The virus. PPE. Part 1

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sphexx said:
I do think it’s possibly excusable in this case given which drug it is etc and the current situation.
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Hopefully this is exactly as it seems and will make a real difference. But I think if this is to be adopted globally, the evidence really needs to be out there basically yesterday - right now we don't even have a bioRxiv preprint. As she says downthread:

View: https://BANNED/angie_rasmussen/status/1272899586068295685
 
Retune said:
Hopefully this is exactly as it seems and will make a real difference. But I think if this is to be adopted globally, the evidence really needs to be out there basically yesterday - right now we don't even have a bioRxiv preprint. As she says downthread:

View: https://BANNED/angie_rasmussen/status/1272899586068295685
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As the NHS started to use it from today, it might help those who really need it.
 
Another interesting thing about this drug is how crucial the timing seems to be. It appears to be useful in the later stages of infection, when the patient's own inflammatory response can be the biggest problem. Given earlier, it may be harmful, since the last thing you want to do is suppress the immune system when it still has a shot a clearing the virus. This is almost the reverse of the situation with another drug, Remdesivir, which interferes with virus replication. That might be really useful early on, but unfortunately because it's an intravenous drug, it's unlikely to be used at this stage (you really want something that you can dish out as a tablet or nasal spray that people can use when they have mild symptoms at home, or perhaps prophylactically when they have been exposed to an infected person). It's analogous to using Zovirax (another viral replication inhibitor) to stop a cold sore - it works best when applied as soon as the tingling starts. But many of the Remdesivir trials have necessarily been on patients in the later stages of infection, when it may be much less effective.
 
Perhaps I'm lucky, but all the 'press' I've seen relating to dexamethasone was quite clear that it's a treatment for those in serious decline requiring invasive support: on ventillators or oxygen. This makes sense in line with the cytokine storm that a minority of patients experience when they should be switching from cellular to humoral immunity.

Perhaps not being a social media user is no disadvantage?

But I certainly agree that the data should be collated and presented ASAP for critical examination.
 
Fuji Dave said:
What I read about it was, once the immune systems starts to go in to overload the drug calms it back down so helped fight it.
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Yes, that's how I read it too. But most people never progress to this stage, as far as we know. In the majority of cases, symptoms have resolved around 9 days after they appeared without a dangerous inflammatory response.
 
ancient_mariner said:
Perhaps I'm lucky, but all the 'press' I've seen relating to dexamethasone was quite clear that it's a treatment for those in serious decline requiring invasive support: on ventillators or oxygen. This makes sense in line with the cytokine storm that a minority of patients experience when they should be switching from cellular to humoral immunity.

Perhaps not being a social media user is no disadvantage?

But I certainly agree that the data should be collated and presented ASAP for critical examination.
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I caught some discussion a while ago (I think it was TWiV with Daniel Griffin) that covered the timing of steroids - as far as I recall, they had learnt early on that using them too soon was counterproductive, but they could be useful later, which as you say makes perfect sense. But I think the evidence was just observational at that point, not a clinical trial like this.
 
jakeblu said:
It's all been a disaster, to be honest right from the very beginning.
The country has been let down horrendously by the government.
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And there speaks the voice of understatement :D

cambsno said:
I suppose we should be grateful that they are open to making u turns!
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:LOL: Brilliant (y)
 
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