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Splinty

Shake 'em off
Admin
Dec 31, 2014
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trump has made the combo of zpack and hydrochloroquine available for prescription at doctor's discretion.
That's not true.
As a physician I don't need Trump's permission for me to write those drugs off label anytime I want.


Nevada's governor isn't having any of that and has banned it.
That's not true either
Gov. Sisolak reiterates position on potential coronavirus drug

It appears that he simply banned hoarding it. Docs can still write it in the ED and hospital, so basically actually sick patients, not asymptomatic or those doing fine with out it. Which is very good since there's now a shortage of these drugs for my lupus patients and rheumatoid patients that rely on them just to live day to day and stay out the hospital
 

SuperPig

Enjoy yourselves
Aug 7, 2015
30,979
51,737
declared a public health emergency
I think it's because this was done but simultaneously follow up with one of his "no big deal, everything is under control, nothing to see here, hoax" speeches. So that is barely even a blip on the radar at this point.
 

Sheepdog

Protecting America from excessive stool loitering
Dec 1, 2015
8,912
14,237
I posted this a few pages back. (not mad or anything just saying.. it's hard to keep up as fast we all post in this thread)

Falwell is such scum. My brother went to Liberty. My sister in law went there. Absolutely brainwashed. They have done some good in Lynchburg though just because of the amount of business that all of the students have brought to the area. But they're a plight to society because ignorant people truly think that they're doing God's work.
The problem is that you're allowed to call people who take the hustle a bit too far out, yet you have to tiptoe around the fact that they are just part of a larger scam.

If we are going to give respectability to profiting off selling fairy tales while molesting children - barely anybody calls the Pope a conman and yet he is the biggest hustler in the game - then who are we to judge people setting up scam universities and selling fake healing products?

Don't legitimize the game and then turn around and hate the player.
 

Papi Chingon

Domesticated Hombre
Oct 19, 2015
25,478
32,248
That's not true.
As a physician I don't need Trump's permission for me to write those drugs off label anytime I want.




That's not true either
Gov. Sisolak reiterates position on potential coronavirus drug

It appears that he simply banned hoarding it. Which is very good since there's now a shortage of these drugs for my lupus patients and rheumatoid patients that rely on them just to live day to day and stay out the hospital
Is this a nationwide thing? If you a a patient with symptoms of whatever, you can write them a prescription for something only approved for something unrelated (I suppose this could be considered related in that it is an infectious disease, but I am just trying to see where the line is drawn)?

He must have done a complete 180 on his stance because he made specific statements which were widely covered a week or so ago specifically banning the use for wuhan. It was widely covered, including in the opposition media.
 

megatherium

el rey del mambo
First 100
Jan 15, 2015
8,798
11,164
If you guys could have seen the look on Brother Angeley's face when buddy told him he had incurable hemorrhoids though.

That was unforgettable :mask:
 

Papi Chingon

Domesticated Hombre
Oct 19, 2015
25,478
32,248
Papi Chingon @Papi Chingon I was very confused about what Trump did in regards to these drugs after his tweeting.
Is it this?
Trump's push for risky malaria drugs disrupts coronavirus response
FDA issues emergency authorization of anti-malaria drug for coronavirus care

Looks like this is about donating to a strategic stockpile and then medicare funds being used to pay for it a doc writes it for this indication?
Trump was the president that signed the "right to try" act or bill into place. There is no wuhan flu shot, there is not cure, but the combo of zpack and hydrochloroquine has shown promise and he is willing to let people try it if the doctor's prescribe it as an alternative to nothing. Am I missing the point?
 

Splinty

Shake 'em off
Admin
Dec 31, 2014
44,116
91,095
Is this a nationwide thing? If you a a patient with symptoms of whatever, you can write them a prescription for something only approved for something unrelated (I suppose this could be considered related in that it is an infectious disease, but I am just trying to see where the line is drawn)?

He must have done a complete 180 on his stance because he made specific statements which were widely covered a week or so ago specifically banning the use for wuhan. It was widely covered, including in the opposition media.
Medical licenses are state by state so I would guess somewhere in there is some limits on specific items in certain states. But in general, yes my medical license lets me do any medicine at my discretion and I can go ahead and get sued for it. Insurance doesn't have to pay for my off-label usage but a great plurality of medicines are probably used off label for non-FDA approved reasons.
Medicine is nearly completely self-policed after license maintenance items. Board certifications are private companies. Hospital privileges are mostly or entirely approved and removed by your peer staff. We try to keep our own house clean which is why there is often such a visceral response from docs against bad docs. Their behavior risks disrupting this and in MOST cases you really don't want politicians writing laws forcing or banning medical decisions between a doc and their patient.

He must have done a complete 180 on his stance because he made specific statements which were widely covered a week or so ago specifically banning the use for wuhan. It was widely covered, including in the opposition media.
In that link it says the AP and others have retracted their word 'ban'. The article implies the media exaggerated the law. So it's no surprising that was reported in that context.

They have a temporary ban against outpatient usage. This is to prevent no testing and writing this med so someone can stick it in their back pocked as a just in case. The governor quite clearly isn't a big fan of the way Trump is going about it, but it says the law allows it to still be written for other usages in the outpatient setting (like lupus and Rhematoid arthritis) and for COVID 19 in the ED and inpatient setting. Longterm, for all the reasons above I don't even like the governor intervening on this. BUT, in this case people are hoarding the supply and this seems like an okay compromise. If you have enough symptoms to go to the ED and get COVID19 tested/treated you can be treated with those two drugs.
 

SuperPig

Enjoy yourselves
Aug 7, 2015
30,979
51,737
Is this a nationwide thing? If you a a patient with symptoms of whatever, you can write them a prescription for something only approved for something unrelated
I'll let him correct me if I'm wrong but I'm pretty sure that Drs are given basically unlimited power when it comes to prescribing a treatment plan even if it is off-label. He could prescribe viagra to treat a vision problem if he reasonably concluded that it was a blood flow issue that caused the problem.

Getting insurance to cover it would be the bigger concern.
 

Splinty

Shake 'em off
Admin
Dec 31, 2014
44,116
91,095
Trump was the president that signed the "right to try" act or bill into place. There is no wuhan flu shot, there is not cure, but the combo of zpack and hydrochloroquine has shown promise and he is willing to let people try it if the doctor's prescribe it as an alternative to nothing. Am I missing the point?
My understanding is the right to try bill allows phase 1 trial meds (meds not proven safe yet) to be used with informed consent on terminal patients. You're gonna die? Your doc can use drugs not proven safe or effective. These are experimental drugs passing on the earliest studies on safety.

This is different than azithromycin and hydroxychloroquine. These meds have gone through an FDA approval process. Such a process proves safety AND benefit for some specific set of treatments. Docs can then use these meds "off-label" if new studies come along. They are proven safe. They might not be effective for the treatment. used off label
 

Splinty

Shake 'em off
Admin
Dec 31, 2014
44,116
91,095
I'll let him correct me if I'm wrong but I'm pretty sure that Drs are given basically unlimited power when it comes to prescribing a treatment plan even if it is off-label. He could prescribe viagra to treat a vision problem if he reasonably concluded that it was a blood flow issue that caused the problem.

Getting insurance to cover it would be the bigger concern.
About 90% of obstetric inductions done in this country are done used an off-label drug. It costs about $0.80 and has great data supporting its use.
The opposing drug is FDA approved and IS nicer for some reasons not worth mentioning here and has about the same outcomes in getting a vaginal delivery induction successfully. It costs about $120.00

I wonder if a majority of our entire prescription system is off-label usage.
 

Papi Chingon

Domesticated Hombre
Oct 19, 2015
25,478
32,248
Medical licenses are state by state so I would guess somewhere in there is some limits on specific items in certain states. But in general, yes my medical license lets me do any medicine at my discretion and I can go ahead and get sued for it. Insurance doesn't have to pay for my off-label usage but a great plurality of medicines are probably used off label for non-FDA approved reasons.
Medicine is nearly completely self-policed after license maintenance items. Board certifications are private companies. Hospital privileges are mostly or entirely approved and removed by your peer staff. We try to keep our own house clean which is why there is often such a visceral response from docs against bad docs. Their behavior risks disrupting this and in MOST cases you really don't want politicians writing laws forcing or banning medical decisions between a doc and their patient.



In that link it says the AP and others have retracted their word 'ban'. The article implies the media exaggerated the law. So it's no surprising that was reported in that context.

They have a temporary ban against outpatient usage. This is to prevent no testing and writing this med so someone can stick it in their back pocked as a just in case. The governor quite clearly isn't a big fan of the way Trump is going about it, but it says the law allows it to still be written for other usages in the outpatient setting (like lupus and Rhematoid arthritis) and for COVID 19 in the ED and inpatient setting. Longterm, for all the reasons above I don't even like the governor intervening on this. BUT, in this case people are hoarding the supply and this seems like an okay compromise. If you have enough symptoms to go to the ED and get COVID19 tested/treated you can be treated with those two drugs.
I don't like you showing off your forum knowledge of skills with this multi quoting, asshole. I have done it by mistake before but never figured it out. I would appreciate I you stopped.

If trump is allowing the off label use by doctor discretion, does that alleviate burden if someone grows a flipper out of their ass or spontaneously combusts?

Tons, if not all news sources were quoting (direct quotes) from the Nevada governor. It was a direct ban for wuhan use. Immnkt going to go digging, but its the major players innnews. He must have caught too much heat and retracted statements because it was clear defiance of trump's call on the use of the medications (like when Trump says literally anything and dems have to go the extreme other way - think wall/border security as an example). Nice of the news to retract on a factual story, as opposed to stating the governor has changed stance, or elaborated on his statement (which is a 180 from the initial statement).
 

Splinty

Shake 'em off
Admin
Dec 31, 2014
44,116
91,095
If trump is allowing the off label use by doctor discretion, does that alleviate burden if someone grows a flipper out of their ass or spontaneously combusts?
Off-label = using FDA approved drugs for non FDA approved reasons. Trump not involved.

Trump allowed "right to try" = access to non FDA approved drugs for terminal patients.
 

Splinty

Shake 'em off
Admin
Dec 31, 2014
44,116
91,095
So has liability changed?
Not on these drugs or off-label use.

On the right to try drugs I would normally not have access to them. If I got access and used them I would be breaking medical licensing laws and maybe federal laws. They are open now so that is removed with right to try approval (99% of applications are approved). And the patient has to sign a bunch of stuff saying they realize the drug might kill them and might not help. So I guess that's a liability change too, since normally it'd be illegal to do and now the patient is swearing they understand the risks.
 

Papi Chingon

Domesticated Hombre
Oct 19, 2015
25,478
32,248
It's been this way waaaay before Trump.


Nope. You can still sue for those flippers. And you can probably get more if that Doc didn't warn you that an ass flipper was a possibility.
Ok, so the Nevada governor banned the use of the two drugs in application of wuhan. According to Splinty @Splinty he retracted it. I'm missing something here if a doctor can prescribe anything to anyone for whatever. 8m obviously not in the medical field.
 

Splinty

Shake 'em off
Admin
Dec 31, 2014
44,116
91,095
So the governor of Nevada banning the use of the combo was illegal? Before apparently pulling a 180?
States can make specific limitations on the physician patient interaction. See all those abortion bills requiring someone to perform an ultrasound before an abortion? That's a state forcing a doctor to perform medicine in a certain way. In Florida they banned doctors from asking patients about guns in the house (a common question in pediatrics and family medicine during well child exams). Again, same thing. State telling a doctor how to do medicine.

Now they CAN do this and generally we hate it and generally its very dangerous.

The Governor didn't do anything illegal. It's his right probably, I don't know the Nevada law. And it's written as an emergency temporary declaration, so it may not be something he could normally do.The above florida requirement later got struck down by courts. So maybe this would too, but I doubt it would in the next 60 days.