thread #COVID-19 GRAND ROUNDS
Special Session: Monoclonal Antibodies #covidtreatments /1
Dr. Robert Salata, Case Western
Convalescent Plasma - not been highly effective
so monoclonal antibodies signaled to be better /2
#Regeneron abandoned use in Hospitalized patients #NIH pivot HIV trials in monoclonal antibody
target ambulatory patients, not using oxygen /3
1.6% of those receiving antibodies needed hospitalization, big improvement over placebo control
creating more outpatient infusion centers /4
targeting their own health care workers and vulnerable populations (all foregoing about Eli Lilly trial) /5
re #Regereron antibody cocktail... #clinicaltrial on mild/moderate (two-arm) within three days of a positive test. 3% vs 8% (placebo) needed hospitalization /6
EUA targeted high risk, BMI >35, diabetes, kidney disease, immuno-compromised, 65+ or 55+ with CVD, COPD, hypertension /7
only 500 monoclonal antibody dose available in Case Western Reserve system
some allergic reactions and other side effects, so infusion sites requires medical observation /8
some states set up lottery systems for treatment. Need more data, larger populations trialed /9
only recommended for children over 12 /10
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Death of competence, pt 1183. Parallels (@ParallelsCares) a virtual machine product on the Mac, used to work fairly well. They switched to a subscription model. they pushed an update which broke basic functionality. Their support is incompetent, can't fix the error they created
After countless hours troubleshooting, and more than hour with tech support in my machine, still no fix. Worse, they refuse to consider a refund, because it is beyond the 30 day renewal of the subscription.
This is a premium product, which I have paid for (on two machines) for the better part of a decade. It was integral to many of my workflows. Workflows now broken. Hours wasted. No solution. No ownership. No competence
9News @cole_sull story on Denver's plan to spend a quarter billion of homeless programs includes no comments from those skeptical of the spending. And no analysis of whether Denver's massive and failed spending actually induces homelessness.
high schoolers taking AP Human Geography know to focus on pull and push factors of migration. Hit the streets, and you'll find service resistant homeless who were never housed in Denver. Ever. They came to the city homeless
Now Denver taxpayers will spend a quarter billion in what will be, in part, a wasted attempt to house them.
First @united cancels our flight Denver to LaGuardia. At 4 am. Citing severe weather, which, of course, was non-existent. They use this dodge to avoid compensating you for whatever ensues.
So, they put us on stand-by on an earlier flight. We race to the airport- and have to drive and park instead of taking train. That flight was delayed, and we didn’t make stand-by.
Another hour dealing with incompetent @united customer mal service. Finally, a competent rep, Sherry Hutchings finds us seats to Dulles. ‘Course they can’t get us to NYC til tomorrow, and citing “severe weather” won’t pay for a hotel in D.C.
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@KPcolorado knew a vaccine was coming for at least 9 months, but didn't use the time to construct systems to ensure efficient and timely vaccinations of seniors.
Seniors who use #Medicare ... so
essentially tax dollars were wasted. We will need investigations and transparency so future public health disasters are better handled. @jaredpolis put senior lives in the hands of providers that lack the capacity
and the capability for an essential task. This despite reams of research that says provider communication is key to successful health outcomes.
We knew our health system was piss-poor at managing #chronicdisease- CVD, metabolic syndrome, obesity