The Coronavirus, not the beer

There has been a bit of a back and forth between Dr. Harvey Risch and a French doctor named Vincent Fleury about HDQ.

Anyhow, I will link and cut and paste a couple paragraphs from the exchange:

From Dr. Fleury

A major error is found in the article : Early Outpatient Treatment of Symptomatic, High_Risk Covid-19
Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis, by Harvey Risch,
which highlights how the work by Prof. Raoult should be read and considered.

Dr. Harvey Risch (1) advocated the use of hydroxychloroquine and azithromycin for the outpatient
treatment of patients with coronavirus 19 (COVID-19). To support his case, he cited the mortality
calculations from 2 cohorts, one presumably treated by Dr. Zelenko (2) in New York, and the other
treated by Million et al.(3) in France. In his article, Dr. Risch made an error in the calculation of the
estimated mortality among at-risk patients who were treated with a combination of
hydroxychloroquine and azithromycin (and possibly also zinc). Indeed, in order to prove the
supposed superiority of this bitherapy over standard care, Risch posited that based on the observed
number of fatalities among at-risk patients in other studies, one would expect 20% of the 1,466
patients in these 2 cohorts to have died (i.e., approximately 293 patients rather than 7), and
therefore the bitherapy of hydroxychloroquine plus azithromycin is 41 times more efficacious than
standard of care.

After the initial online publication of Dr. Risch’s article, it came to light that 405 of these 1,466
patients were the at-risk patients in Dr Zelenko’s cohort; the remaining 1,061 comprised the whole
sample in the study by Million et al. (3). However, as shown in their Table 2, not all of the 1,061
patients had at least 1 comorbid condition that was a risk factor. Adding the numbers of patients
with each chronic condition reveals that less than 45% of the total treated sample had such a
condition. In addition, because patients often have more than 1 comorbid condition (e.g., obesity
and diabetes or obesity and hypertension), the number of patients who were really at risk is
presumably far lower. 56 patients are even mere asymptomatic contacts of documented cases.
Furthermore, the cohort has a striking demographic distribution: The mean age was 43.6 (standard
deviation, 15.6) years, and the group included teenagers as young as 14 years of age. All of this is to
say that the cohort in the study by Million et al. is in no way comparable to a typical cohort of
hospital patients, who are generally older and in worse health. Moreover, a mean age of 44 years in a
group with no children younger than 14 years of age indicates a very young cohort, much younger
than average. When comparing the cohorts, even patients with similar comorbid conditions do not
have a similar magnitude of the risk. To be really at risk, you must be older.

Risch then multiplied 1,466 by 20% to get the expected number of deaths: 293. Here is where the
error is manifest. It is indeed true that the fatality rate in hospitalized patients may be somewhere
between 10% and 20%, as cited by Risch (1); however, there is no reason to expect a similar fatality
rate in a cohort such as the one in the study by Million et al., even if it does contain elderly people
and patients at risk. That cohort comprised patients who came on foot to queue up at the hospital,Fr
whereas in other hospitals, patients are generally admitted to the emergency department.

https://watermark.silverchair.com/k...docsO7WbhS5FejViossN-eLLGNmKwjIQa0qwUoc4QnXXQ

And Dr. Harvey Risch's response:

I thank Dr. Fleury (1) for clarifying various details of one of the studies that I discussed in my
review of efficacy and safety of outpatient medication treatment for COVID-19 patients (2). Dr.
Raoult, the senior investigator of that study (3), has been carrying out a medically aggressive
COVID-19 testing and treatment program in Marseille, France. From this distance, it can be
difficult to glean all of the relevant details of the program and I appreciate Dr. Fleury’s more
local information and extended discussion.

In my analysis, I assumed that the patients described by Dr. Raoult as hospital patients were
high-risk. In fact, it seems that Dr. Raoult’s hospital base was used more as a clinic facility
where outpatient testing and treatment were done, and for a fraction of the patients, full hospital
admission occurred. Thus, Dr. Fleury is indeed correct that the 1,061 patients I discussed were
not all high-risk.


https://watermark.silverchair.com/k...dfrrPdnc6dlx39QQ74kMjIXiJ5Yy1xCxoSyyNZtpwcmwg

bump from 7/23
 
As I said in an earlier post, a lot of doctors have been using HDQ. And some of the studies have shown a positive effect. But they do not support the extravagant claims being made by some people (including Dr. Harvey Risch) that HDQ is some sort of game changer that would save a hundred thousand lives. Risch has impeccable academic credentials. But his paper mainly consists of reviewing other studies and trying to estimate from those other studies what the effect of using HDQ might be. In the absence of a control group there is no good way to do this. And as Dr. Fleury points out he made at least one major error.

I think similar questions can be raised about the other sample group, Dr. Zelenko's patients. Zelenko is a self-described "country doctor" whose patients mainly come from the Hasidic community in Monsey, New York. Some of them may be old and at high risk. But I suspect a good many of them are not. To apply a 20% expected mortality rate to that group also seems dubious.

bump from 7/23
 
The video with the voodoo doctor is curious. Do actual front line doctors not have enough access to information? Of course, they do. They talk to each other and know so much more about actual treatments.

If it isn't meant for doctors, then who is its intended audience and why was it made?
 
Still waiting for the Trumpsters to tell me why Trump bought the world's supply of Remdesivir if HDQ is the miracle drug?
 
just an interesting observation, no more or less

What I read was Google telling almost a quarter of a million people to stay home
until summer of 2021.

"until"
 
just an interesting observation, no more or less

What I read was Google telling almost a quarter of a million people to stay home
until summer of 2021.

"until"

There's a lot more going on in this than just the virus. First, Google has actually opened up some of its offices but has given employees the option to continue working from home. They've extended this option until July of next year.

Silicon Valley companies fight relentlessly for the best talent. One thing that many Millennials value is the option to work from home. This gives Google a chance to really figure out the processes of how to get those employees that wish to working from home permanently (or to find out if it's not practical). So if Google perfects remote work and can offer that as a benefit to prospective employees, it's a leg up on the competition.

Permanent remote work also allows a business to not be tied to the talent found in a specific geographic area. When you work in a physical office you have to hire people who live close by or who are willing to move. That limits the pool of talent to pull from. Suppose you want to hire for a position in California and the best candidate lives in Missouri near their elderly parents and so is unwilling to move. Remote working lets you hire that person.

By doing this Google can also show they have their employees health and safety at heart (or at least appear to have it at heart). People want to work at a place they feel will take care of them. Extending remote work (especially if productivity isn't an issue) is an amazingly cheap way to show their employees they care.

Next, don't discount that it's a tech firm doing this. Google would benefit from more businesses working remotely as Google offers tools to help that happen. They know they're a trend setter and would like to set this trend.

Finally, office space is expensive. Remote work allows businesses to offload the cost of office space, utilities, and even equipment onto their employees...and the employees see it as a benefit. So Google might be discovering what many businesses are right now, that the benefits of physical presence in an office doesn't outweigh the costs of the office space.

So ultimately, the really interesting thing here isn't what this decision tells us about the severity of the pandemic, it's what the decision tells us about the changing attitudes of corporate America. Suffice to say I wouldn't want to be in the office space business right now.
 
Interestingly Google has also invested heavily in prime office space in Manhattan and elsewhere on the theory that personal interaction with creative people working adjacent to them was a key to innovation.

Both theories could be true. I think there are some things you are more likely to learn from having a cup of coffee with someone than from a technology-mediated discussion.
 
Interestingly Google has also invested heavily in prime office space in Manhattan and elsewhere on the theory that personal interaction with creative people working adjacent to them was a key to innovation.

Both theories could be true. I think there are some things you are more likely to learn from having a cup of coffee with someone than from a technology-mediated discussion.

I think there are some situations where in person works better and some where it doesn't. As you say, creative people working together likely benefit from that sharing of ideas. It's easier to bounce things off the person sitting next to you than to schedule a Zoom call.

But it's also not true for every job. Someone who spends 95% of their day buried in computer code or an accountant who spends their day in spreadsheets probably could do just as good of a job at home. They may even be more productive.

So you may end up seeing scaled back offices in the future. Places more geared towards those roles that benefit more from in person contact.
 
There's a lot more going on in this than just the virus. First, Google has actually opened up some of its offices but has given employees the option to continue working from home. They've extended this option until July of next year.

Silicon Valley companies fight relentlessly for the best talent. One thing that many Millennials value is the option to work from home. This gives Google a chance to really figure out the processes of how to get those employees that wish to working from home permanently (or to find out if it's not practical). So if Google perfects remote work and can offer that as a benefit to prospective employees, it's a leg up on the competition.

Permanent remote work also allows a business to not be tied to the talent found in a specific geographic area. When you work in a physical office you have to hire people who live close by or who are willing to move. That limits the pool of talent to pull from. Suppose you want to hire for a position in California and the best candidate lives in Missouri near their elderly parents and so is unwilling to move. Remote working lets you hire that person.

By doing this Google can also show they have their employees health and safety at heart (or at least appear to have it at heart). People want to work at a place they feel will take care of them. Extending remote work (especially if productivity isn't an issue) is an amazingly cheap way to show their employees they care.

Next, don't discount that it's a tech firm doing this. Google would benefit from more businesses working remotely as Google offers tools to help that happen. They know they're a trend setter and would like to set this trend.

Finally, office space is expensive. Remote work allows businesses to offload the cost of office space, utilities, and even equipment onto their employees...and the employees see it as a benefit. So Google might be discovering what many businesses are right now, that the benefits of physical presence in an office doesn't outweigh the costs of the office space.

So ultimately, the really interesting thing here isn't what this decision tells us about the severity of the pandemic, it's what the decision tells us about the changing attitudes of corporate America. Suffice to say I wouldn't want to be in the office space business right now.

This is especially true in the uncertain economic period we are currently going through. Companies everywhere are looking to cut cost to stay afloat. Staying afloat isn't a worry for someone like Google, but cutting costs during economic uncertainty is something all good businesses strive to do.
 
what I gather from the group is Google ( probably not just Google) making Lemonade out of the pandemic ?

still, they are tamping down expectations of even bringing a portion of those 200K back until summer 2021

Am I reading that right ?
 
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The new number for OO is 2.2 million deaths. It's a similar scam he does on property evaluation, but in reverse. On property he exaggerates (aka lies) high when pitching to investors, and then for taxes he exaggerates (aka lies) low.

For Covid he first exaggerated (aka lied) too low, and now he's exaggerating (aka lying) too high.

He is the consummate bullsh't artist. It's a very simple formula. How he gets away with it is beyond me.
 
We gonna hit 150,000 deaths today. And its not the end of July. And the mortality data suggest the official numbers are understating deaths by around 20%.
 
Where are the "but its only 15 deaths and the flu kills 50k" people now?

busy complaining about twitter infringing on the free speech rights of a doctor going around telling people there is a cure and they don't have to wear a mask

it is a special kind of lunacy that we see on these boards
 
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