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Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

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Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#41

Post by javagram »

londons_explore wrote: post #3

So... How was this not discovered 18 months ago? There are plenty of people taking fluvoxamine already, which acts as a natural experiment. After a few thousand hospitalizations, this effect size would have been obvious (ie. March 2020). At that point, a double-blind study could have been run, which (if done in a city with many infections) could have given results within weeks. What bit of health research dropped the…

Universal health care and centralization of patient records would probably be required to do what you’re talking about.

If scientists actually could mine everyone’s data easily it would be a lot easier to do stuff like this. Privacy laws and the fact that so much of the medical system is disconnected from itself get in the way - it’s normal for every new doctor to ask the same questions again because there’s no reliable way to share information.

Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#42

Post by tayo42 »

hhw3h wrote: post #5

What's interesting is Steve Kirsch was touting this months ago alongside Robert Malone and Bret Weinstein. That content got banned from YouTube. Was more or less harm done by stifling this information? In the desire to drive official therapeutics and vaccines was this potentially not surfaced as fast as it could have been? I'm not sure. It's good food for thought though.

> Was more or less harm done by stifling this information?

I dont think the target audience for youtube videos is other researchers and doctors. Pretty sure nothing of value was lost by it not being on youtube. The only thing this would have done is rile up people.

Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#43

Post by s1artibartfast »

didibus wrote: post #30
s1artibartfast wrote: post #19

Earlier quoted context omitted.

It showed a 32% reduction in hospitalization and approx 31% reduction in deaths.

Why does it say: > We found a clinically important absolute risk reduction of 5·0%, and 32% RR reduction, on the primary outcome of hospitalisation Why is the absolute 5% and the RR 32%? What's the difference? Also why does it say: > There were no significant differences between fluvoxamine and placebo for viral clearance at day 7 (p=0·090) and hospitalisations due to COVID (p=0·10), all-cause hospitalisations (p=0·0…

>Why is the absolute 5% and the RR 32%? What's the difference?

Absolute reduction is compared to control in absolute terms (16% hospitalized in control minus 11% with treatment = 5%).

Relative risk reduction is the absolute reduction divided by hospitalizations in the control (5%/16%)

Absolute % tells you how big the effect is, relative risk tells you how big it is in comparison to the reference.

>Why wouldn't they mention anything else but the reduction in hospitalization in their Interpretation section? Is it because all the other effects were not statistically significant to count?

The P values tell you the % chance that the difference could be due to random sampling.

e.g. hospitalization for COVID P = 0·1 means that the there is an 10% chance this difference is due to random sampling. The standard for reportable finding is P >Why wouldn't they mention anything else but the reduction in hospitalization in their Interpretation section? Is it because all the other effects were not statistically significant to count?

The primary test the study was designed to evaluate was:

>risk of hospitalization defined as either retention in a COVID-19 emergency setting or transfer to tertiary hospital due to COVID-19 for patients allocated fluvoxamine versus placebo

This is why most of the discussion focuses on this question. Death was also statistically significant and called out in the findings, most of the other outcomes didn't pass the 95% threshold

Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#44

Post by sampo »

msbarnett wrote: post #33
bananapear wrote: post #12

Earlier quoted context omitted.

Aren't there many (>60) published studies showing varying positive effects of early treatment with Ivermectin though? (Despite a couple having been retracted for obvious fraud). YouTube's policy specifically bans mention of Ivermectin as a possible treatment. Combined with the safety profile and cost of Ivermectin, I'd have thought that it'd at least be worth a try in an emergency - the worst possible case being that…

> Aren't there many (>60) published studies showing varying positive effects of early treatment with Ivermectin though? (Despite a couple having been retracted for obvious fraud). There are a number of low-quality (low numbers, methodological issue) studies with varying results. The primary "evidence" that got people excited about Ivermectin was a meta-analysis of these studies, but the meta-analysis itself pointed o…

> the fact that there's no particular reason to expect Invermectin should have any impact on any particular virus.

Ivermectin (you spell it wrong) is a known antiviral against several viruses, including SARS-CoV-2, when studied in cell cultures. This doesn't mean that it would work as a treatment in real patients. But it gives some reason, maybe just a little, to expect that it maybe could.

https://en.wikipedia.org/wiki/Ivermectin#COVID-19

The trial run by Oxford University might eventually give some good quality data on this.

https://www.ox.ac.uk/news/2021-06-23-ivermectin-be-investiga...

Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#45

Post by wtallis »

bsaul wrote: post #22
omegaworks wrote: post #10

Earlier quoted context omitted.

American history is littered with medical salesmen touting miracle cures to desperate ill people. Would you prefer our modern communication mediums be saturated with their pitches or do we want to wait until there is a reasonable scientific consensus before unleashing re-engagement algorithms?

if you want youtube to get rid of any salesmen touting miracles anything you're going to have to get rid of commercials as well.

There's a big difference between charlatans touting miracle cures and commercials for FDA-approved drugs, but even the latter are considered by many reasonable people to be harmful and worthy of banning.

Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#46

Post by s1artibartfast »

walterbell wrote: post #26
s1artibartfast wrote: post #23

Earlier quoted context omitted.

I'm not sure how this relates to my post. Most of the unvaccinated deaths are people with no vaccine whatsoever. The number of people who were vaccinated less than 14 days that falls into this category is small.

It means the CDC recognizes that the vaccine is not effective for 14 days, so other known treatments (e.g. fluvoxamine) during that period can be helpful.

IF you were just adding a reminder, the point is certainly true. Hopefully it helps the vaccinated, recently vaccinated, and truly unvaccinated.

Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#47

Post by SketchySeaBeast »

hdjjhhvvhga wrote: post #11
SketchySeaBeast wrote: post #6

Earlier quoted context omitted.

Wouldn't this sort of "obvious" link require tracking every patients entire history? Couldn't it be lost in other confounding factors? This seems like it would require a lot of good data and then strong analysis chops to pull that pattern out.

But this is exactly where we should double our efforts, because the problem is technical: we do have lots of data to analyze already. The influence of anti-histamine drugs was relatively quickly discovered because everybody expected asthma patients would get worse and the opposite was happening, so this was an obvious thing to examine. But many more drugs may play a role and these are hiding in plain sight - I hope r…

I'm not saying it wouldn't be a good idea if it was possible, but do we have enough sanitized, high quality, and complete medical data to pull that off? Given the number of potential interactions with all the different medications and conditions, could we actually pull out those links without a ton of confounding variables? Would it produce signal, or just noise?

Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#48

Post by woodruffw »

loudtieblahblah wrote: post #29
bhouston wrote: post #8

Earlier quoted context omitted.

I think the issue is how was it proven back then? There are a lot of people promoting ideas, some of which will eventually get clinical backing that they are correct. Prior to studies being done, how do we evaluate who is a quack and who is correct? There is a lot of harm promoting quack ideas during a pandemic. Based on reputation? Twitter followers? Their passion? I do not believe anyone censored research and scien…

>Prior to studies being done, how do we evaluate who is a quack and who is correct You allow the dialog to take place and make up your own mind. >I would argue that anyone who had a solution to Covid should rush to get it published in a reputable Any tool thats not a vaccine gets associated with Trump or the right wing and is dismissed. Its even stifled funding for anti-virals that give a 50% reduction in hospitaliza…

> The ONLY tool silicon Valley, the msm, much of acamdeia, the DNC and their loyal sycophants care about is the vaccines and even the slightest discussion of any potential alternative gets promoted as inherently anti-vaxx even if it could be used in conjunction with vaccines

There's been plenty of active mainstream reporting of Merck's new COVID pill, as well as other promising treatments. What are you talking about?

Getting a COVID shot continues to be the single best public health policy, which is why people are going to continue to advocate for it. But there has been no lack of mainstream coverage of developments in both proactive and reactive treatment.

Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#49

Post by pitspotter2 »

caymanjim wrote: post #21
Factorium wrote: post #14

Earlier quoted context omitted.

There's an entire suite of cheap drugs with proven positive effects when administered early: https://c19early.com/ Alphabet profits are up 68% because people are forced online. If there is cheap and effective COVID treatment, the world goes back to normal. Its a huge conflict of interest. Same goes for Facebook and the other tech companies. By contrast, look at Apple's muted COVID efforts. They want people out in the…

This is conspiracy dribble. Do you seriously think that there's a room full of executives at Google sitting in the dark rubbing their hands together and cackling as they draw up policies to block beneficial information from spreading so that the pandemic lasts longer and they bring in more revenue? People don't think like this except in movies. Any effort to do so would be immediately obvious to the people tasked wit…

The reason these false conspiracy theories spread is because many people distrust the motives of those in charge, now more than ever I think. Motives can't be observed scientifically of course but they're still there.

In a better world all rulers and experts would be well-motivated and seen to be well-motivated. In practice some of them do 'get with the program' neither because they are convinced of is correctness nor in a spirit of hand-rubbing glee, but out of mundane fear of losing the esteem of their peers.

Re: Effect of early treatment with fluvoxamine on risk of hospitalization for Covid

#50

Post by didibus »

arn wrote: post #35
didibus wrote: post #30

Earlier quoted context omitted.

Why does it say: > We found a clinically important absolute risk reduction of 5·0%, and 32% RR reduction, on the primary outcome of hospitalisation Why is the absolute 5% and the RR 32%? What's the difference? Also why does it say: > There were no significant differences between fluvoxamine and placebo for viral clearance at day 7 (p=0·090) and hospitalisations due to COVID (p=0·10), all-cause hospitalisations (p=0·0…

> Why is the absolute 5% and the RR 32%? What's the difference? Example: (20/100) 20% of patients die without treatment (10/100) 10% of patients die with treatment absolute = 10 percentage points difference (20->10) relative = percent decrease. 20 -> 10 50% difference

Ah cool, that's a great explanation.

So normally people with mean age 50 and varied medical conditions that catch Covid have 16% chance of being hospitalized (based on the study placebo group). And with fluvoxamine administered early, the same people would have 11% chance of being hospitalized.

Makes sense now.

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