1 + 1 + 1 + 1

Apr 28, 2020

One followup plus One explanation plus One essential skill plus One did you know

It seems like months ago that I first posted about the initial study on the use of hydroxychloroquine and azithromycin. However, it was actually March 21st. A wildfire of opinions spread across the globe based on this study because of support from thought leaders and the power of their “tweets”. Since then the initial study has been ridiculed by scientific societies including the one in which it was published. Additional noncontrolled studies have seen no benefit. However, larger more scientific studies have yet to report their outcomes. One interesting note that in China one of these studies was stopped due to the lack of patient population with active COVID 19. They did not  have enough patients???

As researchers and clinicians around the world race to find alternative therapies in addition to vaccines we must be trusting of the scientific process. In a clinical trial that is appropriately powered (enough patients) and appropriately designed (double blind, placebo controlled) then scientific answers that give precise information is obtained. For example, if you are looking for viral clearance from the nose, you have to note is this associated with clinical outcomes: less symptoms, no symptoms, no longer infectious, antibody production which then confers future immunity, etc. If you are looking at the effect a medication has on a disease process then you must look at not only the outcome of disease itself, but the incidents of side effects, what they were, how many continued through the entire treatment regimen and what were the outcomes. There have been many medications that may help a disease but trial is stopped because they kill the patient as an adverse outcome. And this is where I want to give hope. There are many trials that are meeting the strict scientific criteria looking at MANY, MANY medications. These trials don’t operate in a vacuum, devoid of assessment until the trial ends.  If there is a significant difference between a treatment arm and a non-treatment arm then the trial is stopped. It would be unethical to withhold treatment that is proving to be beneficial in the treated group from the untreated group. On the flipside, if the treated group has statistically significant severe adverse outcomes vs. the untreated group then the study would be stopped. This is science. We can take comfort in knowing that at this point, the large trials are progressing and I am hoping to wake to a headline that states, “trial stopped due to success in treatment arm”. Now that would be something to tweet about.

I have one son that has been growing his hair for a while. In fact, this West Coast dweller just proudly revealed his man bun status by Zoom. However, another came down the stairs and looked a little bit like the Shaggy D.A. My daughter had attempted to give her husband and two boys a haircut and as a beginner, I would say that she did a pretty good job. As the quarantine extends longer these tasks previously managed by experts are now in the hands of Edward Scissorhands (remember that movie?).While we wait expectantly for our favorite hairdresser to return to work, I thought I would share with you this great article: How to Cut Your Own Hair


I chose this photo on purpose for today’s post. While the photo was taken four years ago in rural East Africa, I can remember it as if it were yesterday. It was a moment of pure joy and looking at it again brings me another moment of pure joy. Did you know that the study of joy has revealed that the people who rate in the upper reaches of happiness on psychological tests develop about 50% more antibodies than average in response to flu vaccines. It may feel hard to have joy right now, however, a photo of a joyous moment just might make your moment now, more joyous. 

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