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Comment by vasco | Hacker News Reader

I cannot get tested. I live in the Netherlands and unless your case is serious enough that you either have very high fever or a great difficulty breathing, the official instructions are to not even call the health line, much less go to a hospital. I have friends in Portugal, Spain and Italy that have similar symptoms to mine and are home and doing the same because those are the official guidelines.

I agree with these guidelines, the phone lines and hospitals should be open for people who are at risk of dying. But that means that the numbers you're looking at are barely the tip of the iceberg for a lot of these european countries.

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That's too bad. We really need to ramp up PCR tests as well as begin serological studies (there is one I am ware of, and a product on the way.) Immediately. We will not get this under control if we don't. We need to know how fast it's spreading, where, and so on.

It is clear that in some ways our hands are tied on testing, but a case like yours at this time knowing if you have it or not could affect your course of treatment.

Viruses do have treatments.

There aren't as many as for bacteria, for a number of reasons including that viruses don't really clearly fall into "alive" or "dead" in the same way. They hijack your cellular machinery to produce more of themselves but they're not much more than a strand of genetic code wrapped in a bundle. It's hard to say they're more alive than any computer virus.

However, we've studied the way in which viruses do this hijacking and are able to disrupt the process, for instance by blocking their mechanism of entering cells, by blocking their mechanism of exiting cells or by disrupting their ability to replicate their genetic information.

There are even some (albeit new) broad-spectrum antiviral medications such as Remdesivir which was explored in COVID-19. It does work, well even, though as the COVID-19 infection is primarily in the lungs it's difficult to establish a sufficient concentration to be hugely effective.

Hydroxycholorquine is interesting [1] both as an anti-inflammatory and immune modulator. The Azithromycin probably does nothing against nCoV-2 but may well help control secondary infection.

[1] https://watermark.silverchair.com/ciaa237.pdf?token=AQECAHi2...

>Hydroxycholorquine is interesting [1] both as an anti-inflammatory and immune modulator. The Azithromycin probably does nothing against nCoV-2 but may well help control secondary infection.

I had no clarity as to why azithromycin had improved the outcomes in that study to 100% of those treated with it, when HCQ didn't. That's very interesting.

Maybe you could clarify something else for me. Is there any information about whether these two drugs together could function as a prophylactic, or is this something patients have to be administered at the beginning of symptoms, or is this something that can be done late in the course of the disease?

I was speculating about the role of Azithromycin though it appears another peer post mentioned something similar. The study was only 28 patients, open-label, non-randomized, 6 of which were asymptomatic. I think it's too early to say one way or the other, the N is really small on the study.

It could easily have been that some patients in the study developed bacterial pneumonia secondary to their COVID-19 and the azithromycin treated it. Much too early to say.

> Maybe you could clarify something else for me. Is there any information about whether these two drugs together could function as a prophylactic, or is this something patients have to be administered at the beginning of symptoms, or is this something that can be done late in the course of the disease?

Wish I knew, seems to be something we'll hear more about in the near term given the interest in studying it. From what I read it works best in early stages of disease and not as well later on. While not side-effect free, they're pretty highly targeted.

Were you tested for regular bacterial pneumonia?

If not you most likely have the corona.

> Were you tested for regular bacterial pneumonia?

IIRC, that's not incompatible with having a COVID-19 infection.

https://www.consumerreports.org/coronavirus/understanding-pn... (first google link I found):

https://www.consumerreports.org/coronavirus/understanding-pn...

> For instance, viruses can cause pneumonia directly. But in some cases, if a viral respiratory infection is severe enough, it can damage the lungs and leave them vulnerable to a secondary infection: bacterial pneumonia. This is common with flu, though scientists aren’t exactly sure how often it occurs.

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