Covid-19

Dvr55119 said:
@Devildoc we were talking before about chloroquine and azithromycin, I couldn’t find the actual study, but it points to the risk these drugs can pose to the CV circuitry. Small sample size for sure.

Small Chloroquine Study Halted Over Risk of Fatal Heart Complications
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Thanks for sharing. On the one hand I think the risk is overblown. How many millions of people have we put on these meds (for a variety of reasons)?

On the other hand, the combo does potentiate the effect, and in the most at-risk population, there does need to be some judicious use.

I can't help but wonder why this seems to *suddenly* be a problem.

Another article for conideration.
 

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Devildoc said:
Thanks for sharing. On the one hand I think the risk is overblown. How many millions of people have we put on these meds (for a variety of reasons)?

On the other hand, the combo does potentiate the effect, and in the most at-risk population, there does need to be some judicious use.

I can't help but wonder why this seems to *suddenly* be a problem.

Another article for conideration.
Click to expand...

I think the problem isn't suddenly new, it's just getting attention now and hopefully this leads to a better understanding if the benefits truly outweigh the dangers. I think especially among the military community, we should be very cautious about the offbook use of any antimalarial. I definitely trust Dr. Nevin's concerns over the use of chloroquine.

The Quinism Foundation Warns of Dangers from Use of Antimalarial Quinolines Against COVID‑19 Use of Chloroquine, Hydroxychloroquine, Mefloquine, Quinine, and Related Quinoline Drugs Risks Sudden and Lasting Neuropsychiatric Effects from Idiosyncratic Neurotoxicity WHITE RIVER JUNCTION, VT. (PRWEB) MARCH 20, 2020 The Quinism Foundation has warned of a risk of sudden and lasting neuropsychiatric effects from the use of antimalarial quinolines against COVID‑19, the disease caused by the novel coronavirus, and has urged policy makers, physicians, and members of the public to be alert to such effects. “The same endosomotropic properties that likely underlie the effectiveness of quinoline antimalarial drugs such as chloroquine and hydroxychloroquine against the virus may also underlie their dangers, ” said Dr. Remington Nevin, MD, MPH, DrPH, a Johns-Hopkins trained psychiatric epidemiologist and drug safety expert and former U.S. Army public health physician, who now serves as Executive Director of The Quinism Foundation. “These are not safe drugs.” “In susceptible individuals, these drugs act as idiosyncratic neurotoxicants, potentially causing irreversible brain and brainstem dysfunction, even when used at relatively low doses,” said Dr. Nevin. “This drug-induced dysfunction causes a disease of the brain and brainstem called quinoline encephalopathy, or quinism, which can be marked acutely by psychosis, confusion, and risk of suicide, and by lasting psychiatric and neurological symptoms.” “Symptoms of chronic quinoline encephalopathy include tinnitus, dizziness, vertigo, paresthesias, visual disturbances, nightmares, insomnia, anxiety, agoraphobia, paranoia, cognitive dysfunction, depression, personality change, and suicidal thoughts, among others, ” said Dr. Nevin. “Particularly among military veterans, in whom these drugs have been widely used for decades as prophylactic antimalarials, these symptoms can mimic and be mistaken for those of post-traumatic stress disorder and traumatic brain injury.” Dr. Nevin noted a recent report by an ad-hoc committee of the National Academies of Sciences, Engineering, and Medicine identified a critical need for additional research on the long-term effects of antimalarial quinolines. Dr. Nevin also emphasized that the Quinism Foundation has recently called on Congress to fund research into chronic quinoline encephalopathy [1]. Dr. Nevin noted that antimalarial drugs of the quinoline class are amphiphilic weak bases, which lead to their accumulation in acidic cellular endosomes. Dr. Nevin noted that during World War II-era studies, when many antimalarial drugs of the quinoline class were first synthesized, clinical researchers found that many caused a syndrome marked by psychosis, confusion, dizziness, and other psychiatric, cognitive, and neurologic adverse effects [2]. Dr. Nevin noted that other researchers studying the drugs’ toxicity in animals noted they caused widespread and irreversible neurotoxic injury to neurons throughout the brainstem and limbic system [3]. “Although antimalarial quinolines have been commonly prescribed and used by millions of people for prevention of malaria, and more recently, in the treatment of autoimmune diseases, a substantial minority will need to discontinue the drugs early during use owing to the development of prodromal neuropsychiatric symptoms,” said Dr. Nevin. Dr. Nevin noted that mefloquine (previously marketed as Lariam) now contains a boxed warning, cautioning of the need to immediately discontinue the drug at the onset of even seemingly mild symptoms such as abnormal dreams, nightmares, insomnia, anxiety, depression, restlessness, or confusion, as these may be considered “prodromal to a more serious event”. “What could be more serious than anxiety, depression, restlessness, or confusion?” asked Dr. Nevin. “The answer is the risk of permanent neuropsychiatric disability and suicide noted by the drug’s manufacturer and by drug regulators.” Dr. Nevin said that he was troubled by rising interest among members of the public in obtaining chloroquine, hydroxychloroquine, and mefloquine without a doctor’s prescription or public health oversight. “Lax regulation and unethical business practices have resulted in these drugs being widely available for purchase online without proper oversight,” said Dr. Nevin. Dr. Nevin noted his concern that members of the public may even attempt to obtain therapeutic quantities of quinine through questionable channels. “Tonic water, whose bitter taste is produced by the addition of quinine or related naturally-occurring quinolines, is limited by U.S. Food and Drug Administration regulations to 83 mg per liter of quinine and related cinchona alkaloids,” said Dr. Nevin. “However, drinking several bottles of tonic water will result in consuming pharmaceutical quantities, and therefore potentially harmful, amounts of these drugs”, said Dr. Nevin. “Tonic water is a prescription medication masquerading as a cocktail mixer.” Dr. Nevin emphasized the importance of recognizing and properly reporting adverse effects from these medications to the U.S. Food and Drug Administration. “While it may be tempting to attribute anxiety, depression, paranoia, or other mental health symptoms to the psychological effects of the COVID‑19 pandemic, ” said Dr. Nevin, “these symptoms may be an early warning sign of idiosyncratic neurotoxicity, and must be taken seriously.” Dr. Nevin noted that adverse effects from chloroquine, hydroxychloroquine, mefloquine, quinine, and even tonic water may be reported to the U.S. Food and Drug Administration’s MedWatch program, at MedWatch: FDA Safety Information & Adverse Event Reporting Program. About The Quinism Foundation The Quinism Foundation, founded in January 2018, in White River Junction, Vermont, promotes and supports education and research on quinism, the family of medical disorders caused by exposure to quinoline drugs, including mefloquine, tafenoquine, and chloroquine. Dr. Nevin is a board-certified occupational medicine and preventive medicine physician and former U.S. Army medical officer and epidemiologist. He is author of more than 30 scientific publications on malaria and the quinoline antimalarials, including “Neuropsychiatric Quinism: Chronic Encephalopathy Caused by Poisoning by Mefloquine and Related Quinoline Drugs,” published in the Springer Nature book, “Veteran Psychiatry in the US.” (Neuropsychiatric Quinism: Chronic Encephalopathy Caused by Poisoning by Mefloquine and Related Quinoline Drugs). References 1. The Quinism Foundation. The Quinism Foundation and Veterans for Common Sense Call on Congress to Fund Research into Chronic Quinoline Encephalopathy. March 9, 2020. Available at: The Quinism Foundation and Veterans for Common Sense Call on Congress to Fund Research into Chronic Quinoline Encephalopathy. 2. Nevin RL, Croft AM. Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives. Malaria journal. 2016;15:332. Available at: Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives. 3. Nevin RL. Idiosyncratic quinoline central nervous system toxicity: Historical insights into the chronic neurological sequelae of mefloquine. International journal for parasitology Drugs and drug resistance. 2014;4(2):118-125. Available at: Idiosyncratic quinoline central nervous system toxicity: Historical insights into the chronic neurological sequelae of mefloquine.
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https://quinism.org/press-releases/dangers-of-antimalarial-quinolines-against-covid-19/
 
Florida173 said:
Sailor aboard USS Theodore Roosevelt dies of coronavirus

I'm calling it now... This will be Trump's Benghazi
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Eh, I think (regardless of which side of the aisle you're on) we can probably find more egregious examples. Even if the reports are true that Modly only removed Crozier because Trump wanted him fired after that letter leaked, Trump still has a few degrees of separation on this particular case.

Now, the coronavirus response at large? That might be something.

ThunderHorse said:
Denmark will reopen schools for Children 11 and under on Wednesday. Why Denmark is taking steps to open up again
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This is good, and what we need to initiate ourselves.
Slow, methodical reopening of most of the country.

Granted, that makes sense, so we'll probably see states reopen everything at once and then act surprised if numbers spike
 
Looks interesting.

NIH begins study to quantify undetected cases of coronavirus infection

People interested in joining this study should contact clinicalstudiesunit@nih.gov. For more information on the COVID-19 Pandemic Serum Sampling Study Launch, see the Questions and Answers. For more information on this study, please visit ClinicalTrials.gov using identifier NCT04334954. For more information on the U.S. government response to the COVID-19 pandemic, visit www.coronavirus.gov.
Click to expand...
 
Last edited:
Well it looks like I'm home until at least June. I am having a hard time believing they will continue to pay me. Anyone else have any insight on how contractors are to be handled?
 

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