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Wuhan Virus Watch: Trump considers quarantine on New York, New Jersey, Connecticut (UPDATE)

Wuhan Virus Watch: Trump considers quarantine on New York, New Jersey, Connecticut (UPDATE)

Fast test method has FDA approval. French medical team publishes 80-patient study confirming success with Hydroxychloroquine/Azithromycin treatment.

https://youtu.be/wy3NrqNN9uU

President Donald Trump indicated that he is now considering imposing an enforceable quarantine on New York, parts of New Jersey and parts of Connecticut to curb the spread of the coronavirus.

“We’d like to see New York quarantined because it’s a hotspot — New York, New Jersey, maybe one or two other places, certain parts of Connecticut quarantined,” he said outside the White House.

“I’m thinking about that right now. We might not have to do it but there’s a possibility that sometime today we’ll do a quarantine — short term two weeks for New York, probably New Jersey and parts of Connecticut.”

He said that if such a move happened, it would be primarily a restriction on residents of those states traveling to other parts of the country.

“This will be an enforceable quarantine, but hopefully we won’t need it,” he said.

Shipments of urns in Wuhan raise questions about China’s coronavirus reporting

Meanwhile, while the Chinese are reporting that their country has completely turned to normal, new information about funeral urns raises questions on the reliability of those reports.

As families in the central Chinese city began picking up the cremated ashes of those who have died from the virus this week, photos began circulating on social media and local media outlets showing vast numbers of urns at Wuhan funeral homes.

China has reported 3,299 coronavirus-related deaths, with most taking place in Wuhan, the epicenter of the global pandemic. But one funeral home received two shipments of 5,000 urns over the course of two days, according to the Chinese media outlet Caixin.

It’s not clear how many of the urns were filled.

Workers at several funeral parlors declined to provide any details to Bloomberg as to how many urns were waiting to be collected, saying they either did not know or were not authorized to share the number.

FDA authorizes Abbott Labs’ portable, 5-minute coronavirus test the size of a toaster

Rapid testing will be a key component to identifying infections, so that effective choices about isolation can be made.

A five-minute, point-of-care coronavirus test could be coming to hospitals next week, and experts say it could be “game-changing.”

The U.S. Food and Drug Administration issued Emergency Use Authorization to Illinois-based medical device maker Abbott Labs on Friday for a coronavirus test that delivers positive results in as little as five minutes and negative results in 13 minutes, the company said.

The company expects the tests to be available next week and expects to ramp up manufacturing to deliver 50,000 tests per day, according to a press release.

French researchers completed new additional study on 80 patients, results show a combination of Hydroxychloroquine and Azithromycin to be effective in treating COVID-19

Rapid testing paired with an effective, readily-available, and safe treatment will be critical in reducing mortality and speeding recoveries for those infected.

Many Legal Insurrection readers will have heard about the French team and their initial study involving 36 patients. This is a follow-up study on the malaria-drug (hydroxychlorquine) paired with an antibiotic (azithromycin). Prof. Didier Raoult and his team have just published results of their new study of 80 patients.

In 80 in-patients receiving a combination of hydroxychloroquine and azithromycin, the team found a clinical improvement in all but one 86 year-old patient who died, and one 74-year old patient still in intensive care unit. The team also found that, by administering hydroxychloroquine combined with azithromycin, they were able to observe an improvement in all cases, except in one patient who arrived with an advanced form, who was over the age of 86, and in whom the evolution was irreversible, according to a new paper published today in IHU Méditerranée Infection.

“For all other patients in the cohort of 80 people, the combination of hydroxychloroquine and azithromycin resulted in a clinical improvement that appeared significant when compared to the natural evolution in patients with a definite outcome, as described in the literature. In a cohort of 191 Chinese inpatients, of whom 95% received antibiotics and 21% received an association of lopinavir and ritonavir, the median duration of fever was 12 days and that of cough 19 days in survivors, with a 28% case-fatality rate (18),” the team said.

The team went on to say: “Thus, in addition to its direct therapeutic role, this association can play a role in controlling the disease epidemic by limiting the duration of virus shedding, which can last for several weeks in the absence of specific treatment. In our Institute, which contains 75 individual rooms for treating highly contagious patients, we currently have a turnover rate of 1/3 which allows us to receive a large number of these contagious patients with early discharge. Chloroquine and hydroxychloroquine are extremely well-known drugs which have already been prescribed to billions of people.”

“In conclusion, we confirm the efficacy of hydroxychloroquine associated with azithromycin in the treatment of COVID-19 and its potential effectiveness in the early impairment of contagiousness. Given the urgent therapeutic need to manage this disease with effective and safe drugs and given the negligible cost of both hydroxychloroquine and azithromycin, we believe that other teams should urgently evaluate this therapeutic strategy both to avoid the spread of the disease and to treat patients before severe irreversible respiratory complications take hold,” the team concluded.

UPDATE

Trump: No quarantine for NY-NJ-CT

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Comments

This is a signal to Cuomo: save face by calling your own quarantine or other action plan, so Trump doesn’t have to.

Only the Left and MSN can spin this one into a negative… but they will try. This makes going more widespread in treatment testing a go. Considering the safety index for both meds and the ease of administration this may be a silver bullet. ARBs are also showing some early good results. Alaska is in full lockdown except for essential services and needs. The main hit up here is from outside traveling and now passed on to the medical community. One precipitous death yesterday.

    Lucifer Morningstar in reply to alaskabob. | March 28, 2020 at 2:35 pm

    Except that availability might be a problem because doctors have been writing themselves and their family members and relatives and friends prescriptions for huge amounts of these medicines to stockpile. So much so in some states they’ve actually had to prohibit pharmacies from filling such needless orders.

    In my opinion Doctors that engage in such behavior should have their medical licenses reviewed and revoked if appropriate.

      Katy L. Stamper in reply to Lucifer Morningstar. | March 28, 2020 at 3:14 pm

      I disagree strongly. Doctors should be able to write prescriptions for themselves and at least their families.

      Doctors are exposed to this and their families are exposed to them.

      Why would you want to take all these risks, if the payoff is you and/or your family dies?

      If you were willing to go to medical school, do the residency and internships, etc., and then be exposed to these risks, that would be one thing. But I wasn’t willing to do all that, medicine never interested me.

      I agree doctors shouldn’t be allowed to stockpile it, but that’s a different issue. But should they be permitted to give it to all their family and friends, yes.

      This medicine is well known and able to manufactured in bulk.

        healthguyfsu in reply to Katy L. Stamper. | March 28, 2020 at 3:23 pm

        Wrong Katy.

        They have access to pads that no one else does, and that comes with a responsibility (an oath even) as part of that credential. It’s actually a breach of medical ethics to treat your family members, so why should you be able to write them a prescription? Surely, a colleague could do it, but then you have to convince a colleague to risk their credentials for your family, which is easier said than done (and serves as a natural check and balance against such behaviors). I’m 100% with you LM that these doctors should be made to answer for this at some point.

        After reading several of Katy’s ass backward logic posts, I hope she never brings anything impactful to any decisions made anywhere beyond her bubble.

        Also, I will add that if you read any articles about this issue, you will find that the media and a few quotable mouthpieces are doing what they can to blame this on Trump as well. Apparently, his “overpromise” on an “unproven” treatment has led credentialed doctors to fall under his spell and hoard this medication. LOL…you can’t make this garbage reporting up.

        Katy’s got it right.

          healthguyfsu in reply to walls. | March 28, 2020 at 8:20 pm

          walls, that flies in the face of medical ethics and basic human decency. You can join her in timeout.

        CommoChief in reply to Katy L. Stamper. | March 28, 2020 at 6:04 pm

        Katy,

        You are conflating a few separate issues.
        1. Should police, fire, ems, nurses, M.D. etc be taking chloroquine as a probable prophylactic? Hell yes it should be issued daily to them at the beginning of their shift.

        2. Should hospital personnel be going home after their shift? Probably not. This is where local government needs to step in and figure out temporary accommodation for these folks.

        3. Should M.D. be writing RX for chloroquine for in your words
        ‘all their family and friends’? No, Hell no. Way too broad.

        Let’s address 3. You didn’t specify what constitutes family. Is that family a dual income household of two M.D. without children? Is it one M.D., a spouse, 3 kids and a mother in law? Does family extend to cousins, uncles etc? As for friends, does that mean everyone they know down to the level of an acquaintance?

        What limiting principle are you going to employ? You didn’t state one and your stated position will naturally lead to M.D., their family and friends with a ready supply of a limited product. Which in turn will lead to a shortage and rationing or unavailability where it may be more needed.

        Here is another secondary or perhaps tertiary effect of your approval of M.D. hooking up friends and family members. Loss of trust when your M.D. says no RX for you guy. The national inclination, under your regime, will be to assume that the M.D. is only going to write RX for those close to them and everyone else can pound sand. This has much broader implications than the current crisis. Trust, once lost, is very difficult to restore.

Lucifer Morningstar | March 28, 2020 at 2:31 pm

And you forgot to mention that the Governor of Rhode Island has declared that all New Yorker residents entering the state of Rhode Island will be required to undergo a mandatory 14 day quarantine before being allowed into the state.

https://www.upi.com/Top_News/US/2020/03/28/Rhode-Island-actively-stopping-New-Yorkers-to-quarantine/3591585403017/

Alaska, Florida and Hawaii are asking people to do the same.

    All returning medical have to self quarantine for 2 weeks before returning the practice. Recycling hazmat PPE has become a priority and the U of Nebraska protocol is being tried up here .. getting is going is a challenge parts wise.

healthguyfsu | March 28, 2020 at 3:15 pm

It makes a lot of sense to quarantine an epicenter like New York to keep issues within its borders from spreading further. It even makes sense from a resource perspective because less spread means Governor Fredo can get more of the resources to NY that he thinks are for lives that are more important there than anywhere else in the country. Naturally, though, Fredo is denying the reality and value of any such measures.

Connivin Caniff | March 28, 2020 at 3:31 pm

“Fast test method has FDA approval. French medical team publishes 80-patient study confirming success with Hydroxychloroquine/Azithromycin treatment.”

The above is a big hint that the crisis will be ending shortly. Trump and the Swamp managed to sneak in their 2 trillion misappropriation just under the wire, shortly before everyone realizes they didn’t more than a small fraction of that amount.
Don’t let a crisis go to waste, once again. Thanks, Scoundrels.

I see SCOTUS is gonna have enough cases to keep Ruth Bader-Zombieburg fed on brains for some time to come.

With respect to the double blind studies that are going on – if the group that is getting the “good drugs” gets better at a very obvious rate, how can you ethically continue the study?

Are you, at that point in time, becoming the “death panel” in denying life-saving care?

Also, would the study have to test people in various stages – such as take when you have a negative test (like health care workers), asymptomatic but a positive test, light symptoms with a positive test, and then various stages of symptoms up to being on a ventilator. This type of test would determine the best time to give out the drugs.

Another question is the long term effects of having C19. Zika has an impact on fetuses, so are pregnant women at a high risk? What about LT impacts on lung health?

    healthguyfsu in reply to Liz. | March 28, 2020 at 4:19 pm

    You have junk data if you don’t continue the study as is.

      I think that if the impact is very significant in the severe cases, then the trial should be stopped and all patients at that stage should be given the drug.

      You could still continue the trials for the other groups, until that time that the group not receiving the drugs get to the severe stage.

      Otherwise, the people who are conducting the trials are “death panels”.

      I remember seeing info on a drug trial that it was stopped and all patients given the drugs because of the significant impact on the disease progression. The explanation for stopping was that it would have been unethical not to have do. I tried a quick search, but could not find the study.

        healthguyfsu in reply to Liz. | March 28, 2020 at 8:22 pm

        It doesn’t work like that. Not everyone will respond to the drug positively. That’s just the nature of drug treatments. Some will die in spite of the potential help that the drug was providing. The data are already difficult to sift through and keep clean.

        If you do the study wrong then many more die because you based your future treatment protocols on junk data. Gotta see the forest through the trees.

          I understand that drug trials are difficult. If you check out my first post, I mentioned the need to test people at different stages from negative/no symptoms/environmental issues all the way to positive/on ventilator. That is a much larger trial and more complex, but it might give the docs an idea as to the best time to give the drug combo.

          I am open to the larger trials with more layers. I’m also arguing that if the trial reaches a point where it seems to be useful for some patients to get the drug combo, then denying patients at the end stage of the disease is not ethical. Let the patient and their doctor have the choice. Double blind trials at that point in time should be d***.

          Otherwise, I really don’t want anyone to shout “my body, my choice” if I don’t have the choice to get a potential life saving drug.

          We are really in agreement about the purpose of drug trials. I’m more willing to stop the trial if the results seem to be life saving. If this was not a pandemic, then yes, let the trials go on and on.

          As I mentioned before – we also need to be looking at the long-term impacts of this virus – impacts on pregnancy, LT lung impacts, and so on. The CDC needs to be setting up studies on the LT impacts on health and skip the impact of gun violence or shrimp on treadmills studies.

          An aside – RIP to Dr. Tom Coburn. He was a good doctor and a good representative/senator. Wish we had more of his type.

          Another point – you mention seeing the forest through the trees.

          I see the forest and recognize the principles of research for the good of the people.

          I also see the trees and I want to make sure that they are helped.

          Another point – did the blindness of the CDC and the FDA standard operating procedures result in the delay of improving the testing process, of vaccines, of treatments?

          Look what has happened when the states and university and company research teams and labs are able to try, test, and come up with new options!

      Milhouse in reply to healthguyfsu. | March 28, 2020 at 11:51 pm

      Liz is correct. If a study shows very clear signs that the drug being tested is life-saving then it is often terminated early because it would be unethical to continue it. However this practice is controversial. Search the web for “stopping studies early for benefit”.

We need the double blinded studies done to prove that it is really efficacious. It shouldn’t take very long for a study of several 100 (or even several thousand?) to be done and get good data out of it. There are many times in medical history where treatments were given thinking they were working and only later with good studies It was found that more harm was coming from the treatments than good.

I know that most of us are anxious for a treatment, and feel very helpless without treatment. As an ER doctor in Oklahoma I really hope a good treatment will be available right away. As of today in Oklahoma we have a little less than 400 cases but it is doubling every 2 to 4 days. I personally plan on prescribing the combination when I see cases. But I would really like good evidence base data to support continuing to use this treatment.

Studies usually have an independent statistician who continually analyzes the data coming in and recommends stopping a study early if clear difference in outcomes occur. It is interesting to note that sometimes the statistician stops a study because the treatment arm is doing worse then the placebo arm. Keep in mind that not every idea that makes a great headline is also a good medical treatment.

    alaskabob in reply to Dr S. | March 28, 2020 at 6:43 pm

    French study just released… 80 patients (follow on to initial 36) … only one died but really bad off to start, one still critical, and the others got better sooner than should be expected. The question is always when is anecdotal no longer anecdotal? Don’t want to go down a dead-end street with treatments but if one uses a large enough population treated, comparison to other treatments can be sorted out. I would think the general course of the disease can give milestones. Also, some studies are terminated when the treatment arm is so effective.

    Liz in reply to Dr S. | March 28, 2020 at 7:27 pm

    Dr. S – in ’94,I went to Africa for work. I vaguely remember that the malaria drug dose was 1x/wk for 3 wks before through 3 wks after. Is that still the dosage for malaria? And, would that dose be good for the ER docs and all health care professionals to use as a preventative dose? Are you taking the med?

    What county do you work in? I live in OK County, so I’m under the shelter order. The OK DOH website is interesting in that it has a daily report of bed and PPE supply = https://coronavirus.health.ok.gov/ Check under News EO Reports.

    So far, it looks like OK is doing ok with beds and supplies, but how is your ER doing since news are reporting a disconnect between medical people vs gov’t reports.

    Stay safe!

      healthguyfsu in reply to Liz. | March 28, 2020 at 8:25 pm

      Malaria is a protozoan (eukaryotic) parasite and pretty nasty at that. It’s a completely different type of organism (although the virus is not really an organism).

      The questions you are asking are the very questions that should be determined through carefully controlled studies.

        Guinea worm was also a significant thing that I had to worry about….

        But, it has been proposed that the malaria drugs open the cell wall barrier so that other drugs (z-pac or zinc or ?) can then enter and work on disrupting the rna replication of the virus.

        Is that not an option? There should be some underlying process to support the test. It seems to me if A disrupts B and C disrupts D and the results is that the entire process is disrupted, then those processes should be studied.

          healthguyfsu in reply to Liz. | March 29, 2020 at 1:24 am

          That’s the proposed mechanism but no idea how well it works in vivo.

          Malaria is a eukaryotic endoparasite with a very unique, coordinated release in the bloodstream. The COVID 19 virus is not even technically alive, even though it does have a “cadillac” viral coat as these viruses go (coronaviruses vs other classes of viruses). The COVID 19 virus also does most of its damage in lung tissue. This is well-perfused by blood but is a completely different mechanism than an erythocyte endoparasite like malaria. I don’t see how anyone could know the right answer without running trials.

BierceAmbrose | March 28, 2020 at 7:16 pm

“…all New Yorker residents…”

Well, up state isn’t downstate. Quarantine the “New Yorkers”, but please not the rest of us from Up State. (Our case rates are more like the midwest states … and mostly came here from NYC.)

While we’re at it, can we maybe make a Down State quarantine permanent?

    I concur – I lived in upstate for 5 years (Ithaca/Syracuse). I hated my trips to the NYC area, so I agree with the permanent downstate quarantine.

    I’m in the OKC area & the C19-infected counties were first along the major highways (I44-I35-I40) and the infected counties are now expanding outward. For the state maps that I’ve looked at, the interstate trends seem to be significant. The trade route infection route lives!

    The OK governor set a “safer at home” order for any county that has ONE case. Some cities are making some additional rules (OKC, Tulsa, Norman). Somehow, I don’t see some of the counties in the OK panhandle being impacted by that order. So I see the logic with the “by county” policy.

    Are farmers & ranchers “essential businesses”? The winter wheat is going to start growing soon to have a June-Julyish harvesting time frame.

BierceAmbrose | March 28, 2020 at 7:18 pm

The idea of national data, analysis, and policy *by county* has got to be making Gov Soprano and his pals nuts. What’s the point of being an hereditary Overlord if subordinate jurisdictions act like, you know, jurisdictions?

Commenting on several points raised by previous posts.
In most states, it is indeed frowned upon by medical licensing boards for physicians to treat their own families. Obviously medical objectivity and judgement could be compromised in that setting.
As for the updated French study, it still only gives hope, not strong proof, that this therapy will really work. Reading the report, several important points stand out. Firstly, very few of the subjects were seriously ill. They are described as inpatients, but only 15% required oxygen, and most had low symptom scores. I doubt many patients not requiring oxygen and with low symptom scores would be admitted in typical US hospitals. Thus the study has the large question of generalizability to the worrisome group who ARE hospitalized here.
Secondly, the claim of rapid viral reduction is impaired by absence of any similarly selected comparison group. The French group may be observing the natural history of infectivity in mildly ill people. The length of viral shedding is indeed important to decrease if possible as that would reduce further infections; however the comparison is to Chinese patients who were much sicker (based on fatality rate described). The French patients were on average symptomatic for 4 days before study entry and then showed decreased shedding over the following days; again possibly the natural history in such patients. The data does not convince me that the “decreased” time of viral shedding is relevant to sicker patients. And of course laboratory outcomes in China versus France may reflect differences in testing methods.
So, similarly to what Dr. Fauci has said, these medications may offer hope, but proof that they are important just isn’t in hand yet.

    ” it is indeed frowned upon by medical licensing boards for physicians to treat their own families. Obviously medical objectivity and judgement could be compromised in that setting.”

    – REALLY? If my doctor was not able to take care of their immediate family in a pandemic situation which might ensure their own health, then why would I trust that person to take of me? My doctor did some traveling and is a self-imposed time-out. But we are still in contact and she’ll do the drive-thru testing when she can.

    There needs to be trials of patients at the various stages of the illness to test the process. Some reports that I see mention that they are only testing the sickest of the patients. Why? There may be a better point in time to start the therapy to get better results.

    If the tests are only at point X, then the test may be stopped due to bad results. But point Y may be the sweet spot.

    Test everything and don’t give up!

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