Steroid found to help prevent deaths of sickest coronavirus patients

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Northerner

Northerner

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Type 1
A cheap steroid has become the first life-saving treatment in the Covid-19 pandemic, described by scientists as a major breakthrough and raising hopes for the survival of thousands of the most seriously ill.

Dexamethasone is cheap, available from any pharmacy, and easily obtainable anywhere in the world. Investigators said the drug was responsible for the survival of one in eight of the sickest patients – those who were on ventilators – in the Recovery trial, the biggest randomised, controlled trial of coronavirus treatments in the world.

“It is the only drug so far shown to reduce mortality and it reduces it significantly,” said Peter Horby, a professor of emerging infectious diseases in the Nuffield department of medicine, at the University of Oxford, and one of the chief investigators of the trial. “It is a major breakthrough, I think.”

www.theguardian.com

Dexamethasone: low-cost drug helps prevent deaths of sickest coronavirus patients

Trial shows dexamethasone responsible for survival of one in eight patients on ventilators
www.theguardian.com www.theguardian.com

Sounds promising 🙂 Probably freaks out your blood sugar levels, but that's likely to be the least of your worries if you need this treatment 😱
 
Nah shouldn't, if you're on a ventilator then they reduce your consciousness by that stage so you'd be on a sliding scale by then anyway and getting VERY frequents Obs in ITU. Not certain what they do if 'only' on oxygen though.
 
Wearing my Mr Cynical hat, doesn't this announcement by PR, promoted by politicians, without any data published or reviewed by other experts, look just a little bit similar to the hydroxychloroquine fiasco?
 
As usual the politicos are overhyping the findings - Boris could not remember the name of it on last nights briefing even though he only turned up because there was something apparently positive to say.

The guy running the trials on various possible treatments has commented publicly and was also on last nights briefing. He was quite confident that the effect they saw was real and made the comment (and I paraphrase) that what they had found was that Dexamethasone halted the decline of patients who were very, very ill in about one in eight of patients. Looked at another way, seven out of eight still die.

I have been wondering better management of the disease as the medics have gained experience might be a factor in the declining death rate and adding something else to try on something other than a whim has got to be a good thing. Impossible to sort out from the data available.
 
Eddy Edson said:
Wearing my Mr Cynical hat, doesn't this announcement by PR, promoted by politicians, without any data published or reviewed by other experts, look just a little bit similar to the hydroxychloroquine fiasco?
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I think the protocol for any clinical trial is that if it is found that the treatment in question is causing a noticeable benefit, the trial has to halt, and offer it to all patients in the trial, ie, those who were on a different regime, or a placebo. I think this is what has happened here. So the scientists have been following the correct procedure with respect to publishing findings, peer reviewing, etc.
Of course, the politicians have made capital out of it, but imagine a different newspaper headline if they hadn’t. 'UK finds hope for Covid patients, and sits on the reseach while thousands die'
 
Northerner said:
A cheap steroid has become the first life-saving treatment in the Covid-19 pandemic, described by scientists as a major breakthrough and raising hopes for the survival of thousands of the most seriously ill.

Dexamethasone is cheap, available from any pharmacy, and easily obtainable anywhere in the world. Investigators said the drug was responsible for the survival of one in eight of the sickest patients – those who were on ventilators – in the Recovery trial, the biggest randomised, controlled trial of coronavirus treatments in the world.

“It is the only drug so far shown to reduce mortality and it reduces it significantly,” said Peter Horby, a professor of emerging infectious diseases in the Nuffield department of medicine, at the University of Oxford, and one of the chief investigators of the trial. “It is a major breakthrough, I think.”

www.theguardian.com

Dexamethasone: low-cost drug helps prevent deaths of sickest coronavirus patients

Trial shows dexamethasone responsible for survival of one in eight patients on ventilators
www.theguardian.com www.theguardian.com

Sounds promising 🙂 Probably freaks out your blood sugar levels, but that's likely to be the least of your worries if you need this treatment 😱
Click to expand...
Dex is a lot more potent than prednisolone so I hope they have a tanker load of insulin at the ready if anyone needs it.
 
Docb said:
As usual the politicos are overhyping the findings - Boris could not remember the name of it on last nights briefing even though he only turned up because there was something apparently positive to say.

The guy running the trials on various possible treatments has commented publicly and was also on last nights briefing. He was quite confident that the effect they saw was real and made the comment (and I paraphrase) that what they had found was that Dexamethasone halted the decline of patients who were very, very ill in about one in eight of patients. Looked at another way, seven out of eight still die.

I have been wondering better management of the disease as the medics have gained experience might be a factor in the declining death rate and adding something else to try on something other than a whim has got to be a good thing. Impossible to sort out from the data available.
Click to expand...
I could have written that post myself @Docb, totally agree with all you say 🙂 The way the media are talking about it you would think they'd found a cure. It's great that they have a treatment that will help some of the sickest, but the odds are still poor if you end up on a ventilator :(

Has anyone noticed on the slides that, although they say the infections are falling, they do actually appear to have levelled off currently, which suggests that 'R' is around 1. Over 1200 new infections a day still - they say they are testing more, but how can we know that? They stopped showing the actual number of people tested 3 weeks ago, so it's quite possible that they are finding a consistent number of infected people, not a declining proportion (if you see what I mean). I'm afraid the Cummings saga completely destroyed any credibility for the government, with ministers telling bare-faced lies to defend him :(
 
I have been thinking for a while that the death and infection data is decreasing exponentially, that is it is not trending towards zero but towards an asymptote. If you have been listening carefully you will have noted that the politicos have been comparing the daily seven day running average with what it was seven days before. That difference is getting smaller and smaller so now they are glossing over that and comparing it with the peak. More PR sleight of hand I am afraid.

Just been listening to More or Less. A contributor made the point that any suggestion that the excess deaths are merely deaths brought forward by a short period because of co-morbidities is not valid. He should know, he was an actuary with a vested interest in getting it right, after all the one industry who will have a real grip on the mortality figures is the insurance industry. They need to get the interpretation right to make sure they continue to make the profits they do.
 
Docb said:
I have been thinking for a while that the death and infection data is decreasing exponentially, that is it is not trending towards zero but towards an :(. If you have been listening carefully you will have noted that the politicos have been comparing the daily seven day running average with what it was seven days before. That difference is getting smaller and smaller so now they are glossing over that and comparing it with the peak. More PR sleight of hand I am afraid.
Click to expand...
Yes, that comparison with the peak really jars with me - after 12 weeks of lockdown you would expect things to have improved considerably, so it's a pretty meaningless comparison, it says nothing about the current trend :(

I had to look up 'asymptote' - I think that describes our current trajectory, thank you for educating me! 🙂
 
Northerner said:
Yes, that comparison with the peak really jars with me - after 12 weeks of lockdown you would expect things to have improved considerably, so it's a pretty meaningless comparison, it says nothing about the current trend :(

I had to look up 'asymptote' - I think that describes our current trajectory, thank you for educating me! 🙂
Click to expand...

The UK curve looks pretty much like Italy etc - in other words like other countries which have had to rely on "lock downs" to get a slow, painful reduction in new infections - but laggier and falling slower because of the less decisive lock down effort. Because the UK before it ramped up testing was only detecting a small fraction of infections, and is now detecting a much larger fraction, the actual magnitude of the decline can only be estimated by modelling. In any case, it will be larger than the decline in detected cases.

On group I follow is at the LSHTM: https://cmmid.github.io/topics/covid19/global_cfr_estimates.html On their estimates, actual infections fell from 75K+ per day at peak in April to ~25K at the end of May.

Another group is at MIT: https://covid19-projections.com/united-kingdom Different profile, and bigger decline: ~107K per day at peak in March to ~11K per day now, forecast to deline to 2.5K per day by end September.

And so on. These are just models and as seems to be common for most of these model they don't seem to account for what is almost certainly the strongest tool, ie a really effective TTI effort. But I don't think anybody denies that the UK has seen a substantial decline in new infection rate and that the decline is continuing for the moment, at a slowing rate.
 
Some though not totally, are somewhat pre-programed to find much that a Conservative Gov do incorrect and vice versa. The only thing a Gov of any political persuasion is actually guaranteed to achieve is sometimes whatever they do it's going to be wrong. No party whatever will ever be able to please all of the people all of the time. It's a democracy; it is entirely up to us to change it when we get the opportunity to do so, should we not like what we have right now. I have no patience whatever with those that sit in corners and whinge; the scriptwriters of Yes Minister etc got it right. Never stick your head above the parapet unless you have a bullet proof skull !

It's surely got to be easier to live with than a dictatorship.

Let's all look forward to 2021 when we're out of Europe ……. tra la la …..
 
PS - yes of course mistakes have been made - that's what you get with humans running the show.

Lessons will be learned - yeah OK - they always aren't, are they!
 
I have had dex in the past but not for many years until I had IV dex when I was in A & E a few weeks ago. My sister, who has one of the same conditions as me, has dex eyedrops every day.
 
Strikes me that a potent immunosuppressant is the obvious treatment to prevent a cytokine storm. If anyone is worried about their BG levels during such treatment it's a bit like hoping for a soft landing when your parachute fails.
 
OTOH Mike during WWII when first husband's uncle was a rear gunner in a Wellington (I think) the plane was shot down so pilot ordered all to bale out. Denis's one leg was comprehensively buggered already by gunfire so he baled anyway and pulled the cord which then got fouled up in the prop. He only hacked himself free! plane had lost altitude by this time but it still was truly freezing and he landed in a field, in a snow drift which actually stopped him breaking every bone in his body. You'd think he might have frozen to death but farmer's family was obviously aware that planes were being shot down in their vicinity and one of the daughter found him first, and they carried him back to the farmhouse and realising he was still alive got a message through to emergency services who picked him up and took him to hospital where a very skilful surgeon had to amputate both legs (cos the other leg had also been shot unbeknown to Denis) They looked after him well and he was repatriated by the Red Cross - both sides did this with very badly injured servicemen.

He was the only person from that crew who survived.

He was a smashing bloke and when he retired from work, got in touch with the education authority in Brum to get a gang of WW vets together to go into schools to teach children about the war. He and Aunty Glad traced the family that saved him, contacted them and visited them with their children (3 daughters) when both family's kids were growing up and have all stayed in contact as adults.

So then all is not lost when your parachute fails, always travel in hope whatever direction you happen to take!
 
trophywench said:
OTOH Mike during WWII when first husband's uncle was a rear gunner in a Wellington (I think) the plane was shot down so pilot ordered all to bale out. Denis's one leg was comprehensively buggered already by gunfire so he baled anyway and pulled the cord which then got fouled up in the prop. He only hacked himself free! plane had lost altitude by this time but it still was truly freezing and he landed in a field, in a snow drift which actually stopped him breaking every bone in his body. You'd think he might have frozen to death but farmer's family was obviously aware that planes were being shot down in their vicinity and one of the daughter found him first, and they carried him back to the farmhouse and realising he was still alive got a message through to emergency services who picked him up and took him to hospital where a very skilful surgeon had to amputate both legs (cos the other leg had also been shot unbeknown to Denis) They looked after him well and he was repatriated by the Red Cross - both sides did this with very badly injured servicemen.

He was the only person from that crew who survived.

He was a smashing bloke and when he retired from work, got in touch with the education authority in Brum to get a gang of WW vets together to go into schools to teach children about the war. He and Aunty Glad traced the family that saved him, contacted them and visited them with their children (3 daughters) when both family's kids were growing up and have all stayed in contact as adults.

So then all is not lost when your parachute fails, always travel in hope whatever direction you happen to take!
Click to expand...

Great story!
 
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