment.


Peter Maybarduk, a lawyer at the consumer group Public Citizen, called the price “an outrage.”

“This is a drug that received at least $70 million in public funding” toward its development, he said. “Remdesivir should be in the public domain.”

“The price puts to rest any notion that drug companies will ‘do the right thing’ because it is a pandemic,” Dr. Peter Bach, a health policy expert at Memorial Sloan Kettering Cancer Center in New York said in an email. “The price might have been fine if the company had demonstrated that the treatment saved lives. It didn’t.”


I find that quite rich out of Dr. Bach considering Gilead basically gave away millions or billions of dollars in profit on Sovaldi to cure HcV.

I’m much more ready to criticize the government for being in the back pocket of big pharma for favoring these sketch drugs over hydroxychlorique and other cheaper drugs that pretty much do the same thing. Fauci in particular is in big pharmas pocket.


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