MedEwok wrote:
If some antibody cocktail could be easily given to patients like Trump, with a few or ideally a single injection(s), then that would indeed be a major step forward.
Not talking about REGN-COV2 or the Eli Lilly MCA here. They seem to be helpful if given early to patients who don’t have produced antibodies themselves (yet), but hard to produce in great quantity and also expensive.
I think vasointestinal peptide (VIP) seems to be the targeted approach against this virus. So as Mooney put it, “super VIP” but for everybody. Look at the supplementary files here: https://www.researchsquare.com/article/rs-68707/v1
Also the results:
So far, 19 of 21 patients have survived. Improved radiographic appearance was seen in both lungs of 17 patients and in one lung of 2 patients. A mean 2.5-fold increase in PaO2:FiO2 ratio was seen (P<0.0001) with complete remission from respiratory failure in 9 patients and ongoing improvement in 10. Seven patients were discharged from the hospital, 7 sent to intermediate care, and 5 remain in the ICU. Four of 5 patients on ECMO have been decannulated, and thus far three have been discharged. A 75% (95% CI±3%: P<.001) reduction in IL-6 was seen with corresponding decrease in C-reactive protein. A median 3 point reduction (mean 2.7; P<0.001) in the WHO Ordinal Scale was observed (P<.001).
Admittedly, a small n, but very low P-Values. Which to me seems to warrant the qualification as “dramatic” improvements observed. These were all patients that had exhausted all other treatment options, on ventilators, and partly also on ECMO – high chance of death. Hopefully the good results will be confirmed by the ongoing Phase IIb/III trials.
I think these papers have been submitted to Nature and The Lancet… so either they’re very confident, or megalomanic.
Also check out this paper from Brazil: https://www.biorxiv.org/content/10.1101/2020.07.25.220806v3.full.pdf+html
https://www.thesun.ie/news/6001499/donald-trump-steroid-regeneron-claims/
And Doctor Anthony Staines, Professor of Public Health Systems in DCU, said REG-COV2 was not the reason Trump now feld great.
He told the Irish Sun: “I know why he feels so great and that’s not it, like he said.
“The President is also on a steroid called Dexamethasone, which was manufactured about 40 years ago,
“The job of Dexamethasone is to make you feel great and if it didn’t then most likely you’re dead.
“He shouldn’t be going around saying the Regeneron drug is the reason, that’s a bit irresponsible.
“That’s an experimental drug which is at it’s early stages of testing but clearly Trump’s doctors thought it was safe enough to administer to him.
“It’s far too early to say whether it has done him any good, or any harm for that matter, at this stage. But Dexamethasone is the reason he feels so great.”
That’s a very well respected doctor here, but the newspaper is utter rubbish. But I know nothing of Dexamethasone. Perhaps one of our resident doctors could comment.
Indeed the Sun is crap, but all the non-paywall channels hate Trump, mostly badmouth the US, and the BBC carries only totally bland stuff with no useful detail 
This is our local university!
Like in the rest of the UK, the students generally couldn’t care less, which is fine except for the staff, their parents who will get it at xmas, and some small % of students who will get a bad case (nowadays quite a few are seriously obese and thus high risk). If I had children at univ I would be tearing my hair out, and probably insisting they do not come home. The infection rates on campus must be heading for 100%.
This large scale “civil disobedience” right across the country is a huge problem for the govt. There is really no way to deal with this which would be acceptable in a democratic country. The likely outcome is a division between the “young” and everybody else, until a vaccine appears, or until the virus dies out among the former.
Well if Dexamethasone worked so well, Corona would be over. Only problem is that it suppresses the immune system. The latest is that it is only beneficial for patients on respiratory support: https://www.nejm.org/doi/full/10.1056/NEJMoa2021436
Since Trump was given Dexamethasone from Sunday only, when not on a ventilator (he never was to be clear), it was after whatever treatment he had that made him feel better. This was not normal standard of care, and we can suppose his team of doctors knew about all the latest research such as the one linked to above.
According to Trump, it was to reduce “swelling” in his lungs. In my mind they were treating the after effects of inflammation after having given him something else against viral infection.
You can’t prop up someone indefinitely on steroids. And again according to Trump himself he is off all medications since Thursday. Which would be a remarkably quick recovery.
That’s why I didn’t even mention steroids above.
Hello Fellow Pilots;
This is becoming a very interesting thread and since I value to share experience in our community, I would like to write what I have been through since September 10th,2020. I hope this helps little about your way of thinking, living and flying. This may be little long but keep reading please. I am 42 years old, doing cycling and running, no other known illnesses.
After lock down, we began flying in June 2020, and logged some flight hours, not too much for the normal summer season but a lot more than many other airlines. The measures are so tight in air travel in Turkey , as in other countries. We had no problems in our company, during June, July, August, no infected flight crew. On the other hand September began with some reports of infected crew. We decided to take more stringent measures.
It all began when I felt something in my ear,and a runny nose. I am pretty sure you are very familiar with the feeling that your ear tells you NOT to fly because of the baro-traumatic effects. I wanted to visit company doctor, and did so. He checked nose, ear and decided ground me for 2 days with some medication.(September 10th).
However, the day after was pretty different. I began to sweat like an airplane stayed in cool night and morning dew on the wings. I immediately called the doctor and said " this is something different and my body reaction was not ordinary" and the doctor replied " I think time for the PCR test". I rushed to hospital and called my family to stay in the house NOT to endanger any other people around us, also I called friend of my wife [she was very unfortunate to be in our house when I was sitting at the same table with her less than 1 meter, less than a minute I guess. Her symptoms began 2 days later, confirmed positive , she got infected because of me] .They took the samples and I went home to gather my family for isolation( September 11th)
The PCR test result POSITIVE. I learned the PCR positive means POSITIVE, but NEGATIVE may NOT be real NEGATIVE. Please, be careful about this, if you still feel some symptoms, refrain yourself from community. I called the company doctor, and informed him about the results. He told me 2 other captains were confirmed COVID Positive. My isolation timer had began with my family ( September 12th)
The officials from Ministry of Health visited me and my family next day, did some testing on me, check my oxygen level and gave me the medication. Favipiravir is the main element, they did not gave me any other medicine because I had no fever, no heavy symptoms and my oxygen level is OK. I isolated my room, my bathroom and decided NOT to eat together with my family ( September 13 th ).
The symptoms: back pain and loss of smell, debility , NO FEVER, NO COUGH ( September 14,15,16,17, smell test with : coffee and black pepper )
The symptoms: loss of smell, back pain eased, NO DEBILITY, NO FEVER, NO COUGH ( September 18, 19 , smell test with : coffee and black pepper )
The symptoms: regained smell, NO DEBILITY, NO FEVER, NO COUGH ( September 20, smell test : waking up with the smell of filtered coffee )
No symptoms during ( September 21-22 ), I felt perfectly fine.
My isolation period was over by September 22 nd, 23:59:59 local time, 10 day because I was COVID positive and used the medications provided by health officials. My family’s period ended September 26 th 23:59:59 local time. My wife and daughter had no symptoms during the isolation, they were perfectly healthy.
We did an antibody test with a home kit, and my test results were positive for antibody. Wife and Daughter were negative. ( September 27 th )
According to our CAA Covid Health Order, I had my medical check after the 14th day of end of the isolation.
I had my PCR test, antibody test, blood tests , EKG, heart echo test, lung tomography in a full facility hospital approved by our CAA. ( PCR, October 5 th ,others October 6 th).
All doctors aside from Chest Physician were convinced that I am healthy to fly, but the Chest Physician decided to keep me grounded for 10 more days due to lung tomography. He told me that I have “icy glass” appearance in my lungs. ( October 6 th )
So as of October 6th, 2020, it was my first medical check I was grounded since 1998. That was really heartbreaking.
Anyway, I want to add “Lessons Learnt” part here, if you still find this post interesting and think worth reading.
1. Corona Virus is Real, you can get infected anytime. The expert doctors say the virus has changed, maybe less powerful but more infectious. If you have underlying reasons, any chronic illness, it is a real life threatening danger. We lost a relative ( grand uncle of mine at the 8 th day his isolation , age 61 – my another relative grand aunt of mine, in intensive care now, we are ready for bad news, 10 th day of her isolation ) Corona virus is very selective , a friend of mine , same airline. His wife is a Doctor, she is infected, 2 days later their baby, but my friend is NOT. They are perfectly fine now. As in my case, my wife and daughter were not infected .
PLEASE, WEAR YOUR MASK ALL TIME, PLEASE TAKE SIMPLE BUT EFFECTIVE MEASURES.2. If you feel something is different at your body, I believe the pilots are more situation-aware of their bodies, isolate yourself from others, and take the test.
3. If you are confirmed positive, isolate yourself at home from others, keep wearing your mask at all times when out of your isolated area. Keep reading about aviation , or anything motivates you. Motivation is a great helper.
4. If you are confirmed positive and you lose your sense of smell, wait for the smell of the “coffee” tickles your nostrils, this means you are almost healed
5.The antibody test gives the best result after 14-21 days of your isolation. The home kits can give you a simple cue, the best result is given by hospital blood tests.
6. Please check your insurance, loss of licence etc., if NOT , make sure they cover COVID19 related payments, small prints.
I hope I did not give you some eye ache, but I really wanted to share my experience, which is important in our community.
Great report, Skywagon. Many thanks for posting it. I hope you get well soon. I think only fools think this is all a joke…
We have lavender in the garden and I test that every day
Thank you for this report on your personal experience with Covid-19, glad you and your immediate family came out fine.
The “icy glass” in your lungs is interstitial fluid, a remnant of the infection. It shows that you did indeed have a viral pneumonia through the SARS-CoV2, but luckily, judging by your symptoms, not a bad one. How long the formations in your lung remains is anyone’s guess. Given some reports, it could last for months. I hope you will be cleared to fly sooner. Maybe insist on a comprehensive breathing test to rule out any effect on your lung function.
Note that the radiological image does not correspond to the symptoms. Seriously affected patients might have little to no visible alterations in their scans, and vice versa.
@172driver Thanks for your words, you and all of other fellow pilots. You are always more than welcome, I ensure you the best Turkish Coffee. I believe @MedEwok has just explained the “icy glass” appearance.
@Peter You are welcome, I’ll keep posting anything I think to be useful all community. After having lived this period, it is my responsibility to share this information with community I feel belonged to.
@MedEwok Thanks for the explanation. Honestly speaking, I was surprised that the Chest Physician did not ask for further examination, even did not listen to my lungs for any unusual noise. Of course this is his decision which I respect, I have no education to conclude this. You are right , next time I would ask for more progressive examination.
Thanks for the explanation. Honestly speaking, I was surprised that the Chest Physician did not ask for further examination, even did not listen to my lungs for any unusual noise.
Chest examination isn’t very reliable at the best of times – there are experiments where experienced doctors go around respiratory wards listening to people breathing then compare their findings and there is surprisingly little agreement between them. That is not to say that they are never useful, but in my view a lot of clinical examination dates back to the dawn of medicine when fewer investigations such as scans and oxygen saturation monitors were available, and diseases often progressed much further before diagnosis so their signs were more obvious.
I am told that people with even quite bad COVID tend to have remarkably unremarkable chest examinations and that it is not something that we should be doing routinely. At the moment doctors are reluctant to get too close to patients who have, or may have, COVID. It’s one thing to take risks in order to do something worthwhile, but another if you are taking risks to do something that is unlikely to be useful.
I’m glad you seem to be recovering well.
